Yeh Tzu-Lin, Chen Yi-Hsuan Roger, Hsu Hsin-Yin, Tsai Ming-Chieh, Wu Yun-Chun, Lo Wei-Cheng, Huang Tzu-Hsuan, Liu Bo-Chen, Lin Hsien-Ho, Chien Kuo-Liong
Department of Family Medicine, Hsinchu MacKay Memorial Hospital, Hsinchu City.
Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
Acta Cardiol Sin. 2023 Jul;39(4):628-642. doi: 10.6515/ACS.202307_39(4).20221219C.
Studies on disease burden in Taiwan are lacking. We aimed to quantify the burden of cardiovascular disease (CVD) attributable to high body mass index (BMI) in Taiwan.
Using a comparative risk assessment approach from the Global Burden of Disease study, we estimated the population attributable fraction (PAF), attributable CVD burden, and disability-adjusted life years (DALYs) according to sex, age, and area of residence in Taiwan. The BMI distribution for the population was obtained from the National Health Interview Survey in 2013. CVD was defined as an ischemic heart disease or stroke.
The attributable PAF for CVD from high BMI was 18.0% (19.6% in men and 15.6% in women), and it was highest (42.7%) in those aged 25-30 years. Adults aged 60-65 years had the highest absolute DALYs (11,546). The average relative age-standardized attributable burden was 314 DALYs per 100,000 person-years, and it was highest in those aged 75-80 years (1,407 DALYs per 100,000 person-years). Those living in Taitung County had the highest PAF of 21.9% and the highest age-standardized attributable burden (412 DALYs).
In Taiwan, an 18% reduction in CVDs could be achieved if obesity/overweight was prevented. Prevention was most effective in early adulthood. The absolute CVD burden from obesity/overweight was highest in middle-aged men, and the relative burden was highest in older adults. Resource allocation in targeted populations and specific areas to eliminate CVD and health inequities is urgently required.
台湾地区缺乏关于疾病负担的研究。我们旨在量化台湾地区因高体重指数(BMI)导致的心血管疾病(CVD)负担。
采用全球疾病负担研究中的比较风险评估方法,我们根据台湾地区的性别、年龄和居住地区,估算了人群归因分数(PAF)、归因CVD负担和伤残调整生命年(DALYs)。人群的BMI分布数据来自2013年的国民健康访谈调查。CVD定义为缺血性心脏病或中风。
高BMI导致的CVD归因PAF为18.0%(男性为19.6%,女性为15.6%),在25 - 30岁人群中最高(42.7%)。60 - 65岁的成年人DALYs绝对值最高(11,546)。平均相对年龄标准化归因负担为每10万人年314个DALYs,在75 - 80岁人群中最高(每10万人年1,407个DALYs)。居住在台东县的人群PAF最高,为21.9%,年龄标准化归因负担也最高(412个DALYs)。
在台湾地区,如果能预防肥胖/超重,CVD可减少18%。预防在成年早期最为有效。肥胖/超重导致的CVD绝对负担在中年男性中最高,相对负担在老年人中最高。迫切需要在目标人群和特定地区进行资源分配,以消除CVD和健康不平等问题。