ArticleDiabetology & metabolic syndrome2026
Burden of atherosclerotic cardiovascular disease attributable to high body mass index, high fasting plasma glucose or high low density lipoprotein cholesterol in young and middle-aged adults from 1990 to 2050.
Article in Diabetology & metabolic syndrome, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
aimsThis study aims to analyze the global burden of atherosclerotic cardiovascular disease (ASCVD) attributable to high low-density lipoprotein cholesterol (LDL-c), high body mass index (BMI), or high fasting plasma glucose (FPG) in young and middle-aged adults (15-49 years) from 1990 to 2021, with projections extending to 2050.
methodsLeveraging data from the Global Burden of Disease (GBD) 2021 study, we concentrated on ASCVD burden attributable to three risk factors in young and middle-aged adults. We scrutinized crude death rates, number of deaths, and estimated annual percentage changes (EAPCs) across sexes, countries, regions, and socio-demographic index (SDI) categories. To forecast future trends, we employed the Bayesian age-period-cohort (BAPC) model. Locally weighted scatterplot smoothing (LOESS) regression (span = 0.5) was used to visualize associations between crude death rates and SDI levels across 21 GBD regions and 204 countries.
resultsThe ASCVD burden attributable to three risk factors in young and middle-aged adults followed broadly similar epidemiological patterns. In 2021, ischemic heart disease (IHD) burden attributable to three risk factors substantially exceeded ischemic stroke (IS) and lower extremity peripheral artery disease (LEPAD), and men exhibited consistently a higher burden than women. From 1990 to 2021, global trends in crude death rates for ASCVD attributable to three risk factors in young and middle-aged adults remained relatively stable. Significant regional and national variation was observed. At regional SDI levels, crude death rates for IHD showed an inverted M-shaped pattern (peaks at SDI 0.45 and 0.70), while IS and LEPAD demonstrated inverted L-shaped patterns (plateauing at SDI 0.70-0.76). Across 204 countries in 2021, crude death rates from ASCVD attributable to three risk factors increased gradually below SDI 0.60, showed a slight U-shape between 0.60-0.75, and declined sharply above 0.75. Projections indicate that ASCVD attributable to three risk factors will increase to varying degrees in young and middle-aged adults by 2050.
conclusionThe burden of ASCVD attributable to three risk factors in young and middle-aged adults calls for concerted and integrated management strategies. Urgent public health measures targeting these risk factors are needed to mitigate the projected rise in ASCVD burden.
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