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. 2023 Jun 1:11:1149719.
doi: 10.3389/fpubh.2023.1149719. eCollection 2023.

Metabolic risk factors attributed burden in Iran at national and subnational levels, 1990 to 2019

Soroush Moradi  1 , Amirhossein Parsaei  1 , Sahar Saeedi Moghaddam  1 , Armin Aryannejad  1   2 , Sina Azadnajafabad  1 , Negar Rezaei  1   3 , Baharnaz Mashinchi  1   2 , Zahra Esfahani  1 , Parnian Shobeiri  1   4 , Nazila Rezaei  1 ; GBD 2019 Iran MRF Collaborators; Mohsen Naghavi  5   6 , Bagher Larijani  3 , Farshad Farzadfar  1   3
Collaborators, Affiliations

Metabolic risk factors attributed burden in Iran at national and subnational levels, 1990 to 2019

Soroush Moradi et al. Front Public Health. .

Abstract

Introduction: Metabolic risk factors (MRFs) predispose populations to a variety of chronic diseases with a huge burden globally. With the increasing burden of these risk factors in Iran, in this study, we aimed to report the estimated burden attributed to MRFs at national and subnational scales in Iran, from 1990 to 2019.

Methods: Based on the comparative risk assessment method of the Global Burden of Disease (GBD) Study 2019, data of deaths and disability-adjusted life years (DALYs) attributable to four top MRFs in Iran including high systolic blood pressure (SBP), high fasting plasma glucose (FPG), high body mass index (BMI), and high low-density lipoprotein (LDL) for the 1990-2019 period, were extracted. The socio-demographic index (SDI) was used to report the data based on the corresponding socio-economic stratifications. The results were reported in national and subnational 31 provinces of Iran to discover disparities regarding the attributable burden to MRFs. Furthermore, we reported the causes of diseases to which the attributable burden to MRFs was related.

Results: Overall, the age-standardized high LDL, high SBP, high BMI, and high FPG-attributed death rate changed by -45.1, -35.6, +2.8, and +19.9% from 1990 to 2019, respectively. High SBP was the leading risk factor regarding attributed age-standardized death rates reaching 157.8 (95% uncertainty interval: 135.3-179.1) and DALY rates reaching 2973.4 (2652.2-3280.2) per 100,000 person-years, in 2019. All rates increased with aging, and men had higher rates except for the +70 years age group. At the subnational level, provinces in the middle SDI quintile had the highest death and DALY rates regarding all four MRFs. Total deaths, DALYs, YLLs and YLDs number by the causes of diseases linked to MRFs increased over the study period. Cardiovascular diseases, diabetes mellitus, and kidney diseases were the main causes of burden of disease attributable to MRFs.

Conclusion: Herein, we found divergent patterns regarding the burden of MRFs as well as disparities in different regions, sex, and age groups for each risk factor and related causes. This could provide policymakers with a clearer vision toward more appropriate decision-making and resource allocation to prevent the burden of MRFs in Iran.

Keywords: Global Burden of Disease; Iran; cardiometabolic risk factors; hyperglycemia; hyperlipidemia; hypertension; obesity.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The handling editor OD declared a past co-authorship/collaboration (10.1007/S40200-022-01143-8) with the authors AA, SA, NeR, PS, NaR, and BL.

Figures

Figure 1
Figure 1
Time trends of age-standardized death (A) and DALY (B) rates (per 100,000 person-year) attributable to metabolic risk factors including high SBP, high FPG, high BMI, and high LDL by year and sex with 95% uncertainty interval from 1990 to 2019.
Figure 2
Figure 2
Age-standardized death (A) and DALY (B) rates (per 100,000 person-year) attributable to metabolic risk factors including high SBP, high FPG, high BMI, and high LDL in 31 provinces of Iran in 1990 and 2019 for both sexes.
Figure 3
Figure 3
Death (A) and DALY (B) rates (per 100,000 person-year) attributable to metabolic risk factors including high SBP, high FPG, high BMI, and high LDL based on age groups and sex (red, females; blue, males) in 1990 and 2019.
Figure 4
Figure 4
Age-standardized death (A) and DALY (B) rates (per 100,000 person-year) attributable to metabolic risk factors including high SBP, high FPG, high BMI, and high LDL by 22 main causes of deaths in 1990 through 2019 for both sexes.
See this image and copyright information in PMC

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