Global, regional, and national burden of chronic kidney disease attributable to high fasting plasma glucose from 1990 to 2019: a systematic analysis from the global burden of disease study 2019

Abstract

Purpose: Given the rising prevalence of high fasting plasma glucose (HFPG) over the past three decades, it is crucial to assess its global, national, and regional impact on chronic kidney disease (CKD). This study aims to investigate the burden of CKD attributed to HFPG and its distribution across various levels.

Methods and materials: The data for this research was sourced from the Global Burden of Diseases Study 2019. To estimate the burden of CKD attributed to HFPG, we utilized DisMod-MR 2.1, a Bayesian meta-regression tool. The burden was measured using age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life years (DALYs) rate. Correlation analysis was performed using the Spearman rank order correlation method. Temporal trends were analyzed by estimating the estimated annual percentage change (EAPC).

Results: Globally in 2019, there were a total of 487.97 thousand deaths and 13,093.42 thousand DALYs attributed to CKD attributed to HFPG, which represent a substantial increase of 153.8% and 120%, respectively, compared to 1990. Over the period from 1990 to 2019, the burden of CKD attributable to HFPG increased across all regions, with the highest increases observed in regions with high socio-demographic index (SDI) and middle SDI. Regions with lower SDI exhibited higher ASMR and age-standardized DALYs (ASDR) compared to developed nations at the regional level. Additionally, the EAPC values, which indicate the rate of increase, were significantly higher in these regions compared to developed nations. Notably, high-income North America, belonging to the high SDI regions, experienced the greatest increase in both ASMR and ASDR over the past three decades. Furthermore, throughout the years from 1990 to 2019, males bore a greater burden of CKD attributable to HFPG.

Conclusion: With an increasing population and changing dietary patterns, the burden of CKD attributed to HFPG is expected to worsen. From 1990 to 2019, males and developing regions have experienced a more significant burden. Notably, the EAPC values for both ASMR and ASDR were higher in males and regions with lower SDI (excluding high-income North America). This emphasizes the pressing requirement for effective interventions to reduce the burden of CKD attributable to HFPG.

Keywords: GBD 2019; chronic kidney disease; disability-adjusted life year; high fasting plasma glucose; mortality.

Figure 1

Global age standardized mortality rate of chronic kidney disease attributable to high fasting plasma glucose. (A) The all-cause ASMR per 100,000 associated with chronic kidney disease attributable to high fasting plasma glucose, for both sexes in 204 countries and territories in 2019. (B) The EAPC of ASMR of chronic kidney disease attributable to high fasting plasma glucose, for both sexes from 1990 to 2019, in 204 countries and territories. ASMR, age standardized mortality rate; EAPC, estimated annual percentage change.

Figure 2

Global age standardized DALYs rate of chronic kidney disease attributable to high fasting plasma glucose. (A) The all-cause ASDR per 100,000 associated with chronic kidney disease attributable to high fasting plasma glucose, for both sexes in 204 countries and territories in 2019. (B) The EAPC of ASDR of chronic kidney disease attributable to high fasting plasma glucose, for both sexes from 1990 to 2019, in 204 countries and territories. DALYs, disease adjusted life year. ASDR, age standardized DALYs rate; EAPC, estimated annual percentage change.

Figure 3

The burden of chronic kidney disease attributable to high fasting plasma glucose by SDI. (A) The ASMR and (B) ASDR of chronic kidney disease attributable to high fasting plasma glucose in different SDI regions from 1990 to 2019. Results are showed for both sexes worldwide. ASMR, age standardized mortality rate; DALYs, disease adjusted life year. ASDR, age standardized DALYs rate. SDI, sociodemographic index.

Figure 4

Correlations of ASMR as well as ASDR of chronic kidney disease attributable to high fasting plasma glucose and SDI at the regional level. The ASMR (A) and ASDR (B) of chronic kidney disease attributable to high fasting plasma glucose and SDI at the regional level in 21 regions from 1990 to 2019. ASMR, age standardized mortality rate; DALYs, disease adjusted life year. ASDR, age standardized DALYs rate.

Figure 5

The burden of chronic kidney disease attributable to high fasting plasma glucose by age and sex. The all-cause ASMR (A) and ASDR (B) of chronic kidney disease attributable to high fasting plasma glucose worldwide in different age groups. ASMR, age standardized mortality rate; DALYs, disease adjusted life year. ASDR, age standardized DALYs rate.

Figure 6

Global attributable burden of chronic kidney disease attributable to high fasting plasma glucose by sex. The age-standard ASMR (A) and ASDR (B) of chronic kidney disease attributable to high fasting plasma glucose by sex from 1990 to 2019. ASMR, age standardized mortality rate; DALYs, disease adjusted life year. ASDR, age standardized DALYs rate.