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. 2024 Aug 5:15:1408691.
doi: 10.3389/fendo.2024.1408691. eCollection 2024.

Temporal trends of ischemic stroke attributable to high fasting plasma glucose in China from the global burden of disease study 2019

Liangchen Tang #  1 , Li Xie #  1 , Yixin Liu  1
Affiliations

Temporal trends of ischemic stroke attributable to high fasting plasma glucose in China from the global burden of disease study 2019

Liangchen Tang et al. Front Endocrinol (Lausanne). .

Abstract

Background: Currently ischemic stroke poses a serious disease burden globally, and high fasting plasma glucose is one of the important risk factors. The aim of this study was to investigate the disease burden of ischemic stroke due to fasting glucose during 1990-2019 in China, to estimate the effect of age, period, and cohort on the trend of ischemic stroke disease burden, and to predict the disease burden of ischemic stroke in 2020-2030.

Methods: Ischemic stroke burden data were obtained by screening from the Global Burden of Disease Study 2019 (GBD 2019) database for high-risk populations in China. Annual average percentage change (AAPC) was calculated using the Joinpoint regression model to assess the trend of ischemic stroke burden between 1990 and 2019. Age-period-cohort models were introduced to estimate the independent effects of age, period, and cohort on ischemic stroke burden, and to predict the ischemic stroke burden in 2020-2030 based on Bayesian age-period-cohort models.

Results: From 1990 to 2019, the number of ischemic stroke deaths due to high fasting plasma glucose in China continued to increase with an AAPC of 3.61. Trends in age-standardized incidence rates did not show statistical significance. In the age-period-cohort analysis, the age effect of ischemic stroke burden showed a continuously increasing trend over the study period. The period effect showed an overall favorable trend over the study period. The overall and cohort effects for males showed an overall increasing trend, whereas the cohort effect for females showed a decreasing trend after a decreasing trend for the 1945 birth cohort.

Conclusions: This study found that ischemic stroke due to high fasting plasma glucose in China has generally fluctuated between 1990 and 2019, with a decreasing trend in recent years, and projections also suggest that it will continue to show a decreasing trend in the future. Age and period of birth were the main elements influencing the burden of disease, especially among the elderly and men. Policies should be used to promote the prevention of known risk factors and to strengthen health management for key populations.

Keywords: China; age-period-cohort analyses; disease burden; high fasting plasma glucose; ischemic stroke.

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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.

Figures

Figure 1
Figure 1
Burden of ischemic stroke attributable to high fasting plasma glucose in China, by age group, 1990 and 2019. (A) mortality (per 100,000) and deaths (thousand); (B): DALYs rate (per 100,000) and DALYs (ten thousand).
Figure 2
Figure 2
Parameter estimates of age, period, and cohort effects on burden of ischemic stroke attributable to high fasting plasma glucose and sex difference. (A) Age effect on mortality (per 100,000); (B) Period effects on mortality; (C) Cohort effects on mortality; (D) Age effect on DALYs rate (per 100,000); (E): Period effects on DALYs rate; (F) Cohort effects on DALYs rate.
Figure 3
Figure 3
Projected burden of ischemic stroke attributable to high fasting plasma glucose in China, 2020-2030. (A) age-standardized mortality rate; (B) age-standardized DALYs rate.
See this image and copyright information in PMC

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