Author information
1Department of Cardiovascular Medicine, The Heart Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
2Medical Care Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
3Department of Medicine, University of Verona, Verona, Italy; Metabolic Diseases Research Unit, IRCCS Sacro Cuore-Don Calabria Hospital, Negrar di Valpolicella, Italy.
4Southampton National Institute for Health and Care Research Biomedical Research Centre, University Hospital Southampton, and University of Southampton, Southampton General Hospital, Southampton, UK.
5Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Section of Endocrinology, Boston VA Healthcare System, Harvard Medical School, Boston, MA, USA.
6Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China.
7Department of Internal Medicine, Ospedale Civile di Baggiovara (-2023), Azienda Ospedaliero-Universitaria di Modena, Modena, Italy.
8Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
9Pediatric Hepatology, Transplant Unit, Hospital Infantil Menino Jesus and Hospital Sirio Libanes, San Paulo, Brazil.
10Fortis-CDOC Center of Excellence for Diabetes, Metabolic Diseases, and Endocrinology, National Diabetes Obesity and Cholesterol Foundation and Diabetes Foundation, New Delhi, India.
11Department of Upper Gastrointestinal Surgery, Royal Infirmary Edinburgh, Edinburgh, United Kingdom.
12Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.
13Research Unit of Molecular Genetics of Complex Phenotypes, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
14Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China.
15Department of Pediatrics and Pediatric Hepatology, Faculty of Medicine, Cairo University, Cairo, Egypt.
16Weight Management Unit, Royal NMC Hospital, Khalifa City, Abu Dhabi, United Arab Emirates.
17Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, USA.
18First Department of Cardiology, University Hospital of Ioannina and Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.
19Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico.
20Hepatology Research Unit, Department Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium; Liver Research Center Ghent, Ghent University, Ghent, Belgium.
21Department of Surgery, Ashford and St Peter's Hospital, Chertsey, Surrey, UK.
22Department of Internal Medicine, Division of Cardiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
23Department of Paediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
24Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy; Precision Medicine, Biological Resource Center Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
25Department of Paediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
26Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
27Department of Metabolic and Bariatric Surgery, Acibadem Atakent University Hospital, Istanbul, Turkey.
28Department of Medicine, Makerere University of College of Health Sciences, Kampala, Uganda.
29Metabolic and Bariatric, Fatimah Hospital, Tehran, Iran.
30Department of Metabolic and Bariatric Surgery, Hospital Lusiadas Amadora, Amadora, Lisbon, Portugal.
31Department of Hepatology, RCSI School of Medicine and Medical Sciences, Dublin/Beaumont Hospital, Dublin, Ireland.
32Universidad San Ignacio de Loyola, Lima, Peru.
33Department of Medicine, University of Sri Jayewardenepura, Nugegoda, Sri Lanka.
34Department of Bariatric Surgery, University of Montreal, Montreal, Quebec, Canada.
35Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Bandar Seri Begawan, Brunei-Muara, Brunei.
36Liver Vascular Biology Laboratory, IDIBAPS Biomedical Research Institute - Hospital Clínic de Barcelona & CIBEREHD, Barcelona, Spain; Department of Visceral Surgery and Medicine, Inselspital - University of Bern, Bern, Switzerland.
37Division of Gastroenterology and Hepatology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
38Surgical Gastroenterology, Bariatric and Robotic Surgery, Apollo Hospital, New Delhi, India.
39Nacogdoches Center for Metabolic & Weight Loss Surgery, Nacogdoches Medical Center, Nacogdoches, TX, United States.
40Surgical Disease and Bariatric Surgery, Astana Medical University, Astana, Aqmola, Kazakhstan.
41Department of Metabolic, Bariatric and Endocrine Surgery, Fuenlabrada University Hospital, Madrid, Spain.
42Liver Disease Research Center, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
43Department of Metabolic and Bariatric Surgery, Iranian Hospital Dubai, Dubai, United Arab Emirates.
44Department of General Surgery, Alexandria University Faculty of Medicine, Alexandria, Egypt.
45Department of Gastroenterology & Hepatology, Changi General Hospital, Singapore; Duke-NUS Medical School, Singapore.
46Department of Gastroenterology, Hepatology and Endemic Medicine, Faculty of Medicine, Minia University, Minia, Egypt.
47Center for Prevention of Cardiovascular Disease, Section on Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
48Center for Adolescent Medicine and UNESCO Chair in Adolescent Health Care, Aghia Sophia Children's Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece; University Research Institute of Maternal and Child Health & Precision Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
49Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina; Faculty of Health Science, Maimónides University, Buenos Aires, Argentina; Clinical and Molecular Hepatology, Translational Health Research Center (CENITRES), Maimónides University, Buenos Aires, Argentina.
50Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Eastern Ontario, Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
51Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
52Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
53Department of Hepatology, Sir Charles Gairdner Hospital, Perth, Australia; Medical School, The University of Western Australia, Perth, Australia.
54Pediatric Endocrinology and Diabetes, Marmara University School of Medicine, Istanbul, Turkey.
55Departament of Surgery, Universidad del Valle, Cali, Valle del Cauca, Colombia, USA.
56Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina; Systems Biology of Complex Diseases, Centro de Investigación Traslacional en Salud, Universidad Maimónides, Buenos Aires, Argentina.
57Department of Surgery, Marien Hospital Herne, University Hospital of the Ruhr-University of Bochum, Herne, NRW, Germany.
58Department of Surgery, USFQ (Universidad San Francisco), Quito, Pichincha, Ecuador.
59Department Surgical Diseases, Tashkent Medical Academy, Tashkent, Almazar, Uzbekistan.
60Department of Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman.
61Department of Medicine, Aga Khan University, Nairobi, Kenya.
62Department of Surgery, Chinese General Hospital and Medical Center, Manila, Philippines.
63Hepatobiliary Division, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Medical Faculty Universitas Indonesia, Jakarta, Indonesia; Digestive Disease & GI Oncology Center, Medistra Hospital, Jakarta, Indonesia; Gastrointestinal Cancer Center, Mochtar Riyadi Comprehensive Cancer Center (MRCCC) Siloam Semanggi Hospital, Jakarta, Indonesia.
64Department of Gastroenterology, Liaquat National Hospital, Karachi, Pakistan.
65MAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province, Wenzhou, China. Electronic address: zhengmh@wmu.edu.cn.
Abstract
Background: Metabolic risk factors are a significant cause of global burden among adolescents and young adults, but there is a lack of attention to the burden attributable to these metabolic risk factors globally.
Aims: This study aims to provide comprehensive estimates of five important metabolic risk factors and the attributable disease burden in people aged 15-39 years from 1990 to 2021, based on the Global Burden of Disease Study (GBD) database.
Methods: Global total deaths and disability-adjusted life years (DALYs) were used to describe the burden attributable to five common metabolic risk factors, including high fasting plasma glucose (FPG), high low-density lipoprotein cholesterol (LDL-C), high systolic blood pressure (SBP), high body mass index (BMI), and kidney dysfunction, in adolescents and young adults. The estimated annual percentage changes (EAPC) of DALYs were utilized to depict the trends from 1990 to 2021.
Results: From 1990 to 2021, the DALY rates attributable to all metabolic risk factors showed a globally significant upward trend, with EAPC reaching 33.0 % (27.4-38.7). Compared to females, males had a heavier burden and a more significant increase in deaths and DALYs attributable to metabolic risk factors. High BMI and high FPG have become the top two metabolic risk factors in 2021, with summary exposure variables (SEV) rising by 84.2 % and 53.6 %, respectively. Low-middle socio-demographic index (SDI), middle SDI, and high SDI regions experienced upward regional trends in DALY rates, while low SDI regions remained stable. Among 204 countries and territories, 101 (49.5 %) showed a significant increase in DALY rates, as indicated by the EAPC.
Conclusions: There is a substantial global burden attributable to metabolic risk factors in adolescents and young adults in 2021, especially high BMI and high FPG. This calls for further investigation and intervention to address this emerging trend.