RESUMEN
AIMS: Caused by multiple risk factors, heavy burden of major depressive disorder (MDD) poses serious challenges to public health worldwide over the past 30 years. Yet the burden and attributable risk factors of MDD were not systematically known. We aimed to reveal the long-term spatio-temporal trends in the burden and attributable risk factors of MDD at global, regional and national levels during 1990-2019. METHODS: We obtained MDD and attributable risk factors data from Global Burden of Disease Study 2019. We used joinpoint regression model to assess the temporal trend in MDD burden, and age-period-cohort model to measure the effects of age, period and birth cohort on MDD incidence rate. We utilized population attributable fractions (PAFs) to estimate the specific proportions of MDD burden attributed to given risk factors. RESULTS: During 1990-2019, the global number of MDD incident cases, prevalent cases and disability-adjusted life years (DALYs) increased by 59.10%, 59.57% and 58.57%, respectively. Whereas the global age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR) and age-standardized DALYs rate (ASDR) of MDD decreased during 1990-2019. The ASIR, ASPR and ASDR in women were 1.62, 1.62 and 1.60 times as that in men in 2019, respectively. The highest age-specific incidence, prevalence and DALYs rate occurred at the age of 60-64 in women, and at the age of 75-84 in men, but the maximum increasing trends in these age-specific rates occurred at the age of 5-9. Population living during 2000-2004 had higher risk of MDD. MDD burden varied by socio-demographic index (SDI), regions and nations. In 2019, low-SDI region, Central sub-Saharan Africa and Uganda had the highest ASIR, ASPR and ASDR. The global PAFs of intimate partner violence (IPV), childhood sexual abuse (CSA) and bullying victimization (BV) were 8.43%, 5.46% and 4.86% in 2019, respectively. CONCLUSIONS: Over the past 30 years, the global ASIR, ASPR and ASDR of MDD had decreased trends, while the burden of MDD was still serious, and multiple disparities in MDD burden remarkably existed. Women, elderly and populations living during 2000-2004 and in low-SDI regions, had more severe burden of MDD. Children were more susceptible to MDD. Up to 18.75% of global MDD burden would be eliminated through early preventing against IPV, CSA and BV. Tailored strategies-and-measures in different regions and demographic groups based on findings in this studywould be urgently needed to eliminate the impacts of modifiable risk factors on MDD, and then mitigate the burden of MDD.
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Trastorno Depresivo Mayor , Carga Global de Enfermedades , Salud Global , Humanos , Trastorno Depresivo Mayor/epidemiología , Factores de Riesgo , Carga Global de Enfermedades/tendencias , Femenino , Masculino , Incidencia , Salud Global/estadística & datos numéricos , Adulto , Prevalencia , Persona de Mediana Edad , Análisis Espacio-Temporal , Anciano , Años de Vida Ajustados por Discapacidad/tendencias , Adulto Joven , Costo de Enfermedad , AdolescenteRESUMEN
Secular trends of mortality and disability-adjusted life years (DALY) in type 2 diabetes mellitus (T2DM) attributable to PM2.5 exposure in China remain unclear. This study applied the joinpoint regression analysis and age-period-cohort model to assess the secular trends. There was a slight alternation in age-standardized rate of mortality and DALY in the total population, while the changes were increased in males and decreased in females from 1990 to 2019. Meanwhile, the changes attributable to ambient particular matter pollution exposure (APE) increased significantly and reduced household air pollution from solid fuels exposure (HPE). Longitudinal age curves showed that T2DM mortality and DALY increased with age. Period rate ratios (RR) attributable to APE increased but fell to HPE. Similar trends were observed in the cohort RR. PM2.5 exposure is more harmful to males and older people. The type of air pollution responsible for T2DM has changed from HPE to APE.
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Contaminantes Atmosféricos , Diabetes Mellitus Tipo 2 , Exposición a Riesgos Ambientales , Material Particulado , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/etiología , Humanos , Material Particulado/análisis , Material Particulado/efectos adversos , China/epidemiología , Masculino , Femenino , Persona de Mediana Edad , Anciano , Exposición a Riesgos Ambientales/efectos adversos , Adulto , Contaminantes Atmosféricos/análisis , Contaminantes Atmosféricos/efectos adversos , Estudios de Cohortes , Contaminación del Aire/efectos adversos , Anciano de 80 o más Años , Adulto JovenRESUMEN
BACKGROUND: The age-period-cohort effects on youth overweight and obesity among junior and senior high school students in Taiwan is not clear. METHODS: We utilized the 2006-14 nationally representative School Physical Fitness Dataset. Based on the International Obesity Task Force cut-off criteria, a log-linear age-period-cohort analysis was performed to determine the influence of age, period and cohort on the trend in being overweight, obese and severely obese for both sexes. RESULTS: The final dataset included 1073173 individuals (n = 520 382 boys and 552 791 girls). For girls, the prevalence of overweight and obesity declined with age, and the prevalence of overweight declined over time. For boys, the prevalence of overweight and obesity declined with age and over time from 2006 to 2014. The prevalence of severe obesity declined over time and increased with age for the boys. The younger birth cohorts had greater odds of being overweight, obese and severely obese than the older birth cohorts. CONCLUSIONS: After differentiating the age-period-cohort effects, the data suggested a decreasing temporal trend in overweight and obesity among adolescents in Taiwan from 2006 to 2014. Among the birth cohorts of the 1990s, the younger cohorts had greater odds of being overweight and obese than the older cohorts when they reached adolescence.
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Sobrepeso/epidemiología , Adolescente , Distribución por Edad , Índice de Masa Corporal , Niño , Efecto de Cohortes , Femenino , Humanos , Masculino , Obesidad/epidemiología , Prevalencia , Instituciones Académicas , Estudiantes , Taiwán/epidemiologíaRESUMEN
BACKGROUND: Previous studies have reported that the development of pancreatic cancer (PC) may be associated with environment pollution. But the relationship between ambient air pollution and PC remains unclear. OBJECTIVES: This study aimed to examine the association between PC mortality and exposure of fine particular matter. METHODS: We used PC mortality data from 103 continuous points in national Disease Surveillance Point system from 1991 to 2009 in China. The annual concentrations of PM2.5 at 0.1°â¯×â¯0.1° spatial resolution for each points were estimated based on the context of the Global Burden of Disease Study 2015. A spatial age-period-cohort model was used to examine the relative risks of PC mortality associated with PM exposure, after adjusting gender, urban/rural status, spatial variation as well as age, period and cohort effect. RESULTS: The relative risks of PC mortality related to 10⯵g/m3 increase of PM2.5 were 1.16 (95% confidence interval (CI): 1.13, 1.20) for all the population, 1.08 (1.05,1.13) for those aged 40-64 years, 1.21 (1.17,1.25) for those aged 65-84 years, 1.14 (1.10,1.18) for the male, 1.19 (1.14,1.24) for the female, 1.23 (1.16,1.30) for the urban population and 1.29 (1.22, 1.37) for the rural population. CONCLUSIONS: Ambient PM2.5 may raise the risk of mortality from PC, especially in older population. Pollution control policy should be further strengthened to reduce the health damages.
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Contaminación del Aire , Neoplasias Pancreáticas , Material Particulado , Adulto , Anciano , Anciano de 80 o más Años , Contaminantes Atmosféricos , China , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis Espacio-TemporalRESUMEN
Although studies have examined the associations between fine particles (PM2.5) and lung cancer mortality in US and European countries, the evidence is still limited for China. In addition, no study has provided estimates of spatial variation in lung cancer mortality attributable to PM2.5 in China. In this study, we quantified the associations between lung cancer mortality and PM2.5, using a spatiotemporal model with observed data of lung cancer mortality from 75 communities from the National Cancer Registration of China from 1990 to 2009 and the annual concentrations of PM2.5 at 0.5°×0.5° spatial resolution. We also estimated lung cancer mortality burden attributable to PM2.5 in China, with predicted county level lung cancer deaths in 2005. We found that the PM2.5-lung cancer mortality associations were non-linear, with thresholds of 40µg/m3 overall, 45µg/m3 for male, 42µg/m3 for female, 45µg/m3 for those aged 30-64years, 48µg/m3 for those aged 65-74years, and 40µg/m3 for those aged 75years and more, above which the relative risks were 1.08 (95% CI: 1.07, 1.09), 1.07 (95% CI: 1.05, 1.08), 1.12 (95% CI: 1.1, 1.14), 1.05 (95% CI: 1.04, 1.07), 1.07 (95% CI: 1.06, 1.09), and 1.14 (95% CI: 1.12, 1.16) respectively. There were 51,219 (95% CI: 45,745-56,512) lung cancer deaths attributed to PM2.5 in 2005, with attributable fractions of 13.7% (95% CI: 12.23-15.11%) overall, 10.01% (95% CI: 8.37-11.58%) for men, 18.06% (95% CI: 15.81-20.18%) for women, 8.35% (95% CI: 6.07-10.51%) for those aged 65-74years, 9.73% (95% CI: 7.6-11.75%) for those aged 65-74years, 21.7% (95% CI: 19.27-23.99%) for those aged 75years or more. In conclusion, assuming a causal relation a reduction in exposure levels of PM2.5 below thresholds would avert a substantial number of deaths from lung cancer in China.
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Contaminantes Atmosféricos/análisis , Contaminación del Aire/estadística & datos numéricos , Exposición a Riesgos Ambientales/estadística & datos numéricos , Neoplasias Pulmonares/mortalidad , Material Particulado/análisis , China/epidemiología , HumanosRESUMEN
BACKGROUND: China is experiencing more and more days of serious air pollution recently, and has the highest lung cancer burden in the world. OBJECTIVES: To examine the associations between lung cancer incidence and fine particles (PM2.5) and ozone in China. METHODS: We used 75 communities' data of lung cancer incidence from the National Cancer Registration of China from 1990 to 2009. The annual concentrations of fine particles (PM2.5) and ozone at 0.1°×0.1° spatial resolution were generated by combing remote sensing, global chemical transport models, and improvements in coverage of surface measurements. A spatial age-period-cohort model was used to examine the relative risks of lung cancer incidence associated with the air pollutants, after adjusting for impacts of age, period, and birth cohort, sex, and community type (rural and urban) as well as the spatial variation on lung cancer incidence. RESULTS: The relative risks of lung cancer incidence related to a 10 µg/m(3) increase in 2-year average PM2.5 were 1.055 (95% confidence interval (CI): 1.038, 1.072) for men, 1.149 (1.120, 1.178) for women, 1.060 (1.044, 1.075) for an urban communities, 1.037 (0.998, 1.078) for a rural population, 1.074 (1.052, 1.096) for people aged 30-65 years, and 1.111 (1.077, 1.146) for those aged over 75 years. Ozone also had a significant association with lung cancer incidence. CONCLUSIONS: The increased risks of lung cancer incidence were associated with PM2.5 and ozone air pollution. Control measures to reduce air pollution would likely lower the future incidence of lung cancer.