Burden trend analysis of disease attributable to high low density lipoprotein cholesterol in Chinese population from 1990 to 2019_Chinese Journal of Evidence-Based Medicine

Authors：

YUAN Kongjun ¹ , ZHAO Chuangyi ¹ , YANG Yuan ¹ , YAN Danhong ¹ ,  ZHOU Guangqing ²

1. School of Health Management, Southern Medical University, Guangzhou 510080, P. R. China;
2. Health Management Center, Nanfang Hospital, Southern Medical University, Guangzhou 510080, P. R. China;

Corresponding author：

ZHOU Guangqing, Email: 13318898668@189.cn

Keywords：

High LDL-C; Burden of disease; Mortality rate; DALYs; YLLs; YLDs

DOI：

10.7507/1672-2531.202112052

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Objective To analyze the variation trend of high low density lipoprotein cholesterol (LDL-C) attribution disease burden in China from 1990 to 2019. Methods The burden of disease indicators from Global Burden of Disease 2019 (GBD 2019), such as death attributable to high LDL-C, disability-adjusted life years (DALYs), years of life lost (YLLs), and years lost to disability (YLDs) were extracted. The age was standardized using GBD 2019 global standard population, and the trend of rates with the annual percentage change (APC) was analyzed. Results From 1990 to 2019, the disease burden of high LDL-C increased with age in China. The mortality rate, DALYs rate and YLLs rate of males were higher than those of females, while the YLDs rate of males was lower than that of females. Joinpoint regression results showed that from 1990 to 2019, the high LDL-C attribution mortality rate (APC=3.4%, P<0.05), DALYs rate (APC=2.4%, P<0.05), YLLs rate (APC=2.4%, P<0.05), YLDs rate (APC = 2.9%, P<0.05), the standardized mortality rate (APC=0.8%, P<0.05) and the standardized YLDs rate (APC=0.7%, P<0.05) all increased in China. Regarding age, the mortality rate, DALYs rate and YLLs rate increased in the age group over 70 years old, while the YLDs rate increased significantly in the age group over 45 years old. Conclusion From 1990 to 2019, the burden of disease attributable to high LDL-C in China has become increasingly heavy, and the burden varies according to gender and age.

Citation： YUAN Kongjun, ZHAO Chuangyi, YANG Yuan, YAN Danhong, ZHOU Guangqing. Burden trend analysis of disease attributable to high low density lipoprotein cholesterol in Chinese population from 1990 to 2019. Chinese Journal of Evidence-Based Medicine, 2022, 22(4): 444-449. doi: 10.7507/1672-2531.202112052 Copy

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2.	Browning LM, Hsieh SD, Ashwell M. A systematic review of waist-to-weight ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0·5 could be a suitable global boundary value. Nutr Res Rev, 2010, 23(2): 247-269.
3.	Ren J, Grundy SM, Liu J, et al. Long-term coronary heart disease risk associated with very-low-density lipoprotein cholesterol in Chinese: the results of a 15-year Chinese Multi-Provincial Cohort Study (CMCS). Atherosclerosis, 2010, 211(1): 327-332.
4.	Boekholdt SM, Hovingh GK, Mora S, et al. Very low levels of atherogenic lipoproteins and the risk for cardiovascular events: a meta-analysis of statin trials. J Am Coll Cardiol, 2014, 64(5): 485-494.
5.	Zhou M, Wang H, Zeng X, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet, 2019, 394(10204): 1145-1158.
6.	Zhang X, Liu J, Wang M, et al. Twenty-year epidemiologic study on LDL-C levels in relation to the risks of atherosclerotic event, hemorrhagic stroke, and cancer death among young and middle-aged population in China. J Clin Lipidol, 2018, 12(5): 1179-1189.
7.	Zhang M, Deng Q, Wang L, et al. Prevalence of dyslipidemia and achievement of low-density lipoprotein cholesterol targets in Chinese adults: a nationally representative survey of 163 641 adults. Int J Cardiol, 2018, 260: 196-203.
8.	Joint committee for guideline revision. 2016 Chinese guidelines for the management of dyslipidemia in adults. J Geriatr Cardiol, 2018, 15(1): 1-29.
9.	Silverman MG, Ference BA, Im K, et al. Association between lowering LDL-C and cardiovascular risk reduction among different therapeutic interventions: a systematic review and meta-analysis. JAMA, 2016, 316(12): 1289-1297.
10.	Song PK, Man QQ, Li H, et al. Trends in lipids level and dyslipidemia among Chinese adults, 2002-2015. Biomed Environ Sci, 2019, 32(8): 559-570.
11.	GBD 2017 Risk Factor Collaborators. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the global burden of disease study 2017. Lancet, 2018, 392(10159): 1923-1994.
12.	Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: executive summary: a report of the American college of cardiology/American heart association task force on clinical practice guidelines. J Am Coll Cardiol, 2019, 73(24): 3168-3209.
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14.	GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the global burden of disease study 2019. Lancet, 2020, 396(10258): 1204-1222.
15.	GBD 2019 Demographics Collaborators. Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019: a comprehensive demographic analysis for the global burden of disease study 2019. Lancet, 2020, 396(10258): 1160-1203.
16.	GBD 2019 Risk Factors Collaborators. Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the global burden of disease study 2019. Lancet, 2020, 396(10258): 1223-1249.
17.	GBD 2019 Universal Health Coverage Collaborators. Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990-2019: a systematic analysis for the global burden of disease study 2019. Lancet, 2020, 396(10258): 1250-1284.
18.	徐晓慧, 杨静, 王黎君, 等. 2017年中国人群高血清低密度脂蛋白胆固醇归因疾病负担研究. 中华流行病学杂志, 2020, 41(6): 839-844.
19.	徐晓慧. 中国居民高低密度脂蛋白胆固醇归因死亡及其防控措施实施情况研究. 北京: 中国疾病预防控制中心, 2020.
20.	杨静, 王卓群, 赵艳芳, 等. 2013年中国归因于高血清总胆固醇的疾病负担研究. 中华预防医学杂志, 2016, 50(9): 764-768.
21.	Feig JE, Hewing B, Smith JD, et al. High-density lipoprotein and atherosclerosis regression: evidence from preclinical and clinical studies. Circ Res, 2014, 114(1): 205-213.
22.	Duprez DA, Otvos J, Tracy RP, et al. High-density lipoprotein subclasses and noncardiovascular, noncancer chronic inflammatory-related events versus cardiovascular events: the multi-ethnic study of atherosclerosis. J Am Heart Assoc, 2015, 4(9): e002295.
23.	赵旺, 叶平, 胡大一, 等. 根据《中国成人血脂异常防治指南(2016年修订版)》再分析DYSIS-China横断面调查. 中国心血管杂志, 2020, 25(1): 55-61.
24.	Stevens W, Peneva D, Li JZ, et al. Estimating the future burden of cardiovascular disease and the value of lipid and blood pressure control therapies in China. BMC Health Serv Res, 2016, 16: 175.
25.	宋永健, 杜鑫, 郑梦伊, 等. 低密度脂蛋白胆固醇累积暴露对新发急性心肌梗死影响的前瞻性队列研究. 中国循环杂志, 2020, 35(3): 246-253.
26.	Centers for Disease Control and Prevention (CDC). CDC Grand Rounds: the million hearts initiative. MMWR Morb Mortal Wkly Rep, 2012, 61(50): 1017-1021.
27.	赵文华, 孔灵芝, 霍勇. 血脂异常应成为基层慢性病健康管理的核心内容. 中华健康管理学杂志, 2018, 12(4): 289-291.

1. 中国心血管健康与疾病报告编写组. 中国心血管健康与疾病报告2019概要. 中国循环杂志, 2020, 35(9): 833-854.
2. Browning LM, Hsieh SD, Ashwell M. A systematic review of waist-to-weight ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0·5 could be a suitable global boundary value. Nutr Res Rev, 2010, 23(2): 247-269.
3. Ren J, Grundy SM, Liu J, et al. Long-term coronary heart disease risk associated with very-low-density lipoprotein cholesterol in Chinese: the results of a 15-year Chinese Multi-Provincial Cohort Study (CMCS). Atherosclerosis, 2010, 211(1): 327-332.
4. Boekholdt SM, Hovingh GK, Mora S, et al. Very low levels of atherogenic lipoproteins and the risk for cardiovascular events: a meta-analysis of statin trials. J Am Coll Cardiol, 2014, 64(5): 485-494.
5. Zhou M, Wang H, Zeng X, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet, 2019, 394(10204): 1145-1158.
6. Zhang X, Liu J, Wang M, et al. Twenty-year epidemiologic study on LDL-C levels in relation to the risks of atherosclerotic event, hemorrhagic stroke, and cancer death among young and middle-aged population in China. J Clin Lipidol, 2018, 12(5): 1179-1189.
7. Zhang M, Deng Q, Wang L, et al. Prevalence of dyslipidemia and achievement of low-density lipoprotein cholesterol targets in Chinese adults: a nationally representative survey of 163 641 adults. Int J Cardiol, 2018, 260: 196-203.
8. Joint committee for guideline revision. 2016 Chinese guidelines for the management of dyslipidemia in adults. J Geriatr Cardiol, 2018, 15(1): 1-29.
9. Silverman MG, Ference BA, Im K, et al. Association between lowering LDL-C and cardiovascular risk reduction among different therapeutic interventions: a systematic review and meta-analysis. JAMA, 2016, 316(12): 1289-1297.
10. Song PK, Man QQ, Li H, et al. Trends in lipids level and dyslipidemia among Chinese adults, 2002-2015. Biomed Environ Sci, 2019, 32(8): 559-570.
11. GBD 2017 Risk Factor Collaborators. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the global burden of disease study 2017. Lancet, 2018, 392(10159): 1923-1994.
12. Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: executive summary: a report of the American college of cardiology/American heart association task force on clinical practice guidelines. J Am Coll Cardiol, 2019, 73(24): 3168-3209.
13. Mach F, Baigent C, Catapano AL, et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J, 2020, 41(1): 111-188.
14. GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the global burden of disease study 2019. Lancet, 2020, 396(10258): 1204-1222.
15. GBD 2019 Demographics Collaborators. Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019: a comprehensive demographic analysis for the global burden of disease study 2019. Lancet, 2020, 396(10258): 1160-1203.
16. GBD 2019 Risk Factors Collaborators. Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the global burden of disease study 2019. Lancet, 2020, 396(10258): 1223-1249.
17. GBD 2019 Universal Health Coverage Collaborators. Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990-2019: a systematic analysis for the global burden of disease study 2019. Lancet, 2020, 396(10258): 1250-1284.
18. 徐晓慧, 杨静, 王黎君, 等. 2017年中国人群高血清低密度脂蛋白胆固醇归因疾病负担研究. 中华流行病学杂志, 2020, 41(6): 839-844.
19. 徐晓慧. 中国居民高低密度脂蛋白胆固醇归因死亡及其防控措施实施情况研究. 北京: 中国疾病预防控制中心, 2020.
20. 杨静, 王卓群, 赵艳芳, 等. 2013年中国归因于高血清总胆固醇的疾病负担研究. 中华预防医学杂志, 2016, 50(9): 764-768.
21. Feig JE, Hewing B, Smith JD, et al. High-density lipoprotein and atherosclerosis regression: evidence from preclinical and clinical studies. Circ Res, 2014, 114(1): 205-213.
22. Duprez DA, Otvos J, Tracy RP, et al. High-density lipoprotein subclasses and noncardiovascular, noncancer chronic inflammatory-related events versus cardiovascular events: the multi-ethnic study of atherosclerosis. J Am Heart Assoc, 2015, 4(9): e002295.
23. 赵旺, 叶平, 胡大一, 等. 根据《中国成人血脂异常防治指南(2016年修订版)》再分析DYSIS-China横断面调查. 中国心血管杂志, 2020, 25(1): 55-61.
24. Stevens W, Peneva D, Li JZ, et al. Estimating the future burden of cardiovascular disease and the value of lipid and blood pressure control therapies in China. BMC Health Serv Res, 2016, 16: 175.
25. 宋永健, 杜鑫, 郑梦伊, 等. 低密度脂蛋白胆固醇累积暴露对新发急性心肌梗死影响的前瞻性队列研究. 中国循环杂志, 2020, 35(3): 246-253.
26. Centers for Disease Control and Prevention (CDC). CDC Grand Rounds: the million hearts initiative. MMWR Morb Mortal Wkly Rep, 2012, 61(50): 1017-1021.
27. 赵文华, 孔灵芝, 霍勇. 血脂异常应成为基层慢性病健康管理的核心内容. 中华健康管理学杂志, 2018, 12(4): 289-291.

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