文献类型：期刊文献

中文题名：不良饮食危险因素对中国居民结直肠癌疾病负担的影响及变化趋势分析:基于GBD 1990-2021年数据

英文题名：Effects of unhealthy diet risk factors on the burden of colorectal cancer in Chinese residents and its changing trends:based on GBD 1990-2021 data

作者：杨宇琳[1];沈瑞博[2];刘占鹏[1];杜娟[3]

第一作者：杨宇琳

机构：[1]甘肃中医药大学中医临床学院,兰州730000;[2]甘肃中医药大学第一临床医学院,兰州730000;[3]甘肃中医药大学护理学院,兰州730000

第一机构：甘肃中医药大学中医临床学院

年份：2025

卷号：38

期号：3

起止页码：160

中文期刊名：数理医药学杂志

外文期刊名：Journal of Mathematical Medicine

语种：中文

中文关键词：结直肠癌;饮食风险;疾病负担;中国;全球疾病负担研究

外文关键词：Colorectal cancer;Dietary risk;Disease burden;China;Global Burden of Disease Study

摘要：目的分析中国居民归因于不良饮食危险因素的结直肠癌(colorectal cancer,CRC)疾病负担情况及变化趋势,为营养健康管理、肿瘤防控治理策略的制定提供支持。方法从全球疾病负担研究2021(Global Burden of Disease Study 2021,GBD 2021)数据库提取1990—2021年中国居民因不良饮食因素导致的CRC相关数据,采用死亡数、死亡率、伤残调整寿命年(disability-adjusted life years,DALYs)、早死寿命损失年(years of life lost due to premature mortality,YLLs)和伤残寿命损失年(years lived with disability,YLDs)等指标综合评估CRC疾病负担。运用Joinpoint回归分析和年龄-时期-队列模型探讨CRC疾病负担的时间趋势及其与年龄、时期和队列效应的相关性。结果2021年中国居民因不良饮食因素导致的CRC全年龄死亡数为10.27万例[95%不确定区间(uncertain interval,UI):3.61万~16.65万],标化死亡率为5.08/10万(95%UI:1.79/10万~8.21/10万),标化DALYs率为122.93/10万(95%UI:42.56/10万~198.49/10万),标化YLLs率为117.14/10万(95%UI:40.78/10万~189.90/10万),标化YLDs率为5.79/10万(95%UI:1.89/10万~10.07/10万)。不良饮食危险因素中,低奶制品饮食对CRC疾病负担的贡献最大,而低纤维饮食的影响最小。Joinpoint回归分析显示,总饮食风险中CRC死亡数和全年龄DALYs数整体呈上升趋势,平均年度变化百分比(average annual percent change,AAPC)分别为237%、187%;而标化死亡率和DALYs率呈下降趋势,AAPC值分别为-81%、-88%。年龄-时期-队列模型分析显示,总体、男性及女性的CRC死亡率均呈下降趋势,净漂移值分别为-1.12%[95%置信区间(confidence interval,CI):-1.25%~-0.99%]、-0.46%(95%CI:-0.63%~-0.29%)、-2.07%(95%CI:-2.20%~-1.94%)。结论1990—2021年中国居民归因于不良饮食危险因素的CRC标化死亡率、标化DALYs率和标化YLDs率呈下降趋势,疾病负担有所缓解。从性别上看,归因于不良饮食危险因素的CRC疾病负担主要由男性造成;从年龄上看,主要由中老年人造成;从危险因素类别上看,主要由低奶制品饮食、低全谷物饮食造成。营养健康管理、肿瘤防控治理策略应注意向这些特殊人群、类别倾斜,以降低CRC疾病负担。
Objective To analyze the disease burden and trends of colorectal cancer(CRC)attributed to unhealthy diet risk factors in Chinese residents,in order to provide support for the formulation of nutrition and health management,cancer prevention and control management strategies.Methods Based on the Global Burden of Disease Study 2021(GBD 2021)database,the CRC related data of Chinese residents from 1990 to 2021 due to unhealthy diet factors were extracted.Deaths,mortality,disability-adjusted life years(DALYs),years of life lost due to premature mortality(YLLs)and years lived with disability(YLDs)were used to assess CRC disease burden.Joinpoint regression analysis and age-period-cohort model were used to explore the time trend of CRC disease burden and its correlation with age,period and cohort effects.Results In 2021,the number of age-wide CRC deaths caused by unhealthy diet factors in Chinese residents was 102700[95%uncertain interval(UI):36100-166500],and the standardized mortality rate was 5.08/100000(95%UI:1.79/100000-8.21/100000),the standardized DALYs rate was 122.93/100000(95%UI:42.56/100000-198.49/100000),the standardized YLLs rate was 117.14/100000(95%UI:40.78/100000-189.90/100000),and the standardized YLDs rate was 5.79/100000(95%UI:1.89/100000-10.07/100000).Among the unhealthy diet risk factors,the lowdairy diet contributed the most to CRC disease burden,while the low-fiber diets had the least impact.Joinpoint regression analysis revealed that the number of CRC deaths and the number of DALYs at all ages showed an overall upward trend,and the average annual percent change(AAPC)values were 237%and 187%,respectively.The standardized mortality rate and DALYs rate showed a decreasing trend,and the AAPC values were-81%and-88%,respectively.The age-period-cohort model analysis showed a decreasing trend in CRC mortality in general,men and women,with net drift values of-1.12%[95%confidence interval(CI):-1.25%to-0.99%],-0.46%(95%CI:-0.63%to-0.29%),and-2.07%(95%CI:-2.20%to-1.94%).Conclusion From 1990 to 2021,the CRC standardized mortality,standardized DALYs rate and standardized YLLs rate attributed to unhealthy diet risk factors in Chinese residents showed a decreasing trend,and the disease burden was relieved.From the perspective of gender,the CRC disease burden attributed to unhealthy diet risk factors was mainly caused by men;from the perspective of age,it was mainly caused by the middle-aged and old people;from the perspective of risk factor categories,it was mainly caused by low-dairy diet and low whole grain diet.Nutrition and health management,cancer prevention and control management strategies should pay attention to these special groups and categories,in order to reduce the burden of colorectal cancer.