目的 分析1990-2019年我国肾功能损伤所致心血管病(cardiovascular disease attributed to kidney dysfunction,KI-CVD)死亡率变化趋势,并评估年龄、时期及队列对KI-CVD死亡率的影响.方法 利用2019全球疾病负担研究(global burden of disease study 2019,GBD 2019)中1990-2019年中国KI-CVD死亡资料,通过Joinpoint回归模型分析粗死亡率(crude death rate,CDR)及年龄标化死亡率(age-standardized death rate,ASDR)的年度变化百分比(annual percent change,APC)和平均年度变化百分比(average annual percent change,AAPC);建立年龄-时期-队列模型分析年龄、时期及队列对KI-CVD的影响.结果 归因于KI-CVD的CDR总体呈上升趋势,从 1990 年的 12.65/10 万上升至 2019 年的 26.49/10 万,年均上升 3.35％(AAPC=3.35％,95％CI:3.06％～3.64％),ASDR 总体呈上升趋势(AAPC=0.70％,95％CI:0.39％～1.00％).APC 模型显示:1990-2019年归因于KI-CVD的死亡率随年龄增长呈上升趋势,随时间推移呈先下降后上升至平稳再下降的趋势,以2000-2004年为参考,1990-1994年死亡风险相对较高,2015-2019年死亡相对风险较低.队列效应显示呈倒"U"型,1911-1939年队列死亡率呈上升趋势,1931-1939年死亡风险达到高峰(RR=1.100,95％CI:1.046～1.158)后呈下降趋势.结论 1990-2019年我国归因于KI-CVD的CDR总体呈上升趋势,死亡风险受年龄、时期及队列效应的影响.
Joinpoint regression and age-period-cohort analysis of mortality trends of cardiovascular disease attributable to kidney dysfunction in China
Objective To analyze the long-term trends and effects of age,period and cohort on cardiovascular disease mortality attributed to kidney dysfunction(KI-CVD)in China from 1990 to 2019.Methods Data on the absolute number,crude death rate(CDR)and age-standardized mortality(ASDR)for KI-CVD in China were collected from global burden of disease study 2019.The annual percentage change(APC)and average annual percentage change(AAPC)were calculated to analyze the trends of CDR and ASDR by Joinpoint regression model.The age,period and cohort effects were estimated using an age-period-cohort model.Results The CDR of KI-CVD was generally increasing,from 12.65 per 100 000 in 1990 to 26.49 per 100 000 in 2019(AAPC=3.35％,95％CI:3.06％-3.64％).ASDR showed a slight increase(AAPC=0.70％,95％CI:0.39％-1.00％).APC model analysis showed that from 1990 to 2019,age effect exhibited an upward trend with the increase of age.Period effect decreased first,then increased to steady and then decreased over time.Taking 2000-2004 as the reference group,the rate ratio of death was higher in 1990-1994,and lower in 2015-2019.Cohort effect showed an inverted"U"shape,with an upward trend in 1911-1939 cohort,peaking in 1931-1939(RR=1.100,95％CI:1.046-1.158),then decreasing with the year of birth.Conclusions The CDR of KI-CVD in China is generally on the rise from 1990 to 2019 and the risk of death is affected by age,period and cohort effect.
Kidney dysfunctionCardiovascular diseaseMortalityJoinpoint regression modelAge-period-cohort model
NETL
NSTL
万方数据
