实用肿瘤杂志

目的 探讨中国人群归因于高体质量指数（body mass index, BMI）的肿瘤疾病负担，并与全球、美国和日本数据比较，分析中国肿瘤死亡率随年龄、时期和队列因素的变化趋势。方法 基于2021全球疾病负担研究（Global Burden of Disease Study 2021, GBD 2021）数据库，以1990—2021年≥20岁的中国居民为研究对象，提取归因于高BMI的肿瘤死亡数、年龄标准化死亡率（age-standardized mortality rate, ASMR）、伤残调整寿命年（disability-adjusted life years, DALYs）、伤残损失寿命年（years lived with disability, YLDs）和早死所致寿命损失年（years of life lost, YLLs）等指标。同时提取全球、美国和日本的相应数据进行比较。通过年龄-时期-队列（age-period-cohort, APC）模型估算中国肿瘤归因于高BMI的死亡率的年龄、时期和队列效应，使用Stata SE 16.0软件和内生因子估算法进行分析。结果 1990—2021年，中国肿瘤患者因高BMI的疾病负担呈上升趋势，与全球、美国和日本相同。中国肿瘤患者因高BMI的死亡数由1990年的11 556.2例上升至2021年的58 745.2例，ASMR由1990年的1.36/10万上升至2021年的2.81/10万，ASMR增幅达106.62%，远高于全球（14.13%）、美国（7.14%）和日本（7.44%）。APC模型分析显示，1990—2021年，中国肿瘤人群归因于高BMI的死亡率的年龄效应和时期效应均呈逐渐上升趋势，而队列效应呈下降趋势。1990—2021年，中国肿瘤患者中男性和女性的死亡数、DALYs、YLLs和YLDs均持续增长；归因死亡率随年龄增加而升高，且各时期均在≥80岁组达到峰值。结论 1990—2021年我国归因于高BMI的肿瘤疾病负担不断攀升，应加强对于肥胖问题的认识和宣传，通过健康教育活动，引导人们形成健康的生活方式和饮食习惯。针对不同性别和年龄的人群，应采取针对性的干预措施。

Objective To investigate the disease burden of neoplasms attributable to high body mass index(BMI) in the Chinese population, compare it with global data and data from the United States and Japan, and analyze the trend of mortality in China across age, period, and cohort factors. Methods Based on the Global Burden of Disease Study 2021(GBD 2021) database, this study focused on Chinese residents aged ≥20 years from 1990 to 2021. Metrics including the number of deaths, age-standardized mortality rate(ASMR), disability-adjusted life years(DALYs), years lived with disability(YLDs), and years of life lost(YLLs) attributable to high BMI were extracted. Corresponding global data and national data of the United States and Japan were also collected for comparison. The age-period-cohort(APC) model was employed to estimate the age, period, and cohort effects on high BMI-attributable neoplasm mortality in China, using Stata SE 16.0 software and the intrinsic estimator algorithm for analysis. Results From 1990 to 2021, the disease burden of neoplasms attributable to high BMI in China exhibited a significant upward trajectory, consistent with the trends observed globally and in the United States and Japan. The number of deaths in Chinese neoplasm patients due to high BMI rose from 11 556.2 in 1990 to 58 745.2 in 2021. ASMR increased from 1.36/100 000 in 1990 to 2.81/100 000 in 2021, representing a growth of 106.62%, which was markedly higher than those of the world(14.13%), the United States(7.14%), and Japan(7.44%). The APC model analysis showed that from 1990 to 2021, the age and period effects on high BMI-attributable neoplasm mortality in the Chinese population followed a gradual upward trend, while the cohort effect exhibited a downward trend. Sex-and age-specific analyses revealed that deaths, DALYs, YLLs, and YLDs continued to grow for both males and females from 1990 to 2021. High BMI-attributable mortality rates increased with age and consistently peaked in the age group of ≥80 years across all periods. Conclusions The disease burden of neoplasms attributable to high BMI in China from 1990 to 2021 is increasing, and has become a public health problem. The government and all sectors of society should strengthen awareness and publicity about obesity, and guide people to adopt healthy lifestyles and eating habits through health education activities. Interventions should be targeted at people of different genders and ages.