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1990—2021年中国2型糖尿病疾病负担及未来变化趋势预测

Projected changes and burden of type 2 diabetes in China from 1990 to 2021: an analysis of GBD 2021 data

    摘要
  • 摘要:
    目的  分析1990—2021年中国2型糖尿病（T2DM）的疾病负担和变化趋势，预测2022—2026年的T2DM疾病负担，为制定和评估糖尿病防治策略提供数据支持和科学依据。
    方法 从全球疾病负担2021数据库中获取中国T2DM疾病负担数据，分析1990—2021年中国T2DM患病率、死亡率和DALYs率的变化趋势；基于1990—2016年数据（训练集）建立中国T2DM患病率、死亡率及DALYs率的自回归整合移动平均（ARIMA）模型、神经网络自回归（NNAR）模型和ARIMA-NNAR组合模型，利用2017—2021年数据（测试集）进行模型评价；采用平均绝对百分误差（MAPE）、平均绝对误差（MAE）和均方根误差（RMSE）比较模型的拟合和预测效果，选择最佳模型预测2022—2026年中国T2DM疾病负担。
    结果 通过计算1990—2021年中国T2DM的变化率，2021年中国T2DM患病率、死亡率、DALYs率相较1990年均具有明显上升趋势，且男性疾病负担高于女性。ARIMA模型、NNAR模型和ARIMA-NNAR组合模型预测值的动态趋势与实际情况基本一致，但组合预测模型各评价指标的值均显示预测效果好于单预测模型。经ARIMA-NNAR模型预测得到2022—2026年中国T2DM患病率分别为8 353.71/10万、8 565.00/10万、8 776.30/10万、8 987.60/10万、9 198.90/10万，死亡率分别为12.55/10万、12.78/10万、12.99/10万、13.20/10万、13.41/10万，DALYs率分别为826.79/10万、846.22/10万、864.49/10万、881.86/10万、898.54/10万。
    结论 ARIMA-NNAR组合模型在预测中国T2DM疾病负担应用中具有良好的效果，可为T2DM疾病负担短期预测提供借鉴与参考。中国T2DM疾病患病率、死亡率和DALYs率在2022—2026年仍会增长，表明中国T2DM疾病负担将持续加重，疾病防控形势依然严峻。

     

    Abstract:
    Objective To analyze the disease burden and trends of type 2 diabetes mellitus (T2DM) in China from 1990 to 2021, and to predict the T2DM disease burden from 2022 to 2026, providing data support and a scientific basis for the development and evaluation of diabetes prevention and control strategies.
    Methods Data on the disease burden of T2DM in China were obtained from the Global Burden of Disease Study 2021 database. The trends in the prevalence, mortality, and disability-adjusted life years (DALYs) rates of T2DM in China from 1990 to 2021 were analyzed. Autoregressive integrated moving average (ARIMA) models, neural network autoregression (NNAR) models, and combined ARIMA-NNAR models for the prevalence, mortality, and DALYs rates of T2DM in China were established based on data from 1990 to 2016 (training set). Model evaluation was performed using data from 2017 to 2021 (test set). The mean absolute percentage error (MAPE), mean absolute error (MAE), and root mean square error (RMSE) were used to compare the fitting and prediction performance of the models, and the best model was selected to predict the disease burden of T2DM in China from 2022 to 2026.
    Results By calculating the rate of change of T2DM in China from 1990 to 2021, the prevalence, mortality, and DALYs rates of T2DM in China in 2021 showed a significant upward trend compared with 1990, and the disease burden was higher in males than in females. The dynamic trends of the predicted values of the ARIMA model, NNAR model, and combined ARIMA-NNAR model were basically consistent with the actual situation, but the values of each evaluation index of the combined prediction model showed that the prediction effect was better than that of the single prediction model. The prevalence, mortality, and DALYs rates of T2DM in China from 2022 to 2026 predicted by the ARIMA-NNAR model were 8 353.71/105, 8 565.00/105, 8 776.30/105, 8 987.60/105, and 9 198.90/105; 12.55/105, 12.78/105, 12.99/105, 13.20/105, and 13.41/105; and 826.79/105, 846.22/105, 864.49/105, 881.86/105, and 898.54/105, respectively.
    Conclusions The combined ARIMA-NNAR model has a good effect in predicting the disease burden of T2DM in China and can provide a reference for short-term prediction of the T2DM disease burden. The prevalence, mortality, and DALYs rates of T2DM in China will continue to increase from 2022 to 2026, indicating that the disease burden of T2DM in China will continue to increase, and the situation of disease prevention and control remains severe.

     

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