The rising prevalence of non-communicable diseases represents a major public health concern worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides age-sex-location-specific estimates of mortality rates worldwide. This resource can be harnessed to assess the evolving burden of metabolic diseases. Previous GBD studies have investigated the increasing mortality and disability-adjusted life years for each individual metabolic disease entity in isolation. However, metabolic diseases often occur in tandem, with their trajectories closely interlinked. As such, the total global burden and distribution of metabolic diseases remains uncharacterised.
This study aims to shed light on the sex-regional-socioeconomic trends and burden of metabolic diseases (including T2DM, hypertension, hyperlipidaemia, obesity, and NAFLD) using GBD data. To do so, it employs a “global syndemic” framework.
From 2000 to 2019, the prevalence rates of T2DM, hypertension, hyperlipidaemia, obesity, and NAFLD increased worldwide, regardless of socio-demographic index (SDI). However, high SDI countries noted the greatest increase in metabolic disease prevalence. Mortality rates decreased over time in hyperlipidaemia, hypertension, and NAFLD, but remained unchanged in T2DM and obesity. Importantly, the latter was identified as the greatest contributor to the metabolic disease burden. Moreover, the highest mortality was noted in Eastern Mediterranean and low to low-middle SDI countries. Despite global efforts to mitigate the burden of metabolic disease, large sex-regional-socioeconomic disparities in mortality were observed among low- to middle-income countries. These findings highlight the urgent need for effective preventative and therapeutic strategies for metabolic disease at the individual, regional, and national levels.