Assessment of disease burden and trend prediction of ischemic stroke attributable to high fasting plasma glucose in China: prevention and control strategies for key populations—a public health early warning based on GBD 2021

ZHOU Yinjuan; WANG Wen; WEI Haiping

doi:10.16016/j.2097-0927.202511017

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Assessment of disease burden and trend prediction of ischemic stroke attributable to high fasting plasma glucose in China: prevention and control strategies for key populations—a public health early warning based on GBD 2021

Think Tank for Public Health | 更新时间：2026-02-04

- Assessment of disease burden and trend prediction of ischemic stroke attributable to high fasting plasma glucose in China: prevention and control strategies for key populations—a public health early warning based on GBD 2021
- Journal of Army Medical University Vol. 48, Issue 2, Pages: 181-190(2026)
- 作者机构：
  
  1.兰州大学：，第二临床医学院，甘肃兰州
  2.兰州大学：，第二医院神经内科，甘肃兰州
- 作者简介：
  
  WEI Haiping, E-mail：ery_weihpery@lzu.edu.cn
- 基金信息：
  
  the General Program of National Natural Science Foundation of China(82201441;82460245);the Natural Science Foundation of Gansu Province(22JR5RA1002);the Project of “Cuiying Science and Technology Innovation” Program for Applied Basic Research Plan of Lanzhou University Second Hospital(CY2022-MS-A01);the Project of Cuiying Scientific Training Program for Undergraduates of Lanzhou University Second Hospital(CYXZ2024-09;CYXZPT2025-35)
- DOI：10.16016/j.2097-0927.202511017
  CLC： R-05;R195.4;R743.3
- Received：04 November 2025，
  
  Revised：2025-12-16，
  
  Accepted：27 December 2025，
  
  Published：30 January 2026
- 稿件说明：
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周银娟，王文，魏海萍.中国高空腹血糖相关缺血性脑卒中疾病负担评估、趋势预测与重点人群防控策略：基于GBD 2021的公共卫生预警［J］.陆军军医大学学报，2026，48（02）：181-190.DOI：10.16016/j.2097-0927.202511017.

ZHOU Y J，WANG W，WEI H P.Assessment of disease burden and trend prediction of ischemic stroke attributable to high fasting plasma glucose in China： prevention and control strategies for key populations—a public health early warning based on GBD 2021［J］.J Army Med Univ，2026，48（02）：181-190.DOI：10.16016/j.2097-0927.202511017.
周银娟，王文，魏海萍.中国高空腹血糖相关缺血性脑卒中疾病负担评估、趋势预测与重点人群防控策略：基于GBD 2021的公共卫生预警［J］.陆军军医大学学报，2026，48（02）：181-190.DOI：10.16016/j.2097-0927.202511017. DOI：

ZHOU Y J，WANG W，WEI H P.Assessment of disease burden and trend prediction of ischemic stroke attributable to high fasting plasma glucose in China： prevention and control strategies for key populations—a public health early warning based on GBD 2021［J］.J Army Med Univ，2026，48（02）：181-190.DOI：10.16016/j.2097-0927.202511017. DOI：

摘要

目的

本研究基于2021年全球疾病负担研究（global burden of disease， GBD）数据，系统评估1990—2021年中国25岁以上人群归因于高空腹血糖（high fasting plasma glucose， HFPG）的缺血性脑卒中（ischemic stroke， IS）疾病负担，分析人群差异，并预测2022—2035年趋势。

方法

数据来源于GBD 2021数据库，提取中国地区1990—2021年HFPG相关缺血性脑卒中的年龄标化死亡率（age-standardized mortality rate， ASMR）、年龄标化伤残调整生命年率（age-standardized disability-adjusted life years rate， ASDR）及人群亚组数据。采用Joinpoint回归分析时间趋势，贝叶斯年龄-时期-队列（bayesian age-period-cohort， BAPC）模型预测未来负担变化。

结果

1990—2021年中国25岁以上人群HFPG相关缺血性脑卒中的ASMR和ASDR整体呈下降趋势，但2021年ASMR（19.76/10万）和ASDR（354.37/10万人年）仍显著高于全球水平（ASMR=14.69/10万；ASDR=266.36/10万人年）。男性负担高于女性，25~44岁群体负担呈上升趋势，80岁以上人群下降趋势不显著。预测显示，2022—2035年中国ASMR和ASDR将持续下降，降幅预计高于全球，但绝对水平仍高于全球。

结论

中国≥25岁人群HFPG相关缺血性脑卒中疾病负担虽整体下降，但防控形势仍严峻。需针对男性、老年及年轻高危人群制定精准干预策略，加强糖尿病管理与健康促进，以遏制疾病负担上升。对策建议强化高危人群血糖筛查与基层规范管理，针对男性、老年及年轻高危人群制定精准干预策略，完善卒中救治——康复连续服务和医保保障，建立监测评估与预警体系，以遏制HFPG相关IS负担。

Abstract

Objective

To systematically assess the disease burden of ischemic stroke (IS) attributable to high fasting plasma glucose (HFPG) among Chinese adults aged 25 years and older from 1990 to 2021 based on 2021 Global Burden of Disease (GBD) data

and to analyze population disparities and project trends for 2022 to 2035

providing evidence for prevention and control strategies.

Methods

Data were extracted from the GBD 2021 database

including age-standardized mortality rate (ASMR)

disability-adjusted life years per million (ASDR)

and population subgroup data for HFPG-related IS in China from 1990 to 2021. Joinpoint regression model was used to analyze temporal trends

and Bayesian age-period-cohort (BAPC) model was employed to predict future burden changes.

Results

Overall

both the ASMR and ASDR for HFPG-related IS showed a declining trend from 1990 to 2021 among individuals aged 25 and older in China. However

in 2021

the ASMR (19.76 per 100 000) and ASDR (354.37 per 100 000 person-years) remained significantly higher than the global levels (ASMR=14.69 per 100 000; ASDR=266.36 per 100 000 person-years). The disease burden was higher in males than in females

with an increasing trend among those aged 25 to 44 years and a non-significant decline among those aged 80 years and older. Projections indicated that China’s ASMR and ASDR will be in a continuous decline from 2022 to 2035

with a projected rate of decrease exceeding the global average

though absolute levels will still remain higher than the global average.

Conclusion

Although the overall burden of HFPG-related is among Chinese individuals aged ≥25 years has decreased

the prevention and control situation remains severe. Countermeasures　It is recommended to enhance blood glucose screening for high-risk populations and standardized primary care management. Precise intervention strategies should be formulated for males

the elderly

and other young high-risk groups. Additionally

it is essential to improve the continuum of stroke treatment

rehabilitation services

and medical insurance coverage

while establishing a monitoring

evaluation

and early warning system to curb the burden of hyperglycemia-related ischemic stroke.

关键词

Keywords

references

FAN J H ， LI X G ， YU X Y ， et al . Global burden， risk factor analysis， and prediction study of ischemic stroke， 1990—2030 ［J］. Neurology ， 2023 ， 101 （ 2 ）： e137 - e150 . DOI： 10.1212/WNL.0000000000207387 http://dx.doi.org/10.1212/WNL.0000000000207387 .

FU H J ， LIU Z C ， YU H ， et al . The global， regional， and National burden of severe heart failure （SHF） due to intracerebral hemorrhage， ischemic heart disease， or stroke， 1990—2021： a systematic analysis for the global burden of disease study 2021 ［J］. BMC Cardiovasc Disord ， 2025 ， 25 （ 1 ）： 691 . DOI： 10.1186/s12872-025-05172-y http://dx.doi.org/10.1186/s12872-025-05172-y .

FEIGIN V L ， NGUYEN G ， CERCY K ， et al . Global， regional， and country-specific lifetime risks of stroke， 1990 and 2016 ［J］. N Engl J Med ， 2018 ， 379 （ 25 ）： 2429 - 2437 . DOI： 10.1056/NEJMoa1804492 http://dx.doi.org/10.1056/NEJMoa1804492 .

GBD 2021 Nervous System Disorders Collaborators . Global， regional， and national burden of disorders affecting the nervous system， 1990—2021： a systematic analysis for the Global Burden of Disease Study 2021 ［J］. Lancet Neurol ， 2024 ， 23 （ 4 ）： 344 - 381 . DOI： 10.1016/S1474-4422（24）00038-3 http://dx.doi.org/10.1016/S1474-4422（24）00038-3 .

CAO X ， TIAN Y X ， ZHAO Z P ， et al . Disparities in high fasting plasma glucose-related cardiovascular disease burden in China ［J］. Nat Commun ， 2024 ， 15 （ 1 ）： 8817 . DOI： 10.1038/s41467-024-53236-y http://dx.doi.org/10.1038/s41467-024-53236-y .

ZHANG Y ， GU S J ， WANG C C ， et al . Association between fasting blood glucose levels and stroke events： a large-scale community-based cohort study from China ［J］. BMJ Open ， 2021 ， 11 （ 8 ）： e050234 . DOI： 10.1136/bmjopen http://dx.doi.org/10.1136/bmjopen — 2021 - 050234 .

FEIGIN V L ， ABATE M D ， ABATE Y H ， et al . Global， regional， and national burden of stroke and its risk factors， 1990—2021： a systematic analysis for the Global Burden of Disease Study 2021 ［J］. Lancet Neurol ， 2024 ， 23 （ 10 ）： 973 - 1003 . DOI： 10.1016/S1474-4422（24）00369-7 http://dx.doi.org/10.1016/S1474-4422（24）00369-7 .

BRAUER M B ， ROTH G A ， ARAVKIN A Y ， et al . Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations， 1990—2021： a systematic analysis for the Global Burden of Disease Study 2021 ［J］. Lancet ， 2024 ， 403 （ 10440 ）： 2162 - 2203 . DOI： 10.1016/S0140-6736（24）00933-4 http://dx.doi.org/10.1016/S0140-6736（24）00933-4 .

ZHANG Z Y ， WU S J ， JIN T Y ， et al . Comparative analysis of different stroke subtype burden and future trends over 15 years in China and globally from 1990 to 2021 ［J］. Front Neurol ， 2025 ， 16 ： 1631775 . DOI： 10.3389/fneur. 2025. 1631775 http://dx.doi.org/10.3389/fneur.2025.1631775 .

曾四清 . Joinpoint回归模型及其在传染病流行趋势分析中的应用［J］. 中国卫生统计， 2019 ， 36 （ 5 ）： 787 - 791 .

ZENG S Q . Joinpoint regression model and its application in epidemic trend analysis of infectious diseases ［J］. Chin J Health Stat ， 2019 ， 36 （ 5 ）： 787 - 791 .

KIM H J ， FAY M P ， FEUER E J ， et al . Permutation tests for joinpoint regression with applications to cancer rates ［J］. Stat Med ， 2000 ， 19 （ 3 ）： 335 - 351 . DOI： 10.1002/（sici）1097-0258（20000215）19： 3335：： aid-sim336>3.0.co；2-z http://dx.doi.org/10.1002/（sici）1097-0258（20000215）19：3335：：aid-sim336>3.0.co；2-z .

SCHMID V J ， HELD L . Bayesian age-period-cohort modeling and prediction-BAMP ［J］. J Stat Soft ， 2007 ， 21 （ 8 ）： 1 - 15 . DOI： 10.18637/jss.v021.i08 http://dx.doi.org/10.18637/jss.v021.i08 .

TANG L C ， XIE L ， LIU Y X . Temporal trends of ischemic stroke attributable to high fasting plasma glucose in China from the global burden of disease study 2019 ［J］. Front Endocrinol ， 2024 ， 15 ： 1408691 . DOI： 10.3389/fendo. 2024. 1408691 http://dx.doi.org/10.3389/fendo.2024.1408691 .

巢宝华，刘建民，王伊龙，等 . 中国脑卒中防治：成就、挑战和应对［J］. 中国循环杂志， 2019 ， 34 （ 7 ）： 625 - 631 . DOI： 10.3969/j.issn.1000-3614.2019.07.001 http://dx.doi.org/10.3969/j.issn.1000-3614.2019.07.001 .

CHAO B H ， LIU J M ， WANG Y L ， et al . Stroke prevention and control in China： achievements， challenges and responses ［J］. Chin Circ J ， 2019 ， 34 （ 7 ）： 625 - 631 . DOI： 10.3969/j.issn.1000-3614.2019.07.001 http://dx.doi.org/10.3969/j.issn.1000-3614.2019.07.001 .

中国脑卒中血糖管理指导规范［J］. 糖尿病天地（临床）， 2016 ， 10 （ 2 ）： 55 - 58 .

Guidelines for glycemic management in stroke patients in China ［J］. Clin J Diabetes World ， 2016 ， 10 （ 2 ）： 55 - 58 .

王毅 . 关注我国第一部《糖尿病防治指南》：推广项目启动［J］. 中华医学信息导报， 2003 （ 23 ）： 3 - 4 .

WANG Y . Attention to the first national Guidelines for Diabetes Prevention and Control in China： initiation of dissemination program ［J］. Chin Med News ， 2003 （ 23 ）： 3 - 4 .

荆芜 . 糖尿病诊断分类新指南：空腹血糖异常标准从110mg/dl降到100mg/dl ［J］. 辽宁实用糖尿病杂志， 2004 ， 12 （ 2 ）： 60 .

JING W . New guidelines for diabetes classification and diagnosis： impaired fasting glucose threshold reduced from 110 mg/dl to 100 mg/dl ［J］. Liaoning J Pract Diabetol ， 2004 ， 12 （ 2 ）： 60 .

LIU L P ， LIU J Y ， WANG Y L ， et al . Substantial improvement of stroke care in China ［J］. Stroke ， 2018 ， 49 （ 12 ）： 3085 - 3091 . DOI： 10.1161/STROKEAHA. 118. 022618 http://dx.doi.org/10.1161/STROKEAHA.118.022618 .

ZHU Z B ， SHI M Y ， YU Q ， et al . Burden and risk factors of stroke worldwide and in China： an analysis from the Global Burden of Disease Study 2021 ［J］. Chin Med J ， 2025 ， 138 （ 20 ）： 2588 - 2595 . DOI： 10.1097/CM9.0000000000003778 http://dx.doi.org/10.1097/CM9.0000000000003778 .

BAI X P ， LI Z F ， CAI Z ， et al . Gender differences in risk factors for ischemic stroke： a longitudinal cohort study in East China ［J］. BMC Neurol ， 2024 ， 24 （ 1 ）： 171 . DOI： 10.1186/s12883-024-03678-0 http://dx.doi.org/10.1186/s12883-024-03678-0 .

国家心血管病中心，中国心血管健康与疾病报告编写组，胡盛寿 . 中国心血管健康与疾病报告2024概要［J］. 中国循环杂志， 2025 ， 40 （ 6 ）： 521 - 559 . DOI： 10.3969/j.issn.1000-3614.2025.06.001 http://dx.doi.org/10.3969/j.issn.1000-3614.2025.06.001 .

National Center for Cardiovascular Diseases， the Writing Committee of the Report on Cardiovascular Health and Diseases in China， HU S S . Report on cardiovascular health and diseases in China 2024： an updated summary ［J］. Chin Circ J ， 2025 ， 40 （ 6 ）： 521 - 559 . DOI： 10.3969/j.issn.1000-3614.2025.06.001 http://dx.doi.org/10.3969/j.issn.1000-3614.2025.06.001 .

TIAN W X ， ZHU G H ， XIAO W B ， et al . Stroke burden and attributable risk factors in China， 1990—2019 ［J］. Front Neurol ， 2023 ， 14 ： 1193056 . DOI： 10.3389/fneur. 2023.1193056 http://dx.doi.org/10.3389/fneur.2023.1193056 .

呼延小媛，李一君，谷伟军，等 . “糖心”共病管理：从指南和共识看糖尿病患者的心血管一级预防和二级预防策略［J］. 中华糖尿病杂志， 2023 ， 15 （ 12 ）： 1185 - 1189 .

HUYAN X Y ， LI Y J ， GU W J ， et al . Co-management of diabetes and cardiovascular diseases： the primary and secondary prevention strategies for diabetes mellitus patients with cardiovascular diseases based on the guideline and consensus ［J］. Chin J Diabetes Mellit ， 2023 ， 15 （ 12 ）： 1185 - 1189 .

梁栋，杨成琳，林晓茹，等 . 1990—2019年中国成年人归因于糖尿病的心血管疾病负担研究［J］. 中国全科医学， 2024 ， 27 （ 11 ）： 1380 - 1386， 1394 . DOI： 10.12114/j.issn.1007-9572.2023.0627 http://dx.doi.org/10.12114/j.issn.1007-9572.2023.0627 .

LIANG D ， YANG C L ， LIN X R ， et al . Burden of cardiovascular diseases attributable to diabetes among Chinese adults from 1990 to 2019 ［J］. Chin Gen Pract ， 2024 ， 27 （ 11 ）： 1380 - 1386， 1394 . DOI： 10.12114/j.issn.1007-9572.2023.0627 http://dx.doi.org/10.12114/j.issn.1007-9572.2023.0627 .

XU J ， ZHANG X ， JIN A M ， et al . Trends and risk factors associated with stroke recurrence in China， 2007—2018 ［J］. JAMA Netw Open ， 2022 ， 5 （ 6 ）： e2216341 . DOI： 10.1001/jamanetworkopen.2022.16341 http://dx.doi.org/10.1001/jamanetworkopen.2022.16341 .

LIU L P ， LI Z X ， ZHOU H Y ， et al . Chinese Stroke Association guidelines for clinical management of ischaemic cerebrovascular diseases： executive summary and 2023 update ［J］. Stroke Vasc Neurol ， 2023 ， 8 （ 6 ）： e3 . DOI： 10.1136/svn http://dx.doi.org/10.1136/svn — 2023 - 002998 .

国家卫生健康委加强脑卒中防治工作减少百万新发残疾工程专家委员会，吉训明 . 推进国家卫生健康委加强脑卒中防治工作减少百万新发残疾工程：中国脑卒中防治现状与战略［J］. 首都医科大学学报， 2025 ， 46 （ 1 ）： 11 - 14 . DOI： 10.3969/j.issn.1006-7795.2025.01.003 http://dx.doi.org/10.3969/j.issn.1006-7795.2025.01.003 .

Stroke Prevention Project of National Health Commission ， JI X M . Promoting the stroke prevention project， National Health Commission： current status and strategy of stroke prevention and treatment in China ［J］. J Cap Med Univ ， 2025 ， 46 （ 1 ）： 11 - 14 . DOI： 10.3969/j.issn.1006-7795.2025.01.003 http://dx.doi.org/10.3969/j.issn.1006-7795.2025.01.003 .

《改善心血管和肾脏结局的新型抗高血糖药物临床应用中国专家建议》工作组 . 改善心血管和肾脏结局的新型抗高血糖药物临床应用中国专家建议［J］. 中国循环杂志， 2020 ， 35 （ 3 ）： 231 - 238 . DOI： 10.3969/j.issn.1000-3614.2020.03.002 http://dx.doi.org/10.3969/j.issn.1000-3614.2020.03.002 .

Work Group on Expert Consensus on the Use of New Anti-hyperglycemic Agents to Improve Cardiovascular and Renal Outcomes . Expert consensus on the use of new anti-hyperglycemic agents to improve cardiovascular and renal outcomes ［J］. Chin Circ J ， 2020 ， 35 （ 3 ）： 231 - 238 . DOI： 10.3969/j.issn.1000-3614.2020.03.002 http://dx.doi.org/10.3969/j.issn.1000-3614.2020.03.002 .

HONIGBERG M C ， CHANG L S ， MCGUIRE D K ， et al . Use of glucagon-like peptide-1 receptor agonists in patients with type 2 diabetes and cardiovascular disease： a review ［J］. JAMA Cardiol ， 2020 ， 5 （ 10 ）： 1182 - 1190 . DOI： 10.1001/jamacardio.2020.1966 http://dx.doi.org/10.1001/jamacardio.2020.1966 .

涂秋月，彭鑫玉，贺子毅，等 . 中国日益加重的动脉粥样硬化性心血管病负担：基于GBD2021数据库的生活方式和代谢因素分析［J］. 陆军军医大学学报， 2025 （ 22 ）： 2824 - 2836 . DOI： 10.16016/j.2097-0927.202508023 http://dx.doi.org/10.16016/j.2097-0927.202508023 .

TU Q Y ， PENG X Y ， HE Z Y ， et al . Growing burden of atherosclerotic cardiovascular disease in China： an analysis on lifestyle ［J］. J Army Med Univ ， 2025 （ 22 ）： 2824 - 2836 . DOI： 10.16016/j.2097-0927.202508023 http://dx.doi.org/10.16016/j.2097-0927.202508023 .

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