山东医药

目的 分析2008—2021年中国糖尿病患者死亡率及寿命损失年（YLL）变化趋势，评估糖尿病死亡负担。方法 基于2008—2021年全国死因监测数据，采用Excel 2019软件和Python 3.9软件对不同性别、地区、年龄组的糖尿病标化死亡率、标化YLL及年度百分比变化估计值（EAPC）进行整理与分析。结果 中国糖尿病患者标化死亡率从2008年的7.94/10万增加至2021年的9.12/10万，增幅为14.86%。2008—2016年，女性标化死亡率高于男性，但男性标化死亡率的增长速度更快（男性、女性EAPC分别为2.03、0.64）,2017年以后男性标化死亡率高于女性；2008—2010年女性标化YLL率最高，但随着男性标化YLL率持续增长而女性呈下降趋势（EAPC分别为2.42、0.11）,2011年以后男性标化YLL率高于女性。2008—2021年城市地区糖尿病患者标化死亡率和标化YLL率均高于农村地区。2008—2016年东部地区标化死亡率最高，2008—2011年中部地区糖尿病标化YLL率最高，但西部地区标化死亡率和标化YLL率增长速度最快，西部地区逐渐成为标化死亡率（自2017年起）和标化YLL率（自2012年起）最高的地区。糖尿病死亡负担随年龄增长而增加，在≥75岁年龄组最高，在≥85岁年龄组呈现峰值。结论 2008—2021年，中国糖尿病死亡负担显著上升，糖尿病仍是亟需重点防控的慢性病。男性、老年人、农村地区和西部地区人群死亡风险相对更高。

Objective To analyze the trends in diabetes mellitus mortality rates and years of life lost(YLL) across China and its regions from 2008 to 2021, and to assess the burden of diabetes-related deaths. Methods Based on national cause-of-death surveillance data from 2008 to 2021, Excel 2019 and Python 3. 9 software were used to collate and analyze the age-standardized mortality rate, age-standardized YLL rate, and estimated annual percentage change(EAPC) for diabetes across different genders, regions, and age groups. Results The standardized mortality rate for diabetes mellitus in China increased from 7. 94 per 100 000 in 2008 to 9. 12 per 100 000 in 2021, representing a 14. 86% rise. From 2008 to 2016, the age-standardized mortality rate was higher in females than in males. However, the rate increased faster among males(EAPC: 2. 03 for males vs. 0. 64 for females), leading to higher male mortality from 2017 onward. From 2008 to 2010, females had the highest age-standardized YLL rate. Yet, as the male YLL rate showed sustained growth(EAPC: 2. 42) while the female rate declined(EAPC: 0. 11), males exhibited a higher YLL rate than females after 2011. From 2008 to 2021, both the age-standardized mortality rate and YLL rate for diabetes were higher in urban areas compared to rural areas. During 2008-2016, the eastern region had the highest age-standardized mortality rate, and during 2008-2011, the central region had the highest age-standardized YLL rate. However, the western region exhibited the fastest growth in both the mortality rate and YLL rate, gradually becoming the region with the highest age-standardized mortality rate(since 2017) and YLL rate(since 2012). The burden of diabetes-related deaths increased with age, being highest among individuals aged 75 and above, with a peak observed in the ≥85 age group. Conclusions From 2008 to 2021, diabetes mellitus-related mortality in China increased substantially. Diabetes mellitus remains a chronic disease requiring prioritized prevention and control. Males, the elderly, and populations in rural and western regions face relatively higher mortality risks.