J Shanghai Jiaotong Univ Sci

J Shanghai Jiaotong Univ Sci ›› 2026, Vol. 31 ›› Issue (3): 800-810.doi: 10.1007/s12204-026-2942-9

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Global Trends in Early-Onset Ischemic Heart Disease Linked to Obesity, 1990–2021: Insights from the Global Burden of Disease Study

1990–2021年全球与肥胖相关的早发性缺血性心脏病趋势：全球疾病负担研究分析

杨流嘉1,2，纪宏伟3，张佳玟1,2，黄泓豪1,2，徐伟1,2，王东昊1,2，张政1,2，黄新月1,2，刘奇1,2，钟伊明1,2，陈一凡1,2，卜军1,2,4   

  1. 1. State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; 2. Division of Cardiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; 3. Tsinghua Medicine, Tsinghua University, Beijing 100084, China; 4. Aging Biomarker Consortium, Beijing 100000, China
  2. 1. 上海交通大学医学院附属仁济医院 上海市肿瘤研究所 癌基因及相关基因国家重点实验室，上海 200127；2. 上海交通大学医学院附属仁济医院 心内科，上海 200127；3. 清华大学 清华医学部，北京 100084，；4. 中国衰老标志物研究联合体，北京 100000
  • Received:2025-12-11 Revised:2026-05-21 Accepted:2026-05-28 Online:2026-06-28 Published:2026-06-20

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Abstract: Obesity is a major modifiable risk factor for early-onset ischemic heart disease (IHD), yet its contribution to the global burden across regions and demographics is not fully quantified. This study assesses global trends in obesity-related early-onset IHD, focusing on young adults (aged 25–39 years). We utilized Global Burden of Disease Study 2021 data to track 30-year trends in obesity and early-onset IHD via average annual percentage changes (AAPCs) and socio-demographic index (SDI)-stratified disability-adjusted life year (DALY) counts. Pearson correlation was then applied to evaluate the associations between these variables. Further multi-factor adjustment analysis was conducted using a multivariable linear regression model on 5-year age-stratified data. A significant positive correlation was found between the AAPC in obesity age-standardized prevalence rate (ASPR) and the AAPC in early-onset IHD age-standardized mortality rate (ASMR) (ρ=0.36, P<0.001) and ASPR (ρ=0.29, P<0.001) among young males, with stronger associations than in females. The impact of obesity on early-onset IHD prevalence and mortality strengthened with age, peaking at 35–39 years old for both male and female. Even after having adjusted for dietary, environmental, and metabolic risk factors, obesity remains the top IHD risk factor in almost all subgroups. Clearly, obesity is strongly linked to higher morbidity and mortality in early-onset IHD.

Key words: early-onset ischemic heart disease (IHD), obesity, Global Burden of Disease

摘要： 肥胖是早发缺血性心脏病（IHD）的核心可变危险因素，但其对全球不同地区和人群疾病负担的具体贡献尚未得到完全量化。本研究评估了全球与肥胖相关的早发性缺血性心脏病的流行趋势，重点关注青年群体（25–39岁）。我们利用2021年全球疾病负担研究（GBD 2021）的数据，通过平均年度百分比变化（AAPC）和按社会人口学指数（SDI）分层的伤残调整寿命年（DALY）计数，追踪了30年来肥胖与早发性IHD的变化趋势。随后，应用Pearson相关分析评估了这些变量之间的关联。此外，基于5岁年龄分层数据，使用多元线性回归模型进行了多因素调整分析。研究结果显示，在年轻男性中，肥胖年龄标准化患病率（ASPR）的AAPC与早发性IHD年龄标准化死亡率（ASMR）的AAPC（ρ=0.36, P<0.001）以及ASPR的AAPC（ρ =0.29, P<0.001）之间存在显著的正相关，且其关联性明显强于女性。肥胖对早发性IHD患病率和死亡率的影响随年龄增长而增强，在男女群体中均在35–39岁年龄段达到顶峰。即使在调整了饮食、环境和代谢危险因素后，肥胖在几乎所有亚组中仍然是排名首位的IHD危险因素。显而易见，肥胖与早发性IHD发病率和死亡率的上升有着密切的联系。

关键词: 早发性缺血性心脏病，肥胖，全球疾病负担

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