Objectives: To analyze the disease burden and inequalities of lower extremity peripheral artery disorders (LEPAD) among people aged 40 and above in the Belt and Road partner countries from 1990 to 2021.
Methods: Data were retrieved from the Global Burden of Disease 2021 database. The age-standardized prevalence rates, mortality rates, and the annual rate of years lived with disability (YLDs) of LEPAD were analyzed. Trends were measured using the estimated annual percentage change (EAPC), and the slope index of inequality (SII) and concentration index were used to quantify the absolute and relative inequalities.
Results: In 2021, the age-standardized prevalence and mortality rates of LEPAD were 3168.26/105 and 3.09/105, increasing by 4.30% and 19.31% compared to 1990, and YLDs rates decreased by 4.00%. Females had higher age-standardized prevalence and YLDs rates, while males had higher mortality rates. The EAPC for prevalence rates was slightly higher in males (0.22%) than in females (0.17%); while the EAPC of age-standardized mortality rate was 2.02% for females, compared to 1.45% for males. From 1990 to 2021, the age-standardized YLDs rates decreased from 16.23/105 to 15.58/105, with a faster decline in females (－0.12%) than in males (－0.06%). LEPAD prevalence varied across countries, with higher burdens in Europe and faster growth in Gulf states. Higher socio-demographic index countries had higher prevalence. Inequity improved, with the SII at 52.90/105 and concentration index at 0.038 in 2021. Gender disparities persisted, with concentration index rising to 0.058 in females and falling to －0.026 in males.
Conclusions: LEPAD prevalence and mortality among people aged 40 and above in the Belt and Road partner countries were risen, while YLDs rates were decreased from 1990 to 2021. Significant differences exist among peoples with different gender and countries, highlighting the need for enhanced screening, health education, and shared public health strategies across the Belt and Road partner countries.
目的: 评估1990至2021年“一带一路”共建国家40岁及以上人群下肢外周动脉疾病（LEPAD）的负担情况和不公平性，为疾病防治提供依据。方法: 利用2021年全球疾病负担数据库，分析155个“一带一路”共建国家40岁及以上人群的LEPAD年龄标准化患病率、死亡率和伤残寿命损失年（YLD）率，变化趋势使用年估计变化百分比（EAPC）衡量。采用不平等斜率指数和集中指数量化LEPAD国家间负担的绝对不公平和相对不公平。结果: 2021年“一带一路”共建国家40岁及以上人群LEPAD的年龄标准化患病率为3168.26/10万，死亡率为3.09/10万，较1990年分别增加4.30%和19.31%。1990至2021年，YLD率从16.23/10万降至15.58/10万，降幅达4.00%。女性患病率和YLD率高于男性，男性死亡率则高于女性。男性的年龄标准化患病率EAPC为0.22%，略高于女性的0.17%；女性年龄标准化死亡率的EAPC为2.02%，高于男性的1.45%。女性的年龄标准化YLD率下降速度快于男性，EAPC分别为－0.12%和－0.06%。不同国家间LEPAD负担差异显著，欧洲国家负担普遍较高，海湾国家负担增长速度更快。LEPAD患病率与社会人口指数（SDI）相关，高SDI国家的LEPAD患病率较高。公平性分析显示，2021年“一带一路”共建国家年龄标准化YLD率的不平等斜率指数为52.90/10万，年龄标准化YLD数的集中指数为0.038，较1990年下降，表明各国的绝对和相对不公平性改善。女性LEPAD的绝对不公平性始终高于男性。1990年，男性的年龄标准化YLD数的集中指数为0.047，高于女性的0.037；2021年女性的集中指数升至0.058，男性降至－0.026。结论: “一带一路”共建国家40岁及以上人群LEPAD年龄标准化患病率、死亡率持续上升，但YLD率有所下降，不同性别、不同国家间存在明显差异，提示各国应加强对40岁及以上高风险人群的LEPAD早期筛查和健康教育，共享防控经验，共同提升公共卫生治理能力，携手应对慢性疾病挑战，促进健康水平的整体提升。.
Keywords: Belt and Road partner countries; Fairness analysis; Global burden of disease; Lower extremity peripheral artery disease; Middle-aged and elderly people.