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Journal Article•DOI•

A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010

Stephen S Lim1, Theo Vos, Abraham D. Flaxman1, Goodarz Danaei2  +207 more•Institutions (92)
15 Dec 2012-The Lancet (Elsevier)-Vol. 380, Iss: 9859, pp 2224-2260
TL;DR: In this paper, the authors estimated deaths and disability-adjusted life years (DALYs; sum of years lived with disability [YLD] and years of life lost [YLL]) attributable to the independent effects of 67 risk factors and clusters of risk factors for 21 regions in 1990 and 2010.
About: This article is published in The Lancet.The article was published on 2012-12-15 and is currently open access. It has received 9324 citations till now. The article focuses on the topics: Disease burden & Risk factor.

Summary (1 min read)

Jump to: [Convincing evidence] – [Probable evidence] – [Possible evidence] and [Insufficient evidence]

Convincing evidence

  • Evidence based on epidemiological studies showing consistent associations between exposure and disease, with little or no evidence to the contrary.
  • The available evidence is based on a substantial number of studies including prospective observational studies and where relevant, randomised controlled trials of sufficient size, duration, and quality showing consistent effects.

Probable evidence

  • Evidence based on epidemiological studies showing fairly consistent associations between exposure and disease, but for which there are perceived shortcomings in the available evidence or some evidence to the contrary, which precludes a more definite judgment.
  • Shortcomings in the evidence may be any of the following: insufficient duration of trials (or studies); insufficient trials (or studies) available; inadequate sample sizes; or incomplete follow-up.

Possible evidence

  • Evidence based mainly on findings from case-control and cross-sectional studies.
  • Insufficient randomised controlled trials, observational studies, or non-randomised controlled trials are available.
  • Evidence based on non-epidemiological studies, such as clinical and laboratory investigations, is supportive.
  • More trials are needed to support the tentative associations, which should be biologically plausible.

Insufficient evidence

  • Evidence based on findings of a few studies which are suggestive, but insufficient to establish an association between exposure and disease.
  • Burden of disease attributable to individual risk factors are shown sequentially for ease of presentation.

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Citations
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Journal Article•DOI•
Reduced-form modeling of public health impacts of inorganic PM2.5 and precursor emissions

[...]

Jinhyok Heo1, Peter Adams1, H. Oliver Gao2•
Carnegie Mellon University1, Cornell University2
01 Jul 2016-Atmospheric Environment
TL;DR: In this article, the authors developed a method for building statistical regressions that estimate public health cost of emissions accurately like a state-of-the-art chemical transport model (CTM) but without its high computational cost.

104 citations

Journal Article•DOI•
Response of global particulate-matter-related mortality to changes in local precursor emissions.

[...]

Colin J. Lee1, Randall V. Martin1, Randall V. Martin2, Daven K. Henze3, Michael Brauer4, Aaron Cohen5, Aaron van Donkelaar1 •
Dalhousie University1, Harvard University2, University of Colorado Boulder3, University of British Columbia4, Health Effects Institute5
24 Mar 2015-Environmental Science & Technology
TL;DR: Using the adjoint of the GEOS-Chem chemical transport model, sensitivities of global PM2.5-related premature mortality to emissions of precursor gases (SO2, NOx, NH3) and carbonaceous aerosols are calculated.
Abstract: Recent Global Burden of Disease (GBD) assessments estimated that outdoor fine-particulate matter (PM2.5) is a causal factor in over 5% of global premature deaths. PM2.5 is produced by a variety of direct and indirect, natural and anthropogenic processes that complicate PM2.5 management. This study develops a proof-of-concept method to quantify the effects on global premature mortality of changes to PM2.5 precursor emissions. Using the adjoint of the GEOS-Chem chemical transport model, we calculated sensitivities of global PM2.5-related premature mortality to emissions of precursor gases (SO2, NOx, NH3) and carbonaceous aerosols. We used a satellite-derived ground-level PM2.5 data set at approximately 10 × 10 km2 resolution to better align the exposure with population density. We used exposure-response functions from the GBD project to relate mortality to exposure in the adjoint calculation. The response of global mortality to changes in local anthropogenic emissions varied spatially by several orders of m...

103 citations

Journal Article•DOI•
Blutdruck in Deutschland 2008–2011

[...]

Hannelore Neuhauser1, Michael Thamm1, Ute Ellert1•
Robert Koch Institute1
25 May 2013-Bundesgesundheitsblatt-gesundheitsforschung-gesundheitsschutz
TL;DR: The German Health Interview and Examination Survey for Adults (DEGS1) the blood pressure of 7,096 adults aged 18–79 years was measured in a standardised way using oscillometric blood pressure devices (Datascope Accutorr Plus) and the average of the second and third measurements was used for analysis.
Abstract: Hoher Blutdruck gehort zu den wichtigsten Risikofaktoren fur Herz-Kreislauf-Krankheiten und chronische Niereninsuffizienz. Er ist eine wesentliche Determinante fur Morbiditat und Mortalitat in Deutschland. Im Rahmen der bundesweiten Studie zur Gesundheit Erwachsener in Deutschland DEGS1 wurde bei 7096 Erwachsenen im Alter von 18 bis 79 Jahren der Blutdruck standardisiert mit einem oszillometrischen Blutdruckmessgerat (Datascope Accutorr Plus) gemessen und der Durchschnitt der zweiten und dritten Messung ausgewertet. Der mittlere Blutdruck betrug systolisch bei Frauen 120,8 mmHg, bei Mannern 127,4 mmHg, diastolisch bei Frauen 71,2 mmHg, bei Mannern 75,3 mmHg. Die Blutdruckwerte waren hyperton (systolischer Blutdruck ≥ 140 mmHg oder diastolisch ≥ 90 mmHg) bei 12,7 % der Frauen und 18,1 % der Manner. Eine Hypertonie (definiert als hypertoner Messwert oder Einnahme antihypertensiver Medikamente bei bekannter Hypertonie) lag bei 29,9 % der Frauen und 33,3 % der Manner vor. In der hochsten untersuchten Altersgruppe der 70- bis 79-Jahrigen hatten fast 75 % eine Hypertonie. DEGS1 zeigt, dass Bluthochdruck nach wie vor ein weit verbreiteter Risikofaktor in der Bevolkerung ist. Die Methodik der Blutdruckmessung ist im Vergleich zu der im Bundes-Gesundheitssurvey 1998 verbessert worden, sodass Vergleiche erst in Kurze, nach Fertigstellung eines Kalibrierungsverfahrens der Daten von 1998, moglich sein werden.

103 citations

Journal Article•DOI•
Better air for better health: Forging synergies in policies for energy access, climate change and air pollution

[...]

Shilpa Rao1, Shonali Pachauri1, Frank Dentener, Patrick L. Kinney2, Zbigniew Klimont1, Keywan Riahi1, Wolfgang Schoepp1 •
International Institute for Applied Systems Analysis1, Columbia University2
01 Oct 2013-Global Environmental Change-human and Policy Dimensions
TL;DR: In this paper, a state-of-the-art modeling framework is used that combines an integrated assessment model and an atmospheric model to estimate the spatial extent and distribution of outdoor air pollution exposures.
Abstract: Air pollution and its related health impacts are a global concern This paper addresses how current policies on air pollution, climate change and access to clean cooking fuels can effectively reduce both outdoor and household air pollution and improve human health A state of the art modeling framework is used that combines an integrated assessment model and an atmospheric model to estimate the spatial extent and distribution of outdoor air pollution exposures Estimates of household energy access and use are modeled by accounting for heterogeneous household energy choices and affordability constraints for rural and urban populations spanning the entire income distribution Results are presented for 2030 for a set of policy scenarios on air pollution, climate change and energy access and include spatially explicit emissions of air pollutants; ambient concentrations of PM25; and health impacts in terms of disability adjusted life years (DALYs) from both ambient and household air pollution The results stress the importance of enforcing current worldwide air quality legislation in addressing the impacts of outdoor air pollution A combination of stringent policies on outdoor air pollution, climate change and access to clean cooking fuels is found to be effective in achieving reductions in average ambient PM25 exposures to below World Health Organization recommended levels for a majority of the world's population and results in a significant decline in the global burden of disease from both outdoor and household air pollution

103 citations

Journal Article•DOI•
Vitamin D Insufficiency in Overweight and Obese Children and Adolescents.

[...]

Irina Zakharova, Leonid Klimov, Victoria Kuryaninova, Irina P. Nikitina, S.I. Malyavskaya, Svetlana Dolbnya, Anna Kasyanova, Roza Atanesyan, Marina Stoyan, Anastasiya Todieva, Galina N. Kostrova, Andrey V. Lebedev 
01 Mar 2019-Frontiers in Endocrinology
TL;DR: The role of vitamin D insufficiency in immune reactions resulting in development of subclinical inflammation in fat tissue infiltrated with macrophages and lymphocytes is demonstrated and the need for higher cholecalciferol doses to achieve serum calcifediol targets in overweight and obese children and adolescents is underlined.
Abstract: Excessive body weight and obesity in childhood and adolescence are becoming more and more important unfavorable factors that entail extremely adverse consequences and require close attention of physicians of any specialty. Along with the high prevalence of obesity and metabolic syndrome in pediatric patients, children and adolescents in the majority of countries are diagnosed with vitamin D deficiency. Among the non-calcaemic effects of vitamin D, a significant role is played by its impact on the hormonal regulation of glucose metabolism and the synthesis of adipokines by fat tissue. The review presents literature data indicative of a close pathogenic relationship between vitamin D insufficiency and impaired tissue insulin sensitivity. It demonstrates the role of vitamin D insufficiency in immune reactions resulting in development of subclinical inflammation in fat tissue infiltrated with macrophages and lymphocytes. It also shows the role of adipokines, immune system cells and pro-inflammatory cytokines produced by them in the pathogenesis of obesity, as well as the function of vitamin D as an endocrine and paracrine regulator of the process of inflammation in adipose tissue. The relationships between the principal adipokines (leptin, adiponectin, resistin) are revealed in the presence of normal vitamin D content and in vitamin D deficiency. The carbohydrate and lipid metabolism parameters in overweight children and adolescents with vitamin D insufficiency are analyzed. A high prevalence of vitamin D insufficiency in overweight and obese children and adolescents (increasing along with the severity of obesity) is demonstrated. The review also presents the current recommendations for the correction of vitamin D insufficiency and underlines the need for higher cholecalciferol doses to achieve serum calcifediol targets in overweight and obese children and adolescents.

103 citations

References
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Journal Article•DOI•
Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin.

[...]

William C. Knowler1, Elizabeth Barrett-Connor1, Sarah E. Fowler1, Richard F. Hamman1, John M. Lachin1, Elizabeth A. Walker, David M. Nathan1 •
George Washington University1
07 Feb 2002-The New England Journal of Medicine
TL;DR: In this paper, the authors compared a lifestyle intervention with metformin to prevent or delay the development of Type 2 diabetes in nondiabetic individuals. And they found that the lifestyle intervention was significantly more effective than the medication.
Abstract: Background Type 2 diabetes affects approximately 8 percent of adults in the United States. Some risk factors — elevated plasma glucose concentrations in the fasting state and after an oral glucose load, overweight, and a sedentary lifestyle — are potentially reversible. We hypothesized that modifying these factors with a lifestyle-intervention program or the administration of metformin would prevent or delay the development of diabetes. Methods We randomly assigned 3234 nondiabetic persons with elevated fasting and post-load plasma glucose concentrations to placebo, metformin (850 mg twice daily), or a lifestyle modification program with the goals of at least a 7 percent weight loss and at least 150 minutes of physical activity per week. The mean age of the participants was 51 years, and the mean body-mass index (the weight in kilograms divided by the square of the height in meters) was 34.0; 68 percent were women, and 45 percent were members of minority groups. Results The average follow-up was 2.8 years. The incidence of diabetes was 11.0, 7.8, and 4.8 cases per 100 person-years in the placebo, metformin, and lifestyle groups, respectively. The lifestyle intervention reduced the incidence by 58 percent (95 percent confidence interval, 48 to 66 percent) and metformin by 31 percent (95 percent confidence interval, 17 to 43 percent), as compared with placebo; the lifestyle intervention was significantly more effective than metformin. To prevent one case of diabetes during a period of three years, 6.9 persons would have to participate in the lifestyle-intervention program, and 13.9 would have to receive metformin. Conclusions Lifestyle changes and treatment with metformin both reduced the incidence of diabetes in persons at high risk. The lifestyle intervention was more effective than metformin.

17,333 citations

Journal Article•DOI•
Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010

[...]

Rafael Lozano1, Mohsen Naghavi1, Kyle J Foreman2, Stephen S Lim1  +192 more•Institutions (95)
15 Dec 2012-The Lancet
TL;DR: The Global Burden of Diseases, Injuries, and Risk Factors Study 2010 aimed to estimate annual deaths for the world and 21 regions between 1980 and 2010 for 235 causes, with uncertainty intervals (UIs), separately by age and sex, using the Cause of Death Ensemble model.

11,809 citations

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Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies.

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Sarah Lewington, Robert Clarke, Nawab Qizilbash, Richard Peto, Rory Collins 
14 Dec 2002-The Lancet
TL;DR: Throughout middle and old age, usual blood pressure is strongly and directly related to vascular (and overall) mortality, without any evidence of a threshold down to at least 115/75 mm Hg.

9,101 citations

Book•
The global burden of disease: a comprehensive assessment of mortality and disability from diseases injuries and risk factors in 1990 and projected to 2020.

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Christopher J L Murray, Alan D. Lopez
01 Jan 1996
TL;DR: This is the first in a planned series of 10 volumes that will attempt to "summarize epidemiological knowledge about all major conditions and most risk factors" and use historical trends in main determinants to project mortality and disease burden forward to 2020.
Abstract: This is the first in a planned series of 10 volumes that will attempt to "summarize epidemiological knowledge about all major conditions and most risk factors;...generate assessments of numbers of deaths by cause that are consistent with the total numbers of deaths by age sex and region provided by demographers;...provide methodologies for and assessments of aggregate disease burden that combine--into the Disability-Adjusted Life Year or DALY measure--burden from premature mortality with that from living with disability; and...use historical trends in main determinants to project mortality and disease burden forward to 2020." This first volume includes chapters summarizing results from the project as a whole. (EXCERPT)

7,154 citations

Journal Article•DOI•
Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010

[...]

Theo Vos, Abraham D. Flaxman1, Mohsen Naghavi1, Rafael Lozano1  +360 more•Institutions (143)
15 Dec 2012-The Lancet
TL;DR: Prevalence and severity of health loss were weakly correlated and age-specific prevalence of YLDs increased with age in all regions and has decreased slightly from 1990 to 2010, but population growth and ageing have increased YLD numbers and crude rates over the past two decades.

7,021 citations

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Frequently Asked Questions (4)
Q1. What are the contributions mentioned in the paper "A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990—2010: a systematic analysis for the global burden of disease study 2010 author" ?

Lim, Stephen S, Vos, Umer, Shibuya, Shibaya, Kenji, AdairRohani, Heather, Amann, Markus, Anderson, H Ross, Andrews, Kathryn G, Aryee, Martin, Gmel, Gerhard, Graham, Kathryn, Grainger, Rebecca, Grant, Bridget, Gunnell, David, Gutierrez, Hialy R, Hall, Wayne, Hoek, Hans W, Hogan, Anne-Charlson, H Dean, this paper, Nolla, Nissim, Nelson, Paul K 

Shortcomings in the evidence may be any of the following: insufficient duration of trials (or studies); insufficient trials (or studies) available; inadequate sample sizes; or incomplete follow-up. 

The available evidence is based on a substantial number of studies including prospective observational studies and where relevant, randomised controlled trials of sufficient size, duration, and quality showing consistent effects. 

In reality, the burden attributable to different risks overlaps because of multicausality and because the effects of some risk factors are partly mediated throughLim et al.