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

作者：Michael Brauer, G. Roth, A. Aravkin, P. Zheng, K. H. Abate, Y. Abate, C. Abbafati, Rouzbeh Abbasgholizadeh, M. Abbasi, Mohammadreza Abbasian, M. Abbasifard, M. Abbasi-Kangevari, S. ElHafeez, S. Abd-Elsalam, P. Abdi, Mohammad Abdollahi, M. Abdoun, Deldar Morad Abdulah, Auwal Abdullahi, Mesfin Abebe, Aidin Abedi, Armita Abedi, Tadesse M. Abegaz, Roberto Ariel Abeldaño Zuñiga, O. Abiodun, Temesgen Lera Abiso, R. Aboagye, Hassan Abolhassani, M. Abouzid, Girma Beressa Aboye, Lucas Guimarães Abreu, Hasan Abualruz, Bilyaminu Abubakar, Eman Abu-Gharbieh, Hana J. Abukhadijah, Salahdein Aburuz, Ahmed Abu-Zaid, M. M. Adane, Isaac Yeboah Addo, Giovanni Addolorato, R. Adedoyin, Victor Adekanmbi, Bashir Aden, J. B. Adetunji, T. Adeyeoluwa, Rishan Adha, Amin Adibi, Q. Adnani, Leticia Akua Adzigbli, A. Afolabi, R. Afolabi, A. Afshin, Shadi Afyouni, M. Afzal, Saira Afzal, S. B. Agampodi, F. Agbozo, Shahin Aghamiri, A. Agodi, Anurag Agrawal, Williams Agyemang-Duah, B. Ahinkorah, Aqeel Ahmad, Danish Ahmad, Firdos Ahmad, Noah S. Ahmad, Shahzaib Ahmad, Tauseef Ahmad, Ali Ahmed, Anisuddin Ahmed, Ayman Ahmed, Luai A. Ahmed, M. Ahmed, Safoora Ahmed, Syed Anees Ahmed, Marjan Ajami, G. T. Akalu, E. Akara, H. Akbarialiabad, Shiva Akhlaghi, K. Akinosoglou, Tomi F Akinyemiju, Mohammed Ahmed Akkaif, Sreelatha Akkala, B. Akombi-Inyang, S. Awaidy, S. M. Hasan, Fares Alahdab, T. AL-Ahdal, Samer O. Alalalmeh, T. Alalwan, Z. Al-Aly, K. Alam, Nazmul Alam, F. Alanezi, Turki M. Alanzi, Almaza a. Albakri, M. Albataineh, W. Aldhaleei, R. Aldridge, Mulubirhan Assefa Alemayohu, Y. Alemu, B. Al-Fatly, A. Al-Gheethi, Khairat Al-Habbal, K. Alhabib, R. Alhassan, Abid Ali, Amjad Ali, B. Ali, Iman Ali, Liaqat Ali, M. Ali, Rafat Ali, Syed Shujait Shujait Ali, Waad Ali, G. Alicandro, S. M. Alif, S. Aljunid, François Alla, Sabah Al-Marwani, Hesham M Al-Mekhlafi, Sami A. Almustanyir, Mahmoud A. Alomari, Jordi Alonso, J. Alqahtani, A. Alqutaibi, R. Al-Raddadi, Ahmad Alrawashdeh, Rami H Al-Rifai, S. Alrousan, Salman Khalifah Al-Sabah, Najim Z Alshahrani, Z. Altaany, Awais Altaf, J. Al-Tawfiq, K. Altirkawi, D. Aluh, N. Alvis-Guzmán, N. Alvis-Zakzuk, Hassan Alwafi, M. Al-Wardat, Y. Al-Worafi, Hany Aly, Safwat Aly, K. Alzoubi, W. Al-Zyoud, U. A. Amaechi, M. Mohammadi, Reza Amani, Sohrab Amiri, Mohammad Hosein Amirzade-Iranaq, E. Ammirati, Hubert Amu, D. Amugsi, G. Amusa, R. Ancuceanu, D. Anderlini, Jason A Anderson, Pedro Prata Andrade, C. Andrei, Tudorel Andrei, S. Anenberg, Dhanalakshmi Angappan, Colin Angus, Abhishek Anil, Sneha Anil, Afifa Anjum, Amir Anoushiravani, I. Antonazzo, C. Antony, E. Antriyandarti, B. Anuoluwa, Davood Anvari, Saeid Anvari, Saleha Anwar, S. L. Anwar, R. Anwer, Ekenedilichukwu Emmanuel Anyabolo, A. Anyasodor, G. L. Apostol, J. Arabloo, R. Bahri, M. Arafat, D. Areda, Brhane Berhe Aregawi, A. Aremu, B. Armocida, M. B. Arndt, J. Ärnlöv, M. Arooj, A. Artamonov, K. D. Artanti, Idowu Aruleba, Ashokan Arumugam, A. Asbeutah, Saeed Asgary, A. Asgedom, Charlie Ashbaugh, Mubarek Yesse Ashemo, Tahira Ashraf, A. Askarinejad, M. Assmus, T. Astell-Burt, Mohammad Athar, S. Athari, P. Atorkey, A. Atreya, A. Aujayeb, M. Ausloos, L. Ávila-Burgos, Andargie Abate Awoke, B. Quintanilla, H. Ayatollahi, C. Portugal, J. Ayuso-Mateos, S. Azadnajafabad, Rui M S Azevedo, G. Azhar, Hosein Azizi, A. Azzam, I. Backhaus, Muhammad Badar, Ashish D. Badiye, Arvind Bagga, Soroush Baghdadi, Nasser Bagheri, S. Bagherieh, Pegah Bahrami Taghanaki, Ruhai Bai, A. Baig, Jennifer L. Baker, Shankar M. Bakkannavar, Madhan Balasubramanian, Ovidiu Constantin Baltatu, Kiran Bam, Soham Bandyopadhyay, B. Banik, Palash Chandra Banik, A. Banke-Thomas, Hansi Bansal, M. Barchitta, Mainak Bardhan, Erfan Bardideh, S. Barker-Collo, T. Bärnighausen, Francesco Barone-Adesi, H. Barqawi, L. Barrero, Amadou Barrow, S. Barteit, Z. Basharat, A. Basiru, João Diogo Basso, Mohammad-Mahdi Bastan, S. Basu, Sai Batchu, Kavita Batra, Ravi Batra, B. Baune, M. Bayati, N. Bayileyegn, Thomas Beaney, A. Behnoush, Maryam Beiranvand, Y. Béjot, A. Bekele, U. Belgaumi, Arielle Bell, Michelle L. Bell, M. Bello, O. Bello, Luis Belo, Apostolos Beloukas, S. Bendak, Derrick A Bennett, F. Bennitt, I. Benseñor, Habib Benzian, Azizullah Beran, Z. Berezvai, Eduardo Bernabé, Robert S. Bernstein, P. J. Bettencourt, A. Bhagavathula, N. Bhala, D. Bhandari, Nikha Bhardwaj, Pankaj Bhardwaj, Sonu M M Bhaskar, A. Bhat, Vivek Bhat, G. K. Bhatti, Jasvinder Singh Bhatti, M. Bhatti, Rajbir Bhatti, M. Bhuiyan, Z. Bhutta, B. Bikbov, Jessica Bishai, C. Bisignano, Atanu Biswas, Bijit Biswas, R. Biswas, T. Bjørge, M. Boachie, Hosea Boakye, Moses J. Bockarie, V. Bodolica, Aadam Olalekan Bodunrin, Eyob Ketema Bogale, S. Bolla, A. Boloor, M. Hashemi, Sri Harsha Boppana, B. Basara, Hamed Borhany, A. B. Carvajal, S. Bouaoud, S. Boufous, Rupert RA Bourne, Christopher Boxe, Dejana Braithwaite, L. C. Brant, A. Brar, N. Breitborde, S. Breitner, H. Brenner, A. Briko, Gabrielle Britton, C. Brown, A. Browne, A. Brunoni, Dana Bryazka, Norma B. Bulamu, L. Bulto, Danilo Buonsenso, Katrin Burkart, Richard A. Burns, Reinhard Busse, Yasser K. Bustanji, Nadeem Shafique Butt, Z. Butt, F. C. Santos, Jack Cagney, Lucero Cahuana-Hurtado, D. Calina, L. Cámera, L. A. Campos, Ismael Campos-Nonato, Chao Cao, Fan Cao, Yubin Cao, A. Capodici, Rosario Cárdenas, Sinclair Carr, G. Carreras, J. Carrero, A. Carugno, F. Carvalho, Márcia Carvalho, J. Castaldelli-Maia, C. Castañeda-Orjuela, G. Castelpietra, F. Catalá-López, A. Catapano, M. Cattaruzza, A. Caye, Christopher R. Cederroth, L. Cegolon, Muthia Cenderadewi, Kelly M. Cercy, Ester Cerin, J. Chadwick, C. Chakraborty, P. Chakraborty, S. Chakraborty, Jeffrey Shi Kai Chan, Raymond N C Chan, J. Chandan, R. Chandika, P. Chaturvedi, An-Tian Chen, Catherine Chen, Haowei Chen, M. Chen, Mingling Chen, Simiao Chen, Ching-Yu Cheng, Esther T W Cheng, N. Cherbuin, Gerald Chi, Fatemeh Chichagi, Odgerel Chimed-Ochir, Ritesh Chimoriya, Patrick R. Ching, Jesus Lorenzo Chirinos-Caceres, Abdulaal Chitheer, William C. S. Cho, Bryan Chong, Hitesh Chopra, Rajiv Chowdhury, D. Christopher, D. Chu, I. Chukwu, Eric Chung, S. Chung, M. Chutiyami, Iolanda Cioffi, Rebecca M. Cogen, Aaron J. Cohen, A. Columbus, J. Conde, A. Corlăteanu, S. Cortese, P. Cortesi, V. M. Costa, S. Costanzo, M. Criqui, Jessica Cruz, N. Cruz-Martins, Garland T. Culbreth, A. Silva, O. Dadras, X. Dai, Zhaoli Dai, Patience Unekwuojo Daikwo, L. Dalli, G. Damiani, Emanuele D’Amico, L. D’Anna, A. Darwesh, Jai K Das, Subasish Das, N. Dash, M. Dashti, C. Dávila-Cervantes, N. Weaver, D. Davițoiu, F. D. L. Hoz, A. Torre-Luque, Diego De Leo, Shayom Debopadhaya, L. Degenhardt, Cristian Del Bo’, Iván Delgado-Enciso, J. Delgado-Saborit, Chalachew Kassaw Demoze, E. Denova-Gutiérrez, Nikolaos Dervenis, Emina Dervišević, Hardik D. Desai, Rupak Desai, Vinoth Gnana Chellaiyan Devanbu, Syed Masudur Rahman Dewan, A. Dhali, K. Dhama, A. Dhane, Mandira Lamichhane Dhimal, M. Dhimal, Sameer Dhingra, Vishal R Dhulipala, Raja Ram Dhungana, D. Silva, Daniel Diaz, L. A. Díaz, M. J. Diaz, Adriana Dima, Delaney D. Ding, Monica Dinu, S. Djalalinia, T. Do, Thao Phuong Do, C. Prado, Masoud Dodangeh, Sushil Dohare, K. Dokova, Wanyue Dong, Deepa Dongarwar, Mario D’Oria, Fariba Dorostkar, E. Dorsey, Rajkumar Doshi, L. Doshmangir, Robert Kokou Dowou, T. Driscoll, A. C. Dsouza, H. Dsouza, S. Dumith, Bruce B Duncan, A. Durães, Senbagam Duraisamy, A. Dushpanova, Paulina A. Dzianach, Arkadiusz Marian Dziedzic, Alireza Ebrahimi, C. Echieh, Abdelaziz Ed-Dra, H. Edinur, D. Edvardsson · 发表于：The Lancet · 年份：2024 · DOI：10.1016/s0140-6736(24)00933-4 · 被引用次数：1746 · 研究领域：Medicine

Summary Background Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attr...