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Distributions and Trends of the Global Burden of DKD Attributable to Lead Exposure: A Systematic Analysis of GBD from 1990 to 2019

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Abstract

Long-term exposure to lead is associated with an increased risk of diabetic kidney disease (DKD). However, limited data exist on global trends in DKD burden attributable to lead exposure, especially across diverse regions categorized by socioeconomic level. We aimed to assess the spatiotemporal changes in DKD burden attributable to lead exposure from 1990 to 2019 across 204 countries and regions with varying socio-demographic index (SDI) metrics. This retrospective analysis utilized data from the Global Burden of Disease Study 2019 (GBD2019) database. We estimated the burden of DKD attributable to lead exposure using the age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life year rate (ASDR), accounting for sex, age, nationality, and SDI. The annual percentage change (APC) and average annual percentage change (AAPC) were calculated using the Joinpoint model to evaluate trends in the ASMR and ASDR attributable to lead exposure from 1990 to 2019. Gaussian process regression was used to model the relationship between the SDI and ASMR/ASDR. Globally, the burden of DKD attributable to lead exposure has significantly increased since 1990, especially among elderly men and in regions such as Asia, Central Latin America, North Africa, the Middle East, and low-SDI regions. In 2019, the ASMR and ASDR of DKD attributable to lead exposure were 0.68 (95% CI: 0.40, 0.98) per 100,000 people and 15.02 (95% CI: 8.68, 22.26) per 100,000 people, respectively. From 1990 to 2019, the global ASMR and ASDR attributable to lead-associated DKD changed by 15.45% and -1.78%, respectively. The global AAPCs of the ASMR and ASDR were 0.55 (95% CI: 0.45, 0.65) and -0.01 (95% CI: -0.12, 0.1), respectively. Significant declining trends were observed in the high-income Asia Pacific region, eastern sub-Saharan Africa, North Africa, the Middle East, and other regions with high SDIs. Over this 30-year study period, the global burden of DKD attributable to lead exposure has increased, particularly in regions with low SDI. Lead exposure remains a significant concern in the global burden of diabetic kidney disease.

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Acknowledgements

This research was funded by the Natural Science Foundation of Gansu Province (22JR5RA1069) and the Scientific Research Project of Health Industry in Gansu Province (GSWSKY2003-15).

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  1. Yiwen Zhang, Chengxu Xu, and Junpu Yu contributed equally to this manuscript.

Authors and Affiliations

  1. School of Public Health, Lanzhou University, Lanzhou, 730000, China

    Yiwen Zhang, Junpu Yu, Jingli Yang, Shuxia Yu, Nan Li & Li Ma

  2. The Second Hospital of Lanzhou City, Lanzhou, 730030, China

    Chengxu Xu & Sangjiecao Yang

  3. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Special Administrative Region (SAR), Hong Kong, China

    Aimin Yang

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Conceptualization, L.M.; investigation, L.M.; writing—original draft preparation, Y.Z., C.X. and J.Y; writing—review and editing, Y.Z.,C.X.,J.Y.,J.Y.,S.Y.,N.L., S.Y., A.Y. and L.M.; supervision, A.Y. and L.M. All authors have read and agreed to the published version of the manuscript.

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Zhang, Y., Xu, C., Yu, J. et al. Distributions and Trends of the Global Burden of DKD Attributable to Lead Exposure: A Systematic Analysis of GBD from 1990 to 2019. Biol Trace Elem Res (2024). https://doi.org/10.1007/s12011-024-04156-x

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