Background: Chronic kidney disease (CKD) is a global public health concern, but its disease burden and risk-attributable burden in CKD has been poorly studied in low - and middle-income countries (LMICs). This study aimed to estimate CKD burden and risk-attributable burden in LMICs from 1990 to 2019. Methods: Data were collected from the Global Burden of Disease (GBD) Study 2019, which measure CKD burden using the years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life-years (DALYs) and calculate percentage contributions of risk factors to age-standardized CKD DALY using population attributable fraction (PAF) from 1990 to 2019. Trends of disease burden between 1990 and 2019 were evaluated using average annual percent change (AAPC). The 95% uncertainty interval (UI) were calculated and reported for YLDs, YLLs, DALYs and PAF. Results: In 2019, LICs had the highest age-standardized DALY rate at 692.25 per 100,000 people (95%UI: 605.14 to 785.67), followed by Lower MICs (684.72% (95%UI: 623.56 to 746.12)), Upper MICs (447.55% (95%UI: 405.38 to 493.01)). The age-standardized YLL rate was much higher than the YLD rate in various income regions. From 1990 to 2019, the age-standardized DALY rate showed a 13.70% reduction in LICs (AAPC = -0.5, 95%UI: − 0.6 to − 0.5, P < 0.001), 3.72% increment in Lower MICs (AAPC = 0.2, 95%UI: 0.0 to 0.3, P < 0.05). Age-standardized YLD rate was higher in females than in males, whereas age-standardized rates of YLL and DALY of CKD were all higher in males than in females in globally and LMICs. Additionally, the YLD, YLL and DALY rates of CKD increased with age, which were higher in aged≥70 years in various income regions. In 2019, high systolic blood pressure, high fasting plasma glucose, and high body-mass index remained the major causes attributable age-standardized CKD DALY. From 1990 to 2019, there were upward trends in the PAF of age-standardized DALY contributions of high fasting plasma glucose, high systolic blood pressure, and high body-mass index in Global, LICs, Lower MICs and Upper MICs. The greatest increase in the PAF was high body-mass index, especially in Lower MICs (AAPC = 2.7, 95%UI: 2.7 to 2.8, P < 0.001). The PAF of age-standardized DALY for high systolic blood pressure increased the most in Upper MICs (AAPC = 0.6, 95%UI: 0.6 to 0.7, P < 0.001). Conclusions: CKD burden remains high in various income regions, especially in LICs and Lower MICs. More effective and targeted preventive policies and interventions aimed at mitigating preventable CKD burden and addressing risk factors are urgently needed, particularly in geographies with high or increasing burden.

Background and purpose: This study aims to examine the global, regional, and national burden of ischemic stroke from 1990 to 2021.Method: We used data from the Global Burden of Disease (GBD) 2021 database to comprehensively assess ischemic stroke indicators globally, regionally, and in 204 countries, including incidence, deaths, disability‐adjusted life years (DALYs), estimated annual percentage change (EAPC), and Joinpoint regression analysis.Results: In 2021, there were a total of 7,804,449 cases of ischemic stroke globally (95% uncertainty interval = 6,719,760–8,943,692), with an age‐standardized incidence rate (ASIR) of 92.39. This represents a declining trend compared to 1990, with an EAPC of −0.67 (95% confidence interval [CI] = −0.76 to −0.58). Mortality and DALY rates also showed a downward trend (EAPC in age‐standardized mortality rate: −1.83, 95% CI = −1.92 to −1.74; EAPC in age‐standardized DALY rate = −1.59, 95% CI = −1.68 to −1.50). The burden of ischemic stroke was inversely correlated with gross domestic product. Regionally, from 2014 to 2021, the Caribbean experienced the fastest increase in ASIR (annual percent change = 0.15, 95% CI = 0.13 to 0.18). Among 204 countries, North Macedonia had the highest incidence, mortality, and DALY rates. In addition to metabolic risks, particulate matter pollution and low temperatures were significant environmental and occupational risk factors for ischemic stroke. Smoking and a diet high in sodium were identified as key behavioral risk factors.Conclusions: Ischemic stroke remains a serious global health challenge, and our results from this cross‐sectional study suggest that the burden of disease remains high in Eastern Europe, East Asia, Central Asia, and Sub‐Saharan Africa.

Purpose: This study aimed to determine the prevalence of myopia among school-aged children and adolescents at the whole city level of Weifang, China.Methods: This study was a large scale school-based cross-sectional study among children and adolescents aged 5–20 years old. Participants were selected by the school-based registration system in 2020. All the subjects underwent spherical equivalent (SE) error with non-cycloplegic autorefraction measurement. Myopia was defined as an SE refraction of ≤-0.75 diopters (D) and graded into low myopia (−0.75 to −3.00 D), moderate myopia (−3.01 to −5.99 D), and high myopia (≤-6.00 D).Results: A total of 1,059,838 participants were eligible for this survey and 1,013,206 (95.6% participation rate) were selected through data quality control, which comprised 17 districts/counties and 1,254 schools, including 861 elementary schools, 313 middle schools, and 80 high schools. The mean age of participants was 11.57 ± 3.36 years (5–20 years), and the male-to-female ratio was 1.11. The whole city-level prevalence of total myopia was 75.35%. The prevalence of total myopia among the students in the Hanting District was 45.47%, but ≈82.37% of students living in Changyi have myopia. The overall prevalence of low myopia in elementary, middle, and high school students was 48.56, 47.30, and 31.62%, respectively, while high myopia (SE ≤ −6.00 D) prevalence was 1.12, 8.89, and 20.12%, respectively. The overall prevalence of myopia increased fastest in children aged 7–9 years old. The prevalence of high myopia was 7.59% for girls and 6.43% for boys, respectively (p < 0.001). The prevalence of myopia increased with increasing age and grade, but SE decreased with increasing age and grade.Conclusions: The current investigation demonstrated a high proportion of myopia among school students in the city of Weifang, and gradually increased with age, and the prevalence of myopia was the highest in Changyi areas. The high myopia prevalence for girls was higher than that in boys.

Background: Ischemic heart disease (IHD) imposes the greatest disease burden globally, especially in low‐ and middle‐income countries (LMICs). We aim to examine the population‐attributable fraction and risk‐attributable death and disability‐adjusted life years (DALYs) for IHD in 137 low‐ and middle‐income countries. Methods and Results: Using comparative risk assessment framework from the 2019 Global Burden of Disease study, the population‐attributable fraction and IHD burden (death and DALYs) attributable to risk factors in low‐income countries, lower‐middle‐income countries (LMCs), and upper‐middle‐income countries were assessed from 2000 to 2019. In 2019, the population‐attributable fraction (%) of IHD deaths in relation to all modifiable risk factors combined was highest in lower‐middle‐income countries (94.2; 95% uncertainty interval, 91.9–96.2), followed by upper‐middle‐income countries (93.5; 90.4–95.8) and low‐income countries (92.5; 90.0–94.7). There was a >13‐fold difference between Peru and Uzbekistan in age‐standardized rates (per 100 000) of attributable death (44.3 versus 660.4) and DALYs (786.7 versus 10506.1). Dietary risks accounted for the largest proportion of IHD’s behavioral burden in low‐ and middle‐income countries, primarily attributable to diets low in whole grains. High systolic blood pressure and high low‐density lipoprotein cholesterol remained the 2 leading causes of DALYs, with the former topping the list in 116 countries, while the latter led in 21 of the 137 countries. Compared with 2000 to 2010, the increases in risk‐attributable deaths and DALYs among upper‐middle income countries were slower from 2010 to 2019, while the trends in low‐income countries and lower‐middle income countries were opposite. Conclusions: IHD’s attributable burden remains high in low‐ and middle‐income countries. Considerable heterogeneity was observed among different income‐classified regions and countries.

Background: Ischemic heart disease (IHD) is the leading cause of premature death which poses public health challenges worldwide. Previous studies focused on the overall population in China. However, variations in temporal and spatial patterns across subgroups remain unknown. This study was to analyze how the IHD burden among Chinese and subgroup populations changes in response to temporal and spatial trends from 1990 to 2016. Methods: Based on data from the updated estimate in the 2016 Global Burden of Disease (GBD) study, we used years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life years (DALYs) to describe the IHD burden. The percentage and annual average percentage changes were applied to illustrate temporal and spatial variations of the IHD burden stratified by age, sex, and province, over the periods 1990–2016, 1990–2005, and 2005–2016. We estimate population-attributable fraction (PAF) for 24 modifiable risk factors at the provincial level in 2016. Results: YLD rates, YLL rates, and DALY rates for IHD underwent a notable increase among all age groups and increased by 119.4, 83.3, and 84.5% nationally from 1990 to 2016. In YLD rates, a greater increase was seen in females (124.4%) compared to males (114.0%), while males experienced a more substantial increase than that in females in YLL rates (99.3% vs. 60.5%) and DALY rates (99.7% vs. 63.2%) from 1990 to 2016. Compared with 1990–2005, annual average changes in the overall population in YLL rates (3.5% vs. 1.8%) and DALY rates (3.5% vs. 1.9%) showed a tardier increase whereas an opposite increasing trend of YLD rates (3.5% vs. 4.0%) was observed between 2005 and 2016. Geographically, all provinces saw declines in the YLLs/YLDs ratio from 2005 to 2016, with seventeen of thirty-three provinces showing an upward trend between 1990 and 2005. Most provinces witnessed a remarkable upsurge in the age-standardised DALY rate from 1990 to 2016 whereas the economically advantaged region Macao (52.2%) saw the most marked reduction. High systolic blood pressure and high LDL cholesterol remained the two leading risk factors of IHD in all provinces in 2016. Diet high in sodium was the leading behavioral risks in twenty-eight provinces with smoking heading the list in five provinces. Conclusions: China has made significant achievements in preventing premature death from IHD along with the increased risk of disability. Substantial disparities in temporal and spatial trends of the IHD burden emphasize concerns for elderly men and those in economically disadvantaged regions with resource constraints. Regional differences in the IHD burden can be partly explained by modifiable risk factors. By having identified these disparities, targeted IHD prevention and control strategies will help to bridge these gaps.

Background and purpose: Ischemic stroke, a major contributor to global disability and mortality, is underpinned by intricate pathophysiological mechanisms, notably neuroinflammation and immune cell dynamics. Prior research has identified a nuanced and often paradoxical link between immune cell phenotypes and ischemic stroke susceptibility. The aim of this study was to elucidate the potential causal links between the median fluorescence intensity (MFI) and morphological parameters (MP) of 731 immune cell types and ischemic stroke risk.Methods: By analyzing extensive genetic datasets, we conducted comprehensive Mendelian randomization (MR) analyses to discern the genetic correlations between diverse immune cell attributes (MFI and MP) and ischemic stroke risk.Results: Our study identified key immune cell signatures linked to ischemic stroke risk. Both B cells and T cells, among other immune cell types, have a bidirectional influence on stroke risk. Notably, the regulatory T‐cell phenotype demonstrates significant neuroprotective properties, with all odds ratio (OR) values and confidence intervals (CIs) being less than 1. Furthermore, CD39 phenotype immune cells, particularly CD39+ CD8+ T cells (inverse variance weighting [IVW] OR 0.92, 95% CI 0.87–0.97; p = 0.002) and CD39+ activated CD4 regulatory T cells (IVW OR 0.93, 95% CI 0.90–0.97; p < 0.001), show notable neuroprotection against ischemic stroke.Conclusion: This investigation provides new genetic insights into the interplay between various immune cells and ischemic stroke, underscoring the complex role of immune processes in stroke pathogenesis. These findings lay a foundation for future research, which may confirm and expand upon these links, potentially leading to innovative immune‐targeted therapies for stroke prevention and management.