Burdens of non-communicable disease attributable to metabolic risk factors in Australia, 1990–2019: joinpoint regression analysis of the Global Burden of Disease Study

BACKGROUND: Long-term and comparative assessments of trends in non-communicable disease (NCD) burden attributable to metabolic risk are sparse. This study aimed to assess burdens and trends of NCD attributable to metabolic risk factors in Australia, 1990–2019. DESIGN: Population-based observational study. SETTINGS AND DATA SOURCE: Data were extracted from the Global Burden of Disease Study 2019 for Australia and trends in NCD burden attributable metabolic risks were estimated using the joinpoint regression model. MAIN OUTCOME MEASURES: NCD deaths and disability-adjusted life-years (DALYs) attributed to metabolic risk factors, 1990–2019. RESULTS: Results indicate a 1.1% yearly increase in exposure to combined metabolic risk factors from 1990 to 2019. Between 1990 and 2019, the estimated absolute number of deaths from NCDs attributed to combined metabolic risks increased by 17.0%. However, metabolic risk-related NCD burdens in Australia decreased between 1990 and 2019. In 2019, 34.0% of NCD deaths and 20.0% of NCD DALYs were attributed to metabolic risk factors, compared with 42.9% and 24.4%, respectively, in 1990. In 2019, cardiovascular diseases (CVDs), neoplasms and chronic kidney diseases were the most common NCD deaths attributed to metabolic risks. High body mass index accounted for the highest proportion of diabetes deaths (47.0%) and DALYs (58.1%) as well as chronic kidney disease deaths (35.4%) and DALYs (39.7%). Similarly, high systolic blood pressure contributed to a high proportion of chronic kidney disease deaths (60.9%) and DALYs (53.2%), and CVDs deaths (44.0%) and DALYs (46.0%). CONCLUSION: While the contribution of metabolic risk factors to the burden of NCDs has declined from 1990 to 2019, their role in NCD death and disability remains a challenge as the prevalence of these risk factors has increased. Prevention strategies should focus on metabolic risks particularly high body mass index and high systolic blood pressure to substantially reduce NCD burdens.