6 research outputs found
FETUIN-A LEVELS AND THEIR RELATIONSHIP WITH INSULIN RESISTANCE AND LOW-GRADE INFLAMMATION
No full textObjective: This work was aimed to evaluate serum Fetuin-A levels and its probable association with insulin resistance and other relevant metabolic and inflammatory parameters in patients with insulin resistance (IR) and type 2 diabetes mellitus (T2DM). Method: A cross-sectional analytic study was carried out at Tikrit Teaching Hospital from August 2025 to January 2026. Two hundred and fifty subjects, 25–55 years in age were included in the study as follows – healthy (n = 50), insulin resistant but with no overt diabetes mellitus (n = 100) and type two diabetic patients with coexisting insulin resistance (T2D-IR, n = 100). The serum Fetuin-A level, fasting plasma glucose (FPG), fasting insulin, glycosylated hemoglobin (HbA1c), lipid profile, inflammatory markers including high sensitivity C-reactive protein (hs-CRP), IL-6 and TNF-α, as well as liver enzymes were determined. Insulin resistance was evaluated based on the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). Results: The serum levels of Fetuin-A were significantly increased in both insulin resistant subjects with the highest level in type 2 diabetes mellitus patients (p < 0.001). Serum Fetuin-A levels were positively associated with HOMA-IR, fasting insulin, inflammatory parameters, triglycerides, body mass index and liver enzymes and inversely correlated with HDL-C. Novelty: The results of this study corroborate the potential value of Fetuin-A as a biomarker for metabolic disturbance and disease progression. High circulating levels of Fetuin-A strongly correlated with insulin resistance, chronic inflammation and metabolic profile unfavourability
Author Correction: Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017
No full textGlobal, regional, and national mortality among young people aged 10-24 years, 1950-2019: a systematic analysis for the Global Burden of Disease Study 2019
No full textBackground Documentation of patterns and long-term trends in mortality in young people, which reflect huge changes in demographic and social determinants of adolescent health, enables identification of global investment priorities for this age group. We aimed to analyse data on the number of deaths, years of life lost, and mortality rates by sex and age group in people aged 10-24 years in 204 countries and territories from 1950 to 2019 by use of estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019.
Methods We report trends in estimated total numbers of deaths and mortality rate per 100 000 population in young people aged 10-24 years by age group (10-14 years, 15-19 years, and 20-24 years) and sex in 204 countries and territories between 1950 and 2019 for all causes, and between 1980 and 2019 by cause of death. We analyse variation in outcomes by region, age group, and sex, and compare annual rate of change in mortality in young people aged 10-24 years with that in children aged 0-9 years from 1990 to 2019. We then analyse the association between mortality in people aged 10-24 years and socioeconomic development using the GBD Socio-demographic Index (SDI), a composite measure based on average national educational attainment in people older than 15 years, total fertility rate in people younger than 25 years, and income per capita. We assess the association between SDI and all-cause mortality in 2019, and analyse the ratio of observed to expected mortality by SDI using the most recent available data release (2017).
Findings In 2019 there were 1.49 million deaths (95% uncertainty interval 1.39-1.59) worldwide in people aged 10-24 years, of which 61% occurred in males. 32.7% of all adolescent deaths were due to transport injuries, unintentional injuries, or interpersonal violence and conflict; 32.1% were due to communicable, nutritional, or maternal causes; 27.0% were due to non-communicable diseases; and 8.2% were due to self-harm. Since 1950, deaths in this age group decreased by 30.0% in females and 15.3% in males, and sex-based differences in mortality rate have widened in most regions of the world. Geographical variation has also increased, particularly in people aged 10-14 years. Since 1980, communicable and maternal causes of death have decreased sharply as a proportion of total deaths in most GBD super-regions, but remain some of the most common causes in sub-Saharan Africa and south Asia, where more than half of all adolescent deaths occur. Annual percentage decrease in all-cause mortality rate since 1990 in adolescents aged 15-19 years was 1.3% in males and 1.6% in females, almost half that of males aged 1-4 years (2.4%), and around a third less than in females aged 1-4 years (2.5%). The proportion of global deaths in people aged 0-24 years that occurred in people aged 10-24 years more than doubled between 1950 and 2019, from 9.5% to 21.6%.
Interpretation Variation in adolescent mortality between countries and by sex is widening, driven by poor progress in reducing deaths in males and older adolescents. Improving global adolescent mortality will require action to address the specific vulnerabilities of this age group, which are being overlooked. Furthermore, indirect effects of the COVID-19 pandemic are likely to jeopardise efforts to improve health outcomes including mortality in young people aged 10-24 years. There is an urgent need to respond to the changing global burden of adolescent mortality, address inequities where they occur, and improve the availability and quality of primary mortality data in this age group. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Bill & Melinda Gates Foundation
Anemia prevalence in women of reproductive age in low- and middle-income countries between 2000 and 2018
No full textAnemia is a globally widespread condition in women and is associated with reduced economic productivity and increased mortality worldwide. Here we map annual 2000–2018 geospatial estimates of anemia prevalence in women of reproductive age (15–49 years) across 82 low- and middle-income countries (LMICs), stratify anemia by severity and aggregate results to policy-relevant administrative and national levels. Additionally, we provide subnational disparity analyses to provide a comprehensive overview of anemia prevalence inequalities within these countries and predict progress toward the World Health Organization’s Global Nutrition Target (WHO GNT) to reduce anemia by half by 2030. Our results demonstrate widespread moderate improvements in overall anemia prevalence but identify only three LMICs with a high probability of achieving the WHO GNT by 2030 at a national scale, and no LMIC is expected to achieve the target in all their subnational administrative units. Our maps show where large within-country disparities occur, as well as areas likely to fall short of the WHO GNT, offering precision public health tools so that adequate resource allocation and subsequent interventions can be targeted to the most vulnerable populations
Global burden of lower respiratory infections and aetiologies, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023
No full textBackground: Lower respiratory infections (LRIs) remain the world’s leading infectious cause of death. This analysis
from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 provides global, regional, and
national estimates of LRI incidence, mortality, and disability-adjusted life-years (DALYs), with attribution to
26 pathogens, including 11 newly modelled pathogens, across 204 countries and territories from 1990 to 2023. With
new data and revised modelling techniques, these estimates serve as an update and expansion to GBD 2021. Through
these estimates, we also aimed to assess progress towards the 2025 Global Action Plan for the Prevention and
Control of Pneumonia and Diarrhoea (GAPPD) target for pneumonia mortality in children younger than 5 years.
Methods: Mortality from LRIs, defined as physician-diagnosed pneumonia or bronchiolitis, was estimated using
the Cause of Death Ensemble model with data from vital registration, verbal autopsy, surveillance, and minimally
invasive tissue sampling. The Bayesian meta-regression tool DisMod-MR 2.1 was used to model overall morbidity
due to LRIs. DALYs were calculated as the sum of years of life lost (YLLs) and years lived with disability (YLDs) for
all locations, years, age groups, and sexes. We modelled pathogen-specific case-fatality ratios (CFRs) for each age
group and location using splined binomial regression to create internally consistent estimates of incidence and
mortality proportions attributable to viral, fungal, parasitic, and bacterial pathogens. Progress was assessed
towards the GAPPD target of less than three deaths from pneumonia per 1000 livebirths, which is roughly
equivalent to a mortality rate of less than 60 deaths per 100 000 children younger than 5 years.
Findings: In 2023, LRIs were responsible for 2·50 million (95% uncertainty interval [UI] 2·24–2·81) deaths and
98·7 million (87·7–112) DALYs, with children younger than 5 years and adults aged 70 years and older carrying the
highest burden. LRI mortality in children younger than 5 years fell by 33·4% (10·4–47·4) since 2010, with a global
mortality rate of 94·8 (75·6–116·4) per 100000 person-years in 2023. Among adults aged 70 years and older, the burden
remained substantial with only marginal declines since 2010. A mortality rate of less than 60 deaths per 100000 for
children younger than 5 years was met by 129 of the 204 modelled countries in 2023. At a super-regional level, subSaharan Africa had an aggregate mortality rate in children younger than 5 years (hereafter referred to as under-5
mortality rate) furthest from the GAPPD target. Streptococcus pneumoniae continued to account for the largest number
of LRI deaths globally (634000 [95% UI 565000–721000] deaths or 25·3% [24·5–26·1] of all LRI deaths), followed by
Staphylococcus aureus (271000 [243000–298000] deaths or 10·9% [10·3–11·3]), and Klebsiella pneumoniae (228000
[204000–261000] deaths or 9·1% [8·8–9·5]). Among pathogens newly modelled in this study, non-tuberculous
mycobacteria (responsible for 177000 [95% UI 155000–201000] deaths) and Aspergillus spp (responsible for 67800
[59900–75900] deaths) emerged as important contributors. Altogether, the 11 newly modelled pathogens accounted for
approximately 22% of LRI deaths.
Interpretation: This comprehensive analysis underscores both the gains achieved through vaccination and the
challenges that remain in controlling the LRI burden globally. Furthermore, it demonstrates persistent disparities
in disease burden, with the highest mortality rates concentrated in countries in sub-Saharan Africa. Globally, as
well as in these high-burden locations, the under-5 LRI mortality rate remains well above the GAPPD target.
Progress towards this target requires equitable access to vaccines and preventive therapies—including newer
interventions such as respiratory syncytial virus monoclonal antibodies—and health systems capable of early
diagnosis and treatment. Expanding surveillance of emerging pathogens, strengthening adult immunisation
programmes, and combating vaccine hesitancy are also crucial. As the global population ages, the dual challenge
of sustaining gains in child survival while addressing the rising vulnerability in older adults will shape future
pneumonia control strategies
Global burden of lower respiratory infections and aetiologies, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023
No full textBackground Lower respiratory infections (LRIs) remain the world’s leading infectious cause of death. This analysis
from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 provides global, regional, and
national estimates of LRI incidence, mortality, and disability-adjusted life-years (DALYs), with attribution to
26 pathogens, including 11 newly modelled pathogens, across 204 countries and territories from 1990 to 2023. With
new data and revised modelling techniques, these estimates serve as an update and expansion to GBD 2021. Through
these estimates, we also aimed to assess progress towards the 2025 Global Action Plan for the Prevention and
Control of Pneumonia and Diarrhoea (GAPPD) target for pneumonia mortality in children younger than 5 years.
Methods Mortality from LRIs, defined as physician-diagnosed pneumonia or bronchiolitis, was estimated using
the Cause of Death Ensemble model with data from vital registration, verbal autopsy, surveillance, and minimally
invasive tissue sampling. The Bayesian meta-regression tool DisMod-MR 2.1 was used to model overall morbidity
due to LRIs. DALYs were calculated as the sum of years of life lost (YLLs) and years lived with disability (YLDs) for
all locations, years, age groups, and sexes. We modelled pathogen-specific case-fatality ratios (CFRs) for each age
group and location using splined binomial regression to create internally consistent estimates of incidence and
mortality proportions attributable to viral, fungal, parasitic, and bacterial pathogens. Progress was assessed
towards the GAPPD target of less than three deaths from pneumonia per 1000 livebirths, which is roughly
equivalent to a mortality rate of less than 60 deaths per 100 000 children younger than 5 years.
Findings In 2023, LRIs were responsible for 2·50 million (95% uncertainty interval [UI] 2·24–2·81) deaths and
98·7 million (87·7–112) DALYs, with children younger than 5 years and adults aged 70 years and older carrying the
highest burden. LRI mortality in children younger than 5 years fell by 33·4% (10·4–47·4) since 2010, with a global
mortality rate of 94·8 (75·6–116·4) per 100000 person-years in 2023. Among adults aged 70 years and older, the burden
remained substantial with only marginal declines since 2010. A mortality rate of less than 60 deaths per 100000 for
children younger than 5 years was met by 129 of the 204 modelled countries in 2023. At a super-regional level, subSaharan Africa had an aggregate mortality rate in children younger than 5 years (hereafter referred to as under-5
mortality rate) furthest from the GAPPD target. Streptococcus pneumoniae continued to account for the largest number
of LRI deaths globally (634000 [95% UI 565000–721000] deaths or 25·3% [24·5–26·1] of all LRI deaths), followed by
Staphylococcus aureus (271000 [243000–298000] deaths or 10·9% [10·3–11·3]), and Klebsiella pneumoniae (228000
[204000–261000] deaths or 9·1% [8·8–9·5]). Among pathogens newly modelled in this study, non-tuberculous
mycobacteria (responsible for 177000 [95% UI 155000–201000] deaths) and Aspergillus spp (responsible for 67800
[59900–75900] deaths) emerged as important contributors. Altogether, the 11 newly modelled pathogens accounted for
approximately 22% of LRI deaths.
Interpretation This comprehensive analysis underscores both the gains achieved through vaccination and the
challenges that remain in controlling the LRI burden globally. Furthermore, it demonstrates persistent disparities
in disease burden, with the highest mortality rates concentrated in countries in sub-Saharan Africa. Globally, as
well as in these high-burden locations, the under-5 LRI mortality rate remains well above the GAPPD target.
Progress towards this target requires equitable access to vaccines and preventive therapies—including newer
interventions such as respiratory syncytial virus monoclonal antibodies—and health systems capable of early
diagnosis and treatment. Expanding surveillance of emerging pathogens, strengthening adult immunisation
programmes, and combating vaccine hesitancy are also crucial. As the global population ages, the dual challenge
of sustaining gains in child survival while addressing the rising vulnerability in older adults will shape future
pneumonia control strategies
