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目的：分析1990年与2010年中国归因于不合理膳食、吸烟、饮酒和身体活动不足等慢性病主要行为危险因素的疾病负担。方法利用2010年全球疾病负担研究结果，选取1990年与2010年由于不合理膳食、吸烟、饮酒和身体活动不足导致的伤残调整寿命年（DALY）、过早死亡损失寿命年（YLL）和伤残损失寿命年（YLD），分析归因于4种危险因素的疾病负担现况、时间变化和疾病构成。结果1990年中国归因于不合理膳食、吸烟和饮酒的DALY及其95%不确定性区间（95%UI）分别为3728（3288～4212）万、2832（2250～3573）万、1302（1050~1574）万人年，其中男性分别为2117（1826～2448）万、1787（1359～2374）万和1023（822～1238）万人年，均高于女性[分别为1611（1390～1932）万、1045（727～1569）万和279（181～392）万人年]；2010年归因于不合理膳食、吸烟、饮酒和身体活动不足的DALY（95%UI）分别为5170（4607～5665）万、3000（2343～3592）万、1378（1089～1688）万和1144（949～1368）万人年，其中男性分别为3291（2843～3654）万、2271（1709～2827）万、1162（919～1428）万和634（509～774）万人年，均高于女性[分别为1879（1631～2092）万、729（447～973）万、216（125～310）万和510（421～605）万人年]。与1990年相比，2010年男性归因于不合理膳食、吸烟和饮酒的DALY均有所增加，增幅分别为55.5%、27.1%和13.6%；女性除归因于不合理膳食的DALY有所增加外（增幅为16.6%），归因于吸烟和饮酒的DALY均有所下降，变化幅度分别为-30.2%和-22.6%。归因于不合理膳食的DALY中，水果摄入不足所占的比例最高（35.4%），其次为高盐饮食（20.2%）。结论中国归因于不合理膳食、吸烟、饮酒和身体活动不足等慢性病主要行为危险因素的疾病负担较重，且在男性中增长迅速。

Objective To examine burden of disease (BOD) attributable to dietary risk factors, tobacco smoking, alcohol use, and physical inactivity in China in 1990 and 2010. Methods The results of the Global Burden of Diseases Study 2010(GBD 2010) for China were extracted to examine BOD attributable to the four behavioral risk factors in terms of current status, time trend, age patterns, and their diseasecomposition. Measurements for attributable BOD were years of life lost due to premature mortality (YLL), years lived with disability (YLD), and disability-adjusted life years (DALY). Results In 1990, for both genders combined, BOD attributable to dietary risk factors, tobacco smoking, and alcohol use were 37.28 (32.88-42.12), 28.32 (22.50-35.73), and 13.02 (10.50-15.74) million DALYs, respectively;for men, attributable BOD were 21.17 (18.26-24.48), 17.87 (13.59-23.74), and 10.23 (8.22-12.38) million DALYs, respectively, more than those in women (16.11 (13.90-19.32), 10.45 (727-15.69) ,and 2.79 (1.81-392) million DALYs, respectively). In 2010, BOD attributable to dietary risk factors, tobacco smoking, alcohol use, and physical inactivity were 51.70 (46.07-56.65), 30.00 (23.43-35.92), 13.78 (10.89-16.88), and 11.44 (9.49-13.68) million DALYs, respectively, all of which combined accounted for 33.7%of overall BOD;in male BOD attributable to these 4 risk factors were 32.91 (28.43-36.54), 22.71 (17.09-28.27), 11.62 (9.19-14.28), and 6.34 (5.09-7.74) million DALYs, respectively, higher than those in women (18.79 (16.31-20.92), 7.29 (4.47-9.73), 2.16 (1.25-3.10), and 5.10 (4.21-6.05) million, respectively). Compared with 1990, attributable BOD among men in 2010 had increased by 55.5% for dietary risk factors, 27.1% for tobacco smoking and 13.6%for alcohol use, whilst only had BOD attributable dietary risk factors increased (by 16.6%) among women, with decreasing trends in smoking (-30.2%) and alcohol use (-22.6%). Diet low in fruits accounted for the largest portion of 35.4% in total BOD attributable to all dietary risk factors, followed by diet high in sodium which accounted for 20.2%. Conclusion The BOD attributable to the 4 behavioral risk factors was quite high in China, with significant increase in BOD of men.