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September 14, 2026Diabetology & Metabolic SyndromeOpen Access

High LDL-C, BMI, and FPG linked to stable ASCVD burden in adults 15-49, projected to rise.

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Population

Young and middle-aged adults (15–49 years) globally across 204 countries and 21 GBD regions.

Design

Other

Follow-up

1990 to 2021 (with projections to 2050)

Key result

High LDL-c, high BMI, and high fasting plasma glucose contributed to a stable global burden of ASCVD in adults aged 15-49 from 1990 to 2021, with projections indicating an increase by 2050.

Authors

HZHua ZhangJLJun LiJLJun Li

Discussion

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Overview

Projected ASCVD rise by 2050 warrants vigilance in young adults; leaves open whether risk-factor control alters trajectories.

Key Points

  • To evaluate the global burden of atherosclerotic cardiovascular disease attributable to elevated low-density lipoprotein cholesterol, body mass index, and fasting plasma glucose in adults aged 15–49 years from 1990 to 2021, with forecasts through 2050.
  • Extracted epidemiological data from the Global Burden of Disease 2021 study spanning 204 countries and 21 regions for individuals aged 15–49 years.
  • Assessed crude death rates, total deaths, and estimated annual percentage changes by sex and socio-demographic index (SDI) level using locally weighted scatterplot smoothing regression.
  • Projected future mortality trends from 2022 to 2050 utilizing Bayesian age-period-cohort modeling.
  • Ischemic heart disease accounted for a substantially higher proportion of attributable deaths than ischemic stroke or peripheral artery disease across all three metabolic risks, with men experiencing consistently greater burden than women.
  • Global crude death rates remained relatively stable between 1990 and 2021, displaying non-linear SDI relationships where regional ischemic heart disease peaked at SDI values of 0.45 and 0.70 before sharply declining above SDI 0.75.
  • Projections through 2050 indicate that mortality from atherosclerotic cardiovascular disease attributable to high body mass index, fasting plasma glucose, and low-density lipoprotein cholesterol will rise to varying degrees in young and middle-aged adults.

Study Design

Type

Observational

Multicenter

Yes

Structured PICO

P
Population
Global population of young and middle-aged adults (15-49 years) analyzed for ASCVD burden attributable to high LDL-c, high BMI, and high fasting plasma glucose from 1990 to 2021.
O
Outcome
ASCVD burden (crude death rates, number of deaths, and estimated annual percentage changes) attributable to high LDL-c, high BMI, or high FPGhard clinical

The global burden of ASCVD attributable to high BMI, fasting glucose, and LDL-c in young and middle-aged adults has remained stable but is projected to rise by 2050, highlighting the need for targeted public health interventions.

Cite This Study

Zhang et al. (2026) conducted an observational in Atherosclerotic cardiovascular disease (ASCVD). High LDL-c, high BMI, and high fasting plasma glucose was evaluated on Crude death rates, number of deaths, and estimated annual percentage changes (EAPCs) for ASCVD. High LDL-c, high BMI, and high fasting plasma glucose contributed to a stable global burden of ASCVD in adults aged 15-49 from 1990 to 2021, with projections indicating an increase by 2050.

synapsesocial.com/papers/6aa7afef79e9260bc85aad15https://doi.org/10.1186/s13098-026-02236-7
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Comparative analysis of atherosclerotic cardiovascular disease burden between ages 20–54 and over 55 years: insights from the Global Burden of Disease Study 20192024 · 29 citations
  2. 2Global, Regional, and National Burden of Ischemic Heart Disease Due to High LDL Cholesterol, Systolic Blood Pressure, and Fasting Glucose in Young Adults (1990–2021)2025
  3. 3Trends and cross-country inequalities in the global burden of early-onset atherosclerosis - a population-based study2025
  4. 4The global burden and risk factors of cardiovascular diseases in adolescent and young adults, 1990–20192024 · 44 citations
  5. 5Worldwide burden of metabolic risk‐related cardiovascular disease from 1990 to 2021, with projections to 2050: A systematic analysis for the Global Burden of Disease Study 20212025 · 13 citations