{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T05:02:14Z","timestamp":1789448534654,"version":"build-2803163510"},"reference-count":53,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T00:00:00Z","timestamp":1789171200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Diabetol Metab Syndr"],"DOI":"10.1186\/s13098-026-02236-7","type":"journal-article","created":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T10:13:17Z","timestamp":1789207997000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Burden of atherosclerotic cardiovascular disease attributable to high body mass index, high fasting plasma glucose or high low density lipoprotein cholesterol in young and middle-aged adults from 1990 to 2050"],"prefix":"10.1186","volume":"18","author":[{"given":"Hua","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaixin","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenhao","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,12]]},"reference":[{"issue":"1","key":"2236_CR1","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1186\/s12916-024-03527-4","volume":"22","author":"Z Li","year":"2024","unstructured":"Li Z, Yang Y, Wang X, Yang N, He L, Wang J, et al. Comparative analysis of atherosclerotic cardiovascular disease burden between ages 20\u201354 and over 55 years: insights from the global burden of disease study 2019. BMC Med. 2024;22(1):303. https:\/\/doi.org\/10.1186\/s12916-024-03527-4.","journal-title":"BMC Med"},{"key":"2236_CR2","doi-asserted-by":"crossref","unstructured":"Bor\u00e9n J, Chapman MJ, Krauss RM, Packard CJ, Bentzon JF, Binder CJ, Daemen MJ, Demer LL, Hegele RA, Nicholls SJ, Nordestgaard BG, Watts GF, Bruckert E, Fazio S, Ference BA, Graham I, Horton JD, Landmesser U, Laufs U, Masana L, Pasterkamp G, Raal FJ, Ray KK, Schunkert H, Taskinen MR, van de Sluis B, Wiklund O, Tokgozoglu L, Catapano AL, Ginsberg HN. Low-density lipoproteins cause atherosclerotic cardiovascular disease: pathophysiological, genetic, and therapeutic insights: a consensus statement from the European atherosclerosis society consensus panel. Eur Heart J. 2020;41(24):2313\u20132330.","DOI":"10.1093\/eurheartj\/ehz962"},{"key":"2236_CR3","doi-asserted-by":"publisher","unstructured":"Powell-Wiley TM, Poirier P, Burke LE, Despr\u00e9s JP, Gordon-Larsen P, Lavie CJ, Lear SA, Ndumele CE, Neeland IJ, Sanders P, St-Onge MP, American Heart Association Council on Lifestyle and Cardiometabolic Health, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, Council on Epidemiology and Prevention, Stroke Council. Obesity and cardiovascular disease: a scientific statement from the American heart association. Circulation. 2021;143(21):e984-e1010. https:\/\/doi.org\/10.1161\/CIR.0000000000000973","DOI":"10.1161\/CIR.0000000000000973"},{"issue":"7","key":"2236_CR4","doi-asserted-by":"publisher","first-page":"100","DOI":"10.3389\/fcvm.2020.00100","volume":"9","author":"A Nahmias","year":"2020","unstructured":"Nahmias A, Stahel P, Xiao C, Lewis GF. Glycemia and atherosclerotic cardiovascular disease: exploring the gap between risk marker and risk factor. Front Cardiovasc Med. 2020;9(7):100. https:\/\/doi.org\/10.3389\/fcvm.2020.00100. (PMID:32582769;PMCID:PMC7296136).","journal-title":"Front Cardiovasc Med"},{"key":"2236_CR5","doi-asserted-by":"crossref","unstructured":"GBD 2021 Diseases and Injuries Collaborators. Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990\u20132021: a systematic analysis for the global burden of dis-ease study 2021. Lancet. 2024;403(10440):2133\u20132161.","DOI":"10.1016\/S0140-6736(24)00757-8"},{"key":"2236_CR6","doi-asserted-by":"crossref","unstructured":"GBD 2021 Risk Factors Collaborators. Global burden and strength ofevidence for 88 risk factors in 204 countries and 811 subnational locations, 1990\u20132021: a systematic analysis for the Global Burden of Disease study 2021. Lancet. 2024;403(10440):2162\u20132203.","DOI":"10.1016\/S0140-6736(24)00933-4"},{"issue":"4","key":"2236_CR7","doi-asserted-by":"publisher","first-page":"467","DOI":"10.1093\/ehjqcco\/qcae090","volume":"11","author":"H Chen","year":"2025","unstructured":"Chen H, Liu L, Wang Y, Hong L, Zhong W, Lehr T, et al. Burden of cardiovascular disease attributable to metabolic risks in 204 countries and territories from 1990 to 2021. Eur Heart J Qual Care Clin Outcomes. 2025;11(4):467\u201376. https:\/\/doi.org\/10.1093\/ehjqcco\/qcae090.","journal-title":"Eur Heart J Qual Care Clin Outcomes"},{"key":"2236_CR8","doi-asserted-by":"publisher","unstructured":"Zhu XY, Shi MQ, Jiang ZM, Xiao-Li, Tian JW, Su FF. Global, regional, and national burden of cardiovascular diseases attributable to metabolic risks across all age groups from 1990 to 2021: an analysis of the 2021 global burden of disease study data. BMC Public Health. 2025; 25(1):1704. https:\/\/doi.org\/10.1186\/s12889-025-22702-7","DOI":"10.1186\/s12889-025-22702-7"},{"issue":"9","key":"2236_CR9","doi-asserted-by":"publisher","first-page":"2739","DOI":"10.1007\/s11427-025-2948-y","volume":"68","author":"S Xu","year":"2025","unstructured":"Xu S, Liu Y, Zhu M, Chen K, Xu F, Liu Y. Global burden of atherosclerotic cardiovascular disease attributed to lifestyle and metabolic risks. Sci China Life Sci. 2025;68(9):2739\u201354. https:\/\/doi.org\/10.1007\/s11427-025-2948-y.","journal-title":"Sci China Life Sci"},{"issue":"9","key":"2236_CR10","doi-asserted-by":"publisher","first-page":"4859","DOI":"10.1111\/dom.16529","volume":"27","author":"X Dong","year":"2025","unstructured":"Dong X, Wang J, Wang C, Wang B, Li G, Yang J, et al. Worldwide 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 2021. Diabetes Obes Metab. 2025;27(9):4859\u201382. https:\/\/doi.org\/10.1111\/dom.16529.","journal-title":"Diabetes Obes Metab"},{"key":"2236_CR11","unstructured":"Global Health Data Exchange. GBD Results Tool. https:\/\/vizhub.healthdata.org\/gbd-results\/. Accessed July 20, 2025."},{"issue":"4","key":"2236_CR12","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1038\/nrcardio.2017.154","volume":"15","author":"C Andersson","year":"2018","unstructured":"Andersson C, Vasan RS. Epidemiology of cardiovascular disease in young individuals. Nat Rev Cardiol. 2018;15(4):230\u201340. https:\/\/doi.org\/10.1038\/nrcardio.2017.154.","journal-title":"Nat Rev Cardiol"},{"issue":"2","key":"2236_CR13","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1093\/eurjpc\/zwae240","volume":"32","author":"I Mousavi","year":"2025","unstructured":"Mousavi I, Suffredini J, Virani SS, Ballantyne CM, Michos ED, Misra A, et al. Early-onset atherosclerotic cardiovascular disease. Eur J Prev Cardiol. 2025;32(2):100\u201312. https:\/\/doi.org\/10.1093\/eurjpc\/zwae240.","journal-title":"Eur J Prev Cardiol"},{"issue":"2","key":"2236_CR14","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1007\/s11739-023-03204-z","volume":"18","author":"XJ Dong","year":"2023","unstructured":"Dong XJ, Wang BB, Jiao Y, Hou FF, Zhang XQ. Global, regional and national burden of alcohol cardiomyopathy from global burden of disease study 2019. Internal Emerg Med. 2023;18(2):499\u2013511. https:\/\/doi.org\/10.1007\/s11739-023-03204-z.","journal-title":"Internal Emerg Med"},{"issue":"3","key":"2236_CR15","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1002\/bimj.201500263","volume":"59","author":"A Riebler","year":"2017","unstructured":"Riebler A, Held L. Projecting the future burden of cancer: Bayesian age-period-cohort analysis with integrated nested Laplace approximations. Biom J. 2017;59(3):531\u201349. https:\/\/doi.org\/10.1002\/bimj.201500263.","journal-title":"Biom J"},{"issue":"26","key":"2236_CR16","doi-asserted-by":"publisher","first-page":"4627","DOI":"10.1002\/sim.6248","volume":"33","author":"V J\u00fcrgens","year":"2014","unstructured":"J\u00fcrgens V, Ess S, Cerny T, Vounatsou P. A Bayesian generalized age-period-cohort power model for cancer projections. Stat Med. 2014;33(26):4627\u201336. https:\/\/doi.org\/10.1002\/sim.6248. (Epub 2014 Jul 3 PMID: 24996118).","journal-title":"Stat Med"},{"issue":"11","key":"2236_CR17","first-page":"1","volume":"11","author":"SK Garud","year":"2022","unstructured":"Garud SK, Kakade DV, Alate M. The impact of globalization on dietary patterns and health outcomes. IJFANS Int J Food Nutr Sci. 2022;11(11):1\u201310.","journal-title":"IJFANS Int J Food Nutr Sci"},{"issue":"2","key":"2236_CR18","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1136\/bjsports-2020-103640","volume":"56","author":"PT Katzmarzyk","year":"2022","unstructured":"Katzmarzyk PT, Friedenreich C, Shiroma EJ, Lee I-M. Physical inactivity and non-communicable disease burden in low-income, middle-income and high-income countries. Br J Sports Med. 2022;56(2):101\u20136. https:\/\/doi.org\/10.1136\/bjsports-2020-103640.","journal-title":"Br J Sports Med"},{"issue":"2","key":"2236_CR19","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1016\/j.numecd.2023.07.040","volume":"34","author":"P Nsabimana","year":"2024","unstructured":"Nsabimana P, Sombi\u00e9 OO, Pauwels NS, Boynito WG, Tariku EZ, Vasanthakaalam H, et al. Association between urbanization and metabolic syndrome in low- and middle-income countries: a systematic review and meta-analysis. Nutr Metabol Cardiovasc Dis NMCD. 2024;34(2):235\u201350. https:\/\/doi.org\/10.1016\/j.numecd.2023.07.040.","journal-title":"Nutr Metabol Cardiovasc Dis NMCD"},{"issue":"2","key":"2236_CR20","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1016\/j.ddmec.2004.09.010","volume":"1","author":"NN Mehta","year":"2004","unstructured":"Mehta NN, Reilly MP. Mechanisms of the metabolic syndrome. Drug Discov Today Dis Mech. 2004;1(2):187\u201394. https:\/\/doi.org\/10.1016\/j.ddmec.2004.09.010.","journal-title":"Drug Discov Today Dis Mech"},{"issue":"11","key":"2236_CR21","doi-asserted-by":"publisher","first-page":"1087","DOI":"10.1016\/j.clinthera.2023.09.020","volume":"45","author":"L Nedkoff","year":"2023","unstructured":"Nedkoff L, Briffa T, Zemedikun D, Herrington S, Wright FL. Global trends in atherosclerotic cardiovascular disease. Clin Ther. 2023;45(11):1087\u201391. https:\/\/doi.org\/10.1016\/j.clinthera.2023.09.020.","journal-title":"Clin Ther"},{"issue":"6","key":"2236_CR22","doi-asserted-by":"publisher","DOI":"10.29333\/ejgm\/12278","volume":"19","author":"Z T\u00f3th-Vajna","year":"2022","unstructured":"T\u00f3th-Vajna Z, T\u00f3th-Vajna G, Vajna A, J\u00e1rai Z, S\u00f3tonyi P. One-year follow-up of patients screened for lower extremity arterial disease. Electron J Gen Med. 2022;19(6):em399. https:\/\/doi.org\/10.29333\/ejgm\/12278.","journal-title":"Electron J Gen Med"},{"key":"2236_CR23","doi-asserted-by":"publisher","unstructured":"J Ballena-Caicedo, FE Zuzunaga-Montoya, JA Loayza-Castro, LE Milagros V\u00e1squez-Romero, R Tapia-Limonchi, CIG De Carrillo, VJ Vera-Ponce. Global prevalence of dyslipidemias in the general adult population: a systematic review and meta-analysis. J Health Popul Nutr. 2025;44(1):308. https:\/\/doi.org\/10.1186\/s41043-025-01054-3","DOI":"10.1186\/s41043-025-01054-3"},{"issue":"12","key":"2236_CR24","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1016\/j.clnu.2024.11.016","volume":"43","author":"XD Zhou","year":"2024","unstructured":"Zhou XD, Chen QF, Targher G, Byrne CD, Mantzoros CS, et al. Global burden of disease attributable to metabolic risk factors in adolescents and young adults aged 15\u201339, 1990\u20132021. Clin Nutr (Edinburgh, Scotland). 2024;43(12):391\u2013404. https:\/\/doi.org\/10.1016\/j.clnu.2024.11.016.","journal-title":"Clin Nutr (Edinburgh, Scotland)"},{"issue":"10292","key":"2236_CR25","doi-asserted-by":"publisher","first-page":"2385","DOI":"10.1016\/S0140-6736(21)00684-X","volume":"397","author":"B Vogel","year":"2021","unstructured":"Vogel B, Acevedo M, Appelman Y, Merz CNB, Chieffo A, Figtree GA, et al. The lancet women and cardiovascular disease commission: reducing the global burden by 2030. Lancet (London, England). 2021;397(10292):2385\u2013438. https:\/\/doi.org\/10.1016\/S0140-6736(21)00684-X.","journal-title":"Lancet (London, England)"},{"issue":"1","key":"2236_CR26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1152\/physrev.00021.2015","volume":"97","author":"V Regitz-Zagrosek","year":"2017","unstructured":"Regitz-Zagrosek V, Kararigas G. Mechanistic pathways of sex differences in cardiovascular disease. Physiol Rev. 2017;97(1):1\u201337. https:\/\/doi.org\/10.1152\/physrev.00021.2015.","journal-title":"Physiol Rev"},{"key":"2236_CR27","doi-asserted-by":"publisher","first-page":"117269","DOI":"10.1016\/j.atherosclerosis.2023.117269","volume":"384","author":"A Rajendran","year":"2023","unstructured":"Rajendran A, Minhas AS, Kazzi B, Varma B, Choi E, Thakkar A, et al. Sex-specific differences in cardiovascular risk factors and implications for cardiovascular disease prevention in women. Atherosclerosis. 2023;384:117269. https:\/\/doi.org\/10.1016\/j.atherosclerosis.2023.117269.","journal-title":"Atherosclerosis"},{"issue":"1","key":"2236_CR28","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1186\/s12992-016-0223-3","volume":"12","author":"P Baker","year":"2016","unstructured":"Baker P, Friel S. Food systems transformations, ultra-processed food markets and the nutrition transition in Asia. Global Health. 2016;12(1):80. https:\/\/doi.org\/10.1186\/s12992-016-0223-3.","journal-title":"Global Health"},{"key":"2236_CR29","doi-asserted-by":"publisher","DOI":"10.3402\/gha.v2i0.1985","author":"N Ng","year":"2009","unstructured":"Ng N, Hakimi M, Minh HV, Juvekar S, Razzaque A, Ashraf A, et al. Prevalence of physical inactivity in nine rural INDEPTH Health and Demographic Surveillance Systems in five Asian countries. Glob Health Action. 2009. https:\/\/doi.org\/10.3402\/gha.v2i0.1985.","journal-title":"Glob Health Action"},{"issue":"9766","key":"2236_CR30","doi-asserted-by":"publisher","first-page":"680","DOI":"10.1016\/S0140-6736(10)61506-1","volume":"377","author":"A Dans","year":"2011","unstructured":"Dans A, Ng N, Varghese C, Tai ES, Firestone R, Bonita R. The rise of chronic non-communicable diseases in Southeast Asia: time for action. Lancet (London, England). 2011;377(9766):680\u20139. https:\/\/doi.org\/10.1016\/S0140-6736(10)61506-1.","journal-title":"Lancet (London, England)"},{"key":"2236_CR31","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1186\/s12875-016-0458-3","volume":"17","author":"T van Loenen","year":"2016","unstructured":"van Loenen T, van den Berg MJ, Heinemann S, Baker R, Faber MJ, Westert GP. Trends towards stronger primary care in three western European countries 2006\u20132012. BMC Family Pract. 2016;17:59. https:\/\/doi.org\/10.1186\/s12875-016-0458-3.","journal-title":"BMC Family Pract"},{"issue":"1","key":"2236_CR32","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1093\/eurjpc\/zwab154","volume":"29","author":"FLJ Visseren","year":"2022","unstructured":"Visseren FLJ, Mach F, Smulders YM, Carballo D, Koskinas KC, B\u00e4ck M, et al. 2021 ESC guidelines on cardiovascular disease prevention in clinical practice. Eur J Prev Cardiol. 2022;29(1):5\u2013115. https:\/\/doi.org\/10.1093\/eurjpc\/zwab154.","journal-title":"Eur J Prev Cardiol"},{"key":"2236_CR33","doi-asserted-by":"crossref","unstructured":"L Gonz\u00e1lez Fern\u00e1ndez, E Firima, R Gupta, MP Sematle, M Khomolishoele, M Molulela, M Bane, R Meli, M Tlahali, T Lee, F Chammartin, F Gerber, TI Lejone, I Ayakaka, M Weisser, A Amstutz, ND Labhardt. Prevalence and determinants of cardiovascular risk factors in Lesotho: a population-based survey. Int Health. 2024;16(3):313\u2013324.","DOI":"10.1093\/inthealth\/ihad058"},{"key":"2236_CR34","doi-asserted-by":"publisher","first-page":"1213","DOI":"10.1186\/s12889-015-2554-z","volume":"15","author":"MP Mutowo","year":"2015","unstructured":"Mutowo MP, Owen AJ, Billah B, Lorgelly PK, Gumbie KE, Mangwiro JC, et al. Burden attributable to cardiometabolic diseases in Zimbabwe: a retrospective cross-sectional study of national mortality data. BMC Public Health. 2015;15:1213. https:\/\/doi.org\/10.1186\/s12889-015-2554-z.","journal-title":"BMC Public Health"},{"issue":"1","key":"2236_CR35","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-017-2708-z","volume":"17","author":"MM Gianino","year":"2017","unstructured":"Gianino MM, Lenzi J, Fantini MP, Ricciardi W, Damiani G. Declining amenable mortality: a reflection of health care systems? BMC Health Serv Res. 2017;17(1):735. https:\/\/doi.org\/10.1186\/s12913-017-2708-z.","journal-title":"BMC Health Serv Res"},{"key":"2236_CR36","unstructured":"Habicht T, Reinap M, Kasekamp K, Sikkut R, Aaben L, van Ginneken E. Estonia: health system review health systems in transition. 2018;20(1):1\u2013189"},{"key":"2236_CR37","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcha.2020.100691","volume":"32","author":"A Lion","year":"2021","unstructured":"Lion A, Tchicaya A, Theisen D, Delagardelle C. Association between a national public health campaign for physical activity for patients with chronic diseases and the participation in Phase III cardiac rehabilitation in Luxembourg. Int J Cardiol Heart Vascul. 2021;32:100691. https:\/\/doi.org\/10.1016\/j.ijcha.2020.100691.","journal-title":"Int J Cardiol Heart Vascul"},{"issue":"2","key":"2236_CR38","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.06.020701","volume":"6","author":"R Atun","year":"2016","unstructured":"Atun R, Gurol-Urganci I, Hone T, Pell L, Stokes J, Habicht T, et al. Shifting chronic disease management from hospitals to primary care in Estonian health system: analysis of national panel data. J Global Health. 2016;6(2):020701. https:\/\/doi.org\/10.7189\/jogh.06.020701.","journal-title":"J Global Health"},{"issue":"1A","key":"2236_CR39","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1079\/PHN2001295","volume":"5","author":"BM Popkin","year":"2002","unstructured":"Popkin BM. The shift in stages of the nutrition transition in the developing world differs from past experiences! Public Health Nutr. 2002;5(1A):205\u201314. https:\/\/doi.org\/10.1079\/PHN2001295.","journal-title":"Public Health Nutr"},{"key":"2236_CR40","doi-asserted-by":"crossref","unstructured":"NE Ndubuisi. Noncommunicable Diseases Prevention In Low- and Middle- Income Countries: An Overview of Health in All Policies (HiAP). Inquiry J Med Care Org Prov Financ. 2021;58:46958020927885.","DOI":"10.1177\/0046958020927885"},{"issue":"1","key":"2236_CR41","doi-asserted-by":"publisher","first-page":"e13366","DOI":"10.1111\/obr.13366","volume":"23","author":"BM Popkin","year":"2022","unstructured":"Popkin BM, Ng SW. The nutrition transition to a stage of high obesity and noncommunicable disease prevalence dominated by ultra-processed foods is not inevitable. Obes Rev. 2022;23(1):e13366. https:\/\/doi.org\/10.1111\/obr.13366. (Epub 2021 Oct 10. PMID: 34632692; PMCID: PMC8639733).","journal-title":"Obes Rev"},{"issue":"4","key":"2236_CR42","doi-asserted-by":"publisher","first-page":"3580","DOI":"10.3390\/ijerph20043580","volume":"20","author":"M Heine","year":"2023","unstructured":"Heine M, Hanekom S. Chronic disease in low-resource settings: prevention and management throughout the continuum of care-a call for papers. Int J Environ Res Public Health. 2023;20(4):3580. https:\/\/doi.org\/10.3390\/ijerph20043580. (PMID:36834272;PMCID:PMC9966920).","journal-title":"Int J Environ Res Public Health"},{"key":"2236_CR43","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/978-3-030-74786-2_209-1","volume-title":"Handbook of medical and health sciences in developing countries","author":"YM Al-Worafi","year":"2024","unstructured":"Al-Worafi YM. Healthcare facilities in developing countries: infra-structure. In: Al-Worafi YM, editor. Handbook of medical and health sciences in developing countries. Springer; 2024. p. 1\u201321. https:\/\/doi.org\/10.1007\/978-3-030-74786-2_209-1."},{"issue":"15","key":"2236_CR44","doi-asserted-by":"publisher","first-page":"443","DOI":"10.2147\/CEOR.S413546","volume":"13","author":"A Yenet","year":"2023","unstructured":"Yenet A, Nibret G, Tegegne BA. Challenges to the availability and affordability of essential medicines in African countries: a scoping review. Clinicoecon Outcomes Res. 2023;13(15):443\u201358. https:\/\/doi.org\/10.2147\/CEOR.S413546. (PMID:37332489;PMCID:PMC10276598).","journal-title":"Clinicoecon Outcomes Res"},{"issue":"1","key":"2236_CR45","doi-asserted-by":"publisher","first-page":"7","DOI":"10.5334\/gh.1056","volume":"17","author":"P Geldsetzer","year":"2022","unstructured":"Geldsetzer P, De Neve JW, Mohan V, Prabhakaran D, Roy A, Tandon N, et al. Health system performance for multimorbid cardiometabolic disease in India: a population-based cross-sectional study. Glob Heart. 2022;17(1):7. https:\/\/doi.org\/10.5334\/gh.1056.","journal-title":"Glob Heart"},{"key":"2236_CR46","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/ckae144.298","author":"E Gumas","year":"2024","unstructured":"Gumas E, Lewis C, Horstman C, Gunja M. The state of primary health care systems in ten high-income countries. Eur J Public Health. 2024. https:\/\/doi.org\/10.1093\/eurpub\/ckae144.298. (PMCID: PMC11517009).","journal-title":"Eur J Public Health"},{"key":"2236_CR47","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1016\/j.atherosclerosis.2021.05.016","volume":"328","author":"JE Blais","year":"2021","unstructured":"Blais JE, Wei Y, Yap KKW, Alwafi H, Ma TT, Brauer R, et al. Trends in lipid-modifying agent use in 83 countries. Atherosclerosis. 2021;328:44\u201351. https:\/\/doi.org\/10.1016\/j.atherosclerosis.2021.05.016.","journal-title":"Atherosclerosis"},{"issue":"21","key":"2236_CR48","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11216377","volume":"11","author":"T Liu","year":"2022","unstructured":"Liu T, Zhao D, Qi Y. Global trends in the epidemiology and management of dyslipidemia. J Clin Med. 2022;11(21):6377. https:\/\/doi.org\/10.3390\/jcm11216377.","journal-title":"J Clin Med"},{"key":"2236_CR49","doi-asserted-by":"publisher","unstructured":"NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in diabetes prevalence and treatment from 1990 to 2022: a pooled analysis of 1108 population-representative studies with 141 million participants. Lancet (London, England). 2024;404(10467):2077\u20132093. https:\/\/doi.org\/10.1016\/S0140-6736(24)02317-1","DOI":"10.1016\/S0140-6736(24)02317-1"},{"key":"2236_CR50","doi-asserted-by":"publisher","unstructured":"GBD 2021 Diabetes Collaborators. Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet (London, England). 2023;402(10397):203\u2013234 https:\/\/doi.org\/10.1016\/S0140-6736(23)01301-6","DOI":"10.1016\/S0140-6736(23)01301-6"},{"key":"2236_CR51","doi-asserted-by":"publisher","unstructured":"GBD 2021 Adult BMI Collaborators. Global, regional, and national prevalence of adult overweight and obesity, 1990\u20132021, with forecasts to 2050: a forecasting study for the Global Burden of Disease Study 2021.Lancet (London, England). 2025;405(10481):813\u2013838 https:\/\/doi.org\/10.1016\/S0140-6736(25)00355-1","DOI":"10.1016\/S0140-6736(25)00355-1"},{"issue":"3","key":"2236_CR52","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1016\/j.jacc.2025.04.061","volume":"86","author":"B Chong","year":"2025","unstructured":"Chong B, Jayabaskaran J, Jauhari SM, Chia J, le Roux CW, Mehta A, et al. The Global Syndemic of modifiable cardiovascular risk factors projected from 2025 to 2050. J Am Coll Cardiol. 2025;86(3):165\u201377. https:\/\/doi.org\/10.1016\/j.jacc.2025.04.061.","journal-title":"J Am Coll Cardiol"},{"key":"2236_CR53","unstructured":"United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects 2019: Highlights. New York: United Nations. 2019. ST\/ESA\/SER.A\/423."}],"container-title":["Diabetology & Metabolic Syndrome"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13098-026-02236-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13098-026-02236-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13098-026-02236-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T04:06:22Z","timestamp":1789445182000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s13098-026-02236-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,12]]},"references-count":53,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["2236"],"URL":"https:\/\/doi.org\/10.1186\/s13098-026-02236-7","relation":{},"ISSN":["1758-5996"],"issn-type":[{"value":"1758-5996","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,12]]},"assertion":[{"value":"30 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 September 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Not applicable. This study utilized publicly available, de-identified data from the Global Burden of Disease Study 2021, which is exempt from ethical approval and consent requirements.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable. This manuscript does not contain any individual person\u2019s data in any form.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"204"}}