Abstract
OBJECTIVE: Metabolic disorders are a growing global concern, especially among women of reproductive age (15-49 years), where their dual impact on maternal and long-term health remains underexplored. This study aims to quantify the burden and trends of diseases attributable to metabolic risk factors in this population using data from the Global Burden of Disease (GBD) 2021 study. METHODS: We extracted GBD 2021 data on six metabolic risk factors (high body mass index [BMI], high fasting plasma glucose, high systolic blood pressure, high low-density lipoprotein [LDL] cholesterol, kidney dysfunction, and low bone mineral density) from 204 countries and territories, and their attributable disability-adjusted life years (DALYs) and deaths from 1990 to 2021. Analyses included age, Socio-demographic Index (SDI), and region-specific trends; frontier and inequality assessments; and decomposition by aging, population growth, and epidemiological shifts. RESULTS: In 2021, diseases attributable to metabolic risks caused 30.3 million DALYs and 383,874 deaths among women aged 15-49, corresponding to age-standardized rates (ASRs) of 1556.2 and 19.7 per 100,000 population, respectively. From 1990 to 2021, DALYs exhibited a modest but persistent increase (estimated annual percentage change [EAPC]: + 0.28%), while death rates declined slightly (EAPC: -0.25%), suggesting an evolving but inadequately controlled risk landscape. The diseases most associated with metabolic risks included cardiovascular diseases, diabetes, and kidney disorders. High BMI and high fasting glucose were the leading contributors. The greatest disease impact was observed in South Asia and Sub-Saharan Africa, especially in low- and middle-SDI countries. Frontier and inequality analyses revealed marked inefficiencies and persistent disparities, while decomposition analyses showed that population growth (75.0%) and aging (32.6%) were the main drivers of DALY increases. CONCLUSIONS: These findings underscore the urgency of integrating routine metabolic screening and management into reproductive health services, particularly in low- and middle-income settings. Tailored, sex- and age-specific interventions are critical to mitigating long-term metabolic morbidity and enhancing maternal and intergenerational health outcomes.