Burden trends and disparities of metabolic risk-attributable peripheral arterial disease in China (1990–2035): a comparative analysis with G20 countries

Objective Peripheral arterial disease (PAD) presents a significant clinical and public health challenge. This study aimed to comprehensively analyze and compare the burden trends and disparities of PAD attributable to metabolic risks in China and G20 countries. Methods Disability-adjusted life years (DALYs), age-standardized rates, population-attributable fractions, and average annual percentage changes (AAPCs) were used as the burden metrics. Decomposition analysis was conducted to quantify the contributions of population growth, aging, and epidemiological changes. The autoregressive integrated moving average (ARIMA) model was applied to project future burden trends. Results In 2023, China and G20 countries had 100 298 and 704 214 DALYs of PAD attributable to metabolic risks, respectively. Compared to 1990, these figures increased by 210.9% and 114.6%, respectively. Population growth and aging were major drivers of the increasing PAD burden. Significant disparities were observed across ages and sexes. Moreover, projections indicate an increasing DALYs in China and G20 countries by 2035. Conclusion Our findings reveal a substantial and growing absolute PAD burden attributable to metabolic risks in China and G20 countries, with China exhibiting a distinct epidemiological pattern.