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目的:分析2011年与2017年南京市≥25岁人群归因于代谢危险因素的缺血性心脏病（IHD）疾病负担变化情况。方法:利用南京市2011年和2017年死因监测、南京市慢性病及其危险因素监测和2016全球疾病负担（GBD）资料，采用GBD的比较风险评估理论，通过对观察到的健康结局与暴露于反事实水平下可能观察到的健康结局进行比较来估计归因负担。采用人群归因分值估算南京市≥25岁人群高血压、高血糖、高总胆固醇、高体质指数4种代谢因素合并导致IHD死亡例数、伤残调整寿命年（DAIY）以及变化情况。采用2000—2025年世界人口的平均人口结构进行标化。结果:2017年，南京市归因于代谢因素合并的IHD死亡数为3 204例，导致期望寿命损失0.90岁。高收缩压是导致南京市IHD死亡和过早死亡损失寿命年（YLL）的首位代谢因素。2017年人群归因于高收缩压、高总胆固醇和高体质指数的IHD世标化死亡率（25.60/10万、19.94/10万、6.83/10万）和世标化YLL率（389.31/10万、335.16/10万、134.60/10万）均显著低于2011年（31.75/10万、26.74/10万、7.45/10万和469.07/10万、463.70/10万、142.66/10万）；归因于高血糖的IHD世标化死亡率和世标化YLL率（11.90/10万和174.61/10万）则显著高于2011年（9.67/10万和150.61/10万）（均n P<0.05）。男性各代谢因素导致IHD世标化YLL率均高于女性（n P<0.05）。n 结论:代谢危险因素尤其高收缩压是导致南京市IHD死亡的重要危险因素。“,”Objective:To analysis and compare the burden of ischemic heart disease (IHD) attributable to metabolic risks in population aged 25 years and older in 2011 and 2017 in Nanjing.Methods:The data were extracted from the Nanjing Chronic Disease and Risk Factor Surveillance (2011 and 2017), the Nanjing Mortality Surveillance (2011 and 2017) and the 2016 Global Burden of Disease Study (GBD). Using GBD′s Comparative Risk Assessment Theory, the attribution burden was estimated by comparing the observed health outcomes with the health outcomes that may be observed when exposed to counterfactual levels. Based on population attributable fractions, the deaths and life expectancy losses of ischemic heart disease due to high systolic blood pressure (SBP), high fasting plasma glucose (FPG), high total cholesterol (TC), high body mass index (BMI) and combination of four risks were estimated in 2011 and 2017. The average population structure of the world′s population from 2000 to 2025 wasusedas the standard population for standardization.Results:The number of IHD deaths attributable to four metabolic risks combination was 3 204, andwhich resulted in a loss of life expectancy of 0.90 years in 2017. High SBP appeared as the major cause of IHD deaths and Years of Life Lost (YLL). In 2017, the world standardized mortality rate (25.60×10n －5, 19.94×10n －5 and 6.83×10n －5) and the standardized YLL rate (389.31×10n －5, 335.16×10n －5, 134.60×10n －5) of the population due to high systolic blood pressure, high total cholesterol and high body mass index were significantly lower than those in 2011 (31.75×10n －5, 26.74×10n －5, 7.45×10n －5 and 469.07×10n －5, 463.70×10n －5, 142.66×10n －5); the world standardized rate and the standardized YLL rate due to high blood sugar (11.90×10n －5 and 174.61×10n －5) were significantly higher than those in 2011 (9.67×10n －5 and 150.61×10n －5) (all n P<0.05). Males appeared to have higher standardized rate of YLL of IHD deaths than females, due to having metabolism risks(n P<0.05).n Conclusion:Metabolic exposures especially high SBP are the important risk factors whichleadto IHD deaths in Nanjing.