The global burden of disease attributable to metabolic risks in 204 countries and territories from 1990 to 2019

•Summary: Few studies have assessed the disease burden associated with metabolic risks on a global scale. Our study aimed to survey the burden of disease attributed to metabolic risks (MRs) from 1990 to 2019.•Methods: Using methodological framework of the Global Burden of Disease Study 2019, we reported the global number, age-standardized rate and population attributable fraction of deaths and DALYs related to MRs. Furthermore, we analyzed the global burden caused by MRs in detail by gender, age, region, country, disease, SDI level and time trend.•Conclusion: The burden of disease attributed to metabolic risks has continued to rise in the past 30 years, particularly for men and low-middle SDI regions.•Innovation: This is the first study to comprehensively analyze the global disease burden attributable to MRs, high SBP, high FPG and kidney dysfunction through deaths and DALYs. Besides, our study thoroughly describes the influence of MRs and secondary MR on human health by gender, age, region, country, disease, SDI level and time trend.•Significance: Our study provides information and evidence to develop specific strategies to reduce the burden of metabolic risks. Our study aimed to survey the burden of disease attributed to metabolic risks (MRs) and secondary MR from 1990 to 2019. Using methodological framework of the Global Burden of Disease Study 2019, we reported the global number, age-standardized rate and population attributable fraction of deaths and disability adjusted life years related to MRs and secondary MR. Furthermore, we analyzed the global burden caused by MRs and secondary MR in detail by gender, age, region, country, disease and Socio-demographic Index level. The number (million) of deaths and DALYs caused by MRs was 18.6 and 462.8 in 2019, with an increase of 43.6 % and 75.0 % since 1990. However, the ASR of deaths and DALYs attributed to MRs had a decrease of 23.3 % and 17.0 % since 1990. The burden caused by MRs and secondary MR raised with age, and the burden was the heaviest in low - and middle-income countries, especially in Middle East & North Africa. For diseases, the heaviest burden attributed to MRs was observed in ischemic heart disease, followed by stroke. The burden of disease attributed to MRs has continued to rise in the past 30 years, particularly for men and low-middle SDI regions. Therefore, the government should take corresponding actions to reduce the impact of MRs on population health.