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Ding X, Li X, Ye Y, Jiang J, Lu M, Shao L. Epidemiological patterns of chronic kidney disease attributed to type 2 diabetes from 1990-2019. Front Endocrinol (Lausanne) 2024; 15:1383777. [PMID: 38694939 PMCID: PMC11061475 DOI: 10.3389/fendo.2024.1383777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 03/28/2024] [Indexed: 05/04/2024] Open
Abstract
Background This study investigates the burden of chronic kidney disease attributed to type 2 diabetes (CKD-T2D) across different geographical locations and time periods from 1990 to 2019. A total of 204 countries and regions are included in the analysis, with consideration given to their socio-demographic indexes (SDI). The aim is to examine both spatial and temporal variations in CKD-T2D burden. Methods This research utilized data from the 2019 Global Burden of Diseases Study to evaluate the age-standardized incidence rates (ASIR), Disability-Adjusted Life Years (DALYs), and Estimated Annual Percentage Change (EAPC) associated with CKD-T2D. Results Since 1990, there has been a noticeable increase of CKD age-standardized rates due to T2D, with an EAPCs of 0.65 (95% confidence interval [CI]: 0.63 to 0.66) for ASIR and an EAPC of 0.92 (95% CI: 0.8 to 1.05) for age-standardized DALYs rate. Among these regions, Andean Latin America showed a significant increase in CKD-T2D incidence [EAPC: 2.23 (95% CI: 2.11 to 2.34) and North America showed a significant increase in CKD-T2D DALYs [EAPC: 2.73 (95% CI: 2.39 to 3.07)]. The burden was higher in male and increased across all age groups, peaking at 60-79 years. Furthermore, there was a clear correlation between SDI and age-standardized rates, with regions categorized as middle SDI and High SDI experiencing a significant rise in burden. Conclusion The global burden of CKD-T2D has significantly risen since 1990, especially among males aged 60-79 years and in regions with middle SDI. It is imperative to implement strategic interventions to effectively address this escalating health challenge.
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Affiliation(s)
- Xiaoxiao Ding
- Department of Clinical Pharmacy, Beilun District People’s Hospital, Ningbo, China
| | - Xiang Li
- Department of Clinical Laboratory, The Second Hospital of Anhui University of Traditional Chinese Medicine, Hefei, Anhui, China
| | - Yun Ye
- Department of Clinical Pharmacy, Beilun District People’s Hospital, Ningbo, China
| | - Jing Jiang
- Department of Clinical Pharmacy, Beilun District People’s Hospital, Ningbo, China
| | - Mengsang Lu
- Department of Clinical Pharmacy, Beilun District People’s Hospital, Ningbo, China
| | - Lv Shao
- Department of Clinical Pharmacy, Yuyao People’s Hospital, Ningbo, Zhejiang, China
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McClain AC, Cory H, Mattei J. Childhood food insufficiency and adulthood cardiometabolic health conditions among a population-based sample of older adults in Puerto Rico. SSM Popul Health 2022; 17:101066. [PMID: 35313605 PMCID: PMC8933531 DOI: 10.1016/j.ssmph.2022.101066] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 03/02/2022] [Accepted: 03/03/2022] [Indexed: 02/08/2023] Open
Abstract
Childhood food insufficiency negatively influences physical and psychosocial health in children, but less is known about long-term health implications. This study aimed to elucidate the association of childhood food insufficiency with older adulthood cardiometabolic conditions. We conducted cross-sectional analyses using data from the Puerto Rican Elderly: Health Conditions Project (n = 2712), a population-based sample of elderly adults (>60 y) living in Puerto Rico. Childhood food insufficiency was ascertained with a proxy question on childhood economic hardships that prevented eating. Participants self-reported hypertension, diabetes, and cardiovascular disease (CVD; including heart attack, heart disease, or stroke). Obesity was assessed as body mass index using measured height and weight. Multivariable-adjusted, sex-stratified, complex survey logistic regression models tested associations of childhood food insufficiency with each condition, number of cardiometabolic conditions (0-6), and age of onset. Nearly a third (29.4%) of the sample reported childhood food insufficiency; 68.7% reported hypertension, 29.6% reported type 2 diabetes, 34.2% reported CVD, 29.9% were categorized with obesity, and 55.4% had two or more cardiometabolic conditions. In men, but not women, childhood food insufficiency was associated with higher odds of hypertension (Odds Ratio (OR) (95% Confidence Intervals (CI)): 1.7 (1.1, 2.7)), CVD (1.7 (1.1, 2.6)), and having two (1.9 (1.0, 3.4) or three to four (2.3 (1.2, 4.4)) cardiometabolic conditions. Childhood food insufficiency was marginally associated with higher odds of early age of onset of CVD among men (2.2 (1.0, 4.7)). Childhood food insufficiency may increase the likelihood of having cardiometabolic conditions in Puerto Rican older men. Programs that enable access to sufficient, healthy food in childhood may help prevent eventual cardiovascular-related diseases.
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Affiliation(s)
- Amanda C. McClain
- School of Exercise and Nutritional Sciences, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182, USA,Corresponding author.
| | - Hannah Cory
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
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3
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Magny-Normilus C, Whittemore R, Wexler DJ, Schnipper JL, Nunez-Smith M, Fu MR. Barriers to Type 2 Diabetes Management Among Older Adult Haitian Immigrants. Sci Diabetes Self Manag Care 2021; 47:382-390. [PMID: 34610761 PMCID: PMC8939501 DOI: 10.1177/26350106211040435] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE The purpose of this study was to describe the experiences of older adult Haitian immigrants in managing type 2 diabetes mellitus (T2DM). METHODS A descriptive qualitative approach using semistructured interviews was conducted with 20 older adult Haitian immigrants with T2DM. Interviews were transcribed verbatim and categorized using NVivo. An iterative descriptive data analysis method was used to examine the data, compare codes, challenge interpretations, and develop themes inductively. RESULTS Older adult Haitian immigrants reported that T2DM affected every aspect of their lives. Financial hardship and social isolation were described as the major barriers to T2DM management, which forced them to choose between basic needs and health care, and at times, they had to forgo medications or avoid seeking medical care. They recognized that creating and maintaining good community support was the key to self-management of T2DM. CONCLUSIONS Financial hardship and social isolation have a tremendous impact on the ability of older Haitian immigrants to manage T2DM effectively. It is challenging to modify these barriers through individual efforts, and clinical, research, and public efforts may be necessary to address these concerns.
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Affiliation(s)
| | | | - Deborah J Wexler
- Massachusetts General Hospital Diabetes Unit, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Jefferey L Schnipper
- Harvard Medical School, Boston, Massachusetts
- Brigham and Women's Hospital, Boston, Massachusetts
| | | | - Mei R Fu
- Boston College William F. Connell School of Nursing, Chestnut Hill, Massachusetts
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4
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Life-course pathways from childhood socioeconomic status to type 2 diabetes in mid-late Chinese adulthood. Sci Rep 2021; 11:13051. [PMID: 34158532 PMCID: PMC8219676 DOI: 10.1038/s41598-021-91768-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 05/19/2021] [Indexed: 11/17/2022] Open
Abstract
The relationship between childhood socioeconomic status (SES) and type 2 diabetes (T2D) remains inconclusive, and the pathways and mechanisms driving this relationship have yet to be clarified. This study aimed to examine the pathways linking childhood SES to T2D prevalence in mid-late adulthood in a low- and middle-income country. The incidence of T2D diagnosed in mid-late Chinese adulthood was assessed using self-reports from the Health and Retirement Longitudinal Study (CHARLS). Childhood SES was assessed by the education, occupation, survivorship of the parents and the financial situation of the family, whereas adulthood SES was assessed by education and wage. This study performed structural equation modeling to clarify the direct and indirect pathways from childhood SES to T2D via childhood health, childhood food shortage, adulthood SES and physical activity. A total of 15,132 participants were included, and the prevalence of T2D was 5.24%. This study found that childhood SES was directly associated with T2D in mid-late adulthood, the probability of developing T2D increased by 9.20% of the standard deviation for each decrease in standard deviation in childhood SES. Childhood SES was indirectly associated with T2D via adulthood SES, physical activity, childhood health and food shortage. Adulthood SES and physical activity mainly mediated the indirect pathway from childhood SES and T2D. This study showed direct and indirect pathways from disadvantaged childhood SES to increased risk of T2D in mid-late Chinese adulthood. Childhood SES, adulthood SES, physical activity, childhood health and food shortage were identified as life-course interventional targets that should be considered in the development of effective strategies to reduce the burden of T2D and SES-related health inequities in childhood.
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Deng Y, Li N, Wu Y, Wang M, Yang S, Zheng Y, Deng X, Xiang D, Zhu Y, Xu P, Zhai Z, Zhang D, Dai Z, Gao J. Global, Regional, and National Burden of Diabetes-Related Chronic Kidney Disease From 1990 to 2019. Front Endocrinol (Lausanne) 2021; 12:672350. [PMID: 34276558 PMCID: PMC8281340 DOI: 10.3389/fendo.2021.672350] [Citation(s) in RCA: 91] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 06/17/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is a public health problem largely caused by diabetes. The epidemiology of diabetes mellitus-related CKD (CKD-DM) could provide specific support to lessen global, regional, and national CKD burden. METHODS Data were derived from the GBD 2019 study, including four measures and age-standardized rates (ASRs). Estimated annual percentage changes and 95% CIs were calculated to evaluate the variation trend of ASRs. RESULTS Diabetes caused the majority of new cases and patients with CKD in all regions. All ASRs for type 2 diabetes-related CKD increased over 30 years. Asia and Middle socio-demographic index (SDI) quintile always carried the heaviest burden of CKD-DM. Diabetes type 2 became the second leading cause of CKD and CKD-related death and the third leading cause of CKD-related DALYs in 2019. Type 2 diabetes-related CKD accounted for most of the CKD-DM disease burden. There were 2.62 million incident cases, 134.58 million patients, 405.99 thousand deaths, and 13.09 million disability-adjusted life-years (DALYs) of CKD-DM worldwide in 2019. Age-standardized incidence (ASIR) and prevalence rate (ASPR) of type 1 diabetes-related CKD increased, whereas age-standardized death rate (ASDR) and DALY rate decreased for females and increased for males. In high SDI quintile, ASIR and ASPR of type 1 diabetes-related CKD remained the highest, with the slowest increase, whereas the ASDR and age-standardized DALY rate remained the lowest there. In high SDI quintile, ASIR of type 2 diabetes-related CKD was the highest, with the lowest increasing rate. In addition, type 2 diabetes-related CKD occurred most in people aged 80-plus years worldwide. The main age of type 2 diabetes-related CKD patients was 55-64 years in Asia and Africa. The prevalence, mortality, and DALY rate of type 2 diabetes-related CKD increased with age. As for incidence, there was a peak at 80 years, and after age of 80, the incidence declined. CKD-DM-related anemia was mainly in mild to moderate grade. CONCLUSIONS Increasing burden of CKD-DM varied among regions and countries. Prevention and treatment measures should be strengthened according to CKD-DM epidemiology, especially in middle SDI quintile and Asia.
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Affiliation(s)
- Yujiao Deng
- Department of Nephrology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Department of Oncology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Na Li
- Department of Oncology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Ying Wu
- Department of Oncology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Meng Wang
- Department of Oncology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Si Yang
- Department of Oncology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Yi Zheng
- Department of Oncology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Xinyue Deng
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Dong Xiang
- Celilo Cancer Center, Oregon Health Science Center Affiliated Mid-Columbia Medical Center, The Dalles, OR, United States
| | - Yuyao Zhu
- Department of Oncology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Peng Xu
- Department of Oncology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Zhen Zhai
- Department of Oncology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Dai Zhang
- Department of Oncology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Zhijun Dai
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jie Gao
- Department of Nephrology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- *Correspondence: Jie Gao,
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6
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Lago-Peñas S, Rivera B, Cantarero D, Casal B, Pascual M, Blázquez-Fernández C, Reyes F. The impact of socioeconomic position on non-communicable diseases: what do we know about it? Perspect Public Health 2020; 141:158-176. [PMID: 32449467 DOI: 10.1177/1757913920914952] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
AIMS Non-communicable diseases (NCDs) have become a primary health concern for most countries around the world. The aim of this research is to analyze the relevant evidence that determines the effect of socioeconomic position (SEP) on the incidence and prevalence of NCDs. METHODS A systematic literature search was performed using PubMed, Cochrane Library, and Web of Science to identify evidence regarding the relationship between income inequalities and NCDs, between 2005 and 2015. The final selection of papers was based on applied studies focusing on Organisation for Economic Co-operation and Development (OECD) countries and articles referring to three main groups of chronic diseases: cardiovascular and heart diseases, cancer, and diabetes. RESULTS A final set of 47 selected studies were fully taken into account in this review. Despite significant heterogeneity in exposure and outcomes measures, overall the evidence suggests that having low SEP increases the risk of developing cardiovascular diseases (CVDs), lung and breast cancer, and type 2 diabetes. SEP is also associated with multiple NCD risk factors such as smoking and physical inactivity. CONCLUSION Low socioeconomic status appears to have a significant consistent impact on mortality and morbidity caused by NCDs in OECD countries. Social and economic disadvantages are associated with health inequalities in terms of access to care, increased incident risk of NCDs, and early death. These findings point to the need for public health strategies and research to address socioeconomic status disparity among individuals.
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Affiliation(s)
- S Lago-Peñas
- GEN Governance and Economics Network-Spain, Faculty of Business Sciences and Tourism, University of Vigo, Ourense, Spain.,Department of Applied Economics, Faculty of Business Sciences and Tourism, University of Vigo, Ourense, Spain
| | - B Rivera
- Department of Economics, Faculty of Economics and Business, University of A Coruña, Campus de Elviña, A Coruña 15071, Spain.,GEN Governance and Economics Network-Spain, Faculty of Business Sciences and Tourism, University of Vigo, Ourense, Spain
| | - D Cantarero
- GEN Governance and Economics Network-Spain, Faculty of Business Sciences and Tourism, University of Vigo, Ourense, Spain.,Department of Economics, Faculty of Business and Economics, University of Cantabria, Santander, Spain
| | - B Casal
- GEN Governance and Economics Network-Spain, Faculty of Business Sciences and Tourism, University of Vigo, Ourense, Spain.,Department of Economics, Faculty of Economics and Business, University of A Coruña, A Coruña, Spain
| | - M Pascual
- GEN Governance and Economics Network-Spain, Faculty of Business Sciences and Tourism, University of Vigo, Ourense, Spain.,Department of Economics, Faculty of Business and Economics, University of Cantabria, Santander, Spain
| | - C Blázquez-Fernández
- GEN Governance and Economics Network-Spain, Faculty of Business Sciences and Tourism, University of Vigo, Ourense, Spain.,Department of Economics, Faculty of Business and Economics, University of Cantabria, Santander, Spain
| | - F Reyes
- GEN Governance and Economics Network-Spain, Faculty of Business Sciences and Tourism, University of Vigo, Ourense, Spain.,Department of Applied Economics, Faculty of Business Sciences and Tourism, University of Vigo, Ourense, Spain
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7
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Clements JM, West BT, Yaker Z, Lauinger B, McCullers D, Haubert J, Tahboub MA, Everett GJ. Disparities in diabetes-related multiple chronic conditions and mortality: The influence of race. Diabetes Res Clin Pract 2020; 159:107984. [PMID: 31846667 PMCID: PMC6959124 DOI: 10.1016/j.diabres.2019.107984] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 11/21/2019] [Accepted: 12/13/2019] [Indexed: 01/03/2023]
Abstract
AIMS The aims of this study are to confirm disparities in diabetes mortality rates based on race, determine if race predicts combinations of diabetes and multiple chronic conditions (MCC) that are leading causes of death (LCD), and determine if combinations of diabetes plus MCC mediate the relationship between race and mortality. METHODS We performed a retrospective cohort study of 443,932 Medicare beneficiaries in the State of Michigan with type 2 diabetes mellitus and MCC. We applied Cox proportional hazards regression to determine predictors of mortality. We applied multinomial logistic regression to determine predictors of MCC combinations. RESULTS We found that race influences mortality in Medicare beneficiaries with Type 2 diabetes mellitus and MCC. Prior to adjusting for MCC combinations, we observed that Blacks and American Indian/Alaska Natives have increased risk of mortality compared to Whites, while there is no difference in mortality between Hispanics and Whites. Regarding MCC combinations, Black/African American beneficiaries experience increased odds for most MCC combinations while Asian/Pacific Islanders and Hispanics experience lower odds for MCC combinations, compared to Whites. When adjusting for MCC, mortality disparities observed between Whites, Black/African Americans, and American Indians/Alaska Natives persist. CONCLUSIONS Compared to Whites, Black/African Americans in our cohort had increased odds of most MCC combinations, and an increased risk of mortality that persisted even after adjusting for MCC combinations.
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Affiliation(s)
- John M Clements
- Central Michigan University, College of Medicine, 1280 East Campus Dr., Mount Pleasant, MI 48859, United States.
| | - Brady T West
- Survey Research Center, Institute for Social Research, University of Michigan-Ann Arbor, United States
| | - Zachary Yaker
- Central Michigan University, College of Medicine, 1280 East Campus Dr., Mount Pleasant, MI 48859, United States
| | - Breanna Lauinger
- Central Michigan University, College of Medicine, 1280 East Campus Dr., Mount Pleasant, MI 48859, United States
| | - Deven McCullers
- Central Michigan University, College of Medicine, 1280 East Campus Dr., Mount Pleasant, MI 48859, United States
| | - James Haubert
- Central Michigan University, College of Medicine, 1280 East Campus Dr., Mount Pleasant, MI 48859, United States
| | - Mohammad Ali Tahboub
- Central Michigan University, College of Medicine, 1280 East Campus Dr., Mount Pleasant, MI 48859, United States
| | - Gregory J Everett
- Central Michigan University, College of Medicine, 1280 East Campus Dr., Mount Pleasant, MI 48859, United States
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Xiang M, Konishi M, Hu H, Nishimaki M, Kim HK, Tabata H, Shimizu H, Fang Y, Li X, Xu J, Zhang Z, Liang H, Arao T, Sakamoto S. When and How Should Chinese Pregnant Women Exercise? A Longitudinal Study in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010180. [PMID: 31881803 PMCID: PMC6981545 DOI: 10.3390/ijerph17010180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 12/21/2019] [Accepted: 12/22/2019] [Indexed: 11/26/2022]
Abstract
This study aimed to examine when and how physical activity (PA) influences gestational weight gain (GWG) and infant birthweight (BW) by considering the PA’s total volume, timing, intensity, and type, controlling for the influence of energy intake. A total of 1272 participants in different stages of pregnancy were recruited from hospital. The associations between PA and GWG or BW in the latter half of pregnancy were significant. Women with the highest PA volume in the third trimester had significantly lower risks of inadequate and excessive GWG by 69% (OR = 0.31, 95%CI: 0.10–0.91) and 67% (OR = 0.33, 95% CI: 0.12–0.91), respectively, compared to women in the lowest quartile. Women who achieved the recommended moderate intensity of PA during their second and third trimesters, independent of total volume of PA, had infants with significantly lower BWs compared to those who did not (β = −0.15, SE = 66.33, p = 0.04; β = −0.20, SE = 64.54, p = 0.01, respectively). Therefore, the effects of total volume and intensity of PA on GWG and BW were different. Interventions to prevent inappropriate GWG and macrosomia may need to set different priorities and timing regarding total volume or intensity of PA.
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Affiliation(s)
- Mi Xiang
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China; (M.X.); (Y.F.); (X.L.); (J.X.)
| | - Masayuki Konishi
- Faculty of Health Science, Tokoha University, Shizuoka 431-2102, Japan;
| | - Huanhuan Hu
- National Center for Global Health and Medicine, Tokyo 162-8655, Japan;
| | - Mio Nishimaki
- Japan Institute of Sports Sciences, Tokyo 115-0056, Japan;
| | - Hyeon-Ki Kim
- School of Advanced Science and Engineering, Waseda University, Tokyo 162-8480, Japan;
| | - Hiroki Tabata
- Faculty of Sport Sciences, Waseda University, Saitama 359-1192, Japan; (H.T.); (H.S.); (S.S.)
| | - Hisao Shimizu
- Faculty of Sport Sciences, Waseda University, Saitama 359-1192, Japan; (H.T.); (H.S.); (S.S.)
| | - Yue Fang
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China; (M.X.); (Y.F.); (X.L.); (J.X.)
| | - Xueyuan Li
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China; (M.X.); (Y.F.); (X.L.); (J.X.)
| | - Jiawei Xu
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China; (M.X.); (Y.F.); (X.L.); (J.X.)
| | - Zhiruo Zhang
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China; (M.X.); (Y.F.); (X.L.); (J.X.)
- Correspondence: (Z.Z.); (H.L.); Tel./Fax: +86-021-63846590 (Z.Z.)
| | - Huigang Liang
- Department of Business Information & Technology, Fogelman College of Business & Economics, University of Memphis, Memphis, TN 38152, USA
- Correspondence: (Z.Z.); (H.L.); Tel./Fax: +86-021-63846590 (Z.Z.)
| | - Takashi Arao
- Meiji Yasuda Life Foundation of Health and Welfare, Physical Fitness Research Institute, Tokyo 192-0001, Japan;
| | - Shizuo Sakamoto
- Faculty of Sport Sciences, Waseda University, Saitama 359-1192, Japan; (H.T.); (H.S.); (S.S.)
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9
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Xiang M, Zhang J, Liang H, Zhang Z, Konishi M, Hu H, Nishimaki M, Kim HK, Tabata H, Shimizu H, Arao T, Sakamoto S. Physical activity and dietary intake among Chinese pregnant women: an observational study. BMC Pregnancy Childbirth 2019; 19:295. [PMID: 31412799 PMCID: PMC6693271 DOI: 10.1186/s12884-019-2452-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 08/07/2019] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Physical activity (PA) and dietary intake are important modifiable factors associated with health outcomes. However, Chinese pregnant women's PA and dietary intake are only vaguely understood. The aim of this study was to reveal the characteristics of PA and dietary intake of Chinese women in different trimesters as well as the associations between PA and dietary intake. METHODS This is a cross-sectional observational study. PA, dietary intake, and demographics of 1077 Chinese pregnant women were measured. The Chi-square test, Kruskal-Wallis test, multiple logistic regression, and multiple linear regression were used for data analysis. RESULTS About 57.1% of the participants met the international guideline for PA. Household activity and occupational activity contributed the most to the total PA, while sports/exercise contributed little. The mean energy intake of the participants was 2008 ± 748.0 kcal. Most participants had normal energy intake, but they obtained excessive energy from fat (mean = 41.7 ± 8.7%). PA was not found to be significantly associated with dietary intake. Further, the participants who were unemployed during pregnancy (OR = 0.72, 95% CI: 0.55-0.95; p < 0.05) or had no exercise habits before pregnancy (OR = 0.62, 95% CI: 0.47-0.80; p < 0.01) were less likely to meet the PA guideline. The participants in the third trimester (OR = 1.43, 95% CI: 1.03-1.99; p < 0.05) were more likely to meet the PA guideline compared to those in the first trimester. The older participants (> 30 years) showed higher dietary intake than the younger (< 25 years) participants (p < 0.01). CONCLUSIONS The total PA of Chinese women during pregnancy mostly consists of household and occupational activities, but little sports/exercise. Starting exercise before pregnancy may help women achieve adequate PA during pregnancy. Moreover, these women consumed an excessive amount of fat and their diet intake varies by age.
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Affiliation(s)
- Mi Xiang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Jing Zhang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Huigang Liang
- Department of Business Information & Technology, Fogelman College of Business & Economics, University of Memphis, Memphis, USA
| | - Zhiruo Zhang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | | | - Huanhuan Hu
- National Center for Global Health and Medicine, Tokyo, Japan
| | - Mio Nishimaki
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - Hyeon-Ki Kim
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
- Research Fellow of the Japan Society for the Promotion of Science, Tokyo, Japan
| | - Hiroki Tabata
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
- Research Fellow of the Japan Society for the Promotion of Science, Tokyo, Japan
| | - Hisao Shimizu
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - Takashi Arao
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Shizuo Sakamoto
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
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10
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Khalequzzaman M, Chiang C, Choudhury SR, Yatsuya H, Al-Mamun MA, Al-Shoaibi AAA, Hirakawa Y, Hoque BA, Islam SS, Matsuyama A, Iso H, Aoyama A. Prevalence of non-communicable disease risk factors among poor shantytown residents in Dhaka, Bangladesh: a community-based cross-sectional survey. BMJ Open 2017; 7:e014710. [PMID: 29138190 PMCID: PMC5695399 DOI: 10.1136/bmjopen-2016-014710] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES This study aims to describe the prevalence of non-communicable disease (NCD) risk factors among the urban poor in Bangladesh. DESIGN We conducted a community-based cross-sectional epidemiological study. SETTING The study was conducted in a shantytown in the city of Dhaka. There were 8604 households with 34 170 residents in the community. Those households were categorised into two wealth strata based on the housing structure. PARTICIPANTS The study targeted residents aged 18-64 years. A total of 2986 eligible households with one eligible individual were selected by simple random sampling stratified by household wealth status. A total of 2551 residents completed the questionnaire survey, and 2009 participated in the subsequent physical and biochemical measurements. OUTCOME MEASURES A modified WHO survey instrument was used for assessing behavioural risk factors and physical and biochemical measurements, including glycated haemoglobin (HbA1c). The prevalence of NCD risk factors, such as tobacco use, fruit and vegetable intake, overweight/obesity, hypertension, diabetes (HbA1c ≥6.5%) and dyslipidaemia, was described according to household wealth status and gender differences. RESULTS The prevalence of current tobacco use was 60.4% in men and 23.5% in women. Most of them (90.8%) consumed more than 1 serving of fruits and vegetables per day; however, only 2.1% consumed more than 5 servings. Overweight/obesity was more common in women (39.2%) than in men (18.9%), while underweight was more common in men (21.0%) than in women (7.1%). The prevalence of hypertension was 18.6% in men and 20.7% in women. The prevalence of diabetes was 15.6% in men and 22.5% in women, which was much higher than the estimated national prevalence (7%). The prevalence of raised total cholesterol (≥190 mg/dL) was 25.7% in men and 34.0% in women. CONCLUSION The study identified that tobacco use, both overweight and underweight, diabetes, hypertension and dyslipidaemia were prevalent among the urban poor in Bangladesh.
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Affiliation(s)
- Md Khalequzzaman
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Chifa Chiang
- Department of Public Health and Health Systems, Nagoya University School of Medicine, Nagoya, Japan
| | - Sohel Reza Choudhury
- Department of Epidemiology and Research, National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh
| | - Hiroshi Yatsuya
- Department of Public Health and Health Systems, Nagoya University School of Medicine, Nagoya, Japan
- Department of Public Health, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Mohammad Abdullah Al-Mamun
- Department of Epidemiology and Research, National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh
| | | | - Yoshihisa Hirakawa
- Department of Public Health and Health Systems, Nagoya University School of Medicine, Nagoya, Japan
| | | | - Syed Shariful Islam
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Akiko Matsuyama
- Department of Public Health and Health Systems, Nagoya University School of Medicine, Nagoya, Japan
- Nagasaki University School of Tropical Medicine and Global Health, Nagasaki, Japan
| | - Hiroyasu Iso
- Public Health Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Atsuko Aoyama
- Department of Public Health and Health Systems, Nagoya University School of Medicine, Nagoya, Japan
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Derks IPM, Koster A, Schram MT, Stehouwer CDA, Dagnelie PC, Groffen DAI, Bosma H. The association of early life socioeconomic conditions with prediabetes and type 2 diabetes: results from the Maastricht study. Int J Equity Health 2017; 16:61. [PMID: 28381297 PMCID: PMC5382485 DOI: 10.1186/s12939-017-0553-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 03/20/2017] [Indexed: 02/06/2023] Open
Abstract
Background Using cross-sectional data from The Maastricht Study, we examined the association of socioeconomic conditions in early life with prediabetes and T2DM in adulthood. We also examined potential mediating pathways via both adulthood socioeconomic conditions and adult BMI and health behaviours. Methods Of the 3263 participants (aged 40–75 years), 493 had prediabetes and 906 were diagnosed with T2DM. By using logistic regression analyses, the associations and possible mediating pathways were examined. Results Participants with low early life socioeconomic conditions had a 1.56 times higher odds of prediabetes (95% confidence interval (CI) = 1.21-2.02) and a 1.61 times higher odds of T2DM (95% CI = 1.31-1.99). The relation between low early life socioeconomic conditions and prediabetes was independent of current socioeconomic conditions (OR = 1.38, 95% CI = 1.05-1.80), whereas the relation with T2DM was not independent of current socioeconomic conditions (OR = 1.10, 95% CI = 0.87-1.37). BMI party mediated the association between early life socioeconomic conditions and prediabetes. Conclusions Socioeconomic inequalities starting in early life were associated with diabetes-related outcomes in adulthood and suggest the usefulness of early life interventions aimed at tackling these inequalities. Electronic supplementary material The online version of this article (doi:10.1186/s12939-017-0553-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ivonne P M Derks
- Department of Social Medicine, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.,CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.,The Generation R Study Group, Erasmus Medical Centre, Rotterdam, The Netherlands.,Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands
| | - Annemarie Koster
- Department of Social Medicine, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.,CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Miranda T Schram
- Department of Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands.,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Coen D A Stehouwer
- Department of Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands.,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Pieter C Dagnelie
- CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands.,Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
| | - Danielle A I Groffen
- Department of Social Medicine, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.,CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Hans Bosma
- Department of Social Medicine, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands. .,CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
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Camelo LV, Giatti L, Duncan BB, Chor D, Griep RH, Schmidt MI, Barreto SM. Gender differences in cumulative life-course socioeconomic position and social mobility in relation to new onset diabetes in adults—the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Ann Epidemiol 2016; 26:858-864.e1. [DOI: 10.1016/j.annepidem.2016.09.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 08/19/2016] [Accepted: 09/28/2016] [Indexed: 10/20/2022]
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Abstract
OBJECTIVES Many patients with diabetes and their care providers are unaware of the presence of the disease. Dysglycemia encompassing hyperglycemia, hypoglycemia, and glucose variability is common in the ICU in patients with and without diabetes. The purpose of this study was to determine the impact of unknown diabetes on glycemic control in the ICU. DESIGN Prospective observational study. SETTING Nine ICUs in an academic, tertiary hospital and a hybrid academic/community hospital. PATIENTS Hemoglobin A1c levels were ordered at all ICU admissions from March 1, 2011 to September 30, 2013. Electronic medical records were examined for a history of antihyperglycemic medications or International Classification of Diseases, 9th Edition diagnosis of diabetes. Patients were categorized as having unknown diabetes (hemoglobin A1c > 6.5%, without history of diabetes), no diabetes (hemoglobin A1c < 6.5%, without history of diabetes), controlled known diabetes (hemoglobin A1c < 6.5%, with documented history of diabetes), and uncontrolled known diabetes (hemoglobin A1c > 6.5%, with documented history of diabetes). INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS A total of 15,737 patients had an hemoglobin A1c and medical record evaluable for the history of diabetes, and 5,635 patients had diabetes diagnosed by either medical history or an elevated hemoglobin A1c in the ICU. Of these, 1,460 patients had unknown diabetes, accounting for 26.0% of all patients with diabetes. This represented 41.0% of patients with an hemoglobin A1c > 6.5% and 9.3% of all ICU patients. Compared with patients without diabetes, patients with unknown diabetes had a higher likelihood of requiring an insulin infusion (44.3% vs 29.3%; p < 0.0001), a higher average blood glucose (172 vs 126 mg/dL; p < 0.0001), an increased percentage of hyperglycemia (19.7% vs 7.0%; blood glucose > 180 mg/dL; p < 0.0001) and hypoglycemia (8.9% vs 2.5%; blood glucose < 70 mg/dL; p < 0.0001), higher glycemic variability (55.6 vs 28.8, average of patient SD of glucose; p < 0.0001), and increased mortality (13.8% vs 11.4%; p = 0.01). CONCLUSIONS Patients with unknown diabetes represent a significant percentage of ICU admissions. Measurement of hemoglobin A1c at admission can prospectively identify a population that are not known to have diabetes but have significant challenges in glycemic control in the ICU.
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Racial-ethnic disparities in the association between risk factors and diabetes: The Northern Manhattan Study. Prev Med 2016; 83:31-6. [PMID: 26658025 PMCID: PMC4724287 DOI: 10.1016/j.ypmed.2015.11.023] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 11/02/2015] [Accepted: 11/27/2015] [Indexed: 12/21/2022]
Abstract
PURPOSE To identify risk factors (RF) for diabetes within a multiethnic cohort and to examine whether race-ethnicity modified their effects. METHODS Participants in the Northern Manhattan Study without diabetes at baseline were studied from 1993 to 2014 (n=2430). Weibull regression models with interval censoring data were fit to calculate hazard ratios and 95% confidence intervals for incident diabetes. We tested for interactions between RF and race-ethnicity. RESULTS During a mean follow-up period of 11years, there were 449 diagnoses of diabetes. Being non-Hispanic black (HR 1.69 95% CI 1.11-2.59) or Hispanic (HR 2.25 95% CI 1.48-3.40) versus non-Hispanic white, and body mass index (BMI; HR 1.34 per SD 95% CI 1.21-1.49) were associated with greater risk of diabetes; high-density lipoprotein cholesterol (HR 0.75 95% CI 0.66-0.86) was protective. There were interactions by race-ethnicity. In stratified models, the effects of BMI, current smoking, and C-reactive protein (CRP) on risk of diabetes differed by race-ethnicity (p for interaction <0.05). The effects were greater among non-Hispanic whites than non-Hispanic blacks and Hispanics. CONCLUSIONS Although Hispanics and non-Hispanic blacks had a greater risk of diabetes than whites, there were variations by race-ethnicity in the association of BMI, smoking, and CRP with risk of diabetes. Unique approaches should be considered to reduce diabetes as traditional RF may not be as influential in minority populations.
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Heidemann DL, Joseph NA, Kuchipudi A, Perkins DW, Drake S. Racial and Economic Disparities in Diabetes in a Large Primary Care Patient Population. Ethn Dis 2016; 26:85-90. [PMID: 26843800 DOI: 10.18865/ed.26.1.85] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE We sought to determine if, after adjusting for economic status, race is an independent risk factor for glycemic control among diabetic patients in a large primary care patient population. DESIGN SETTING PARTICIPANTS We performed a retrospective chart review of 264,000 primary care patients at our large, urban academic medical center to identify patients with a diagnosis of diabetes (n=25,123). Zip code was used to derive median income levels using US Census Bureau demographic information. Self-reported race was extracted from registration data. MAIN OUTCOME MEASURES The prevalence of diabetes, average glycated hemoglobin (A1c), and prevalence of uncontrolled diabetes of White and Black patients at all income levels were determined. RESULTS White patients had a lower average A1c level and a lower prevalence of diabetes than Black patients in all income quartiles (P<.001). Among White patients, the prevalence of diabetes (P<.001), uncontrolled diabetes (P<.001), and A1c level (P=.014) were inversely proportional to income level. No significant difference in the prevalence of diabetes (P=.214), A1c level (P=.282), or uncontrolled diabetes related to income was seen in Black patients (P=.094). CONCLUSIONS Race had an independent association with diabetes prevalence and glycemic control. Our study does not support two prominent theories that economic and insurance status are the main factors in diabetes disparities, as we attempted to control for economic status and nearly every patient had insurance. It will be important for future analysis to explore how health care system factors affect these observed gaps in quality.
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Affiliation(s)
| | | | | | | | - Sean Drake
- Department of Internal Medicine, Henry Ford Hospital, Detroit, MI
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16
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Abstract
In the USA, compared to whites, African-Americans are disproportionately impacted by the diabetes epidemic. Traditional diabetes risk factors, such as obesity, are more common among African-Americans, but these traditional risk factors do not explain all of the disparity in diabetes risk. Recent research has identified novel environmental, lifestyle, physiologic, and genetic risk factors for diabetes, some of which appear to impact African-Americans more than whites. This manuscript reviews the recent literature to highlight some of these novel risk factors that may be contributing to the racial disparity in diabetes risk. Further study is needed of the modifiable risk factors for development of interventions to reduce the risk of diabetes in African-Americans, as well as other high-risk populations.
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Affiliation(s)
- Ranee Chatterjee
- Division of General Internal Medicine, Duke University, 411 West Chapel Hill Street, Suite 500, Durham, NC, 27701, USA.
| | - Nisa M Maruthur
- Division of General Internal Medicine, Johns Hopkins University, 2024 E Monument St., Baltimore, MD, 21287, USA.
| | - David Edelman
- Division of General Internal Medicine, Duke University, 411 West Chapel Hill Street, Suite 500, Durham, NC, 27701, USA.
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Prevalence and Clustering of Cardiovascular Disease Risk Factors among Tibetan Adults in China: A Population-Based Study. PLoS One 2015; 10:e0129966. [PMID: 26047133 PMCID: PMC4457922 DOI: 10.1371/journal.pone.0129966] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 05/14/2015] [Indexed: 11/19/2022] Open
Abstract
Objectives The prevalence of cardiovascular disease risk factors has increased worldwide. However, the prevalence and clustering of cardiovascular disease risk factors among Tibetans is currently unknown. We aimed to explore the prevalence and clustering of cardiovascular disease risk factors among Tibetan adults in China. Methods In 2011, 1659 Tibetan adults (aged ≥18 years) from Changdu, China were recruited to this cross-section study. The questionnaire, physical examinations and laboratory testing were completed and the prevalence of cardiovascular disease risk factors, including hypertension, diabetes, overweight/obesity, dyslipidemia, and current smoking, were counted. The association between the clustering of cardiovascular disease risk factors and demographic characteristics, and geographic altitude were assessed. Results The age-standardized prevalence of hypertension, diabetes, overweight or obesity, dyslipidemia, and current smoking were 62.4%, 6.4%, 34.3%, 42.7%, and 6.1%, respectively, and these risk factors were associated with age, gender, education level, yearly family income, altitude, occupation, and butter tea consumption (P < 0.05). Overall, the age-adjusted prevalence of clustering of ≥1, ≥2, and ≥3 cardiovascular disease risk factors were 79.4%, 47.1%, and 20.9%, respectively. There appeared higher clustering of ≥2 and ≥3 cardiovascular disease risk factors among Tibetans with higher education level and family income yearly, and those living at an altitude < 3500 m and in a township. Conclusions The prevalence of cardiovascular disease risk factors, especially hypertension, was high in Tibetans. Moreover, there was an increased clustering of cardiovascular disease risk factors among those with higher socioeconomic status, lamas and those living at an altitude < 3500 m. These findings suggest that without the immediate implementation of an efficient policy to control these risk factors, cardiovascular disease will eventually become a major disease burden among Tibetans.
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