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Awad SF, A Toumi A, A Al-Mutawaa K, A Alyafei S, A Ijaz M, A H Khalifa S, B Kokku S, C M Mishra A, V Poovelil B, B Soussi M, G El-Nahas K, O Al-Hamaq A, A Critchley J, H Al-Thani M, Abu-Raddad LJ. Type 2 diabetes epidemic and key risk factors in Qatar: a mathematical modeling analysis. BMJ Open Diabetes Res Care 2022; 10:10/2/e002704. [PMID: 35443971 PMCID: PMC9021773 DOI: 10.1136/bmjdrc-2021-002704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 03/27/2022] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION We aimed to characterize and forecast type 2 diabetes mellitus (T2DM) disease burden between 2021 and 2050 in Qatar where 89% of the population comprises expatriates from over 150 countries. RESEARCH DESIGN AND METHODS An age-structured mathematical model was used to forecast T2DM burden and the impact of key risk factors (obesity, smoking, and physical inactivity). The model was parametrized using data from T2DM natural history studies, Qatar's 2012 STEPwise survey, the Global Health Observatory, and the International Diabetes Federation Diabetes Atlas, among other data sources. RESULTS Between 2021 and 2050, T2DM prevalence increased from 7.0% to 14.0%, the number of people living with T2DM increased from 170 057 to 596 862, and the annual number of new T2DM cases increased from 25 007 to 45 155 among those 20-79 years of age living in Qatar. Obesity prevalence increased from 8.2% to 12.5%, smoking declined from 28.3% to 26.9%, and physical inactivity increased from 23.1% to 26.8%. The proportion of incident T2DM cases attributed to obesity increased from 21.9% to 29.9%, while the contribution of smoking and physical inactivity decreased from 7.1% to 6.0% and from 7.3% to 7.2%, respectively. The results showed substantial variability across various nationality groups residing in Qatar-for example, in Qataris and Egyptians, the T2DM burden was mainly due to obesity, while in other nationality groups, it appeared to be multifactorial. CONCLUSIONS T2DM prevalence and incidence in Qatar were forecasted to increase sharply by 2050, highlighting the rapidly growing need of healthcare resources to address the disease burden. T2DM epidemiology varied between nationality groups, stressing the need for prevention and treatment intervention strategies tailored to each nationality.
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Affiliation(s)
- Susanne F Awad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine - Qatar, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Doha, Dawha, Qatar
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York City, New York, USA
| | - Amine A Toumi
- Public Health Department, Ministry of Public Health Qatar, Doha, Ad Dawhah, Qatar
| | - Kholood A Al-Mutawaa
- Public Health Department, Ministry of Public Health Qatar, Doha, Ad Dawhah, Qatar
| | - Salah A Alyafei
- Public Health Department, Ministry of Public Health Qatar, Doha, Ad Dawhah, Qatar
| | - Muhammad A Ijaz
- Public Health Department, Ministry of Public Health Qatar, Doha, Ad Dawhah, Qatar
| | | | - Suresh B Kokku
- Public Health Department, Ministry of Public Health Qatar, Doha, Ad Dawhah, Qatar
| | - Amit C M Mishra
- Public Health Department, Ministry of Public Health Qatar, Doha, Ad Dawhah, Qatar
| | - Benjamin V Poovelil
- Public Health Department, Ministry of Public Health Qatar, Doha, Ad Dawhah, Qatar
| | - Mounir B Soussi
- Public Health Department, Ministry of Public Health Qatar, Doha, Ad Dawhah, Qatar
| | | | | | - Julia A Critchley
- Population Health Research Institute, St. George's, University of London, London, UK
| | - Mohammed H Al-Thani
- Public Health Department, Ministry of Public Health Qatar, Doha, Ad Dawhah, Qatar
| | - Laith J Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine - Qatar, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Doha, Dawha, Qatar
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York City, New York, USA
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
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Al-Thani MH, Al-Mutawa KA, Alyafei SA, Ijaz MA, Khalifa SAH, Kokku SB, Mishra ACM, Poovelil BV, Soussi MB, Toumi AA, Dargham SR, Awad SF, Abu-Raddad LJ. Characterizing epidemiology of prediabetes, diabetes, and hypertension in Qataris: A cross-sectional study. PLoS One 2021; 16:e0259152. [PMID: 34699571 PMCID: PMC8547702 DOI: 10.1371/journal.pone.0259152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 10/13/2021] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To characterize the epidemiologic profiles of prediabetes mellitus (preDM), diabetes mellitus (DM), and hypertension (HTN) in Qataris using the nationally representative 2012 Qatar STEPwise Survey. METHODS A secondary data analysis of a cross-sectional survey that included 2,497 Qatari nationals aged 18-64 years. Descriptive and analytical statistical analyses were conducted. RESULTS Prevalence of preDM, DM, and HTN in Qataris aged 18-64 years was 11.9% (95% confidence interval [CI] 9.6%-14.7%), 10.4% (95% CI 8.4%-12.9%), and 32.9% (95% CI 30.4%-35.6%), respectively. Age was the common factor associated with the three conditions. Adjusted analyses showed that unhealthy diet (adjusted odds ratio (aOR) = 1.84, 95% CI 1.01-3.36) was significantly associated with preDM; that physical inactivity (aOR = 1.66, 95% CI 1.12-2.46), central obesity (aOR = 2.08, 95% CI 1.02-4.26), and HTN (aOR = 2.18, 95% CI 1.40-3.38) were significantly associated with DM; and that DM (aOR = 2.07, 95% CI 1.34-3.22) was significantly associated with HTN. Population attributable fraction of preDM associated with unhealthy diet was 7.7%; of DM associated with physical inactivity, central obesity, and HTN, respectively, was 14.9%, 39.8%, and 17.5%; and of HTN associated with DM was 3.0%. CONCLUSIONS One in five Qataris is living with either preDM or DM, and one in three is living with HTN, conditions that were found to be primarily driven by lifestyle factors. Prevention, control, and management of these conditions should be a national priority to reduce their disease burden and associated disease sequelae.
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Affiliation(s)
| | | | - Salah A. Alyafei
- Public Health Department, Ministry of Public Health, Doha, Qatar
| | - Muhammad A. Ijaz
- Public Health Department, Ministry of Public Health, Doha, Qatar
| | | | - Suresh B. Kokku
- Public Health Department, Ministry of Public Health, Doha, Qatar
| | | | | | - Mounir B. Soussi
- Public Health Department, Ministry of Public Health, Doha, Qatar
| | - Amine A. Toumi
- Public Health Department, Ministry of Public Health, Doha, Qatar
| | - Soha R. Dargham
- Infectious Disease Epidemiology Group, Weill Cornell Medicine—Qatar, Cornell University, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine–Qatar, Cornell University, Doha, Qatar
| | - Susanne F. Awad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine—Qatar, Cornell University, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine–Qatar, Cornell University, Doha, Qatar
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, New York, United States of America
| | - Laith J. Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine—Qatar, Cornell University, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine–Qatar, Cornell University, Doha, Qatar
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, New York, United States of America
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
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Al Thani M, Al Thani AA, Al-Chetachi W, Al Malki B, Khalifa SAH, Haj Bakri A, Hwalla N, Nasreddine L, Naja F. A 'High Risk' Lifestyle Pattern Is Associated with Metabolic Syndrome among Qatari Women of Reproductive Age: A Cross-Sectional National Study. Int J Mol Sci 2016; 17:ijms17060698. [PMID: 27271596 PMCID: PMC4926323 DOI: 10.3390/ijms17060698] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 04/18/2016] [Accepted: 04/29/2016] [Indexed: 11/16/2022] Open
Abstract
This study investigated the effect of lifestyle patterns, as a combination of diet, physical activity and smoking, on Metabolic Syndrome (MetS) among Qatari women of childbearing age (n = 418), a population group particularly vulnerable to the health sequela of this syndrome. Using data from the National WHO STEPwise survey conducted in Qatar in 2012, Principal Component Factor Analysis was performed to derive lifestyle patterns with survey variables related to the frequency of consumption of 13 foods/food groups, physical activity levels, and smoking status. MetS was diagnosed using ATPIII criteria. Three lifestyle patterns were identified: 'High Risk' pattern, characterized by intakes of fast foods, sweets and sugar sweetened beverages, in addition to lower levels of physical activity and higher smoking prevalence; 'Prudent' pattern, driven mainly by higher intakes of fruits, vegetables, fish, and whole grains; and 'Traditional' pattern which included beans, meat, dairy products, and a low prevalence of smoking. Among these three lifestyle patterns, only the 'High Risk' was associated with MetS, whereby subjects belonging to the third tertile of this pattern's score had 2.5 times the odds of MetS compared to those belonging to the first tertile. The findings of this study demonstrated the synergy among high risk behaviors among Qatari women in increasing the odds of MetS; the latter being a major risk factor for cardiovascular diseases.
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Affiliation(s)
- Mohammed Al Thani
- Public Health Department, Ministry of Public Health, Doha, Al Rumaila West, 42 Doha, Qatar.
| | - Al Anoud Al Thani
- Health Promotion and Non Communicable Disease Prevention Division, Ministry of Public Health, Doha, Al Rumaila West, 42 Doha, Qatar.
| | - Walaa Al-Chetachi
- Health Promotion and Non Communicable Disease Prevention Division, Ministry of Public Health, Doha, Al Rumaila West, 42 Doha, Qatar.
| | - Badria Al Malki
- Health Promotion and Non Communicable Disease Prevention Division, Ministry of Public Health, Doha, Al Rumaila West, 42 Doha, Qatar.
| | - Shamseldin A H Khalifa
- Health Promotion and Non Communicable Disease Prevention Division, Ministry of Public Health, Doha, Al Rumaila West, 42 Doha, Qatar.
| | - Ahmad Haj Bakri
- Health Promotion and Non Communicable Disease Prevention Division, Ministry of Public Health, Doha, Al Rumaila West, 42 Doha, Qatar.
| | - Nahla Hwalla
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, P.O. BOX 11-0.236, Riad El Solh, 11072020 Beirut, Lebanon.
| | - Lara Nasreddine
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, P.O. BOX 11-0.236, Riad El Solh, 11072020 Beirut, Lebanon.
| | - Farah Naja
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, P.O. BOX 11-0.236, Riad El Solh, 11072020 Beirut, Lebanon.
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Al Thani M, Al Thani AA, Al-Chetachi W, Al Malki B, Khalifa SAH, Bakri AH, Hwalla N, Nasreddine L, Naja F. Lifestyle Patterns Are Associated with Elevated Blood Pressure among Qatari Women of Reproductive Age: A Cross-Sectional National Study. Nutrients 2015; 7:7593-615. [PMID: 26371041 PMCID: PMC4586550 DOI: 10.3390/nu7095355] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 08/23/2015] [Accepted: 08/27/2015] [Indexed: 12/28/2022] Open
Abstract
Women of childbearing age are particularly vulnerable to the adverse effects of elevated blood pressure (BP), with dietary and lifestyle habits being increasingly recognized as important modifiable environmental risk factors for this condition. Using data from the National STEPwise survey conducted in Qatar in year 2012, we aimed to examine lifestyle patterns and their association with elevated BP among Qatari women of childbearing age (18–45 years). Socio-demographic, lifestyle, dietary, anthropometric and BP data were used (n = 747). Principal component factor analysis was applied to identify the patterns using the frequency of consumption of 13 foods/food groups, physical activity level, and smoking status. Multivariate logistic regression analyses were used to evaluate the association of the identified lifestyle patterns with elevated BP and to examine the socio-demographic correlates of these patterns. Three lifestyle patterns were identified: a “healthy” pattern characterized by intake of fruits, natural juices, and vegetables; a “fast food & smoking” pattern characterized by fast foods, sweetened beverages, and sweets, in addition to smoking; and a “traditional sedentary” pattern which consisted of refined grains, dairy products, and meat in addition to low physical activity. The fast food & smoking and the traditional & sedentary patterns were associated with an approximately 2-fold increase in the risk of elevated BP in the study population. The findings of this study highlight the synergistic effect that diet, smoking and physical inactivity may have on the risk of elevated BP among Qatari women.
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Affiliation(s)
- Mohammed Al Thani
- Public Health Department, Supreme Council of Health, Doha, Al Rumaila West, 42 Doha, Qatar.
| | - Al Anoud Al Thani
- Health Promotion and Non Communicable Disease Prevention Division, Supreme Council of Health, Doha, Al Rumaila West, 42 Doha, Qatar.
| | - Walaa Al-Chetachi
- Health Promotion and Non Communicable Disease Prevention Division, Supreme Council of Health, Doha, Al Rumaila West, 42 Doha, Qatar.
| | - Badria Al Malki
- Health Promotion and Non Communicable Disease Prevention Division, Supreme Council of Health, Doha, Al Rumaila West, 42 Doha, Qatar.
| | - Shamseldin A H Khalifa
- Health Promotion and Non Communicable Disease Prevention Division, Supreme Council of Health, Doha, Al Rumaila West, 42 Doha, Qatar.
| | - Ahmad Haj Bakri
- Health Promotion and Non Communicable Disease Prevention Division, Supreme Council of Health, Doha, Al Rumaila West, 42 Doha, Qatar.
| | - Nahla Hwalla
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, P. O. Box 11-0.236 Riad El Solh, 11072020 Beirut, Lebanon.
| | - Lara Nasreddine
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, P. O. Box 11-0.236 Riad El Solh, 11072020 Beirut, Lebanon.
| | - Farah Naja
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, P. O. Box 11-0.236 Riad El Solh, 11072020 Beirut, Lebanon.
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