论文部分内容阅读
目的利用世界卫生组织调查的数据,分析49个发展中国家糖尿病的患病率变化及其与体质量和初级卫生保健之间的联系。方法本研究中,糖尿病的界定是利用内科医生关于糖尿病诊断的个体报告;体质量指数(BMI)的计算是体质量(Kg)与身高平方(m2)的比值;治疗状态是评估是否获得卫生保健支持临床治疗以及糖尿病病人是否遵医并有行为改变;糖尿病和BMI以及治疗状态的关联使用横断面分析。结果共纳入215 898位个体进行研究。糖尿病年龄调整患病率范围从0.27%(马里)到15.54%(毛里求斯)。低体质量人群(BMI<18.5kg/m2),超体质量人群(BMI 25～29.9kg/m2)以及肥胖人群(BMI≥30kg/m2)患糖尿病的风险与正常体质量人群(BMI 18.5～24.9kg/m2)相比,差异具有统计学意义,多因素校正的OR值(95%CI)分别为1.15(1.07～1.24),1.56(1.44～1.68)和2.38(2.17～2.61)。所有纳入研究者中糖尿病患者的未治疗率为9.6%,低体质量患者的未治疗率最高,依次为正常体质量患者、超体质量患者、肥胖患者。结论在中低收入国家中,糖尿病的患病率变化以及糖尿病的初级卫生保健支持度的变化具有统计学意义。积极地预防人群超体质量和提高卫生保健支持度对于在发展中国家改善糖尿病的高流行可以发挥非常重要作用。
Objectives To analyze the prevalence of diabetes in 49 developing countries and their link to body mass and primary health care using data from WHO surveys. Methods In this study, the definition of diabetes was made using physicians’ individual reports on the diagnosis of diabetes; the body mass index (BMI) was calculated as the ratio of body mass (Kg) to height squared (m2); the treatment status was to assess whether access to health care Supports clinical treatment and whether diabetic patients follow a medical course and has behavioral changes; Diabetes and BMI and treatment status are cross-sectional analyzed. Results A total of 215 898 individuals were included in the study. The age-adjusted prevalence of diabetes ranged from 0.27% (Mali) to 15.54% (Mauritius). Patients with low body mass (BMI <18.5 kg / m 2), overweight (BMI 25-29.9 kg / m 2), and obese (BMI ≥ 30 kg / m 2) had similar risk to those with normal body mass (BMI 18.5-24.9 (95% CI) were 1.15 (1.07-1.24), 1.56 (1.44-1.68) and 2.38 (2.17-2.61), respectively. The difference was statistically significant (P <0.05). The untreated rate of all diabetic patients was 9.6%. The lowest untreated patients with low body weight were the highest, followed by normal weight patients, overweight patients and obese patients. Conclusions In low- and middle-income countries, changes in the prevalence of diabetes and changes in primary health care support for diabetes were statistically significant. Proactive prevention of overpopulation and improved health care support play an important role in improving the prevalence of diabetes in developing countries.