Prevalence of behavioural risk factors for cardiovascular disease in adolescents in low-income and middle-income countries: an individual participant data meta-analysis
Prevalence of behavioural risk factors for cardiovascular disease in adolescents in low-income and middle-income countries: an individual participant data meta-analysis
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DOI：
10.1016/s2213-8587(15)00076-5
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发表时间：
2015-07-01
影响因子：
44.5
通讯作者：
Kengne, Andre P.
中科院分区：
文献类型：
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作者：
Caleyachetty, Rishi;Echouffo-Tcheugui, Justin B.;Kengne, Andre P.
背景：虽然心血管疾病(CVD)的明显表现很少在成年前出现，但心血管疾病的危险因素经常出现在青少年中。然而，低收入和中等收入国家青少年中的行为心血管危险因素的流行率和程度仍不清楚。我们估计了2003至2011年间65个低收入和中等收入国家12-15岁青少年的行为心血管危险因素的大小和共生情况。方法我们从疾病控制和预防中心(CDC)的网站上提取全球学校学生健康调查(GSHS)数据集。用随机效应荟萃分析计算了世卫组织各地区和总体当前吸烟、饮酒、水果和蔬菜摄入量低、体力活动少、肥胖和心血管疾病危险因素共同出现的患病率估计值。2003年至2011年，169 369名青少年中，12.1%(95%可信区间10.2~14.1)吸烟，15.7%(12.3~19.5)饮酒，74.3%(71.9~76.5)水果蔬菜摄入量低，71.4%(69.5~73.3)体力活动不足，7.1%(5.6~8.7)肥胖。暴露于三种或三种以上心血管危险因素的地区合并患病率在东南亚地区最低(3.8%，95%可信区间1.2-7.5)，在西太平洋地区最高(18.6%，12.8-25.3)。在低收入和中等收入国家，青少年承受着行为心血管疾病风险因素的巨大负担，这些因素往往是同时发生的。监测、预防、检测和控制举措是全球卫生优先事项。
Background Although overt manifestations of cardiovascular disease (CVD) rarely emerge before adulthood, CVD risk factors are often present in adolescents. However, the prevalence and magnitude of behavioural CVD risk factors in adolescents in low-income and middle-income countries remains unclear. We estimated the magnitude and co-occurrence of behavioural CVD risk factors in adolescents aged 12-15 years for 65 low-income and middle-income countries between 2003 and 2011.Methods We extracted Global School-Based Student Health Surveys (GSHS) datasets from the Centers for Disease Control and Prevention (CDC) website. Pooled prevalence estimates of current tobacco use, alcohol use, low fruit and vegetable intake, low physical activity, obesity and co-occurrence of CVD risk factors for WHO regions and overall, was calculated with random-effects meta-analysis. We explored potential sources of heterogeneity for each CVD risk factor through random- effects meta-regression analysis.Findings Between 2003 and 2011, of 169 369 adolescents, 12.1% (95% CI 10.2-14.1) used tobacco, 15.7% (12.3-19.5) used alcohol, 74.3% (71.9-76.5) had low fruit and vegetable intake, 71.4% (69.5-73.3) reported low physical activity and 7.1% (5.6-8.7) were obese. The pooled regional prevalence of exposure to three or more CVD risk factors was lowest in the southeast Asian region (3.8%, 95% CI 1.2- 7.5) and highest in the western Pacific region (18.6%,12.8-25.3). Substantial heterogeneities within and across regions were not fully explained by major study characteristics.Interpretation In low-income and middle-income countries, adolescents carry a substantial burden of behavioural CVD risk factors, which tend to co-occur. Surveillance, prevention, detection, and control initiatives are a global health priority.