The global cardiovascular risk transition: associations of four metabolic risk factors with national income, urbanization, and Western diet in 1980 and 2008.
The global cardiovascular risk transition: associations of four metabolic risk factors with national income, urbanization, and Western diet in 1980 and 2008.
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DOI：
10.1161/circulationaha.113.001470
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发表时间：
2013-04-09
期刊：
影响因子：
37.8
通讯作者：
Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group
中科院分区：
文献类型：
--
作者：
Danaei G;Singh GM;Paciorek CJ;Lin JK;Cowan MJ;Finucane MM;Farzadfar F;Stevens GA;Riley LM;Lu Y;Rao M;Ezzati M;Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group
人们普遍认为，全球心血管疾病的危险因素与富裕和西方化有关。我们调查了1980年和2008年的体重指数（BMI），空腹血糖（FPG），收缩压（SBP）和血清总胆固醇（TC）与国民收入，西方饮食和（BMI）城市化的关系。1980年至2008年期间199个国家的国家一级风险因素估计数来自先前对基于人口的数据进行的系统分析。我们分析了危险因素与人均GDP的自然对数[Ln（GDP）]（一种西方饮食的衡量标准）和（BMI）城市人口百分比之间的关系。1980年，国民收入与人口平均BMI、SBP和TC呈正相关。到2008年，Ln（国内生产总值）和SBP之间的关联斜率在女性中为负值，在男性中为零。TC与整个时期的国民收入和西方饮食有关。1980年，BMI随着人均GDP的上升而上升，然后在7000美元左右持平;到2008年，女性的BMI关系类似于倒U型，在中等收入水平达到顶峰。在1980年和2008年，BMI与城市人口百分比呈正相关。FPG与这些国家宏观特征的相关性较弱，但与BMI呈正相关。代谢风险因素与宏观经济变量之间的关系不断变化，表明除非采取有效的生活方式和药物干预措施，否则高血糖症和糖尿病将在全球范围内流行，高血压也将在低收入国家流行。
It is commonly assumed that globally CVD risk factors are associated with affluence and Westernization. We investigated the associations of body mass index (BMI), fasting plasma glucose (FPG), systolic blood pressure (SBP), and serum total cholesterol (TC) with national income, Western diet, and (for BMI) urbanization in 1980 and 2008. Country-level risk factor estimates for 199 countries between 1980 and 2008 were from a previous systematic analysis of population-based data. We analyzed the associations between risk factors and natural logarithm of per-capita GDP [Ln(GDP)], a measure of Western diet, and (for BMI) percent population living in urban areas. In 1980, there was a positive association between national income and population mean BMI, SBP, and TC. By 2008, the slope of the association between Ln(GDP) and SBP became negative for women and zero for men. TC was associated with national income and Western diet throughout the period. In 1980, BMI rose with per-capita GDP and then flattened at about Int$7000; by 2008, the relationship resembled an inverted-U for women, peaking at middle income levels. BMI had a positive relationship with percent urban population in both 1980 and 2008. FPG had weaker associations with these country macro characteristics, but was positively associated with BMI. The changing associations of metabolic risk factors with macroeconomic variables indicate that there will be a global pandemic of hyperglycemia and diabetes, together with high blood pressure in low income countries, unless effective lifestyle, and pharmacological interventions are implemented.