An updated systematic review and meta-analysis on the social determinants of diabetes and related risk factors in the Caribbean.
An updated systematic review and meta-analysis on the social determinants of diabetes and related risk factors in the Caribbean.
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DOI：
10.26633/rpsp.2018.171
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发表时间：
2018-01-01
期刊：
影响因子：
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通讯作者：
Unwin, Nigel
中科院分区：
文献类型：
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作者：
Guariguata, Leonor;Brown, Catherine;Unwin, Nigel
目的：对按性别和其他社会健康决定因素分列的糖尿病及其风险因素的最新数据进行分析，以了解加勒比地区妇女患病率高于男子的原因;为加勒比地区糖尿病预防和控制的政策制定提供信息;并确定需要进一步研究的证据差距。先前对描述在加勒比地区进行的研究的文献进行了系统综述，这些研究按一种或多种社会决定因素介绍了糖尿病的分布、其结果和风险因素，已更新，以纳入2007年1月1日至2016年12月31日的来源。世界卫生组织（世卫组织）的调查也包括在内。在数据充足的情况下，进行荟萃分析。结果：共识别出8326篇稿件。其中，282人被选为全文审查，114人被选为摘要。总共有36篇论文，包括世卫组织相关调查，有足够的信息进行荟萃分析。与男性相比，更多的女性患有肥胖症（OR：2.1; 95%CI = 1.65 - 2.69）、缺乏体力活动（OR：2.18; 95%CI = 1.75 - 2.72）和糖尿病（OR：1.48; 95%CI = 1.25 - 1.76）。更多的男性吸烟（或：4.27;结论：共纳入36篇文献，其中13篇纳入Meta分析。糖尿病及其风险因素（主要是肥胖和缺乏体育活动）继续对加勒比妇女造成不成比例的影响。吸烟干预措施应针对这一地理区域的男性。
OBJECTIVES: To conduct an analysis of the most recent data on diabetes and its risk factors by gender and other social determinants of health to understand why its prevalence is higher among women than men in the Caribbean; to inform policy agenda-setting for diabetes prevention and control in the Caribbean; and to identify gaps in the evidence that require further research.METHODS: A previous systematic review of the literature describing studies conducted in the Caribbean that presented the distribution of diabetes, its outcomes, and risk factors, by one or more social determinants, was updated to include sources from 1 January 2007 - 31 December 2016. Surveys by the World Health Organization (WHO) were also included. Where data were sufficient, meta-analyses were undertaken.RESULTS: A total of 8 326 manuscripts were identified. Of those, 282 were selected for full text review, and 114, for abstraction. In all, 36 papers, including WHO-related surveys, had sufficient information for meta-analysis. More women compared to men were obese (OR: 2.1; 95%CI = 1.65 - 2.69), physically inactive (OR: 2.18; 95%CI = 1.75 - 2.72), and had diabetes (OR: 1.48; 95%CI = 1.25 - 1.76). More men smoked (OR: 4.27; 95%CI = 3.18 - 5.74) and had inadequate fruit and vegetable intake (OR: 1.37; 95%CI = 1.21 - 1.57).CONCLUSION: Thirty-six papers were added to the previously conducted systematic review; of those, 13 were added to the meta-analysis. Diabetes and its risk factors (primarily obesity and physical inactivity) continue to disproportionately affect women in the Caribbean. Smoking interventions should be targeted at men in this geographic area.