Secondary analyses of global datasets: do obesity and physical activity explain variation in diabetes risk across populations?
Secondary analyses of global datasets: do obesity and physical activity explain variation in diabetes risk across populations?
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DOI：
10.1038/s41366-021-00764-y
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发表时间：
2021-05
期刊：
影响因子：
--
通讯作者：
Lessan N
中科院分区：
文献类型：
--
作者：
Alkaf B;Blakemore AI;Järvelin MR;Lessan N
不同地区的2型糖尿病发病率差异很大。这些差异有时被认为完全是由环境诱因的不同分布所驱动的，包括肥胖和身体活动不足（IPA）。在这篇综述中，我们讨论了与这一假设相冲突的数据。我们对公开数据进行了二次分析，以揭示不同人群中肥胖和IPA对糖尿病风险的相对贡献。我们使用了来自非传染性疾病风险因素协作（NCD-RisC）对200个国家的糖尿病（1980-2014）和肥胖症（1975-2016）发病率的性别特异性、年龄标准化估计，以及来自世卫组织对2016年168个国家IPA发病率的估计。非传染性疾病- risc和世卫组织将各国划分为九个超级区域。所有的分析都是地区和性别特异性的。尽管自1975年以来，肥胖在世界各地一直在增加，但这并没有反映在包括中欧和东欧以及高收入西方国家在内的几个地区糖尿病发病率的比例增加上。同样，缺乏身体活动与糖尿病的关联在各个地区也不是均匀的。世界上不同地区的国家可能有非常相似的糖尿病发病率，尽管在IPA发病率谱上处于相反的两端。在全球和国家层面分析了肥胖和IPA对糖尿病风险的综合影响。总体研究结果强调了肥胖对疾病风险的更大影响；当肥胖率高时，低IPA率似乎对糖尿病没有保护作用。尽管如此，一些国家偏离了这一总体观察。在我们所有的分析中都观察到了性别差异。总的来说，本综述中的数据表明，不同的人群虽然经历了相似的环境变化，但患糖尿病的风险明显不同。观察到的与性别有关的差异表明，男性和女性要么受到不同的风险因素暴露，要么对它们有不同的反应。
Type 2 diabetes rates vary significantly across geographic regions. These differences are sometimes assumed to be entirely driven by differential distribution of environmental triggers, including obesity and insufficient physical activity (IPA). In this review, we discuss data which conflicts with this supposition. We carried out a secondary analysis of publicly available data to unravel the relative contribution of obesity and IPA towards diabetes risk across different populations. We used sex-specific, age-standardized estimates from Non-Communicable Disease Risk Factor Collaboration (NCD-RisC) on diabetes (1980–2014) and obesity (1975–2016) rates, in 200 countries, and from WHO on IPA rates in 168 countries in the year 2016. NCD-RisC and WHO organized countries into nine super-regions. All analyses were region- and sex-specific. Although obesity has been increasing since 1975 in every part of the world, this was not reflected in a proportional increase in diabetes rates in several regions, including Central and Eastern Europe, and High-income western countries region. Similarly, the association of physical inactivity with diabetes is not homogeneous across regions. Countries from different regions across the world could have very similar rates of diabetes, despite falling on opposite ends of IPA rate spectrum. The combined effect of obesity and IPA on diabetes risk was analyzed at the worldwide and country level. The overall findings highlighted the larger impact of obesity on disease risk; low IPA rates do not seem to be protective of diabetes, when obesity rates are high. Despite that, some countries deviate from this overall observation. Sex differences were observed across all our analyses. Overall, data presented in this review indicate that different populations, while experiencing similar environmental shifts, are apparently differentially subject to diabetes risk. Sex-related differences observed suggest that males and females are either subject to different risk factor exposures or have different responses to them.
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20.3
作者：
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通讯作者：
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34.3
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