Insulin-requiring diabetes in Ethiopia: associations with poverty, early undernutrition and anthropometric disproportion
Insulin-requiring diabetes in Ethiopia: associations with poverty, early undernutrition and anthropometric disproportion
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DOI：
10.1038/ejcn.2010.143
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发表时间：
2010-10-01
影响因子：
4.7
通讯作者：
Parry, E. H. O.
中科院分区：
文献类型：
--
作者：
Fekadu, S.;Yigzaw, M.;Parry, E. H. O.
背景/目标：埃塞俄比亚大多数需要胰岛素的糖尿病患者患有非典型疾病，类似于之前对营养不良相关糖尿病的描述。由于对其病因知之甚少，我们进行了一项病例对照研究，以评估其社会和营养决定因素。 对象/方法：在两个中心招募了年龄 18-40 岁的需要胰岛素的糖尿病患者 (n = 107)，分别位于首都亚的斯亚贝巴西北 750 公里和西南 330 公里的贡德尔和吉马。从其他医院诊所就诊的患者中招募了年龄和性别相似的对照 (n = 110)。 结果：糖尿病与自给农业密切相关，比值比 = 3.5（95% 置信区间：1.5-7.8）和文盲/低教育水平，比值比 = 4.0 (2.0-8.0)。糖尿病还与儿童营养不良史、儿童时期母亲死亡的比值比 -5.5 (1.0-29.0)、比值比 -3.9 (1.0-14.8) 以及贫困标志包括卫生设施较差 (P = 0.004)、清洁水 (P = 0.009)、更严重的过度拥挤 (P = 0.04)、距诊所的距离增加 (P = 0.01）并且拥有较少的财产（P = 0.01）。与对照组相比，糖尿病患者的中上臂围、体重指数 (BMI) 和脂肪/瘦体重 (P
Background/Objectives: Most insulin-requiring diabetes patients in Ethiopia have an atypical form of the disease, which resembles previous descriptions of malnutrition-related diabetes. As so little is known about its aetiology, we have carried out a case-control study to evaluate its social and nutritional determinants.Subjects/Methods: Men and women with insulin-requiring diabetes (n = 107), aged 18-40 years, were recruited in two centres, Gondar and Jimma, 750 km northwest and 330 km southwest of the capital, Addis Ababa, respectively. Controls of similar age and sex (n = 110) were recruited from patients attending other hospital clinics.Results: Diabetes was strongly associated with subsistence farming, odds ratio = 3.5 (95% confidence interval: 1.5-7.8) and illiteracy/low levels of education, odds ratio = 4.0 (2.0-8.0). Diabetes was also linked with a history of childhood malnutrition, odds ratio -5.5 (1.0-29.0) the mother's death during childhood, odds ratio -3.9 (1.0-14.8), and markers of poverty including poorer access to sanitation (P = 0.004), clean water (P = 0.009), greater overcrowding (P = 0.04), increased distance from the clinic (P = 0.01) and having fewer possessions (P = 0.01). Compared with controls, people with diabetes had low mid upper arm circumference, body mass index (BMI) and fat/lean body mass (P