Trends in obesity and diabetes across Africa from 1980 to 2014: an analysis of pooled population-based studies
Trends in obesity and diabetes across Africa from 1980 to 2014: an analysis of pooled population-based studies
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DOI：
10.1093/ije/dyx078
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发表时间：
2017-10-01
影响因子：
7.7
通讯作者：
Mbanya, Jean Claude N.
中科院分区：
文献类型：
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作者：
Kengne, Andre Pascal;Bentham, James;Mbanya, Jean Claude N.
背景：2016年《达累斯萨拉姆防治糖尿病和其他非传染性疾病行动呼吁》倡导基于撒哈拉以南非洲及其他地区国家现有数据和信息的国家多部门非传染性疾病战略和行动计划。我们估计了1980年至2014年这些国家的年龄标准化平均体重指数（BMI）和糖尿病患病率的趋势，以评估共同进展并协助政策制定。方法：我们汇集了来自非洲和世界范围内基于人群的研究数据，这些研究测量了身高、体重和生物标志物，以评估年龄在bb0 = 18岁的成年人的糖尿病状况。贝叶斯分层模型用于估计200个国家和地区的性别趋势，其中包括非洲5个地区（中部、东部、北部、南部和西部）的53个国家，平均BMI和糖尿病患病率（定义为空腹血糖值>= 7.0 mmol/l，糖尿病诊断史，或使用胰岛素或口服葡萄糖控制药物）。结果：非洲的数据来自245项基于人口的BMI调查（120万参与者）和76项糖尿病患病率调查（18.2万参与者）。BMI数据来源最多的国家是南非（n = 17）、尼日利亚（n = 15）和埃及（n = 13）；对于糖尿病的估计，坦桑尼亚（n = 8）、突尼斯（n = 7）、喀麦隆、埃及和南非（均为n = 6）。男性年龄标准化平均BMI从21.0 kg/m(2)（95%可信区间：20.3-21.7）增加到23.0 kg/m(2)(22.7-23.3)，女性从21.9 kg/m(2)（21.3-22.5）增加到24.9 kg/m(2)（24.6-25.1）。男性糖尿病年龄标准化患病率从3.4%（1.5-6.3）增加到8.5%(6.5-10.8)，女性从4.1%（2.0-7.5）增加到8.9%（6.9-11.2）。北部和南部地区的估计数大多高于全球平均水平；中、东、西部地区的死亡率低于全球平均水平。1980年和2014年，平均BMI与男女糖尿病患病率呈正相关（相关系数相似或等于0.9）。结论：这些基于有限数据来源的估计证实了非洲糖尿病负担的迅速增加。这种上升至少部分是由肥胖增加所驱动的，但观察到的趋势存在地区差异。非洲国家预防和控制糖尿病和肥胖的努力应与建立可靠的监测系统相结合，符合世界卫生组织的全球监测系统框架。
Background: The 2016 Dar Es Salaam Call to Action on Diabetes and Other non-communicable diseases (NCDs) advocates national multi-sectoral NCD strategies and action plans based on available data and information from countries of sub-Saharan Africa and beyond. We estimated trends from 1980 to 2014 in age-standardized mean body mass index (BMI) and diabetes prevalence in these countries, in order to assess the coprogression and assist policy formulation.Methods: We pooled data from African and worldwide population-based studies which measured height, weight and biomarkers to assess diabetes status in adults aged >= 18 years. A Bayesian hierarchical model was used to estimate trends by sex for 200 countries and territories including 53 countries across five African regions (central, eastern, northern, southern and western), in mean BMI and diabetes prevalence (defined as either fasting plasma glucose of >= 7.0 mmol/l, history of diabetes diagnosis, or use of insulin or oral glucose control agents).Results: African data came from 245 population-based surveys (1.2 million participants) for BMI and 76 surveys (182 000 participants) for diabetes prevalence estimates. Countries with the highest number of data sources for BMI were South Africa (n = 17), Nigeria (n = 15) and Egypt (n = 13); and for diabetes estimates, Tanzania (n = 8), Tunisia (n = 7), and Cameroon, Egypt and South Africa (all n = 6). The age-standardized mean BMI increased from 21.0 kg/m(2) (95% credible interval: 20.3-21.7) to 23.0 kg/m(2) (22.7-23.3) in men, and from 21.9 kg/m(2) (21.3-22.5) to 24.9 kg/m(2) (24.6-25.1) in women. The age-standardized prevalence of diabetes increased from 3.4% (1.5-6.3) to 8.5% (6.5-10.8) in men, and from 4.1% (2.0-7.5) to 8.9% (6.9-11.2) in women. Estimates in northern and southern regions were mostly higher than the global average; those in central, eastern and western regions were lower than global averages. A positive association (correlation coefficient similar or equal to 0.9) was observed between mean BMI and diabetes prevalence in both sexes in 1980 and 2014.Conclusions: These estimates, based on limited data sources, confirm the rapidly increasing burden of diabetes in Africa. This rise is being driven, at least in part, by increasing adiposity, with regional variations in observed trends. African countries' efforts to prevent and control diabetes and obesity should integrate the setting up of reliable monitoring systems, consistent with the World Health Organization's Global Monitoring System Framework.