Impact of disasters, including pandemics, on cardiometabolic outcomes across the life-course: a systematic review.
Impact of disasters, including pandemics, on cardiometabolic outcomes across the life-course: a systematic review.
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DOI：
10.1136/bmjopen-2020-047152
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发表时间：
2021-05-03
期刊：
影响因子：
2.9
通讯作者：
Anderson LN
中科院分区：
文献类型：
--
作者：
De Rubeis V;Lee J;Anwer MS;Yoshida-Montezuma Y;Andreacchi AT;Stone E;Iftikhar S;Morgenstern JD;Rebinsky R;Neil-Sztramko SE;Alvarez E;Apatu E;Anderson LN
灾难是指扰乱社区或社会日常功能的事件，并可能增加心脏代谢不良后果的长期风险，包括心血管疾病、肥胖症和糖尿病。这项研究的目的是进行系统的回顾，以确定包括大流行在内的灾害对整个生命过程中心脏代谢结果的影响。利用EMBASE和Medline两个电子数据库，于2020年5月进行了系统检索。所有研究在标题、摘要和全文水平上进行一式两份的筛选。如果研究评估了人口水平或社区灾难与灾难发生后1个月≥心脏代谢结果之间的关联，则有资格纳入研究。没有年龄、出版年份、国家或人口的限制。数据被提取的研究特征，暴露(例如，灾害类型，地区，年份)，心脏代谢结果和影响的措施。研究质量使用乔安娜·布里格斯研究所的关键评估工具进行评估。共纳入58项研究，其中24项研究报告了孕期/童年期间暴露于灾难的影响，34项研究报告了成年期间暴露的影响。研究包括暴露于自然灾害(n=35；60%)和人为灾害(n=23；40%)，其中只有3项(5%)研究对以前的流行病进行了评估。大多数研究报告心脏代谢风险增加，包括心血管疾病发病率或死亡率增加，糖尿病和肥胖，但不是全部。很少有研究评估生物机制或高危亚群，这些亚群可能在灾难后产生负面健康后果的风险更大。这项研究的结果表明，灾难的负担超出了已知的直接伤害，需要注意对心脏代谢健康的有害间接长期影响。鉴于目前的新冠肺炎大流行，这些发现可能会为公共卫生预防战略提供参考，以减轻未来心脏代谢风险的影响。CRD42020186074。
Disasters are events that disrupt the daily functioning of a community or society, and may increase long-term risk of adverse cardiometabolic outcomes, including cardiovascular disease, obesity and diabetes. The objective of this study was to conduct a systematic review to determine the impact of disasters, including pandemics, on cardiometabolic outcomes across the life-course. A systematic search was conducted in May 2020 using two electronic databases, EMBASE and Medline. All studies were screened in duplicate at title and abstract, and full-text level. Studies were eligible for inclusion if they assessed the association between a population-level or community disaster and cardiometabolic outcomes ≥1 month following the disaster. There were no restrictions on age, year of publication, country or population. Data were extracted on study characteristics, exposure (eg, type of disaster, region, year), cardiometabolic outcomes and measures of effect. Study quality was evaluated using the Joanna Briggs Institute critical appraisal tools. A total of 58 studies were included, with 24 studies reporting the effects of exposure to disaster during pregnancy/childhood and 34 studies reporting the effects of exposure during adulthood. Studies included exposure to natural (n=35; 60%) and human-made (n=23; 40%) disasters, with only three (5%) of these studies evaluating previous pandemics. Most studies reported increased cardiometabolic risk, including increased cardiovascular disease incidence or mortality, diabetes and obesity, but not all. Few studies evaluated the biological mechanisms or high-risk subgroups that may be at a greater risk of negative health outcomes following disasters. The findings from this study suggest that the burden of disasters extend beyond the known direct harm, and attention is needed on the detrimental indirect long-term effects on cardiometabolic health. Given the current COVID-19 pandemic, these findings may inform public health prevention strategies to mitigate the impact of future cardiometabolic risk. CRD42020186074.
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DOI：
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