Exposure over the life course to an urban environment and its relation with obesity, diabetes, and hypertension in rural and urban Cameroon
Exposure over the life course to an urban environment and its relation with obesity, diabetes, and hypertension in rural and urban Cameroon
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DOI：
10.1093/ije/dyh044
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发表时间：
2004-08-01
影响因子：
7.7
通讯作者：
Alberti, K
中科院分区：
文献类型：
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作者：
Sobngwi, E;Mbanya, JC;Alberti, K
本研究旨在评估撒哈拉以南非洲成年人终生暴露于城市环境（EU）与肥胖、糖尿病和高血压之间的关系。方法对年龄大于等于25岁的999名女性和727名男性进行研究。他们代表所有年龄大于或等于25岁的成年人，居住在喀麦隆农村和城市社区随机选择的家庭，参与率分别为98%和96%。测量了所有受试者的身高、体重、血压和空腹血糖。目前的身体活动水平（代谢当量[MET]）通过撒哈拉以南非洲活动问卷进行评估。回顾性收集了关于终生迁移的时间顺序数据，并以终生暴露于城市环境的总数（EUt）或百分比（EU%）表示。结果终生EUt与体重指数（BMI） （r = 0.42; P < 0.0001）、空腹血糖（r = 0.23; P < 0.0001）和血压（r = 0.17; P < 0.0001）相关，但与年龄无关。最近在城市定居（少于或等于2年）的受试者BMI较高(+2.9 kg/m(2)；P < 0.001)，空腹血糖（+0.8 mmol/l, P < 0.001），收缩压（+23 mmHg, P < 0.001）和舒张压（+9 mmHg, P = 0.001）血压高于2年欧盟病史的农村居民。生命最初5年的EU本身与血糖或BMI无关。然而，终生EUt和当前居住地都与肥胖和糖尿病独立相关。终生EUt与高血压之间的关联并非独立于当前居住地和当前体力活动水平。结论本研究表明，对于肥胖和糖尿病的研究，除了目前的居住地外，还应调查终生暴露于城市环境和最近的移民史。
Background This study aimed to assess the association between lifetime exposure to urban environment (EU) and obesity, diabetes, and hypertension in an adult population of Sub-Saharan Africa.Methods We studied 999 women and 727 men aged greater than or equal to25 years. They represent all the adults aged greater than or equal to25 years living in households randomly selected from a rural and an urban community of Cameroon with a 98% and 96% participation rate respectively. Height, weight, blood pressure, and fasting blood glucose were measured in all subjects. Current levels of physical activity (in metabolic equivalents [MET]) were evaluated through the Sub-Saharan African Activity Questionnaire. Chronological data on lifetime migration were collected retrospectively and expressed as the total (EUt) or percentage (EU%) of lifetime exposure to urban environment.Results Lifetime EUt was associated with body mass index (BMI) (r = 0.42; P < 0.0001), fasting glycaemia (r = 0.23; P < 0.0001), and blood pressure (r = 0.17; P < 0.0001) but not with age. The subjects who recently settled in a city (less than or equal to2 years) had higher BMI (+2.9 kg/m(2); P < 0.001), fasting glycaemia (+0.8 mmol/l; P < 0.001), systolic (+23 mmHg; P < 0.001) and diastolic (+9 mmHg; P = 0.001) blood pressure than rural dwellers with a history of 2 years EU. EU during the first 5 years of life was not, on its own, associated with glycaemia or BMI. However, both lifetime EUt and current residence were independently associated with obesity and diabetes. The association between lifetime EUt and hypertension was not independent of current residence and current level of physical activity.Conclusions This study suggests that for the study of obesity and diabetes, in addition to current residence, both lifetime exposure to an urban environment and recent migration history should be investigated.