Chow Clara Kayei, Naidu Shanthi, Raju Krishnam, Raju Rama, Joshi Rohina, Sullivan David, Celermajer David S, Neal Bruce C
The George Institute for International Health, University of Sydney, PO Box M 201, Camperdown, Missenden Road, Sydney 2050, Australia.
Atherosclerosis. 2008 Feb;196(2):943-52. doi: 10.1016/j.atherosclerosis.2007.02.027. Epub 2007 Apr 27.
Both migrant and local urban populations of Asian Indians have high rates of cardiovascular disease. Metabolic risk factors appear key to this phenomenon but data from rural India are few. We sought to determine the prevalence and distribution of lipids, obesity and metabolic syndrome in a rural region of Andhra Pradesh.
Sampling was done in 20 villages representative of the project area with an age- and sex-stratified group of 4535 adults > or =30 years selected at random from a local census list. The sample represented 13% of all adults > or =30 years in the 20 villages with a response rate of 81%. All participants had interviewer administered questionnaire, physical examination and fasting finger-prick glucose. Every fourth individual had venous blood testing for lipid profile (n=1085). Analysis was done using weighting to obtain estimates of risk factor levels for the adult population in the 20 villages. In addition to standard WHO and 2005 NCEP-ATPIII classifications, exploratory 'Asian' definitions were used for overweight and abdominal obesity.
The population mean levels of total, LDL, HDL-cholesterol and triglycerides were 4.5 (4.4-4.6) mmol/L, 2.8 (2.7-2.9) mmol/L, 1.1 (1.06-1.13) mmol/L, 1.5 (1.4-1.6) mmol/L for men; and 4.8 (4.7-4.9) mmol/L, 3.0 (3.0-3.1) mmol/L, 1.2 (1.16-1.22) mmol/L, 1.3 (1.2-1.4) mmol/L for women. 18.4% of men and 26.3% of women were overweight rising to 32.4% of men and 41.4% of women if 'Asian' definitions were used. Criteria for NCEP-ATPIII metabolic syndrome were met by 26.9% of men and 18.4% of women with figures of 32.5% and 23.9%, respectively, if 'Asian' waist cut-offs were substituted.
Dyslipidaemia, adiposity and metabolic syndrome were common in this rural Indian population and prevalence was much greater if proposed Asian definitions for adiposity were used. Metabolic risk factors likely play a major role in cardiovascular disease in this region.
亚洲印度裔移民和当地城市人口的心血管疾病发病率均较高。代谢风险因素似乎是这一现象的关键，但来自印度农村的数据较少。我们试图确定安得拉邦一个农村地区血脂、肥胖和代谢综合征的患病率及分布情况。
在该项目地区具有代表性的20个村庄进行抽样，从当地人口普查名单中随机选取4535名年龄≥30岁的成年人，按年龄和性别分层。该样本占20个村庄所有年龄≥30岁成年人的13%，应答率为81%。所有参与者均接受访员管理的问卷调查、体格检查和空腹指尖血糖检测。每四个人中就有一人进行静脉血血脂谱检测（n = 1085）。采用加权分析以获得20个村庄成年人群危险因素水平的估计值。除了世界卫生组织标准和2005年美国国家胆固醇教育计划成人治疗组第三次报告（NCEP - ATPIII）分类外，还采用了探索性的“亚洲”超重和腹型肥胖定义。
男性总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和甘油三酯的人群平均水平分别为4.5（4.4 - 4.6）mmol/L、2.8（2.7 - 2.9）mmol/L、1.1（1.06 - 1.13）mmol/L、1.5（1.4 - 1.6）mmol/L；女性分别为4.8（4.7 - 4.9）mmol/L、3.0（3.0 - 3.1）mmol/L、1.2（1.16 - 1.22）mmol/L、1.3（1.2 - 1.4）mmol/L。18.4%的男性和26.3%的女性超重，若采用“亚洲”定义，超重男性比例升至32.4%，超重女性比例升至41.4%。符合NCEP - ATPIII代谢综合征标准的男性为26.9%，女性为18.4%，若采用“亚洲”腰围切点，则分别为32.5%和23.9%。
血脂异常、肥胖和代谢综合征在印度农村人群中很常见，若采用提议的亚洲肥胖定义，患病率会更高。代谢风险因素可能在该地区心血管疾病中起主要作用。
