社会经济和生活方式因素对突尼斯移民、非移民突尼斯人以及法国人中超重和营养相关疾病的影响。
Influence of socio-economic and lifestyle factors on overweight and nutrition-related diseases among Tunisian migrants versus non-migrant Tunisians and French.
作者信息
Méjean Caroline, Traissac Pierre, Eymard-Duvernay Sabrina, El Ati Jalila, Delpeuch Francis, Maire Bernard
机构信息
Nutrition Unit R106 (WHO collaborating centre for nutrition), Institut de Recherche pour le Développement (IRD), BP 64501, 34394 Montpellier, France.
出版信息
BMC Public Health. 2007 Sep 25;7:265. doi: 10.1186/1471-2458-7-265.
BACKGROUND
Migrant studies in France revealed that Mediterranean migrant men have lower mortality and morbidity than local-born populations for non-communicable diseases (NCDs). We studied overweight and NCDs among Tunisian migrants compared to the population of the host country and to the population of their country of origin. We also studied the potential influence of socio-economic and lifestyle factors on differential health status.
METHODS
A retrospective cohort study was conducted to compare Tunisian migrant men with two non-migrant male groups: local-born French and Tunisians living in Tunisia, using frequency matching. We performed quota sampling (n = 147) based on age and place of residence. We used embedded logistic regression models to test socio-economic and lifestyle factors as potential mediators for the effect of migration on overweight, hypertension and reported morbidity (hypercholesterolemia, type-2 diabetes, cardiovascular diseases (CVD)).
RESULTS
Migrants were less overweight than French (OR = 0.53 [0.33-0.84]) and had less diabetes and CVD than Tunisians (0.18 [0.06-0.54] and 0.25 [0.07-0.88]). Prevalence of hypertension (grade-1 and -2) and prevalence of hypercholesterolemia were significantly lower among migrants than among French (respectively 0.06 [0.03-0.14]; 0.04 [0.01-0.15]; 0.11 [0.04-0.34]) and Tunisians (respectively OR = 0.07 [0.03-0.18]; OR = 0.06 [0.02-0.20]; OR = 0.23 [0.08-0.63]). The effect of migration on overweight was mediated by alcohol consumption. Healthcare utilisation, smoking and physical activity were mediators for the effect of migration on diabetes. The effect of migration on CVD was mediated by healthcare utilisation and energy intake. No obvious mediating effect was found for hypertension and hypercholesterolemia.
CONCLUSION
Our study clearly shows that lifestyle (smoking) and cultural background (alcohol) are involved in the observed protective effect of migration.
背景
法国的移民研究表明，地中海移民男性在非传染性疾病（NCDs）方面的死亡率和发病率低于当地出生人口。我们研究了突尼斯移民与东道国人口以及其原籍国人口相比的超重和非传染性疾病情况。我们还研究了社会经济和生活方式因素对不同健康状况的潜在影响。
方法
进行了一项回顾性队列研究，采用频率匹配的方法，将突尼斯移民男性与两个非移民男性群体进行比较：当地出生的法国人和居住在突尼斯的突尼斯人。我们根据年龄和居住地进行配额抽样（n = 147）。我们使用嵌入式逻辑回归模型来测试社会经济和生活方式因素作为移民对超重、高血压和报告发病率（高胆固醇血症、2型糖尿病、心血管疾病（CVD））影响的潜在中介因素。
结果
移民的超重情况少于法国人（OR = 0.53 [0.33 - 0.84]），糖尿病和心血管疾病的发病率低于突尼斯人（0.18 [0.06 - 0.54] 和0.25 [0.07 - 0.88]）。移民中高血压（1级和2级）患病率和高胆固醇血症患病率显著低于法国人（分别为0.06 [0.03 - 0.14]；0.04 [0.01 - 0.15]；0.11 [0.04 - 0.34]）和突尼斯人（分别为OR = 0.07 [0.03 - 0.18]；OR = 0.06 [0.02 - 0.20]；OR = 0.23 [0.08 - 0.63]）。移民对超重的影响通过饮酒介导。医疗保健利用、吸烟和体育活动是移民对糖尿病影响的中介因素。移民对心血管疾病的影响通过医疗保健利用和能量摄入介导。未发现高血压和高胆固醇血症有明显的中介作用。
结论
我们的研究清楚地表明，生活方式（吸烟）和文化背景（饮酒）与观察到的移民保护作用有关。
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