Achutha Menon Centre for Health Science Studies, Department of Biochemistry, Sree Chitra Tirunal Institute for Medical Sciences & Technology, Thiruvananthapuram, India.
Indian J Med Res. 2010 Jan;131:53-63.
BACKGROUND & OBJECTIVES: Kerala State is a harbinger of what will happen in future to the rest of India in chronic non-communicable diseases (NCD). We assessed: (i) the burden of NCD risk factors; (ii) estimated the relations of behavioural risk factors to socio-demographic correlates, anthropometric risk factors with behavioural risk factors; (iii) evaluated if socio-demographic, behavioural and anthropometric risk factors predicted biochemical risk factors; and (iv) estimated awareness, treatment and adequacy of control of hypertension and diabetes, in Kerala state.
A total of 7449 individuals (51% women) stratified by age group, sex and place of residence were selected and information on behavioural risk factors; tobacco use, diet, physical activity, alcohol use, measured anthropometry, blood pressure was collected. Fasting blood samples were analysed for blood glucose, total cholesterol, high density lipoprotein cholesterol and triglycerides in a sample subset.Using multiple logistic regression models the associations between socio-demographic and anthropometric variables with biochemical risk factors were estimated.
The burden of NCD risk factors was high in our sample. Prevalence of behavioural and each of the biochemical risk factors increased with age, adjusting for other factors including sex and the place of residence. The odds ratios relating anthropometric variables to biochemical variables were modest, suggesting that anthropometric variables may not be useful surrogates for biochemical risk factors for population screening purposes.
INTERPRETATION & CONCLUSIONS: In this large study of community-based sample in Kerala, high burden of NCD risk factors was observed, comparable to that in the United States. These data may serve to propel multisectoral efforts to lower the community burden of NCD risk factors in India in general, and in Kerala, in particular.
喀拉拉邦是印度其他地区未来慢性非传染性疾病（NCD）状况的先兆。我们评估了：（i）NCD 风险因素的负担；（ii）评估行为风险因素与社会人口统计学相关因素、人体测量风险因素与行为风险因素之间的关系；（iii）评估社会人口统计学、行为和人体测量风险因素是否预测生化风险因素；（iv）评估喀拉拉邦高血压和糖尿病的知晓率、治疗率和控制率。
从年龄组、性别和居住地分层选择了总共 7449 人（51%为女性），并收集了行为风险因素、烟草使用、饮食、体力活动、酒精使用、测量人体测量学、血压的信息。在样本亚集中分析空腹血样的血糖、总胆固醇、高密度脂蛋白胆固醇和甘油三酯。使用多因素逻辑回归模型估计社会人口统计学和人体测量学变量与生化风险因素之间的关联。
我们样本中的 NCD 风险因素负担很高。在调整了其他因素（包括性别和居住地）后，行为和每种生化风险因素的患病率均随年龄增长而增加。人体测量变量与生化变量之间的比值比适中，这表明人体测量变量可能不适用于人群筛查目的的生化风险因素的替代指标。
在喀拉拉邦的这项大型社区样本研究中，观察到 NCD 风险因素的负担很高，与美国相当。这些数据可能有助于推动多部门努力，降低印度，特别是喀拉拉邦社区的 NCD 风险因素负担。
