Non-communicable Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK.
BMJ. 2010 Sep 27;341:c4974. doi: 10.1136/bmj.c4974.
To investigate the sociodemographic patterning of non-communicable disease risk factors in rural India.
Cross sectional study.
About 1600 villages from 18 states in India. Most were from four large states due to a convenience sampling strategy.
1983 (31% women) people aged 20-69 years (49% response rate).
Prevalence of tobacco use, alcohol use, low fruit and vegetable intake, low physical activity, obesity, central adiposity, hypertension, dyslipidaemia, diabetes, and underweight.
Prevalence of most risk factors increased with age. Tobacco and alcohol use, low intake of fruit and vegetables, and underweight were more common in lower socioeconomic positions; whereas obesity, dyslipidaemia, and diabetes (men only) and hypertension (women only) were more prevalent in higher socioeconomic positions. For example, 37% (95% CI 30% to 44%) of men smoked tobacco in the lowest socioeconomic group compared with 15% (12% to 17%) in the highest, while 35% (30% to 40%) of women in the highest socioeconomic group were obese compared with 13% (7% to 19%) in the lowest. The age standardised prevalence of some risk factors was: tobacco use (40% (37% to 42%) men, 4% (3% to 6%) women); low fruit and vegetable intake (69% (66% to 71%) men, 75% (71% to 78%) women); obesity (19% (17% to 21%) men, 28% (24% to 31%) women); dyslipidaemia (33% (31% to 36%) men, 35% (31% to 38%) women); hypertension (20% (18% to 22%) men, 22% (19% to 25%) women); diabetes (6% (5% to 7%) men, 5% (4% to 7%) women); and underweight (21% (19% to 23%) men, 18% (15% to 21%) women). Risk factors were generally more prevalent in south Indians compared with north Indians. For example, the prevalence of dyslipidaemia was 21% (17% to 33%) in north Indian men compared with 33% (29% to 38%) in south Indian men, while the prevalence of obesity was 13% (9% to 17%) in north Indian women compared with 24% (19% to 30%) in south Indian women.
The prevalence of most risk factors was generally high across a range of sociodemographic groups in this sample of rural villagers in India; in particular, the prevalence of tobacco use in men and obesity in women was striking. However, given the limitations of the study (convenience sampling design and low response rate), cautious interpretation of the results is warranted. These data highlight the need for careful monitoring and control of non-communicable disease risk factors in rural areas of India.
调查印度农村地区非传染性疾病危险因素的社会人口学模式。
横断面研究。
印度 18 个邦的大约 1600 个村庄。由于采用了便利抽样策略，大多数村庄来自四个邦。
1983 人（31%为女性），年龄 20-69 岁（49%的应答率）。
烟草使用、饮酒、水果和蔬菜摄入量低、体力活动少、肥胖、中心性肥胖、高血压、血脂异常、糖尿病和体重不足的流行情况。
大多数危险因素的流行率随着年龄的增长而增加。在较低社会经济地位的人群中，烟草和酒精使用、水果和蔬菜摄入不足以及体重不足更为常见；而在较高社会经济地位的人群中，肥胖、血脂异常和糖尿病（仅男性）以及高血压（仅女性）更为普遍。例如，在最低社会经济群体中，37%（95%CI，30%-44%）的男性吸烟，而在最高社会经济群体中，这一比例为 15%（12%-17%）；在最高社会经济群体中，35%（30%-40%）的女性肥胖，而在最低社会经济群体中，这一比例为 13%（7%-19%）。一些危险因素的年龄标准化流行率为：烟草使用（40%（37%-42%）的男性，4%（3%-6%）的女性）；水果和蔬菜摄入不足（69%（66%-71%）的男性，75%（71%-78%）的女性）；肥胖（19%（17%-21%）的男性，28%（24%-31%）的女性）；血脂异常（33%（31%-36%）的男性，35%（31%-38%）的女性）；高血压（20%（18%-22%）的男性，22%（19%-25%）的女性）；糖尿病（6%（5%-7%）的男性，5%（4%-7%）的女性）；体重不足（21%（19%-23%）的男性，18%（15%-21%）的女性）。与北方印度人相比，这些危险因素在南方印度人中更为普遍。例如，北方印度男性血脂异常的患病率为 21%（17%-33%），而南方印度男性的患病率为 33%（29%-38%）；北方印度女性肥胖的患病率为 13%（9%-17%），而南方印度女性的患病率为 24%（19%-30%）。
在印度农村地区，本研究样本中大多数社会人口学群体的大多数危险因素的流行率普遍较高；特别是，男性吸烟和女性肥胖的流行率尤为显著。然而，考虑到研究的局限性（便利抽样设计和低应答率），对结果的解释需要谨慎。这些数据突显了在印度农村地区需要仔细监测和控制非传染性疾病危险因素。
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