The George Institute for Global Health, University of Sydney, Sydney, Australia.
Diabetes Res Clin Pract. 2011 Dec;94(3):471-6. doi: 10.1016/j.diabres.2011.10.002. Epub 2011 Oct 22.
To estimate the population attributable fraction (PAF) of elevated body mass index (BMI) for diabetes mortality by country, sex and age group, for the Western Pacific and South-East Asia regions.
Published data on nationally representative mean BMI (since year 2000) and age-specific hazard ratios for death due to diabetes for a unit increase in BMI were used to calculate PAFs using the methodology of the WHO Global Burden of Disease project, taking a BMI of 21 kg/m(2) as the ideal.
Data were available for 15 countries in the Western Pacific and South East Asia regions. This included data from 330,374 individuals. Age-standardized male PAFs ranged from 11% for India to 98% for American Samoa. Age-standardized female PAFs ranged from 9% in India to 95% in American Samoa. For males, several countries had PAFs at or below 30% - these were India, Indonesia and Japan; whereas, India and Indonesia were the only two countries with PAFs below approximately 30% for females.
Although this study is not a trial and thus not able to definitively state the proportions of diabetes deaths that could be averted by reducing mean BMI, this paper demonstrates that theoretically between 9% and 98% of deaths from diabetes could be prevented by tackling obesity in the Asia Pacific region. Preventing these deaths is likely to have an enormous positive social and economic impact, particularly in this region consisting of many low and middle-income countries.
估计按国家、性别和年龄组划分的西太平洋和东南亚地区肥胖（BMI）导致糖尿病死亡率的人群归因分数（PAF）。
使用了关于各国代表性平均 BMI（自 2000 年以来）和 BMI 每增加一个单位导致糖尿病死亡的特定年龄危险比的已发表数据，采用世界卫生组织全球疾病负担项目的方法计算 PAF，将 BMI 为 21kg/m² 作为理想值。
西太平洋和东南亚地区的 15 个国家提供了数据。这包括来自 330374 人的数据。年龄标准化的男性 PAF 范围从印度的 11%到美属萨摩亚的 98%。年龄标准化的女性 PAF 范围从印度的 9%到美属萨摩亚的 95%。对于男性，有几个国家的 PAF 处于或低于 30% - 这些国家是印度、印度尼西亚和日本；而印度和印度尼西亚是仅有的两个女性 PAF 低于约 30%的国家。
尽管这项研究不是一项试验，因此不能明确说明通过降低平均 BMI 可以避免的糖尿病死亡比例，但本文表明，从理论上讲，通过解决亚太地区的肥胖问题，可以预防 9%至 98%的糖尿病死亡。预防这些死亡可能会产生巨大的积极的社会和经济效益，特别是在这个由许多低收入和中等收入国家组成的地区。
