Oggioni C, Lara J, Wells J C K, Soroka K, Siervo M
Human Nutrition Research Centre, Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne NE4 5PL, UK.
Childhood Nutrition Research Centre, UCL Institute of Child Health, London, UK.
Nutr Metab Cardiovasc Dis. 2014 Oct;24(10):1105-11. doi: 10.1016/j.numecd.2014.05.005. Epub 2014 May 24.
The worldwide epidemiology of diabetes is rapidly changing as a result of the spreading of westernised nutritional and lifestyle habits. We conducted an ecological analysis to identify dietary, lifestyle and socio-economic factors associated with global diabetes prevalence.
Country-specific estimates of diabetes prevalence were obtained. Data were then matched to year- and country-specific food and energy availability for consumption, and to year-specific information on obesity, physical inactivity, urbanisation, gross domestic product (GDP), and smoking. Data were obtained from publicly available databases compiled by the Food Agricultural Organisation (FAO), World Health Organisation (WHO) and World Bank. Cluster analysis was used to derive dietary patterns of global food consumption. The association with diabetes prevalence was evaluated. Stepwise multiple regression analysis was conducted to identify predictors associated with worldwide diabetes prevalence. 96 countries were eligible for inclusion in the analysis. The average diabetes prevalence was 7.0% and the highest rate was observed in the Middle-Eastern region (13.1%). The worldwide prevalence of obesity and physical inactivity was 15.1% and 36.1%, respectively. Diabetes prevalence was associated with age and physical inactivity prevalence in a fully adjusted multiple regression model. Three dietary patterns (agricultural, transitional and westernised) were identified by the cluster analysis. Diabetes prevalence showed a direct dose-response association with the degree of exposure to a westernised dietary pattern.
The adoption of sedentary lifestyle and westernised dietary patterns appears to be closely linked to the global rise in diabetes prevalence.
由于西方化的营养和生活方式习惯的传播，全球糖尿病流行病学正在迅速变化。我们进行了一项生态分析，以确定与全球糖尿病患病率相关的饮食、生活方式和社会经济因素。
获得了各国糖尿病患病率的估计值。然后将数据与各国特定年份的可供消费的食物和能量供应情况，以及肥胖、身体活动不足、城市化、国内生产总值（GDP）和吸烟等特定年份的信息进行匹配。数据来自联合国粮食及农业组织（FAO）、世界卫生组织（WHO）和世界银行编制的公开可用数据库。聚类分析用于得出全球食物消费的饮食模式。评估其与糖尿病患病率的关联。进行逐步多元回归分析以确定与全球糖尿病患病率相关的预测因素。96个国家符合纳入分析的条件。平均糖尿病患病率为7.0%，中东地区患病率最高（13.1%）。全球肥胖和身体活动不足的患病率分别为15.1%和36.1%。在完全调整的多元回归模型中，糖尿病患病率与年龄和身体活动不足患病率相关。聚类分析确定了三种饮食模式（农业型、过渡型和西方化型）。糖尿病患病率与西方化饮食模式暴露程度呈直接剂量反应关系。
久坐不动的生活方式和西方化饮食模式的采用似乎与全球糖尿病患病率的上升密切相关。
