Saw Swee Hock School of Public Health, National University of Singapore and National University Health System , Singapore.
Saw Swee Hock School of Public Health, National University of Singapore and National University Health System , Singapore ; Department of Statistics and Applied Probability , Faculty of Science, National University of Singapore , Singapore.
BMJ Open Diabetes Res Care. 2014 Jun 11;2(1):e000012. doi: 10.1136/bmjdrc-2013-000012. eCollection 2014.
Singapore is a microcosm of Asia as a whole, and its rapidly ageing, increasingly sedentary population heralds the chronic health problems other Asian countries are starting to face and will likely face in the decades ahead. Forecasting the changing burden of chronic diseases such as type 2 diabetes in Singapore is vital to plan the resources needed and motivate preventive efforts.
This paper describes an individual-level simulation model that uses evidence synthesis from multiple data streams-national statistics, national health surveys, and four cohort studies, and known risk factors-aging, obesity, ethnicity, and genetics-to forecast the prevalence of type 2 diabetes in Singapore. This comprises submodels for mortality, fertility, migration, body mass index trajectories, genetics, and workforce participation, parameterized using Markov chain Monte Carlo methods, and permits forecasts by ethnicity and employment status.
We forecast that the obesity prevalence will quadruple from 4.3% in 1990 to 15.9% in 2050, while the prevalence of type 2 diabetes (diagnosed and undiagnosed) among Singapore adults aged 18-69 will double from 7.3% in 1990 to 15% in 2050, that ethnic Indians and Malays will bear a disproportionate burden compared with the Chinese majority, and that the number of patients with diabetes in the workforce will grow markedly.
If the recent rise in obesity prevalence continues, the lifetime risk of type 2 diabetes in Singapore will be one in two by 2050 with concomitant implications for greater healthcare expenditure, productivity losses, and the targeting of health promotion programmes.
新加坡是整个亚洲的缩影，其人口迅速老龄化，越来越多的人久坐不动，预示着其他亚洲国家开始面临并可能在未来几十年面临的慢性健康问题。预测 2 型糖尿病等慢性疾病在新加坡的变化负担对于规划所需资源和激励预防工作至关重要。
本文描述了一种个体水平的模拟模型，该模型使用来自多个数据流的证据综合，包括国家统计数据、国家健康调查和四项队列研究，以及已知的风险因素，如年龄增长、肥胖、种族和遗传，来预测新加坡 2 型糖尿病的流行情况。该模型包括死亡率、生育率、移民、体重指数轨迹、遗传学和劳动力参与的子模型，使用马尔可夫链蒙特卡罗方法进行参数化，并允许按种族和就业状况进行预测。
我们预测肥胖患病率将从 1990 年的 4.3%增加到 2050 年的 15.9%，而 18-69 岁新加坡成年人中 2 型糖尿病（已诊断和未诊断）的患病率将从 1990 年的 7.3%增加到 2050 年的 15%，印度裔和马来裔与华裔多数族裔相比将承担不成比例的负担，并且劳动力中糖尿病患者的数量将显著增加。
如果肥胖患病率的近期上升趋势持续下去，到 2050 年，新加坡 2 型糖尿病的终身风险将达到二分之一，这将对医疗保健支出、生产力损失以及健康促进计划的目标产生相应影响。
