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关于西班牙加那利群岛2型糖尿病相关死亡率的问题。达里奥斯研究。

On the problem of type 2 diabetes-related mortality in the Canary Islands, Spain. The DARIOS Study.

作者信息

Marcelino-Rodríguez Itahisa, Elosua Roberto, Pérez María del Cristo Rodríguez, Fernández-Bergés Daniel, Guembe María Jesús, Alonso Tomás Vega, Félix Francisco Javier, González Delia Almeida, Ortiz-Marrón Honorato, Rigo Fernando, Lapetra José, Gavrila Diana, Segura Antonio, Fitó Montserrat, Peñafiel Judith, Marrugat Jaume, de León Antonio Cabrera

机构信息

Unidad de Investigación de Atención Primaria y del Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, España; Red de Investigación Cardiovascular del Instituto Carlos III Institute de Salud, Madrid, España.

Red de Investigación Cardiovascular del Instituto Carlos III Institute de Salud, Madrid, España; Grupo de Epidemiología y Genética Cardiovascular, Programa de Investigación en Procesos Inflamatorios y Cardiovasculares, IMIM, Barcelona, España; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, España.

出版信息

Diabetes Res Clin Pract. 2016 Jan;111:74-82. doi: 10.1016/j.diabres.2015.10.024. Epub 2015 Oct 23.

Abstract

AIMS

To compare diabetes-related mortality rates and factors associated with this disease in the Canary Islands compared with other 10 Spanish regions.

METHODS

In a cross-sectional study of 28,887 participants aged 35-74 years in Spain, data were obtained for diabetes, hypertension, dyslipidemia, obesity, insulin resistance (IR), and metabolic syndrome. Healthcare was measured as awareness, treatment and control of diabetes, dyslipidemia, and hypertension. Standardized mortality rate ratios (SRR) were calculated for the years 1981 to 2011 in the same regions.

RESULTS

Diabetes, obesity, and hypertension were more prevalent in people under the age of 64 in the Canary Islands than in Spain. For all ages, metabolic syndrome and insulin resistance (IR) were also more prevalent in those from the Canary Islands. Healthcare parameters were similar in those from the Canary Islands and the rest of Spain. Diabetes-related mortality in the Canary Islands was the highest in Spain since 1981; the maximum SRR was reached in 2011 in men (6.3 versus the region of Madrid; p<0.001) and women (9.5 versus Madrid; p<0.001). Excess mortality was prevalent from the age of 45 years and above.

CONCLUSIONS

Diabetes-related mortality is higher in the Canary Islands population than in any other Spanish region. The high mortality and prevalence of IR warrants investigation of the genetic background associated with a higher incidence and poor prognosis for diabetes in this population. The rise in SRR calls for a rapid public health policy response.

摘要

目的

比较加那利群岛与西班牙其他10个地区的糖尿病相关死亡率以及与该疾病相关的因素。

方法

在一项针对西班牙28887名年龄在35 - 74岁参与者的横断面研究中,获取了糖尿病、高血压、血脂异常、肥胖、胰岛素抵抗(IR)和代谢综合征的数据。医疗保健情况通过糖尿病、血脂异常和高血压的知晓率、治疗率和控制率来衡量。计算了1981年至2011年同一地区的标准化死亡率比值(SRR)。

结果

加那利群岛64岁以下人群中的糖尿病、肥胖和高血压比西班牙其他地区更为普遍。对于所有年龄段,加那利群岛居民的代谢综合征和胰岛素抵抗(IR)也更为普遍。加那利群岛居民与西班牙其他地区居民在医疗保健参数方面相似。自1981年以来,加那利群岛的糖尿病相关死亡率在西班牙最高;2011年男性的SRR最高(与马德里地区相比为6.3;p<0.001),女性的SRR最高(与马德里相比为9.5;p<0.001)。45岁及以上人群普遍存在超额死亡率。

结论

加那利群岛人群的糖尿病相关死亡率高于西班牙其他任何地区。IR的高死亡率和高患病率值得对该人群中与糖尿病发病率较高和预后较差相关的遗传背景进行调查。SRR的上升需要公共卫生政策迅速做出回应。

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