Agyemang Charles, Meeks Karlijn, Beune Erik, Owusu-Dabo Ellis, Mockenhaupt Frank P, Addo Juliet, de Graft Aikins Ama, Bahendeka Silver, Danquah Ina, Schulze Matthias B, Spranger Joachim, Burr Tom, Agyei-Baffour Peter, Amoah Stephen K, Galbete Cecilia, Henneman Peter, Klipstein-Grobusch Kerstin, Nicolaou Mary, Adeyemo Adebowale, van Straalen Jan, Smeeth Liam, Stronks Karien
Department of Public Health, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands.
School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
BMC Med. 2016 Oct 21;14(1):166. doi: 10.1186/s12916-016-0709-0.
Rising rates of obesity and type 2 diabetes (T2D) are impending major threats to the health of African populations, but the extent to which they differ between rural and urban settings in Africa and upon migration to Europe is unknown. We assessed the burden of obesity and T2D among Ghanaians living in rural and urban Ghana and Ghanaian migrants living in different European countries.
A multi-centre cross-sectional study was conducted among Ghanaian adults (n = 5659) aged 25-70 years residing in rural and urban Ghana and three European cities (Amsterdam, London and Berlin). Comparisons between groups were made using prevalence ratios (PRs) with adjustments for age and education.
In rural Ghana, the prevalence of obesity was 1.3 % in men and 8.3 % in women. The prevalence was considerably higher in urban Ghana (men, 6.9 %; PR: 5.26, 95 % CI, 2.04-13.57; women, 33.9 %; PR: 4.11, 3.13-5.40) and even more so in Europe, especially in London (men, 21.4 %; PR: 15.04, 5.98-37.84; women, 54.2 %; PR: 6.63, 5.04-8.72). The prevalence of T2D was low at 3.6 % and 5.5 % in rural Ghanaian men and women, and increased in urban Ghanaians (men, 10.3 %; PR: 3.06; 1.73-5.40; women, 9.2 %; PR: 1.81, 1.25-2.64) and highest in Berlin (men, 15.3 %; PR: 4.47; 2.50-7.98; women, 10.2 %; PR: 2.21, 1.30-3.75). Impaired fasting glycaemia prevalence was comparatively higher only in Amsterdam, and in London, men compared with rural Ghana.
Our study shows high risks of obesity and T2D among sub-Saharan African populations living in Europe. In Ghana, similarly high prevalence rates were seen in an urban environment, whereas in rural areas, the prevalence of obesity among women is already remarkable. Similar processes underlying the high burden of obesity and T2D following migration may also be at play in sub-Saharan Africa as a consequence of urbanisation.
肥胖率和2型糖尿病（T2D）的上升正成为非洲人群健康面临的主要威胁，但在非洲农村和城市地区以及移民到欧洲后两者的差异程度尚不清楚。我们评估了生活在加纳农村和城市的加纳人以及生活在欧洲不同国家的加纳移民中肥胖和T2D的负担。
对居住在加纳农村和城市以及三个欧洲城市（阿姆斯特丹、伦敦和柏林）的25至70岁加纳成年人（n = 5659）进行了一项多中心横断面研究。使用患病率比（PRs）并对年龄和教育程度进行调整后对组间进行比较。
在加纳农村，男性肥胖患病率为1.3%，女性为8.3%。加纳城市的患病率显著更高（男性为6.9%；PR：5.26，95%CI为2.04 - 13.57；女性为33.9%；PR：4.11，3.13 - 5.40），在欧洲甚至更高，尤其是在伦敦（男性为21.4%；PR：15.04，5.98 - 37.84；女性为54.2%；PR：6.63，5.04 - 8.72）。加纳农村男性和女性的T2D患病率较低，分别为3.6%和5.5%，在加纳城市有所上升（男性为10.3%；PR：3.06；1.73 - 5.40；女性为9.2%；PR：1.81，1.25 - 2.64），在柏林最高（男性为15.3%；PR：4.47；2.50 - 7.98；女性为10.2%；PR：2.21，1.30 - 3.75）。仅在阿姆斯特丹以及伦敦的男性中，空腹血糖受损患病率相对较高，与加纳农村相比。
我们的研究表明，生活在欧洲的撒哈拉以南非洲人群中肥胖和T2D风险很高。在加纳，城市环境中也出现了类似的高患病率，而在农村地区，女性肥胖患病率已经很高。城市化导致的肥胖和T2D高负担背后的类似过程在撒哈拉以南非洲可能也在起作用。
