Addo Juliet, Agyemang Charles, de-Graft Aikins Ama, Beune Erik, Schulze Matthias B, Danquah Ina, Galbete Cecilia, Nicolaou Mary, Meeks Karlijn, Klipstein-Grobusch Kerstin, Bahendaka Silver, Mockenhaupt Frank P, Owusu-Dabo Ellis, Kunst Anton, Stronks Karien, Smeeth Liam
Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
J Epidemiol Community Health. 2017 Jul;71(7):633-639. doi: 10.1136/jech-2016-208322. Epub 2017 Mar 27.
The prevalence of diabetes has been shown to be socially patterned but the direction of the association in low-income countries and among migrant populations in Europe has varied in the literature. This study examined the association between socioeconomic position (SEP) and diabetes in Ghanaians in Europe and in Ghana.
Data were derived from the multicentre Research on Obesity and Diabetes among African Migrants (RODAM) study of Ghanaian adults aged 25-70 years residing in Europe (Amsterdam, Berlin and London) and in urban and rural Ghana. Educational attainment (elementary, secondary or higher) and occupational class (low or high) were used as indicators of SEP. Age-standardised prevalence of diabetes and prevalence ratios were evaluated separately for men and women of different SEP in Ghana and Europe.
A total of 5290 participants were included in the analyses. The prevalence of diabetes decreased with increasing level of education in Ghanaian men and women in Europe and in men in urban Ghana, whereas diabetes prevalence increased with increasing level of education in men and women in rural Ghana. The association between occupational class and the prevalence of diabetes followed a less consistent pattern in men and women in the different locations.
The association of diabetes and SEP differed in rural Ghana compared with urban settings in Ghana and Europe and comparing men and women, highlighting the complex interaction of SEP and the development of diabetes. These findings have important implications for diabetes prevention strategies in Ghanaians in different locations.
糖尿病的患病率已显示出具有社会模式,但在低收入国家以及欧洲的移民人群中,这种关联的方向在文献中有所不同。本研究调查了欧洲加纳人和加纳国内社会经济地位(SEP)与糖尿病之间的关联。
数据来自多中心的非洲移民肥胖与糖尿病研究(RODAM),研究对象为居住在欧洲(阿姆斯特丹、柏林和伦敦)以及加纳城乡地区的25至70岁加纳成年人。教育程度(小学、中学或更高)和职业阶层(低或高)被用作SEP的指标。分别对加纳和欧洲不同SEP的男性和女性评估年龄标准化的糖尿病患病率和患病率比。
共有5290名参与者纳入分析。在欧洲的加纳男性和女性以及加纳城市男性中,糖尿病患病率随着教育水平的提高而降低,而在加纳农村的男性和女性中,糖尿病患病率随着教育水平的提高而增加。在不同地点的男性和女性中,职业阶层与糖尿病患病率之间的关联模式不太一致。
与加纳城市以及欧洲的情况相比,加纳农村地区糖尿病与SEP之间的关联有所不同,而且在男性和女性之间也存在差异,这突出了SEP与糖尿病发展之间复杂的相互作用。这些发现对不同地区加纳人的糖尿病预防策略具有重要意义。