Mutyambizi Chipo, Chola Lumbwe, Groot Wim, Pavlova Milena, Labadarios Demetre, Hongoro Charles
Population Health, Health Systems and Innovation, Human Sciences Research Council, HSRC Building, 134 Pretorius Street, Pretoria, 0002, South Africa.
School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
BMC Public Health. 2017 Sep 26;17(1):745. doi: 10.1186/s12889-017-4792-8.
Diabetes is a major health problem and cause of death worldwide. It is predicted that the prevalence of diabetes will increase from 415 million in 2015 to 642 million in 2040. However, the burden of diabetes in low- and middle-income countries is not clearly understood, particularly its interaction with other chronic illnesses. This study investigates the self-reported prevalence of and factors associated with diabetes and cardiovascular comorbidity in South Africa.
Data used in this study are from the 2012 South African National Health and Nutrition Examination Survey; a nationally representative cross-sectional household survey (N = 25,532). Diabetes and cardiovascular disease comorbidity was defined as the coexistence of diabetes plus one or more cardiovascular diseases reported at the time of the survey. This study makes use of multinomial logistic regression models to analyse the relationship between diabetes - cardiovascular disease comorbidity and several predictors including race, income, socio-economic status and obesity.
According to the survey data we analysed, 5% of South Africans aged 15 and above had self-reported diabetes in 2011-2012. Among those with self-reported diabetes, 73% had at least one additional cardiovascular chronic illness. Diabetes and its cardiovascular disease comorbidity was more prevalent in Africans (66%), females (66%), those who lived in urban areas (75%), had secondary education (44%) and were unemployed (62%). Factors strongly associated with diabetes - cardiovascular disease comorbidity were older age (Odds ratio [OR] 1.09; 95% Confidence Interval [CI] 1.06-1.12), high household income (0.27; 0.10-0.76) versus low income, moderate (0.33; 0.11-0.96) and good self-rated health (0.24; 0.08-0.68) versus bad self-rated health, occasional (0.29; 0.10-0.88) and regular smokers (0.25; 0.12-0.53) versus non-smokers and physical activity (0.15; 0.03-0.68) versus no physical activity.
The study provides insight into the factors associated with cardiovascular disease comorbidity in diabetic individuals. The findings indicate that there are differences in the factors associated with diabetes and those associated with diabetes - cardiovascular disease comorbidity. This provides information, which can be used to design programmes that encourage healthy lifestyles in people living with diabetes.
糖尿病是一个全球性的重大健康问题和死亡原因。据预测，糖尿病患病率将从2015年的4.15亿增加到2040年的6.42亿。然而，低收入和中等收入国家的糖尿病负担尚不清楚，尤其是其与其他慢性病的相互作用。本研究调查了南非糖尿病及糖尿病与心血管疾病合并症的自我报告患病率及其相关因素。
本研究使用的数据来自2012年南非国家健康与营养检查调查，这是一项具有全国代表性的横断面家庭调查（N = 25,532）。糖尿病与心血管疾病合并症定义为在调查时报告的糖尿病与一种或多种心血管疾病并存。本研究利用多项逻辑回归模型分析糖尿病 - 心血管疾病合并症与包括种族、收入、社会经济地位和肥胖在内的几个预测因素之间的关系。
根据我们分析的调查数据，在2011 - 2012年，15岁及以上的南非人中有5%自我报告患有糖尿病。在那些自我报告患有糖尿病的人中，73%至少还患有一种心血管慢性病。糖尿病及其与心血管疾病的合并症在非洲人（66%）、女性（66%）、居住在城市地区的人（75%）、接受过中等教育的人（44%）和失业者（62%）中更为普遍。与糖尿病 - 心血管疾病合并症密切相关的因素包括年龄较大（优势比[OR] 1.09；95%置信区间[CI] 1.06 - 1.12）、家庭收入高（0.27；0.10 - 0.76）与低收入相比、自我健康评价中等（0.33；0.11 - 0.96）和良好（0.24；0.08 - 0.68）与自我健康评价差相比、偶尔吸烟（0.29；0.10 - 0.88）和经常吸烟（0.25；0.12 - 0.53）与不吸烟相比以及有体育活动（0.15；0.03 - 0.68）与无体育活动相比。
该研究深入了解了糖尿病患者心血管疾病合并症的相关因素。研究结果表明，与糖尿病相关的因素和与糖尿病 - 心血管疾病合并症相关的因素存在差异。这提供了可用于设计鼓励糖尿病患者健康生活方式项目的信息。
