欧洲加纳人群中的移民与心血管疾病风险：RODAM研究（非洲移民肥胖与糖尿病研究）

Migration and Cardiovascular Disease Risk Among Ghanaian Populations in Europe: The RODAM Study (Research on Obesity and Diabetes Among African Migrants).

作者信息

Boateng Daniel, Agyemang Charles, Beune Erik, Meeks Karlijn, Smeeth Liam, Schulze Matthias, Addo Juliet, de-Graft Aikins Ama, Galbete Cecilia, Bahendeka Silver, Danquah Ina, Agyei-Baffour Peter, Owusu-Dabo Ellis, Mockenhaupt Frank P, Spranger Joachim, Kengne Andre P, Grobbee Diederick E, Stronks Karien, Klipstein-Grobusch Kerstin

机构信息

From Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands (D.B., D.E.G., K.K.-G.); School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (D.B., P.A.B., E.O.-D.); Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, The Netherlands (C.A., E.B., K.M., K.S.); Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom (L.S., J.A.); Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (M.S., C.G., I.D.); Regional Institute for Population Studies, University of Ghana, Legon, Ghana (A.d.-G.A.); Mother Kevin Postgraduate Medical School, Uganda Martyrs University, Kampala (S.B.); Kumasi Centre for Collaborative Research, Kwame NKrumah University of Science and Technology, Ghana (E.O.-D.); Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Germany (F.P.M.); Charite Center for Cardiovascular Research, Berlin, Germany (J.S.); Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa (A.P.K.); and Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (K.K.-G.).

出版信息

Circ Cardiovasc Qual Outcomes. 2017 Nov;10(11). doi: 10.1161/CIRCOUTCOMES.117.004013.

DOI:10.1161/CIRCOUTCOMES.117.004013

PMID:29150534

Abstract

BACKGROUND

For migrant populations from sub-Saharan Africa, adverse cardiovascular disease (CVD) risk factors have been observed to be higher than found in their home country-based counterparts or among the host populations in high-income countries. Differences in absolute overall CVD risk, however, remain largely unexplained. We, therefore, predicted the differences in 10-year CVD risk among sub-Saharan African migrants (Ghanaians) living in 3 European cities and Ghana.

METHODS AND RESULTS

For 3864 subjects aged 40 to 70 years from the multicenter RODAM study (Research on Obesity and Diabetes Among African Migrants) conducted among Ghanaian adults residing in rural and urban Ghana and 3 European cities (Amsterdam, Berlin, and London), 10-year risk of CVD was estimated using the Pooled Cohort Equations with estimates ≥7.5% defining high CVD risk. Logistic regressions were used to determine the association of migration on CVD risk. The proportion with CVD risk ≥7.5% among Ghanaian men was 34.7% in rural Ghana, 45.4% in urban Ghana, 53.9% in Amsterdam, 61.0% in Berlin, and 52.2% in London. Compared with rural Ghana, CVD risk was significantly increased for Ghanaian men living in Berlin (adjusted odds ratio, 2.80; 95% confidence interval, 1.76-4.45) and Amsterdam (1.88; 1.25-2.84). Increased risk observed for men was largely not seen for women. CVD risk increased with longer stay in Europe.

CONCLUSIONS

Knowledge about predictors of increased CVD risk among sub-Saharan African migrants in Europe and nonmigrants in urban centers will inform and support targeted health care and interventions to these populations.

摘要

背景

对于来自撒哈拉以南非洲的移民群体，已观察到其不良心血管疾病（CVD）风险因素高于其在原籍国的同龄人或高收入国家的东道国人群。然而，绝对总体CVD风险的差异在很大程度上仍无法解释。因此，我们预测了居住在3个欧洲城市和加纳的撒哈拉以南非洲移民（加纳人）之间10年CVD风险的差异。

方法与结果

在多中心RODAM研究（非洲移民肥胖与糖尿病研究）中，对3864名年龄在40至70岁之间的受试者进行了研究，这些受试者来自居住在加纳农村和城市以及3个欧洲城市（阿姆斯特丹、柏林和伦敦）的加纳成年人。使用合并队列方程估计10年CVD风险，估计值≥7.5%定义为高CVD风险。采用逻辑回归确定移民与CVD风险之间的关联。加纳男性中CVD风险≥7.5%的比例在加纳农村为34.7%，在加纳城市为45.4%，在阿姆斯特丹为53.9%，在柏林为61.0%，在伦敦为52.2%。与加纳农村相比，居住在柏林（调整后的优势比，2.80；95%置信区间，1.76 - 4.45）和阿姆斯特丹（1.88；1.25 - 2.84）的加纳男性CVD风险显著增加。男性中观察到的风险增加在很大程度上在女性中未观察到。CVD风险随着在欧洲停留时间的延长而增加。