马哈拉施特拉邦西部和北部部落社区高血压与糖尿病患病率及危险因素的多中心研究
Multicentric study on prevalence and risk factors for hypertension and diabetes in tribal communities in Western and Northern Maharashtra.
作者信息
Deo M G, Pawar P V, Kanetkar S R, Kakade S V
机构信息
Research Laboratory, Moving Academy of Medicine and Biomedicine, Pune, Maharashtra, India.
Department of Pathology (KSR) and Biochemistry (KSV), Krishna Institute of Medical Sciences, Karad, Maharashtra, India.
出版信息
J Postgrad Med. 2018 Jan-Mar;64(1):23-34. doi: 10.4103/jpgm.JPGM_245_17.
BACKGROUND AND OBJECTIVES
Although a number of studies have been conducted on the prevalence of hypertension (HTN) and diabetes on tribal populations in different parts of India, comparative tribe-specific information is very meager. The main objective of this study is to generate tribe-specific information on the noncommunicable disorders (NCDs) and associated risk factors in scheduled tribes (STs) in Coastal and Western Maharashtra.
METHODS
The study was conducted on 1864 (females 960) adults (≥18 years) of both sexes in four dominant tribes in the region, namely, Bhils (748), Katkaris (560), Kokana (352), and Thakars (204), using the protocols approved by the Institutional Review Board. The study areas were geographically separated by large distances (250-500 km apart). Prevalence of overweight, diabetes, HTN, and hypercholesterolemia was measured using standard field-based techniques described in our earlier publication.
RESULTS
All STs in this study are grossly underweight; the Katkaris are worst affected. The prevalence of obesity (body mass index ≥30 kg/m2), HTN (blood pressure ≥140 mmHg), diabetes (capillary blood glucose >126 mg/dl), and hypercholesterolemia (cholesterol ≥200 mg/dl) was 0.9%, 11.7%, 6.7%, and 0.6% respectively. There are no statistically significant inter-tribal differences in the prevalence of these parameters. Age and obesity appeared to be the most dominant risk factors for HTN. However, there is no clear-cut picture about the influence of risk factors on diabetes or hypercholesterolemia.
INTERPRETATION AND CONCLUSION
The prevalence of NCDs is still very low in STs, probably due to near absence of the risk factors such as obesity, sedentary lifestyle, and hyperlipidemia. STs are highly endogamous, and the study areas are separated by large distances ruling out intermingling of tribes. Yet, there is no consistent inter-tribal prevalence pattern for NCDs. Although the sample size is small, the results support the view that environmental factors are likely to be more important than host genetics in the causation of NCDs.
背景与目的
尽管已经针对印度不同地区部落人群的高血压（HTN）和糖尿病患病率开展了多项研究，但特定部落的比较信息却非常匮乏。本研究的主要目的是获取马哈拉施特拉邦沿海地区和西部地区在册部落（STs）非传染性疾病（NCDs）及相关危险因素的特定部落信息。
方法
本研究采用经机构审查委员会批准的方案，对该地区四个主要部落（即比尔族（748人）、卡特卡里族（560人）、科卡纳族（352人）和萨卡尔族（204人））的1864名（女性960名）成年人（≥18岁）进行了研究。研究区域在地理上相距甚远（相距250 - 500公里）。超重、糖尿病、高血压和高胆固醇血症的患病率采用我们早期出版物中描述的基于现场的标准技术进行测量。
结果
本研究中的所有在册部落体重均严重不足；卡特卡里族受影响最为严重。肥胖（体重指数≥30 kg/m²）、高血压（血压≥140 mmHg）、糖尿病（毛细血管血糖>126 mg/dl）和高胆固醇血症（胆固醇≥200 mg/dl）的患病率分别为0.9%、11.7%、6.7%和0.6%。这些参数的患病率在部落间无统计学显著差异。年龄和肥胖似乎是高血压最主要的危险因素。然而，关于危险因素对糖尿病或高胆固醇血症的影响尚无明确情况。
解读与结论
在册部落中非传染性疾病的患病率仍然很低，这可能是由于肥胖、久坐不动的生活方式和高脂血症等危险因素几乎不存在。在册部落高度近亲结婚，且研究区域相距甚远，排除了部落间的通婚。然而，非传染性疾病的部落间患病率模式并不一致。尽管样本量较小，但结果支持以下观点：在非传染性疾病的病因中，环境因素可能比宿主基因更重要。
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