尼日利亚糖尿病的患病率及危险因素：一项系统评价与荟萃分析

Prevalence and Risk Factors for Diabetes Mellitus in Nigeria: A Systematic Review and Meta-Analysis.

作者信息

Uloko Andrew E, Musa Baba M, Ramalan Mansur A, Gezawa Ibrahim D, Puepet Fabian H, Uloko Ayekame T, Borodo Musa M, Sada Kabiru B

机构信息

Department of Medicine, Aminu Kano Teaching Hospital Kano, Bayero University Kano, Kano, Nigeria.

Department of Medicine, Jos University Teaching Hospital Jos, University of Jos, Jos, Nigeria.

出版信息

Diabetes Ther. 2018 Jun;9(3):1307-1316. doi: 10.1007/s13300-018-0441-1. Epub 2018 May 14.

DOI:10.1007/s13300-018-0441-1

PMID:29761289

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5984944/

Abstract

INTRODUCTION

There has been no nationwide health (diabetes) survey in Nigeria since 1992, when a diabetes mellitus (DM) prevalence of 2.2% was reported. We aimed to determine the prevalence of and risk factors for DM in Nigeria by performing a systematic review and meta-analysis.

METHODS

We searched Medline, EMBASE, PubMed, PapersFirst, the Cochrane Library, Scopus, Bioline, African Journals Online, Institute of Scientific Information, and Google Scholar from the year 1990 to 2017. Using MeSH headings, the terms "diabetes mellitus," "risk factors," "prevalence," and "Nigeria" as well as variations thereof were searched for. The last search was performed on 26 November 2017. We only included studies that utilized the random plasma glucose test, the fasting plasma glucose test, the oral glucose tolerance test (OGTT), or HbA1c to diagnose DM. A total of 23 studies (n = 14,650 persons) were evaluated. A random effects model was used to estimate the pooled prevalence of DM. We estimated the overall pooled prevalence of DM and subgroup-specific DM prevalences while accounting for inter-study and intra-study variability/heterogeneity.

RESULTS

The overall pooled prevalence of DM was 5.77% (95% CI 4.3-7.1). The pooled prevalences of DM in the six geopolitical zones of Nigeria were 3.0% (95% CI 1.7-4.3) in the north-west, 5.9% (95% CI 2.4-9.4) in the north-east, 3.8% (95% CI 2.9-4.7) in the north-central zone, 5.5% (95% CI 4.0-7.1) in the south-west, 4.6% (95% CI 3.4-5.9) in the south-east, and 9.8% (95% CI 7.2-12.4) in the south-south zone. Risk factors for the pooled prevalence of DM were a family history of DM (4.6%; 95% CI 3.5-5.6); urban dwelling (6.0%; 95% CI 4.3-7.8); unhealthy dietary habits (8.0%; 95% CI 5.4-10.5); cigarette smoking (4.4%; 95% CI 1.3-10.2); older age (6.6%; 95% CI 4.5-8.7); physical inactivity (4.8%; 95% CI 3.2-6.4); and obesity (5.3%; 95% CI 3.8-6.9).

CONCLUSION

There has been an increase in the prevalence of DM in Nigeria. All regions of the country have been affected, with the highest prevalence seen in the south-south geopolitical zone. Urban dwelling, physical inactivity, advanced age, and unhealthy diet are important risk factors for DM among Nigerians. A national diabetes care and prevention policy is highly recommended.

摘要

引言

自1992年以来，尼日利亚尚未开展过全国性的健康（糖尿病）调查，当时报告的糖尿病（DM）患病率为2.2%。我们旨在通过进行系统评价和荟萃分析来确定尼日利亚DM的患病率及其危险因素。

方法

我们检索了1990年至2017年期间的Medline、EMBASE、PubMed、PapersFirst、Cochrane图书馆、Scopus、Bioline、非洲期刊在线、科学信息研究所和谷歌学术。使用医学主题词，检索了“糖尿病”、“危险因素”、“患病率”和“尼日利亚”等术语及其变体。最后一次检索于2017年11月26日进行。我们仅纳入了使用随机血糖检测、空腹血糖检测、口服葡萄糖耐量试验（OGTT）或糖化血红蛋白（HbA1c）诊断DM的研究。共评估了23项研究（n = 14650人）。采用随机效应模型估计DM的合并患病率。我们在考虑研究间和研究内变异性/异质性的同时，估计了DM的总体合并患病率和亚组特异性DM患病率。

结果

DM的总体合并患病率为5.77%（95%CI 4.3 - 7.1）。尼日利亚六个地理政治区域的DM合并患病率分别为：西北部3.0%（95%CI 1.7 - 4.3），东北部5.9%（95%CI 2.4 - 9.4），中北部3.8%（95%CI 2.9 - 4.7），西南部5.5%（95%CI 4.0 - 7.1），东南部4.6%（95%CI 3.4 - 5.9），南部5.5%（95%CI 7.2 - 12.4）。DM合并患病率的危险因素包括：DM家族史（4.6%；95%CI 3.5 - 5.6）；城市居住（6.0%；95%CI 4.3 - 7.8）；不健康饮食习惯（8.0%；95%CI 5.4 - 10.5）；吸烟（4.4%；95%CI 1.3 - 10.2）；年龄较大（6.6%；95%CI 4.5 - 8.7）；身体活动不足（4.8%；95%CI 3.2 - 6.4）；肥胖（5.3%；95%CI 3.8 - 6.9）。