Guariguata Leonor, Brown Catherine, Sobers Natasha, Hambleton Ian, Samuels T Alafia, Unwin Nigel
George Alleyne Chronic Disease Research Centre, Caribbean Institute for Health Research, The University of the West Indies, Bridgetown, Barbados.
Faculty of Medical Sciences, The University of the West Indies, Bridgetown, Barbados.
Rev Panam Salud Publica. 2018 Dec 17;42:e171. doi: 10.26633/RPSP.2018.171. eCollection 2018.
To conduct an analysis of the most recent data on diabetes and its risk factors by gender and other social determinants of health to understand why its prevalence is higher among women than men in the Caribbean; to inform policy agenda-setting for diabetes prevention and control in the Caribbean; and to identify gaps in the evidence that require further research.
A previous systematic review of the literature describing studies conducted in the Caribbean that presented the distribution of diabetes, its outcomes, and risk factors, by one or more social determinants, was updated to include sources from 1 January 2007 - 31 December 2016. Surveys by the World Health Organization (WHO) were also included. Where data were sufficient, meta-analyses were undertaken.
A total of 8 326 manuscripts were identified. Of those, 282 were selected for full text review, and 114, for abstraction. In all, 36 papers, including WHO-related surveys, had sufficient information for meta-analysis. More women compared to men were obese (OR: 2.1; 95%CI = 1.65 - 2.69), physically inactive (OR: 2.18; 95%CI = 1.75 - 2.72), and had diabetes (OR: 1.48; 95%CI = 1.25 - 1.76). More men smoked (OR: 4.27; 95%CI = 3.18 - 5.74) and had inadequate fruit and vegetable intake (OR: 1.37; 95%CI = 1.21 - 1.57).
Thirty-six papers were added to the previously conducted systematic review; of those, 13 were added to the meta-analysis. Diabetes and its risk factors (primarily obesity and physical inactivity) continue to disproportionately affect women in the Caribbean. Smoking interventions should be targeted at men in this geographic area.
分析有关糖尿病及其风险因素的最新数据，按性别和其他健康社会决定因素进行分类，以了解在加勒比地区糖尿病患病率女性高于男性的原因；为加勒比地区糖尿病预防和控制的政策议程设定提供信息；并找出证据方面需要进一步研究的差距。
对之前一项系统性文献综述进行更新，该综述描述了在加勒比地区开展的研究，这些研究按一个或多个社会决定因素呈现了糖尿病的分布、其后果及风险因素，更新内容包括2007年1月1日至2016年12月31日的资料来源。世界卫生组织（WHO）的调查也被纳入。在数据充足的情况下，进行荟萃分析。
共识别出8326篇手稿。其中，282篇被选作全文审查，114篇用于提取数据。总共有36篇论文，包括与WHO相关的调查，有足够信息用于荟萃分析。与男性相比，更多女性肥胖（比值比：2.1；95%置信区间=1.65 - 2.69）、缺乏身体活动（比值比：2.18；95%置信区间=1.75 - 2.72）且患有糖尿病（比值比：1.48；95%置信区间=1.25 - 1.76）。更多男性吸烟（比值比：4.27；95%置信区间=3.18 - 5.74）且水果和蔬菜摄入量不足（比值比：1.37；95%置信区间=1.21 - 1.57）。
在之前进行的系统性综述基础上新增了36篇论文；其中13篇被纳入荟萃分析。糖尿病及其风险因素（主要是肥胖和缺乏身体活动）在加勒比地区对女性的影响仍然不成比例。该地理区域的吸烟干预措施应针对男性。
