Pakistan Health Research Council (PHRC) Research Center, Fatima Jinnah Medical University, Lahore, PK.
National Health Research Complex, PHRC Research Center, Shaikh Zayed Hospital, Lahore, PK.
Ann Glob Health. 2020 Jan 31;86(1):7. doi: 10.5334/aogh.2679.
The clinical and methodological diversity observed in national and regional diabetes surveys, emphasized on the need of the weighted average prevalence of diabetes.
To measure the pooled prevalence of type 2 diabetes mellitus in the adult population of Pakistan.
The prospective cross-sectional studies reporting adult diabetes in Pakistan and published on any date were retrieved from PubMed, ScienceDirect and PakMediNet databases. In the meta-analysis, PRISMA guidelines were used for reporting; the AXIS tool for assessing quality and risk of bias within studies; I statistics for measuring heterogeneity between studies and subgroups; and Tableau Public 10.4 for geographic mapping of included studies. Using Meta-Analyst 3.13 βeta, overall and subgroup pooled estimates were measured by random effects model.
The pooled sample of twelve studies included 42,051 adults (≥20 years) comprised of both sexes from urban and rural Pakistan. The pooled prevalence of diabetes was 13.7% (95% CI, 10.7-17.3). None of the twelve studies was of poor quality (<10 scores). Ten studies were published in ISI indexed journals, and nine of them were indexed for Medline. The level of heterogeneity observed across studies and between subgroups was moderate (<50%). The subgroup analysis revealed a higher pooled estimate of diabetes in males than in females (13.1 vs. 12.4%). It was also higher in urban than in rural patients (15.1 vs. 1.6%), and in HbA1c than in OGTT tests (23.9 vs. 14.4%). However, pooled estimates of the WHO and the ADA criteria were similar (13.8 vs. 13.5%).
The prevalence of diabetes is on the rise in the adult population of Pakistan. The heterogeneity across studies observed in the meta-analysis suggested that the design of future diabetes surveys should be efficient and purposeful, and that valid tools and methods should be used to generate more precise data. Moreover, harmony between the stakeholders is much needed to seek a true picture of the diabetes burden in the country.
国家和地区糖尿病调查中观察到的临床和方法学多样性强调了加权平均糖尿病患病率的必要性。
测量巴基斯坦成年人口中 2 型糖尿病的合并患病率。
从 PubMed、ScienceDirect 和 PakMediNet 数据库中检索到报告巴基斯坦成人糖尿病的前瞻性横断面研究，并在任何日期发表。在荟萃分析中，使用 PRISMA 指南进行报告；使用 AXIS 工具评估研究内的质量和偏倚风险；使用 I 统计量衡量研究之间和亚组之间的异质性；使用 Tableau Public 10.4 进行纳入研究的地理映射。使用 Meta-Analyst 3.13 βeta，通过随机效应模型测量总体和亚组合并估计值。
纳入的 12 项研究的合并样本包括来自巴基斯坦城乡的 42051 名（≥20 岁）男女成年人。糖尿病的合并患病率为 13.7%（95%CI，10.7-17.3）。12 项研究中没有一项质量差（<10 分）。10 项研究发表在 ISI 索引期刊上，其中 9 项被 Medline 索引。研究之间和亚组之间观察到的异质性程度为中度（<50%）。亚组分析显示，男性的糖尿病合并患病率高于女性（13.1 对 12.4%）。在城市患者中也高于农村患者（15.1 对 1.6%），在 HbA1c 检测中高于 OGTT 检测（23.9 对 14.4%）。然而，WHO 和 ADA 标准的合并估计值相似（13.8 对 13.5%）。
糖尿病在巴基斯坦成年人口中的患病率呈上升趋势。荟萃分析中观察到的研究之间的异质性表明，未来糖尿病调查的设计应具有效率和针对性，并应使用有效工具和方法生成更精确的数据。此外，利益相关者之间需要协调一致，以寻求该国糖尿病负担的真实情况。
