Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA.
Dhaka Medical College Hospital, Dhaka, Bangladesh.
J Biosoc Sci. 2021 Mar;53(2):157-166. doi: 10.1017/S0021932020000085. Epub 2020 Mar 9.
The prevalences of hypertension, diabetes and overweight/obesity are increasing in most developing countries, including Bangladesh. Although earlier studies have investigated the factors associated with these three conditions, little is known about whether socioeconomic status is associated with their co-existence. This cross-sectional study analysed data from the 2011 Bangladesh Demographic and Health Survey. An individual was considered hypertensive, diabetic and overweight/obese if their systolic/diastolic blood pressure, fasting plasma glucose concentration, and body mass index were ≥130/80 mmHg, ≥7 mmol/l and ≥23 kg/m2, respectively. Furthermore, individuals who reported taking anti-hypertensive and anti-diabetic drugs were also considered as hypertensive and diabetic, respectively. Two socioeconomic variables were investigated: education level and household wealth quintile. Descriptive analyses and multilevel logistic regression were conducted. Among the 7932 respondents (50.5% female) aged ≥35 years, the prevalences of hypertension, diabetes, overweight/obesity, any one condition and the co-existence of the three conditions were 48.0%, 11.0%, 25.3%, 60.9% and 3.6%, respectively. In adjusted analysis, individuals with secondary (adjusted odds ratio [AOR]: 1.8, 95% confidence interval [CI]: 1.2-2.8) and college or above (AOR: 3.6; 95% CI: 2.2-5.7) education levels had higher odds of the co-existence of all three conditions compared with those with no formal education. Similarly, compared with the poorest wealth quintile, the richer (AOR: 4.6; 95% CI: 2.2-9.4) and richest (AOR: 11.8; 95% CI: 5.8-24.1) wealth quintiles had higher odds of co-existence of these three conditions. Education and wealth quintile also showed significant relationships with each of the three conditions separately. In conclusion, in Bangladesh, hypertension, diabetes and overweight/obesity are associated with indicators of higher socioeconomic status. These findings highlight the importance of developing healthy lifestyle interventions (e.g. physical exercise and dietary modification) targeting individuals of higher socioeconomic status to minimize the burden of these non-communicable diseases.
高血压、糖尿病和超重/肥胖在大多数发展中国家（包括孟加拉国）的患病率正在上升。尽管早期的研究已经调查了与这三种情况相关的因素，但对于社会经济地位是否与它们的共存有关知之甚少。本横断面研究分析了 2011 年孟加拉国人口与健康调查的数据。如果个体的收缩压/舒张压、空腹血糖浓度和体重指数分别≥130/80mmHg、≥7mmol/l 和≥23kg/m2，则将其视为高血压、糖尿病和超重/肥胖。此外，报告服用抗高血压和抗糖尿病药物的个体也分别被视为高血压和糖尿病。研究了两个社会经济变量：教育水平和家庭财富五分位数。进行了描述性分析和多水平逻辑回归分析。在 7932 名（50.5%为女性）年龄≥35 岁的受访者中，高血压、糖尿病、超重/肥胖、任何一种疾病和三种疾病共存的患病率分别为 48.0%、11.0%、25.3%、60.9%和 3.6%。在调整分析中，与没有正规教育的人相比，具有中学（调整后的优势比 [AOR]：1.8，95%置信区间 [CI]：1.2-2.8）和大学或以上（AOR：3.6；95% CI：2.2-5.7）教育水平的个体更有可能同时存在这三种情况。同样，与最贫穷的财富五分位数相比，较富裕（AOR：4.6；95% CI：2.2-9.4）和最富裕（AOR：11.8；95% CI：5.8-24.1）的财富五分位数更有可能同时存在这三种情况。教育和财富五分位数也与这三种情况中的每一种分别显示出显著的关系。总之，在孟加拉国，高血压、糖尿病和超重/肥胖与较高的社会经济地位指标有关。这些发现强调了针对较高社会经济地位个体制定健康生活方式干预措施（如体育锻炼和饮食调整）的重要性，以尽量减少这些非传染性疾病的负担。
