School of Occupational and Public Health, Ryerson University, Toronto, ON M5B 2K3, Canada.
Department of Physical and Environmental Sciences, University of Toronto, Toronto, ON M1C 1A4, Canada.
Int J Environ Res Public Health. 2020 Oct 28;17(21):7894. doi: 10.3390/ijerph17217894.
Diabetes mellitus is a growing public health problem affecting persons in both developed and developing nations. The prevalence of type 2 diabetes mellitus (T2DM) is reported to be several times higher among Indigenous populations compared to their non-Indigenous counterparts. Discriminant function analysis (DFA) is a potential tool that can be used to quantitatively evaluate the effectiveness of Indigenous health-and-wellness programs (e.g., on-the-land programs, T2DM interventions), by creating a type of pre-and-post-program scoring system. As the communities of the Eeyou Istchee territory, subarctic Quebec, Canada, have varying degrees of isolation, we derived a DFA tool for point-of-contact evaluations to aid in monitoring and assessment of health-and-wellness programs in rural and remote locations. We developed several DFA models to discriminate between those with and without T2DM status using age, fasting blood glucose, body mass index, waist girth, systolic and diastolic blood pressure, high-density lipoprotein, triglycerides, and total cholesterol in participants from the Eeyou Istchee. The models showed a ~97% specificity (i.e., true positives for non-T2DM) in classification. This study highlights how varying risk factor models can be used to discriminate those without T2DM with high specificity among James Bay Cree communities in Canada.
糖尿病是一个日益严重的公共卫生问题,影响着发达国家和发展中国家的人们。与非土著人相比,报告称 2 型糖尿病(T2DM)在土著人群中的患病率要高出数倍。判别函数分析(DFA)是一种潜在的工具,可以通过创建一种预-后程序评分系统,定量评估土著健康和福利计划(例如,在土地上的计划、T2DM 干预)的效果。由于加拿大魁北克省北极地区的伊休蒂埃地区的社区存在不同程度的隔离,我们开发了一种用于接触点评估的 DFA 工具,以帮助监测和评估农村和偏远地区的健康和福利计划。我们使用来自伊休蒂埃的参与者的年龄、空腹血糖、体重指数、腰围、收缩压和舒张压、高密度脂蛋白、甘油三酯和总胆固醇,开发了几种 DFA 模型来区分有和没有 T2DM 状态的人。这些模型在分类中表现出约 97%的特异性(即非 T2DM 的真阳性)。这项研究强调了如何使用不同的风险因素模型来区分加拿大詹姆斯湾克里社区中没有 T2DM 的人,并具有很高的特异性。