Department of Basic Medical Sciences, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
Department of Biostatistics, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
Front Public Health. 2020 Oct 16;8:570676. doi: 10.3389/fpubh.2020.570676. eCollection 2020.
The global escalating prevalence of lifestyle-related non-communicable diseases places a significant burden on health systems. Chronic diseases of lifestyle (CDL) are a group of diseases that share similar modifiable risk factors that can result in long-term disease processes. Considering the socio-behavioral-metabolic risk profiles of communities and risk factors predictive of the presence of CDL can assist in the development of focused and effective community-based prevention, intervention, and treatment programs for CDL. To determine the socio-behavioral-metabolic risk profiles and identify associated factors for the following CDL: obesity, cardiovascular disease, hypertension, and type 2 diabetes mellitus in rural and urban communities in central South Africa. This cross-sectional study included adults aged 25-65 years in the rural Southern Free State and urban Mangaung. Social determinants, behavioral and metabolic risk factors, and inflammatory biomarkers for CDL were determined. In total, 575 rural (mean age: 42 years; 71% female) and 429 urban (mean age: 44 years; 76% female) participants were included in the study. More than 20% of participants in both communities reported being previously diagnosed with cardiovascular diseases; with reported hypertension and diabetes mellitus more prevalent among rural participants. Insufficient intake of fruit and vegetables, alcohol use, and high blood pressure were among the top five risk factors in both communities. Physical inactivity ranked among the top two risk factors in the urban community; while alcohol and tobacco use was significantly higher in the rural community. Fibrinogen was the most prevalent inflammatory marker in both communities (32.9 rural vs. 48.3% urban). High sensitivity C-reactive protein (Hs-CRP), only available for rural participants, was high with increased levels in more than 80% of participants. In both communities, being female, having high blood pressure and increased fibrinogen levels were associated with obesity. This study illustrated the high prevalence of socio-behavioral-metabolic risk factors for CDL, and identified similarities and distinct differences in the risk profiles of rural and urban communities. Considering the CDL risk profiles of communities can assist in prioritizing health needs and contribute to the development of tailor-made community-based primary health care prevention, intervention, and health promotion programs.
全球不断上升的与生活方式相关的非传染性疾病患病率给卫生系统带来了巨大负担。生活方式相关的慢性疾病（CDL）是一组具有相似可改变风险因素的疾病，这些因素可能导致长期的疾病过程。考虑到社区的社会行为代谢风险特征以及可预测 CDL 存在的风险因素，可以帮助制定有针对性和有效的基于社区的 CDL 预防、干预和治疗计划。
本研究旨在确定南非中部农村和城市社区中与以下 CDL 相关的社会行为代谢风险特征，并确定相关因素：肥胖、心血管疾病、高血压和 2 型糖尿病。本横断面研究纳入了南非南部自由州农村和马加翁城市 25-65 岁的成年人。确定了与 CDL 相关的社会决定因素、行为和代谢风险因素以及炎症生物标志物。
共有 575 名农村（平均年龄：42 岁；71%为女性）和 429 名城市（平均年龄：44 岁；76%为女性）参与者纳入研究。两个社区都有超过 20%的参与者报告曾被诊断患有心血管疾病；农村参与者报告的高血压和糖尿病患病率更高。在两个社区中，水果和蔬菜摄入不足、饮酒和高血压都是排名前五的风险因素。城市社区中，缺乏身体活动位居前两个风险因素之列；而农村社区中，饮酒和吸烟的比例明显更高。纤维蛋白原是两个社区中最常见的炎症标志物（农村 32.9%，城市 48.3%）。仅在农村参与者中可用的高敏 C 反应蛋白（Hs-CRP），超过 80%的参与者的水平升高。在两个社区中，女性、高血压和纤维蛋白原水平升高都与肥胖有关。
本研究说明了 CDL 的社会行为代谢风险因素的高患病率，并确定了农村和城市社区风险特征的相似之处和明显差异。考虑社区的 CDL 风险特征有助于确定卫生需求的优先级，并有助于制定定制化的基于社区的初级卫生保健预防、干预和健康促进计划。
