Department of Community Medicine, UiT The Arctic University of Norway, Tromso, Norway
Department of Community Medicine, UiT The Arctic University of Norway, Tromso, Norway.
BMJ Open Diabetes Res Care. 2021 Mar;9(1). doi: 10.1136/bmjdrc-2020-002021.
Compared with many other countries Russia has a high prevalence of diabetes in men and women. However, contrary to what is found in most other populations, the risk is greater among women than men. The reasons for this are unclear.
Prevalence and risk factors for diabetes at ages 40-69 years were compared in two population-based studies: Know Your Heart (KYH) (Russia, 2015-2018, n=4121) and the seventh wave of the Tromsø Study (Tromsø 7) (Norway, 2015-2016, n=17 649). Diabetes was defined by the level of glycated hemoglobin and/or self-reported diabetes and/or diabetes medication use. Marginal structural models were used to estimate the role of key risk factors for diabetes in differences between the studies.
Age-standardized prevalence of diabetes was higher in KYH compared with Tromsø 7 in men (11.6% vs 6.2%) and in women (13.2% vs 4.3%). Age-adjusted ORs for diabetes in KYH compared with Tromsø 7 were 2.01 (95% CI 1.68 to 2.40) for men and 3.66 (95% CI 3.13 to 4.26) for women. Adiposity (body mass index and waist circumference) explained none of this effect for men but explained 46.0% (39.6, 53.8) for women. Addition of smoking and C reactive protein, as further mediators, slightly increased the percentage explained of the difference between studies to 55.5% (46.5, 66.0) for women but only to 9.9% (-0.6, 20.8) for men.
Adiposity is a key modifiable risk factor that appears to explain half of the almost threefold higher female prevalence of diabetes in Russia compared with Norway, but none of the twofold male difference.
与许多其他国家相比，俄罗斯的男性和女性糖尿病患病率都很高。然而，与大多数其他人群不同的是，女性的患病风险高于男性。造成这种情况的原因尚不清楚。
在两项基于人群的研究中比较了 40-69 岁人群的糖尿病患病率和危险因素：Know Your Heart（KYH）（俄罗斯，2015-2018 年，n=4121）和特罗姆瑟研究第七波（Tromsø 7）（挪威，2015-2016 年，n=17649）。糖尿病通过糖化血红蛋白水平和/或自我报告的糖尿病和/或糖尿病药物使用来定义。使用边缘结构模型来估计关键危险因素在研究之间差异中的作用。
KYH 中标准化后的糖尿病患病率在男性（11.6%比 6.2%）和女性（13.2%比 4.3%）中均高于 Tromsø 7。与 Tromsø 7 相比，KYH 中男性糖尿病的调整年龄比值比为 2.01（95%CI 1.68 至 2.40），女性为 3.66（95%CI 3.13 至 4.26）。肥胖（体重指数和腰围）对男性没有任何影响，但对女性的解释为 46.0%（39.6，53.8）。添加吸烟和 C 反应蛋白作为进一步的中介物，略微增加了研究之间差异的解释百分比，女性为 55.5%（46.5，66.0），男性为 9.9%（-0.6，20.8）。
肥胖是一个关键的可改变的危险因素，它似乎可以解释俄罗斯女性糖尿病患病率几乎是挪威的三倍的原因，而男性的两倍差异则无法解释。
