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埃塞俄比亚非传染性疾病的代谢风险因素:系统评价和荟萃分析。

Metabolic risk factors for non-communicable diseases in Ethiopia: a systematic review and meta-analysis.

机构信息

Department of Global Health, National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australian Capital Territory, Australia

College of Medical and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.

出版信息

BMJ Open. 2021 Nov 11;11(11):e049565. doi: 10.1136/bmjopen-2021-049565.

Abstract

OBJECTIVES

Non-communicable diseases (NCDs) are causing a new and yetsignificant health challenge in low-income countries. In Ethiopia, although 39% of deaths are NCD related, the health system remains underprepared, highlighting the clear need for evidence on risk factor distributions to inform resource planning and the health response. Therefore, this review investigates prevalence distributions and sex and age variations of metabolic risk factors among Ethiopian adults.

RESEARCH DESIGN AND METHODS

This systematic review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies published until 6 January 2021 were searched from PubMed, Scopus, ProQuest and Web of Science databases, reference lists of selected studies and grey literature. Studies reporting prevalence of metabolic risk factors: overweight/obesity, hypertension, impaired glucose homoeostasis and metabolic syndrome among Ethiopian adults were eligible for this systematic review and meta-analysis. Two authors independently extracted data and used the Joanna Briggs Institute tool for quality appraisal. The random effects model was used to conduct meta-analysis using Stata V.16. Subgroup analyses examined prevalence differences by region, study year, sample size and settings.

RESULTS

From 6087 records, 74 studies including 104 382 participants were included. Most showed high prevalence of metabolic risk factors. Meta-analysis revealed pooled prevalence of metabolic risk factors from 12% to 24% with the highest prevalence observed for overweight/obesity (23.9%, 95% CI 19.9% to 28.0%) and hypertension (21.1%, 95% CI 18.7% to 23.5%), followed by metabolic syndrome (14.7%, 95% CI 9.8% to 19.6%) and impaired glucose tolerance (12.4%, 95% CI 8.7% to 16.1%). The prevalence of overweight/obesity was higher in women. All metabolic risk factors were higher among people aged above 45 years.

CONCLUSIONS

A signficant proportion of Ethiopian adults have at least one metabolic risk factor for NCDs. Despite heterogeneity of studies limiting the certainty of evidence, the result suggests the need for coordinated effort among policymakers, healthcare providers, non-governmental stakeholders and the community to implement appropriate preventive measures to reduce these factors.

摘要

目的

非传染性疾病(NCD)正在给低收入国家带来新的、重大的健康挑战。在埃塞俄比亚,尽管 39%的死亡与 NCD 相关,但卫生系统仍准备不足,这清楚地表明需要有关于风险因素分布的证据,以为资源规划和卫生应对提供信息。因此,本综述调查了埃塞俄比亚成年人中代谢风险因素的流行分布以及性别和年龄差异。

研究设计和方法

本系统综述使用了《系统评价和荟萃分析的首选报告项目》指南。从 PubMed、Scopus、ProQuest 和 Web of Science 数据库、选定研究的参考文献列表和灰色文献中搜索了截至 2021 年 1 月 6 日发表的研究。符合本系统综述和荟萃分析标准的研究报告了埃塞俄比亚成年人中代谢风险因素(超重/肥胖、高血压、葡萄糖稳态受损和代谢综合征)的流行情况。两名作者独立提取数据,并使用 Joanna Briggs 研究所工具进行质量评估。使用 Stata V.16 采用随机效应模型进行荟萃分析。亚组分析按地区、研究年份、样本量和研究场所考察了流行率差异。

结果

从 6087 条记录中,纳入了 74 项研究,共包括 104382 名参与者。大多数研究显示代谢风险因素的高流行率。荟萃分析显示,代谢风险因素的总体流行率为 12%至 24%,其中超重/肥胖的流行率最高(23.9%,95%CI 19.9%至 28.0%)和高血压(21.1%,95%CI 18.7%至 23.5%),其次是代谢综合征(14.7%,95%CI 9.8%至 19.6%)和葡萄糖耐量受损(12.4%,95%CI 8.7%至 16.1%)。女性超重/肥胖的流行率更高。所有代谢风险因素在 45 岁以上人群中更高。

结论

埃塞俄比亚成年人中相当一部分人至少有一种 NCD 的代谢风险因素。尽管研究的异质性限制了证据的确定性,但结果表明,政策制定者、医疗保健提供者、非政府利益相关者和社区需要协调努力,实施适当的预防措施来降低这些因素。

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