Institute of Medical Biometry and Epidemiology Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Glob Health Action. 2021 Jan 1;14(1):2001144. doi: 10.1080/16549716.2021.2001144.
Diabetes is increasing rapidly in South-East Asia. Studies have reported typical risk factors associated with all-age adult diabetes and highlighted the roles of economic transition and childhood development factors in diabetes in later life. However, little is known about whether these factors were associated with young adult diabetes risk.
The study has two main aims: (1) estimate diabetes prevalence among adult participants of the Indonesian Family Life Survey (IFLS), and (2) identify childhood development factors associated with early-onset adult diabetes (diagnosed between age 20 and 40) in Indonesia.
Data were taken from adults participating in 4 and 5 IFLS (in 2007 and 2014) and linked to childhood history from previous surveys. Diabetes was ascertained from self-report and HbA1c testing in a subsample. Diabetes prevalence rates were estimated by age and source of diagnosis. Cox regression analysis was applied to assess potential risk factors for early-onset adult diabetes.
A total of 34,767 participants were included in the study. Crude total prevalence estimate from self-report was 2,3% and increased with age. Including HbA1c measurements yielded nearly eight times higher prevalence estimates, depending on age. The proportion of yet undiagnosed cases is considerably higher in young age groups. Regression analyses showed that urban childhood residence and high education increased early-onset diabetes risk by 50-70%. Sex, childhood general health, socio-economic level and starvation exposure were not associated with early-onset diabetes risk.
Remarkable differences between diabetes prevalence rates based on self-report and HbA1c measurement indicated the need for better diagnosis, especially in young adults. Urban childhood residence and high education increased early-onset adult diabetes risk. Incorporating these factors and diabetes awareness in existing child health programs, together with screening of individuals at risk, could improve early diabetes detection and prevention strategies among young urban Indonesian adults.
糖尿病在东南亚迅速增加。研究报告了与全年龄段成年糖尿病相关的典型风险因素，并强调了经济转型和儿童发展因素在晚年糖尿病中的作用。然而，对于这些因素是否与青年成人糖尿病风险相关，知之甚少。
本研究有两个主要目的：（1）估计印度尼西亚家庭生活调查（IFLS）中成年参与者的糖尿病患病率，（2）确定与印度尼西亚青年成人（20-40 岁之间诊断）早发性糖尿病相关的儿童发展因素。
数据来自于参加 IFLS 4 期和 5 期（2007 年和 2014 年）的成年人，并与之前调查的儿童期历史数据相联系。糖尿病通过自我报告和亚样本中的 HbA1c 检测来确定。根据年龄和诊断来源估计糖尿病患病率。应用 Cox 回归分析评估青年成人早发性糖尿病的潜在风险因素。
共有 34767 名参与者纳入研究。自我报告的总粗患病率估计为 2.3%，且随年龄增长而增加。包括 HbA1c 测量结果在内，患病率估计值要高近 8 倍，这取决于年龄。在年轻年龄组中，尚未确诊的病例比例要高得多。回归分析显示，城市儿童期居住和高教育水平使早发性糖尿病风险增加了 50-70%。性别、儿童期总体健康状况、社会经济水平和饥饿暴露与早发性糖尿病风险无关。
基于自我报告和 HbA1c 测量的糖尿病患病率存在显著差异，表明需要更好的诊断，尤其是在青年成人中。城市儿童期居住和高教育水平增加了青年成人早发性糖尿病的风险。将这些因素和糖尿病意识纳入现有的儿童健康计划中，并对有风险的个体进行筛查，可以改善印度尼西亚青年城市成年人的早期糖尿病检测和预防策略。
