Tajdar Daniel, Schäfer Ingmar, Lühmann Dagmar, Fertmann Regina, Steinberg Tim, van den Bussche Hendrik, Scherer Martin
Department of Primary Care at Hamburg University Medical Center, Hamburg, Germany.
Hamburg Authority for Work, Health, Social Affairs, Family and Integration, Hamburg, Germany.
Diabetes Metab Syndr Obes. 2022 May 26;15:1639-1650. doi: 10.2147/DMSO.S363823. eCollection 2022.
Health literacy (HL) intervention could be a potential prevention strategy to reduce the risk of metabolic syndrome (MS), but the association between low HL and MS is controversial. Therefore, the aim of this study was to investigate whether low HL is associated with obesity, diabetes, and hypertension, considering them as one cluster.
We used data from the Hamburg Diabetes Prevention Survey, a population-based cross-sectional study in Germany. The 1349 eligible subjects were 18-60 years old. The European Health Literacy Questionnaire (HLS-EU-Q16) was used to assess HL. Depending on the reported number of metabolic syndrome conditions (CMS), four groups were categorized as follows: "0", any "1", any "2" and "3" CMS. Ordered logistic regression was used to analyze the relationship between HL level (independent variable) and the reported number of CMS (dependent variable) adjusted for age, gender and education.
63.9% of subjects (n=862) reported having "0", 25.7% (n=346) only "1", 8.2% (n=111) only "2" and 2.2% (n=30) "3" of the three CMS. In the group with sufficient HL, rates of "1," "2," or "3" CMS were lower than in the group with problematic or inadequate HL. Subjects with inadequate HL showed a 1.62-fold higher risk of having a higher number of CMS than subjects with sufficient HL (OR 1.62; 95% CI 1.13 to 2.31). The risk increased with each life year (OR 1.05; 95% CI 1.04 to 1.06), and was higher in persons with low education (OR 2.89; 95% CI 2.08 to 4.01) than in highly educated persons. Women showed lower risk (OR 0.73; 95% CI 0.58 to 0.91) than men.
Lower HL was associated with a higher number of MS conditions. Our findings suggest that HL intervention on health-promoting behaviors could help reduce MS risk in people with limited HL.
健康素养（HL）干预可能是降低代谢综合征（MS）风险的一种潜在预防策略，但低健康素养与代谢综合征之间的关联存在争议。因此，本研究的目的是将肥胖、糖尿病和高血压视为一个集群，调查低健康素养是否与它们相关。
我们使用了来自德国一项基于人群的横断面研究——汉堡糖尿病预防调查的数据。1349名符合条件的受试者年龄在18至60岁之间。使用欧洲健康素养问卷（HLS-EU-Q16）评估健康素养。根据报告的代谢综合征状况（CMS）数量，分为四组：“0”种、任意“1”种、任意“2”种和“3”种CMS。使用有序逻辑回归分析健康素养水平（自变量）与报告的CMS数量（因变量）之间的关系，并对年龄、性别和教育程度进行了调整。
63.9%的受试者（n = 862）报告有“0”种CMS，25.7%（n = 346）只有“1”种，8.2%（n = 111）只有“2”种，2.2%（n = 30）有“3”种CMS。在健康素养充足的组中，“1”种、“2”种或“3”种CMS的发生率低于健康素养有问题或不足的组。健康素养不足的受试者出现更多CMS的风险比健康素养充足的受试者高1.62倍（OR 1.62；95% CI 1.13至2.31）。风险随年龄增长而增加（OR 1.05；95% CI 1.04至1.06），且低教育程度者的风险（OR 2.89；95% CI 2.08至4.01）高于高教育程度者。女性的风险（OR 0.73；95% CI 0.58至0.91）低于男性。
较低的健康素养与更多的代谢综合征状况相关。我们的研究结果表明，针对健康促进行为的健康素养干预可能有助于降低健康素养有限人群的代谢综合征风险。
