Global Adolescent Health Group, Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, VIC 3010, Australia.
Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC 3010, Australia.
Int J Environ Res Public Health. 2023 Jun 26;20(13):6228. doi: 10.3390/ijerph20136228.
Cardiovascular disease and type 2 diabetes mellitus are leading contributors to the health inequity experienced by Aboriginal and Torres Strait Islander peoples, and their antecedents can be identified from early childhood. We aimed to establish the quality of available data and the prevalence of cardiometabolic risk markers among Aboriginal and Torres Strait Islander children and youths (0-24-year-olds) to inform public health approaches. A systematic review of the peer-reviewed and grey literature was conducted between 1 January 2000-28 February 2021. Included studies reported population prevalence of cardiometabolic risks, including elevated blood pressure, obesity, central adiposity, dyslipidaemia, hyperglycaemia, and 'metabolic syndrome' for Aboriginal and Torres Strait Islander people aged 0-24 years. Fifteen studies provided population estimates. Data quality was limited by low response rates (10/15 studies) and suboptimal outcome measurements. Obesity is the most reported risk (13/15 studies). Aboriginal and Torres Strait Islander children have an excess risk of obesity from early childhood and prevalence increases with age: 32.1% of Aboriginal and Torres Strait Islander 18-24-year-olds had obesity and 50.8% had central adiposity. In a cohort of 486 9-14-year-olds in Darwin, 70% had ≥1 component of metabolic syndrome; 14% met the full criteria for the syndrome. The prevalence of cardiometabolic risk in Aboriginal and Torres Strait Islander young people is difficult to estimate due to limitations in measurement quality and sampling representativeness. Available data suggest that cardiometabolic risk markers are evident from early childhood. The establishment of national and state-level datasets and a core outcome set for cardiometabolic screening would provide opportunities for preventative action.
心血管疾病和 2 型糖尿病是导致原住民和托雷斯海峡岛民健康不平等的主要原因,其前因可追溯至儿童早期。我们旨在评估现有的数据质量和原住民和托雷斯海峡岛民儿童和青少年(0-24 岁)心血管代谢风险标志物的流行情况,以为公共卫生措施提供信息。我们对 2000 年 1 月 1 日至 2021 年 2 月 28 日期间的同行评议文献和灰色文献进行了系统评价。纳入的研究报告了心血管代谢风险的人群流行率,包括升高的血压、肥胖、中心性肥胖、血脂异常、高血糖和“代谢综合征”,研究对象为年龄在 0-24 岁的原住民和托雷斯海峡岛民。有 15 项研究提供了人群估计值。数据质量受到低应答率(10/15 项研究)和非最佳结局测量的限制。肥胖是最常报道的风险(13/15 项研究)。原住民和托雷斯海峡岛民儿童从幼儿期就存在肥胖风险增加,且随着年龄的增长患病率增加:18-24 岁的原住民和托雷斯海峡岛民中有 32.1%的人肥胖,50.8%的人有中心性肥胖。在达尔文的一个 486 名 9-14 岁儿童的队列中,70%的人有≥1 项代谢综合征成分;14%符合该综合征的全部标准。由于测量质量和抽样代表性的限制,原住民和托雷斯海峡岛民年轻人的心血管代谢风险的流行情况难以估计。现有数据表明,心血管代谢风险标志物从儿童早期就已显现。建立国家和州级数据集以及心血管代谢筛查的核心结局集将为预防行动提供机会。