Mallikarjuna Majgi Sumanth, Channa Basappa Yogish, Belagihalli Manjegowda Srikanta, Nageshappa Savitha, Suresh Harshini, Babu Giridhar R, Srinivas Prashanth Nuggehalli
Department of Community Medicine, Mysore Medical College and Research Institute, Mysore, India.
Health Equity Cluster, Institute Public Health, Bengaluru, India.
PLOS Glob Public Health. 2024 May 20;4(5):e0002807. doi: 10.1371/journal.pgph.0002807. eCollection 2024.
While NCDs are in rise globally, tribal and rural populations residing near to reserve forests with limited exposure to modern lifestyles may bear a unique burden. This study investigates the prevalence and risk factors of hypertension, diabetes, and dyslipidemia among these communities. We conducted a cross-sectional study between 2018 and 2020 in the forest-dwelling population of Chamarajanagar, India. Using multistage stratified sampling based on caste and remoteness, we enrolled 608 participants aged over 18 years, including 259 non-tribal and 349 tribal individuals. Data collection includes the administration of STEPS questionnaire and measurement of fasting blood sugar, lipid levels, and blood pressure. The prevalence of diabetes, hypertension, and dyslipidemia were 4.6%, 28.8%, and 85.7%, respectively, among the study population. We also found abnormal levels of low-density lipoprotein (LDL), high-density lipoprotein (HDL), Triglycerides (TGA), Total cholesterol (TC), and very low-density lipoprotein (VLDL)in 4.9%, 82.4%, 22.7%, 5.8%, and 7.4% of participants, respectively. Significant differences were observed in diabetes, LDL abnormality, TGA abnormality, VLDL abnormality, and TC abnormality, but not in hypertension, dyslipidemia, or HDL abnormality, across the Socio Geographic Discrimination Index. We found a significant difference in diabetes and HDL abnormality, but not in hypertension, dyslipidemia, LDL abnormality, TGA abnormality, TC abnormality, or VLDL abnormality, between tribal and non-tribal populations living in the forest-dwelling area. Waist circumference was a significant independent predictor of diabetes among tribal participants, while wealth index, age, and waist circumference were significant predictors of hypertension. There were no significant predictors for dyslipidemia among tribal participants. Our study suggests that tribal population living in a remote area are at a lower risk of developing diabetes compared to non-tribal populations living in the same geographic area. However, the prevalence of hypertension and dyslipidemia among tribal populations remains high and comparable to that of the general population.
虽然全球非传染性疾病呈上升趋势,但居住在靠近保留森林、接触现代生活方式有限的部落和农村人口可能承受着独特的负担。本研究调查了这些社区中高血压、糖尿病和血脂异常的患病率及危险因素。2018年至2020年期间,我们在印度恰马勒贾纳加尔的森林居住人群中开展了一项横断面研究。基于种姓和偏远程度采用多阶段分层抽样,我们纳入了608名18岁以上的参与者,包括259名非部落个体和349名部落个体。数据收集包括实施STEPS问卷以及测量空腹血糖、血脂水平和血压。在研究人群中,糖尿病、高血压和血脂异常的患病率分别为4.6%、28.8%和85.7%。我们还发现,分别有4.9%、82.4%、22.7%、5.8%和7.4%的参与者低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、甘油三酯(TGA)、总胆固醇(TC)和极低密度脂蛋白(VLDL)水平异常。在社会地理歧视指数方面,糖尿病、LDL异常、TGA异常、VLDL异常和TC异常存在显著差异,但高血压、血脂异常或HDL异常无显著差异。我们发现,生活在森林居住地区的部落和非部落人群在糖尿病和HDL异常方面存在显著差异,但在高血压、血脂异常、LDL异常、TGA异常、TC异常或VLDL异常方面无显著差异。腰围是部落参与者中糖尿病的显著独立预测因素,而财富指数、年龄和腰围是高血压的显著预测因素。部落参与者中血脂异常无显著预测因素。我们的研究表明,与生活在同一地理区域的非部落人群相比,生活在偏远地区的部落人群患糖尿病的风险较低。然而,部落人群中高血压和血脂异常的患病率仍然很高,与一般人群相当。