Sundaresan Mohanraj, Velmurugan Ganesan, Dhivakar Mani, Ramakrishnan Arulraj, Cherian Mathew, Alexander Thomas, Swaminathan Krishnan
Department of Biochemistry and Microbiology, KMCH Research Foundation, Kovai Medical Center & Hospital, Coimbatore, Tamil Nadu, India.
Department of Biochemistry, Dr. NGP Arts and Science College, Coimbatore, Tamil Nadu, India.
Glob Heart. 2024 Sep 9;19(1):72. doi: 10.5334/gh.1354. eCollection 2024.
India is facing triple epidemic of Non communicable diseases (NCDs) including high body mass index (BMI), high blood pressure and high blood glucose, contributing to more than half of deaths of all mortality, however, information in different demographics is limited, especially, in India. The aim of the study is to compare the prevalence of overweight, obesity, hypertension, and diabetes, along with the occurrence of multi-morbidity, across gender-specific populations in rural, suburban, and urban regions of India.
This was a cross-sectional, population-based study including adults aged 20 and above in rural, suburban, and urban areas near Coimbatore, India. All participants were interviewed using a detailed questionnaire and had their anthropometric measurements, including height, weight, blood pressure, and blood samples collected. Gender specific and location specific prevalence of overweight, obesity, hypertension, diabetes, and multimorbidity were assessed.
This study included 2976 individuals, of which 865 were from rural areas, 1030 from sub-urban areas, and 1081 from metropolitan areas. The mean systolic and diastolic blood pressure were higher in rural participants than in sub-urban and urban participants, despite the fact that the prevalence of hypertension was higher in sub-urban (47.1%) than in rural (36.4%) and urban (39.7%, < 0.001). In sub-group analysis, sub-urban areas had a greater prevalence of hypertension in both men and women (53.5% and 41.7%, < 0.001) than rural areas (41.9% and 31.3%, = 0.001) or urban areas (45.9% and 35.5%, < 0.001). Compared to rural (16.1%) and urban (23%), sub-urban areas had a greater prevalence of diabetes (25.8%, < 0.001). Urban residents (47.5%) had higher rates of overweight and obesity than rural (31.4%) and sub-urban (34.1%, < 0.001) residents. The association between diabetes and hypertension was present in the unadjusted model and persisted even after age and BMI adjustments. Though not in men, higher levels of education were associated to a higher prevalence of diabetes in women. Diabetes was associated to being overweight or obese in women, however this association was significantly reduced once BMI was taken into account. The overall multimorbidity was 3.8%, however, women had a higher overlapping prevalence (2.8%) compared to men (1%, < 0.001).
Diabetes and hypertension were prevalent comorbidities across all demographics, with higher rates in suburban and urban areas. Women exhibited higher rates of multimorbidity than men, regardless of the demographic area.
印度正面临包括高体重指数（BMI）、高血压和高血糖在内的非传染性疾病（NCDs）的三重流行，这些疾病导致了超过一半的死亡，但不同人口统计学信息有限，尤其是在印度。本研究的目的是比较印度农村、郊区和城市地区不同性别群体中超重、肥胖、高血压和糖尿病的患病率，以及多重疾病的发生率。
这是一项基于人群的横断面研究，纳入了印度哥印拜陀附近农村、郊区和城市地区20岁及以上的成年人。所有参与者均通过详细问卷进行访谈，并进行人体测量，包括身高、体重、血压测量以及采集血样。评估了超重、肥胖、高血压、糖尿病和多重疾病的性别和地区特异性患病率。
本研究共纳入2976人，其中865人来自农村地区，1030人来自郊区，1081人来自大都市地区。尽管郊区高血压患病率（47.1%）高于农村（36.4%）和城市（39.7%，P<0.001），但农村参与者的平均收缩压和舒张压高于郊区和城市参与者。在亚组分析中，郊区男性和女性的高血压患病率（分别为53.5%和41.7%，P<0.001）均高于农村地区（分别为41.9%和31.3%，P = 0.001）或城市地区（分别为45.9%和35.5%，P<0.001）。与农村（16.1%）和城市（23%）相比，郊区糖尿病患病率更高（25.8%，P<0.001）。城市居民超重和肥胖率（47.5%）高于农村（31.4%）和郊区居民（34.1%，P<0.001）。在未调整模型中，糖尿病与高血压之间存在关联，即使在调整年龄和BMI后仍持续存在。虽然在男性中并非如此，但在女性中，较高的教育水平与较高的糖尿病患病率相关。糖尿病与女性超重或肥胖相关，但在考虑BMI后，这种关联显著降低。总体多重疾病发生率为3.8%，然而，女性的重叠患病率（2.8%）高于男性（1%，P<0.001）。
糖尿病和高血压在所有人口统计学中都是常见的合并症，在郊区和城市地区发生率更高。无论在哪个地区，女性的多重疾病发生率都高于男性。
