Cini Karly I, Dumuid Dorothea, Francis Kate L, Wulan Nisaa R, Sawyer Susan M, Handy Agung Fransisca, Pham Minh D, Kennedy Elissa C, Fisher Jane, Tran Thach, Medise Bernie E, Devaera Yoga, Riyanti Aida, Wiweko Budi, Kaligis Fransiska, Wiguna Tjhin, Ansariadi Ansariadi, Azzopardi Peter S
Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia.
Department of Paediatrics, School of Medicine Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.
BMC Public Health. 2024 Dec 18;24(1):3416. doi: 10.1186/s12889-024-20902-1.
Risk factors for non-communicable diseases (NCDs, cardiovascular diseases, cancers, chronic respiratory diseases, diabetes, and mental disorders) arise in adolescence but are mostly framed as relevant to health in adulthood; little is known about the relationship between co-occurring NCD risks and mental wellbeing in young people. This study aims to describe the prevalence and co-occurrence of distinct NCD risk factors, and how they relate to current mental wellbeing amongst adolescents in Indonesia, a young and populous country where NCD burden is increasing rapidly.
We assessed NCD risk and mental wellbeing amongst 1,331 school-based 16-18-year-olds in Jakarta (N = 609) and South Sulawesi (N = 722). Five domains of NCD risk (adiposity, substance use, physical inactivity, excess sedentary time, and diet) were either measured or self-reported. In Jakarta, we also measured blood glucose, triglycerides, cholesterol, and blood pressure. Wellbeing was assessed using three indicators: general quality of life (QoL), physical function QoL, and psychological distress. We used linear regression to estimate the associations between co-occurring risks and wellbeing, adjusted for covariates of wellbeing: province, sex, socioeconomic status, and religion.
NCD risk clustering was common, and more than half of adolescents had co-occurring risks in 3 or more of the 5 domains (58.9% (95%CI 53.7-63.9)). Adolescents with any NCD risk were more likely to report psychological distress, with this relationship most pronounced in those with excess sedentary time spent on video gaming and computer use. A higher number of NCD risk factors was associated with poorer psychological wellbeing and decreased general and physical function QoL. In the Jakarta subsample, reduced HDL and raised blood glucose was associated with psychological distress; and a higher number of risk biomarkers was associated with lower physical function QoL.
Our analysis also shows that these NCD risks (both individual risks and co-occurring risk count) are related to poorer profiles of mental wellbeing in adolescents, after adjusting for likely confounders.
非传染性疾病（如心血管疾病、癌症、慢性呼吸道疾病、糖尿病和精神障碍）的风险因素在青少年时期就已出现，但大多被认为与成年期健康相关；对于青少年中同时存在的非传染性疾病风险与心理健康之间的关系，我们知之甚少。印度尼西亚是一个年轻且人口众多的国家，非传染性疾病负担正在迅速增加。本研究旨在描述不同非传染性疾病风险因素的患病率和共现情况，以及它们与印度尼西亚青少年当前心理健康的关系。
我们对雅加达（N = 609）和南苏拉威西岛（N = 722）的1331名16 - 18岁在校学生进行了非传染性疾病风险和心理健康评估。通过测量或自我报告的方式评估了非传染性疾病风险的五个领域（肥胖、物质使用、身体活动不足、久坐时间过长和饮食）。在雅加达，我们还测量了血糖、甘油三酯、胆固醇和血压。使用三个指标评估心理健康：总体生活质量（QoL）、身体功能生活质量和心理困扰。我们使用线性回归来估计同时存在的风险与心理健康之间的关联，并对心理健康的协变量进行了调整：省份、性别、社会经济地位和宗教。
非传染性疾病风险聚集现象很常见，超过一半的青少年在五个领域中的三个或更多领域同时存在风险（58.9%（95%CI 53.7 - 63.9））。有任何非传染性疾病风险的青少年更有可能报告心理困扰，这种关系在那些在视频游戏和电脑使用上久坐时间过长的青少年中最为明显。更多的非传染性疾病风险因素与较差的心理健康以及总体和身体功能生活质量下降相关。在雅加达子样本中，高密度脂蛋白降低和血糖升高与心理困扰相关；更多的风险生物标志物与较低的身体功能生活质量相关。
我们的分析还表明，在调整了可能的混杂因素后，这些非传染性疾病风险（包括个体风险和同时存在的风险数量）与青少年较差的心理健康状况相关。
