Diabetes and urbanization in the Omani population: an analysis of national survey data

Siba Al-Moosa1, Sara Allin1, Nadia Jemiai1, Jawad Al-Lawati2, Elías Mossialos1
1The London School of Economics and Political Science, LSE Health and Social Care, UK
2Ministry of Health, Oman

Tóm tắt

AbstractBackground

The prevalence of type 2 diabetes in Oman is high and appears to be rising. Rising rates of diabetes and associated risk factors have been observed in populations undergoing epidemiological transition and urbanization. A previous study in Oman indicated that urban-dwellers were not significantly more likely to have diabetes. This study was undertaken to determine if a more accurate urban and rural categorization would reveal different findings.

Methods

This study included 7179 individuals aged 20 years or above who participated in a cross-sectional interviewer-administered survey in Oman including blood and anthropomorphic tests. Multiple logistic regression analyses were conducted to analyze the factors associated with diabetes, first in the whole population and then stratified according to region.

Results

The prevalence of diabetes (fasting blood glucose ≥ 7 mmol/l) in the capital region of Muscat was 17.7% compared to 10.5% in rural areas. The prevalence of self-reported diabetes was 4.3%. Urban residence was significantly associated with diabetes (adjusted odds ratio (OR) = 1.7, 95% confidence interval (CI): 1.4–2.1), as was age (OR = 1.2, 95% CI: 1.1- 1.2), obesity (abnormal waist circumference) (OR = 1.8, 95% CI: 1.5–2.1), and systolic blood pressure (SBP) 120–139 (OR = 1.4, 95% CI:1.04–1.8), SBP 140–159 (OR = 1.9, 95% CI: 1.4–2.6), SBP ≥ 160 (OR = 1.7, 95% CI: 1.2–2.5). Stratified analyses revealed higher education was associated with reduced likelihood of diabetes in rural areas (OR = 0.6, 95% CI: 0.4–0.9).

Conclusion

A high prevalence of diabetes, obesity, hypertension and high cholesterol exist in the Omani population, particularly among urban-dwellers and older individuals. It is vital to continue monitoring chronic disease in Oman and to direct public health policy towards preventing an epidemic.

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Tài liệu tham khảo

King H, Aubert RE, Herman WH: Global burden of diabetes, 1995–2025. Diabetes Care 1998, 21: 1414-1431.

Hennis A, Wu S-Y, Nemesure B, Li X, Leske M: Diabetes in a Caribbean population: epidemiological profile and implications. Int J Epidemiol 2002, 31: 234-239. 10.1093/ije/31.1.234

Hamman RF: Genetic and environmental determinants of non-insulin dependent diabetes mellitus (NIDDM). Diabetes Metab Rev 1993, 8: 287-338.

King H, Rewers M: WHO Ad Hoc Diabetes Reporting Care Global estimates for prevalence of diabetes mellitus and impaired glucose tolerance in adults. Diabetes Care 1993, 16: 157-177.

Zimmet P: The pathogenesis and prevention of diabetes in adults: genes, autoimmunity and demography. Diabetes Care 1995, 18: 1050-1064.

Abdul-Rahim HF, Abu-Rmeileh NM, Husseini A, Holmboe-Ottesen G, Jervell J, Bjertness E: Obesity and selected co-morbidities in an urban Palestinian population. International Journal of Obesity and Related Metabolic Disorders 2001, 25: 1736-1740. 10.1038/sj.ijo.0801799

Abdul-Rahim HF, Holmboe-Ottesen G, Stene LC, Husseini A, Giacaman R, Jervell J, Bjertness E: Obesity in a rural and an urban Palestinian West Bank population. Int J Obes Relat Metab Disord 2003, 27: 140-146. 10.1038/sj.ijo.0802160

el Mugamer IT, Ali Zayat AS, Hossain MM, Pugh RN: Diabetes, obesity and hypertension in urban and rural people of Bedouin origin in the United Arab Emirates. J Trop Med Hyg 1995, 98: 407-415.

Al-Nozha MM, Al-Maatouq MA, Al-Mazrou YY, Al-Harthi SS, Arafah MR, Khalil MZ, Khan NB, Al-Khadra A, Al-Marzouki K, Nouh MS, Abdullah M, Attas O, Al-Shahid MS, Al-Mobeireek A: Diabetes mellitus in Saudi Arabia. Saudi Medical Journal 2004, 25: 1603-1610.

Country information: Oman[http://www.who.int/countries/omn/en/]

Al-Riyami A, Afifi M: Distribution and Correlates of Total Impaired Fasting Glucose in Oman. Eastern Mediterranean Health Journal 2003, 9: 377-389.

Alwan A, Jarrett J: Review of the National Diabetes Programme in Oman. Geneva: World Health Organization 2002.

Asfour MG, Lambourne A, Soliman A, Al-Behlani S, Al-Asfoor D, Bold A, Mahtab H, King H: High Prevalence of Diabetes Mellitus and Impaired Glucose Tolerance in the Sultanate of Oman: Results of the 1991 National Survey. Diabet Med 1995, 12: 112-1125.

Al-Lawati JA, Mohammed AJ, Al-Hinai HQ, Jousilahti P: Prevalence of the Metabolic Syndrome Among Omani Adults. Diabetes Care 2003, 26: 1781-1785.

World Health Organization: Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: Diagnosis and classification of diabetes mellitus. Geneva: World Health Organization 1999.

The 2002 Revision and World Urbanization Prospects[http://esa.un.org/unpp/]

Information Communications and Technologies at a glance: Oman[http://www.worldbank.org/cgi-bin/sendoff.cgi?page=%2Fdata%2Fcountrydata%2Fict%2Fomn_ict.pdf]

Kharoufi M: Urbanization and Urban Research in the Arab World. Discussion Paper Series – No 11 1996.

Roberts B: Urban Management in Asia: Issues, Priorities and Opportunities. UMP: Urban Management Programme Regional Office for Asia -Pacific; 2000.

Sultanate of Oman Ministry of National Economy: Final results of the census 2003. Muscat: Ministry of National Economy 2003.

King H, Minjoot-Preriera G: Diabetes and Non-Communicable Diseases Risk Factor Survey- a field guide. Geneva: World Health Organization; 2000.

Sultanate of Oman Ministry of Health: National Health Survey, 2000: Volume 1 – study of life style risk factors. Muscat: Ministry of Health 2000.

De Fronzo RA, Ferrannini E, Keen H, Zimmet P: International Textbook of Diabetes Mellitus, 3rd Edition. Chichester: John Wiley & Sons, Inc; 2004.

Zimmet P: Type 2 (Non-insulin-dependent) diabetes: an epidemiological review. Diabetologia 1982, 22: 399-411. 10.1007/BF00282581

Zimmet P, Taylor R, Ram P, King H, Sloman G, Raper LR, Hunt D: Prevalence of diabetes and impaired glucose tolerance in the biracial (Melanesian and Indian) population of Fiji: a rural-urban comparison. American Journal of Epidemiology 1983, 118: 673-688.

Levitt NS, Katzenellenbogen JM, Bradshaw D, Hoffman MN, Bonnici F: The Prevalence and Identification of Risk factors for NIDDM in Urban Africans in Cape Town, South Africa. Diabetes Care 1993, 16: 601-607.

Al-Lawati JA, Al Riyami AM, Mohammed AJ, Jousilahti P: Increasing prevalence of diabetes mellitus in Oman. Diabet Med 2002, 19: 954-957. 10.1046/j.1464-5491.2002.00818.x

Al-Lawati J, Jousilahti P: Prevalence and 10-year Secular Trend of Obesity in Oman. Saudi Medical Journal 2004, 25: 346-351.

Al-Mahroos F, Al-Roomi K, McKeigue PM: Relation of high blood pressure to glucose intolerance, plasma lipids and educational status in an Arabian Gulf population. Int J Epidemiol 2000, 29: 71-76. 10.1093/ije/29.1.71

Haffner SM: The prediabetic problem: development of non-insulin-dependent diabetes mellitus and related abnormalities. Journal of Diabetes Complication 1997, 11: 69-76. 10.1016/S1056-8727(96)00099-2

Njolstad I, Arnesen E, Lund-Larsen PG: Sex differences in risk factors for clinical diabetes mellitus in a general population: a 12-year follow-up of the Finnmark Study. American Journal of Epidemiology 1998, 147: 49-58.

Gress TW: Hypertension and antihypertensive therapy as risk factors for type 2 diabetes mellitus. N Engl J Med 2000, 342: 905-912. 10.1056/NEJM200003303421301

Al-Riyami A, Afifi M: Accuracy of self-reporting of diabetes mellitus and hypertension and its determinants among Omani adults. Saudi Medical Journal 2003, 24: 1025-1026.