Incident type 2 diabetes and its risk factors in men and women aged 40-60 years from four sub-Saharan African countries: results from the AWI-Gen study.

IF 19.9 1区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Lancet Global Health Pub Date : 2025-03-01 DOI:10.1016/S2214-109X(24)00520-5

Raylton P Chikwati, Nigel J Crowther, Michèle Ramsay, Lisa K Micklesfield, Shane A Norris, Kagiso P Seakamela, Engelbert A Nonterah, Godfred Agongo, Shukri F Mohamed, Isaac Kisiangani, Palwende R Boua, Alisha N Wade

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Abstract

Background: The incidence of type 2 diabetes in sub-Saharan Africa is expected to increase, but few longitudinal studies have characterised its risk factors. This study aimed to determine the incidence of type 2 diabetes over 33 481 person-years and identify its principal risk factors in middle-aged adults (ie, those aged 40-60 years) from four sub-Saharan African countries.

Methods: Longitudinal data were available from 6553 participants aged 40-60 years at baseline from study centres in South Africa, Kenya, Ghana, and Burkina Faso. Sociodemographic, behavioural, clinical, and biochemical data were collected at baseline and after an interval of 5-6 years. The prevalence of type 2 diabetes was determined at each timepoint and diabetes incidence was calculated. A two-stage individual participant data meta-analysis was used to identify baseline risk factors for incident diabetes.

Findings: The overall incidence of type 2 diabetes was 14·6 (95% CI 13·4-16·0) cases per 1000 person-years. The incidence was highest in South Africa with 21·8 (19·5-24·4) cases per 1000 person-years, and lowest in west Africa with 5·5 (4·4-6·9) cases per 1000 person-years. Baseline glucose (adjusted odds ratio 1·37; 95% CI 1·16-1·42), being male (1·32; 1·12-1·54), family history of type 2 diabetes (1·22; 1·01-1·46), unemployment (1·19; 1·03-1·37), hypertension (1·21; 1·01-1·45), BMI (1·03; 1·02-1·04), and waist circumference (1·02; 1·01-1·03), were associated with a higher risk of incident type 2 diabetes, while adequate baseline physical activity (0·87; 0·76-1·00) was associated with lower risk.

Interpretation: The high incidence of type 2 diabetes in this middle-aged sub-Saharan Africa population is influenced by several modifiable risk factors that should inform interventions to mitigate the disease burden.

Funding: National Institutes of Health, Department of Science and Innovation (South Africa), and the South African Medical Research Council.

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四个撒哈拉以南非洲国家 40-60 岁男性和女性的 2 型糖尿病发病率及其风险因素：AWI-Gen 研究的结果。

背景：2型糖尿病在撒哈拉以南非洲的发病率预计会增加，但很少有纵向研究描述其危险因素。本研究旨在确定来自四个撒哈拉以南非洲国家的中年人（即40-60岁的人）中超过33481人年的2型糖尿病发病率，并确定其主要危险因素。方法：来自南非、肯尼亚、加纳和布基纳法索研究中心的6553名年龄在40-60岁的参与者的纵向数据。在基线和间隔5-6年后收集社会人口学、行为、临床和生化数据。测定每个时间点2型糖尿病的患病率，并计算糖尿病发病率。采用两阶段个体参与者数据荟萃分析来确定发生糖尿病的基线危险因素。结果：2型糖尿病的总发病率为每1000人年14.6例（95% CI 13.4 - 16.0）。南非发病率最高，为21.8（19.5 - 24.4）例/ 1000人年，西非发病率最低，为5.5（4.4 -6）例/ 1000人年。基线血糖(校正优势比为1.37；95% CI为1.16 - 1.42)，男性(1.32；1·12-1·54)，2型糖尿病家族史(1·22；1.01 - 1.46)，失业率(1.19；1·03-1·37)，高血压(1·21；1.01 - 1.45), bmi (1.03；1·02-1·04)，腰围(1·02；1.01 - 1.03)与较高的2型糖尿病发生风险相关，而充足的基线体力活动(0.87；0.76 - 0.00)与较低的风险相关。解释：撒哈拉以南非洲中年人群中2型糖尿病的高发病率受到几个可改变的危险因素的影响，这些因素应该为干预措施提供信息，以减轻疾病负担。资助：国家卫生研究院、科学与创新部（南非）和南非医学研究理事会。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lancet Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

44.10

自引率

1.20%

发文量

763

审稿时长

10 weeks

期刊介绍： The Lancet Global Health is an online publication that releases monthly open access (subscription-free) issues.Each issue includes original research, commentary, and correspondence.In addition to this, the publication also provides regular blog posts. The main focus of The Lancet Global Health is on disadvantaged populations, which can include both entire economic regions and marginalized groups within prosperous nations.The publication prefers to cover topics related to reproductive, maternal, neonatal, child, and adolescent health; infectious diseases (including neglected tropical diseases); non-communicable diseases; mental health; the global health workforce; health systems; surgery; and health policy.