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Substance use and lifestyle risk factors for somatic disorders among psychiatric patients in Greenland. 格陵兰精神病患者躯体疾病的药物使用和生活方式风险因素。
IF 1.3 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-12-01 Epub Date: 2024-10-27 DOI: 10.1080/22423982.2024.2421049
Ida Margrethe Nielsen, Lisbeth Uhrskov Sørensen, Søren Wichmand, Parnûna Heilmann, Michael Lynge Pedersen

Patients with psychotic disorders exhibit elevated mortality and morbidity rates compared to the general population primarily due to comorbid somatic diseases. This study aims to describe the prevalence of selected risk factors and somatic disorders among psychiatric patients with a diagnosis of psychotic disorder. Material and methods: Data were retrieved from Greenland's nationwide electronic medical record. The study population consists of 104 patients diagnosed with a psychotic disorder, encompassing schizophrenia or schizotypal and delusional disorders, residing in Nuuk. The study population comprised 104 patients (68 males and 36 females) with a mean age of 40 years. More than 80% were daily smokers, and 68% had harmful use of cannabis. More than half had dyslipidemia (any imbalance in lipids), while over a quarter were classified as obese with body mass index of 30 kg/m2 or higher. Eighteen percent had hypertension, and six percent suffered from diabetes. This study revealed a notable prevalence of risk factors for somatic diseases, particularly smoking and cannabis use among patients with schizophrenia in Nuuk, indicating that a high prevalence of somatic diseases might be expected as the population gets older and the risk of developing somatic diseases becomes greater. Increased focus on monitoring and preventing those as part of the health care is recommended.

与普通人群相比,精神病患者的死亡率和发病率较高,这主要是由于合并躯体疾病所致。本研究旨在描述被诊断为精神障碍的精神病患者中某些风险因素和躯体疾病的患病率。材料和方法数据取自格陵兰的全国电子病历。研究对象包括居住在努克的 104 名被诊断患有精神障碍的患者,包括精神分裂症或精神分裂分型和妄想障碍。研究对象包括 104 名患者(68 名男性和 36 名女性),平均年龄为 40 岁。80%以上的人每天吸烟,68%的人有害使用大麻。半数以上患有血脂异常(任何血脂失衡),超过四分之一的人被归类为肥胖,体重指数为 30 kg/m2 或更高。18%的人患有高血压,6%的人患有糖尿病。这项研究显示,在努克的精神分裂症患者中,躯体疾病的风险因素,尤其是吸烟和吸食大麻的情况非常普遍,这表明随着人口年龄的增长,躯体疾病的患病率可能会越来越高。建议在保健工作中更加注重监测和预防这些疾病。
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引用次数: 0
Quality of care among patients diagnosed with atrial fibrillation in Greenland. 格陵兰确诊心房颤动患者的护理质量。
IF 1.3 4区 医学 Q2 Social Sciences Pub Date : 2024-12-01 Epub Date: 2024-02-08 DOI: 10.1080/22423982.2024.2311965
Marie Tolver Nielsen, Maja Hykkelbjerg Nielsen, Stig Andersen, Sam Riahi, Uka Wilhjelm Geisler, Michael Lynge Pedersen, Nadja Albertsen

This cross-sectional study sought to assess the prevalence of atrial fibrillation (AF) diagnosis in Greenland among various age groups and examine the corresponding quality of care. We collected data from Greenland's electronic medical records and evaluated the quality of care using six internationally recommended indicators, which are: percentage of AF patients with an assessment of smoking status within the previous year, an assessment of body mass index within the previous year, assessment of blood pressure within the previous year, measurement of thyroid stimulating hormone (TSH), treatment with an anticoagulant and percentage of patients with a measurement of serum-creatinine. We found the prevalence of AF among patients aged 20 years or older in Greenland to be 1.75% (95% CI 1.62-1.88). We found an increasing prevalence of AF with age and a greater proportion of men than women until the age of 74 years. Our study suggests that the associated quality of care could be higher as the requirement of only one of the six quality indicators was met. A lack of registration may partly explain this, and initiatives to improve the quality of care are recommended.

这项横断面研究旨在评估格陵兰岛各年龄组心房颤动(房颤)的诊断率,并检查相应的护理质量。我们从格陵兰的电子病历中收集了数据,并采用国际推荐的六项指标对护理质量进行了评估,这六项指标分别是:前一年内进行过吸烟状况评估的房颤患者比例、前一年内进行过体重指数评估的患者比例、前一年内进行过血压评估的患者比例、促甲状腺激素(TSH)测量的患者比例、接受过抗凝剂治疗的患者比例以及测量过血清肌酐的患者比例。我们发现格陵兰 20 岁或以上患者的房颤患病率为 1.75%(95% CI 1.62-1.88)。我们发现心房颤动的患病率随着年龄的增长而增加,而且在 74 岁之前,男性的比例高于女性。我们的研究表明,相关的护理质量可能更高,因为只达到了六项质量指标中的一项要求。缺乏登记可能是造成这种情况的部分原因,建议采取措施提高护理质量。
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引用次数: 0
Community directed assessment of pain in a northern Saskatchewan Cree community. 在萨斯喀彻温省北部的克里社区,由社区指导对疼痛进行评估。
IF 1.3 4区 医学 Q2 Social Sciences Pub Date : 2024-12-01 Epub Date: 2024-01-07 DOI: 10.1080/22423982.2023.2300858
Tayah Zhang, Elder Rose Dorian, Sally Sewap, Rachel Johnson, Heather Foulds, Brenna Bath, Stacey Lovo

Indigenous Elder advisors in Pelican Narrows, a Cree community in Northern Saskatchewan, have indicated that Western pain scales may not be responsive tools for pain assessments within their community. This study employed a mixed methods research design that involved two phases. Phase one was the development of a pain scale in collaboration with an Elder and a Knowledge Keeper. Phase two was a pilot of the CDPS utilised during virtual physiotherapy sessions for chronic back pain. Twenty-seven participants completed the pre-physiotherapy treatment questionnaires, and 10 participants engaged in semi-structured interviews (9 community members; 1 healthcare provider). A weighted kappa analysis yielded k = 0.696, indicating a good agreement between the CDPS and Faces Pain Scale-Revised in terms of documenting participants' pain. Qualitative data from interviews with community members revealed three major themes: 1) Learnings Regarding Pain Scales, 2) Patient Centered Care; and 3) Strength-Based Solutions for Improving Pain Communication. Two themes were uncovered through conversations with the HCP: 1) Perspectives on CDPS and 2) Healthcare Provider Experiences Communicating about Pain. Moreover, a patient-centredcentred approach is important to ensure comprehensive pain assessments.

萨斯喀彻温省北部一个克里族社区 Pelican Narrows 的原住民长老顾问表示,西方疼痛量表可能不是他们社区内疼痛评估的响应工具。本研究采用了混合方法研究设计,包括两个阶段。第一阶段是与一位长者和一位知识守护者合作开发疼痛量表。第二阶段是在针对慢性背痛的虚拟物理治疗过程中试用 CDPS。27 名参与者完成了物理治疗前的问卷调查,10 名参与者参与了半结构化访谈(9 名社区成员;1 名医疗保健提供者)。加权卡帕分析得出 k = 0.696,表明 CDPS 与《面孔疼痛量表-修订版》在记录参与者疼痛方面具有良好的一致性。与社区成员访谈的定性数据揭示了三大主题:1)关于疼痛量表的学习;2)以患者为中心的护理;3)改善疼痛沟通的基于力量的解决方案。通过与医疗保健提供者的对话,发现了两个主题:1)对 CDPS 的看法;2)医疗保健提供者的疼痛沟通经验。此外,以患者为中心的方法对于确保全面的疼痛评估非常重要。
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引用次数: 0
The social and organisational factors shaping acceptability of a self-management education and exercise intervention for people with hip or knee osteoarthritis in Greenland. 影响格陵兰岛髋关节或膝关节骨关节炎患者接受自我管理教育和锻炼干预的社会和组织因素。
IF 1.3 4区 医学 Q2 Social Sciences Pub Date : 2024-12-01 Epub Date: 2024-05-05 DOI: 10.1080/22423982.2024.2350120
Marie Tolver Nielsen, Maja Hykkelbjerg Nielsen, Sonja Sørensen, Morten Skovdal

This study aimed to explore the experiences and perspectives of people with osteoarthritis attending the "Osteoarthritis School" (OA School) in Nuuk, Greenland to generate insights and lessons that can inform the development of self-management education and exercise interventions for people with other lifestyle conditions in a Greenland context. We conducted a qualitative interpretive description (ID) study based on ten semi-structured interviews with people with hip or knee osteoarthritis. Interviews were audio-recorded, transcribed, and coded. Using ID, we identified three themes: 1) perceptions and experiences of how the OA School intervention was organised (time and place); 2) perspectives and experiences of the education and exercise components (social factors, motivation, and education); and 3) significant change stories (physical and mental improvements and increased knowledge of OA). Social and organisational factors, such as working out with peers and the time and place of the intervention, influenced the participants' acceptance of the OA School intervention. Knowledge from this study will help us gain insight into what to address when developing future self-management education and exercise interventions in the Greenlandic healthcare system.

本研究旨在探索参加格陵兰努克 "骨关节炎学校"(OA 学校)的骨关节炎患者的经历和观点,从而获得启示和经验,为格陵兰其他生活方式疾病患者的自我管理教育和运动干预措施的发展提供参考。我们对髋关节或膝关节骨关节炎患者进行了十次半结构式访谈,并在此基础上开展了一项定性解释性描述(ID)研究。我们对访谈进行了录音、转录和编码。通过 ID,我们确定了三个主题:1)对 "OA 学校 "干预活动组织方式的看法和体验(时间和地点);2)对教育和锻炼内容的看法和体验(社会因素、动机和教育);3)重大变化的故事(身体和精神方面的改善以及对 OA 知识的增加)。社会和组织因素,如与同伴一起锻炼以及干预的时间和地点,影响了参与者对 OA 学校干预的接受程度。这项研究的知识将帮助我们深入了解未来在格陵兰医疗保健系统中开展自我管理教育和运动干预时需要解决的问题。
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引用次数: 0
Metal exposure in the Greenlandic ACCEPT cohort: follow-up and comparison with other Arctic populations. 格陵兰 ACCEPT 队列中的金属暴露:跟踪调查以及与其他北极地区人群的比较。
IF 1.3 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-12-01 Epub Date: 2024-07-30 DOI: 10.1080/22423982.2024.2381308
Maria Wielsøe, Manhai Long, Jens Søndergaard, Eva Cecilie Bonefeld-Jørgensen

Humans are exposed to metals through diet and lifestyle e.g. smoking. Some metals are essential for physiologically body functions, while others are non-essential and can be toxic to humans. This study follows up on metal concentrations in the Greenlandic ACCEPT birth-cohort (mothers and fathers) and compares with other Arctic populations. The data from 2019 to 2020 include blood metal concentrations, lifestyle and food frequency questionnaires from 101 mothers and 76 fathers, 24-55 years, living in Nuuk, Sisimiut, and Ilulissat. A high percentage (25-45%) exceeded international guidance values for Hg. For the mothers, the metal concentrations changed significantly from inclusion at pregnancy to this follow-up 3-5 years after birth; some increased and others decreased. Most metals differed significantly between mothers and fathers, while few also differed between residential towns. Several metals correlated significantly with marine food intake and socio-economic factors, but the direction of the correlations varied. Traditional marine food intake was associated positively with Se, As and Hg. To the best of our knowledge, this study provides the most recent data on metal exposure of both men and women in Greenland, elucidating metal exposure sources among Arctic populations, and documents the need for continuing biomonitoring to follow the exceeding of guidance values for Hg. [Figure: see text].

人类通过饮食和生活方式(如吸烟)接触金属。一些金属是人体生理功能所必需的,而另一些则是非必需的,可能对人体有毒。这项研究跟踪格陵兰 ACCEPT 出生队列(母亲和父亲)中的金属浓度,并与其他北极人群进行比较。2019 年至 2020 年的数据包括居住在努克、西西米尤特和伊卢利萨特的 101 名母亲和 76 名父亲(24-55 岁)的血液金属浓度、生活方式和食物频率问卷。超过汞国际指导值的比例很高(25-45%)。从怀孕到出生后 3-5 年的随访期间,母亲体内的金属浓度发生了显著变化;有些浓度上升,有些浓度下降。大多数金属在母亲和父亲之间存在明显差异,少数金属在不同居住城镇之间也存在差异。有几种金属与海洋食物摄入量和社会经济因素有明显的相关性,但相关性的方向各不相同。传统海洋食物摄入量与硒、砷和汞呈正相关。据我们所知,这项研究提供了格陵兰岛男性和女性接触金属的最新数据,阐明了北极地区人口接触金属的来源,并证明有必要继续进行生物监测,以跟踪汞指导值的超标情况。[图:见正文]。
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引用次数: 0
The trends in perceived health, well-being, and risk behaviours among high school students in Finnmark, Norway, compared to the national average. 与全国平均水平相比,挪威芬马克地区高中生的健康、幸福感和风险行为认知趋势。
IF 1.3 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-12-01 Epub Date: 2024-10-30 DOI: 10.1080/22423982.2024.2420480
Shiho Hansen

This study examines trends in health, well-being, and risk behaviours among high school students in Finnmark, Norway, and compares them with the national average. Data were drawn from the Ungdata survey, covering three waves between 2014 and 2023. The sample included 6,084 high school students in Finnmark and 254,048 students nationwide. MANOVA with polynomial contrasts assessed linear trends among students in Finnmark, and MANOVA with difference contrast tested pairwise differences between Finnmark and national samples. Trend analysis revealed that 26 out of 63 variables, including digital use, school-related variables, antisocial behaviours, and depressive thoughts, increased over time, while 25 variables, such as physical activities, local environment, and bullying remained unchanged. Relationships with parents and substance use improved. Pairwise comparisons showed worse outcomes for Finnmark students in 43 and 41 out of 63 variables across waves, except for substance use and antisocial behaviours. This study indicates limited improvement in health and risk behaviours among high school students in Finnmark. Public health policies tailored to adolescents in Finnmark should focus on mental health services, promoting physical activity, and reducing antisocial behaviours and bullying. Further research should explore Finnmark's multiethnic context, including the Sámi and Kven populations.

本研究探讨了挪威芬马克地区高中生的健康、福祉和风险行为趋势,并将其与全国平均水平进行了比较。数据来自Ungdata调查,涵盖2014年至2023年的三次调查。样本包括芬马克的6084名高中生和全国的254048名学生。多项式对比的 MANOVA 分析评估了芬马克学生的线性趋势,而差异对比的 MANOVA 分析则检验了芬马克和全国样本之间的成对差异。趋势分析表明,在 63 个变量中,有 26 个变量(包括数字使用、学校相关变量、反社会行为和抑郁想法)随着时间的推移而增加,而 25 个变量(如体育活动、当地环境和欺凌)则保持不变。与父母的关系和药物使用情况则有所改善。配对比较结果表明,除了药物使用和反社会行为外,芬马克学生在63个变量中的43个和41个变量上的结果都不如其他学生。这项研究表明,芬马克高中生在健康和危险行为方面的改善有限。针对芬马克青少年的公共卫生政策应侧重于心理健康服务、促进体育锻炼、减少反社会行为和欺凌行为。进一步的研究应探讨芬马克的多民族背景,包括萨米人和克文人。
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引用次数: 0
A Nunavut community-directed Inuit youth mental wellness initiative: making I-SPARX fly. 努勒维特社区指导的因努伊特青年心理健康倡议:让 I-SPARX 飞起来。
IF 1.3 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-12-01 Epub Date: 2024-10-10 DOI: 10.1080/22423982.2024.2401210
Yvonne Bohr, Jeffrey Hankey, Alaina Thomas, Marette Abdelmaseh, Leigh Armour, Hugh McCague, Jenna Barnhardt, Megis Oskalns, Nichaela Garvey, Yogita Singh, Cassie Danz, Chelsea Singoorie, Reuben Qaunaq, Iola Oshoweetok, Mathijs Lucassen, Sally Merry, Matthew Shepherd, Marc H Bornstein, Farah Ahmad, Shmuel Shulman, Jonathan Weiss

Inuit youth in Nunavut (NU) are resilient but face a protracted suicide crisis. The SPARX serious game and e-intervention, developed originally in New Zealand, teaches youth cognitive behavioural therapy (CBT) skills to ameliorate stress and depression. Inuit youth in NU reviewed and culturally adapted SPARX and an existing wellness outcome measure for Inuit. One hundred and twenty-one youth, aged 13 to 24, across NU then tested, played, and evaluated I(nuit)-SPARX, showing improvement in several areas of wellbeing post-play. Youth completed a CBT skills survey, engaged in sharing circles to assess CBT skill retention, and shared their thoughts about the usefulness and cultural fit of I-SPARX with Inuit Qaujimajatuqangit (IQ). Communication Skills, Listening Skills, and Problem Solving emerged as the most helpful learned CBT skills, and NU youth provided real-world examples of using I-SPARX skills to support their mental wellness. Several principles of IQ were exemplified and upheld in the content of the adapted SPARX tool and the process of the project as a whole. Empirically grounded, asynchronous e-tools, developed in collaboration with Inuit communities to ensure cultural specificity, may support psychological wellness in communities where mental health resources are scarce.

努纳武特地区(NU)的因纽特青年具有顽强的生命力,但却面临着长期的自杀危机。SPARX 严重游戏和电子干预最初是在新西兰开发的,它教授青少年认知行为疗法 (CBT) 技能,以减轻压力和抑郁。新西兰大学的因纽特人青年对 SPARX 和现有的因纽特人健康结果测量方法进行了审查和文化改编。随后,全国各地 121 名年龄在 13 至 24 岁之间的青少年对 I(nuit)-SPARX 进行了测试、游戏和评估,结果显示游戏后多个方面的健康状况有所改善。青少年完成了一项 CBT 技能调查,参与了评估 CBT 技能保持情况的分享圈,并分享了他们对 I-SPARX 与因纽特 Qaujimajatuqangit (IQ) 的实用性和文化契合度的看法。交流技能、倾听技能和解决问题成为最有用的 CBT 技能,纽大青年提供了使用 I-SPARX 技能支持心理健康的真实案例。经过改编的 SPARX 工具的内容和整个项目的过程都体现并坚持了智商的几项原则。与因纽特人社区合作开发的、以经验为基础的异步电子工具可为心理健康资源匮乏的社区提供心理健康支持。
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引用次数: 0
Ethnic differences in CT derived abdominal body composition measures: a comparative retrospect pilot study between European and Inuit study population. CT 导出的腹部身体成分测量的种族差异:欧洲人和因纽特人研究人群的对比回顾性试验研究。
IF 1.3 4区 医学 Q2 Social Sciences Pub Date : 2024-12-01 Epub Date: 2024-02-05 DOI: 10.1080/22423982.2024.2312663
Mia Solholt Godthaab Brath, Marina Sahakyan, Esben Bolvig Mark, Henrik Højgaard Rasmussen, Lasse Riis Østergaard, Jens Brøndum Frøkjær, Ulla Møller Weinreich, Marit Eika Jørgensen

Understanding ethnic variations in body composition is crucial for assessing health risks. Universal models may not suit all ethnicities, and there is limited data on the Inuit population. This study aimed to compare body composition between Inuit and European adults using computed tomography (CT) scans and to investigate the influence of demographics on these measurements. A retrospective analysis was conducted on 50 adults (29 Inuit and 21 European) who underwent standard trauma CT scans. Measurements focused on skeletal muscle index (SMI), various fat indices, and densities at the third lumbar vertebra level, analyzed using the Wilcoxon-Mann-Whitney test and multiple linear regression. Inuit women showed larger fat tissue indices and lower muscle and fat densities than European women. Differences in men were less pronouncehd, with only Intramuscular fat density being lower among Inuit men. Regression indicated that SMI was higher among men, and skeletal muscle density decreased with Inuit ethnicity and age, while visceral fat index was positively associated with age. This study suggests ethnic differences in body composition measures particularly among women, and indicates the need for Inuit-specific body composition models. It higlights the importance of further research into Inuit-specific body composition measurements for better health risk assessment.

了解身体成分的种族差异对于评估健康风险至关重要。通用模型可能并不适合所有种族,有关因纽特人的数据也很有限。本研究旨在使用计算机断层扫描(CT)比较因纽特人和欧洲成年人的身体成分,并研究人口统计学对这些测量结果的影响。研究人员对接受标准创伤 CT 扫描的 50 名成年人(29 名伊努伊特人和 21 名欧洲人)进行了回顾性分析。测量的重点是骨骼肌指数(SMI)、各种脂肪指数和第三腰椎水平的密度,并使用 Wilcoxon-Mann-Whitney 检验和多元线性回归进行分析。与欧洲妇女相比,因纽特妇女的脂肪组织指数较大,肌肉和脂肪密度较低。男性的差异则不明显,因纽特男性只有肌内脂肪密度较低。回归结果表明,男性的 SMI 值较高,骨骼肌密度随着因纽特人的种族和年龄而降低,而内脏脂肪指数则与年龄呈正相关。这项研究表明,在身体成分测量方面存在种族差异,尤其是在女性中,并指出需要建立针对因纽特人的身体成分模型。它强调了进一步研究因纽特人特有的身体成分测量方法以更好地评估健康风险的重要性。
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引用次数: 0
COVID-19 impacts in Northernmost Finland. COVID-19 对芬兰北部的影响。
IF 1.3 4区 医学 Q2 Social Sciences Pub Date : 2024-12-01 Epub Date: 2024-02-15 DOI: 10.1080/22423982.2024.2314368
Ulla Timlin, Arja Rautio

The COVID-19 pandemic challenged our lives during the years 2020-2022. Impacts could be seen in everyday life, both locally and nationally, through economic, mental and social elements. However, these effects varied depending on the life situation of individuals. This paper aims to gather information from the representatives and operators working in two Finnish municipalities, Inari and Utsjoki, to understand and learn about their experiences during the COVID-19 pandemic. The data (20 interviews) were collected between December 2021 and February 2022 and analysed following the principles of the qualitative content analysis. The results suggest that the effects of COVID-19 emerged through issues related to the national border between Finland and Norway, economic challenges, and the pressure that people experienced. However, despite challenges, people were supported by everyday life and a connection to nature, communality and close co-operation. Additionally, local needs were highlighted among participants. The results provide a deeper understanding about the public health impacts in these Northernmost municipalities and can therefore be utilised in future development work. They also provide relevant information on the experiences of Sámi people, and specific views related to Sámi people can be recognised.

在 2020-2022 年期间,COVID-19 大流行给我们的生活带来了挑战。通过经济、精神和社会因素,我们可以在当地和全国的日常生活中看到其影响。然而,这些影响因个人的生活状况而异。本文旨在收集在芬兰伊纳里(Inari)和乌兹约基(Utsjoki)两个城市工作的代表和操作人员的信息,以了解和学习他们在 COVID-19 大流行期间的经历。数据(20 个访谈)收集于 2021 年 12 月至 2022 年 2 月期间,并按照定性内容分析的原则进行了分析。结果表明,COVID-19 的影响通过与芬兰和挪威之间的国界、经济挑战以及人们所经历的压力相关的问题显现出来。然而,尽管面临挑战,人们还是得到了日常生活的支持,以及与自然、社区和密切合作的联系。此外,参与者还强调了当地的需求。研究结果加深了人们对这些最北部城市的公共卫生影响的了解,因此可用于未来的发展工作。这些结果还提供了有关萨米人经历的相关信息,与萨米人有关的具体观点也可以得到认可。
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引用次数: 0
Evidence-based screening, clinical care and health education recommendations for Alaska Native peoples with prediabetes living in southcentral Alaska: findings from the Alaska EARTH follow-up study. 为居住在阿拉斯加中南部的阿拉斯加原住民糖尿病前期患者提供循证筛查、临床护理和健康教育建议:阿拉斯加 EARTH 跟踪研究的结果。
IF 1.3 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-12-01 Epub Date: 2024-05-01 DOI: 10.1080/22423982.2024.2343143
Kathryn R Koller, Sarah H Nash, Julie A Beans, Gretchen M Day, Vanessa Y Hiratsuka, Ai-Ling Lin, Meera Narayanan, Christi A Patten, Sherry A Hammock, Barbara V Howard, Jason G Umans

Pre-diabetes (pre-DM) is a strong predictor of diabetes (DM) over time. This study investigated how much of the recent increase in pre-DM identified among Alaska Native (AN) peoples living in urban southcentral Alaska may be due to changes in diagnostic methods. We used clinical and demographic data collected at baseline between 2004 and 2006 and at follow-up collected between 2015 and 2017 from the urban southcentral Alaska Education and Research Towards Health (EARTH) cohort. We used descriptive statistics and logistic regression to explore differences in demographic and clinical variables among the identified pre-DM groups. Of 388 participants in the follow-up study, 243 had A1c levels indicating pre-DM with only 20 demonstrating pre-DM also by fasting blood glucose (FBG). Current smoking was the sole predictor for pre-DM by A1c alone while abdominal obesity and elevated FBG-predicted pre-DM by A1c+FBG. No participants had an elevated FBG without an A1c elevation. A substantial portion of the rise in pre-DM found among urban southcentral AN peoples in the EARTH follow-up study was due to the addition of A1c testing. Pre-DM by A1c alone should be used to motivate behavioural changes that address modifiable risk factors, including smoking cessation, physical activity and weight management.

随着时间的推移,糖尿病前期(pre-DM)是糖尿病(DM)的有力预测因素。本研究调查了生活在阿拉斯加中南部城市的阿拉斯加原住民(AN)中发现的糖尿病前期病例最近有所增加,其中有多少可能是由于诊断方法的改变造成的。我们使用了 2004 年至 2006 年期间基线收集的临床和人口统计数据,以及 2015 年至 2017 年期间从阿拉斯加中南部城市健康教育与研究 (EARTH) 队列中收集的随访数据。我们使用描述性统计和逻辑回归来探讨已确定的DM前群体之间人口统计学和临床变量的差异。在后续研究的 388 名参与者中,有 243 人的 A1c 水平显示为糖尿病前期,只有 20 人的空腹血糖 (FBG) 也显示为糖尿病前期。仅从 A1c 角度看,当前吸烟是预测糖尿病前期的唯一因素,而从 A1c+FBG 角度看,腹部肥胖和 FBG 升高则是预测糖尿病前期的因素。没有人在 A1c 未升高的情况下出现 FBG 升高。在 EARTH 跟踪研究中发现,城市中南部 AN 族人的 DM 前值上升很大一部分是由于增加了 A1c 检测。仅通过 A1c 预测血糖值应能促使人们改变行为,以应对可改变的风险因素,包括戒烟、体育锻炼和体重管理。
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引用次数: 0
期刊
International Journal of Circumpolar Health
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