Evaluating the prevalence and analysis of the main risk factors of type 2 diabetes mellitus among residents of Aktobe and Aktobe region (Republic of Kazakhstan)
Background. In the emergence and progression of chronic non-infectious diseases, risk factors play an important role, which are common to many diseases, and with simultaneous action they potentiate the influence of each other, thereby dramatically increasing the risk of the disease. The most important feature of diabetes mellitus (DM) is a significant incidence of cardiovascular complications, a high mortality rate, as well as the cost of treatment for decompensated patients. The urgent and priority task of the healthcare system today is the development and implementation of a modern system for epidemiological monitoring of the main chronic non-infectious diseases, including type 2 DM. The purpose of the study was to assess the epidemiological situation based on the main risk factors for the development of type 2 DM on the basis of a cross-sectional study of the population of Aktobe and Aktobe region of Kazakhstan. Materials and methods. 1515 patients aged 18–69 (mean age 45.9 ± 13.6) years, living in Aktobe and Aktobe region were enrolled in the study. The study was conducted in three stages: interviewing the respondents, physical measurements and laboratory research. Results. The study showed 5.6 % of cases of newly diagnosed type 2 DM in Aktobe and Aktobe region. At the same time, the prevalence of DM among urban dwellers was 6.1 % (n = 45), compared to 4.9 % in the village (n = 28), the prevalence among men was 6.9 % (n = 20), among women — 5.3 % (n = 53). Analysis based on nationality revealed a significant prevalence of DM among people of Russian nationality (17.5 %) compared with Kazakhs (9.2 %, p < 0.01), but comparison of the prevalence of diabetes among Russians with people of other Asian nationality (18.7 %, p > 0.05) and other European nationalities (14.9 %, p > 0.05) did not reveal significant differences. The next non-modifiable factor in the development of type 2 DM is age, and in the age group over 45 years, the risk of developing type 2 DM increases. Among the respondents in Aktobe and Aktobe region, the odds ratio was 1 : 7 (7.114), i.e. in the age group over 45 years, the risk of developing type 2 DM increases by 7 times. When analyzing these questionnaires, it was found that 250 respondents indicated relatives of the first degree of kinship with diabetes, with DM developing in 13.2 % (n = 33). The remaining 1,265 people did not have family history of DM, and the rate of diabetes among them was 9 % (n = 114). The odds ratio was almost 1 : 1.5 (1.535), the difference is statistically significant, p < 0.05. At present, there is no doubt that obesity is the leading etiologic factor in the pathogenesis of type 2 DM, and the risk of developing DM increases with the degree of obesity. The study of this parameter revealed that almost 90 % of people with diabetes have overweight or obesity of varying degrees. Analysis of body mass index among those surveyed showed a significant prevalence in all obesity rates in the group of respondents with DM. It is known that DM is one of the leading causes of the increase in morbidity and mortality from diseases of the circulatory system, but on the other hand, cardiovascular diseases are independent risk factors for the development of type 2 DM. According to the results of the study, it was found that people with diabetes in comparison with people without DM suffer from hypertension 5 times more often, from chronic heart failure — more than 6 times, myocardial infarction and chronic heart failure occur more than 6 times more often, arrhythmias of different etiology — 4 times more often, stroke — 2 times. Conclusions. The analysis of risk factors for the development of type 2 DM in the studied population confirmed the influence of such absolute factors as race, age and hereditary predisposition on the prevalence of diabetes. A significant contribution to the development of the disease is also made by such relative or modifiable factors as obesity, glucose and cholesterol levels and concomitant cardiovascular pathology.
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