1887
Volume 2014, Issue 2
  • ISSN: 0253-8253
  • E-ISSN: 2227-0426

Abstract

Type II diabetes mellitus (DM) is one of the leading chronic diseases in Qatar as well as worldwide. However, the risk factors for DM in Qatar and their prevalence are not well understood. We conducted a case-control study with the specific aim of estimating, based on data from outpatients with DM in Qatar (cases) and outpatient/inpatient controls, the association between demographic/lifestyle factors and DM. A total of 459 patients with DM from Hamad General Hospital (HGH) outpatient adult diabetes clinics, and 342 control patients from various outpatient clinics and inpatient departments within Hamad Medical Corporation (HMC) (years 2006–2008), were recruited. The association between risk factors and DM was evaluated using bivariate and multivariable logistic regression analyses. In addition to odds ratios (OR) and 95% confidence intervals (95% CI), we estimated the population attributable risk fractions for the DM demographic/lifestyle risk factors. Qatari nationality was the strongest risk factor for DM (adjusted OR = 5.5; 95% CI = 3.5–8.6; p < 0.0001), followed by higher monthly income (defined as ≥ 3000 Qatari Riyals, adjusted OR = 5.1; 95% CI = 3.0–8.7; p < 0.0001), age >65 years (adjusted OR = 3.3; 95% CI = 0.9–11.4; p = 0.06), male gender (adjusted OR = 2.9; 95% CI = 1.8-4.8; p < 0.0001), obesity (BMI ≥ 30, adjusted OR = 2.2; 95% CI = 1.5-3.2; p < 0.0001), no college education (adjusted OR = 1.7; 95% CI = 1.2–2.6; p = 0.009), and no daily vigorous/moderate activity (adjusted OR = 1.5; 95% CI = 0.9–2.3; p = 0.12). Among Qatari nationals, obesity was found to be the main risk factor for DM (unadjusted OR = 3.0; 95% CI = 1.6–5.6; p < 0.0001), followed by no college education (unadjusted OR = 2.7; 95% CI = 1.5–5.1; p = 0.001), while consanguinity did not appear to play a major role in predicting DM (unadjusted OR = 1.5; 95% CI = 0.8–2.8; p = 0.21). Our findings further suggested that eliminating obesity and improving access to education may reduce DM cases by up to one third for the population at large (31.7% and 26.8%, respectively) and up to half (46.9% and 49.3%, respectively) for Qatari nationals. Promoting physical activity may reduce the burden of DM by up to 9.4% for the population at large and up to 17.3% for Qatari nationals. Demographic/lifestyle factors appear to be the main risk factors for the high DM levels observed in Qatar, with a contribution that outweighs that of genetic risk factors. While further evaluation of DM risk factors among the Qatari population (as opposed to the resident population) is important and of interest, these findings highlight the need to focus short-term DM interventions on addressing demographic/lifestyle risk factors to achieve substantial and timely declines in DM levels.

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2015-01-01
2019-08-18
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References

  1. [1]. International Diabetes Federation. International Diabetes Federation Diabetes Atlas. 2013 [cited 2013 February 19]; Fifth edition. Available from: http://www.idf.org/diabetesatlas/download-book .
  2. [2]. World Health Organization (WHO). Diabetes Fact Sheets. 2013 September 12, 2012 [cited 2013 February 19]; Available from: http://www.who.int/mediacentre/factsheets/fs312/en/index.html .
  3. [3]. Akala   FA., , El-Saharty   S. . Public-health challenges in the Middle East and North Africa. . Lancet . 2006; ;  367: 9515 : 961– 964 .
    [Google Scholar]
  4. [4]. Alhyas   L., , McKay   A., , Majeed   A. . Prevalence of type 2 diabetes in the States of the co-operation council for the Arab States of the Gulf: a systematic review. . PLoS One . 2012; ;7: 8 : e40948 .
    [Google Scholar]
  5. [5]. Musaiger   AO. . Diet and prevention of coronary heart disease in the Arab Middle East countries. . Med Princ Pract . 2002; ;11: Suppl 2 : 9– 16 .
    [Google Scholar]
  6. [6]. Health, S.C.o. , Qatar Stepwise Report 2012: Chronic Disease Risk factor Surveillance , 2013; ; , Supreme Council of Health; : Qatar:. p. 124 .
    [Google Scholar]
  7. [7]. International Organization for Migration . World Migration Report 2013 . Geneva, Switzerland: : International Organization for Migration;   2013; :p. 220 .
    [Google Scholar]
  8. [8]. Yusuf   S., , Reddy   S., , Ounpuu   S., , Anand   S. . Global burden of cardiovascular diseases: part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. . Circulation . 2001; ;104: 22 : 2746– 2753 .
    [Google Scholar]
  9. [9]. El-Menyar   A., , Al Thani   H., , Hussein   A., , Sadek   A., , Sharaf   A., , Al Suwaidi   J. . Diabetic retinopathy: a new predictor in patients on regular hemodialysis. . Curr Med Res Opin . 2012; ;28: 6 : 999– 1055 .
    [Google Scholar]
  10. [10]. Elshafei   M., , Gamra   H., , Khandekar   R., , Al Hashimi   M., , Pai   A., , Ahmed   MF. . Prevalence and determinants of diabetic retinopathy among persons ≥ 40 years of age with diabetes in Qatar: a community-based survey. . Eur J Ophthalmol . 2011; ;21: 1 : 39– 47 .
    [Google Scholar]
  11. [11]. Davidson   JC., , Smith   GW. . Retinopathy in pancreatic diabetes in Qatar. . Diabetes Care . 1986; ;9: 4 : 432– 433 .
    [Google Scholar]
  12. [12]. Al-Malki   H., , Sadek   M., , Rashed   A., , Asim   M., , Fituri   O., , Abbass   M. . Acute renal failure in the State of Qatar: presentation and outcome. . Transplant Proc . 2009; ;  41: 5 : 1530– 1532 .
    [Google Scholar]
  13. [13]. Rashed   A., , Aboud   O. . Renal transplantation: seventeen years of follow-up in Qatar. . Transplant Proc . 2004; ;36: 6 : 1835– 1838 .
    [Google Scholar]
  14. [14]. Bener   A., , Alsaied   A., , Al-Ali   M., , Al-Kubaisi   A., , Basha   B., , Abraham   A., , Guiter   G., , Mian   M. . High prevalence of vitamin D deficiency in type 1 diabetes mellitus and healthy children. . Acta Diabetol . 2009; ;46: 3 : 183– 189 .
    [Google Scholar]
  15. [15]. El-Menyar   AA., , Albinali   HA., , Bener   A., , Mohammed   I., , Al Suwaidi   J. . Prevalence and impact of diabetes mellitus in patients with acute myocardial infarction: a 10-year experience. . Angiology . 2009; ;60: 6 : 683– 688 .
    [Google Scholar]
  16. [16]. Khan   FY. . Risk factors of young ischemic stroke in Qatar. . Clin Neurol Neurosurg . 2007; ;109: 9 : 770– 773 .
    [Google Scholar]
  17. [17]. Chaikhouni   A., , Chouhan   L., , Pomposiello   C., , Banna   A., , Mahrous   F., , Thomas   G., , al-Hassan   NA., , Khalifa   S., , Jaddan   A., , Bsata   MW., , Hajar   HA. . Myocardial infarction in Qatar: the first 2515 patients. . Clin Cardiol . 1993; ;16: 3 : 227– 230 .
    [Google Scholar]
  18. [18]. Christos   PJ., , Chemaitelly   H., , Abu-Raddad   LJ., , Gehani   AR., , Deleu   D., , Mushlin   AI. . Prevention during the epidemiologic shift to chronic illness: a case control study of risk factors associated with cardiovascular disease in Qatar. . Journal of Local and Global Health Perspectives . 2013; ;2013:4: .
    [Google Scholar]
  19. [19]. Musaiger   AO., , Hassan   AS., , Obeid   O. . The paradox of nutrition-related diseases in the Arab countries: the need for action. . Int J Environ Res Public Health . 2011; ;8: 9 : 3637– 3671 .
    [Google Scholar]
  20. [20]. World Health Organization . Global status report on non-communicable diseases, 2010 . Geneva, Switzerland: : World Health Organization;   2011; .
    [Google Scholar]
  21. [21]. National Health Strategy. Qatar National Health Strategy 2011–2016. 2013 [cited 2013 February 20]; Available from: http://www.nhsq.info/strategy-goals-and-projects/preventive-healthcare/preventive-healthcare .
  22. [22]. National Health and Nutrition Examination. 2007 [cited 2007 November 1]; Available from: www.cdc.gov/nchs/nhanes.htm .
  23. [23]. Bruzzi   P., , Green   SB., , Byar   DP., , Brinton   LA., , Schairer   C. . Estimating the population attributable risk for multiple risk factors using case-control data. . Am J Epidemiol . 1985; ;122: 5 : 904– 914 .
    [Google Scholar]
  24. [24]. Hanley   JA. . A heuristic approach to the formulas for population attributable fraction. . J Epidemiol Community Health . 2001; ;55: 7 : 508– 514 .
    [Google Scholar]
  25. [25]. Rockhill   B., , Weinberg   CR., , Newman   B. . Population attributable fraction estimation for established breast cancer risk factors: considering the issues of high prevalence and unmodifiability. . Am J Epidemiol . 1998; ;147: 9 : 826– 833 .
    [Google Scholar]
  26. [26]. Badii   R., , Bener   A., , Zirie   M., , Al-Rikabi   A., , Simsek   M., , Al-Hamaq   AO., , Ghoussaini   M., , Froguel   P., , Wareham   NJ. . Lack of association between the Pro12Ala polymorphism of the PPAR-gamma 2 gene and type 2 diabetes mellitus in the Qatari consanguineous population. . Acta Diabetol . 2008; ;45: 1 : 15– 21 .
    [Google Scholar]
  27. [27]. Bener   A., , Zirie   M., , Al-Rikabi   A. . Genetics, obesity, and environmental risk factors associated with type 2 diabetes. . Croat Med J . 2005; ;46: 2 : 302– 307 .
    [Google Scholar]
  28. [28]. Hone   J., , Accili   D., , Psiachou   H., , Alghband-Zadeh   J., , Mitton   S., , Wertheimer   E., , Sinclair   L., , Taylor   SI. . Homozygosity for a null allele of the insulin receptor gene in a patient with leprechaunism. . Hum Mutat . 1995; ;6: 1 : 17– 22 .
    [Google Scholar]
  29. [29]. Ben-Omran   T., , Ali   R., , Almureikhi   M., , Alameer   S., , Al-Saffar   M., , Walsh   CA., , Felie   JM., , Teebi   A. . Phenotypic heterogeneity in Woodhouse-Sakati syndrome: two new families with a mutation in the C2orf37 gene. . Am J Med Genet A . 2011; ;155A: 11 : 2647– 2653 .
    [Google Scholar]
  30. [30]. Nielsen   JV. . Diabetes in the Arab World: prevalence and risk factors. . Practical Diabetes International . 1999; ;16: 3 : 82– 86 .
    [Google Scholar]
  31. [31]. Musaiger   AO., , Al-Hazzaa   HM. . Prevalence and risk factors associated with nutrition-related noncommunicable diseases in the Eastern Mediterranean region. . Int J Gen Med . 2012; ;5: : 199– 217 .
    [Google Scholar]
  32. [32]. Economics., T. Qatar GDP annual growth rate. 2013 [cited 2012 February 24]; Available from: http://www.tradingeconomics.com/qatar/gdp-growth-annual .
  33. [33]. Mabry   RM., , Reeves   MM., , Eakin   EG., , Owen   N. . Evidence of physical activity participation among men and women in the countries of the Gulf cooperation council: a review. . Obes Rev . 2010; ;11: 6 : 457– 464 .
    [Google Scholar]
  34. [34]. Bener   A., , Zirie   M., , Janahi   IM., , Al-Hamaq   AO., , Musallam   M., , Wareham   NJ. . Prevalence of diagnosed and undiagnosed diabetes mellitus and its risk factors in a population-based study of Qatar. . Diabetes Res Clin Pract . 2009; ;84: 1 : 99– 106 .
    [Google Scholar]
  35. [35]. Daghash   MH., , Bener   A., , Zirie   M., , Dabdoob   W., , Al-Hamaq   AO., , Al-Arabi   ZA. . Lipoprotein profile in Arabian type 2 diabetic patients. Relationship to coronary artery diseases. . Int J Cardiol . 2007; ;121: 1 : 91– 92 .
    [Google Scholar]
  36. [36]. 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: 1 : 71– 76 .
    [Google Scholar]
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  • Article Type: Research Article
Keyword(s): demographic factors , diabetes mellitus , epidemiology , lifestyle , Middle East , North Africa and Qatar
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