Epidemiology of prediabetes mellitus among hill tribe adults in Thailand

Abstract

Background Prediabetes is a major silent health problem that leads to the development of diabetes within a few years, particularly among those who have a low socioeconomic status. Hill tribe people are vulnerable to prediabetes due to their unique cultural cooking methods and their hard work on farms, as well as their low economic status and educational levels. This study aimed to estimate the prevalence of prediabetes among hill tribe people in Thailand and identify the related factors. Methods This cross-sectional study included participants who belong to one of the six main hill tribes: Akah, Lahu, Hmong, Yao, Karen, and Lisu. The study was conducted in 30 hill tribe villages in Chiang Rai Province, Thailand. A validated questionnaire was administered, and 5-mL blood specimens were collected. Data were collected between November 2019 and March 2020. Logistic regression was used to determine the associations between independent variables and prediabetes. Results A total of 1,406 participants were recruited for the study; 67.8% were women, 77.2% were between 40 and 59 years old, and 82.9% were married. The majority worked in the agricultural sector (57.2%), had an annual income ≤ 50,000 baht (67.5%), and had never attended school (69.3%). The prevalence of prediabetes was 11.2%. After controlling for age and sex, five factors were found to be associated with prediabetes. Members of the Akha and Lisu tribes had 2.03 (95% CI = 1.03–3.99) and 2.20 (95% CI = 1.10–4.42) times higher odds of having prediabetes than Karen tribe members, respectively. Those with hypertension (HT) had 1.47 (95% CI = 1.03–2.08) times higher odds of having prediabetes than those with normal blood pressure. Those with a normal total cholesterol level had 2.43 (95% CI = 1.65–3.58) times higher odds of having prediabetes than those with a high total cholesterol level. Those with a high triglyceride level had 1.64 (95% CI = 1.16–2.32) times higher odds of having prediabetes than those with a normal triglyceride level. Those with a high low-density lipoprotein cholesterol (LDL-C) level had 1.96 (95% CI = 1.30–2.96) times higher odds of having prediabetes than those with a normal LDL-C level. Conclusion Appropriate dietary guidelines and exercise should be promoted among hill tribe people between 30 and 59 years old to reduce the probability of developing prediabetes.

National cross-sectional data on coexisting prehypertension and prediabetes among adults in Ecuador

“…In terms of PreDM, we found that older age, and elevated TC increased the risk, and male sex, secondary or higher education level decreased the risk of PreDM. Consistent with some previous studies [21][22][23] , we found that older age, lower education level, and elevated TC increased the odds of PreDM. Furthermore, unlike previous research [21][22][23] , we did not find significant differences in the prevalence of PreDM in terms of ethnicity, obesity, daily smoking and alcohol use.…”

“…Consistent with some previous studies [21][22][23] , we found that older age, lower education level, and elevated TC increased the odds of PreDM. Furthermore, unlike previous research [21][22][23] , we did not find significant differences in the prevalence of PreDM in terms of ethnicity, obesity, daily smoking and alcohol use.…”

“…Adjusted multinomial logistic regression was applied to assess the factors associated with PreHTN and PreDM, PreHTN only, and PreDM only (with both normoglycemia and normotension group as reference category). Covariates were selected based on literature review [10][11][12][13][16][17][18][19][20][21][22][23] , and included sociodemographic factors (age, gender, ethnicity, education level, and marital status), health risk behaviors (fruit/vegetable intake, salt intake, smoking, alcohol dependence, and physical activity), BMI, and elevated TC. The missing values were discarded and the significance was set at p<0.05.…”

“…Factors associated with PreHTN include older age 14 , men 14,17,18 , lower socioeconomic status [17][18][19] , high salt intake 20 , physical inactivity [17][18][19] , low fruit and vegetable intake 17 , smoking 17 , alcohol use 17,19 , obesity 14,17,18,20 , abnormal triglycerides 14 . Factors associated with PreDM include older age 21 , lower socioeconomic status 21 , ethnicity 21,22 , smoking, alcohol use, obesity 23 , abnormal triglycerides 22 , and normal total cholesterol 22,23 . The aim of the study was to assess the prevalence and associated factors of PreHTN/PreDM among people aged 18-69 years, in Ecuador.…”

Correlation of lipid profile, glucose, and body composition on insulin resistance in overweight and obese subjects

“…In Thailand, those with a low socioeconomic status who are over 30 years of age are more likely to have prediabetes. Smoking, alcohol consumption, lack of exercise, moderate to high levels of stress, being overweight, and high total cholesterol, triglyceride, and LDL cholesterol levels are risk factors for diabetes in this country (Apidechkul et al, 2022;Al Rahmad, 2021). Participants with high lipid profiles, such as total cholesterol, lowdensity lipoprotein (LDL), and triglycerides, may experience metabolic problems and intestinal and adipose tissue inflammation via the TLR4 signaling pathway (Kim et al, 2012).…”