Prevalence, Management, and Associated Factors of Obesity, Hypertension, and Diabetes in Tibetan Population Compared with China Overall

Peng, Wen; Li, Ké; Yan, Alice; Shi, Zumin; Zhang, Junyi; Hussain, Ahktar; Wang, Youfa

doi:10.3390/ijerph19148787

Cited by 26 publications

(24 citation statements)

References 39 publications

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“…The particular high SMRs due to cardiovascular and chronic respiratory diseases in the PG may be explained by the extra stress placed on the cardiovascular and respiratory systems from the hypobaric hypoxia environment. Our recently published study showed higher hypertension prevalence among Tibetans, who usually reside on the Plateau, as compared with China's national average ( 18 , 19 , 40 ). Another earlier study also showed a positive association between altitude and hypertension.…”

Section: Discussionmentioning

confidence: 70%

“…NCD burdens probably have contributed largely to the health disparity between the Plateau and developed areas. Our recent field study and meta-analysis showed a high prevalence of obesity, hypertension, and dyslipidemia, the metabolic risk factors of NCDs, among Tibetan adults on the Qinghai-Tibet Plateau (18)(19)(20). However, we did not find any study that investigated the NCD disparities between residents of the Qinghai-Tibet Plateau and those in developed areas.…”

Section: Introductionmentioning

confidence: 99%

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Disparities of obesity and non-communicable disease burden between the Tibetan Plateau and developed megacities in China

Peng

Jian

et al. 2023

Front. Public Health

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BackgroundNon-communicable diseases (NCDs) including risk factors, e.g., obesity, are the major causes of preventable deaths in China, yet NCD disparities in China remain under-studied.ObjectiveThis study aimed to compare the determinants and burden of NCDs within four selected provinces in mainland China: the least developed Qinghai-Tibet Plateau group (PG, Tibetan Autonomous Region [TAR] and Qinghai Province) and most developed megacity group (MCG, Shanghai, and Beijing).MethodsStudies, reports, and other official sources with comparable data for NCD burden and related determinants for the four provinces were searched. Geographic, demographic, socioeconomic, and dietary characteristics and selected health indicators (e.g., life expectancy) were extracted from the China Statistical Yearbook and China Health Statistics Yearbook. Data on NCD burdens were extracted from the National Chronic Disease and Risk Factor Surveillance Study and other nationally representative studies.ResultsThe overall NCD mortality rates and prevalence of metabolic risk factors including obesity, hypertension, and diabetes in mainland China have increased in the past 20 years, and this trend is expected to continue. The PG had the highest level of standardized mortality rates (SMRs) on NCDs (711.6–896.1/100,000, 6th/6-level); the MCG had the lowest (290.6–389.6/100,000, 1st/6-level) in mainland China. The gaps in SMRs were particularly high with regard to chronic respiratory diseases (PG 6th/6-level, MCG 1st/6-level) and cardiovascular diseases (6th/6 and 4th/6 in TAR and Qinghai; 1st/6-level and 2nd/6-level in Shanghai and Beijing). In contrast, the prevalence rates of obesity, hypertension, and diabetes were generally higher or comparable in MCG compared to PG. Diabetes prevalence was particularly high in MCG (5th/5-level, 13.36–14.35%) and low in PG (1st/5-level, 6.20–10.39%). However, awareness, treatment, and control of hypertension were poor in PG. Additionally, PG had much lower and severely inadequate intakes of vegetables, fruits, and dairy products, with additional indicators of lower socioeconomic status (education, income, etc.,) compared with MCG.ConclusionEvidence showed large disparities in NCD burden in China's provinces. Socioeconomic disparity and dietary determinants are probably the reasons. Integrated policies and actions are needed.

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Section: Discussionmentioning

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Disparities of obesity and non-communicable disease burden between the Tibetan Plateau and developed megacities in China

Peng

Jian

et al. 2023

Front. Public Health

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“…Overall, the Tibetan children in this study demonstrate normal heart rate and blood pressure regulation. While there is a clear association between increasing altitude and the prevalence of hypertension among Tibetans (37), we argue that there are other key factors, likely unhealthy diets with excessive salt intake (32), which do not manifest in children but gradually drive the occurrence of hypertension in adults (38).…”

Section: Discussionmentioning

confidence: 81%

Anthropometric indices, body function, and physical fitness reference values for Tibetan ethnic children aged 6–17 residing at 3,650 meters above sea level

Mao²,

Wang

et al. 2022

Front. Nutr.

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ObjectivesIt is known that high altitude influences the growth metrics of high-altitude residents. Using a WHO-recommended standard, the research aimed to establish growth and development reference values for children of Tibetan ethnicity between the ages of 6 and 17 years old.MethodsThe measurements took place in Jomda County, Tibet with an average altitude of 3,650 m above sea level. A total of 3,955 observations (1,932 boys and 2,023 girls) were utilized to model the centile estimations. Included in the measurements are height, weight, body mass index, heart rate, blood pressure, forced lung capacity, sit and reach, and standing long jump. The measurements were modeled using the generalized additive models for location, scale, and shape (GAMLSS). Models were fitted with suitable distributions and locally smoothed using the P-spline for each GAMLSS hyper-parameter. Using the smallest Schwarz Bayesian criterion, the optimal model for each measurement was selected. After model adjustment, centile estimations were calculated for each model.ResultsCompared to the height reference values at the 50th percentile for multi-ethnic Chinese children residing at low altitudes, Tibetan ethnic children exhibit apparent stunted growth. In terms of forced vital capacity, it is remarkable that Tibetan ethnic children lag behind multi-ethnic Chinese children residing at low altitudes. Heart rate and blood pressure regulation are generally normal. Centile estimations are provided in this article and tabulated centiles (1p, 3p, 5p, 15p, 25p, 50p, 75p, 85p, 95p, 97p, 99p) in Chinese, Tibetic, and English are openly available in FigShare (doi: 10.6084/m9.figshare.20898196.v1).ConclusionThis study established the first GAMLSS based growth and development reference values for Tibetan ethnic children aged 6–17. These reference values have numerous clinical and scientific applications. We offer Chinese policymakers with practical initiatives to further enhance the health of Tibetan ethnic children.

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“…More than half of the hypertension patients under health management in PCs are not under standardized management, and low quality health management may not be effective in controlling hypertension. The quality of health management is as important as the development of management, and the management quality of PCs and NPCs needs to be further improved [ 36 , 37 ]. Strengthening the EPHS, which includes hypertension and diabetes health management services, is one of the crucial measures for the HPAP for chronic disease control.…”

Section: Discussionmentioning

confidence: 99%

The effect gap of hypertension health management services in poverty and non-poverty counties on the hypertension control: evidence from China Chronic Diseases Risk Factors Surveillance

Jiang

Wang

Zhang

et al. 2023

J Health Popul Nutr

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Background The Chinese government implemented the health poverty alleviation project (HPAP) since 2016 in poverty counties (PCs). To evaluate the effect of the HPAP on hypertension health management and control in PCs is vital for the policy improvement. Methods China Chronic Disease and Risk Factors Surveillance programme were conducted from August 2018 to June 2019. A total of 95,414 participants aged 35 and above from 59 PCs and 129 non-poverty counties (NPCs) were involved in this study. Hypertension prevalence, hypertension control, treatment and health management prevalence, and physical examination proportion were calculated and compared by PCs and NPCs. Logistic regression was employed to explore the association between hypertension control and management services. Results The hypertension prevalence in NPCs was significantly higher than that in PCs (NPCs 46.1% vs. PCs 41.2%, P < 0.001). The NPCs participants had a higher hypertension control prevalence (NPCs 32.7% vs. PCs 27.3%, P < 0.001) and treatment prevalence (NPCs 86.0% vs. PCs 80.0%, P < 0.001) than that in PCs. The proportion of physical examination in one year in NPCs was significantly higher than that in PCs (NPCs 37.0% vs. PCs 29.5%, P < 0.001). The proportion of diagnosed hypertension patients without hypertension health management in NPCs was significantly higher than that in PCs (NPCs 35.7% vs. PCs 38.4%, P < 0.001). Multivariable logistic regression showed that standardized and non-standardized hypertension health management were positively correlated with hypertension control in NPCs, and standardized hypertension health management was positively correlated with hypertension control in PCs. Conclusions These findings show the equity and accessibility gap of health resources still existed between PCs and NPCs under the influence of the HPAP. Hypertensive health management was effective for hypertension control in both PCs and NPCs. However, the quality of management services still needs to be improved.

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Prevalence, Management, and Associated Factors of Obesity, Hypertension, and Diabetes in Tibetan Population Compared with China Overall

Cited by 26 publications

References 39 publications

Disparities of obesity and non-communicable disease burden between the Tibetan Plateau and developed megacities in China

Disparities of obesity and non-communicable disease burden between the Tibetan Plateau and developed megacities in China

Anthropometric indices, body function, and physical fitness reference values for Tibetan ethnic children aged 6–17 residing at 3,650 meters above sea level

The effect gap of hypertension health management services in poverty and non-poverty counties on the hypertension control: evidence from China Chronic Diseases Risk Factors Surveillance

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