Анализ взаимосвязей заболеваемости взрослого населения инсулиннезависимым сахарным диабетом и алкогольных показателей

Abstract

INTRODUCTION: In the Russian Federation, since 2000, there has been a more than twofold increase in the prevalence of mellitus diabetes, mainly due to insulin-independent type 2 and higher rates in the adult population. The rise is partly due to the improvement in the screening and diagnostics organization in risk groups. A significant role in the development of type 2 diabetes mellitus (DM2) is assigned to behavioral risk factors, the leading of which are tobacco and alcohol consumption, irrational nutrition and low physical activity, the combination of which has potentiating or synergistic, mitigating and leveling effects. The interdependence of DM2 and obesity is indisputable, although insufficiently studied. According to the Federal Information Fund for Social and Hygienic Monitoring, the Republic of Mari El (RME) is an area of increased risk of morbidity of the adult population with DM2, while the Republic of Tatarstan (RT) is relatively prosperous. AIM: To identify common and specific territorial factors of population risk of diabetes based on the analysis results of the interconnections between the incidence of adult population with insulin-dependent diabetes mellitus and obesity and the sale of alcohol through the retail network, indicators of alcohol dependence syndrome for 2005–2019 in two Russian regions. MATERIALS AND METHODS: The analysis includes data from official federal and regional statistics on the incidence of adult population with DM2, obesity and alcohol dependence syndrome for 2005–2019, as well as sales of alcoholic beverages in alcohol equivalent per capita for 2000–2019 in the RT and the RME. The dynamics of the indicators were assessed by the coefficient of determination (R2) of the trend line, the statistical significance of the differences in time series according to the Mann–Whitney criterion, the relationship between the samples according to the parameters of the Spearman coefficient from year to year and with a time lag. RESULTS: In 2005–2019, the primary incidence of DM2 in the adult population of RME increased and was significantly higher than in RT in the absence of interregional differences in its prevalence. Both indicators of the obesity incidence have increased in the RT, and only the prevalence in the RME. In the RT, the effect of new cases of obesity on newly diagnosed cases of type 2 diabetes persisted for 3 years, in the RME for 2 years. The prevalence of obesity was determined by the risk factor for the prevalence of diabetes with a lag of 8 years in RT and 9 years in the RME. During the analyzed years, the structure of retail sales of alcohol has changed in the regions: the share of vodka has decreased and the share of beer has increased. The correlation of the primary incidence of DM2 and obesity with per capita sales of vodka in alcohol equivalent was insignificant. In the RT there was a large prolongation and strength of relationship between the sales of all alcohol and beer with the prevalence of obesity, in the RME with the prevalence of DM2. Per capita vodka sales in the RT did not correlate with the prevalence of DM2 and obesity, whereas in the RME the relationship became significant with DM2 at a lag of 7 years; with obesity at a lag of 3 years. The correlation between beer sales and the prevalence of DM2 remained the longest in the REM (up to 12 years). CONCLUSION: According to the results of the study the delayed and prolonged effects of alcohol sales in the adult population are more clearly manifested in the prevalence of DM2 and obesity than their new cases with regional peculiarities of the role of various alcoholic beverages and the parameters of the correlation coefficient. In the RT sales volumes of all alcohol and beer in alcohol equivalent correlated more and longer with the overall incidence of obesity, in the RME with DM2. In addition, the RME noted a significant correlation between the prevalence of mellitus diabetes and obesity with the retail sale of vodka per capita, which was absent in the RT. Thus, priorities in regional projects to prevent and reduce the incidence of DM2 in the adult population should differ, increasing their effectiveness.