Journal Article

Geographic variation in cardiometabolic risk distribution: A cross-sectional study of 256,525 adult residents in the Illawarra-Shoalhaven region of the NSW, Australia

Mayne, Darren J., Feng, Xiaoqi, Toms, Renin, Bonney, Andrew

2019

Overview

Metabolic risk factors for cardiovascular disease (CVD) warrant significant public health concern globally. This study aims to utilise the regional database of a major laboratory network to describe the geographic distribution pattern of eight different cardiometabolic risk factors (CMRFs), which in turn can potentially generate hypotheses for future research into locality specific preventive approaches. A cross-sectional design utilising de-identified laboratory data on eight CMRFs including fasting blood sugar level (FBSL); glycated haemoglobin (HbA1c); total cholesterol (TC); high density lipoprotein (HDL); albumin creatinine ratio (ACR); estimated glomerular filtration rate (eGFR); body mass index (BMI); and diabetes mellitus (DM) status was used to undertake descriptive and spatial analyses. CMRF test results were dichotomised into 'higher risk' and 'lower risk' values based on existing risk definitions. Australian Census Statistical Area Level 1 (SA1) were used as the geographic units of analysis, and an Empirical Bayes (EB) approach was used to smooth rates at SA1 level. Choropleth maps demonstrating the distribution of CMRFs rates at SA1 level were produced. Spatial clustering of CMRFs was assessed using Global Moran's I test and Local Indicators of Spatial Autocorrelation (LISA). A total of 1,132,016 test data derived from 256,525 individuals revealed significant geographic variation in the distribution of 'higher risk' CMRF findings. The populated eastern seaboard of the study region demonstrated the highest rates of CMRFs. Global Moran's I values were significant and positive at SA1 level for all CMRFs. The highest spatial autocorrelation strength was found among obesity rates (0.328), and the lowest for albuminuria (0.028). LISA tests identified significant High-High (HH) and Low-Low (LL) spatial clusters of CMRFs, with LL predominantly in the less populated northern, central and southern regions of the study area. The study describes a range of CMRFs with different distributions in the study region. The results allow generation of hypotheses to test in future research concerning location specific population health approaches.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adolescent / Adult / Adults / Albumin / Albumins / Australia - epidemiology / Autocorrelation / Bayes Theorem / Bayesian analysis / Biology and Life Sciences / Blood Glucose / Blood Pressure / Body mass / Body Mass Index / Body size / Cardiovascular diseases / Cardiovascular Diseases - blood / Cardiovascular Diseases - epidemiology / Care and treatment / Cholesterol / Cholesterol - blood / Chronic illnesses / Clustering / Complications and side effects / Computer and Information Sciences / Control / Creatinine / Cross-sectional studies / Diabetes / Diabetes mellitus / Diabetes Mellitus - blood / Diabetes Mellitus - epidemiology / Distribution patterns / Earth Sciences / Empirical analysis / Epidermal growth factor receptors / Fasting / Female / Geographic information systems / Geographical distribution / Geography / Glomerular Filtration Rate / Glucose / Glycated Hemoglobin - metabolism / Glycosylated hemoglobin / Health risks / Health services / Health surveys / Heart diseases / Hemoglobin / Hemoglobins / High density lipoprotein / Humans / Hyperglycemia / Hypotheses / Internet / Lipoproteins, HDL - blood / Male / Medical research / Medicine / Medicine and health sciences / Metabolic Syndrome - blood / Metabolic Syndrome - epidemiology / Mortality / Obesity / Obesity - blood / Obesity - epidemiology / People and Places / Population / Public health / Risk analysis / Risk Factors / Rural areas / Socioeconomic factors / Spatial analysis / Studies / Sugar / Weight control / Young Adult