Relationship between carbohydrate metabolism disorders and the residential area infrastructure: an epidemiological study

The prevalence of carbohydrate metabolism disorders remains high worldwide and has the nature of an epidemic despite widespread drug support. Therefore, the problem of search, modification and detailed assessment of new risk factors becomes especially urgent. Objective. To assess the prevalence of carbohydrate metabolism disorders in the population of the Kemerovo region and determine their relationship with infrastructure parameters. Material and methods. The study included 1.598 subjects (35 to 70 years old) living in Kemerovo and surrounding rural areas. The group of subjects with impaired carbohydrate metabolism included respondents with fasting glucose levels≥6.1 and <7.0 mmol/L, with impaired glucose tolerance (glucose level ≥7.0 mmol/L), and diagnosed with diabetes mellitus. The residential area was assessed based on the respondents’ subjective opinions about the elements of infrastructure (Neighborhood Environmental Walkability Scale questionnaire). Depending on the responses to the questions, the questionnaire highlighted the parameters of the residence territory, which were considered unfavorable or inconvenient. Then, an analysis was carried out to identify associations between these variants of infrastructure and carbohydrate metabolism disorders. To eliminate the type I error when making multiple comparisons, the Holm-Bonferroni correction was used. Results. Overall incidence of various carbohydrate metabolism disorders among the study participants was 23.9% (n=383) (24.2% in males, 20.8% in females, p=0.137). In urban and rural areas, no significant differences in the prevalence of hyperglycemia were identified. Respondents who indicated such unfavorable infrastructure parameters as the absence of a sidewalk and the distant location of a public transport stop had a higher prevalence of carbohydrate metabolism disorders than those not disturbed by these elements of urban planning: 25.6% vs. 19.4% (p=0.012) and 30.1% vs. 19.9% (p=0.002). Street lighting at night was associated with hyperglycemia in the urban population (OR=1.72) and the absence of sidewalks in rural residents (OR=2.16). Conclusion. Studying the residence territory elements and the associations with the main factors of cardiovascular risk will allow the organization a high-quality, health-oriented space to set a new trend in preventing non-communicable diseases.