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Title: Public health preventive action to start from the fourth decade of life?
Authors: Cuschieri, Sarah
Grech, Stephan
Keywords: Chronic diseases -- Prevention -- Research -- Malta
Medical care -- Research -- Malta
Health surveys -- Malta
Public health -- Malta
Diabetes -- Malta
Issue Date: 2020
Publisher: Elsevier
Citation: Cuschieri, S., & Grech, S. (2020). Public health preventive action to start from the fourth decade of life?. Clinical Epidemiology and Global Health, doi: 10.1016/j.cegh.2020.04.022.
Abstract: Problem considered: Non-communicable diseases (NCDs) are a global epidemic. With the start of a new decade, new strategies and health goals are expected to be formulated. The aim was to investigate a highly prevalent NCD European state to assess the age of onset for most NCDs. Such evidence can aid in the development of new preventive strategies. Methods: A national health examination survey was conducted to explore the adult population (18–70 years) of Malta for common NCDs. Both self-reported and examination data were used to diagnose type 2 diabetes, dyslipidaemia, hypertension, overweight and obesity. The study population was stratified by ten years agegroups and sex for both descriptive and analytic analyses. Association studies were conducted to identify links between type 2 diabetes, dyslipidaemia, hypertension, overweight and obese status and different age groups, while adjusting for confounders. Results: The men were significantly more metabolically unhealthy that the women across all age groups. However, a higher newly diagnosed diabetes prevalence across all age groups was established for women. Dyslipidemia, diabetes and hypertension were observed to be present from the 30–39 year age group. On modelling, this age group was associated with these NCDs even after adjusting for confounders. Conclusion: The fourth decade of life appears to be the starting point of metabolic dysregulation, contributing to long-term health and economic burdens. Furthermore, considering this is a childbearing age group, metabolic impact can be transmitted on to their offspring. Preventive action including dysglycaemia and dyslipidaemia screening should be considered from a young age.
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