Effect of age and sex on the associations between potential modifable risk factors and both type 2

Issaka et al. BMC Public Health (2022) 22:1211

https://doi.org/10.1186/s12889-022-13588-w

RESEARCH

Efect of age and sex on the associations

between potential modifable risk factors

and both type 2 diabetes and impaired fasting

glycaemia among West African adults

Ayuba Issaka1,2,3* , Adrian J. Cameron1

, Yin Paradies2

, William K. Bosu4

, Yèssito Corine N. Houehanou5

,

Jean B. Kiwallo6

, Chea S. Wesseh7

, Dismand S. Houinato8

, Diarra J. P. Nazoum9 and Christopher Stevenson1

Abstract

Background: Type 2 diabetes mellitus (T2DM) is becoming one of the leading causes of morbidity and mortal￾ity worldwide, including among Africans. Knowledge of the association between traditional risk factors and both

diabetes and pre-diabetes, and whether these difer by age and sex, is important for designing targeted interventions.

However, little is known about these associations for African populations.

Methods: The study used data from WHO STEPS surveys, comprising 15,520 participants (6,774 men and 8,746

women) aged 25–64 years, from 5 diferent West African countries, namely Burkina Faso (4,711), Benin (3,816), Mali

(1,772), Liberia (2,594), and Ghana (2,662). T-test and chi-square tests were used to compare diferences in the preva￾lence of traditional risk factors for both sexes. Multinomial logistic regression was conducted to ascertain the relative

risks (RR) and 95% confdence intervals (CI) for both T2DM and impaired fasting glucose (IFG) relating to each risk fac￾tor, including obesity [defned by BMI, waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio

(WHtR)], high blood pressure (HBP), fruit and vegetable consumption, physical inactivity, alcohol consumption, and

smoking. Models for each of these traditional risk factors and interactions with age and sex were ftted.

Results: Factors associated with T2DM and IFG were age, obesity [defned by BMI, WC, WHtR, and WHR], HBP, smok￾ing, physical inactivity, and fruit and vegetable consumption (p<0.05). Analysis of interaction efects showed few

signifcant diferences in associations between risk factors and T2DM according to age or sex. Signifcant interaction

with age was observed for HBP*age and T2DM [RR; 1.20, 95% CI: (1.01, 1.42)) (p=0.04)], WHtR*age and T2DM [RR; 1.23,

95% CI: (1.06, 1.44) (p=0.007)] and WHR*age and IFG [RR: 0.79, 95% CI: (0.67, 0.94) (p=0.006)]. Some interactions with

age and sex were observed for the association of alcohol consumption and both IFG and T2DM, but no clear patterns

were observed.

Conclusion: The study found that with very few exceptions, associations between traditional risk factors examined

and both IFG and T2DM did not vary by age or sex among the West African population. Policies and public health

intervention strategies for the prevention of T2DM and IFG should target adults of any age or sex in West Africa.

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Open Access

*Correspondence: [email protected]; [email protected]

1

School of Health and Social Development, Faculty of Health, Deakin

University, Waurn Ponds Campus, Locked Bag 20000, Geelong, VIC 3220,

Australia

Full list of author information is available at the end of the article