OBJECTIVETo determine the prevalence of impaired fasting glucose (IFG) and undiagnosed and diagnosed diabetes in Thai adults in 2009 and examine the extent of changes in proportions of diagnosis, treatment, and control for blood glucose, high blood pressure, and high total cholesterol between 2004 and 2009.RESEARCH DESIGN AND METHODSData from the multistage cross-sectional National Health Examination Survey (NHES) IV of 18,629 Thai adults aged ≥20 years conducted in 2009 were used to analyze and compare with the data from NHES III in 2004.RESULTSThe prevalence of IFG and diabetes was 10.6 and 7.5%, respectively. Of all diabetes diagnoses, 35.4% were not previously diagnosed, and the proportion was higher in men than in women (47.3 vs. 23.4%, P < 0.05). Compared with those in year 2004, the proportions of individuals with diabetes and concomitant hypertension did not significantly decrease in 2009 in both sexes, but the proportions of women with diabetes who were abdominally obese or had high total cholesterol (≥5.2 mmol/L) significantly increased in 2009 by 18.0 and 23.5%, respectively (all P < 0.01). The rates of treatment and control of blood glucose, high blood pressure, and high total cholesterol were favorably improved in 2009. However, in substantial proportions of individuals with diabetes these concomitants were still controlled suboptimally.CONCLUSIONSThe prevalence of diabetes and IFG remained high in Thai adults. Improvement in detection and control of diabetes and associated metabolic risk factors, particularly obesity and high serum cholesterol, are necessary.

Despite improvement in awareness and control of hypertension in Thai population, a large proportion of hypertensive individuals remained suboptimally controlled. Strengthening measures to control high blood pressure and metabolic risk factors, especially obesity and hypercholesterolemia, in individuals with hypertension are needed.

We determined the prevalence of obesity in Thai adults aged 20 and over in 2009 and examined trends of body mass index (BMI) between 1991 and 2009. Data from Thai National Health Examination Survey for 19,181 adults in 2009 and 64,480 adults between 1991 and 2004 were used to calculate age-adjusted mean and prevalence. Logistic regression was used to examine the association of obesity with education level. In 2009, age-adjusted prevalence of obesity classes I (BMI 25–29.9 kg/m2) and II (BMI ≥30 kg/m2) in Thai adults aged ≥20 years were 26.0% and 9.0%, respectively. Compared with primary education, the odds of obesity class I were highest in men with university education. For women, the odds of obesity classes I and II were highest in those with primary education. BMI significantly increased from 21.6 kg/m2 in men and 22.8 kg/m2 in women in 1991 to 23.3 kg/m2 and 24.4 kg/m2 in 2009, respectively. The average BMI increases per decade were highest in men with secondary education (1.0 kg/m2, P < 0.001) and in women with primary education with the same rate. There were increasing trends in BMI with slight variation by SES groups in Thai men and women during 1991–2009.

BackgroundInformation on the distribution of Metabolic syndrome (MetS) and its combinations by urban/rural areas in lower-middle income countries has been limited. It is not clear how the various combinations of MetS components varied by urban/rural population and if particular combinations of MetS are more common. This study aimed to estimate the prevalence of MetS and combinations of MetS components according to sex and urban/rural areas from a nationally representative sample of Thai adults.MethodsData from the fourth National Health Examination Survey of 19,256 Thai adults aged 20 years and over were analyzed. MetS was defined using the harmonized criteria of six international expert groups with Asian-specific cut-point for waist circumference.ResultsThe prevalence of MetS was 23.2% among adults aged ≥ 20 years (19.5% in men and 26.8% in women). Among men, the prevalence of MetS in urban was higher than those in rural areas (23.1% vs 17.9%, P < 0.05), but among women, the prevalence was higher in rural areas (27.9% vs 24.5%, P < 0.05). Overall, an individual component of low high density lipoprotein (HDL) and hypertriglyceridemia were more common in rural areas, while obesity, high blood pressure and hyperglycemia were more common in urban areas. The most common combination of MetS components in men was the clustering of low HDL, hypertriglyceridemia, and high blood pressure (urban: 3.4% vs. rural: 3.9%, adjusted OR 0.9, 95%CI 0.7, 1.1). Among women, the most common combination was the clustering of obesity, low HDL, and hypertriglyceridemia (urban: 3.9% vs rural: 5.9%, adjusted OR 0.8, 95%CI 0.6, 0.9), followed by the clustering of these three components with high blood pressure (urban: 3.1% vs. rural 4.5%, adjusted OR 0.8, 95%CI 0.7, 0.9).ConclusionMetabolic syndrome affects both urban and rural population with different pattern of MetS combinations. Dyslipidemia and obesity were the most common components among women in rural areas, hence, interventions to prevent and control these factors should be strengthened.

Objective: The objectives of this study are: 1.) To calculate the probability of Cardiovascular Disease (CVD) events by applying three different equations, which are: the Asia-Pacific Cohort Study (APCS) equation, the Framingham-Asia equation and the original Framingham equation, to the individual risk factors data from the NHESIV, Thailand. 2) To estimate the number of 8-10 years CVD events. 3) To validate and identify the most suitable CVD risk equations for the Thai population. The individual risk factors from the NHESIV dataset was entered into a Microsoft Excel spreadsheet as the baseline population.Methods: Asia-Pacific Collaborative Cohort Study (APCCS) equations, the Framingham-Asia equation and the original Framingham equation, are applied to calculate the probability of 8 to 10 years CVD events by age groups and gender. The CVD events in this analysis refer to all fatal and non-fatal CVD events (ICD10, I00-I99), which include Ischemic heart disease (IHD) (ICD10, I20-I25) and stroke (ICD10, I60-I69). Results:The 4th National Health Examination Survey IV 2009 (NHESIV) dataset has been entered into a Microsoft Excel spreadsheet as the baseline population. APCCS, the Framingham-Asia and the original Framingham equations, were applied to the NHESIV dataset. The APCCS equation calculated the average 8-years probability of getting CVD as 8.3% in men and 7.8% in women. The 8-year likelihood of CVD in the Framingham-Asia equation was 7.2% in men and 8.1% in women. The original Framingham equation showed the highest probability of 10-years CVD which were 18.8% in men and 11.1% in women. Conclusions:The original Framingham equation overestimated the risk of CVD in the Thai population in all age groups. The Asia-Pacific Cohort Study (APCCS) and the Framingham-Asia equations, both performed better estimation than the original Framingham equation in both men and women.

Background: Cardiovascular disease (CVD) has become a leading cause of death and disability in Thailand due to the unhealthy lifestyle of the populace; triggering high risk of exposure to CVD, and increased the number of hospital admissions year on year. Objectives: The concerns generated by the inflation in the health care expenditure among service providers motivated this study to examine the costs of hospitalisation of inpatients with (CVD) conditions in Thailand, 2009. Methods: Anonymised secondary data of 327,435 CVD inpatients under "Universal Coverage" (UC) health care scheme were obtained from the National Health Security Office (NHSO), Thailand. The data (51.69% women and 48.31% men) were classified using International Classification of Diseases, Tenth Revision (ICD-10) code, of which I20-I25 are Ischemic heart disease (IHD), I60-I69 are stroke and I00-I99 are all CVD conditions. Results: Average costs of treatments for all CVD conditions, IHD and stroke were ฿21,921 (£1 = ฿50), ฿32,884 (highest) and ฿25617.67 per patient respectively. Absolute total cost increased with age and the cost of admission of male patients is higher than female. The average (three months) length of stay for stroke patients was found to be the highest. Conclusion: Providers generally spent a total of ฿7177 million on the treatment of CVD with IHD and stroke taking ฿2544 million and ฿1920 million respectively.

Traffic accidents are a major and crucial problem worldwide. The development of a traffic accident simulation system applied by using a geographic information system and multiple logistic regression with clustering can provide drivers with safe routes as well as guidelines for assessing the risk points of accidents in each subdistrict. This research is based on case-control study design. The data were collected by using two types of questionnaires: a questionnaire for 35 community leaders and a questionnaire for 580 community residents based on the distance at which main routes pass through the subdistrict area. The data were analysed through multiple logistic regression with clustering, and the standardized coefficient of the selected variables was then added to the equation as a weight in the traffic accident simulation system. The results of the study indicated that 11 variables affected traffic accidents. These factors were evaluated in order to predict traffic accidents (Pseudo R square=0.5906). Standardized coefficient of variables was applied in a geographic information system to simulate traffic accidents on roads. This study was distinctive for its analysis, which examined the clusters of variables that were the subdistrict-level data, including surroundings and road conditions at the riskiest location in each subdistrict. The data were analysed based on their quality as subdistrict data clusters. The analysis results were then applied as the weight of variables used in the GIS to obtain the values appropriate to the data clusters’ quality for the GIS to properly simulate traffic accidents in each area.

Objectives: This study aims to describe the current situation of Cardiovascular Disease (CVD) and to explore the association of the modifiable risk factors with Coronary heart disease (CHD) and stroke in Thailand. Methods:The 4th National Health Examination Survey (NHESIV) dataset has been used in this study. 19,342 participants aged ≥15 years have completed the data gathering process on CVD risk factors have been included in the analysis, which comprises 9,246 men and 10,096 women. The descriptive statistic, the bivariate analysis and the multiple logistic regression have been performed to describe and explore the association among CVD risk factors, CHD and stroke. The modifiable risk factors included in the analysis are age, BMI, total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C), systolic blood pressure (SBP), diabetes and regular smoking. Results:The mean age of the participants is 52.7 years. The prevalence of CHD was 2.5% in men, and 2.3% in women and the prevalence of stroke was 2.5% in men and 1.6% in women. The overall prevalence of diabetes was 10.1%, and regular smoking was 17.9%. When exploring the association of the modifiable risk factors with CHD and stroke, using the bivariate and multivariate analysis, the results show that factors associated with both CHD and stroke are being aged 55 and over, high blood pressure and diabetes. Obesity, high triglyceride level and low HDL-C, only showed association with CHD but does not show any significant association to stroke. Having a high triglyceride level was related to stroke just in women but does not show any association in men. The factors that do not show significant association in both CHD and stroke are high total cholesterol and being a regular smoker. Conclusions:Although the analysis of the cross-sectional data was not able to identify the cause and effect of the factors relating to CHD or stroke, it showed some association with these modifiable risk factors for CVD. The modifiable risk factors, such as high blood pressure, obesity and diabetes need to be of concern in considering the CVD prevention strategies in Thailand Research