Rie Fukuoka1,2,3, Miwako Takeda3, Takafumi Abe3, Masayuki Yamasaki3,4, Shinji Kimura3,5, Kenta Okuyama3,6, Minoru Isomura3,4, Toru Nabika2,3. 1. Department of Community Health and Gerontological Nursing, Faculty of Medicine, Shimane University, Izumo, Shimane 693-8501, Japan. 2. Department of Functional Pathology, Faculty of Medicine, Shimane University, Izumo, Shimane 693-8501, Japan. 3. The Center for Community-Based Healthcare Research and Education (CoHRE), Shimane University, Izumo, Shimane 693-8501, Japan. 4. Faculty of Human Sciences, Shimane University, Matsue, Shimane 690-8504, Japan. 5. Department of Clinical Nursing, Faculty of Medicine, Shimane University, Izumo, Shimane 693-8501, Japan. 6. Center for Primary Health Care Research, Lund University, Jan Waldenströms gata 35, 20502 Malmö, Sweden.
Abstract
BACKGROUND: It has been shown that the socio-geographical environment of residential areas, such as altitude, affects the health status and health-maintenance behavior of residents. Here, we examined a hypothesis that altitude of residence would influence glycemic control in a general elderly population living in a rural area. METHODS: A thousand and sixteen participants living in a mountainous region in Japan were recruited at health examinations. Hemoglobin A1c (HbA1c) was measured in serum as a parameter of glycemic control. The altitude of residence, distance to grocery stores and to medical facilities were estimated using a geographic information system. RESULTS: Linear regression analysis confirmed a significant effect of the altitude on log HbA1c even after adjustment of other demographic and biochemical factors. When the distance to grocery stores or medical facilities were used instead of the altitude in a linear regression analysis, distance to secondary medical facilities alone showed a significant effect on HbA1c. CONCLUSIONS: We found a positive correlation between HbA1c level and residential altitude in a rural area of Japan. The altitude seemed to be a parameter substituting the inconvenicence of residential areas. Socio-geographical factors of living place, such as inconvenience, may influence glycemic control of the residents.
BACKGROUND: It has been shown that the socio-geographical environment of residential areas, such as altitude, affects the health status and health-maintenance behavior of residents. Here, we examined a hypothesis that altitude of residence would influence glycemic control in a general elderly population living in a rural area. METHODS: A thousand and sixteen participants living in a mountainous region in Japan were recruited at health examinations. Hemoglobin A1c (HbA1c) was measured in serum as a parameter of glycemic control. The altitude of residence, distance to grocery stores and to medical facilities were estimated using a geographic information system. RESULTS: Linear regression analysis confirmed a significant effect of the altitude on log HbA1c even after adjustment of other demographic and biochemical factors. When the distance to grocery stores or medical facilities were used instead of the altitude in a linear regression analysis, distance to secondary medical facilities alone showed a significant effect on HbA1c. CONCLUSIONS: We found a positive correlation between HbA1c level and residential altitude in a rural area of Japan. The altitude seemed to be a parameter substituting the inconvenicence of residential areas. Socio-geographical factors of living place, such as inconvenience, may influence glycemic control of the residents.
Entities:
Keywords:
a cross-sectional study; altitude; diabetes mellitus; geographical information system
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