A comparison of glycaemic and metabolic control over time among South Asian and European patients with Type 2 diabetes: results from follow-up in a routine diabetes clinic
A comparison of glycaemic and metabolic control over time among South Asian and European patients with Type 2 diabetes: results from follow-up in a routine diabetes clinic
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DOI：
10.1111/j.1464-5491.2005.01735.x
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发表时间：
2006-01-01
影响因子：
3.5
通讯作者：
Sattar, N
中科院分区：
文献类型：
--
作者：
Mukhopadhyay, B;Forouhi, NG;Sattar, N
虽然南亚人有较高的糖尿病发病率，在较年轻的年龄，在诊断后代谢参数的变化数据相对稀少。因此，我们希望确定南亚糖尿病患者与欧洲人相比，代谢参数是否有类似或更大的逐年恶化。方法我们分析了代谢参数[糖化血红蛋白（HbA（1c）），血压，体重指数（BMI），在南亚人（n = 210）和欧洲人中，（n = 1557）在平均5.3年的时间里连续到同一个糖尿病诊所就诊的患者。结果南亚人开始时比欧洲人年轻记录的糖尿病诊断（平均年龄45.9对57.3岁，P < 0.001），BMI和血压显著较低（相似于1.2个单位）。首次访视时，各种族组的平均HbA（1c）无差异，但随着时间的推移，南亚人的血糖控制比欧洲人差，亚洲人平均恶化1.31%（= 0.23%/年），欧洲人平均恶化0.82%（0.16%/年），P = 0.003。在线性回归分析中，调整年龄、性别、基线HbA（1c）和体重变化后，HbA（1c）平均变化的种族差异持续存在（β = 0.46，95% CI 0.24-0.69，P < 0.001），并进一步调整转诊时间和糖尿病持续时间（P = 0.01）。此外，南亚人有显着较小的改善，血压（P < 0.001）和胆固醇（P = 0.044）在随访期间，在保持较少处方的抗高血压药物和降脂agents.Conclusions这些数据表明，需要更加积极的管理糖尿病和相关的危险因素在南亚人。
Aims Although South Asians have a higher prevalence of diabetes which develops at a younger age, data on change in metabolic parameters post-diagnosis are relatively sparse. We therefore wished to determine whether South Asians with diabetes had similar or greater year-on-year deterioration in metabolic parameters compared with Europeans.Methods We analysed longitudinal change in metabolic parameters [glycated haemoglobin (HbA(1c)), blood pressure, body mass index (BMI), lipids] among South Asian (n = 210) and European (n = 1557) patients consecutively attending the same diabetes clinic over a mean period of 5.3 years.Resulst South Asians were younger than Europeans at first recorded diagnosis of diabetes (mean age 45.9 vs. 57.3 years, P < 0.001) and had significantly lower (similar to 1.2 units) BMI and blood pressure. Mean HbA(1c) was not different across ethnic groups at first visit, but with time glycaemic control was worse in South Asians than Europeans, with average deterioration 1.31% (= 0.23%/year) in Asians vs. 0.82% (0.16%/year) in Europeans, P = 0.003. This ethnic difference in mean change in HbA(1c) persisted after adjustment for age, sex, baseline HbA(1c), and weight change in linear regression analysis (beta = 0.46, 95% CI 0.24-0.69, P < 0.001), and with additional adjustment for time to referral and duration of diabetes (P = 0.01). Moreover, South Asians had significantly smaller improvements in blood pressure (P < 0.001) and cholesterol (P = 0.044) over the follow-up period in keeping with fewer prescriptions of anti-hypertensive agents and lipid-lowering agents.Conclusions These data suggest the need to be more aggressive in the management of diabetes and related risk factors in South Asians.