Influence of Acculturation on Risk for Gestational Diabetes Among Asian Women.
Influence of Acculturation on Risk for Gestational Diabetes Among Asian Women.
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DOI：
10.5888/pcd16.190212
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发表时间：
2019-12-05
影响因子：
5.5
通讯作者：
Chao, Shin Margaret
中科院分区：
文献类型：
--
作者：
Chen, Liwei;Shi, Lu;Chao, Shin Margaret
简介：亚洲女性妊娠期糖尿病的患病率高于其他种族/民族的女性。我们的目的是比较亚裔美国女性与其他种族/族裔群体中妊娠期糖尿病的患病率，并探讨亚裔女性中这种疾病的较高发生率是否可以用文化适应来解释。 方法：我们对参加 2007 年加利福尼亚州洛杉矶县洛杉矶妈妈和婴儿研究 (LAMB) 的 5,562 名女性进行了一项基于人群的横断面研究。参与本研究的所有女性均于 2007 年分娩，且未患有孕前 I 型或 II 型糖尿病。我们应用多变量加权逻辑回归来比较不同种族/民族群体中妊娠糖尿病的患病率，并调整其已知的危险因素。我们进行了中介分析，以测试不同种族/族裔群体之间患病率的差异是否可以用文化适应来解释。 结果：在所研究的 5,562 名女性中，亚裔美国女性妊娠期糖尿病的加权患病率为 15.5%，其次是非西班牙裔黑人女性为 9.0%，西班牙裔女性为 10.7%，非西班牙裔白人女性为 7.9%。与非西班牙裔白人女性相比，亚洲女性患妊娠期糖尿病的几率是非西班牙裔白人女性的 2.44 倍（95% 置信区间 [CI]，1.81-3.29；P < .001），与母亲年龄、教育程度、婚姻状况、收入、产前护理充分性、孕前 BMI 和体力活动无关。文化适应与妊娠糖尿病呈负相关（比值比 [OR] = 0.93；95% CI，0.86-0.99），并解释了亚洲种族与病情之间关联的 15.9%（95% CI，11.38%-25.08%；P < .001）。 结论：我们发现亚洲种族是妊娠糖尿病的独立危险因素，并且较高文化适应 可能对亚裔美国女性起到保护作用。
INTRODUCTION: Asian women have a higher prevalence of gestational diabetes mellitus than women of other races/ethnicities. We aimed to compare the prevalence of gestational diabetes among Asian American women to other racial/ethnic groups and explore whether the higher occurrence of the disorder among Asian women can be explained by acculturation.METHODS: We conducted a population-based, cross-sectional study among 5,562 women who participated in the 2007 Los Angeles Mommy and Baby Study (LAMB) in Los Angeles County, California. All women included in this study had a live delivery in 2007 and did not have pre-pregnancy type I or II diabetes. We applied multivariate, weighted logistic regressions to compare gestational diabetes prevalence among racial/ethnic groups, adjusting for its known risk factors. We conducted mediation analysis to test whether the difference in prevalence across racial/ethnic groups could be explained by acculturation.RESULTS: Among the 5,562 women studied, the weighted prevalence of gestational diabetes was 15.5% among Asian American women, followed by 9.0% among non-Hispanic black women, 10.7% among Hispanic women, and 7.9% among non-Hispanic white women. Compared with non-Hispanic white women, Asian women had 2.44 (95% confidence interval [CI], 1.81-3.29; P < .001) times the odds of having gestational diabetes, independent of maternal age, education, marital status, income, prenatal care adequacy, prepregnancy BMI, and physical activity. Acculturation was negatively associated with having gestational diabetes (odds ratio [OR] = 0.93; 95% CI, 0.86-0.99) and explained 15.9% (95% CI, 11.38%-25.08%; P < .001) of the association between Asian race and the condition.CONCLUSION: We found that Asian race was an independent risk factor for gestational diabetes, and higher acculturation may play a protective role against it in Asian American women.