Neighborhood level risk factors for type 1 diabetes in youth: the SEARCH case-control study.
Neighborhood level risk factors for type 1 diabetes in youth: the SEARCH case-control study.
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DOI：
10.1186/1476-072x-11-1
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发表时间：
2012-01-09
影响因子：
4.9
通讯作者：
Mayer-Davis EJ
中科院分区：
文献类型：
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作者：
Liese AD;Puett RC;Lamichhane AP;Nichols MD;Dabelea D;Lawson AB;Porter DE;Hibbert JD;D'Agostino RB Jr;Mayer-Davis EJ
欧洲生态研究表明，较高的社会经济地位与较高的1型糖尿病发病率有关。使用来自美国不同种族/民族青年糖尿病病例对照研究的数据，我们的目的是评估社区特征对1型糖尿病风险的独立影响。2003-2006年在南卡罗来纳州和科罗拉多招募了507名1型糖尿病青年和208名10-22岁的健康对照者。家庭住址被用来确定人口普查居住区。社区层面的变量来自2000年美国人口普查。多元广义线性混合模型。控制个别风险因素（年龄、性别、种族/民族、婴儿喂养、出生体重、母亲年龄、家庭居民人数、父母教育程度、收入、州），较高的社区家庭收入（p = 0.005），从事管理工作的人口比例（p = 0.02）、至少高中教育程度（p = 0.005）、在县外工作（p = 0.04）和拥有车辆（p = 0.03）均与1型糖尿病发病率的增加独立相关。相反，较高的少数民族人口比例（p = 0.0003），社会保障收入（p = 0.002），拥挤的家庭比例（p = 0.0497）和贫困（p = 0.008）与几率降低有关。我们的研究表明，与更富裕，职业和教育相关的社区特征与1型糖尿病风险较高相关。需要进一步的研究来了解邻里环境影响的机制。
European ecologic studies suggest higher socioeconomic status is associated with higher incidence of type 1 diabetes. Using data from a case-control study of diabetes among racially/ethnically diverse youth in the United States (U.S.), we aimed to evaluate the independent impact of neighborhood characteristics on type 1 diabetes risk. Data were available for 507 youth with type 1 diabetes and 208 healthy controls aged 10-22 years recruited in South Carolina and Colorado in 2003-2006. Home addresses were used to identify Census tracts of residence. Neighborhood-level variables were obtained from 2000 U.S. Census. Multivariate generalized linear mixed models were applied. Controlling for individual risk factors (age, gender, race/ethnicity, infant feeding, birth weight, maternal age, number of household residents, parental education, income, state), higher neighborhood household income (p = 0.005), proportion of population in managerial jobs (p = 0.02), with at least high school education (p = 0.005), working outside the county (p = 0.04) and vehicle ownership (p = 0.03) were each independently associated with increased odds of type 1 diabetes. Conversely, higher percent minority population (p = 0.0003), income from social security (p = 0.002), proportion of crowded households (0.0497) and poverty (p = 0.008) were associated with a decreased odds. Our study suggests that neighborhood characteristics related to greater affluence, occupation, and education are associated with higher type 1 diabetes risk. Further research is needed to understand mechanisms underlying the influence of neighborhood context.