Diabetes incidence based on linkages with health plans: the multiethnic cohort.
Diabetes incidence based on linkages with health plans: the multiethnic cohort.
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DOI：
10.2337/db08-1685
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发表时间：
2009-08
期刊：
影响因子：
7.7
通讯作者：
Kolonel LN
中科院分区：
文献类型：
--
作者：
Maskarinec G;Erber E;Grandinetti A;Verheus M;Oum R;Hopping BN;Schmidt MM;Uchida A;Juarez DT;Hodges K;Kolonel LN
使用多种族队列（MEC）的夏威夷部分，我们估计了高加索人、日裔美国人和夏威夷土著人的糖尿病发病率。在排除基线时报告糖尿病或有缺失值的受试者后，93，860名队列成员参与了这项分析。通过随访问卷（1999-2000年）、药物问卷（2003-2006年）和与两个主要健康计划的联系（2007年）确定了新的病例受试者。我们计算了年龄标准化发病率，并估计了种族、BMI、教育和这些变量的联合效应的风险比（HR），使用考克斯回归分析。在总随访时间为1，119，224人-年后，确定了11，838例糖尿病病例，年发病率为10.4/1，000人-年。夏威夷原住民的发病率最高，为15.5，其次是日裔美国人，为12.5，高加索人为5.8/1000人年;调整后的HR为日裔美国人2.65，夏威夷原住民1.93。BMI与所有种族的发病率呈正相关。与最低类别相比，BMI为22.0-24.9、25.0-29.9和≥30.0 kg/m2的相应HR分别为2.10、4.12和9.48。然而，在每个BMI类别中，日裔美国人的风险最高，夏威夷原住民的风险居中。教育成就与糖尿病风险呈负相关，但保护作用仅限于白人。在这个多种族人群中，日裔美国人和夏威夷土著人的糖尿病发病率是高加索人的两倍。种族与BMI和教育的显着相互作用表明糖尿病病因的种族差异。
Using the Hawaii component of the Multiethnic Cohort (MEC), we estimated diabetes incidence among Caucasians, Japanese Americans, and Native Hawaiians. After excluding subjects who reported diabetes at baseline or had missing values, 93,860 cohort members were part of this analysis. New case subjects were identified through a follow-up questionnaire (1999–2000), a medication questionnaire (2003–2006), and linkage with two major health plans (2007). We computed age-standardized incidence rates and estimated hazard ratios (HRs) for ethnicity, BMI, education, and combined effects of these variables using Cox regression analysis. After a total follow-up time of 1,119,224 person-years, 11,838 incident diabetic case subjects were identified with an annual incidence rate of 10.4 per 1,000 person-years. Native Hawaiians had the highest rate with 15.5, followed by Japanese Americans with 12.5, and Caucasians with 5.8 per 1,000 person-years; the adjusted HRs were 2.65 for Japanese Americans and 1.93 for Native Hawaiians. BMI was positively related to incidence in all ethnic groups. Compared with the lowest category, the respective HRs for BMIs of 22.0–24.9, 25.0–29.9, and ≥30.0 kg/m2 were 2.10, 4.12, and 9.48. However, the risk was highest for Japanese Americans and intermediate for Native Hawaiians in each BMI category. Educational achievement showed an inverse association with diabetes risk, but the protective effect was limited to Caucasians. Within this multiethnic population, diabetes incidence was twofold higher in Japanese Americans and Native Hawaiians than in Caucasians. The significant interaction of ethnicity with BMI and education suggests ethnic differences in diabetes etiology.
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影响因子：
12.7
作者：
Maskarinec, G
通讯作者：
Maskarinec, G
影响因子：
5.1
作者：
Robbins, JM;Vaccarino, V;Kasl, SV
通讯作者：
Kasl, SV
影响因子：
5.1
作者：
Fukushima, M;Suzuki, H;Seino, Y
通讯作者：
Seino, Y
影响因子：
16.2
作者：
Ohnishi, H;Saitoh, S;Shimamoto, K
通讯作者：
Shimamoto, K
影响因子：
16.2
作者：
Boyko, EJ;Fujimoto, WY;Newell-Morris, L
通讯作者：
Newell-Morris, L