What explains the American disadvantage in health compared with the English? The case of diabetes.
What explains the American disadvantage in health compared with the English? The case of diabetes.
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DOI：
10.1136/jech.2010.108415
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发表时间：
2012-03
影响因子：
6.3
通讯作者：
Zaninotto P
中科院分区：
文献类型：
--
作者：
Banks J;Kumari M;Smith JP;Zaninotto P
美国中老年男性和女性患糖尿病的比例几乎是英国男性和女性的两倍。这种差异不能用传统的危险因素来解释，包括年龄、吸烟、社会地位和身体质量指数。我们使用了1999-2006年美国NHANES和2004年英国老龄化纵向研究中52至85岁非少数民族成年人的大量代表性样本。我们的调查包括糖尿病的自我报告和客观的生物疾病标志物，以及糖尿病的主要危险因素指标，包括BMI、身高和腰围等人体测量指标。老年美国人患糖尿病的比率比英国人高得多——这种差异尚未得到解释。但我们发现，在每个BMI水平上，这个人群的腰围都比英国的同类人群要大。我们发现，通过控制这些腰围差异，并考虑腰围对每个国家糖尿病的不同影响，我们可以解释大约四分之三的女性和38%的男性的国家差异。美国老年人口的糖尿病发病率高于英国，主要是由于腰围增加，而不是BMI差异，尤其是在女性中。此外，与英国人相比，美国人的腰围越大，患糖尿病的风险就越高，这可能是由许多不同的机制引起的。研究这些机制的相对重要性是一个值得进一步研究的重要课题。
Middle aged and older American men and women have almost twice the rate of diabetes of men and women in England. This differential was not explained by conventional risk factors including age, smoking, social position, and BMI. We use large and representative samples of non-minority adults ages 52 to 85 years old taken from the 1999–2006 American NHANES and the 2004 English Longitudinal Study of Aging. Our surveys contain self-reported and objective biological disease markers of diabetes as well as indicators of major risk factors for diabetes including anthropometric measures of BMI, height and waist circumference. The older American population has much higher rates of diabetes than the English population—a differential not yet explained. But we show that this population also has higher waist circumference at each level of BMI than does the equivalent group in England. We find that by controlling for such waist circumference differences and allowing for different effects of waist on diabetes in each country, we can explain about three-quarters of the country differences for women and 38% among men. Higher rates of diabetes in the US old-age population than in England were largely accounted for by raised waist circumference and not BMI differences, especially among women. In addition, elevated diabetes risk associated with higher waist circumference in the US as opposed to England could arise as a result of a number of different mechanisms. Investigation of the relative importance of such mechanisms is an important topic for further study.
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影响因子：
4.9
作者：
Flegal, K. M.
通讯作者：
Flegal, K. M.
DOI：
10.1073/pnas.0611234104
发表时间：
2007-08-14
影响因子：
11.1
作者：
Smith, James P.
通讯作者：
Smith, James P.
影响因子：
120.7
作者：
Davidson, MB;Schriger, DL;Lorber, B
通讯作者：
Lorber, B
影响因子：
--
作者：
LEAN, MEJ;HAN, TS;MORRISON, CE
通讯作者：
MORRISON, CE
影响因子：
5.8
作者：
Kumari, Meena;Chandola, Tarani;Kivimaki, Mika
通讯作者：
Kivimaki, Mika