Diabetes prevalence and diagnosis in US states: analysis of health surveys.
Diabetes prevalence and diagnosis in US states: analysis of health surveys.
复制标题
DOI：
10.1186/1478-7954-7-16
复制
发表时间：
2009-09-25
影响因子：
3.3
通讯作者：
Ezzati M
中科院分区：
文献类型：
--
作者：
Danaei G;Friedman AB;Oza S;Murray CJ;Ezzati M
目前，美国的监测数据提供了使用国家一级实验室检测以及州一级自我报告数据的糖尿病估计值。自我报告的糖尿病患病率可能有偏差，因为受访者可能不知道他们的风险状况。我们的目标是估计各州已诊断和未诊断糖尿病的患病率。我们在2003-2006年的全国健康和营养调查中使用logistic回归估计了未诊断的糖尿病患病率作为一组卫生系统和社会人口学变量的函数。我们将这种关系应用于行为风险因素监测系统（2003-2007年）的相同变量，以估计按年龄组和性别划分的未确诊糖尿病的州一级患病率。我们假设那些在两次调查中报告被诊断为糖尿病的人是真正的糖尿病患者。在美国，≥ 30岁的男性糖尿病患病率为13.7%，女性为11.7%。密西西比、西弗吉尼亚、路易斯安那、得克萨斯、南卡罗来纳州、亚拉巴马和格鲁吉亚的糖尿病标准化患病率最高（男性15.8 - 16.6%，女性12.4 - 14.8%）。佛蒙特州、明尼苏达州、蒙大拿州和科罗拉多州的患病率最低（男性为11.0%至12.2%，女性为7.3%至8.4%）。所有州的男性糖尿病患病率都高于女性。未确诊糖尿病的绝对患病率占总人口的百分比最高的是新墨西哥州、得克萨斯州、佛罗里达和加州（3.5 - 3.7个百分点），最低的是蒙大拿州、俄克拉荷马州、俄勒冈州、阿拉斯加州、佛蒙特州、犹他州、华盛顿和夏威夷（2.1 - 3个百分点）。在没有确诊糖尿病的人群中，肥胖、西班牙裔、没有保险和≥ 60岁与未确诊糖尿病的风险较高显著相关。糖尿病患病率在南部和阿巴拉契亚州最高，在中西部和东北部最低。许多州需要更好的糖尿病诊断。
Current US surveillance data provide estimates of diabetes using laboratory tests at the national level as well as self-reported data at the state level. Self-reported diabetes prevalence may be biased because respondents may not be aware of their risk status. Our objective was to estimate the prevalence of diagnosed and undiagnosed diabetes by state. We estimated undiagnosed diabetes prevalence as a function of a set of health system and sociodemographic variables using a logistic regression in the National Health and Nutrition Examination Survey (2003-2006). We applied this relationship to identical variables from the Behavioral Risk Factor Surveillance System (2003-2007) to estimate state-level prevalence of undiagnosed diabetes by age group and sex. We assumed that those who report being diagnosed with diabetes in both surveys are truly diabetic. The prevalence of diabetes in the U.S. was 13.7% among men and 11.7% among women ≥ 30 years. Age-standardized diabetes prevalence was highest in Mississippi, West Virginia, Louisiana, Texas, South Carolina, Alabama, and Georgia (15.8 to 16.6% for men and 12.4 to 14.8% for women). Vermont, Minnesota, Montana, and Colorado had the lowest prevalence (11.0 to 12.2% for men and 7.3 to 8.4% for women). Men in all states had higher diabetes prevalence than women. The absolute prevalence of undiagnosed diabetes, as a percent of total population, was highest in New Mexico, Texas, Florida, and California (3.5 to 3.7 percentage points) and lowest in Montana, Oklahoma, Oregon, Alaska, Vermont, Utah, Washington, and Hawaii (2.1 to 3 percentage points). Among those with no established diabetes diagnosis, being obese, being Hispanic, not having insurance and being ≥ 60 years old were significantly associated with a higher risk of having undiagnosed diabetes. Diabetes prevalence is highest in the Southern and Appalachian states and lowest in the Midwest and the Northeast. Better diabetes diagnosis is needed in a number of states.