Modifiable Lifestyle Risk Factors and Incident Diabetes in African Americans.

Modifiable Lifestyle Risk Factors and Incident Diabetes in African Americans.
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DOI:
10.1016/j.amepre.2017.06.018
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发表时间:
2017-11
影响因子:
5.5
通讯作者:
Golden SH
Golden SH
中科院分区:
医学2区
文献类型:
--
作者:
Joseph JJ;Echouffo-Tcheugui JB;Talegawkar SA;Effoe VS;Okhomina V;Carnethon MR;Hsueh WA;Golden SH

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在非裔美国人(AAs)中,可改变的生活方式危险因素与糖尿病发病率的关系尚未得到很好的研究。本研究调查了可改变的生活方式危险因素(运动、饮食、吸烟、看电视和睡眠呼吸障碍负担)与AA中糖尿病事件的相关性。在杰克逊心脏研究(2000-2004年)中,使用基线问卷对基线时无糖尿病的3,252例AA中可改变的生活方式风险因素进行了表征,并将其合并为风险因素类别:差(0-3分)、平均(4-7分)和最佳(8-11分)。使用Poisson回归模型估计糖尿病(空腹血糖≥126 mg/dL、医生诊断、使用糖尿病药物或糖化血红蛋白A1 c(HbA 1c)≥6.5%)的发病率比(IRR),调整年龄、性别、教育、职业、收缩压和BMI。2005-2012年收集了结果,2016年分析了数据。在7.6年中,有560例糖尿病病例(平均年龄=53.3岁,64%为女性)。与不良风险因素分类相比,平均或最佳风险因素分类与糖尿病风险降低21%(IRR=0.79,95% CI=0.62,0.99)和31%(IRR=0.69,95% CI=0.48,1.01)相关。在BMI <30 kg/m2的参与者中,与较差分类相比,平均或最佳分类的IRR为0.60(95% CI=0.40,0.91)和0.53(95% CI=0.29,0.97),而BMI ≥30 kg/m2的受试者为0.90(95% CI=0.67,1.21)和0.83(95% CI=0.51,1.34)。可改变的生活方式因素的组合与AA中糖尿病的风险较低相关,特别是在那些没有肥胖的人中。
The associations of modifiable lifestyle risk factors with incident diabetes are not well investigated in African Americans (AAs). This study investigated the association of modifiable lifestyle risk factors (exercise, diet, smoking, TV watching, and sleep disordered breathing burden) with incident diabetes among AAs. Modifiable lifestyle risk factors were characterized among 3,252 AAs in the Jackson Heart Study free of diabetes at baseline (2000–2004) using baseline questionnaires and combined into risk factor categories: poor (0–3 points), average (4–7 points), and optimal (8–11 points). Incidence rate ratios (IRR) for diabetes (fasting glucose ≥126 mg/dL, physician diagnosis, use of diabetes drugs, or glycosylated hemoglobin A1c (HbA1c) ≥6.5%) were estimated using Poisson regression modeling adjusting for age, sex, education, occupation, systolic blood pressure, and BMI. Outcomes were collected 2005–2012 and data analyzed in 2016. Over 7.6 years there were 560 incident diabetes cases (mean age=53.3 years, 64% female). An average or optimal compared to a poor risk factor categorization was associated with a 21% (IRR=0.79, 95% CI=0.62, 0.99) and 31% (IRR=0.69, 95% CI=0.48, 1.01) lower risk of diabetes. Among BMI <30 kg/m2 participants, IRRs for average or optimal compared to poor categorization were 0.60 (95% CI=0.40, 0.91) and 0.53 (95% CI=0.29, 0.97), versus 0.90 (95% CI=0.67, 1.21) and 0.83 (95% CI=0.51, 1.34) among participants with BMI ≥30 kg/m2. A combination of modifiable lifestyle factors are associated with a lower risk of diabetes among AAs, particularly among those without obesity.
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