Prevalence of and Racial Disparities in Risk Factor Control in Older Adults With Diabetes: The Atherosclerosis Risk in Communities Study.
Prevalence of and Racial Disparities in Risk Factor Control in Older Adults With Diabetes: The Atherosclerosis Risk in Communities Study.
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DOI：
10.2337/dc15-0016
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发表时间：
2015-07
期刊：
影响因子：
16.2
通讯作者：
Selvin E
中科院分区：
文献类型：
--
作者：
Parrinello CM;Rastegar I;Godino JG;Miedema MD;Matsushita K;Selvin E
关于老年糖尿病患者适当的危险因素目标存在争议。我们评估了满足不同目标的老年糖尿病患者的比例，重点关注种族之间可能存在的差异，并评估了人口统计学和临床特征是否可以解释差异。我们对5018名67-90岁的参与者进行了一项横断面研究（其中1574名患有糖尿病，3444名未诊断为糖尿病），他们参加了社区动脉粥样硬化风险（ARIC）研究（2011-2013）的第5次访问。使用严格（和不严格）目标定义危险因素目标：血红蛋白A1c (HbA1c) <7%, <53 mmol/mol (<8%, <64 mmol/mol)；低密度脂蛋白胆固醇(LDL-c) < 100mg /dL (< 130mg /dL)；血压(BP) <140/90 mmHg （<150/90 mmHg）。我们使用泊松回归获得患病率（pr）。大多数老年糖尿病患者达到了严格（或不太严格）的目标：HbA1c达到72% (90%)，LDL-c达到63% (86%)，BP达到73% (87%)；但只有35%（68%）的人满足了这三个要求。无论如何定义，白人达到目标的比例都高于黑人。在接受危险因素治疗的人群中，即使在调整后，达到严格目标的患病率的种族差异仍然存在：HbA1c的pr（白人与黑人）为1.03 (95% CI 0.91, 1.17)， LDL-c的pr为1.21 (95% CI 1.09, 1.35)， BP的pr为1.10 (95% CI 1.00, 1.21)，三者的pr均为1.28 （95% CI 0.99, 1.66）。使用不那么严格的目标时，结果相似，但略有减弱。黑人女性比白人女性更不可能达到BP和所有三个风险因素的目标；这种差异在男性中没有观察到。在老年糖尿病患者的危险因素控制方面，黑人和白人的差异不能完全用人口学或临床特征来解释，女性的差异大于男性。进一步研究这些差异的决定因素很重要。
Controversy surrounds appropriate risk factor targets in older adults with diabetes. We evaluated the proportion of older adults with diabetes meeting different targets, focusing on possible differences by race, and assessed whether demographic and clinical characteristics explained disparities. We conducted a cross-sectional study of 5,018 participants aged 67–90 years (1,574 with and 3,444 without diagnosed diabetes) who attended visit 5 of the Atherosclerosis Risk in Communities (ARIC) study (2011–2013). Risk factor targets were defined using both stringent (and less stringent) goals: hemoglobin A1c (HbA1c) <7%, <53 mmol/mol (<8%, <64 mmol/mol); LDL cholesterol (LDL-c) <100 mg/dL (<130 mg/dL); and blood pressure (BP) <140/90 mmHg (<150/90 mmHg). We used Poisson regression to obtain prevalence ratios (PRs). Most older adults with diabetes met stringent (and less stringent) targets: 72% (90%) for HbA1c, 63% (86%) for LDL-c, and 73% (87%) for BP; but only 35% (68%) met all three. A higher proportion of whites than blacks met targets, however defined. Among people treated for risk factors, racial disparities in prevalence of meeting stringent targets persisted even after adjustment: PRs (whites vs. blacks) were 1.03 (95% CI 0.91, 1.17) for HbA1c, 1.21 (1.09, 1.35) for LDL-c, 1.10 (1.00, 1.21) for BP, and 1.28 (0.99, 1.66) for all three. Results were similar but slightly attenuated using less stringent goals. Black women were less likely than white women to meet targets for BP and all three risk factors; this disparity was not observed in men. Black-white disparities in risk factor control in older adults with diabetes were not fully explained by demographic or clinical characteristics and were greater in women than men. Further study of determinants of these disparities is important.
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DOI：
10.1093/gerona/61.4.380
发表时间：
2006-04-01
影响因子：
5.1
作者：
Kuo, HK;Bean, JF;Leveille, SG
通讯作者：
Leveille, SG
影响因子：
158.5
作者：
Gaede, Peter;Lund-Andersen, Henrik;Pedersen, Oluf
通讯作者：
Pedersen, Oluf
影响因子：
158.5
作者：
Gerstein, Hertzel C.;Miller, Michael E.;Friedewald, William T.
通讯作者：
Friedewald, William T.
影响因子：
16.2
作者：
Buse, John B.;Ginsberg, Henry N.;Stone, Neil J.
通讯作者：
Stone, Neil J.
影响因子：
16.2
作者：
Chatterji P;Joo H;Lahiri K
通讯作者：
Lahiri K