Sex Differences in Factors Contributing to the Racial Disparity in Diabetes Risk.
Sex Differences in Factors Contributing to the Racial Disparity in Diabetes Risk.
复制标题
DOI：
10.1016/j.amepre.2020.09.016
复制
发表时间：
2021-04
影响因子：
5.5
通讯作者：
Cushman M
中科院分区：
文献类型：
--
作者：
Carson AP;Long DL;Cherrington AL;Dutton GR;Howard VJ;Brown TM;Howard G;Safford MM;Cushman M
在美国，糖尿病的发病率因种族而异，一直有报道说黑白不一致然而，导致中年和老年人这种过度风险的因素尚不清楚。这项前瞻性队列研究纳入了7，171名基线（2003-2007）时年龄≥45岁、无糖尿病、完成随访检查（2013-2016）的黑人和白色成人。采用改良Poisson回归获得糖尿病的性别分层RR。中介分析使用β系数的变化评估了导致糖尿病发病率种族差异的个人和社区因素。于二零一八年至二零一九年进行统计分析。黑人男性（16.2%）和女性（17.7%）的糖尿病累积发病率高于白色男性（11.0%）和女性（8.1%）。调整年龄和糖尿病前期，黑人女性糖尿病风险高于白色女性（RR=1.75，95% CI=1.47，2.07），黑人男性高于白色男性（RR=1.33，95% CI=1.09，1.64）。减少种族差异最多的个体因素是南方饮食模式（β变化42.8%）和社区社会经济环境（β变化26.3%），女性BMI（β变化34.4%）和腰围（β变化32.4%）。当综合考虑所有因素时，男性糖尿病发病率的种族差异相似（RR=1.38，95% CI=1.04，1.83），女性的差异减弱（RR=1.41，95% CI=1.11，1.81）。在考虑了个人和邻里因素后，糖尿病发病率的种族差异仍然存在。需要进一步调查导致这种种族差异的其他因素，以告知糖尿病预防的多层次策略。
Diabetes incidence differs by race in the U.S., with a persistent reported Black–White disparity. However, the factors that contribute to this excess risk in middle-aged and older adults are unclear. This prospective cohort study included 7,171 Black and White adults aged ≥45 years without diabetes at baseline (2003–2007) who completed a follow-up exam (2013–2016). Modified Poisson regression was used to obtain sex-stratified RRs for diabetes. Mediation analyses using change in β coefficient assessed individual and neighborhood factors that contribute to the racial disparity in diabetes incidence. Statistical analyses were conducted in 2018–2019. The cumulative incidence of diabetes was higher for Black men (16.2%) and women (17.7%) than White men (11.0%) and women (8.1%). Adjusting for age and prediabetes, diabetes risk was higher for Black women than White women (RR=1.75, 95% CI=1.47, 2.07) and Black men than White men (RR=1.33, 95% CI=1.09, 1.64). The individual factors that attenuated the racial disparity the most were Southern dietary pattern (42.8% change in β) and neighborhood socioeconomic environment (26.3% change in β) among men and BMI (34.4% change in β) and waist circumference (32.4% change in β) among women. When including all factors collectively, the racial disparity in diabetes incidence was similar for men (RR=1.38, 95% CI=1.04, 1.83) and was attenuated for women (RR=1.41, 95% CI=1.11, 1.81). The racial disparity in diabetes incidence remained after accounting for individual and neighborhood factors. Further investigation of additional factors underlying this racial disparity is needed to inform multilevel strategies for diabetes prevention.
登录
查看更多内容
影响因子：
5
作者：
COHEN, S;KAMARCK, T;MERMELSTEIN, R
通讯作者：
MERMELSTEIN, R
老年黑人和白人成年人心血管危险因素发生率的种族差异。
影响因子：
6.3
作者：
Howard G;Safford MM;Moy CS;Howard VJ;Kleindorfer DO;Unverzagt FW;Soliman EZ;Flaherty ML;McClure LA;Lackland DT;Wadley VG;Pulley L;Cushman M
通讯作者：
Cushman M
影响因子：
9.9
作者：
Tsivgoulis, Georgios;Judd, Suzanne;Wadley, Virginia G.
通讯作者：
Wadley, Virginia G.
影响因子：
16.2
作者：
通讯作者：
--
影响因子：
16.2
作者：
Resnick, HE;Valsania, P;Lin, XH
通讯作者：
Lin, XH