Relationship between ethnicity and glycemic control, lipid profiles, and blood pressure during the first 9 years of type 2 diabetes - UK prospective diabetes study (UKPDS 55)
Relationship between ethnicity and glycemic control, lipid profiles, and blood pressure during the first 9 years of type 2 diabetes - UK prospective diabetes study (UKPDS 55)
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DOI：
10.2337/diacare.24.7.1167
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发表时间：
2001-07-01
期刊：
影响因子：
16.2
通讯作者：
Holman, RR
中科院分区：
文献类型：
--
作者：
Davis, TME;Cull, CA;Holman, RR
目的-评估自我报告的种族，代谢控制和2型糖尿病治疗期间血压之间的关系。研究设计和方法-我们研究了2,999例新诊断的2型糖尿病患者招募到英国。前瞻性糖尿病研究，如果他们的空腹血糖水平在饮食导入后仍>6 mmol/l，则随机接受常规或强化血糖控制策略。共有2，484例患者（83%）为白色高加索人（WC），265例患者（9%）为非洲裔加勒比人（AC），250例患者（8%）为印度裔亚洲人（W）。结果-在9年的研究期间，WC患者的体重增加（平均5.0 kg）多于AC（3.0 kg）和W。(2.5 kg组（P < 0.001）。校正年龄、性别、基线值、治疗分配和体重变化后，持续血糖或HM 1c的平均变化无一致的种族差异。调整降压治疗后，AC患者9年时收缩压升高最大（7 mmHg; P < 0.01 vs. WC患者）。平均舒张压、总胆固醇和低密度脂蛋白胆固醇在9年内逐渐下降。在AC患者中，HDL胆固醇的平均增加（0.16 mmol/l），维持至9年，血浆甘油三酯水平平均降低（0.4 mmol/l）高于WC和IA患者（P < 0.001）。结论--这项研究显示了体重、血脂和血压的重要种族差异，但血糖控制没有差异，在诊断2型糖尿病后的9年内。AC患者保持了最有利的血脂谱，但高血压发生在更多的AC患者比WC或IA患者。2型糖尿病的种族特异性血糖控制似乎是不必要的，但其他危险因素需要独立解决。
OBJECTIVE - To assess the relationship among self-reported ethnicity, metabolic control, and blood pressure during treatment of type 2 diabetes.RESEARCH DESIGN AND METHODS - We studied 2,999 newly diagnosed type 2 diabetic patients recruited to the U.K. Prospective Diabetes Study who were randomized to conventional or intensive glucose control policies if their fasting plasma glucose levels remained >6 mmol/l after a dietary run-in. A total of 2,484 patients (83%) were white Caucasian (WC), 265 patients (9%) were Afro-Caribbean (AC), and 250 patients (8%) were Asian of Indian origin (W). Variables were assessed at 3, 6, and 9 years.RESULTS - During the 9-year study period, body weight increased more in WC patients (mean 5.0 kg) than in AC (3.0 kg) and W.(2.5 kg) patients (P < 0.001). After adjusting for age, sex, baseline value, treatment allocation, and change in weight, there were no consistent ethnic differences in mean change in lasting plasma glucose or HM1c. After adjustment for antihypertensive therapy, increase in systolic blood pressure at 9 years was greatest in AC patients (7 mmHg; P < 0.01 vs. WC patients). Mean diastolic blood pressure, total cholesterol, and LDL cholesterol decreased progressively during the 9 years in each group. In AC patients, the mean increase in HDL cholesterol(0.16 mmol/l) at 3 years, maintained to 9 years, and the mean decrease in plasma triglyceride level (0.4 mmol/l) at 9 years were greater than in WC and IA patients (P < 0.001).CONCLUSIONS - This study shows important ethnic differences in body weight, lipid profiles, and blood pressure, but not glycemic control, during 9 years after diagnosis of type 2 diabetes. AC patients maintained the most favorable lipid profiles, but hypertension developed in more AC patients than WC or IA patients. Ethnicity-specific glycemic control of type 2 diabetes seems unnecessary, but other risk factors need to be addressed independently.