Differential effects of BMI on diabetes risk among black and white Americans
Differential effects of BMI on diabetes risk among black and white Americans
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DOI：
10.2337/diacare.21.11.1828
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发表时间：
1998-11-01
期刊：
影响因子：
16.2
通讯作者：
Lin, XH
中科院分区：
文献类型：
--
作者：
Resnick, HE;Valsania, P;Lin, XH
目的 - 确定 BMI 和脂肪分布与糖尿病风险的关联是否会因种族而改变。 研究设计和方法 - 使用来自全国健康和营养检查调查、流行病学随访研究 (1971-1992) 的数据来调查 BMI 和脂肪分布与种族之间的潜在相互作用。糖尿病事件的定义是医生诊断糖尿病的自我报告、医院和疗养院出院记录以及死亡证明。 结果 - 在 1,531 名基线时非糖尿病的黑人和 9,852 名白人受试者中，1,139 名 (10.0%) 在 20 年的随访期间发展为糖尿病。尽管在所有四个种族性别组中，糖尿病的累积风险随着基线 BMI 的增加而增加，但黑人与白人受试者的性别特异性比值比 (OR) 随着 BMI 的增加而降低。特别是，对于BMI为22 kg/m(2)的情况，黑人与白人患糖尿病的OR分别为1.87和1.76（P < 0.01）；男性和女性； BMI 为 32 kg/m(2) 时，男性和女性的 OR 分别降至 0.99 和 1.20 (NS)。在所有种族和性别群体中，皮褶比也与糖尿病风险增加相关，但并没有改变种族与糖尿病之间的关联。结论 - 这些发现表明，BMI 对美国黑人和白人糖尿病风险的影响不同，低 BMI 的黑人比白人的风险更大，高 BMI 的两组糖尿病风险相当。 BMI较高的黑人内脏肥胖程度较低或BMI较低的黑人内脏肥胖影响较大可能有助于解释种族和BMI对糖尿病风险的相互作用。
OBJECTIVE - To determine whether the associations of BMI and fat distribution with diabetes risk are modified by race.RESEARCH DESIGN AND METHODS - Data from the National Health and Nutrition Examination Survey, Epidemiologic Follow-up Study (1971-1992), were used to investigate potential interactions of BMI and fat distribution with race. Incident diabetes was defined by self-report of physician-diagnosed diabetes, hospital and nursing home discharge records, and death certificates.RESULTS - Among the 1,531 black and 9,852 white subjects who were nondiabetic at baseline, 1,139 (10.0%) developed diabetes during 20 years of follow-up. Although the cumulative risk of diabetes increased with baseline BMI in all four race-sex groups, the sex-specific odds ratios (ORs) for black:white subjects decreased with increasing BMI. In particular, for BMI of 22 kg/m(2), the OR of diabetes for black:white individuals was 1.87 and 1.76 (P < 0.01) for men and women, respectively; for BMI of 32 kg/m(2), the OR decreased to 0.99 and 1.20 (NS) for men and women, respectively. Skinfold ratio was also associated with increased diabetes risk in all race-sex groups, but did not modify the association between race and diabetes.CONCLUSIONS - These findings suggest that the effect of BMI on diabetes risk is different for black and white Americans, with a larger risk for blacks than whites at low BMI and an equivalent risk for both groups at high BMI. A lower degree of visceral adiposity among blacks at higher BMI or a greater impact of visceral adiposity among blacks at low BMI may help explain the interaction of race and BMI on diabetes risk.