Association of community types and features in a case-control analysis of new onset type 2 diabetes across a diverse geography in Pennsylvania.
Association of community types and features in a case-control analysis of new onset type 2 diabetes across a diverse geography in Pennsylvania.
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宾夕法尼亚州不同地区新发2型糖尿病病例对照分析中社区类型和特征的关联
DOI：
10.1136/bmjopen-2020-043528
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发表时间：
2021-01-13
期刊：
影响因子：
2.9
通讯作者：
Hirsch AG
中科院分区：
文献类型：
--
作者：
Schwartz BS;Pollak J;Poulsen MN;Bandeen-Roche K;Moon K;DeWalle J;Siegel K;Mercado C;Imperatore G;Hirsch AG
评估不同社区的社区类型和特征与新发2型糖尿病的关系。了解地理差异的位置和规模可以导致社区一级的干预措施。在卫生系统患者的开放动态队列中进行巢式病例对照研究。美国宾夕法尼亚州中部和东北部37个县的大型综合卫生系统。我们使用电子健康记录识别2008年至2016年新发2型糖尿病患者（n= 15888）。糖尿病患者的年龄、性别和年龄与非糖尿病患者（n=79 435）相匹配（1:5）。我们使用广义估计方程来控制个人水平的混杂变量，考虑到社区内人群的聚集性。社区被定义为：(1)乡镇、市镇和城市人口普查区；(2)城市化地区（大城市）、城市群（小城镇）和农村；(3)前两者的结合；(4)县。社区社会经济剥夺和绿色度分别在单独和按社区类型分层的模型中进行评估。市镇和城市人口普查区居住（与乡镇相比）与较高的2型糖尿病发病率相关（OR (95% CI)）（分别为1.10（1.04至1.16）和1.34(1.25至1.44)）。城市化地区（与农村地区相比）患2型糖尿病的几率也有所增加（1.14(1.08至1.21)）。在综合定义中，最强的关联（相对于农村地区的乡镇）是城市群中的城市人口普查区（1.41(1.22至1.62)）和城市化地区的城市人口普查区（1.33(1.22至1.45)）。较高的社区社会经济剥夺和较低的绿化程度都与增加的几率有关。与其他地区相比，城市居民患2型糖尿病的几率更高。城市人口普查区较高的社区社会经济剥夺和所有社区类型的绿化程度较低也与2型糖尿病有关。
To evaluate associations of community types and features with new onset type 2 diabetes in diverse communities. Understanding the location and scale of geographic disparities can lead to community-level interventions. Nested case–control study within the open dynamic cohort of health system patients. Large, integrated health system in 37 counties in central and northeastern Pennsylvania, USA. We used electronic health records to identify persons with new-onset type 2 diabetes from 2008 to 2016 (n=15 888). Persons with diabetes were age, sex and year matched (1:5) to persons without diabetes (n=79 435). We used generalised estimating equations to control for individual-level confounding variables, accounting for clustering of persons within communities. Communities were defined as (1) townships, boroughs and city census tracts; (2) urbanised area (large metro), urban cluster (small cities and towns) and rural; (3) combination of the first two; and (4) county. Community socioeconomic deprivation and greenness were evaluated alone and in models stratified by community types. Borough and city census tract residence (vs townships) were associated (OR (95% CI)) with higher odds of type 2 diabetes (1.10 (1.04 to 1.16) and 1.34 (1.25 to 1.44), respectively). Urbanised areas (vs rural) also had increased odds of type 2 diabetes (1.14 (1.08 to 1.21)). In the combined definition, the strongest associations (vs townships in rural areas) were city census tracts in urban clusters (1.41 (1.22 to 1.62)) and city census tracts in urbanised areas (1.33 (1.22 to 1.45)). Higher community socioeconomic deprivation and lower greenness were each associated with increased odds. Urban residence was associated with higher odds of type 2 diabetes than for other areas. Higher community socioeconomic deprivation in city census tracts and lower greenness in all community types were also associated with type 2 diabetes.
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影响因子：
3.7
作者：
Geiss LS;Kirtland K;Lin J;Shrestha S;Thompson T;Albright A;Gregg EW
通讯作者：
Gregg EW
影响因子：
5.5
作者：
Hipp JA;Chalise N
通讯作者：
Chalise N
影响因子：
4.9
作者：
Cohen, Steven A.;Cook, Sarah K.;Sando, Trisha A.
通讯作者：
Sando, Trisha A.
影响因子：
3.2
作者：
Jagai, Jyotsna S.;Krajewski, Alison K.;Sargis, Robert M.
通讯作者：
Sargis, Robert M.
DOI：
10.1038/oby.2005.15
发表时间：
2005-01-01
期刊：
OBESITY RESEARCH
影响因子：
--
作者：
Ford, ES;Mokdad, AH;Serdula, MK
通讯作者：
Serdula, MK