Burke J P, Williams K, Haffner S M, Villalpando C G, Stern M P
Department of Health Sciences Research, Harwick 6, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA.
Diabetes Care. 2001 Sep;24(9):1573-8. doi: 10.2337/diacare.24.9.1573.
To compare the incidence of type 2 diabetes between low-income Mexican-Americans residing in San Antonio, Texas, and low-income residents in Mexico City, Mexico.
Using data from the San Antonio Heart Study and the Mexico City Diabetes Study, we compared the incidence of type 2 diabetes in 35- to 64-year-old low-income Mexican-American residents of San Antonio with similarly aged low-income residents of Mexico City. Because of the different follow-up times in the two studies, Poisson regression was used to compare the rates of diabetes. Potential risk factors for diabetes were also analyzed to determine whether they explained or contributed to a difference in incidence.
The age- and sex-adjusted incidence of type 2 diabetes was significantly higher in San Antonio (RR 2.01) compared with Mexico City. This difference was seen primarily in the oldest age group (55-64 years of age) and remained statistically significant after adjusting for a number of diabetes risk factors, including demographic, anthropometric, and metabolic variables. Follow-up rates were similar in both cities.
We conclude that there was a higher incidence of type 2 diabetes in San Antonio than in Mexico City, and that difference occurred primarily in individuals in the oldest age group. The potential mediating factors we examined did not account for this difference. Other factors, such as exercise and diet, which were not available for analysis in this study, in addition to a cohort effect, may have contributed to the difference in incidence of type 2 diabetes in the two cities. In addition, there was no evidence of a higher case fatality among diabetic individuals from Mexico City compared with San Antonio.
比较居住在得克萨斯州圣安东尼奥市的低收入墨西哥裔美国人与墨西哥城低收入居民中2型糖尿病的发病率。
利用圣安东尼奥心脏研究和墨西哥城糖尿病研究的数据，我们比较了圣安东尼奥市35至64岁低收入墨西哥裔美国居民与墨西哥城同龄低收入居民中2型糖尿病的发病率。由于两项研究的随访时间不同，采用泊松回归比较糖尿病发病率。还分析了糖尿病的潜在危险因素，以确定它们是否解释或导致了发病率的差异。
与墨西哥城相比，圣安东尼奥市经年龄和性别调整的2型糖尿病发病率显著更高（相对风险2.01）。这种差异主要出现在年龄最大的组（55至64岁），在调整了包括人口统计学、人体测量学和代谢变量在内的多种糖尿病危险因素后，差异仍具有统计学意义。两个城市的随访率相似。
我们得出结论，圣安东尼奥市的2型糖尿病发病率高于墨西哥城，且这种差异主要出现在年龄最大的人群中。我们研究的潜在中介因素并不能解释这种差异。本研究中无法分析的其他因素，如运动和饮食，以及队列效应，可能导致了两个城市2型糖尿病发病率的差异。此外，没有证据表明墨西哥城糖尿病患者的病死率高于圣安东尼奥市。
