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腹部肥胖与糖尿病认知、治疗及血糖控制方面的种族差异。

Abdominal obesity and ethnic differences in diabetes awareness, treatment, and glycemic control.

作者信息

Okosun Ike S, Dever G E Alan

机构信息

Department of Community Medicine, Mercer University School of Medicine, Macon, Georgia 31207, USA.

出版信息

Obes Res. 2002 Dec;10(12):1241-50. doi: 10.1038/oby.2002.169.

Abstract

OBJECTIVE

To compare racial/ethnic differences in diabetes awareness, treatment, and glycemic control between non-Hispanic white, non-Hispanic black, and Hispanic Americans. We also determined the impact of abdominal obesity on racial/ethnic differences in diabetes awareness, treatment, and glycemic control between these population groups.

RESEARCH METHODS AND PROCEDURES

Third National Health and Nutrition Examination Survey (NHANES III) data were utilized for this study. Diabetes awareness was defined as acknowledging diabetic status. Diabetes treatment was defined as current use of anti-diabetic medications, good glycemic control as HbA(1c) < 8%, and abdominal obesity as waist circumference larger than expected. The impacts of abdominal obesity on racial/ethnic differences in diabetes awareness, treatment, and glycemic control were assessed using logistic regression analyses. Adjustments were made for age, education, smoking, alcohol intake, and health insurance.

RESULTS

Rates of diabetes awareness in whites, blacks, and Hispanics suffering from abdominal obesity were approximately 74%, 30%, and 21% in men and 77%, 32%, and 19% in women, respectively. Rates of diabetes treatment were 70%, 23%, and 14% in men and 57%, 45%, and 23% in women, respectively. In men, rates of glycemic control were 64%, 40%, and 30%, and in women, they were 62%, 51%, and 27%, respectively. Abdominal obesity was associated with decreased diabetes awareness and glycemic control in women.

DISCUSSION

Subjects with abdominal obesity were found to have poorer glycemic controls compared to those without abdominal obesity. Because diabetes prevalences were partially explained by racial/ethnic differences in diabetes awareness, treatment, and glycemic control, there is a need to craft diabetes awareness, treatment, and control programs along racial/ethnic origins.

摘要

目的

比较非西班牙裔白人、非西班牙裔黑人及西班牙裔美国人在糖尿病知晓率、治疗情况及血糖控制方面的种族/族裔差异。我们还确定了腹型肥胖对这些人群在糖尿病知晓率、治疗情况及血糖控制方面种族/族裔差异的影响。

研究方法与步骤

本研究使用了第三次全国健康与营养检查调查(NHANES III)的数据。糖尿病知晓率定义为知晓糖尿病状态。糖尿病治疗定义为当前正在使用抗糖尿病药物,血糖控制良好定义为糖化血红蛋白(HbA1c)<8%,腹型肥胖定义为腰围大于预期值。使用逻辑回归分析评估腹型肥胖对糖尿病知晓率、治疗情况及血糖控制方面种族/族裔差异的影响。对年龄、教育程度、吸烟、饮酒及健康保险情况进行了校正。

结果

患有腹型肥胖的白人、黑人和西班牙裔男性的糖尿病知晓率分别约为74%、30%和21%,女性分别为77%、32%和19%。糖尿病治疗率男性分别为70%、23%和14%,女性分别为57%、45%和23%。男性的血糖控制率分别为64%、40%和30%,女性分别为62%、51%和27%。腹型肥胖与女性糖尿病知晓率降低及血糖控制不佳有关。

讨论

发现腹型肥胖的受试者与无腹型肥胖的受试者相比血糖控制更差。由于糖尿病患病率部分可由糖尿病知晓率、治疗情况及血糖控制方面的种族/族裔差异来解释,因此有必要根据种族/族裔背景制定糖尿病知晓、治疗及控制方案。

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