El-Kebbi Imad M, Cook Curtiss B, Ziemer David C, Miller Christopher D, Gallina Daniel L, Phillips Lawrence S
Division of Endocrinology and Metabolism, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30303, USA.
Arch Intern Med. 2003 Jan 13;163(1):69-75. doi: 10.1001/archinte.163.1.69.
Type 2 diabetes mellitus is highly prevalent in minority populations in the United States. We studied the relationship of age to glycemic control in a predominantly urban African American population with type 2 diabetes.
We selected all patients with type 2 diabetes who were enrolled in the Grady Diabetes Clinic, Atlanta, Ga, between April 1, 1991, and December 31, 1998, and had a hemoglobin A(1c) (HbA(1c)) level measured at their initial visit and at follow-up 5 to 12 months later (n = 2539). Patients were divided into 4 age categories: less than 30 years, 30 to 49 years, 50 to 69 years, and more than 69 years old. We also studied the relationship of age to HbA(1c) level in a primary care clinic.
At baseline, average HbA(1c) levels were 9.9%, 9.5%, 9.2%, and 8.8% in the 4 groups ranked in increasing age, respectively (P<.001), and body mass indexes (calculated as weight in kilograms divided by the square of height in meters) were 37.8, 33.9, 31.6, and 29.2, respectively (P<.001). On follow-up, HbA( 1c) level improved in all groups (P<.001), but there was still a trend for younger patients to have higher levels of HbA(1c). There was little change in body mass index with time. Younger age, longer diabetes duration, higher body mass index, less frequent interval visits, and treatment with oral agents or insulin were associated with a higher HbA(1c) level at follow-up. Our findings in a primary care clinic showed also that HbA( 1c) level and body mass index were negatively correlated with age (P<.001).
Our data show a high prevalence of obesity and poor glycemic control in young adult urban African Americans with diabetes.
2型糖尿病在美国少数族裔人群中高度流行。我们研究了在以城市为主的非裔美国2型糖尿病患者中年龄与血糖控制之间的关系。
我们选取了1991年4月1日至1998年12月31日期间在佐治亚州亚特兰大格雷迪糖尿病诊所登记的所有2型糖尿病患者，这些患者在初次就诊时以及5至12个月后的随访中均测量了糖化血红蛋白（HbA1c）水平（n = 2539）。患者被分为4个年龄组：小于30岁、30至49岁、50至69岁以及大于69岁。我们还在一家初级保健诊所研究了年龄与HbA1c水平之间的关系。
在基线时，按年龄递增排序的4组患者的平均HbA1c水平分别为9.9%、9.5%、9.2%和8.8%（P<0.001），体重指数（计算方法为体重千克数除以身高米数的平方）分别为37.8、33.9、31.6和29.2（P<0.001）。在随访中，所有组的HbA1c水平均有所改善（P<0.001），但仍存在年轻患者HbA1c水平较高的趋势。体重指数随时间变化不大。年龄较小、糖尿病病程较长、体重指数较高、就诊间隔时间较短以及使用口服药物或胰岛素治疗与随访时较高的HbA1c水平相关。我们在初级保健诊所的研究结果还表明，HbA1c水平和体重指数与年龄呈负相关（P<0.001）。
我们的数据显示，患有糖尿病的年轻成年城市非裔美国人中肥胖和血糖控制不佳的患病率很高。
