Mitchell B D, Haffner S M, Hazuda H P, Patterson J K, Stern M P
Department of Medicine, University of Texas Health Science Center, San Antonio 78284-7873.
Ann Epidemiol. 1992 Jan-Mar;2(1-2):101-6. doi: 10.1016/1047-2797(92)90043-p.
Mexican Americans have a high prevalence of diabetes relative to non-Hispanic whites, but paradoxically experience a lower prevalence of myocardial infarction and lower cardiovascular mortality (at least in men). To determine whether Mexican Americans might be more resistant to the atherogenic effects of diabetes than non-Hispanic whites, we examined the associations between diabetes and myocardial infarction and selected coronary heart disease (CHD) risk factors in these two ethnic groups. The study population consisted of 5149 Mexican Americans and non-Hispanic whites who were 25 to 64 years old and recruited from the San Antonio Heart Study, a population-based study of cardiovascular risk factors and diabetes conducted between 1979 and 1988. Diabetic men were more than twice as likely to have an electrocardiography (ECG)-documented myocardial infarction than were nondiabetic men, while diabetic women were more than three times as likely to have a myocardial infarction than were nondiabetic women. In both sexes the association between myocardial infarction and diabetes was nearly identical between the two ethnic groups. In both ethnic groups diabetes was also more strongly associated with conventional CHD risk factors (e.g., triglycerides, systolic blood pressure, and high-density-lipoprotein cholesterol) in women than in men. Furthermore, these associations were at least as strong, if not stronger, in Mexican Americans as in non-Hispanic whites. Thus, these data provide no evidence to suggest that Mexican Americans are resistant to the lipid-altering effects of diabetes. We conclude that the protective effect against CHD conferred by Mexican American ethnicity may be obscured in part by the high prevalence of diabetes in this ethnic group.
与非西班牙裔白人相比，墨西哥裔美国人糖尿病患病率较高，但矛盾的是，他们心肌梗死的患病率较低，心血管疾病死亡率也较低（至少在男性中如此）。为了确定墨西哥裔美国人是否比非西班牙裔白人对糖尿病的致动脉粥样硬化作用更具抵抗力，我们研究了这两个种族群体中糖尿病与心肌梗死以及选定的冠心病（CHD）危险因素之间的关联。研究人群包括5149名25至64岁的墨西哥裔美国人和非西班牙裔白人，他们来自圣安东尼奥心脏研究，这是一项基于人群的心血管危险因素和糖尿病研究，于1979年至1988年进行。糖尿病男性发生心电图（ECG）记录的心肌梗死的可能性是非糖尿病男性的两倍多，而糖尿病女性发生心肌梗死的可能性是非糖尿病女性的三倍多。在两个种族群体中，心肌梗死与糖尿病之间的关联在男女两性中几乎相同。在两个种族群体中，糖尿病与传统冠心病危险因素（如甘油三酯、收缩压和高密度脂蛋白胆固醇）的关联在女性中也比男性更强。此外，这些关联在墨西哥裔美国人中至少与在非西班牙裔白人中一样强，甚至更强。因此，这些数据没有证据表明墨西哥裔美国人对糖尿病的脂质改变作用具有抵抗力。我们得出结论，墨西哥裔美国人种族对冠心病的保护作用可能部分被该种族群体中糖尿病的高患病率所掩盖。
