巴基斯坦南亚裔人群中糖尿病与中心性肥胖的种族差异及决定因素

Ethnic differences and determinants of diabetes and central obesity among South Asians of Pakistan.

作者信息

Jafar T H, Levey A S, White F M, Gul A, Jessani S, Khan A Q, Jafary F H, Schmid C H, Chaturvedi N

机构信息

Clinical Epidemiology Unit, Department of Community Health Sciences, The Aga Khan University, PO Box 3500, Stadium Road, Karachi, Pakistan.

出版信息

Diabet Med. 2004 Jul;21(7):716-23. doi: 10.1111/j.1464-5491.2004.01140.x.

DOI:10.1111/j.1464-5491.2004.01140.x

PMID:15209764

Abstract

AIMS

To study the within ethnic subgroup variations in diabetes and central obesity among South Asians.

METHODS

Data from 9442 individuals age > or = 15 years from the National Health Survey of Pakistan (NHSP) (1990-1994) were analysed. Diabetes was defined as non-fasting blood glucose > or = 7.8 mmol/l, or known history of diabetes. Central obesity was measured at the waist circumference. Distinct ethnic subgroups Muhajir, Punjabi, Sindhi, Pashtun, and Baluchi were defined by mother tongue.

RESULTS

The age-standardized prevalence of diabetes varied among ethnic subgroups (P = 0.002), being highest among the Muhajirs (men 5.7%, women 7.9%), then Punjabis (men 4.6%, women 7.2%), Sindhis (men 5.1%, women 4.8%), Pashtuns (men 3.0%, women 3.8%), and lowest among the Baluchis (men 2.9%, women 2.6%). While diabetes was more prevalent in urban vs. rural dwellers [odds ratio (OR) 1.50, 95% confidence interval (CI) 1.24, 1.82], this difference was no longer significant after adjusting for central obesity (OR 1.15, 95% CI 0.95, 1.42). However, the ethnic differences persisted after adjusting for major sociodemographic risk factors (unadjusted OR for Pashtun vs. Punjabi 0.59, 95% CI 0.42, 0.84, adjusted OR 0.54, 95% CI 0.37, 0.78). Ethnic variation was also observed in central obesity, which varied with gender, and did not necessarily track with ethnic differences in diabetes.

CONCLUSIONS

Unmeasured environmental or genetic factors account for ethnic variations in diabetes and central obesity, and deserve further study.

摘要

目的

研究南亚人群中不同族裔亚组的糖尿病和中心性肥胖差异。

方法

分析了来自巴基斯坦全国健康调查（NHSP）（1990 - 1994年）的9442名年龄≥15岁个体的数据。糖尿病定义为非空腹血糖≥7.8 mmol/l或有糖尿病病史。通过腰围测量中心性肥胖。根据母语定义了不同的族裔亚组，包括穆哈吉尔人、旁遮普人、信德人、普什图人和俾路支人。

结果

糖尿病的年龄标准化患病率在不同族裔亚组中存在差异（P = 0.002），在穆哈吉尔人中最高（男性5.7%，女性7.9%），其次是旁遮普人（男性4.6%，女性7.2%）、信德人（男性5.1%，女性4.8%）、普什图人（男性3.0%，女性3.8%），在俾路支人中最低（男性2.9%，女性2.6%）。虽然糖尿病在城市居民中比农村居民更普遍[优势比（OR）1.50，95%置信区间（CI）1.24，1.82]，但在调整中心性肥胖后，这种差异不再显著（OR 1.15，95% CI 0.95，1.42）。然而，在调整主要社会人口学风险因素后，族裔差异仍然存在（普什图人与旁遮普人的未调整OR为0.59，95% CI 0.42，0.84，调整后OR为0.54，95% CI 0.37，0.78）。在中心性肥胖方面也观察到族裔差异，其因性别而异，且不一定与糖尿病的族裔差异一致。