Boltri John M, Okosun Ike S, Davis-Smith Monique, Vogel Robert L
Mercer University School of Medicine, Department of Family Medicine, Macon, GA 31206, USA.
Ethn Dis. 2005 Autumn;15(4):562-7.
Although the prevalence of diabetes among various racial/ethnic groups has been well studied, little is known about the racial/ ethnic differences in Hemoglobin A1c (HbA1c) in diagnosed and undiagnosed diabetes. HbA1c correlates with morbidity and mortality in diabetes. Knowledge of the racial/ethnic differences in HbA1c would impact screening and intervention in primary care settings. This study describes racial/ethnic differences in HbA1c among US Black, Hispanic, and White diagnosed and undiagnosed persons with diabetes.
This study included participants in the 1999-2000 National Health and Nutrition Examination Survey who were > or =20 years old with a HbA1c measurement. The association between HbA1c and race in diagnosed and undiagnosed persons with diabetes (with body mass index [BMI] and age as covariates) was determined. The distribution of HbA1c and mean HbA1c in diagnosed and undiagnosed diabetes and the rates of diagnosed and undiagnosed diabetes with their corresponding HbA1c levels are described by race/ethnicity.
Estimated diabetes prevalence in US persons > or =20 years is 8.2%, with 2.3% having undiagnosed diabetes. Whites with diabetes had lower mean HbA1c levels (7.6%, standard error [SEI 0.2) than Blacks (8.1%, SE 0.3) or Hispanics (8.2%, SE .3). Whites with diagnosed diabetes were less likely to have HbA1c> or =11% (1.7%) than Blacks (11.1%) or Hispanics (10.4%). Hispanics with undiagnosed diabetes were more likely to have HbA1c-7% (60.5%) than Blacks (39.3%) or Whites (37.8%).
Significant numbers of persons with diabetes are undiagnosed. There are significant racial/ethnic differences in HbA1c levels, which are significantly higher in Blacks and Hispanics. Comprehensive risk-based screening and intervention for diabetes is needed in order to address racial and ethnic disparities, especially in minorities.
尽管已经对不同种族/族裔群体中糖尿病的患病率进行了充分研究，但对于已诊断和未诊断糖尿病患者的糖化血红蛋白（HbA1c）的种族/族裔差异却知之甚少。HbA1c与糖尿病的发病率和死亡率相关。了解HbA1c的种族/族裔差异将影响初级保健机构中的筛查和干预措施。本研究描述了美国黑人、西班牙裔和白人已诊断和未诊断糖尿病患者中HbA1c的种族/族裔差异。
本研究纳入了1999 - 2000年国家健康与营养检查调查中年龄≥20岁且有HbA1c测量值的参与者。确定了已诊断和未诊断糖尿病患者（以体重指数[BMI]和年龄作为协变量）中HbA1c与种族之间的关联。按种族/族裔描述了已诊断和未诊断糖尿病患者中HbA1c的分布、平均HbA1c以及已诊断和未诊断糖尿病的患病率及其相应的HbA1c水平。
估计美国≥20岁人群中的糖尿病患病率为8.2%，其中2.3%患有未诊断糖尿病。患有糖尿病的白人平均HbA1c水平（7.6%，标准误[SE] 0.2）低于黑人（8.1%，SE 0.3）或西班牙裔（8.2%，SE 0.3）。已诊断糖尿病的白人HbA1c≥11%的可能性（1.7%）低于黑人（11.1%）或西班牙裔（10.4%）。未诊断糖尿病的西班牙裔HbA1c≥7%的可能性（60.5%）高于黑人（39.3%）或白人（37.8%）。
大量糖尿病患者未被诊断。HbA1c水平存在显著的种族/族裔差异，黑人和西班牙裔的水平显著更高。需要进行基于综合风险的糖尿病筛查和干预，以解决种族和族裔差异问题，尤其是在少数族裔中。
