Koya Deepika L, Egede Leonard E
Department of Medicine, Division of General Internal Medicine & Center for Health Disparities Research, Medical University of South Carolina, 135 Rutledge Avenue, Room 280H, Charleston, SC 29425, USA.
J Gen Intern Med. 2007 Jun;22(6):841-6. doi: 10.1007/s11606-007-0163-y. Epub 2007 Mar 9.
Although differences in cardiovascular disease (CVD) risk factors between immigrants and nonimmigrants have been examined previously, the effect of acculturation on CVD risk factors in immigrants has been less well studied.
To determine the association between length of U.S. residence (proxy for acculturation) and major CVD risk factors.
Data on 5,230 immigrant adults from the 2002 National Health Interview Survey (NHIS) was analyzed. Primary independent variable was length of U.S. residence < 10, 10 to < 15, and > or = 15 years. Main outcome measures included obesity, hypertension, diabetes, hyperlipidemia, smoking, and physical inactivity. Multiple logistic regression was used to assess the association between length of residence and odds of multiple CVD risk factors adjusting for confounders. SAS-callable SUDAAN was used for statistical analysis.
Among the patients, 55.4% were obese, 17.3% had hypertension, 15.9% had hyperlipidemia, 6.6% had diabetes, 79.3% were physically inactive, and 14.3% were smokers. Using < 10 years as reference, those with length of residence > or = 15 years were more likely to be obese (OR 1.31, 95% CI 1.03-1.65), have hyperlipidemia (OR 1.59, 95% CI 1.14-2.22), and be smokers (OR 1.39, 95% CI 1.04-1.85). Length of residence > or = 15 years was associated with decreased odds of sedentary lifestyle (OR 0.63, 95% CI 0.47-0.84). Length of residence > or = 15 years was not associated with odds of having diabetes (OR 1.40, 95% CI 0.78-2.51) or hypertension (OR 1.21, 95% CI 0.86-1.71).
Among immigrants from diverse ethnic backgrounds, longer length of residence in the United States is associated with increased odds of obesity, hyperlipidemia, and cigarette smoking even after adjusting for relevant confounding factors.
尽管此前已对移民和非移民之间心血管疾病(CVD)风险因素的差异进行了研究,但文化适应对移民CVD风险因素的影响研究较少。
确定在美国居住时间(文化适应的替代指标)与主要CVD风险因素之间的关联。
分析了2002年美国国家健康访谈调查(NHIS)中5230名成年移民的数据。主要自变量为在美国的居住时间<10年、10至<15年以及≥15年。主要结局指标包括肥胖、高血压、糖尿病、高脂血症、吸烟和身体活动不足。采用多因素logistic回归评估居住时间与经混杂因素校正后的多种CVD风险因素发生几率之间的关联。使用可调用SAS的SUDAAN进行统计分析。
在这些患者中,55.4%为肥胖,17.3%患有高血压,15.9%患有高脂血症,6.6%患有糖尿病,79.3%身体活动不足,14.3%为吸烟者。以<10年作为参照,居住时间≥15年的人更有可能肥胖(比值比[OR]1.31,95%置信区间[CI]1.03 - 1.65)、患有高脂血症(OR 1.59,95% CI 1.14 - 2.22)以及吸烟(OR 1.39,95% CI 1.04 - 1.85)。居住时间≥15年与久坐不动生活方式的发生几率降低相关(OR 0.63,95% CI 0.47 - 0.84)。居住时间≥15年与患糖尿病(OR 1.40,95% CI 0.78 - 2.51)或高血压(OR 1.21,95% CI 0.86 - 1.71)的几率无关。
在来自不同种族背景的移民中,即使在调整了相关混杂因素后,在美国居住时间较长仍与肥胖、高脂血症和吸烟几率增加相关。