Kandula Namratha R, Diez-Roux Ana V, Chan Cheeling, Daviglus Martha L, Jackson Sharon A, Ni Hanyu, Schreiner Pamela J
Division of General Internal Medicine, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.
Diabetes Care. 2008 Aug;31(8):1621-8. doi: 10.2337/dc07-2182. Epub 2008 May 5.
The prevalence of type 2 diabetes among Hispanic and Asian Americans is increasing. These groups are largely comprised of immigrants who may be undergoing behavioral and lifestyle changes associated with development of diabetes. We studied the association between acculturation and diabetes in a population sample of 708 Mexican-origin Hispanics, 547 non-Mexican-origin Hispanics, and 737 Chinese participants in the Multi-Ethnic Study of Atherosclerosis (MESA).
Diabetes was defined as fasting glucose >/=126 mg/dl and/or use of antidiabetic medications. An acculturation score was calculated for all participants using nativity, years living in the U.S., and language spoken at home. The score ranged from 0 to 5 (0 = least acculturated and 5 = most acculturated). Relative risk regression was used to estimate the association between acculturation and diabetes.
For non-Mexican-origin Hispanics, the prevalence of diabetes was positively associated with acculturation score, after adjustment for sociodemographics. The prevalence of diabetes was significantly higher among the most acculturated versus the least acculturated non-Mexican-origin Hispanics (prevalence ratio 2.49 [95% CI 1.14-5.44]); the higher the acculturation score is, the higher the prevalence of diabetes (P for trend 0.059). This relationship between acculturation and diabetes was partly attenuated after adjustment for BMI or diet. Diabetes prevalence was not related to acculturation among Chinese or Mexican-origin Hispanics.
Among non-Mexican-origin Hispanics in MESA, greater acculturation is associated with higher diabetes prevalence. The relation is at least partly mediated by BMI and diet. Acculturation is a factor that should be considered when predictors of diabetes in racial/ethnic groups are examined.
西班牙裔和亚裔美国人中2型糖尿病的患病率正在上升。这些群体主要由移民组成，他们可能正在经历与糖尿病发展相关的行为和生活方式变化。我们在动脉粥样硬化多族裔研究（MESA）中，对708名墨西哥裔西班牙人、547名非墨西哥裔西班牙人和737名华裔参与者的人群样本进行了研究，以探讨文化适应与糖尿病之间的关联。
糖尿病定义为空腹血糖≥126mg/dl和/或使用抗糖尿病药物。使用出生地、在美国居住的年限以及在家中使用的语言，为所有参与者计算文化适应得分。得分范围为0至5（0=文化适应程度最低，5=文化适应程度最高）。采用相对风险回归来估计文化适应与糖尿病之间的关联。
对于非墨西哥裔西班牙人，在调整社会人口统计学因素后，糖尿病患病率与文化适应得分呈正相关。文化适应程度最高的非墨西哥裔西班牙人比文化适应程度最低的人群糖尿病患病率显著更高（患病率比2.49[95%CI 1.14 - 5.44]）；文化适应得分越高，糖尿病患病率越高（趋势P值为0.059）。在调整体重指数（BMI）或饮食因素后，这种文化适应与糖尿病之间的关系部分减弱。华裔或墨西哥裔西班牙人的糖尿病患病率与文化适应无关。
在MESA研究中的非墨西哥裔西班牙人里，更高的文化适应程度与更高的糖尿病患病率相关。这种关系至少部分由BMI和饮食介导。在研究种族/族裔群体糖尿病的预测因素时，文化适应是一个应考虑的因素。
