School of Community and Environmental Health, Old Dominion University, Norfolk, VA, USA.
Ethn Health. 2009 Oct;14(5):439-57. doi: 10.1080/13557850802699155.
Ethnic minority status and obesity are two independent risk factors for Type 2 diabetes (T2D). There is no clear understanding of how they may have interacted and influenced disparities in T2D prevalence over time. This study examined the trends in racial/ethnic disparities in the prevalence of T2D by weight status among US adults.
We used nationally representative data from the National Health and Nutrition Examination Surveys I (1971-1975), II (1976-1980), and III (1988-1994), and 1999-2004 among 49,574 adults aged 20-74 years. The prevalences of diagnosed and undiagnosed T2D were estimated by race/ethnicity groups (non-Hispanic White, non-Hispanic Black, and Mexican American) and body mass index (BMI) groups (normal, 18.5-24.9; overweight, 25-29.9; obese, 30-34.9; severely obese, >or=35). We used logistic regression controlling for age, gender, and education to estimate the odds ratio of T2D across race/ethnicity and BMI groups.
Trends in racial/ethnic disparities in prevalence of diagnosed T2D varied by BMI. Normal weight group saw increasing racial disparities. In the overweight group, ethnic disparities worsened as diabetes prevalence increased 33.3% in Whites, compared to 60.0% in Blacks, and 227.3% in Mexican Americans. Minimal racial/ethnic disparities were observed in obese and severely obese groups over time. In contrast to diagnosed diabetes, overall racial/ethnic disparities in undiagnosed T2D declined in all BMI groups.
Racial/ethnic disparities in diabetes prevalence have become most pronounced among normal and overweight groups. Eliminating racial/ethnic disparities in diabetes will require prevention efforts not only in obese minority individuals, but also in normal and overweight minority individuals.
少数民族身份和肥胖是 2 型糖尿病（T2D）的两个独立危险因素。目前尚不清楚它们如何相互作用并影响 T2D 患病率随时间的变化。本研究调查了美国成年人中按体重状况划分的 T2D 种族/民族差异的趋势。
我们使用了全国代表性数据，包括国家健康和营养检查调查 I（1971-1975 年）、II（1976-1980 年）和 III（1988-1994 年）以及 1999-2004 年期间 49574 名 20-74 岁的成年人的数据。通过种族/族裔群体（非西班牙裔白人、非西班牙裔黑人、墨西哥裔美国人）和体重指数（BMI）群体（正常，18.5-24.9；超重，25-29.9；肥胖，30-34.9；严重肥胖，≥35）估计诊断和未诊断的 T2D 的患病率。我们使用 logistic 回归控制年龄、性别和教育程度，以估计 T2D 在不同种族/族裔和 BMI 群体之间的优势比。
按 BMI 划分的 T2D 患病率的种族/族裔差异趋势各不相同。正常体重组的种族差异不断扩大。在超重组中，随着白人糖尿病患病率增加 33.3%，而黑人增加 60.0%，墨西哥裔美国人增加 227.3%，族裔差异恶化。在肥胖和严重肥胖组中，随着时间的推移，种族/族裔差异最小。与诊断出的糖尿病相反，所有 BMI 组中未诊断出的 T2D 的总体种族/族裔差异均有所下降。
糖尿病患病率的种族/族裔差异在正常体重和超重组中最为明显。要消除糖尿病的种族/族裔差异，不仅需要在肥胖的少数族裔个体中，而且需要在正常和超重的少数族裔个体中开展预防工作。
