Centre for Research on Inner City Health, Keenan Research Centre, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Universityof Toronto, Toronto, Ont.
CMAJ. 2010 May 18;182(8):781-9. doi: 10.1503/cmaj.091551. Epub 2010 Apr 19.
The majority of immigrants to Canada originate from the developing world, where the most rapid increase in prevalence of diabetes mellitus is occurring. We undertook a population-based study involving immigrants to Ontario, Canada, to evaluate the distribution of risk for diabetes in this population.
We used linked administrative health and immigration records to calculate age-specific and age-adjusted prevalence rates among men and women aged 20 years or older in 2005. We compared rates among 1,122,771 immigrants to Ontario by country and region of birth to rates among long-term residents of the province. We used logistic regression to identify and quantify risk factors for diabetes in the immigrant population.
After controlling for age, immigration category, level of education, level of income and time since arrival, we found that, as compared with immigrants from western Europe and North America, risk for diabetes was elevated among immigrants from South Asia (odds ratio [OR] for men 4.01, 95% CI 3.82-4.21; OR for women 3.22, 95% CI 3.07-3.37), Latin America and the Caribbean (OR for men 2.18, 95% CI 2.08-2.30; OR for women 2.40, 95% CI: 2.29-2.52), and sub-Saharan Africa (OR for men 2.31, 95% CI 2.17-2.45; OR for women 1.83, 95% CI 1.72-1.95). Increased risk became evident at an early age (35-49 years) and was equally high or higher among women as compared with men. Lower socio-economic status and greater time living in Canada were also associated with increased risk for diabetes.
Recent immigrants, particularly women and immigrants of South Asian and African origin, are at high risk for diabetes compared with long-term residents of Ontario. This risk becomes evident at an early age, suggesting that effective programs for prevention of diabetes should be developed and targeted to immigrants in all age groups.
加拿大的移民多数来自发展中国家，而这些国家的糖尿病发病率增长最快。我们开展了一项基于人群的研究，对象是加拿大安大略省的移民，以评估该人群的糖尿病发病风险分布。
我们使用链接的行政健康和移民记录，计算了 2005 年年龄在 20 岁及以上的男性和女性的年龄特异性和年龄调整患病率。我们将移民的患病率与该省的长期居民进行了比较，移民按原籍国和地区进行了分类。我们使用逻辑回归识别和量化了移民人群中糖尿病的危险因素。
在控制了年龄、移民类别、教育程度、收入水平和到达时间后，我们发现与来自西欧和北美的移民相比，来自南亚（男性的比值比[OR]为 4.01，95%置信区间[CI]为 3.82-4.21；女性的 OR 为 3.22，95%CI 为 3.07-3.37）、拉丁美洲和加勒比地区（男性的 OR 为 2.18，95%CI 为 2.08-2.30；女性的 OR 为 2.40，95%CI 为 2.29-2.52）和撒哈拉以南非洲地区（男性的 OR 为 2.31，95%CI 为 2.17-2.45；女性的 OR 为 1.83，95%CI 为 1.72-1.95）的糖尿病发病风险更高。这种风险在早年（35-49 岁）就已经显现，而且女性的风险与男性一样高，甚至更高。较低的社会经济地位和在加拿大生活的时间更长也与糖尿病发病风险增加相关。
与安大略省的长期居民相比，新移民，特别是南亚和非洲裔移民中的女性，患糖尿病的风险较高。这种风险在早年就已经显现，这表明应该为所有年龄段的移民制定和实施有效的糖尿病预防计划。
