Division of General Internal Medicine, University of British Columbia, British Columbia, Canada.
Diabetes Care. 2011 Jan;34(1):96-101. doi: 10.2337/dc10-0865. Epub 2010 Oct 26.
Diabetes guidelines recommend aggressive screening for type 2 diabetes in Asian patients because they are considered to have a higher risk of developing diabetes and potentially worse prognosis. We determined incidence of diabetes and risk of death or macrovascular complications by sex among major Asian subgroups, South Asian and Chinese, and white patients with newly diagnosed diabetes.
Using population-based administrative data from British Columbia and Alberta, Canada (1997-1998 to 2006-2007), we identified patients with newly diagnosed diabetes aged ≥35 years and followed them for up to 10 years for death, acute myocardial infarction, stroke, or hospitalization for heart failure. Ethnicity was determined using validated surname algorithms.
There were 15,066 South Asian, 17,754 Chinese, and 244,017 white patients with newly diagnosed diabetes. Chinese women and men had the lowest incidence of diabetes relative to that of white or South Asian patients, who had the highest incidence. Mortality in those with newly diagnosed diabetes was lower in South Asian (hazard ratio 0.69 [95% CI 0.62-0.76], P < 0.001) and Chinese patients (0.69 [0.63-0.74], P < 0.001) then in white patients. Risk of acute myocardial infarction, stroke, or heart failure was similar or lower in the ethnic groups relative to that of white patients and varied by sex.
The incidence of diagnosed diabetes varies significantly among ethnic groups. Mortality was substantially lower in South Asian and Chinese patients with newly diagnosed diabetes than in white patients.
糖尿病指南建议对亚洲患者进行 2 型糖尿病的积极筛查，因为他们被认为患糖尿病的风险更高，且可能预后更差。我们确定了在新诊断患有糖尿病的主要亚洲亚组（南亚和华裔）和白人患者中，按性别划分的糖尿病发病率和死亡或大血管并发症风险。
我们利用来自加拿大不列颠哥伦比亚省和艾伯塔省的基于人群的行政数据（1997-1998 年至 2006-2007 年），确定了年龄≥35 岁的新诊断为糖尿病的患者，并对其进行了长达 10 年的随访，以记录死亡、急性心肌梗死、中风或心力衰竭住院情况。通过验证姓氏算法确定种族。
有 15066 名南亚裔、17754 名华裔和 244017 名白人新诊断为糖尿病。华裔男女的糖尿病发病率相对白人或南亚患者最低，而后者的发病率最高。新诊断为糖尿病的患者中，南亚裔（风险比 0.69[95%CI 0.62-0.76]，P<0.001）和华裔（0.69[0.63-0.74]，P<0.001）患者的死亡率均低于白人患者。与白人患者相比，各民族的急性心肌梗死、中风或心力衰竭风险相似或更低，且存在性别差异。
诊断出的糖尿病发病率在不同种族之间存在显著差异。新诊断患有糖尿病的南亚裔和华裔患者的死亡率明显低于白人患者。
