University of Hawaii Cancer Center, Honolulu, HI 96813, USA.
Ann Epidemiol. 2011 Jul;21(7):526-35. doi: 10.1016/j.annepidem.2011.03.009. Epub 2011 Apr 16.
To estimate the population-attributable risk (PAR) associated with modifiable risk factors for diabetes among Caucasians, Native Hawaiians, and Japanese Americans in the Hawaii component of the Multiethnic Cohort.
This analysis is based on 74,970 cohort participants ages 45-75 years who completed a questionnaire on demographics, diet, and lifestyle factors in 1993-1996. After a mean follow-up time of 12.1 (0.01-14.4) years, 8,559 diabetes cases were identified by self-report, a medication questionnaire, and through health plan linkages. Hazard ratios for diabetes and partial PARs for single and different combinations of modifiable risk factors were estimated.
Overweight, physical inactivity, high meat intake, no alcohol consumption, and smoking were positively associated with diabetes risk in all ethnic groups. The estimated PARs suggested that among men, 78%, and among women, 83%, of new diabetes cases could have been avoided if all individuals had been in the low risk category for all of the modifiable risk factors. The slightly lower PARs in Japanese Americans were not significantly different from those in Caucasian and Native Hawaiian subjects.
Although PARs varied slightly over ethnicity, our findings do not support ethnic-specific prevention strategies; interventions targeted at multiple behaviors are needed in all ethnic groups.
评估可改变的糖尿病风险因素在夏威夷多民族队列的白种人、夏威夷原住民和日裔美国人中的人群归因风险（PAR）。
本分析基于 1993-1996 年完成了人口统计学、饮食和生活方式因素问卷的 74970 名 45-75 岁队列参与者。在平均 12.1 年（0.01-14.4 年）的随访后，通过自我报告、药物问卷和健康计划联系确定了 8559 例糖尿病病例。估计了糖尿病的风险比和单一及不同组合的可改变风险因素的部分 PAR。
超重、身体活动不足、高肉类摄入、不饮酒和吸烟与所有族裔的糖尿病风险呈正相关。估计的 PAR 表明，如果所有个体的所有可改变风险因素都处于低风险类别，那么男性中有 78%，女性中有 83%的新糖尿病病例是可以避免的。日裔美国人的 PAR 略低，但与白种人和夏威夷原住民的 PAR 没有显著差异。
尽管 PAR 在种族间略有差异，但我们的研究结果并不支持特定于种族的预防策略；所有族裔都需要针对多种行为的干预措施。
