与挪威人相比，五种少数民族群体的糖尿病状态心血管疾病。
Cardiovascular disease by diabetes status in five ethnic minority groups compared to ethnic Norwegians.
机构信息
Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway.
出版信息
BMC Public Health. 2011 Jul 13;11:554. doi: 10.1186/1471-2458-11-554.
BACKGROUND
The population in Norway has become multi-ethnic due to migration from Asia and Africa over the recent decades. The aim of the present study was to explore differences in the self-reported prevalence of cardiovascular disease (CVD) and associated risk factors by diabetes status in five ethnic minority groups compared to ethnic Norwegians.
METHODS
Pooled data from three population-based cross-sectional studies conducted in Oslo between 2000 and 2002 was used. Of 54,473 invited individuals 24,749 (45.4%) participated. The participants self-reported health status, underwent a clinical examination and blood samples were drawn. A total of 17,854 individuals aged 30 to 61 years born in Norway, Sri-Lanka, Pakistan, Iran, Vietnam or Turkey were included in the study. Chi-square tests, one-way ANOVAs, ANCOVAs, multiple and logistic regression were used.
RESULTS
Age- and gender-standardized prevalence of self-reported CVD varied between 5.8% and 8.2% for the ethnic minority groups, compared to 2.9% among ethnic Norwegians (p < 0.001). Prevalence of self-reported diabetes varied from 3.0% to 15.0% for the ethnic minority groups versus 1.8% for ethnic Norwegians (p < 0.001). Among individuals without diabetes, the CVD prevalence was 6.0% versus 2.6% for ethnic minorities and Norwegians, respectively (p < 0.001). Corresponding CVD prevalence rates among individuals with diabetes were 15.3% vs. 12.6% (p = 0.364). For individuals without diabetes, the odds ratio (OR) for CVD in the ethnic minority groups remained significantly higher (range 1.5-2.6) than ethnic Norwegians (p < 0.05), after adjustment for age, gender, education, employment, and body height, except for Turkish individuals. Regardless of diabetes status, obesity and physical inactivity were prevalent in the majority of ethnic minority groups, whereas systolic- and diastolic- blood pressures were higher in Norwegians. In nearly all ethnic groups, individuals with diabetes had higher triglycerides, waist-to-hip ratio (WHR), and body mass index compared to individuals without diabetes. Age, diabetes, hypertension, hypercholesterolemia, and WHR were significant predictors of CVD in both ethnic Norwegians and ethnic minorities, but significant ethnic differences were found for age, diabetes, and hypercholesterolemia.
CONCLUSIONS
Ethnic differences in the prevalence of CVD were prominent for individuals without diabetes. Primary CVD prevention including identification of undiagnosed diabetes should be prioritized for ethnic minorities without known diabetes.
背景
由于近几十年来亚洲和非洲移民的涌入，挪威人口已经呈现出多元化。本研究的目的是探讨五个少数族裔群体与挪威族裔相比，不同糖尿病状态下心血管疾病（CVD）的自我报告患病率和相关危险因素的差异。
方法
本研究使用了 2000 年至 2002 年在奥斯陆进行的三项基于人群的横断面研究的汇总数据。在受邀的 54473 人中，有 24749 人（45.4%）参与了研究。参与者自我报告了健康状况，接受了临床检查并抽取了血液样本。共有 17854 名年龄在 30 至 61 岁之间的人，他们出生于挪威、斯里兰卡、巴基斯坦、伊朗、越南或土耳其，纳入了本研究。使用了卡方检验、单因素方差分析、协方差分析、多元和逻辑回归。
结果
在年龄和性别标准化的基础上，少数族裔群体的自我报告 CVD 患病率为 5.8%至 8.2%，而挪威族裔为 2.9%（p<0.001）。少数族裔群体的自我报告糖尿病患病率为 3.0%至 15.0%，而挪威族裔为 1.8%（p<0.001）。在没有糖尿病的人群中，CVD 患病率为 6.0%，而少数族裔和挪威族裔分别为 2.6%（p<0.001）。在患有糖尿病的人群中，相应的 CVD 患病率分别为 15.3%和 12.6%（p=0.364）。对于没有糖尿病的人群，少数族裔群体的 CVD 比值比（OR）仍然显著高于挪威族裔（范围为 1.5-2.6）（p<0.05），调整年龄、性别、教育、就业和身高后，除了土耳其人。无论是否患有糖尿病，大多数少数族裔群体都普遍存在肥胖和身体活动不足，而挪威人的收缩压和舒张压都较高。在几乎所有族裔群体中，患有糖尿病的个体的甘油三酯、腰臀比（WHR）和体重指数都高于没有糖尿病的个体。年龄、糖尿病、高血压、高胆固醇血症和 WHR 是挪威族裔和少数族裔 CVD 的重要预测因素，但在年龄、糖尿病和高胆固醇血症方面存在显著的族裔差异。
结论
在没有糖尿病的个体中，CVD 的患病率存在显著的族裔差异。应优先考虑对没有已知糖尿病的少数族裔进行初级 CVD 预防，包括发现未确诊的糖尿病。
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