Harris M I
National Institutes of Health, Bethesda, MD 20892.
Diabetes Metab Rev. 1990 Mar;6(2):71-90. doi: 10.1002/dmr.5610060202.
This report presents an overview of the prevalence, characteristics, morbidity, mortality, and risk factors for noninsulin-dependent diabetes (NIDDM) in Blacks and Whites in the United States. Data are drawn primarily from national surveys, but the report also includes the few clinical studies that have differentiated the two races. NIDDM constitutes 90-95% of all diabetes in the United States and is more prevalent in Black Americans than in Whites. Diabetes prevalence increases with age for both races and reaches 26% among Blacks aged 65-74 years compared with 18% among Whites. Rates of diabetes among persons aged 20-74 years are 30% higher in White women, 70% higher in Black men, and 100% higher in Black women, compared with White men. Approximately half of diabetes is undiagnosed in both races. White and Black diabetics are similar with regard to age, duration of diabetes, and diabetes therapies, although Blacks of both sexes are more obese than their White counterparts. Rates of vision loss, amputations, and renal disease are 1.5-4 times higher in Blacks than in Whites, although prevalence of hypertension is about equal in the two races. Blacks and Whites see the same physician specialists for their diabetes, but Whites have approximately 40% more visits to office-based physicians each year. Diabetes-specific mortality has declined significantly in the past decade and may now be lower in Black than in White diabetics. Risk factors for diabetes, including age, sex, obesity, and family history of diabetes, all operate within both race groups and probably interact with each other. The effect of gender and family history on rates of diabetes is similar in Blacks and Whites. Blacks have higher rates of diabetes at each obesity level, indicating that obesity alone cannot explain the differential in prevalence between the races. Impaired glucose tolerance (IGT), a strong risk factor for development of diabetes, increases with age in all race/sex groups except for Black women older than 54 years in whom rates of IGT, decline, possibly because of conversion of IGT to diabetes.
本报告概述了美国黑人和白人中非胰岛素依赖型糖尿病（NIDDM）的患病率、特征、发病率、死亡率及风险因素。数据主要取自全国性调查，但该报告也纳入了少数区分这两个种族的临床研究。NIDDM占美国所有糖尿病病例的90%至95%，在美国黑人中比在白人中更为普遍。两个种族的糖尿病患病率均随年龄增长而上升，在65至74岁的黑人中达到26%，而在白人中为18%。与白人男性相比，20至74岁人群中，白人女性的糖尿病发病率高30%，黑人男性高70%，黑人女性高100%。两个种族中约一半的糖尿病患者未被诊断出来。白人和黑人糖尿病患者在年龄、糖尿病病程及糖尿病治疗方面相似，不过两个性别的黑人都比白人更肥胖。黑人的视力丧失、截肢和肾病发生率比白人高1.5至4倍，尽管两个种族的高血压患病率大致相当。黑人和白人因糖尿病看相同的专科医生，但白人每年看门诊医生的次数比黑人多约40%。在过去十年中，糖尿病特异性死亡率显著下降，现在黑人糖尿病患者的死亡率可能低于白人。糖尿病的风险因素，包括年龄、性别、肥胖及糖尿病家族史，在两个种族群体中均起作用，且可能相互影响。性别和家族史对糖尿病发病率的影响在黑人和白人中相似。在每个肥胖水平上，黑人的糖尿病发病率都更高，这表明仅肥胖不能解释两个种族之间患病率的差异。糖耐量受损（IGT）是糖尿病发展的一个重要风险因素，在所有种族/性别群体中均随年龄增长而上升，但54岁以上的黑人女性除外，在她们中IGT发生率下降，这可能是因为IGT转化为糖尿病。
