Department of Psychological Medicine, Institute of Psychiatry, King's College London, London SE5 8AZ, UK.
Diabetologia. 2013 Jun;56(6):1272-81. doi: 10.1007/s00125-013-2873-5. Epub 2013 Mar 14.
AIMS/HYPOTHESIS: This study aimed to investigate the clinical features of newly diagnosed type 2 diabetes in an urban multi-ethnic cohort.
A population-based cross-sectional design was used. People diagnosed with type 2 diabetes in the preceding 6 months were recruited from primary care practices in three adjacent inner-city boroughs of South London, serving a population in which 20% of residents are of black African or Caribbean ethnicity. Sociodemographic and biomedical data were collected by standardised clinical assessment and from medical records. Multiple logistic regression methods were used to report associations between ethnicity and diabetes-complication status.
From 96 general practices, 1,506 patients were recruited. Their mean age was 55.6 (± 11.07) years, 55% were men, 60% were asymptomatic at diagnosis and 51%, 38% and 11% were of white, black and South Asian/other ethnicity, respectively. Compared with white participants, black and South Asian/other participants were: younger (mean age 58.9 [± 10.09], 52.4 [± 11.19] and 51.5 [± 10.42] years, respectively; p < 0.0001); less likely to have neuropathy (10.1%, 3.6% and 4.4%; p < 0.0001) or report coronary artery disease (12.7%, 4.8% and 7.3%; p < 0.0001). In logistic regression, compared with white participants, black participants had lower levels of macrovascular complications (OR 0.52, 95% CI 0.32, 0.84; p = 0.01). Male sex was independently associated with microvascular disease (OR 1.69, 95% CI 1.26, 2.28; p < 0.0001).
CONCLUSIONS/INTERPRETATION: The prevalence of complications at time of diagnosis was lower than expected, especially in black and South Asian/other ethnic groups. However, in multi-ethnic inner-city populations, onset of type 2 diabetes occurred almost 10 years earlier in non-white populations than in white participants, predicating a prolonged morbidity.
目的/假设：本研究旨在调查城市多民族队列中新发 2 型糖尿病的临床特征。
采用基于人群的横断面设计。从伦敦三个相邻内城区的基层医疗实践中招募了在过去 6 个月内被诊断患有 2 型糖尿病的人群，这些地区的居民中有 20%是非洲裔或加勒比裔。通过标准化临床评估和病历收集社会人口统计学和生物医学数据。采用多逻辑回归方法报告种族与糖尿病并发症状况之间的关联。
从 96 家全科诊所招募了 1506 名患者。他们的平均年龄为 55.6（±11.07）岁，55%为男性，60%在诊断时无症状，51%、38%和 11%分别为白种人、黑人和南亚/其他种族。与白人参与者相比，黑人参与者和南亚/其他参与者：年龄更小（平均年龄分别为 58.9（±10.09）、52.4（±11.19）和 51.5（±10.42）岁；p <0.0001）；神经病变的可能性较低（10.1%、3.6%和 4.4%；p <0.0001）或报告冠心病（12.7%、4.8%和 7.3%；p <0.0001）。在逻辑回归中，与白人参与者相比，黑人参与者的大血管并发症水平较低（OR 0.52，95%CI 0.32，0.84；p = 0.01）。男性独立与微血管疾病相关（OR 1.69，95%CI 1.26，2.28；p <0.0001）。
结论/解释：诊断时并发症的患病率低于预期，尤其是在黑人和南亚/其他族裔群体中。然而，在多民族的市中心人口中，非白人人群的 2 型糖尿病发病年龄比白人参与者早近 10 年，预示着更长的发病期。
