School of Medicine and Pharmacology, Fremantle Hospital, University of Western Australia, Fremantle, Western Australia, Australia.
Intern Med J. 2013 Oct;43(10):1125-32. doi: 10.1111/imj.12246.
Asian migrants represent an expanding proportion of the Australian population and are from a region with an increasing diabetes burden. There are few data detailing the characteristics and outcome of type 2 diabetes in Asian Australians.
To determine whether the phenotype and prognosis of Asians with type 2 diabetes differ from those in Anglo-Celt (AC) patients from the same Australian community.
We studied 44 Asian and 796 AC patients from the Fremantle Diabetes Study. Each had a detailed assessment between 1993 and 1996, and was invited to annual reviews for ≥5 years. Data linkage provided additional endpoints to end-2010. Cox proportional hazards modelling was used to determine predictors of cardiovascular disease (CVD) death and all-cause mortality.
The prevalence of type 2 diabetes in Asians and the general population in Fremantle was similar (1.5% vs 1.6%; P = 0.60). The Asian patients were younger, less obese and less likely to be hypertensive than the AC subjects, but they had a higher retinopathy prevalence (27.3% vs 13.5%; P = 0.023). During up to 18 years of follow up, 12 Asians and 428 AC patients died, 2 (16.7%) vs 205 (47.9%) from CVD (P = 0.040). Asian ethnicity was independently protective against CVD death (hazard ratio 0.13 (95% confidence interval: 0.02-0.96); P = 0.046) but not all-cause mortality (hazard ratio 0.58 ( 95% confidence interval: 0.31-1.10); P = 0.10).
The phenotype of type 2 diabetes in a relatively small group of well-characterised Asian Australians differed from that in AC patients from the same urban community. Their favourable cardiovascular prognosis may reflect a healthy migrant effect.
亚洲移民在澳大利亚人口中所占比例不断扩大，且他们来自糖尿病负担日益加重的地区。关于澳大利亚亚裔 2 型糖尿病患者的特征和结局，相关数据较少。
旨在明确与来自同一澳大利亚社区的盎格鲁-撒克逊（AC）患者相比，亚裔 2 型糖尿病患者的表型和预后是否存在差异。
我们研究了来自弗里曼特尔糖尿病研究的 44 名亚裔患者和 796 名 AC 患者。每位患者均于 1993 年至 1996 年间接受了详细评估，并受邀参加了至少 5 年的年度复查。数据链接提供了截至 2010 年底的其他终点。使用 Cox 比例风险模型确定心血管疾病（CVD）死亡和全因死亡率的预测因素。
在弗里曼特尔，亚裔和普通人群中 2 型糖尿病的患病率相似（1.5%比 1.6%；P=0.60）。亚裔患者比 AC 患者更年轻、体重较轻且高血压患病率较低，但他们的视网膜病变患病率较高（27.3%比 13.5%；P=0.023）。在长达 18 年的随访期间，有 12 名亚裔和 428 名 AC 患者死亡，2 名（16.7%）死于 CVD，205 名（47.9%）死于其他原因（P=0.040）。亚裔族群独立于其他因素，可降低 CVD 死亡风险（风险比 0.13（95%置信区间：0.02-0.96）；P=0.046），但对全因死亡率无影响（风险比 0.58（95%置信区间：0.31-1.10）；P=0.10）。
在一个相对较小的、特征明确的亚裔澳大利亚人群中，2 型糖尿病的表型与来自同一城市社区的 AC 患者不同。他们良好的心血管预后可能反映了健康移民效应。
