Department of Diabetes and Endocrinology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, University Paris-Diderot Paris-7, Paris, France; Department of Clinical Sciences, Faculty of Health Sciences, University of Buea, Buea, Cameroon.
Department of Diabetes and Endocrinology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, University Paris-Diderot Paris-7, Paris, France.
Diabetes Metab. 2014 Feb;40(1):56-60. doi: 10.1016/j.diabet.2013.07.004. Epub 2013 Sep 26.
This study compared the clinical and biochemical characteristics and microvascular complications found in three groups of type 2 diabetes (T2D) patients: Africans living in Africa; African immigrants living in France; and Caucasians living in France.
Diagnosed T2D Africans living in Cameroon (n=100) were compared with 98 African migrants diagnosed with T2D after having moved to France, and a group of 199 T2D Caucasian patients living in France. All underwent clinical and biochemical evaluations, and all were assessed for microvascular complications.
The median duration of stay of the migrants in France was 15years before being diagnosed with diabetes. Despite similar durations of diagnosis, they were 8.9years younger at the time of diagnosis than Africans living in Cameroon (P<0.001). Caucasians and African immigrants in France had lower HbA1c values than Africans in Cameroon (P<0.001); they were also more aggressively treated for hypertension and dyslipidaemia and, therefore, had significantly lower blood pressure levels and better lipid profiles. Diabetic nephropathy and retinopathy rates were higher in Cameroon than in the two other groups. After adjusting for age, diabetes duration, HbA1c, hypertension and other covariates, only the prevalence of diabetic nephropathy (OR: 5.61, 95% CI: 2.32-13.53; P<0.0001) was higher in Cameroon compared with those living in France.
Our results suggest that Africans who emigrate to France may develop diabetes earlier than those staying in their home country. However, the latter may be a reflection of late diagnosis of diabetes. Also, the less adequate diabetes and hypertension control in the latter would explain their higher rates of nephropathy. Large-scale cohorts are now warranted to substantiate these observations.
本研究比较了三组 2 型糖尿病（T2D）患者的临床和生化特征及微血管并发症：非洲裔居住在非洲的人群；移居法国的非洲移民；以及居住在法国的白种人。
将喀麦隆的 100 名诊断为 T2D 的非洲裔患者与移居法国后被诊断为 T2D 的 98 名非洲移民进行比较，并与居住在法国的 199 名 T2D 白种人患者进行比较。所有患者均接受了临床和生化评估，并评估了微血管并发症。
移民在法国的居住时间中位数为 15 年，然后被诊断出患有糖尿病。尽管诊断时间相似，但与居住在喀麦隆的非洲人相比，他们的诊断年龄小 8.9 岁（P<0.001）。法国的白种人和非洲移民的 HbA1c 值低于喀麦隆的非洲人（P<0.001）；他们也更积极地治疗高血压和血脂异常，因此血压水平显著降低，血脂谱更好。喀麦隆的糖尿病肾病和视网膜病变发生率高于其他两组。在调整年龄、糖尿病病程、HbA1c、高血压和其他混杂因素后，只有糖尿病肾病的患病率（比值比：5.61，95%可信区间：2.32-13.53；P<0.0001）在喀麦隆高于法国。
我们的结果表明，移居法国的非洲人可能比留在祖国的人更早患上糖尿病。然而，后者可能反映了糖尿病的晚期诊断。此外，后者糖尿病和高血压的控制较差，这解释了他们更高的肾病发生率。现在需要大规模的队列研究来证实这些观察结果。
