出生国和社会经济地位在 2 型糖尿病发生中的独立作用。
Independent roles of country of birth and socioeconomic status in the occurrence of type 2 diabetes.
机构信息
School of Medicine, University of Western Sydney, Sydney, Australia.
出版信息
BMC Public Health. 2013 Dec 23;13:1223. doi: 10.1186/1471-2458-13-1223.
BACKGROUND
There is strong evidence based on previous studies that ethnicity and socioeconomic status are important determinants of diversity in the occurrence of diabetes. However, the independent roles of socioeconomic status, country of birth and lifestyle factors in the occurrence of type 2 diabetes have not been clearly identified. This study investigated the relationships between socioeconomic status, country of birth and type 2 diabetes in a large diverse sample of residents of New South Wales, Australia, and aged 45 years and over.
METHODS
The analysis used self-reported baseline questionnaire data from 266,848 participants in the 45 and Up Study. Educational attainment, work status and income were used as indicators of socioeconomic status. Logistic regression models were built to investigate associations between socioeconomic status, country of birth and type 2 diabetes.
RESULTS
The adjusted odds of type 2 diabetes were significantly higher for people born in many overseas countries, compared to Australian-born participants. Compared with participants who had a university degree or higher qualification, the adjusted odds ratio (OR) for diabetes was higher in all other educational categories. Diabetes was more prevalent in people who were retired, unemployed or engaged in other types of work, compared with people who were in paid work. The prevalence of diabetes was higher in people with lower incomes. Compared with people who earned more than $50,000, the adjusted OR for diabetes was 2.05 (95% CI 1.95-2.14) for people who had an income less than $20,000 per annum. The relationships between socioeconomic factors and country of birth and diabetes were attenuated slightly when all were included in the model. Addition of smoking, obesity and physical activity to the model had marked impacts on adjusted ORs for some countries of birth, but relationships between diabetes and all measures of socioeconomic status and country of birth remained strong and significant.
CONCLUSIONS
Country of birth and socioeconomic status are independent predictors of type 2 diabetes. However, in this population, country of birth had a stronger association with type 2 diabetes.
背景
基于以往研究的有力证据表明，种族和社会经济地位是糖尿病发生多样性的重要决定因素。然而，社会经济地位、出生地和生活方式因素在 2 型糖尿病发生中的独立作用尚未明确确定。本研究调查了澳大利亚新南威尔士州年龄在 45 岁及以上的大量不同人群中社会经济地位、出生地与 2 型糖尿病之间的关系。
方法
该分析使用了来自 45 岁及以上研究的 266848 名参与者的基线自我报告问卷数据。教育程度、工作状况和收入用作社会经济地位的指标。建立了 logistic 回归模型来调查社会经济地位、出生地和 2 型糖尿病之间的关联。
结果
与澳大利亚出生的参与者相比，许多海外国家出生的人患 2 型糖尿病的调整后几率明显更高。与具有大学学位或更高学历的参与者相比，所有其他教育类别的糖尿病调整后比值比（OR）均较高。与从事有薪工作的人相比，退休、失业或从事其他类型工作的人患糖尿病的患病率更高。收入较低的人患糖尿病的比例更高。与收入超过 50000 澳元的人相比，年收入低于 20000 澳元的人患糖尿病的调整后 OR 为 2.05（95%CI 1.95-2.14）。当所有因素都包含在模型中时，社会经济因素与出生地和糖尿病之间的关系略有减弱。将吸烟、肥胖和身体活动添加到模型中对某些出生地的调整 OR 有明显影响，但糖尿病与所有社会经济地位和出生地衡量指标之间的关系仍然很强且具有统计学意义。
结论
出生地和社会经济地位是 2 型糖尿病的独立预测因素。然而，在本人群中，出生地与 2 型糖尿病的关联更强。
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