Shah Arti D, Vittinghoff Eric, Kandula Namratha R, Srivastava Shweta, Kanaya Alka M
Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Francisco, San Francisco.
Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco.
Ann Epidemiol. 2015 Feb;25(2):77-83. doi: 10.1016/j.annepidem.2014.10.013. Epub 2014 Oct 22.
In this study, we aim to elucidate the role of sociodemographic, lifestyle, and cultural factors in prediabetes and diabetes in South Asian immigrants to the United States, a population at high risk of type II diabetes.
We performed a cross-sectional analysis of a community-based cohort of 899 South Asians without known cardiovascular disease from the Mediators of Atherosclerosis in South Asians Living in America study. Glycemic status was determined by fasting glucose, 2-hour postchallenge glucose, and use of diabetes medication. We used multinomial logistic regression models to estimate the independent associations of sociodemographic, lifestyle, and cultural factors with prediabetes and diabetes, adjusting for confounders identified using directed acyclic graphs.
Approximately 33% of participants had prediabetes and 25% had diabetes. In multivariate analyses, an independent correlate of prediabetes was low exercise. Additional covariates associated with diabetes included lower family income, less education, high chronic psychological burden score, and greater time spent watching television; and fasting monthly or annually was inversely associated with diabetes prevalence.
We found several modifiable risk factors associated with prediabetes and diabetes that may help guide diabetes prevention interventions for South Asian immigrants to the United States.
在本研究中,我们旨在阐明社会人口统计学、生活方式和文化因素在移居美国的南亚移民(患II型糖尿病的高危人群)的糖尿病前期和糖尿病中所起的作用。
我们对来自“生活在美国的南亚人动脉粥样硬化的介导因素”研究中899名无已知心血管疾病的南亚人社区队列进行了横断面分析。通过空腹血糖、餐后2小时血糖和糖尿病药物使用情况来确定血糖状态。我们使用多项逻辑回归模型来估计社会人口统计学、生活方式和文化因素与糖尿病前期和糖尿病之间的独立关联,并对使用有向无环图确定的混杂因素进行调整。
约33%的参与者患有糖尿病前期,25%患有糖尿病。在多变量分析中,糖尿病前期的一个独立相关因素是运动量低。与糖尿病相关的其他协变量包括家庭收入较低、受教育程度较低、慢性心理负担得分较高以及看电视时间较长;每月或每年禁食与糖尿病患病率呈负相关。
我们发现了一些与糖尿病前期和糖尿病相关的可改变风险因素,这可能有助于指导针对移居美国的南亚移民的糖尿病预防干预措施。