美国老年男性和女性中的糖尿病、种族与功能受限情况
Diabetes, race, and functional limitations in older U.S. men and women.
作者信息
Kalyani Rita Rastogi, Rodriguez Diana C, Yeh Hsin-Chieh, Golden Sherita H, Thorpe Roland J
机构信息
Division of Endocrinology, Diabetes & Metabolism, Department of Medicine, The Johns Hopkins University, Baltimore, MD, USA; Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
出版信息
Diabetes Res Clin Pract. 2015 Jun;108(3):390-7. doi: 10.1016/j.diabres.2015.04.003. Epub 2015 Apr 13.
AIMS
The presence of diabetes is associated with increased odds of difficulties in functional tasks but it remains unclear if the burden is similar by race.
METHODS
Our study included 122,004 non-Hispanic Black (NHB) and non-Hispanic White (NHW) adults ≥50 years from the U.S. National Health Interview Survey (2001-2012). Diabetes was defined as self-reported diagnosis or medication use. Functional limitations were defined as any self-reported difficulty in performing mobility tasks, general physical activities (GPA), or leisure and social activities (LSA). Logistic regression models were created to investigate the relationship of race with functional limitations accounting for key covariates, among men and women, by diabetes status.
RESULTS
Among older U.S. adults, NHB versus NHW women without diabetes had a higher odds of limitations in mobility (OR=1.39, 1.30-1.49) and LSA (OR=1.13, 1.05-1.23) without diabetes but a similar odds of these limitations with diabetes by race, after adjusting for age, income, education, obesity, arthritis, heart disease, stroke, COPD, and cancer. Interestingly, NHB versus NHW women had significantly lower odds of GPA, irrespective of diabetes status. However, NHB versus NHW men with diabetes had a persistently higher odds for mobility and LSA limitations with diabetes as follows: mobility (OR=1.30, 1.12-1.51) and LSA limitations (OR=1.07, 1.06-1.34). The interaction of race and diabetes was significant among women for mobility limitations (p<0.01), but not men.
CONCLUSIONS
The burden of functional limitations differs by race among both men and women with diabetes. Future studies should examine mechanisms underlying these differences to prevent progression to disability in older adults with diabetes.
目的
糖尿病的存在与功能任务困难几率增加相关，但种族之间的负担是否相似仍不清楚。
方法
我们的研究纳入了来自美国国家健康访谈调查（2001 - 2012年）的122,004名年龄≥50岁的非西班牙裔黑人（NHB）和非西班牙裔白人（NHW）成年人。糖尿病定义为自我报告的诊断或药物使用。功能受限定义为自我报告的在进行移动任务、一般身体活动（GPA）或休闲和社交活动（LSA）方面的任何困难。建立逻辑回归模型以研究在考虑关键协变量的情况下，按糖尿病状态、性别划分的种族与功能受限之间的关系。
结果
在年龄较大的美国成年人中，未患糖尿病的NHB女性与NHW女性相比，在移动方面受限几率更高（比值比[OR]=1.39，1.30 - 1.49），在LSA方面也更高（OR = 1.13，1.05 - 1.23）；但在调整年龄、收入、教育程度、肥胖、关节炎、心脏病、中风、慢性阻塞性肺疾病（COPD）和癌症后，患糖尿病时按种族划分的这些受限几率相似。有趣的是，无论糖尿病状态如何，NHB女性与NHW女性相比，GPA几率显著更低。然而，患糖尿病的NHB男性与NHW男性相比，在移动和LSA受限方面几率持续更高，如下：移动方面（OR = 1.30，1.12 - 1.51）和LSA受限方面（OR = 1.07，1.06 - 1.34）。种族与糖尿病的交互作用在女性的移动受限方面具有显著性（p<0.01），但在男性中不显著。
结论
糖尿病患者中，功能受限的负担因种族在男性和女性中存在差异。未来研究应探讨这些差异背后的机制，以预防糖尿病老年患者发展为残疾。
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