Njeru Jane W, Tan Eugene M, St Sauver Jennifer, Jacobson Debra J, Agunwamba Amenah A, Wilson Patrick M, Rutten Lila J, Damodaran Swathi, Wieland Mark L
Division of Primary Care Internal Medicine, Mayo Clinic, 200 First Street, SW, Rochester, MN, 55905, USA.
Mayo School of Graduate Medical Education, Mayo Clinic, Rochester, MN, USA.
J Immigr Minor Health. 2016 Dec;18(6):1343-1349. doi: 10.1007/s10903-015-0280-3.
We examined the prevalence of cardiovascular risk factors among Somali refugees at a midwestern hospital in the U.S. This was a retrospective cohort study of 1007 adult Somali patients and an age and frequency-matched cohort of non-Somali patients actively empanelled to a large, academic primary care practice network in the Midwest United States between January 1, 2011 and December 31, 2012. Cardiovascular risk factors were obtained by chart review and compared between the two cohorts using a Chi squared test. Median age was 35 years (Q1, Q3; 27, 50). The prevalence of diabetes was significantly higher among Somali versus non-Somali patients (12.1 vs 5.3 %; p = 0.0001), as was prediabetes (21.3 vs 17.2 %; p < 0.02) and obesity (34.6 vs 32.1 %; p = 0.047). After adjusting for age, sex, body mass index, education and employment, among the Somali patients, the odds ratio (95 % confidence interval) for diabetes was 2.78 (1.76-4.40) and 1.57 (1.16-2.13) for pre-diabetes. There was a significantly higher prevalence of diabetes, pre-diabetes and obesity among Somali patients compared with non-Somali patients. Further research into the specific causes of these disparities and development of targeted effective and sustainable interventions to address them is needed.
我们在美国中西部一家医院调查了索马里难民心血管危险因素的流行情况。这是一项回顾性队列研究，研究对象为1007名成年索马里患者以及年龄和就诊频率匹配的非索马里患者队列，这些非索马里患者于2011年1月1日至2012年12月31日期间积极加入了美国中西部一个大型学术初级保健实践网络。通过查阅病历获取心血管危险因素，并使用卡方检验在两个队列之间进行比较。中位年龄为35岁（第一四分位数，第三四分位数；27, 50）。索马里患者中糖尿病的患病率显著高于非索马里患者（12.1%对5.3%；p = 0.0001），糖尿病前期也是如此（21.3%对17.2%；p < 0.02），肥胖情况同样如此（34.6%对32.1%；p = 0.047）。在对年龄、性别、体重指数、教育程度和就业情况进行调整后，在索马里患者中，糖尿病的优势比（95%置信区间）为2.78（1.76 - 4.40），糖尿病前期为1.57（1.16 - 2.13）。与非索马里患者相比，索马里患者中糖尿病、糖尿病前期和肥胖的患病率显著更高。需要进一步研究这些差异的具体原因，并制定有针对性的有效且可持续的干预措施来解决这些问题。
