Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
Slone Epidemiology Center at Boston University, Boston University Medical Campus, 72 East Concord Street, L-7, Boston, MA, 02118, USA.
Diabetologia. 2017 Nov;60(11):2221-2225. doi: 10.1007/s00125-017-4400-6. Epub 2017 Aug 15.
AIMS/HYPOTHESIS: Our aim was to assess the association of perceived racism with type 2 diabetes, and the possible mediating influence of diet and BMI.
The Black Women's Health Study, a follow-up of 59,000 African-American women, began in 1995. Over 16 years 5344 incident cases of diabetes occurred during 576,577 person-years. Cox proportional hazards models were used to estimated HRs and 95% CIs for categories of 'everyday racism' (interpersonal racism in daily life) and 'lifetime racism' (reporting ever treated unfairly due to race with respect to police, housing or work) and incident type 2 diabetes. Models were adjusted for age, questionnaire cycle, marital status, socioeconomic status, education, family history of diabetes, physical activity, alcohol use and smoking status, with and without inclusion of terms for dietary patterns and adult BMI.
Compared with women in the lowest quartile of exposure, women in the highest quartile of exposure to everyday racism had a 31% increased risk of diabetes (HR 1.31; 95% CI 1.20, 1.42) and women with the highest exposure to lifetime racism had a 16% increased risk (HR 1.16; 95% CI 1.05, 1.27). Mediation analysis estimated that BMI accounted for half of the association between either the everyday or lifetime racism measure and incident diabetes.
CONCLUSIONS/INTERPRETATION: Perceived everyday and lifetime racism were associated with increased risk of type 2 diabetes in this cohort of African-American women and appear to be at least partly mediated by BMI.
目的/假设：我们的目的是评估感知到的种族主义与 2 型糖尿病之间的关联，以及饮食和 BMI 可能的中介作用。
黑人妇女健康研究是对 59000 名非裔美国女性进行的一项随访研究，始于 1995 年。在 16 年的时间里，在 576577 人年中发生了 5344 例糖尿病新发病例。使用 Cox 比例风险模型估计了“日常种族主义”（日常生活中的人际种族主义）和“终身种族主义”（因种族原因在警察、住房或工作方面受到不公平待遇的报告）类别与 2 型糖尿病发病风险的 HR 和 95%CI。模型调整了年龄、问卷周期、婚姻状况、社会经济地位、教育、糖尿病家族史、身体活动、饮酒和吸烟状况，包括和不包括饮食模式和成人 BMI 的术语。
与暴露最低四分位的女性相比，暴露最高四分位的女性患糖尿病的风险增加了 31%（HR 1.31；95%CI 1.20，1.42），而暴露最高的女性患糖尿病的风险增加了 16%（HR 1.16；95%CI 1.05，1.27）。中介分析估计，BMI 解释了日常或终身种族主义测量与新发糖尿病之间关联的一半。
结论/解释：在这个非裔美国女性队列中，感知到的日常和终身种族主义与 2 型糖尿病风险增加相关，并且似乎至少部分由 BMI 介导。
