Assari Shervin, Moghani Lankarani Maryam, Piette John D, Aikens James E
Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA.
Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
Healthcare (Basel). 2017 Nov 1;5(4):83. doi: 10.3390/healthcare5040083.
: This study aimed to investigate differences in the association between socioeconomic status (SES) and glycemic control in type 2 diabetes mellitus (DM) across race by gender groups. : Using a convenient sampling strategy, participants were 112 patients with type 2 DM who were prescribed insulin (ns = 38 Black women, 34 Black men, 14 White women, and 26 White men, respectively). Linear regression was used to test the associations between sociodemographic variables (race, gender, SES, governmental insurance) and Hemoglobin A1c (HbA1c) in the pooled sample and within subgroups defined by race and gender. : In the pooled sample, neither SES nor governmental insurance were associated with HbA1c. However, the race by gender interaction approached statistical significance (B = 0.34, 95% CI = -0.24-3.00, =0.094), suggesting higher HbA1c in Black women, compared to other race by gender groups. In stratified models, SES (B = -0.33, 95% CI = -0.10-0.00, = 0.050), and governmental insurance (B = 0.35, 95% CI = 0.05-2.42, = 0.042) were associated with HbA1c for Black men, but not for any of the other race by gender subgroups. : Socioeconomic factors may relate to health outcomes differently across race by gender subgroups. In particular, SES may be uniquely important for glycemic control of Black men. Due to lack of generalizability of the findings, additional research is needed.
本研究旨在调查2型糖尿病（DM）患者中社会经济地位（SES）与血糖控制之间的关联在不同种族和性别群体中的差异。采用便利抽样策略，研究对象为112例接受胰岛素治疗的2型糖尿病患者（分别为38名黑人女性、34名黑人男性、14名白人女性和26名白人男性）。使用线性回归来检验在合并样本以及按种族和性别定义的亚组中，社会人口统计学变量（种族、性别、SES、政府保险）与糖化血红蛋白（HbA1c）之间的关联。在合并样本中，SES和政府保险均与HbA1c无关。然而，种族与性别的交互作用接近统计学显著性（B = 0.34，95%置信区间 = -0.24 - 3.00，P = 0.094），表明与其他种族和性别群体相比，黑人女性的HbA1c水平更高。在分层模型中，SES（B = -0.33，95%置信区间 = -0.10 - 0.00，P = 0.050）和政府保险（B = 0.35，95%置信区间 = 0.05 - 2.42，P = 0.042）与黑人男性的HbA1c相关，但在其他任何种族和性别亚组中均无此关联。社会经济因素在不同种族和性别亚组中与健康结果的关联可能不同。特别是，SES对黑人男性的血糖控制可能具有独特的重要性。由于研究结果缺乏普遍性，需要进一步研究。
