Department of Family and Community Medicine, University of Kentucky College of Medicine, 2195 Harrodsburg Road, Suite 125, Lexington, KY 40505, USA.
Department of Family Medicine and Community Health, Duke University School of Medicine, 2200 West Main Street, Suite 600, Durham, NC 27705, USA.
Int J Environ Res Public Health. 2020 Feb 4;17(3):950. doi: 10.3390/ijerph17030950.
The aim of this study was to determine whether racial differences in HbA1c persist in older adults (≥65 years) living with type 2 diabetes. Data from The National Health and Nutrition Examination Survey (NHANES) 2003-2014 were used to examine the association between HbA1c and older adults (≥65 years) over time. Compared to non-Hispanic Whites, Mexican Americans had the greatest difference in average HbA1c among minority groups, followed by those with unspecified/mixed ethnicities and non-Hispanic Blacks. In the adjusted linear model, racial minorities had a statistically significant relationship with HbA1c. There was no relationship between HbA1c and older age and insulin use. Trends in mean HbA1c over time increased for non-Hispanic Blacks and Mexican Americans and decreased for non-Hispanic Whites. The findings suggest that racial differences in HbA1c persist into older age and compared to non-Hispanic Whites, non-Hispanic Blacks and Mexican Americans are at an increased risk of morbidity, mortality, and disability due to high HbA1c. Furthermore, alternate measures of glycemic control may be needed to screen and manage T2DM in racial minorities.
本研究旨在确定 2 型糖尿病老年患者(≥65 岁)的糖化血红蛋白(HbA1c)是否存在种族差异。本研究使用了 2003-2014 年全国健康和营养调查(NHANES)的数据,以随时间观察 HbA1c 与老年患者(≥65 岁)之间的关联。与非西班牙裔白人相比,墨西哥裔美国人在少数族裔群体中的平均 HbA1c 差异最大,其次是未指定/混合族裔和非西班牙裔黑人。在调整后的线性模型中,少数族裔与 HbA1c 呈统计学显著关系。HbA1c 与年龄较大和使用胰岛素无关。非西班牙裔黑人和墨西哥裔美国人的平均 HbA1c 随时间呈上升趋势,而非西班牙裔白人则呈下降趋势。研究结果表明,HbA1c 的种族差异持续存在于老年时期,与非西班牙裔白人相比,非西班牙裔黑人和墨西哥裔美国人因 HbA1c 升高而面临更高的发病率、死亡率和残疾风险。此外,可能需要替代的血糖控制措施来筛查和管理少数族裔的 2 型糖尿病。