Samsung Health Research Institute, Samsung Electronics Co., Ltd., Hwaseong 18448, Republic of Korea.
Department of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA; Department of Epidemiology, Johns Hopkins University, Baltimore, MD 21205, USA.
J Diabetes Complications. 2020 Dec;34(12):107679. doi: 10.1016/j.jdiacomp.2020.107679. Epub 2020 Jul 18.
Acculturation has been shown to be an important factor for immigrants' health in the United States. We investigate whether nativity is associated with a greater risk for cardiometabolic diseases among Asian Americans (Asians) vs. non-Hispanic whites (whites).
Based on data from the U.S. National Health Interview Survey in 2006-2015, 146,862 Asians and whites aged ≥30 years were evaluated. Nativity as a proxy for acculturation was defined using a combination of birthplace and the duration of U.S. residency. Cardiometabolic diseases were defined based on self-reported diagnoses of diabetes, prediabetes, or cardiovascular diseases (CVD). Using 10-year pooled data accounting for complex sampling designs and weights, multiple logistic regression models were used to assess associations. Four Asian subgroups, including Chinese, Filipinos, Asian Indians and other Asians, were evaluated in subgroup analyses.
Compared to U.S.-born whites, prevalent type 2 diabetes and prediabetes were higher among Asians depending on nativity. However, the prevalence of CVD was lower among Asians than among whites regardless of nativity (OR = 0.5 [95% CI:0.5-0.6], OR = 0.7 [95% CI:0.6-0.8]). In addition, compared to U.S.-born whites, prevalent type 2 diabetes and prediabetes increased with an increasing length of U.S. residency for foreign-born Asians among Asians overall (≥15 years: OR = 1.5 [95% CI:1.3-1.7]; OR = 1.3 [95% CI:1.2-1.6]) and Asian Indians and Filipinos. Furthermore, a significant graded association between prediabetes and length of U.S. residency was found among foreign-born Asians.
The prevalence of diabetes and prediabetes is higher among Asian immigrants who have spent more years in the U.S., than those in U.S.-born whites. Monitoring and prevention efforts for diabetes should target this group.
在美国，文化适应已被证明是移民健康的一个重要因素。我们研究了出生国是否与亚洲裔美国人（亚裔）与非西班牙裔白人（白人）相比，患心血管代谢疾病的风险更高有关。
基于 2006-2015 年美国国家健康访谈调查的数据，评估了 146862 名年龄≥30 岁的亚裔和白人。通过出生地和在美国居住时间的组合，将出生国作为文化适应的替代指标来定义。心血管代谢疾病是根据自我报告的糖尿病、糖尿病前期或心血管疾病（CVD）的诊断来定义的。使用考虑复杂抽样设计和权重的 10 年汇总数据，使用多变量逻辑回归模型评估关联。在亚组分析中，评估了包括中国人、菲律宾人、印度人和其他亚洲人在内的四个亚洲亚组。
与美国出生的白人相比，根据出生国的不同，亚裔人群中 2 型糖尿病和糖尿病前期的患病率更高。然而，无论出生国如何，亚裔人群的 CVD 患病率均低于白人（OR=0.5[95%CI：0.5-0.6]，OR=0.7[95%CI：0.6-0.8]）。此外，与美国出生的白人相比，对于所有亚裔人群（≥15 年：OR=1.5[95%CI：1.3-1.7]；OR=1.3[95%CI：1.2-1.6]）和印度裔和菲律宾裔亚裔人群，随着在美国居住时间的增加，新发 2 型糖尿病和糖尿病前期的患病率也随之增加。此外，在外国出生的亚裔人群中，发现糖尿病前期与在美国居住时间之间存在显著的分级关联。
与美国出生的白人相比，在美国居住时间较长的亚洲移民中，糖尿病和糖尿病前期的患病率更高。应针对这一人群开展糖尿病监测和预防工作。
