Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands; Department of Internal and Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands; Department of Physiology, University of Ghana Medical School, Ghana.
Prim Care Diabetes. 2021 Jun;15(3):528-534. doi: 10.1016/j.pcd.2021.02.008. Epub 2021 Mar 3.
To assess ethnic differences in diabetes-related microvascular and macrovascular complication rates in a multi-ethnic population in the Netherlands.
STUDY, DESIGN AND SETTING: Data from the HELIUS study comprising of 165 Dutch, 591 South-Asian Surinamese, 494 African Surinamese, 272 Ghanaian, 368 Turkish, and 444 Moroccan participants with diabetes were analyzed. Logistic regression was used to assess ethnic differences in microvascular (nephropathy) and macrovascular (coronary heart disease (CHD), peripheral artery disease (PAD) and stroke) complications, with adjustments for age, sex, education, and the conventional risk factors.
In an age-sex adjusted model, ethnic minorities had higher odds of nephropathy than Dutch except for Ghanaians and African Surinamese. The difference remained statistically significant in South-Asian Surinamese (odds ratio: 2.29; 95% CI, 1.09-4.80), but not in the Turkish (1.01; 0.43-2.38) and Moroccan (1.56; 0.68-3.53) participants. The odds of CHD was higher in all ethnic minorities than in Dutch, with the odds ratios ranging from 2.73 (1.09-6.84) in Ghanaians to 6.65 (2.77-15.90) in Turkish in the fully-adjusted model. There were no ethnic differences in the odds of PAD and stroke.
The findings suggest ethnic inequalities in macrovascular and microvascular complications in diabetes, with nephropathy and CHD being the most common complications affecting ethnic minorities.
评估荷兰多民族人群中糖尿病相关微血管和大血管并发症发生率的种族差异。
对 HELIUS 研究的数据进行分析，该研究包括 165 名荷兰人、591 名南亚苏里南人、494 名非洲苏里南人、272 名加纳人、368 名土耳其人和 444 名摩洛哥糖尿病患者。采用逻辑回归评估微血管（肾病）和大血管（冠心病（CHD）、外周动脉疾病（PAD）和中风）并发症的种族差异，并对年龄、性别、教育程度和传统危险因素进行调整。
在年龄和性别调整模型中，除加纳人外，少数民族发生肾病的几率均高于荷兰人。在南亚苏里南人中，这种差异仍然具有统计学意义（比值比：2.29；95%置信区间，1.09-4.80），但在土耳其人（1.01；0.43-2.38）和摩洛哥人（1.56；0.68-3.53）中则无统计学意义。所有少数民族发生 CHD 的几率均高于荷兰人，比值比范围从加纳人的 2.73（1.09-6.84）到土耳其人的 6.65（2.77-15.90）。在完全调整模型中，PAD 和中风的发病几率在各民族之间没有差异。
研究结果表明，糖尿病患者的大血管和微血管并发症存在种族不平等，肾病和 CHD 是影响少数民族的最常见并发症。
