Lam Vincent, Sharma Shivam, Gupta Sonali, Spouge John L, Jordan I King, Mariño-Ramírez Leonardo
National Institutes of Health.
Georgia Institute of Technology.
Res Sq. 2023 Sep 22:rs.3.rs-2976764. doi: 10.21203/rs.3.rs-2976764/v1.
Diabetes is a common disease with a major burden on morbidity, mortality, and productivity. Type 2 diabetes (T2D) accounts for roughly 90% of all diabetes cases in the United States and has greater observed prevalence among those who identify as Black or Hispanic.
The aims of this study were to determine whether T2D racial and ethnic disparities can be observed in data from the Research Program and to measure associations of genetic ancestry (GA) and socioeconomic deprivation with T2D. The Researcher Workbench was used to calculate T2D prevalence and to model T2D associations with GA, individual-level (iSDI) and zip code-based (zSDI) socioeconomic deprivation indices within and between participant self-identified race and ethnicity (SIRE) groups.
The study cohort of 86,488 participants from the four largest SIRE groups in : Asian (n=2,311), Black (n=16,282), Hispanic (n=16,966), and White (n=50,292). SIRE groups show characteristic genetic ancestry patterns, consistent with their diverse origins, together with a continuum of ancestry fractions within and between groups. The Black and Hispanic groups show the highest median SDI values, followed by the Asian and White groups. Black participants show the highest age- and sex-adjusted T2D prevalence (21.9%), followed by the Hispanic (19.9%), Asian (15.1%), and White (14.8%) groups. Minority SIRE groups and socioeconomic deprivation are positively associated with T2D, when the entire cohort is analyzed together. However, SIRE and GA both show negative interaction effects with SDI on T2D. Higher levels of SDI are negatively associated with T2D in the Black and Hispanic groups, and higher levels of SDI are negatively associated with T2D at high levels of African and Native American ancestry.
Socioeconomic deprivation is positively associated with the SIRE group T2D disparities observed here but negatively associated with T2D within the Black and Hispanic groups that show the highest T2D prevalence. These results are paradoxical and have not been reported elsewhere. We discuss possible explanations for this paradox related to the nature of the data along with SIRE group differences in access to healthcare, diet, and lifestyle.
糖尿病是一种常见疾病，在发病率、死亡率和生产力方面带来重大负担。2型糖尿病（T2D）约占美国所有糖尿病病例的90%，在自我认定为黑人或西班牙裔的人群中观察到的患病率更高。
本研究的目的是确定在研究项目的数据中是否能观察到T2D的种族和民族差异，并测量遗传血统（GA）和社会经济剥夺与T2D的关联。研究人员工作台用于计算T2D患病率，并对参与者自我认定的种族和民族（SIRE）组内及组间的GA、个体水平（iSDI）和基于邮政编码的（zSDI）社会经济剥夺指数与T2D的关联进行建模。
该研究队列包括来自四个最大SIRE组的86488名参与者：亚洲人（n = 2311）、黑人（n = 16282）、西班牙裔（n = 16966）和白人（n = 50292）。SIRE组显示出特征性的遗传血统模式，与其不同的起源一致，组内和组间存在连续的血统比例。黑人和西班牙裔组的SDI中位数最高，其次是亚洲人和白人组。黑人参与者的年龄和性别调整后的T2D患病率最高（21.9%），其次是西班牙裔（19.9%）、亚洲人（15.1%）和白人（14.8%）组。当对整个队列进行分析时，少数SIRE组和社会经济剥夺与T2D呈正相关。然而，SIRE和GA在T2D方面均与SDI表现出负向交互作用。在黑人和西班牙裔组中，较高水平的SDI与T2D呈负相关，在非洲和美洲原住民血统水平较高时，较高水平的SDI也与T2D呈负相关。
社会经济剥夺与这里观察到的SIRE组T2D差异呈正相关，但在T2D患病率最高的黑人和西班牙裔组中与T2D呈负相关。这些结果自相矛盾，在其他地方尚未有报道。我们讨论了与数据性质以及SIRE组在获得医疗保健、饮食和生活方式方面的差异相关的这一矛盾的可能解释。
