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弱势群体中患有糖尿病的青少年的心血管风险

Cardiovascular Risks in Adolescents With Diabetes From Vulnerable Populations.

作者信息

Faulkner Melissa Spezia, Fritschi Cynthia, Quinn Lauretta, Hepworth Joseph T

机构信息

College of Nursing, University of Arizona, Tucson, AZ, USA.

College of Nursing, University of Illinois at Chicago, IL, USA.

出版信息

Home Health Care Manag Pract. 2010 Feb;22(2):123-130. doi: 10.1177/1084822309343944. Epub 2009 Nov 6.

Abstract

Limited data exist on the predisposition for an early trajectory of cardiovascular (CV) disease in adolescents with diabetes. We explored the effects of types of diabetes and sociodemographic factors (i.e., race, gender, income level, family structure) on the following CV risks: glucose control (A1c), blood pressure (BP), and lipid profile. Adolescents with type 1 DM (T1DM) or type 2 DM (T2DM) participated: 109 with T1DM and 42 with T2DM. The general linear model was used to examine the influence of type of DM, sociodemographic factors, and the interaction of type of DM and the sociodemographic factors on CV risks. Systolic and diastolic BP were increased in youth with T2DM versus T1DM. Non-Hispanic Blacks had a higher A1c and resting diastolic BP than non-Hispanic Whites. Lower income was also associated with higher resting diastolic BP. Males with T1DM had higher A1c, whereas females with T2DM had higher A1c. With low income, individuals with T1DM had higher A1c values than those with T2DM; those with high income and T2DM had higher A1c than those with T1DM. Adolescents with T1DM from single, divorced, or separated families had higher average A1c values. In comparison, those with T2DM from married families had higher A1c values. Triglycerides were increased for those with T2DM, with the greatest amount for Hispanics as compared with non-Hispanic Blacks. In summary, minority status, lower income, and family structure may have a greater impact on vulnerability for poor outcomes in adolescents with DM, regardless of the type of the disease.

摘要

关于糖尿病青少年心血管(CV)疾病早期发展倾向的数据有限。我们探讨了糖尿病类型和社会人口学因素(即种族、性别、收入水平、家庭结构)对以下心血管风险的影响:血糖控制(糖化血红蛋白)、血压(BP)和血脂谱。患有1型糖尿病(T1DM)或2型糖尿病(T2DM)的青少年参与了研究:109例T1DM患者和42例T2DM患者。采用一般线性模型来检验糖尿病类型、社会人口学因素以及糖尿病类型与社会人口学因素的相互作用对心血管风险的影响。与T1DM青少年相比,T2DM青少年的收缩压和舒张压升高。非西班牙裔黑人的糖化血红蛋白和静息舒张压高于非西班牙裔白人。低收入也与较高的静息舒张压相关。T1DM男性的糖化血红蛋白较高,而T2DM女性的糖化血红蛋白较高。在低收入情况下,T1DM患者的糖化血红蛋白值高于T2DM患者;高收入且患有T2DM的患者的糖化血红蛋白高于患有T1DM的患者。来自单亲、离异或分居家庭的T1DM青少年的平均糖化血红蛋白值较高。相比之下,来自已婚家庭的T2DM青少年的糖化血红蛋白值较高。T2DM患者的甘油三酯升高,与非西班牙裔黑人相比,西班牙裔患者升高幅度最大。总之,少数族裔身份、低收入和家庭结构可能对糖尿病青少年不良结局的易感性有更大影响,无论疾病类型如何。

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Cardiovascular Risks in Adolescents With Diabetes From Vulnerable Populations.弱势群体中患有糖尿病的青少年的心血管风险
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