Chaudhry Umar Ahmed Riaz, Fortescue Rebecca, Bowen Liza, Woolford Stephen J, Knights Felicity, Cook Derek G, Harris Tess, Critchley Julia
Population Health Research Institute, St George's, University of London, London, United Kingdom.
The Migrant Health Research Group, Institute for Infection and Immunity, St George's University of London, London, United Kingdom.
PLoS One. 2025 Jan 17;20(1):e0314318. doi: 10.1371/journal.pone.0314318. eCollection 2025.
Type 2 diabetes (T2D) is more common in certain ethnic groups. This systematic review compares mortality risk between people with T2D from different ethnic groups and includes recent larger studies.
We searched nine databases using PRISMA guidelines (PROSPERO CRD42022372542). We included community-based prospective studies among adults with T2D from at least two different ethnicities. Two independent reviewers undertook screening, data extraction and quality assessment using the Newcastle-Ottawa Scale. The primary outcome compared all-cause mortality rates between ethnic groups (hazard ratio (HR) with 95% confidence intervals).
From 30,825 searched records, we included 13 studies (7 meta-analysed), incorporating 573,173 T2D participants; 12 were good quality. Mortality risk was lower amongst people with T2D from South Asian [HR 0.68 (0.65-0.72)], Black [HR 0.82 (0.77-0.87)] and Chinese [HR 0.57 (0.46-0.70)] ethnicity compared to people of White ethnicity. Narrative synthesis corroborated these findings but demonstrated that people of indigenous Māori ethnicity had greater mortality risk compared to European ethnicity.
People with T2D of South Asian, Black and Chinese ethnicity have lower all-cause mortality risk than White ethnicity, with Māori ethnicity having higher mortality risk. Factors explaining mortality differences require further study, including understanding complication risk by ethnicity, to improve diabetes outcomes.
2型糖尿病（T2D）在某些种族群体中更为常见。本系统评价比较了不同种族的T2D患者之间的死亡风险，并纳入了近期规模较大的研究。
我们按照PRISMA指南（PROSPERO CRD42022372542）检索了九个数据库。我们纳入了至少两个不同种族的成年T2D患者的社区前瞻性研究。两名独立的评审员使用纽卡斯尔-渥太华量表进行筛选、数据提取和质量评估。主要结局比较了不同种族之间的全因死亡率（风险比（HR）及95%置信区间）。
在检索到的30825条记录中，我们纳入了13项研究（7项进行了荟萃分析），涉及573173名T2D参与者；其中12项质量良好。与白人种族的T2D患者相比，南亚裔[HR 0.68（0.65 - 0.72）]、黑人[HR 0.82（0.77 - 0.87）]和华裔[HR 0.57（0.46 - 0.70）]种族的T2D患者死亡风险较低。叙述性综合分析证实了这些发现，但表明与欧洲种族相比，毛利原住民种族的人死亡风险更高。
南亚裔、黑人和华裔种族的T2D患者全因死亡风险低于白人种族，而毛利种族的死亡风险较高。解释死亡率差异的因素需要进一步研究，包括了解不同种族的并发症风险，以改善糖尿病治疗效果。
