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老年人群中不同种族/族裔群体2型糖尿病相关微血管并发症的风险轨迹

Risk Trajectories of Type 2 Diabetes-Related Microvascular Complications Across Racial/Ethnic Groups Among Older Adults.

作者信息

Parab Kaustubh V, Gao Xiaotian, Gothe Neha P, Wilund Kenneth R, Mahajan Harshal P, Singleton Chelsea R

机构信息

Department of Cardiovascular and Thoracic Services, Aurora St. Luke's Medical Center, Milwaukee, WI, USA.

Center for Epidemiology and Population Health, Pediatrics, Baylor College of Medicine, Houston, TX, USA.

出版信息

J Racial Ethn Health Disparities. 2025 Sep 9. doi: 10.1007/s40615-025-02625-0.

Abstract

INTRODUCTION

Type 2 diabetes mellitus (T2DM) microvascular complications are a major public health issue that disproportionately affects racial/ethnic minorities in the US. We aimed to address the limited understanding of racial/ethnic disparities in the longitudinal natural history of microvascular complications over eight years among older adults with T2DM in the US and Canada.

METHODS

From 10,251 participants in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) (2003-2009) trial, we derived 6323 participants. We examined racial/ethnic disparities of composite microvascular complications, nephropathy, neuropathy, and retinopathy outcomes among adults of Black (n = 1099), White (n = 4071), and Other races (n = 1156), over 8 years. We used linear mixed-effects model with random intercept to account for intra-person correlation.

RESULTS

Our linear mixed-effects models displayed that the odds of composite microvascular complications for other race, which primarily consisted of Hispanic adults declined over a period of time [OR: 0.95 (0.93-0.99)]. The odds increased over time for Black [1.06 (1.03-1.09)] and White [1.11 (1.09-1.13)] adults (P < 0.001).

CONCLUSION

Other race adults had a declining risk of microvascular complications over time. This decline was not observed among Black and White adults.

摘要

引言

2型糖尿病(T2DM)微血管并发症是一个重大的公共卫生问题,对美国的少数种族/族裔群体影响尤为严重。我们旨在解决对美国和加拿大患有T2DM的老年人在八年期间微血管并发症纵向自然史中种族/族裔差异的了解有限的问题。

方法

从糖尿病心血管风险控制行动(ACCORD)(2003 - 2009年)试验的10251名参与者中,我们选取了6323名参与者。我们研究了黑人(n = 1099)、白人(n = 4071)和其他种族(n = 1156)的成年人在8年期间复合微血管并发症、肾病、神经病变和视网膜病变结局的种族/族裔差异。我们使用具有随机截距的线性混合效应模型来考虑个体内相关性。

结果

我们的线性混合效应模型显示,主要由西班牙裔成年人组成的其他种族发生复合微血管并发症的几率在一段时间内有所下降[比值比:0.95(0.93 - 0.99)]。黑人[1.06(1.03 - 1.09)]和白人[1.11(1.09 - 1.13)]成年人发生复合微血管并发症的几率随时间增加(P < 0.001)。

结论

其他种族的成年人随着时间的推移微血管并发症风险下降。在黑人和白人成年人中未观察到这种下降。

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