Pugh J A, Medina R A, Cornell J C, Basu S
University of Texas Health Science Center at San Antonio, USA.
Diabetes. 1995 Dec;44(12):1375-80. doi: 10.2337/diab.44.12.1375.
Diabetes is the single largest cause of end-stage renal disease (ESRD) in adults in the U.S. Insulin-dependent diabetes mellitus (IDDM) has been recognized for some time as an important cause of ESRD, but non-insulin-dependent diabetes mellitus (NIDDM) has been assumed, until recently, to rarely cause ESRD. The objective of this study is to determine the incidence of treatment of diabetic ESRD by diabetic type for three ethnic/racial groups: non-Hispanic whites, African-Americans, and Mexican-Americans. A population-based incidence cohort was assembled from all dialysis centers in Bexar (San Antonio) and Dallas counties in Texas. All patients with diabetic ESRD beginning dialysis between 1 December 1987 (Bexar) or 1 December 1988 (Dallas) and 31 July 1991 were identified. All non-hispanic whites and African-Americans and a 1/2 random sample of Mexican-Americans were approached for enrollment. Individuals were confirmed to have diabetes using the World Health Organization criteria. Diabetes typing was done using a computerized historical algorithm. Age-specific and age-adjusted incidence rates were obtained by diabetic type and ethnic/racial group. NIDDM causes the majority of diabetic ESRD: 59.5% for non-Hispanic whites, 92.8% for Mexican-Americans, and 84.3% for African-Americans. Mexican-Americans and African-Americans, respectively, have 6.1 and 6.5 times higher incidence of treatment for diabetic ESRD than non-Hispanic whites. NIDDM results in more ESRD than does IDDM. Minorities (African-Americans and Mexican-Americans) are at increased risk, and programs aimed at prevention of NIDDM-related ESRD must focus on them.
糖尿病是美国成年人终末期肾病（ESRD）的单一最大病因。胰岛素依赖型糖尿病（IDDM）一直以来都被公认为是ESRD的一个重要病因，但直到最近，非胰岛素依赖型糖尿病（NIDDM）一直被认为很少导致ESRD。本研究的目的是确定三个种族/族裔群体（非西班牙裔白人、非裔美国人、墨西哥裔美国人）中糖尿病性ESRD的治疗发病率。从得克萨斯州贝克斯县（圣安东尼奥）和达拉斯县的所有透析中心组建了一个基于人群的发病队列。确定了所有在1987年12月1日（贝克斯县）或1988年12月1日（达拉斯县）至1991年7月31日期间开始透析的糖尿病性ESRD患者。所有非西班牙裔白人和非裔美国人以及墨西哥裔美国人的二分之一随机样本被邀请参加研究。根据世界卫生组织标准确认个体患有糖尿病。使用计算机化的历史算法进行糖尿病分型。按糖尿病类型和种族/族裔群体获得年龄特异性和年龄调整发病率。NIDDM导致大多数糖尿病性ESRD：非西班牙裔白人中占59.5%，墨西哥裔美国人中占92.8%，非裔美国人中占84.3%。墨西哥裔美国人和非裔美国人糖尿病性ESRD的治疗发病率分别比非西班牙裔白人高6.1倍和6.5倍。NIDDM导致的ESRD比IDDM更多。少数族裔（非裔美国人和墨西哥裔美国人）风险增加，旨在预防与NIDDM相关的ESRD的项目必须关注他们。
