在保险人群中糖尿病并发症的种族差异
Andrew J Karter1, Assiamira Ferrara, Jennifer Y Liu
1Division of Research, Kaiser Permanente, 2000 Broadway, Oakland, CA 94612, USA. Andy.J.Karter@kp.org
JAMA
|May 22, 2002
概括
糖尿病并发症的种族差异仍然存在,少数群体的末期脏病 (ESRD) 发病率较高,但心肌梗塞 (MI),中风,充血性心力衰竭 (CHF) 和下肢截肢 (LEA) 的风险与白人相比相似或较低,即使有统一的医疗保健.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 健康差异 在健康上的差异
背景情况:
- 少数群体经常表现出更高的微血管并发症率.
- 在获得医疗保健方面的差异经常被认为是糖尿病并发症率的种族差异的原因.
- 研究具有一致医疗覆盖的多样化人口可以阐明这些差异.
研究的目的:
- 调查糖尿病并发症发生率的种族差异.
- 分析非营利性预付费医疗保健系统中的这些差异.
主要方法:
- 从1995年到1998年进行了一项纵向观察性研究.
- 这项研究包括来自不同种族 (亚洲人,黑人,拉丁裔,白人) 的62432名糖尿病患者.
- 关键结局包括心肌梗塞 (MI),中风,充血性心力衰竭 (CHF),下肢截肢 (LEA) 和末期病 (ESRD).
主要成果:
- 复发率的种族差异不一致,并且在调整人口,社会经济,行为和临床因素后经常持续存在.
- 少数群体,特别是黑人和亚洲人,对末期脏病 (ESRD) 的调整风险比率显著更高.
- 相反,与白人相比,亚洲人和拉丁裔人心肌梗塞 (MI),中风,充血性心力衰竭 (CHF) 和下肢截肢 (LEA) 的调整后危险比率较低.
结论:
- 这项研究证实少数民族的末期病 (ESRD) 发病率高,即使有统一的医疗保健.
- 新证据表明,其他糖尿病并发症在少数群体中相对于白人而言发生率相似或更低.
- 差异的持续表明潜在的遗传因素,未测量的环境影响,或它们的组合.
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