Yun Shen1,2, Lizheng Shi3, Elizabeth Nauman4, Peter T Katzmarzyk1, Eboni G Price-Haywood5, Ping Yin1,6, Alessandra N Bazzano7, Somesh Nigam8, Gang Hu1. 1. Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA. 2. Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China. 3. Department of Global Health Management and Policy, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA. 4. Louisiana Public Health Institute, New Orleans, Louisiana, USA. 5. Ochsner Health System Center for Applied Health Services Research, New Orleans, Louisiana, USA. 6. Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. 7. Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA. 8. Blue Cross and Blue Shield of Louisiana, Baton Rouge, Louisiana, USA.
Abstract
BACKGROUND: Studies on racial differences in diabetic complications are very limited. The aim of this study was to investigate the race and sex differences in diabetic complications between African Americans and Whites with type 2 diabetes (T2D) in Louisiana. METHODS: A prospective cohort study was performed of 27 113 African Americans and 40 431 Whites with T2D who were 35 to 95 years of age from three healthcare systems located in south Louisiana. Four major diabetic complications were assessed: coronary heart disease (CHD), heart failure, stroke, and end-stage renal disease (ESRD). RESULTS: The age- and sex-adjusted incident rates per 1000 person-years and 95% confidence intervals (CI) for CHD, heart failure, stroke, and ESRD for African Americans with diabetes were 43.1 (95% CI 41.6-44.6), 36.6 (95% CI 35.2-37.9), 29.6 (95% CI 28.4-30.8), and 38.3 (95% CI 36.9-39.7), respectively. Cox regression models showed that African American women had a higher risk than White women for heart failure (hazard ratio (HR) 1.26; 95% CI 1.18-1.34), stroke (HR 1.15; 95% CI 1.08-1.22), and ESRD (HR 1.32; 95% CI 1.24-1.40), whereas African American men had higher risks than White men for heart failure (HR 1.33; 95% CI 1.25-1.43) and ESRD (HR 1.47; 95% CI 1.37-1.57) but a lower risk of CHD (HR 0.88; 95% CI 0.83-0.94). CONCLUSIONS: The incidence of major diabetic complications varied among difference race and sex groups. More race- or sex-specific studies on complications in patients with diabetes are needed to see whether incident rates are changing over time.
BACKGROUND: Studies on racial differences in diabetic complications are very limited. The aim of this study was to investigate the race and sex differences in diabetic complications between African Americans and Whites with type 2 diabetes (T2D) in Louisiana. METHODS: A prospective cohort study was performed of 27 113 African Americans and 40 431 Whites with T2D who were 35 to 95 years of age from three healthcare systems located in south Louisiana. Four major diabetic complications were assessed: coronary heart disease (CHD), heart failure, stroke, and end-stage renal disease (ESRD). RESULTS: The age- and sex-adjusted incident rates per 1000 person-years and 95% confidence intervals (CI) for CHD, heart failure, stroke, and ESRD for African Americans with diabetes were 43.1 (95% CI 41.6-44.6), 36.6 (95% CI 35.2-37.9), 29.6 (95% CI 28.4-30.8), and 38.3 (95% CI 36.9-39.7), respectively. Cox regression models showed that African American women had a higher risk than White women for heart failure (hazard ratio (HR) 1.26; 95% CI 1.18-1.34), stroke (HR 1.15; 95% CI 1.08-1.22), and ESRD (HR 1.32; 95% CI 1.24-1.40), whereas African American men had higher risks than White men for heart failure (HR 1.33; 95% CI 1.25-1.43) and ESRD (HR 1.47; 95% CI 1.37-1.57) but a lower risk of CHD (HR 0.88; 95% CI 0.83-0.94). CONCLUSIONS: The incidence of major diabetic complications varied among difference race and sex groups. More race- or sex-specific studies on complications in patients with diabetes are needed to see whether incident rates are changing over time.
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Authors: Yun Shen; Jian Zhou; Lizheng Shi; Elizabeth Nauman; Peter T Katzmarzyk; Eboni G Price-Haywood; Ronald Horswell; Alessandra N Bazzano; Somesh Nigam; Gang Hu Journal: Diabetes Obes Metab Date: 2020-10-07 Impact factor: 6.577
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