Yasmin Ezzatvar1, Robinson Ramírez-Vélez2,3, Mikel Izquierdo2,3, Antonio García-Hermoso4,5,6. 1. Department of Nursing, Universitat de València, Valencia, Spain. 2. Navarrabiomed, Navarra Hospital Complex (CHN), Public University of Navarra (UPNA), IdiSNA, Pamplona, Spain. 3. CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain. 4. Navarrabiomed, Navarra Hospital Complex (CHN), Public University of Navarra (UPNA), IdiSNA, Pamplona, Spain. antonio.garciah@unavarra.es. 5. CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain. antonio.garciah@unavarra.es. 6. Sciences of Physical Activity, Sports and Health School, University of Santiago of Chile (USACH), Santiago, Chile. antonio.garciah@unavarra.es.
Abstract
AIMS/HYPOTHESIS: The aim of this work was to quantify racial/ethnic differences in risk for future diabetic complications and all-cause mortality by performing a meta-analysis of prospective studies. METHODS: A systematic search in PubMed and EMBASE was performed from inception to May 2021. Prospective cohort studies that reported HRs and associated 95% CIs of diabetes complications and all-cause mortality among racial/ethnic groups, with White people as the reference group, were included. Study characteristics and HR estimates were extracted from each study. Estimates were pooled using random-effects inverse-variance model with the Hartung-Knapp-Sidik-Jonkman variance estimator. RESULTS: A total of 23 studies were included, comprising 2,416,516 individuals diagnosed with diabetes (White 59.3%, Black 11.2%, Asian 1.3%, Hispanic-American 2.4%, Native American 0.2%, East Asian 1.9%, South Asian 0.8%, Pacific Islander 2.3%, Māori 2.4% and others 18.2%). Compared with White individuals with diabetes, individuals of Māori ethnicity were at higher risk for all-cause mortality (HR 1.88 [95% CI 1.61, 2.21]; I2 = 7.1%), Hispanic-American individuals had a significantly lower risk for CVD (HR 0.66 [95% CI 0.53, 0.81]; I2 = 0%) and Black individuals had higher risk for end-stage renal disease (HR 1.54 [95% CI 1.05, 2.24]; I2 = 95.4%). No significant higher risk for diabetes complications was found in other racial/ethnic groups relative to White people. CONCLUSIONS/ INTERPRETATION: Racial/ethnic differences exist in the risk for future diabetic complications and all-cause mortality. Our results support the use of such categories for international diabetes clinical guideline recommendations until better predictors become available. Efforts to identify high-risk groups and to better control cardiovascular risk factors across ethnically diverse populations are therefore needed. REGISTRATION: PROSPERO registration ID CRD42021239274.
AIMS/HYPOTHESIS: The aim of this work was to quantify racial/ethnic differences in risk for future diabetic complications and all-cause mortality by performing a meta-analysis of prospective studies. METHODS: A systematic search in PubMed and EMBASE was performed from inception to May 2021. Prospective cohort studies that reported HRs and associated 95% CIs of diabetes complications and all-cause mortality among racial/ethnic groups, with White people as the reference group, were included. Study characteristics and HR estimates were extracted from each study. Estimates were pooled using random-effects inverse-variance model with the Hartung-Knapp-Sidik-Jonkman variance estimator. RESULTS: A total of 23 studies were included, comprising 2,416,516 individuals diagnosed with diabetes (White 59.3%, Black 11.2%, Asian 1.3%, Hispanic-American 2.4%, Native American 0.2%, East Asian 1.9%, South Asian 0.8%, Pacific Islander 2.3%, Māori 2.4% and others 18.2%). Compared with White individuals with diabetes, individuals of Māori ethnicity were at higher risk for all-cause mortality (HR 1.88 [95% CI 1.61, 2.21]; I2 = 7.1%), Hispanic-American individuals had a significantly lower risk for CVD (HR 0.66 [95% CI 0.53, 0.81]; I2 = 0%) and Black individuals had higher risk for end-stage renal disease (HR 1.54 [95% CI 1.05, 2.24]; I2 = 95.4%). No significant higher risk for diabetes complications was found in other racial/ethnic groups relative to White people. CONCLUSIONS/ INTERPRETATION: Racial/ethnic differences exist in the risk for future diabetic complications and all-cause mortality. Our results support the use of such categories for international diabetes clinical guideline recommendations until better predictors become available. Efforts to identify high-risk groups and to better control cardiovascular risk factors across ethnically diverse populations are therefore needed. REGISTRATION: PROSPERO registration ID CRD42021239274.
Authors: Katherine M Flegal; Deanna Kruszon-Moran; Margaret D Carroll; Cheryl D Fryar; Cynthia L Ogden Journal: JAMA Date: 2016-06-07 Impact factor: 56.272
Authors: Yeyi Zhu; Margo A Sidell; David Arterburn; Matthew F Daley; Jay Desai; Stephanie L Fitzpatrick; Michael A Horberg; Corinna Koebnick; Emily McCormick; Caryn Oshiro; Deborah R Young; Assiamira Ferrara Journal: Diabetes Care Date: 2019-09-19 Impact factor: 19.112
Authors: Loes C Lanting; Inez M A Joung; Johan P Mackenbach; Steven W J Lamberts; Aart H Bootsma Journal: Diabetes Care Date: 2005-09 Impact factor: 19.112
Authors: Pouya Saeedi; Paraskevi Salpea; Suvi Karuranga; Inga Petersohn; Belma Malanda; Edward W Gregg; Nigel Unwin; Sarah H Wild; Rhys Williams Journal: Diabetes Res Clin Pract Date: 2020-02-14 Impact factor: 5.602
Authors: Elizabeth R Mayeda; Andrew J Karter; Elbert S Huang; Howard H Moffet; Mary N Haan; Rachel A Whitmer Journal: Diabetes Care Date: 2013-11-22 Impact factor: 19.112