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Incident type 2 diabetes mellitus in African American and white adults: the Atherosclerosis Risk in Communities Study.

TitleIncident type 2 diabetes mellitus in African American and white adults: the Atherosclerosis Risk in Communities Study.
Publication TypeJournal Article
Year of Publication2000
AuthorsBrancati FL, Kao WH, Folsom AR, Watson RL, Szklo M
JournalJAMA
Volume283
Issue17
Pagination2253-9
Date Published2000 May 03
ISSN0098-7484
KeywordsBlacks, Blood Glucose, Blood Pressure, Diabetes Mellitus, Type 2, Female, Humans, Lipids, Male, Middle Aged, Multivariate Analysis, Proportional Hazards Models, Prospective Studies, Risk Factors, United States, Whites
Abstract

CONTEXT: Although the excess prevalence of type 2 diabetes mellitus in African Americans is well established, few studies have compared incident diabetes in African American and white persons.

OBJECTIVES: To compare risk of incident diabetes in African American vs white adults and to identify explanatory factors for racial disparities.

DESIGN: Prospective cohort study using baseline data collected from 1986 to 1989 from the ongoing Atherosclerosis Risk in Communities (ARIC) Study, with 9 years of follow-up.

SETTING AND PARTICIPANTS: A total of 2646 African American and 9461 white adults aged 45 to 64 years without diabetes at baseline, sampled from 4 US communities.

MAIN OUTCOME MEASURES: Incident type 2 diabetes, ascertained by self-report of physician diagnosis, use of diabetes medications, or fasting glucose level of at least 7.0 mmol/L (126 mg/dL), compared among white and African American subjects and by presence of potentially modifiable risk factors.

RESULTS: Diabetes incidence per 1000 person-years was about 2.4-fold greater in African American women (25.1 [95% confidence interval [CI], 22.4-28.1] vs 10.4 [95% CI, 9.4-11.4]) and about 1.5-fold greater in men (23.4 [95% CI, 19.9-27.2] vs 15.9 [95% CI, 14.6-17.2]) than in their white counterparts (P<.001 results="" from="" proportional="" hazards="" regression="" models="" indicated="" that="" racial="" differences="" in="" potentially="" modifiable="" risk="" factors="" particularly="" adiposity="" accounted="" for="" of="" the="" excess="" african="" american="" women="" but="" little="" men.="" compared="" with="" their="" white="" counterparts="" men="" and="" had="" higher="" blood="" pressures="" before="" diabetes="" onset="" pressure="" difference="5.6" mm="" hg="" p=".005).</p">

CONCLUSIONS: Our data indicate that compared with their white counterparts, middle-aged African Americans are at greater risk of developing type 2 diabetes and have higher blood pressure prior to development of diabetes. In women, almost 50% of this excess risk might be related to potentially modifiable factors.

DOI10.1001/jama.283.17.2253
Alternate JournalJAMA
PubMed ID10807384
Grant ListN01 HC55015 / HC / NHLBI NIH HHS / United States
N01 HC55016 / HC / NHLBI NIH HHS / United States
N01 HC55018 / HC / NHLBI NIH HHS / United States