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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
KeywordsAfrican Continental Ancestry Group, Blood Glucose, Blood Pressure, Diabetes Mellitus, Type 2, European Continental Ancestry Group, Female, Humans, Lipids, Male, Middle Aged, Multivariate Analysis, Proportional Hazards Models, Prospective Studies, Risk Factors, United States
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