Limits...
Diabetes incidence based on linkages with health plans: the multiethnic cohort.

Maskarinec G, Erber E, Grandinetti A, Verheus M, Oum R, Hopping BN, Schmidt MM, Uchida A, Juarez DT, Hodges K, Kolonel LN - Diabetes (2009)

Bottom Line: We computed age-standardized incidence rates and estimated hazard ratios (HRs) for ethnicity, BMI, education, and combined effects of these variables using Cox regression analysis.Compared with the lowest category, the respective HRs for BMIs of 22.0-24.9, 25.0-29.9, and > or =30.0 kg/m(2) were 2.10, 4.12, and 9.48.However, the risk was highest for Japanese Americans and intermediate for Native Hawaiians in each BMI category.

View Article: PubMed Central - PubMed

Affiliation: Cancer Research Center, University of Hawaii, Honolulu, Hawaii, USA. gertraud@crch.hawaii.edu

ABSTRACT

Objective: Using the Hawaii component of the Multiethnic Cohort (MEC), we estimated diabetes incidence among Caucasians, Japanese Americans, and Native Hawaiians.

Research design and methods: After excluding subjects who reported diabetes at baseline or had missing values, 93,860 cohort members were part of this analysis. New case subjects were identified through a follow-up questionnaire (1999-2000), a medication questionnaire (2003-2006), and linkage with two major health plans (2007). We computed age-standardized incidence rates and estimated hazard ratios (HRs) for ethnicity, BMI, education, and combined effects of these variables using Cox regression analysis.

Results: After a total follow-up time of 1,119,224 person-years, 11,838 incident diabetic case subjects were identified with an annual incidence rate of 10.4 per 1,000 person-years. Native Hawaiians had the highest rate with 15.5, followed by Japanese Americans with 12.5, and Caucasians with 5.8 per 1,000 person-years; the adjusted HRs were 2.65 for Japanese Americans and 1.93 for Native Hawaiians. BMI was positively related to incidence in all ethnic groups. Compared with the lowest category, the respective HRs for BMIs of 22.0-24.9, 25.0-29.9, and > or =30.0 kg/m(2) were 2.10, 4.12, and 9.48. However, the risk was highest for Japanese Americans and intermediate for Native Hawaiians in each BMI category. Educational achievement showed an inverse association with diabetes risk, but the protective effect was limited to Caucasians.

Conclusions: Within this multiethnic population, diabetes incidence was twofold higher in Japanese Americans and Native Hawaiians than in Caucasians. The significant interaction of ethnicity with BMI and education suggests ethnic differences in diabetes etiology.

Show MeSH

Related in: MedlinePlus

Incident diabetic case subjects (N = 11,838) identified at different follow-up periods within the Hawaii component of the MEC. *Number of subjects provided to BCBS; health plan membership not established for noncase subjects.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2712787&req=5

Figure 1: Incident diabetic case subjects (N = 11,838) identified at different follow-up periods within the Hawaii component of the MEC. *Number of subjects provided to BCBS; health plan membership not established for noncase subjects.

Mentions: Of the original 103,898 members within the Hawaii subset of the MEC, 10,028 (9.7%) subjects who reported a diagnosis of diabetes at baseline (Table 1) and 10 subjects who had missing information were excluded from the incidence analysis (Fig. 1). Subjects who indicated having diabetes at any point after baseline or who were classified as case subjects by one of the health plans were considered incident at the time of the first report. Individuals who never reported diabetes and who were not identified as diabetic patients by the health plans were categorized as noncase subjects. As described above, data on diabetes status were available at three subsequent time points from four different sources: the FuQx, the MedQx, and the linkage with the BCBS and KP health plans. Of the 86,732 participants who completed the FuQx, 9,964 (11.5%) indicated diabetes. At the time of the MedQx, 4,425 (11.1%) of the 39,787 subjects reported use of diabetes medications. Finally, of the 88,004 MEC subjects linked with the BCBS plan, 11,375 were identified as diabetic case subjects (16.9% of estimated BCBS members, i.e., 88,004 minus 20,539 KP members), while 20,539 (23.3%) MEC subjects were identified as KP members of whom 4,003 (19.5%) were diabetic case subjects.


Diabetes incidence based on linkages with health plans: the multiethnic cohort.

Maskarinec G, Erber E, Grandinetti A, Verheus M, Oum R, Hopping BN, Schmidt MM, Uchida A, Juarez DT, Hodges K, Kolonel LN - Diabetes (2009)

Incident diabetic case subjects (N = 11,838) identified at different follow-up periods within the Hawaii component of the MEC. *Number of subjects provided to BCBS; health plan membership not established for noncase subjects.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2712787&req=5

Figure 1: Incident diabetic case subjects (N = 11,838) identified at different follow-up periods within the Hawaii component of the MEC. *Number of subjects provided to BCBS; health plan membership not established for noncase subjects.
Mentions: Of the original 103,898 members within the Hawaii subset of the MEC, 10,028 (9.7%) subjects who reported a diagnosis of diabetes at baseline (Table 1) and 10 subjects who had missing information were excluded from the incidence analysis (Fig. 1). Subjects who indicated having diabetes at any point after baseline or who were classified as case subjects by one of the health plans were considered incident at the time of the first report. Individuals who never reported diabetes and who were not identified as diabetic patients by the health plans were categorized as noncase subjects. As described above, data on diabetes status were available at three subsequent time points from four different sources: the FuQx, the MedQx, and the linkage with the BCBS and KP health plans. Of the 86,732 participants who completed the FuQx, 9,964 (11.5%) indicated diabetes. At the time of the MedQx, 4,425 (11.1%) of the 39,787 subjects reported use of diabetes medications. Finally, of the 88,004 MEC subjects linked with the BCBS plan, 11,375 were identified as diabetic case subjects (16.9% of estimated BCBS members, i.e., 88,004 minus 20,539 KP members), while 20,539 (23.3%) MEC subjects were identified as KP members of whom 4,003 (19.5%) were diabetic case subjects.

Bottom Line: We computed age-standardized incidence rates and estimated hazard ratios (HRs) for ethnicity, BMI, education, and combined effects of these variables using Cox regression analysis.Compared with the lowest category, the respective HRs for BMIs of 22.0-24.9, 25.0-29.9, and > or =30.0 kg/m(2) were 2.10, 4.12, and 9.48.However, the risk was highest for Japanese Americans and intermediate for Native Hawaiians in each BMI category.

View Article: PubMed Central - PubMed

Affiliation: Cancer Research Center, University of Hawaii, Honolulu, Hawaii, USA. gertraud@crch.hawaii.edu

ABSTRACT

Objective: Using the Hawaii component of the Multiethnic Cohort (MEC), we estimated diabetes incidence among Caucasians, Japanese Americans, and Native Hawaiians.

Research design and methods: After excluding subjects who reported diabetes at baseline or had missing values, 93,860 cohort members were part of this analysis. New case subjects were identified through a follow-up questionnaire (1999-2000), a medication questionnaire (2003-2006), and linkage with two major health plans (2007). We computed age-standardized incidence rates and estimated hazard ratios (HRs) for ethnicity, BMI, education, and combined effects of these variables using Cox regression analysis.

Results: After a total follow-up time of 1,119,224 person-years, 11,838 incident diabetic case subjects were identified with an annual incidence rate of 10.4 per 1,000 person-years. Native Hawaiians had the highest rate with 15.5, followed by Japanese Americans with 12.5, and Caucasians with 5.8 per 1,000 person-years; the adjusted HRs were 2.65 for Japanese Americans and 1.93 for Native Hawaiians. BMI was positively related to incidence in all ethnic groups. Compared with the lowest category, the respective HRs for BMIs of 22.0-24.9, 25.0-29.9, and > or =30.0 kg/m(2) were 2.10, 4.12, and 9.48. However, the risk was highest for Japanese Americans and intermediate for Native Hawaiians in each BMI category. Educational achievement showed an inverse association with diabetes risk, but the protective effect was limited to Caucasians.

Conclusions: Within this multiethnic population, diabetes incidence was twofold higher in Japanese Americans and Native Hawaiians than in Caucasians. The significant interaction of ethnicity with BMI and education suggests ethnic differences in diabetes etiology.

Show MeSH
Related in: MedlinePlus