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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.

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Related in: MedlinePlus

Influence of education on diabetes incidence by ethnicity. Data are HRs and 95% CIs from the Cox regression analysis (adjusted for age, sex, and BMI). Caucasians with <13 years of education are the reference category.
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Figure 3: Influence of education on diabetes incidence by ethnicity. Data are HRs and 95% CIs from the Cox regression analysis (adjusted for age, sex, and BMI). Caucasians with <13 years of education are the reference category.

Mentions: With regard to education, subjects with >12 years of education experienced a significantly lower diabetes risk; the HRs were 0.94 (95% CI 0.89–0.98) for subjects with 13–15 years of education and 0.83 (0.79–0.87) for college graduates. In the interaction model (Fig. 3), the respective HRs were 0.67 (0.61–0.74), 1.96 (1.79–2.14), and 1.62 (1.42–1.84) for Caucasians, Japanese Americans, and Native Hawaiians when the highest level was compared with the lowest category in Caucasians. As indicated by the CIs, risk in Japanese Americans and Native Hawaiians did not differ significantly by education.


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)

Influence of education on diabetes incidence by ethnicity. Data are HRs and 95% CIs from the Cox regression analysis (adjusted for age, sex, and BMI). Caucasians with <13 years of education are the reference category.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

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

Figure 3: Influence of education on diabetes incidence by ethnicity. Data are HRs and 95% CIs from the Cox regression analysis (adjusted for age, sex, and BMI). Caucasians with <13 years of education are the reference category.
Mentions: With regard to education, subjects with >12 years of education experienced a significantly lower diabetes risk; the HRs were 0.94 (95% CI 0.89–0.98) for subjects with 13–15 years of education and 0.83 (0.79–0.87) for college graduates. In the interaction model (Fig. 3), the respective HRs were 0.67 (0.61–0.74), 1.96 (1.79–2.14), and 1.62 (1.42–1.84) for Caucasians, Japanese Americans, and Native Hawaiians when the highest level was compared with the lowest category in Caucasians. As indicated by the CIs, risk in Japanese Americans and Native Hawaiians did not differ significantly by education.

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