Abstract：
OBJECTIVE: Racial and ethnic minorities are disproportionately affected by diabetes. Social characteristics, such as family structure, social support, and loneliness, may contribute to these health disparities. In a nationally representative sample of diverse older adults, we evaluated longitudinal rates of both progression from prediabetes to diabetes and reversion from prediabetes to normoglycemia.
METHODS: Using the longitudinal Health and Retirement Study (2006-2014), our sample included 2625 follow-up intervals with a prediabetes baseline (provided by 2229 individuals). We analyzed 4-year progression and reversion rates using HbA1c and reported presence or absence of physician-diagnosed diabetes. We utilized chi-square and logistic regression models to determine how race/ethnicity and social variables influenced progression or reversion controlling for comorbidities and demographics.
RESULTS: Overall, progression to diabetes was less common than reversion (17% vs. 36%). Compared to Whites, Hispanic/Latino respondents had higher odds of progression to diabetes from prediabetes while Black respondents had lower odds of reversion, adjusting for physical health and demographics. For social variables, Hispanics/Latinos had the highest reliance on and openness with family and the lowest rates of loneliness. The inclusion of social variables in regression models reduced the odds of progression for Hispanics/Latinos but did not alter Black\'s lower rate of reversion.
CONCLUSIONS: Hispanic/Latinos and Blacks not only had different transition pathways leading to diabetes, but also had different social profiles, affecting Hispanic/Latino progression, but not Black reversion. These differences in the influence of social variables on diabetes risk may inform the design of culturally-specific efforts to reduce disparities in diabetes burden.
METHODS: Using the longitudinal Health and Retirement Study (2006-2014), our sample included 2625 follow-up intervals with a prediabetes baseline (provided by 2229 individuals). We analyzed 4-year progression and reversion rates using HbA1c and reported presence or absence of physician-diagnosed diabetes. We utilized chi-square and logistic regression models to determine how race/ethnicity and social variables influenced progression or reversion controlling for comorbidities and demographics.
RESULTS: Overall, progression to diabetes was less common than reversion (17% vs. 36%). Compared to Whites, Hispanic/Latino respondents had higher odds of progression to diabetes from prediabetes while Black respondents had lower odds of reversion, adjusting for physical health and demographics. For social variables, Hispanics/Latinos had the highest reliance on and openness with family and the lowest rates of loneliness. The inclusion of social variables in regression models reduced the odds of progression for Hispanics/Latinos but did not alter Black\'s lower rate of reversion.
CONCLUSIONS: Hispanic/Latinos and Blacks not only had different transition pathways leading to diabetes, but also had different social profiles, affecting Hispanic/Latino progression, but not Black reversion. These differences in the influence of social variables on diabetes risk may inform the design of culturally-specific efforts to reduce disparities in diabetes burden.
摘要：
目标：种族和少数民族受糖尿病的影响不成比例。社会特征,比如家庭结构，社会支持,和孤独，可能会导致这些健康差异。在具有全国代表性的不同老年人样本中，我们评估了从糖尿病前期进展为糖尿病和从糖尿病前期进展为血糖恢复正常的纵向速率.
方法：使用纵向健康与退休研究（2006-2014），我们的样本包括2625个糖尿病前期基线随访间隔(由2229例个体提供).我们使用HbA1c分析了4年的进展和逆转率，并报告了是否存在医生诊断的糖尿病。我们利用卡方和逻辑回归模型来确定种族/民族和社会变量如何影响合并症和人口统计学的进展或逆转控制。
结果：总体而言，进展为糖尿病的情况不如逆转(17%vs.36%）。与白人相比,西班牙裔/拉丁裔受访者从糖尿病前期发展为糖尿病的几率较高，而黑人受访者的逆转几率较低，调整身体健康和人口统计。对于社会变量，西班牙裔/拉丁美洲人对家庭的依赖和开放程度最高，孤独率最低。在回归模型中纳入社会变量降低了西班牙裔/拉丁美洲人的发展几率，但并未改变Black的较低回归率。
结论：西班牙裔/拉丁裔和黑人不仅有不同的过渡途径导致糖尿病，但也有不同的社会特征，影响西班牙裔/拉丁裔的发展，但不是黑色回归。社会变量对糖尿病风险的影响的这些差异可能会为减少糖尿病负担差异的文化特异性努力的设计提供信息。
方法：使用纵向健康与退休研究（2006-2014），我们的样本包括2625个糖尿病前期基线随访间隔(由2229例个体提供).我们使用HbA1c分析了4年的进展和逆转率，并报告了是否存在医生诊断的糖尿病。我们利用卡方和逻辑回归模型来确定种族/民族和社会变量如何影响合并症和人口统计学的进展或逆转控制。
结果：总体而言，进展为糖尿病的情况不如逆转(17%vs.36%）。与白人相比,西班牙裔/拉丁裔受访者从糖尿病前期发展为糖尿病的几率较高，而黑人受访者的逆转几率较低，调整身体健康和人口统计。对于社会变量，西班牙裔/拉丁美洲人对家庭的依赖和开放程度最高，孤独率最低。在回归模型中纳入社会变量降低了西班牙裔/拉丁美洲人的发展几率，但并未改变Black的较低回归率。
结论：西班牙裔/拉丁裔和黑人不仅有不同的过渡途径导致糖尿病，但也有不同的社会特征，影响西班牙裔/拉丁裔的发展，但不是黑色回归。社会变量对糖尿病风险的影响的这些差异可能会为减少糖尿病负担差异的文化特异性努力的设计提供信息。
