The Prevalence of Cardiovascular Disease and Other Comorbidities Among American Indian and Alaska Native Adults with Diabetes.

EC endocrinology and metabolic research Pub Date : 2021-02-01 Epub Date: 2021-01-27

Joan M O'Connell, Jennifer E Rockell, Judith C Ouellet, Sherri Yoder, Kimberly E Lind, Charlton Wilson, Andrew Friedson, Spero M Manson

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Abstract

Aims: American Indians and Alaska Native (AI/ANs) peoples experience significant health disparities compared to the U.S. general population. We report comorbidities among AI/ANs with diabetes to guide efforts to improve their health status.

Methods: Drawing upon data for over 640,000 AI/ANs who used services funded by the Indian Health Service, we identified 43,518 adults with diabetes in fiscal year 2010. We reported the prevalence of comorbidities by age and cardiovascular disease (CVD) status. Generalized linear models were estimated to describe associations between CVD and other comorbidities.

Results: Nearly 15% of AI/AN adults had diabetes. Hypertension, CVD and kidney disease were comorbid in 77.9%, 31.6%, and 13.3%, respectively. Nearly 25% exhibited a mental health disorder; 5.7%, an alcohol or drug use disorder. Among AI/ANs with diabetes absent CVD, 46.9% had 2 or more other chronic conditions; the percentage among adults with diabetes and CVD was 75.5%. Hypertension and tobacco use disorders were associated with a 71% (95% CI for prevalence ratio: 1.63 - 1.80) and 33% (1.28 - 1.37) higher prevalence of CVD, respectively, compared to adults without these conditions.

Conclusion: Detailed information on the morbidity burden of AI/ANs with diabetes may inform enhancements to strategies implemented to prevent and treat CVD and other comorbidities.

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美国印第安人和阿拉斯加原住民成人糖尿病患者心血管疾病及其他并发症的患病率。

目的：与美国普通人群相比，美国印第安人和阿拉斯加原住民（AI/ANs）在健康方面存在显著差异。我们报告了美国印第安人和阿拉斯加原住民中糖尿病患者的合并症，以便为改善他们的健康状况提供指导：根据使用印第安人医疗服务机构资助服务的 64 万多名亚裔美国人/印第安人的数据，我们确定了 2010 财年的 43518 名成年糖尿病患者。我们按年龄和心血管疾病（CVD）状况报告了合并症的患病率。我们估算了广义线性模型，以描述心血管疾病与其他合并症之间的关联：结果：近 15%的美国原住民/印第安人成年人患有糖尿病。合并高血压、心血管疾病和肾病的比例分别为 77.9%、31.6% 和 13.3%。近 25% 的人患有精神疾病；5.7% 的人患有酗酒或吸毒疾病。在患有糖尿病且无心血管疾病的亚裔美国人/印第安人中，46.9%的人患有 2 种或 2 种以上其他慢性疾病；在患有糖尿病和心血管疾病的成年人中，这一比例为 75.5%。与没有这些病症的成年人相比，高血压和烟草使用障碍与心血管疾病的患病率分别高出 71% （患病率比值 95% CI：1.63 - 1.80）和 33% （1.28 - 1.37）：关于亚裔美国人/印第安人糖尿病患者发病负担的详细信息可为加强预防和治疗心血管疾病及其他合并症的策略提供参考。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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