| 21. |
- Tan, Kristin H. X., et al.
(författare)
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Diabetes mellitus prevalence is increasing in South Asians but is stable in Chinese living in Singapore and Mauritius
- 2017
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Ingår i: Journal of Diabetes. - : John Wiley & Sons. - 1753-0393 .- 1753-0407. ; 9:9, s. 855-864
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Asia is experiencing a type 2 diabetes epidemic but prevalence differs by ethnicity and level of socio-economic development. Singapore and Mauritius have implemented comprehensive campaigns to address this public health problem. We compared diabetes and obesity prevalence trends among Chinese and South Asians living in Singapore and Mauritius to determine the contribution of ethnicity and economic development to diabetes.METHODS: Age-specific data from serial national population-based surveys in Singapore and Mauritius between 1987 and 2010 were used to estimate age-standardised diabetes and obesity prevalence. Modified Breslow-Cox Proportional hazard models were used to obtain rate ratios for diabetes risk factors.RESULTS: In Singapore, the age-standardised prevalence of diabetes remained stable for Chinese (men 14% in 1992 and 13% in 2010; women 12% in 1992 and 10% in 2010); however, increases were observed for South Asians (men 20% in 1992 and 26% in 2010; women 18% in 1992 and 20% in 2010). There were similar patterns in Mauritius. In both countries, obesity prevalence trends were stable for Chinese women, but increased for Chinese men and South Asians. Associations between obesity and diabetes were stronger in Chinese than South Asians irrespective of country.CONCLUSIONS: Despite different socio-economic settings in Singapore and Mauritius, we observed rising diabetes prevalence among South Asians but stable prevalence in Chinese in both countries. This provides further evidence that ethnicity contributes to the development of diabetes, and that there should be an increased emphasis on future prevention strategies targeting South Asian populations in these countries.
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| 22. |
- Tanamas, Stephanie K., et al.
(författare)
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The performance of diabetes risk prediction models in new populations : the role of ethnicity of the development cohort
- 2015
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Ingår i: Acta Diabetologica. - : Springer Science and Business Media LLC. - 0940-5429 .- 1432-5233. ; 52:1, s. 91-101
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Tidskriftsartikel (refereegranskat)abstract
- It is believed that diabetes risk scores need to be ethnic specific. However, this prerequisite has not been tested. We examined the performance of several risk models, developed in various populations, in a Europid and a South Asian population. The performance of 14 published risk prediction models were tested in two prospective studies: the Australian Diabetes, Obesity and Lifestyle (AusDiab) study and the Mauritius non-communicable diseases survey. Eight models were developed in Europid populations; the remainder in various non-Europid populations. Model performance was assessed using area under the receiver operating characteristic curves (discrimination), Hosmer-Lemeshow tests (goodness-of-fit) and Brier scores (accuracy). In both AusDiab and Mauritius, discrimination was highest for a model developed in a mixed population (non-Hispanic white and African American) and lowest for a model developed in a Europid population. Discrimination for all scores was higher in AusDiab than in Mauritius. For almost all models, goodness-of-fit was poor irrespective of the ethnicity of the development cohort, and accuracy was higher in AusDiab compared to Mauritius. Our results suggest that similarity of ethnicity or similarity of diabetes risk may not be the best way of identifying models that will perform well in another population. Differences in study methodology likely account for much of the difference in the performance. Thus, identifying models which use measurements that are clearly described and easily reproducible for both research and clinical settings may be more important.
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