Race/Ethnicity Disparities in Dysglycemia Among US Women of Childbearing Age Found Mainly in the Nonoverweight/Nonobese

• Type of Material: Article
• Authors: Jessica A. Marcinkevage, Centers for Disease Control and Prevention; C.J. Alverson, Centers for Disease Control and Prevention; K.M. Venkat Narayan, Emory University; Henry S. Kahn, Centers for Disease Control and Prevention; Julia Ruben, D-Tree International; Adolfo Correa, University of Mississippi Medical Center
• Language: English
• Date: 2013-10-01
• Publisher: American Diabetes Association
• Publication Version: Final Published Version
• Copyright Statement: © 2013 by the American Diabetes Association.
• License: Creative Commons Attribution-NonCommerical-NoDerivs 3.0 Unported
• Final Published Version (URL): http://dx.doi.org/10.2337/dc12-2312
• Title of Journal or Parent Work: Diabetes Care
• ISSN: 0149-5992
• Volume: 36
• Issue: 10
• Start Page: 3033
• End Page: 3039
• Grant/Funding Information: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.; This project was supported in part by an appointment to the Research Participation Program for the Centers for Disease Control and Prevention administered by the Oak Ridge Institute for Science and Education through an agreement between the Department of Energy and the Centers of Disease Control and Prevention.
• Keywords: AFRICAN-AMERICANS; OBESITY; Science & Technology; PREVALENCE; INSULIN SENSITIVITY; RISK; GLYCATED HEMOGLOBIN; ADIPOSE-TISSUE; BETA-CELL FUNCTION; Life Sciences & Biomedicine; Endocrinology & Metabolism; METABOLIC SYNDROME; DIABETES-MELLITUS
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Public Health

Abstract

OBJECTIVE To describe the burden of dysglycemiadabnormal glucose metabolism indicative of diabetes or high risk for diabetesdamong U.S. women of childbearing age, focusing on differences by race/ethnicity. RESEARCH DESIGN ANDMETHODSdUsing U.S. National Health and Nutrition Examination Survey data (1999-2008), we calculated the burden of dysglycemia (i.e., prediabetes or diabetes from measures of fasting glucose, A1C, and self-report) in nonpregnant women of childbearing age (15-49 years) by race/ethnicity status. We estimated prevalence risk ratios (PRRs) for dysglycemia in subpopulations stratified by BMI (measured as kilograms divided by the square of height in meters), using predicted marginal estimates and adjusting for age, waist circumference, C-reactive protein, and socioeconomic factors. RESULTSdBased on data from 7,162 nonpregnant women, representing > 59,000,000 women nationwide, 19% (95% CI 17.2-20.9) had some level of dysglycemia, with higher crude prevalence among non-Hispanic blacks and Mexican Americans vs. non-Hispanic whites (26.3% [95% CI 22.3-30.8] and 23.8% [19.5-28.7] vs. 16.8% [14.4-19.6], respectively). In women with BMI < 25 kg/m2, dysglycemia prevalence was roughly twice as high in both non-Hispanic blacks and Mexican Americans vs. non-Hispanic whites. This relative increase persisted in adjusted models (PRRadj 1.86 [1.16-2.98] and 2.23 [1.38-3.60] for non-Hispanic blacks and Mexican Americans, respectively). For women with BMI 25-29.99 kg/m2, only non-Hispanic blacks showed increased prevalence vs. non-Hispanic whites (PRRadj 1.55 [1.03-2.34] and 1.28 [0.73-2.26] for non-Hispanic blacks andMexican Americans, respectively). In women with BMI > 30 kg/m2, there was no significant increase in prevalence of dysglycemia by race/ethnicity category. CONCLUSIONS Our findings show that dysglycemia affects a significant portion of U.S. women of childbearing age and that disparities by race/ethnicity are most prominent in the nonoverweight/nonobese.