Diabetes mellitus prevalence is increasing in South Asians but is stable in Chinese living in Singapore and Mauritius

Background Asia is experiencing a type 2 diabetes epidemic, but prevalence differs by ethnicity and level of socioeconomic 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‐standardized 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‐standardized prevalence of diabetes remained stable for Chinese (men: 14% in 1992, 13% in 2010; women: 12% in 1992, 10% in 2010), but increases were observed for South Asians (men: 20% in 1992, 26% in 2010; women: 18% in 1992, 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 regardless of country. Conclusions Despite different socioeconomic 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. 摘要 背景2型糖尿病在亚洲日益流行,但是患病率却因为种族以及社会经济发展水平不同而有所差异。新加坡与毛里求斯已经实施了全面的综合性措施以解决这个公共卫生问题。为了明确种族以及经济发展水平对糖尿病的影响,我们在居住于新加坡以及毛里求斯的华裔与南亚人之间比较了糖尿病以及肥胖患病率的变化趋势。 方法使用1987至2010年之间新加坡与毛里求斯连续全国人口调查中特定年龄段的数据评估按照年龄标准化后的糖尿病以及肥胖患病率。使用改进后的Breslow‐Cox比例风险模型获取糖尿病危险因素的比率(rate ratios)。 结果在新加坡,按照年龄标准化后的华裔糖尿病患病率保持稳定(男性:1992年为14%,2010年为13%;女性:1992年为12%,2010年为10%),但是在南亚人中却观察到糖尿病患病率不断增加(男性:1992年为20%,2010年为26%;女性:1992年为18%,2010年为20%)。在毛里求斯也可以看到类似的变化趋势。在这两个国家中,华裔女性的肥胖患病率变化趋势都很稳定,但是华裔男性以及南亚人的肥胖患病率却增加了。如果不考虑国家因素,与南亚人相比,在华裔中肥胖与糖尿病之间的相关性更强。 结论尽管新加坡与毛里求斯的社会经济环境不同,但是我们在这两个国家中都能够观察到南亚人的糖尿病患病率在不断上升,但是华裔的糖尿病患病率却保持稳定。这进一步证明种族对糖尿病的发生有影响,因此在这些国家中应该重点针对南亚人群制定未来的预防策略。 Age‐standardized prevalence of diabetes and obesity (body mass index ≥27.5 kg/m2) of (a) Chinese men, (b) Chinese women, (c) South Asian men, and (d) South Asian women in Singap