Metabolic changes in immigrants from Africa to a Western country: time‐lag effects of 20 years since immigration 从非洲迁到一个西方国家后移民的代谢变化:从迁移开始的20年滞后效应 Academic Article uri icon

abstract

  • Background An increase in the prevalence of type 2 diabetes mellitus occurs in immigrants from developing regions to Western countries. However, the dynamics of these transitions in relation to the duration of residence in the new environment are not clearly defined. Methods Data concerning cardiovascular risk factors were retrospectively extracted from medical charts of 736 Ethiopian immigrants and 575 randomly-chosen, age and sex matched non-Ethiopian subjects (“reference group”). Ethiopian immigrants were designated “established” (≥20 years of residence), “intermediate” (10–15 years of residence), or “recent” (<10 years of residence). Results Compared to non-Ethiopians, the age- and sex-adjusted odds ratio (OR) for diabetes was 1.00 (95%CI: 0.66–1.49) for established, 0.55 (95%CI: 0.29–1.03) for intermediate, and 0.15 (95%CI: 0.04–0.50) for recent immigrants (P < 0.001). The corresponding OR for hypertension was 0.94 (95%CI: 0.68–1.31), 0.42 (95%CI: 0.26–0.69), and 0.14 (95%CI: 0.06–0.30) for the established, intermediate, and recent immigrants respectively (P < 0.001). In contrast to the gradual increase in prevalence of diabetes and hypertension, the Ethiopian immigrants maintained their lower body mass index (BMI) (28.7 ± 5 vs 25.5 ± 5 kg/m2 respectively, P < 0.001) and serum low-density-lipoprotein cholesterol (129 ± 36 vs 118 ± 34 mg/dL, P < 0.001) compared to the non-Ethiopians even after 20 years of residence in Israel. Conclusions The prevalence of diabetes and hypertension among the immigrants increased to about half that of the local population within 15 years and became equal to that of the local population after a time-lag of 20 years. These metabolic derangements occurred despite maintaining desirable BMI levels, reinforcing the need for re-defining optimal BMI ranges in relation to the ethnic origin. 摘要 背景: 从发展中地区迁到西方国家后,移民的2型糖尿病患病率增加了。然而,目前尚未十分明确的是与在新环境居留时间相关的转变的动力学。 方法: 从736名埃塞俄比亚移民和575名随机选择的年龄与性别相匹配的非埃塞俄比亚裔受试者(“参照组”)病历中回顾性提取心血管危险因素相关的数据。埃塞俄比亚移民被分为“久居组”(居住时间 ≥20年)、“中间组”居住时间10–15年)、或者“近期组”(居住时间 <10年)。 结果: 与非埃塞俄比亚裔相比较,经过年龄与性别校正后久居组移民的糖尿病患病率优势比(OR)为1.00(95% CI:0.66–1.49),中间组为0.55(95% CI:0.29–1.03),近期组为0.15(95% CI:0.04–0.50)(P < 0.001)。久居组、中间组以及近期组移民相应的高血压OR分别为0.94(95% CI:0.68–1.31)、0.42(95% CI:0.26–0.69)与0.14(95% CI:0.06–0.30)(P < 0.001)。与埃塞俄比亚移民的糖尿病以及高血压患病率逐渐升高大不相同的是,即使他们已经在以色列居留了20年以上,但是与非埃塞俄比亚裔相比较,他们的体重指数(BMI)(分别为28.7 ± 5与25.5 ± 5 kg/m2,P < 0.001)与血清低密度脂蛋白胆固醇(分别为129 ± 36与118 ± 34 mg/dL,P < 0.001)仍然保持在较低的水平。 结论: 移民的糖尿病与高血压患病率在15年内就大约升高至当地人群水平的一半,且经过20年的滞后效应后就变得与当地人群相同了。尽管他们能够保持理想的BMI水平,但是这些代谢紊乱仍然发生了,因此急需根据不同种族起源重新定义最佳的BMI范围。

publication date

  • January 1, 2015