Introduction The burden of type 2 diabetes mellitus (T2DM) and related vascular complications is particularly high in Asians and ethnic minorities living in the West. However, the association of T2DM with socioeconomic status (SES) and ethnicity has not been widely studied in populations living in Asia. Therefore, we investigated these associations among the multiethnic population with uncontrolled hypertension in Singapore. Research design and methods In a cross-sectional study using baseline data of a 2-year randomized trial in Singapore, we obtained demographic, SES, lifestyle and clinical factors from 915 patients aged ≥40 years with uncontrolled hypertension. T2DM was defined as having either: (i) self-reported ‘physician-diagnosed diabetes confirmed through medical records’ or taking antidiabetes medications, (ii) fasting blood glucose levels ≥7.0 mmol/dL or (iii) hemoglobin A1c ≥6.5%. The SES proxies included education, employment status, housing ownership and housing type, and the ethnicities were Chinese, Malays and Indians. Logistic regression analyses were used to evaluate the association of T2DM with SES and ethnicity. Results Higher proportion of T2DM was observed in Malays (40.0%) and Indians (56.0%) than Chinese (26.8%) (p<0.001), and in patients with lower SES (ranging from 25.7% to 66.2% using different proxies) than those with higher SES (19.4% to 32.0%). In a multivariate model comprising age, gender, ethnicity and SES, Malay ethnicity (OR 1.59; 95% CI 1.04 to 2.44, p=0.031) or Indian ethnicity (OR 3.65; 95% CI 2.25 to 5.91, p<0.001) versus Chinese and housing type (residing in one to three rooms (OR 2.00; 95% CI 1.16 to 3.43, p=0.012) or four to five rooms public housing (OR 1.86; 95% CI 1.13 to 3.04, p=0.013) vs private housing) were associated with higher T2DM odds. The associations of Indians and one to three rooms public housing with T2DM met the significance after accounting for multiple testing (p≤0.0125). Conclusion Our study suggests that housing type and ethnic variation are independently associated with higher T2DM risk in patients with uncontrolled hypertension in Singapore. Further studies are needed to validate our results. Trial registration number [NCT02972619][1]. Data are available on reasonable request from THJ subject to approval by SingHypertension IRB. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT02972619&atom=%2Fbmjdrc%2F9%2F1%2Fe002064.atom

中文翻译：

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新加坡未受控制的高血压患者与 2 型糖尿病相关的社会经济状况和种族差异

简介 亚洲人和西方少数民族的 2 型糖尿病 (T2DM) 和相关血管并发症的负担特别高。然而，T2DM 与社会经济地位 (SES) 和种族的关系尚未在亚洲人群中得到广泛研究。因此，我们调查了新加坡高血压未受控制的多种族人群之间的这些关联。研究设计和方法 在一项横断面研究中，我们使用新加坡一项为期 2 年的随机试验的基线数据，从 915 名年龄≥40 岁且未受控制的高血压患者中获得了人口统计学、社会经济地位、生活方式和临床因素。T2DM 的定义为：(i) 自我报告“通过病历证实医生诊断为糖尿病”或服用抗糖尿病药物，(ii) 空腹血糖水平≥7.0 mmol/dL 或 (iii) 糖化血红蛋白≥6.5%。SES指标包括教育程度、就业状况、住房拥有率和住房类型，种族为华人、马来人和印度人。Logistic 回归分析用于评估 T2DM 与 SES 和种族的关联。结果 马来人 (40.0%) 和印度人 (56.0%) 的 T2DM 比例高于华人 (26.8%) (p<0.001)，而 SES 较低的患者（使用不同指标的范围为 25.7% 至 66.2%）则高于华人 (26.8%)（p<0.001）。社会经济地位较高的人（19.4％至32.0％）。在包含年龄、性别、种族和社会经济地位的多变量模型中，马来族（OR 1.59；95% CI 1.04 至 2.44，p=0.031）或印度族（OR 3.65；95% CI 2.25 至 5.91，p<0.001）与华人相比和住房类型（居住一至三间房间（OR 2.00；95% CI 1.16 至 3.43，p=0.012）或四至五间公共住房（OR 1.86；95% CI 1.13 至 3.04，p=0.013）与私人住房）与较高的 T2DM 几率相关。印度人和一到三间公共住房与 T2DM 的关联在考虑多重测试后达到显着性 (p≤0.0125)。结论 我们的研究表明，住房类型和种族差异与新加坡高血压未受控制的患者较高的 T2DM 风险独立相关。需要进一步的研究来验证我们的结果。试用注册号[NCT02972619][1]。数据可根据 THJ 的合理要求提供，并经 SingHypertension IRB 批准。[1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT02972619&atom=%2Fbmjdrc%2F9%2F1%2Fe002064.atom