AIMS/HYPOTHESIS The aim of this work was to quantify racial/ethnic differences in risk for future diabetic complications and all-cause mortality by performing a meta-analysis of prospective studies. METHODS A systematic search in PubMed and EMBASE was performed from inception to May 2021. Prospective cohort studies that reported HRs and associated 95% CIs of diabetes complications and all-cause mortality among racial/ethnic groups, with White people as the reference group, were included. Study characteristics and HR estimates were extracted from each study. Estimates were pooled using random-effects inverse-variance model with the Hartung-Knapp-Sidik-Jonkman variance estimator. RESULTS A total of 23 studies were included, comprising 2,416,516 individuals diagnosed with diabetes (White 59.3%, Black 11.2%, Asian 1.3%, Hispanic-American 2.4%, Native American 0.2%, East Asian 1.9%, South Asian 0.8%, Pacific Islander 2.3%, Māori 2.4% and others 18.2%). Compared with White individuals with diabetes, individuals of Māori ethnicity were at higher risk for all-cause mortality (HR 1.88 [95% CI 1.61, 2.21]; I2 = 7.1%), Hispanic-American individuals had a significantly lower risk for CVD (HR 0.66 [95% CI 0.53, 0.81]; I2 = 0%) and Black individuals had higher risk for end-stage renal disease (HR 1.54 [95% CI 1.05, 2.24]; I2 = 95.4%). No significant higher risk for diabetes complications was found in other racial/ethnic groups relative to White people. CONCLUSIONS/INTERPRETATION Racial/ethnic differences exist in the risk for future diabetic complications and all-cause mortality. Our results support the use of such categories for international diabetes clinical guideline recommendations until better predictors become available. Efforts to identify high-risk groups and to better control cardiovascular risk factors across ethnically diverse populations are therefore needed. REGISTRATION PROSPERO registration ID CRD42021239274.

中文翻译：

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糖尿病患者全因死亡率和未来并发症的种族差异：对超过 240 万人数据的系统回顾和荟萃分析。

目的/假设 这项工作的目的是通过对前瞻性研究进行荟萃分析，量化未来糖尿病并发症和全因死亡率风险的种族/民族差异。方法 从开始到 2021 年 5 月，在 PubMed 和 EMBASE 中进行了系统搜索。前瞻性队列研究报告了种族/族裔群体中糖尿病并发症和全因死亡率的 HR 和相关 95% CI，以白人为参考组，是包括。从每项研究中提取研究特征和 HR 估计值。使用带有 Hartung-Knapp-Sidik-Jonkman 方差估计器的随机效应逆方差模型汇总估计值。结果 共纳入 23 项研究，包括 2,416,516 名被诊断患有糖尿病的个体（白人 59.3%，黑人 11.2%，亚裔 1.3%，西班牙裔美国人 2.4%，美洲原住民 0.2%、东亚 1.9%、南亚 0.8%、太平洋岛民 2.3%、毛利人 2.4% 和其他 18.2%）。与患有糖尿病的白人相比，毛利人的全因死亡率风险更高（HR 1.88 [95% CI 1.61, 2.21]；I2 = 7.1%），西班牙裔美国人的 CVD 风险显着降低（ HR 0.66 [95% CI 0.53, 0.81]；I2 = 0%)，黑人个体患终末期肾病的风险更高（HR 1.54 [95% CI 1.05, 2.24]；I2 = 95.4%）。与白人相比，其他种族/族裔群体的糖尿病并发症风险没有显着增加。结论/解释 未来糖尿病并发症和全因死亡率的风险存在种族/民族差异。我们的结果支持将此类类别用于国际糖尿病临床指南建议，直到有更好的预测指标可用。因此，需要努力识别高危人群并更好地控制不同种族人群的心血管危险因素。注册 PROSPERO 注册 ID CRD42021239274。