Abstract NS5: Pre-diabetes in the Reasons for Geographic and Racial Differences in Stroke Study: A Disregarded Stroke Risk?
Background: Pre-diabetes is a new diagnostic category that is highly associated with a future diagnosis of diabetes. Given the risk for stroke associated with diabetes, we sought to determine bio-behavioral factors associated with pre-diabetes in the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort.
Methods: Participants who were normoglycemic (15,121) and pre-diabetic (4,768) were included. Logistic regression was used to assess the association of bio-behavioral factors (smoking, alcohol use, physical activity) and prevalence of pre-diabetes.
Results: The analysis cohort was 36% African American and 64% White, with more Whites (67%) living within the Stroke Belt. Mean age of subjects was 64.5 + 10 years. The odds of having pre-diabetes as an African American regardless of region was 1.28 (95% CI: 1.19-1.36) compared to Whites, while the odds of having pre-diabetes as an African American living in the Stroke Belt was 1.29 (95% CI: 1.21-1.38) . African Americans with pre-diabetes were less educated (p<.0001) and had lower income (p< .0001) than Whites overall, and those with pre-diabetes within the Stroke Belt were less educated (p< .0001) and had lower income (p< .0001) than their counterparts from other regions. A majority of pre-diabetes African Americans (69%) and Whites (53%) reported no alcohol use at all, as did a majority of pre-diabetes subjects living inside (63%) and outside (53%) the Stroke Belt. Almost one half did not report current or past smoking. Only a minority of participants reported participation in intense physical activity > 4 times/week. A higher perceived health status was reported among Whites and people living outside the Stroke Belt with pre-diabetes (p<.0001).
Conclusion: African American race and living in the Stroke Belt region are associated with increased odds of pre-diabetes. Interventions that aim to prevent pre-diabetes, as well as those that minimize development of a subsequent diabetes diagnosis, may play an important role in reducing future stroke events.
- © 2012 by American Heart Association, Inc.