Health Disparities in Endocrine Disorders: Biological, Clinical, and Nonclinical Factors—An Endocrine Society Scientific Statement

Abstract

Several themes emerged in the statement, including a need for basic science, population-based, translational and health services studies to explore underlying mechanisms contributing to endocrine health disparities. Compared to non-Hispanic whites, non-Hispanic blacks have worse outcomes and higher mortality from certain disorders despite having a lower (e.g. macrovascular complications of diabetes mellitus and osteoporotic fractures) or similar (e.g. thyroid cancer) incidence of these disorders. Obesity is an important contributor to diabetes risk in minority populations and to sex disparities in thyroid cancer, suggesting that population interventions targeting weight loss may favorably impact a number of endocrine disorders. There are important implications regarding the definition of obesity in different race/ethnic groups, including potential underestimation of disease risk in Asian-Americans and overestimation in non-Hispanic black women. Ethnic-specific cut-points for central obesity should be determined so that clinicians can adequately assess metabolic risk. There is little evidence that genetic differences contribute significantly to race/ethnic disparities in the endocrine disorders examined. Multilevel interventions have reduced disparities in diabetes care, and these successes can be modeled to design similar interventions for other endocrine diseases.

Prevalence of Undiagnosed Type 2 Diabetes Mellitus and Its Associated Factors Among the Malaysian Population: The 2015 National Health and Morbidity Survey, Malaysia

“…Married individuals are 1.21 times more likely to have undiagnosed DM compared to single individuals. Some finding suggest that time constrain when managing careers and family life among married couples may cause lack of opportunity and awareness for prevention practices (Golden et al, 2012). However, other study have suggested that single, divorced and widowed statuses increase the risk of developing DM (Poljičanin, T., Šekerija, M., Boras, Kolarić, Vuletić, & Metelko, 2012).…”

Triglyceride-Based Screening Tests Fail to Recognize Cardiometabolic Disease in African Immigrant and African-American Men

“…[11][12][13] In growing recognition of the failure of the metabolic syndrome to detect risk for cardiometabolic disease in African Americans, the 2012 Endocrine Society Position Statement on Health Disparities suggests moving away from the metabolic syndrome and focusing instead on blood pressure and degree of glycemia. 16 Due to the similarities that we have demonstrated between African Americans and African immigrants, the same approach should be applied to Africans. In an earlier investigation, we found that metabolic syndrome performed poorly in predicting cardiometabolic risk in Africans.…”

“…Blood samples for the measurement of glucose and insulin levels were obtained at -10, -5, -1, 1, 2, 3,4,5,6,7,8,10,12,14,16,19,22,23,24,25,27,30,40,50,60,70,80,90, 100, 120, 150, and 180 min. IM-FSIGT data were used to calculate the insulin sensitivity index (S I ) and acute insulin response to glucose (AIRg).…”

“…[6][7][8][9][10][11][12][13][14][15] Therefore, TG-based tests usually fail to recognize African Americans at risk. 16 It is possible that the African-American experience with cardiometabolic disease screening will forecast the African experience. Prior to investing scarce health-care resources, it is critical to determine the effectiveness of TG-based screening tests in Africans.…”

Vitamin D intakes of adults differ by income, gender and race/ethnicity in the USA, 2007 to 2010

“…Fortified foods represent the major dietary source of vitamin D (6) and more than one-half of the US population uses dietary supplements (7) . In addition, vitamin D is produced endogenously through exposure of skin to UV light, which stimulates conversion of the precursor 7-dehydrocholesterol to pre-vitamin D 3 that is rapidly converted to cholecalciferol (8) .…”