Kim C, McHugh C, Kwok Y, Smith A
United States Public Health Service, Crownpoint Healthcare Facility, New Mexico.
West J Med. 1999 Apr;170(4):210-3.
Diabetes mellitus afflicts over one-fifth of the Navajo population aged over 20 years, but the prevalence of diabetes in Navajo adolescents is unclear. We conducted voluntary testing for diabetes mellitus at two high schools on the Navajo reservation to clarify the prevalence as well as to assess the utility of a high-school based screening program. Body mass index measurements (BMI), oral glucose tolerance tests, and hemoglobin A1C measurements were obtained in consenting high school students. Of the 276 students that participated, 234 were Navajo. Only one Navajo student (0.4%) had diabetes mellitus, although eight (3%) had impaired glucose tolerance or impaired fasting glucose. Participant BMI did not differ significantly from nonparticipant BMI. No correlation existed between BMI or impaired glucose handling, and significant overlap existed between the hemoglobin A1C values of students with impaired glucose handling and students without impaired glucose handling. Increased participation in screening programs may reveal higher disease prevalence, but high school-based screening is not justified by this study, despite the high rates of diabetes mellitus in the Navajo population.
糖尿病折磨着超过五分之一的20岁以上纳瓦霍族人口,但纳瓦霍族青少年的糖尿病患病率尚不清楚。我们在纳瓦霍保留地的两所高中进行了糖尿病自愿检测,以明确患病率,并评估基于高中的筛查项目的效用。对同意参与的高中生进行了体重指数测量(BMI)、口服葡萄糖耐量试验和糖化血红蛋白测量。在参与的276名学生中,234名是纳瓦霍族。只有一名纳瓦霍族学生(0.4%)患有糖尿病,不过有八名(3%)学生葡萄糖耐量受损或空腹血糖受损。参与学生的BMI与未参与学生的BMI无显著差异。BMI或葡萄糖处理受损之间不存在相关性,葡萄糖处理受损的学生与未受损的学生糖化血红蛋白值之间存在显著重叠。增加对筛查项目的参与可能会发现更高的疾病患病率,但尽管纳瓦霍族人口中糖尿病发病率很高,但本研究并不支持基于高中的筛查。