Burke James P, Williams Ken, Narayan K M Venkat, Leibson Cynthia, Haffner Steven M, Stern Michael P
Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota 55905, USA.
Diabetes Care. 2003 Jul;26(7):1999-2004. doi: 10.2337/diacare.26.7.1999.
To examine the influence of obesity and prevention of weight gain on the incidence of type 2 diabetes.
We examined participants in the San Antonio Heart Study, a prospective population-based study of Mexican Americans and non-Hispanic whites residing in San Antonio, Texas. BMI was stratified into four categories: normal (<25 kg/m(2)), overweight (> or =25 kg/m(2) and <30 kg/m(2)), obese (> or =30 kg/m(2) and <35 kg/m(2)), and very obese (> or =35 kg/m(2)). The number and proportion of incident cases prevented by targeting each BMI category were estimated. In addition, we calculated the decrease in risk of developing type 2 diabetes associated with weight gain prevention across both the BMI and age spectra.
Preventing normal individuals from becoming overweight would result in the greatest reduction in incidence of type 2 diabetes. This would result in a 62 and 74% reduction in the incidence of type 2 diabetes in Mexican Americans and non-Hispanic whites, respectively. Preventing the entire population from gaining, on average, 1 BMI unit would result in a reduction in incidence of type 2 diabetes of 12.4 and 13.0% in Mexican Americans and non-Hispanic whites, respectively.
The majority of cases of type 2 diabetes were in individuals who were overweight or mildly obese with a family history of type 2 diabetes. Public health resources should be directed toward the prevention of weight gain among normal and overweight individuals in order to prevent the maximum number of cases of type 2 diabetes.
研究肥胖及体重增加预防对2型糖尿病发病率的影响。
我们对圣安东尼奥心脏研究中的参与者进行了调查，这是一项基于人群的前瞻性研究，研究对象为居住在得克萨斯州圣安东尼奥的墨西哥裔美国人及非西班牙裔白人。体重指数（BMI）被分为四类：正常（<25kg/m²）、超重（≥25kg/m²且<30kg/m²）、肥胖（≥30kg/m²且<35kg/m²）和极度肥胖（≥35kg/m²）。估计了针对每个BMI类别预防的发病例数及比例。此外，我们计算了在BMI和年龄范围内与预防体重增加相关的2型糖尿病发病风险的降低情况。
防止正常个体超重将导致2型糖尿病发病率最大程度降低。这将使墨西哥裔美国人和非西班牙裔白人的2型糖尿病发病率分别降低62%和74%。防止整个人口平均体重增加1个BMI单位，将使墨西哥裔美国人和非西班牙裔白人的2型糖尿病发病率分别降低12.4%和13.0%。
大多数2型糖尿病病例发生在超重或轻度肥胖且有2型糖尿病家族史的个体中。公共卫生资源应致力于预防正常和超重个体的体重增加，以预防最多数量的2型糖尿病病例。
