Thommasen H V, Patenaude J, Anderson N, Mc Arthur A, Tildesley H
Faculty of Medicine, University of British Columbia, British Columbia, Canada.
Rural Remote Health. 2004 Oct-Dec;4(4):319. Epub 2004 Oct 8.
(1) To identify which medical disorders are significantly associated with being a diabetic in the setting of an isolated, rural community; and (2) to determine if there are differences between Aboriginal and non-Aboriginal diabetics.
population based retrospective chart review.
people living in the Bella Coola Valley, Canada, and having a chart at the Bella Coola Medical Clinic as at September 2001.
known diabetes related co-morbidity (retinopathy, nephropathy, coronary artery disease, peripheral vascular disease, neuropathy).
There were 126 adult (>18 years old) diabetics living in the Bella Coola Valley. Prevalence rates for history of alcohol issues, retinopathy, coronary artery disease, cerebrovascular disease, peripheral vascular disease, peripheral neuropathy, hypertension, hypercholesterolemia, and nephropathy were 44%, 14%, 19%, 8%, 7%, 10%, 54%, 47%, and 7% respectively. For the 1597 non-diabetics living in the Bella Coola Valley, respective prevalence rates for these same co-morbidities were 20%, 0.3%, 2%, 1.5%, 1%, 1%, 10%, 6%, and 0.6%. The study did not demonstrate that Aboriginal people living in the Bella Coola Valley have an increased prevalence of diabetes associated co-morbidities over and above that found in the non-Aboriginal diabetic population. This was despite the fact the smoking rate was higher in the Aboriginal population.
The development of diabetes in both Aboriginal and non-Aboriginal people living in the Bella Coola Valley was clearly associated with the presence of multiple co-morbidities, including hypertension, hypercholesterolemia, coronary artery disease, cerebrovascular disease, and neuropathy. Rates of diabetes associated co-morbidities were similar for both Aboriginal and non-Aboriginal diabetic populations. The authors speculate that a diet rich in fish oils (omega-3 fatty acids) accounted for the lower than expected rates of cardiovascular disease among this Aboriginal population.
（1）确定在一个偏远农村社区中，哪些医学病症与糖尿病显著相关；（2）确定原住民糖尿病患者与非原住民糖尿病患者之间是否存在差异。
基于人群的回顾性病历审查。
居住在加拿大贝拉库拉山谷且截至2001年9月在贝拉库拉医疗诊所拥有病历的人。
已知的与糖尿病相关的合并症（视网膜病变、肾病、冠状动脉疾病、外周血管疾病、神经病变）。
有126名居住在贝拉库拉山谷的成年（>18岁）糖尿病患者。酒精问题史、视网膜病变、冠状动脉疾病、脑血管疾病、外周血管疾病、外周神经病变、高血压、高胆固醇血症和肾病的患病率分别为44%、14%、19%、8%、7%、10%、54%、47%和7%。对于居住在贝拉库拉山谷的1597名非糖尿病患者，这些相同合并症的患病率分别为20%、0.3%、2%、1.5%、1%、1%、10%、6%和0.6%。该研究未表明居住在贝拉库拉山谷的原住民糖尿病相关合并症的患病率高于非原住民糖尿病患者。尽管原住民人群中的吸烟率较高，但情况依然如此。
居住在贝拉库拉山谷的原住民和非原住民人群中糖尿病的发生显然与多种合并症有关，包括高血压、高胆固醇血症、冠状动脉疾病、脑血管疾病和神经病变。原住民和非原住民糖尿病患者的糖尿病相关合并症发生率相似。作者推测，富含鱼油（ω-3脂肪酸）的饮食是该原住民人群中心血管疾病发生率低于预期的原因。
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