Pavkov Meda E, Hanson Robert L, Knowler William C, Bennett Peter H, Krakoff Jonathan, Nelson Robert G
Diabetes Epidemiology and Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 1550 East Indian School Rd., Phoenix, AZ 85014-4972, USA.
Diabetes Care. 2007 Jul;30(7):1758-63. doi: 10.2337/dc06-2010. Epub 2007 Apr 27.
The rising prevalence of obesity and high prevalence of diabetes among Pima Indians suggest that the incidence of diabetes has risen over time. We examined trends in the incidence rate of type 2 diabetes among Pima Indians between 1965 and 2003.
Incidence rates were computed independently in three 13-year time periods in Pima Indians aged > or = 5 years. Diabetes was defined by the presence of at least one of two criteria: 1) 2-h plasma glucose concentration > or = 200 mg/dl (11.1 mmol/l) or 2) hypoglycemic treatment.
Among 8,236 subjects without diabetes at baseline, 1,005 incident cases occurred during follow-up. Age- and sex-adjusted incidence rates of diabetes were 25.3 cases/1,000 patient-years (95% CI 22.5-28.0) in 1965-1977, 22.9 cases/1,000 patient years (20.0-25.8) in 1978-1990, and 23.5 cases/1,000 patient years (20.5-26.5) in 1991-2003 (P = 0.3). The incidence rate in subjects aged 5-14 years was 5.7 (1.9-17.4) times as high in the last as in the first period, but the rate declined in those aged 25-34 years (incidence rate ratio 0.6 [0.4-0.8]). Sex-adjusted prevalence increased significantly over time only in those aged 5-24 years (P(trend) < 0.0001).
The overall incidence of diabetes among Pima Indians remained stable over the past four decades, with a significant rise occurring only in the youth.
皮马印第安人中肥胖患病率的上升以及糖尿病的高患病率表明，糖尿病的发病率随时间有所上升。我们研究了1965年至2003年间皮马印第安人2型糖尿病发病率的变化趋势。
对年龄≥5岁的皮马印第安人，在三个13年时间段内分别独立计算发病率。糖尿病的定义为满足以下两项标准中的至少一项：1）2小时血浆葡萄糖浓度≥200mg/dl（11.1mmol/l）或2）进行降糖治疗。
在基线时无糖尿病的8236名受试者中，随访期间有1005例新发病例。经年龄和性别调整后的糖尿病发病率在1965 - 1977年为25.3例/1000人年（95%可信区间22.5 - 28.0），1978 - 1990年为22.9例/1000人年（20.0 - 25.8），1991 - 2003年为23.5例/1000人年（20.5 - 26.5）（P = 0.3）。5 - 14岁受试者的发病率在最后一个时间段是第一个时间段的5.7（1.9 - 17.4）倍，但25 - 34岁受试者的发病率有所下降（发病率比值0.6 [0.4 - 0.8]）。仅在5 - 24岁人群中，经性别调整后的患病率随时间显著增加（P趋势<0.0001）。
在过去四十年中，皮马印第安人糖尿病的总体发病率保持稳定，仅在年轻人中显著上升。
