Yu Catherine H Y, Zinman Bernard
Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, Ontario, Canada.
Diabetes Res Clin Pract. 2007 Nov;78(2):159-70. doi: 10.1016/j.diabres.2007.03.022. Epub 2007 May 9.
To perform a systematic review of the prevalence of type 2 diabetes and impaired glucose tolerance (IGT) in aboriginal populations worldwide.
A Medline search from 1966 to 2005 was conducted. Studies were selected if they utilized accepted diagnostic criteria for type 2 diabetes. Year of study, sample size, response rate, age range, and prevalence of type 2 diabetes and IGT were documented.
Forty-two studies were selected, comprising 59 populations. Although the majority demonstrated a several-fold elevation of type 2 diabetes prevalence as compared to non-aboriginal populations, this was not a universal finding; a small number of populations studied actually had a low prevalence of type 2 diabetes and IGT. Lower prevalences were found in rural compared with urban populations. Interestingly, we were also able to document an inverse relationship between the ratio of IGT/type 2 diabetes and type 2 diabetes prevalence. These data are consistent with the hypothesis that those populations with the very highest rates of type 2 diabetes appear to have progressed past the prediabetes stages in the natural history of this metabolic disorder.
Type 2 diabetes and IGT prevalence rates vary widely amongst the world's aboriginal populations. Despite very different histories and cultures, the consequences of rapid changes in nutrition and exercise appear to have very similar metabolic consequences on aboriginal populations, the magnitude of which may be determined by the strength of the genetic susceptibility.
对全球原住民人群中2型糖尿病和糖耐量受损（IGT）的患病率进行系统综述。
对1966年至2005年的Medline数据库进行检索。若研究采用公认的2型糖尿病诊断标准，则被纳入。记录研究年份、样本量、应答率、年龄范围以及2型糖尿病和IGT的患病率。
共选取42项研究，涵盖59个人群。尽管大多数研究表明，与非原住民人群相比，2型糖尿病患病率升高了数倍，但并非所有情况均如此；少数被研究人群的2型糖尿病和IGT患病率实际上较低。农村人群的患病率低于城市人群。有趣的是，我们还发现IGT/2型糖尿病比值与2型糖尿病患病率之间呈负相关。这些数据与以下假设一致，即2型糖尿病患病率极高的人群似乎已在这种代谢紊乱的自然病程中越过了糖尿病前期阶段。
全球原住民人群中2型糖尿病和IGT的患病率差异很大。尽管历史和文化差异很大，但营养和运动的快速变化对原住民人群似乎产生了非常相似的代谢影响，其程度可能由遗传易感性的强度决定。
