Shah A, Parthasarathi D, Sarkar D, Saha C G
Department of Physiology, Manipal College of Medical Sciences, Pokhara, Nepal.
Kathmandu Univ Med J (KUMJ). 2006 Jan-Mar;4(1):4-10.
Diabetes Mellitus (DM) is the most common endocrine disorder world-wide. The prevalence of diabetes mellitus is increasing. In the present study an attempt has been made (i) to examine the relation between obesity and diabetes mellitus in Nepalese people, (ii) to find out whether BMI cut-off points for determining over weight and obesity as per WHO criteria are applicable in Nepalese study population.
The present study was carried out in Manipal College of Medical Sciences (MCOMS) and Manipal Teaching Hospital (MTH), Pokhara. The Diabetic patients of Pokhara and surroundings who attended the 'Diabetic Clinic' and Out Patient Department (OPD) during August 2004 to November 2004 at Manipal Teaching Hospital were included in the present study. The number of diabetic patients was two hundred (200), out of which, one hundred and fourteen (114) were male and eighty six (86) were female. In addition one hundred (100) non-diabetic subjects who attended the OPD at MTH were taken for comparison with the diabetic patients, of which, forty seven (47) were male and fifty three (53) were female. Age, height and weight were recorded for every subject. BMI was calculated by the standard formula. In the present study, body mass index (BMI) of the diabetic subjects was found to be more than that of non-diabetic subjects. BMI of non-diabetic males and females were found to be around 22 kg/m2 which is within normal range as per WHO recommendations. On the other hand, diabetic subjects' BMI were found to be around 25 kg/m2, which denotes borderline obesity. It is clear from the present study that 51.5% of the diabetic subjects were within the normal range (BMI 18.5-24.9 kg/m2). More diabetic subjects were found in over-weight (25-29.9) category than non-diabetic subjects. As per WHO criteria 56% of the non-diabetic subjects were within the normal BMI range (BMI 18.5-24.9 kg/m2). It is also evident that when BMI in the range of 25.0-29.9 kg/m2 is considered as over-weight, only 33% were found to be over-weight in diabetic subjects. But when BMI > or =23 kg/m2 (as recommended for Asians) is taken as the determining factor for overweight, 64% of overweight male subjects and 72.09% of overweight female subjects were found to be diabetic.
According to the observations of the present study on Nepalese it can be concluded that BMI cut-off points for determining over-weight and obesity should be lowered to 23 kg/m2 or less which can provide an adequate basis of taking action on risks related to overweight and obesity in Nepal.
糖尿病（DM）是全球最常见的内分泌疾病。糖尿病的患病率正在上升。在本研究中，已尝试（i）研究尼泊尔人群中肥胖与糖尿病之间的关系，（ii）查明根据世界卫生组织（WHO）标准确定超重和肥胖的体重指数（BMI）切点是否适用于尼泊尔研究人群。
本研究在博卡拉的马尼帕尔医学科学学院（MCOMS）和马尼帕尔教学医院（MTH）进行。2004年8月至2004年11月期间在马尼帕尔教学医院“糖尿病诊所”和门诊部（OPD）就诊的博卡拉及周边地区的糖尿病患者被纳入本研究。糖尿病患者有200人，其中男性114人，女性86人。此外，选取了100名在MTH门诊部就诊的非糖尿病受试者与糖尿病患者进行比较，其中男性47人，女性53人。记录了每位受试者的年龄、身高和体重。BMI通过标准公式计算。在本研究中，发现糖尿病受试者的体重指数高于非糖尿病受试者。非糖尿病男性和女性的BMI约为22kg/m²，根据WHO建议，这在正常范围内。另一方面，糖尿病受试者的BMI约为25kg/m²，这表示临界肥胖。从本研究可以清楚地看出，51.5%的糖尿病受试者在正常范围内（BMI 18.5 - 24.9kg/m²）。超重（25 - 29.9）类别的糖尿病受试者比非糖尿病受试者更多。根据WHO标准，56%的非糖尿病受试者在正常BMI范围内（BMI 18.5 - 24.9kg/m²）。同样明显的是，当将BMI在25.0 - 29.9kg/m²范围内视为超重时，仅发现33%的糖尿病受试者超重。但是，当将BMI≥23kg/m²（如针对亚洲人所建议的）作为超重的决定因素时，发现64%的超重男性受试者和72.09%的超重女性受试者患有糖尿病。
根据本研究对尼泊尔人的观察结果，可以得出结论，确定超重和肥胖的BMI切点应降至23kg/m²或更低，这可为在尼泊尔针对与超重和肥胖相关的风险采取行动提供充分依据。
