General Internal Medicine Unit, Massachusetts General Hospital, Boston, Massachusetts, USA.
Diabetes Care. 2010 Aug;33(8):1865-71. doi: 10.2337/dc10-0641.
In the book Epidemiology of Diabetes and Its Vascular Lesions (1978), Kelly West summarized extant knowledge of the distribution and causes of diabetes. The 30 years of epidemiological research that followed have seen remarkable advances in the understanding of obesity as a risk factor for type 2 diabetes, and diabetes and pre-diabetes as risk factors for cardiovascular disease. Increasingly detailed understanding of these relationships has, unfortunately, been accompanied by an alarming increase in the prevalence of obesity, diabetes, and cardiovascular disease. West recognized that pre-diabetes is recognizable as what we now call metabolic syndrome. He predicted that novel insight into diabetes pathogenesis would come from biochemical and genetic epidemiology studies. He predicted that type 2 diabetes could be prevented by healthy lifestyle change. The challenge now is for us to translate these insights into effective strategies for the prevention of the modern epidemic of diabetes and vascular disease.
在《糖尿病及其血管病变的流行病学》（1978 年）一书中，凯利·韦斯特总结了当时已有的关于糖尿病分布和病因的知识。此后的 30 年流行病学研究使人们对肥胖作为 2 型糖尿病的危险因素，以及糖尿病和糖尿病前期作为心血管疾病的危险因素有了显著的认识。令人遗憾的是，随着对这些关系的认识越来越深入，肥胖、糖尿病和心血管疾病的发病率也令人震惊地上升了。韦斯特认识到，糖尿病前期可被识别为我们现在所说的代谢综合征。他预测，对糖尿病发病机制的新认识将来自生化和遗传流行病学研究。他预测，通过健康的生活方式改变可以预防 2 型糖尿病。现在的挑战是，我们如何将这些认识转化为预防现代糖尿病和血管疾病流行的有效策略。
