澳大利亚原住民 2 型糖尿病的发病率：一项为期 11 年的前瞻性队列研究。
Incidence of type 2 diabetes in Aboriginal Australians: an 11-year prospective cohort study.
机构信息
Centre for Chronic Disease, School of Medicine, University of Queensland, Herston, 4029 QLD, Australia.
出版信息
BMC Public Health. 2010 Aug 17;10:487. doi: 10.1186/1471-2458-10-487.
BACKGROUND
Diabetes is an important contributor to the health inequity between Aboriginal and non-Aboriginal Australians. This study aims to estimate incidence rates of diabetes and to assess its associations with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) among Aboriginal participants in a remote community.
METHODS
Six hundred and eighty six (686) Aboriginal Australians aged 20 to 74 years free from diabetes at baseline were followed for a median of 11 years. During the follow-up period, new diabetes cases were identified through hospital records. Cox proportional hazards models were used to assess relationships of the incidence rates of diabetes with IFG, IGT and body mass index (BMI).
RESULTS
One hundred and twenty four (124) new diabetes cases were diagnosed during the follow up period. Incidence rates increased with increasing age, from 2.2 per 1000 person-years for those younger than 25 years to 39.9 per 1000 person-years for those 45-54 years. By age of 60 years, cumulative incidence rates were 49% for Aboriginal men and 70% for Aboriginal women. The rate ratio for developing diabetes in the presence of either IFG or IGT at baseline was 2.2 (95% CI: 1.5, 3.3), adjusting for age, sex and BMI. Rate ratios for developing diabetes were 2.2 (95% CI: 1.4, 3.5) for people who were overweight and 4.7 (95% CI: 3.0, 7.4) for people who were obese at baseline, with adjustment of age, sex and the presence of IFG/IGT.
CONCLUSIONS
Diabetes incidence rates are high in Aboriginal people. The lifetime risk of developing diabetes among Aboriginal men is one in two, and among Aboriginal women is two in three. Baseline IFG, IGT and obesity are important predictors of diabetes.
背景
糖尿病是造成澳大利亚原住民与非原住民之间健康不平等的一个重要因素。本研究旨在评估糖尿病的发病率，并评估其与原住民参与者空腹血糖受损（IFG）和葡萄糖耐量受损（IGT）之间的关系。
方法
在基线时，686 名年龄在 20 至 74 岁之间、无糖尿病的澳大利亚原住民被随访了中位数为 11 年。在随访期间，通过医院记录确定新的糖尿病病例。使用 Cox 比例风险模型评估糖尿病发病率与 IFG、IGT 和体重指数（BMI）的关系。
结果
在随访期间诊断出 124 例新的糖尿病病例。发病率随年龄的增加而增加，25 岁以下人群为每 1000 人年 2.2 例，45-54 岁人群为每 1000 人年 39.9 例。到 60 岁时，男性原住民的累积发病率为 49%，女性原住民的累积发病率为 70%。在基线时存在 IFG 或 IGT 的情况下，发生糖尿病的比率比为 2.2（95%CI：1.5，3.3），调整年龄、性别和 BMI。与基线时超重的人相比，发生糖尿病的比率比为 2.2（95%CI：1.4，3.5），与基线时肥胖的人相比，发生糖尿病的比率比为 4.7（95%CI：3.0，7.4），调整年龄、性别和 IFG/IGT 的存在。
结论
原住民的糖尿病发病率很高。在男性原住民中，一生中患糖尿病的风险是二分之一，在女性原住民中，一生中患糖尿病的风险是三分之二。基线 IFG、IGT 和肥胖是糖尿病的重要预测因素。
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