Ramaiya K L, Swai A B, McLarty D G, Alberti K G
Department of Medicine, Muhimbili Medical Centre, University of Dar es Salaam, Tanzania.
Diabetes Res Clin Pract. 1990 Nov-Dec;10(3):245-55. doi: 10.1016/0168-8227(90)90068-5.
Oral glucose tolerance was studied following a 75 g glucose load in 108 (82.4%) of 131 male and 110 (79.1%) of 139 female members of a Hindu subcommunity aged 15 years and over in Dar es Salaam. One year later, the glucose tolerance tests were repeated in 93 (86.1%) and 93 (84.5%) of the 108 male, and 110 of the female subjects, respectively. In the first survey, 25 (26.9%) of the 93 male and 24 (25.8%) of the 93 female subjects had impaired glucose tolerance (IGT), 6 (6.4%) and 15 (16.1%), respectively, had diabetes mellitus; and 62 (66.7%) and 54 (58.1%), respectively, had normal glucose tolerance. In the repeat survey, of the 93 male and 93 female subjects, 8 (8.6%) and 7 (7.5%) had IGT, 4 (4.3%) and 10 (10.8%) had diabetes; and 81 (87.1%) and 76 (81.7%) were normal, respectively. Of the 21 subjects diagnosed as having diabetes in the first survey, 13 (61.9%) continued to show diabetic glucose tolerance; 4 (19%) IGT and 4 (19%) had normal glucose tolerance with no gender difference. One (1.6%) of the 62 male subjects and none of the 54 females with normal glucose tolerance in the first survey progressed to IGT, while the remainder retained normal glucose tolerance. Diabetes and IGT rates in both surveys were higher for the older than the younger persons. A significant fall in mean fasting and post-75 g blood glucose levels, and in mean systolic and diastolic pressure levels was observed between the first and second surveys in both genders. There was, however, no significant difference in body mass index (BMI), serum total cholesterol and triglyceride levels between surveys, suggesting that major dietary changes had not taken place. Male subjects who showed persistent IGT had significantly lower mean level of body mass index (kg/m2) than subjects who reverted to normal, whilst for the whole group those who had persistent IGT were older. It is tempting to speculate that these changes were due to community action. However, in view of the lack of change in weight and lipids and similar results in other communities in Tanzania when retested at 1 week, further studies are needed to establish the significance of the findings.
在达累斯萨拉姆，对一个印度教亚群体中131名15岁及以上男性成员中的108名（82.4%）和139名女性成员中的110名（79.1%）进行了75克葡萄糖负荷后的口服葡萄糖耐量研究。一年后，分别对108名男性和110名女性受试者中的93名（86.1%）和93名（84.5%）重复进行了葡萄糖耐量试验。在首次调查中，93名男性受试者中有25名（26.9%）和93名女性受试者中有24名（25.8%）存在糖耐量受损（IGT），分别有6名（6.4%）和15名（16.1%）患有糖尿病；分别有62名（66.7%）和54名（58.1%）葡萄糖耐量正常。在重复调查中，93名男性和93名女性受试者中，分别有8名（8.6%）和7名（7.5%）存在IGT，4名（4.3%）和10名（10.8%）患有糖尿病；分别有81名（87.1%）和76名（81.7%）正常。在首次调查中被诊断为患有糖尿病的21名受试者中，13名（61.9%）继续表现出糖尿病性葡萄糖耐量；4名（19%）为IGT，4名（19%）葡萄糖耐量正常，无性别差异。首次调查中62名葡萄糖耐量正常的男性受试者中有1名（1.6%）进展为IGT，54名女性受试者中无人进展为IGT，其余受试者仍保持正常葡萄糖耐量。两个调查中，老年人的糖尿病和IGT患病率均高于年轻人。在首次和第二次调查之间，观察到男女两性的平均空腹和75克葡萄糖负荷后血糖水平以及平均收缩压和舒张压水平均显著下降。然而，两次调查之间的体重指数（BMI）、血清总胆固醇和甘油三酯水平无显著差异，表明未发生重大饮食变化。持续存在IGT的男性受试者的平均体重指数（kg/m2）显著低于恢复正常的受试者，而对于整个组而言，持续存在IGT的受试者年龄更大。很容易推测这些变化是由于社区行动所致。然而，鉴于体重和血脂没有变化，以及坦桑尼亚其他社区在1周后重新检测时也有类似结果，需要进一步研究以确定这些发现的意义。
