Diabetes Association of Sri Lanka, National Diabetes Centre, Colombo, Sri Lanka.
PLoS One. 2012;7(2):e31309. doi: 10.1371/journal.pone.0031309. Epub 2012 Feb 13.
South-Asian's are predisposed to early onset type 2 diabetes (T2DM). The prevalence of cardio-metabolic risk-factors in young Sri-Lankans is unknown.
METHODOLOGY/PRINCIPAL FINDINGS: To determine by questionnaire and anthropometry the prevalence of first degree family history (FH) of T2DM, physical inactivity, raised waist circumference (WC) and raised body mass index (BMI) in a representative healthy urban population selected by cluster sampling. Those with ≥ 2 risk-factors were evaluated for metabolic syndrome (MS) and recruited for an intervention trial. Of 23,296 participants screened, 22,507 (53% Female) were eligible [8,497 aged 10-14 yrs, 4,763 aged 15-19 yrs and 9,247 aged 20-40 yrs]. 51% had none of the 4 risk-factors, 26% 1 risk-factor and 23% (5,163) ≥ 2 risk-factors of whom 4,532 were assessed for MS. Raised BMI was noted in 19.7% aged 10-14 yrs, 15.3% between 15-19 yrs, and between 20-40 yrs, 27.4% of males vs. 21.8% of females p<0.001. Prevalence of raised WC was greater in females for each age group: 42.7% vs. 32.1%; 28.1% vs. 16.1%; 34.5% vs. 25.7% (p<0.05 for all) as was physical inactivity: 39.9% vs. 14.5%; 51.7% vs. 20.0%; 62.7% vs. 41.3% which rose in both sexes with age (p<0.05 for all). FH of T2DM was present in 26.2%. In 4532 (50%<16 yrs) with ≥ 2 risk-factors, impaired fasting glycaemia/impaired glucose tolerance (pre-diabetes) prevalence was 16%. MS was more prevalent in males [10-16 yrs (13.0% vs. 8.8%), 16-40 yrs (29.5% vs. 20.0%) p<0.001 for both].
CONCLUSIONS/SIGNIFICANCE: There is a high prevalence of modifiable cardio-metabolic risk-factors in young urban Sri-Lankans with significant gender differences. A primary prevention intervention trial is ongoing in this cohort. Clinical Trial Registration Number SLCTR/2008/World Health Organization (WHO) international clinical trial registry platform.
南亚人易患 2 型糖尿病（T2DM），且发病年龄较早。目前尚不清楚年轻的斯里兰卡人患心血管代谢危险因素的流行情况。
方法/主要发现：采用问卷调查和人体测量学方法，对通过聚类抽样选择的具有代表性的健康城市人群中，T2DM 一级亲属史、身体活动不足、腰围升高和体重指数升高的患病率进行了评估。对≥2 个危险因素的人群进行代谢综合征（MS）评估，并招募其参加干预试验。在筛查的 23296 名参与者中，有 22507 名（女性占 53%）符合条件[年龄在 10-14 岁的有 8497 人，年龄在 15-19 岁的有 4763 人，年龄在 20-40 岁的有 9247 人]。51%的人没有 4 个危险因素中的任何一个，26%的人有 1 个危险因素，23%（5163 人）有≥2 个危险因素，其中 4532 人接受了 MS 评估。在 10-14 岁的人群中，19.7%的人存在超重的 BMI，在 15-19 岁的人群中，15.3%的人存在超重的 BMI，在 20-40 岁的人群中，27.4%的男性与 21.8%的女性相比，BMI 升高的比例更高（p<0.001）。每个年龄组女性腰围升高的比例均高于男性：42.7%比 32.1%；28.1%比 16.1%；34.5%比 25.7%（p<0.05），身体活动不足的比例也更高：39.9%比 14.5%；51.7%比 20.0%；62.7%比 41.3%，这一比例随着年龄的增长在两性中均有所上升（p<0.05）。T2DM 的一级亲属史占 26.2%。在 4532 名（<16 岁者占 50%）存在≥2 个危险因素的人群中，空腹血糖受损/糖耐量受损（糖尿病前期）的患病率为 16%。MS 在男性中更为常见[10-16 岁者（13.0%比 8.8%），16-40 岁者（29.5%比 20.0%），p<0.001]。
结论/意义：年轻的斯里兰卡城市居民存在较高的可改变心血管代谢危险因素，且存在显著的性别差异。目前正在对该队列进行一级预防干预试验。临床试验注册号 SLCTR/2008/世界卫生组织（WHO）国际临床试验注册平台。
