Fujimoto Wilfred Y, Boyko Edward J, Hayashi Tomoshige, Kahn Steven E, Leonetti Donna L, McNeely Marguerite J, Shuman William P
Department of Medicine, University of Washington, Seattle, Washington.
J Diabetes Investig. 2012 Jun 1;3(3):212-224. doi: 10.1111/j.2040-1124.2012.00195.x. Epub 2012 Jan 27.
Migrant Japanese populations in both the United States and Brazil have for a long time shown a higher prevalence of type 2 diabetes than in native Japanese, suggesting an interaction of lifestyle and genetic predisposition in the etiology of type 2 diabetes. The overall objective of the Seattle Japanese American Community Diabetes Study was to learn more about the etiology and pathogenesis of type 2 diabetes in Japanese Americans. This metabolically based epidemiologic study included extensive assessments of insulin sensitivity, insulin response, and adiposity with the latter including measurements of body fat distribution by both anthropometry and computed tomography. Because of this, the importance of visceral adiposity as a risk factor for abnormal glucose tolerance, hypertension, coronary heart disease, and the metabolic syndrome was demonstrated. In conjunction with an examination of diet and physical activity patterns, the result was a clearer understanding of the etiology and pathogenesis of type 2 diabetes in Japanese Americans. Wepropose that a lifestyle that fosters increased weight gain, especially in the visceral adipose depot, promotes the development of insulin resistance which in turn exposes an underlying reduced beta-cell reserve in susceptible individuals, resulting in glucose intolerance and eventually in many the development of diabetes. We have shown that it may be possible to delay or prevent the development of diabetes through dietary and exercise interventions in individuals identified as having impaired glucose tolerance. The lessons learned from studying migrant Japanese in Seattle may in many ways be applicable to other populations of Asian origin.
长期以来，美国和巴西的日本移民群体中2型糖尿病的患病率一直高于日本本土人群，这表明在2型糖尿病的病因中，生活方式与遗传易感性之间存在相互作用。西雅图日裔美国人社区糖尿病研究的总体目标是更深入地了解日裔美国人中2型糖尿病的病因和发病机制。这项基于代谢的流行病学研究对胰岛素敏感性、胰岛素反应和肥胖进行了广泛评估，其中肥胖评估包括通过人体测量和计算机断层扫描测量体脂分布。因此，内脏脂肪作为葡萄糖耐量异常、高血压、冠心病和代谢综合征的危险因素的重要性得到了证实。结合对饮食和身体活动模式的调查，结果是对日裔美国人中2型糖尿病的病因和发病机制有了更清晰的认识。我们提出，一种促进体重增加的生活方式，尤其是在内脏脂肪储存部位，会促进胰岛素抵抗的发展，而胰岛素抵抗反过来会使易感个体潜在的β细胞储备减少，导致葡萄糖耐量异常，并最终在许多人中发展为糖尿病。我们已经表明，通过饮食和运动干预，有可能延缓或预防被确定为葡萄糖耐量受损的个体患糖尿病。从对西雅图日本移民的研究中吸取的经验教训在许多方面可能适用于其他亚洲裔人群。
