Menzies School of Health Research, Charles Darwin University, Casuarina, Australia.
Diabetes Res Clin Pract. 2013 Apr;100(1):133-41. doi: 10.1016/j.diabres.2012.12.017. Epub 2013 Jan 9.
Indigenous populations of Australia and Canada experience disproportionately high rates of chronic disease. We hypothesized that despite the common outcome of increased diabetes prevalence, differences in cardiometabolic risk profile may exist between these populations.
We compared community-based data on cardiometabolic risks in Aboriginal Australians (n=297 without, 45 with diabetes), and Aboriginal Canadians (n=409 without, 87 with diabetes).
Despite strikingly lower weight (62 vs 83 kg, p<0.0001) and body mass index (BMI, 22 vs 29 kg/m(2), p<0.0001), Aboriginal Australians without diabetes had similar waist-hip ratio (WHR, 0.91 vs 0.91, p=0.732), lower HDL-cholesterol (0.97 vs 1.25 mmol/L, p<0.0001) and higher HbA1c (5.4 vs 5.2%, p<0.0001) than Aboriginal Canadians without diabetes. Waist was the obesity measure most strongly related to diabetes or cardiometabolic risk in Australians while BMI performed similarly to other obesity measures only in Canadians. Multiple regression of HbA1c revealed age and fasting glucose as independent predictors in each study group, with the addition of WHR in Aboriginal Australians.
The notable finding was that waist or WHR are preferred obesity measures to appropriately reflect cardiometabolic risk in Aboriginal Australians, who although leaner by BMI criteria, displayed a similarly adverse risk profile to Aboriginal Canadians. Waist or WHR should be routinely included in clinical assessment in these high-risk populations.
澳大利亚和加拿大的土著居民慢性病发病率极高。我们假设，尽管糖尿病的患病率普遍增加，但这些人群的心血管代谢风险特征可能存在差异。
我们比较了澳大利亚原住民（无糖尿病 297 例，有糖尿病 45 例）和加拿大原住民（无糖尿病 409 例，有糖尿病 87 例）的社区为基础的心血管代谢风险数据。
尽管澳大利亚原住民的体重（62 公斤与 83 公斤，p<0.0001）和体重指数（22 公斤/平方米与 29 公斤/平方米，p<0.0001）明显较低，但无糖尿病的澳大利亚原住民的腰臀比（0.91 与 0.91，p=0.732）、高密度脂蛋白胆固醇（0.97 与 1.25mmol/L，p<0.0001）和糖化血红蛋白（5.4%与 5.2%，p<0.0001）与无糖尿病的加拿大原住民相似。在澳大利亚人中，腰围是与糖尿病或心血管代谢风险最密切相关的肥胖指标，而 BMI 仅在加拿大人群中与其他肥胖指标表现相似。对糖化血红蛋白进行多元回归分析显示，在每个研究组中，年龄和空腹血糖是独立的预测因子，而在澳大利亚原住民中，还加入了腰臀比。
值得注意的是，腰围或腰臀比是反映澳大利亚原住民心血管代谢风险的首选肥胖指标，这些原住民尽管按照 BMI 标准较瘦，但与加拿大原住民具有相似的不良风险特征。腰围或腰臀比应常规纳入这些高危人群的临床评估中。
