Young T K, Szathmary E J, Evers S, Wheatley B
Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada.
Soc Sci Med. 1990;31(2):129-39. doi: 10.1016/0277-9536(90)90054-v.
The prevalence of diagnosed diabetes was determined for 76% of the registered Indian and Inuit (Eskimo) population of Canada from case registers maintained by the federal agency responsible for Indian health services. A total of 5324 cases were ascertained. The age-sex adjusted rate varied among the Indians from a low of 0.8% in the Northwest Territories to a high of 8.7% in the Atlantic region. Among Inuit, the prevalence was 0.4%. Most cases occur in middle-aged or older individuals, with a higher prevalence among Indian (but not Inuit) females. An ecologic analysis was performed with the crude prevalence of individual communities regressed upon independent variables that included longitude, latitude, geographic isolation, culture area, and language family. Stepwise regressions were also carried out within the Algonkian, Athapaskan, and Eskimoan language families. For the national sample, composite language phylum-culture area predictors were used. The results in the national sample confirmed most findings in the individual language family analysis. Six predictors: latitude, Northeast-Algonkian, Northeast-Iroquoian, Subarctic-Algonkian, Plains-Siouan, and Plains-Algonkian, ranked here in decreasing order of importance, explained 48.4% of the variation in diabetes prevalence. All the named groups had rates significantly greater than found in the reference group of Arctic-Eskimoans. We conclude that the distribution of diabetes among Canadian natives is determined by both genetic and environmental factors.
通过负责印第安人健康服务的联邦机构所维护的病例登记册，确定了加拿大76%的已登记印第安人和因纽特人（爱斯基摩人）人口中确诊糖尿病的患病率。共查明了5324例病例。年龄性别调整率在印第安人中各不相同，从西北地区的低至0.8%到大西洋地区的高至8.7%。在因纽特人中，患病率为0.4%。大多数病例发生在中年或老年人中，印第安女性（但因纽特女性不包括在内）的患病率更高。进行了一项生态分析，将各个社区的粗患病率与包括经度、纬度、地理隔离、文化区域和语系在内的自变量进行回归分析。还在阿尔冈昆语系、阿萨巴斯卡语系和爱斯基摩语系内进行了逐步回归分析。对于全国样本，使用了综合语系 - 文化区域预测因子。全国样本的结果证实了个体语系分析中的大多数发现。六个预测因子：纬度、东北阿尔冈昆语、东北易洛魁语、亚北极阿尔冈昆语、平原苏语和平原阿尔冈昆语，按重要性降序排列，解释了糖尿病患病率变化的48.4%。所有上述群体的患病率均显著高于北极爱斯基摩人参考组。我们得出结论，加拿大原住民中糖尿病的分布是由遗传和环境因素共同决定的。
