Kann Peter Herbert, Münzel Mark, Hadji Peyman, Daniel Hanna, Flache Stephan, Nyarango Peter, Wilhelm Anneke
Division of Endocrinology and Diabetology (P.H.K., S.F., A.W.), Institute of Cultural and Social Anthropology (P.H.K., M.M.), Department of Gynecology (P.H.), Institute of Medical Biometry and Epidemiology (H.D.), Philipp's University Marburg, D 35033 Marburg, Germany; Department of Surgery (S.F.), Asklepios Hospital, Naumburger Str. 76, D 06667 Weißenfels, Germany; Dean, Faculty of Medicine (P.N.), University of Namibia, 140 Mandume Ndemufayo Avenue, Pioneerspark, Private Bag 13301, Windhoek, Namibia.
J Clin Endocrinol Metab. 2015 Mar;100(3):E482-6. doi: 10.1210/jc.2014-2625. Epub 2014 Dec 18.
Diabetes mellitus is increasingly affecting Africa.
Urbanization of the Ovahimba people in Namibia is associated with an increased prevalence of disorders of glucose metabolism, and may thus be attributed to changes of cortisol homeostasis.
A prospective, cross-sectional, diagnostic study was applied.
The study was conducted in the field. Location of the Diabetes Epidemic: Africa and Namibia.
Ovahimba people: group 1 "urban" n = 60, 42 females, 46.3 ± 11.3 years (town); group 2 "rural" n = 63, 44 females, 51.1 ± 12.0 years (seminomadic).
oGTT, sunrise and sunset saliva cortisol, metabolic parameters, questionnaire.
The prevalence of disorders of glucose metabolism (DM, IGT, IFT).
The prevalence of disorders of glucose metabolism differed significantly: urban group n = 17(28.3%) vs rural group n = 8(12.7%) (P = 0.04). The saliva cortisol concentrations also differed significantly: sunrise 0.34 ± 0.18 vs 0.12 ± 0.15 μg/dL, sunset 0.18 ± 0.20 vs 0.07 ± 0.09 μg/dL, area under the curve 6.16 ± 3.48 vs 2.28 ± 2.56 μg/dL * 24 h (all P < 0.001). Further metabolic parameters were unfavorably changed in the urban group: hip circumference (P < 0.001), waist circumference (P < 0.001), body mass index (P = 0.014), systolic BP at rest (P < 0.001), diastolic BP at rest (P = 0.002), systolic BP after exercise (P < 0.001), heart rate after exercise (P = 0.007), fasting glucose (P < 0.001), 2-h-glucose by OGTT (P = 0.002), triglycerides (P = 0.04), HDL-cholesterol (P = 0.014), prevalence of the metabolic syndrome (P < 0.001). Physical activity was higher in the rural group, and intake of fast food and sweets were higher in the urban group.
Urbanization of the Ovahimba people is associated with an increasing prevalence of disorders of glucose metabolism and other unfavorable metabolic parameters. Besides changes of lifestyle, this may be attributed to an increased cortisol exposure of the Ovahimba people living in an urban environment.
糖尿病对非洲的影响日益增大。
纳米比亚奥瓦希姆巴人的城市化与糖代谢紊乱患病率增加有关，因此可能归因于皮质醇稳态的变化。
采用前瞻性、横断面诊断研究。
该研究在实地进行。糖尿病流行地区：非洲和纳米比亚。
奥瓦希姆巴人：第1组“城市”组n = 60，女性42名，年龄46.3±11.3岁（城镇）；第2组“农村”组n = 63，女性44名，年龄51.1±12.0岁（半游牧）。
口服葡萄糖耐量试验、日出和日落时唾液皮质醇、代谢参数、问卷调查。
糖代谢紊乱（糖尿病、糖耐量受损、空腹血糖受损）的患病率。
糖代谢紊乱的患病率有显著差异：城市组n = 17（28.3%），农村组n = 8（12.7%）（P = 0.04）。唾液皮质醇浓度也有显著差异：日出时0.34±0.18 vs 0.12±0.15μg/dL，日落时0.18±0.20 vs 0.07±0.09μg/dL，曲线下面积6.16±3.48 vs 2.28±2.56μg/dL * 24小时（所有P < 0.001）。城市组的其他代谢参数也有不利变化：臀围（P < 0.001）、腰围（P < 0.001）、体重指数（P = 0.014）、静息收缩压（P < 0.001）、静息舒张压（P = 0.002）、运动后收缩压（P < 0.001）、运动后心率（P = 0.007）、空腹血糖（P < 0.001）、口服葡萄糖耐量试验2小时血糖（P = 0.002）、甘油三酯（P = 0.04）、高密度脂蛋白胆固醇（P = 0.014）、代谢综合征患病率（P < 0.001）。农村组的体力活动较高，城市组的快餐和甜食摄入量较高。
奥瓦希姆巴人的城市化与糖代谢紊乱及其他不利代谢参数的患病率增加有关。除生活方式改变外，这可能归因于生活在城市环境中的奥瓦希姆巴人皮质醇暴露增加。
