McLarty D G, Swai A B, Kitange H M, Masuki G, Mtinangi B L, Kilima P M, Makene W J, Chuwa L M, Alberti K G
Department of Medicine, Muhimbili Medical Centre, Tanzania.
Lancet. 1989 Apr 22;1(8643):871-5. doi: 10.1016/s0140-6736(89)92866-3.
The prevalence of diabetes mellitus and impaired glucose tolerance (IGT) was assessed by use of WHO diagnostic criteria in 6299 Africans aged 15 years and above living in six villages in Tanzania. 0.87% (1.1% male, 0.68% female) had diabetes and 7.8% (6.9% male, 7.7% female) had IGT. Prevalence rates were 1.1% and 8.4%, respectively, when age-adjusted to the USA population. Only 7 (13.5%) of the 53 individuals with diabetes had been known to have the disorder; 34 (74%) of the other 46 were symptom-free. Mean age was 54 (SD 20) for diabetic subjects and 37 (17) years for the whole population. Diabetes and IGT rates did not differ significantly between villages despite geographical, socioeconomic, and dietary differences. Diabetes rates increased modestly with age and body mass index (BMI). Fasting blood glucose (FBG) levels did not rise significantly with age but correlated positively with systolic blood pressure (BP) and negatively with haemoglobin concentration (Hb) and BMI. The 2 hour post-glucose load blood glucose values correlated positively with age, sex, and systolic BP and negatively with Hb. Diabetes is less prevalent in rural Africa than in developed countries, even when age has been corrected for. This difference is probably related to body weight, diet, and exercise.
采用世界卫生组织的诊断标准,对居住在坦桑尼亚六个村庄的6299名15岁及以上的非洲人进行了糖尿病和糖耐量受损(IGT)患病率的评估。0.87%(男性1.1%,女性0.68%)患有糖尿病,7.8%(男性6.9%,女性7.7%)患有IGT。年龄调整至美国人群后,患病率分别为1.1%和8.4%。在53名糖尿病患者中,只有7名(13.5%)此前已知患有该疾病;在其他46名患者中,34名(74%)无症状。糖尿病患者的平均年龄为54岁(标准差20),整个人群的平均年龄为37岁(标准差17)。尽管存在地理、社会经济和饮食差异,但不同村庄之间的糖尿病和IGT患病率并无显著差异。糖尿病患病率随年龄和体重指数(BMI)略有增加。空腹血糖(FBG)水平并未随年龄显著升高,但与收缩压(BP)呈正相关,与血红蛋白浓度(Hb)和BMI呈负相关。葡萄糖负荷后2小时血糖值与年龄、性别和收缩压呈正相关,与Hb呈负相关。即使校正了年龄因素,非洲农村地区的糖尿病患病率仍低于发达国家。这种差异可能与体重、饮食和运动有关。