Haffner S M, Stern M P, Hazuda H P, Pugh J A, Patterson J K
N Engl J Med. 1986 Jul 24;315(4):220-4. doi: 10.1056/NEJM198607243150403.
The prevalence of non-insulin-dependent diabetes mellitus (NIDDM) is higher in Mexican Americans than in non-Hispanic white Americans, even after adjustment for the former's greater overall and more centralized adiposity. We postulated that this excess risk of NIDDM could be due to resistance to insulin. We performed oral glucose-tolerance tests with measurements of serum insulin concentrations in 225 Mexican Americans and 180 non-Hispanic whites without diabetes as part of the San Antonio Heart Study, a population-based study of risk factors for diabetes. Changes in serum insulin concentrations in response to the glucose challenge were quantified by the area under the serum insulin curve. Overall adiposity was characterized by body-mass index, and regional body-fat distribution by the ratio of subscapular to triceps skinfolds and the ratio of waist to hip circumference. After adjustment for these indicators of adiposity and also for differences in glucose tolerance, Mexican Americans were found to have significantly greater areas under the serum insulin curve than non-Hispanic whites. These data suggest that, like other populations at high risk for NIDDM such as Pima Indians and Micronesians, Mexican Americans have more hyperinsulinemia than can be accounted for by their adiposity.
非胰岛素依赖型糖尿病（NIDDM）在墨西哥裔美国人中的患病率高于非西班牙裔美国白人，即便在对前者更高的总体肥胖程度和更集中的脂肪分布进行校正之后亦是如此。我们推测，NIDDM的这种额外风险可能归因于胰岛素抵抗。作为一项基于人群的糖尿病危险因素研究——圣安东尼奥心脏研究的一部分，我们对225名无糖尿病的墨西哥裔美国人和180名无糖尿病的非西班牙裔白人进行了口服葡萄糖耐量试验，并测量了血清胰岛素浓度。通过血清胰岛素曲线下面积来量化葡萄糖激发试验后血清胰岛素浓度的变化。总体肥胖程度用体重指数来表征，局部体脂分布则用肩胛下皮褶厚度与三头肌皮褶厚度之比以及腰围与臀围之比来表示。在校正这些肥胖指标以及葡萄糖耐量差异之后，发现墨西哥裔美国人血清胰岛素曲线下面积显著大于非西班牙裔白人。这些数据表明，与皮马印第安人和密克罗尼西亚人等其他NIDDM高危人群一样，墨西哥裔美国人存在比由其肥胖所能解释的更多的高胰岛素血症。
