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墨西哥南部瓦哈卡山谷一个与世隔绝的米克社区中,环境驱动的2型糖尿病、超重和肥胖的变化。

Environment driven changes in type 2 diabetes, overweight and obesity in an isolated Mixe community in the Valley of Oaxaca, southern Mexico.

作者信息

Little Bert, Escobedo Jorge, Pena Reyes Maria Eugenia, Shakib Shaminul Hoque, O'Brien Liz, Kerber Rich, Velasco Xochitl, Lopez Miguel Cruz, Tillquist Christopher

机构信息

School of Public Health and Information Sciences, University of Louisville, Louisville, Kentucky, USA.

Department of Anthropology, University of Louisville, Louisville, Kentucky, USA.

出版信息

Am J Hum Biol. 2024 Oct;36(10):e24119. doi: 10.1002/ajhb.24119. Epub 2024 Jul 16.

Abstract

BACKGROUND

This study focused on type 2 diabetes mellitus (T2DM) in a group of adult Mixe, an Indigenous population from Oaxaca, Mexico. Mixe comprised an estimated 9.4% (n ≅ 90 000) of the Indigenous population in Oaxaca. Mexico.

OBJECTIVE

This study focused on a group of adult Mixe, an Indigenous population from Oaxaca, Mexico. To compare the prevalence of T2DM, overweight (OW), obesity (OB), and hypertension (HTN) between 2007 and 2017 for a small, isolated Mixe community in the Valley of Oaxaca, Mexico. We test whether or not environmental changes have affected T2DM prevalence.

METHODS AND MATERIALS

Demographic and medical record data were collected in the community in 2007 and 2017 from the medical clinic and the mayor's office. T2DM was medically diagnosed among adults (>34 years old), in 2007 (n = 730) and in 2017 (n = 829).

RESULTS

T2DM crude prevalence increased from 6.7% to 12.1% (p < .001) from 2007 to 2017. The mean age of the sample analyzed was 60.6 (SD = 9.7). Age-adjusted T2DM prevalence increased from 6.7% to 10.8% (p < .002). T2DM was 5.7%-5.5% among males (p < .53) and 7.1%-13.6% among females (p < .001). Sex-specific OW and OB simulation studies indicate females had 7% less OW in 2007, and males were unchanged compared with 2017. OB among males and females was significantly higher in 2017 compared with 2007 (increased by 15.2% and 8.3%, males and females, respectively). Sexes combined OW + OB increased 12.7% among males but was unchanged in females (-0.5%). In the sexes combined analysis, OW prevalence increased 12.7% to 27.1% (p < .001) and OB prevalence increased 10.7%-27.9% (p < .001) from 2007 to 2017. HTN did not change significantly from 2007 to 2017 (15.4% and 14.6%, respectively) (p = .63) in adults. Among T2DM individuals, the frequency of HTN was not significantly different in 2007 and 2017 (57.1% and 37%, respectively) (p = .65). Transition to a Western diet consisting of high-carbohydrate foods occurred at the same time as increased T2DM from 2007 to 2017, with a higher prevalence of T2DM noted among females in 2017.

CONCLUSIONS

An increased prevalence of T2DM, OW, and OB but not HTN was observed in the Mixe community from 2007 to 2017 and was associated with the adoption of a high-carbohydrate Western diet.

摘要

背景

本研究聚焦于墨西哥瓦哈卡州的一个原住民群体——成年米克人(Mixe)中的2型糖尿病(T2DM)。米克人约占墨西哥瓦哈卡州原住民人口的9.4%(约90000人)。

目的

本研究聚焦于墨西哥瓦哈卡州的一个成年米克人群体。为比较2007年至2017年间墨西哥瓦哈卡山谷一个小型孤立米克社区中T2DM、超重(OW)、肥胖(OB)和高血压(HTN)的患病率。我们检验环境变化是否影响了T2DM患病率。

方法与材料

2007年和2017年在该社区的医疗诊所和市长办公室收集了人口统计学和医疗记录数据。在2007年(n = 730)和2017年(n = 829)对成年人(>34岁)进行了T2DM的医学诊断。

结果

从2007年到2017年,T2DM的粗患病率从6.7%升至12.1%(p <.001)。所分析样本的平均年龄为60.6岁(标准差 = 9.7)。年龄调整后的T2DM患病率从6.7%升至10.8%(p <.002)。男性的T2DM患病率为5.7% - 5.5%(p <.53),女性为7.1% - 13.6%(p <.

001)。按性别进行的OW和OB模拟研究表明,2007年女性的OW比2017年少7%,男性与2017年相比无变化。与2007年相比(男性和女性分别增加了15.2%和8.3%),2017年男性和女性的OB显著更高。男性OW + OB的总和增加了12.7%,而女性则无变化( - 0.5%)。在综合性别分析中,从2007年到2017年,OW患病率从12.7%升至27.1%(p <.001),OB患病率从10.7%升至27.9%(p <.001)。2007年至2017年成年人的HTN无显著变化(分别为15.4%和14.6%)(p =.63)。在T2DM患者中,2007年和2017年HTN的发生率无显著差异(分别为57.1%和37%)(p =.65)。从2007年到2017年,向以高碳水化合物食物为主的西方饮食的转变与T2DM的增加同时发生,2017年女性中T2DM的患病率更高。

结论

2007年至2017年在米克社区观察到T2DM、OW和OB的患病率增加,但HTN未增加,且这与采用高碳水化合物的西方饮食有关。

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