Stern M P, Gaskill S P, Hazuda H P, Gardner L I, Haffner S M
Diabetologia. 1983 Apr;24(4):272-7. doi: 10.1007/BF00282712.
Obesity and Type 2 (non-insulin-dependent) diabetes mellitus are common in the Mexican American population. It is not clear whether this is merely a specific instance of the more general phenomenon of excess Type 2 diabetes and obesity among poor people, or whether Mexican Americans have a discrete genetic susceptibility to Type 2 diabetes. The latter consideration arises because Mexican Americans are of mixed native American and European ancestry and native Americans may have a genetic predisposition to Type 2 diabetes which Mexican Americans could share. We studied 936 Mexican Americans and 398 Anglo-Americans randomly selected from three socially and culturally distinct neighborhoods in San Antonio, Texas. Three categories of obesity--lean, average, and obese--were defined using the Anglo-American distribution of the sum of the triceps and subscapular skinfold. Mexican Americans were two to four times as likely to fall into the obese category as Anglo-Americans, but within categories, the two ethnic groups were closely matched in terms of sum of skinfolds. The prevalence of Type 2 diabetes, however, was significantly greater in Mexican Americans than in Anglo-Americans even when the comparisons were made within the three obesity categories. The summary prevalence ratio, controlling for obesity, was 2.54 for men (p = 0.004) and 1.70 for women (p = 0.036). Thus, lean Mexican Americans are still at greater risk of Type 2 diabetes than equally lean Anglo-Americans. Conversely, although Type 2 diabetes prevalence increases as expected with increasing obesity in both ethnic groups, obese Anglo-Americans are still relatively protected compared with equally obese Mexican Americans. Plasma glucose was significantly higher in Mexican Americans than in Anglo-Americans even after controlling for obesity. These results indicate that, although obesity contributes to Type 2 diabetes in Mexican Americans, it does not by itself explain the entire excess prevalence rate.
肥胖症和2型（非胰岛素依赖型）糖尿病在墨西哥裔美国人中很常见。目前尚不清楚这仅仅是贫困人口中2型糖尿病和肥胖症更为普遍现象的一个具体例子，还是墨西哥裔美国人对2型糖尿病具有独特的遗传易感性。后一种考虑的产生是因为墨西哥裔美国人有美洲原住民和欧洲人的混合血统，而美洲原住民可能对2型糖尿病有遗传易感性，墨西哥裔美国人可能也有。我们从得克萨斯州圣安东尼奥市三个社会和文化不同的社区中随机选取了936名墨西哥裔美国人和398名英裔美国人进行研究。根据英裔美国人肱三头肌和肩胛下皮褶厚度之和的分布情况，定义了三类肥胖——偏瘦、中等和肥胖。墨西哥裔美国人进入肥胖类别的可能性是英裔美国人的两到四倍，但在各个类别中，两个种族群体在皮褶厚度总和方面非常接近。然而，即使在三个肥胖类别中进行比较，墨西哥裔美国人中2型糖尿病的患病率仍显著高于英裔美国人。控制肥胖因素后的总体患病率比值，男性为2.54（p = 0.004），女性为1.70（p = 0.036）。因此，体型偏瘦的墨西哥裔美国人患2型糖尿病的风险仍然高于同样偏瘦的英裔美国人。相反，尽管两个种族群体中2型糖尿病的患病率都随着肥胖程度的增加而如预期那样上升，但与同样肥胖的墨西哥裔美国人相比，肥胖的英裔美国人仍然相对受到保护。即使控制了肥胖因素，墨西哥裔美国人的血糖水平仍显著高于英裔美国人。这些结果表明，尽管肥胖症在墨西哥裔美国人中会导致2型糖尿病，但它本身并不能解释全部的超额患病率。
