Monterrosa A E, Haffner S M, Stern M P, Hazuda H P
Department of Medicine, University of Texas Health Science Center at San Antonio 78284-7873, USA.
Diabetes Care. 1995 Apr;18(4):448-56. doi: 10.2337/diacare.18.4.448.
Little is known about the role of lifestyle factors in non-insulin-dependent diabetes mellitus (NIDDM) incidence among Mexican-Americans. Therefore, we examined whether baseline lifestyle factors predictive of 8-year NIDDM incidence differ in Mexican-American men and women.
We studied 353 Mexican-American men and 491 Mexican-American women free of diabetes at baseline who participated in the San Antonio Heart Study follow-up. Lifestyle factors examined were body mass index (BMI), energy intake (total calories/kg), grams of alcohol consumed per week, efforts to control weight by dieting and exercise, leisure physical activity, sugar avoidance, saturated fat/cholesterol avoidance, and 24-h dietary recall assessment of total calories and percentage of calories from total carbohydrate, sucrose, and starch and from total, saturated, monounsaturated, and polyunsaturated fat. Incidence of NIDDM was regressed on lifestyle factors separately for men and women using a backward elimination procedure.
Lifestyle factors significantly associated with NIDDM incidence differed for the two sexes. In men, leisure physical activity, was inversely associated and alcohol consumption, weight control by dieting, and BMI were positively associated with NIDDM. In women, BMI was positively associated with NIDDM and was the strongest lifestyle predictor. Sugar avoidance and leisure physical activity were also associated with increased NIDDM risk, while weight control by dieting was associated with decreased NIDDM risk. Saturated fat/cholesterol avoidance, grams of alcohol consumed per week, and energy intake were also negatively and indirectly associated with NIDDM in women by means of their direct effects on BMI.
It may be important to tailor interventions designed to prevent NIDDM in Mexican-Americans to address sex differences in lifestyle precursors of this disease
关于生活方式因素在墨西哥裔美国人非胰岛素依赖型糖尿病（NIDDM）发病中的作用，人们了解甚少。因此，我们研究了预测8年NIDDM发病率的基线生活方式因素在墨西哥裔美国男性和女性中是否存在差异。
我们对353名基线时无糖尿病的墨西哥裔美国男性和491名墨西哥裔美国女性进行了研究，这些人参与了圣安东尼奥心脏研究随访。所研究的生活方式因素包括体重指数（BMI）、能量摄入（总卡路里/千克）、每周饮酒量、通过节食和运动控制体重的努力、休闲体力活动、避免食糖、避免饱和脂肪/胆固醇，以及通过24小时饮食回顾评估的总卡路里和来自总碳水化合物、蔗糖、淀粉以及总脂肪、饱和脂肪、单不饱和脂肪和多不饱和脂肪的卡路里百分比。使用向后消除程序分别对男性和女性的NIDDM发病率与生活方式因素进行回归分析。
与NIDDM发病率显著相关的生活方式因素在两性中有所不同。在男性中，休闲体力活动与NIDDM呈负相关，而饮酒量、通过节食控制体重和BMI与NIDDM呈正相关。在女性中，BMI与NIDDM呈正相关，且是最强的生活方式预测因素。避免食糖和休闲体力活动也与NIDDM风险增加相关，而通过节食控制体重与NIDDM风险降低相关。避免饱和脂肪/胆固醇、每周饮酒量和能量摄入也通过对BMI的直接影响与女性的NIDDM呈负相关且间接相关。
针对墨西哥裔美国人预防NIDDM设计的干预措施可能需要考虑到该疾病生活方式前驱因素中的性别差异，这一点很重要。
