Collins V R, Dowse G K, Plehwe W E, Imo T T, Toelupe P M, Taylor H R, Zimmet P Z
International Diabetes Institute, Melbourne, Australia.
Diabetes Care. 1995 Aug;18(8):1140-9. doi: 10.2337/diacare.18.8.1140.
To determine the prevalence of diabetic retinopathy and nephropathy retinopathy and nephropathy and to define associated risk factors in Polynesian Western Samoans with non-insulin-dependent diabetes mellitus (NIDDM) or impaired glucose tolerance (IGT).
A 1991 population-based study in Samoan adults (ages 25-74 years) included a 75-g oral glucose tolerance test, anthropometric measurements, and blood pressure recordings. Subjects with NIDDM or IGT had 45-degree stereo photographs taken (n = 263) (three standard fields of the right eye), and retinopathy was graded in comparison with Airlie House photographs. First-morning urine samples (n = 304) were also collected from these subjects and from a subsample with normal glucose tolerance. Urinary albumin concentration (UAC) was measured by radioimmunoassay: microalbuminuria was defined as UAC of 30-299 micrograms/ml; and macroalbuminuria among subjects with Proliferative diabetic retinopathy was found in 4.5% of known diabetic subjects. The prevalence of elevated UAC was 15.0% in subjects with IGT, 26.0% in newly diagnosed diabetes subjects, and 23.4% in known diabetes subjects. For all diabetic subjects (n = 162), the factors independently associated with diabetic retinopathy (logistic regression) were duration of diabetes, fasting plasma glucose, and body mass index (inversely). Duration of diabetes, serum triglyceride concentrations, and systolic blood pressure were independently associated with elevated UAC in all diabetic subjects (n = 138), and fasting plasma glucose had borderline significance.
Diabetic retinopathy and albuminuria are common in Polynesian Western Samoans. Duration of diabetes and level of glycemia were the most important associated factors. These data underline the need for cost-effective programs for the detection and early treatment of diabetes in Western Samoa and other developing populations with high susceptibility to NIDDM.
确定西萨摩亚波利尼西亚人非胰岛素依赖型糖尿病（NIDDM）或糖耐量受损（IGT）患者中糖尿病视网膜病变和肾病视网膜病变的患病率，并明确相关危险因素。
1991年对萨摩亚成年人（25 - 74岁）进行的一项基于人群的研究，包括75克口服葡萄糖耐量试验、人体测量和血压记录。患有NIDDM或IGT的受试者拍摄了45度立体照片（n = 263）（右眼三个标准视野），并与艾利屋照片对比对视网膜病变进行分级。还从这些受试者以及糖耐量正常的子样本中收集了首次晨尿样本（n = 304）。通过放射免疫分析法测量尿白蛋白浓度（UAC）：微量白蛋白尿定义为UAC为30 - 299微克/毫升；增殖性糖尿病视网膜病变患者中的大量白蛋白尿在已知糖尿病患者中占4.5%。IGT患者中UAC升高的患病率为15.0%，新诊断糖尿病患者中为26.0%，已知糖尿病患者中为23.4%。对于所有糖尿病患者（n = 162），与糖尿病视网膜病变独立相关的因素（逻辑回归）为糖尿病病程、空腹血糖和体重指数（呈负相关）。糖尿病病程、血清甘油三酯浓度和收缩压在所有糖尿病患者（n = 138）中与UAC升高独立相关，空腹血糖具有临界显著性。
糖尿病视网膜病变和蛋白尿在西萨摩亚波利尼西亚人中很常见。糖尿病病程和血糖水平是最重要的相关因素。这些数据强调了在西萨摩亚以及其他对NIDDM高度易感的发展中人群中开展具有成本效益的糖尿病检测和早期治疗项目的必要性。
