Ravussin E, Valencia M E, Esparza J, Bennett P H, Schulz L O
Clinical Diabetes and Nutrition Section, Phoenix, AZ 85016.
Diabetes Care. 1994 Sep;17(9):1067-74. doi: 10.2337/diacare.17.9.1067.
The Pima Indians of Arizona have the highest reported prevalences of obesity and non-insulin-dependent diabetes mellitus (NIDDM). In parallel with abrupt changes in lifestyle, these prevalences in Arizona Pimas have increased to epidemic proportions during the past decades. To assess the possible impact of the environment on the prevalences of obesity and NIDDM, data were collected on members of a population of Pima ancestry (separation 700-1,000 years ago) living in a remote mountainous location in northwestern Mexico, with a lifestyle contrasting markedly with that in Arizona.
Pima heritage was established by history and by use of Pima language. Measurements of weight, height, body fat (bioimpedance), blood pressure, plasma levels of glucose, cholesterol, and HbA1c were obtained in 19 women (36 +/- 13 years of age) and 16 men (48 +/- 14 years of age) and compared with sex-, age- and diabetes status-matched Pimas living in Arizona (10 Arizona Pimas for each Mexican Pima).
Mexican Pimas were lighter (64.2 +/- 13.9 vs. 90.2 +/- 21.1 kg, P < 0.0001; means +/- SD) and shorter (160 +/- 8 vs. 164 +/- 8 cm, P < 0.01) with lower body mass indexes (24.9 +/- 4.0 vs. 33.4 +/- 7.5 kg/m2, P < 0.0001) and lower plasma total cholesterol levels (146 +/- 30 vs. 174 +/- 31 mg/dl, P < 0.0001) than Arizona Pimas. Only two women (11%) and one man (6%) had NIDDM, contrasting with the expected prevalences of 37 and 54% in female and male Arizona Pimas, respectively.
This preliminary investigation shows that obesity, and perhaps NIDDM, is less prevalent among people of Pima heritage living a "traditional" lifestyle than among Pimas living in an "affluent" environment. These findings suggest that, despite a similar potential genetic predisposition to these conditions, a traditional lifestyle, characterized by a diet including less animal fat and more complex carbohydrates and by greater energy expenditure in physical labor, may protect against the development of cardiovascular disease risk factors, obesity, and NIDDM.
据报道，亚利桑那州的皮马印第安人肥胖症和非胰岛素依赖型糖尿病（NIDDM）的患病率最高。随着生活方式的突然改变，在过去几十年里，亚利桑那州皮马人的这些患病率已上升到流行程度。为了评估环境对肥胖症和NIDDM患病率的可能影响，收集了居住在墨西哥西北部偏远山区的一群有皮马血统（700 - 1000年前分离）人群的数据，他们的生活方式与亚利桑那州的皮马人明显不同。
通过历史记录和皮马语的使用来确定皮马血统。对19名女性（36 ± 13岁）和16名男性（48 ± 14岁）进行了体重、身高、体脂（生物电阻抗）、血压、血浆葡萄糖、胆固醇和糖化血红蛋白水平的测量，并与生活在亚利桑那州的性别、年龄和糖尿病状况相匹配的皮马人（每一名墨西哥皮马人对应10名亚利桑那州皮马人）进行比较。
墨西哥皮马人比亚利桑那州皮马人更轻（64.2 ± 13.9 vs. 90.2 ± 21.1 kg，P < 0.0001；均值 ± 标准差）、更矮（160 ± 8 vs. 164 ± 8 cm，P < 0.01），体重指数更低（24.9 ± 4.0 vs. 33.4 ± 7.5 kg/m2，P < 0.0001），血浆总胆固醇水平更低（146 ± 30 vs. 174 ± 31 mg/dl，P < 0.0001）。只有两名女性（11%）和一名男性（6%）患有NIDDM，这与亚利桑那州皮马女性和男性预期的患病率分别为37%和54%形成对比。
这项初步调查表明，与生活在“富裕”环境中的皮马人相比，过着“传统”生活方式的有皮马血统的人群中肥胖症甚至可能还有NIDDM不太普遍。这些发现表明，尽管对这些疾病有相似的潜在遗传易感性，但以包含较少动物脂肪和较多复合碳水化合物的饮食以及体力劳动中更多能量消耗为特征的传统生活方式，可能有助于预防心血管疾病风险因素、肥胖症和NIDDM的发生。
