Delisle H F, Ekoé J M
Département de nutrition, Université de Montréal, Que.
CMAJ. 1993 Jan 1;148(1):41-7.
To assess and compare the prevalence of non-insulin-dependent diabetes mellitus (NIDDM) and impaired glucose tolerance (IGT) in two native Indian communities.
Population-based study.
Two Algonquin communities in Quebec: River Desert and Lac Simon.
All native Indian residents aged at least 15 years were eligible; 621 (59%) of them volunteered to enroll in the study. The participation rate was 49% in River Desert and 76% in Lac Simon.
Fasting blood glucose level and serum glucose level 2 hours after 75-g oral glucose tolerance test, as described by the World Health Organization, in all subjects except those with confirmed diabetes. Other measures included body mass index (BMI), fat distribution and blood pressure.
The age-sex standardized prevalence rate of NIDDM was 19% in Lac Simon (95% confidence interval [CI] 16% to 21%); this was more than twice the rate of 9% in River Desert (95% CI 7% to 11%). The IGT rates were comparable in the two communities (River Desert 5%, Lac Simon 6%). NIDDM and IGT were uncommon under the age of 35 years. Only in Lac Simon was the NIDDM prevalence rate significantly higher among the women than among the men (23% v. 14%); almost half of the women aged 35 years or more had diabetes. In Lac Simon the rate of marked obesity (BMI greater than 30) was significantly higher among the women than among the men (37% v. 19%; p < 0.001); this sex-related difference was not found in River Desert (rates 31% and 23% respectively). Previously undiagnosed NIDDM accounted for 25% of all the cases. NIDDM and IGT were significantly associated with high BMI, sum of skinfold thicknesses and waist:hip circumference ratio (p < 0.001). The subscapular:triceps skinfold ratio, however, did not display such an association, nor did the age-adjusted systolic blood pressure.
The prevalence of NIDDM is high in Algonquin communities and may vary markedly between communities. Although widespread, particularly in women, obesity cannot entirely explain the much higher rate of NIDDM in Lac Simon. Family and lifestyle risk factors, in particular diet and activity patterns, are being analysed in the two communities.
评估并比较两个印度原住民社区中非胰岛素依赖型糖尿病（NIDDM）和糖耐量受损（IGT）的患病率。
基于人群的研究。
魁北克的两个阿尔冈昆社区：里弗德塞特和拉克西蒙。
所有年龄至少15岁的印度原住民居民均符合条件；其中621人（59%）自愿参加该研究。里弗德塞特的参与率为49%，拉克西蒙为76%。
除确诊糖尿病患者外，所有受试者均进行75克口服葡萄糖耐量试验后测定空腹血糖水平及2小时血清葡萄糖水平，这是世界卫生组织所描述的指标。其他测量指标包括体重指数（BMI）、脂肪分布和血压。
拉克西蒙NIDDM的年龄 - 性别标准化患病率为19%（95%置信区间[CI] 16%至21%）；这是里弗德塞特9%患病率（95% CI 7%至11%）的两倍多。两个社区的IGT患病率相当（里弗德塞特5%，拉克西蒙6%）。35岁以下人群中NIDDM和IGT并不常见。仅在拉克西蒙，女性中的NIDDM患病率显著高于男性（23%对14%）；35岁及以上女性中几乎一半患有糖尿病。在拉克西蒙，显著肥胖（BMI大于30）的女性患病率显著高于男性（37%对19%；p < 0.001）；在里弗德塞特未发现这种性别差异（患病率分别为31%和23%）。之前未被诊断出的NIDDM占所有病例的25%。NIDDM和IGT与高BMI、皮褶厚度总和及腰臀围比显著相关（p < 0.001）。然而，肩胛下与肱三头肌皮褶比以及年龄调整后的收缩压并未显示出这种关联。
阿尔冈昆社区中NIDDM的患病率较高，且社区之间可能存在显著差异。尽管肥胖普遍存在，尤其是在女性中，但肥胖并不能完全解释拉克西蒙NIDDM患病率高得多的原因。目前正在对这两个社区的家庭和生活方式风险因素，特别是饮食和活动模式进行分析。
