Delisle H F, Rivard M, Ekoé J M
Department of Nutrition, University of Montreal, Quebec, Canada.
Diabetes Care. 1995 Sep;18(9):1255-9. doi: 10.2337/diacare.18.9.1255.
To compare the prevalence of non-insulin-dependent diabetes mellitus (NIDDM) in the two largest Algonquin communities of Quebec (Canada) with that of other native groups and to describe the different patterns of NIDDM and other cardiovascular risk markers in these communities (River Desert [RD] and Lac Simon [LS]).
The population-based study targeted all residents aged 15 years and older. In the age-group considered here (30-64 years), there were 480 eligible subjects and 299 participants (50.8% in RD and 86.9% in LS). All except those with confirmed diabetes underwent an oral glucose tolerance test. Serum triglyceride and lipoprotein cholesterol levels, blood pressure, body mass index (BMI), and waist-to-hip ratio (WHR) were measured.
The age-standardized (world population) prevalence of NIDDM in women was twice as high in LS as in RD (48.6% vs. 23.9%). In men, it was 23.9% in LS and 16.3% in RD. Upper-body obesity followed the same pattern. In contrast, high-risk serum low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol levels were significantly more prevalent in RD than in LS, particularly among men. The rate of high blood pressure was twice as high in men as in women, with little community differences. When we controlled for age, sex, diabetic, and obesity status, mean fasting serum glucose remained significantly higher triglycerides and LDL cholesterol lower in LS than in RD. There was also an independent community effect on WHR but no on BMI.
The prevalence of NIDDM in LS women reaches the rate observed in Pima Indian women. The observed differences between two Algonquin communities suggest a highly heterogeneous pattern of NIDDM and cardiovascular disease risk factors in Amerindian populations, even within a given tribe and a limited geographic area.
比较加拿大魁北克省两个最大的阿尔冈昆社区中非胰岛素依赖型糖尿病（NIDDM）的患病率与其他原住民群体的患病率，并描述这些社区（里弗沙漠[RD]和西蒙湖[LS]）中NIDDM及其他心血管风险标志物的不同模式。
这项基于人群的研究针对所有15岁及以上的居民。在此考虑的年龄组（30 - 64岁）中，有480名符合条件的受试者，299名参与者（RD社区为50.8%，LS社区为86.9%）。除已确诊糖尿病的患者外，所有参与者均接受口服葡萄糖耐量试验。测量血清甘油三酯和脂蛋白胆固醇水平、血压、体重指数（BMI）和腰臀比（WHR）。
按年龄标准化（世界人口）后，LS社区女性NIDDM的患病率是RD社区的两倍（48.6%对23.9%）。男性中，LS社区为23.9%，RD社区为16.3%。上身肥胖呈现相同模式。相比之下，高危血清低密度脂蛋白（LDL）和高密度脂蛋白（HDL）胆固醇水平在RD社区比在LS社区更普遍，尤其是在男性中。男性高血压患病率是女性的两倍，社区间差异不大。当我们控制年龄、性别、糖尿病和肥胖状态后，LS社区的平均空腹血清葡萄糖仍显著高于RD社区，甘油三酯和LDL胆固醇则低于RD社区。WHR也存在独立的社区效应，但BMI不存在。
LS社区女性NIDDM的患病率达到了皮马印第安女性中观察到的水平。两个阿尔冈昆社区之间观察到的差异表明美洲印第安人群中NIDDM和心血管疾病风险因素存在高度异质性模式，即使在同一部落和有限地理区域内也是如此。
