Heine R J, Nijpels G, Mooy J M
Institute for Research in Extramural Medicine, Vrije Universiteit, Amsterdam, The Netherlands.
Diabet Med. 1996;13(3 Suppl 2):S12-4.
The Hoorn study has investigated the prevalence of impaired glucose tolerance (IGT) and diabetes in a random sample of the population, 50-75 years of age, in the small Dutch town of Hoorn. The percentage of the population identified as having IGT was 10.3%, while 8.4% had diabetes. The prevalence of both diabetes and IGT was higher in older subjects (70-74 years of age) than in younger subjects (50-54 years of age), suggesting that age is a major determinant of the prevalence of IGT and diabetes in a population. A prospective study of the development of non-insulin dependent diabetes mellitus (NIDDM) in the subjects identified as having IGT was then initiated. Preliminary results for the 158 subjects who have been followed for a mean of 2 years indicated that 28.5% (95% confidence interval, 15-42%) have progressed to NIDDM within this period. The progression rate calculated from this value is 13.8%/year (95% confidence interval, 3.5-24%/year). Analysis of possible determinants of conversion has revealed that 2-hour plasma glucose levels greater than 9.4 mmol/litre and increased fasting proinsulin levels are predictive of progression to NIDDM. This suggests that beta cell dysfunction, rather than increased insulin resistance, is responsible for the development of NIDDM.
霍伦研究调查了荷兰小镇霍伦50至75岁随机抽样人群中糖耐量受损（IGT）和糖尿病的患病率。被确定患有IGT的人群比例为10.3%，而患有糖尿病的比例为8.4%。糖尿病和IGT的患病率在老年受试者（70至74岁）中高于年轻受试者（50至54岁），这表明年龄是人群中IGT和糖尿病患病率的主要决定因素。随后对被确定患有IGT的受试者进行了非胰岛素依赖型糖尿病（NIDDM）发展的前瞻性研究。对平均随访2年的158名受试者的初步结果表明，在此期间28.5%（95%置信区间，15 - 42%）已进展为NIDDM。根据该值计算的进展率为13.8%/年（95%置信区间，3.5 - 24%/年）。对可能的转变决定因素的分析表明，2小时血浆葡萄糖水平大于9.4毫摩尔/升和空腹胰岛素原水平升高可预测进展为NIDDM。这表明β细胞功能障碍而非胰岛素抵抗增加是NIDDM发生的原因。
