Braun B, Zimmermann M B, Kretchmer N, Spargo R M, Smith R M, Gracey M
Department of Pediatrics, University of California, San Francisco.
Diabetes Care. 1996 May;19(5):472-9. doi: 10.2337/diacare.19.5.472.
To test the hypothesis that hyperinsulinemia and glucose intolerance are present at an early age in australian aborigines and can be used to predict the eventual development of NIDDM.
Baseline anthropometric, pubertal stage, and blood pressure data were collected for 100 Australian aboriginal children and adolescents in 1989. Plasma concentrations of glucose, insulin, C-peptide, triglycerides, and LDL, HDL, and total cholesterol were measured before and during an oral glucose tolerance test. All measurements were repeated in 74 individuals from the original study population in 1994. Results were compared among hyperinsulinemic and normoinsulinemic subjects, and subjects with normal or abnormal glucose tolerance.
The percentage of subjects who were overweight increased from 2.7% at baseline to 17.6% 5 years later. At a mean age of 18.5 years, 8.1% of the population had impaired glucose tolerance (IGT), 2.7% had diabetes, and 21.6% had elevated cholesterol concentrations in plasma. Dyslipidemia was particularly prevalent among male subjects in the population: 34.4% had elevated plasma cholesterol and 21.9% had elevated LDL cholesterol values. Of the eight subjects who had diabetes or IGT in 1994, four were classified as hyperinsulinemic in 1989 and four were not.
The major finding of this study is the high prevalence of risk factors for NIDDM and cardiovascular disease in this population of aboriginal children and adolescents. Abnormalities of carbohydrate and lipid metabolism were well established by late in the second decade of life. Although many subjects had high insulin levels and there was evidence of insulin resistance in the population, hyperinsulinemia did not predict the development of abnormal glucose tolerance 5 years later.
验证澳大利亚原住民在幼年时即存在高胰岛素血症和葡萄糖耐量异常，且可用于预测非胰岛素依赖型糖尿病（NIDDM）最终发展情况这一假说。
1989年收集了100名澳大利亚原住民儿童及青少年的基线人体测量数据、青春期阶段及血压数据。在口服葡萄糖耐量试验前及试验期间，测量血浆葡萄糖、胰岛素、C肽、甘油三酯、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）及总胆固醇浓度。1994年，对原研究人群中的74人重复进行了所有测量。比较了高胰岛素血症和正常胰岛素血症受试者以及葡萄糖耐量正常或异常的受试者的结果。
超重受试者的百分比从基线时的2.7%增至5年后的17.6%。平均年龄18.5岁时，8.1%的人群存在葡萄糖耐量受损（IGT），2.7%患有糖尿病，21.6%的人血浆胆固醇浓度升高。血脂异常在该人群男性受试者中尤为普遍：34.4%的人血浆胆固醇升高，21.9%的人LDL胆固醇值升高。在1994年患有糖尿病或IGT的8名受试者中，4人在1989年被归类为高胰岛素血症，4人不是。
本研究的主要发现是，在这群原住民儿童及青少年中，NIDDM和心血管疾病的危险因素普遍存在。碳水化合物和脂质代谢异常在生命的第二个十年后期已很明显。尽管许多受试者胰岛素水平较高，且有证据表明该人群存在胰岛素抵抗，但高胰岛素血症并不能预测5年后葡萄糖耐量异常的发展。
