Adler A I, Boyko E J, Schraer C D, Murphy N J
Department of Health Services, Research and Development, Veterans Affairs Medical Center, Seattle, Washington, USA.
Diabet Med. 1996 Jun;13(6):555-60. doi: 10.1002/(SICI)1096-9136(199606)13:6<555::AID-DIA109>3.0.CO;2-V.
The once low prevalence of non-insulin-dependent (Type 2) diabetes (NIDDM) in Eskimos and Indians has risen approximately fourfold over the past 30 years, suggesting the presence of a non-genetic factor affecting NIDDM prevalence. At the same time, traditional physical activities required of a subsistence (self-sufficiency) lifestyle have diminished. Since physical activity has been shown to prevent NIDDM in other populations, we performed a case-control study of physical activity and glucose intolerance in 666 Yup'ik Eskimos and Athabaskan Indians > or = 40 years old in 15 villages in the Yukon Kuskokwim Delta in Alaska. Self-administered questionnaires were used to determine whether subjects participated in a number of traditional activities and/or their modern counterpart (for example, dog sledding and riding motorized vehicles). Intensity values and a score were defined for the activities. Cases included known or newly discovered impaired glucose tolerance or NIDDM. Newly discovered cases were defined by oral glucose tolerance testing of those individuals were screening blood glucose values > or = 6.7 mmol l-1 by random capillary blood glucose testing. Cases included 11 newly discovered (1 with a history of IGT) and 26 known cases of NIDDM, and 17 newly discovered and 1 known cases of IGT. The results showed that, compared to a reference group with low-level physical activity, moderate level physical activity (odds ratio, OR, 0.7, 95% confidence interval [CI] 0.4-1.3) and high level activity (OR 0.2, CI 0.1-0.6) were associated with a lower prevalence of glucose intolerance, adjusted for age, ethnicity, body mass index, and sex.
爱斯基摩人和印第安人中曾经患病率较低的非胰岛素依赖型（2型）糖尿病（NIDDM）在过去30年中增长了约四倍，这表明存在影响NIDDM患病率的非遗传因素。与此同时，维持生计（自给自足）生活方式所需的传统体力活动减少了。由于体力活动已被证明可预防其他人群患NIDDM，我们对阿拉斯加育空-库斯科基姆三角洲15个村庄中666名年龄≥40岁的Yup'ik爱斯基摩人和阿萨巴斯卡印第安人的体力活动与葡萄糖耐量进行了病例对照研究。使用自行填写的问卷来确定受试者是否参与了一些传统活动和/或其现代对应活动（例如，狗拉雪橇和驾驶机动车辆）。为这些活动定义了强度值和分数。病例包括已知或新发现的葡萄糖耐量受损或NIDDM。新发现的病例通过对随机毛细血管血糖检测血糖值≥6.7 mmol/l的个体进行口服葡萄糖耐量试验来定义。病例包括11例新发现的（1例有IGT病史）和26例已知的NIDDM病例，以及17例新发现的和1例已知的IGT病例。结果表明，与体力活动水平较低的参照组相比，经年龄、种族、体重指数和性别校正后，中等水平体力活动（优势比，OR，0.7，95%置信区间[CI] 0.4 - 1.3）和高水平活动（OR 0.2，CI 0.1 - 0.6）与葡萄糖耐量受损患病率较低相关。
