Ferreira S R, Iunes M, Franco L J, Iochida L C, Hirai A, Vivolo M A
Department of Preventive Medicine, Escola Paulista de Medicina, Federal University of São Paulo, Brazil.
Diabetes Res Clin Pract. 1996 Oct;34 Suppl:S59-63. doi: 10.1016/s0168-8227(96)90009-1.
Increased prevalence of self-reported NIDDM in Japanese-Brazilians was reported when compared to Japan. This study aimed at determining the prevalence of NIDDM and IGT in Japanese-Brazilians living in the city of Bauru, São Paulo, Brazil. The impact of western environment on the frequency of obesity, dyslipidemia and hypertension was investigated. All Issei (first generation; n = 238) and a random sample of Nisei (second generation; n = 292), aged 40-79 years, were selected for clinical examination and OGTT (WHO criteria). Age-adjusted prevalence of NIDDM did not differ between men and women for Issei (12.4 vs. 11.6%, respectively), but it became different for Nisei (21.7 vs. 11.4%, P < 0.03) due to an increased rate among men. Increased IGT prevalence was also observed between Issei and Nisei men (8.5 vs. 19.3%, P < 0.03). Issei women had a higher IGT rate than Issei men (27. 3 vs. 8.5%, P < 0.0005). Body mass index (BMI) was higher in the second generation (24.1 +/- 3.6 vs. 23.3 +/- 3.1 kg/m2, P < 0.00005) and also the frequency of obesity, defined as BMI > 25 kg/m2. Comparison of waist/hip ratio by gender showed that only among women, Nisei had lower ratio than Issei (0.90 vs. 0.88, P < 0.05). Nisei had a lower total and LDL-cholesterol than Issei but triglyceride and HDL-cholesterol did not differ. Nisei women (younger than the Issei) had lower triglyceride and total cholesterol. This pattern was not seen between the two generations of men. Considering the mean blood pressure values, Issei and Nisei groups with normal glucose tolerance were not hypertensive. Systolic blood pressure was lower in Nisei and the inverse was found concerning diastolic levels. NIDDM prevalence in Japanese-Brazilians is higher than in Japan and in the general Brazilian population. Besides environment, genetic factors may confer susceptibility to NIDDM when they are exposed to a western environment. Before developing glucose intolerance, disturbances of lipid profile and blood pressure could be detected. Nisei may be more affected due to a longer exposure to an unfavorable environment and these changes seem to occur earlier among men than women.
据报道，与日本相比，巴西日裔人群中自我报告的非胰岛素依赖型糖尿病（NIDDM）患病率有所上升。本研究旨在确定居住在巴西圣保罗州包鲁市的巴西日裔人群中NIDDM和糖耐量受损（IGT）的患病率。研究了西方环境对肥胖、血脂异常和高血压发生率的影响。选取了所有40 - 79岁的第一代日裔（n = 238）和随机抽取的第二代日裔（n = 292）进行临床检查和口服葡萄糖耐量试验（OGTT，采用世界卫生组织标准）。第一代日裔中，按年龄调整后的NIDDM患病率在男性和女性之间无差异（分别为12.4%和11.6%），但第二代日裔中出现了差异（分别为21.7%和11.4%，P < 0.03），原因是男性患病率上升。第一代和第二代日裔男性的IGT患病率也有所增加（分别为8.5%和19.3%，P < 0.03）。第一代日裔女性的IGT发生率高于男性（分别为27.3%和8.5%，P < 0.0005）。第二代日裔的体重指数（BMI）更高（24.1±3.6 vs. 23.3±3.1 kg/m²，P < 0.00005），肥胖（定义为BMI > 25 kg/m²）的发生率也更高。按性别比较腰臀比发现，仅在女性中，第二代日裔的腰臀比比第一代日裔低（分别为0.90和0.88，P < 0.05）。第二代日裔的总胆固醇和低密度脂蛋白胆固醇低于第一代日裔，但甘油三酯和高密度脂蛋白胆固醇无差异。第二代日裔女性（比第一代日裔年轻）的甘油三酯和总胆固醇较低。两代男性之间未观察到这种模式。考虑平均血压值，糖耐量正常的第一代和第二代日裔人群均无高血压。第二代日裔的收缩压较低，而舒张压则相反。巴西日裔人群中的NIDDM患病率高于日本和巴西普通人群。除环境因素外，遗传因素在接触西方环境时可能使个体易患NIDDM。在出现糖耐量异常之前，可检测到血脂谱和血压的紊乱。第二代日裔可能因更长时间暴露于不利环境而受影响更大，且这些变化在男性中似乎比女性更早出现。
