Rapid rise in the incidence of type 2 diabetes from 1987 to 1996 - Results from the San Antonio Heart Study
Rapid rise in the incidence of type 2 diabetes from 1987 to 1996 - Results from the San Antonio Heart Study
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DOI：
10.1001/archinte.159.13.1450
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发表时间：
1999-07-12
影响因子：
--
通讯作者：
Stern, MP
中科院分区：
文献类型：
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作者：
Burke, JP;Williams, K;Stern, MP
背景：世纪早期，2型糖尿病的患病率增加，特别是在发展中国家。现在有证据表明，包括美国在内的发达国家的流行率也在继续上升。然而，目前尚不清楚这种增加是否是由于糖尿病的发病率上升或降低糖尿病死亡率或both.Methods：参与者在圣安东尼奥心脏研究，谁是非糖尿病在基线和谁返回了7- 8年的随访检查，进行了检查的长期趋势2型糖尿病的发病率。糖尿病的危险因素，如肥胖，也进行了检查。1979年至1988年，患者参加了圣安东尼奥心脏研究，并确定了1987年至1996年7至8年的糖尿病发病率。在墨西哥裔美国人中观察到2型糖尿病7至8年发病率的显着长期趋势（1979年登记的参与者为5.7%，1988年登记的参与者为15.7%）。在非西班牙裔白人中，发病率从1980年入组的2.6%增加到1988年入组的9.4%（P = .07）。在调整了年龄和性别后，长期趋势在墨西哥裔美国人中仍然显着，在非西班牙裔白人中处于边缘显着。这表明，在1987年至1996年期间，两个种族群体中7至8年的2型糖尿病发病率大约增加了两倍。在调整了糖尿病的其他风险因素（如肥胖）后，总体长期趋势仍然显著。长期肥胖的上升趋势也observed.Conclusions：有一个显着增加长期的趋势，在墨西哥裔美国人的2型糖尿病的发病率和边界显着的趋势，在非西班牙裔白人参加的圣安东尼奥心脏研究。与其他心血管风险因素（如血脂水平、吸烟和血压）不同，这些因素要么正在下降，要么正在逐步得到更好的医疗管理和控制，也与心血管死亡率（也在下降）不同，肥胖和2型糖尿病呈现出上升趋势。因此，肥胖和糖尿病很容易成为美国最突出的公共卫生问题。
Background: The prevalence of type 2 diabetes has increased in the early part of the 20th century, particularly in developing countries. There is now evidence that the prevalence also continues to increase in developed countries, including the United States. However, it is unknown whether this increase is due to a rise in the incidence of diabetes or to decreasing diabetic mortality or both.Methods: Participants in the San Antonio Heart Study, who were nondiabetic at baseline and who returned for a 7- to 8-year follow-up examination, were examined for secular trends in the incidence of type 2 diabetes. Risk factors for diabetes, such as obesity, were also examined. Patients were enrolled in the San Antonio Heart Study from 1979 to 1988 and 7- to 8-year incidence of diabetes was determined from 1987 to 1996.Results: A significant secular trend in the 7- to 8-year incidence of type 2 diabetes was observed in Mexican Americans (5.7% for participants enrolled in 1979 to 15.7% for participants enrolled in 1988). In non-Hispanic whites, the incidence increased from 2.6% for participants enrolled in 1980 to 9.4% for participants enrolled in 1988 (P = .07). After adjusting for age and sex, the secular trend remained significant in Mexican Americans and borderline significant in non-Hispanic whites. This indicates that between 1987 and 1996 the 7- to 8-year incidence of type 2 diabetes approximately tripled in both ethnic groups. The overall secular trend also remained significant after adjusting fur additional risk factors for diabetes, such as obesity. A rising secular trend in obesity was also observed.Conclusions: There has been a significant increasing secular trend in the incidence of type 2 diabetes in Mexican Americans and a borderline significant trend in non-Hispanic whites participating in the San Antonio Heart Study. Unlike other cardiovascular risk factors such as lipid levels, cigarette smoking, and blood pressure, which are either declining or under progressively better medical management and control, and unlike cardiovascular mortality, which is also declining, obesity and type 2 diabetes are exhibiting increasing trends. Thus, obesity and diabetes could easily become the preeminent US public health problem.