Obesity, insulin resistance and diabetes - a worldwide epidemic
Obesity, insulin resistance and diabetes - a worldwide epidemic
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DOI：
10.1017/s000711450000088x
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发表时间：
2000-03-01
影响因子：
3.6
通讯作者：
Seidell, JC
中科院分区：
文献类型：
--
作者：
Seidell, JC
现在，成年人的肥胖通常定义为体重指数为30公斤/米(2)。发达市场经济(欧洲、美国、加拿大、澳大利亚等)的肥胖率差异很大，但经过权衡的估计表明，平均患病率在15%-20%左右。随着时间的推移，这些国家的流行率总体上呈上升趋势。肥胖在拉丁美洲也相对普遍，但在撒哈拉以南的非洲和亚洲要少得多，这些地区生活着世界上大多数人口。然而，那里的肥胖率也在上升，更重要的是，糖尿病的发病率上升得更快，特别是在亚洲国家。在这些国家，2型糖尿病的风险往往会急剧增加，达到欧洲和北美白人通常认为可以接受的BMI水平。有人建议在亚洲人中采用肥胖的具体分类(例如，超重的BMI为23，肥胖的BMI为25或27 kg/m(2))，这将极大地影响全球肥胖率的估计(目前约为2.5亿人)。特别是为了促进健康，体重指数可以被基于腰围的分类所取代，但也可能需要针对不同种族的具体分类。糖尿病患者的数量预计将从1995年的1.35亿人增加到2025年的3亿人。其中很大一部分增长将出现在亚洲。总而言之，肥胖和2型糖尿病都是生活方式改变(久坐不动的生活方式和饮食能量密度增加)的共同后果。这两种疾病都有可能通过在人口层面上改变生活方式来预防，但这需要一个连贯和多方面的战略。这样的战略并未制定或实施。这些事态发展表明，迫切需要制定全球和国家计划，充分预防和管理肥胖症和2型糖尿病。
Obesity is now commonly defined in adults as a BMI > 30 kg/m(2). The prevalence of obesity in established market economies (Europe, USA, Canada, Australia, etc.) varies greatly, but a weighed estimate suggests an average prevalence in the order of 15-20 %. The prevalence in these countries generally shows increasing trends over time. Obesity is also relatively common in Latin America, but much less so in sub-Saharan Africa and Asia where the majority of the world population lives. Nevertheless obesity rates are increasing there as well and, more importantly, rates of diabetes are increasing even more quickly, particularly in Asian countries. The risks of type 2 diabetes mellitus in these countries tend to increase sharply at levels of BMI generally classified as acceptable in European and North American white people. There have been suggestions to adopt specific classifications of obesity in Asians (e.g. BMI 23 for overweight and 25 or 27 kg/m(2) for obesity) and this will greatly affect the prevalence estimates of obesity worldwide (currently at about 250 million people). Particularly for health promotion purposes BMI may be replaced by a classification based on waist circumference, but also specific classifications for different ethnic groups may be necessary. The number of diabetics has been projected to increase from 135 million in 1995 to 300 million in 2025. Much of this increase will be seen in Asia. In summary, both obesity and type 2 diabetes are common consequences of changing lifestyles (increased sedentary lifestyles and increased energy density of diets). Both are potentially preventable through lifestyle modification on a population level, but this requires a coherent and multifaceted strategy. Such strategies are not developed or implemented. These developments point toward the great urgency to develop global and national plans for adequate prevention and management of obesity and type 2 diabetes mellitus.