Incidence of type 2 diabetes in two Indigenous Australian populations: a 6-year follow-up study
Incidence of type 2 diabetes in two Indigenous Australian populations: a 6-year follow-up study
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DOI：
10.5694/j.1326-5377.2010.tb03636.x
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发表时间：
2010-05-17
影响因子：
11.4
通讯作者：
Campbell, Sandra K.
中科院分区：
文献类型：
--
作者：
McDermott, Robyn A.;Li, Ming;Campbell, Sandra K.
目的：为了估计2型糖尿病的发病率在两个种族不同的土著人口在北昆士兰州，澳大利亚。设计，设置和参与者：一项基于社区的后续研究，1814澳大利亚土著和托雷斯海峡岛民成年人从1999年至2007年。参与者最初是免费的糖尿病，住在远北昆士兰州的19个偏远社区。主要结果measurements：空腹血糖水平;糖尿病的诊断;血脂水平;体重;腰围（WC）;和血压。结果：在554名成年人谁完成了这项研究，100发展糖尿病超过3412人年（py）的后续行动。尽管基线体重指数（BMI）和WC存在较大差异，但土著居民（29.7 [95% CI，20.4-38.4]/1000 py）和托雷斯海峡岛民（29.0 [95% CI，21.8-38.6]/1000 py）的糖尿病发病率相似。两个人群的年龄标准化发病率为30.5/1000 py。与正常WC相比，WC定义的肥胖增加了原住民（比率[RR]，2.0 [95%CI，1.1-3.6]）和托雷斯海峡岛民（RR，6.3 [95%CI，2.5-16.1]）患糖尿病的风险。代谢综合征（MetS）的存在是糖尿病事件的强预测因子（校正风险比，2.4 [95% CI，1.6-3.7]）。对于这两个群体，腰臀比和存在的MetS更好地预测糖尿病比WC或BMI.Conclusions：糖尿病的发病率在这些土著澳大利亚人是近4倍，高于非土著人口和50%的发病率比10年前在澳大利亚原住民。目前使用的BMI临界点不适合澳大利亚原住民预测糖尿病。
Objective: To estimate the incidence of type 2 diabetes in two ethnically distinct Indigenous populations in north Queensland, Australia.Design, setting and participants: A community-based follow-up study of 1814 Australian Aboriginal and Torres Strait Islander adults from 1999 to 2007. Participants were initially free of diabetes and lived in 19 remote communities in Far North Queensland.Main outcome measures: Fasting blood glucose level; diagnosis of diabetes; blood lipid levels; weight; waist circumference (WC); and blood pressure.Results: Of the 554 adults who completed the study, 100 developed diabetes over 3412 person-years (py) of follow-up. The incidence of diabetes was similar for Aboriginals (29.7 [95% Cl, 20.4-38.4] per 1000 py) and Torres Strait Islanders (29.0 [95% Cl, 21.8-38.6] per 1000 py) despite large differences in baseline body mass index (BMI) and WC. The age-standardised incidence for both populations was 30.5 per 1000 py. Obesity defined by WC increased the risk of developing diabetes for Aboriginals (rate ratio [RR], 2.0 [95% Cl, 1.1-3.6]) and for Torres Strait Islanders (RR, 6.3 [95% Cl, 2.5-16.1]) compared with normal WC. Presence of the metabolic syndrome (MetS) was a strong predictor of incident diabetes (adjusted hazard ratio, 2.4 [95% Cl, 1.6-3.7]). For both groups, waist-to-hip ratio and the presence of the MetS better predicted diabetes than WC or BMI.Conclusions: The incidence of diabetes in these Indigenous Australians is nearly four times higher than for the non-Indigenous population and 50% higher than the incidence reported 10 years ago in Australian Aboriginals. Currently used BMI cut-off points are not appropriate for Indigenous Australians to predict diabetes.