| 概要 |
To clarify the prevalence and incidence of diabetes and to evaluate which risk factors are predictive of future diabetes in the general population of Okinawa, 1,690 residents were screened in 1989 and... 758 were prospectively followed-up in 1999. Of the 1,690 residents surveyed in 1989 and 1, 163 in1999, diabetes was found in 91 (5.4%) in1989 and 52 (4.5%) in 1999. Residents with diabetes were significantly older, more likely to have significantly higher levels of HbA1c, fasting glucose, serum triglyceride, ALT, BMI, systolic blood pressure, and a history of hypertension than non diabetic residents, both in 1989 and 1999. 717 residents who did not have diabetes at the 1989 screening were re-examined in 1999. Among them, 17 (incidence rate 2.4%) had developed diabetes over the ten years. Multivariate logistic regression analysis showed HbA1c, BMI, and systolic blood pressure to be independent risk factors for newly developed diabetes (p < 0.0001, odds ratio ; 28.1, p = 0.020, odds ratio ; 1.21, p = 0.039, odds ratio ; 1.04, respectively) after adjusting for age, sex, BMI, blood pressure, hystory of hypertension, HbA1c, fasting glucose, serum triglyceride, ALT, and γ GTP. Our results showed that the prevalence and incidence of diabetes are low in the general population of the Yaeyama district of Okinawa and that elevated HbA1c level, even in the normal range, is one of the best predictors of diabetes. Following BMI and systolic blood pressure is important.
【目的】沖縄県八重山地区の一般住民において, 糖尿病の有病率及び10 年後の糖尿病の新規発症率とその危険因子について検討した. 【方法】1989年に1,693名，1999年に1,163 名に対し住民検診を施行した. 糖尿病の診断は, ①空腹時血糖値が126mg/dl以上② HbA1c 6.9％（国際標準値）以上③糖尿病治療中④ 75 ｇ糖負荷試験結果が糖尿病型のいずれかで診断した. 【結果】1989年に検診を受けた住民1,693名のうち計91名（5.4％）が糖尿病と診断され, 1999年は1,163 名のうち計52 名（4.5％）が糖尿病と診断されたが, 有意な経年的変化は認めなかった. 糖尿病と診断された住民は, 非糖尿病住民と比べて, 年齢, BMI, 収縮期血圧, 高血圧の病歴, 血清中性脂肪値, ALT 値が有意に高値であった, 追跡調査可能で1989 年時に非糖尿病であった717名の住民のうち, 17 名が10 年後に新規に糖尿病に罹患していた（罹患率2.4％）.糖尿病発症の独立した危険因子として, HbA1c, BMI, 収縮期血圧が抽出された（p<0.0001, odds ratio ; 28.1, p=0.020, odds ratio ; 1.21, p=0.039, odds ratio ; 1.04，respectively).【結論】沖縄県八重山地区の一般住民は, 他地域と比べ糖尿病の有病率及び罹患率が低く, HbA1c, BMI, 収縮期血圧が正常範囲内であっても危険因子になりうることが示唆された.続きを見る
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