Fatores derisco;diabetes; populaçãomuçulmananaChina; noroestedaChina Descritores e hábitosalimentaresruins. comparada comapopulaçãoHan. Issopodeserexplicadopordiferençasgenéticaspotenciais população muçulmanaeéespecialmente maisaltanafaixaetáriade20anosidade,quando also different withrespecttoageintheHan(P<0.001) andMuslimpopulation(P<0.001) re between theHanandMuslimpopulationsweredifferent (P=0.041). And theprevalencewere Arq Bras Metab. Endocrinol 2014;58/7 0,001) foiumfatorprotetor. e o tabagismo (P = 0,011) foram fatores de risco para o DM e PDM, mas o consumo de álcool (P < 0,001) econsumodeálcool (P<0,001) forammaisbaixos. OIMC(P<0,001), aidade(P=0,025) na população muçulmana foi mais alta do que na população Han, enquanto o tabagismo (P < as outrasfaixasetárias(P>0,05). (P<0,001)A ingestãodesal(P<0,001) eóleoscomestíveis mana foimaiordoquenapopulaçãoHan(P=0,013), para nãohavendodiferençassignificativas Exceto pelafaixaetáriade20anosidade,aprevalênciado DMePDMnapopulaçãomuçul com relação àidade na população Han (P < 0,001) e muçulmana (P <0,001), respectivamente. lações Hanemuçulmanafoidiferente(P=0,041),asprevalências tambémforamdiferentes oral àglicose(TTOG) para660sujeitos. local hámaisdetrêsgerações.Foram feitoseanalisadosumquestionáriootestedetolerância e porcluster.Ossujeitoseramresidentescom≥20anosdeidadefamílias queestavamno ionamos trêsvilarejosdeacordocomarendaepopulação,usando umaamostraestratificada ção muçulmananonoroes Objetivo: RESUMO Conclusions: forDMandPDM,butalcoholconsumption(P<0.001) wasfactor.were riskfactors aprotective tion (P<0.001) was lower. BMI(P<0.001), age(P=0.025),andsmokingcigarettes (P=0.011) population was higherthantheHan,whilecigarette smoking(P<0.001) andalcoholconsump other agegroups(P>0.05). ofsalt(P<0.001) andedible oil(P<0.001)The intake intheMuslim lim populationwas higherthantheHan(P=0.013), wedidnotfindany significantdiffe spectively. Exceptforthe20-year-old agegrouptheprevalenceofDMandPDMwithinMus ds: Objective: ABSTRACT Wei Liu da glicoseemchineses muçulmanos: umestudononoroeste daChina Prevalência epossíveis fatores dedistúrbiosnometabolismo derisco a studyfrom China northwest factors:Muslims andpossiblerisk metabolism disturbancesinChinese The prevalence ofglucose Risk factors;diabetes;MuslimpopulationinChina;northwestChina Keywords in the Muslim population in northwest China, and discuss the risk factor. (OGTT) were completed and analyzed for 660 subjects. which havebeenlocalfor>3generations. The questionnaireandoralglucosetolerancetest and clustersampling. ofage,andwerefromfamilies The subjectswereresidents≥20years by thepotentialgeneticdifferences andpoordietaryhabits. and itwas specialhigheronthe20-year-old agecomparedtotheHan. This mightbeexplained According totheincomeandpopulation,werandomlyselected3villageswithstratified 1 , LinHua Avaliar aprevalênciadediabetesmelito(DM)epré-diabetes(PDM)napopula To surveytheprevalenceofdiabetesmellitus(DM)andpre-diabetes(PDM) In northwest China,theprevalenceofDMwas higherintheMuslimpopulation, 2 , Wan-FuLiu te daChinaediscutirosfatoresderisco. Conclusões: Arq BrasEndocrinolMetab. 2014;58(7):715-23 3 , Hui-LingSong Resultados: No noroeste da China, a prevalência de DM é maior na No noroestedaChina,aprevalência deDMémaiorna A prevalênciadoDMePDMentreaspopu 4 , Xin-Wen Dai Results: Arq BrasEndocrinolMetab. 2014;58(7):715-23 The prevalence of DM and PDM Materiais emétodos: 3 ,Jin-Kui Yang Materials and metho 1 rence for Selec ------3 2 1 DOI: 10.1590/0004-2730000002654 Accepted onJuly/11/2014 Received onFeb/14/2014 [email protected] [email protected] Beijing 100730, China Medical University, Beijing Tongren Capital Hospital, Wei Liu,LinHua Correspondence to: 4 Beijing, China MedicalUniversity Capital Medical University, Beijing,China Beijing Tongren Capital Hospital, Yuanzhou Region, Guyuan, China and Prevention (CDC), Guyuan, China Ningxia Teachers’University, BiomedicalEngineeringInstitute, DepartmentofEndocrinology, Centersfor DiseaseControl DepartmentofMedicine, original article original 715
Copyright© ABE&M todos os direitos reservados. Copyright© ABE&M todos os direitos reservados. 716 uncommon.There rations, andmobile populationsare gene thanthree formore dents livedinthesamearea Moreover,due toeconomicbackwardness. mostresi isuncommon ms livetogetherwithHan,intermarriage inUygur,residents Kazak,andKirgiz. AlthoughMusli otherlocalChineseancientMuslims,such as from rent diffe ofPersiaandArab,are Muslimmerchants were Muslim populationinGuyuancity, whoseancestors oftotalpopulation.The is accountedfor44.1percent 0.65millionwhich among themMuslimpopulationare graphic statistics,populationinGuyuanis1.53million, to the 2008 demo lim population (Hui). According ofSilkRoadandinhabitedbyatraditionalMus route Autonomous Region,isasmalltowninthenorthern oftheNingxiaHui mountainarea cated inthesouthern Muslim populationinChina.Guyuancity, whichislo habitation forChineseMuslims,makeup>40%ofthe the NingxiaHuiAutonomousRegion,amajorplaceof Residents in otherChinesegroups. characteristics from inthe hascleardifferences the largest minoritygroups, habits,theMuslimpopulationinChina,oneof dietary the otherhand,owingtospecialcharacteristicsof of thefindingsinotherethnicitypopulations.On ter characterizedandcanbeeasierforthecomparison gs inHanpopulation.Thepopulationisthusbet to the findin in relation group can be used as a control the findingsofChinesepopulationingeneraland represent thatHanpopulationcan findings supported inChina(7,8).These 9.7%and15.5%respectively were valence oftotalDMandpre-diabetes mellitus(PDM) pre theage-standardized conducted in2010reported study Da QingIGTandDiabetesStudy(3).Arecent ofDMinChina, suchasThe tics andtheprevalence dies have described the social-demographiccharacteris inhabitants ofChina.Currently, theexistingmanystu 92% of the It represents is the largest majority group. In China, the Han population same geographic area. races in the of DM in different sed on theprevalence (1,3-6).However,and exercise few studies havefocu tors, suchasdyslipidemia,obesity, habits, poordietary bysomeknownriskfac years,whichisaffected recent in trend ofDMhasshownanupward the prevalence ly history, and dyslipidemia (1,2). In many countries D INTRODUCTION Glucose metabolism inChineseMuslims the development ofDMinclude central obesity, fami complications.Commonrisk factors for macro-vascular diseases worldwide and may lead to micro- and diseases worldwideandmayleadtomicro- iabetes mellitus(DM)isoneofthemostcommon ------demographic characteristics,dietintheMuslimpopu distinctive demographic characteristics. In additionto common,whichalsoleadsto are multiple pregnancies theMuslimpopulation,so nopoliciestocontrol are distinctive demographiccharacteristicsand special eat whether ornotthe the samegeographicenvironment, (11,12). Within Muslims inthesamegeographicareas especiallycomparisonswithothernon- been reported, and PDMorriskfactorsintheMuslimpopulationhave ofDM theprevalence (9,10). Fewstudiesregarding ofDM dan infastingsubjectswithDMorthetreatment during Rama studies havefocused on glycemic trends DMintheMuslimpopulation. dressed tables, whichleadstohighsaltintakeforpeople. vege almostno fresh are non-staple foodbecausethere foodisthemain population. Inthewinter, preserved themainmeatsconsumedbyMuslim mutton are population subsistsmainlyonpork;however, beefand theHanpopulation.The from lation isdifferent year (14,15). For eachincomelevel,we sampledone RMB], andlowlevel[<1000 RMB])percapita 1500 Renminbi{RMB},middle level[1000-1500 stratification basedonthe income levels(highlevel[> thepopulation of DMandPDM,wethus performed theincidence affect the diet habits whichcanfurther incomelevelsmightaffect first stage,considerdifferent tocollectsamples.Inthe two-stage samplingprocedure 2011.Inourstudy,2009 andFebruary weselectedthe studiedbetweenJanuary A totalof1,963villagerswere Participants MATERIALS ANDMETHODS study previous toour tween HanandMuslimpopulations,according be significantdifference are population, becausethere especially theMuslim of thepopulationinthisregion, investigationandresearch further toperform necessary higher thanothercitiesinNingxia,China(13).Itis was area, therural populationsurrounding permanent in Guyuancity, whichwasbasedonthesubjectsin study showed that glucose metabolic disorders previous Our diseases, such as DM, isalways our main concern. in some theintrinsicfactorswhich result ing habitsare and determined thespecialriskfactorsintheirrace. and determined of DMandPDMintheMuslimpopulationChina We manypaperswhichhavead havereviewed In the current study we determined the prevalence theprevalence studywedetermined In thecurrent
(13). Arq Bras Metab. Endocrinol 2014;58/7 Most ofthe ------
Arq Bras Metab. Endocrinol 2014;58/7 subjects glucosetolerance (IGT).Theresearch paired diagnosed withim (> 7.8and<11.1mmol/L)were FBGandelevatedPBG2h others whohadanormal glucosetolerance(NGT),and diagnosed asnormal range,4.4-7.8mmol/L)were and aPBG2h(normal range,4.4-6.1 mmol/L) FBG(normal with anormal subjects,those tion criteria.Amongalloftheresearch of the 75 gOGTTandWorldresults Health Organiza Jiangsu, China)(16).Thediagnosiswasbasedonthe analyzer;BeckmanLtd.,Suzhou, Dxc800 biochemistry Beckman-Unicel (OGTT; lerance testwasperformed mmol/L (140mg/dL),anextra75goralglucoseto ≥ 5.60mmol/L(105mg/dL)andaPBG2h7.8 whohadaFBG level.Inparticipants cut-off screening 5.6 mmol/Lastheoralglucosetolerancetest(OGTT) (5,6); thus,wechoseafastingplasmaglucoselevel≥ DM ve thesensitivityoffasting glucose inpredicting mmol/L, thediagnosisofIFGcansignificantlyimpro of<5.6 afastingbloodglucosecut-off blood. With withvenous ter, <±15%compared whichhasanerror subjectsusingRoche’ssuperiorbloodglucoseme arch foralloftherese measured meal)were after anormal least 8h),and2-hpostprandialbloodglucose(PBG2h; The leveloffastingbloodglucose(FBG;forat Methods Ningxia Teachers’ University. by theEthicsCommittee of The studywas approved consent. signedinformed ached. Alloftheparticipants wasre continued untilthetargeted numberofsurveys theneighbor. tigators attemptedtosurvey Thisprocess voluntary. theinves Ifsubjectsdeclinedtoparticipate, was inthesurvey Participation to collect800responses. planned research generations.Thecurrent than three was limitedtofamiliesthathadbeenlocalforgreater includedinthestudy.gxia were Thesamplepopulation inthevillagefor≥20yearsofGuyuan,Nin residence = 45.79±14.65y;288malesand372females) ≥20yofage(mean 660participants information, missing ted. Afterexcludingthosesampleswithgreater selec villages were three total of1,963villagersfrom inthefirststage.Finally,selected eachcountryside a the ted theclustersamplingtoextractonevillagefrom is similar; we thus adop countryside the corresponding villagefrom economical situationofeachsubordinate the secondstage,considerpopulationsizeand selected.In were countrysides stratified sampling,three the city withthesameincomelevels.Afterperforming Guyuan around thosecountrysides from countryside ------glucose (IFG). The research subjects with an eleva glucose (IFG).The research fasting diagnosedwithimpaired < 7.0mmol/L)were PBG2handanelevated FBG(>6.1and with anormal completed the questionnaire anddidnot havethein completed thequestionnaire and126only andchildbirth) onpregnancy formation as wellasin (e.g., oilandsaltintakewasnotcaptured 50hadmissing information the 836questionnaires, During thesurvey, used.Of were 836questionnaires of oilandsalt,statusthesubject’sawareness. smokingandalcoholconsumptionhabits,intake rette cal history, familyhistory, physical work, income, ciga Medicine, andconsistedofethnic,healthstatus,medi basedontheChineseAcademyofPreventive were repeatedly.> 11.1mmol/L,theOGTTwasmeasured 11.1 mmol/LoraFBG<7.0andPBG2h subjects withaFBG>7.0mmol/LandPBG2h< diagnosedwithDM.Theresearch 11.1 mmol/L)were ted FBG(>7.0mmol/L)andanelevatedPBG2h hes 15grams (5.47 kg/year). ly saltintake, which reac 2190 g(2.19kg/year).Beijing isacitywithhighdai per personday, thus theannualsaltintakeshouldbe advocate thatthedailysalt intake shouldbe<6grams not calculatedmonthly, butyearly. guidelines Dietary fried foodforfestivals,theedibleoilandsaltintakewas plentyof for thewinterinsomeseasonsandpreparing saltedfood localcustoms, suchaspreserved were there edible oilintakeperpersonwasestimated.Because tion ofsaltandedibleoilmonthly?Then,the inyourfamily?Whatistheconsump years ofageare take wasdesignedasfollows:howmanypeople≥20 orHan(whocanhavenot). lieving inthereligion) of the subjects to verify their ethnicity as Muslim (be generations three searched excluded. Theresearchers were history developed. Peoplewithanintermarriage was was asked when the questionnaire intermarriage Thequestion regarding migrated tootherregions. donotoccur.marriages couples Thefewintermarriage becauseoftradition, inter-ethnictions. Inthisarea, genera thanthree forgreater inanethnicgroup were Muslim orHanpopulationwasidentifiedwhenthey by inheritance andidentity. the In this observation, includedinthestatisticalanalysis. sults were and intact blood glucose re completed questionnaire 660subjectswhohadmatched Theremaining dure. aftertherapidfinger-blood glucoseproce performed tact bloodglucoseindicatorbecausenoOGTTwas Questionnaires fortheDMepidemiologicstudy Questionnaires The questionnaire regarding edibleoilandsaltin regarding The questionnaire differentiated The Muslim and Han populations are Glucose metabolism inChineseMuslims 717 ------
Copyright© ABE&M todos os direitos reservados. Copyright© ABE&M todos os direitos reservados. 718 Data arelistedasx Table 1. CharacteristicsoftheHanpeopleandMuslimpopulationinChina training,fieldsurvey, datacollection,entry,staff survey,the entire andincludedthestudydesign,survey during wasperformed pletion ofskills.Qualitycontrol andcom prompting andsurveys of thequestionnaire, thecontentandstructure theprocedures, tion before prepara pre-survey andglucosemeasurement, pressure blood tion (height,weight,andwaistcircumference), ject began.Thetrainingincludedaphysicalexamina an City. thepro training before proper They received ofYuanzhou andPrevention Control DistrictinGuyu intheCentersforDisease ers’ Universityandthestaff ofMedicineatNingxiaTeachdents intheDepartment weight≥8kilograms. defined asafetuswithbirth is Macrosomia performed. ments andOGTTtestswere glucosemeasure in themedicalhistory, andcapillary nancy, recorded were times,andmacrosomia parturition result. and thediagnosiswasbasedonthird time forathird wasmeasured thebloodpressure rent, result wasdiffe If the wasconfirmed. of hypertension wasthesame,diagnosis Iftheresult blood pressure. the to measure and would re-visit to have hypertension was> 90mmHg,thevillagerwouldbesuspected sure was>140mmHgorthediastolicpres systolic pressure Ifthe adiagnosis of hypertension. was usedtoconfirm measurements 2minutes.Theaverageofthethree every readings andobtained3bloodpressure reading, pressure withthehighestblood pickedthearm right. Researchers (bothleftand measurement minutes forbloodpressure examined in the seated position after 3 were pertension ofhy when indicated.Thosewhodidnothaveahistory tension andmedicationusenoted“hypertension”, ofhyper aboutahistory inquired ded. Theresearcher andrecor measured were and bloodpressure ference, the saltintakewasexcessiveinMuslimpopulation. whetherornot wedetermined Based ontherecords, Glucose metabolism inChineseMuslims Han people characteristics Clinical P-Value in China Muslim population This research wasconductedbyteachersandstu This research thisstudybecausepreg excludedfrom Gravidas were The bodymassindex(BMI),waistandhipcircum - ±s.*Pvalues<0.05wereconsidered tobesignificant. patients Number 195 465 of - 264/201 Gender 108/87 0.368 (F/M) 58.34 ±14.16 61.00 ±13.7 (years) 0.110 Age 23.62 ±2.93 23.70 ±3.23 (kg/m 0.867 BMI 2 ) ------Waist-to-hip ratio (WHR) 0.88 ±0.06 0.87 ±0.05 0.612 summarization, statistics,andanalysis.Thequalitycon sults. P values < 0.05 were considered significant. considered sults. Pvalues<0.05were OGTTre of alltheclinicalcharacteristicsondifferent todetectpotentialriskfactors regression binary-logistic Also,weused agegroups. andindifferent race groups intwo inprevalence thedifference and todetermine thecategoricaldata usedtocompare tests were -square usingatwo-samplet-test.Chi compared and were deviation, asthemean±standard expressed China were characteristics oftheHanandMuslimpopulationin dows; SPSSInc.,Chicago,IL,USA).Thequantitative analyzedusingSPSS(version17.0forWin Data were Statistical analysis a secondvisit.Thislimitedpotentialerrors. aswellglucoseby andbloodpressure questionnaires ineachteamrandomlyexamined2%ofthe supervisor andthe wasespeciallyimportant inthefieldsurvey trol for otherclinicalcharacteristics(P>0.05;Table 1). betweentworaces nosignificant difference were there and theDBPislower(P=0.037)inHanpopulation, ishigher(P=0.007) ofhypertension” lence of“history between the two races. In summary, except the preva ofhypertension totheDBPandhistory with respect (P >0.05);however, wasasignificantdifference there diseasebetweentheHanandMuslimpopulation heart gender, age,BMI,WHR,SBP, ofcoronary andhistory respect to wasdetected with No significantdifference ristics oftheHanandMuslimpopulationsinChina. thequantitativeandcategorical characte to compare used testswere The two-samplet-testsandchi-square population inChina Race-specific characteristicsoftheHanandMuslim RESULTS 160.00 ±20.12 168.67 ±9.90 (mmHg) 0.251 SBP 82.08 ±8.88 94.00 ±3.46 (mmHg) 0.037* DBP Arq Bras Metab. Endocrinol 2014;58/7 hypertension History of History 19/100 0.007* 21/42 (Y/N) disease (Y/N) History of History coronary coronary 17/102 12/51 0.404 heart ------A drinking alcohol in the Muslim population were sig drinking alcoholintheMuslimpopulationwere smoking,andthe intakeofoilandsalt,cigarette Arq Bras Metab. Endocrinol 2014;58/7 Han andMuslimpopulation inChina. Figure 2. Comparisonofthedifferencesinfrequency ofpregnancy(A)andparturitionB), offetalmacrosomia (C) betweenthe andcaseswithahistory population inChina. Figure 1. Comparisonofthedifferencesinintakeoil(A)andsaltB),C), cigarettesmoking( andalcoholconsumption(D)betweentheHanMuslim (3.34±1.57;P>0.05)existedbe of parturition (3.72±1.71;P>0.05)andfrequency of pregnancy inthefrequency 1).Nosignificantdifferences Figure theHanpeople(P<0.001; from nificantly different C
Frequency of pregnancy A Based onthedataelicitedinquestionnaires, 0 2 4 6 8
Smoking cases
Han people Intake of oil (kg) 100 150 50 10 15 20 0 0 5
Han people Han people Muslim population P =0.064 in China P <0.001 Muslim population Muslim population P <0.001 in China in China
Frequency of partuaition B 0 2 4 6 Smoking No smoking Han people - - D B
between theHanandMuslimpopulationusingLRχ DM, PDM, and NGT was not significantlydifferent of 2),andthelevelofawareness (P >0.05;Figure between theHanandMuslimpopulationinChina existed infetalmacrosomia no significantdifference tween theHanandMuslimpopulation.Inaddition, Alcohol drinking cases 3).test (P=0.152;Figure 100 150 Muslim population Intake of salt (kg) 50 10 0 0 2 4 6 8 P =0.166 in China Han people Han people
Cases of history of fatal macrosomia C 20 40 60 80 0 Han people Glucose metabolism inChineseMuslims P <0.001 Muslim population Muslim population P <0.001 in China in China Alcohol drinking No alcoholdrinking P =0.077 Muslim population in China
Yes No 719 2
Copyright© ABE&M todos os direitos reservados. Copyright© ABE&M todos os direitos reservados. * Pvalues<0.05were considered tobesignificant. Charactersinbrackets are the95%CIofprevalencediabetesand pre-diabetes. Δ An age-adjustedCochran–Mantel–Haenszel(CMH) testwasperformed. Age wasstratifiedintotwogroups, <65yearsand≥years. 720 Table 2. Prevalenceofdiabetesandpre-diabetesintheHanpeopleMuslim population inChina pulations inChinaafteradjustingtheage(P=0.041). of DMandPDMbetweentheHanMuslimpo intheprevalence wasasignificantdifference that there results showed age stratification(<65yand≥65y).The the performed of people≥ 65 years ofage,we therefore in the proportion the worldappearstobeincrease across demographicchangetoDMprevalence portant Considerthemostim between thetworacegroups. inprevalence test wasusedtoanalyzethedifferences An age-adjustedCochran–Mantel–Haenszel(CMH) rustics Race-specific prevalence ofDMandPDMamong Han peopleandMuslimpopulationinChina(above). Figure 3. Awareness ofdiabetesandpre-diabetes, NGT(under)inthe Glucose metabolism inChineseMuslims Race Han people Muslim populationinChina
Awareness cases Awareness cases 100 200 300 400 500 100 200 300 400 0 0
Han people Diabetes and pre-diabetes (0.064-0.152) (0.025-0.061) IFG (95%CI) P =0.054 P =0.152 Muslim population 0.108 0.043 in China NGT Known Unknown Prevalence ofdiabetesandpre-diabetes (0.040-0.114) (0.075-0.131) Known Unknown IGT (95%CI) 0.077 0.103 - -
pulation inChinausingthePearsonχ intheMuslimpo agegroups amongdifferent fferent of DM andPDM was significantlydi The prevalence in Chinaandtheriskfactors Prevalence ofDMandPDMintheMuslimpopulation Han people(Table 2). lowerthanthe IFG (4.3%),and+IGT(5.2%)were higherthanthe Han people, (5.8%), IGT(10.3%)were of DM In the Muslim population, the prevalence groups (P > 0.05; Figure 4andTable (P>0.05;Figure groups 3). tween theHanandMuslimpopulationforotherage be 0.013), wedidnotfindanysignificantdifference the MuslimpopulationwashigherthanHan(P= of DMandPDMinthe20-year-old within agegroup ars and40-49to50-59yearsofage.Theprevalence Decreasing trends existedinthose20-29to30-39 ye trends Decreasing 30-39 to40-49yearsand50-59>70ofage. inthose 60-69 to>70yearsofage.TheIFGincreased aged 20-29to30-39years,40-4950-59and foundinthose were trends 69 yearsofage.Decreasing inthose30-39to40-49yearsand50-5960- trends upward 49 yearsofage.TheIFG+IGThaddifferent inthose>40- in those<40-49yearsofanddecreased inthose>50-59yearsofage.DMincreased decreased inthose<50-59yearsofageand The IGTincreased population innorthwestChina. Figure 4. (0.007-0.055) (0.037-0.079)
DM (95%CI) Prevalence of diabetes 0.031 0.058 and pre-diabetes in Muslims 15 10 0 5 Case Prevalence of diabetes and pre-diabetes in the Muslim 20~29 IFG +IGT(95%CI) 30~39 (0.064-0.152) (0.032-0.072) 0.108 0.052 40~49 Arq Bras Metab. Endocrinol 2014;58/7 50~59 Age-adjusted CMH-χ 4.176 60~69 2 test (P<0.001). 2 Δ 70~ 0.041* P IFG IGT DM IFG+IGT Age - - - - Arq Bras Metab. Endocrinol 2014;58/7 and Yin (3.16% in a2008 survey) xia Lingwu region ofdiabeteswashigher than theNing the prevalence wefoundthat of theMuslimpopulationin thisregion stratifiedclusterrandom samplingstudy In aprevious distinct geographicanddemographic characteristics. with otherregions from local populationisdifferent generations,the thanthree greater and mostrepresent population accounts for 44.1% of the total residents China.BecausetheMuslim innorthwest ped region Autonomous Region,aneconomicallyunderdevelo NingxiaHui Guyuan Cityislocatedinthesouthern DISCUSSION * Pvalues<0.05wereconsideredtobesignificant. population inChina Table 4. Riskfactorsfordiabetesandpre-diabetesintheMuslim factor(P<0.001) (Tabletion wasaprotective 4). over no-smoking(P=0.011),whilealcoholconsump theriskofDMand PDM 3.41-fold smoking increased respectively.when BMI and age increased, Cigarette lence 2.196-fold(P<0.001)and1.186-fold=0.025) thepreva PDM. TheriskofDMandPDMincreased ofDMand totheprevalence related consumption were smoking, andalcohol showed thatBMI,age,cigarette ditional risk factors for DM and PDM, and the results * Pvalues<0.05wereconsideredtobesignificant. Table 3. Prevalenceofnormal, diabetesandpre-diabetesinthreevillagesnorthwestChinan(%) Alcohol drinking Smoking Based onages Based onBMI χ Total IFG +IGT DM IGT IFG Normal Variables P Diagnosis 2 We used binary-logistic regression to detect the tra We regression used binary-logistic 15 (100.0%) Regression coefficient 20- -2.471 15 1.224 0.170 0.786 0 0 0 0 27 (81.8%) 13.701 12.737 6 (18.2%) 6.421 5.001 χ 30- 2 33 0 0 0 < 0.001* < 0.001* 0.011* 0.025* Age (year) P < 0.001* 15 (62.5%) 57.583 6 (25.0%) 3 (12.5%) Han 40- 24 0 0 0.084 3.401 1.186 2.196 OR 42 (70.0%) (0.022, 0.323) (1.320, 8.768) (1.021, 1.377) (1.426, 3.382) 9 (15.0%) 6 (10.0%) 3 (5.0%) 50- 95%CI 60 0 ------12 (19.0%) 33 (52.4%) 6 (9.5%) 6 (9.5%) 6 (9.5%) ≥ 60 63 IGT was higher than the Lingwu area (IGTstandar IGT washigherthantheLingwuarea of population wasdominatedbyHan.Theprevalence inwhichtheresident chuan (5.0%ina2009survey), while there was a significant difference inthepreva wasasignificantdifference while there rate=4.0%), (IFGprevalence was closetoYinchuan of IFG rate=7.32%);theprevalence dized prevalence obese residents are uncommon in rural population in population in uncommonin rural are obese residents DM andPDM. of forthehighprevalence reason may beanimportant lence inDMandPDM.Ethnic andgeneticdifferences inpreva forthedifferences not thereason istics were indemographiccharacter habits. Thus,thedifferences living raceswithdifferent tion belongedtodifferent characteristics, althoughtheHanandMuslimpopula indemographic wasnosignificantdifference that there whichindicated racegroups, similar inthedifferent such asgender(F/M),age,BMI,andWHR,were epidemiologic study, weshowedthatcharacteristics, fortheDM Based onananalysisofthequestionnaires (P=0.002)(13,17). inthearea the generalprevalence and IFG+IGTwaslowerthantheHanpopulation of IFG and the prevalence in the area, eral prevalence than theHanpopulationandalsohighergen higherintheMuslim population Guyuan citywere residents around rural IGT inthestratifiedsamplingof population intheregion. intheMuslim research further toperform is necessary ofglucosemetabolismdisturbance, thusit prevalence the Muslim population has a high residents), ding rural Han andMuslimpopulation(P=0.002) lence ofIFG,IGT, DM,andIFG+IGTbetweenthe results suggestthatinGuyuanCity(based onsurroun results Previous studies have shown that overweight and and studies haveshownthatoverweight Previous We of DM and haveshownthattheprevalence 71 (79.8%) 4 (4.5%) 4 (4.5%) 4 (4.5%) 6 (6.7%) 20- 89 74 (83.1%) 2 (2.2%) 5 (5.6%) 8 (9.0%) 30- 89 0 Muslim populationinChina Glucose metabolism inChineseMuslims 79 (66.9%) 12 (10.2%) Age (year) 10 (8.5%) < 0.001* 8 (6.8%) 9 (7.6%) 46.551 118 40- 72 (79.1%) 14 (15.4%) 5 (5.5%) 50- 91 0 0
(13). These 50 (64.1%) 10 (12.8%) 8 (10.3%) 5 (6.4%) 5 (6.4%) ≥ 60 78 721 ------
Copyright© ABE&M todos os direitos reservados. Copyright© ABE&M todos os direitos reservados. populations in the region. BMIwasariskfactorforglu populations intheregion. between the Muslim andHan not statistically different urban-rural divide, the Muslim rural populationofover divide,theMuslimrural urban-rural the andreducing livingstandards Thus, withimproved 2.196-fold and WHR is not a major factor.increased Health [2007],China) totheZhengzhouUniversitySchoolofPublic according (25.85% areas subjectsinrural ofoverweight prevalence thantheaverage of the population,whichwasgreater 722 (only25.34%)in theMuslimpopulationwas awareness complications. Inthisstudywefoundthat ease-related indicator ofthediseasedetection rateandseverityofdis PDM intheMuslimpopulation. ofDMand theprevalence notaffected were rosomia ofpregnancy,the frequency andfetal mac parturition, in factors.Thus,thedifferences not riskorprotective were offetalmacrosomia andahistory and parturition, ofpregnancy in the Muslim population, the frequency WhenweestimatedtheriskforDMandPDM groups. race factor forDM,whichwassimilarinthedifferent arisk isoften considered offetalmacrosomia A history intheHanandMuslimpopulation. nificant differences studyinthefuture further worth withgenes in theMuslim population, are related are characteristics, andwhetherornotthecharacteristics tically significantintheMuslimpopulation.Allthese statis factor forglucosemetabolismdisturbancewere as a risk factor and alcohol consumption as a protective smoking less thantheHan.Theamountofcigarette significantly alcohol intheMuslimpopulationwere smokinganddrinking lower thantheHan;cigarette wassignificantly rateofhypertension the prevalence was significantly higher than the Han, but of the survey appetites. OilandsaltintakeintheMuslimpopulation smoking, and drinking alcohol consumption, cigarette oilandsalt inbloodpressure, ethnicdifferences were for the DMepidemiologicstudy, wefoundthatthere tabolism disturbanceandDMriskfactorshavechanged. andglucoseme weight andobesesubjectsincreased for each1kg/m cose metabolismdisturbanceintheMuslimpopulation; subjects (28>BMI≥24kg/m studywefoundthatoverweight BMI. Inourprevious family history, anddyslipidemia,ratherthananelevated mainlycentralobesity,China. RiskfactorsforDMare Glucose metabolism inChineseMuslims many pregnancies and deliveries, but there were nosig were anddeliveries,butthere many pregnancies In epidemiologic studies, awareness is an important isanimportant In epidemiologicstudies,awareness survey Basedontheanalysisofquestionnaire We had alsofoundthatmostfemalesinthearea 2 increase in BMI, the prevalence risk risk inBMI,theprevalence increase
(13). The BMI and WHR were (13). TheBMIandWHRwere 2 ) accounted for 27.7% ) accountedfor27.7%
(18,19). ------ethnic minorities, rural areas, andeconomicbackward areas, ethnic minorities,rural remoteness, wasnotsignificant.Dueto the difference slightly higherthanglucosemetabolismdisturbance,but slightly higherthantheHannationality, andNGTwas glucose (fastingandpostprandial2hours).Thedif fingerblood outonthenormal test wasnotcarried subjectsinthestudy. more serve OGTT Thestandard study. offurther is worthy relevant Muslim population and this characteristic were habitsofthe Whether ornotthegeneticanddietary higherthantheHan. in the Muslim populationwere valence of DM and PDM in the 20-year-old age group distribution ofMuslimandHanpopulation.Thepre ofDMandPDMintheage in theprevalence ferences isstillimportant. literacyworkinthisarea DM-related ofthediseasewasactuallylow.and theoverallawareness isolationwiththeoutsideworld, low and the relative thelevelofeducationwasgenerally ness intheregion, 1. REFERENCES was reported. relevant tothisarticle nopotentialconflictofinterest Disclosure: withthis paper.special thankstoLiuWFandhismemory ofNingxiaHigherSchool([2010]297).We Project arch give (SQKM201210025008) andtheScienceTechnology Rese ofBeijingMunicipalCommission ofEducation lopment Project tion (GrantNos.7142015)andtheScienceTechnology Deve bytheBeijingNaturalScienceFounda supported was partially grity ofthedataandaccuracyanalysis.Thiswork fortheinte access toallofthedata,andtakefullresponsibility Teachers’ theguarantorsofthiswork,hadfull University),are University), andDr. ofMedicine,Ningxia LiuWF(Department Dr. HuaL(BiomedicalEngineeringInstitute,CapitalMedical logy, BeijingTongren Hospital,CapitalMedicalUniversity), Ackonwledgements: Dr. ofEndocrino LiuW(Department contributed tothediscussion.Yang themanuscript. JKreviewed cussion. LiuWF, dataand SongHL,andDaiXWresearched data,andcontributedtothedis manuscript. HuaLresearched the data,andreviewed/edited ted tothediscussion,researched themanuscript,contribu LiuWwrote Additional information: in thefuture. issues, wewillcontinuetoconductin-depthresearch notstudiedindepth.Forthese unresolved tions were ingeneticsbetweenMuslimand Hanpopula ferences
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