第二十一章糖尿病.ppt

* Abdominal obesity has reached epidemic proportions worldwide Surveys in various countries suggest a high prevalence of abdominal obesity, using criteria similar to those used for the metabolic syndrome by NCEP/ATP III. Further details of the populations in each country are given below: Country Year Age range studied US 1999–2000 ? 20 France 2003 ? 15 Spain 1997–8 18-74 Italy 1998 35-74 Netherlands 1993-97 20-59 UK 2000–1 19-64 Germany 1994–5 25–74 Alvarez Leon EE, Ribas Barba L, Serra Majem L. Prevalence of the metabolic syndrome in the population of Canary Islands, Spain. Med Clin (Barc) 2003;120:172-4. Charles MA, Basdevant A, Eschwege E. Prevalence of obesity in adults in France: the situation in 2000 established from the OBEPI Study. Ann Endocrinol (Paris) 2002;63:154-8. Osservatorio Epidemiologico Cardiovascolare Italiano. Ital Heart J 2004,5(suppl.3):49-92. Visscher TLS, Seidell JC. Time trends (1993-1997) and seasonal variation in body mass index and waist circumference in the Netherlands. Int J Obes 2004;28:1309-16. Ruston D, Hoare J, Henderson L, Gregory J. The National Diet Nutrition Survey: adults aged 19 to 64 years. Office of National Statistics (UK), 2004, National Diet and Nutrition Survey, vol. 4. Ford ES, Mokdad AH, Giles WH. Trends in waist circumference among U.S. adults. Obes Res 2003;11:1223-31. Liese AD, D?ring A, Hense HW, Keil U. Five year changes in waist circumference, body mass index and obesity in Augsburg, Germany. Eur J Nutr 2001;40: 282-8. * Abdominal obesity increases the risk of developing type 2 diabetes These data are from the Nurses’ Health Study,1 an observational study that followed a cohort of 43,581 women between 1986 and 1994 in the USA. The analysis presented here was designed to define the association between waist circumference and the risk of developing type 2 diabetes. The risk of developing type 2 diabetes increased linearly with an increasing waist circumference. The relative risk for w