ABNORMAL GLUCOSE-TOLERANCE AND OTHER CORONARY HEART-DISEASE RISK-FACTORS IN AN ISOLATED ABORIGINAL COMMUNITY IN CENTRAL AUSTRALIA

OBJECTIVE - To determine the age- and sex-specific prevalence of diabe tes, impaired glucose tolerance (IGT), and coronary heart disease risk factors in a remote central Australian Aboriginal community maintaini ng some degree of traditional lifestyle, living in homeland communitie s on their ancestral land. RESEARCH DESIGN AND METHODS - A cross-secti onal survey of 437 subjects greater than or equal to 15 years of age ( 189 men, 248 women), representing 80% of the adult population residing in the community at the time of the survey, was performed and the fol lowing parameters measured: BMI, glucose tolerance, circulating insuli n and lipids, and blood pressure. RESULTS - The mean BMI for this popu lation was 22.9 +/- 4.8 kg/m(2). The prevalence of diabetes in the age group of 15-34 years (103 men and 140 women) was 2 and 6% for men and women, respectively. In the 35-years-and-older age group (86 men and 108 women), diabetes prevalence was 19 and 13% for men and women, resp ectively Over half the diabetic subjects did not exhibit fasting hyper glycemia. IGT occurred in 8 and 15% of younger men and women, respecti vely, and in 17 and 32% of older men and women, respectively Smoking w as common among men (53% current smokers) but rare among women (2% cur rent smokers). The prevalence of hypercholesterolemia, hypertriglyceri demia, hypertension, and overweight rose with increasing degrees of gl ucose intolerance. The two communities adjacent to the only store in t he area had a higher prevalence of abnormal glucose tolerance than did the more remote homeland communities (odds ratio for abnormal glucose tolerance: 2.92; 95% CI 1.51-5.63). CONCLUSIONS - Despite their relat ive leanness, this Aboriginal population exhibited relatively high pre valences of IGT and diabetes without fasting hyperglycemia. The data s uggest a protective effect of a decentralized mode of living, as oppos ed to a more urbanized lifestyle, on the occurrence of glucose intoler ance. Abnormal lipid profiles (particularly high triglycerides and low HDL cholesterol) and the high prevalence of smoking in men indicated a high-risk profile for coronary heart disease in this population.