INSULIN-RESISTANCE SYNDROME IN AUSTRALIAN ABORIGINAL PEOPLE

1. Like many indigenous populations, Australian Aboriginal people have developed high rates of obesity, non-insulin-dependent diabetes melli tus (NIDDM) and cardiovascular and renal disease following the transit ion from a traditional to an 'urbanized' lifestyle, These conditions t end to cluster as part of the insulin resistance syndrome, 2. The prev alence of overweight people and obesity in Australian Aboriginal popul ations ranges from 0% in communities with a traditionally orientated l ifestyle to well over 50% in the worst affected communities, There is a predominantly central pattern of fat deposition in both men and wome n, which is associated with greater insulin resistance and cardiovascu lar risk than is peripheral fat deposition, 3. Data from four previous ly published, population-based surveys in Aboriginal communities were combined to give a cohort of 1079 subjects of 15 years and older, Seve ral conditions of the insulin resistance syndrome had a strong, positi ve association with increasing body mass index (BMI): NIDDM (both cros s-sectionally and longitudinally), hypertension, dyslipidaemia and alb uminuria, Remaining lean (BMI<20kg/m(2)) protected even older Aborigin al people from these conditions to a large extent, 4. Community based programmes to increase physical activity and improve dietary quality a re likely to be the major means by which conditions associated with in sulin resistance can be prevented in Aboriginal populations.