Diabetes Care, Vol 21, Issue 4 549-554, Copyright © 1998 by American Diabetes Association
Prevalence of glucose intolerance among Native Hawaiians in two rural communities. Native Hawaiian Health Research (NHHR) Project
A Grandinetti, HK Chang, MK Mau, JD Curb, EK Kinney, R Sagum and RF Arakaki
Pacific Biomedical Research Center, Manoa, Hawaii. andrew@pbrc.hawaii.edu
OBJECTIVE: To estimate prevalence of type 2 diabetes and impaired glucose
tolerance (IGT) among a population of native Hawaiians in two rural
communities. RESEARCH DESIGN AND METHODS: Prevalence of glucose intolerance
was assessed in two rural communities by history (confirmed by record
review) or with a 75-g oral glucose tolerance test according to World
Health Organization criteria. Anthropometric and demographic data were also
obtained. A short survey was used to estimate the prevalence of known
diabetes among nonparticipants. Prevalence rates were adjusted using the
standard world population of Segi. RESULTS: A total of 574 native Hawaiians
age > or = 30 years participated. The crude prevalence of IGT and type 2
diabetes were 15.5 and 20.4%, respectively. Only IGT prevalence was
significantly higher (P = 0.03) among women (18.7%) than among men (10.9%).
Prevalence of glucose intolerance was significantly associated with BMI,
waist circumference, and waist-to-hip ratio (WHR). After adjusting for age
and BMI, waist circumference and WHR were significantly and independently
associated with type 2 diabetes prevalence only among women. Prevalence of
type 2 diabetes was not significantly associated with the percentage of
Hawaiian ancestry after adjusting for age. CONCLUSIONS: This study observed
a high prevalence of glucose intolerance associated with being overweight
among native Hawaiians. Age-adjusted type 2 diabetes prevalence was four
times higher than among the U.S. National Health and Nutrition Examination
Survey (NHANES) II population. Prevalence was high despite high rates of
admixture with other ethnic groups of Hawaii, suggesting that these other
Asian and Pacific Island populations share similar susceptibility to type 2
diabetes risk.