Læknablaðið - 15.03.1980, Side 34

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LÆKNABLADID
Niðurstöðum pessarar rannsóknar Hjarta-
verndar ber vel saman við enskar og amer-
ískar hóprannsóknir, sem hafa sýnt, að getnað-
arvarnartöflur (eins og pær voru notaðar
hérlendis 1969-1974) skerða sykurþol sumra
kvenna nokkuð (43, 45). Hins vegar virðist sú
sykurþolstruflun ganga til baka í flestum
tilvikum og sjaldnast leiða til sykursýki (43),
enda þótt vert sé að hafa þann möguleika í
huga.
Jákvæð ættarsaga um sykursýki reyndist
ekki auka algengi skerts sykurþols nema
meðal eldri kvennahópsins. Erlendar hóprann-
sóknir benda heldur ekki til þess, að ættarsaga
hafi mikið forspárgildi m.t.t. skerts sykurþols
(23, 30).
Gildi sykurþolsprófs til greiningar á sykur-
sýki á byrjunarstigi verður einungis metið af
ferilrannsóknum, þar sem fylgt er eftir hópi
fólks um árabil. í annarri grein verða gerð skil
á ferli þátttakenda í hóprannsókn Hjartavernd-
ar m.t.t. síðari sykurþolsprófa svo og hjarta-
og æðasjúkdóma á þeim tíma, sem liðinn er
síðan þeir komu fyrst til rannsóknar.
Höfundar þakka þátttkendum og starfs-
fólki Rannsóknarstöðvar Hjartaverndar. Helgi
Sigvaldason verkfræðingur annaðist tölvuúr-
vinnslu. Brynhildi Þorkelsdóttur lyfjadeild
Borgarspítalans þökkum við vélritun grein-
arinnar.
SUMMARY
Community screening for diabetes by an oral
carbohydrate tolerance test in the Reykjavik area.
This report presents the results of blood glucose
determinations (fasting and during 50 gm oral
glucose tolerance test) in a prospective health
survey 1967-1974 conducted by the lcelandic Heart
Association.
The population invited were 22 year groups of
males and females in the age- range 20-61 years in
the Reykjavik area, selected from National Roster
according to birthdays. The response rate was about
75% in the age groups 34-61 years and about 56,5 %
in the age groups 20-34 years. Total number of
males examined was 3.697 and 3.183 females.
Blood glucose (capillary blood) was determined
by Technicon Autoanalyzer Methodology-N-9.
The distribution of blood glucose values was
found to be unimodal though positively skewed. The
mean fasting blood glucose was significantly higher
in men than women (mean difference 3,5 mg/dl) and
increased with age (3,5 mg/dl per decade in men and
1,5 in women).
The mean post-glucose load (1 */2 hr) values were
siginificantly higher in women than men (mean 7,9
mg/dl), possibly reflecting that 50 g of oral glucose
is not enough load for nten. The mean values
increased in both sexes with age (6,5 mg/dl in men
and 5,9 mg/dl in women per decade).
Those who had blood sugar values > 130 mg/dl
at 1 '/2 hr post glucose load (50 g) were said to have
a positive screening test and were invited for a
confirmatory glucose tolerance test (100 g). 15 % of
the whole female group had positive screening test
(18,5% in the age range 34-61 years and 5,0% in
the age range 20-34), compared to 10.8% of the
male group (13,6 % in the age range 34-61 years and
2,5 % in the age range 20-34).
The confirmatory glucose tolerance test (100 g
per os) was called »positive« (impaired glucose
tolerance) when blood glucose values were > 120
mg/dl at 2 hr. Under the age of forty 0,4-0,6 % of
men and 1,8-1,9 % of women had »positive« confir-
matory test, in the age group 40 — 49 6,1 % of men
and 8,75 % of women were positive compared to
10,2 % and 13,2 % in the age group 50-61.
Known diabetics according to a health questiona-
ire (not included in the figures above) were 0.2-
0.8 % in the age groups 20 — 50 year of both sexes
and 1,4—1,6% in the age groups 50 — 61. This
prevalence rate of known diabetics and impaired
glucose tolerance is fairly similar to that reported
for other western societies although a direct compa-
rison is difficult because of different criteria being
used.
This study has also confirmed the results of
others showing a considerable intraindividual vari-
ability of oral glucose tolerance test indicating that
the diagnosis of »impaired glucose tolerance«
should not be made usually on the results of a single
test.
HEIMILDIR
1. Allander, E., Björnsson, O. B„ Kolbeinsson, A„
Ólafsson, Ó„ Sigfússon, N. & Thorsteinsson, J.
Rheumatoid factor in lceland: A population
study. Int. J. Epidemiol. 1:211, 1972.
2. Andres, R. Aging and Diabetes í Symposium on
Diabetes Mellitus, Med. Clin. North Am. 55:835,
1971.
3. Björnsson, Ottó-Davíðsson, Davíð, Ólafsson, Ól-
afur, Sigfússon, Nikulás & Þorsteinsson, Þor-
steinn. Survey of serum lipid levels in lcelandic
men aged 34-61 years. Acta Medica Scandinavi-
ca, Suppl. 616, 1977.
4. Brilish Diabetic Association; Diagnostic criteria
for diabetes ntellitus. Recommendations of the
Medical and Scientific Section, 1978.
5. College of General Practitioners; Report of
working party. A Diabetes Survey. Brit. Med. J.,
5291. 1962.
6. College of General Practitioners; Report of
working party. Glucose tolerance and glycosu-