Standardized comparison of glucose intolerance in west African-origin populations of rural and urban Cameroon, Jamaica, and Caribbean migrants to Britain.
OBJECTIVE
To compare the prevalence of glucose intolerance in genetically similar African-origin populations within Cameroon and from Jamaica and Britain.


METHODS
Subjects studied were from rural and urban Cameroon or from Jamaica, or were Caribbean migrants, mainly Jamaican, living in Manchester, England. Sampling bases included a local census of adults aged 25-74 years in Cameroon, districts statistically representative in Jamaica, and population registers in Manchester. African-Caribbean ethnicity required three grandparents of this ethnicity. Diabetes was defined by the World Health Organization (WHO) 1985 criteria using a 75-g oral glucose tolerance test (2-h > or = 11.1 mmol/l or hypoglycemic treatment) and by the new American Diabetes Association criteria (fasting glucose > or = 7.0 mmol/l or hypoglycemic treatment).


RESULTS
For men, mean BMIs were greatest in urban Cameroon and Manchester (25-27 kg/m2); in women, these were similarly high in urban Cameroon and Jamaica and highest in Manchester (27-28 kg/m2). The age-standardized diabetes prevalence using WHO criteria was 0.8% in rural Cameroon, 2.0% in urban Cameroon, 8.5% in Jamaica, and 14.6% in Manchester, with no difference between sexes (men: 1.1%, 1.0%, 6.5%, 15.3%, women: 0.5%, 2.8%, 10.6%, 14.0%), all tests for trend P < 0.001. Impaired glucose tolerance was more frequent in Jamaica.


CONCLUSIONS
The transition in glucose intolerance from Cameroon to Jamaica and Britain suggests that environment determines diabetes prevalence in these populations of similar genetic origin.
Mbanya
J C
JC
Diabetes and Endocrine Unit, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon. jean-claude.mbanya@camnet.cm
Cruickshank
J K
JK
Forrester
T
T
Balkau
B
B
Ngogang
J Y
JY
Riste
L
L
Forhan
A
A
Anderson
N M
NM
Bennett
F
F
Wilks
R
R
D000328:Adult; D000354:Africa, Western / Q000208:ethnology; D002163:Cameroon / Q000208:ethnology; D017691:Caribbean Region / Q000208:ethnology; D004739:England / Q000453:epidemiology; D005260:Female; D018149:Glucose Intolerance / Q000453:epidemiology* / Q000208:ethnology*; D006801:Humans; D007563:Jamaica / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012423:Rural Health; D014171:Transients and Migrants; D014504:Urban Health