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The study of different ethnic groups living in the same physical environment provides the opportunity to examine interaction of genetic and environmental factors in the aetiology of diabetes mellitus. In rural New Caledonia, the prevalence of diabetes was higher in part-Polynesians than in Melanesians: males - 6.6 versus 0.5%; females - 6.3 versus 3.5% respectively. The prevalence of abnormal glucose tolerance (impaired glucose tolerance and diabetes) was 11.5 and 15.7% in part-Polynesian males and females, respectively, and 4.7 and 9.2% in Melanesian males and females. Mean age and degree of obesity in these ethnic groups were sufficiently similar to suggest that these factors played no significant role in the difference in diabetes prevalence. Furthermore, adjustment of relative risk of impaired glucose tolerance and diabetes for age and obesity indicated that the modest differences between groups were not responsible for the observed variation in diabetes prevalence. The differences in prevalence of impaired glucose tolerance and diabetes between Melanesians and part-Polynesians may be genetically determined, although the role of certain environmental factors other than obesity, e.g. differences in physical activity or qualitative aspects of diet, cannot be excluded.

Peripheral lymphocyte subpopulations have been quantified by a direct and indirect, immunofluorescence technique, using monoclonal antibodies, in 22 patients with continued heavy drinking, hepatocellular dysfunction (spider angiomata, ascites, and factor V decrease) (group I), in 16 patients with a history of heavy drinking and abstinence maintained for at least 6 months and hepatocellular dysfunction (group II) and in 28 patients admitted for continued heavy drinking, without hepatocellular dysfunction (group III). Sixteen normal subjects were studied as controls. The total number of lymphocytes and T lymphocytes (OKT3+) were significantly reduced (p less than 0.001) in groups I and II. A significant decrease of B lymphocytes was observed in group II (p less than 0.02). The OKT8+ lymphocytes were significantly reduced in group I (p less than 0.01) and in group II (p less than 0.001); the decrease of the OKT4+ lymphocytes was significant in group II (p less than 0.01) only. The OKT4/OKT8 ratio was higher in group I (p less than 0.05) and group II (p less than 0.01) than in the control group. Normal values of total lymphocytes, B lymphocytes, T lymphocytes subsets and OKT4/OKT8 ratio were observed in group III. In group III, the lymphocyte subpopulations and OKT4/OKT8 ratio were similar in patients with or without abnormalities of liver function tests. In group I and II, no correlation was found between the lymphocyte subpopulations or the OKT4/OKT8 ratio and factor V or nutritional status assessed by anthropometrical and biological tests. T-cell imbalance in alcoholic liver disease does not seem to be related to alcohol consumption, factor V decrease or malnutrition.

Following acute intoxication with alcohol, 8 patients developed 16 episodes of arrhythmia, including 15 supraventricular tachycardias and one torsade de pointe. Seven of the 8 patients were chronically abusing of alcoholic drinks. None of the patients had clinically obvious cardiac pathology nor echocardiographic evidence of myocardiopathy. In 7 of them, however, baseline electrocardiograms disclosed disorders of intra-atrial conduction. The role of the different factors which might determine the occurrence of arrhythmia (notably alcohol, the autonomic nervous system, associated metabolic abnormalities and absorption of medicines) is discussed.