Doctoral Dissertation Improvement: Social and Biological Determinants of Cardiovascular Risk among Urban and Rural Yakut: The Impact of Socioeconomic Upheaval

苏联解体是一个分水岭事件，导致西伯利亚土著人的寿命和健康状况灾难性下降。 苏联解体后的社会和经济解体导致了心血管疾病的流行性死亡。 这项研究将调查这种高死亡率背后的社会、行为和生理现象。 本研究采用城乡结合的设计，调查心血管疾病风险的主要决定因素在雅库特，西伯利亚土著群体。 这一假设将得到验证，即快速的社会变化导致饮食变化，产生基因-饮食相互作用，导致城市受试者胆固醇水平高，心血管疾病发病率增加。 将从雅库茨克市、Tiungiuliu村和周围定居点招募约500名成年受试者。 血脂和C反应蛋白将用作心血管风险的标志物，并将使用干血斑进行测量。 将使用食物频率问卷评估饱和脂肪和胆固醇的饮食摄入量。 将通过问卷调查收集有关健康行为（饮酒、吸烟）和社会人口学方面的数据。 这项研究将加强美国和国际科学家之间的国际合作和科学知识交流，并将为美国未来的科学家提供必要的培训。 这项研究的意义在于它解释了现代化失败的健康后果，估计了基因-饮食相互作用的影响，并增加了我们对在城乡社会变革背景下如何快速发生流行病变化的认识。

The collapse of the Soviet Union was a watershed event that resulted in a catastrophic decline in longevity and health status for indigenous Siberians. The social and economic disintegration following the breakup of the Soviet Union resulted in epidemic mortality from cardiovascular diseases. This study will investigate the social, behavioral and physiological phenomena underlying this higher mortality. This research uses an urban-rural design to investigate major determinants of cardiovascular risk in the Yakut, an indigenous Siberian group. The hypothesis will be tested that rapid social change has lead to dietary changes, producing a gene-diet interaction leading to high cholesterol levels among urban subjects and increased incidence of cardiovascular disease. Approximately 500 adult subjects will be recruited from the city of Yakutsk, the village of Tiungiuliu and surrounding settlements. Serum lipids and C-reactive protein will be used as markers of cardiovascular risk and will be measured using dried blood spots. Dietary intake of saturated fats and cholesterol will be assessed using a food frequency questionnaire. Data on health behavior (alcohol consumption, smoking) and sociodemographic dimensions will be collected by questionnaire. This research will enhance international collaboration and the exchange of scientific knowledge between U.S. and international scientists and will provide essential training for future scientists in the United States. This research is significant in that it explains the health consequences of failed modernization, estimates the effect of gene-diet interactions, and increases our knowledge of how rapid epidemiological change can occur within the context of rural-urban social change.