DIABETES PREVENTION IN YUPIK ESKIMOS

尤皮克爱斯基摩人的糖尿病预防

• 批准号: 2146422
• 负责人: SVEN O EBBESSON
• 金额: $ 21.72万
• 依托单位: UNIVERSITY OF ALASKA FAIRBANKS
• 依托单位国家: 美国
• 财政年份: 1993
• 资助国家: 美国
• 起止时间: 1993-09-10 至 2000-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2146422
• 关键词: Alaskan Native American; behavioral /social science research tag; cardiovascular disorder; disease /disorder prevention /control; disease /disorder proneness /risk; electrocardiography; exercise; health behavior; health surveys; human subject; hyperinsulinism; interview; lifestyle; noninsulin dependent diabetes mellitus; nutrition; nutrition related tag; respiratory airflow measurement

Support is requested for a collaborative research project to determine to what extent intervention can decrease the prevalence of diabetes, hyperinsulinemia, and cardiovascular risk factors among Yupik Eskimos living on St. Lawrence Island and the west coast of Alaska. The project would also investigate dietary patterns, physical activity levels, and anthropometric data and attempt to correlate these with the occurrence of diabetes, cardiovascular risk factors, diabetes complications, and insulin levels. As part of the ongoing Alaska-Siberia Medical Research Program, identical baseline data are currently being gathered in the population of Yupik Eskimos across the Bering Straits on the Chukotka Peninsula in Siberia. Age-adjusted prevalence of non-insulin dependent diabetes mellitus (NIDDM) among Alaska's Eskimos, Indians, and Aleuts overall increased 11%, from 15.7 to 17.4 per 1000 over the two-year period form 1985 to 1987 (Schraer et al., 1988 and in press). Rates in 1987 varied from 6.7 to 40.8 per 1000 in various Indian Health Service units in Alaska. These estimates are based only on clinically recognized cases. Comparing preliminary rates to Chukotka Natives 15 years and older, we find that the SL Lawrence Island rate is 9.7/1000 while the Chukotka rate is 1/1000. Since Siberian Yupik Eskimos of Chukotka and Alaska are genetically closely related, our working hypothesis is that dietary and lifestyle differences account for the difference in diabetes prevalence. We believe this represents a unique opportunity for research since these populations were essentially one until 1948, when contact ceased due to political reasons, and lifestyles diverged as a result. Initially, a survey of 800 subjects of both sexes on St. Lawrence Island and western Alaska will be carried out using similar methodology as in the ongoing Strong Heart Study among other non-Alaskan groups of Native Americans. The surveys will be followed by an intervention in which half of the participating villages will receive specific education about diet and risk factors and will be encouraged to: a) eat more traditional foods, b) decrease foods with low nutrient density such as sugar in their diet, c) decrease intake of saturated fats, and d) increase physical exercise. Additional interventions will be implemented, based on recommendations and input from the community. The "control" villages will not receive these interventions. During the fifth year of this grant the effectiveness of the interventions will be tested by a careful comparison of diabetes and cardiovascular risk factors, repeating the same survey as given during year 1. Considering that the Alaskan Eskimos began abandoning traditional diets and lifestyles only recently, it is possible that the study might lead to a reversal in this trend by providing significant insights into the etiology of NIDDM and lead to identification of the causative lifestyle factors that can be modified to prevent diabetes.

请求对合作研究项目提供支持，以确定 什么程度的干预可以降低糖尿病的患病率， 爱斯基摩人高胰岛素血症和心血管危险因素 生活在圣劳伦斯岛和阿拉斯加西海岸。项目 还将调查饮食模式，身体活动水平， 人体测量数据，并试图将这些数据与 糖尿病、心血管危险因素、糖尿病并发症和胰岛素 程度.作为正在进行的阿拉斯加-西伯利亚医学研究计划的一部分， 目前正在收集人口的相同基线数据， 年楚科奇半岛上的爱斯基摩人穿越白令海峡 西伯利亚 非胰岛素依赖型糖尿病（NIDDM）的经年龄调整的患病率 阿拉斯加的爱斯基摩人、印第安人和阿留申人的死亡率总体上上升了11%， 15.7从1985年到1987年的两年期间，每1000人中有17.4人死亡（Schraer 例如，1988年出版）。1987年的比率从每1000人6.7人到40.8人不等 在阿拉斯加的印第安人健康服务中心工作该等估计乃 仅基于临床认可的病例。将初步费率与 楚科奇原住民15岁及以上，我们发现，SL劳伦斯岛 发病率为9.7/1000，而楚科奇则为1/1000。自从西伯利亚尤皮克 楚科奇和阿拉斯加的爱斯基摩人在基因上密切相关，我们的 工作假设是饮食和生活方式的差异解释了 糖尿病患病率的差异。我们相信这代表了一种独特的 因为这些人群基本上是一个 直到1948年，由于政治原因和生活方式， 因此产生了分歧。 最初，一项对圣劳伦斯岛800名男女受试者的调查 和阿拉斯加西部将使用类似的方法进行， 正在其他非阿拉斯加原住民群体中进行的强心研究 美国人调查之后将进行干预， 的参与村将接受有关饮食的具体教育， 和风险因素，并将被鼓励：a）吃更多的传统食物， B）减少饮食中营养密度低的食物，如糖， c）减少饱和脂肪的摄入，d）增加体育锻炼。 将根据建议采取更多的干预措施， 来自社区的投入。“控制”村将不会收到这些 干预措施。在第五年的补助金的有效性， 这些干预措施将通过仔细比较糖尿病和 心血管危险因素，重复相同的调查， 第一年。 考虑到阿拉斯加爱斯基摩人开始放弃传统饮食 和生活方式，这项研究可能会导致 这一趋势的逆转，提供了重要的见解， NIDDM的病因学，并导致确定致病的生活方式 这些因素可以被修改以预防糖尿病。