PLANNING GRANT--DIABETES/NEPHROPATHY IN APACHE INDIANS

本申请是对RFA 91-DK-01的回应，代表一项建议 为发展拨款申请所需的规划提供支援 研究与以下疾病相关的患病率、并发症发生率和危险因素 美洲印第安人中的糖尿病。其规划工作 请求的支持将集中在白山研究上 阿帕奇预订。在这一地区还有一个霍皮人部落 可以用来提供可比较的数据，并允许比较两个 不同的美洲原住民群体。然而，主要的焦点将是 直接指向白山阿帕奇组织，因为这些人 已经被研究过了，并且有一个独特的相关特征 这一群体与他们的营养状况有关，这就做出了评估 糖尿病在这一阿帕奇群体中尤为重要。在……里面 与PIMA等其他群体相比，PIMA已经得到了很好的研究和 他们过度肥胖和糖尿病的发生率非常高，两个 对学龄儿童营养状况的相对最近的评估 在这个白山阿帕奇小组中，未能确定 皮马和其他纳瓦霍人的肥胖问题已经被记录在案。 来自白山阿帕奇印第安人的数据与来自 其他美洲原住民应该帮助发展信息 这对于决定过度肥胖是否是最严重的 与非胰岛素依赖型糖尿病相关的重要危险因素 糖尿病。赠款规划过程将包括认真关注 适当的人口抽样调查以及确定 描述糖尿病患病率的最准确方法 糖尿病是年龄和营养状况的函数。此外，任何 成功的规划必须包括与 白山阿帕奇社区的领导人以及印第安人 确保阿帕奇社区最佳合作的健康服务是 在启动任何研究项目之前获得。此外，评估 包括高血压和肾脏损害在内的并发症 地址。

This application i in response to RFA 91-DK-01 and represents a proposal for support of the planning necessary to develop a grant application to study prevalence, complication rate and risk factors associated with diabetes mellitus in American Indians. The planning effort for which support is requested will be focused upon a study of the White Mountain Apache reservation. There is also available in this area a Hopi Tribe that could be used to provide comparable data and permit comparison of two different native American groups. The primary focus, however, will be directed toward the White Mountain Apache group since these individuals have been studied in the past and there is a uniquely relevant feature of this group related to their nutritional status which makes the assessment of diabetes mellitus in this Apache group of particular importance. In contrast to other groups such as the Pima who have been well-studied and who have a very high incidence of excess obesity as well as diabetes, two relatively recent assessments of the nutritional status of school children of this White Mountain Apache group failed to identify the prevalence of obesity that has been documented for the Pima and for other Navajo. Comparison of data from the White Mountain Apache Indians with data from other Native American populations should aid development of information that is of importance in deciding whether the excess obesity is the most important risk factor associated with non-insulin dependent diabetes mellitus. The grant planning process will include careful attention to appropriate population sampling as well as to the identification of the most accurate approach to characterization of the prevalence of diabetes mellitus as a function of age and nutritional status. Furthermore, any successful planning must involve close consultation and collaboration with the leaders of the White Mountain Apache community as well as the Indian Health Service to ensure optimal cooperation of the Apache community is obtained before any research project is initiated. In addition assessment of the complications including hypertension and renal involvement will be addressed.