PREVALENCE AND PROGRESSION OF DM2 RISK IN MA YOUTH

在过去的5年里，有报道称美国少数族裔儿童患有2型糖尿病(DM2)，其中包括墨西哥裔美国人(MA)。在当地，在过去的三年中，患有DM2的MA儿童比患有1型糖尿病(DM1)的MA儿童更多，尽管DM1的发病率并没有下降。虽然在MA成人中DM2、相关危险因素和共病的高患病率和不断上升的发病率被广泛记录在案，但关于具有相同遗传遗传和生活在相同环境中的MA儿童的这些问题的流行率或发病率的信息很少。对儿童从遗传风险到显性疾病的自然进展更是知之甚少。因此，这项建议的具体目的是：1.确定大约2000名MA儿童(4年级、9岁和10岁)的危险因素、高胰岛素血症、空腹血糖受损和糖尿病的患病率(阶段1)2.通过详细的临床评估和广泛的生化调查，探讨危险因素与大约300名MA儿童血糖稳态异常的关系。这些儿童将分为3个亚组：空腹血糖受损、高风险和低风险。(第二阶段)。3.检查3个子集的物理和生化参数在4年内的时间变化(阶段3)。每年都会看到孩子们，因为这是一个身体动态变化的时期。拟议研究的完成将提供对MA儿童中葡萄糖稳态异常患病率的估计，在相对较早的年龄和阶段增加对代谢异常的了解，允许检查这些异常的自然进展，并对新的美国糖尿病协会筛查MA儿童的指南的适用性进行评估。

Over the past 5 years there have been reports of type 2 diabetes (DM2) in minority children in the U.S., including Mexican Americans (MA). Locally, in the past 3 years more MA children were seen with DM2 than type 1 diabetes (DM1), although the incidence of DM1 has not decreased. While the high prevalence and rising incidence of DM2, related risk factors and co-morbidities in MA adults is extensively documented, minimal information is available on the prevalence or incidence of these problems in MA children who share the same genetic heritage and live in the same environment. Even less is known about the natural progression from genetic risk to overt disease in children. Therefore, the specific aims of this proposal are to: 1. Determine the prevalence of risk factors, hyperinsulinism, impaired fasting glucose and diabetes in a homogenous group of approximately 2000 MA children 4th grade, 9 and 10 years of age) (Phase 1) 2. Explore the relationship between risk factors and glucose homeostasis abnormalities in approximately 300 MA children using a detailed clinical assessment and extensive biochemical investigations. The children will be in 3 subsets: impaired fasting glucose, high-risk, and low risk. (Phase 2). 3. Examine the temporal change in physical and biochemical parameters in the 3 subsets over 4-years (Phase 3). Children will be seen annually, because this is a period of dynamic physical change. Completion of the proposed studies will provide an estimate of the prevalence of glucose homeostasis abnormalities in MA children, increase understanding of the metabolic abnormalities at a relatively early age and stage, permit an examination of the natural progression of these abnormalities, and provide an assessment of the applicability of the new American Diabetes Association guidelines for screening MA children.