The Human Life Course and the Biodemography of Aging

描述(申请人提供)：这项建议的目标是检验一个普遍的假设，即由于沉重的传染病负担和低能量平衡，玻利维亚亚马逊地区的Tsimane Foager-园艺师比发达国家的人经历更多的心脏和肾脏感染损伤，但较少的血管疾病和代谢途径导致的糖尿病。齐曼人是玻利维亚的觅食园艺家，他们生活在没有电、没有自来水或垃圾处理的情况下，获得现代医学的机会极其有限。为了实现我们的目标，这次竞争性修订对现有的R01《人类生命历程和老龄化生物人口学》有三个具体目标。目标1是测量齐曼人的血管、心脏、肾脏和糖尿病疾病的患病率和发病率，齐曼人是一个生活在前现代背景下的觅食园艺社会。目的2是评估和测试关于炎症、感染和代谢因素在血管、心脏、糖尿病和肾脏疾病病因中的相对重要性的假说。目标3是分析社区内部和社区之间的差异，以评估生活方式变化和社会支持对疾病风险的身体、行为和心理社会影响。这个项目的增加将使我们能够 建立一个大样本成人的横截面和纵向轮廓，以模拟感染、饮食、体力活动、心理社会因素和器官功能之间的相互作用 以及在前现代、高度传染性的环境中达到成熟的人口中的损害。我们将使用多种方法(血清和尿液分析、心电图、心脏、肾脏和颈动脉超声，以及医学检查)来评估动脉粥样硬化、心脏和肾脏疾病以及糖尿病。由于齐曼人正在经历快速的变化，我们还将能够通过检查社区和个人层面上文化适应对心血管和肾脏疾病的影响，以及个人层面对饮食、体力活动和心理社会因素的估计，来评估群体内的差异。我们还将将我们的结果与美国和其他国家的结果进行比较，以评估炎症来源(无论是感染、吸烟还是肥胖)如何影响慢性病的发展以及其他因素，以及慢性病本身的性质在不同的生态制度和生活方式下如何变化。 与公共卫生相关：此次更新将提供有关南美前现代园艺人口中心脏和肾脏疾病性质的详细信息，这些人的人口状况与19世纪中叶的欧洲相似。在大量老年人中对动脉、心脏、肾脏和糖尿病疾病进行调查可以 揭示饮食、能量消耗、感染和炎症在包括当代美国人在内的广泛社会中对生理性衰老速度的相对贡献的独特见解。这一结果，再加上美国和印度尼西亚等其他人口的老龄化和疾病指标，可能有助于解释过去几个世纪以来预期寿命的历史性增长。

DESCRIPTION (provided by applicant): The goal of this proposal is to test the general hypothesis that due to the heavy burden of infectious disease and low energy balance, Tsimane forager-horticulturalists of the Bolivian Amazon experience more heart and kidney damage due to infection but less vascular disease and diabetes due to metabolic pathways than do people in developed nations. The Tsimane are Bolivian forager-horticulturalists that live with no electricity running water, or waste disposal, and have extremely limited access to modern medicine. To accomplish our goal, there are three specific aims of this competitive revision to the existing R01 "The Human Life Course and the Biodemography of Aging". Aim 1 is to measure the prevalence and incidence of vascular, heart, kidney and diabetic disease among the Tsimane, a forager-horticultural society living in a pre-modern context. Aim 2 is to assess and test hypotheses regarding the relative importance of inflammation, infection and metabolic factors on the etiology of vascular, heart, diabetic, and kidney disease. Aim 3 is to analyze within and among community variation to assess the physical, behavioral and psychosocial impacts of lifestyle change and of social support on disease risk. The addition of this project will allow us to build a cross-sectional and longitudinal profile of a large sample of adults to model interactions between infection, diet, physical activity, psychosocial factors and organ functioning and damage in a population that reached maturity in a pre-modern, highly infectious environment. We will employ a combination of methods (serum and urine analysis, electrocardiogram, ultrasound of heart, kidney and carotid artery, and medical exams) to assess atherosclerosis, heart and kidney disease and diabetes. As the Tsimane are undergoing rapid change, we will also be able to assess within-population variance by examining the effects of acculturation on cardiovascular and renal disease at the community and individual level, as well as individual-level estimates of diet, physical activity and psychosocial factors. We will also compare our results to those obtained in the U.S. and other countries, to assess differences in how source of inflammation, whether infection, smoking or obesity, can impact the development of chronic disease, along with other factors, and how the nature of chronic disease itself can vary under different ecological regimes and lifestyles. PUBLIC HEALTH RELEVANCE: This renewal will provide detailed information on the nature of heart and kidney disease in a pre-modern population of forager-horticulturalists of South America experiencing similar demographic conditions as those in mid-19th century Europe. Investigation of arterial, heart, kidney and diabetic disease in a large sample of older adults can reveal unique insights about the relative contributions of diet, energy expenditure, infection and inflammation on the rate of physiological aging in a wide range of societies including the contemporary American experience. The results, combined with measures of aging and disease in other populations such as the U.S. and Indonesia, may help to explain the historical increases in life expectancy over the past several centuries.