Vascular function, cardiovascular disease biomarkers and the Latino paradox

拉丁美洲人的健康悖论困扰着研究人员，因为它似乎太好了，不可能是真的： 为资源较少的个人提供服务。为什么文化适应在美国的规范，尽管是 伴随着获得卫生资源和收入的机会增加，似乎导致健康状况恶化 成果？到目前为止，文化适应和健康风险的研究主要集中在行为因素上，而不是 生理表型上。公共卫生迫切需要深入了解心血管疾病 拉丁美洲人的健康，尤其是墨西哥裔美国人，这是一个越来越容易患肥胖相关合并症的族群 但对心血管危险因素研究不足。这个跨学科的项目将决定 不同世代和移民身份的年轻人和老年人的心血管功能， 增加对拉丁美洲文化适应悖论的基础的理解。来自100个家庭的200名受试者， 东洛杉矶，包括一个家庭成员从两个老一代和年轻一代将 注册了该项目的目的是1）评估心血管表型，包括动脉僵硬度， 拉丁美洲家庭的内皮功能、心血管危险因素和代谢综合征; 2）评估 拉丁裔悖论在这些家庭中的程度，基于他们的代际地位， 文化适应的水平。将在基线和24个月随访后确定测量值。的 主要结果是通过压平张力计测量的动脉硬度。次要结局包括 通过肱动脉血流介导的舒张来改善内皮功能， 运动试验和心血管疾病风险生物标志物，包括内皮功能障碍标志物 （可溶性细胞内粘附分子-1和E-选择素）、氧化应激（氧化的LDL和 髓过氧化物酶）、全身性炎症（C-反应蛋白）和纤维蛋白溶解。需要取得的其他成果 测试的假设包括代谢综合征的组成部分，饮食，体力活动水平和措施， 文化适应如果我们的假设是支持的，更重要的可能是把文化适应， 在设计旨在改善拉丁美洲人心血管健康的生活方式改变干预措施时，

The Latino health paradox intrigues researchers because it seems too good to be true: Better health outcomes for individuals with fewer resources. Why does acculturation to norms in the US, despite being accompanied by increased access to health resources and income, seem to contribute to worse health outcomes? To date, the study of acculturation and health risk has focused on behavioral factors, rather than on physiological phenotypes. There is an urgent public health need to gain insight into the cardiovascular health of Latinos, especially Mexican-Americans, an ethnic group increasingly prone to obesity-related comorbidities but understudied for cardiovascular risk factors. This interdisciplinary project will determine cardiovascular function in younger and older related adults varying in generational and immigrant status to increase understanding of the basis for the Latino acculturation paradox. 200 subjects from 100 families in East Los Angeles, including one family member from both an older and a younger generation will be enrolled. The project aims are to 1) Evaluate cardiovascular phenotypes, including arterial stiffness, endothelial function, cardiovascular risk factors and metabolic syndrome in Latino families; and 2) Evaluate the extent to which the Latino paradox holds within these families, based on their generational status and level of acculturation. Measurements will be determined at baseline and after 24 months follow-up. The primary outcome is arterial stiffness measured by applanation tonometry. Secondary outcomes include endothelial function via brachial artery flow-mediated dilation, cardiorespiratory fitness via incremental exercise test, and cardiovascular disease risk biomarkers including markers of endothelial dysfunction (soluble intracellular adhesion molecule-1 and E-selectin), oxidative stress (oxidized LDL and myeloperoxidase), systemic inflammation (C-reactive protein), and fibrinolysis. Other outcomes required to test the hypotheses include components of metabolic syndrome, diet, physical activity level and measures of acculturation. If our hypotheses are supported, more importance may be placed on taking acculturation into account when designing lifestyle change interventions designed to improve Latino cardiovascular health.