Epidemiology of the gut microbiome, prediabetes and diabetes in Latinos

西班牙裔/拉丁裔人口是美国人口中快速增长的部分。糖尿病 对这个群体的影响不成比例。美国2007-09年的全国数据发现，20岁以上的西班牙裔（11.8%） 与非西班牙裔白人（7.1%）相比，糖尿病发病率高出66%。在以人口为基础的 西班牙裔社区健康研究（HCHS）/拉丁裔研究（SOL），糖尿病的基线患病率为 约17%。最近的数据表明，肠道微生物组（GMB）是 糖尿病由于不同的祖先群体具有不同的糖尿病相关GMB组， 有必要研究糖尿病发病率高的西班牙裔/拉丁裔人群，以确定 GMB和糖尿病之间的联系了解GMB与糖尿病的关系， 导致一个预防和治疗选择的新时代，特别是因为 这是针对GMB的。尽管如此，在了解艾滋病的流行病学方面仍存在重大差距。 GMB在人群中及其在糖尿病发展中的作用。拟议的研究将利用 HCHS/SOL研究将在2014-2017年重新检查参与者。这项研究的主要重点是 糖尿病，包括空腹2小时葡萄糖耐量试验（GTT），标准化和普遍接受的 葡萄糖代谢指标，以及其他特定的实验室和临床测量。这 拟议的辅助研究将检验以下假设，即肠道微生物组的特定模式将被 与糖尿病前期和糖尿病显著相关，建立在对糖尿病的最新认识基础上， GMB在人类健康和代谢疾病中的重要性。该项目将收集并确定 来自2,000名队列成员的粪便微生物组的遗传组成。拟议的研究已 建立了一个独特的多学科小组，以解决以下具体目标：（1）调查 流行病学因素影响不同年龄组的西班牙裔/拉丁裔个体样本中的肠道微生物组 具有正常碳水化合物代谢指标的背景。我们将测试 地理/祖先背景（例如，墨西哥人、波多黎各人）、美国出生状态、性别、年龄、BMI、共享 家庭和相关性，以及GBM组成的其他变量;（2）利用横截面 旨在评估肠道微生物组（GMB）与以下疾病的存在之间的关联： 碳水化合物代谢，包括糖尿病和前驱糖尿病;和（3）检查纵向 GMB与患糖尿病风险的关联。我们将在整个活动中积极跟进 队列，以确定患有糖尿病的个体，并估计与糖尿病相关的疾病的相对风险。 不同的微生物我们假设发现的微生物组与 目标2中的糖尿病将预测最初糖尿病前期和 血糖正常的个体。 1

The Hispanic/Latino population is the fasting growing segment of the US population. Diabetes disproportionately affects this group. National US 2007-09 data found that >20 yr old Hispanics (11.8%) have a 66% higher rate of diabetes compared to non-Hispanic whites (7.1%). In the population-based Hispanic Community Health Study (HCHS)/Study of Latinos (SOL), diabetes had a baseline prevalence of approximately 17%. Very recent data implicates the gut microbiome (GMB) as a key determinant of diabetes. Since different ancestral populations harbor different diabetes-associated sets of GMBs, it is necessary to study Hispanic/Latino populations with high rates of diabetes to determine the relationship between the GMB and diabetes. Understanding the relationship of the GMB to diabetes is anticipated to lead to a new era of prevention and treatment options, especially since therapeutic interventions are available that target the GMB. Nevertheless, there are major gaps in understanding the epidemiology of the GMB in the population and its role in the development of diabetes. The proposed study will leverage the HCHS/SOL study that will re-examine the participants in 2014-2017. This study has a major focus on diabetes including a fasting 2h glucose tolerance test (GTT), a standardized and universally accepted metric of glucose metabolism, in addition to specific other laboratory and clinical measurements. This proposed ancillary study will test the hypothesis that specific patterns of the gut microbiome will be significantly associated with pre-diabetes and diabetes, building upon recent advances in understanding the importance of the GMB in human health and metabolic diseases. This project will collect and determine the genetic composition of the fecal microbiome from 2,000 cohort members. The proposed study has developed a unique multidisciplinary team to address the following specific aims: (1) to investigate epidemiological factors affecting the gut microbiome in the sample of Hispanic/Latino individuals of diverse background who have normal indices of carbohydrate metabolism. We will test the association of geographic/ancestral background (e.g., Mexican, Puerto Rican), US birth status, gender, age, BMI, shared household and relatedness, and other variables with the GBM composition; (2) to utilize a cross-sectional design to evaluate the association of the gut microbiome (GMB) with the presence of disorders of carbohydrate metabolism including diabetes and prediabetes; and (3) to examine the longitudinal association of the GMB with risk of developing diabetes. We will use the active follow-up in the entire cohort to identify individuals who develop diabetes and estimate the relative risk of disease associated with different microbiomes. We hypothesize that the microbiomes found to be cross-sectionally associated with diabetes in Aim 2 will be predictive of the development of diabetes among initially pre-diabetic and normoglycemic individuals. 1