SOLAir: Environmental Factors and Diabetes Development in Latinos

项目摘要 糖尿病是一个主要的健康问题;在美国，近一半的成年人患有糖尿病或糖尿病前期。 糖尿病肥胖与2型糖尿病（T2 DM）发展之间的联系已得到充分表征， 但环境因素对2型糖尿病风险的影响知之甚少。越来越多的研究表明， 交通相关空气污染物（TRAP）增加了T2 DM的风险，特别是在脆弱的城市人群中， 但迄今为止的研究结果范围很广，或者在方法上有很大的局限性。其他 社区规模的环境因素，包括建筑和自然环境的各个方面， T2 DM的潜在风险或保护因素，可能通过与体力活动、饮食和 内脏肥胖这项研究将结合最先进的环境暴露评估， 健康措施和潜在混杂因素的数据，包括遗传易感性，以研究这些 关系-在一个全面的框架内-重点关注处于不成比例的风险中的快速增长的人口 2型糖尿病的风险，通过西班牙裔社区健康研究/拉丁裔研究（HCHS/SOL）队列。HCHS/SOL 提供了血糖控制的纵向评估沿着与广泛的临床，人体测量， 和心理社会因素，并于2020年初开始开始第三次全面临床检查。该提案增加了一个 对HCHS/SOL群组进行多维环境评估，有效利用计划的 考试和其他资助的辅助研究。通过空气污染监测和建模， 数据，GPS记录，遗传聚类分析和先进的地质统计学方法，该提案需要 测量身体活动（数量和位置）的特殊可用资源集的优势， 个体TRAP暴露、建筑环境特征、遗传易感性和健康指标 同时。“SOLAir”的目标是进行一系列假设驱动的、与政策相关的分析， 了解环境对T2 DM的影响，应用包括相互作用的理论框架 环境因素和体力活动之间的关系。 这项建议将针对以下目标：1）评估长期暴露于与交通有关的空气中是否 污染物（TRAP）增加了拉丁美洲人患糖尿病前期和T2 DM的风险; 2）确定环境如何 与体力活动相互作用的因素影响T2 DM风险; 3）检查环境因素是否 对通过遗传簇、表型特征和 代谢特征

Project Summary Diabetes mellitus is a major health problem; nearly half of adults in the U.S. have either diabetes or pre- diabetes. The link between adiposity and the development of Type 2 diabetes (T2DM) is well characterized, but less is known about the impact of environmental factors on risk of T2DM. Research increasingly implicates traffic-related air pollutants (TRAP) with increased risk of T2DM—especially in vulnerable urban populations, but studies thus far have wide ranges of results or have substantial methodological limitations. Other community-scale environmental factors, including aspects of the built and natural environment are also potential risk or protective factors for T2DM and may act through interactions with physical activity, diet and visceral adiposity. This study will incorporate state-of-the-art environmental exposure assessment with detailed health measures and data on potential confounders, including genetic susceptibility, to study these relationships---in a comprehensive framework—focusing on a fast-growing population at disproportionate risk of T2DM risk, through the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) cohort. HCHS/SOL provides a longitudinal assessment of glycemic control along with a broad range of clinical, anthropometric, and psychosocial factors, and begin a third comprehensive clinical exam in early 2020. This proposal adds a multi-dimensional environmental assessment to the HCHS/SOL cohort, effectively leveraging the planned examination and other funded ancillary studies. Through air pollution monitoring and modeling, accelerometry data, GPS logging, genetic cluster analysis, and advanced geostatistical approaches, the proposal takes advantage of extraordinary set of available resources to measure physical activity (amount and location), individual TRAP exposure, built environment features, genetic susceptibility, and health measures concurrently. The objective of “SOLAir” is a series of hypothesis-driven, policy-relevant analyses, to understand the environmental influences on T2DM, applying a theoretical framework that includes the interplay between environmental factors and physical activity. This proposal will address the following aims: 1) to assess whether long-term exposures to traffic-related air pollutants (TRAP) increase risk of pre-diabetes and T2DM among Latinos; 2) to determine how environmental factors interact with physical activity to influence T2DM risk; and 3) to examine whether environmental factors contribute differently to sub-types of T2DM identified by genetic clusters, phenotypic characteristics, and metabolomic features.