Building Infrastructure to Address Social, Cultural and Biological Determinants of Diabetes in Lebanon

建设基础设施以解决黎巴嫩糖尿病的社会、文化和生物决定因素

• 批准号: 10237378
• 负责人: Leonard E. Egede
• 金额: $ 18.97万
• 依托单位: AMERICAN UNIVERSITY OF BEIRUT
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-01 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10237378
• 关键词: Address; Adult; Affect; African; Aging; American; Attitude; Belief; Biological; Biological Factors; Biological Markers; Blood Glucose; Blood Pressure; Cardiovascular Diseases; Communities; Complications of Diabetes Mellitus; Cultural Backgrounds; Data; Developing Countries; Development; Diabetes Mellitus; Discipline; Disease; Disease Outcome; Disease Progression; Dyslipidemias; Economic Conditions; Economics; Education; Epigenetic Process; Etiology; Funding; Gender; Glycosylated hemoglobin A; Health; Health Status; High Prevalence; Home; Hunger; Hyperglycemia; Hypertension; Incidence; Income; Individual; Infrastructure; Institution; Interdisciplinary Study; Kidney Diseases; Knowledge; Lebanon; Life Expectancy; Life Style; Lipids; Marmota; Measures; Middle East; Non-Insulin-Dependent Diabetes Mellitus; Occupations; Outcome; Patients; Plant Roots; Plasma; Policies; Population; Population trends; Poverty; Prevalence; Prevention strategy; Prostate-Specific Antigen; Proteomics; Public Health; Research; Research Infrastructure; Resources; Retinal Diseases; Risk; Risk Factors; Role; Social Conditions; Social support; Socioeconomic Status; Surveys; Time trend; Transportation; Universities; Wisconsin; Work; base; burden of illness; cardiovascular disorder risk; cohort; connective tissue growth factor; diabetes education; evidence base; evidence based guidelines; health care availability; health care disparity; health management; macrovascular disease; medical schools; patient population; patient registry; productivity loss; proteomic signature; racism; response; social; social determinants; social factors; social health determinants; treatment strategy

ABSTRACT Diabetes is a major public health problem currently affecting over 40 million people living in the Middle East and North African (MENA) region. Lebanon is one of the MENA nations with a higher prevalence of diabetes than the regional average of 9.2%, estimated at 14.6% of adults in 2017. Despite this tremendous burden, the risk determinants that contribute to the development of diabetes and its serious microvascular (retinopathy and nephropathy) and macrovascular complications are not well understood. In response to the increasing impact of diabetes on the nation, Lebanon has created an operational policy for diabetes, however, there is no comprehensive Lebanese registry of patients with diabetes, no national survey in which blood glucose was measured, and only partial implementation of evidence-based guidelines for diabetes treatment. As a result, this patient population is largely uncharacterized, and the current preventative and treatment strategies remain sub- optimal. In addition, there is a paucity of information detailing the etiological factors of patients with type 2 diabetes, the status and determinants of their outcomes, or the time trends in incidence/prevalence of diabetes or disparities in care. While it is known that diabetes knowledge, attitudes, beliefs, social determinants, and biomarkers all have individual relationship with diabetes, the incremental influence of each of these factors on diabetes outcomes in the Lebanese adult population is unknown. Combining expertise across three institutions and multiple disciplines, we seek to understand the role of a variety of factors on diabetes outcomes, disease progression, and complications in Lebanese adults with type 2 diabetes through the following specific aims: (1) Build a multi-institutional and multi-disciplinary collaboration to address diabetes and cardiovascular disease (CVD) in the MENA region. (2) Identify the role of beliefs, knowledge and attitudes on diabetes and CVD risk factor control (HbA1c, blood pressure, lipid profile). (3) Determine the role of social determinants of health on diabetes and CVD risk factor control. (4) Identify biomarkers of disease progression and complications (such as CTGF and plasma prekallikrein) in individuals with diabetes and CVD risk factors. By investigating the role of cultural, social, and biological factors influencing diabetes outcomes in Lebanese adults, this study will provide an opportunity to build research infrastructure and capacity across multiple institutions and disciplines that will facilitate an application for R01 funding to investigate epigenetics and proteomics in Lebanese adults with diabetes.

摘要 糖尿病是一个主要的公共卫生问题，目前影响着生活在中东的4000多万人， 北非（MENA）地区。黎巴嫩是中东和北非地区糖尿病患病率高于 该地区的平均水平为9.2%，2017年估计为14.6%。尽管负担巨大， 导致糖尿病及其严重微血管（视网膜病变和 肾病）和大血管并发症还不清楚。为了应对日益增加的影响， 在全国糖尿病，黎巴嫩已经建立了糖尿病的业务政策，但是，没有 黎巴嫩糖尿病患者的全面登记，没有全国性的血糖调查， 测量，只有部分实施糖尿病治疗的循证指南。结果这个 患者人群在很大程度上是不确定的，目前的预防和治疗策略仍然不足， 最佳此外，缺乏详细说明2型糖尿病患者病因的信息。 糖尿病、其结局的状态和决定因素，或糖尿病发病率/患病率的时间趋势 或照顾上的差异。虽然众所周知，糖尿病知识、态度、信念、社会决定因素和 生物标志物都与糖尿病有个体关系，这些因素中的每一个对糖尿病的影响都是递增的。 黎巴嫩成年人群的糖尿病结局尚不清楚。整合三个机构的专业知识 和多学科，我们寻求了解各种因素对糖尿病结局，疾病， 黎巴嫩2型糖尿病成人的进展和并发症，通过以下具体目标：（1） 建立多机构和多学科合作，以应对糖尿病和心血管疾病 (CVD)在中东地区。(2)确定信念、知识和态度对糖尿病和心血管疾病风险的作用 因子控制（HbA 1c、血压、血脂）。(3)确定健康的社会决定因素在以下方面的作用： 糖尿病和CVD危险因素控制。(4)确定疾病进展和并发症的生物标志物（如 CTGF和血浆前激肽释放酶）。通过研究 文化，社会和生物因素影响黎巴嫩成年人糖尿病的结果，这项研究将提供 有机会在多个机构和学科建立研究基础设施和能力， 促进R 01资金的申请，以研究黎巴嫩成年人的表观遗传学和蛋白质组学， 糖尿病