EVALUATION OF NIDDM RISK FACTORS IN THE CHEROKEES

糖尿病，特别是非胰岛素依赖型糖尿病（NIDDM）， 及其并发症已经成为一个日益重要的健康问题 这是许多美洲印第安人的问题。进展数据 早期NIDDM的危险因素很少。本申请提出 一项流行病学研究，以评估一些潜在的危险因素， 俄克拉荷马州的切罗基族成员中的NIDDM。分层 将从不同年龄和学位的受试者中抽取样本 从童年到成年都有印第安血统其中一些风险因素 也与心血管疾病有关，心血管疾病是心脏病的主要并发症， 糖尿病 该研究将使用伪队列设计来评估空腹血糖， 胰岛素，葡萄糖耐量，以及一些潜在的危险因素， NIDDM（和心血管疾病），如糖尿病家族史， 印度血液，肥胖，饮食，脂质和脂蛋白，身体的程度 活动，以及社会和经济因素，在5至40岁 年主要目的是（1）估计 肥胖、糖耐量受损（IGT）和糖尿病 40岁以上，（2）估计 这些变量从童年到成年，（3）以确定 危险因素与空腹血糖和胰岛素之间的关系， 和葡萄糖耐量之间的关系， 随着年龄的变化，（4）估计肥胖，升高的年龄范围 空腹血糖、葡萄糖耐受不良、胰岛素抵抗和异常 脂质和脂蛋白发生，（5）以确定程度的影响， 印度血对空腹血糖、胰岛素、葡萄糖耐受不良等 NIDDM（和CVD）的潜在危险因素，以及（6）基于 获得的信息，以建议教育方案和其他及时 预防措施，从而减少糖尿病的负担， 改善美国印第安人的健康状况。 1992年完成了一项有218名参与者参加的试验性研究， 来自NIDDK。通过试点研究，血液样本的物流 收集、运输、分析以及数据收集和分析已经 解决了根据评估结果确定的风险因素估计值 初步研究有助于确定样本量。 选择切罗基民族作为研究人群是因为其 糖尿病发病率高，印度血统程度不同， 会员资格，优秀的医疗保健设施，以及对 领导人和卫生专业人员之间的研究。

Diabetes, particularly non-insulin dependent diabetes mellitus (NIDDM), and its complications have become an increasingly important health problem for many American Indian populations. Data on the progression of NIDDM risk factors from early ages are scarce. This application proposes an epidemiologic study to evaluate a number of potential risk factors for NIDDM among members of the Cherokee Nation of Oklahoma. A stratified sample of subjects will be taken across a wide range of ages and degrees of Indian blood from childhood to adulthood. Some of these risk factors are also related to cardiovascular disease, a major complication of diabetes. The study will use a pseudo-cohort design to evaluate fasting glucose and insulin, glucose tolerance, and a number of potential risk factors for NIDDM (and cardiovascular disease), such as family history of diabetes, degree of Indian blood, obesity, diet, lipids and lipoproteins, physical activity, and social and economic factors, in the Cherokees aged 5 to 40 years. The major objectives are (1) to estimate the prevalence of obesity, impaired glucose tolerance (IGT), and diabetes in Cherokees less than 40 years of age, (2) to estimate the progressive differences in these variables from childhood to adulthood, (3) to determine the relationships between the risk factors and fasting glucose and insulin, and glucose tolerance at different ages and whether the relationships vary with age, (4) to estimate the age ranges in which obesity, elevated fasting glucose, glucose intolerance, insulin resistance, and abnormal lipids and lipoproteins occur, (5) to determine the effect of degree of Indian blood on fasting glucose, insulin, glucose intolerance, and other potential risk factors for NIDDM (and CVD), and (6) based on the information obtained, to recommend educational programs and other timely preventive measures and, consequently, reduce the burden of diabetes and improve the health status of American Indians. A pilot study of 218 participants was completed in 1992 with a planning grant from NIDDK. Through the pilot study, logistics of blood sample collection, transport, assay, and data collection and analysis have been worked out. Estimates of risk factors determined from the results of the pilot study facilitated sample size determination. The Cherokee Nation is selected as the study population because of its high prevalence of diabetes, varying degree of Indian blood, large membership, excellent health care facilities, and strong interest in research among the leaders and health professionals.