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)， 它的并发症已经成为一个日益重要的健康问题 这对许多美国印第安人来说是个问题。关于中国经济发展的数据 早期的NIDDM危险因素很少。此应用程序建议 一项流行病学研究，以评估一些潜在的危险因素 俄克拉荷马州切诺基民族成员中的NIDDM。一个分层的 研究对象的样本将涵盖不同的年龄和学位。 从童年到成年的印第安人血统。其中一些风险因素 也与心血管疾病有关，心血管疾病是 糖尿病。 这项研究将使用伪队列设计来评估空腹血糖和 胰岛素、糖耐量和一些潜在的危险因素 NIDDM(和心血管疾病)，如糖尿病家族史， 印度人的血液程度，肥胖，饮食，血脂和脂蛋白，身体状况 5至40岁的切罗基人的活动以及社会和经济因素 好几年了。主要目标是：(1)评估艾滋病的流行情况 切诺基人的肥胖、糖耐量受损(IGT)和糖尿病 年龄在40岁以下，(2)估计在 从童年到成年的这些变量，(3)决定 危险因素与空腹血糖、胰岛素的关系 和不同年龄的糖耐量之间的关系 随年龄变化，(4)估计肥胖，升高的年龄范围 空腹血糖、糖耐量异常、胰岛素抵抗和异常 脂类和脂蛋白的发生，(5)判断影响的程度 印度血液对空腹血糖、胰岛素、糖耐量异常等的影响 NIDDM(和心血管疾病)的潜在风险因素，以及(6)基于 获取信息，及时推荐教育方案等 预防措施，从而减轻糖尿病的负担，并 改善美国印第安人的健康状况。 1992年完成了一项对218名参与者的初步研究，并计划 来自NIDDK的格兰特。通过试点研究，血样物流 收集、传输、化验以及数据收集和分析 已经解决了。根据调查结果确定的风险因素估计数 试点研究促进了样本量的确定。 切罗基民族之所以被选为研究人群，是因为它 糖尿病患病率高，不同程度的印度血液， 会员资格，一流的医疗设施，以及对 在领导和卫生专业人员中进行研究。

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.