Genetic/Behavior/Lifestyle Risk-Diabetes Mexican-America

2型糖尿病是个人、家庭和人群的主要健康负担。某些人群似乎特别容易患2型糖尿病（T2DM）。在这些人群中，墨西哥裔美国人承担着不成比例的2型糖尿病负担。这一数字在过去20年里翻了一番，随着人口的快速增长和相对年轻人群的老龄化，以及2型糖尿病的早期发病，这一数字可能会进一步增加。2型糖尿病并发症的代价将越来越高，患者人数将越来越多，寿命将比我们迄今所见的更早。虽然对2型糖尿病的易感性长期以来一直被认为具有实质性的遗传成分，但我们假设也存在各种并发症的遗传成分。这些影响的风险因素还将包括一系列行为和生活方式的组成部分，这些因素目前尚不明确。我们现有的项目不仅检查了遗传成分，还检查了西班牙裔人群中与2型糖尿病相关的生活方式和社会经济因素。这些研究目前受限于参与者人数不足，这些参与者既可以跟踪其糖尿病的演变，也可以跟踪疾病进展时出现的并发症。我们尤其希望将我们的理解扩展到疾病发展的一些社会和行为因素之外，

Type 2 diabetes mellitus poses major health burdens for individuals, families, and populations. Particular populations appear to be especially vulnerable to type 2 diabetes (T2DM). Among these is the Mexican American population that bears a disproportionate burden of T2DM. This has doubled in the last 2 decades, and is likely to increase further with rapid population growth and aging of this relatively young population, and earlier onset of T2DM. There will be increasingly costly and debilitating consequences of complications of Type 2 diabetes in larger numbers of patients, and earlier in life than we have seen hitherto. While susceptibility to type 2 diabetes mellitus has long been known to have a substantial genetic component, we hypothesize that there are also genetic components of the various complications. Risk factors for these implications will also encompass a range of behavioral and life style components which are at presently ill-defined. Our existing program examines not only the genetic component, but also life style and socioeconomic factors associated with T2DM in the Hispanic population in a small cohort. These studies are currently limited by an insufficiently large population of participants who can be followed both for the evolution of their diabetes, as well as the complications arising as disease progresses. In particular we wish to expand our understanding beyond some of the social and behavioral components of disease progress, and in particular assess the contribution of anxiety and depression, which is little studied in Mexican Americans. To this end, we propose to expand the existing funded and approved cohort study we have established among the Mexican American population in the Lower Rio Grande Valley. We now have access to the sophisticated genome scanning studies which have proceeded rapidly and the human gene expression map is maturing. Our strategy is therefore to exploit the interaction of genomics with behavioral, socioeconomic and lifestyle measures to provide the most robust measures of the components which predispose and lead to T2DM and its complications. The identification of precise risk factors for T2DM and ts complications in a Mexican American cultural/gene interaction setting will be the most productive way to move from general to individual approaches to prevention of both disease and its many complications.