BASIS FOR TYPE 2 DIABETES DISPARITY IN AMERICAN INDIAN YOUTH

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。为什么美国印第安人的2型糖尿病患病率是高加索人的2-3倍，在理解这一点上存在根本性的差距。本应用程序的目的是获得有关美国印第安儿童的胰岛素敏感性、脂肪量和心血管健康的数据。这些变量在两年内的变化模式将在一组至少有一个一级亲属确诊为2型糖尿病的肥胖美国印第安人和高加索儿童中进行检查。三个具体目标是：1)比较肥胖的美国印第安儿童和相似的高加索儿童两年内胰岛素敏感性的变化率。2)比较一组肥胖的美国印第安儿童和一组类似的高加索儿童在两年内脂肪质量和分布的变化率。3)比较一组肥胖的美国印第安儿童和一组相似的高加索儿童在两年内心血管健康的变化率。这种方法是创新的，因为代谢和生理机制的时间差异导致美国印第安人2型糖尿病发病率更高的概念尚未完全了解。这项提议的研究意义重大，因为这项研究的结果有望导致基于机械的研究，重点关注最可能的时间候选者。预计更明确的重点将加快建立因果关系的步伐，从而加快开发和实施新的干预措施和战略的速度，以降低美国印第安人社区患2型糖尿病的风险。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. There is a fundamental gap in understanding why the prevalence of type 2 diabetes is 2-3 times higher in American-Indians than in Caucasians. The objective of this application is to obtain data pertinent to insulin sensitivity, fat mass, and cardiovascular fitness among American-Indian children. The pattern of change in these variables over two-years will be examined in a group of obese American-Indian and Caucasian children with at least one first-degree relative with confirmed type 2 diabetes. The three specific aims are: 1) Compare the rate of change in insulin sensitivity over a two-year period in a cohort of obese American Indian children and a similar cohort of Caucasian children. 2) Compare the rate of change in the mass and distribution of fat over a two-year period in a cohort of obese American-Indian children and a similar cohort of Caucasian children. 3) Compare the rate of change in cardiovascular fitness over a two-year period in a cohort of obese American-Indian children and a similar cohort of Caucasian children. The approach is innovative because the concept that temporal differences in metabolic and physiologic mechanisms contributing to the greater incidence of type 2 diabetes in American-Indians has yet to be fully understood. The proposed research is significant because the results of this study are expected to lead to mechanistically based research that focuses on the most likely temporal candidates. The sharper focus is expected to accelerate the pace at which causal relationships are established and, therefore, the speed with which new interventions and strategies can be developed and implemented to reduce the risk of type 2 diabetes to the American-Indian community.