Diabetes and Obesity in Mexican Pima Indians

1995年，NIDDK的凤凰城流行病学和临床研究分会进行了一项横断面研究，以确定传统和西方环境对墨西哥和美国皮马印第安人2型糖尿病和肥胖症流行的影响。墨西哥皮马人生活在Maycoba村的一个偏远山区，1995年他们的传统生活方式几乎没有变化。同样数量的非皮马墨西哥人生活在梅科巴。与墨西哥皮马不同的是，美国皮马生活在更加西化的社会，糖尿病的患病率很高。调查发现，尽管糖尿病和肥胖症在墨西哥PIMA比非PIMA更普遍，但这两个墨西哥群体的这些疾病的患病率都明显低于美国PIMA。 本项目是与来自北亚利桑那大学和墨西哥Hermosillo的食品和食品调查中心的调查人员合作进行的。正在Maycoba的皮马居民和非皮马居民中进行另一项调查，使用1995年调查中使用的相同方法，以确定自第一次调查以来2型糖尿病、肥胖症和相关情况的流行程度发生了多大的变化。主要调查将试图招收尽可能多的梅科巴居民。在人群的一个子集(100个个体)中，休息和总能量消耗分别通过使用通风罩的间接量热法和双标记水来测量。根据这些测量结果，将计算出体力活动能量消耗。还在另一组个人中进行了一项人种学调查，以收集有关健康信念、社区环境变化和口腔健康做法的信息。 马科巴的调查现已完成。在主要调查中，共有657名梅科巴居民参加；其中369人至少有部分皮马血统。这占梅科巴合格皮马人口的84%，占合格非皮马人口的81%。初步分析表明，糖尿病和肥胖症的患病率在PIMA和非PIMA中都有所增加，而且两组之间的患病率几乎没有差异。目前正在对饮食、体力活动和遗传多态进行分析。

In 1995 the Phoenix Epidemiology and Clinical Research Branch of NIDDK conducted a cross-sectional study to identify the effects of traditional and western environments on prevalence of type 2 diabetes mellitus and obesity in Pima Indians in Mexico and the United States. The Mexican Pimas live in a remote mountainous region in the village of Maycoba and in 1995 had experienced little change from their traditional lifestyle. A similar number of non-Pima Mexicans live in Maycoba. In contrast to the Mexican Pimas, the U.S. Pimas live in more westernized society and they have a high prevalence of diabetes. The survey found that although diabetes and obesity were more prevalent in Mexican Pimas than non-Pimas, both Mexican groups had a significantly lower prevalence of these disorders than U.S. Pimas. The present project is being conducted in collaboration with investigators from Northern Arizona University and Centro de Investigacion en Alimentacion y Desarollo in Hermosillo, Mexico. Another survey is being undertaken among the Pima and non-Pima residents of Maycoba, using the same methods used in the 1995 survey, to determine the extent to which the prevalence of T2DM, obesity and related conditions have changed since the original survey. The main survey will attempt to enroll as many of the residents of Maycoba as possible. In a subset of the population (100 individuals), resting and total energy expenditure are being measured by indirect calorimetry using a ventilated hood and by doubly-labeled water, respectively. From these measurements, physical activity energy expenditure will be calculated. An ethnographic survey has also been conducted in a different subset of individuals to collect information about health beliefs, environmental changes in the community and oral health practices. The surveys in Maycoba have now been completed. In the main survey a total of 657 residents of Maycoba have participated; 369 of the individuals are of at least partial Pima heritage. This constitutes 84% of the eligible Pima population of Maycoba, and 81% of the eligible non-Pima population. Preliminary analyses suggest that the prevalence of diabetes and obesity has increased in both Pimas and non-Pimas, and that there are few differences in prevalence between the groups. Analyses of diet, physical activity and of genetic polymorphisms are currently underway.