Association of Acculturation with Type 2 Diabetes Risk Among US Latinos

描述（由申请人提供）：2型糖尿病（T2D）及其长期后遗症的发病率在美国正在增加，尤其是在拉丁美洲人中。与非西班牙裔白人相比，拉美裔人患肥胖和2型糖尿病（T2D）的风险更高，且发病年龄更小，体重指数更低。由于这些原因，拉丁美洲人已被确定为NIDDK的优先人群，NIDDK的研究议程包括影响T2D患病率和并发症的生物、社会经济和社会文化因素。文化适应是一个重要的社会文化因素，可以解释拉丁美洲人的T2D不成比例的健康负担。文化适应被定义为移民文化接受东道国文化的信仰和习俗的过程。关于T2D危险因素和文化适应以及这种关系如何影响T2D中间过程和结果（如偶发性T2D和亚临床心血管疾病）的研究有限。在已发表的文献中，文化适应与T2D之间的关系在拉丁美洲人中并不一致。这项拨款将研究文化适应与T2D风险和风险因素的关系，使用来自多个完善的流行病学NIH队列研究的数据，使用经过验证的多维文化适应量表，捕捉文化价值观，信仰和文化适应过程的行为的复杂领域。这5个队列是：圣安东尼奥心脏研究、萨克拉门托拉丁裔老龄化研究、波士顿地区社区健康调查、达拉斯心脏研究和弗雷明汉心脏研究全队列。同时比较研究结果将最大限度地探索先前研究结果的异质性是否由于潜在的拉丁裔队列特征的差异，美国文化适应过程中的地理差异和/或文化适应测量的差异。洛佩兹博士的长期目标是成为一名独立的以患者为导向的糖尿病护理研究员。在K23奖励期间，通过生物统计学和社会流行病学的高级课程，Lopez博士将在国内和国际知名研究人员的指导下，在一个支持性的学术环境中获得额外的研究技能和经验。1

DESCRIPTION (provided by applicant): The incidence of type 2 diabetes (T2D) and its long term sequelae are increasing in the US, particularly among Latinos. Latinos are at increased risk for obesity and type 2 diabetes (T2D) and develop T2D at younger ages and at a lower body weight index compared to non-Hispanic whites. For these reasons, Latinos have been identified as a NIDDK priority population with a NIDDK research agenda that includes both biologic, socioeconomic and sociocultural factors that affect T2D prevalence and complications. Acculturation is an important socio-cultural factor that may explain the disproportionate health burden of T2D among Latinos. Acculturation is defined as the process whereby an immigrant culture adopts the beliefs and practices of a host culture. There are limited studies of T2D risk factors and acculturation and how this relationship affects intermediary T2D processes and outcomes such as incident T2D and subclinical cardiovascular disease. The association between acculturation and T2D is inconsistent among Latinos in the published literature. This grant will study the association of acculturation with T2D risk and risk factors using data from multiple well- established epidemiologic NIH cohort studies using validated multidimensional acculturation scales that capture the complex domains of cultural values, beliefs, and behaviors of the acculturation process. The 5 cohorts are: San Antonio Heart Study, Sacramento Latino Study of Aging, Boston Area Community Health Survey, Dallas Heart Study and the Framingham Heart Study Omni Cohort. The simultaneous comparison of findings will maximize the potential for exploring whether the reported heterogeneity of prior study findings is due to differences in underlying Latino cohort characteristics, geographic differences in the process of acculturation in the US and/or differences in the measure of acculturation. Dr. Lopez's long-term goal is to become an independent patient-oriented researcher in diabetes care. Aided by advanced coursework in biostatistics and social epidemiology during the K23 award period, Dr. Lopez will acquire additional research skills and experience under the mentorship of nationally and internationally known researchers in a supportive academic environment. 1