Diabetes and Obesity in Mexican Pima Indians

1995年，NIDDK的凤凰流行病学和临床研究处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型糖尿病和肥胖症患病率的影响。墨西哥皮马人住在偏远山区的马科巴村，1995年他们的传统生活方式几乎没有改变。同样数量的非皮马裔墨西哥人居住在梅科巴。与墨西哥的皮马人相比，美国的皮马人生活在更加西化的社会中，他们的糖尿病患病率很高。调查发现，尽管糖尿病和肥胖症在墨西哥皮玛人中比非皮玛人更普遍，但两组墨西哥人患这些疾病的比例都明显低于美国皮玛人。

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. The prevalence of diabetes increased in non-Pima men and in both non-Pima and Pima women, but not in Pima men. Prevalence of obesity increased in all groups, and obesity was strongly associated with the number of modern technological features to which an individual had access, suggesting it is influenced by "modernization". Additional analyses of diet, physical activity and of genetic polymorphisms are currently underway.