Diabetes and Obesity in Mexican Pima Indians

1995年，NIDDK的凤凰城流行病学和临床研究分支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。同样数量的非皮马族墨西哥人生活在Maycoba。与墨西哥的皮马人相比，美国的皮马人生活在一个更加西化的社会，他们的糖尿病患病率很高。调查发现，尽管墨西哥皮马人的糖尿病和肥胖症比非皮马人更普遍，但墨西哥两个群体的糖尿病和肥胖症患病率都明显低于美国皮马人。 本项目是与来自北方亚利桑那大学和墨西哥埃莫西约的食品和营养研究中心的研究人员合作进行的。 目前正在Maycoba的皮马和非皮马居民中进行另一项调查，使用的方法与1995年调查相同，以确定自最初调查以来T2 DM、肥胖症和相关疾病的流行程度发生了多大变化。主要调查将试图招募尽可能多的Maycoba居民。在一个子集的人口（100人），休息和总能量消耗正在测量间接热量法使用通风罩和双标记水，分别。根据这些测量结果，将计算身体活动能量消耗。 还在不同的个人子集中进行了人种学调查，以收集有关健康信念、社区环境变化和口腔健康实践的信息。 在Maycoba的调查现已完成。 在主要调查中，共有657名Maycoba居民参加，其中369人至少有部分皮马血统。 这占Maycoba符合条件的皮马人人口的84%，占符合条件的非皮马人人口的81%。 糖尿病患病率在非Pima男性和非Pima和Pima女性中均增加，但在Pima男性中没有增加。 所有群体的肥胖患病率都有所增加，肥胖与个人获得的现代技术特征的数量密切相关，这表明它受到“现代化”的影响。目前正在对饮食、体力活动和遗传多态性进行进一步分析。初步分析表明，大多数已建立的2型糖尿病变异在墨西哥Pimas和亚利桑那Pimas之间的患病率没有差异;然而，在HLA上观察到频率的显着差异。

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 a 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. Preliminary analyses suggest that most established type 2 diabetes variants do not differ in prevalence between Mexican Pimas and Arizona Pimas; however a marked difference in frequency is observed at HLA.