The Pacific Ocean Native Observational (PONO) Health Legacy Study

项目总结 夏威夷是美国种族最多元化的州。夏威夷土著(NH)、太平洋岛民(PI)和亚洲人 美国人(ASA)占该州人口的近70%，其人口占全美NHPI的50%。 这项UG3/UH3提案将建立一个新的预期的、多代人的队列来进行调查 夏威夷NH和密克罗尼西亚人的心肺和代谢(CPM)健康。这两个截然不同但 在未得到充分研究的情况下，亚人群对CPM疾病结局的负担过重。糖尿病(DM) 发生在28%的NHPI和37%的糖尿病前期(&gt；20yo.)，这表明&gt；50%的NHPI有DM的风险或处于DM的风险中。 合并糖尿病的NHPI患者的心血管疾病死亡率是非糖尿病患者的4倍。心脑血管疾病死亡是 NHPI中的死亡。尽管在NHPI和CPM之间进行了数十年的临床和干预研究，但健康不平等 基本保持不变，在年轻的NH和PI人群中呈上升趋势。我们的提议，太平洋 原生观察性(PONO)健康遗产研究将直接面对方法学挑战(即 种族聚集、样本量小等)之前的NHPI研究，并将进行创新、技术驱动 “大众经济学”方法改变NH和PI之间CPM健康差距的进程。我们的方法建立在 在一支强大的跨学科科学和社区领导者团队中，他们带来了数十年的社区经验， 临床、流行病学和表观基因组学专业知识。我们将与协调中心密切合作， 最大限度地提高ASA-NHPI队列的整体能力，以进行多假设检验的研究。我们的特定 AIMS(S.A.)详情如下： 美国#1(UG3)：建立一个以预期、社区参与、多代人为基础的人口 对夏威夷2500名夏威夷原住民和太平洋岛民的队列研究。我们长期的合作伙伴关系 以临床和社区为基础的小组已做好准备，热衷于招募、保留和实施标准化 数据&将投资于子孙后代健康的生物标本收集。 S.A.#2(UH3)：描述风险和复原力因素与临床血液基础的关系 代谢和免疫功能的生物标记物与CPM条件相关。确定流行率 CPM亚临床疾病&应用CPM进行多水平风险与复原力因素的关联研究 条件。 S.A.#3(UH3)：评估CPM相关风险和复原力因素对事件CPM的影响- 在夏威夷和大陆的NH和PI人群之间随时间测量的结果-- NHPI队列研究。确定与多级别风险/复原力因素相关的CPM结果的发生率 将数据与整个AsANHPI队列中的相关亚群进行比较。 Pono研究的总体影响是它有可能通过以下方式改变健康差距研究 在美国AsanHPI有代表性的人群中采用新的“大众经济学”方法。

PROJECT SUMMARY Hawai‘i is the most ethnically diverse state in the US. Native Hawaiians (NH), Pacific Islanders (PI) and Asian Americans (AsA) account for nearly 70% of the state’s population & it is home to >50% of all NHPI in the US. This UG3/UH3 proposal will establish a new prospective, multi-generational cohort to investigate cardiopulmonary & metabolic (CPM) health among NH & Micronesian PI in Hawai‘i. These 2 distinct, yet understudied, sub-populations have an excess burden of CPM disease outcomes. Diabetes mellitus (DM) occurs in 28% and preDM in 37% of NHPI (>20y.o.), suggesting >50% of NHPI have or are at-risk for DM. CVD mortality is 4-fold higher in NHPI with DM compared with nonDM. CVD mortality is the leading cause of death among NHPI. Despite decades of clinical & intervention studies among NHPI, CPM health inequities remain largely unchanged & is increasing among younger NH and PI people. Our proposal, the Pacific Ocean Native Observational (PONO) Health Legacy Study, will directly confront methodological challenges (i.e. racial aggregation, small sample size, etc.) of prior NHPI studies & will conduct innovative, technology-driven “populomics” approaches to change the course of CPM health disparities among NH & PI. Our approach builds on a strong interdisciplinary team of scientific & community-based leaders who bring decades of community, clinical, epidemiological & epigenomic expertise. We will work closely with the Coordinating Center to maximize the overall AsA-NHPI cohort’s ability to conduct studies of multiple hypotheses testing. Our specific aims (S.A.) are as follows: S.A.#1 (UG3): Establish a prospective, community-engaged, multi-generational population-based cohort study of 2,500 Native Hawaiians and Pacific Islanders in Hawai‘i. Our longstanding partnerships with clinical & community-based groups are primed & enthusiastic to recruit, retain & conduct standardized data & biological specimen collection that will invest in the health of future generations. S.A. #2 (UH3): Characterize the relationship of risk and resilience factors with clinical blood-based biomarkers of metabolic and immunologic function relevant to CPM conditions. Determine prevalence of CPM subclinical disease & conduct association studies of multi-level risk & resilience factors by CPM conditions. S.A. #3 (UH3): Assess the impact of CPM-associated risk and resilience factors on incident CPM- outcomes measured over time between Hawai‘i and continental populations of NH and PI in the AsA- NHPI cohort study. Determine incidence of CPM outcomes associated with multi-level risk/resilience factors & to compare data with relevant subpopulations in the overall AsANHPI cohort. The overall impact of the PONO study is its potential to transform health disparity research through novel “populomics” approaches in a representative population of AsANHPI in the US.