Vascular function, cardiovascular disease biomarkers and the Latino paradox

拉丁裔健康悖论引起了研究人员的兴趣，因为它似乎好得令人难以置信：更好的健康 资源较少的个人的结果。为什么文化适应美国的规范，尽管 伴随着获得卫生资源和收入的增加，似乎会导致健康状况恶化 结果呢？到目前为止，文化适应和健康风险的研究主要集中在行为因素上，而不是 生理表型。公共卫生迫切需要深入了解心血管疾病 拉丁美洲人，特别是墨西哥裔美国人的健康状况，这一族群越来越容易患上与肥胖有关的合并症 但对心血管危险因素的研究不足。这个跨学科的项目将决定 不同世代和移民状况的年轻和老年相关成年人的心血管功能 增加对拉丁裔文化适应悖论的基础的理解。来自100个家庭的200名受试者 东洛杉矶，包括一名来自老一辈和年轻一代的家庭成员将是 已注册。该项目的目的是1)评估心血管表型，包括动脉僵硬， 拉丁裔家庭的内皮功能、心血管危险因素和代谢综合征；以及2)评估 拉丁裔悖论在这些家庭中的存在程度，基于他们的世代地位和 文化适应程度。测量将在基线时确定，并在24个月后进行随访。这个 主要结果是通过压平眼压计测量动脉僵硬。次要结果包括 通过肱动脉血流介导的扩张实现内皮功能，通过递增实现心肺功能 运动试验和心血管疾病风险生物标记物，包括内皮功能障碍的标记物 (可溶性细胞间黏附分子-1和E-选择素)，氧化应激(氧化型低密度脂蛋白和 髓过氧化物酶)、全身炎症(C反应蛋白)和纤溶。所需的其他结果 检验假设包括代谢综合征的组成部分、饮食、体力活动水平和 文化适应。如果我们的假设得到支持，那么将文化适应放在更重要的位置上。 在设计旨在改善拉丁裔心血管健康的生活方式改变干预措施时考虑到这一点。

The Latino health paradox intrigues researchers because it seems too good to be true: Better health outcomes for individuals with fewer resources. Why does acculturation to norms in the US, despite being accompanied by increased access to health resources and income, seem to contribute to worse health outcomes? To date, the study of acculturation and health risk has focused on behavioral factors, rather than on physiological phenotypes. There is an urgent public health need to gain insight into the cardiovascular health of Latinos, especially Mexican-Americans, an ethnic group increasingly prone to obesity-related comorbidities but understudied for cardiovascular risk factors. This interdisciplinary project will determine cardiovascular function in younger and older related adults varying in generational and immigrant status to increase understanding of the basis for the Latino acculturation paradox. 200 subjects from 100 families in East Los Angeles, including one family member from both an older and a younger generation will be enrolled. The project aims are to 1) Evaluate cardiovascular phenotypes, including arterial stiffness, endothelial function, cardiovascular risk factors and metabolic syndrome in Latino families; and 2) Evaluate the extent to which the Latino paradox holds within these families, based on their generational status and level of acculturation. Measurements will be determined at baseline and after 24 months follow-up. The primary outcome is arterial stiffness measured by applanation tonometry. Secondary outcomes include endothelial function via brachial artery flow-mediated dilation, cardiorespiratory fitness via incremental exercise test, and cardiovascular disease risk biomarkers including markers of endothelial dysfunction (soluble intracellular adhesion molecule-1 and E-selectin), oxidative stress (oxidized LDL and myeloperoxidase), systemic inflammation (C-reactive protein), and fibrinolysis. Other outcomes required to test the hypotheses include components of metabolic syndrome, diet, physical activity level and measures of acculturation. If our hypotheses are supported, more importance may be placed on taking acculturation into account when designing lifestyle change interventions designed to improve Latino cardiovascular health.