Epidemiology of the gut microbiome, prediabetes and diabetes in Latinos

拉美裔/拉丁裔人口是美国人口中增长最快的部分。糖尿病 对这一群体的影响不成比例。美国2007-09年度的全国数据发现，20岁的拉美裔美国人(11.8%) 与非西班牙裔白人(7.1%)相比，糖尿病的发病率高出66%。在以人口为基础的 西班牙裔社区健康研究(HCHS)/拉丁裔研究(SOL)，糖尿病的基线患病率为 大约17%。最近的数据表明，肠道微生物群(GMB)是 糖尿病。由于不同的祖先拥有不同的糖尿病相关的GMB，所以 有必要对糖尿病发病率较高的西班牙裔/拉丁裔人群进行研究以确定两者之间的关系 GMB和糖尿病之间的关系。了解GMB与糖尿病的关系有望 导致预防和治疗选择的新时代，特别是在治疗干预措施 针对GMB的可用。然而，在理解猪流感的流行病学方面仍有很大差距。 GMB在人群中的作用及其在糖尿病发展中的作用。拟议的研究将利用 HCHS/SOL研究将在2014-2017年重新检查参与者。这项研究主要集中在 糖尿病包括空腹2小时糖耐量试验(GTT)，这是一项标准化和普遍接受的 除了特定的其他实验室和临床测量外，还可以测量葡萄糖代谢。这 拟议的辅助研究将检验肠道微生物组的特定模式将是 与糖尿病前期和糖尿病显著相关，建立在理解的最新进展基础上 GMB在人类健康和代谢性疾病中的重要性。该项目将收集和确定 来自2000名队列成员的粪便微生物组的遗传组成。拟议的研究已经 建立了一个独特的多学科团队，以解决以下具体目标：(1)调查 影响西班牙裔/拉丁裔不同种族样本肠道微生物群的流行病学因素 背景碳水化合物代谢指标正常的人群。我们将测试它们之间的关联 地理/祖先背景(例如墨西哥人、波多黎各人)、美国出生状况、性别、年龄、BMI、共享 家庭和关联度，以及与GBM组成的其他变量；(2)利用横截面 评估肠道微生物组(GMB)与存在的疾病的相关性的设计 碳水化合物代谢包括糖尿病和糖尿病前期；以及(3)检查纵向 GMB与发展为糖尿病的风险之间的关系。我们将在整个过程中积极跟进 队列以确定罹患糖尿病的个体并估计与以下疾病相关的相对风险 不同的微生物群。我们假设发现的微生物群横截面上与 AIM 2中的糖尿病将预测最初的糖尿病前期和 血糖正常的个体。 1

The Hispanic/Latino population is the fasting growing segment of the US population. Diabetes disproportionately affects this group. National US 2007-09 data found that >20 yr old Hispanics (11.8%) have a 66% higher rate of diabetes compared to non-Hispanic whites (7.1%). In the population-based Hispanic Community Health Study (HCHS)/Study of Latinos (SOL), diabetes had a baseline prevalence of approximately 17%. Very recent data implicates the gut microbiome (GMB) as a key determinant of diabetes. Since different ancestral populations harbor different diabetes-associated sets of GMBs, it is necessary to study Hispanic/Latino populations with high rates of diabetes to determine the relationship between the GMB and diabetes. Understanding the relationship of the GMB to diabetes is anticipated to lead to a new era of prevention and treatment options, especially since therapeutic interventions are available that target the GMB. Nevertheless, there are major gaps in understanding the epidemiology of the GMB in the population and its role in the development of diabetes. The proposed study will leverage the HCHS/SOL study that will re-examine the participants in 2014-2017. This study has a major focus on diabetes including a fasting 2h glucose tolerance test (GTT), a standardized and universally accepted metric of glucose metabolism, in addition to specific other laboratory and clinical measurements. This proposed ancillary study will test the hypothesis that specific patterns of the gut microbiome will be significantly associated with pre-diabetes and diabetes, building upon recent advances in understanding the importance of the GMB in human health and metabolic diseases. This project will collect and determine the genetic composition of the fecal microbiome from 2,000 cohort members. The proposed study has developed a unique multidisciplinary team to address the following specific aims: (1) to investigate epidemiological factors affecting the gut microbiome in the sample of Hispanic/Latino individuals of diverse background who have normal indices of carbohydrate metabolism. We will test the association of geographic/ancestral background (e.g., Mexican, Puerto Rican), US birth status, gender, age, BMI, shared household and relatedness, and other variables with the GBM composition; (2) to utilize a cross-sectional design to evaluate the association of the gut microbiome (GMB) with the presence of disorders of carbohydrate metabolism including diabetes and prediabetes; and (3) to examine the longitudinal association of the GMB with risk of developing diabetes. We will use the active follow-up in the entire cohort to identify individuals who develop diabetes and estimate the relative risk of disease associated with different microbiomes. We hypothesize that the microbiomes found to be cross-sectionally associated with diabetes in Aim 2 will be predictive of the development of diabetes among initially pre-diabetic and normoglycemic individuals. 1