DIABETES PREVENTION IN YUPIK ESKIMOS

尤皮克爱斯基摩人的糖尿病预防

• 批准号: 2328524
• 负责人: SVEN O EBBESSON
• 金额: $ 2.5万
• 依托单位: UNIVERSITY OF ALASKA FAIRBANKS
• 依托单位国家: 美国
• 财政年份: 1993
• 资助国家: 美国
• 起止时间: 1993-09-10 至 2000-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2328524
• 关键词: Alaskan Native American; behavioral /social science research tag; cardiovascular disorder; disease /disorder prevention /control; disease /disorder proneness /risk; electrocardiography; exercise; health behavior; health surveys; human subject; hyperinsulinism; interview; lifestyle; noninsulin dependent diabetes mellitus; nutrition; nutrition related tag; respiratory airflow measurement

Support is requested for a collaborative research project to determine to what extent intervention can decrease the prevalence of diabetes, hyperinsulinemia, and cardiovascular risk factors among Yupik Eskimos living on St. Lawrence Island and the west coast of Alaska. The project would also investigate dietary patterns, physical activity levels, and anthropometric data and attempt to correlate these with the occurrence of diabetes, cardiovascular risk factors, diabetes complications, and insulin levels. As part of the ongoing Alaska-Siberia Medical Research Program, identical baseline data are currently being gathered in the population of Yupik Eskimos across the Bering Straits on the Chukotka Peninsula in Siberia. Age-adjusted prevalence of non-insulin dependent diabetes mellitus (NIDDM) among Alaska's Eskimos, Indians, and Aleuts overall increased 11%, from 15.7 to 17.4 per 1000 over the two-year period form 1985 to 1987 (Schraer et al., 1988 and in press). Rates in 1987 varied from 6.7 to 40.8 per 1000 in various Indian Health Service units in Alaska. These estimates are based only on clinically recognized cases. Comparing preliminary rates to Chukotka Natives 15 years and older, we find that the SL Lawrence Island rate is 9.7/1000 while the Chukotka rate is 1/1000. Since Siberian Yupik Eskimos of Chukotka and Alaska are genetically closely related, our working hypothesis is that dietary and lifestyle differences account for the difference in diabetes prevalence. We believe this represents a unique opportunity for research since these populations were essentially one until 1948, when contact ceased due to political reasons, and lifestyles diverged as a result. Initially, a survey of 800 subjects of both sexes on St. Lawrence Island and western Alaska will be carried out using similar methodology as in the ongoing Strong Heart Study among other non-Alaskan groups of Native Americans. The surveys will be followed by an intervention in which half of the participating villages will receive specific education about diet and risk factors and will be encouraged to: a) eat more traditional foods, b) decrease foods with low nutrient density such as sugar in their diet, c) decrease intake of saturated fats, and d) increase physical exercise. Additional interventions will be implemented, based on recommendations and input from the community. The "control" villages will not receive these interventions. During the fifth year of this grant the effectiveness of the interventions will be tested by a careful comparison of diabetes and cardiovascular risk factors, repeating the same survey as given during year 1. Considering that the Alaskan Eskimos began abandoning traditional diets and lifestyles only recently, it is possible that the study might lead to a reversal in this trend by providing significant insights into the etiology of NIDDM and lead to identification of the causative lifestyle factors that can be modified to prevent diabetes.

请求支持一个协作研究项目，以确定 干预措施可以降低糖尿病的患病率， Yupik Eskimos中的高胰岛素血症和心血管危险因素 居住在圣劳伦斯岛和阿拉斯加的西海岸。项目 还将研究饮食模式，体育活动水平和 人体测量数据，并试图将这些数据与出现 糖尿病，心血管危险因素，糖尿病并发症和胰岛素 水平。作为正在进行的阿拉斯加 - 西伯利亚医学研究计划的一部分， 目前正在收集相同的基线数据 Yupik Eskimos横跨Chukotka半岛的白仓海峡 西伯利亚。 非胰岛素依赖性糖尿病（NIDDM）的年龄调整的患病率 在阿拉斯加的爱斯基摩人中，印第安人和阿留勒特人总体上增长了11％，从 1985年至1987年，在两年期间的15.7至17.4 等人，1988年，印刷中）。 1987年的费率从每1000次从6.7到40.8 在阿拉斯加的各种印度卫生服务部门中。这些估计是 仅基于临床认可的病例。比较初步费用 Chukotka本地人15岁以上，我们发现SL Lawrence Island 费率为9.7/1000，而Chukotka速率为1/1000。自西伯利亚Yupik以来 Chukotka和Alaska的Eskimos在遗传上密切相关，我们 工作假设是饮食和生活方式差异解释了 糖尿病患病率的差异。我们相信这代表了一个独特的 研究机会，因为这些人口本质上是一个 直到1948年，由于政治原因和生活方式，联系停止 结果差异。 最初，对圣劳伦斯岛的800名受试者进行了调查 和阿拉斯加西部将使用与 其他非阿拉斯加人的心脏研究正在进行 美国人。调查将进行干预，其中一半 参与的村庄将获得有关饮食的特定教育 和风险因素，并将鼓励：a）吃更多传统食物， b）减少营养密度低的食物，例如饮食中的糖， c）减少饱和脂肪的摄入量，d）增加体育锻炼。 将根据建议和 社区的输入。 “控制”村庄不会收到这些 干预措施。在这笔赠款的第五年中 干预措施将通过仔细比较糖尿病和 心血管危险因素，重复与期间相同的调查 1年。 考虑到阿拉斯加爱斯基摩人开始放弃传统饮食 和生活方式直到最近，研究可能会导致 通过对这种趋势的逆转，通过对 NIDDM的病因，并导致鉴定因果关系 可以修改以防止糖尿病的因素。