DIABETES PREVENTION IN YUPIK ESKIMOS

尤皮克爱斯基摩人的糖尿病预防

基本信息

批准号：
2661267
负责人：
SVEN O EBBESSON
金额：
$ 24.51万
依托单位：
UNIVERSITY OF ALASKA FAIRBANKS
依托单位国家：
美国
项目类别：
财政年份：
1996
资助国家：
美国
起止时间：
1996-09-01 至 2000-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/2661267
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

项目摘要

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.

请求支持合作研究项目以确定干预措施可以在多大程度上降低糖尿病的患病率，尤皮克爱斯基摩人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西海岸。项目还将调查饮食模式、体力活动水平和人体测量数据并尝试将这些数据与发生的情况联系起来糖尿病、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，目前正在人口中收集相同的基线数据尤皮克爱斯基摩人横跨白令海峡，位于楚科奇半岛西伯利亚。非胰岛素依赖型糖尿病 (NIDDM) 的年龄调整患病率阿拉斯加的爱斯基摩人、印第安人和阿留申人总体增加了 11%， 1985 年至 1987 年两年期间每 1000 人 15.7 至 17.4（Schraer 等人，1988 年并正在出版）。 1987 年的比率从每 1000 人 6.7 人到 40.8 人不等阿拉斯加的各个印第安健康服务单位。这些估计是仅基于临床公认的病例。比较初步费率楚科奇原住民 15 岁及以上，我们发现 SL 劳伦斯岛比率为 9.7/1000，而楚科奇比率为 1/1000。自西伯利亚尤皮克语起楚科奇和阿拉斯加的爱斯基摩人在基因上密切相关工作假设是饮食和生活方式的差异导致糖尿病患病率的差异。我们相信这代表了一种独特的研究的机会，因为这些人群本质上是一个直到1948年，由于政治原因和生活方式而停止联系结果出现了分歧。最初，对圣劳伦斯岛的 800 名男女受试者进行了一项调查阿拉斯加西部将使用与其他非阿拉斯加原住民群体正在进行的强心脏研究美国人。调查之后将进行干预，其中一半的参与村庄将接受有关饮食的专门教育和风险因素，并将被鼓励：a）多吃传统食物， b) 减少饮食中营养密度低的食物，例如糖， c) 减少饱和脂肪的摄入量，以及 d) 增加体育锻炼。将根据建议和建议实施额外的干预措施来自社区的意见。 “控制”村庄将不会收到这些干预措施。在该补助金的第五年中，将通过仔细比较糖尿病和糖尿病患者来测试干预措施心血管危险因素，重复与期间相同的调查第一年。考虑到阿拉斯加爱斯基摩人开始放弃传统饮食和最近的生活方式，这项研究可能会导致通过提供对这一趋势的重要见解来扭转这一趋势 NIDDM 的病因学并确定致病生活方式可以改变一些因素来预防糖尿病。