EPIDEMIOLOGY OF COMPLICATIONS OF NONINSULIN DEPENDENT DIABETES

非胰岛素依赖型糖尿病并发症的流行病学

• 批准号: 6162065
• 负责人: W C KNOWLER
• 金额: --
• 依托单位: NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/6162065
• 关键词: Native Americans; albuminuria; biomarker; blood chemistry; child (0-11); clinical research; coronary artery; diabetes mellitus genetics; diabetic angiopathy; diabetic nephropathy; diabetic neuropathy; diabetic retinopathy; electrocardiography; epidemiology; eye fundus photography; family genetics; gene environment interaction; human subject; hypertension; longitudinal human study; medical complication; noninsulin dependent diabetes mellitus; pathologic process; urinalysis

The purpose of this project is to determine the incidence rates, rates of progression, and risk factors for the chronic complications of NIDDM. The study is conducted in the Pima Indians of the Gila River Indian Community, who have participated in a longitudinal epidemiologic study since 1965 (see project Z01 DK 69000). Risk factors for the major complications of diabetes, retinopathy, nephropathy, and coronary artery disease, are determined by longitudinal follow-up of diabetic subjects. Methods of ascertainment of these complications include fundus photography, measurement of urine albumin and serum creatinine concentrations, and electrocardiography. Not only is the familial pattern of type 2 diabetes in the Pima Indians consistent with an effect of a major gene, but so is the pattern of diabetic nephropathy among the diabetic subjects. Statistical modeling of the risk of nephropathy as a function of duration of diabetes suggests the importance of a single gene. Linkage analyses among those persons who were part of a genome-wide linkage study (see project # Z01 DK 69028-09 PECR) suggest two possible locations for such a gene. It is hypothesized that one gene may influence ultimate susceptibility to nephropathy and the other the duration of diabetes necessary for its appearance. Despite the suggestion of genetic determinants of diabetic nephropathy, this complication is clearly influenced by a large number of factors. We have recently found that low concentrations of HDL cholesterol predict the onset of the early stages of nephropathy ("micro-albuminuria") in Pima women, but not men. Data from the Pima Indian study on the relationship between 2-hour post-load plasma glucose and complications have previously been very influential in the selection of internationally-accepted diagnostic criteria for diabetes. These observations have recently been expanded to include fasting plasma glucose and glycohemoglobin, and confirmatory findings have been made in other populations.

该项目的目的是确定发病率，费率 NIDDM的慢性并发症的进展和危险因素。 该研究是在吉拉河印第安人的皮马印第安人进行的 社区，参加了纵向流行病学研究 自1965年以来（请参阅项目Z01 DK 69000）。 主要因素 糖尿病，视网膜病，肾病和冠状动脉的并发症 疾病，由糖尿病患者的纵向随访确定。 确定这些并发症的方法包括眼底 摄影，尿白蛋白和血清肌酐的测量 浓度和心电图。 不仅是家族 PIMA印第安人中2型糖尿病的模式与效果一致 一个主要基因，但糖尿病性肾病的模式也是如此 糖尿病患者。 肾病风险的统计建模为 糖尿病持续时间的功能表明一个单一的重要性 基因。 属于的人之间的链接分析 全基因组链接研究（请参阅项目＃Z01 DK 69028-09 PECR）建议 这种基因的两个可能位置。 假设一个 基因可能会影响最终对肾病的敏感性 糖尿病的外观所需的持续时间。 尽管有 糖尿病性肾病的遗传决定因素的建议，这 并发症显然受大量因素的影响。 我们 最近发现低浓度的HDL胆固醇预测 肾病早期（“微α” 皮马妇女，但不是男人。 PIMA印度研究的数据 2小时后血浆葡萄糖与并发症之间的关系 以前在选择方面非常有影响力 糖尿病的国际认可的诊断标准。 这些 最近已经扩展了观察结果，包括禁食等离子体 已做出葡萄糖和Glyemoglobin，以及确认性发现 在其他人群中。