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Brown SA, Winter MA, Becker HA, García AA, Velasquez MM, Tanaka H, Perkison WB, Brown EL, Aguilar D, Hanis CL. Transitioning From an In-Person Intervention to Augmented Text Messaging During COVID-19 in Mexican Americans With Prediabetes: The Starr County Diabetes Prevention Randomized Clinical Trial. Sci Diabetes Self Manag Care 2024; 50:107-115. [PMID: 38454633 PMCID: PMC11062239 DOI: 10.1177/26350106241233475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
PURPOSE The purpose of the study was to explore the feasibility of using commonly available technology, such as text messaging, for diabetes prevention in rural Mexican American communities during COVID-19. METHODS Participants were selected from a diabetes prevention study funded by the National Institutes of Health that, prior to COVID-19, involved in-person group intervention sessions. Participants were predominantly female adults born in Mexico and Spanish-speaking. A subsample (n = 140) was divided into 3 cohorts: (1) 50 who completed the initial in-person intervention prior to the COVID-19 research pause, (2) 60 who needed additional support sessions to complete the intervention and thus received 10 text messages with links to relevant online diabetes prevention videos (TM+), and (3) 30 who received enhanced usual care involving health guidance offered during data collection (control). Repeated measures analysis of covariance was used to evaluate cohort differences at 24 months post baseline. RESULTS No significant cohort differences were found for depression, eating self-efficacy, alcohol intake, fat avoidance, or sedentary behaviors. Differences in A1C showed both in-person and TM+ cohorts having lower mean A1C levels (5.5%) than the control cohort (5.7%). The TM+ cohort had lower body mass index than other cohorts and a lower diabetes conversion rate (22.2%) compared to the control cohort (28%). Participants indicated preferences for in-person/TM+ combination interventions. The strongest positive feedback was for the TM+ intervention cooking demonstration videos. CONCLUSIONS Augmented text messaging combined with in-person sessions had similar outcomes to the all in-person strategy and thus has the potential for expanding the reach of diabetes prevention to many Mexican American communities.
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Affiliation(s)
- Sharon A. Brown
- The University of Texas at Austin School of Nursing, Austin, Texas
| | - Mary A. Winter
- The University of Texas at Austin School of Nursing, Austin, Texas
| | | | | | - Mary M. Velasquez
- The University of Texas at Austin School of Social Work, Austin, Texas
| | - Hirofumi Tanaka
- The University of Texas at Austin Department of Kinesiology & Health Education, Austin, Texas
| | - William B. Perkison
- The University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Houston, Texas
| | - Eric L. Brown
- The University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Houston, Texas
| | - David Aguilar
- LSU Health New Orleans School of Medicine, Division of Cardiovascular Medicine, New Orleans, Louisiana
| | - Craig L. Hanis
- The University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Houston, Texas
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Weiss MC, Shih YH, Bryan MS, Jackson BP, Aguilar D, Brown EL, Jun G, Hanis CL, Argos M, Sargis RM. Arsenic metabolism, diabetes prevalence, and insulin resistance among Mexican Americans: A mendelian randomization approach. ENVIRONMENTAL ADVANCES 2023; 12:100361. [PMID: 37426694 PMCID: PMC10328543 DOI: 10.1016/j.envadv.2023.100361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Background Differences in arsenic metabolism capacity may influence risk for type 2 diabetes, but the mechanistic drivers are unclear. We evaluated the associations between arsenic metabolism with overall diabetes prevalence and with static and dynamic measures of insulin resistance among Mexican Americans living in Starr County, Texas. Methods We utilized data from cross-sectional studies conducted in Starr County, Texas, from 2010-2014. A Mendelian randomization approach was utilized to evaluate the associations between arsenic metabolism and type 2 diabetes prevalence using the intronic variant in the arsenic methylating gene, rs9527, as the instrumental variable for arsenic metabolism. To further assess mechanisms for diabetes pathogenesis, proportions of the urinary arsenic metabolites were employed to assess the association between arsenic metabolism and insulin resistance among participants without diabetes. Urinary biomarkers of arsenic metabolites were modeled as individual proportions of the total. Arsenic metabolism was evaluated both with a static outcome of insulin resistance, homeostatic measure of assessment (HOMA-IR), and a dynamic measure of insulin sensitivity, Matsuda Index. Results Among 475 Mexican American participants from Starr County, higher metabolism capacity for arsenic is associated with higher diabetes prevalence driven by worse insulin resistance. Presence of the minor T allele of rs9527 is independently associated with an increase in the proportion of monomethylated arsenic (MMA%) and is associated with an odds ratio of 0.50 (95% CI: 0.24, 0.90) for type 2 diabetes. This association was conserved after potential covariate adjustment. Furthermore, among participants without type 2 diabetes, the highest quartile of MMA% was associated with 22% (95% CI: -33.5%, -9.07%) lower HOMA-IR and 56% (95% CI: 28.3%, 91.3%) higher Matsuda Index for insulin sensitivity. Conclusions Arsenic metabolism capacity, indicated by a lower proportion of monomethylated arsenic, is associated with increased diabetes prevalence driven by an insulin resistant phenotype among Mexican Americans living in Starr County, Texas.
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Affiliation(s)
- Margaret C. Weiss
- School of Public Health, University of Illinois at Chicago, Chicago, IL, United States of America
- College of Medicine, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Yu-Hsuan Shih
- School of Public Health, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Molly Scannell Bryan
- Institute for Minority Health Research, University of Illinois at Chicago, United States of America
- Center for Infectious Disease, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Brian P. Jackson
- Department of Earth Sciences, Dartmouth College, Hanover, NH, United States of America
| | - David Aguilar
- Division of Cardiovascular Medicine, LSU Health School of Medicine, New Orleans, LA, United States
| | - Eric L. Brown
- Center for Infectious Disease, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Goo Jun
- Human Genetics Center, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Craig L. Hanis
- Human Genetics Center, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Maria Argos
- School of Public Health, University of Illinois at Chicago, Chicago, IL, United States of America
- Chicago Center for Health and Environment, Chicago, IL, United States of America
| | - Robert M. Sargis
- College of Medicine, University of Illinois at Chicago, Chicago, IL, United States of America
- Chicago Center for Health and Environment, Chicago, IL, United States of America
- Section of Endocrinology, Diabetes, and Metabolism, Jesse Brown Veterans Affairs Medical Center, Chicago, IL, United States of America
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Brown SA, Becker HA, García AA, Velasquez MM, Tanaka H, Winter MA, Perkison WB, Brown EL, Aguilar D, Hanis CL. The effects of gender and country of origin on acculturation, psychological factors, lifestyle factors, and diabetes-related physiological outcomes among Mexican Americans: The Starr County diabetes prevention initiative. Chronic Illn 2023; 19:444-457. [PMID: 35331025 PMCID: PMC9508285 DOI: 10.1177/17423953221089315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Examine acculturation and psychological, lifestyle, and physiological factors based on gender and country of origin (U.S. vs. Mexico). METHODS Baseline data from the Starr County diabetes prevention study (N = 300) were analyzed - acculturation (language), psychological factors (depression), lifestyle factors (sedentary behaviors), and diabetes-related physiological outcomes (insulin resistance). MANOVA and linear regression were used to examine variable relationships based on gender and country of origin and identify predictors of depression and insulin resistance. RESULTS Participants were: predominantly female (73%); 51 years of age, on average; born in Mexico (71%); and Spanish-speaking. Individuals spent 11 of their waking hours (range = 0-18 h) in sedentary activities. Compared to females, more males spoke English and reported fewer hours in sedentary activities. Compared to participants born in Mexico, those born in the U.S. were more likely to: speak English; report depressive symptoms; and exhibit elevated BMI and insulin resistance rates. Two distinct models significantly predicted depression (R2 = 14.5%) and insulin resistance (R2 = 26.8%), with acculturation-language entering into both models. DISCUSSION Significant gender and country-of-origin differences were found. Future research on diabetes prevention should examine other Hispanic subgroups and strategies for addressing individual differences, while employing cost-effective group interventions that incorporate these differences and reach more at-risk individuals.
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Affiliation(s)
- Sharon A Brown
- School of Nursing, 12330The University of Texas at Austin, Austin, TX, USA
| | - Heather A Becker
- School of Nursing, 12330The University of Texas at Austin, Austin, TX, USA
| | - Alexandra A García
- School of Nursing, 12330The University of Texas at Austin, Austin, TX, USA
| | - Mary M Velasquez
- 143057School of Social Work, The University of Texas at Austin, Austin, TX, USA
| | - Hirofumi Tanaka
- Department of Kinesiology & Health Education, College of Education, 12330The University of Texas at Austin, Austin, TX, USA
| | - Mary A Winter
- School of Nursing, 12330The University of Texas at Austin, Austin, TX, USA
| | - William B Perkison
- 49219School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Eric L Brown
- 49219School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - David Aguilar
- UK HealthCare, Department of Internal Medicine, 12252University of Kentucky, Lexington, KY, USA
| | - Craig L Hanis
- 49219School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
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Brown SA, Becker HA, García AA, Velasquez MM, Tanaka H, Winter MA, Perkison WB, Brown EL, Aguilar D, Hanis CL. Acculturation, Dietary Behaviors, and Macronutrient Intake Among Mexican Americans With Prediabetes: The Starr County Diabetes Prevention Initiative. Sci Diabetes Self Manag Care 2023; 49:65-76. [PMID: 36683588 PMCID: PMC9937503 DOI: 10.1177/26350106221146473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
PURPOSE The purpose of the study was to examine the influences of sex and acculturation on dietary behaviors, macronutrient intake, and dietary quality in participants enrolled in a diabetes prevention initiative in Starr County, Texas. METHODS Baseline data from the Starr County diabetes prevention study (N = 300) were analyzed-acculturation (country of origin, years in Starr County, language and food preferences), depressive symptoms (Patient Health Questionnaire-9), healthy eating self-efficacy (Weight Efficacy Lifestyle Questionnaire-Short Form), diet quality (USDA Healthy Eating Index), fat avoidance (Fat Avoidance Scale, Spanish version), and macronutrients. Descriptive statistics and univariate analysis of covariance were used to examine differences based on acculturation, controlling for sex. RESULTS Participants were predominantly female (73%) and, on average, 51 years of age. Language and food preferences favored Spanish language and Hispanic foods, respectively. The majority (71%) was born in Mexico but had resided in Starr County for 33 years, on average. Depressive symptoms were moderate, and eating self-efficacy scores suggested low confidence in making healthy food choices, particularly for saturated fats. Spanish language preference was associated with worse dietary habits. The mean dietary quality score was lower than the national average (54 vs 59 nationally); females had slightly higher dietary quality than males and a higher mean fat avoidance score, although differences were not clinically significant. Intakes of carbohydrate, saturated fats, and cholesterol were higher than recommended daily allowances. CONCLUSIONS The overall preference for speaking Spanish and the influence of language on dietary intake should inform future dietary interventions. Accommodating cultural norms and food preferences remain major challenges to improving dietary quality among the diverse Hispanic ethnic groups.
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Affiliation(s)
- Sharon A. Brown
- The University of Texas at Austin School of Nursing 1710
Red River Street, Austin TX 78712
| | - Heather A. Becker
- The University of Texas at Austin School of Nursing 1710
Red River Street, Austin TX 78712
| | - Alexandra A. García
- The University of Texas at Austin School of Nursing 1710
Red River Street, Austin TX 78712
| | - Mary M. Velasquez
- The University of Texas at Austin School of Social Work
1925 San Jacinto Blvd., Austin TX 78712
| | - Hirofumi Tanaka
- The University of Texas at Austin Department of Kinesiology
& Health Education, College of Education, 2109 San Jacinto Blvd., Austin TX
78712
| | - Mary A. Winter
- The University of Texas at Austin School of Nursing 1710
Red River Street, Austin TX 78712
| | - William B. Perkison
- The University of Texas Health Science Center at Houston
(UTHealth), School of Public Health 1200 Pressler St., Houston TX 77030
| | - Eric L. Brown
- The University of Texas Health Science Center at Houston
(UTHealth), School of Public Health 1200 Pressler St., Houston TX 77030
| | - David Aguilar
- LSU Health New Orleans School of Medicine, Division of
Cardiovascular Medicine 2020 Gravier Street, New Orleans, LA 70112
| | - Craig L. Hanis
- The University of Texas Health Science Center at Houston
(UTHealth), School of Public Health 1200 Pressler St., Houston TX 77030
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Weiss MC, Shih YH, Bryan MS, Jackson BP, Aguilar D, Hanis CL, Argos M, Sargis RM. Relationships Between Urinary Metals and Diabetes Traits Among Mexican Americans in Starr County, Texas, USA. Biol Trace Elem Res 2023; 201:529-538. [PMID: 35247137 PMCID: PMC10766113 DOI: 10.1007/s12011-022-03165-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 02/14/2022] [Indexed: 01/25/2023]
Abstract
Hispanics/Latinos have higher rates of type 2 diabetes (T2D), and the origins of these disparities are poorly understood. Environmental endocrine-disrupting chemicals (EDCs), including some metals and metalloids, are implicated as diabetes risk factors. Data indicate that Hispanics/Latinos may be disproportionately exposed to EDCs, yet they remain understudied with respect to environmental exposures and diabetes. The objective of this study is to determine how metal exposures contribute to T2D progression by evaluating the associations between 8 urinary metals and measures of glycemic status in 414 normoglycemic or prediabetic adults living in Starr County, Texas, a Hispanic/Latino community with high rates of diabetes and diabetes-associated mortality. We used multivariable linear regression to quantify the differences in homeostatic model assessments for pancreatic β-cell function, insulin resistance, and insulin sensitivity (HOMA-β, HOMA-IR, HOMA-S, respectively), plasma insulin, plasma glucose, and hemoglobin A1c (HbA1c) associated with increasing urinary metal concentrations. Quantile-based g-computation was utilized to assess mixture effects. After multivariable adjustment, urinary arsenic and molybdenum were associated with lower HOMA-β, HOMA-IR, and plasma insulin levels and higher HOMA-S. Additionally, higher urinary copper levels were associated with a reduced HOMA-β. Lastly, a higher concentration of the 8 metal mixtures was associated with lower HOMA-β, HOMA-IR, and plasma insulin levels as well as higher HOMA-S. Our data indicate that arsenic, molybdenum, copper, and this metal mixture are associated with alterations in measures of glucose homeostasis among non-diabetics in Starr County. This study is one of the first to comprehensively evaluate associations of urinary metals with glycemic measures in a high-risk Mexican American population.
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Affiliation(s)
- Margaret C Weiss
- School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
- College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Yu-Hsuan Shih
- School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | - Molly Scannell Bryan
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA
- Chicago Center for Health and Environment, Chicago, IL, USA
| | - Brian P Jackson
- Department of Earth Sciences, Dartmouth College, Hanover, NH, USA
| | - David Aguilar
- Human Genetics Center, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Craig L Hanis
- Human Genetics Center, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Maria Argos
- School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
- Chicago Center for Health and Environment, Chicago, IL, USA
| | - Robert M Sargis
- College of Medicine, University of Illinois at Chicago, Chicago, IL, USA.
- Chicago Center for Health and Environment, Chicago, IL, USA.
- Section of Endocrinology, Diabetes, and Metabolism, Jesse Brown Veterans Affairs Medical Center, Chicago, IL, USA.
- Division of Endocrinology, Diabetes, and Metabolism, University of Illinois at Chicago, 835 S. Wolcott, Suite E625, M/C 640, Chicago, IL, 60612, USA.
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Chun S, Akle S, Teodosiadis A, Cade BE, Wang H, Sofer T, Evans DS, Stone KL, Gharib SA, Mukherjee S, Palmer LJ, Hillman D, Rotter JI, Hanis CL, Stamatoyannopoulos JA, Redline S, Cotsapas C, Sunyaev SR. Leveraging pleiotropy to discover and interpret GWAS results for sleep-associated traits. PLoS Genet 2022; 18:e1010557. [PMID: 36574455 PMCID: PMC9829185 DOI: 10.1371/journal.pgen.1010557] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/09/2023] [Accepted: 12/06/2022] [Indexed: 12/28/2022] Open
Abstract
Genetic association studies of many heritable traits resulting from physiological testing often have modest sample sizes due to the cost and burden of the required phenotyping. This reduces statistical power and limits discovery of multiple genetic associations. We present a strategy to leverage pleiotropy between traits to both discover new loci and to provide mechanistic hypotheses of the underlying pathophysiology. Specifically, we combine a colocalization test with a locus-level test of pleiotropy. In simulations, we show that this approach is highly selective for identifying true pleiotropy driven by the same causative variant, thereby improves the chance to replicate the associations in underpowered validation cohorts and leads to higher interpretability. Here, as an exemplar, we use Obstructive Sleep Apnea (OSA), a common disorder diagnosed using overnight multi-channel physiological testing. We leverage pleiotropy with relevant cellular and cardio-metabolic phenotypes and gene expression traits to map new risk loci in an underpowered OSA GWAS. We identify several pleiotropic loci harboring suggestive associations to OSA and genome-wide significant associations to other traits, and show that their OSA association replicates in independent cohorts of diverse ancestries. By investigating pleiotropic loci, our strategy allows proposing new hypotheses about OSA pathobiology across many physiological layers. For example, we identify and replicate the pleiotropy across the plateletcrit, OSA and an eQTL of DNA primase subunit 1 (PRIM1) in immune cells. We find suggestive links between OSA, a measure of lung function (FEV1/FVC), and an eQTL of matrix metallopeptidase 15 (MMP15) in lung tissue. We also link a previously known genome-wide significant peak for OSA in the hexokinase 1 (HK1) locus to hematocrit and other red blood cell related traits. Thus, the analysis of pleiotropic associations has the potential to assemble diverse phenotypes into a chain of mechanistic hypotheses that provide insight into the pathogenesis of complex human diseases.
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Affiliation(s)
- Sung Chun
- Division of Genetics, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
- Division of Pulmonary Medicine, Boston Children’s Hospital, Boston, Massachusetts, United States of America
- Altius Institute for Biomedical Sciences, Seattle, Washington, United States of America
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Sebastian Akle
- Division of Genetics, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
- Altius Institute for Biomedical Sciences, Seattle, Washington, United States of America
- Department of Organismic and Evolutionary Biology, Harvard University, Cambridge, Massachusetts, United States of America
| | | | - Brian E. Cade
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts, United States of America
| | - Heming Wang
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts, United States of America
| | - Tamar Sofer
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Daniel S. Evans
- California Pacific Medical Center Research Institute, San Francisco, California, United States of America
| | - Katie L. Stone
- California Pacific Medical Center Research Institute, San Francisco, California, United States of America
| | - Sina A. Gharib
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Seattle, Washington, United States of America
- Computational Medicine Core at Center for Lung Biology, University of Washington, Seattle, Washington, United States of America
| | - Sutapa Mukherjee
- Respiratory and Sleep Services, Southern Adelaide Local Health Network, Adelaide, South Australia, Australia
- Adelaide Institute for Sleep Health, Flinders University, Adelaide, South Australia, Australia
| | - Lyle J. Palmer
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | - David Hillman
- Centre for Sleep Science, University of Western Australia, Perth, Australia
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, Australia
| | - Jerome I. Rotter
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, California, United States of America
| | - Craig L. Hanis
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, United States of America
| | - John A. Stamatoyannopoulos
- Altius Institute for Biomedical Sciences, Seattle, Washington, United States of America
- Departments of Medicine and Genome Sciences, University of Washington, Seattle, Washington, United States of America
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
| | - Chris Cotsapas
- Altius Institute for Biomedical Sciences, Seattle, Washington, United States of America
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts, United States of America
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut, United States of America
- Department of Genetics, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Shamil R. Sunyaev
- Division of Genetics, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
- Altius Institute for Biomedical Sciences, Seattle, Washington, United States of America
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America
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Parra OD, Kohler LN, Landes L, Soto AA, Garcia D, Mullins J, Molina P, Pereira E, Spegman DJ, Soltani L, Mandarino LJ. Biobanking in Latinos: current status, principles for conduct, and contribution of a new biobank, El Banco por Salud, designed to improve the health of Latino patients of Mexican ancestry with type 2 diabetes. BMJ Open Diabetes Res Care 2022; 10:e002709. [PMID: 35504695 PMCID: PMC9066498 DOI: 10.1136/bmjdrc-2021-002709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 03/19/2022] [Indexed: 11/03/2022] Open
Abstract
Underserved Latino communities experience a greater burden of type 2 diabetes mellitus (T2DM) than the general population. Predictors of glycemic control are likely to include both biological/genetic and social determinants of health (SDOH). A variety of approaches have been used with cohorts of Latino patients to study aspects of this health disparity, and those are reviewed briefly here. Such projects range from cohorts that are studies for a primary purpose, for example, to discover genetic variation associated with T2DM or to examine a particular aspect of SDOH that might be involved. Other studies have been conducted more as infrastructure that is broadly based in order to provide a resource that can be used by many investigators to address a variety of questions. From our experience and those of others, we propose a set of principles to ensure that needs of the community are identified and taken into account during the conduct of these studies. As an example of the implementation of these principles, we also describe a new biobank El Banco por Salud (El Banco), which was designed to improve access to studies designed to improve glycemic control and health in Latinos in partnership with Federally Qualified Health Centers in Arizona.
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Affiliation(s)
- Oscar D Parra
- Department of Medicine, University of Arizona Medical Center-University Campus, Tucson, Arizona, USA
| | - Lindsay N Kohler
- Health Promotion Sciences, The University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA
- Mel and Edith Zuckerman College of Public Health, University of Arizona Medical Center-University Campus, Tucson, Arizona, USA
| | - Lori Landes
- El Rio Community Health Centers, Tucson, Arizona, USA
- Department of Family Medicine and Population Health, Virginia Commonwealth University Medical Center, Richmond, Virginia, USA
| | - Alexis A Soto
- Department of Medicine, University of Arizona Medical Center-University Campus, Tucson, Arizona, USA
| | - Diana Garcia
- Department of Medicine, University of Arizona Medical Center-University Campus, Tucson, Arizona, USA
| | | | - Patty Molina
- Mariposa Community Health Centers, Nogales, Arizona, USA
| | - Eladio Pereira
- Mariposa Community Health Centers, Nogales, Arizona, USA
| | | | - Lisa Soltani
- El Rio Community Health Centers, Tucson, Arizona, USA
| | - Lawrence J Mandarino
- Department of Medicine, University of Arizona Medical Center-University Campus, Tucson, Arizona, USA
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8
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Cade BE, Lee J, Sofer T, Wang H, Zhang M, Chen H, Gharib SA, Gottlieb DJ, Guo X, Lane JM, Liang J, Lin X, Mei H, Patel SR, Purcell SM, Saxena R, Shah NA, Evans DS, Hanis CL, Hillman DR, Mukherjee S, Palmer LJ, Stone KL, Tranah GJ, Abecasis GR, Boerwinkle EA, Correa A, Cupples LA, Kaplan RC, Nickerson DA, North KE, Psaty BM, Rotter JI, Rich SS, Tracy RP, Vasan RS, Wilson JG, Zhu X, Redline S. Whole-genome association analyses of sleep-disordered breathing phenotypes in the NHLBI TOPMed program. Genome Med 2021; 13:136. [PMID: 34446064 PMCID: PMC8394596 DOI: 10.1186/s13073-021-00917-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 05/28/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Sleep-disordered breathing is a common disorder associated with significant morbidity. The genetic architecture of sleep-disordered breathing remains poorly understood. Through the NHLBI Trans-Omics for Precision Medicine (TOPMed) program, we performed the first whole-genome sequence analysis of sleep-disordered breathing. METHODS The study sample was comprised of 7988 individuals of diverse ancestry. Common-variant and pathway analyses included an additional 13,257 individuals. We examined five complementary traits describing different aspects of sleep-disordered breathing: the apnea-hypopnea index, average oxyhemoglobin desaturation per event, average and minimum oxyhemoglobin saturation across the sleep episode, and the percentage of sleep with oxyhemoglobin saturation < 90%. We adjusted for age, sex, BMI, study, and family structure using MMSKAT and EMMAX mixed linear model approaches. Additional bioinformatics analyses were performed with MetaXcan, GIGSEA, and ReMap. RESULTS We identified a multi-ethnic set-based rare-variant association (p = 3.48 × 10-8) on chromosome X with ARMCX3. Additional rare-variant associations include ARMCX3-AS1, MRPS33, and C16orf90. Novel common-variant loci were identified in the NRG1 and SLC45A2 regions, and previously associated loci in the IL18RAP and ATP2B4 regions were associated with novel phenotypes. Transcription factor binding site enrichment identified associations with genes implicated with respiratory and craniofacial traits. Additional analyses identified significantly associated pathways. CONCLUSIONS We have identified the first gene-based rare-variant associations with objectively measured sleep-disordered breathing traits. Our results increase the understanding of the genetic architecture of sleep-disordered breathing and highlight associations in genes that modulate lung development, inflammation, respiratory rhythmogenesis, and HIF1A-mediated hypoxic response.
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Affiliation(s)
- Brian E. Cade
- grid.38142.3c000000041936754XDivision of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115 USA ,grid.38142.3c000000041936754XDivision of Sleep Medicine, Harvard Medical School, Boston, MA 02115 USA ,grid.66859.34Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02142 USA
| | - Jiwon Lee
- grid.38142.3c000000041936754XDivision of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115 USA
| | - Tamar Sofer
- grid.38142.3c000000041936754XDivision of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115 USA ,grid.38142.3c000000041936754XDivision of Sleep Medicine, Harvard Medical School, Boston, MA 02115 USA
| | - Heming Wang
- grid.38142.3c000000041936754XDivision of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115 USA ,grid.38142.3c000000041936754XDivision of Sleep Medicine, Harvard Medical School, Boston, MA 02115 USA ,grid.66859.34Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02142 USA
| | - Man Zhang
- grid.411024.20000 0001 2175 4264Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201 USA
| | - Han Chen
- grid.267308.80000 0000 9206 2401Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030 USA ,grid.267308.80000 0000 9206 2401Center for Precision Health, School of Public Health and School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX 77030 USA
| | - Sina A. Gharib
- grid.34477.330000000122986657Computational Medicine Core, Center for Lung Biology, UW Medicine Sleep Center, Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, WA 98195 USA
| | - Daniel J. Gottlieb
- grid.38142.3c000000041936754XDivision of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115 USA ,grid.38142.3c000000041936754XDivision of Sleep Medicine, Harvard Medical School, Boston, MA 02115 USA ,grid.410370.10000 0004 4657 1992VA Boston Healthcare System, Boston, MA 02132 USA
| | - Xiuqing Guo
- grid.239844.00000 0001 0157 6501The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA 90502 USA
| | - Jacqueline M. Lane
- grid.38142.3c000000041936754XDivision of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115 USA ,grid.38142.3c000000041936754XDivision of Sleep Medicine, Harvard Medical School, Boston, MA 02115 USA ,grid.66859.34Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02142 USA ,grid.32224.350000 0004 0386 9924Center for Genomic Medicine and Department of Anesthesia, Pain, and Critical Care Medicine, Massachusetts General Hospital, Boston, MA 02114 USA
| | - Jingjing Liang
- grid.67105.350000 0001 2164 3847Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH 44106 USA
| | - Xihong Lin
- grid.38142.3c000000041936754XDepartment of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115 USA
| | - Hao Mei
- grid.410721.10000 0004 1937 0407Department of Data Science, University of Mississippi Medical Center, Jackson, MS 29216 USA
| | - Sanjay R. Patel
- grid.21925.3d0000 0004 1936 9000Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA 15213 USA
| | - Shaun M. Purcell
- grid.38142.3c000000041936754XDivision of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115 USA ,grid.38142.3c000000041936754XDivision of Sleep Medicine, Harvard Medical School, Boston, MA 02115 USA ,grid.66859.34Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02142 USA
| | - Richa Saxena
- grid.38142.3c000000041936754XDivision of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115 USA ,grid.38142.3c000000041936754XDivision of Sleep Medicine, Harvard Medical School, Boston, MA 02115 USA ,grid.66859.34Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02142 USA ,grid.32224.350000 0004 0386 9924Center for Genomic Medicine and Department of Anesthesia, Pain, and Critical Care Medicine, Massachusetts General Hospital, Boston, MA 02114 USA
| | - Neomi A. Shah
- grid.59734.3c0000 0001 0670 2351Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029 USA
| | - Daniel S. Evans
- grid.17866.3e0000000098234542California Pacific Medical Center Research Institute, San Francisco, CA 94107 USA
| | - Craig L. Hanis
- grid.267308.80000 0000 9206 2401Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030 USA
| | - David R. Hillman
- grid.3521.50000 0004 0437 5942Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia 6009 Australia
| | - Sutapa Mukherjee
- Sleep Health Service, Respiratory and Sleep Services, Southern Adelaide Local Health Network, Adelaide, South Australia Australia ,grid.1014.40000 0004 0367 2697Adelaide Institute for Sleep Health, Flinders University, Adelaide, South Australia Australia
| | - Lyle J. Palmer
- grid.1010.00000 0004 1936 7304School of Public Health, University of Adelaide, Adelaide, South Australia 5000 Australia
| | - Katie L. Stone
- grid.17866.3e0000000098234542California Pacific Medical Center Research Institute, San Francisco, CA 94107 USA
| | - Gregory J. Tranah
- grid.17866.3e0000000098234542California Pacific Medical Center Research Institute, San Francisco, CA 94107 USA
| | | | - Gonçalo R. Abecasis
- grid.214458.e0000000086837370Department of Biostatistics and Center for Statistical Genetics, University of Michigan School of Public Health, Ann Arbor, MI 48109 USA
| | - Eric A. Boerwinkle
- grid.267308.80000 0000 9206 2401Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030 USA ,grid.39382.330000 0001 2160 926XHuman Genome Sequencing Center, Baylor College of Medicine, Houston, TX 77030 USA
| | - Adolfo Correa
- grid.410721.10000 0004 1937 0407Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216 USA ,Jackson Heart Study, Jackson, MS 39216 USA
| | - L. Adrienne Cupples
- grid.189504.10000 0004 1936 7558Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118 USA ,grid.510954.c0000 0004 0444 3861Framingham Heart Study, Framingham, MA 01702 USA
| | - Robert C. Kaplan
- grid.251993.50000000121791997Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, 10461 USA
| | - Deborah A. Nickerson
- grid.34477.330000000122986657Department of Genome Sciences, University of Washington, Seattle, WA 98195 USA ,grid.34477.330000000122986657Northwest Genomics Center, Seattle, WA 98105 USA
| | - Kari E. North
- grid.410711.20000 0001 1034 1720Department of Epidemiology and Carolina Center of Genome Sciences, University of North Carolina, Chapel Hill, NC 27514 USA
| | - Bruce M. Psaty
- grid.34477.330000000122986657Cardiovascular Health Study, Departments of Medicine, Epidemiology, and Health Services, University of Washington, Seattle, WA 98101 USA ,grid.488833.c0000 0004 0615 7519Kaiser Permanente Washington Health Research Institute, Seattle, WA 98101 USA
| | - Jerome I. Rotter
- grid.239844.00000 0001 0157 6501The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA 90502 USA
| | - Stephen S. Rich
- grid.27755.320000 0000 9136 933XCenter for Public Health Genomics, University of Virginia, Charlottesville, VA 22908 USA
| | - Russell P. Tracy
- grid.59062.380000 0004 1936 7689Department of Pathology, University of Vermont, Colchester, VT 05405 USA
| | - Ramachandran S. Vasan
- grid.510954.c0000 0004 0444 3861Framingham Heart Study, Framingham, MA 01702 USA ,grid.189504.10000 0004 1936 7558Sections of Preventive Medicine and Epidemiology and Cardiology, Department of Medicine, Boston University School of Medicine, Boston, MA 02118 USA ,grid.189504.10000 0004 1936 7558Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118 USA
| | - James G. Wilson
- grid.410721.10000 0004 1937 0407Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS 39216 USA
| | - Xiaofeng Zhu
- grid.67105.350000 0001 2164 3847Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH 44106 USA
| | - Susan Redline
- grid.38142.3c000000041936754XDivision of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115 USA ,grid.38142.3c000000041936754XDivision of Sleep Medicine, Harvard Medical School, Boston, MA 02115 USA ,grid.239395.70000 0000 9011 8547Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215 USA
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9
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Lalrohlui F, Zohmingthanga J, Hruaii V, Vanlallawma A, Senthil Kumar N. Whole exome sequencing identifies the novel putative gene variants related with type 2 diabetes in Mizo population, northeast India. Gene 2020; 769:145229. [PMID: 33059026 DOI: 10.1016/j.gene.2020.145229] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 09/30/2020] [Accepted: 10/07/2020] [Indexed: 11/30/2022]
Abstract
The contribution of genes towards T2D development varies among different population groups across the world. It has been reported that a number of loci involved in T2D susceptibility are common across certain population groups, but ethnicity specific variants are also observed. The population of Mizoram has an independent ethnic identity and there are no scientific records about the history of the Mizo people; which makes this ethnic group unique and interesting to study. The aim of the study focuses on the identification of the gene variants which may contribute to T2D susceptibility in Mizo-Mongloid ethnic tribe of North east India through whole exome sequencing. The variants like 328G > C (KRT18), 997G > T (CYP4A11), 2368 T > C (SLC4A3), 508G > A (SLC26A5), 1659C > T (KCNS1), 650C > A (ABCD1) 821A > T (YTHDC2), 931G > T (PINX1), 3280C > A (TNRC6A), 48C > A(TACO1), 6035A > T(LAMA1), 805C > A(ACP7) and 806A > G(ACP7) variants were not reported for any disease in the database and were found to be pathogenic in different insilico analysis softwares. The changes in protein stability upon mutation has been predicted where 35.71% increases the stability of the protein, while 64.28% of the variants decrease the stability of the protein. These findings present the population specific variants which might involve in the susceptibility to T2D in Mizo population. Further, in this study some gene variants have contribution as a possible diagnostic or prognostic marker for other diseases as well, which suggests the need for performing association analysis for different disease manifestations in Mizo population in the near future.
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Affiliation(s)
- Freda Lalrohlui
- Department of Biotechnology, Mizoram University, Aizawl 796004, Mizoram, India
| | | | - Vanlal Hruaii
- Department of Medicine, Zoram Medical College, Aizawl 796005, Mizoram, India
| | - Andrew Vanlallawma
- Department of Biotechnology, Mizoram University, Aizawl 796004, Mizoram, India
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10
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Cade BE, Chen H, Stilp AM, Louie T, Ancoli-Israel S, Arens R, Barfield R, Below JE, Cai J, Conomos MP, Evans DS, Frazier-Wood AC, Gharib SA, Gleason KJ, Gottlieb DJ, Hillman DR, Johnson WC, Lederer DJ, Lee J, Loredo JS, Mei H, Mukherjee S, Patel SR, Post WS, Purcell SM, Ramos AR, Reid KJ, Rice K, Shah NA, Sofer T, Taylor KD, Thornton TA, Wang H, Yaffe K, Zee PC, Hanis CL, Palmer LJ, Rotter JI, Stone KL, Tranah GJ, Wilson JG, Sunyaev SR, Laurie CC, Zhu X, Saxena R, Lin X, Redline S. Associations of variants In the hexokinase 1 and interleukin 18 receptor regions with oxyhemoglobin saturation during sleep. PLoS Genet 2019; 15:e1007739. [PMID: 30990817 PMCID: PMC6467367 DOI: 10.1371/journal.pgen.1007739] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 10/03/2018] [Indexed: 12/12/2022] Open
Abstract
Sleep disordered breathing (SDB)-related overnight hypoxemia is associated with cardiometabolic disease and other comorbidities. Understanding the genetic bases for variations in nocturnal hypoxemia may help understand mechanisms influencing oxygenation and SDB-related mortality. We conducted genome-wide association tests across 10 cohorts and 4 populations to identify genetic variants associated with three correlated measures of overnight oxyhemoglobin saturation: average and minimum oxyhemoglobin saturation during sleep and the percent of sleep with oxyhemoglobin saturation under 90%. The discovery sample consisted of 8,326 individuals. Variants with p < 1 × 10(-6) were analyzed in a replication group of 14,410 individuals. We identified 3 significantly associated regions, including 2 regions in multi-ethnic analyses (2q12, 10q22). SNPs in the 2q12 region associated with minimum SpO2 (rs78136548 p = 2.70 × 10(-10)). SNPs at 10q22 were associated with all three traits including average SpO2 (rs72805692 p = 4.58 × 10(-8)). SNPs in both regions were associated in over 20,000 individuals and are supported by prior associations or functional evidence. Four additional significant regions were detected in secondary sex-stratified and combined discovery and replication analyses, including a region overlapping Reelin, a known marker of respiratory complex neurons.These are the first genome-wide significant findings reported for oxyhemoglobin saturation during sleep, a phenotype of high clinical interest. Our replicated associations with HK1 and IL18R1 suggest that variants in inflammatory pathways, such as the biologically-plausible NLRP3 inflammasome, may contribute to nocturnal hypoxemia.
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Affiliation(s)
- Brian E. Cade
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, United States of America
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States of America
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, United States of America
| | - Han Chen
- Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX United States of America
- Center for Precision Health, School of Public Health and School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX United States of America
| | - Adrienne M. Stilp
- Department of Biostatistics, University of Washington, Seattle, WA United States of America
| | - Tin Louie
- Department of Biostatistics, University of Washington, Seattle, WA United States of America
| | - Sonia Ancoli-Israel
- Department of Psychiatry, University of California, San Diego, CA, United States of America
| | - Raanan Arens
- The Children’s Hospital at Montefiore, Division of Respiratory and Sleep Medicine, Albert Einstein College of Medicine, Bronx, NY, United States of America
| | - Richard Barfield
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Jennifer E. Below
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - Jianwen Cai
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States of America
| | - Matthew P. Conomos
- Department of Biostatistics, University of Washington, Seattle, WA United States of America
| | - Daniel S. Evans
- California Pacific Medical Center Research Institute, San Francisco, CA, United States of America
| | - Alexis C. Frazier-Wood
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States of America
| | - Sina A. Gharib
- Computational Medicine Core, Center for Lung Biology, UW Medicine Sleep Center, Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle WA, United States of America
| | - Kevin J. Gleason
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, United States of America
- Department of Public Health Sciences, University of Chicago, Chicago, IL, United States of America
| | - Daniel J. Gottlieb
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, United States of America
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States of America
- VA Boston Healthcare System, Boston, MA, United States of America
| | - David R. Hillman
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - W. Craig Johnson
- Department of Biostatistics, University of Washington, Seattle, WA United States of America
| | - David J. Lederer
- Departments of Medicine and Epidemiology, Columbia University, New York, NY, United States of America
| | - Jiwon Lee
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, United States of America
| | - Jose S. Loredo
- Division of Pulmonary Critical Care and Sleep Medicine, Department of Medicine, UC San Diego School of Medicine, La Jolla, CA, United States of America
| | - Hao Mei
- Department of Data Science, University of Mississippi Medical Center, Jackson, MS, United States of America
| | - Sutapa Mukherjee
- Sleep Health Service, Respiratory and Sleep Services, Southern Adelaide Local Health Network, Adelaide, South Australia
- Adelaide Institute for Sleep Health, Flinders University, Adelaide, South Australia
| | - Sanjay R. Patel
- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Wendy S. Post
- Division of Cardiology, Johns Hopkins University, Baltimore, MD, United States of America
| | - Shaun M. Purcell
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, United States of America
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States of America
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, United States of America
| | - Alberto R. Ramos
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States of America
| | - Kathryn J. Reid
- Department of Neurology, Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
| | - Ken Rice
- Department of Biostatistics, University of Washington, Seattle, WA United States of America
| | - Neomi A. Shah
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Tamar Sofer
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, United States of America
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States of America
- Department of Biostatistics, University of Washington, Seattle, WA United States of America
| | - Kent D. Taylor
- The Institute for Translational Genomics and Population Sciences, Departments of Pediatrics and Medicine, LABioMed at Harbor-UCLA Medical Center, Torrance, CA, United States of America
| | - Timothy A. Thornton
- Department of Biostatistics, University of Washington, Seattle, WA United States of America
| | - Heming Wang
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, United States of America
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States of America
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, United States of America
| | - Kristine Yaffe
- Department of Psychiatry, Neurology, and Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA, United States of America
- San Francisco VA Medical Center, San Francisco, CA, United States of America
| | - Phyllis C. Zee
- Department of Neurology, Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
| | - Craig L. Hanis
- Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX United States of America
| | - Lyle J. Palmer
- School of Public Health, University of Adelaide, South Australia, Australia
| | - Jerome I. Rotter
- The Institute for Translational Genomics and Population Sciences, Departments of Pediatrics and Medicine, LABioMed at Harbor-UCLA Medical Center, Torrance, CA, United States of America
| | - Katie L. Stone
- California Pacific Medical Center Research Institute, San Francisco, CA, United States of America
| | - Gregory J. Tranah
- California Pacific Medical Center Research Institute, San Francisco, CA, United States of America
| | - James G. Wilson
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson MS, United States of America
| | - Shamil R. Sunyaev
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, United States of America
- Division of Genetics, Brigham and Women's Hospital, Boston, MA, United States of America
- Division of Medical Sciences, Harvard Medical School, Boston, MA, United States of America
| | - Cathy C. Laurie
- Department of Biostatistics, University of Washington, Seattle, WA United States of America
| | - Xiaofeng Zhu
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, United States of America
| | - Richa Saxena
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, United States of America
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States of America
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, United States of America
- Center for Genomic Medicine and Department of Anesthesia, Pain, and Critical Care Medicine, Massachusetts General Hospital, Boston, MA, United States of America
| | - Xihong Lin
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, United States of America
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States of America
- Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
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11
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Avilés-Santa ML, Colón-Ramos U, Lindberg NM, Mattei J, Pasquel FJ, Pérez CM. From Sea to Shining Sea and the Great Plains to Patagonia: A Review on Current Knowledge of Diabetes Mellitus in Hispanics/Latinos in the US and Latin America. Front Endocrinol (Lausanne) 2017; 8:298. [PMID: 29176960 PMCID: PMC5687125 DOI: 10.3389/fendo.2017.00298] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 10/16/2017] [Indexed: 12/13/2022] Open
Abstract
The past two decades have witnessed many advances in the prevention, treatment, and control of diabetes mellitus (DM) and its complications. Increased screening has led to a greater recognition of type 2 diabetes mellitus (type 2 DM) and prediabetes; however, Hispanics/Latinos, the largest minority group in the US, have not fully benefited from these advances. The Hispanic/Latino population is highly diverse in ancestries, birth places, cultures, languages, and socioeconomic backgrounds, and it populates most of the Western Hemisphere. In the US, the prevalence of DM varies among Hispanic/Latino heritage groups, being higher among Mexicans, Puerto Ricans, and Dominicans, and lower among South Americans. The risk and prevalence of diabetes among Hispanics/Latinos are significantly higher than in non-Hispanic Whites, and nearly 40% of Hispanics/Latinos with diabetes have not been formally diagnosed. Despite these striking facts, the representation of Hispanics/Latinos in pharmacological and non-pharmacological clinical trials has been suboptimal, while the prevalence of diabetes in these populations continues to rise. This review will focus on the epidemiology, etiology and prevention of type 2 DM in populations of Latin American origin. We will set the stage by defining the terms Hispanic, Latino, and Latin American, explaining the challenges identifying Hispanics/Latinos in the scientific literature and databases, describing the epidemiology of diabetes-including type 2 DM and gestational diabetes mellitus (GDM)-and cardiovascular risk factors in Hispanics/Latinos in the US and Latin America, and discussing trends, and commonalities and differences across studies and populations, including methodology to ascertain diabetes. We will discuss studies on mechanisms of disease, and research on prevention of type 2 DM in Hispanics/Latinos, including women with GDM, youth and adults; and finalize with a discussion on lessons learned and opportunities to enhance research, and, consequently, clinical care oriented toward preventing type 2 DM in Hispanics/Latinos in the US and Latin America.
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Affiliation(s)
- M. Larissa Avilés-Santa
- National Heart, Lung, and Blood Institute at the National Institutes of Health, Bethesda, MD, United States
| | - Uriyoán Colón-Ramos
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - Nangel M. Lindberg
- Kaiser Permanente Center for Health Research, Portland, OR, United States
| | - Josiemer Mattei
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, United States
| | - Francisco J. Pasquel
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States
| | - Cynthia M. Pérez
- University of Puerto Rico Graduate School of Public Health, San Juan, Puerto Rico
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12
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Wang H, Cade BE, Chen H, Gleason KJ, Saxena R, Feng T, Larkin EK, Vasan RS, Lin H, Patel SR, Tracy RP, Liu Y, Gottlieb DJ, Below JE, Hanis CL, Petty LE, Sunyaev SR, Frazier-Wood AC, Rotter JI, Post W, Lin X, Redline S, Zhu X. Variants in angiopoietin-2 (ANGPT2) contribute to variation in nocturnal oxyhaemoglobin saturation level. Hum Mol Genet 2017; 25:5244-5253. [PMID: 27798093 DOI: 10.1093/hmg/ddw324] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 09/19/2016] [Indexed: 12/30/2022] Open
Abstract
Genetic determinants of sleep-disordered breathing (SDB), a common set of disorders that contribute to significant cardiovascular and neuropsychiatric morbidity, are not clear. Overnight nocturnal oxygen saturation (SaO2) is a clinically relevant and easily measured indicator of SDB severity but its genetic contribution has never been studied. Our recent study suggests nocturnal SaO2 is heritable. We performed linkage analysis, association analysis and haplotype analysis of average nocturnal oxyhaemoglobin saturation in participants in the Cleveland Family Study (CFS), followed by gene-based association and additional tests in four independent samples. Linkage analysis identified a peak (LOD = 4.29) on chromosome 8p23. Follow-up association analysis identified two haplotypes in angiopoietin-2 (ANGPT2) that significantly contributed to the variation of SaO2 (P = 8 × 10-5) and accounted for a portion of the linkage evidence. Gene-based association analysis replicated the association of ANGPT2 and nocturnal SaO2. A rare missense SNP rs200291021 in ANGPT2 was associated with serum angiopoietin-2 level (P = 1.29 × 10-4), which was associated with SaO2 (P = 0.002). Our study provides the first evidence for the association of ANGPT2, a gene previously implicated in acute lung injury syndromes, with nocturnal SaO2, suggesting that this gene has a broad range of effects on gas exchange, including influencing oxygenation during sleep.
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Affiliation(s)
- Heming Wang
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH, USA
| | - Brian E Cade
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Han Chen
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Kevin J Gleason
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.,Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Richa Saxena
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.,Center for Human Genetic Research and Department of Anesthesia, Pain, and Critical Care Medicine, Massachusetts General Hospital, Boston, MA, USA.,Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
| | - Tao Feng
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH, USA
| | - Emma K Larkin
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Ramachandran S Vasan
- Preventive Medicine & Epidemiology, Boston University School of Medicine, Boston, MA, USA.,Framingham Heart Study, Framingham, MA
| | - Honghuang Lin
- Section of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Sanjay R Patel
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.,Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Russell P Tracy
- Department of Pathology & Laboratory Medicine, University of Vermont, Burlington, VT, USA
| | - Yongmei Liu
- Epidemiology and Prevention Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Daniel J Gottlieb
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.,Sleep Disorders Center, VA Boston Healthcare System, Boston, MA, USA
| | - Jennifer E Below
- Human Genetics Center, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Craig L Hanis
- Human Genetics Center, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Lauren E Petty
- Human Genetics Center, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Shamil R Sunyaev
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA.,Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Jerome I Rotter
- Institute for Translational Genomics and Population Sciences, Los Angeles BioMedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Wendy Post
- Division of Cardiology, Johns Hopkins University, Baltimore, MD, USA
| | - Xihong Lin
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.,Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Xiaofeng Zhu
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH, USA
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13
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González Silos R, Karadag Ö, Peil B, Fischer C, Kabisch M, Legrand C, Lorenzo Bermejo J. Using next-generation DNA sequence data for genetic association tests based on allele counts with and without consideration of zero inflation. BMC Proc 2016; 10:397-404. [PMID: 27980668 PMCID: PMC5133473 DOI: 10.1186/s12919-016-0062-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The relationship between genetic variability and individual phenotypes is usually investigated by testing for association relying on called genotypes. Allele counts obtained from next-generation sequence data could be used for this purpose too. Genetic association can be examined by treating alternative allele counts (AACs) as the response variable in negative binomial regression. AACs from sequence data often contain an excess of zeros, thus motivating the use of Hurdle and zero-inflated models. Here we examine rough type I error rates and the ability to pick out variants with small probability values for 7 different testing approaches that incorporate AACs as an explanatory or as a response variable. Model comparisons relied on chromosome 3 DNA sequence data from 407 Hispanic participants in the Type 2 Diabetes Genetic Exploration by Next-generation sequencing in Ethnic Samples (T2D-GENES) project 1 with complete information on diastolic blood pressure and related medication. Our results suggest that in the investigation of the relationship between AAC as response variable and individual phenotypes as explanatory variable, Hurdle-negative binomial regression has some advantages. This model showed a good ability to discriminate strongly associated variants and controlled overall type I error rates. However, probability values from Hurdle-negative binomial regression were not obtained for approximately 25 % of the investigated variants because of convergence problems, and the mass of the probability value distribution was concentrated around 1.
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Affiliation(s)
- Rosa González Silos
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, 69120 Germany
| | - Özge Karadag
- Department of Statistics, Hacettepe University, Ankara, 06800 Turkey
| | - Barbara Peil
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, 69120 Germany
| | - Christine Fischer
- Institute of Human Genetics, University of Heidelberg, Heidelberg, 69120 Germany
| | - Maria Kabisch
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, 69120 Germany ; Molecular Genetics of Breast Cancer (B072), German Cancer Research Center (DKFZ), Heidelberg, 69120 Germany
| | - Carine Legrand
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, 69120 Germany
| | - Justo Lorenzo Bermejo
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, 69120 Germany
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14
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Blangero J, Teslovich TM, Sim X, Almeida MA, Jun G, Dyer TD, Johnson M, Peralta JM, Manning A, Wood AR, Fuchsberger C, Kent JW, Aguilar DA, Below JE, Farook VS, Arya R, Fowler S, Blackwell TW, Puppala S, Kumar S, Glahn DC, Moses EK, Curran JE, Thameem F, Jenkinson CP, DeFronzo RA, Lehman DM, Hanis C, Abecasis G, Boehnke M, Göring H, Duggirala R, Almasy L. Omics-squared: human genomic, transcriptomic and phenotypic data for genetic analysis workshop 19. BMC Proc 2016; 10:71-77. [PMID: 27980614 PMCID: PMC5133484 DOI: 10.1186/s12919-016-0008-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background The Genetic Analysis Workshops (GAW) are a forum for development, testing, and comparison of statistical genetic methods and software. Each contribution to the workshop includes an application to a specified data set. Here we describe the data distributed for GAW19, which focused on analysis of human genomic and transcriptomic data. Methods GAW19 data were donated by the T2D-GENES Consortium and the San Antonio Family Heart Study and included whole genome and exome sequences for odd-numbered autosomes, measures of gene expression, systolic and diastolic blood pressures, and related covariates in two Mexican American samples. These two samples were a collection of 20 large families with whole genome sequence and transcriptomic data and a set of 1943 unrelated individuals with exome sequence. For each sample, simulated phenotypes were constructed based on the real sequence data. ‘Functional’ genes and variants for the simulations were chosen based on observed correlations between gene expression and blood pressure. The simulations focused primarily on additive genetic models but also included a genotype-by-medication interaction. A total of 245 genes were designated as ‘functional’ in the simulations with a few genes of large effect and most genes explaining < 1 % of the trait variation. An additional phenotype, Q1, was simulated to be correlated among related individuals, based on theoretical or empirical kinship matrices, but was not associated with any sequence variants. Two hundred replicates of the phenotypes were simulated. The GAW19 data are an expansion of the data used at GAW18, which included the family-based whole genome sequence, blood pressure, and simulated phenotypes, but not the gene expression data or the set of 1943 unrelated individuals with exome sequence.
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Affiliation(s)
- John Blangero
- South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Harlingen, TX 78550 USA
| | - Tanya M Teslovich
- Department of Biostatistics, Center for Statistical Genetics, University of Michigan, Ann Arbor, MI 48109 USA
| | - Xueling Sim
- Department of Biostatistics, Center for Statistical Genetics, University of Michigan, Ann Arbor, MI 48109 USA
| | - Marcio A Almeida
- South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Harlingen, TX 78550 USA
| | - Goo Jun
- Department of Biostatistics, Center for Statistical Genetics, University of Michigan, Ann Arbor, MI 48109 USA ; Department of Epidemiology, Human Genetics and Environmenal Sciences, University of Texas Health Science Center at Houston, Houston, TX 77030 USA
| | - Thomas D Dyer
- South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Harlingen, TX 78550 USA
| | - Matthew Johnson
- South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Harlingen, TX 78550 USA
| | - Juan M Peralta
- South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Harlingen, TX 78550 USA
| | - Alisa Manning
- Department of Genetics, Massachusetts General Hospital, Boston, MA 02114 USA
| | - Andrew R Wood
- Genetics of Complex Traits, Peninsula College of Medicine and Dentistry, University of Exeter, Exeter, UK
| | - Christian Fuchsberger
- Department of Biostatistics, Center for Statistical Genetics, University of Michigan, Ann Arbor, MI 48109 USA
| | - Jack W Kent
- Department of Genetics, Texas Biomedical Research Institute, 7620 NW Loop 410, San Antonio, TX 78227 USA
| | - David A Aguilar
- Cardiovascular Division, Baylor College of Medicine, Houston, TX 77030 USA
| | - Jennifer E Below
- Department of Epidemiology, Human Genetics and Environmenal Sciences, University of Texas Health Science Center at Houston, Houston, TX 77030 USA
| | - Vidya S Farook
- South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Harlingen, TX 78550 USA
| | - Rector Arya
- South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Harlingen, TX 78550 USA
| | - Sharon Fowler
- Division of Clinical Epidemiology, Department of Medicine, University of San Antonio Health Science Center at San Antonio, San Antonio, TX 78229 USA
| | - Tom W Blackwell
- Department of Biostatistics, Center for Statistical Genetics, University of Michigan, Ann Arbor, MI 48109 USA
| | - Sobha Puppala
- Department of Genetics, Texas Biomedical Research Institute, 7620 NW Loop 410, San Antonio, TX 78227 USA
| | - Satish Kumar
- South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Harlingen, TX 78550 USA
| | - David C Glahn
- Department of Psychiatry, Yale University, New Haven, CT 06106 USA
| | - Eric K Moses
- Centre for Genetic Origins of Health and Disease, University of Western Australia, Crawley, Australia
| | - Joanne E Curran
- South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Harlingen, TX 78550 USA
| | - Farook Thameem
- Department of Biochemistry, Faculty of Medicine, Kuwait University, Safat, Kuwait City, 13110 Kuwait
| | - Christopher P Jenkinson
- South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Harlingen, TX 78550 USA
| | - Ralph A DeFronzo
- Texas Diabetes Institute, University of San Antonio Health Science Center at San Antonio, San Antonio, TX 78229 USA
| | - Donna M Lehman
- Division of Clinical Epidemiology, Department of Medicine, University of San Antonio Health Science Center at San Antonio, San Antonio, TX 78229 USA
| | - Craig Hanis
- Department of Epidemiology, Human Genetics and Environmenal Sciences, University of Texas Health Science Center at Houston, Houston, TX 77030 USA
| | - Goncalo Abecasis
- Department of Biostatistics, Center for Statistical Genetics, University of Michigan, Ann Arbor, MI 48109 USA
| | - Michael Boehnke
- Department of Biostatistics, Center for Statistical Genetics, University of Michigan, Ann Arbor, MI 48109 USA
| | - Harald Göring
- South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Harlingen, TX 78550 USA
| | - Ravindranath Duggirala
- South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Harlingen, TX 78550 USA
| | - Laura Almasy
- South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Harlingen, TX 78550 USA ; Department of Genetics, University of Pennsylvania, Philadelphia, PA 19104 USA
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15
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Tayo BO, Tong L, Cooper RS. Association of polymorphisms in the aldosterone-regulated sodium reabsorption pathway with blood pressure among Hispanics. BMC Proc 2016; 10:343-348. [PMID: 27980660 PMCID: PMC5133472 DOI: 10.1186/s12919-016-0054-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Whereas genome-wide association study (GWAS) has proven to be an important tool for discovery of variants influencing many human diseases and traits, unfortunately its performance has not been much of all-around success for some complex conditions, for example, hypertension. Because some of the existing effective pharmacotherapeutic agents act by targeting known biological pathways, pathway-based analytical approaches could lead to more success in discovery of disease-associated variants. The objective of the present study was to identify functional variants associated with blood pressure in the aldosterone-regulated sodium reabsorption pathway using the simulated and real blood pressure phenotypes provided for Genetic Analysis Workshop 19. METHODS The present analysis included 1942 samples with exome sequencing data and for whom blood pressure phenotypes were available. Because only odd-numbered autosomes were available, we restricted analysis to 127 quality-controlled single-nucleotide polymorphisms from the aldosterone-regulated sodium reabsorption pathway. We performed pathway-based association analysis using appropriate regression models for single variant, haplotype and epistasis association analyses. To account for multiple comparisons, statistical significance was empirically derived by permutation procedure and Bonferroni correction. RESULTS The topmost pathway-based association signals were observed in PRKCA gene for diastolic blood pressure (DBP), systolic blood pressure (SBP), and mean arterial pressure (MAP) in both real and simulated data. The associations remained significant (P <0.05) after multiple testing corrections for the number of genes. Similarly, the pathway-based 2-locus epistasis analysis indicated significant interactions between INSR and PRKCG for SBP and MAP; INS and PIK3R2 for DBP; PIK3CD and ATP1B2 for hypertension in the real data set. We also observed significant within-gene interactions in INSR for SBP, DBP, and hypertension in the simulated data set. CONCLUSION The findings from this study show that pathway-based analytical approach targeting known biological pathways can be useful in identification of disease-associated variants that are otherwise undetectable by GWAS. The approach takes advantage of the assumption of nonindependence of variants within and across pathway genes which leads to reduced penalty of multiple testing and thus less-stringent statistical significance threshold.
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Affiliation(s)
- Bamidele O. Tayo
- Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153 USA
| | - Liping Tong
- Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153 USA
| | - Richard S. Cooper
- Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153 USA
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16
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Cade BE, Chen H, Stilp AM, Gleason KJ, Sofer T, Ancoli-Israel S, Arens R, Bell GI, Below JE, Bjonnes AC, Chun S, Conomos MP, Evans DS, Johnson WC, Frazier-Wood AC, Lane JM, Larkin EK, Loredo JS, Post WS, Ramos AR, Rice K, Rotter JI, Shah NA, Stone KL, Taylor KD, Thornton TA, Tranah GJ, Wang C, Zee PC, Hanis CL, Sunyaev SR, Patel SR, Laurie CC, Zhu X, Saxena R, Lin X, Redline S. Genetic Associations with Obstructive Sleep Apnea Traits in Hispanic/Latino Americans. Am J Respir Crit Care Med 2016; 194:886-897. [PMID: 26977737 PMCID: PMC5074655 DOI: 10.1164/rccm.201512-2431oc] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 03/14/2016] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Obstructive sleep apnea is a common disorder associated with increased risk for cardiovascular disease, diabetes, and premature mortality. Although there is strong clinical and epidemiologic evidence supporting the importance of genetic factors in influencing obstructive sleep apnea, its genetic basis is still largely unknown. Prior genetic studies focused on traits defined using the apnea-hypopnea index, which contains limited information on potentially important genetically determined physiologic factors, such as propensity for hypoxemia and respiratory arousability. OBJECTIVES To define novel obstructive sleep apnea genetic risk loci for obstructive sleep apnea, we conducted genome-wide association studies of quantitative traits in Hispanic/Latino Americans from three cohorts. METHODS Genome-wide data from as many as 12,558 participants in the Hispanic Community Health Study/Study of Latinos, Multi-Ethnic Study of Atherosclerosis, and Starr County Health Studies population-based cohorts were metaanalyzed for association with the apnea-hypopnea index, average oxygen saturation during sleep, and average respiratory event duration. MEASUREMENTS AND MAIN RESULTS Two novel loci were identified at genome-level significance (rs11691765, GPR83, P = 1.90 × 10-8 for the apnea-hypopnea index, and rs35424364; C6ORF183/CCDC162P, P = 4.88 × 10-8 for respiratory event duration) and seven additional loci were identified with suggestive significance (P < 5 × 10-7). Secondary sex-stratified analyses also identified one significant and several suggestive associations. Multiple loci overlapped genes with biologic plausibility. CONCLUSIONS These are the first genome-level significant findings reported for obstructive sleep apnea-related physiologic traits in any population. These findings identify novel associations in inflammatory, hypoxia signaling, and sleep pathways.
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Affiliation(s)
- Brian E. Cade
- Division of Sleep and Circadian Disorders and
- Division of Sleep Medicine and
| | - Han Chen
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Adrienne M. Stilp
- Department of Biostatistics, University of Washington, Seattle, Washington
| | | | - Tamar Sofer
- Department of Biostatistics, University of Washington, Seattle, Washington
| | - Sonia Ancoli-Israel
- Department of Medicine and
- Department of Psychiatry, University of California, San Diego, California
- Department of Veterans Affairs San Diego Center of Excellence for Stress and Mental Health, San Diego, California
| | - Raanan Arens
- The Children’s Hospital at Montefiore, Division of Respiratory and Sleep Medicine, Albert Einstein College of Medicine, Bronx, New York
| | - Graeme I. Bell
- Section of Adult and Pediatric Endocrinology, Diabetes, and Metabolism, The University of Chicago, Chicago, Illinois
| | - Jennifer E. Below
- Human Genetics Center, School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Andrew C. Bjonnes
- Division of Genetics, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Sung Chun
- Division of Genetics, Brigham and Women’s Hospital, Boston, Massachusetts
- Division of Medical Sciences, Harvard Medical School, Boston, Massachusetts
| | - Matthew P. Conomos
- Department of Biostatistics, University of Washington, Seattle, Washington
| | - Daniel S. Evans
- California Pacific Medical Center Research Institute, San Francisco, California
| | - W. Craig Johnson
- Department of Biostatistics, University of Washington, Seattle, Washington
| | | | - Jacqueline M. Lane
- Division of Sleep and Circadian Disorders and
- Division of Sleep Medicine and
- Center for Human Genetic Research and Department of Anesthesia, Pain, and Critical Care Medicine, Massachusetts General Hospital, Boston, Massachusetts
- Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts
| | - Emma K. Larkin
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jose S. Loredo
- Division of Pulmonary Critical Care and Sleep Medicine, Department of Medicine, UC San Diego School of Medicine, La Jolla, California
| | - Wendy S. Post
- Division of Cardiology, Johns Hopkins University, Baltimore, Maryland
| | - Alberto R. Ramos
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida
| | - Ken Rice
- Department of Biostatistics, University of Washington, Seattle, Washington
| | - Jerome I. Rotter
- Institute for Translational Genomics and Population Sciences, Los Angeles BioMedical Research Institute at Harbor-UCLA Medical Center, Torrance, California
| | - Neomi A. Shah
- Department of Medicine, Montefiore Medical Center, Bronx, New York
| | - Katie L. Stone
- California Pacific Medical Center Research Institute, San Francisco, California
| | - Kent D. Taylor
- Institute for Translational Genomics and Population Sciences, Los Angeles BioMedical Research Institute at Harbor-UCLA Medical Center, Torrance, California
| | | | - Gregory J. Tranah
- California Pacific Medical Center Research Institute, San Francisco, California
| | - Chaolong Wang
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Genome Institute of Singapore, Singapore
| | - Phyllis C. Zee
- Department of Neurology and Sleep Medicine Center, Northwestern University, Chicago, Illinois
| | - Craig L. Hanis
- Human Genetics Center, School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Shamil R. Sunyaev
- Division of Genetics, Brigham and Women’s Hospital, Boston, Massachusetts
- Division of Medical Sciences, Harvard Medical School, Boston, Massachusetts
- Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts
| | - Sanjay R. Patel
- Division of Sleep and Circadian Disorders and
- Division of Sleep Medicine and
- Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts; and
| | - Cathy C. Laurie
- Department of Biostatistics, University of Washington, Seattle, Washington
| | - Xiaofeng Zhu
- Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Richa Saxena
- Division of Sleep and Circadian Disorders and
- Center for Human Genetic Research and Department of Anesthesia, Pain, and Critical Care Medicine, Massachusetts General Hospital, Boston, Massachusetts
- Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts
| | - Xihong Lin
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Susan Redline
- Division of Sleep and Circadian Disorders and
- Division of Sleep Medicine and
- Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts; and
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17
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Daviglus ML, Pirzada A, Durazo-Arvizu R, Chen J, Allison M, Avilés-Santa L, Cai J, González HM, Kaplan RC, Schneiderman N, Sorlie PD, Talavera GA, Wassertheil-Smoller S, Stamler J. Prevalence of Low Cardiovascular Risk Profile Among Diverse Hispanic/Latino Adults in the United States by Age, Sex, and Level of Acculturation: The Hispanic Community Health Study/Study of Latinos. J Am Heart Assoc 2016; 5:e003929. [PMID: 27543802 PMCID: PMC5015308 DOI: 10.1161/jaha.116.003929] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 07/27/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Favorable levels of all readily measurable major cardiovascular disease risk factors (ie, low risk [LR]) are associated with lower risks of cardiovascular disease morbidity and mortality. Data are not available on LR prevalence among Hispanic/Latino adults of diverse ethnic backgrounds. This study aimed to describe the prevalence of a low cardiovascular disease risk profile among Hispanic/Latino adults in the United States and to examine cross-sectional associations of LR with measures of acculturation. METHODS AND RESULTS The multicenter, prospective, population-based Hispanic Community Health Study/Study of Latinos examined 16 415 men and women aged 18 to 74 years at baseline (2008-2011) with diverse Hispanic/Latino backgrounds. Analyses involved 14 757 adults (mean age 41.3 years; 60.6% women). LR was defined using national guidelines for favorable levels of serum cholesterol, blood pressure, and body mass index and by not having diabetes mellitus and not currently smoking. Age-adjusted LR prevalence was low (8.4% overall; 5.1% for men, 11.2% for women) and varied by background (4.2% in men of Mexican heritage versus 15.0% in women of Cuban heritage). Lower acculturation (assessed using proxy measures) was significantly associated with higher odds of a LR profile among women only: Age-adjusted odds ratios of having LR were 1.64 (95% CI 1.24-2.17) for foreign-born versus US-born women and 1.96 (95% CI 1.49-2.58) for women residing in the United States <10 versus ≥10 years. CONCLUSIONS Among diverse US Hispanic/Latino adults, the prevalence of a LR profile is low. Lower acculturation is associated with higher odds of a LR profile among women but not men. Comprehensive public health strategies are needed to improve the cardiovascular health of US Hispanic/Latino adults.
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Affiliation(s)
- Martha L Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, IL Department of Preventive Medicine, Northwestern University, Chicago, IL
| | - Amber Pirzada
- Institute for Minority Health Research, University of Illinois at Chicago, IL
| | - Ramon Durazo-Arvizu
- Institute for Minority Health Research, University of Illinois at Chicago, IL Department of Public Health Sciences, Loyola University, Chicago, IL
| | - Jinsong Chen
- Institute for Minority Health Research, University of Illinois at Chicago, IL
| | - Matthew Allison
- Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA
| | - Larissa Avilés-Santa
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Jianwen Cai
- Department of Biostatistics, Collaborative Studies Coordinating Center, University of North Carolina at Chapel Hill, NC
| | - Hector M González
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI
| | - Robert C Kaplan
- Department of Epidemiology and Biostatistics, Albert Einstein College of Medicine, Bronx, NY
| | - Neil Schneiderman
- Department of Psychology, Behavioral Medicine Research Center, University of Miami, FL
| | - Paul D Sorlie
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Gregory A Talavera
- Graduate School of Public Health, San Diego State University, San Diego, CA
| | | | - Jeremiah Stamler
- Department of Preventive Medicine, Northwestern University, Chicago, IL
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18
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Brown SA, Duchin SP, Villagomez ET. Diabetes Education in a Mexican-American Population: Pilot Testing of a Research-Based Videotape. DIABETES EDUCATOR 2016; 18:47-51. [PMID: 1370266 DOI: 10.1177/014572179201800108] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A diabetes education videotape was designed and pilot tested in a sample of 30 Spanish-speaking Hispanic diabetic adults in a rural Texas-Mexico border community. The videotape provided an overview of diabetes, with emphasis on the concept of blood glucose; relationships between food, medications, exercise, and blood glucose levels; and blood glucose monitoring. Outcomes of videotape effectiveness were based on a 20-item knowledge test and interview data to assess acceptability of videotapes as a learning tool. Comparison of the knowledge test scores of the experimental group (those who viewed the tape before taking the knowledge test) with the control group (those who took the test before viewing the tape) produced a positive, moderate effect size of 0.61. Interviews with subjects indicated enthusiastic acceptance of the videotape as a means of transmitting diabetes information.
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19
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Benavides-Vaello S, Brown SA. Sociocultural construction of food ways in low-income Mexican-American women with diabetes: a qualitative study. J Clin Nurs 2016; 25:2367-77. [PMID: 27301464 DOI: 10.1111/jocn.13291] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2016] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES The aim of the study was to explore how low-income Hispanic women, with at least 10 years of having type 2 diabetes, successfully manage the disease within a sociocultural context, especially in relation to foodways. BACKGROUND Managing type 2 diabetes is challenging, particularly for underserved populations such as low-income Hispanic women. This population segment has higher rates of type 2 diabetes, diabetes-related complications, obesity, and sedentary lifestyles than the general U.S. POPULATION Dietary management is a critical aspect of diabetes care, but it is perhaps the most difficult health behaviour to modify. DESIGN A qualitative and ethnographically based study was used. METHODS Participant observation and individual interviews explored the interrelationships of culture, food habits and type 2 diabetes among 12 low-income Hispanic women residing in an impoverished rural community located on the Texas-Mexico border. RESULTS Hispanic women used unique strategies to adjust their diet, particularly portion control; for example, they emphasised the 'use of the fork', based on the notion that Hispanic finger foods are less healthy. Women categorised foods as bad or acceptable, depending on the context, such as important family or social gatherings. Those with years of diabetes experience confidently took charge of the disease based on knowledge of their bodies and a desire to avoid complications, while acknowledging brief infractions of dietary 'rules' and balancing various social roles and expectations. CONCLUSIONS Hispanic women manage their type 2 diabetes within a sociocultural environment. Those with expertise make changes in how they eat to care for their diabetes, but also continue to maintain traditional foodways. RELEVANCE TO CLINICAL PRACTICE Foodways are critical to most cultural groups and modifying dietary behaviours can be challenging. Clinicians must develop self-management guidance within the sociocultural context of the patient if diabetes outcomes are to improve and be sustained.
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Affiliation(s)
| | - Sharon A Brown
- School of Nursing, The University of Texas at Austin, Austin, TX, USA
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20
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Hanis CL, Redline S, Cade BE, Bell GI, Cox NJ, Below JE, Brown EL, Aguilar D. Beyond type 2 diabetes, obesity and hypertension: an axis including sleep apnea, left ventricular hypertrophy, endothelial dysfunction, and aortic stiffness among Mexican Americans in Starr County, Texas. Cardiovasc Diabetol 2016; 15:86. [PMID: 27266869 PMCID: PMC4897940 DOI: 10.1186/s12933-016-0405-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 05/28/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is an increasing appreciation for a series of less traditional risk factors that should not be ignored when considering type 2 diabetes, obesity, hypertension, and cardiovascular disease. These include aortic stiffness, cardiac structure, impaired endothelial function and obstructive sleep apnea. They are associated to varying degrees with each disease categorization and with each other. It is not clear whether they represent additional complications, concomitants or antecedents of disease. Starr County, Texas, with its predominantly Mexican American population has been shown previously to bear a disproportionate burden of the major disease categories, but little is known about the distribution of these less traditional factors. METHODS Type 2 diabetes, obesity and hypertension frequencies were determined through a systematic survey of Starr County conducted from 2002 to 2006. Individuals from this examination and an enriched set with type 2 diabetes were re-examined from 2010 to 2014 including assessment of cardiac structure, sleep apnea, endothelial function and aortic stiffness. Individual and combined frequencies of these inter-related (i.e., axis) conditions were estimated and associations evaluated. RESULTS Household screening of 5230 individuals aged 20 years and above followed by direct physical assessment of 1610 identified 23.7 % of men and 26.7 % of women with type 2 diabetes, 46.2 and 49.5 % of men and women, respectively with obesity and 32.1 and 32.4 % with hypertension. Evaluation of pulse wave velocity, left ventricular mass, endothelial function and sleep apnea identified 22.3, 12.7, 48.6 and 45.2 % of men as having "at risk" values for each condition, respectively. Corresponding numbers in women were 16.0, 17.9, 23.6 and 28.8 %. Cumulatively, 88 % of the population has one or more of these while 50 % have three or more. CONCLUSIONS The full axis of conditions is high among Mexican Americans in Starr County, Texas. Individual and joint patterns suggest a genesis well before overt disease. Whether they are all mediated by common underlying factors or whether there exist multiple mechanisms remains to be seen.
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Affiliation(s)
- Craig L Hanis
- Human Genetics Center, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, 77225, USA.
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA.,Beth Israel Hospital, Boston, MA, 02215, USA
| | - Brian E Cade
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Graeme I Bell
- Departments of Medicine and Human Genetics, The University of Chicago, Chicago, IL, 60637, USA
| | - Nancy J Cox
- Vanderbilt Genetics Institute, Vanderbilt University School of Medicine, Nashville, TN, 37232, USA
| | - Jennifer E Below
- Human Genetics Center, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, 77225, USA
| | - Eric L Brown
- Human Genetics Center, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, 77225, USA.,Center for Infectious Disease, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, 77225, USA
| | - David Aguilar
- Cardiology, Baylor College of Medicine, Houston, TX, 77030, USA
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21
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Dean DA, Goldberger AL, Mueller R, Kim M, Rueschman M, Mobley D, Sahoo SS, Jayapandian CP, Cui L, Morrical MG, Surovec S, Zhang GQ, Redline S. Scaling Up Scientific Discovery in Sleep Medicine: The National Sleep Research Resource. Sleep 2016; 39:1151-64. [PMID: 27070134 DOI: 10.5665/sleep.5774] [Citation(s) in RCA: 183] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 01/25/2016] [Indexed: 12/20/2022] Open
Abstract
ABSTRACT Professional sleep societies have identified a need for strategic research in multiple areas that may benefit from access to and aggregation of large, multidimensional datasets. Technological advances provide opportunities to extract and analyze physiological signals and other biomedical information from datasets of unprecedented size, heterogeneity, and complexity. The National Institutes of Health has implemented a Big Data to Knowledge (BD2K) initiative that aims to develop and disseminate state of the art big data access tools and analytical methods. The National Sleep Research Resource (NSRR) is a new National Heart, Lung, and Blood Institute resource designed to provide big data resources to the sleep research community. The NSRR is a web-based data portal that aggregates, harmonizes, and organizes sleep and clinical data from thousands of individuals studied as part of cohort studies or clinical trials and provides the user a suite of tools to facilitate data exploration and data visualization. Each deidentified study record minimally includes the summary results of an overnight sleep study; annotation files with scored events; the raw physiological signals from the sleep record; and available clinical and physiological data. NSRR is designed to be interoperable with other public data resources such as the Biologic Specimen and Data Repository Information Coordinating Center Demographics (BioLINCC) data and analyzed with methods provided by the Research Resource for Complex Physiological Signals (PhysioNet). This article reviews the key objectives, challenges and operational solutions to addressing big data opportunities for sleep research in the context of the national sleep research agenda. It provides information to facilitate further interactions of the user community with NSRR, a community resource.
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Affiliation(s)
- Dennis A Dean
- Brigham and Women's Hospital, Boston, MA.,Harvard Medical School, Boston, MA
| | - Ary L Goldberger
- Harvard Medical School, Boston, MA.,Beth Israel Deaconess Medical Center, Boston, MA.,WYSS Institute at Harvard University
| | - Remo Mueller
- Brigham and Women's Hospital, Boston, MA.,Harvard Medical School, Boston, MA
| | - Matthew Kim
- Brigham and Women's Hospital, Boston, MA.,Harvard Medical School, Boston, MA
| | | | | | - Satya S Sahoo
- Division of Medical Informatics and Electrical Engineering Computer Science Department, Case Western Reserve University, Cleveland, OH
| | - Catherine P Jayapandian
- Division of Medical Informatics and Electrical Engineering Computer Science Department, Case Western Reserve University, Cleveland, OH
| | - Licong Cui
- Division of Medical Informatics and Electrical Engineering Computer Science Department, Case Western Reserve University, Cleveland, OH
| | | | | | - Guo-Qiang Zhang
- Institute of Biomedical Informatics, University of Kentucky, Lexington, KY
| | - Susan Redline
- Brigham and Women's Hospital, Boston, MA.,Harvard Medical School, Boston, MA.,Beth Israel Deaconess Medical Center, Boston, MA.,Harvard School of Public Health, Boston, MA
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22
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Abstract
As the Hispanic population in the United States increases, more primary care physicians are being challenged to address the high incidence of diabetes and related metabolic disorders in Hispanic American patients. A variety of genetic, environmental, and socioeconomic factors contribute to this group's high susceptibility to diabetes. In this article, Drs Idrogo and Mazze discuss diagnosis of diabetes in Hispanic patients, as well as culturally sensitive screening and treatment strategies.
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Affiliation(s)
- Manuel Idrogo
- Department of Family Medicine, University of Minnesota Medical School-Twin Cities, ST Paul 55103, USA.
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23
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Estrada K, Aukrust I, Bjørkhaug L, Burtt NP, Mercader JM, García-Ortiz H, Huerta-Chagoya A, Moreno-Macías H, Walford G, Flannick J, Williams AL, Gómez-Vázquez MJ, Fernandez-Lopez JC, Martínez-Hernández A, Jiménez-Morales S, Centeno-Cruz F, Mendoza-Caamal E, Revilla-Monsalve C, Islas-Andrade S, Córdova EJ, Soberón X, González-Villalpando ME, Henderson E, Wilkens LR, Le Marchand L, Arellano-Campos O, Ordóñez-Sánchez ML, Rodríguez-Torres M, Rodríguez-Guillén R, Riba L, Najmi LA, Jacobs SBR, Fennell T, Gabriel S, Fontanillas P, Hanis CL, Lehman DM, Jenkinson CP, Abboud HE, Bell GI, Cortes ML, Boehnke M, González-Villalpando C, Orozco L, Haiman CA, Tusié-Luna T, Aguilar-Salinas CA, Altshuler D, Njølstad PR, Florez JC, MacArthur DG. Association of a low-frequency variant in HNF1A with type 2 diabetes in a Latino population. JAMA 2014; 311:2305-14. [PMID: 24915262 PMCID: PMC4425850 DOI: 10.1001/jama.2014.6511] [Citation(s) in RCA: 176] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
IMPORTANCE Latino populations have one of the highest prevalences of type 2 diabetes worldwide. OBJECTIVES To investigate the association between rare protein-coding genetic variants and prevalence of type 2 diabetes in a large Latino population and to explore potential molecular and physiological mechanisms for the observed relationships. DESIGN, SETTING, AND PARTICIPANTS Whole-exome sequencing was performed on DNA samples from 3756 Mexican and US Latino individuals (1794 with type 2 diabetes and 1962 without diabetes) recruited from 1993 to 2013. One variant was further tested for allele frequency and association with type 2 diabetes in large multiethnic data sets of 14,276 participants and characterized in experimental assays. MAIN OUTCOME AND MEASURES Prevalence of type 2 diabetes. Secondary outcomes included age of onset, body mass index, and effect on protein function. RESULTS A single rare missense variant (c.1522G>A [p.E508K]) was associated with type 2 diabetes prevalence (odds ratio [OR], 5.48; 95% CI, 2.83-10.61; P = 4.4 × 10(-7)) in hepatocyte nuclear factor 1-α (HNF1A), the gene responsible for maturity onset diabetes of the young type 3 (MODY3). This variant was observed in 0.36% of participants without type 2 diabetes and 2.1% of participants with it. In multiethnic replication data sets, the p.E508K variant was seen only in Latino patients (n = 1443 with type 2 diabetes and 1673 without it) and was associated with type 2 diabetes (OR, 4.16; 95% CI, 1.75-9.92; P = .0013). In experimental assays, HNF-1A protein encoding the p.E508K mutant demonstrated reduced transactivation activity of its target promoter compared with a wild-type protein. In our data, carriers and noncarriers of the p.E508K mutation with type 2 diabetes had no significant differences in compared clinical characteristics, including age at onset. The mean (SD) age for carriers was 45.3 years (11.2) vs 47.5 years (11.5) for noncarriers (P = .49) and the mean (SD) BMI for carriers was 28.2 (5.5) vs 29.3 (5.3) for noncarriers (P = .19). CONCLUSIONS AND RELEVANCE Using whole-exome sequencing, we identified a single low-frequency variant in the MODY3-causing gene HNF1A that is associated with type 2 diabetes in Latino populations and may affect protein function. This finding may have implications for screening and therapeutic modification in this population, but additional studies are required.
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Affiliation(s)
| | - Karol Estrada
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, Massachusetts2Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston3Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Ingvild Aukrust
- KG Jebsen Center for Diabetes Research, Department of Clinical Science, University of Bergen, Bergen, Norway6Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Lise Bjørkhaug
- KG Jebsen Center for Diabetes Research, Department of Clinical Science, University of Bergen, Bergen, Norway5Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
| | - Noël P Burtt
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, Massachusetts
| | - Josep M Mercader
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, Massachusetts7Center for Human Genetic Research and Diabetes Research Center (Diabetes Unit), Massachusetts General Hospital, Boston8Joint BSC-CRG-IRB Research Prog
| | | | - Alicia Huerta-Chagoya
- Instituto de Investigaciones Biomédicas, UNAM Unidad de Biología Molecular y Medicina Genómica, UNAM/INCMNSZ, Coyoacán, Mexico City, Mexico
| | | | - Geoffrey Walford
- Department of Medicine, Harvard Medical School, Boston, Massachusetts7Center for Human Genetic Research and Diabetes Research Center (Diabetes Unit), Massachusetts General Hospital, Boston
| | - Jason Flannick
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, Massachusetts13Department of Molecular Biology, Harvard Medical School, Boston, Massachusetts
| | - Amy L Williams
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, Massachusetts14Department of Biological Sciences, Columbia University, New York, New York
| | - María J Gómez-Vázquez
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Sección XVI, Tlalpan, Mexico City, Mexico
| | | | | | | | | | | | - Cristina Revilla-Monsalve
- Unidad de Investigación Médica en Enfermedades Metabólicas, CMN SXXI, Instituto Mexicano del Seguro Social, Mexico City
| | - Sergio Islas-Andrade
- Unidad de Investigación Médica en Enfermedades Metabólicas, CMN SXXI, Instituto Mexicano del Seguro Social, Mexico City
| | - Emilio J Córdova
- Instituto Nacional de Medicina Genómica, Tlalpan, Mexico City, Mexico
| | - Xavier Soberón
- Instituto Nacional de Medicina Genómica, Tlalpan, Mexico City, Mexico
| | - María E González-Villalpando
- Centro de Estudios en Diabetes, Unidad de Investigacion en Diabetes y Riesgo Cardiovascular, Centro de Investigacion en Salud Poblacional, Instituto Nacional de Salud Publica, Mexico City, Mexico
| | - E Henderson
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles
| | - Lynne R Wilkens
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu
| | - Loic Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu
| | - Olimpia Arellano-Campos
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Sección XVI, Tlalpan, Mexico City, Mexico
| | - Maria L Ordóñez-Sánchez
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Sección XVI, Tlalpan, Mexico City, Mexico
| | - Maribel Rodríguez-Torres
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Sección XVI, Tlalpan, Mexico City, Mexico
| | - Rosario Rodríguez-Guillén
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Sección XVI, Tlalpan, Mexico City, Mexico
| | - Laura Riba
- Instituto de Investigaciones Biomédicas, UNAM Unidad de Biología Molecular y Medicina Genómica, UNAM/INCMNSZ, Coyoacán, Mexico City, Mexico
| | - Laeya A Najmi
- KG Jebsen Center for Diabetes Research, Department of Clinical Science, University of Bergen, Bergen, Norway23Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway
| | - Suzanne B R Jacobs
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, Massachusetts
| | - Timothy Fennell
- The Genomics Platform, The Broad Institute of Harvard and MIT, Cambridge, Massachusetts
| | - Stacey Gabriel
- The Genomics Platform, The Broad Institute of Harvard and MIT, Cambridge, Massachusetts
| | - Pierre Fontanillas
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, Massachusetts
| | - Craig L Hanis
- Human Genetics Center, University of Texas Health Science Center at Houston
| | - Donna M Lehman
- Department of Medicine, University of Texas Health Science Center at San Antonio
| | | | - Hanna E Abboud
- Department of Medicine, University of Texas Health Science Center at San Antonio
| | - Graeme I Bell
- Department of Human Genetics, University of Chicago, Chicago, Illinois28Department of Medicine, University of Chicago, Chicago, Illinois
| | - Maria L Cortes
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts
| | - Michael Boehnke
- Department of Biostatistics, Center for Statistical Genetics, University of Michigan, Ann Arbor
| | - Clicerio González-Villalpando
- Centro de Estudios en Diabetes, Unidad de Investigacion en Diabetes y Riesgo Cardiovascular, Centro de Investigacion en Salud Poblacional, Instituto Nacional de Salud Publica, Mexico City, Mexico
| | - Lorena Orozco
- Instituto Nacional de Medicina Genómica, Tlalpan, Mexico City, Mexico
| | - Christopher A Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles
| | - Teresa Tusié-Luna
- Instituto de Investigaciones Biomédicas, UNAM Unidad de Biología Molecular y Medicina Genómica, UNAM/INCMNSZ, Coyoacán, Mexico City, Mexico17Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Sección XVI, Tlalpan, Mexico City, Mexico
| | - Carlos A Aguilar-Salinas
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Sección XVI, Tlalpan, Mexico City, Mexico
| | - David Altshuler
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, Massachusetts3Department of Medicine, Harvard Medical School, Boston, Massachusetts7Center for Human Genetic Research and Diabetes Research Center (Diabetes Unit)
| | - Pål R Njølstad
- KG Jebsen Center for Diabetes Research, Department of Clinical Science, University of Bergen, Bergen, Norway5Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
| | - Jose C Florez
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, Massachusetts3Department of Medicine, Harvard Medical School, Boston, Massachusetts7Center for Human Genetic Research and Diabetes Research Center (Diabetes Unit)
| | - Daniel G MacArthur
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, Massachusetts3Department of Medicine, Harvard Medical School, Boston, Massachusetts
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24
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Salinas JJ, Abdelbary B, Rentfro A, Fisher-Hoch S, McCormick J. Cardiovascular disease risk among the Mexican American population in the Texas-Mexico border region, by age and length of residence in United States. Prev Chronic Dis 2014; 11:E58. [PMID: 24721218 PMCID: PMC3984943 DOI: 10.5888/pcd11.130253] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Introduction Although the relationship between health behaviors and outcomes such as smoking and obesity with longer residence in the United States among Mexican American immigrants is established, the relationship between length of residency in the United States and risk for cardiovascular disease (CVD) is not fully understood. The objective of this study was to determine the relationship between immigrant status, length of residence in the United States, age, and CVD markers in a sample of Mexican American adults living in Brownsville, Texas. Methods We categorized participants in the Cameron County Hispanic Cohort study as immigrants in the United States for 10 years or less, immigrants in the United States for more than 10 years, or born in the United States. We conducted logistic and ordinary least squares regression for self-reported chronic conditions and CVD biomarkers. Results We found bivariate differences in the prevalence of self-reported conditions and 1 CVD biomarker (low-density lipoprotein cholesterol) by length of residence in the middle (41–64 y) and younger (18–40 y) age groups. After adjusting for covariates, the following varied significantly by immigrant status: stroke and high cholesterol (self-reported conditions) and diastolic blood pressure, systolic blood pressure, total cholesterol, and low-density lipoprotein cholesterol (CVD biomarkers). Conclusion The association between immigrant status, length of residence in the United States, and CVD markers varied. The effect of length of residence in the United States or immigrant status may depend on age and may be most influential in middle or older age.
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Affiliation(s)
- Jennifer J Salinas
- University of Texas Health Science Center, School of Public Health, Brownsville Campus, 80 Fort Brown, Brownsville, TX 78520. E-mail:
| | - Bassent Abdelbary
- University of Texas Health Science Center, School of Public Health, Brownsville Campus, Brownsville, Texas
| | - Anne Rentfro
- University of Texas at Brownsville, Brownsville, Texas
| | - Susan Fisher-Hoch
- University of Texas Health Science Center, School of Public Health, Brownsville Campus, Brownsville, Texas
| | - Joseph McCormick
- University of Texas Health Science Center, School of Public Health, Brownsville Campus, Brownsville, Texas
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25
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Brown SA, Kouzekanani K, García AA, Orlander PR, Hanis CL. Diabetes self-management and leptin in Mexican Americans with type 2 diabetes: the Starr County border health initiative. THE DIABETES EDUCATOR 2013; 39:820-7. [PMID: 24047926 PMCID: PMC8359772 DOI: 10.1177/0145721713505153] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE The purpose of the study was to (1) characterize leptin in Mexican Americans with poorly controlled type 2 diabetes, (2) examine relationships among leptin and indicators of diabetes status (body mass index and A1C), and (3) explore the effects of a culturally tailored diabetes self-management education intervention on leptin. METHODS In Starr County, an impoverished Texas-Mexico border community, 252 Mexican Americans with type 2 diabetes were recruited to test a diabetes self-management education intervention culturally tailored in terms of language, dietary recommendations, social emphasis, family participation, and incorporation of cultural health beliefs. Groups of 8 participants were randomized to experimental or wait-listed control conditions. Outcomes were measured at 3, 6, and 12 months; by 12 months, 109 had complete leptin data. RESULTS Most participants were women and, on average, 55 years of age, diagnosed with diabetes for 8 years, obese, and in poor glycemic control. Three variables-body mass index, sex, A1C-explained 36% of the variance in baseline leptin; there were no intervention effects on leptin. Sex, time, and gender × time interaction effects on leptin were statistically significant; greater increases in leptin over time occurred in women compared to men. In women, fasting blood glucose changes from baseline to 12 months significantly predicted leptin changes from baseline to 12 months; in men, body mass index changes predicted leptin change. CONCLUSIONS With increasing obesity rates, further research is warranted to determine if leptin is a useful intervention target in type 2 diabetes.
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Affiliation(s)
- Sharon A Brown
- School of Nursing, The University of Texas at Austin, TX, USA (Dr Brown, Prof García)
| | | | - Alexandra A García
- School of Nursing, The University of Texas at Austin, TX, USA (Dr Brown, Prof García)
| | - Philip R Orlander
- The University of Texas Medical School at Houston, TX, USA (Dr Orlander)
| | - Craig L Hanis
- The University of Texas Health Science Center at Houston, TX, USA (Prof Hanis)
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26
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Guinn B. The Overweight Status of Low-Income Mexican American Children 10 Through 14 Years of Age. ACTA ACUST UNITED AC 2013. [DOI: 10.1080/10556699.1993.10616379] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Bobby Guinn
- a Department of Health and Kinesiology , University of Texas — Pan American , Edinburg , TX , 78539 , USA
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García AA. The Diabetes Symptom Self-Care Inventory: development and psychometric testing with Mexican Americans. J Pain Symptom Manage 2011; 41:715-27. [PMID: 21276705 PMCID: PMC3075383 DOI: 10.1016/j.jpainsymman.2010.06.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2010] [Revised: 06/21/2010] [Accepted: 07/08/2010] [Indexed: 11/18/2022]
Abstract
CONTEXT Type 2 diabetes is prevalent throughout the world. In previous studies of Mexican Americans with type 2 diabetes, 95%-97% of those sampled reported having symptoms they believe were caused by diabetes and most self-treated their symptoms. To more accurately capture Mexican Americans' symptom prevalence and their self-treatments, the Diabetes Symptom Self-Care Inventory (DSSCI) was adapted from the Diabetes Self-Care Instrument. OBJECTIVES This article describes the modification process used to perfect the DSSCI for use in improving self-care among people with type 2 diabetes. METHODS This instrumentation study used qualitative and quantitative methods. The study was completed in four phases that used focus groups, cognitive interviews, and survey administration. Four convenience samples were drawn from community-dwelling Mexican American adults, aged 25-75 years, with type 2 diabetes in an urban area and a rural location in Texas. RESULTS Phase I: Seven focus groups (n=45) generated data for revising items. Phase II: Cognitive interviews with 16 participants were used to evaluate four revisions of the questionnaire. Phase III: Surveys were administered to 81 participants. Total number of symptoms on the DSSCI correlated with scores on the Centers for Epidemiological Studies-Depression scale (r=0.65, P<0.001), Illness Perception Questionnaire-Revised Diabetes Symptom subscale (r=0.57, P<0.001), and Audit of Diabetes-Dependent Quality of Life scale (r=-0.42, P<0.001). Minor revisions followed. Phase IV: Test-retest stability was demonstrated (n=44). CONCLUSION The DSSCI is a culturally relevant, sound measure of Mexican Americans' diabetes symptoms and the actions they take to address them.
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Affiliation(s)
- Alexandra A García
- The University of Texas at Austin School of Nursing, Austin, Texas 78701, USA.
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28
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Peltz G, Aguirre MT, Sanderson M, Fadden MK. The role of fat mass index in determining obesity. Am J Hum Biol 2011; 22:639-47. [PMID: 20737611 DOI: 10.1002/ajhb.21056] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES The objective of this study is to compare body mass index (BMI), percent body fat (PBF), and fat mass index (FMI) and to investigate the accuracy of FMI as a convenient tool for assessing obesity. DESIGN Anthropometric measurements and bioelectrical impedance analyses were performed on 538 Mexican Americans (373 women and 165 men). Correlations between BMI and PBF and between FMI and PBF were investigated. The percentage of persons misclassified as obese using different classifications was calculated. Multiple linear regression analysis was performed to generate predictive models of FMI for males and females separately. RESULTS BMI and PBF were correlated in men (rho = 0.877; P < 0.0001) and women (rho = 0.966; P < 0.0001); however, 20 and 67.2% of the men and 9.2 and 84.2% of women, classified as normal weight and overweight by BMI, respectively, were diagnosed as obese by PBF. FMI and PBF were also correlated in men (rho = 0.975; P < 0.0001) and women (rho = 0.992; P < 0.0001). Four percent of the men classified as normal weight and 65.5% classified as overweight by BMI were obese by FMI, while 71.3% of women classified as overweight by BMI were obese by FMI. Misclassification of obesity between FMI and PBF categories was observed in 5.4% of men and 7.8% of women. CONCLUSIONS The discrepancy observed between BMI and PBF reflects a limitation of BMI. Conversely, FMI accurately assessed obesity in our study of Mexican Americans, but further studies are necessary to confirm our findings in different ethnic groups.
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Affiliation(s)
- Gerson Peltz
- Department of Biological Sciences and Center of Biomedical Studies, University of Texas at Brownsville, Texas 78520, USA.
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29
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Surani S, Aguillar R, Komari V, Surani A, Subramanian S. Influence of Hispanic ethnicity in prevalence of diabetes mellitus in sleep apnea and relationship to sleep phase. Postgrad Med 2009; 121:108-12. [PMID: 19820279 DOI: 10.3810/pgm.2009.09.2057] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Recent studies have shown a strong association between insulin resistance, diabetes mellitus, and obstructive sleep apnea (OSA). This association has not been previously reported in the Hispanic population. The objective of this study was to study the prevalence of diabetes in a cohort of Hispanic patients with OSA in comparison with a white cohort. METHOD We performed a retrospective chart review of 103 Hispanic patients and 69 white patients with OSA. All patients had undergone full-night baseline polysomnography. We excluded charts of patients who underwent split-night studies and those who did not have rapid eye movement (REM) sleep. RESULTS Both groups were well matched in terms of age, gender distribution, and body mass index. The prevalence of self-reported diabetes in Hispanic patients with OSA was 42.71% compared with 24.28% of whites (P = 0.005). A REM apnea hypopnea index (AHI) of > 20 was significantly associated with an increased prevalence of diabetes in the Hispanic population; this association was not seen in the white population. CONCLUSION There was a very high prevalence of diabetes in an unselected cohort of Hispanic patients with OSA compared with white patients.
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Florez JC, Price AL, Campbell D, Riba L, Parra MV, Yu F, Duque C, Saxena R, Gallego N, Tello-Ruiz M, Franco L, Rodríguez-Torres M, Villegas A, Bedoya G, Aguilar-Salinas CA, Tusié-Luna MT, Ruiz-Linares A, Reich D. Strong association of socioeconomic status with genetic ancestry in Latinos: implications for admixture studies of type 2 diabetes. Diabetologia 2009; 52:1528-36. [PMID: 19526211 PMCID: PMC3113605 DOI: 10.1007/s00125-009-1412-x] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2009] [Accepted: 05/07/2009] [Indexed: 12/17/2022]
Abstract
AIMS/HYPOTHESIS Type 2 diabetes is more prevalent in US American minority populations of African or Native American descent than it is in European Americans. However, the proportion of this epidemiological difference that can be ascribed to genetic or environmental factors is unknown. To determine whether genetic ancestry is correlated with diabetes risk in Latinos, we estimated the proportion of European ancestry in case-control samples from Mexico and Colombia in whom socioeconomic status had been carefully ascertained. METHODS We genotyped 67 ancestry-informative markers in 499 participants with type 2 diabetes and 197 controls from Medellín (Colombia), as well as in 163 participants with type 2 diabetes and 72 controls from central Mexico. Each participant was assigned a socioeconomic status scale via various measures. RESULTS Although European ancestry was associated with lower diabetes risk in Mexicans (OR [95% CI] 0.06 [0.02-0.21], p = 2.0 x 10(-5)) and Colombians (OR 0.26 [0.08-0.78], p = 0.02), adjustment for socioeconomic status eliminated the association in the Colombian sample (OR 0.64 [0.19-2.12], p = 0.46) and significantly attenuated it in the Mexican sample (OR 0.17 [0.04-0.71], p = 0.02). Adjustment for BMI did not change the results. CONCLUSIONS/INTERPRETATION The proportion of non-European ancestry is associated with both type 2 diabetes and lower socioeconomic status in admixed Latino populations from North and South America. We conclude that ancestry-directed search for genetic markers associated with type 2 diabetes in Latinos may benefit from information involving social factors, as these factors have a quantitatively important effect on type 2 diabetes risk relative to ancestry effects.
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Affiliation(s)
- J. C. Florez
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Diabetes Research Center (Diabetes Unit), Massachusetts General Hospital, Simches Research Building, CPZN 5.250, 185 Cambridge Street, Boston, MA 02114, USA
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA
| | - A. L. Price
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
- Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA
| | - D. Campbell
- The Galton Laboratory, Department of Genetics, Evolution and Environment, University College London, Wolfson House, 4 Stephenson Way, London NW1 2HE, UK
| | - L. Riba
- Unidad de Biología Molecular y Medicina Genómica, Instituto de Investigaciones Biomédicas, UNAM / Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga #15, Col. Sección 16, Tlalpan, 14000 Mexico D.F., Mexico
| | - M. V. Parra
- Laboratorio de Genética Molecular, Universidad de Antioquía, Medellín, Colombia
| | - F. Yu
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Human Genome Sequencing Center, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - C. Duque
- Laboratorio de Genética Molecular, Universidad de Antioquía, Medellín, Colombia
| | - R. Saxena
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA
- Department of Genetics, Harvard Medical School, Boston, MA, USA
| | - N. Gallego
- Laboratorio de Genética Molecular, Universidad de Antioquía, Medellín, Colombia
| | - M. Tello-Ruiz
- Cold Spring Harbor Laboratory, Cold Spring Harbor, NY, USA
| | - L. Franco
- Laboratorio de Genética Molecular, Universidad de Antioquía, Medellín, Colombia
| | - M. Rodríguez-Torres
- Unidad de Biología Molecular y Medicina Genómica, Instituto de Investigaciones Biomédicas, UNAM / Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga #15, Col. Sección 16, Tlalpan, 14000 Mexico D.F., Mexico
| | - A. Villegas
- Laboratorio de Genética Molecular, Universidad de Antioquía, Medellín, Colombia
| | - G. Bedoya
- Laboratorio de Genética Molecular, Universidad de Antioquía, Medellín, Colombia
| | - C. A. Aguilar-Salinas
- Departamento de Endocrinología y Metabolismo, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - M. T. Tusié-Luna
- Unidad de Biología Molecular y Medicina Genómica, Instituto de Investigaciones Biomédicas, UNAM / Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga #15, Col. Sección 16, Tlalpan, 14000 Mexico D.F., Mexico
| | - A. Ruiz-Linares
- The Galton Laboratory, Department of Genetics, Evolution and Environment, University College London, Wolfson House, 4 Stephenson Way, London NW1 2HE, UK
- Laboratorio de Genética Molecular, Universidad de Antioquía, Medellín, Colombia
| | - D. Reich
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Department of Genetics, Harvard Medical School, Boston, MA, USA
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Ingram M, Ruis M, Mayorga MT, Rosales C. The Animadora Project: identifying factors related to the promotion of physical activity among Mexican Americans with diabetes. Am J Health Promot 2009; 23:396-402. [PMID: 19601479 PMCID: PMC4457370 DOI: 10.4278/ajhp.08021915] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE There is a dearth of information about factors related to physical activity among Mexican-Americans with diabetes. Self-efficacy and social support are associated with physical activity; however, little is known about their roles within different cultural groups. DESIGN Focus groups were used to identify factors that motivated walking. SETTING Two Mexican-American communities located in Tucson, Arizona. SUBJECTS Individuals who attended diabetes education. INTERVENTION A community-based provider organized walking groups with people who previously attended diabetes classes. Walkers participated in focus groups exploring themes related to their experiences. MEASURES Self-efficacy, social support, and collective efficacy. Grounded theory was used to analyze focus group results using two rounds of analysis; the first identified references to self-efficacy and social support, and the second added collective efficacy as a theoretic basis for walking. RESULTS Among 43 eligible participants, 20 participated in focus groups. Social support was expressed as commitment and companionship. Walkers demonstrated a high level of self-efficacy for walking. Development of group identity/social cohesion was also a motivator to walk. Collective efficacy emerged as an applicable theoretic model encompassing these themes and their interrelationship. CONCLUSION Collective efficacy, or the belief that the group can improve their lives through collective effort, is a viable theoretic construct in the development of physical activity interventions targeting Mexican-Americans with diabetes.
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Affiliation(s)
- Maia Ingram
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 2495 N. Martin, Campus POB 245209, Tucson, AZ 85724, (520) 626-2267, Fax (520) 626-8716
| | - Maricruz Ruis
- Mexican American Studies, University of Arizona, César Chavez Building, Room 208, Tucson, AZ 85721-0023, (520) 621-7551, Fax (520 621-7966
| | - Maria Theresa Mayorga
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 2495 N. Martin, Campus POB 245209, Tucson, AZ 85724, (520) 626-2267, Fax (520) 626-8716
| | - Cecilia Rosales
- 1295 N. Martin Rm A239, Campus POB 245210, Tucson, AZ 85724, (520) 626-0720, (520) 626-8716
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Sixta CS, Ostwald S. Texas-Mexico Border Intervention by Promotores for Patients With Type 2 Diabetes. DIABETES EDUCATOR 2008; 34:299-309. [DOI: 10.1177/0145721708314490] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose The purpose of this study is to evaluate the impact of a promotores-led diabetes self-management program by comparing the outcomes (knowledge, beliefs, and HbA1c level) of Mexican American patients with type 2 diabetes who received usual diabetic care in a wait-list control group to those who received self-management education and follow-up by promotores in consultation with clinic providers and staff. Methods This randomized control study compared the results of 63 patients who attended a promotores-led culturally sensitive diabetes self-management course at a commu- nity clinic with 68 patients in a wait-list, usual-care control group. Participants were Mexican Americans with type 2 diabetes who were patients at the clinic and at least 18 years of age. At baseline, 3 months, and 6 months, the Diabetes Knowledge Questionnaire (DKQ), Health Beliefs Questionnaire (HBQ), and HbA1c levels (drawn by the clinic laboratory) were collected. Results There was a significant improvement in the intervention group's DKQ scores over time and in treatment by time. The baseline HbA1c level was 7.49 and did not change over time in either group. The DKQ, HBQ, and HbA1c results were significantly affected by age; the DKQ and HbA1c were affected by years with diabetes. Conclusions The promotores-led diabetes self-management course improved the knowledge of patients with diabetes. Participant baseline HbA1c level was close to therapeutic level (much lower than reported in previous studies), suggesting participants received good medical care within the community clinic.
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Affiliation(s)
- Constance S. Sixta
- University of Texas Health Science Center Houston, School
of Nursing, Sixta Consulting Inc, Pearland, Texas,
| | - Sharon Ostwald
- University of Texas Health Science Center Houston, School
of Nursing
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Hayes MG, Pluzhnikov A, Miyake K, Sun Y, Ng MCY, Roe CA, Below JE, Nicolae RI, Konkashbaev A, Bell GI, Cox NJ, Hanis CL. Identification of type 2 diabetes genes in Mexican Americans through genome-wide association studies. Diabetes 2007; 56:3033-44. [PMID: 17846124 DOI: 10.2337/db07-0482] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The objective of this study was to identify DNA polymorphisms associated with type 2 diabetes in a Mexican-American population. RESEARCH DESIGN AND METHODS We genotyped 116,204 single nucleotide polymorphisms (SNPs) in 281 Mexican Americans with type 2 diabetes and 280 random Mexican Americans from Starr County, Texas, using the Affymetrix GeneChip Human Mapping 100K set. Allelic association exact tests were calculated. Our most significant SNPs were compared with results from other type 2 diabetes genome-wide association studies (GWASs). Proportions of African, European, and Asian ancestry were estimated from the HapMap samples using structure for each individual to rule out spurious association due to population substructure. RESULTS We observed more significant allelic associations than expected genome wide, as empirically assessed by permutation (14 below a P of 1 x 10(-4) [8.7 expected]). No significant differences were observed between the proportion of ancestry estimates in the case and random control sets, suggesting that the association results were not likely confounded by substructure. A query of our top approximately 1% of SNPs (P < 0.01) revealed SNPs in or near four genes that showed evidence for association (P < 0.05) in multiple other GWAS interrogated: rs979752 and rs10500641 near UBQLNL and OR52H1 on chromosome 11, rs2773080 and rs3922812 in or near RALGPS2 on chromosome 1, and rs1509957 near EGR2 on chromosome 10. CONCLUSIONS We identified several SNPs with suggestive evidence for replicated association with type 2 diabetes that merit further investigation.
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Affiliation(s)
- M Geoffrey Hayes
- Department of Medicine, University of Chicago, 5841 S. Maryland Ave., MC6091, Chicago, IL 60637, USA
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Davis KL, O'Toole ML, Brownson CA, Llanos P, Fisher EB. Teaching how, not what: the contributions of community health workers to diabetes self-management. DIABETES EDUCATOR 2007; 33 Suppl 6:208S-215S. [PMID: 17620403 DOI: 10.1177/0145721707304133] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE The purpose of this study is to describe ways in which community health workers (CHWs) are used in various clinic and community settings to support diabetes self-management. METHODS Descriptive quantitative data were collected from logs completed by CHWs. Logs described mode, place, type, duration, and focus of individual contact between the CHW and the patient. Qualitative data were collected from semistructured interviews with patients. Interviews were conducted on site from June to August 2006. Interviewees included a purposeful sample of 47 patients who perceived being helped by CHWs. RESULTS CHWs reported providing assistance and teaching or practicing skills as the focus of most of the 1859 individual contacts. The assistance CHWs reported providing was most often in the form of encouragement/motivation. During interviews, patients shared that CHWs were helpful in demonstrating how to incorporate diabetes self-management (DSM) into their daily lives. The information patients shared also provided insight into what they perceived as encouragement/motivation from the CHWs. Quotes from interviews provide specific examples of how support from CHWs was different from that received from family and health care team members. CONCLUSIONS Both CHWs and patients perceived assistance being provided in similar ways, with consistent emphasis on encouragement/motivation. Interviews with the patients revealed that a personal connection along with availability and provision of key resources and supports for self-management made the CHW-patient interaction successful for DSM. Examples provide insight into the valuable contributions of CHWs to DSM. This insight should encourage guidelines that make CHWs a routine, standard part of the diabetes care team.
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Affiliation(s)
- Kia L Davis
- The Health Communication Research Laboratory, St Louis University School of Public Health, St Louis, Missouri (Ms Davis)
| | - Mary L O'Toole
- Division of Health Behavior Research, Washington University School of Medicine, St Louis, Missouri (Dr O’Toole, Ms Brownson)
| | - Carol A Brownson
- Division of Health Behavior Research, Washington University School of Medicine, St Louis, Missouri (Dr O’Toole, Ms Brownson)
| | - Patricia Llanos
- The Growing Connection Coordination & General Program Support, Liaison Office for North America, Food and Agriculture Organization of the United Nations (Ms Llanos)
| | - Edwin B Fisher
- The Department of Health Behavior and Health Education, School of Public Health, University of North Carolina at Chapel Hill (Dr Fisher)
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Greenwood TA, Libiger O, Kardia S, Hanis C, Morrison AC, Gu CC, Rice T, Miller M, Turner ST, Myers RH, Grove J, Hsiao CF, Weder AB, Schork NJ. Comprehensive linkage and linkage heterogeneity analysis of 4344 sibling pairs affected with hypertension from the Family Blood Pressure Program. Genet Epidemiol 2007; 31:195-210. [PMID: 17266112 DOI: 10.1002/gepi.20202] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Linkage analyses of complex, multifactorial traits and diseases, such as essential hypertension, have been difficult to interpret and reconcile. Many published studies provide evidence suggesting that different genes and genomic regions influence hypertension, but knowing which of these studies reflect true positive results is challenging. The reasons for this include the diversity of analytical methods used across these studies, the different samples and sample sizes in each study, and the complicated biological underpinnings of hypertension. We have undertaken a comprehensive linkage analysis of 371 autosomal microsatellite markers genotyped on 4,334 sibling pairs affected with hypertension from five ethnic groups sampled from 13 different field centers associated with the Family Blood Pressure Program (FBPP). We used a single analytical technique known to be robust to interpretive problems associated with a lack of completely informative markers to assess evidence for linkage to hypertension both within and across the ethnic groups and field centers. We find evidence for linkage to a number of genomic regions, with the most compelling evidence from analyses that combine data across field center and ethnic groups (e.g., chromosomes 2 and 9). We also pursued linkage analyses that accommodate locus heterogeneity, which is known to plague the identification of disease susceptibility loci in linkage studies of complex diseases. We find evidence for linkage heterogeneity on chromosomes 2 and 17. Ultimately our results suggest that evidence for linkage heterogeneity can only be detected with large sample sizes, such as the FBPP, which is consistent with theoretical sample size calculations.
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Affiliation(s)
- Tiffany A Greenwood
- Polymorphism Research Laboratory, Department of Psychiatry, University of California, San Diego, La Jolla, California 92093-0603, USA
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Abstract
Type 2 diabetes (T2DM) is now a pediatric disease. As in adults, it disproportionately affects ethnic and racial minorities, including Hispanics. The preponderance of Hispanics in south Texas are of Mexican American (MA) heritage. Over the past 16 years, we have accumulated a large cohort of children with diabetes. We have noted distinct differences in numerous parameters between MA children with T2DM and those with type 1 diabetes (T1DM). In order to explore these observations, we have reviewed the records of all children diagnosed with diabetes (n = 669) during the 9 years between January, 1990 and December, 1998 and seen by our pediatric diabetes group. In this cohort were 329 MA, 287 non-Hispanic whites (EA) and 53 African Americans. Compared to EA children with T1DM, MA children were more likely to have a parent with diabetes, to be hospitalized at the time of diagnosis and to lack health insurance. The differences between MA children with T1DM and T2DM were significant: specifically, children with T2DM were more likely to be female and pubertal with a body mass index >25 kg/m(2) and have acanthosis nigricans. Slightly more than 2/3 of the MA children with T2DM had at least one parent already diagnosed with T2DM. Less than 1/3 of the children with T2DM required hospitalization at the time of diagnosis and only a 1/4 have private health insurance. Over this 9-year interval, the apparent incidence of diabetes almost tripled in south Texas with the great majority of that increase due to the increasing numbers of children with T2DM.
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Affiliation(s)
- Daniel E Hale
- Santa Rosa Children's Hospital and The Children's Center at the Texas Diabetes Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA.
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Rosal MC, Olendzki B, Reed GW, Gumieniak O, Scavron J, Ockene I. Diabetes self-management among low-income spanish-speaking patients: A pilot study. Ann Behav Med 2005; 29:225-35. [PMID: 15946117 DOI: 10.1207/s15324796abm2903_9] [Citation(s) in RCA: 110] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND The prevalence of type 2 diabetes and diabetes-related morbidity and mortality is higher among low-income Hispanics when compared to that of Whites. However, little is known about how to effectively promote self-management in this population. PURPOSE The objectives were first to determine the feasibility of conducting a randomized clinical trial of an innovative self-management intervention to improve metabolic control in low-income Spanish-speaking individuals with type 2 diabetes and second to obtain preliminary data of possible intervention effects. METHODS Participants for this pilot study were recruited from a community health center, an elder program, and a community-wide database developed by the community health center, in collaboration with other agencies serving the community, by surveying households in the entire community. Participants were randomly assigned to an intervention (n = 15) or a control (n = 10) condition. Assessments were conducted at baseline and at 3 months and 6 months postrandomization. The intervention consisted of 10 group sessions that targeted diabetes knowledge, attitudes, and self-management skills through culturally specific and literacy-sensitive strategies. The intervention used a cognitive-behavioral theoretical framework. RESULTS Recruitment rates at the community health center, elder program, and community registry were 48%, 69%, and 8%, respectively. Completion rates for baseline, 3-month, and 6-month assessments were 100%, 92%, and 92%, respectively. Each intervention participant attended an average of 7.8 out of 10 sessions, and as a group the participants showed high adherence to intervention activities (93% turned in daily logs, and 80% self-monitored glucose levels at least daily). There was an overall Group x Time interaction (p = .02) indicating group differences in glycosylated hemoglobin over time. The estimated glycosylated hemoglobin decrease at 3 months for the intervention group was -0.8% (95% confidence intervals = -1.1%, -0.5%) compared with the change in the control group (p = .02). At 6 months, the decrease in the intervention group remained significant, -0.85% (95% confidence intervals = -1.2, -0.5), and the decrease was still significantly different from that of the controls (p = .005). There was a trend toward increased physical activity in the intervention group as compared to that of the control group (p = .11) and some evidence (nonsignificant) of an increase in blood glucose self-monitoring in the intervention participants but not the control participants. Adjusting for baseline depressive scores, we observed a significant difference in depressive symptoms between intervention participants and control participants at the 3-month assessment (p = .02). CONCLUSIONS Low-income Spanish-speaking Hispanics are receptive to participate in diabetes-related research. This study shows that the pilot-tested diabetes self-management program is promising and warrants the conduct of a randomized clinical trial.
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Affiliation(s)
- Milagros C Rosal
- University of Massachusetts Medical School, Preventative and Behavioural Medicine, Worcester, MA 01655, USA.
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Fanning EL, Selwyn BJ, Larme AC, DeFronzo RA. Improving efficacy of diabetes management using treatment algorithms in a mainly Hispanic population. Diabetes Care 2004; 27:1638-46. [PMID: 15220240 DOI: 10.2337/diacare.27.7.1638] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To compare clinical outcomes obtained using treatment algorithms versus standard "usual care" to treat patients with type 2 diabetes in a community setting. RESEARCH DESIGN AND METHODS An observational group comparison was implemented in three community-based clinics in San Antonio, Texas: 1). a community clinic following treatment algorithms (CC-TA), 2). university clinic following treatment algorithms (UC-TA), and 3). a community clinic following standard "usual care" practices (CC-SC). Three hundred fifty-eight recently diagnosed type 2 diabetic patients (90% Mexican American, from low-income neighborhoods) who were consecutively identified at the three clinics were recruited. Following medical and laboratory evaluation, participants were started on treatment for hyperglycemia, hypertension, and dyslipidemia and followed for 12 months. RESULTS Decrements in HbA(1c) at 12 months in the CC-TA and UC-TA were 3.1 and 3.3%, respectively, compared to 1.3% in the CC-SC (P < 0.0001). Corresponding decrements in fasting plasma glucose at 12 months were 94 and 99 mg/dl, respectively, versus 38 mg/dl in CC-SC (P < 0.0001). Reductions in total cholesterol, LDL cholesterol, and triglycerides at 12 months were greater in both algorithm-managed clinics compared to standard care-managed clinics (P < 0.0001). In algorithm-managed clinics, there were 30% more documented eye exams and 24% more documented foot exams than in standard care-managed patients. CONCLUSIONS Adherence to the treatment algorithms improved metabolic outcomes in type 2 diabetic patients to a greater extent than standard care practices. These results have important clinical implications for the treatment of type 2 diabetic patients.
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Affiliation(s)
- Etta L Fanning
- Department of Medicine, University of Texas Health Science Center, San Antonio, TX 78284, USA.
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Benavides-Vaello S, Garcia AA, Brown SA, Winchell M. Using focus groups to plan and evaluate diabetes self-management interventions for Mexican Americans. DIABETES EDUCATOR 2004; 30:238, 242-4, 247-50 passim. [PMID: 15095514 DOI: 10.1177/014572170403000217] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Cooper SP, Heitman E, Fox EE, Quill B, Knudson P, Zahm SH, MacNaughton N, Ryder R. Ethical issues in conducting migrant farmworker studies. ACTA ACUST UNITED AC 2004; 6:29-39. [PMID: 14762322 DOI: 10.1023/b:joih.0000014640.64905.02] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Migrant farmworkers should be considered a vulnerable population because they work in a hazardous industry, are often members of an ethnic minority, have known difficulty in accessing health care, and are often of lower socioeconomic status. For these reasons, too, it is extremely important to conduct health-related research with this often-underserved group. However, because migrant farmworkers are vulnerable, investigators must be especially vigilant in protecting them from the potential harms of research and in ensuring that the special ethical issues that arise in research with this population are identified and addressed for every project. In response to the National Cancer Institute's concerns about the feasibility of conducting epidemiologic studies among migrant farmworkers, researchers undertook four feasibility studies near the Texas-Mexico border. Each study raised different, complex ethical questions that challenged the investigators, but whose resolution turned out to be crucial to the success of the studies.
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Affiliation(s)
- Sharon P Cooper
- Texas A&M School of Rural Public Health, Bryan, Texas 77082, USA.
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Poston WSC, Reeves RS, Haddock CK, Stormer S, Balasubramanyam A, Satterwhite O, Taylor JE, Foreyt JP. Weight loss in obese Mexican Americans treated for 1-year with orlistat and lifestyle modification. Int J Obes (Lond) 2004; 27:1486-93. [PMID: 14634679 DOI: 10.1038/sj.ijo.0802439] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of a culturally appropriate lifestyle intervention combined with orlistat in producing weight loss with obese Mexican-American women. SUBJECTS Mexican-American women (N=108), aged 21-65 y, with a body mass index (BMI) > or =27 kg/m(2) were randomized to 1 y of treatment with orlistat and a culturally tailored lifestyle modification intervention (OLM; n=56) or a wait-list control group (WLC; n=52). DESIGN A randomized, controlled, open-label 12-month study. Orlistat was dosed at 120 mg, three times per day. The OLM intervention included behavior modification, a low-fat (< or =30% of total daily calories) diet, and moderate physical activity (> or =150 min/week). MEASUREMENT Primary outcomes included changes in body weight (kg), BMI, waist circumference, blood pressure, glucose, and lipids. RESULTS A total of 72 (37 OLM, 35 WLC) and 66 participants (32 OLM, 34 WLC) completed the 6- and 12-month follow-ups, respectively. Repeated-measures ANOVA demonstrated a significant time x treatment interaction (Wilks' lambda=12.61; P<0.001), indicating that OLM-treated patients achieved significant weight loss relative to the WLC group during the study (mean percentage weight loss+/-s.e.m.; -8.1%+/-1.2 vs -1.6%+/-0.7 at 6 months and -8.8%+/-1.5 vs -0.2%+/-1.0 at 12 months, respectively). OLM-treated patients also experienced significant reductions in waist circumference, low-density-lipoprotein, and total cholesterol. CONCLUSIONS This study demonstrates the effectiveness of an intervention combining orlistat and lifestyle modification with Mexican-American women, a population with substantial risk for obesity.
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Affiliation(s)
- W S Carlos Poston
- Mid America Heart Institute and University of Missouri-Kansas City, Kansas City, MO 64110, USA.
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Kuo YF, Raji MA, Markides KS, Ray LA, Espino DV, Goodwin JS. Inconsistent use of diabetes medications, diabetes complications, and mortality in older mexican americans over a 7-year period: data from the Hispanic established population for the epidemiologic study of the elderly. Diabetes Care 2003; 26:3054-60. [PMID: 14578239 DOI: 10.2337/diacare.26.11.3054] [Citation(s) in RCA: 96] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The aim of this study was to examine the relationship between inconsistency in use of diabetes drugs and risk of renal, eye, and circulation problems and death over a 7-year period in community-dwelling older Mexican Americans. RESEARCH DESIGN AND METHODS Data are from the four waves of the Hispanic Established Population for the Epidemiologic Study of the Elderly. In-home interviewers assessed consistency in use of diabetes medications among 908 diabetic Mexican Americans, aged >or=65 years. Diabetes and complications were by self-report. Subjects with poor consistency in use of medication were those who, at any time during the 7-year follow-up, discontinued or inconsistently used their diabetes medications and those who had no diabetic medications at home despite self-report of taking medicine for diabetes. RESULTS Thirty-six percent of our sample were inconsistent with diabetes medication usage. Older age and lack of supplemental health insurance were significantly associated with inconsistency of use of medication. In a multivariate logistic regression model, subjects with poor consistency in use of medication were more likely to report kidney problems (odds ratio [OR] 1.59; 95% CI 1.13-2.23; P = 0.008) at follow-up compared with those with good consistency, after controlling for age, sex, medication type, duration of diabetes, education, income, marital status, language of interview, insurance status, cognitive function, presence of depressive symptoms, activities of daily living, and instrumental activities of daily living. In Cox regression models, poor consistency with diabetic medication was also associated with increased all-cause mortality (hazard ratio [HR] 1.43; 95% CI 1.13-1.82; P = 0.003) and diabetes-related deaths (1.66; 1.20-2.30; P = 0.002) over a 7-year period after adjusting for relevant confounders. CONCLUSIONS Inconsistent use of diabetic medication was associated with an increased risk of kidney problems and deaths over a 7-year period in older Mexican Americans.
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Affiliation(s)
- Yong-Fang Kuo
- Center on Aging, University of Texas Medical Branch, Galveston, Texas 77555-0460, USA.
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Wu JH, Haan MN, Liang J, Ghosh D, Gonzalez HM, Herman WH. Impact of diabetes on cognitive function among older Latinos: a population-based cohort study. J Clin Epidemiol 2003; 56:686-93. [PMID: 12921938 DOI: 10.1016/s0895-4356(03)00077-5] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND OBJECTIVES Type 2 diabetes, which is highly prevalent in older Mexican Americans, may influence cognitive functioning. We examined the association of diabetes with decline in global cognitive function and memory function over a 2-year period. METHODS Study subjects were derived from an existing cohort of Latinos aged 60 and over in the SALSA project (n=1,789). Statistical analysis was conducted using logistic regression and a generalized estimating equation (GEE). RESULTS Logistic regression analysis indicated that baseline diabetes was a significant predictor of major cognitive impairment in Modified Mini Mental State Exam (3MSE) (OR=1.68, 95% CI=1.21, 2.34) and word-list test (OR=1.31, 95% CI=0.99, 1.75). GEE analysis showed that there was no significant difference between diabetic and nondiabetic subjects in change of cognitive scores over 2 years (3MSE, mean=-0.58, 95% CI=-1.48, 0.32; word-list test, mean=-0.10, 95% CI=-0.32, 0.11). CONCLUSIONS More diabetic complications were associated with major cognitive decline among diabetic subjects. Research on long-term impact of treatment for type 2 diabetes is warranted.
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Affiliation(s)
- Jasmanda H Wu
- University of Michigan, School of Public Health, Department of Epidemiology, 611 Church St., Ann Arbor, MI 48104, USA
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Jiménez-Cruz A, Bacardí-Gascón M, Spindler AA. Obesity and hunger among Mexican-Indian migrant children on the US-Mexico border. Int J Obes (Lond) 2003; 27:740-7. [PMID: 12833120 DOI: 10.1038/sj.ijo.0802286] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Although Mexican-Indian migrant workers live under precarious conditions in both Mexico and the USA, they have more access to food than they did in their original communities. The nutritional status and food security among the children of these workers have not been reported. OBJECTIVE The purpose of this study was to assess the prevalence of overweight, obesity, undernutrition and hunger among migrant children in a city on the US-Mexico border. DESIGN During 2001-2002, a total of 1767 children from six schools from the Tijuana Indian school system was measured to assess anthropometric status. Third and fifth grade children were also interviewed for their perception of hunger experience and dietary intake by 24-h recall method. RESULTS The overall prevalence of overweight and obesity was 38%. Abdominal obesity was found in 26% of subjects, while 43% had both obesity and abdominal obesity. The prevalence of undernutrition according to weight-for-age was 1.2%, and by height-for-age it was 4.8%. The prevalence of hunger was 2.5%, and at risk of hunger was 44%. Daily intake of food groups in servings was: 8.7 grains, 1.2 fruit, 1.0 vegetable, 2.1 milk and 2.6 meat. Only one child (0.07%) consumed The Apple of Health recommended portions. CONCLUSIONS This study confirmed the coexistence of obesity, hunger, undernutrition and limited food group consumption among Indian children living in a prosperous and the largest US-Mexico border city.
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Affiliation(s)
- A Jiménez-Cruz
- 1Medical School, Universidad Autónoma de Baja California (UABC), Mesa de Otay, Tijuana, BC, Mexico.
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Wu JH, Haan MN, Liang J, Ghosh D, Gonzalez HM, Herman WH. Impact of antidiabetic medications on physical and cognitive functioning of older Mexican Americans with diabetes mellitus: a population-based cohort study. Ann Epidemiol 2003; 13:369-76. [PMID: 12821276 DOI: 10.1016/s1047-2797(02)00464-7] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE The current study was designed to evaluate the utility of antidiabetic medications in affecting changes in physical and cognitive functioning among older Mexican Americans with diabetes over a 2-year period. METHODS A longitudinal analysis with repeated measurements between 1999 and 2001 was performed in a cohort of Mexican Americans, 60 or older, in the SALSA Project. Statistical analysis was conducted using a generalized estimating equation. RESULTS For subjects with diagnosed diabetes </= 5 years (N = 381), there was less decline in physical and cognitive functioning over 2 years among subjects on treatment, compared to those without treatment. For subjects with diagnosed diabetes of 5+ years (N = 337), the effect of antidiabetic medications was more significant in preventing the decline in physical and cognitive functioning (ADL: mean in log scale = -0.10, 95% CI = -0.16, -0.04, 3MS: mean = 6.35, 95% CI = 3.23, 9.48). Combination therapy of antidiabetic agents appeared to be more effective than monotherapy in preventing the decline in physical and cognitive functioning for subjects. CONCLUSIONS Antidiabetic drugs appear to be useful in alleviating the decline in physical and cognitive functioning among older Mexican Americans with diabetes, especially for those with a longer duration of the disease.
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Affiliation(s)
- Jasmanda H Wu
- University of Michigan, School of Public Health, Epidemiology, Ann Arbor, MI 48109, USA
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Otiniano ME, Du X, Ottenbacher K, Black SA, Markides KS. Lower extremity amputations in diabetic Mexican American elders: incidence, prevalence and correlates. J Diabetes Complications 2003; 17:59-65. [PMID: 12614970 DOI: 10.1016/s1056-8727(02)00175-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study was designed to determine the incidence and prevalence of amputations in diabetic Mexican American elders and to identify correlates of lower extremity amputations. Data for this study came from baseline and two follow-up interviews of the Hispanic Established Population for the Epidemiological Study of the Elderly (EPESE) conducted in five southwestern states (Texas, California, New Mexico, Colorado and Arizona) in 1993-1994. Of the 3050 subjects aged 65 and older, 690 reported diabetes, and from these, 60 (8%) reported having at least one lower extremity amputation. Losing a leg was the most common type of amputation (53%). Twelve percent of respondents reported a new amputation and 40% of amputees reported a second amputation during follow-up. Mortality among amputees was 46% during a 5-year follow-up. Multiple logistic regression analysis showed that being male and having eye problems, hip fracture and diabetes for 10 or more years were significantly associated with lower extremity amputations at baseline, whereas obesity, stroke and 10 or more years with diabetes were significantly associated with new amputations at 5-year follow-up. Gender and disease history were associated with lower extremity amputations at baseline and follow-up. These variables may be useful in developing patient education and intervention programs.
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Affiliation(s)
- Max E Otiniano
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX 77555, USA.
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Wu JH, Haan MN, Liang J, Ghosh D, Gonzalez HM, Herman WH. Diabetes as a predictor of change in functional status among older Mexican Americans: a population-based cohort study. Diabetes Care 2003; 26:314-9. [PMID: 12547855 DOI: 10.2337/diacare.26.2.314] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Epidemiological studies have demonstrated that older Mexican Americans are at high risk for type 2 diabetes and its complications. Type 2 diabetes leads to a more rapid decline in functional status among older Mexican Americans with diabetes. This study was designed to examine the impact of diabetes on change in self-reported functional status over a 2-year period among older Mexican Americans with diabetes. RESEARCH DESIGN AND METHODS We performed a longitudinal analysis with repeated measurements of functional limitations in a cohort of Mexican Americans aged > or =60 years in the Sacramento Area Latino Study on Aging (SALSA). Diabetes was diagnosed on the basis of self-report of physician diagnosis, medication use, and fasting plasma glucose. Functional status was measured by assessment of activities of daily living (ADL) and instrumental activities of daily living (IADL) at baseline and 1 and 2 years. RESULTS Of 1,789 SALSA participants, 585 (33%) had diabetes at baseline. Diabetic subjects reported 74% more limitations than nondiabetic subjects in ADL (summary score for number of limitations, 0.99 vs. 0.57; P = 0.002) and 50% more limitations in IADL (summary score for number of limitations, 7.83 vs. 5.25; P < 0.0001). The annual rate of increase in limitations of ADL and IADL was 0.046 and 0.033 (log scale) on each scale among diabetic subjects compared with 0.013 and 0.003 (log scale) among nondiabetic subjects (P < 0.0005). Complications of diabetes were found to increase ADL and IADL limitations among diabetic subjects. Longer duration of diabetes was also associated with an increase in ADL and IADL limitations. CONCLUSIONS There was lower baseline functional status and a more rapid decline in functional status among older Mexican Americans with diabetes versus those without diabetes.
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Affiliation(s)
- Jasmanda H Wu
- Department of Epidemiology, University of Michigan, School of Public Health, Ann Arbor 48109, USA
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Bermudez OI, Velez-Carrasco W, Schaefer EJ, Tucker KL. Dietary and plasma lipid, lipoprotein, and apolipoprotein profiles among elderly Hispanics and non-Hispanics and their association with diabetes. Am J Clin Nutr 2002; 76:1214-21. [PMID: 12450885 DOI: 10.1093/ajcn/76.6.1214] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND There are limited data about dietary intakes and plasma lipids of elderly US Hispanics. OBJECTIVE The disparity in prevalence of type 2 diabetes among population groups underscored our need to assess dietary and plasma risk factors for cardiovascular disease. DESIGN Plasma lipids and apolipoproteins and dietary intakes of macronutrients were measured in elderly subjects (60-98 y): 490 Hispanics of Caribbean origin (Puerto Ricans and Dominicans) and 163 non-Hispanic whites. Plasma values were related to ethnicity and to macronutrient intake. Differences in plasma lipids due to diabetes were assessed among the Hispanics. RESULTS Intakes of carbohydrate and polyunsaturated fatty acids were higher and intakes of cholesterol and saturated and monounsaturated fatty acids were lower in Hispanics than in non-Hispanic whites. Concentrations of total cholesterol, HDL cholesterol, and apolipoprotein A-I were significantly lower among Hispanic women than among non-Hispanic white women; a similar trend was seen in men. Dyslipidemia (high triacylglycerols and low HDL cholesterol) was more prevalent among Hispanics with than without diabetes. CONCLUSIONS Ethnic differences in serum lipids exist and appear to be associated with differences in dietary intakes. However, both Hispanics and non-Hispanic whites had lipid profiles indicating a high risk of cardiovascular disease. Hispanics with diabetes were at higher risk of dyslipidemia than were those without diabetes. Our data suggest that lifestyle changes, including diet modification and exercise, could be of significant benefit to both ethnic groups.
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Affiliation(s)
- Odilia I Bermudez
- Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111, USA.
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Bastida E, Pagán JA. The impact of diabetes on adult employment and earnings of Mexican Americans: findings from a community based study. HEALTH ECONOMICS 2002; 11:403-413. [PMID: 12112490 DOI: 10.1002/hec.676] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Epidemiological studies indicate that minority populations in the US - including African Americans, Native Americans and Mexican Americans - are particularly at risk for diabetes and that their complications are more frequent and severe. Using microdata from a 1994-1999 population based study of middle aged and older Mexican Americans in the Southwest, this study analyzes the impact of diabetes on the employment and earnings outcomes of adults 45 years of age and older. The empirical results from estimating maximum likelihood employment and earnings models suggest that diabetes leads to lower productivity and earnings for women but has no statistically significant impact on their employment probability. In the case of men, however, diabetes leads to a lower employment propensity but has no effect on earnings. Thus, the problems associated with this condition could lead to potential future financial difficulties particularly for high-risk populations in their later years.
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Affiliation(s)
- Elena Bastida
- Department of Sociology and Center on Aging and Health, College of Social and Behavioral Sciences, The University of Texas-Pan American, Edinburg 78539, USA
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Abstract
Diabetes self-management education has gained in importance over the past decade as research has documented the benefits of such interventions in improving glucose control and reducing diabetes-related complications. Although minority populations bear a disproportionate burden of diabetes, past strategies have not addressed cultural characteristics of groups typically underrepresented in diabetes research. Recent research literature on the development of culturally competent diabetes self-management is summarized and an example of a culturally competent intervention designed for Spanish-speaking Mexican Americans is presented. Recent research is laying the foundation for future intervention development to meet the cultural needs of racial/ethnic groups.
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Affiliation(s)
- Sharon A Brown
- University of Texas at Austin, School of Nursing, 1700 Red River, Austin, TX 78701, USA.
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