Diabetes, Gallbladder Disease, Obesity, and Hypertension Among Hispanics in New Mexico

Samet, Jonathan M.; Coultas, David B.; Howard, Cheryl A.; Skipper, Betty J.; Hanis, Craig L.

doi:10.1093/oxfordjournals.aje.a115083

Cited by 94 publications

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“…1013 The chronic disease pattern among MexicanAmericans in Texas and elsewhere is dominated by high frequencies of non-insulin-dependent diabetes mellitus, obesity, and gallbladder disease, but there does not seem to be a corresponding increase in cardiovascular disease. 19 " 24 We have undertaken detailed physical and laboratory evaluations on 1,004 randomly selected Mexican-American residents of Starr County, Tex. Chronic disease frequencies are considerably elevated in this population, but lipid, lipoprotein, and apo levels do not demonstrate a general tendency for untoward profiles.…”

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Effects of the apolipoprotein E polymorphism on levels of lipids, lipoproteins, and apolipoproteins among Mexican-Americans in Starr County, Texas.

Hanis

Hewett‐Emmett

Douglas

et al. 1991

Arterioscler Thromb

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Genetic variability has been implicated as a significant contributor to the variation in levels of lipids, lipoproteins, and apolipoproteins (apos) through a variety of direct and indirect investigations. Among the direct investigations, apo E has been shown to be polymorphic and to explain a small but statistically significant proportion of the variability in cholesterol. The apo E polymorphism was typed in 964 randomly selected Mexican-Americans from StanCounty, Tex., and its effects determined on levels of cholesterol, triglycerides, total high density lipoprotein (HDL) cholesterol, subtractions (HDL? and HDL,), at-and ^-lipoprotein cholesterol, low density lipoprotein (LDL) cholesterol, and apos A-I, A-II, B, C-II, C-III, and E. Effects are reported for the entire sample and in each of three groups, namely, premenopausal females, postmenopausal women, and males. In the entire sample, significant effects were observed on cholesterol, ^-lipoprotein cholesterol, LDL, apo B, and apo E. There is evidence for significant physiological interaction of the apo E polymorphism effect in females by menopausal status. This is most evident for apo E levels, in which 5.9% of the variability in the entire sample is explained by the apo E polymorphism. In premenopausal females, however, the polymorphism accounts for 27.5% of the variability. In postmenopausal women and males, there is no significant effect It is shown that the apo E polymorphism can be treated as a two-locus, two-allele system. Doing so identifies substitutions in amino acid position 158 as the mediators of most of the observed effects of this polymorphism. [Arteriosclerosis and Thrombosis 1991;ll:362-370) O f the many factors affecting cardiovascular disease risk, cholesterol is one of the best understood. With this understanding has come the technology for measuring cholesterol content in the various lipoprotein particles involved in cholesterol metabolism and the concentrations of many of the associated apolipoproteins (apos). lipid-related measures rather than simple cholesterol levels. Levels of lipids, lipoproteins, and apos vary markedly from individual to individual, and several studies have shown that a significant proportion of this variability is attributable to inferred genetic differences among individuals. 3 -6 Direct studies of genetic variation at loci known to be important in lipid metabolism have revealed how simply inherited variation can contribute to the differences in levels among individuals. The apo E polymorphism 7 ' 8 is among the best studied, and it explains a consistently significant albeit small proportion of the variability in cholesterol levels.9 - 13 The effect has been shown to be primarily on low density lipoprotein (LDL) cholesterol levels and explains approximately 5% or less of the variability observed in the population. 9 -13 Other work has shown that the apo E polymorphism has more substantial effects on concentrations of apo E, explaining as much as 20% or more of the variability in levels of apo E.

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Section: -2mentioning

confidence: 99%

Effects of the apolipoprotein E polymorphism on levels of lipids, lipoproteins, and apolipoproteins among Mexican-Americans in Starr County, Texas.

Hanis

Hewett‐Emmett

Douglas

et al. 1991

Arterioscler Thromb

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“…[1][2][3][4] Currently, among Mexican-American women and men, the prevalence of overweight or obesity (body mass index (BMI) Z25 kg/m 2 ) is 71.9 and 74.7%, respectively. 5 The prevalence of abdominal obesity (ie, waist circumference 488 cm for women and 4102 cm for men) is 62.7% for Mexican-American women and 30.6% for Mexican-American men.…”

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Weight loss in obese Mexican Americans treated for 1-year with orlistat and lifestyle modification

et al. 2003

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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 ¼ 108), aged 21-65 y, with a body mass index (BMI) Z27 kg/m 2 were randomized to 1 y of treatment with orlistat and a culturally tailored lifestyle modification intervention (OLM; n ¼ 56) or a wait-list control group (WLC; n ¼ 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 (r30% of total daily calories) diet, and moderate physical activity (Z150 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 Â treatment interaction (Wilks' l ¼ 12.61; Po0.001), indicating that OLM-treated patients achieved significant weight loss relative to the WLC group during the study (mean percentage weight loss7s.e.m.; À8.1%71.2 vs À1.6%70.7 at 6 months and À8.8%71.5 vs À0.2%71.0 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. International Journal of Obesity (2003) 27, 1486-1493. doi:10.1038/sj.ijo.0802439Keywords: Mexican American; women; orlistat; culturally appropriate Mexican Americans in the United States are at increased risk for overweight and obesity and tend to develop obesity at an earlier age than non-Hispanics. 1-4 Currently, among Mexican-American women and men, the prevalence of overweight or obesity (body mass index (BMI) Z25 kg/m 2 ) is 71.9 and 74.7%, respectively. 5 The prevalence of abdominal obesity (ie, waist circumference 488 cm for women and 4102 cm for men) is 62.7% for Mexican-American women and 30.6% for Mexican-American men. 6 Mexican Americans are also predisposed to develop more atherogenic patterns of body fat distribution. 7,8 Early weight gain and centralized and upper body fat have been associated with the onset of diabetes in Mexican Americans. 9 For example, Mexican Americans with centralized obesity are at significantly greater risk for low HDL-C, high total cholesterol, and high blood glucose than nonobese individuals or those with nonabdominal obesity. 8 In addition, 50% of Mexican-American adults 35 y or older either have diabetes themselves or have a first-degree relative with diabetes. 10 Modest weight loss can have a beneficial effect on cardiovascular disease and diabetes risk factors. 1,[11][12][13][14] It is likely that Mexican Americans, and other minority groups, would also ...

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Metabolic factors have been shown to be important risk factors for the development of NIDDM.

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“…The Mexican American population is characterized by increased adiposity [1][2][3][4]6], a more centralized distribution of body fat [6,7], hyperinsulinaemia [8][9][10] and insulin resistance [11,12].Metabolic factors have been shown to be important risk factors for the development of NIDDM. Both insulin resistance [13,14] and hyperinsulinaemia [13,[15][16][17][18][19] have been shown to predict NIDDM.…”

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Are risk factors for conversion to NIDDM similar in high and low risk populations?

1997

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Numerous studies have shown that Mexican Americans have an increased prevalence [1][2][3][4] and incidence [5] of non-insulin-dependent diabetes mellitus (NIDDM) relative to non-Hispanic whites. The Mexican American population is characterized by increased adiposity [1][2][3][4]6], a more centralized distribution of body fat [6,7], hyperinsulinaemia [8][9][10] and insulin resistance [11,12].Metabolic factors have been shown to be important risk factors for the development of NIDDM. Both insulin resistance [13,14] and hyperinsulinaemia [13,[15][16][17][18][19] have been shown to predict NIDDM. Likewise, decreased insulin secretion in response to various stimuli may predict NIDDM. A low acute insulin response has been found to predict NIDDM in Pima Indians [13], but not in children of two Caucasian diabetic parents [14]. A low 30-min increment in insulin relative to the 30-min increment in glucose (DI 30 /DG 30 ) during an oral glucose tolerance test predicts conversion to NIDDM, especially in subjects with impaired glucose tolerance [20][21][22][23]. A low insulin response 60 min after an intravenous glucose challenge also predicted NIDDM [24,25]. A low 2-h insulin in response to an oral glucose load also Diabetologia (1997) 40: 62-66 Are risk factors for conversion to NIDDM similar in high and low risk populations? Summary Mexican Americans have an increased risk of non-insulin-dependent diabetes mellitus (NIDDM) relative to non-Hispanic whites which is only partially explained by their excess overall obesity and unfavourable body fat distribution. Non-diabetic Mexican Americans have hyperinsulinaemia and insulin resistance relative to non-Hispanic whites. We therefore hypothesized that the insulin resistance might be a more important predictor of NIDDM in high-risk populations characterized by obesity and insulin resistance, while compromised insulin secretion might be a more important risk factor for NIDDM in low-risk populations. We assessed the ability of ethnicity (Mexican American vs non-Hispanic white), age, overall adiposity (body mass index [BMI]), unfavourable body fat distribution (as assessed by waist-to-hip ratio [WHR]), glucose tolerance (impaired glucose tolerance vs normal glucose tolerance), fasting insulin and compromised insulin secretion (as assessed by increment in insulin to the increment in glucose over the first 30 min of an oral glucose tolerance test (DI 30 /DG 30 )) to predict future NIDDM. In the 8-year follow-up of the San Antonio Heart Study, NIDDM developed in 11.7 % (107/914) of Mexican Americans and in 5.0 % (18/362) of nonHispanic whites (p < 0.001). Multivariate predictors of NIDDM by multiple logistic regression analysis included increased age, BMI, WHR, fasting insulin and impaired glucose tolerance and decreased insulin secretion. The strongest independent predictors of NIDDM were high fasting insulin and decreased insulin secretion. These risk factors predicted NIDDM equally well in high and low-risk populations. [Diabetologia (1997) 40: 62-66]

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Diabetes, Gallbladder Disease, Obesity, and Hypertension Among Hispanics in New Mexico

Cited by 94 publications

References 0 publications

Effects of the apolipoprotein E polymorphism on levels of lipids, lipoproteins, and apolipoproteins among Mexican-Americans in Starr County, Texas.

Effects of the apolipoprotein E polymorphism on levels of lipids, lipoproteins, and apolipoproteins among Mexican-Americans in Starr County, Texas.

Weight loss in obese Mexican Americans treated for 1-year with orlistat and lifestyle modification

Are risk factors for conversion to NIDDM similar in high and low risk populations?

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