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PURPOSE: To investigate to what degree the presence of hypertension (HTN) and poor glycemic control (GC) influences the likelihood of having microalbuminuria (MAU) among Cuban Americans with type 2 diabetes (T2D). METHODS: A cross-sectional study conducted in Cuban Americans (n = 179) with T2D. Participants were recruited from a randomly generated mailing list purchased from Knowledge-Base Marketing, Inc. Blood pressure (BP) was measured twice and averaged using an adult size cuff. Glycosylated hemoglobin (A1c) levels were measured from whole blood samples with the Roche Tina-quant method. First morning urine samples were collected from each participant to determine MAU by a semiquantitative assay (ImmunoDip). RESULTS: MAU was present in 26% of Cuban Americans with T2D. A significantly higher percentage of subjects with MA had HTN (P = 0.038) and elevated A1C (P = 0.002) than those with normoalbuminuria. Logistic regression analysis showed that after controlling for covariates, subjects with poor GC were 6.76 times more likely to have MAU if they had hypertension compared with those without hypertension (P = 0.004; 95% confidence interval [CI]: 1.83, 23.05). CONCLUSION: The clinical significance of these findings emphasizes the early detection of MAU in this Hispanic subgroup combined with BP and good GC, which are fundamentals in preventing and treating diabetes complications and improving individuals' renal and cardiovascular outcomes.
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Relationship between high-sensitivity C-reactive protein (hs-CRP) and adiposity by diabetes status and gender in Cuban-Americans with and without type 2 diabetes (T2D) was studied. Adult subjects, 226 females, 129 males participated in a case control, single time point study. Subjects with T2D were older, had higher waist circumference (WC) and body mass index (BMI). WC and BMI were associated with ln hs-CRP (P < 0.001). An interaction with diabetes status was found for BMI (P = 0.037). Gender showed a strong relationship with ln hs-CRP (P < 0.001), which was moderated by diabetes status. Only males without diabetes exhibited a significant relationship for both WC and BMI with ln hs-CRP. In this sample of Cuban-Americans, WC and BMI had stronger associations with ln hs-CRP but not with diabetes status. Obesity prevention and controlling for CRP levels may be necessary to eliminate its contributions to develop diabetes and cardiovascular disease (CVD).
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Índice de Massa Corporal , Proteína C-Reativa/análise , Diabetes Mellitus Tipo 2/fisiopatologia , Circunferência da Cintura , Idoso , Estudos de Casos e Controles , Cuba/etnologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Estados UnidosRESUMO
BACKGROUND/AIMS: Genetic polymorphisms in the paraoxonase 2 (PON2) gene are thought to alter its activity and contribute to the development of cardiovascular and renal disease risk. The purpose of this study is to determine whether the Arg148Gly, Cys311Ser and rs12794795 polymorphisms of PON2 examined previously by others, are associated with type 2 diabetes (T2DM), and subclinical measures of cardiovascular and renal disease risk in Mexican Americans. METHODS: Study participants (n = 848; 21 families) were genotyped for the three polymorphisms by TaqMan assay. Association between the genotypic and phenotypic data was performed by measured genotype approach as implemented in the variance component analytical tools. RESULTS: The Arg148Gly variant was found to be monomorphic in our dataset. Of the phenotypes examined for association, the A/C variant located in intron-1 (rs12794795) exhibited statistically significant association only with diastolic blood pressure (p = 0.018) after accounting for the trait-specific covariate effects. The Cys311Ser variant failed to show statistically significant association with any of the phenotypes examined. CONCLUSION: In conclusion, the variants examined at the PON2 locus in Mexican Americans do not appear to be a major contributor to T2DM, cardiovascular or renal disease risk, although they exhibited a small effect on the blood pressure values.
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Arildialquilfosfatase/genética , Doenças Cardiovasculares/genética , Predisposição Genética para Doença/genética , Nefropatias/genética , Polimorfismo Genético , Pressão Sanguínea/genética , Doenças Cardiovasculares/etnologia , Diabetes Mellitus Tipo 2/genética , Saúde da Família , Predisposição Genética para Doença/etnologia , Genótipo , Humanos , Nefropatias/etnologia , Americanos Mexicanos/genética , Epidemiologia Molecular , FenótipoRESUMO
The T-786C, Glu298Asp, and 27 bp variable number of tandem repeats (27 bp-VNTR-a/b) polymorphsims of the endothelial nitric oxide synthase (eNOS) gene are thought to alter nitric oxide production and contribute to the development of vascular and renal disease risk. The objective of this study is to investigate whether these three polymorphisms examined previously by others are associated with cardiovascular and renal disease risk in Mexican Americans. Study participants (N = 848; 21 families) were genotyped for T-786C, Glu298Asp, and 27 bp-VNTR-a/b polymorphisms by PCR followed by restriction digestion. Association analyses were performed by a measured genotype approach implemented in the program SOLAR. Of the phenotypes (type 2 diabetes, hypertension, body mass index, waist circumference, total cholesterol, high density lipoprotein cholesterol, triglycerides, systolic and diastolic blood pressure, albumin to creatinine ratio (ACR), and estimated glomerular filtration rate) examined for association, the 27 bp-VNTR-a/b variant exhibited statistically significant association with ACR (P = 0.047) after accounting for the trait specific covariate effects. In addition, the promoter variant (T-786C) showed a significant association with triglycerides (P = 0.034) after accounting for covariate influences. In conclusion, the present study adds evidence to the role of eNOS candidate gene polymorphisms in modulating the risk factors related to cardiovascular-renal disease in Mexican Americans although the magnitude of the genetic effect is small.
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Albuminas/metabolismo , Pareamento de Bases/genética , Creatinina/metabolismo , Íntrons/genética , Americanos Mexicanos/genética , Repetições Minissatélites/genética , Óxido Nítrico Sintase Tipo III/genética , Família , Feminino , Frequência do Gene , Predisposição Genética para Doença , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo GenéticoRESUMO
BACKGROUND: Elevated serum uric acid is associated with several cardiovascular disease (CVD) risk factors such as hypertension, inflammation, endothelial dysfunction, insulin resistance, dyslipidemia, and obesity. However, the role of uric acid as an independent risk factor for CVD is not yet clear. OBJECTIVE: The aim of the study was to localize quantitative trait loci regulating variation in serum uric acid and also establish the relationship between serum uric acid and other CVD risk factors in Mexican Americans (n = 848; men = 310, women = 538) participating in the San Antonio Family Heart Study. METHODS: Quantitative genetic analysis was conducted using variance components decomposition method, implemented in the software program SOLAR. RESULTS: Mean +/- SD of serum uric acid was 5.35 +/- 1.38 mg/dl. Univariate genetic analysis showed serum uric acid and other CVD risk markers to be significantly heritable (P < 0.005). Bivariate analysis showed significant correlation of serum uric acid with body mass index, waist circumference, waist/hip ratio, total body fat, plasma insulin, serum triglycerides, high-density lipoprotein cholesterol, C-reactive protein, and granulocyte macrophage-colony stimulating factor (P < 0.05). A genome-wide scan for detecting quantitative trait loci regulating serum uric acid variation showed a significant logarithm of odds (LOD) score of 4.72 (empirical LOD score = 4.62; P < 0.00001) on chromosome 3p26. One LOD support interval contains 25 genes, of which an interesting candidate gene is chemokine receptor 2. SUMMARY: There is a significant genetic component in the variation in serum uric acid and evidence of pleiotropy between serum uric acid and other cardiovascular risk factors.
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Doenças Cardiovasculares/genética , Variação Genética , Americanos Mexicanos/genética , Ácido Úrico/sangue , Adulto , Doenças Cardiovasculares/sangue , Cromossomos Humanos Par 3 , Feminino , Predisposição Genética para Doença , Genótipo , Humanos , Escore Lod , Masculino , Pessoa de Meia-Idade , Locos de Características Quantitativas , Fatores de RiscoRESUMO
OBJECTIVES: We investigated the relationship among factors predicting inadequate glucose control among 182 Cuban-American adults (Females = 110, Males = 72) with type 2 diabetes mellitus (CAA). STUDY DESIGN: Cross-sectional study of CAA from a randomized mailing list in two counties of South Florida. METHODS: Fasted blood parameters and anthropometric measures were collected during the study. BMI was calculated (kg/m2). Characteristics and diabetes care of CAA were self-reported Participants were screened by trained interviewers for heritage and diabetes status (inclusion criteria: self-reported having type 2 diabetes; age > or = 35 years, male and female; not pregnant or lactating; no thyroid disorders; no major psychiatric disorders). Participants signed informed consent form. Statistical analyses used SPSS and included descriptive statistic, multiple logistic and ordinal logistic regression models, where all CI 95%. RESULTS: Eighty-eight percent of CAA had BMI of > or = 25 kg/m2. Only 54% reported having a diet prescribed/told to schedule meals. We found CAA told to schedule meals were 3.62 more likely to plan meals (1.81, 7.26), p < 0.001) and given a prescribed diet, controlling for age, corresponded with following a meal plan OR 4.43 (2.52, 7.79, p < 0.001). The overall relationship for HbA1c < 8.5 to following a meal plan was OR 9.34 (2.84, 30.7. p < 0.001). CONCLUSIONS: The advantage of having a medical professional prescribe a diet seems to be an important environmental support factor in this sample's diabetes care, since obesity rates are well above the national average. Nearly half CAA are not given dietary guidance, yet our results indicate CAA may improve glycemic control by receiving dietary instructions.
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Diabetes Mellitus Tipo 2/etnologia , Disparidades nos Níveis de Saúde , Hispânico ou Latino/estatística & dados numéricos , Cooperação do Paciente/etnologia , Autocuidado , Adulto , Idoso , Glicemia/análise , Índice de Massa Corporal , Estudos Transversais , Cuba/etnologia , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/dietoterapia , Feminino , Florida , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Qualidade da Assistência à Saúde , Autocuidado/psicologia , Autocuidado/estatística & dados numéricosRESUMO
The aim of this study is to examine whether the ACE-I/D, AGT-M235T, and AT1R-A1166C polymorphisms of the renin-angiotensin system (RAS) genes are associated with cardiovascular and renal-related risk factors in Mexican Americans. Study participants (N = 848) were genotyped by Taqman assays. Association analyses were performed by measured genotype approach. Of the phenotypes examined, the ACE-I/D, AGT-M235T, and AT1R-A1166C polymorphisms exhibited significant association with systolic blood pressure, glomerular filtration rate and body mass index, respectively. The data suggest that the polymorphisms examined in the RAS may modulate the risk factors associated with cardiovascular-renal disease.
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Doenças Cardiovasculares/genética , Variação Genética , Nefropatias/genética , Americanos Mexicanos/genética , Sistema Renina-Angiotensina/genética , Albuminúria/genética , Alelos , Angiotensinogênio/genética , Diabetes Mellitus Tipo 2/genética , Feminino , Frequência do Gene , Genótipo , Humanos , Hipertensão/genética , Mutação INDEL , Masculino , Peptidil Dipeptidase A/genética , Polimorfismo de Nucleotídeo Único , Receptor Tipo 1 de Angiotensina/genética , Fatores de Risco , TexasRESUMO
Insulin resistance is a major biochemical defect underlying the pathogenesis of cardiovascular disease (CVD). Mexican-Americans are known to have an unfavorable cardiovascular profile. Thus, the aim of this study was to investigate the genetic effect on variation in HOMA-IR and to evaluate its genetic correlations with other phenotypes related to risk of CVD in Mexican-Americans. The homeostatic model assessment method (HOMA-IR) is one of several approaches that are used to measure insulin resistance and was used here to generate a quantitative phenotype for genetic analysis. For 644 adults who had participated in the San Antonio Family Heart Study (SAFHS), estimates of genetic contribution were computed using a variance components method implemented in SOLAR. Traits that exhibited significant heritabilities were body mass index (BMI) (h (2) = 0.43), waist circumference (h (2) = 0.48), systolic blood pressure (h (2) = 0.30), diastolic blood pressure (h (2) = 0.21), pulse pressure (h (2) = 0.32), triglycerides (h (2) = 0.51), LDL cholesterol (h (2) = 0.31), HDL cholesterol (h (2) = 0.24), C-reactive protein (h (2) = 0.17), and HOMA-IR (h (2) = 0.33). A genome-wide scan for HOMA-IR revealed significant evidence of linkage on chromosome 12q24 (close to PAH (phenylalanine hydroxylase), LOD = 3.01, p < 0.001). Bivariate analyses demonstrated significant genetic correlations (p < 0.05) of HOMA-IR with BMI (rho (G) = 0.36), waist circumference (rho (G) = 0.47), pulse pressure (rho (G) = 0.39), and HDL cholesterol (rho (G) = -0.18). Identification of significant linkage for HOMA-IR on chromosome 12q replicates previous family-based studies reporting linkage of phenotypes associated with type 2 diabetes in the same chromosomal region. Significant genetic correlations between HOMA-IR and phenotypes related to CVD risk factors suggest that a common set of gene(s) influence the regulation of these phenotypes.
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Doenças Cardiovasculares/etnologia , Doenças Cardiovasculares/genética , Predisposição Genética para Doença , Variação Genética , Resistência à Insulina/genética , Americanos Mexicanos/genética , Feminino , Humanos , Escore Lod , Masculino , Pessoa de Meia-Idade , FenótipoRESUMO
PURPOSE: Microalbuminuria, defined as urine albumin-to-creatinine ratio of 0.03 to 0.299 mg/mg, is a major risk factor for cardiovascular disease. Several genetic epidemiological studies have established that microalbuminuria clusters in families, suggesting a genetic predisposition. METHOD: We estimated heritability of microalbuminuria and performed a genome-wide linkage analysis to identify chromosomal regions influencing urine albumin-to-creatinine ratio in 486 Mexican Americans from 26 multiplex families. RESULTS: Significant heritability was demonstrated for urine albumin-to-creatinine ratio (h = 24%, P < 0.003) after accounting for age, sex, body mass index, triglycerides, and hypertension. Genome scan revealed significant evidence of linkage of urine albumin-to-creatinine ratio to a region on chromosome 20q12 (LOD score of 3.5, P < 0.001) near marker D20S481. This region also exhibited a LOD score of 2.8 with diabetes status as a covariate and 3.0 with hypertension status as a covariate suggesting that the effect of this locus on urine albumin-to-creatinine ratio is largely independent of diabetes and hypertension. CONCLUSION: Findings indicate that there is a gene or genes located on human chromosome 20q12 that may have functional relevance to albumin excretion in Mexican Americans. Identifying and understanding the role of the genes that determine albumin excretion would lead to the development of novel therapeutic strategies targeted at high-risk individuals in whom intensive preventive measures may be most beneficial.
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Albuminúria/epidemiologia , Albuminúria/genética , Mapeamento Cromossômico/estatística & dados numéricos , Cromossomos Humanos Par 20/genética , Predisposição Genética para Doença/genética , Americanos Mexicanos/genética , Fatores Etários , Albuminúria/etnologia , Pressão Sanguínea , Índice de Massa Corporal , Feminino , Humanos , Padrões de Herança , Funções Verossimilhança , Masculino , Linhagem , Fatores Sexuais , Texas/epidemiologia , Triglicerídeos/sangueRESUMO
Cuban Americans, one of three major Hispanic subgroups, represent = 4% of total US Hispanics. Coronary heart disease (CHD) is the leading cause of death among Cuban Americans. Yet, we know very little about the risk factors of CHD. Findings from one Hispanic subgroup cannot be applicable or extrapolative to other Hispanic subgroups because each subgroup's social histories, cultural identities, health behaviors, and genetic compositions are unique. This paper reviews the existing information on Cuban-American health behavior in relation to CHD. Analyses of the Hispanic Health and Nutrition Examination Survey (HHANES) data revealed a high prevalence of overweight, cigarette smoking, and type 2 diabetes among Cuban Americans. However, the cross-sectional nature of HHANES precludes identifying a cause-and-effect relationship. Well-designed studies are warranted to identify the lifestyle, biochemical, and emerging risk factors of CHD among Cuban Americans.
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Doença das Coronárias/etnologia , Hispânico ou Latino , Aculturação , Adolescente , Adulto , Idoso , Consumo de Bebidas Alcoólicas/sangue , Consumo de Bebidas Alcoólicas/etnologia , Consumo de Bebidas Alcoólicas/fisiopatologia , Doença das Coronárias/sangue , Doença das Coronárias/fisiopatologia , Cuba/etnologia , Depressão/sangue , Depressão/etnologia , Depressão/fisiopatologia , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/etnologia , Diabetes Mellitus Tipo 2/fisiopatologia , Feminino , Humanos , Hipertensão/sangue , Hipertensão/etnologia , Hipertensão/fisiopatologia , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Atividade Motora/fisiologia , Inquéritos Nutricionais , Obesidade/sangue , Obesidade/etnologia , Obesidade/fisiopatologia , Sobrepeso/etnologia , Prevalência , Fatores de Risco , Fumar/sangue , Fumar/etnologia , Fumar/fisiopatologia , Classe Social , Estados Unidos/epidemiologiaRESUMO
OBJECTIVE: To assess the validity of a 131-item semiquantative food frequency questionnaire (FFQ) by comparison with multiple food records in Cuban Americans. DESIGN: The Willet FFQ was administered and food consumptions of three random days (two weekdays and one weekend day) were collected. SETTING: Cuban Americans residing in Miami. PARTICIPANTS: Twenty adult Cuban American volunteers who participated in a larger epidemiological study to evaluate the dietary risk of type 2 diabetes and cardiovascular disease. RESULTS: There were no significant differences in the mean intakes of energy, macronutrients, cholesterol and alcohol estimated by the Willett FFQ and the 3-day food records. For most of the macronutrients the correlation coefficients ranged from 0.14 to 0.71. The correlation coefficient was highest for polyunsaturated fatty acid (r = 0.71, P<0.001) and lowest for protein (r = 0.14, P=0.56). Correlation coefficients for carbohydrate (r = 0.42) and monounsaturated fatty acid (r = 0.43) were only marginally significant (P=0.06). CONCLUSION: Compared with 3-day food records, the Willett FFQ is a reasonable instrument to assess the intakes of most macronutrients and alcohol among Cuban Americans. Further studies should be conducted to validate the usefulness of the Willett FFQ in Cuban Americans for other nutrients.