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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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Doenças Cardiovasculares/etiologia , Emigração e Imigração , Obesidade/epidemiologia , Fumar/epidemiologia , Aculturação , Adulto , Idoso , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Características de Residência , Fatores de Risco , Texas/epidemiologia , Fatores de TempoRESUMO
BACKGROUND: The prevalence of diabetes is alarmingly high among Mexican American adults residing near the U.S.-Mexico border. Depression is also common among Mexican Americans with diabetes, and may have a negative influence on diabetes management. Thus, the purpose of the current study was to evaluate the associations of depression and anxiety with the behavioral management of diabetes and glycemic control among Mexican American adults living near the border. METHODS: The characteristics of Mexican Americans with diabetes living in Brownsville, TX (N = 492) were compared by depression/anxiety status. Linear regression models were conducted to evaluate the associations of depression and anxiety with BMI, waist circumference, physical activity, fasting glucose, and glycated hemoglobin (HbA1c). RESULTS: Participants with clinically significant depression and/or anxiety were of greater age, predominantly female, less educated, more likely to have been diagnosed with diabetes, and more likely to be taking diabetes medications than those without depression or anxiety. In addition, anxious participants were more likely than those without anxiety to have been born in Mexico and to prefer study assessments in Spanish rather than English. Greater depression and anxiety were associated with poorer behavioral management of diabetes (i.e., greater BMI and waist circumference; engaging in less physical activity) and poorer glycemic control (i.e., higher fasting glucose, HbA1c). CONCLUSIONS: Overall, depression and anxiety appear to be linked with poorer behavioral management of diabetes and glycemic control. Findings highlight the need for comprehensive interventions along the border which target depression and anxiety in conjunction with diabetes management.
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Transtorno Depressivo/epidemiologia , Diabetes Mellitus Tipo 2 , Adesão à Medicação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Glicemia/metabolismo , Índice de Massa Corporal , Transtorno Depressivo/etiologia , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/tratamento farmacológico , Feminino , Hemoglobinas Glicadas/metabolismo , Humanos , Hipoglicemiantes/administração & dosagem , Masculino , Americanos Mexicanos/estatística & dados numéricos , Pessoa de Meia-Idade , Prevalência , Texas/epidemiologiaRESUMO
The study aims to determine whether place of origin has an effect on Mexican American cardiovascular disease (CVD) risk on the South Texas Border. Although many studies have investigated the effect of immigration on Mexican American health, few have considered how region of origin may impact CVD risk. Subjects in the Cameron County Cohort Study were divided into 3 groups according to place of origin: Southern Mexico, Northern Mexico, and U.S. Border States. Descriptive statistics and regression analyses were conducted using CVD biomarkers and self-reported angina, stroke, and elevated blood pressure. Logistic regression revealed that subjects born in U.S. Border States and Northern Mexico states were significantly less likely to have high glucose levels (p < .05) than those born in Southern Mexico. Subjects born in Northern Mexico were less likely to have high triglycerides (p = .05). This study illustrates the importance of considering region of origin in studying the effect of immigration on Mexican American health beyond the standard: number of years in the United States.
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Doenças Cardiovasculares/epidemiologia , Americanos Mexicanos/estatística & dados numéricos , Adulto , Angina Pectoris/epidemiologia , Angina Pectoris/etnologia , Glicemia/análise , Doenças Cardiovasculares/etnologia , Emigrantes e Imigrantes/estatística & dados numéricos , Feminino , Humanos , Hipertensão/epidemiologia , Hipertensão/etnologia , Masculino , México/etnologia , Pessoa de Meia-Idade , Análise de Regressão , Fatores de Risco , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/etnologia , Texas/epidemiologia , Triglicerídeos/sangueRESUMO
BACKGROUND AND AIMS: Elevated alanine aminotransferase (ALT >40 IU/mL) is a marker of liver injury but provides little insight into etiology. We aimed to identify and stratify risk factors associated with elevated ALT in a randomly selected population with a high prevalence of elevated ALT (39%), obesity (49%) and diabetes (30%). METHODS: Two machine learning methods, the support vector machine (SVM) and Bayesian logistic regression (BLR), were used to capture risk factors in a community cohort of 1532 adults from the Cameron County Hispanic Cohort (CCHC). A total of 28 predictor variables were used in the prediction models. The recently identified genetic marker rs738409 on the PNPLA3 gene was genotyped using the Sequenom iPLEX assay. RESULTS: The four major risk factors for elevated ALT were fasting plasma insulin level and insulin resistance, increased BMI and total body weight, plasma triglycerides and non-HDL cholesterol, and diastolic hypertension. In spite of the highly significant association of rs738409 in females, the role of rs738409 in the prediction model is minimal, compared to other epidemiological risk factors. Age and drug and alcohol consumption were not independent determinants of elevated ALT in this analysis. CONCLUSIONS: The risk factors most strongly associated with elevated ALT in this population are components of the metabolic syndrome and point to nonalcoholic fatty liver disease (NAFLD). This population-based model identifies the likely cause of liver disease without the requirement of individual pathological diagnosis of liver diseases. Use of such a model can greatly contribute to a population-based approach to prevention of liver disease.
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Alanina Transaminase/sangue , Feminino , Humanos , Masculino , Americanos Mexicanos , Fatores de Risco , Máquina de Vetores de Suporte , TexasRESUMO
PURPOSE: This study examined genetic associations of patatin-like phospholipase domain containing 3 gene (PNPLA3) polymorphisms and liver aminotransferases in an extensively documented, randomly recruited Mexican American population at high risk of liver disease. METHODS: Two single nucleotide polymorphisms (SNP) in the PNPLA3 gene (i.e., rs738409 and rs2281135) were genotyped in 1532 individuals. Population stratification was corrected by the genotyping of 103 ancestry informative markers (AIMs) for Mexican Americans. RESULTS: Both PNPLA3 SNPs showed highly significant association with alanine aminotransferase (ALT) levels, but was also, in males, associated with aspartate aminotransferase (AST) levels. Haplotypic association test of the two SNPs suggested stronger genetic association with rs738409 than rs2281135. Obvious sex effects were observed: rs738409-sex interaction in ALT levels P = 8.37 x 10(-4); rs738409-sex interaction in AST levels P = 5.03 x 10(-3). CONCLUSIONS: This population study highlights a sex-specific association of PNPLA3 polymorphisms and elevated liver enzymes in a population-based study, independent of common pathological factors of the metabolic syndrome. The strong genetic association found in women ≤ 50 years old, but not in women > 50 years old, suggests that sex hormones may mediate the sex effect.
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Alanina Transaminase/genética , Aspartato Aminotransferases/metabolismo , Lipase/genética , Hepatopatias/genética , Proteínas de Membrana/genética , Polimorfismo de Nucleotídeo Único , Caracteres Sexuais , Adulto , Fatores Etários , Alanina Transaminase/metabolismo , Aspartato Aminotransferases/genética , Feminino , Genótipo , Humanos , Lipase/metabolismo , Fígado/metabolismo , Hepatopatias/metabolismo , Masculino , Proteínas de Membrana/metabolismo , Síndrome Metabólica/genética , Síndrome Metabólica/metabolismo , Americanos Mexicanos , Pessoa de Meia-IdadeRESUMO
INTRODUCTION: Diabetes, hypertension, and hypercholesterolemia are common chronic diseases among Hispanics, a group projected to comprise 30% of the US population by 2050. Mexican Americans are the largest ethnically distinct subgroup among Hispanics. We assessed the prevalence of and risk factors for undiagnosed and untreated diabetes, hypertension, and hypercholesterolemia among Mexican Americans in Cameron County, Texas. METHODS: We analyzed cross-sectional baseline data collected from 2003 to 2008 in the Cameron County Hispanic Cohort, a randomly selected, community-recruited cohort of 2,000 Mexican American adults aged 18 or older, to assess prevalence of diabetes, hypertension, and hypercholesterolemia; to assess the extent to which these diseases had been previously diagnosed based on self-report; and to determine whether participants who self-reported having these diseases were receiving treatment. We also assessed social and economic factors associated with prevalence, diagnosis, and treatment. RESULTS: Approximately 70% of participants had 1 or more of the 3 chronic diseases studied. Of these, at least half had had 1 of these 3 diagnosed, and at least half of those who had had a disease diagnosed were not being treated. Having insurance coverage was positively associated with having the 3 diseases diagnosed and treated, as were higher income and education level. CONCLUSIONS: Although having insurance coverage is associated with receiving treatment, important social and cultural barriers remain. Failure to provide widespread preventive medicine at the primary care level will have costly consequences.
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Diabetes Mellitus/etnologia , Disparidades em Assistência à Saúde/etnologia , Hipercolesterolemia/etnologia , Hipertensão/etnologia , Americanos Mexicanos/psicologia , Adolescente , Adulto , Idoso , Estudos de Coortes , Estudos Transversais , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/terapia , Feminino , Acessibilidade aos Serviços de Saúde/economia , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde/estatística & dados numéricos , Humanos , Hipercolesterolemia/diagnóstico , Hipercolesterolemia/terapia , Hipertensão/diagnóstico , Hipertensão/terapia , Masculino , Pessoas sem Cobertura de Seguro de Saúde/estatística & dados numéricos , Americanos Mexicanos/estatística & dados numéricos , Pessoa de Meia-Idade , Pobreza/etnologia , Prevalência , Autorrelato , Fatores Socioeconômicos , Texas/epidemiologiaRESUMO
BACKGROUND: Framingham risk scores (FRS) were validated in a mostly Caucasian population. Evaluation of subclinical atherosclerosis by carotid ultrasound may improve ascertainment of risk in nonwhite populations. This study aimed to evaluate carotid intima-media thickness (cIMT) and carotid plaquing among Mexican Americans, and to correlate these markers with coronary risk factors and the FRS. METHODS/RESULTS: Participants (n = 141) were drawn from the Cameron County Hispanic Cohort. Carotid artery ultrasound was performed and cIMT measured. Carotid plaque was defined as areas of thickening >50% of the thickness of the surrounding walls. Mean age was 53.1 ± 11.7 years (73.8% female). Most were overweight or obese (88.7%) and more than half (53.2%) had the metabolic syndrome. One third (34.8%) had abnormal carotid ultrasound findings (either cIMT ≥75th percentile for gender and age or presence of plaque). Among those with abnormal carotid ultrasound, the majority were classified as being at low 10-year risk for cardiovascular events. Carotid ultrasound reclassified nearly a third of the cohort as being at high risk. This discordance between 10-year FRS and carotid ultrasound was noted whether risk was assessed for hard coronary events or global risk. Concordance between FRS and carotid ultrasound findings was best when long-term (30-year) risk was assessed and no subject with an abnormal carotid ultrasound was categorized as low risk by the 30-year FRS algorithm. CONCLUSIONS: Integration of carotid ultrasound findings to coronary risk assessments and use of longer term prediction models may provide better risk assessment in this minority population, with earlier initiation of appropriate therapies.
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Aterosclerose/etnologia , Artérias Carótidas/diagnóstico por imagem , Doenças das Artérias Carótidas/etnologia , Previsões , Americanos Mexicanos , Medição de Risco/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Aterosclerose/diagnóstico por imagem , Doenças das Artérias Carótidas/diagnóstico por imagem , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Texas/epidemiologia , Ultrassonografia , Adulto JovemRESUMO
BACKGROUND: Resting ischemic electrocardiographic abnormalities have been associated with cardiovascular mortality. Simple markers of abnormal autonomic tone have also been associated with diabetes, obesity, and the metabolic syndrome in some populations. Data on these electrocardiographic abnormalities and correlations with coronary risk factors are lacking among Mexican Americans wherein these conditions are prevalent. OBJECTIVE: This study aimed to evaluate the prevalent resting electrocardiographic abnormalities among community-dwelling Mexican Americans, and correlate these findings with coronary risk factors, particularly diabetes, obesity, and the metabolic syndrome. METHODS: Study subjects (n=1280) were drawn from the Cameron County Hispanic Cohort comprised of community-dwelling Mexican Americans living in Brownsville, Texas at the United States-Mexico border. Ischemic electrocardiographic abnormalities were defined as presence of ST/T wave abnormalities suggestive of ischemia, abnormal Q waves, and left bundle branch block. Parameters that reflect autonomic tone, such as heart rate-corrected QT interval and resting heart rate, were also measured. RESULTS: Ischemic electrocardiographic abnormalities were more prevalent among older persons and those with hypertension, diabetes, obesity, and the metabolic syndrome. Subjects in the highest quartiles of QTc interval and resting heart rate were also more likely to be diabetic, hypertensive, obese, or have the metabolic syndrome. CONCLUSIONS: Among Mexican Americans, persons with diabetes, obesity, and the metabolic syndrome were more likely to have ischemic electrocardiographic abnormalities, longer QTc intervals, and higher resting heart rates. A resting electrocardiogram can play a complementary role in the comprehensive evaluation of cardiovascular risk in this minority population.
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The goal of the study was to determine the association between diabetes and inflammation in clinically diagnosed diabetes patients. We hypothesized that low-grade inflammation in diabetes is associated with the level of glucose control. Using a cross-sectional design we compared pro- and anti-inflammatory cytokines in a community-recruited cohort of 367 Mexican Americans with type 2-diabetes having a wide range of blood glucose levels. Cytokines (IL-6, TNF-α, IL-1ß, IL-8) and adipokines (adiponectin, resistin and leptin) were measured using multiplex ELISA. Our data indicated that diabetes as whole was strongly associated with elevated levels of IL-6, leptin, CRP and TNF-α, whereas worsening of glucose control was positively and linearly associated with high levels of IL-6, and leptin. The associations remained statistically significant even after controlling for BMI and age (p=0.01). The association between TNF-α, however, was attenuated when comparisons were performed based on glucose control. Strong interaction effects between age and diabetes and BMI and diabetes were observed for IL-8, resistin and CRP. The cytokine/adipokine profiles of Mexican Americans with diabetes suggest an association between low-grade inflammation and quality of glucose control. Unique to in our population is that the chronic inflammation is accompanied by lower levels of leptin.
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Adiponectina/sangue , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/etnologia , Interleucina-6/sangue , Leptina/sangue , Americanos Mexicanos , Fator de Necrose Tumoral alfa/sangue , Adulto , Biomarcadores/sangue , Glicemia/metabolismo , Índice de Massa Corporal , Estudos Transversais , Demografia , Feminino , Hemoglobinas Glicadas/metabolismo , Humanos , Mediadores da Inflamação/sangue , Masculino , Modelos Biológicos , Razão de Chances , Estatísticas não ParamétricasRESUMO
BACKGROUND AND AIMS: Obesity is increasingly a health problem and a risk factor for diabetes in young Mexican-American populations. Genetic association studies in older, mostly non-Hispanic populations have reported that polymorphisms in the candidate genes HSD11B1, CRP, ADIPOQ, PPARG, ANKK1, ABCC8 and SERPINF1 are associated with obesity or diabetes. We analyzed the polymorphisms rs846910, rs1205, rs1501299, rs1801282, rs1800497, rs757110 and rs1136287 in these candidate genes, for association with obesity and metabolic traits in a young Mexican-American population from south Texas. METHODS: Genotyping of the seven common SNPs were performed by allelic discrimination assays in 448 unrelated Mexican Americans (median age = 16 years) from south Texas. χ(2) tests and regression analyses using additive models were used for genetic association analyses adjusting for covariates; p values were corrected for multiple testing by permutation analyses. RESULTS: rs1800497 (ANKK1) shows association with waist circumference (p = 0.009) and retains the association (p = 0.03) after permutation testing. Analysis of metabolic quantitative traits shows that rs846910 (HSD11B1) was associated with HOMA-IR (p = 0.04) and triglycerides (p = 0.03), and rs1205 (CRP) with HOMA-IR (p = 0.03) and fasting glucose levels (p = 0.007). However, the quantitative traits associations are not maintained after permutation analysis. None of the other SNPs in this study showed associations with obesity or metabolic traits in this young Mexican-American population. CONCLUSIONS: We report a potential association between rs1800497 (linked to changes in brain dopamine receptor levels) and central obesity in a young Mexican-American population.
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Predisposição Genética para Doença , Americanos Mexicanos/genética , Obesidade/genética , Polimorfismo de Nucleotídeo Único , Adolescente , DNA/genética , DNA/isolamento & purificação , Humanos , TexasRESUMO
OBJECTIVE: Adiponectin and leptin play critical roles in the development of Metabolic Syndrome (MetS). This study was designed to assess the feasibility of using circulating levels of adiponectin and leptin for the early diagnosis of MetS. METHODS: A cross-sectional study was performed using data from 367 participants randomly selected from a well-characterized cohort of Mexican-Americans living at the US-Mexico border. RESULTS: Significant differences in circulating levels of adiponectin and leptin were observed between males and females. Adiponectin/leptin correlated significantly with MetS in this population. A receiver-operator characteristic (ROC) analysis demonstrated that adiponectin/leptin showed a high sensitivity (70.9% for males, 78.9% for females) and specificity (90.2% for males and 69.8% for females) for the diagnosis of MetS, independent of BMI measurements. CONCLUSION: These data support the central role of adiponectin and leptin in MetS, and demonstrated that adiponectin/leptin can be used as a highly sensitive and specific biomarker for MetS.
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Adiponectina/sangue , Leptina/sangue , Síndrome Metabólica/sangue , Adulto , Estudos Transversais , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Masculino , Americanos Mexicanos , Pessoa de Meia-Idade , Fatores SexuaisRESUMO
OBJECTIVE: Previous studies in mice and humans observed down-regulation of the gene expression of ATP6V1H associated with type 2 diabetes. This study identified prospectively changes in ATP6V1H expression before and after overt diabetes. METHODS: Expression of ATP6V1H in peripheral blood was compared pre and post development of diabetes in nine individuals. RESULTS: Considerable variation of ATP6V1H mRNA levels was observed between different individuals. However, within each individual the decrease in expression of ATP6V1H with the development of diabetes was highly statistically significant. CONCLUSIONS: ATP6V1H may represent a critical molecular mechanism involved in the development of type 2 diabetes and its compilations through its important regulatory effect on vacuolar-ATPase activity.
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Diabetes Mellitus Tipo 2/genética , Regulação para Baixo , Adulto , Idoso , Diabetes Mellitus Tipo 2/epidemiologia , Humanos , Masculino , Americanos Mexicanos , Pessoa de Meia-Idade , Projetos Piloto , RNA Mensageiro/biossíntese , Risco , Distribuição Tecidual , Transcriptoma , Estados Unidos/epidemiologia , Estados Unidos/etnologia , ATPases Vacuolares Próton-Translocadoras/sangue , ATPases Vacuolares Próton-Translocadoras/genéticaRESUMO
OBJECTIVE: The lack of standardized reference range for the homeostasis model assessment-estimated insulin resistance (HOMA-IR) index has limited its clinical application. This study defines the reference range of HOMA-IR index in an adult Hispanic population based with machine learning methods. METHODS: This study investigated a Hispanic population of 1854 adults, randomly selected on the basis of 2000 Census tract data in the city of Brownsville, Cameron County. Machine learning methods, support vector machine (SVM) and Bayesian Logistic Regression (BLR), were used to automatically identify measureable variables using standardized values that correlate with HOMA-IR; K-means clustering was then used to classify the individuals by insulin resistance. RESULTS: Our study showed that the best cutoff of HOMA-IR for identifying those with insulin resistance is 3.80. There are 39.1% individuals in this Hispanic population with HOMA-IR>3.80. CONCLUSIONS: Our results are dramatically different using the popular clinical cutoff of 2.60. The high sensitivity and specificity of HOMA-IR>3.80 for insulin resistance provide a critical fundamental for our further efforts to improve the public health of this Hispanic population.
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Inteligência Artificial , Homeostase , Resistência à Insulina , Americanos Mexicanos , Adulto , Humanos , Curva ROC , Valores de ReferênciaRESUMO
INTRODUCTION: Rates of obesity and overweight, which frequently lead to type 2 diabetes, have increased dramatically among US children during the past 30 years. We analyzed associations between insulin resistance and other markers of disease in a sample of Mexican American adolescents from a severely disadvantaged community on the Texas-Mexico border. METHODS: We analyzed results from 325 students from 1 high school in this descriptive study. We measured height, weight, waist circumference, blood pressure, blood glucose, and lipids; calculated body mass index; and estimated insulin resistance. RESULTS: Approximately 50% of our sample (mean age, 16 y) were overweight or obese, and more participants were obese than overweight. More than 40% had high waist circumference, and 66% had elevated high-density lipoprotein cholesterol. These characteristics were already present in the youngest participants (aged 12 y). Although only 1% of participants had elevated fasting blood glucose, 27% exhibited insulin resistance and most of these were also obese. Similarly, participants with high waist circumference were more likely to exhibit insulin resistance than those with normal waist circumference. CONCLUSION: Participants in this sample had insulin resistance, a potent predictor of diabetes. Two markers, low high-density lipoprotein cholesterol and high waist circumference, were strongly linked to insulin resistance; the surrogate for central adiposity, waist circumference, exhibited strong association. We identified high levels of obesity and markers for future disease in our sample. These findings emphasize the need to address insulin resistance at least as early as adolescence to prevent adverse economic, social, and health consequences.
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Adiposidade/fisiologia , Biomarcadores , Resistência à Insulina/etnologia , Americanos Mexicanos , Adolescente , Glicemia , Estudos Transversais , Feminino , Humanos , Masculino , SobrepesoRESUMO
The present study sought to determine gender- and age-specific prevalences of chronic diseases in an urban Mexican American border community. The Cameron County Hispanic Cohort (CCHC; n = 2,000) was selected using a multistaged cluster design. Sociodemographics, anthropometric measures, and blood samples were collected on each participant. More women were obese (55.1%) than men (44.8%). Men had significantly higher rates of diabetes (20.4% for men vs. 15.8% for women, p < .05) and undiagnosed diabetes (6.2% for men vs. 2.4% for women, p < .01); the prevalence of diabetes rose steeply between the ages of 40 and 49 years. Men were significantly more likely to have serum cholesterol levels of 200 mg/dL and elevated low-density lipoprotein levels (22.6% vs. 26.1%, p < .01). Mexican American males in the U.S./Mexico border region have a high prevalence of obesity in younger men and higher overall rates of diabetes, including undiagnosed diabetes, and significantly higher serum cholesterol levels than women.
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Diabetes Mellitus/epidemiologia , Disparidades nos Níveis de Saúde , Saúde do Homem , Americanos Mexicanos/estatística & dados numéricos , Obesidade/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Antropometria , Índice de Massa Corporal , Distribuição de Qui-Quadrado , Colesterol/sangue , Doença Crônica , Análise por Conglomerados , Estudos Transversais , Feminino , Acessibilidade aos Serviços de Saúde , Humanos , Modelos Logísticos , Masculino , México/etnologia , Pessoa de Meia-Idade , Medição de Risco , Fatores Sexuais , Fatores Socioeconômicos , Estados Unidos/epidemiologia , Adulto JovemRESUMO
INTRODUCTION: Mexican Americans are at increased risk for obesity and diabetes. We established a cohort on the United States-Mexico border to determine the prevalence of obesity and diabetes in this Mexican American population and to see whether minor economic advantages had any effect on health. METHODS: We randomly selected and extensively documented 810 people aged 35 to 64 years. Weighted data were analyzed to establish prevalence of obesity and diabetes and other markers of poor health such as elevated glycated hemoglobin levels. RESULTS: Rates of obesity (body mass index > or = 30 kg/m(2)) were 57% in the first (lower) of 4 socioeconomic strata by income and were 55.5% in the third (higher). People in the higher socioeconomic stratum were significantly less likely to have undiagnosed diabetes (2% vs 9%). Among people aged 55 to 64 years, rates of diabetes were significantly higher among those in the lower socioeconomic stratum than among those in the higher stratum. Rates of undiagnosed diabetes had similar differences. Approximately three-fourths of the respondents reported having no health insurance, and we found no difference between people in different socioeconomic strata. CONCLUSION: Rates of obesity and diabetes in this border community are among the highest in the United States. Belonging to the lower socioeconomic stratum significantly increased the likelihood of having undiagnosed diabetes and, in patients too young to be eligible for Medicare, the overall risk of developing diabetes. Modest improvement in income has a beneficial effect on health in this racial/ethnic minority community.