Division of Endocrinology, Diabetes and Metabolism, General Clinical Research Center, University of Tennessee Health Science Center, Memphis, Tennessee 38163, USA.
Ethn Dis. 2011 Winter;21(1):33-9.
In contrast to the widely reported ethnic differences in prevalence, the incidence of type 2 diabetes was surprisingly similar (approximately 11%) among individuals from the different US ethnic groups in the Diabetes Prevention Program (DPP). Because DPP participants had impaired glucose tolerance (IGT) at baseline, we hypothesized that ethnic disparities are initiated at the pre-IGT stage during evolution of type 2 diabetes. The Pathobiology of Prediabetes in a Biracial Cohort (POP-ABC) is designed to test that hypothesis by tracking the natural history of early dysglycemia in a biracial cohort comprising offspring of parents with type 2 diabetes. The POP-ABC study has an enrollment target of 400 participants (200 African American, 200 Caucasian), aged 18-65 years, with at least 1 parent with type 2 diabetes. All subjects must have normal fasting glucose and/ or normal glucose tolerance, as determined by a 75-gram oral glucose tolerance test (OGTT). Subjects are recruited over approximately 3 years and followed for another 2 years, with repeated metabolic assessments. The latter include OCTT, body composition, indirect calorimetry, euglycemic clamp, beta cell function, and biochemistries. Repository specimens (DNA, RNA and proteome) are obtained for future studies. The primary outcome is the occurrence of prediabetes (ICT and/or impaired fasting glucose). The sample size provides 85% power to detect a hazard ratio of 1.75 between Black and White offspring in the primary outcome (alpha = .05). Secondary endpoints include behavioral, biochemical and socioeconomic predictors of dysglycemia. The POP-ABC study will elucidate the nosogeny of ethnic disparities in glucose dysregulation.
与广泛报道的流行率的种族差异形成对比的是，在美国不同种族群体的糖尿病预防计划（DPP）中，2 型糖尿病的发病率惊人地相似（约为 11%）。由于 DPP 参与者在基线时糖耐量受损（IGT），我们假设种族差异是在 2 型糖尿病演变过程中的 IGT 前阶段开始的。在一个由 2 型糖尿病父母的后代组成的、种族混合的队列中，前驱糖尿病的病理生物学（POP-ABC）研究旨在通过追踪早期糖血症的自然病史来检验这一假说。POP-ABC 研究的入组目标是 400 名参与者（200 名非裔美国人，200 名白人），年龄在 18-65 岁之间，至少有 1 位父母患有 2 型糖尿病。所有受试者的空腹血糖和/或葡萄糖耐量必须正常，这是通过 75 克口服葡萄糖耐量试验（OGTT）确定的。大约需要 3 年的时间招募受试者，并随访 2 年，期间进行多次代谢评估。后者包括 OCTT、身体成分、间接测热法、葡萄糖钳夹、β细胞功能和生物化学。为将来的研究获得储存标本（DNA、RNA 和蛋白质组）。主要结果是前驱糖尿病（ICT 和/或空腹血糖受损）的发生。样本量为 85%，可检测到主要结局中黑人和白人后代的风险比为 1.75（α=0.05）。次要终点包括血糖异常的行为、生化和社会经济预测因素。POP-ABC 研究将阐明葡萄糖失调中种族差异的发病机制。
