Hicks Patrice M, Melendez Samuel A Collazo, Vitale Albert, Self William, Hartnett Mary Elizabeth, Bernstein Paul, Morgan Denise J, Feehan Michael, Shakoor Akbar, Kim Ivana, Owen Leah A, DeAngelis Margaret M
Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, UT, USA.
Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA.
J Community Med Public Health. 2019;3(1). Epub 2019 Jun 10.
Understanding disease risk is challenging in multifactorial conditions as it can differ by environment, ethnicity and race. The Confederated Tribes of the Goshute Reservation are one of the most isolated populations in the United States. Retinal changes are a reliable indicator for systemic disease. We conducted a cross-sectional study to identify correlations between genetic data and epidemiological risk factors for blinding retinal disease in this tribe. As part of the "Supporting Prediction and Prevention Blindness Project (SPBPP)" in the Native American Population of the Intermountain West, we found that hypertensive retinopathy was the most prevalent retinal disease. We found that forty-two percent of the Goshute population was affected. Blood samples, fundus photos and intraocular pressure were obtained for all participants. In addition, a standardized questionnaire was administered. DNA and total cholesterol, HDL, LDL, VLDL, triglycerides and HbA1c were also evaluated. Our study interrogated genetic variants from the PAGE study (ARMS2 rs10490924, CFH rs800292, rs1061170) and additional studies that looked at previously associated genetic variants with retinal disease associated with cardiovascular disease. We conducted univariate and multivariate logistic regression in Stata v15.0. We found an association between hypertriglyceridemia and HTR (adj = .05) within the Goshute population. To the best of our knowledge, this is the first study to demonstrate the prevalence of hypertensive retinopathy in a Native American population. Moreover, our study is the first to demonstrate an independently predictive relationship between hypertriglyceridemia and hypertensive retinopathy in an American Indian population. This study furthers our knowledge about prevalent blinding eye disease within the most geographically isolated federally recognized native United States American tribe, for which nothing has been published with respect to any disease. Although, this study furthers our understanding about the prevalence of genetic epidemiological risk factors within this population, it has greater implications for the screening of blinding diseases in underserved populations in general. This study can inform public health on planning and delivering of quality, accessible and relevant care to this population.
在多因素疾病中，了解疾病风险具有挑战性，因为它会因环境、种族和民族的不同而有所差异。戈舒特保留地联邦部落是美国最与世隔绝的人群之一。视网膜变化是全身性疾病的可靠指标。我们进行了一项横断面研究，以确定该部落中遗传数据与致盲性视网膜疾病的流行病学风险因素之间的相关性。作为美国西部山间地区原住民“支持预测和预防失明项目（SPBPP）”的一部分，我们发现高血压性视网膜病变是最普遍的视网膜疾病。我们发现42%的戈舒特人群受到影响。为所有参与者采集了血样、眼底照片和眼压数据。此外，还发放了一份标准化问卷。同时对DNA以及总胆固醇、高密度脂蛋白、低密度脂蛋白、极低密度脂蛋白、甘油三酯和糖化血红蛋白进行了评估。我们的研究检测了来自PAGE研究（ARMS2 rs10490924、CFH rs800292、rs1061170）的基因变异，以及其他一些研究中曾观察到的与心血管疾病相关的视网膜疾病的先前关联基因变异。我们在Stata v15.0中进行了单变量和多变量逻辑回归分析。我们发现戈舒特人群中高甘油三酯血症与高血压性视网膜病变之间存在关联（校正P值=0.05）。据我们所知，这是第一项证明高血压性视网膜病变在美洲原住民人群中患病率的研究。此外，我们的研究也是第一项证明高甘油三酯血症与美国印第安人群中高血压性视网膜病变之间存在独立预测关系的研究。这项研究进一步增进了我们对美国最偏远的联邦认可的原住民部落中普遍存在的致盲性眼病的了解，此前关于该部落任何疾病均无相关发表。虽然这项研究进一步加深了我们对该人群中遗传流行病学风险因素患病率的理解，但它对一般服务不足人群中致盲性疾病的筛查具有更大的意义。这项研究可为公共卫生部门针对该人群规划和提供优质、可及且相关的医疗服务提供参考。
