Diabetes Care, Vol 14, Issue 7 649-654, Copyright © 1991 by American Diabetes Association

ARTICLES

Genetic and environmental determinants of type II diabetes in Mexican Americans. Is there a "descending limb" to the modernization/diabetes relationship?

MP Stern, JA Knapp, HP Hazuda, SM Haffner, JK Patterson and BD Mitchell
Department of Medicine, University of Texas Health Science Center, San Antonio 78284.

Evidence from migrant population studies and secular trend data indicates that environmental factors play a role in the etiology of non-insulin-dependent (type II) diabetes. These environmental factors appear to be concomitants of the process whereby traditional populations become "modernized" or "westernized" and include increased intake of total calories, fat, and sucrose, decreased intake of total and complex carbohydrates, including fiber, and decreased physical exercise. There also appears to be a "postmodernization" process, which we have characterized as the "descending limb of the curve." In Mexican Americans in San Antonio, the prevalence of type II diabetes declines with acculturation to the values, attitudes, and behaviors of "postmodernized" American society. However, examination of the dietary and exercise concomitants of this process revealed a mixed picture. There was some suggestion that Mexican-American women, although not men, had entered onto the descending limb of the curve. However, Native American genetic admixture in Mexican Americans also covaried with affluence and acculturation in such a way that the declining prevalence of diabetes could as easily be due to genetic factors as to environmental factors. The "pancreatic exhaustion" theory holds that resistance to insulin action is a principal lesion leading to hypersecretion of insulin, hyperinsulinemia, and eventual islet cell failure and clinical diabetes. This theory predicts that prediabetic subjects will be hyperinsulinemic. In conformity with this theory, we have shown that subgroups of the Mexican-American population, defined on the basis of family history of diabetes, who would be expected a priori to be enriched with prediabetic subjects, are hyperinsulinemic as predicted.(ABSTRACT TRUNCATED AT 250 WORDS)
CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				C. J. Rodriguez, F. Lin, R. L. Sacco, Z. Jin, B. Boden-Albala, S. Homma, and M. R. Di Tullio Prognostic Implications of Left Ventricular Mass Among Hispanics: The Northern Manhattan Study Hypertension, July 1, 2006; 48(1): 87 - 92. [Abstract] [Full Text] [PDF]

				A. Huertas-Vazquez, C. Aguilar-Salinas, A. J. Lusis, R. M. Cantor, S. Canizales-Quinteros, J. C. Lee, L. Mariana-Nunez, R.-M. L. Riba-Ramirez, A. Jokiaho, T. Tusie-Luna, et al. Familial Combined Hyperlipidemia in Mexicans: Association With Upstream Transcription Factor 1 and Linkage on Chromosome 16q24.1 Arterioscler. Thromb. Vasc. Biol., September 1, 2005; 25(9): 1985 - 1991. [Abstract] [Full Text] [PDF]

				A. F. Brown, S. L. Ettner, J. Piette, M. Weinberger, E. Gregg, M. F. Shapiro, A. J. Karter, M. Safford, B. Waitzfelder, P. A. Prata, et al. Socioeconomic Position and Health among Persons with Diabetes Mellitus: A Conceptual Framework and Review of the Literature Epidemiol. Rev., July 1, 2004; 26(1): 63 - 77. [Full Text] [PDF]

				A. S Levine, C. M Kotz, and B. A Gosnell Sugars: hedonic aspects, neuroregulation, and energy balance Am. J. Clinical Nutrition, October 1, 2003; 78(4): 834S - 842. [Abstract] [Full Text] [PDF]

				L. A. Jaber, M. B. Brown, A. Hammad, Q. Zhu, and W. H. Herman Lack of Acculturation Is a Risk Factor for Diabetes in Arab Immigrants in the U.S. Diabetes Care, July 1, 2003; 26(7): 2010 - 2014. [Abstract] [Full Text] [PDF]

				L. C. Cuasay, E. S. Lee, P. P. Orlander, L. Steffen-Batey, and C. L. Hanis Prevalence and Determinants of Type 2 Diabetes Among Filipino-Americans in the Houston, Texas Metropolitan Statistical Area Diabetes Care, December 1, 2001; 24(12): 2054 - 2058. [Abstract] [Full Text] [PDF]

				C. H D Fall Non-industrialised countries and affluence: Relationship with Type 2 diabetes Br. Med. Bull., November 1, 2001; 60(1): 33 - 50. [Abstract] [Full Text] [PDF]

				C. A. Aguilar-Salinas, G. Olaiz, V. Valles, J. M. R. Torres, F. J. G. Perez, J. A. Rull, R. Rojas, A. Franco, and J. Sepulveda High prevalence of low HDL cholesterol concentrations and mixed hyperlipidemia in a Mexican nationwide survey J. Lipid Res., August 1, 2001; 42(8): 1298 - 1307. [Abstract] [Full Text] [PDF]