The long term goal of our research team is to determine the environmental and genetic mechanisms of the interaction of diabetes/insulin resistance, obesity and hypertension in blacks so that we and others can design and test preventive strategies in the US as well as in black populations around the world. We have chosen the island nation of Dominica as a research site because the third leading cause of death is hypertension and the seventh cause of death is diabetes. In addition it is an English speaking, mostly rural, predominately black society which has a high literacy rate, and access to health care is guaranteed. The specific goal of this project is to test the feasibility of a new rapid epidemiologic survey method to estimate the prevalence of diabetes, obesity and hypertension in this society which has a social milieu strikingly different from US urban blacks. The preliminary data will be used to develop an R01 application to investigate the cause of geographic differences in the prevelance of diabetes, insulin resistance, obesity an hypertension between US and Caribbean blacks. The goal will be met by carrying out the following specific aims: 1. To refine and finalize our protocol by working with NIDDK staff and investigators at the NIH Clinical Center and in Dominica. This will include a working/consultation visit of the major Dominican investigator (Dr.Gerald Gell) to the Drew/UCLA Hypertension Research Center in Los Angeles and possibly to Bethesda, MD. 2. To train and certify 6 Dominican examiners in the rapid epidemiologic survey method and our questionaire, anthropometrics, in blood pressure measurement, and in obtaining blood by finger stick and/or venipuncture. Some will be trained in data entry using our portable computer. This will be done in Dominica 1 week before the 7 day rapid survey takes place. 3. Train a local laboratory person in fingerstick blood glucose assay and in the microcolumn method of assaying glycohemoblobin (GHb) which will be measured in all participants. 4. Utilize a 2 stage cluster technique to select 30 clusters of 7 subjects (total of 210 subjects) and perform the examination and testing in the home of the subjects. All Subjects will be asked to come the regional health clinic the following week for a 2 hr GTT. 5. Enter the demographic, family history, anthropometric, blood pressure and biochemical data into a portable computer, perform a rapid analysis of the prevalence of diabetes, obesity and hypertension to the local Pl and the government health service before the US investigators return. 6. Utilize this experience and preliminary data to develop a detailed application that will evaluate the relative role of genes and environment to the prevalence of diabetes, obesity and hypertension in the US, Caribbean and West African populations.
| Lee, Seong Min; Meyer, Mark B; Benkusky, Nancy A et al. (2015) Mechanisms of Enhancer-mediated Hormonal Control of Vitamin D Receptor Gene Expression in Target Cells. J Biol Chem 290:30573-86 |
