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- All Subjects: Endocrinology
- Creators: Shaibi, Gabriel Q
Description
The shape of glucose response and one hour (1-hr) glucose during an oral glucose tolerance test (OGTT) are emerging biomarkers for type 2 diabetes. The purpose of this study was two-fold: (1) to investigate the utility of these novel biomakers to differentiate type 2 diabetes risk in Latino youth, and (2) to examine the genetic determinants in a Latino population.
Data from the ASU Arizona Insulin Registry (AIR) registry and the USC Study of Latino Adolescents at Risk for diabetes project were used to test the cross-sectional and prospective utility of novel biomarkers to identify youth at risk for type 2 diabetes. Pediatric and adult data from the ASU AIR registry were assessed to examine the association of single nucleotide polymorphisms (SNPs) with type 2 diabetes risk. Three KCNQ1 SNPs (rs151290; rs2237892; rs2237895) were examined as novel genetic variants for type 2 diabetes in Latinos.
Latino youth with a biphasic response in the AIR registry exhibited significantly better β-cell function (P < 0.05) compared to youth with a monophasic response. Additionally, Latino youth with a 1-hr glucose ≥155 mg/dL exhibited a significantly greater decline in β-cell function over 8 years compared with the <155 mg/dL group (β=-327.8±126.2, P = 0.01). Moreover, a 1-hr glucose ≥155 mg/dL was associated with a 2.5 times greater risk for developing prediabetes over time (P = 0.0001). 1-hr glucose was the most powerful predictor of prediabetes (area under the receiver operating characteristic curve=0.73) when compared to the traditional biomarkers including HbA1c (0.58), fasting (0.67), and 2-hr glucose (0.64). Two KCNQ1 SNPs (rs151290 and rs2237892) exhibited significant associations with type 2 diabetes risk factors. For the novel glycemic markers, 15 SNPs were associated with the glucose response curve, while 18 SNPs were associated with 1-hr glucose.
These data suggest that glucose response curve and 1-hr glucose during an OGTT independently differentiate type 2 diabetes risk among Latino youth. Furthermore, it was successful to replicate the association of type 2 diabetes risk with 2 KCNQ1 SNPs in a Latino population. Data suggest that novel glycemic biomarkers are influenced by genetic background in this high-risk population.
Data from the ASU Arizona Insulin Registry (AIR) registry and the USC Study of Latino Adolescents at Risk for diabetes project were used to test the cross-sectional and prospective utility of novel biomarkers to identify youth at risk for type 2 diabetes. Pediatric and adult data from the ASU AIR registry were assessed to examine the association of single nucleotide polymorphisms (SNPs) with type 2 diabetes risk. Three KCNQ1 SNPs (rs151290; rs2237892; rs2237895) were examined as novel genetic variants for type 2 diabetes in Latinos.
Latino youth with a biphasic response in the AIR registry exhibited significantly better β-cell function (P < 0.05) compared to youth with a monophasic response. Additionally, Latino youth with a 1-hr glucose ≥155 mg/dL exhibited a significantly greater decline in β-cell function over 8 years compared with the <155 mg/dL group (β=-327.8±126.2, P = 0.01). Moreover, a 1-hr glucose ≥155 mg/dL was associated with a 2.5 times greater risk for developing prediabetes over time (P = 0.0001). 1-hr glucose was the most powerful predictor of prediabetes (area under the receiver operating characteristic curve=0.73) when compared to the traditional biomarkers including HbA1c (0.58), fasting (0.67), and 2-hr glucose (0.64). Two KCNQ1 SNPs (rs151290 and rs2237892) exhibited significant associations with type 2 diabetes risk factors. For the novel glycemic markers, 15 SNPs were associated with the glucose response curve, while 18 SNPs were associated with 1-hr glucose.
These data suggest that glucose response curve and 1-hr glucose during an OGTT independently differentiate type 2 diabetes risk among Latino youth. Furthermore, it was successful to replicate the association of type 2 diabetes risk with 2 KCNQ1 SNPs in a Latino population. Data suggest that novel glycemic biomarkers are influenced by genetic background in this high-risk population.
ContributorsKim, Joon Young (Author) / Shaibi, Gabriel Q (Thesis advisor) / Mandarino, Lawrence J (Committee member) / Coletta, Dawn K (Committee member) / De Filippis, Elena A (Committee member) / Arizona State University (Publisher)
Created2015
Description
Introduction: The incidence of type 2 diabetes (T2D) in youth is projected to increase through 2060, especially in minority youth. Every Little Step Counts (ELSC) has demonstrated efficacy in reducing T2D risk factors in Latino youth. Documenting the adaptation of ELSC to a family diabetes prevention program (FDPP) could support future adaptation and scaling of FDPPs.Purpose: To describe the process that guided the adaptation of a culturally grounded evidenced-based DPP tailored to Latino families, with the aim of using the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME) to classify adaptations.
Methods/Design: The approach that guided the adaptation involved community-based participatory research (CBPR) and phases commonly used to adapt health interventions. Inductive and deductive content analysis guided by the FRAME was conducted on data collected throughout the phases to identify and classify adaptations. Data was then triangulated with the entities involved in the adaptation, analyzed to determine the frequency and proportion of adaptations across the FRAME categories and levels, and cross tabulated.
Results: A total of N=66 adaptations were identified. Adaptations occurred with the highest frequency during the grant preparation and after the pilot study. Most adaptations were led by both the academic institution and community partners. Content modifications were most common. Prominent reasons for adaptation included organization/setting time constraints and integrating community partners’ and interventionists’ feedback.
Discussion: Study results align with the CBPR approach that guided the adaptation and the ELSC core tenet of integrating community partnerships throughout all aspects of the intervention. To efficiently track adaptations, consensus as to what constitutes varying levels of adaptation granularity (i.e., macro, meso, micro) is needed. While tracking adaptations can be time and resource intensive, tracking adaptations may support the development of strategies to tie adaptations to outcomes.
Conclusion: It is critical to determine when adaptations are needed to avoid a “culture of adaptation hyperactivity”. There is an opportunity to analyze past and future ELSC adaptations to better understand the intervention’s core tenets and the relationship between adaptations and outcomes. Future ELSC adaptations would benefit from considering how to incorporate feedback from diverse stakeholders and populations in preparation for scaling.
ContributorsDiaz, Monica (Author) / Shaibi, Gabriel Q (Thesis advisor) / Bruening, Meg (Committee member) / Shepard, Christina (Committee member) / Arizona State University (Publisher)
Created2024