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首页> 外文期刊>Journal of Clinical Medicine >Systemic Disease and Ocular Comorbidity Analysis of Geographically Isolated Federally Recognized American Indian Tribes of the Intermountain West
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Systemic Disease and Ocular Comorbidity Analysis of Geographically Isolated Federally Recognized American Indian Tribes of the Intermountain West

机译：地理上孤立的联邦公认美国印度部落的全身疾病和眼镜合并症分析

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Background: The American Indian Navajo and Goshute peoples are underserved patient populations residing in the Four Corners area of the United States and Ibupah, Utah, respectively. Methods: We conducted a cross-sectional study of epidemiological factors and lipid biomarkers that may be associated with type II diabetes, hypertension and retinal manifestations in tribal and non-tribal members in the study areas (n = 146 participants). We performed multivariate analyses to determine which, if any, risk factors were unique at the tribal level. Fundus photos and epidemiological data through standardized questionnaires were collected. Blood samples were collected to analyze lipid biomarkers. Univariate analyses were conducted and statistically significant factors at p 0.10 were entered into a multivariate regression. Results: Of 51 participants for whom phenotyping was available, from the Four Corners region, 31 had type II diabetes (DM), 26 had hypertension and 6 had diabetic retinopathy (DR). Of the 64 participants from Ibupah with phenotyping available, 20 had diabetes, 19 had hypertension and 6 had DR. Navajo participants were less likely to have any type of retinopathy as compared to Goshute participants (odds ratio (OR) = 0.059; 95% confidence interval (CI) = 0.016–0.223; p 0.001). Associations were found between diabetes and hypertension in both populations. Older age was associated with hypertension in the Four Corners, and the Navajo that reside there on the reservation, but not within the Goshute and Ibupah populations. Combining both the Ibupah, Utah and Four Corners study populations, being American Indian ( p = 0.022), residing in the Four Corners ( p = 0.027) and having hypertension ( p 0.001) increased the risk of DM. DM ( p 0.001) and age ( p = 0.002) were significantly associated with hypertension in both populations examined. When retinopathy was evaluated for both populations combined, hypertension ( p = 0.037) and living in Ibupah ( p 0.001) were associated with greater risk of retinopathy. When combining both American Indian populations from the Four Corners and Ibupah, those with hypertension were more likely to have DM ( p 0.001). No lipid biomarkers were found to be significantly associated with any disease state. Conclusions: We found different comorbid factors with retinal disease outcome between the two tribes that reside within the Intermountain West. This is indicated by the association of tribe and with the type of retinopathy outcome when we combined the populations of American Indians. Overall, the Navajo peoples and the Four Corners had a higher prevalence of chronic disease that included diabetes and hypertension than the Goshutes and Ibupah. To the best of our knowledge, this is the first study to conduct an analysis for disease outcomes exclusively including the Navajo and Goshute tribe of the Intermountain West.
机译：背景：美国印度纳瓦霍和古哲族人是居住在美国和犹他州Ibupah的四个角落区的患者人口。方法：我们对研究领域的部落和非部落成员的II型糖尿病，高血压和视网膜表现有关的流行病学因子和脂质生物标志物进行了横截面研究（n = 146名参与者）。我们进行了多变量分析，以确定部落层面是哪些风险因素的。通过标准化问卷的眼底照片和流行病学数据。收集血液样品以分析脂质生物标志物。对单变量分析进行，并且P <0.10的统计学意义因素被进入多元回归。结果：51名参与者可获得表型的参与者，从四个角区，31型患有II型糖尿病（DM），26例高血压和6例患有糖尿病视网膜病变（DR）。来自IBUPAH的64名与会者的可用表型，20例患有糖尿病，19件有高血压，6人有博士。与GOSHURE参与者相比，NAVAJO参与者不太可能有任何类型的视网膜病变（OTA比（或）= 0.059; 95％置信区间（CI）= 0.016-0.223; p <0.001）。在糖尿病和两种种群的高血压之间发现了联合。年龄较大的年龄与四个角落的高血压相关，纳瓦霍在保留期间居住在那里，但不在GOSHUTE和IBUPAH人口中。结合IBUPAH，犹他州和四个角落研究人口，是美国印第安人（P = 0.022），居住在四个角落（P = 0.027）并具有高血压（P <0.001）增加了DM的风险。 DM（P <0.001）和年龄（p = 0.002）与检查的群体的高血压显着相关。当对两种群体评估视网膜疗法时，高血压（P = 0.037），居住在IBUPAH（P <0.001）中均具有更大的视网膜病变风险。当与四个角落和IBUPAH相结合时，高血压的人更有可能具有DM（P <0.001）。发现没有脂质生物标志物与任何疾病状态显着相关。结论：我们发现两种部落之间的视网膜疾病结果不同，这些因子仍然存在于居住在中间的西部。这是由部落协会和随着视网膜病变的类型表示，当我们组合美国印第安人人口时。总的来说，纳瓦霍人民和四个角落具有比GOSHUTE和IBUPAH所含糖尿病和高血压的慢性疾病患病率更高。据我们所知，这是第一项对疾病成果进行分析的一项研究，该研究仅包括纳瓦霍和宇宙部部落的西部。

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