Online Program

Exploring the association of behavioral, physiological and inflammatory markers with glycemic control in Mexican americans with type 2 diabetes

Tuesday, November 5, 2013

Ranjita Misra, PhD, CHES, FASHA, Social and Behavioral Health Sciences, West Virginia University, School of Public Health, Morgantown, WV
Sukho Lee, PhD, Curriculum & Pedagogy, Texas A&M International University, Laredo, TX
Steve Riechman, PhD, Health and Kinesiology, Texas A&M University, College Station, TX
Roxana Valdes Ramos, PhD, Medicine, Universidad Autónoma del Estado de México, Toluca, Mexico
Martha Kaufer-Horwitz, DSc NC, Endocrinology and Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico, Mexico
Ivonne Vizcarra Bordi, PhD, Medicine, Universidad Autónoma del Estado de México, Toluca, Mexico
Julio Guerrero, PhD, Department of Health Studies, Texas Woman's University, Denton, TX
Background/Significance: Hispanics experience a disproportionate burden of type 2 diabetes, worse glycemic control and a greater risk of diabetes-related complications than non-Hispanic whites, suggesting an ethnic vulnerability that may have genetic and/or lifestyle causative links.

Objective: We examined the association of hemoglobin A1c with adiposity [BMI and percent body fat], behavioral factors [nutrition and physical activity] and physiological and novel inflammatory markers [Vitamin D, IL6, adiponectin, C-reactive protein, and lipoprotein-associated phospholipase A2, blood pressure, lipids] after controlling for demographic [age, gender, education, number of years with diabetes] factors in the regression model.

Methods: The sample comprised of 107 Mexican American aged 18 years and older with type 2 diabetes, recruited from churches, communities and clinics in Laredo, McAllen and College Station TX. Trained interviewers and phlebotomists collected survey/clinical data via face-to-face interviews and fasting blood work.

Results: The mean age and age of onset was 53.9±11.9 and 42.3±11.4 years, respectively. Mean hemoglobin A1c level was 7.98%. The majority of the participants were females [78%] and obese [67%]; percent body fat was 37.8%. Of the participants, 10.3% had a serum 25Vitamin D deficiency, 46.7% had insufficiency, and 43% were sufficient. After adjustment of factors [age, sex, blood pressure, behavioral factors, age of onset of diabetes, and anthropometrics], poor glycemic control was significantly associated with serum creatinine, high-sensitivity C-reactive protein, adiponectin, higher percent of body fat, and female gender [R2 = 0.33; p<.01].

Conclusion: Results provide evidence of association between inflammatory factors and adiposity with poor glycemic control.

Learning Areas:

Chronic disease management and prevention
Diversity and culture
Planning of health education strategies, interventions, and programs

Learning Objectives:
Describe the mean hemoglobin A1c of the participants. List the predictors of poor glycemic control. Discuss if novel inflammatory markers are associated with A1c.

Keyword(s): Latino Health, Diabetes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Dr. Misra is recognized for her investigations in epidemiological and intervention studies, for using a Transdisciplinary team approach, and for combining public health and clinical models of inquiry. She has led several studies to examine the Mexican Diasporas to investigate for acculturative changes among native Mexicans in Mexico and Mexican Americans in the border and interior areas of Texas.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.