Incidence of Diabetes and Cardiovascular Disease in Mexican Americans - Full Text View

Sponsor:	National Heart, Lung, and Blood Institute (NHLBI)
Information provided by:	National Heart, Lung, and Blood Institute (NHLBI)
ClinicalTrials.gov Identifier:	NCT00005205

Purpose

To determine the incidence of type II diabetes and cardiovascular disease among Mexican-American and non-Hispanic whites in a 15 to 24 year follow-up of the San Antonio Heart Study 1 participants. Also, to perform a 15 to 24 year mortality follow-up of the cohort and to examine the "Hispanic paradox".

Condition
Cardiovascular Diseases Heart Diseases Myocardial Infarction Angina Pectoris Death, Sudden, Cardiac Cerebrovascular Disorders Peripheral Vascular Diseases Coronary Disease Diabetes Mellitus, Non-Insulin Dependent Diabetes Mellitus

Study Type:	Observational
Study Design:	Natural History

Resource links provided by NLM:

MedlinePlus related topics: Angina Cardiac Arrest Coronary Artery Disease Diabetes Heart Attack Heart Diseases Peripheral Arterial Disease Vascular Diseases

U.S. FDA Resources

Further study details as provided by National Heart, Lung, and Blood Institute (NHLBI):

Study Start Date:	August 1987
Estimated Study Completion Date:	July 2003

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More Information

Publications:

Haffner SM, Mykkanen L, Gruber KK, Rainwater DL, Laakso M. Lack of association between sex hormones and Lp(a) concentrations in American and Finnish men. Arterioscler Thromb. 1994 Jan;14(1):19-24.

Haffner SM, Gonzales C, Valdez RA, Mykkanen L, Hazuda HP, Mitchell BD, Monterrosa A, Stern MP. Is microalbuminuria part of the prediabetic state? The Mexico City Diabetes Study. Diabetologia. 1993 Oct;36(10):1002-6.

Haffner SM, Diehl AK, Valdez R, Mitchell BD, Hazuda HP, Morales P, Stern MP. Clinical gallbladder disease in NIDDM subjects. Relationship to duration of diabetes and severity of glycemia. Diabetes Care. 1993 Sep;16(9):1276-84.

Stern MP, Valdez RA, Haffner SM, Mitchell BD, Hazuda HP. Stability over time of modern diagnostic criteria for type II diabetes. Diabetes Care. 1993 Jul;16(7):978-83.

Haffner SM, Mykkanen L, Stern MP, Valdez RA, Heisserman JA, Bowsher RR. Relationship of proinsulin and insulin to cardiovascular risk factors in nondiabetic subjects. Diabetes. 1993 Sep;42(9):1297-302.

Stern MP, Morales PA, Valdez RA, Monterrosa A, Haffner SM, Mitchell BD, Hazuda HP. Predicting diabetes. Moving beyond impaired glucose tolerance. Diabetes. 1993 May;42(5):706-14.

Haffner SM, Morales PA, Gruber MK, Hazuda HP, Stern MP. Cardiovascular risk factors in non-insulin-dependent diabetic subjects with microalbuminuria. Arterioscler Thromb. 1993 Feb;13(2):205-10.

Morales PA, Mitchell BD, Valdez RA, Hazuda HP, Stern MP, Haffner SM. Incidence of NIDDM and impaired glucose tolerance in hypertensive subjects. The San Antonio Heart Study. Diabetes. 1993 Jan;42(1):154-61.

Haffner SM, Morales PA, Hazuda HP, Stern MP. Level of control of hypertension in Mexican Americans and non-Hispanic whites. Hypertension. 1993 Jan;21(1):83-8.

Haffner SM, Miettinen H, Stern MP. Relatively more atherogenic coronary heart disease risk factors in prediabetic women than in prediabetic men. Diabetologia. 1997 Jun;40(6):711-7.

Haffner SM, Miettinen H, Stern MP. Are risk factors for conversion to NIDDM similar in high and low risk populations? Diabetologia. 1997 Jan;40(1):62-6.

Wei M, Stern MP, Haffner SM. Serum leptin levels in Mexican Americans and non-Hispanic whites: association with body mass index and cigarette smoking. Ann Epidemiol. 1997 Feb;7(2):81-6.

Wei M, Gaskill SP, Haffner SM, Stern MP. Waist circumference as the best predictor of noninsulin dependent diabetes mellitus (NIDDM) compared to body mass index, waist/hip ratio and other anthropometric measurements in Mexican Americans--a 7-year prospective study. Obes Res. 1997 Jan;5(1):16-23.

Haffner SM, Miettinen H, Gaskill SP, Stern MP. Decreased insulin action and insulin secretion predict the development of impaired glucose tolerance. Diabetologia. 1996 Oct;39(10):1201-7.

Wei M, Valdez RA, Mitchell BD, Haffner SM, Stern MP, Hazuda HP. Migration status, socioeconomic status, and mortality rates in Mexican Americans and non-Hispanic whites: the San Antonio Heart Study. Ann Epidemiol. 1996 Jul;6(4):307-13.

Haffner SM, Gingerich RL, Miettinen H, Stern MP. Leptin concentrations in relation to overall adiposity and regional body fat distribution in Mexican Americans. Int J Obes Relat Metab Disord. 1996 Oct;20(10):904-8.

Wei M, Mitchell BD, Haffner SM, Stern MP. Effects of cigarette smoking, diabetes, high cholesterol, and hypertension on all-cause mortality and cardiovascular disease mortality in Mexican Americans. The San Antonio Heart Study. Am J Epidemiol. 1996 Dec 1;144(11):1058-65.

Wei M, Gonzalez C, Haffner SM, O'Leary DH, Stern MP. Ultrasonographically assessed maximum carotid artery wall thickness in Mexico City residents and Mexican Americans living in San Antonio, Texas. Association with diabetes and cardiovascular risk factors. Arterioscler Thromb Vasc Biol. 1996 Nov;16(11):1388-92.

Gonzalez Villalpando C, Stern MP, Arredondo Perez B, Martinez Diaz S, Islas Andrade S, Revilla C, Gonzalez Villalpando ME, Rivera Martinez D. Nephropathy in low income diabetics: the Mexico City Diabetes Study. Arch Med Res. 1996 Autumn;27(3):367-72.

Haffner SM, Miettinen H, Gaskill SP, Stern MP. Metabolic precursors of hypertension. The San Antonio Heart Study. Arch Intern Med. 1996 Sep 23;156(17):1994-2001.

Gonzalez Villalpando C, Stern MP, Arredondo Perez B, Martinez Diaz S, Haffner S. Undiagnosed hypercholesterolemia: a serious health challenge. The Mexico City Diabetes Study. Arch Med Res. 1996 Spring;27(1):19-23.

Haffner SM, Stern MP, Miettinen H, Robbins D, Howard BV. Apolipoprotein E polymorphism and LDL size in a biethnic population. Arterioscler Thromb Vasc Biol. 1996 Sep;16(9):1184-8.

Haffner SM, Miettinen H, Stern MP. Nondiabetic Mexican-Americans do not have reduced insulin responses relative to nondiabetic non-Hispanic whites. Diabetes Care. 1996 Jan;19(1):67-9.

Haffner SM, Miettinen H, Stern MP, Agil A, Jialal I. Plasma oxidizability in Mexican-Americans and non-Hispanic whites. Metabolism. 1996 Jul;45(7):876-81.

Haffner SM, Stern MP, Miettinen H, Wei M, Gingerich RL. Leptin concentrations in diabetic and nondiabetic Mexican-Americans. Diabetes. 1996 Jun;45(6):822-4.

Haffner SM, Miettinen H, Stern MP. Insulin secretion and resistance in nondiabetic Mexican Americans and non-Hispanic whites with a parental history of diabetes. J Clin Endocrinol Metab. 1996 May;81(5):1846-51.

Haffner SM, Agil A, Mykkanen L, Stern MP, Jialal I. Plasma oxidizability in subjects with normal glucose tolerance, impaired glucose tolerance, and NIDDM. Diabetes Care. 1995 May;18(5):646-53.

Haffner SM, Mykkanen L, Robbins D, Valdez R, Miettinen H, Howard BV, Stern MP, Bowsher R. A preponderance of small dense LDL is associated with specific insulin, proinsulin and the components of the insulin resistance syndrome in non-diabetic subjects. Diabetologia. 1995 Nov;38(11):1328-36.

Valdez R, Gonzalez-Villalpando C, Mitchell BD, Haffner SM, Stern MP. Differential impact of obesity in related populations. Obes Res. 1995 Sep;3 Suppl 2:223s-232s.

Monterrosa AE, Haffner SM, Stern MP, Hazuda HP. Sex difference in lifestyle factors predictive of diabetes in Mexican-Americans. Diabetes Care. 1995 Apr;18(4):448-56.

Haffner SM, Miettinen H, Gaskill SP, Stern MP. Decreased insulin secretion and increased insulin resistance are independently related to the 7-year risk of NIDDM in Mexican-Americans. Diabetes. 1995 Dec;44(12):1386-91.

Haffner SM, Stern MP, Miettinen H, Gingerich R, Bowsher RR. Higher proinsulin and specific insulin are both associated with a parental history of diabetes in nondiabetic Mexican-American subjects. Diabetes. 1995 Oct;44(10):1156-60.

Valdez R, Howard BV, Stern MP, Haffner SM. Apolipoprotein E polymorphism and insulin levels in a biethnic population. Diabetes Care. 1995 Jul;18(7):992-1000.

Mitchell BD, Gonzalez Villalpando C, Arredondo Perez B, Garcia MS, Valdez R, Stern MP. Myocardial infarction and cardiovascular risk factors in Mexico City and San Antonio, Texas. Arterioscler Thromb Vasc Biol. 1995 Jun;15(6):721-5.

Haffner SM, Stern MP, Mitchell BD, Hazuda HP, Patterson JK. Incidence of type II diabetes in Mexican Americans predicted by fasting insulin and glucose levels, obesity, and body-fat distribution. Diabetes. 1990 Mar;39(3):283-8.

Haffner SM, Stern MP, Hazuda HP, Mitchell BD, Patterson JK. Cardiovascular risk factors in confirmed prediabetic individuals. Does the clock for coronary heart disease start ticking before the onset of clinical diabetes? JAMA. 1990 Jun 6;263(21):2893-8.

Haffner SM, Stern MP, Gruber MK, Hazuda HP, Mitchell BD, Patterson JK. Microalbuminuria. Potential marker for increased cardiovascular risk factors in nondiabetic subjects? Arteriosclerosis. 1990 Sep-Oct;10(5):727-31.

Mitchell BD, Hazuda HP, Haffner SM, Patterson JK, Stern MP. Myocardial infarction in Mexican-Americans and non-Hispanic whites. The San Antonio Heart Study. Circulation. 1991 Jan;83(1):45-51.

Haffner SM, Mitchell BD, Stern MP, Hazuda HP, Patterson JK. Public health significance of upper body adiposity for non-insulin dependent diabetes mellitus in Mexican Americans. Int J Obes Relat Metab Disord. 1992 Mar;16(3):177-84.

Gonzalez-Villalpando C, Stern MP, Villalpando E, Hazuda H, Haffner SM, Lisci E. [Prevalence of diabetes and glucose intolerance in a urban population at a low economic level] Rev Invest Clin. 1992 Jul-Sep;44(3):321-8. Spanish.

Pugh JA, Tuley MR, Hazuda HP, Stern MP. The influence of outpatient insurance coverage on the microvascular complications of non-insulin-dependent diabetes in Mexican Americans. J Diabetes Complications. 1992 Oct-Dec;6(4):236-41.

Haffner SM, Gruber KK, Aldrete G Jr, Morales PA, Stern MP, Tuttle KR. Increased lipoprotein(a) concentrations in chronic renal failure. J Am Soc Nephrol. 1992 Nov;3(5):1156-62.

Haffner SM, Gruber KK, Morales PA, Hazuda HP, Valdez RA, Mitchell BD, Stern MP. Lipoprotein(a) concentrations in Mexican Americans and non-Hispanic whites: the San Antonio Heart Study. Am J Epidemiol. 1992 Nov 1;136(9):1060-8.

Stern MP, Morales PA, Haffner SM, Valdez RA. Hyperdynamic circulation and the insulin resistance syndrome ("syndrome X"). Hypertension. 1992 Dec;20(6):802-8.

Haffner SM, Morales PA, Stern MP, Gruber MK. Lp(a) concentrations in NIDDM. Diabetes. 1992 Oct;41(10):1267-72.

Haffner SM, Tuttle KR, Rainwater DL. Lack of change of lipoprotein (a) concentration with improved glycemic control in subjects with type II diabetes. Metabolism. 1992 Feb;41(2):116-20.

Stern MP, Mitchell BD, Haffner SM, Hazuda HP. Does glycemic control of type II diabetes suffice to control diabetic dyslipidemia? A community perspective. Diabetes Care. 1992 May;15(5):638-44.

Haffner SM, Ferrannini E, Hazuda HP, Stern MP. Clustering of cardiovascular risk factors in confirmed prehypertensive individuals. Hypertension. 1992 Jul;20(1):38-45.

Haffner SM, Valdez RA, Hazuda HP, Mitchell BD, Morales PA, Stern MP. Prospective analysis of the insulin-resistance syndrome (syndrome X). Diabetes. 1992 Jun;41(6):715-22.

Haffner SM, Stern MP, Watanabe RM, Bergman RN. Relationship of insulin clearance and secretion to insulin sensitivity in non-diabetic Mexican Americans. Eur J Clin Invest. 1992 Mar;22(3):147-53.

Haffner SM, Mitchell BD, Valdez RA, Hazuda HP, Morales PA, Stern MP. Eight-year incidence of hypertension in Mexican-Americans and non-Hispanic whites. The San Antonio Heart Study. Am J Hypertens. 1992 Mar;5(3):147-53.

Jameel N, Pugh JA, Mitchell BD, Stern MP. Dietary protein intake is not correlated with clinical proteinuria in NIDDM. Diabetes Care. 1992 Feb;15(2):178-83.

Haffner SM, Dunn JF, Katz MS. Relationship of sex hormone-binding globulin to lipid, lipoprotein, glucose, and insulin concentrations in postmenopausal women. Metabolism. 1992 Mar;41(3):278-84.

Stern MP. Kelly West Lecture. Primary prevention of type II diabetes mellitus. Diabetes Care. 1991 May;14(5):399-410. Review.

Haffner SM, Hazuda HP, Mitchell BD, Patterson JK, Stern MP. Increased incidence of type II diabetes mellitus in Mexican Americans. Diabetes Care. 1991 Feb;14(2):102-8.

Hazuda HP, Mitchell BD, Haffner SM, Stern MP. Obesity in Mexican American subgroups: findings from the San Antonio Heart Study. Am J Clin Nutr. 1991 Jun;53(6 Suppl):1529S-1534S.

Stern MP, Patterson JK, Mitchell BD, Haffner SM, Hazuda HP. Overweight and mortality in Mexican Americans. Int J Obes. 1990 Jul;14(7):623-9.

Haffner SM, Gonzalez C, Miettinen H, Howard BV, Stern MP. LDL size and subclass pattern in Mexico City residents and San Antonio Mexican Americans. Arterioscler Thromb Vasc Biol. 1995 Dec;15(12):2136-41.

Haffner SM, Karhapaa P, Rainwater DL, Mykkanen L, Aldrete G Jr, Laakso M. Insulin sensitivity and Lp(a) concentrations in normoglycemic men. Diabetes Care. 1995 Feb;18(2):193-9.

Haffner SM, Mykkanen L, Valdez RA, Stern MP, Holloway DL, Monterrosa A, Bowsher RR. Disproportionately increased proinsulin levels are associated with the insulin resistance syndrome. J Clin Endocrinol Metab. 1994 Dec;79(6):1806-10.

Haffner S, Gonzalez Villalpando C, Hazuda HP, Valdez R, Mykkanen L, Stern M. Prevalence of hypertension in Mexico City and San Antonio, Texas. Circulation. 1994 Sep;90(3):1542-9.

Gonzelez C, Stern MP, Mitchell BD, Valdez RA, Haffner SM, Perez BA. Clinical characteristics of type II diabetic subjects consuming high versus low carbohydrate diets in Mexico City and San Antonio, Texas. Diabetes Care. 1994 May;17(5):397-404.

Stern MP, Wei M. Do Mexican Americans really have low rates of cardiovascular disease? Prev Med. 1999 Dec;29(6 Pt 2):S90-5. Review.

Gonzalez-Villalpando C, Gonzalez-Villalpando ME, Rivera Martinez D, Stern MP. [Incidence and progression of diabetic retinopathy in low income population of Mexico City] Rev Invest Clin. 1999 May-Jun;51(3):141-50. Spanish.

Gonzalez-Villalpando C, Stern MP, Haffner SM, Gonzalez Villapando ME, Gaskill S, Rivera Martinez D. Prevalence of hypertension in a Mexican population according to the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. J Cardiovasc Risk. 1999 Jun;6(3):177-81.

Haffner SM, Miettinen H, Mykkanen L, Stern MP. Leptin concentrations are associated with higher proinsulin and insulin concentrations but a lower proinsulin/insulin ratio in non-diabetic subjects. Int J Obes Relat Metab Disord. 1998 Sep;22(9):899-905.

Wei M, Gibbons LW, Mitchell TL, Kampert JB, Stern MP, Blair SN. Low fasting plasma glucose level as a predictor of cardiovascular disease and all-cause mortality. Circulation. 2000 May 2;101(17):2047-52.

Haffner SM, Mykkanen L, Festa A, Burke JP, Stern MP. Insulin-resistant prediabetic subjects have more atherogenic risk factors than insulin-sensitive prediabetic subjects: implications for preventing coronary heart disease during the prediabetic state. Circulation. 2000 Mar 7;101(9):975-80.

Lorenzo C, Serrano-Rios M, Martinez-Larrad MT, Gabriel R, Williams K, Gonzalez-Villalpando C, Stern MP, Hazuda HP, Haffner S. Prevalence of hypertension in Hispanic and non-Hispanic white populations. Hypertension. 2002 Feb;39(2):203-8.

del Rincon ID, Williams K, Stern MP, Freeman GL, Escalante A. High incidence of cardiovascular events in a rheumatoid arthritis cohort not explained by traditional cardiac risk factors. Arthritis Rheum. 2001 Dec;44(12):2737-45.

Lorenzo C, Serrano-Rios M, Martinez-Larrad MT, Gabriel R, Williams K, Gonzalez-Villalpando C, Stern MP, Hazuda HP, Haffner SM. Was the historic contribution of Spain to the Mexican gene pool partially responsible for the higher prevalence of type 2 diabetes in mexican-origin populations? The Spanish Insulin Resistance Study Group, the San Antonio Heart Study, and the Mexico City Diabetes Study. Diabetes Care. 2001 Dec;24(12):2059-64.

Burke JP, Williams K, Haffner SM, Villalpando CG, Stern MP. Elevated incidence of type 2 diabetes in San Antonio, Texas, compared with that of Mexico City, Mexico. Diabetes Care. 2001 Sep;24(9):1573-8.

Burke JP, Hazuda HP, Stern MP. Rising trend in obesity in Mexican Americans and non-Hispanic whites: is it due to cigarette smoking cessation? Int J Obes Relat Metab Disord. 2000 Dec;24(12):1689-94.

Stern MP, Williams K, Haffner SM. Identification of persons at high risk for type 2 diabetes mellitus: do we need the oral glucose tolerance test? Ann Intern Med. 2002 Apr 16;136(8):575-81.

Stern MP, Fatehi P, Williams K, Haffner SM. Predicting future cardiovascular disease: do we need the oral glucose tolerance test? Diabetes Care. 2002 Oct;25(10):1851-6.

Hunt KJ, Williams K, Resendez RG, Hazuda HP, Haffner SM, Stern MP. All-cause and cardiovascular mortality among diabetic participants in the San Antonio Heart Study: evidence against the "Hispanic Paradox". Diabetes Care. 2002 Sep;25(9):1557-63.

Lorenzo C, Serrano-Rios M, Martinez-Larrad MT, Gabriel R, Williams K, Gomez-Gerique JA, Stern MP, Haffner SM. Central adiposity determines prevalence differences of the metabolic syndrome. Obes Res. 2003 Dec;11(12):1480-7.

Ferrannini E, Nannipieri M, Williams K, Gonzales C, Haffner SM, Stern MP. Mode of onset of type 2 diabetes from normal or impaired glucose tolerance. Diabetes. 2004 Jan;53(1):160-5.

Hunt KJ, Resendez RG, Williams K, Haffner SM, Stern MP, Hazuda HP. All-cause and cardiovascular mortality among Mexican-American and non-Hispanic White older participants in the San Antonio Heart Study- evidence against the "Hispanic paradox". Am J Epidemiol. 2003 Dec 1;158(11):1048-57.

Del Rincon I, Williams K, Stern MP, Freeman GL, O'Leary DH, Escalante A. Association between carotid atherosclerosis and markers of inflammation in rheumatoid arthritis patients and healthy subjects. Arthritis Rheum. 2003 Jul;48(7):1833-40.

Lorenzo C, Okoloise M, Williams K, Stern MP, Haffner SM; San Antonio Heart Study. The metabolic syndrome as predictor of type 2 diabetes: the San Antonio heart study. Diabetes Care. 2003 Nov;26(11):3153-9.

Burke JP, Williams K, Narayan KM, Leibson C, Haffner SM, Stern MP. A population perspective on diabetes prevention: whom should we target for preventing weight gain? Diabetes Care. 2003 Jul;26(7):1999-2004.

Hanley AJ, Williams K, Gonzalez C, D'Agostino RB Jr, Wagenknecht LE, Stern MP, Haffner SM. Prediction of type 2 diabetes using simple measures of insulin resistance: combined results from the San Antonio Heart Study, the Mexico City Diabetes Study, and the Insulin Resistance Atherosclerosis Study. Diabetes. 2003 Feb;52(2):463-9.

Meigs JB, Williams K, Sullivan LM, Hunt KJ, Haffner SM, Stern MP, Gonzalez Villalpando C, Perhanidis JS, Nathan DM, D'Agostino RB Jr, D'Agostino RB Sr, Wilson PW. Using metabolic syndrome traits for efficient detection of impaired glucose tolerance. Diabetes Care. 2004 Jun;27(6):1417-26.

Stern MP, Williams K, Gonzalez-Villalpando C, Hunt KJ, Haffner SM. Does the metabolic syndrome improve identification of individuals at risk of type 2 diabetes and/or cardiovascular disease? Diabetes Care. 2004 Nov;27(11):2676-81.

Hunt KJ, Resendez RG, Williams K, Haffner SM, Stern MP; San Antonio Heart Study. National Cholesterol Education Program versus World Health Organization metabolic syndrome in relation to all-cause and cardiovascular mortality in the San Antonio Heart Study. Circulation. 2004 Sep 7;110(10):1251-7. Epub 2004 Aug 23.

Study ID Numbers:	1084
Study First Received:	May 25, 2000
Last Updated:	June 23, 2005
ClinicalTrials.gov Identifier:	NCT00005205 History of Changes
Health Authority:	United States: Federal Government

Additional relevant MeSH terms:

Death
Myocardial Ischemia
Angina Pectoris
Pain
Arteriosclerosis
Brain Diseases
Cerebrovascular Disorders
Signs and Symptoms
Necrosis
Pathologic Processes
Cardiovascular Diseases
Death, Sudden, Cardiac
Myocardial Infarction
Arterial Occlusive Diseases
Metabolic Diseases

Peripheral Vascular Diseases
Heart Diseases
Nervous System Diseases
Vascular Diseases
Diabetes Mellitus
Endocrine System Diseases
Central Nervous System Diseases
Heart Arrest
Ischemia
Chest Pain
Coronary Disease
Diabetes Mellitus, Type 2
Death, Sudden
Glucose Metabolism Disorders
Infarction

ClinicalTrials.gov processed this record on November 30, 2009

Ages Eligible for Study:	24 Years to 64 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No