Cardiovascular Diseases Clinical Trial
To characterize the epidemiology and genetics of apolipoproteins A-I, A-II, B, C-II, C-III, and E in a population of Mexican-Americans in Starr County, Texas.
BACKGROUND:
Evidence has established that the distribution and burden of several common chronic diseases
among Mexican-Americans differ from that in the general population. These diseases include
diabetes (almost exclusively noninsulin dependent diabetes), hypertension, and gallbladder
disorders. While progress was made towards an elucidation of their epidemiology within this
population, there was a paucity of data regarding other cardiovascular risk factors, most
notably, the distribution of lipoproteins and their constituent apoproteins. With regard to
the apolipoproteins, there were only minimal data from any population dealing with their
distribution and relationships in the general population or pedigrees. This project provided
as complete a profile on the distribution of metabolic cardiovascular risk factors as could
be claimed for any other study of comparable size and provided baseline values for apo A-I,
A-II, B, C-II, C-III and E.
DESIGN NARRATIVE:
One thousand randomly selected individuals were given a complete physical examination. From
those 1,000, 100 probands with gallbladder disease were selected. Approximately 1,200 first
degree relatives of the probands were invited to participate in the study and given a
physical examination. Additionally, 100 control individuals, their spouses and first degree
relatives were followed longitudinally for five years. Blood samples were obtained for
determination of total cholesterol, LDL cholesterol, HDL2 and HDL3 cholesterol, and genetic
markers. Data were collected on age, sex, body mass and fat distribution, diet, smoking, and
alcohol consumption. Annual follow-up assessed the dynamics of changes in apolipoprotein
levels and profiles and those factors which contributed to their change. The random and
longitudinal data were combined with pedigree data to determine the effects of major genes,
polygenes, and the environment on the variability of each apolipoprotein and on the
relationship between these and other risk factors. An assessment was made in 100 individuals
of the contribution of genetic variability at the DNA level in determining apolipoprotein
levels.
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