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The Emirate of Abu Dhabi is confronting major public health challenges in obesity, diabetes, and cardiovascular disease. These factors have complex co-determinants in human genetic susceptibility and social conditions, ranging potentially from the built environment to the human microbial milieu (microbiome). Recent prevalence rates of obesity and overweight in Abu Dhabi were 35 percent and 32 percent, respectively; 57 percent having central obesity.
Although similar rates pertain in the United States, the population of Abu Dhabi is much younger. Using criteria from the American Diabetes Association criteria, 44 percent of people in Abu Dhabi have either pre-diabetes or diabetes. Without intervention, 41 percent will convert to diabetes in five years, with an overall diabetes prevalence rate of 30 percent by 2014. The age-adjusted mortality rate for cardiovascular disease in Abu Dhabi in 2002 was »370/100,000, at that time the second highest in the world.
Our laboratories have discovered biochemical mechanisms that contribute to the the impact of obesity and diabetes on cardiovascular health. Our overall hypothesis is that plasma levels of advanced glycation end products (AGEs) differ by diabetes status and have unique relationships to insulin sensitivity, and longitudinal risk for diabetes and cardiovascular disease.
Further, we predict that interactions of these products with RAGE, their central signal transduction receptor, contribute to the pathogenesis of metabolic dysfunction and that together these factors are directly correlated with surrogate indices of cardiovascular disease and dysfunction.
To address this hypothesis, we propose to enroll a 5,000 subject cohort of Emirati and examine the relationship between markers of glycation and insulin resistance and cardiovascular disease.
Our research is the first mechanism-seeking study on the biochemical and molecular risk factors that contribute to the pathogenesis of obesity, metabolic dysfunction and diabetes in citizens of Abu Dhabi. Similarly, it is developing a comprehensive assessment of the association between metabolic dysfunction and two key measures of cardiovascular risk: carotid intima-media thickness and vascular dysfunction as assessed by flow mediated dilation. Our goal is to develop and prospectively study this cohort of 5000 subjects to identify risk factors. We aim to propose novel targets for therapeutic intervention in Abu Dhabi.