The purpose of this paper is to present the genetic distribution at the HLA-A, B, C, and DR loci in the Hopi and the Navajo. A sample of 100 out-patients from each tribe was selected at the Public Health Service Indian Hospital in Keam's Canyon, Arizona, and was typed for the antigens at the four loci. The distributions of the alleles and the haplotypes are similar in each tribe. A distance measure, f, confirms the genetic similarity of the two populations. It is concluded that the great cultural diversity of the Hopi and the Navajo is the result of a cultural evolution and diversification that has greatly outstripped the genetic evolution at the major histocompatibility loci over the past 20,000 years.

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In a cross-sectional study of Hopi and Navajo Indians with non-insulin-dependent diabetes mellitus, we found vascular complications to be strongly related to the duration of diabetes. In patients with diabetes of at least 10 yr duration, retinopathy was found in 57%, nephropathy in 40%, peripheral neuropathy in 21%, and peripheral vascular disease in 28%. For the Hopi and Navajo, the duration-specific prevalence rates of microvascular disease were very similar to prevalence rates found in many other populations. Thus we question the concept, based on reports in the late 1960s, that the Hopi and Navajo Indians have hyperglycemia as an isolated chemical abnormality unaccompanied by other manifestations of diabetes mellitus.

"Navajo arthritis" was described in 1971 as an acute, self-limited, asymmetric polyarthritis of unknown etiology seen in Navajo Indian patients. This description was before published accounts relating HLA-B27 to certain seronegative arthropathies. Review of 92 cases of arthritis seen between 1977 through 1979 in adult Navajo Indians revealed 16 cases of complete Reiter's syndrome, 6 cases of incomplete Reiter's syndrome, and 7 cases of ankylosing spondylitis. The phenotype frequency of HLA-B27 in this Navajo population is 36% and, of the Reiter's syndrome and ankylosing spondylitis patients tested, 85% were found to be HLA-B27 positive. We suggest that "Navajo arthritis" may not be a unique form of arthritis affecting only the Navajo, but a variant of either Reiter's syndrome or ankylosing spondylitis.In 1971, Muggia, Bennahum, and Williams described 21 cases of an acute, self-limited, asymmetric polyarthritis of unknown etiology in Navajo patients (I). The entity was termed "Navajo arthritis" and felt to be a distinct syndrome. Our recent clinical experience