Short life expectancy and metabolic syndrome in Romanies (gypsies) in Slovakia.

The aim of this review is to explain short life expectancy in Romanies. Romanies represent the second largest minority in Slovakia (about 7%). Most of them exist on the fringes of the majority society. Their general situation worsened after the fall of communism in 1989. In a market oriented society the unemployment of Romanies further increased due to their poor education and lack of skills. Romany general health is substantially worse than that of the majority population: They have high prevalence of communicable diseases due to poor sanitary and living conditions. Furthermore, epidemiological and metabolic studies revealed in Romanies high prevalence of obesity associated with increased cardiovascular risk. There is no explanation for this seemingly paradoxical phenomenon, in a population living in poor economic conditions. It is possible that in the course of the many generation-long migration from India to Europe, pregnant Romanies and their fetuses sufferred excessive nutritional deficiency. This might have induced adaptive metabolic and genetic changes aimed at optimum utilization of scarce food supply. There is a hypothetical possibility that in them "thrifty gene" was formed. Arrival of Romanies to Europe resulted in somewhat better nutrition, along with sharply reduced physical expenditure. The consequence is a metabolic syndrome with type 2 diabetes and increased cardiovascular mortality. Such unique metabolic feature in Romanies will undoubtedly stimulate further research in molecular biology that may ultimately clarify the role of "thrifty genes".