Grace M Egeland1, Zhirong Cao, T Kue Young. 1. Centre for Indigenous Peoples' Nutrition and Environment and School of Dietetics and Human Nutrition, McGill University, Ste. Anne-de-Bellevue, Quebec. grace.egeland@mcgill.ca
Abstract
BACKGROUND: Inuit have not experienced an epidemic in type 2 diabetes mellitus, and it has been speculated that they may be protected from obesity's metabolic consequences. We conducted a population-based screening for diabetes among Inuit in the Canadian Arctic and evaluated the association of visceral adiposity with diabetes. METHODS: A total of 36 communities participated in the International Polar Year Inuit Health Survey. Of the 2796 Inuit households approached, 1901 (68%) participated, with 2595 participants. Households were randomly selected, and adult residents were invited to participate. Assessments included anthropometry and fasting plasma lipids and glucose, and, because of survey logistics, only 32% of participants underwent a 75 g oral glucose tolerance test. We calculated weighted prevalence estimates of metabolic risk factors for all participants. RESULTS: Participants' mean age was 43.3 years; 35% were obese, 43.8% had an at-risk waist, and 25% had an elevated triglyceride level. Diabetes was identified in 12.2% of participants aged 50 years and older and in 1.9% of those younger than 50 years. A hypertriglyceridemic-waist phenotype was a strong predictor of diabetes (odds ratio [OR] 8.6, 95% confidence interval [CI] 2.1-34.6) in analyses adjusted for age, sex, region, family history of diabetes, education and use of lipid-lowering medications. INTERPRETATION: Metabolic risk factors were prevalent among Inuit. Our results suggest that Inuit are not protected from the metabolic consequences of obesity, and that their rate of diabetes prevalence is now comparable to that observed in the general Canadian population. Assessment of waist circumference and fasting triglyceride levels could represent an efficient means for identifying Inuit at high risk for diabetes.
BACKGROUND: Inuit have not experienced an epidemic in type 2 diabetes mellitus, and it has been speculated that they may be protected from obesity's metabolic consequences. We conducted a population-based screening for diabetes among Inuit in the Canadian Arctic and evaluated the association of visceral adiposity with diabetes. METHODS: A total of 36 communities participated in the International Polar Year Inuit Health Survey. Of the 2796 Inuit households approached, 1901 (68%) participated, with 2595 participants. Households were randomly selected, and adult residents were invited to participate. Assessments included anthropometry and fasting plasma lipids and glucose, and, because of survey logistics, only 32% of participants underwent a 75 g oral glucose tolerance test. We calculated weighted prevalence estimates of metabolic risk factors for all participants. RESULTS:Participants' mean age was 43.3 years; 35% were obese, 43.8% had an at-risk waist, and 25% had an elevated triglyceride level. Diabetes was identified in 12.2% of participants aged 50 years and older and in 1.9% of those younger than 50 years. A hypertriglyceridemic-waist phenotype was a strong predictor of diabetes (odds ratio [OR] 8.6, 95% confidence interval [CI] 2.1-34.6) in analyses adjusted for age, sex, region, family history of diabetes, education and use of lipid-lowering medications. INTERPRETATION: Metabolic risk factors were prevalent among Inuit. Our results suggest that Inuit are not protected from the metabolic consequences of obesity, and that their rate of diabetes prevalence is now comparable to that observed in the general Canadian population. Assessment of waist circumference and fasting triglyceride levels could represent an efficient means for identifying Inuit at high risk for diabetes.
Authors: S O Ebbesson; C D Schraer; P M Risica; A I Adler; L Ebbesson; A M Mayer; E V Shubnikof; J Yeh; O T Go; D C Robbins Journal: Diabetes Care Date: 1998-04 Impact factor: 19.112
Authors: T Kue Young; Peter Bjerregaard; Eric Dewailly; Patricia M Risica; Marit E Jørgensen; Sven E O Ebbesson Journal: Am J Public Health Date: 2007-02-28 Impact factor: 9.308
Authors: Ying Jiang; Susan Rogers Van Katwyk; Yang Mao; Heather Orpana; Gina Argwal; Margaret de Groh; Monique Skinner; Robyn Clarke; Howard Morrison Journal: Health Promot Chronic Dis Prev Can Date: 2017-04 Impact factor: 3.240
Authors: Sophia S K Yu; Natalie L M Ramsey; Darleen C Castillo; Madia Ricks; Anne E Sumner Journal: Metab Syndr Relat Disord Date: 2012-12-05 Impact factor: 1.894
Authors: Richard T Oster; Jeffrey A Johnson; Stephanie U Balko; Larry W Svenson; Ellen L Toth Journal: Int J Circumpolar Health Date: 2012-05-07 Impact factor: 1.228