Metabolic profile and cardiovascular risk patterns of an indian tribe living in the amazon region of Brazil
2003
AbstractThe Parkateje Indians, belonging to the
Je group and inhabiting the Mae Maria Reservation in the
southeast of the state of Para in the Amazon Region of Brazil, have
suffered rapid and intensive cultural changes in recent years. This survey
was designed to characterize the metabolic profile and the frequency of
cardiovascular risk factors in this community. Ninety subjects (90.0% of
the adult population without admixture) were investigated. Anthropometric
measurements were performed and the following clinical characteristics
measured: glycemia, serum insulin and proinsulin (fasting and
2-hr post 75 g of glucose load), s-cell function (%B) and
insulin sensitivity (%S) estimated by HOMA, HbA1c, GAD65 antibody, serum
lipids, uric acid, creatinine, leptin, and blood pressure. Information
about alcohol use, smoking, and medical history was obtained through
individual interviews. The prevalences were: overweight, 67.8%; obesity,
14.4%; central obesity, 72.2%; hypertension, 4.4%; dyslipidemia, 44.4%;
hyperuricemia, 5.6%; GAD65 antibody positivity, 4.4%; smoking, 25.6%;
chronic alcohol use, 0.0%. One case of impaired glucose tolerance (1.1%)
and one case of impaired fasting glycemia (1.1%) were diagnosed during
this study and one case of diabetes (1.1%) was diagnosed previously. The
diabetic woman was excluded from the analyses involving HbA1c, glycemia,
insulin, proinsulin, %B, and %S. All creatinine values were normal. Blood
pressure did not correlate with age, anthropometric measurements,
insulin, proinsulin, and natural logarithm (ln) transformed %S. After
adjustment for age and sex, there were positive correlations between total
cholesterol and body mass index (BMI; r = 0.24), triglycerides
and BMI (r = 0.44), triglycerides and waist-to-hip ratio (WHR;
r = 0.52), ln leptin and BMI (r = 0.41), ln leptin and WHR
(r = 0.29), uric acid and systolic blood pressure (r =
0.34), uric acid and triglycerides (r = 0.22). Systolic (r
= 0.04; r = 0.70) and diastolic (r = 0.14; p =
0.18) blood pressure did not correlate with BMI. Ln leptin had a weak
positive correlation with 2-hr insulin (r = 0.14) adjusted for
age, sex, and BMI. The multiple linear regression model containing the
variables sex, BMI, and 2-hr insulin concentrations explained 77.2%
of the variation of ln leptin. In conclusion, the high rates of cardiovascular risk factors found among
these Indians point to there being a high-risk group to develop diabetes
and cardiovascular diseases. To reduce this risk they need to receive
preventive interventions.
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