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Sagastume D, Siero I, Mertens E, Peñalvo JL. Cardiometabolic Profile and Outcomes in Migrant Populations: A Review of Comparative Evidence from Migrants in Europe in Relation to Their Country of Origin. Curr Cardiol Rep 2022; 24:1799-1810. [PMID: 36348148 DOI: 10.1007/s11886-022-01802-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/11/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND The potential effect of migration on increasing cardiometabolic risk factors remains partially understood. We aim to synthesize the evidence comparing the burden of diabetes and adiposity of migrating populations in Europe, with that of their country of origin. METHODS We conducted a scoping literature review. We searched PubMed for studies investigating the effect of migration on diabetes or adiposity outcomes among migrants in countries from the European Union or the United Kingdom compared to the population in the country of origin. Studies were qualitatively synthesized in evidence tables and the demographic characteristics, study design, risk factors investigated, and outcomes were quantitatively summarized using measures of central tendency. FINDINGS Of 1175 abstracts retrieved, 28 studies were eligible. Most of the studies included migrating populations residing in Western (50%), Northern (39%), and Southern Europe (11%) originating from countries in Africa (46%), Asia (29%), or European overseas (25%) regions of which 85% were classified as low-middle-income countries. Most of the studies (93%) had a cross-sectional design. The median number of individuals in the country of origin was greater [917; IQR: 231-1378] than in the receiving country [249; 150-883]. Thirty-five percent of the studies investigated migration as an independent risk factor, whereas 28% contextualized migration into lifestyle changes. The majority of the studies (57%) reported both diabetes and adiposity outcomes. Within the limited evidence available, controversial results were found as some studies showed poorer outcomes for the migrating populations, while others showed the opposite. CONCLUSION Studies assessing the impact of migration by comparing migrating populations and the population of origin on diabetes and adiposity outcomes have gained interest. So far, the available evidence is highly heterogeneous to inform public health strategies in the receiving countries. We recommend further research including a more robust methodology and in-depth characterization of the migrant populations.
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Affiliation(s)
- Diana Sagastume
- Unit of Non-Communicable Diseases, Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium.
| | - Irene Siero
- Unit of Non-Communicable Diseases, Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium
| | - Elly Mertens
- Unit of Non-Communicable Diseases, Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium
| | - José L Peñalvo
- Unit of Non-Communicable Diseases, Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium
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Nielsen MH, Backe MB, Pedersen ML. Prevalence of patients using antihypertensive medication in Greenland, and an assessment of the importance of diagnosis for the associated quality of care - a cross-sectional study. Int J Circumpolar Health 2022; 81:2110675. [PMID: 35938701 PMCID: PMC9364711 DOI: 10.1080/22423982.2022.2110675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study aimed to estimate the age- and sex specific prevalence of patients using antihypertensive medication in Greenland, and compared the quality of care between patients with and without a diagnosis for hypertension. The study was a cross-sectional study comparing patients using antihypertensive medication in 2020 (6,629 patients) and 2021 (7,008 patients), respectively. For data from 2021, patients with a medical diagnosis code were identified. Data was obtained from the Greenlandic electronic medical record. The population of Greenland was used as background population. Quality of care was evaluated based on suggested indicators by international guidelines and goals from Steno Diabetes Centre Greenland. The prevalence of patients aged ≥20 years using antihypertensive medication had increased from 16.7% in 2020 to 17.5% in 2021. The prevalence increased by age and was higher among women compared to men. In 2021, the prevalence of patients aged ≥20 years with a medical diagnosis code for hypertension was 7.9%. The use of antihypertensive medication in Greenland is common. The associated quality of care was low. However, process indicators were significantly improved when patients had a medical diagnosis code. Future focus must be on initiating initiatives ensuring that more patients are registered with a medical diagnosis code.
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Affiliation(s)
- Maja Hykkelbjerg Nielsen
- Steno Diabetes Centre Greenland, Queen Ingrid's Hospital, Nuuk, Greenland.,Greenland Centre for Health Research, Institute of Health and Nature, University of Greenland, Nuuk, Greenland
| | - Marie Balslev Backe
- Steno Diabetes Centre Greenland, Queen Ingrid's Hospital, Nuuk, Greenland.,Greenland Centre for Health Research, Institute of Health and Nature, University of Greenland, Nuuk, Greenland
| | - Michael Lynge Pedersen
- Steno Diabetes Centre Greenland, Queen Ingrid's Hospital, Nuuk, Greenland.,Greenland Centre for Health Research, Institute of Health and Nature, University of Greenland, Nuuk, Greenland
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Kok Grouleff M, Wielsøe M, Berthelsen D, Mulvad G, Isidor S, Long M, Bonefeld-Jørgensen EC. Anthropometric measures and blood pressure of Greenlandic preschool children. Int J Circumpolar Health 2021; 80:1954382. [PMID: 34291707 PMCID: PMC8300929 DOI: 10.1080/22423982.2021.1954382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The study aims to describe anthropometric data of Greenlandic preschool children, blood pressure (BP) measures and effects of maternal smoking during pregnancy in a follow-up of the ACCEPT birth cohort. The study included 102 children (55 boys and 47 girls) aged 3.5–5.5 years. Anthropometric measures included weight, height, head circumference (HC), body mass index (BMI), waist and hip circumference, ratio for height/weight, waist/height, waist/hip and BP measurements. Overweight and obesity-prevalence was determined using the international obesity task force BMI references for children. Significant increases in anthropometrics from 3.5 to 5.5 years included weight, height, HC and hip circumference, whereas ratio for height/weight, waist/hip and waist/height decreased. Boys had significantly larger HC than girls. The prevalence of overweight and obesity was similar (35.1%) between genders. Mean systolic and diastolic BP were 104 and 68 mmHg, respectively. Children of mothers smoking during pregnancy had higher hip circumference, lower waist/hip ratio and higher diastolic BP. The study present updated anthropometric data and BP of Greenlandic preschool children and effects of maternal smoking during pregnancy. The prevalence of overweight and obesity was higher than previously reported and maternal smoking during pregnancy affected the child data. Abbreviations ACCEPT: Adaptation to Climate Change, Environmental Pollution and dietary Transition; BMI: Body Mass Index; BP: Blood Pressure; Circ: Circumference; DBP: Diastolic Blood Pressure; FFH: Fisher-Freeman-Halton exact test; HC: Head Circumference; H: Height; HDL: high-density lipoprotein; HiC: Hip Circumference; IOTF International Obesity Task Force, Max: maximum, Min: minimum, P25: 25th percentile, P75: 75th percentile, SBP: Systolic Blood Pressure, SD: Standard Deviation; VDLD: very-low-density lipoprotein; WaC: Waist Circumference, W: Weight, WHO: World Health Organization.
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Affiliation(s)
- Magnus Kok Grouleff
- Center for Arctic Health and Molecular Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Maria Wielsøe
- Center for Arctic Health and Molecular Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Dina Berthelsen
- Department of Health Care, Queen Ingrid's Health Center, Nuuk, Greenland
| | - Gert Mulvad
- Greenland Centre for Health Research, Institute of Nursing and Health Sciences,University of Greenland, Nuuk, Greenland
| | - Silvia Isidor
- Greenland Centre for Health Research, Institute of Nursing and Health Sciences,University of Greenland, Nuuk, Greenland
| | - Manhai Long
- Center for Arctic Health and Molecular Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Eva Cecilie Bonefeld-Jørgensen
- Center for Arctic Health and Molecular Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark.,Greenland Centre for Health Research, Institute of Nursing and Health Sciences,University of Greenland, Nuuk, Greenland
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Pedersen ML, Jacobsen JL, Lynge AR. Micro-and macrovascular complications among Greenlanders and Danes with type 2 diabetes mellitus in Nuuk, Greenland. Int J Circumpolar Health 2016; 69:195-207. [DOI: 10.3402/ijch.v69i2.17442] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Backer V, Baines KJ, Powell H, Porsbjerg C, Gibson PG. Increased asthma and adipose tissue inflammatory gene expression with obesity and Inuit migration to a western country. Respir Med 2015; 111:8-15. [PMID: 26764119 DOI: 10.1016/j.rmed.2015.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 12/12/2015] [Accepted: 12/14/2015] [Indexed: 01/15/2023]
Abstract
BACKGROUND An overlap between obesity and asthma exists, and inflammatory cells in adipose tissue could drive the development of asthma. Comparison of adipose tissue gene expression among Inuit living in Greenland to those in Denmark provides an opportunity to assess how changes in adipose tissue inflammation can be modified by migration and diet. OBJECTIVE To examine mast cell and inflammatory markers in adipose tissue and the association with asthma. METHODS Two Inuit populations were recruited, one living in Greenland and another in Denmark. All underwent adipose subcutaneous biopsy, followed by clinical assessment of asthma, and measurement of AHR. Adipose tissue biopsies were homogenised, RNA extracted, and PCR was performed to determine the relative gene expression of mast cell (tryptase, chymase, CPA3) and inflammatory markers (IL-6, IL-1β, and CD163). RESULTS Of the 1059 Greenlandic Inuit participants, 556 were living in Greenland and 6.4% had asthma. Asthma was increased in Denmark (9%) compared to Greenland (3.6%, p < 0.0001) and associated with increased adipose tissue IL-6 gene expression and increased BMI. There was no association between asthma and adipose tissue mast cell gene expression. Pro-inflammatory gene expression (IL-6, IL-1β) was higher in those living in Denmark, and with increasing BMI and dietary changes. The anti-inflammatory (M2) macrophage marker, CD163, was higher in Greenland-dwelling Inuit (p < 0.01). CONCLUSIONS No association was found between gene expression of mast cell markers in adipose tissue and asthma. Among Greenlandic Inuit, adipose tissue inflammation is also increased in those who migrate to Denmark, possibly as a result of dietary changes.
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Affiliation(s)
- Vibeke Backer
- Department of Respiratory Medicine L, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark.
| | - Katherine J Baines
- Priority Research Centre for Asthma and Respiratory Diseases, Hunter Medical Research Institute, The University of Newcastle, New Lambton Heights, NSW 2305 Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, New Lambton, NSW 2305 Australia
| | - Heather Powell
- Priority Research Centre for Asthma and Respiratory Diseases, Hunter Medical Research Institute, The University of Newcastle, New Lambton Heights, NSW 2305 Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, New Lambton, NSW 2305 Australia
| | - Celeste Porsbjerg
- Department of Respiratory Medicine L, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Peter G Gibson
- Priority Research Centre for Asthma and Respiratory Diseases, Hunter Medical Research Institute, The University of Newcastle, New Lambton Heights, NSW 2305 Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, New Lambton, NSW 2305 Australia
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Tvermosegaard M, Dahl-Petersen IK, Nielsen NO, Bjerregaard P, Jørgensen ME. Cardiovascular Disease Susceptibility and Resistance in Circumpolar Inuit Populations. Can J Cardiol 2015; 31:1116-23. [PMID: 26239003 DOI: 10.1016/j.cjca.2015.06.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 06/05/2015] [Accepted: 06/05/2015] [Indexed: 11/26/2022] Open
Abstract
Cardiovascular disease (CVD) is a major public health issue in indigenous populations in the Arctic. These diseases have emerged concomitantly with profound social changes over the past 60 years. The aim of this study was to summarize the literature on CVD risk among Arctic Inuit. Literature on prevalence, incidence, and time trends for CVD and its risk factors in Arctic Inuit populations was reviewed. Most evidence supports a similar incidence of coronary heart disease and a higher incidence of cerebrovascular disease among Arctic Inuit than seen in western populations. Factors that may increase CVD risk include aging of the population, genetic susceptibility, and a rapid increase in obesity, diabetes, and hypertension in parallel with decreasing physical activity and deterioration of the lipid profile. In contrast, and of great importance, there has been a decrease in smoking and alcohol intake (at least documented in Greenland), and contaminant levels are declining. Although there have been marked socioeconomic and dietary changes, it remains unsolved and to some extent controversial how this may have influenced cardiovascular risk among Arctic Inuit. The increase in life expectancy, in combination with improved prognosis for patients with manifest CVD, will inevitably lead to a large increase in absolute numbers of individuals affected by CVD in Arctic Inuit populations, exacerbated by the rise in most CVD risk factors over the past decades. For preventive purposes and for health care planning, it is crucial to carefully monitor disease incidence and trends in risk factors in these vulnerable Arctic populations.
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Affiliation(s)
- Maria Tvermosegaard
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark; Steno Diabetes Center, Gentofte, Denmark
| | - Inger K Dahl-Petersen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Nina Odgaard Nielsen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Peter Bjerregaard
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark; Greenland Centre for Health Research, University of Greenland, Nuuk, Greenland
| | - Marit Eika Jørgensen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark; Steno Diabetes Center, Gentofte, Denmark.
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Baines KJ, Backer V, Gibson PG, Powell H, Porsbjerg CM. Investigating the effects of arctic dietary intake on lung health. Eur J Clin Nutr 2015; 69:1262-6. [PMID: 26014265 DOI: 10.1038/ejcn.2015.85] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 04/22/2015] [Accepted: 04/23/2015] [Indexed: 01/15/2023]
Abstract
BACKGROUND/OBJECTIVE Preservation of lung health requires understanding the modifiable risk factors of airflow limitation. This study investigates the association between diet and lung function in a population of Greenland Inuit residing in the Arctic (Greenland) or Western Europe (Denmark). SUBJECTS/METHODS Two unselected Inuit populations were recruited, one living in Greenland (Urban (Nuuk) n=358; Rural (Uummannaq) n=207) and the other in Denmark (n=539). Lung function was measured using spirometry and diet by a food frequency questionnaire. Factors associated with airflow limitation were assessed using multiple linear regression models. RESULTS The dietary composition differed significantly in the two regions, with higher whale, seal and wild meat intake and lower fruit and vegetable intake in the Arctic regions compared with Denmark. Consumption of vegetables (P=0.004) and whale and/or seal (P<0.0001) was significantly and positively associated with FEV1, as well as with FVC (vegetables: P=0.001, whale and/or seal: P=0.002). Regular fruit intake was included in the statistical models; however, it did not reach statistical significance (FEV1: P=0.053; FVC: P=0.055). CONCLUSIONS High dietary intake of vegetables as well as intake of arctic marine mammals had independent positive associations with lung function in this cohort of Greenlandic Inuit. These findings suggest an additive role of dietary intake of antioxidants and unsaturated fatty acids in lung health, which warrants prospective evaluation.
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Affiliation(s)
- K J Baines
- Priority Research Centre for Asthma and Respiratory Diseases, Hunter Medical Research Institute, The University of Newcastle, New Lambton Heights, New Lambton, New South Wales, Australia.,Department of Respiratory and Sleep Medicine, John Hunter Hospital, New Lambton, New South Wales, Australia
| | - V Backer
- Respiratory Research Unit, Bispebjerg University Hospital, Copenhagen, Denmark
| | - P G Gibson
- Priority Research Centre for Asthma and Respiratory Diseases, Hunter Medical Research Institute, The University of Newcastle, New Lambton Heights, New Lambton, New South Wales, Australia.,Department of Respiratory and Sleep Medicine, John Hunter Hospital, New Lambton, New South Wales, Australia
| | - H Powell
- Priority Research Centre for Asthma and Respiratory Diseases, Hunter Medical Research Institute, The University of Newcastle, New Lambton Heights, New Lambton, New South Wales, Australia.,Department of Respiratory and Sleep Medicine, John Hunter Hospital, New Lambton, New South Wales, Australia
| | - C M Porsbjerg
- Respiratory Research Unit, Bispebjerg University Hospital, Copenhagen, Denmark
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Wändell PE. Population groups in dietary transition. Food Nutr Res 2013; 57:21668. [PMID: 24106456 PMCID: PMC3790911 DOI: 10.3402/fnr.v57i0.21668] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Revised: 04/25/2013] [Accepted: 04/26/2013] [Indexed: 12/12/2022] Open
Abstract
Background Little is known about the effects of dietary acculturation in minority groups in the Nordic countries, including immigrants from non-Western societies. Methods A search was performed in Medlin33e/PubMed and SweMed+ for articles published in 1990–2011. Results A total of 840 articles were identified, with a final 32 articles used to tabulate results which were included in the primary analysis. High rates of vitamin D deficiency (23 articles) were found in immigrants of non-Western origin; deficiency rates were very high among both pregnant and non-pregnant women, and also among children, with young children of immigrant parents showing 50 times higher risk for rickets when compared to children of indigenous parents. The risk of iron deficiency (two articles) was high among immigrant women, while the results were inconclusive regarding children. High rates of dental caries (seven articles) were found among pre-school and younger school children of immigrant origin, while the risk of caries was not as evident among older children. In a secondary analysis, including 48 articles (results not tabulated), overweight and obesity (14 articles) were seen in many immigrant groups, resulting in a high prevalence of diabetes (2 review articles from a total of 14 original articles) and incidence of coronary heart disease (CHD; seven articles). For hypertension (three articles), dyslipidemia (four articles), and dietary patterns among immigrants (10 articles), the results were contradictory. Conclusions Risk of vitamin D deficiency is alarmingly high in the Nordic countries among immigrants of non-Western origin, especially among women. Dental caries is high among immigrant children aged 0–7 years due to a higher intake of sugary products. Overweight and obesity, associated with a higher risk of diabetes and CHD, are prevalent in many immigrant groups and need further attention.
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Affiliation(s)
- Per E Wändell
- Centre for Family Medicine, Karolinska Institutet, Huddinge, Sweden
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Jørgensen ME, Pedersen MB, Siggaard C, Sørensen TB, Mulvad G, Hansen JC, Skjoldborg H, Pedersen EB. Ethnic, geographic and dietary influences upon vasoactive hormones and blood pressure among Greenland Inuit and Danes. Blood Press 2009; 12:298-306. [PMID: 14763661 DOI: 10.1080/08037050310016646] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
AIM To study levels of vasoactive hormones and urinary excretion of sodium and potassium between groups of Greenland Inuit and Danes, and to analyse the relationship between these hormones and 24-h blood pressure, including nightly blood pressure dips and pulse pressure. METHODS 145 Greenlandic participants were categorized in three groups according to degree of westernization, based on dietary habits and current place of residence; 41 Danes were included as controls. Twenty-four-hour blood pressure was measured. Venous plasma concentrations of vasoactive hormones were measured. Urine was collected for 24 hours for analysis of excretion of sodium and potassium. RESULTS The Inuit population of Greenland had a lower diastolic blood pressure, a higher pulse pressure and lower nocturnal blood pressure dip than Danes had. Angiotensin II in plasma and urine excretion of potassium were higher among Greenlanders compared with Danes, irrespective of diet and place of residence. Aldosterone and urine excretion of sodium were significantly higher among participants in Denmark compared with participants in Greenland. Brain natriuretic peptide and atrial natriuretic peptide were independently and negatively associated with diastolic blood pressure, and vasopressin was positively associated with systolic blood pressure and pulse pressure. Ethnic differences in the effect of vasoactive hormones or urinary sodium and potassium excretion could not explain the difference in blood pressure. CONCLUSION It is suggested that a high dietary intake of potassium and low sodium intake among Greenlanders may affect blood pressure. Further attention should be drawn to the occurrence of high pulse pressure and high activity in the renin-angiotensin system in Inuit populations.
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Kjaergaard JJ, Gelvan A. Risk factors for ischaemic stroke in young Greenlanders. Int J Circumpolar Health 2005; 63 Suppl 2:287-9. [PMID: 15736669 DOI: 10.3402/ijch.v63i0.17920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Contrary to a widely held belief, ischaemic cerebral infarction is not a rare disease in Greenland, as shown recently by our institution. We report data on some of the known risk factors in patients below 60 years of age with ischaemic stroke. METHOD Retrospective data collection and review of charts from Greenlandic patients from all of Greenland admitted to the central hospital, Dronning Ingrids Hospital in Nuuk, in the years 2001 and 2002. RESULTS A total of 37 patients below 60 years of age were discharged with a diagnosis of cerebral infarction. All had a CT, which showed infarction in 32. Five were reported normal, and the diagnosis of infarction rested on the absence of haemorrhage combined with long-standing, major neurological defect. Median age of the group was 54 years. Fifteen (40%) were women, thirty (81%) were smokers. Nine (24%) had hypertension. Two had diabetes, one had atrial fibrillation, and one had dilated cardiomyopathy. Two had significant carotid atherosclerosis diagnosed by duplex ultrasound. Of the rest, fifteen had transoesophageal echocardiography done, thirteen of which showed atherosclerotic changes. The cholesterol levels showed relatively high HDL levels. CONCLUSION Ischaemic stroke is a common disease in young Greenlanders and seems to be associated with atherosclerosis with smoking as the only outstanding risk factor--though not more common than in the general population.
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Pedersen EB, Jørgensen ME, Pedersen MB, Siggaard C, Sørensen TB, Mulvad G, Hansen JC, Torstensen AM, Aagaard O, Skjoldborg H. Plasma amino acids in Greenlanders and Danes. influence of seasons, residence, ethnicity, and diet. Am J Hum Biol 2005; 18:99-111. [PMID: 16378345 DOI: 10.1002/ajhb.20460] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Basal metabolic rate is elevated among circumpolar populations. It has been our hypotheses that this is reflected in the levels of plasma amino acids, that amino acid concentration in plasma differs between Greenlanders and Danes, and that this difference is related to residence, ethnicity, diet, and season. The purpose of the study was to measure plasma amino acids in Greenlanders and Danes and to analyze the influence of residence, ethnicity, diet, and season. Amino acids in plasma were measured in four groups of healthy subjects both during summer and winter: Group 1, Danes living in Denmark consuming European food; Group 2, Greenlanders living in Denmark consuming European food; Group 3, Greenlanders living in Greenland consuming European food; and Group 4, Greenlanders living in Greenland consuming mainly traditional Greenlandic food. Amino acids were determined by pre-column derivatization with o-phthaldialdehyde and reverse-phase high-performance liquid chromatography with gradient elution and fluorescence detection. Most plasma amino acids were lower during summer than winter in Greenlanders living in Greenland. Comparison of the four groups showed that residence in Greenland was the most important influencing factor for the concentration of plasma amino acids, whereas ethnicity and diet had only a very modest or no effect. These findings could not be attributed to changes in thyroid function. However, the level of physical activity was significantly higher in Groups 3 and 4 than in Groups 1 and 2. Because exercise reduces the amino acid pool in plasma, it is possibly that the higher physical activity among Greenlanders living in Greenland explains the reduction in plasma amino acids during summer. It is concluded that plasma amino acids were lower during summer than winter in Greenlanders living in Greenland compared with Greenlanders in Denmark and Danes. This difference might be due to the higher level of physical activity among Greenlanders in Greenland during the summer period.
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Affiliation(s)
- Erling B Pedersen
- Department of Medical Research, Holstebro Hospital, Holstebro, Denmark.
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Rejnmark L, Vestergaard P, Charles P, Hermann AP, Brot C, Eiken P, Mosekilde L. No effect of vitamin A intake on bone mineral density and fracture risk in perimenopausal women. Osteoporos Int 2004; 15:872-80. [PMID: 15034644 DOI: 10.1007/s00198-004-1618-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2003] [Accepted: 02/19/2004] [Indexed: 11/25/2022]
Abstract
In recent studies from Sweden and the United States, a high vitamin A intake has been associated with low bone mineral density (BMD) and increased fracture risk. In Sweden and the United States, food items such as milk and breakfast cereals are fortified with vitamin A, whereas in Denmark there is no mandatory fortification with vitamin A. In the present study, we investigated relations between vitamin A intake and BMD and fracture risk in a Danish population consuming mostly unfortified food items. Within a population-based cohort study in 2,016 perimenopausal women, associations between BMD and vitamin A intake were assessed at baseline and after 5-year follow-up. Moreover, associations between baseline vitamin A intake and 5-year changes in BMD were studied. Finally, fracture risk was assessed in relation to vitamin A intake. In our cohort, dietary retinol intake (0.53 mg/day) was lower than the intake reported in recent studies form Sweden (0.78 mg/day) and the United States (1.66 mg/day). Cross-sectional and longitudinal analyses showed no associations between intake of vitamin A and BMD of the femoral neck or lumbar spine. Neither did BMD differ between those 5% who had the highest, and those 5% who had the lowest, vitamin A intake. During the 5-year study period, 163 subjects sustained a fracture (cases). Compared to 978 controls, logistic regression analyses revealed no difference in vitamin A intake. Thus, in a Danish population, average vitamin A intake is lower than in Sweden and the United States and not associated with detrimental effects on bone.
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Affiliation(s)
- L Rejnmark
- Department of Endocrinology and Metabolism C, Aarhus Amtssygehus, Aarhus University Hospital, Tage-Hansens Gade 2, 8000 Aarhus, Denmark.
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