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Carrera-Bastos P, Fontes-Villalba M, Ahrén B, Lindblad U, Råstam L, Frostegård J, Åkerfeldt T, Granfeldt Y, Sundquist K, Jönsson T. Total adiponectin in indigenous Melanesians on Kitava. Am J Hum Biol 2024:e24134. [PMID: 38989782 DOI: 10.1002/ajhb.24134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 07/01/2024] [Accepted: 07/02/2024] [Indexed: 07/12/2024] Open
Abstract
OBJECTIVES Experimental and small human studies have indicated that high total adiponectin levels have beneficial cardiometabolic effects. In contrast, however, high total adiponectin levels are also associated with higher all-cause and cardiovascular mortality in thoroughly adjusted epidemiological studies. To gain further insight into these seemingly contradictory results, we report results on total adiponectin from the indigenous Melanesian population of Kitava, Trobriand Islands, Papua New Guinea, where an apparent absence of cardiometabolic disease has been previously reported. METHODS Fasting levels of serum total adiponectin were measured cross-sectionally in ≥40-year-old Kitavans (n = 102) and Swedish controls matched for age and sex (n = 108). Multivariable linear regression was used for the analysis of associations with total adiponectin when controlled for group, sex, smoking, hypertension and/or type 2 diabetes, age, and body mass index. RESULTS Total adiponectin was lower for Kitavans compared to Swedish controls (Median [Mdn] 4.6 μg/mL, range 1.0-206 μg/mL and Mdn 9.7 μg/mL, range 3.1-104 μg/mL, respectively, r = .64, p < .001). Lower total adiponectin was associated with Kitavan group, male sex (only in Swedish controls), smoking (only in Kitavans and Swedish controls combined), younger age (not in Swedish controls), higher BMI, lower total, low-density lipoprotein, high-density lipoprotein (HDL) (only in Kitavans and Swedish controls combined), and non-HDL cholesterol, and higher anti-PC IgG (only in Kitavans and Swedish controls combined). CONCLUSION Total adiponectin in Kitavans was significantly lower than in Swedish controls.
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Affiliation(s)
- Pedro Carrera-Bastos
- Center for Primary Health Care Research, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
| | - Maelán Fontes-Villalba
- Center for Primary Health Care Research, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
| | - Bo Ahrén
- Department of Clinical Sciences, Lund, Lund University, Lund, Sweden
| | - Ulf Lindblad
- School of Public Health and Community Medicine, University of Gothenburg, Göteborg, Sweden
| | - Lennart Råstam
- Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
| | - Johan Frostegård
- IMM, Karolinska Institute, Unit of Immunology and chronic disease, Stockholm, Sweden
| | - Torbjörn Åkerfeldt
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- Uppsala University Hospital, Uppsala, Sweden
| | - Yvonne Granfeldt
- Department of Food Technology, Engineering and Nutrition, Lund, Lund University, Sweden
| | - Kristina Sundquist
- Center for Primary Health Care Research, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
- University Clinic Primary Care Skåne, Region Skåne, Sweden
| | - Tommy Jönsson
- Center for Primary Health Care Research, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
- University Clinic Primary Care Skåne, Region Skåne, Sweden
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Venketasubramanian N. Stroke Epidemiology in Oceania: A Review. Neuroepidemiology 2021; 55:1-10. [PMID: 33601397 DOI: 10.1159/000512972] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 11/11/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND PURPOSE Oceania, comprising the regions Australasia, Melanesia, Micronesia, and Polynesia, is home to 42 million living in 8.5 million square kilometres of land. This paper comprises a review of the epidemiology of stroke in countries in this region. METHODS Information on epidemiology of stroke in Oceania was sought from data from the Global Burden of Disease (GBD) study (incidence, mortality, incidence:mortality ratio [IMR], prevalence, disability-adjusted life-years [DALYs] lost due to stroke, and subtypes), World Health Organization (WHO) (vascular risk factors in the community), and PubMed (incidence, prevalence, and stroke subtypes). Data were analyzed by region to allow inter-country comparison within each region. RESULTS In 2010, age- and sex-standardized stroke mortality rates were lowest in Australasia (29.85-31.67/100,000) and highest in Melanesia and Micronesia (56.04-187.56/100,000), with wide ranges especially in Melanesia. Incidence rates were lowest in Australasia (101.36-105.54/100,000), similarly high elsewhere. Standardized IMR (0.98-3.39) was the inverse of the mortality rates and mirrored the prevalence rates (202.91-522.29/100,000). DALY rates (398.22-3,781.78/100,0000) mirrored the mortality rates. Stroke risk factors show a variable pattern - hypertension is generally the most common medical risk factor among males (18.0-26.6%), while among females, diabetes mellitus is the most common in Micronesia and Polynesia (21.5-28.4%). Among the lifestyle factors, current smoking is the most common in Melanesia among males, while obesity is generally the most common factor among females. Ischaemic stroke comprises 70% of stroke subtypes. Trend data show significant falls in standardized mortality rates and DALYs in most regions and falls in incidence in almost all countries. There is significant economic impact, particularly due to young strokes; some ethnicities are at higher risk than others, for example, Maoris and Pacific Islanders. CONCLUSIONS Stroke is a major healthcare problem in Oceania. Variations in stroke epidemiology are found between countries in Oceania. Data are lacking in some; more research into the burden of stroke in Oceania is needed. With the expected increase in life expectancy and vascular risk factors, the burden of stroke in Oceania will likely rise. Some of the disparities in stroke burden may be addressed by great investment in healthcare.
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Carrera-Bastos P, Fontes-Villalba M, Gurven M, Muskiet FAJ, Åkerfeldt T, Lindblad U, Råstam L, Frostegård J, Shapira Y, Shoenfeld Y, Granfeldt Y, Sundquist K, Jönsson T. C-reactive protein in traditional melanesians on Kitava. BMC Cardiovasc Disord 2020; 20:524. [PMID: 33334321 PMCID: PMC7745357 DOI: 10.1186/s12872-020-01812-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 12/06/2020] [Indexed: 01/01/2023] Open
Abstract
Background Population-based levels of the chronic low-grade systemic inflammation biomarker, C-reactive protein (CRP), vary widely among traditional populations, despite their apparent absence of chronic conditions associated with chronic low-grade systemic inflammation, such as type 2 diabetes, metabolic syndrome and cardiovascular disease. We have previously reported an apparent absence of aforementioned conditions amongst the traditional Melanesian horticulturalists of Kitava, Trobriand Islands, Papua New Guinea. Our objective in this study was to clarify associations between chronic low-grade systemic inflammation and chronic cardiometabolic conditions by measuring CRP in a Kitava population sample. For comparison purposes, CRP was also measured in Swedish controls matched for age and gender.
Methods Fasting levels of serum CRP were measured cross-sectionally in ≥ 40-year-old Kitavans (N = 79) and Swedish controls (N = 83). Results CRP was lower for Kitavans compared to Swedish controls (Mdn 0.5 mg/L range 0.1—48 mg/L and Mdn 1.1 mg/L range 0.1—33 mg/L, respectively, r = .18 p = .02). Among Kitavans, there were small negative associations between lnCRP for CRP values < 10 and total, low-density lipoprotein (LDL) and non-high-density lipoprotein (non-HDL) cholesterol. Among Swedish controls, associations of lnCRP for CRP values < 10 were medium positive with weight, body mass index, waist circumference, hip circumference and waist-hip ratio and low positive with triglyceride, total cholesterol-HDL cholesterol ratio, triglyceride-HDL cholesterol ratio and serum insulin. Conclusions Chronic low-grade systemic inflammation, measured as CRP, was lower among Kitavans compared to Swedish controls, indicating a lower and average cardiovascular risk, respectively, for these populations.
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Affiliation(s)
- Pedro Carrera-Bastos
- Center for Primary Health Care Research, Lund University/Region Skåne, Skåne University Hospital, Jan Waldenströms gata 35, CRC, hus 28 plan 11, 205 02, Malmö, Sweden
| | - Maelán Fontes-Villalba
- Center for Primary Health Care Research, Lund University/Region Skåne, Skåne University Hospital, Jan Waldenströms gata 35, CRC, hus 28 plan 11, 205 02, Malmö, Sweden
| | - Michael Gurven
- Department of Anthropology, University of California, Santa Barbara, USA
| | - Frits A J Muskiet
- Department of Laboratory Medicine, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Torbjörn Åkerfeldt
- Department of Medical Sciences, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
| | - Ulf Lindblad
- School of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Lennart Råstam
- Department of Clinical Sciences, Community Medicine, Lund University, Lund, Sweden
| | - Johan Frostegård
- IMM, Unit of Immunology and Chronic Disease, Karolinska Institutet, Stockholm, Sweden
| | - Yinon Shapira
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel
| | - Yehuda Shoenfeld
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center (Affiliated To Tel-Aviv University), Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Hashomer, Israel.,I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Saint Petersburg, Russia
| | - Yvonne Granfeldt
- Department of Food Technology, Engineering and Nutrition, Lund University, Lund, Sweden
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University/Region Skåne, Skåne University Hospital, Jan Waldenströms gata 35, CRC, hus 28 plan 11, 205 02, Malmö, Sweden
| | - Tommy Jönsson
- Center for Primary Health Care Research, Lund University/Region Skåne, Skåne University Hospital, Jan Waldenströms gata 35, CRC, hus 28 plan 11, 205 02, Malmö, Sweden.
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Eaton JC, Iannotti LL. Genome-nutrition divergence: evolving understanding of the malnutrition spectrum. Nutr Rev 2017; 75:934-950. [PMID: 29112753 DOI: 10.1093/nutrit/nux055] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Humans adapted over a period of 2.3 million years to a diet high in quality and diversity. Genome-nutrition divergence describes the misalignment between modern global diets and the genome formed through evolution. A survey of hominin diets over time shows that humans have thrived on a broad range of foods. Earlier diets were highly diverse and nutrient dense, in contrast to modern food systems in which monotonous diets of staple cereals and ultraprocessed foods play a more prominent role. Applying the lens of genome-nutrition divergence to malnutrition reveals shared risk factors for undernutrition and overnutrition at nutrient, food, and environmental levels. Mechanisms for food system shifts, such as crop-neutral agricultural policy, agroecology, and social policy, are explored as a means to realign modern diets with the nutritional patterns to which humans may be better adapted to thrive.
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Affiliation(s)
- Jacob C Eaton
- Institute for Public Health, Brown School, Washington University, St Louis, Missouri, USA
| | - Lora L Iannotti
- Institute for Public Health, Brown School, Washington University, St Louis, Missouri, USA
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Gurven MD, Trumble BC, Stieglitz J, Blackwell AD, Michalik DE, Finch CE, Kaplan HS. Cardiovascular disease and type 2 diabetes in evolutionary perspective: a critical role for helminths? Evol Med Public Health 2016; 2016:338-357. [PMID: 27666719 PMCID: PMC5101910 DOI: 10.1093/emph/eow028] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 09/09/2016] [Indexed: 12/17/2022] Open
Abstract
Heart disease and type 2 diabetes are commonly believed to be rare among contemporary subsistence-level human populations, and by extension prehistoric populations. Although some caveats remain, evidence shows these diseases to be unusual among well-studied hunter-gatherers and other subsistence populations with minimal access to healthcare. Here we expand on a relatively new proposal for why these and other populations may not show major signs of these diseases. Chronic infections, especially helminths, may offer protection against heart disease and diabetes through direct and indirect pathways. As part of a strategy to insure their own survival and reproduction, helminths exert multiple cardio-protective effects on their host through their effects on immune function and blood lipid metabolism. Helminths consume blood lipids and glucose, alter lipid metabolism, and modulate immune function towards Th-2 polarization - which combined can lower blood cholesterol, reduce obesity, increase insulin sensitivity, decrease atheroma progression, and reduce likelihood of atherosclerotic plaque rupture. Traditional cardiometabolic risk factors, coupled with the mismatch between our evolved immune systems and modern, hygienic environments may interact in complex ways. In this review, we survey existing studies in the non-human animal and human literature, highlight unresolved questions and suggest future directions to explore the role of helminths in the etiology of cardio-metabolic disease.
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Affiliation(s)
- Michael D Gurven
- Department of Anthropology, University of California-Santa Barbara, Santa Barbara, CA 93106
| | - Benjamin C Trumble
- School of Human Evolution and Social Change & Center for Evolution and Medicine, Arizona State University, Tempe, AZ 85287
| | - Jonathan Stieglitz
- Institute for Advanced Study in Toulouse, 21 allée de Brienne, 31015 Toulouse Cedex 6, France
| | - Aaron D Blackwell
- Department of Anthropology, University of California-Santa Barbara, Santa Barbara, CA 93106
| | - David E Michalik
- University of California, Irvine School of Medicine; Depts of Pediatrics and Infectious Diseases
| | - Caleb E Finch
- Andrus Gerontology Center and Dept. Neurobiology USC College, University of Southern California, Los Angeles, CA 90089
| | - Hillard S Kaplan
- Department of Anthropology, University of New Mexico, Albuquerque, NM 87131
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Lindeberg S, Cordain L, Eaton SB. Biological and Clinical Potential of a Palaeolithic Diet*. ACTA ACUST UNITED AC 2009. [DOI: 10.1080/13590840310001619397] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Viel KR, Machiah DK, Warren DM, Khachidze M, Buil A, Fernstrom K, Souto JC, Peralta JM, Smith T, Blangero J, Porter S, Warren ST, Fontcuberta J, Soria JM, Flanders WD, Almasy L, Howard TE. A sequence variation scan of the coagulation factor VIII (FVIII) structural gene and associations with plasma FVIII activity levels. Blood 2007; 109:3713-24. [PMID: 17209060 PMCID: PMC1874571 DOI: 10.1182/blood-2006-06-026104] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2006] [Accepted: 11/03/2006] [Indexed: 11/20/2022] Open
Abstract
Plasma factor VIII coagulant activity (FVIII:C) level is a highly heritable quantitative trait that is strongly correlated with thrombosis risk. Polymorphisms within only 1 gene, the ABO blood-group locus, have been unequivocally demonstrated to contribute to the broad population variability observed for this trait. Because less than 2.5% of the structural FVIII gene (F8) has been examined previously, we resequenced all known functional regions in 222 potentially distinct alleles from 137 unrelated nonhemophilic individuals representing 7 racial groups. Eighteen of the 47 variants identified, including 17 single-nucleotide polymorphisms (SNPs), were previously unknown. As the degree of linkage disequilibrium across F8 was weak overall, we used measured-genotype association analysis to evaluate the influence of each polymorphism on the FVIII:C levels in 398 subjects from 21 pedigrees known as the Genetic Analysis of Idiopathic Thrombophilia project (GAIT). Our results suggested that 92714C>G, a nonsynonymous SNP encoding the B-domain substitution D1241E, was significantly associated with FVIII:C level. After accounting for important covariates, including age and ABO genotype, the association persisted with each C-allele additively increasing the FVIII:C level by 14.3 IU dL(-1) (P = .016). Nevertheless, because the alleles of 56010G>A, a SNP within the 3' splice junction of intron 7, are strongly associated with 92714C>G in GAIT, additional studies are required to determine whether D1241E is itself a functional variant.
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Affiliation(s)
- Kevin R Viel
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA
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Abstract
BACKGROUND In some western populations, increased serum uric acid has been positively associated with cardiovascular disease, possibly because hyperuricaemia could be an untoward part of the insulin-resistant metabolic syndrome. However, there is evidence that uric acid is a free radical scavenger capable of inhibiting LDL oxidation. Amongst the traditional horticulturalists of Kitava, Trobriand Islands, Papua New Guinea, cardiovascular disease, hypertension, hyperinsulinaemia and abdominal obesity are absent or rare. In contrast, serum triglycerides are similar to Swedish levels. OBJECTIVE To compare serum uric acid between nonwesternized and westernized populations. METHODS Fasting levels of serum uric acid were measured cross-sectionally in 171 Kitavans aged 20-86 years and in 244 randomly selected Swedish subjects aged 20-80 years. RESULTS There were small differences in serum uric acid between the two populations, although a slight increase with age was found only in Swedish males (r = 0.20; P = 0.03) and females (r = 0.36; P < 0.0001). Above 40 years of age, uric acid was approximately 10% lower in Kitavans, a difference which was statistically significant only in males, possibly because of the limited number of females. Regarding hyperuricaemia, two Kitavan males had uric acid above 450 micromol L-1 whilst none of the females was above 340 micromol L-1. Amongst the Swedish subjects, five of 117 males and 19 of 127 females had hyperuricaemia according to these definitions. CONCLUSION The rather similar uric acid levels between Kitava and Sweden imply that uric acid is of minor importance to explain the apparent absence of cardiovascular disease in Kitava.
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Affiliation(s)
- S Lindeberg
- Department of Medicine, Lund University, Lund, Sweden.
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The Northern Sweden MONICA Project. Bibliography. Scand J Public Health 2003; 61:85-91. [PMID: 14660252 DOI: 10.1080/14034950310001478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Lindeberg S, Söderberg S, Ahrén B, Olsson T. Large differences in serum leptin levels between nonwesternized and westernized populations: the Kitava study. J Intern Med 2001; 249:553-8. [PMID: 11422662 DOI: 10.1046/j.1365-2796.2001.00845.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To compare serum leptin between nonwesternized and westernized populations. SETTING (i) The tropical island of Kitava, Trobriand Islands, Papua New Guinea and (ii) the Northern Sweden MONICA study population. Design. Cross-sectional survey. METHODS Fasting levels of serum leptin were analysed in 163 randomly selected Kitavans aged 20-86 years and in 224 Swedes aged 25-74. MAIN OUTCOME MEASURE Mean and determinants of serum leptin. RESULTS Geometric mean of serum leptin in Kitavan males and females were 1.5 and 4.0 vs. 4.9 and 13.8 ng mL-1 in Swedish male and females (P < 0.0001 for both sexes). In Kitavans, observed geometric mean were close to predicted levels (1.8 ng mL(-1) for males and 4.5 ng mL-1 for females) based on multiple linear regression equations including body mass index (BMI), triceps skinfolds (TSF) and age from the Swedish population-based sample. In Kitavans serum leptin was positively related to TSF amongst both sexes and, amongst females, to BMI. In Kitavans leptin was not related to fasting serum insulin. TSF explained 55% of the variation of leptin amongst females. There was a slight age-related increase of leptin amongst males. In Kitava leptin was not related to fasting serum insulin which was substantially lower than in Sweden. CONCLUSION The low concentrations of serum leptin amongst Kitavans probably relates to the absence of overweight and hyperinsulinaemia. At a population level serum leptin can apparently be predicted from simple measures of adiposity.
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Affiliation(s)
- S Lindeberg
- Department of Community Medicine, Lund University, Malmö, Sweden.
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Affiliation(s)
- H H Vorster
- Department of Nutrition, Potchefstroom Universiteit, Republic of South Africa.
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Stormorken H, Sakariassen KS. Hemostatic risk factors in arterial thrombosis and atherosclerosis: the thrombin-fibrin and platelet-vWF axis. Thromb Res 1997; 88:1-25. [PMID: 9336870 DOI: 10.1016/s0049-3848(97)00157-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- H Stormorken
- Department of Biology, University of Oslo, Norway
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