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Brath MSG, Sahakyan M, Mark EB, Rasmussen HH, Østergaard LR, Frøkjær JB, Weinreich UM, Jørgensen ME. Ethnic differences in CT derived abdominal body composition measures: a comparative retrospect pilot study between European and Inuit study population. Int J Circumpolar Health 2024; 83:2312663. [PMID: 38314517 PMCID: PMC10846476 DOI: 10.1080/22423982.2024.2312663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 01/28/2024] [Indexed: 02/06/2024] Open
Abstract
Understanding ethnic variations in body composition is crucial for assessing health risks. Universal models may not suit all ethnicities, and there is limited data on the Inuit population. This study aimed to compare body composition between Inuit and European adults using computed tomography (CT) scans and to investigate the influence of demographics on these measurements. A retrospective analysis was conducted on 50 adults (29 Inuit and 21 European) who underwent standard trauma CT scans. Measurements focused on skeletal muscle index (SMI), various fat indices, and densities at the third lumbar vertebra level, analyzed using the Wilcoxon-Mann-Whitney test and multiple linear regression. Inuit women showed larger fat tissue indices and lower muscle and fat densities than European women. Differences in men were less pronouncehd, with only Intramuscular fat density being lower among Inuit men. Regression indicated that SMI was higher among men, and skeletal muscle density decreased with Inuit ethnicity and age, while visceral fat index was positively associated with age. This study suggests ethnic differences in body composition measures particularly among women, and indicates the need for Inuit-specific body composition models. It higlights the importance of further research into Inuit-specific body composition measurements for better health risk assessment.
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Affiliation(s)
- Mia Solholt Godthaab Brath
- Department of Respiratory Medicine, Aalborg University Hospital, Aalborg, Denmark
- Respiratory Research Aalborg, Reaal, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Marina Sahakyan
- Department of Radiology, Aalborg University Hospital, Aalborg, Denmark
| | - Esben Bolvig Mark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Mech-Sense, Department. of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark
| | - Henrik Højgaard Rasmussen
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Danish Nutrition Science Center, Department. of Gastroenterology & Hepatology, Aalborg University Hospital, Aalborg, Denmark
- Center for Nutrition and Intestinal Failure, Department. of Gastroenterology & Hepatology, Aalborg University Hospital, Aalborg, Denmark
- The Dietitians and Nutritional Research Unit, EATEN, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Lasse Riis Østergaard
- Medical Informatics group, Department. of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Jens Brøndum Frøkjær
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Radiology, Aalborg University Hospital, Aalborg, Denmark
| | - Ulla Møller Weinreich
- Department of Respiratory Medicine, Aalborg University Hospital, Aalborg, Denmark
- Respiratory Research Aalborg, Reaal, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Marit Eika Jørgensen
- Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark
- Institute of Health and Nature, University of Greenland, Nuuk, Greenland
- Steno Diabetes Center Greenland, Queen Ingrid’s Hospital, Nuuk, Greenland
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2
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Mashayekhi M, Sheng Q, Bailin SS, Massier L, Zhong J, Shi M, Wanjalla CN, Wang TJ, Ikizler TA, Niswender KD, Gabriel CL, Palacios J, Turgeon-Jones R, Reynolds CF, Luther JM, Brown NJ, Das S, Dahlman I, Mosley JD, Koethe JR, Rydén M, Bachmann KN, Shah RV. The subcutaneous adipose transcriptome identifies a molecular signature of insulin resistance shared with visceral adipose. Obesity (Silver Spring) 2024; 32:1526-1540. [PMID: 38967296 PMCID: PMC11269023 DOI: 10.1002/oby.24064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 04/05/2024] [Accepted: 04/23/2024] [Indexed: 07/06/2024]
Abstract
OBJECTIVE The objective of this study was to identify the transcriptional landscape of insulin resistance (IR) in subcutaneous adipose tissue (SAT) in humans across the spectrum of obesity. METHODS We used SAT RNA sequencing in 220 individuals with metabolic phenotyping. RESULTS We identified a 35-gene signature with high predictive accuracy for homeostatic model of IR that was expressed across a variety of non-immune cell populations. We observed primarily "protective" IR associations for adipocyte transcripts and "deleterious" associations for macrophage transcripts, as well as a high concordance between SAT and visceral adipose tissue (VAT). Multiple SAT genes exhibited dynamic expression 5 years after weight loss surgery and with insulin stimulation. Using available expression quantitative trait loci in SAT and/or VAT, we demonstrated similar genetic effect sizes of SAT and VAT on type 2 diabetes and BMI. CONCLUSIONS SAT is conventionally viewed as a metabolic buffer for lipid deposition during positive energy balance, whereas VAT is viewed as a dominant contributor to and prime mediator of IR and cardiometabolic disease risk. Our results implicate a dynamic transcriptional architecture of IR that resides in both immune and non-immune populations in SAT and is shared with VAT, nuancing the current VAT-centric concept of IR in humans.
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Affiliation(s)
- Mona Mashayekhi
- Vanderbilt University Medical Center, Department of Medicine, Division of Diabetes, Endocrinology and Metabolism, Nashville, Tennessee, USA
| | - Quanhu Sheng
- Vanderbilt University Medical Center, Department of Biostatistics, Nashville, Tennessee, USA
| | - Samuel S. Bailin
- Vanderbilt University Medical Center, Department of Medicine, Division of Infectious Disease, Nashville, Tennessee, USA
| | - Lucas Massier
- Karolinska Institutet, Department of Medicine, Huddinge (H7), Stockholm, Sweden
| | - Jiawei Zhong
- Karolinska Institutet, Department of Medicine, Huddinge (H7), Stockholm, Sweden
| | - Mingjian Shi
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Celestine N. Wanjalla
- Vanderbilt University Medical Center, Department of Medicine, Division of Infectious Disease, Nashville, Tennessee, USA
| | - Thomas J. Wang
- UT Southwestern Medical Center, Department of Internal Medicine, Dallas, Texas, USA
| | - T. Alp Ikizler
- Vanderbilt University Medical Center, Department of Medicine, Division of Nephrology and Hypertension, Nashville, Tennessee, USA
- Veterans Health Administration, Tennessee Valley Healthcare System, Nashville, Tennessee, USA
| | - Kevin D. Niswender
- Vanderbilt University Medical Center, Department of Medicine, Division of Diabetes, Endocrinology and Metabolism, Nashville, Tennessee, USA
- Veterans Health Administration, Tennessee Valley Healthcare System, Nashville, Tennessee, USA
| | - Curtis L. Gabriel
- Vanderbilt University Medical Center, Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition, Nashville, Tennessee, USA
| | - Julia Palacios
- Vanderbilt University Medical Center, Department of Medicine, Division of Diabetes, Endocrinology and Metabolism, Nashville, Tennessee, USA
| | - Rachel Turgeon-Jones
- Vanderbilt University Medical Center, Department of Medicine, Division of Diabetes, Endocrinology and Metabolism, Nashville, Tennessee, USA
| | - Cassandra F. Reynolds
- Vanderbilt Translational and Clinical Cardiovascular Research Center, Department of Medicine, Cardiology Division, Nashville, Tennessee, USA
| | - James M. Luther
- Vanderbilt University Medical Center, Department of Medicine, Division of Nephrology and Hypertension, Nashville, Tennessee, USA
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | | | - Saumya Das
- Cardiology Division, Massachusetts General Hospital, Boston, MA, USA
| | - Ingrid Dahlman
- Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden
| | - Jonathan D. Mosley
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - John R. Koethe
- Vanderbilt University Medical Center, Department of Medicine, Division of Infectious Disease, Nashville, Tennessee, USA
- Veterans Health Administration, Tennessee Valley Healthcare System, Nashville, Tennessee, USA
| | - Mikael Rydén
- Karolinska Institutet, Department of Medicine, Huddinge (H7), Stockholm, Sweden
| | - Katherine N. Bachmann
- Vanderbilt University Medical Center, Department of Medicine, Division of Diabetes, Endocrinology and Metabolism, Nashville, Tennessee, USA
- Veterans Health Administration, Tennessee Valley Healthcare System, Nashville, Tennessee, USA
| | - Ravi V. Shah
- Vanderbilt Translational and Clinical Cardiovascular Research Center, Department of Medicine, Cardiology Division, Nashville, Tennessee, USA
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3
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Lin L, Andersen MK, Stæger FF, Li Z, Hanghøj K, Linneberg A, Grarup N, Jørgensen ME, Hansen T, Moltke I, Albrechtsen A. Analysis of admixed Greenlandic siblings shows that the mean genotypic values for metabolic phenotypes differ between Inuit and Europeans. Genome Med 2024; 16:71. [PMID: 38778393 PMCID: PMC11112775 DOI: 10.1186/s13073-024-01326-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 03/28/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Disease prevalence and mean phenotype values differ between many populations, including Inuit and Europeans. Whether these differences are partly explained by genetic differences or solely due to differences in environmental exposures is still unknown, because estimates of the genetic contribution to these means, which we will here refer to as mean genotypic values, are easily confounded, and because studies across genetically diverse populations are lacking. METHODS Leveraging the unique genetic properties of the small, admixed and historically isolated Greenlandic population, we estimated the differences in mean genotypic value between Inuit and European genetic ancestry using an admixed sibling design. Analyses were performed across 26 metabolic phenotypes, in 1474 admixed sibling pairs present in a cohort of 5996 Greenlanders. RESULTS After FDR correction for multiple testing, we found significantly lower mean genotypic values in Inuit genetic ancestry compared to European genetic ancestry for body weight (effect size per percentage of Inuit genetic ancestry (se), -0.51 (0.16) kg/%), body mass index (-0.20 (0.06) kg/m2/%), fat percentage (-0.38 (0.13) %/%), waist circumference (-0.42 (0.16) cm/%), hip circumference (-0.38 (0.11) cm/%) and fasting serum insulin levels (-1.07 (0.51) pmol/l/%). The direction of the effects was consistent with the observed mean phenotype differences between Inuit and European genetic ancestry. No difference in mean genotypic value was observed for height, markers of glucose homeostasis, or circulating lipid levels. CONCLUSIONS We show that mean genotypic values for some metabolic phenotypes differ between two human populations using a method not easily confounded by possible differences in environmental exposures. Our study illustrates the importance of performing genetic studies in diverse populations.
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Affiliation(s)
- Long Lin
- Section for Computational and RNA Biology, Department of Biology, University of Copenhagen, Ole Maaløes Vej 5, 2200, Copenhagen, Denmark
| | - Mette K Andersen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Frederik Filip Stæger
- Section for Computational and RNA Biology, Department of Biology, University of Copenhagen, Ole Maaløes Vej 5, 2200, Copenhagen, Denmark
| | - Zilong Li
- Section for Computational and RNA Biology, Department of Biology, University of Copenhagen, Ole Maaløes Vej 5, 2200, Copenhagen, Denmark
| | - Kristian Hanghøj
- Section for Computational and RNA Biology, Department of Biology, University of Copenhagen, Ole Maaløes Vej 5, 2200, Copenhagen, Denmark
| | - Allan Linneberg
- Centre for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region of Denmark, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Niels Grarup
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Marit Eika Jørgensen
- Centre for Public Health in Greenland, National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
- Clinical Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
- Steno Diabetes Center Greenland, Nuuk, Greenland
| | - Torben Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark.
| | - Ida Moltke
- Section for Computational and RNA Biology, Department of Biology, University of Copenhagen, Ole Maaløes Vej 5, 2200, Copenhagen, Denmark.
| | - Anders Albrechtsen
- Section for Computational and RNA Biology, Department of Biology, University of Copenhagen, Ole Maaløes Vej 5, 2200, Copenhagen, Denmark.
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4
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Muhammad AG, Hansen FO, Gantzel RH, Rex KF, Villadsen GE, Grønbæk H, Pedersen ML. Non-alcoholic fatty liver disease in patients with type 2 diabetes in Greenland: a register-based cross-sectional study. Int J Circumpolar Health 2022; 81:2065755. [PMID: 35440282 PMCID: PMC9037206 DOI: 10.1080/22423982.2022.2065755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide due to its close association to the metabolic syndrome of type 2 diabetes mellitus (T2DM), obesity and insulin resistance. However, the prevalence and severity of NAFLD in Greenland remain unexplored. We aimed to estimate the prevalence of liver steatosis and fibrosis among Greenlanders and Danes with T2DM living in Greenland using biochemical surrogate markers. We included 1409 Greenlanders and 182 Danes with T2DM in this register-based cross-sectional study. Greenlanders had higher BMI and plasma lipid levels and lower HbA1c levels compared with Danes (p<0.05). Their median alanine aminotransferase (ALAT) levels were similar. However, more Greenlanders had elevated ALAT levels (20.5% vs. 11.5%, p<0.05). Greenlanders had lower FIB-4 scores than Danes, 0.91 (IQR: 0.66–1.27) vs. 0.97 (IQR: 0.78–1.34), without difference in FIB-4 score categories (p=0.27). The prevalence of advanced fibrosis was low in both populations (1.7–2.6%). In conclusion, Greenlanders with T2DM had better glycaemic control despite higher BMI and plasma lipids. A larger proportion of Greenlanders had elevated plasma ALAT levels, while FIB-4 scores were lower than Danes. These findings suggest that Greenlanders with T2DM may be less likely to develop liver complications than Danes with T2DM in Greenland.
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Affiliation(s)
- Abdullah Ghassan Muhammad
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.,Steno Diabetes Center Greenland, Nuuk, Greenland
| | - Frederik Orm Hansen
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.,Steno Diabetes Center Greenland, Nuuk, Greenland
| | - Rasmus Hvidbjerg Gantzel
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | - Gerda Elisabeth Villadsen
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Henning Grønbæk
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Michael Lynge Pedersen
- Steno Diabetes Center Greenland, Nuuk, Greenland.,Greenland Center for Health Research, Institute of Health and Nature, University of Greenland, Nuuk, Greenland
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5
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Schnurr TM, Jørsboe E, Chadt A, Dahl-Petersen IK, Kristensen JM, Wojtaszewski JFP, Springer C, Bjerregaard P, Brage S, Pedersen O, Moltke I, Grarup N, Al-Hasani H, Albrechtsen A, Jørgensen ME, Hansen T. Physical activity attenuates postprandial hyperglycaemia in homozygous TBC1D4 loss-of-function mutation carriers. Diabetologia 2021; 64:1795-1804. [PMID: 33912980 PMCID: PMC8245392 DOI: 10.1007/s00125-021-05461-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/24/2021] [Indexed: 12/28/2022]
Abstract
AIMS/HYPOTHESIS The common muscle-specific TBC1D4 p.Arg684Ter loss-of-function variant defines a subtype of non-autoimmune diabetes in Arctic populations. Homozygous carriers are characterised by elevated postprandial glucose and insulin levels. Because 3.8% of the Greenlandic population are homozygous carriers, it is important to explore possibilities for precision medicine. We aimed to investigate whether physical activity attenuates the effect of this variant on 2 h plasma glucose levels after an oral glucose load. METHODS In a Greenlandic population cohort (n = 2655), 2 h plasma glucose levels were obtained after an OGTT, physical activity was estimated as physical activity energy expenditure and TBC1D4 genotype was determined. We performed TBC1D4-physical activity interaction analysis, applying a linear mixed model to correct for genetic admixture and relatedness. RESULTS Physical activity was inversely associated with 2 h plasma glucose levels (β[main effect of physical activity] -0.0033 [mmol/l] / [kJ kg-1 day-1], p = 6.5 × 10-5), and significantly more so among homozygous carriers of the TBC1D4 risk variant compared with heterozygous carriers and non-carriers (β[interaction] -0.015 [mmol/l] / [kJ kg-1 day-1], p = 0.0085). The estimated effect size suggests that 1 h of vigorous physical activity per day (compared with resting) reduces 2 h plasma glucose levels by an additional ~0.7 mmol/l in homozygous carriers of the risk variant. CONCLUSIONS/INTERPRETATION Physical activity improves glucose homeostasis particularly in homozygous TBC1D4 risk variant carriers via a skeletal muscle TBC1 domain family member 4-independent pathway. This provides a rationale to implement physical activity as lifestyle precision medicine in Arctic populations. DATA REPOSITORY The Greenlandic Cardio-Metabochip data for the Inuit Health in Transition study has been deposited at the European Genome-phenome Archive ( https://www.ebi.ac.uk/ega/dacs/EGAC00001000736 ) under accession EGAD00010001428.
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Affiliation(s)
- Theresia M Schnurr
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Emil Jørsboe
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- The Bioinformatics Centre, Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Alexandra Chadt
- Institute for Clinical Biochemistry and Pathobiochemistry, German Diabetes Center (DDZ), Leibniz Center for Diabetes research at the Heinrich-Heine-University Duesseldorf, Medical Faculty, Duesseldorf, Germany
- German Center for Diabetes Research (DZD), Duesseldorf, Germany
| | - Inger K Dahl-Petersen
- National Institute of Public Health, University of Southern Denmark, Odense, Denmark
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Jonas M Kristensen
- Section of Molecular Physiology, Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Jørgen F P Wojtaszewski
- Section of Molecular Physiology, Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Christian Springer
- Institute for Clinical Biochemistry and Pathobiochemistry, German Diabetes Center (DDZ), Leibniz Center for Diabetes research at the Heinrich-Heine-University Duesseldorf, Medical Faculty, Duesseldorf, Germany
- German Center for Diabetes Research (DZD), Duesseldorf, Germany
| | - Peter Bjerregaard
- National Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Søren Brage
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Oluf Pedersen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ida Moltke
- The Bioinformatics Centre, Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Niels Grarup
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Hadi Al-Hasani
- Institute for Clinical Biochemistry and Pathobiochemistry, German Diabetes Center (DDZ), Leibniz Center for Diabetes research at the Heinrich-Heine-University Duesseldorf, Medical Faculty, Duesseldorf, Germany
- German Center for Diabetes Research (DZD), Duesseldorf, Germany
| | - Anders Albrechtsen
- The Bioinformatics Centre, Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Marit E Jørgensen
- National Institute of Public Health, University of Southern Denmark, Odense, Denmark
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
- Greenland Center for Health Research, University of Greenland, Nuuk, Greenland
| | - Torben Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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6
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Senftleber NK, Overvad M, Dahl-Petersen IK, Bjerregaard P, Jørgensen ME. Diet and physical activity in Greenland: genetic interactions and associations with obesity and diabetes. Appl Physiol Nutr Metab 2021; 46:849-855. [PMID: 34107227 DOI: 10.1139/apnm-2021-0020] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The Inuit in Greenland have gone through dramatic lifestyle changes during the last half century. More time is spent being sedentary and imported foods replaces traditional foods like seal and whale. The population has also experienced a rapid growth in obesity and metabolic disturbances and diabetes is today common despite being almost unknown few decades ago. In this paper, we describe and discuss the role of lifestyle changes and genetics for Inuit metabolic health. Novelty: Cardiometabolic disease risk has increased in Greenland. Lifestyle changes and possibly gene-lifestyle interactions play a role.
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Affiliation(s)
| | | | | | - Peter Bjerregaard
- National Institute of Public Health, Southern Denmark University, Copenhagen, Denmark
| | - Marit Eika Jørgensen
- Steno Diabetes Center Copenhagen, Gentofte, Denmark.,National Institute of Public Health, Southern Denmark University, Copenhagen, Denmark.,University of Greenland, Nuuk, Greenland
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7
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Rønn PF, Andersen GS, Lauritzen T, Christensen DL, Aadahl M, Carstensen B, Grarup N, Jørgensen ME. Abdominal visceral and subcutaneous adipose tissue and associations with cardiometabolic risk in Inuit, Africans and Europeans: a cross-sectional study. BMJ Open 2020; 10:e038071. [PMID: 32928857 PMCID: PMC7490939 DOI: 10.1136/bmjopen-2020-038071] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES Abdominal fat has been identified as a risk marker of cardiometabolic disease independent of overall adiposity. However, it is not clear whether there are ethnic disparities in this risk. We investigated the associations of visceral adipose tissue (VAT) and abdominal subcutaneous adipose tissue (SAT) with cardiometabolic risk factors in three ethnic diverse populations of Inuit, Africans and Europeans. DESIGN Cross-sectional pooled study. SETTING Greenland, Kenya and Denmark. METHODS A total of 5113 participants (2933 Inuit, 1397 Africans and 783 Europeans) from three studies in Greenland, Kenya and Denmark were included. Measurements included abdominal fat distribution assessed by ultrasound, oral glucose tolerance test, hepatic insulin resistance, blood pressure and lipids. The associations were analysed using multiple linear regressions. RESULTS Across ethnic group and gender, an increase in VAT of 1 SD was associated with higher levels of hepatic insulin resistance (ranging from 14% to 28%), triglycerides (8% to 16%) and lower high-density lipoprotein cholesterol (HDL-C, -1.0 to -0.05 mmol/L) independent of body mass index. VAT showed positive associations with most of the other cardiometabolic risk factors in Inuit and Europeans, but not in Africans. In contrast, SAT was mainly associated with the outcomes in Inuit and Africans. Of notice was that higher SAT was associated with higher HDL-C in African men (0.11 mmol/L, 95% CI: 0.03 to 0.18) and with lower HDL-C in Inuit (-0.07 mmol/L, 95% CI: -0.12 to -0.02), but not in European men (-0.02 mmol/L, 95% CI: -0.09 to 0.05). Generally weaker associations were observed for women. Furthermore, the absolute levels of several of the cardiometabolic outcomes differed between the ethnic groups. CONCLUSIONS VAT and SAT were associated with several of the cardiometabolic risk factors beyond overall adiposity. Some of these associations were specific to ethnicity, suggesting that ethnicity plays a role in the pathway from abdominal fat to selected cardiometabolic risk factors.
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Affiliation(s)
- Pernille Falberg Rønn
- Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark
- Department of Public Health, Centre for Arctic Health, Aarhus University, Aarhus, Denmark
| | | | - Torsten Lauritzen
- Department of Public Health, General Practice, Aarhus University, Aarhus, Denmark
| | - Dirk Lund Christensen
- Department of Public Health, Global Health Section, University of Copenhagen, Copenhagen, Denmark
| | - Mette Aadahl
- Center for Clinical Research and Prevention, Frederiksberg and Bispebjerg Hospital, Frederiksberg, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Bendix Carstensen
- Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Niels Grarup
- Novo Nordisk Foundation, Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Kobenhavn, Denmark
| | - Marit Eika Jørgensen
- Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
- Greenland University, Nuuk, Greenland
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8
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Estimating narrow-sense heritability using family data from admixed populations. Heredity (Edinb) 2020; 124:751-762. [PMID: 32273574 DOI: 10.1038/s41437-020-0311-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 03/17/2020] [Accepted: 03/17/2020] [Indexed: 01/05/2023] Open
Abstract
Estimating total narrow-sense heritability in admixed populations remains an open question. In this work, we used extensive simulations to evaluate existing linear mixed-model frameworks for estimating total narrow-sense heritability in two population-based cohorts from Greenland, and compared the results with data from unadmixed individuals from Denmark. When our analysis focused on Greenlandic sib pairs, and under the assumption that shared environment among siblings has a negligible effect, the model with two relationship matrices, one capturing identity by descent and one capturing identity by state, returned heritability estimates close to the true simulated value, while using each of the two matrices alone led to downward biases. When phenotypes correlated with ancestry, heritability estimates were inflated. Based on these observations, we propose a PCA-based adjustment that recovers the true simulated heritability. We use this knowledge to estimate the heritability of ten quantitative traits from the two Greenlandic cohorts, and report differences such as lower heritability for height in Greenlanders compared with Europeans. In conclusion, narrow-sense heritability in admixed populations is best estimated when using a mixture of genetic relationship matrices on individuals with at least one first-degree relative included in the sample.
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9
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The derived allele of a novel intergenic variant at chromosome 11 associates with lower body mass index and a favorable metabolic phenotype in Greenlanders. PLoS Genet 2020; 16:e1008544. [PMID: 31978080 PMCID: PMC7001991 DOI: 10.1371/journal.pgen.1008544] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 02/05/2020] [Accepted: 11/27/2019] [Indexed: 11/19/2022] Open
Abstract
The genetic architecture of the small and isolated Greenlandic population is advantageous for identification of novel genetic variants associated with cardio-metabolic traits. We aimed to identify genetic loci associated with body mass index (BMI), to expand the knowledge of the genetic and biological mechanisms underlying obesity. Stage 1 BMI-association analyses were performed in 4,626 Greenlanders. Stage 2 replication and meta-analysis were performed in additional cohorts comprising 1,058 Yup'ik Alaska Native people, and 1,529 Greenlanders. Obesity-related traits were assessed in the stage 1 study population. We identified a common variant on chromosome 11, rs4936356, where the derived G-allele had a frequency of 24% in the stage 1 study population. The derived allele was genome-wide significantly associated with lower BMI (beta (SE), -0.14 SD (0.03), p = 3.2x10-8), corresponding to 0.64 kg/m2 lower BMI per G allele in the stage 1 study population. We observed a similar effect in the Yup'ik cohort (-0.09 SD, p = 0.038), and a non-significant effect in the same direction in the independent Greenlandic stage 2 cohort (-0.03 SD, p = 0.514). The association remained genome-wide significant in meta-analysis of the Arctic cohorts (-0.10 SD (0.02), p = 4.7x10-8). Moreover, the variant was associated with a leaner body type (weight, -1.68 (0.37) kg; waist circumference, -1.52 (0.33) cm; hip circumference, -0.85 (0.24) cm; lean mass, -0.84 (0.19) kg; fat mass and percent, -1.66 (0.33) kg and -1.39 (0.27) %; visceral adipose tissue, -0.30 (0.07) cm; subcutaneous adipose tissue, -0.16 (0.05) cm, all p<0.0002), lower insulin resistance (HOMA-IR, -0.12 (0.04), p = 0.00021), and favorable lipid levels (triglyceride, -0.05 (0.02) mmol/l, p = 0.025; HDL-cholesterol, 0.04 (0.01) mmol/l, p = 0.0015). In conclusion, we identified a novel variant, where the derived G-allele possibly associated with lower BMI in Arctic populations, and as a consequence also leaner body type, lower insulin resistance, and a favorable lipid profile.
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Naseribafrouei A, Eliassen BM, Melhus M, Svartberg J, Broderstad AR. Estimated 8-year cumulative incidence of diabetes mellitus among Sami and non-Sami inhabitants of Northern Norway - The SAMINOR Study. BMC Endocr Disord 2019; 19:66. [PMID: 31234837 PMCID: PMC6591838 DOI: 10.1186/s12902-019-0399-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 06/19/2019] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The aim of the study was to estimate and compare the 8-year cumulative incidence of diabetes mellitus (DM) among Sami and non-Sami inhabitants of rural districts in Northern Norway. METHODS Longitudinal study based on linkage of two cross-sectional surveys, the SAMINOR 1 Survey (2003-2004) and the SAMINOR 2 Clinical Survey (2012-2014). Ten municipalities in rural Northern Norway were included in the study. DM-free participants aged 30 and 36-71 years in SAMINOR 1 were followed from 2 years after SAMINOR 1 to attendance in SAMINOR 2. The average follow-up time was 8.1 years. Of 5875 subjects who had participated in SAMINOR 1 and could potentially be followed to SAMINOR 2, 3303 were included in the final analysis. Self-reported DM and/or HbA1c ≥ 6.5% were used to identify incident cases of DM. RESULTS At baseline, body mass index (BMI) and waist-to-height ratio (WHtR) were higher among Sami than among their non-Sami counterparts. After 8 years of follow-up, 201 incident cases of DM were identified (6.1% both Sami and non-Sami subjects). No statistically significant difference was observed in the cumulative incidence of DM between the Sami and non-Sami. CONCLUSIONS No statistically significant difference in the 8-year cumulative incidence of DM among Sami and non-Sami was observed, although Sami men and women had higher baseline BMI and WHtR.
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Affiliation(s)
- Ali Naseribafrouei
- Centre for Sami Health Research, Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Box 6050 Langnes, N-9037 Tromsø, Norway
| | | | - Marita Melhus
- Centre for Sami Health Research, Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Box 6050 Langnes, N-9037 Tromsø, Norway
| | - Johan Svartberg
- Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
- Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ann Ragnhild Broderstad
- Centre for Sami Health Research, Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Box 6050 Langnes, N-9037 Tromsø, Norway
- Department of Medicine, University Hospital of North Norway, Harstad, Norway
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Veyhe AS, Andreassen J, Halling J, Grandjean P, Skaalum Petersen M, Weihe P. Prevalence of prediabetes and type 2 diabetes in two non-random populations aged 44-77 years in the Faroe Islands. J Clin Transl Endocrinol 2019; 16:100187. [PMID: 31032180 PMCID: PMC6477859 DOI: 10.1016/j.jcte.2019.100187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 03/15/2019] [Accepted: 03/18/2019] [Indexed: 11/20/2022] Open
Abstract
AIMS The prevalence of type 2 diabetes is increasing worldwide but little known about the status in the Faroe Islands. The aim was therefore to determine the prevalence of type 2 diabetes mellitus and prediabetes in two non-random populations aged 44-77 years. METHODS This cross-sectional survey was conducted between 2011 and 2012 and included two sub-populations, namely 518 Septuagenarians aged 74-77 years (84% of the invited) and 401 Mark aged 44-73 years (87% of the invited). Subjects were screened for glycosylated haemoglobin, type A1c, non-fasting random plasma glucose, fasting plasma glucose followed by an oral glucose tolerance test. The screening was based on a diagnostic algorithm that included screening, diagnostic and confirmatory steps. RESULTS Each group was analysed separately. In the Septuagenarian group 20.4% had type 2 diabetes, with 5.2% being newly detected and a total of 59% had prediabetes. In the Mark group 4.1% had diabetes, with 2.1% being newly detected and 22.3% had prediabetes. Diabetes increased with age and was significantly more prevalent among men. Women had lower mean fasting plasma glucose concentrations and men had lower values for 2-hours plasma glucose. Significant predictors associated with diabetes mellitus included obesity (BMI ≥ 30, abnormal waist/hip ratio and vegetable consumption. CONCLUSIONS Among the Faroese populations studied, the prevalence of type 2 diabetes increased with age and was more prevalent among men. The detected prevalence was comparable to other Nordic countries for all age-groups.
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Key Words
- 2hPG, 2-hour plasma glucose
- BMI, body mass index
- CDC, Centers for Disease Control and Prevention
- Diagnostic criteria
- FPG, fasting plasma glucose
- Faroe Islands
- HbA1c, glycosylated heamoglobin type A1c
- IFG, impaired fasting glycaemia
- IGT, impaired glucose tolerance
- Impaired glucose regulation
- K-T2D, Previously Known Type 2 Diabetes
- M, Mark
- N-T2D, newly diagnosed diabetes
- NGT, normal glucose tolerance
- OCP, organochlorine pollutant
- OGTT, oral glucose tolerance test
- Prediabetes
- Prevalence
- RPG, random plasma glucose
- S, Septuagenarians
- SD, standard deviation
- T2D, type 2 diabetes
- Type 2 diabetes mellitus
- WHO, World Health Organization
- WHR, waist/hip ratio
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Affiliation(s)
- Anna Sofía Veyhe
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, Faroe Islands
- Center of Health Sciences, Faculty of Health Science and Nursing, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - Jens Andreassen
- National Hospital of the Faroe Islands, Tórshavn, Faroe Islands
| | - Jónrit Halling
- Department of Science and Technology, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - Philippe Grandjean
- Institute of Public Health, University of Southern Denmark, Odense, Denmark
- Department of Environmental Health, Harvard School of Public Health, Boston, MA, United States
| | - Maria Skaalum Petersen
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, Faroe Islands
- Center of Health Sciences, Faculty of Health Science and Nursing, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - Pál Weihe
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, Faroe Islands
- Center of Health Sciences, Faculty of Health Science and Nursing, University of the Faroe Islands, Tórshavn, Faroe Islands
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Bank-Nielsen PI, Long M, Bonefeld-Jørgensen EC. Pregnant Inuit Women's Exposure to Metals and Association with Fetal Growth Outcomes: ACCEPT 2010⁻2015. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1171. [PMID: 30939809 PMCID: PMC6479494 DOI: 10.3390/ijerph16071171] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 03/26/2019] [Accepted: 03/27/2019] [Indexed: 12/23/2022]
Abstract
Environmental contaminants such as heavy metals are transported to the Arctic regions via atmospheric and ocean currents and enter the Arctic food web. Exposure is an important risk factor for health and can lead to increased risk of a variety of diseases. This study investigated the association between pregnant women's levels of heavy and essential metals and the birth outcomes of the newborn child. This cross-sectional study is part of the ACCEPT birth cohort (Adaption to Climate Change, Environmental Pollution, and dietary Transition) and included 509 pregnant Inuit women ≥18 years of age. Data were collected in five Greenlandic regions during 2010⁻2015. Population characteristics and birth outcomes were obtained from medical records and midwives, respectively, and blood samples were analyzed for 13 metals. Statistical analysis included one-way ANOVA, Spearman's rho, and multiple linear and logistic regression analyses. The proportion of current smokers was 35.8%. The levels of cadmium, chromium, and nickel were higher compared to reported normal ranges. Significant regional differences were observed for several metals, smoking, and parity. Cadmium and copper were significantly inversely related to birth outcomes. Heavy metals in maternal blood can adversely influence fetal development and growth in a dose⁻response relationship. Diet and lifestyle factors are important sources of toxic heavy metals and deviant levels of essential metals. The high frequency of smokers in early pregnancy is of concern, and prenatal exposure to heavy metals and other environmental contaminants in the Greenlandic Inuit needs further research.
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Affiliation(s)
- Per I. Bank-Nielsen
- Centre for Arctic Health and Molecular Epidemiology, Department of Public Health, Aarhus University, 8000 Aarhus C, Denmark; (P.I.B.-N.); (M.L.)
| | - Manhai Long
- Centre for Arctic Health and Molecular Epidemiology, Department of Public Health, Aarhus University, 8000 Aarhus C, Denmark; (P.I.B.-N.); (M.L.)
| | - Eva C. Bonefeld-Jørgensen
- Centre for Arctic Health and Molecular Epidemiology, Department of Public Health, Aarhus University, 8000 Aarhus C, Denmark; (P.I.B.-N.); (M.L.)
- Greenland Center for Health Research, University of Greenland, 3900 Nuuk, Greenland
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Kwon S, Han AL. The Correlation between the Ratio of Visceral Fat Area to Subcutaneous Fat Area on Computed Tomography and Lipid Accumulation Product as Indexes of Cardiovascular Risk. J Obes Metab Syndr 2019; 28:186-193. [PMID: 31583383 PMCID: PMC6774443 DOI: 10.7570/jomes.2019.28.3.186] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 04/26/2019] [Accepted: 09/09/2019] [Indexed: 01/22/2023] Open
Abstract
Background Visceral obesity and cardiovascular disease are closely related. Research on relevant indexes of cardiovascular disease is particularly important. One of these indexes is lipid accumulation product (LAP). However, the relationship between LAP and the ratio of visceral fat area to subcutaneous fat area (V/S ratio) remains unclear. Methods Individuals who visited the university hospital health promotion center and underwent abdominal computed tomography (CT) were included in the study. We analyzed the V/S ratio obtained using CT with cardiovascular factors and indexes. Standardized coefficients were used to obtain uniform units of all independent variables, and the relationship between LAP and V/S ratio was determined using multiple logistic regression analysis. Results A positive correlation between the V/S ratio and LAP was observed even after adjustment for age, smoking history, alcohol drinking history, and exercise (P<0.001). The highest quartile of LAP was independently associated with abdominal obesity (odds ratio [OR], 1.160; 95% confidence interval [CI], 1.093-1.232) and visceral fat ≥100 cm2 (OR, 1.018; 95% CI, 1.010-1.026), but not with hypertension or diabetes. Conclusion LAP is closely related to the V/S ratio and can be used to predict the condition of visceral fat tissue.
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Affiliation(s)
- SoHee Kwon
- Professional Graduate School of Oriental Medicine, Wonkwang University, Iksan, Korea
| | - A Lum Han
- Department of Family Medicine, Wonkwang University Hospital, Iksan, Korea
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Skotte L, Jørsboe E, Korneliussen TS, Moltke I, Albrechtsen A. Ancestry‐specific association mapping in admixed populations. Genet Epidemiol 2019; 43:506-521. [DOI: 10.1002/gepi.22200] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 01/10/2019] [Accepted: 02/19/2019] [Indexed: 12/21/2022]
Affiliation(s)
- Line Skotte
- Department of Epidemiology ResearchStatens Serum InstituteCopenhagen Denmark
| | - Emil Jørsboe
- Department of Biology, The Bioinformatics CentreUniversity of CopenhagenCopenhagen Denmark
| | - Thorfinn S. Korneliussen
- Centre for GeoGenetics, Natural History Museum of DenmarkUniversity of CopenhagenCopenhagen Denmark
| | - Ida Moltke
- Department of Biology, The Bioinformatics CentreUniversity of CopenhagenCopenhagen Denmark
| | - Anders Albrechtsen
- Department of Biology, The Bioinformatics CentreUniversity of CopenhagenCopenhagen Denmark
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Andersen MK, Hansen T. Genetics of metabolic traits in Greenlanders: lessons from an isolated population. J Intern Med 2018; 284:464-477. [PMID: 30101502 DOI: 10.1111/joim.12814] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In this review, we describe the extraordinary population of Greenland, which differs from large outbred populations of Europe and Asia, both in terms of population history and living conditions. Many years in isolation, small population size and an extreme environment have shaped the genetic composition of the Greenlandic population. The unique genetic background combined with the transition from a traditional Inuit lifestyle and diet, to a more Westernized lifestyle, has led to an increase in the prevalence of metabolic conditions like obesity, where the prevalence from 1993 to 2010 has increased from 16.4% to 19.4% among men, and from 13.0% to 25.4% among women, type 2 diabetes and cardiovascular diseases. The genetic susceptibility to metabolic conditions has been explored in Greenlanders, as well as other isolated populations, taking advantage of population-genetic properties of these populations. During the last 10 years, these studies have provided examples of loci showing evidence of positive selection, due to adaption to Arctic climate and Inuit diet, including TBC1D4 and FADS/CPT1A, and have facilitated the discovery of several loci associated with metabolic phenotypes. Most recently, the c.2433-1G>A loss-of-function variant in ADCY3 associated with obesity and type 2 diabetes was described. This locus has provided novel biological insights, as it has been shown that reduced ADCY3 function causes obesity through disrupted function in primary cilia. Future studies of isolated populations will likely provide further genetic as well as biological insights.
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Affiliation(s)
- M K Andersen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - T Hansen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Hou X, Chen P, Hu G, Wei L, Jiao L, Wang H, Liang Y, Bao Y, Jia W. Abdominal Subcutaneous Fat: A Favorable or Nonfunctional Fat Depot for Glucose Metabolism in Chinese Adults? Obesity (Silver Spring) 2018; 26:1078-1087. [PMID: 29719132 PMCID: PMC9208318 DOI: 10.1002/oby.22183] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 02/26/2018] [Accepted: 03/11/2018] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The objective of this study was to assess the associations of abdominal visceral and subcutaneous adipose tissue with blood glucose and beta-cell function. METHODS In this study, 11,223 participants without known diabetes were selected for this cross-sectional analysis. Visceral and subcutaneous fat area (VFA and SFA) were measured by magnetic resonance imaging. An oral glucose tolerance test was conducted, and beta-cell function was evaluated. RESULTS Men had significantly larger VFA but smaller SFA than women. After controlling for age, linear regression showed that SFA was adversely associated with 0-minute, 30-minute, and 2-hour plasma glucose (PG) and early-, first- and second-phase disposition indices (DIs). After further adjustment for BMI and VFA, some associations of SFA with PG indices and DIs disappeared, while the other associations became significantly weaker in men (2-hour PG: 0.05 and DI2nd : -0.05) or were reversed in women (0-minute, 30-minute, and 2-hour PG: from -0.07 to -0.04; DI1st : 0.04, P < 0.05). After adjustment for age, BMI, and SFA, VFA was significantly and adversely associated with PG indices and DIs, with the largest standardized regression coefficients with 2-hour PG. CONCLUSIONS The associations of SFA with blood glucose and beta-cell function were clinically insignificant in Chinese adults. VFA had the strongest association with 2-hour PG.
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Affiliation(s)
- Xuhong Hou
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- Shanghai Diabetes Institute, Shanghai, China
- Shanghai Clinical Center for Diabetes, Shanghai, China
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Peizhu Chen
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- Shanghai Diabetes Institute, Shanghai, China
- Shanghai Clinical Center for Diabetes, Shanghai, China
- Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Gang Hu
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Li Wei
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- Shanghai Diabetes Institute, Shanghai, China
- Shanghai Clinical Center for Diabetes, Shanghai, China
- Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Lei Jiao
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Hongmei Wang
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Yebei Liang
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- Shanghai Diabetes Institute, Shanghai, China
- Shanghai Clinical Center for Diabetes, Shanghai, China
- Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Yuqian Bao
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- Shanghai Diabetes Institute, Shanghai, China
- Shanghai Clinical Center for Diabetes, Shanghai, China
- Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Weiping Jia
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- Shanghai Diabetes Institute, Shanghai, China
- Shanghai Clinical Center for Diabetes, Shanghai, China
- Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
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Veyhe AS, Andreassen J, Halling J, Grandjean P, Petersen MS, Weihe P. Prevalence of type 2 diabetes and prediabetes in the Faroe Islands. Diabetes Res Clin Pract 2018; 140:162-173. [PMID: 29596941 DOI: 10.1016/j.diabres.2018.03.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 02/16/2018] [Accepted: 03/20/2018] [Indexed: 01/02/2023]
Abstract
AIMS To determine the prevalence of type 2 diabetes mellitus and prediabetes among the population aged 40-74 years in the Faroe Islands. METHODS This population-based cross-sectional survey, conducted between 2011 and 2012, invited 2186 randomly selected individuals (corresponding to 11.1% of the entire population aged 40-74 years). Subjects were screened using finger capillary blood for glycosylated hemoglobin, type A1c, non-fasting random plasma glucose, fasting plasma glucose followed by oral glucose tolerance test. The test was based on an algorithm that accounts for screening, diagnostic and confirmatory steps. Anthropometric measures and a questionnaire including medical history, medication, hereditary conditions, and food intake were included. RESULTS The study included 1772 participants. Of the 1772, 169 (9.5%) had type 2 diabetes mellitus (3.0% of which were diagnosed upon study inclusion), thus 31.4% of subjects with diabetes were undiagnosed at the time of examination. A total of 271 (15.3%) had prediabetes. Diabetes was more prevalent among men, significantly from age ≥60 years. Women had lower mean fasting plasma glucose concentrations and men had lower values for 2-h plasma glucose. Predictors associated with diabetes mellitus included obesity (BMI ≥ 30), abnormal waist/hip ratio, history of hypertension or cardiovascular attack and family history of diabetes mellitus and leisure activity. CONCLUSIONS The prevalences of diabetes and prediabetes increased with age and were more frequent among men. The detected prevalence in the Faroe Islands was slightly higher than other Nordic countries.
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Affiliation(s)
- Anna Sofía Veyhe
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, Faroe Islands; Center of Health Science, Faculty of Natural and Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - Jens Andreassen
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, Faroe Islands; National Hospital of the Faroe Islands, Tórshavn, Faroe Islands
| | - Jónrit Halling
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, Faroe Islands; Center of Health Science, Faculty of Natural and Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands; Department of Science and Technology, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - Philippe Grandjean
- Institute of Public Health, University of Southern Denmark, Odense, Denmark; Department of Environmental Health, Harvard School of Public Health, Boston, MA, United States
| | - Maria Skaalum Petersen
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, Faroe Islands; Center of Health Science, Faculty of Natural and Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - Pál Weihe
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, Faroe Islands; Center of Health Science, Faculty of Natural and Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands.
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Appel EVR, Moltke I, Jørgensen ME, Bjerregaard P, Linneberg A, Pedersen O, Albrechtsen A, Hansen T, Grarup N. Genetic determinants of glycated hemoglobin levels in the Greenlandic Inuit population. Eur J Hum Genet 2018; 26:868-875. [PMID: 29483669 PMCID: PMC5974304 DOI: 10.1038/s41431-018-0109-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 01/12/2018] [Accepted: 01/23/2018] [Indexed: 02/06/2023] Open
Abstract
We previously showed that a common genetic variant leads to a remarkably increased risk of type 2 diabetes (T2D) in the small and historically isolated Greenlandic population. Motivated by this, we aimed at discovering novel genetic determinants for glycated hemoglobin (HbA1C) and at estimating the effect of known HbA1C-associated loci in the Greenlandic population. We analyzed genotype data from 4049 Greenlanders generated using the Illumina Cardio-Metabochip. We performed the discovery association analysis by an additive linear mixed model. To estimate the effect of known HbA1C-associated loci, we modeled the effect in the European and Inuit ancestry proportions of the Greenlandic genome (EAPGG and IAPGG, respectively). After correcting for multiple testing, we found no novel significant associations. When we investigated loci known to associate with HbA1C levels, we found that the lead variant in the GCK locus associated significantly with HbA1C levels in the IAPGG ([Formula: see text]). Furthermore, for 10 of 15 known HbA1C loci, the effects in IAPGG were similar to the previously reported effects. Interestingly, the ANK1 locus showed a statistically significant ancestral population differential effect, with opposing directions of effect in the two ancestral populations. In conclusion, we found only 1 of the 15 known HbA1C loci to be significantly associated with HbA1C levels in the IAPGG and that two-thirds of the loci showed similar effects in Inuit as previously found in European and East Asian populations. Our results shed light on the genetic effects across ethnicities.
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Affiliation(s)
- Emil V R Appel
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section for Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, 2200, Copenhagen, Denmark.
| | - Ida Moltke
- The Bioinformatics Centre, Department of Biology, University of Copenhagen, 2200, Copenhagen, Denmark
| | | | - Peter Bjerregaard
- National Institute of Public Health, University of Southern Denmark, 1353, Copenhagen, Denmark
- Greenland Centre for Health Research, University of Greenland, Nuuk, Greenland
| | - Allan Linneberg
- Research Centre for Prevention and Health, Capital Region of Denmark, Copenhagen, Denmark
- Department of Clinical Experimental Research, Rigshospitalet, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Oluf Pedersen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section for Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, 2200, Copenhagen, Denmark
| | - Anders Albrechtsen
- The Bioinformatics Centre, Department of Biology, University of Copenhagen, 2200, Copenhagen, Denmark
| | - Torben Hansen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section for Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, 2200, Copenhagen, Denmark
| | - Niels Grarup
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section for Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, 2200, Copenhagen, Denmark
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Jena D, Choudhury AK, Mangaraj S, Singh M, Mohanty BK, Baliarsinha AK. Study of Visceral and Subcutaneous Abdominal Fat Thickness and Its Correlation with Cardiometabolic Risk Factors and Hormonal Parameters in Polycystic Ovary Syndrome. Indian J Endocrinol Metab 2018; 22:321-327. [PMID: 30090722 PMCID: PMC6063187 DOI: 10.4103/ijem.ijem_646_17] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
AIM OF THE STUDY This study aimed to compare the different adiposity parameters, namely visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) between patients with polycystic ovary syndrome (PCOS) and controls. In addition, it aimed to correlate these adiposity indices with hormonal parameters as well as cardiovascular (CV) risk factors in patients with PCOS. MATERIALS AND METHODS Newly diagnosed PCOS patients of reproductive age group according to Rotterdam criteria were included. Age- and body mass index (BMI)-matched healthy females with normal menstrual cycles were taken as controls. All the study participants underwent detailed clinical, biochemical, and hormonal evaluation. Transabdominal ultrasound (US) was performed for detailed ovary imaging and assessment of adiposity (SAT and VAT) parameters. RESULTS A total of 58 PCOS patients and 40 age- and BMI-matched controls were included. PCOS patients had significantly higher levels of androgens (P < 0.001), elevated highly sensitive C-reactive protein (P = 0.007), and higher degree of insulin resistance (P < 0.001) than controls. PCOS patients had a mean SAT of 2.37 ± 0.7 cm and mean VAT of 8.65 ± 1.78 cm. These parameters were significantly higher than controls who had a mean SAT of 2.01 ± 0.7 cm (P = 0.014) and mean VAT of 7.4 ± 1.89 cm (P = 0.003), despite both groups having similar BMI. Among PCOS cohort, VAT correlated positively with total testosterone (r = 0.295, P = 0.025) and negatively with dehydroepiandrosterone sulfate (r = -0.210, P = 0.114). However, no significant correlation was observed between SAT and androgens in PCOS group. CONCLUSION PCOS patients, whether obese or nonobese, had elevated visceral adiposity than controls. VAT correlated positively with adverse CV risk factors and testosterone in PCOS patients. Hence, a simple and inexpensive ultrasonography screening of visceral fat may identify women who have adverse metabolic profile and enhanced CV risk.
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Affiliation(s)
- Debarchan Jena
- Department of Endocrinology, S.C.B Medical College, Cuttack, India
| | | | | | - Mamata Singh
- Department of Radiology, S.C.B Medical College, Cuttack, India
| | - Binoy Kumar Mohanty
- Department of Endocrinology, M.K.C.G Medical College, Berhampur, Odisha, India
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20
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Bjerregaard P, Larsen CVL. Three lifestyle-related issues of major significance for public health among the Inuit in contemporary Greenland: a review of adverse childhood conditions, obesity, and smoking in a period of social transition. Public Health Rev 2018; 39:5. [PMID: 29692943 PMCID: PMC5901873 DOI: 10.1186/s40985-018-0085-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 01/25/2018] [Indexed: 01/17/2023] Open
Abstract
Greenland is a country in transition from a colonial past with subsistence hunting and fishing to an urban Nordic welfare state. Epidemiological transition from infectious to chronic diseases has been evident since the 1950s. Ninety percent of the population is Inuit. We studied three public health issues based on published literature, namely adverse childhood experiences, addictive behavior, and suicide; diet and obesity; and smoking. Alcohol consumption was high in the 1970s and 1980s with accompanying family and social disruption. This is still a cause of poor mental health and suicides in the generations most affected. The diet is changing from a traditional diet of fish and marine mammals to imported food including food items rich in sugar and fat from domestic animals, and the level of physical activity is decreasing with an ensuing epidemic rise in obesity. The prevalence of smoking is high at around 60% among both men and women and is only slowly decreasing. Smoking shows large social variation, and tobacco-related diseases are widespread. The diseases and conditions outlined above all contribute towards a low life expectancy at birth—69 years for men and 74 years for women in 2011–2015—compared with 78 and 84 years for men and women, respectively, on average in the European countries. The translation of government public health programs into local activities needs strengthening, and it must be realized that the improvement of public health is a long-term process.
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Affiliation(s)
- Peter Bjerregaard
- 1National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.,2Greenland Centre for Health Research, University of Greenland, Nuuk, Greenland
| | - Christina V L Larsen
- 1National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.,2Greenland Centre for Health Research, University of Greenland, Nuuk, Greenland
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21
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Sam S. Differential effect of subcutaneous abdominal and visceral adipose tissue on cardiometabolic risk. Horm Mol Biol Clin Investig 2018. [PMID: 29522417 DOI: 10.1515/hmbci-2018-0014] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Metabolic and cardiovascular diseases are increasing worldwide due to the rise in the obesity epidemic. The metabolic consequences of obesity vary by distribution of adipose tissue. Visceral and ectopic adipose accumulation are associated with adverse cardiometabolic consequences, while gluteal-femoral adipose accumulation are negatively associated with these adverse complications and subcutaneous abdominal adipose accumulation is more neutral in its associations. Gender, race and ethnic differences in adipose tissue distribution have been described and could account for the observed differences in risk for cardiometabolic disease. The mechanisms behind the differential impact of adipose tissue on cardiometabolic risk have started to be unraveled and include differences in adipocyte biology, inflammatory profile, connection to systemic circulation and most importantly the inability of the subcutaneous adipose tissue to expand in response to positive energy balance.
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Affiliation(s)
- Susan Sam
- University of Chicago Pritzker School of Medicine, Department of Medicine, Section of Endocrinology, 5841 S. Maryland Avenue, Chicago, IL 60637, USA, Phone: +773-702 5641, Fax: +773-702 7686
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22
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Dahl-Petersen IK, Brage S, Bjerregaard P, Tolstrup JS, Jørgensen ME. Physical Activity and Abdominal Fat Distribution in Greenland. Med Sci Sports Exerc 2018; 49:2064-2070. [PMID: 28574874 DOI: 10.1249/mss.0000000000001337] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE We examined how total volume of physical activity and reallocation of time spent at various objectively measured intensities of physical activity (PA) were associated with overall and abdominal fat distribution in adult Inuit in Greenland. METHODS Data were collected as part of a countrywide cross-sectional health survey in Greenland. A combined accelerometer and HR monitor measured total physical activity energy expenditure (PAEE) and intensities of PA (N = 1536). Visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were assessed by ultrasonography. Isotemporal substitution modeling was used to analyze the association between substitution of 1 h of sedentary time to light- or moderate-intensity PA and 1 h light-intensity PA to moderate- or vigorous-intensity PA in relation to body mass index (BMI), waist circumference (WC), SAT, and VAT. RESULTS A negative linear association was found for total PAEE and BMI, WC, VAT, and SAT. Exchanging 1 h of sedentary time with light-intensity PA was associated with lower WC (-0.6 cm, P = 0.01), SAT (-0.08 cm, P < 0.001), and VAT (-0.04 cm, P = 0.359). Exchanging light-intensity PA with vigorous-intensity PA resulted in -6.1-cm lower WC (P < 0.001), -0.7-cm lower VAT (P = 0.018) and -0.7-cm lower SAT (P < 0.001). When further adjusting for BMI, the associations were attenuated; however, most of them remained significant, and the directions were mostly unchanged. All 1-, 5-, and 10-min bouts of MVPA were negatively associated with overall and abdominal fat distribution. CONCLUSION Physical activity energy expenditure is associated with lower BMI, WC, and abdominal fat among Greenland Inuit. The importance of promoting an upward shift of the whole PA intensity distribution and to spur even short bouts of MVPA to limit excessive accumulation of SAT and VAT is highlighted.
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Affiliation(s)
- Inger Katrine Dahl-Petersen
- 1National Institute of Public Health, University of Southern Denmark, Copenhagen, DENMARK; 2MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge, UNITED KINGDOM; 3Greenland Centre for Health Research, University of Greenland, Nuuk, GREENLAND; and 4Steno Diabetes Center Copenhagen, Gentofte, DENMARK
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23
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Grarup N, Moltke I, Andersen MK, Dalby M, Vitting-Seerup K, Kern T, Mahendran Y, Jørsboe E, Larsen CVL, Dahl-Petersen IK, Gilly A, Suveges D, Dedoussis G, Zeggini E, Pedersen O, Andersson R, Bjerregaard P, Jørgensen ME, Albrechtsen A, Hansen T. Loss-of-function variants in ADCY3 increase risk of obesity and type 2 diabetes. Nat Genet 2018; 50:172-174. [PMID: 29311636 PMCID: PMC5828106 DOI: 10.1038/s41588-017-0022-7] [Citation(s) in RCA: 106] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 11/29/2017] [Indexed: 01/08/2023]
Abstract
We have identified a variant in ADCY3 (encoding adenylate cyclase 3) associated with markedly increased risk of obesity and type 2 diabetes in the Greenlandic population. The variant disrupts a splice acceptor site, and carriers have decreased ADCY3 RNA expression. Additionally, we observe an enrichment of rare ADCY3 loss-of-function variants among individuals with type 2 diabetes in trans-ancestry cohorts. These findings provide new information on disease etiology relevant for future treatment strategies.
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Affiliation(s)
- Niels Grarup
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ida Moltke
- Bioinformatics Centre, Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Mette K Andersen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Maria Dalby
- Bioinformatics Centre, Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Kristoffer Vitting-Seerup
- Bioinformatics Centre, Department of Biology, University of Copenhagen, Copenhagen, Denmark
- Biotech Research and Innovation Centre (BRIC), University of Copenhagen, Copenhagen, Denmark
| | - Timo Kern
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Yuvaraj Mahendran
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Emil Jørsboe
- Bioinformatics Centre, Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Christina V L Larsen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
- Greenland Centre for Health Research, University of Greenland, Nuuk, Greenland
| | - Inger K Dahl-Petersen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Arthur Gilly
- Department of Human Genetics, Wellcome Trust Sanger Institute, Hinxton, UK
| | - Daniel Suveges
- Department of Human Genetics, Wellcome Trust Sanger Institute, Hinxton, UK
| | - George Dedoussis
- Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - Eleftheria Zeggini
- Department of Human Genetics, Wellcome Trust Sanger Institute, Hinxton, UK
| | - Oluf Pedersen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Robin Andersson
- Bioinformatics Centre, Department of Biology, University of Copenhagen, 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 E Jørgensen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
- Greenland Centre for Health Research, University of Greenland, Nuuk, Greenland.
- Steno Diabetes Center Copenhagen, Gentofte, Denmark.
| | - Anders Albrechtsen
- Bioinformatics Centre, Department of Biology, University of Copenhagen, Copenhagen, Denmark.
| | - Torben Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
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24
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Sato F, Maeda N, Yamada T, Namazui H, Fukuda S, Natsukawa T, Nagao H, Murai J, Masuda S, Tanaka Y, Obata Y, Fujishima Y, Nishizawa H, Funahashi T, Shimomura I. Association of Epicardial, Visceral, and Subcutaneous Fat With Cardiometabolic Diseases. Circ J 2017; 82:502-508. [PMID: 28954947 DOI: 10.1253/circj.cj-17-0820] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Excess of visceral fat is a central factor in the pathogenesis of metabolic syndrome (MetS) and atherosclerosis. However, little is known about how much epicardial fat affects cardiometabolic disorders in comparison with visceral or subcutaneous fat.Methods and Results:Participants suspected as having angina pectoris underwent cardiac computed tomography (CT) imaging. Of them, 374 subjects were analyzed the association of clinical characteristics and CT-based fat distribution measured as epicardial fat volume (EFV), visceral fat area (VFA), and subcutaneous fat area (SFA). EFV was highly associated with VFA (R=0.58). Serum adiponectin was significantly decreased in high VFA subjects (VFA ≥100 cm2) and was also reduced in the high EFV group (EFV ≥80 cm3). Among the low VFA groups, the numbers of subjects with diabetes and coronary atherosclerosis were increased in high EFV group. Among the low EFV groups, the numbers of subjects with diabetes, hyperuricemia, and coronary atherosclerosis were increased among the high VFA subjects. In an age-, sex-, and body mass index (BMI)-adjusted model, EFV was associated with dyslipidemia and MetS, and VFA was significantly associated with hypertension, dyslipidemia, MetS, and coronary atherosclerosis, while SFA was not related with coronary risks and atherosclerosis. CONCLUSIONS Epicardial fat accumulation may be a risk for coronary atherosclerosis in subjects without visceral fat accumulation. Visceral fat is the strongest risk for cardiometabolic diseases among the 3 types of fat depot.
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Affiliation(s)
- Fumi Sato
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University.,Department of Cardiology, KKR Otemae Hospital
| | - Norikazu Maeda
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University.,Department of Metabolism and Atherosclerosis, Graduate School of Medicine, Osaka University
| | | | | | - Shiro Fukuda
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University
| | - Tomoaki Natsukawa
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University.,Senri Critical Care Medical Center, Osaka Saiseikai Senri Hospital
| | - Hirofumi Nagao
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University
| | - Jun Murai
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University.,Department of Internal Medicine, Kawasaki Hospital
| | - Shigeki Masuda
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University
| | - Yoshimitsu Tanaka
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University
| | - Yoshinari Obata
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University
| | - Yuya Fujishima
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University
| | - Hitoshi Nishizawa
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University
| | - Tohru Funahashi
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University.,Department of Metabolism and Atherosclerosis, Graduate School of Medicine, Osaka University
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University
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25
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Rønn PF, Andersen GS, Lauritzen T, Christensen DL, Aadahl M, Carstensen B, Jørgensen ME. Ethnic differences in anthropometric measures and abdominal fat distribution: a cross-sectional pooled study in Inuit, Africans and Europeans. J Epidemiol Community Health 2017; 71:536-543. [DOI: 10.1136/jech-2016-207813] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 12/13/2016] [Accepted: 12/16/2016] [Indexed: 01/27/2023]
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26
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Viskum ES, Pedersen ML. Prevalence of diagnosed diabetes and quality of care among Greenlanders and non-Greenlanders in Greenland. Diabetes Res Clin Pract 2016; 121:91-98. [PMID: 27690318 DOI: 10.1016/j.diabres.2016.09.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 06/21/2016] [Accepted: 09/05/2016] [Indexed: 10/21/2022]
Abstract
AIMS To estimate the actual prevalence of diagnosed diabetes in Greenland as at 2014, and to evaluate the quality of diabetes care among Greenlanders and non-Greenlanders in Greenland, six years after a national diabetes program was initiated. METHODS The study was designed as an observational cross-sectional study based on review of data obtained from the electronic medical record (EMR) in Greenland. All permanent residents of Greenland who as at October 2014 were registered with the diagnosis diabetes in the EMR (n=1071) were included in the study. The prevalence was calculated using the population in Greenland as at first of June 2014 as background population. Quality of diabetes care was determined using indicators proposed by the Organization for Economic Cooperation and Development. RESULTS The prevalence among Greenlanders aged 20-79years was 2.36% (95% CI 2.19-2.52) and significantly lower than the prevalence among non-Greenlanders in the same age group, which was 3.69% (95% CI 2.18-4.20). More Greenlanders than non-Greenlanders had glycosylated haemoglobin below 7.0% (53mmol/mol), blood pressure below 140/90mmHg and their blood pressure measured within the last year. No other differences in quality of diabetes care were observed between the groups. CONCLUSIONS A higher prevalence of diagnosed diabetes was observed among non-Greenlanders compared to Greenlanders, while no major differences were observed in quality of care between the two groups. The overall prevalence of diagnosed diabetes has increased compared to earlier studies. Continued monitoring of prevalence and quality of care is recommended.
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Affiliation(s)
- Elizabeth Sejr Viskum
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Queen Ingrid Primary Health Care Center, Nuuk, Greenland.
| | - Michael Lynge Pedersen
- Queen Ingrid Primary Health Care Center, Nuuk, Greenland; Greenland Center of Health Research Greenland, Institute of Nursing and Health Science, University of Greenland, Nuuk, Greenland.
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27
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Andersen MK, Pedersen CET, Moltke I, Hansen T, Albrechtsen A, Grarup N. Genetics of Type 2 Diabetes: the Power of Isolated Populations. Curr Diab Rep 2016; 16:65. [PMID: 27189761 DOI: 10.1007/s11892-016-0757-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Type 2 diabetes (T2D) affects millions of people worldwide. Improving the understanding of the underlying mechanisms and ultimately improving the treatment strategies are, thus, of great interest. To achieve this, identification of genetic variation predisposing to T2D is important. A large number of variants have been identified in large outbred populations, mainly from Europe and Asia. However, to elucidate additional variation, isolated populations have a number of advantageous properties, including increased amounts of linkage disequilibrium, and increased probability for presence of high frequency disease-associated variants due to genetic drift. Collectively, this increases the statistical power to detect association signals in isolated populations compared to large outbred populations. In this review, we elaborate on why isolated populations are a powerful resource for the identification of complex disease variants and describe their contributions to the understanding of the genetics of T2D.
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Affiliation(s)
- Mette Korre Andersen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 1, 2100, Copenhagen, Denmark
| | - Casper-Emil Tingskov Pedersen
- The Bioinformatics Centre, Department of Biology, University of Copenhagen, Ole Maaløes Vej 5, 2200, Copenhagen, Denmark
| | - Ida Moltke
- The Bioinformatics Centre, Department of Biology, University of Copenhagen, Ole Maaløes Vej 5, 2200, Copenhagen, Denmark
| | - Torben Hansen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 1, 2100, Copenhagen, Denmark
- Faculty of Health Sciences, University of Southern Denmark, J.B. Winsløws Vej 19, 3, 5000, Odense, Denmark
| | - Anders Albrechtsen
- The Bioinformatics Centre, Department of Biology, University of Copenhagen, Ole Maaløes Vej 5, 2200, Copenhagen, Denmark
| | - Niels Grarup
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 1, 2100, Copenhagen, Denmark.
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28
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Zeggini E, Gloyn AL, Hansen T. Insights into metabolic disease from studying genetics in isolated populations: stories from Greece to Greenland. Diabetologia 2016; 59:938-41. [PMID: 26993633 PMCID: PMC4826421 DOI: 10.1007/s00125-016-3926-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 01/25/2016] [Indexed: 12/30/2022]
Abstract
Over the last 10 years substantial progress has been made in our understanding of the genetic basis for type 2 diabetes and related traits. These developments have been facilitated by technological advancements that have allowed comprehensive genome-wide assessments of the impact of common genetic variation on disease risk. Current efforts are now focused on extending this to genetic variants in the rare and low-frequency spectrum by capitalising on next-generation sequencing technologies. This review discusses the important contributions that studies in isolated populations are making to this effort for diabetes and metabolic disease, drawing on specific examples from populations in Greece and Greenland. This review summarises a presentation given at the 'Exciting news in genetics of diabetes' symposium at the 2015 annual meeting of the EASD, with topics presented by Eleftheria Zeggini and Torben Hansen, and an overview by the Session Chair, Anna Gloyn.
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Affiliation(s)
- Eleftheria Zeggini
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, CB10 1HH, UK.
| | - Anna L Gloyn
- Oxford Centre for Diabetes Endocrinology & Metabolism, University of Oxford, Oxford, UK
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
- Oxford NIHR Biomedical Research Centre, Churchill Hospital, Oxford, UK
| | - Torben Hansen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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29
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Grarup N, Moltke I, Albrechtsen A, Hansen T. Diabetes in Population Isolates: Lessons from Greenland. Rev Diabet Stud 2016; 12:320-9. [PMID: 27111118 PMCID: PMC5275757 DOI: 10.1900/rds.2015.12.320] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 09/27/2015] [Accepted: 10/16/2015] [Indexed: 12/19/2022] Open
Abstract
Type 2 diabetes (T2D) is an increasing health problem worldwide with particularly high occurrence in specific subpopulations and ancestry groups. The high prevalence of T2D is caused both by changes in lifestyle and genetic predisposition. A large number of studies have sought to identify the genetic determinants of T2D in large, open populations such as Europeans and Asians. However, studies of T2D in population isolates are gaining attention as they provide several advantages over open populations in genetic disease studies, including increased linkage disequilibrium, homogeneous environmental exposure, and increased allele frequency. We recently performed a study in the small, historically isolated Greenlandic population, in which the prevalence of T2D has increased to more than 10%. In this study, we identified a common nonsense variant in TBC1D4, which has a population-wide impact on glucose-stimulated plasma glucose, serum insulin levels, and T2D. The variant defines a specific subtype of non-autoimmune diabetes characterized by decreased post-prandial glucose uptake and muscular insulin resistance. These and other recent findings in population isolates illustrate the value of performing medical genetic studies in genetically isolated populations. In this review, we describe some of the advantages of performing genetic studies of T2D and related cardio-metabolic traits in a population isolate like the Greenlandic, and we discuss potentials and perspectives for future research into T2D in this population.
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Affiliation(s)
- Niels Grarup
- Section for Metabolic Genetics, The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Ida Moltke
- The Bioinformatics Centre, Department of Biology, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Anders Albrechtsen
- The Bioinformatics Centre, Department of Biology, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Torben Hansen
- Section for Metabolic Genetics, The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
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30
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Fumagalli M, Moltke I, Grarup N, Racimo F, Bjerregaard P, Jorgensen ME, Korneliussen TS, Gerbault P, Skotte L, Linneberg A, Christensen C, Brandslund I, Jorgensen T, Huerta-Sanchez E, Schmidt EB, Pedersen O, Hansen T, Albrechtsen A, Nielsen R. Greenlandic Inuit show genetic signatures of diet and climate adaptation. Science 2015; 349:1343-7. [DOI: 10.1126/science.aab2319] [Citation(s) in RCA: 320] [Impact Index Per Article: 35.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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31
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Scheuer SH, Færch K, Philipsen A, Jørgensen ME, Johansen NB, Carstensen B, Witte DR, Andersen I, Lauritzen T, Andersen GS. Abdominal Fat Distribution and Cardiovascular Risk in Men and Women With Different Levels of Glucose Tolerance. J Clin Endocrinol Metab 2015; 100:3340-7. [PMID: 26120787 DOI: 10.1210/jc.2014-4479] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
CONTEXT Regional fat distribution rather than overall obesity has been recognized as important to understanding the link between obesity and cardiovascular disease. OBJECTIVE We examined the associations of abdominal visceral adipose tissue (VAT) and abdominal subcutaneous adipose tissue (SAT) with cardiovascular risk factors in a Caucasian population of men and women with normal glucose tolerance, prediabetes, or screen-detected diabetes. DESIGN, SETTING, AND PARTICIPANTS The study was based on cross-sectional analysis of data from 1412 adults age 45-80 years. VAT and SAT were assessed by ultrasound. The associations of VAT and SAT with blood pressure and lipids were examined by linear regression analysis adjusted for age, sex, smoking, alcohol, physical activity, glucose tolerance status (GTS), medication use, and body mass index. Effect modification by GTS and sex was examined, and stratified analyses performed. RESULTS Independent of SAT and overall obesity, VAT was associated with higher triglyceride and lower high-density lipoprotein (HDL) cholesterol levels in both men and women and additionally associated with higher total cholesterol in men. SAT was independently associated with higher total cholesterol and low-density lipoprotein cholesterol levels in both sexes, and SAT was additionally associated with higher triglyceride and lower HDL cholesterol levels in women and with higher blood pressure in participants with diabetes. CONCLUSION Both abdominal VAT and SAT are independent of overall obesity associated with cardiovascular risk in a population of men and women at low to high risk of diabetes or with screen-detected diabetes.
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Affiliation(s)
- Stine H Scheuer
- Steno Diabetes Center (S.H.S., K.F., A.P., M.E.J., N.B.J., B.C., G.S.A.), 2820 Gentofte, Denmark; Danish Diabetes Academy (N.B.J., D.R.W.), 5000 Odense, Denmark; Institute of Public Health, Section of General Practice (D.R.W., T.L.), Aarhus University, 8000 Aarhus, Denmark; Section of Social Medicine, Department of Public Health (I.A.), University of Copenhagen, 1123 Copenhagen, Denmark
| | - Kristine Færch
- Steno Diabetes Center (S.H.S., K.F., A.P., M.E.J., N.B.J., B.C., G.S.A.), 2820 Gentofte, Denmark; Danish Diabetes Academy (N.B.J., D.R.W.), 5000 Odense, Denmark; Institute of Public Health, Section of General Practice (D.R.W., T.L.), Aarhus University, 8000 Aarhus, Denmark; Section of Social Medicine, Department of Public Health (I.A.), University of Copenhagen, 1123 Copenhagen, Denmark
| | - Annelotte Philipsen
- Steno Diabetes Center (S.H.S., K.F., A.P., M.E.J., N.B.J., B.C., G.S.A.), 2820 Gentofte, Denmark; Danish Diabetes Academy (N.B.J., D.R.W.), 5000 Odense, Denmark; Institute of Public Health, Section of General Practice (D.R.W., T.L.), Aarhus University, 8000 Aarhus, Denmark; Section of Social Medicine, Department of Public Health (I.A.), University of Copenhagen, 1123 Copenhagen, Denmark
| | - Marit E Jørgensen
- Steno Diabetes Center (S.H.S., K.F., A.P., M.E.J., N.B.J., B.C., G.S.A.), 2820 Gentofte, Denmark; Danish Diabetes Academy (N.B.J., D.R.W.), 5000 Odense, Denmark; Institute of Public Health, Section of General Practice (D.R.W., T.L.), Aarhus University, 8000 Aarhus, Denmark; Section of Social Medicine, Department of Public Health (I.A.), University of Copenhagen, 1123 Copenhagen, Denmark
| | - Nanna B Johansen
- Steno Diabetes Center (S.H.S., K.F., A.P., M.E.J., N.B.J., B.C., G.S.A.), 2820 Gentofte, Denmark; Danish Diabetes Academy (N.B.J., D.R.W.), 5000 Odense, Denmark; Institute of Public Health, Section of General Practice (D.R.W., T.L.), Aarhus University, 8000 Aarhus, Denmark; Section of Social Medicine, Department of Public Health (I.A.), University of Copenhagen, 1123 Copenhagen, Denmark
| | - Bendix Carstensen
- Steno Diabetes Center (S.H.S., K.F., A.P., M.E.J., N.B.J., B.C., G.S.A.), 2820 Gentofte, Denmark; Danish Diabetes Academy (N.B.J., D.R.W.), 5000 Odense, Denmark; Institute of Public Health, Section of General Practice (D.R.W., T.L.), Aarhus University, 8000 Aarhus, Denmark; Section of Social Medicine, Department of Public Health (I.A.), University of Copenhagen, 1123 Copenhagen, Denmark
| | - Daniel R Witte
- Steno Diabetes Center (S.H.S., K.F., A.P., M.E.J., N.B.J., B.C., G.S.A.), 2820 Gentofte, Denmark; Danish Diabetes Academy (N.B.J., D.R.W.), 5000 Odense, Denmark; Institute of Public Health, Section of General Practice (D.R.W., T.L.), Aarhus University, 8000 Aarhus, Denmark; Section of Social Medicine, Department of Public Health (I.A.), University of Copenhagen, 1123 Copenhagen, Denmark
| | - Ingelise Andersen
- Steno Diabetes Center (S.H.S., K.F., A.P., M.E.J., N.B.J., B.C., G.S.A.), 2820 Gentofte, Denmark; Danish Diabetes Academy (N.B.J., D.R.W.), 5000 Odense, Denmark; Institute of Public Health, Section of General Practice (D.R.W., T.L.), Aarhus University, 8000 Aarhus, Denmark; Section of Social Medicine, Department of Public Health (I.A.), University of Copenhagen, 1123 Copenhagen, Denmark
| | - Torsten Lauritzen
- Steno Diabetes Center (S.H.S., K.F., A.P., M.E.J., N.B.J., B.C., G.S.A.), 2820 Gentofte, Denmark; Danish Diabetes Academy (N.B.J., D.R.W.), 5000 Odense, Denmark; Institute of Public Health, Section of General Practice (D.R.W., T.L.), Aarhus University, 8000 Aarhus, Denmark; Section of Social Medicine, Department of Public Health (I.A.), University of Copenhagen, 1123 Copenhagen, Denmark
| | - Gregers S Andersen
- Steno Diabetes Center (S.H.S., K.F., A.P., M.E.J., N.B.J., B.C., G.S.A.), 2820 Gentofte, Denmark; Danish Diabetes Academy (N.B.J., D.R.W.), 5000 Odense, Denmark; Institute of Public Health, Section of General Practice (D.R.W., T.L.), Aarhus University, 8000 Aarhus, Denmark; Section of Social Medicine, Department of Public Health (I.A.), University of Copenhagen, 1123 Copenhagen, Denmark
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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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Philipsen A, Jørgensen ME, Vistisen D, Sandbaek A, Almdal TP, Christiansen JS, Lauritzen T, Witte DR. Associations between ultrasound measures of abdominal fat distribution and indices of glucose metabolism in a population at high risk of type 2 diabetes: the ADDITION-PRO study. PLoS One 2015; 10:e0123062. [PMID: 25849815 PMCID: PMC4388843 DOI: 10.1371/journal.pone.0123062] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 02/17/2015] [Indexed: 01/07/2023] Open
Abstract
Aims Visceral adipose tissue measured by CT or MRI is strongly associated with an adverse metabolic risk profile. We assessed whether similar associations can be found with ultrasonography, by quantifying the strength of the relationship between different measures of obesity and indices of glucose metabolism in a population at high risk of type 2 diabetes. Methods A cross-sectional analysis of 1342 participants of the ADDITION-PRO study. We measured visceral adipose tissue and subcutaneous adipose tissue with ultrasonography, anthropometrics and body fat percentage by bioelectrical impedance. Indices of glucose metabolism were derived from a three point oral glucose tolerance test. Linear regression of obesity measures on indices of glucose metabolism was performed. Results Mean age was 66.2 years, BMI 26.9kg/m2, subcutaneous adipose tissue 2.5cm and visceral adipose tissue 8.0cm. All measures of obesity were positively associated with indicators of glycaemia and inversely associated with indicators of insulin sensitivity. Associations were of equivalent magnitude except for subcutaneous adipose tissue and the visceral/subcutaneous adipose tissue ratio, which showed weaker associations. One standard deviation difference in BMI, visceral adipose tissue, waist circumference, waist/height ratio and body fat percentage corresponded approximately to 0.2mmol/l higher fasting glucose, 0.7mmol/l higher 2-hr glucose, 0.06-0.1% higher HbA1c, 30 % lower HOMA index of insulin sensitivity, 20% lower Gutt’s index of insulin sensitivity, and 100 unit higher Stumvoll’s index of beta-cell function. After adjustment for waist circumference visceral adipose tissue was still significantly associated with glucose intolerance and insulin resistance, whereas there was a trend towards inverse or no associations with subcutaneous adipose tissue. After adjustment, a 1cm increase in visceral adipose tissue was associated with ~5% lower insulin sensitivity (p≤0.0004) and ~0.18mmol/l higher 2-hr glucose (p≤0.001). Conclusion Visceral and subcutaneous adipose tissue assessed by ultrasonography are significantly associated with glucose metabolism, even after adjustment for other measures of obesity.
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Affiliation(s)
| | | | | | - Annelli Sandbaek
- Department of Public Health, Section for General Practice, Aarhus University, Aarhus, Denmark
| | - Thomas P. Almdal
- Department of Internal Medicine F, Gentofte Hospital, Gentofte, Denmark
| | | | - Torsten Lauritzen
- Department of Public Health, Section for General Practice, Aarhus University, Aarhus, Denmark
| | - Daniel R. Witte
- Department of Public Health, Section for General Practice, Aarhus University, Aarhus, Denmark
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Uncovering the genetic history of the present-day Greenlandic population. Am J Hum Genet 2015; 96:54-69. [PMID: 25557782 PMCID: PMC4289681 DOI: 10.1016/j.ajhg.2014.11.012] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 11/20/2014] [Indexed: 01/06/2023] Open
Abstract
Because of past limitations in samples and genotyping technologies, important questions about the history of the present-day Greenlandic population remain unanswered. In an effort to answer these questions and in general investigate the genetic history of the Greenlandic population, we analyzed ∼200,000 SNPs from more than 10% of the adult Greenlandic population (n = 4,674). We found that recent gene flow from Europe has had a substantial impact on the population: more than 80% of the Greenlanders have some European ancestry (on average ∼25% of their genome). However, we also found that the amount of recent European gene flow varies across Greenland and is far smaller in the more historically isolated areas in the north and east and in the small villages in the south. Furthermore, we found that there is substantial population structure in the Inuit genetic component of the Greenlanders and that individuals from the east, west, and north can be distinguished from each other. Moreover, the genetic differences in the Inuit ancestry are consistent with a single colonization wave of the island from north to west to south to east. Although it has been speculated that there has been historical admixture between the Norse Vikings who lived in Greenland for a limited period ∼600–1,000 years ago and the Inuit, we found no evidence supporting this hypothesis. Similarly, we found no evidence supporting a previously hypothesized admixture event between the Inuit in East Greenland and the Dorset people, who lived in Greenland before the Inuit.
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Rønn PF, Smith LS, Andersen GS, Carstensen B, Bjerregaard P, Jørgensen ME. Birth weight and risk of adiposity among adult Inuit in Greenland. PLoS One 2014; 9:e115976. [PMID: 25551382 PMCID: PMC4281098 DOI: 10.1371/journal.pone.0115976] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 11/28/2014] [Indexed: 01/08/2023] Open
Abstract
Objective The Inuit population in Greenland has undergone rapid socioeconomic and nutritional changes simultaneously with an increasing prevalence of obesity. Therefore, the objective was to examine fetal programming as part of the aetiology of obesity among Inuit in Greenland by investigating the association between birth weight and measures of body composition and fat distribution in adulthood. Methods The study was based on cross-sectional data from a total of 1,473 adults aged 18–61 years in two population-based surveys conducted in Greenland between 1999–2001 and 2005–2010. Information on birth weight was collected from birth records. Adiposity was assessed by anthropometry, fat mass index (FMI), fat-free mass index (FFMI), and visceral (VAT) and subcutaneous adipose tissue (SAT) estimated by ultrasound. The associations to birth weight were analyzed using linear regression models and quadratic splines. Analyses were stratified by sex, and adjusted for age, birthplace, ancestry and family history of obesity. Results Spline analyses showed linear relations between birth weight and adult adiposity. In multiple regression analyses, birth weight was positively associated with BMI, waist circumference, FMI, FFMI and SAT with generally weaker associations among women compared to men. Birth weight was only associated with VAT after additional adjustment for waist circumference and appeared to be specific and inverse for men only. Conclusions Higher birth weight among Inuit was associated with adiposity in adulthood. More studies are needed to explore a potential inverse association between birth size and VAT.
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Affiliation(s)
| | | | | | | | - Peter Bjerregaard
- Centre for Health Research in Greenland, National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Petrenya N, Brustad M, Dobrodeeva L, Bichkaeva F, Lutfalieva G, Cooper M, Odland JØ. Obesity and obesity-associated cardiometabolic risk factors in indigenous Nenets women from the rural Nenets Autonomous Area and Russian women from Arkhangelsk city. Int J Circumpolar Health 2014; 73:23859. [PMID: 25147770 PMCID: PMC4111876 DOI: 10.3402/ijch.v73.23859] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 05/31/2014] [Accepted: 06/08/2014] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The prevalence of obesity and obesity-related conditions varies by population groups. Indigenous women of the circumpolar north are believed to be at high risk of obesity. OBJECTIVE We studied, first the obesity prevalence in indigenous Arctic women, Nenets, compared to urban Russian women. Second, the association between obesity and cardiometabolic risk factors in the combined group of Nenets and Russian women. Third, ethnic differences in the association between obesity and cardiometabolic risk factors. DESIGN Cross-sectional study performed in 2008-2009. SUBJECTS 93 Nenets women, aged 19-77 (the indigenous village, the Nenets Autonomous Area) and 132 Russian women, aged 21-72 (Arkhangelsk city). Obesity was defined as body mass index (BMI)≥30 kg/m(2), waist circumference (WC)≥88 cm and or waist-to-hip ratio (WHR)≥0.85%. We assessed associations between obesity and cardiometabolic risk factors by linear and logistic regression models that included covariates of ethnicity, age, smoking and physical activity. We also tested for interaction between obesity measurements and ethnicity. RESULTS Prevalence of obesity estimated through BMI, WC and WHR were 42.5, 45.3 and 41.9% in Nenets and 34.4, 46.4 and 29.5% in Russians, respectively, with no differences found. BMI, WC and WHR associated positively with triglycerides, fasting insulin and Homeostasis Model Assessment of Insulin Resistance index. In addition, BMI and WC correlated negatively with high-density lipoprotein cholesterol and positively with systolic blood pressure and apolipoprotein B/apoliporotein A-I ratio. WC explained significant variation in fasting glucose (FG) level. BMI predicted type 2 diabetes history. FG level associated strongly with ethnicity and was found to be higher in Russians. CONCLUSIONS We found no differences in prevalence of obesity between Nenets and Russian females. Obesity was associated with cardiometabolic risk factors independently of ethnicity in the sample studied. There was no link between obesity measurements and ethnicity.
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Affiliation(s)
- Natalia Petrenya
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Magritt Brustad
- Department of Community Medicine, Faculty of Health Sciences, Centre for Sami Health Research, UiT The Arctic University of Norway, Tromsø, Norway
| | - Liliya Dobrodeeva
- FGBUN Institute of Physiology of Natural Adaptations, Ural Branch, The Russian Academy of Sciences, Arkhangelsk, Russia
| | - Fatima Bichkaeva
- FGBUN Institute of Physiology of Natural Adaptations, Ural Branch, The Russian Academy of Sciences, Arkhangelsk, Russia
| | - Gulnara Lutfalieva
- FGBUN Institute of Physiology of Natural Adaptations, Ural Branch, The Russian Academy of Sciences, Arkhangelsk, Russia
| | - Marie Cooper
- Norwegian Institute of Food, Fisheries and Aquaculture Research, Tromsø, Norway
| | - Jon Øyvind Odland
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Moltke I, Grarup N, Jørgensen ME, Bjerregaard P, Treebak JT, Fumagalli M, Korneliussen TS, Andersen MA, Nielsen TS, Krarup NT, Gjesing AP, Zierath JR, Linneberg A, Wu X, Sun G, Jin X, Al-Aama J, Wang J, Borch-Johnsen K, Pedersen O, Nielsen R, Albrechtsen A, Hansen T. A common Greenlandic TBC1D4 variant confers muscle insulin resistance and type 2 diabetes. Nature 2014; 512:190-3. [PMID: 25043022 DOI: 10.1038/nature13425] [Citation(s) in RCA: 270] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 04/30/2014] [Indexed: 01/19/2023]
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