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PubMed1996

CYP2C19 genotyping and associated mephenytoin hydroxylation polymorphism in a Canadian Inuit population.

The CYP2C19-associated oxidation polymorphism of mephenytoin was investigated in an Inuit population living in the high Arctic of Canada. Results were obtained for 152 subjects, of whom 90 were unrelated to first degree relatives. Phenotyping was based on the capillary gas chromatographic determination of the S/R enantiomeric ratio in overnight urine collected after a dose of 100 mg (R,S)-mephenytoin. The phenotype was confirmed by determining the S/R enantiomeric ratio after acid treatment of urine samples, and for some subjects, by determining urinary recovery of 4'-hydroxymephenytoin using capillary electrophoresis analysis. DNA was analysed for the m1 and m2 mutations of CYP2C19. Three of 152 subjects (2.0%; 95% confidence limits: 0.0-4.2%) were phenotypically classified as poor metabolizers (PMs). Genotype analysis characterized three individuals as homozygous, and 28 individuals as heterozygous for the m1 mutation, the remaining individuals being homozygous for the wild-type allele. The genotype of the three PMs was concordant with that of the phenotype. DNA fingerprinting confirmed that these three individuals were genetically unrelated. The allele frequency of the CYP2C19m1 mutation, determined in unrelated subjects, was 0.12 (95% confidence limits: 0.07-0.17). CYP2C19m2 was not detected in this population. Thus, the Canadian Inuit resemble Caucasian rather than Asian populations in both the incidence of PM phenotype and the molecular basis of the polymorphism.

Adolescent↗
PubMed1993

Oral health status of a group of elderly Canadian Inuit (Eskimo).

Fifty-four Inuit elders, representing 90% of the individuals 60 yr of age and older in three communities in the Keewatin region of the Canadian Northwest Territories, were examined for dental caries, periodontal disease, levels of edentulism, and the fit and quality of denture prostheses. These elders had a mean of 2.8 +/- 3.5 decayed teeth and a DMFT of 26 +/- 13 which reflected significant tooth loss. The Root Caries Index for subjects with gingival recession was 19%. Periodontal pocket assessments revealed that 86% of the individuals examined had CPITN readings of either 3 or 4. Over one third of the elders were totally edentulous, most of them female. Only 47% of these individuals wore complete dentures. Denture fit assessment revealed that 36% of the complete maxillary dentures and 42% of the complete mandibular dentures fit poorly. The overall oral health findings for these Inuit elders differed from those found in other older populations; however, the present findings may be the norm for a population undergoing a cultural transition.

Aged↗
PubMed1978

Effect of a local cold stress on peripheral temperatures of Inuit, Oriental, and Caucasian subjects.

Male subjects comprised of six Inuit from Igloolik, N.W.T., and five Orientals and six Caucasians from Toronto, Ont., volunteered for tests to determine the effect of localized cold stress on peripheral temperatures. In each subject, skin temperatures of the right index finger, the arm, and the cheek, as well as blood pressure and heart rate, were measured before, during, and after foot immersion in water of 10 degrees C temperature for 10 min. There was an immediate decrease in finger temperature on foot immersion in all three subject groups; however, the Inuit finger temperatures recovered very quickly to control values, the Caucasian finger temperatures began to increase after decreasing for 7.5 min, and the Oriental finger temperatures decreased continuously during the foot immersion and remained cool even 10 min after the removal of the cold stimulus. The cold stimulus did not affect the cheek or arm temperatures of any of the groups. In all subjects, systolic and diastolic blood pressures and heart rates increased on foot immersion, gradually returning towards normal values. No intergroup differences were seen in these parameters.

Adult↗
PubMed1984

Ten years of "civilization": fitness of Canadian Inuit.

Data on the cardiorespiratory fitness of the Canadian Inuit has been obtained before and after 10 yr exposure to "white civilization." The population tested comprises 201 males (aged 9-76 yr) and 143 females (aged 10-69 yr), about 70% of the eligible population of Igloolik (69 degrees 40'N). During direct maximum tests to exhaustion, a higher maximum heart rate was attained in 1980-81 (194.4 beats X min-1) than in 1970-71 (184.5 beats X min-1); this probably reflects a closer approach to a centrally limited maximum as the Inuit have become familiar with white investigators. The Astrand nomogram currently underestimates the directly measured maximum O2 intake (VO2max) by some 3% in subjects making a good maximum effort. Comparing the 1980-81 data with results for 1970-71, there has been a 15% decrease of predicted VO2max, accompanied by a 2- to 4-kg increase of body mass, accumulation of subcutaneous fat, and a decrease of leg extension strength, these changes affecting all subjects except boys aged 9-15 yr. It is suggested that the loss of personal fitness is related to adoption of a more sedentary lifestyle, particularly the use of tracked vehicles in place of walking through deep snow.

Adolescent↗
PubMed1994

Acculturation and the growth of lung function: three cross-sectional surveys of an Inuit community.

The influence of acculturation to a sedentary lifestyle upon the growth and development of lung volumes has been studied in Inuit children aged 9-19 years. Surveys were conducted in the circumpolar community of Igloolik (69 degrees 40'N, 81 degrees W) in 1969/70, 1979/80 and 1989/90. Over this period, the children showed little change of height or body mass at any given age, but a progressive loss of what initially had been a high level of health-related fitness. The sample for each survey comprised about 70% of children in the chosen age range: in the most recent study 87 males and 65 females. Respiratory data included forced vital capacity, one-second forced expiratory volume, maximal mid-expiratory flow rate (second and third surveys only), smoking habits and respiratory health. In each of the 3 surveys, many of the older children in the community were regular smokers. The average cigarette consumption currently rises progressively to 13 +/- 8 cigarettes/day in 87% of males and 11 +/- 7 cigarettes/day in 95% of females over 17 years of age. Nevertheless, lung volumes show the anticipated increase as a logarithmic function of stature. Furthermore, statistically fitted curves show only minor inter-survey differences in volumes for a given standing height. We thus conclude that the deterioration in other aspects of health-related fitness has not yet influenced the growth and development of respiratory function within this Inuit population.

Acculturation↗
PubMed1997

Airway function among Inuit primary school children in far northern Quebec.

The study of the prevalence and determinants of asthma and allergy in different populations may provide clues to their etiology. We describe airway function and its determinants among Inuit schoolchildren living in far Northern Quebec. We assessed the presence of airways hyperresponsiveness (AHR), defined as a 15% drop in FEV1 with exercise, airflow obstruction, as judged by a reduced FEV1/FVC, and atopy, as evidenced by skin test positivity to inhaled aeroallergens, among 509 Inuit aged mostly from 6 to 13 yr. Smoking by the children (31.9%) and their parents was common, including maternal smoking during pregnancy (79.5%). Atopy was found in only 5.3% of children. Apart from age, there were no significant associations between AHR and any of the determinants examined. Airflow obstruction was present among 7.7% of children and occurred most commonly among children with higher levels of salivary cotinine and in those with four or more lower respiratory illnesses in the first 2 yr of life. Asthma and atopy were uncommon in this population whereas evidence of chronic airflow obstruction was frequently found. Measures to reduce the spread of respiratory infection and prevention of smoking are likely to be of most benefit in improving respiratory health in these isolated communities.

Adolescent↗
PubMed2003

Tuberculosis in the Inuit community of Quebec, Canada.

In low-incidence countries targeting tuberculosis (TB) elimination, TB remains a problem of a few high-risk groups. In Canada, Aboriginals, and particularly the Arctic Inuit communities, have witnessed dramatic decreases in TB during the 1960s to 1970s, but rates remain at least 10 to 20 times higher than the national average. We are describing the results of an integrated traditional and molecular epidemiology study of all culture-positive Mycobacterium tuberculosis cases in the Arctic Inuit communities of Quebec from 1990 until 2000. The demographic characteristics of the 46 TB cases included in the study were most notable for a bimodal age distribution (48% under 25 years). Genotyping analysis using multiple modalities (IS6110 restriction fragment length polymorphism, spoligotype, mycobacterial interspersed repetitive units-variable number tandem repeats) showed that 76% (35/46) of TB cases were clustered (six clusters, median size four cases) and estimated that at least 62.5% of TB cases were due to ongoing transmission. By integrating the epidemiologic and genotyping data, we observed that the genotyping clustering results were concordant with recognized epidemiologic links but most notably identified previously unrecognized intervillage transmission. This study demonstrates significant ongoing transmission in a geographically isolated, low-density population. In a resource-rich country such as Canada, these communities illustrate some of the persistent challenges of TB control and elimination.

Adolescent↗
PubMed1993

Psychiatric consultation in the eastern Canadian Arctic: III. Mental health issues in Inuit women in the eastern Arctic.

This report describes mental health issues affecting Inuit women as seen in psychiatric consultation. Recent public and governmental attention has focused on the emotional and behavioural sequelae of rapid cultural change, spousal assault and sexual violence. The process of psychiatric consultant with the Inuit woman patient will be described. The need for innovative, community-based treatment strategies in this population will be emphasized.

Adult↗
PubMed1998

Attempted suicide among Inuit youth: psychosocial correlates and implications for prevention.

OBJECTIVE: To identify potential risk and protective factors associated with attempted suicide among Inuit youth, a population known to have a high rate of both attempted and completed suicide in recent years. METHOD: A secondary analysis of data on 203 Inuit youth (aged 15 to 24 years) from a random community survey conducted by Santé Québec in 1992. Factors previously identified in the literature and in clinical consultation and ethnographic research were tested with bivariate statistics and logistic regression models for each gender. RESULTS: At the bivariate level, positive correlates included substance use (solvents, cannabis, cocaine), recent alcohol abuse, evidence of a psychiatric problem, and a greater number of life events in the last year. Regular church attendance was negatively associated with attempted suicide. Multivariate analysis indicated that a psychiatric problem, recent alcohol abuse, and cocaine or crack use were the strongest correlates of attempted suicide for females, while solvent use and number of recent life events were the strongest correlates for males. CONCLUSIONS: Suicide prevention programs can be targeted at youth who are using substances, particularly solvents, cocaine, and alcohol, have psychiatric illness, and have experienced recent negative life events. Involvement in church or other community activities may reduce the risk for suicide. Consideration of gender differences may allow more precise identification of those at risk for attempted suicide.

Adolescent↗
PubMed2001

Common genomic variation in LMNA modulates indexes of obesity in Inuit.

We discovered that rare mutations in LMNA, which encodes lamins A and C, underlie autosomal dominant Dunnigan-type familial partial lipodystrophy. Because familial partial lipodystrophy is an extreme example of genetically disturbed adipocyte differentiation, it is possible that common variation in LMNA is associated with obesity-related phenotypes. We subsequently discovered a common single nucleotide polymorphism (SNP) in LMNA, namely 1908C/T, which was associated with obesity-related traits in Canadian Oji-Cree. We now report association of this LMNA SNP with anthropometric indexes in 186 nondiabetic Canadian Inuit. We found that physical indexes of obesity, such as body mass index, waist circumference, waist to hip circumference ratio, subscapular skinfold thickness, and subscapular to triceps skinfold thickness ratio were each significantly higher among Inuit subjects with the LMNA 1908T allele than in subjects with the 1908C/1908C genotype. For each significantly associated obesity-related trait, the LMNA 1908C/T SNP genotype accounted for between approximately 10--100% of the attributable variation. The results indicate that common genetic variation in LMNA is an important determinant of obesity-related quantitative traits.

Adult↗
PubMed2002

High age-adjusted prevalence of Parkinson's disease among Inuits in Greenland.

The prevalence of PD among Inuits in Greenland has not been determined. The authors found 40 patients with PD at the prevalence date January 1, 2000. The crude prevalence of PD was estimated to be 81.0 per 100.000 inhabitants born in Greenland. However, owing to the low proportion of 50+ year old Inuits (16.5 vs 33.5% in Denmark) the age-adjusted prevalence was much higher-187.5 per 100,000 persons.

Age Distribution↗
PubMed2000

Susceptibility to infections and immune status in Inuit infants exposed to organochlorines.

We investigated whether organochlorine exposure is associated with the incidence of infectious diseases in Inuit infants from Nunavik (Arctic Quebec, Canada). We compiled the number of infectious disease episodes during the first year of life for 98 breast-fed and 73 bottle-fed infants. Concentrations of organochlorines were measured in early breast milk samples and used as surrogates to prenatal exposure levels. Immune system parameters were determined in venous blood samples collected from infants at 3, 7, and 12 months of age. Otitis media was the most frequent disease, with 80. 0% of breast-fed and 81.3% of bottle-fed infants experiencing at least one episode during the first year of life. During the second follow-up period, the risk of otitis media increased with prenatal exposure to p,p'-DDE, hexachlorobenzene, and dieldrin. The relative risk (RR) for 4- to 7-month-old infants in the highest tertile of p, p'-DDE exposure as compared to infants in the lowest tertile was 1. 87 [95% confidence interval (CI), 1.07-3.26]. The RR of otitis media over the entire first year of life also increased with prenatal exposure to p,p'-DDE (RR, 1.52; CI, 1.05-2.22) and hexachlorobenzene (RR, 1.49; CI, 1.10-2.03). Furthermore, the RR of recurrent otitis media ( [Greater/equal to] 3 episodes) increased with prenatal exposure to these compounds. No clinically relevant differences were noted between breast-fed and bottle-fed infants with regard to immunologic parameters, and prenatal organochlorine exposure was not associated with immunologic parameters. We conclude that prenatal organochlorine exposure could be a risk factor for acute otitis media in Inuit infants.

Acute Disease↗
PubMed2005

History of Inuit community exposure to lead, cadmium, and mercury in sewage lake sediments.

Exposure to lead, cadmium, and mercury is known to be high in many arctic Inuit communities. These metals are emitted from industrial and urban sources, are distributed by long-range atmospheric transport to remote regions, and are found in Inuit country foods. Current community exposure to these metals can be measured in food, but feces and urine are also excellent indicators of total exposure from ingestion and inhalation because a high percentage of each metal is excreted. Bulk domestic sewage or its residue in a waste treatment system is a good substitute measure. Domestic waste treatment systems that accumulate metals in sediment provide an accurate historical record of changes in ingestion or inhalation. We collected sediment cores from an arctic lake used for facultative domestic sewage treatment to identify the history of community exposure to Pb, Cd, and Hg. Cores were dated and fluxes were measured for each metal. A nearby lake was sampled to measure combined background and atmospheric inputs, which were subtracted from sewage lake data. Pb, Cd, and Hg inputs from sewage grew rapidly after the onset of waste disposal in the late 1960s and exceeded the rate of population growth in the contributing community from 1970 to 1990. The daily per-person Pb input in 1990 (720,000 ng/person per day) exceeded the tolerable daily intake level. The Cd input (48,000 ng/person per day) and Hg input (19,000 ng/person per day) were below the respective TDI levels at the time.

Cadmium↗
PubMedDate not supplied

Assessment of dietary exposure to trace metals in Baffin Inuit food.

Chronic metal toxicity is a concern in the Canadian Arctic because of the findings of high metal levels in wildlife animals and the fact that traditional food constitutes a major component of the diet of indigenous peoples. We examined exposure to trace metals through traditional food resources for Inuit living in the community of Qikiqtarjuaq on Baffin Island in the eastern Arctic. Mercury, cadmium, and lead were determined in local food resources as normally prepared and eaten. Elevated concentrations of mercury ( > 50 micrograms/100 g) were found in ringed seal liver, narwhal mattak, beluga meat, and beluga mattak, and relatively high concentrations of cadmium and lead ( > 100 micrograms/100 g) were found in ringed seal liver, mussels, and kelp. Quantified dietary recalls taken seasonally reflected normal consumption patterns of these food resources by adult men and women ( > 20 years old) and children (3-12 years old). Based on traditional food consumption, the average daily intake levels of total mercury for both adults (65 micrograms for women and 97 micrograms for men) and children (38 micrograms) were higher than the Canadian average value (16 micrograms). The average weekly intake of mercury for all age groups exceeded the intake guidelines (5.0 micrograms/kg/day) established by the Joint Food and Agriculture Organization/World Health Organization Expert Committee on Food Additives and Contaminants. The primary foods that contributed to metal intake for the Baffin Inuit were ringed seal meat, caribou meat, and kelp. We review the superior nutritional benefits and potential health risks of traditional food items and implications for monitoring metal contents of food, clinical symptoms, and food use.

Adult↗
PubMed2005

Glycogen storage disease type III in Inuit children.

Glycogen storage disease type III (GSD III) was diagnosed in 4 Inuit children (3 confirmed, 1 suspected case) at our institution over the last decade. This rare autosomal recessive disease, which results from a deficiency of the debranching enzyme required for complete degradation of the glycogen molecule, has not been previously described in this population. The possible clinical presentations are heterogeneous, as is the spectrum of severity of this disease. The long-term sequelae can be severe, including recurrent hypoglycemia, hepatic cirrhosis and progressive muscle weakness. These 4 cases would suggest an increased prevalence of GSD III in the Inuit population. Therefore, it is important for health care providers caring for this population to consider and recognize this rare but serious disease.

Child↗
PubMed2006

Relationships between sperm DNA fragmentation, sperm apoptotic markers and serum levels of CB-153 and p,p'-DDE in European and Inuit populations.

Persistent organochlorine pollutants (POPs) are suspected to interfere with hormone activity and the normal homeostasis of spermatogenesis. We investigated the relationships between sperm DNA fragmentation, apoptotic markers identified on ejaculated spermatozoa and POP levels in the blood of 652 adult males (200 Inuits from Greenland, 166 Swedish, 134 Polish and 152 Ukrainian). Serum levels of 2, 2', 4, 4', 5, 5'-hexachlorobiphenyl (CB-153), as a proxy of the total POP burden, and of 1,1-dichloro-2,2-bis(p-chlorophenyl)-ethylene (p,p'-DDE), as a proxy of the total DDT exposure were determined. Sperm DNA fragmentation was measured by using the TUNEL assay, whereas immunofluorescence methods were utilized for detecting pro-apoptotic (Fas) and anti-apoptotic (Bcl-xL) markers. Both TUNEL assay and apoptotic markers were statistically differed across the four populations. No correlation between neither sperm DNA fragmentation nor apoptotic sperm parameters and the large variations in POPs exposure was observed for the separate study groups. However, considering the European populations taken together, we showed that both %TUNEL positivity and Bcl-xL were related to CB-153 serum levels, whereas our study failed to demonstrate any relations between DDE and %TUNEL positivity and apoptotic sperm biomarkers (Fas and Bcl-xL) in any region or overall regions. These results suggest that CB-153 and related chemicals might alter sperm DNA integrity and Bcl-xL levels in European adult males, but not in the highly exposed Inuit men. Additional issues (genetic background, lifestyle habits and characterization of total xeno-hormonal activities) need to be investigated in order to fully assess the population variations observed.

Adult↗
PubMed1996

Cancer among Circumpolar Inuit 1969-1988. Introduction and methods.

Cancer incidence data for Circumpolar Inuit populations were developed and compiled from Greenland, Canada and Alaska from 1969 to 1988 to provide the largest possible base of data for documenting the unusual patterns of cancer previously reported for these populations. Cancer incidence and population data were transferred to the Danish Cancer Registry. Coded information from various ICD-classifications and codes for the basis of diagnosis were transformed to one format, enabling joint analysis. Standard descriptive analysis was carried out with presentation of number of cases, crude incidence rates (CR), age-standardized rates (world) (ASR), cumulative rates to age 64 years, and indirectly standardized ratios (SIR) to the populations of Connecticut (USA), Canada and Denmark. The resulting database can be used to support collaborative international research among the Inuit populations.

Adolescent↗
PubMed1996

Cancer of the respiratory system in Circumpolar Inuit.

Cancer incidence of the nasal cavities in Inuit men are high (ASR=3.0 1984-1988), and higher than seen in Denmark, Connecticut (USA) and Canada. Lung cancer incidence is among the highest in the world, for both men and women, and larynx cancer among the lowest. The smoking pattern among Inuit, possibly combined with co-factors related to environment and diet, are believed to be the relevant causal factors.

Adolescent↗