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Epidemiologic patterns in childhood hearing loss: a review.

In an attempt to clarify international epidemiologic trends, a review of the published literature pertaining to childhood hearing loss is presented. Inconsistencies of methodology and classification, which complicate the interpretation of data and make difficult the quantification of the influence of genuine population differences, are discussed. Selective review of the literature allows certain crude statements to be made regarding childhood hearing loss. In developed countries, serous otitis media is the most common cause of hearing loss in children, affecting up to two thirds of preschool children. In addition, 1.0-2.0/1000 children have bilateral SNHL of at least 50 dB. In underdeveloped countries, suppurative middle ear disease is common and is still frequently associated with either an intratemporal or intracranial complication. SNHL appears to occur almost twice as often as in developed countries, with a greater proportion being of infectious etiology. In specific populations, the Inuits, Amerindians and Aboriginals, acute and chronic suppurative otitis media are almost endemic, yet both cholesteatoma and serous otitis media are uncommon.

Child↗

Organochlorine residues in harbour porpoises from Southwest Greenland.

During the 1995 hunting season, 75 harbour porpoises (Phocoena phocoena) were sampled in three locations in West Greenland: Maniitsoq, Nuuk, and Paamiut. Sex, age, morphometrics, reproductive condition, and organochlorine compound (OC) levels in blubber were determined for each individual. OC levels were extremely low and, therefore considered unlikely to affect the population adversely: mean blubber concentrations, expressed on lipid weight basis were 1.98 (S.D.=1.1) mg/kg for PCBs, 2.76 (S.D.=1.66) mg/kg for tDDT and 0.21 (S.D.=0.11) mg/kg for HCB. No statistical differences were observed among individuals caught in the various locations. OC concentrations showed statistically significant positive associations with age in males but negative in females; consequently, mature females presented lower pollutant loads than their male counterparts. Juveniles did not show differences between sexes. A higher proportion of less chlorinated and more metabolizable polychlorinated biphenyls (PCBs) compared to tPCBs was found in calves (age< or =1) than in mature females, indicating that the feeding habits of these two groups differ and that a greater transfer of less chlorinated compounds is passed from females to their pups through lactation and parturition. Harbour porpoises significantly contribute to the dietary intake of OCs by local Inuit populations. This contribution could be reduced if mature males were selectively avoided; however, current hunting procedures make this selection impracticable.

Adipose Tissue↗

Characterization of a new SNP c767A/T (Arg222Trp) in the candidate TSG FUS2 on human chromosome 3p21.3: prevalence in Asian populations and analysis of association with nasopharyngeal cancer.

The FUS2 gene, encoding a novel cytoplasmic acetyltransferase, resides in the tumor suppressor gene region on human chromosome 3p21.3 and is considered a promising candidate tumor suppressor gene. We have identified a new single nucleotide polymorphism (SNP), c767A/T, in the coding region of the gene. The polymorphism leads to a non-conservative amino acid change (R222W) located between the acetyltransferase (GNAT) and the proline-rich domains of the protein. We have analyzed 254 subjects included in 14 sub-populations. The occurrence of the SNP varies with the ethnicity of the population, suggesting that this SNP could be a valuable biomarker for population genetics. It is most prevalent in various Asian populations (T allele frequency>0.54), followed by the Canadian polar Inuit (T allele frequency=0.3), African American (T allele frequency=0.17), and Caucasian population (T allele frequency=0.1). Since nasopharyngeal carcinoma (NPC) is frequent in Southern China, Taiwan, Borneo and polar Canada, we further tested for the possible association of the FUS2 SNP with this form of endemic cancer. Our analysis, albeit limited, suggests no likely association between NPC and the FUS2 gene polymorphism. Further large-scale case-control studies are necessary and warranted to prove the strength of this contention.

Acetyltransferases↗

Enlarged clitoris in wild polar bears (Ursus maritimus) can be misdiagnosed as pseudohermaphroditism.

A 23-year-old female polar bear (Ursus maritimus) killed in an Inuit hunt in East Greenland on July 9, 1999 had a significantly enlarged clitoris resembling, in size, form and colour, those of previously reported 'pseudohermaphroditic' polar bears from Svalbard. It has been suggested that an enzyme defect (21-hydroxylase deficiency), androgen producing tumour or high exposure to organochlorines during the foetal stage or early development could be the reason for the supposed pseudohermaphroditism observed for Svalbard bears. Except for the enlarged clitoris, all dimensions of the external and internal reproductive organs of the present were similar to a reference group of 23 normal adult female polar bears from East Greenland collected in 1999-2002. The aberrant bear was a female genotype, and macroscopic examination of her internal reproductive organs indicated that she was reproductively functional. A histological examination of the clitoral enlargement in the present East Greenland specimen allows a first-time histological evaluation of the earlier macroscopic field diagnosis from Svalbard. This examination revealed intense chronic ulcerative and perivascular clitoriditis similar to "acral lick dermatitis" frequently seen in domestic dogs (i.e., we did not find any signs of pseudohermaphroditic hyperplasia of clitoral tissue due to androgenic or antiestrogenic endocrine disruption). The levels of organohalogens and TEQ values were lower than concentration thresholds of toxicological risk. It is hence possible that the previously reported adult female polar bear pseudohermaphrodites from Svalbard are in fact misdiagnoses. Therefore, future studies examining pseudohermaphroditism in wildlife should consider that certain occurrences are natural events, e.g., enlarged clitoris in the present East Greenland polar bear. Furthermore, caution should be exercised in suggesting linkages of such inflammatory abnormalities with correlations to anthropogenic pollutant exposures.

Adipose Tissue↗

Abandoned Mid-Canada Radar Line sites in the Western James region of Northern Ontario, Canada: a source of organochlorines for First Nations people?

The potential exists for human exposure to polychlorinated biphenyls (PCBs) and other contaminants originating from abandoned Mid-Canada Radar Line (MCRL) sites in sub-arctic Canada. We examined patterns of differences with respect to body burden of organochlorines (lipid-adjusted) between residents of the Ontario First Nations of Fort Albany (the site of MCRL Site 050) and Kashechewan (no radar base) and Hamilton (an industrial, southern Ontario community) to assess whether the presence of Site 050 influenced organochlorine body burden with respect to the people of Fort Albany. PCBs (Aroclor 1260 and summation operator14 PCBs congeners [CBs]) and DDE in the plasma of Fort Albany and Kashechewan subjects were elevated relative to Hamilton participants. PCB and DDE-plasma levels in First Nation women were of comparable magnitude to those reported for Inuit women living in the west/central Northwest Territories. Significantly lower DDE/DDT ratios observed for Fort Albany indicates exposure to higher levels of DDT compared to Kashechewan. The probable source of DDT exposure for Fort Albany people is the DDT-contaminated soil surrounding buildings of Site 050. The results of the correspondence analysis (CA) indicated that people from Hamilton had relatively higher pesticides and lower CB body burdens, while people from Fort Albany and Kashechewan exhibited relatively higher CBs and lower pesticide levels (CA-1). The separation of Fort Albany and Kashechewan from Hamilton was also clear using questionnaire data (i.e., plotting dietary principal component [PC]-1 scores against PC-2); PC-1 was correlated with the consumption of a traditional diet. Separation of Kashechewan and Albany residents occurred because the people of Kashechewan ate more traditional meats and consumed shorebirds. Only one significant relationship was found between PC analysis and contaminant loadings; PC-1 versus CA-3 for Kashechewan. The presence of Site 050 on Anderson Island appears to have influenced organochlorine body burden of the people of Fort Albany. ANCOVA results revealed that it was not activity on Anderson Island that was important, but activity on Site 050 was the influential variable. When these results are considered with the DDE/DDT ratio data and the CB 187 results (Fort Albany and Kashechewan residents differed significantly), the findings are suggestive that Site 050 did influence organochlorine body burden of people from Fort Albany.

Adult↗

Outbreak of trichinellosis associated with consumption of game meat in West Greenland.

The Inuit population of the Arctic has always been at risk of acquiring trichinellosis and severe outbreaks have been recorded in Alaska and Canada. In West Greenland, a number of large outbreaks took place during the 1940s and 1950s; they involved total 420 cases including 37 deaths. Since then only sporadic cases have been reported. Here, we describe an outbreak of infection with Trichinella spp. after consumption of infected meat presumably from walrus or polar bear caught in western Greenland. Six persons who had eaten of the walrus and polar bear meat were two males and four females, age range 6--47 years. Using ELISA and Western blot analysis (Trichinella-specific IgG antibodies against excreted/secreted antigen and synthetic tyvelose antigen, respectively) four of these persons were found to be sero-positive for Trichinella antibodies, with three of these having clinical symptoms compatible with trichinellosis. On re-test, 12--14 months later one of the two sero-negative persons had sero-converted, probably due to a new, unrelated infection. This study demonstrates that acquiring Trichinella from the consumption of marine mammals remains a possibility in Greenland, and that cases may go undetected. Trichinellosis in Greenland can be prevented by the implementation of public health measures.

Adult↗

Novel mutations in CPT 1A define molecular heterogeneity of hepatic carnitine palmitoyltransferase I deficiency.

Liver carnitine palmitoyltransferase I (CPT I) deficiency is a rare disorder of hepatic mitochondrial long-chain fatty acid oxidation. It characteristically presents with symptoms associated with failure of ketogenesis (hypoketotic hypoglycemia). The disorder is due to mutations in the CPT 1A gene for which few patients have been characterized. We present here four novel mutations in five patients from four families with severe enzyme deficiency. Three of these are missense mutations (G465W, R316G, and F343V) and the fourth a nonsense mutation (R160X). Other than small Inuit and Hutterite populations in Canada and the Northern plains, there is complete heterogeneity of disease-causing mutations within CPT I deficient families with each demonstrating unique mutations. Because there are no easily recognizable disease-specific metabolite markers, diagnostic confirmation of this disorder requires a combination of enzymatic analysis and whole gene sequencing.

Adolescent↗

Factor V Leiden, prothrombin 20210A, methylenetetrahydrofolate reductase 677T, and population genetics.

Thrombosis results from the interaction between predisposing genetic polymorphisms and acquired risk factors. Two of the main prothrombotic alleles, Factor V (FV) Leiden and prothrombin 20210A, are only encountered among European populations. They are estimated to have arisen about 21,000-34,000 years ago as founding mutations after the evolutionary divergence of Caucasians from Asians, and have been subsequently dispersed by the Neolithic migrations. These polymorphisms may have developed by means of genetic drift or natural selection by possibly conferring a reduced risk of bleeding. Of note, FV Leiden is nearly absent in the Basques, a European population of pre-Neolithic individualization. The C677T mutation of the methylenetetrahydrofolate reductase gene may induce hyperhomocysteinemia and could slightly increase the risk of arterial or venous thrombosis and pregnancy loss in individuals with folic acid deficiency. Through a selective phenomenon, the frequency of the mutation may parallel the intake of this vitamin within populations. Hence, this allele is underrepresented in Sub-Saharan Africa, Indonesia, and in the Inuits and a positive North to South gradient has been described in Europe. Thus, these three inherited prothrombotic polymorphisms represent interesting tools for population genetics studies.

Evolution, Molecular↗

Atherosclerosis in coronary arteries and aorta among Greenlanders: an autopsy study.

In a cross-sectional autopsy study of 107 Inuit in Greenland, the extent of arterial surface involvement with atherosclerosis was evaluated in the presence of known or estimated environmental risk factors for coronary heart disease (CHD): age, gender, obesity, serum lipids, smoking, and hypertension. Mean, median, and range values for all of the risk factor variables and for the extent of atherosclerosis in the thoracic aorta, abdominal aorta, right coronary artery, and left anterior descending coronary artery are reported by age strata, along with the results of covariant analysis of the dependence of the extent of atherosclerosis upon the risk factors. No significant differences between females and males were found in either the risk factors or prevalence and extent of atherosclerosis in the aorta and in the coronary arteries. It appears that the extent of advanced atherosclerotic lesions in Greenlanders appears to be the same as that previously reported in a similar study in Alaska Natives.

Adult↗

Absence of association between genetic variation in the LIPC gene promoter and plasma lipoproteins in three Canadian populations.

The promoter sequence variant -480T in the hepatic lipase gene (LIPC) has been shown to be significantly associated with low post-heparin hepatic lipase activity. Some studies have also found that the -480T variant is associated with elevation in plasma HDL cholesterol. We tested for associations of LIPC -480T with plasma lipoprotein traits in samples taken from three distinct Canadian populations: 657 Alberta Hutterites, 328 Ontario Oji-Cree and 210 Keewatin Inuit. Plasma HL activity was not available for analyses. The LIPC -480T allele frequencies in these three groups, respectively, were 0.219, 0.527 and 0.383, and the prevalence of LIPC -480T/T homozygotes was, respectively, 0.042, 0.274 and 0.167. No significant association was found between LIPC -480T and plasma HDL cholesterol or apolipoprotein AI concentration, after adjusting for covariates including gender and body mass index. There was no consistent relationship between the population mean plasma HDL cholesterol concentration and the population LIPC -480T frequency. Our findings are consistent with the idea that the common promoter variation in LIPC, which has been reported to be associated with variation in post heparin HL activity and HDL triglyceride concentration, is not always associated with variation in plasma HDL cholesterol concentration, possibly due to yet unspecified environmental or genetic factors.

Adolescent↗

Is early response to portoenterostomy predictive of long-term outcome for patients with biliary atresia?

PURPOSE: Therapy for biliary atresia (BA) typically involves portoenterostomy (PE). In light of the development of liver transplantation (LT) as an option for therapy in infancy, the authors reviewed their experience to determine factors that might predict the requirement for LT. METHODS: Cases of BA diagnosed between September 1980 and September 1994 were reviewed. Responses to PE were rated as poor (PR; death or LT by 3 years), temporary (TR; LT > 3 years), or good (GR; anicteric). RESULTS: Twenty-nine patients were identified; 24% were native indian or Inuit. Twenty-three had PE; 11 responded. Seven (32%) became anicteric and continue to do well (GR). Four (18%) required LT after age 3 (TR). Twelve patients had PR; 3 underwent LT (average age, 1.3 years), 4 are listed for LTX, and 5 died by age 2.8 years. (Six patients did not have PE; 2 died in infancy and 4 had LT.) All transplant recipients are well. Factors associated with PR were older age at time of surgery (67 +/- 7 days v 51 +/- 4 days in the GR group), nadir of AST (273 +/- 84 U/Lv 70 +/- 26 U/L in the GR group), and number of post-PE complications (3.6 v per patient v 1 per patient in the GR group). TR was differentiated from GR by bilirubin nadir (46 +/- 10 mumol/Lv 14 +/- 3 mumol/L, respectively) and rate of bilirubin decline (2.6 +/- 1.5 mumol/L/d v 10.8 +/- 3.0 mumol/L/d, respectively). (P < .05 for all comparisons.) CONCLUSION: Outcomes are comparable to those of North American series, but the incidence is lower overall and is higher among natives. Factors that correlate with outcome include age at time of surgery, post-PE complications, postoperative decline and rate of decline of bilirubin and AST. The latter had not been reported previously and may prove useful in planning therapy for partial responders after PE.

Analysis of Variance↗

A Darwinian view of obstructed labor.

This essay discusses the evolutionary biology of dystocia. From a Darwinian standpoint, the high frequency of dystocia observed today seems evolutionarily untenable. Hunter-gatherers, most notably the Inuit, appear not to suffer from dystocia. It may be that people from an agriculture-based background are, obstetrically speaking, less well adapted to the good nutrition of a modern affluent diet.

Animals↗

Persistent organic pollutants in plasma of delivering women from Arkhangelsk.

The high levels of persistent organic pollutants have caused concern about human health, especially the health of the foetus and newborn child. This has especially been the case for Greenlandic and Canadian Inuits, where elevated levels of PCB and p,p'-DDE have been reported. In recent studies from arctic Russia the levels of beta-HCH and the DDT-group have been reported to be high, whereas the levels of PCB are low. However, the information from Northern Russia is, so far, incomplete. In this study, 27 delivering women from the city of Arkhangelsk, Russia, participated. They completed a questionnaire before delivery and plasma samples were collected after delivery. The analytical method developed to support this study involved gel permeation chromatography and silica gel purification, in addition to a traditional GC-MS method, and thus include acid labile compounds. The arithmetic mean levels of p,p'-DDE, beta-HCH and p,p'-DDT were 5.42, 3.59 and 1.17 microg/l, respectively. Toxaphene 26 and 50 were the only toxaphenes above the limit of detection, with arithmetic mean levels of 0.05 and 0.09 microg/l, respectively. Among the PCB congeners, PCB 138/163 was the most abundant with an arithmetic mean of 0.53 microg/l. The elevated levels of beta-HCH and p,p'-DDT as well as a low DDE/DDT ratio is a strong indication of fresh and maybe local sources in this area.

Adolescent↗

Effect of supplementation with dietary seal oil on selected cardiovascular risk factors and hemostatic variables in healthy male subjects.

The average daily consumption of seal oil by the Inuit people is approximately 8-9 g, yet there is very little information on the effect of seal oil consumption on cardiovascular disease risk factors. In this study, 19 healthy, normocholesterolemic subjects consumed 20 g of encapsulated seal oil containing eicosapentaenoic acid (EPA; 20:5n-3), docosahexaenoic acid (DHA; 22:6n-3), and docosapentaenoic acid (DPA; 22:5n-3) or 20 g of vegetable oil (control) per day for 42 days. Levels of selected cardiovascular and thrombotic risk factors as well as fatty acid profiles of serum phospholipid and nonesterified fatty acid (NEFA) were determined. EPA levels in serum phospholipid and NEFA increased by 4.3- and 2.7-fold, respectively, in the seal oil supplemented group. DHA levels rose 1.5- and 2.1-fold, respectively, and DPA levels rose 0.5- and 0.7-fold, respectively. Arachidonic acid (AA) levels dropped by 26% in both serum phospholipid and serum NEFA. There was a significant decrease in the ratio of n-6 to n-3 fatty acids in serum phospholipid from 7.2 to 2.1 and a significant increase in the ratio of EPA/AA in NEFA. Ingestion of seal oil raised the coagulant inhibitor, protein C, values by 7% and decreased plasma fibrinogen by 18%. No alterations in other hemostatic variables, including plasma activity of Factors VII, VIII, IX, and X and antithrombin, or in the concentrations of von Willebrand Factor, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglyceride, glucose, Apo A-1, or lipoprotein(a) were observed in either group. Other risk factors for cardiovascular disease, including hematocrit, white blood cell count, plasma viscosity, systolic and diastolic blood pressures, heart rate, and platelet aggregation after stimulation with ADP or collagen did not change. Our results indicate that seal oil supplementation in healthy, normocholesterolemic subjects decreased the n-6/n-3 ratio and increased EPA, DHA, and DPA and the ratio of EPA/AA and DHA/AA in the serum phospholipid and NEFA, while exhibiting a modest beneficial effect on fibrinogen and protein C levels.

Adult↗

Acute otitis media and sociomedical risk factors among unselected children in Greenland.

OBJECTIVE: To describe the sociomedical risk factors associated with episodes of acute otitis media (AOM), recurrent AOM (rAOM), and chronic otitis media (COM) in Greenlandic children and especially to point out children at high risk of rAOM (defined as > 5 AOM episodes since birth) and COM which are prevalent among Inuit children all over the Arctic. METHODS: The study design was cross-sectional and included 740 unselected children, 3, 4, 5, and 8-years-old, living in two major Greenlandic towns, Nuuk and Sisimiut. All children were otologically examined and the parents answered a questionnaire containing sociomedical variables including ethnicity, family history of OM, housing, insulation, crowding, daycare, passive cigarette smoking, breast feeding, type of diet, allergy, and chronic diseases. Historical data were cross-checked in medical records which also formed the basis for the drop-out analyses. Statistical analyses included frequency tests, calculation of odds ratio (OR), and multiple logistic regression. RESULTS: The attendance rate was 86%. Former episode of AOM was reported by 2/3 of the children, rAOM by 20%, and COM by 9%. The following variables were found significantly more often in children with AOM by simple frequency testing: Parental (OR = 1.83), sibling (OR = 1.62), and parental plus sibling (OR = 2.56) history of OM, crowding (OR = 5.55), long period of exclusive breast feeding ( > 4 months) (OR = 2.47), and recent acute disease (P = 0.034). The following variables were found significantly more often in children with rAOM or COM by simple frequency testing: Parental history of OM (OR = 1.60; OR = 2.11, respectively) and no recall of breast feeding (P = 0.005; P = 0.003, respectively). Also, COM was found significantly more often in children with two Greenlandic parents (OR = 3.07). A multiple logistic regression test denoted only parental history of OM (OR = 1.82) and long period of exclusive breast feeding (OR = 1.14) as significant predictors of AOM. CONCLUSIONS: Many of the risk factors usually associated with AOM could not be confirmed as risk factors in this survey. Parental history of OM and long period of exclusive breast feeding were the strongest factors associated with AOM in Greenlandic children and ethnicity was associated with COM. However, the study confirms that AOM is a multifactorial disease determined by a number of genetic and environmental factors.

Acute Disease↗

Genetic link between Asians and native Americans: evidence from HLA genes and haplotypes.

We have been studying polymorphisms of HLA class I and II genes in East Asians including Buryat in Siberia, Mongolian, Han Chinese, Man Chinese, Korean Chinese, South Korean, and Taiwan indigenous populations in collaboration with many Asian scientists. Regional populations in Japan, Hondo-Japanese, Ryukyuan, and Ainu, were also studied. HLA-A, -B, and -DRB1 gene frequencies were subjected to the correspondence analysis and calculation of DA distances. The correspondence analysis demonstrated several major clusters of human populations in the world. "Mongoloid" populations were highly diversified, in which several clusters such as Northeast Asians, Southeast Asians, Oceanians, and Native Americans were observed. Interestingly, an indigenous population in North Japan, Ainu, was placed relatively close to Native Americans in the correspondence analysis. Distribution of particular HLA-A, -B, -DRB1 alleles and haplotypes was also analyzed in relation to migration and dispersal routes of ancestral populations. A number of alleles and haplotypes showed characteristic patterns of regional distribution. For example, B39-HR5-DQ7 (B*3901-DRB1*1406-DQB1*0301) was shared by Ainu and Native Americans. A24-Cw8-B48 was commonly observed in Taiwan indigenous populations, Maori in New Zealand, Orochon in Northeast China, Inuit, and Tlingit. These findings further support the genetic link between East Asians and Native Americans. We have proposed that various ancestral populations in East Asia, marked by different HLA haplotypes, had migrated and dispersed through multiple routes. Moreover, relatively small genetic distances and the sharing of several HLA haplotypes between Ainu and Native Americans suggest that these populations are descendants of some Upper Paleolithic populations of East Asia.

Alleles↗

Environmental contaminants and human health in the Arctic.

Monitoring of human exposure to persistent organic pollutants POPs and heavy metals have taken place since 1994 in a circumpolar study conducted under the Arctic monitoring and assessment programme (AMAP). The study has confirmed that Arctic populations relying on marine food (Inuit) have an exposure level of POPs and methyl mercury related to the amount of traditional food eaten and in some areas at a level where health effects cannot be excluded. Weighing the benefits of traditional food against the risks, AMAP have so far recommended that consumption of traditional food continues. There is a need for dietary advice to Arctic peoples so they can make informed choices concerning the food they eat.

Animals↗

Obesity, Type II diabetes and the Ala54Thr polymorphism of fatty acid binding protein 2 in the Tongan population.

Genetic variation of fatty acid binding protein 2 (FABP2) may contribute to the high prevalence of obesity and Type II diabetes in Tonga. To explore this we assessed the frequency of the FABP2 Ala54Thr polymorphism, obesity, and Type II diabetes in Tongans and possible inter-relationships. We investigated 1022 Tongan subjects, 433 men and 589 women aged 15-85 years, to identify possible associations between the FABP2 Ala54Thr polymorphism, obesity, Type II diabetes, BMI, glucose tolerance and standard lipid variables. The prevalence of the polymorphism was compared with that reported for other ethnic populations (studies from: Japanese, Finnish, African American, Native Canadian and Inuit, Swedish, Guadeloupe Indians, European males, and Caucasian populations). We found that 84% of the Tongan men and 93% of the Tongan women were overweight or obese (BMI> or =25kg/m2). The mean BMI+/-SD was not significantly different among those who were and were not carrying the Thr allele (males: Ala/Ala 30.4+/-5.4 and Thr carriers 29.8+/-5.1; females: Ala/Ala 33.8+/-6.4 and Thr carriers 33.6+/-5.1). The genotype frequencies were 76.2% Ala/Ala, 22.8% Ala/Thr, and 1.0% Thr/Thr. The Alal/Ala frequency is higher than the prevalences reported for all populations studied. The Thr allele was significantly associated with lower total cholesterol and LDL cholesterol in both sexes and in women also with lower HDL cholesterol. We conclude that there is a high prevalence of the FABP2 Ala54Thr polymorphism in Tongans. The polymorphism may be involved in lipid metabolism as the Thr allele is associated with low total and LDL cholesterol levels in this population.

Adolescent↗