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F5 Q506 mutation and the low prevalence of cardiovascular disease in Canadian Inuit.

BACKGROUND: The Keewatin Inuit have a very low age-adjusted mortality rate from vascular diseases compared to the general population of Canada. Interethnic differences in both genetic and lifestyle factors have been offered as explanations for this observation. We previously found that compared to white subjects, the Inuit had a significantly increased prevalence of 4 candidate alleles for atherosclerosis-related phenotypes, namely AGT T235, FABP2 T54, PONI R192, and APOE E4, and a significantly decreased prevalence of 2 candidate alleles for atherosclerosis-related phenotypes, namely ACE D and MTHFR 677T. METHODS: We tested the hypothesis that 165 Canadian Inuit would have a significantly different frequency of the thrombosis-associated F5 Q506 allele compared with reference controls. RESULTS: We found a complete absence of F5 Q506 in 165 Inuit, which was significantly different from the frequency of 3.92% observed in regional control White subjects. CONCLUSIONS: The aggregate of results from our studies in Inuit to date suggests that the beneficial influence of the low prevalence of any or all of the ACE D, MTHFR 677T and F5 Q506 outweighs the deleterious influence of the high prevalence of any or all of the other disease-associated alleles. However, it remains possible that other genetic and/or environmental factors determine the low susceptibility to vascular disease in the Inuit.

Adolescent↗

Guiding health promotion efforts with urban Inuit: a community-specific perspective on health information sources and dissemination strategies.

OBJECTIVE: To develop a community-specific perspective of health information sources and dissemination strategies of urban Inuit to better guide health promotion efforts. METHODS: Through a collaborative partnership with the Tungasuvvingat Inuit Family Resource Centre, a series of key informant interviews and focus groups were conducted to gather information on specific sources of health information, strategies of health information dissemination, and overall themes in health information processes. FINDINGS: Distinct patterns of health information sources and dissemination strategies emerged from the data. Major themes included: the importance of visual learning, community Elders, and cultural interpreters; community cohesion; and the Inuit and non-Inuit distinction. The core sources of health information are family members and sources from within the Inuit community. The principal dissemination strategy for health information was direct communication, either through one-on-one interactions or in groups. CONCLUSION: This community-specific perspective of health information sources and dissemination strategies shows substantial differences from current mainstream models of health promotion and knowledge translation. Health promotion efforts need to acknowledge the distinct health information processes of this community, and should strive to integrate existing health information sources and strategies of dissemination with those of the community.

Canada↗

mtDNA variation in Inuit populations of Greenland and Canada: migration history and population structure.

We examined 395 mtDNA control-region sequences from Greenlandic Inuit and Canadian Kitikmeot Inuit with the aim of shedding light on the migration history that underlies the present geographic patterns of genetic variation at this locus in the Arctic. In line with previous studies, we found that Inuit populations carry only sequences belonging to haplotype clusters A2 and D3. However, a comparison of Arctic populations from Siberia, Canada, and Greenland revealed considerable differences in the frequencies of these haplotypes. Moreover, large sample sizes and regional information about birthplaces of maternal grandmothers permitted the detection of notable differences in the distribution of haplotypes among subpopulations within Greenland. Our results cast doubt on the prevailing hypothesis that contemporary Inuit trace their all of their ancestry to so-called Thule groups that expanded from Alaska about 800-1,000 years ago. In particular, discrepancies in mutational divergence between the Inuit populations and their putative source mtDNA pool in Siberia/Alaska for the two predominant haplotype clusters, A2a and A2b, are more consistent with the possibility that expanding Thule groups encountered and interbred with existing Dorset populations in Canada and Greenland.

Canada↗

Cultural awareness of Inuit patients' experiences with emergency nursing care.

Around 1500 Inuit patients fly annually from Nunavik to hospital centres in Montreal. This is a tense experience for many Inuit, due to cultural differences, and task-driven nursing practices often inadequately meeting their holistic health beliefs. In this qualitative study, we explored the experiences of Inuit patients with emergency nursing (EN) in the McGill University Health Centre, to inform on the best holistic nursing practices to meet culturally specific needs. Data analysis from semi-structured interviews with four participants generated a single theme: "rationalizing the care". While staying in the emergency department (ED), Inuit patients progressed through three steps in this rationalization process: first impressions of EN, perceiving the realities of EN, and appreciating EN care. "Being away from home" emerged as a stressor, and "other Inuit support", acted as a mediator. The participants in this study felt they had been shown culturally sensitive treatment through being kept informed, and skills of the nurses. As instruments of healing, therefore, the nurses in this study were able to apply a holistic approach to provide culturally sensitive care. Participants also highlighted speaking the same language and having direct access to an interpreter as key to improving ED experiences.

Adult↗

Prevalence and the duration of linear enamel hypoplasia: a comparative study of Neandertals and Inuit foragers.

As a dental indicator of generalized physiological stress, enamel hypoplasia has been the subject of several Neandertal studies. While previous studies generally have found high frequencies of enamel hypoplasia in Neandertals, the significance of this finding varies with frequencies of enamel hypoplasia in comparative samples. The present investigation was undertaken to ascertain if the enamel hypoplasia evidence in Neandertals suggests a high level of physiological stress relative to a modern human foraging group, represented here by an archaeological sample of Inuit from Point Hope, Alaska. Unlike previous studies, this study focused specifically on linear enamel hypoplasia (LEH), emphasizing systemic over localized causes of this defect by considering LEH to be present in an individual only if LEH defects occur on two anterior teeth with overlapping crown formation periods. Moreover, this study is the first to evaluate the average growth disruption duration represented by these defects in Neandertals and a comparative foraging group. In the prevalence analysis, 7/18 Neandertal individuals (from Krapina and southern France) and 21/56 Neandertal anterior teeth were affected by LEH, or 38.9% and 37.5% respectively. These values do not differ significantly from those of the Inuit sample in which 8/21, or 38.1% of individuals, and 32/111, or 28.8% of anterior teeth were affected. For the growth disruption duration analysis, 22 defects representing separate episodes of growth disruption in Neandertals were compared with 22 defects in the Inuit group using three indicators of duration: the number of perikymata (growth increments) in the occlusal walls of LEH defects, the total number of perikymata within them, and defect width. Only one indicator, the total number of perikymata within defects, differed significantly between the Inuit and Neandertal groups (an average of 13.4 vs. 7.3 perikymata), suggesting that if there is any difference between them, the Inuit defects may actually represent longer growth disruptions than the Neandertal defects. Thus, while stress indicators other than linear enamel hypoplasia may eventually show that Neandertal populations were more stressed than those of modern foragers, the evidence from linear enamel hypoplasia does not lend support to this idea.

Alaska↗

Apolipoprotein E and atherosclerosis in Greenland Inuit.

Arterial, liver, and serum specimens were collected from Greenland Inuit at autopsy and apolipoprotein E genotyping was done on 42 females (mean age = 61.3 years) and 56 males (mean age = 56.8 years). Estimates of the allele frequencies of the apo E, derived from the observed frequencies of the six common apolipoprotein E genotypes, are E2: 0.015+/-0.009; E3: 0.776+/-0.030; and E4: 0.209+/-0.029. No significant difference was found between these frequencies and those previously reported for Greenland Inuit, Canadian Inuit, or Alaska natives; however, differences were observed in comparison with frequencies reported for Japan, Norway, Sweden, USA-Blacks and USA-Whites. Anthropometric data (body mass index, panniculus adiposus thickness), blood analyte levels (total serum cholesterol, HDL-cholesterol, LDL + VLDL-cholesterol, and glycohemoglobin), and prevalence and extent of atherosclerotic lesions in the aorta and coronary arteries were analyzed for any associations with apolipoprotein E genotype. The occurrence of apolipoprotein E2 alleles are very rare and the E4 alleles are slightly more frequent in the Greenland Inuit population as compared to other populations. No significant association between apolipoprotein E genotypes and the extent of atherosclerotic lesions in the aorta and coronary arteries were found, and there does not appear to be any strong evidence for an association of either serum lipids, glycohemoglobin levels, or adiposity measurements to apolipoprotein E genotype in Greenland Inuit.

Adult↗

Elements in autopsy liver tissue samples from Greenlandic Inuit and Danes. I. Sulphur, chlorine, potassium and bromine measured by X-ray fluorescence spectrometry.

The purpose of this study was to measure the content of the elements Sulphur (S), Chlorine (C1), Potassium (K) and Bromine (Br) in normal liver tissue samples from Greenlandic Inuit using X-ray fluorescence spectrometry, and compare the results with those obtained in normal liver tissue samples from Danes. Liver tissue sample were obtained at autopsy from 50 Greenlandic Inuit (27 men, 23 women) with a median age of 61 years (range 20-83) and from 74 Danes (44 men, 30 women) with a median age of 52 years (range 15-87). In Inuit, the content of elements given as median and (5-95 percentile) was: sulphur, 108.07 mmol/kg dry liver (86.78 - 169.44); chlorine, 92.16 mmol/kg dry liver (45.39-128.42); potassium, 181.66 mmol/kg dry liver (146.41-236.35); bromine, 0.0901 mmol/kg dry liver (0.0563-0.1589). In Danes, the corresponding values were: sulphur, 147.58 mmol/kg dry liver (70.41-236.81); chlorine, 96.95 mmol/kg dry liver (54.01-162.52); potassium, 198.40 mmol/kg dry liver (150.68-256.37); bromine, 0.1101 mmol/kg dry liver (0.0701 - 0.4203). None of the elements displayed any significant gender difference, neither in Inuit nor in Danes. Inuit had a lower liver content of sulphur (p < 0.0001), potassium (p < 0.008) and bromine (p < 0.002) as compared with Danes.

Adult↗

Cancer pattern among Greenlandic Inuit migrants in Denmark, 1968-1982.

For several cancer sites the incidence among Inuit (Eskimos) in Alaska, Canada and Greenland differs markedly from that in non-Inuit in adjacent areas. This is the first study of Inuit migrants. Among 11,571 Inuit Greenlandic people living in Denmark in the period 1968-1982 we found 69 cases of cancer. Significantly increased risks compared to the Danish population were found for cancer of the rectum (RR = 5.5) in males and for nasopharyngeal cancer (RR = 185.2) and cancer of the cervix uteri (RR = 1.9). The significance of these findings in relation to the role of environmental factors in the aetiology of cancer in Inuit is discussed.

Adult↗

High blood cadmium levels are not associated with consumption of traditional food among the Inuit of Nunavik.

High levels of cadmium in the liver and kidneys of caribous and sea mammals of the Canadian Arctic have led to recommendations to remove such offal from the traditional diet. Blood cadmium levels have been found to be very high in samples of Inuit volunteers, hence the hypothesis that the Inuit might be exposed to cadmium through their diet. This survey of a population-based random sample of Nunavik residents (n = 518) confirms that blood cadmium of Inuit is indeed very high by comparison to published reports. Blood cadmium levels are closely associated with the current smoking status and are independent of dietary patterns among nonsmokers. Plasma omega-3 fatty acids concentrations have been used to assess the reliability of the dietary information collected by questionnaires and to test for any association of blood cadmium with the consumption of sea mammals. Blood cadmium levels are not related to the reported consumption of sea mammals. Blood cadmium levels are very high among smokers and are associated with levels of exposure to tobacco. Among nonsmoking Inuit, blood cadmium levels are comparable with those reported in nonsmokers elsewhere in the world. In reference to international standards, blood cadmium concentrations are high enough among the Inuit to warrant energetic public health interventions.

Adolescent↗

Xenoestrogenic activity in blood of European and Inuit populations.

BACKGROUND: Human exposure to persistent organic pollutants (POPs) is ubiquitous and found in all individuals. Studies have documented endocrine disrupting effects and impact on reproduction. The aim of the present study was to compare the level of xenoestrogenic activity in serum of groups with varying POP exposure, and to evaluate correlations to the POP biomarkers, 2,2',4,4',5,5'-hexachlorobiphenyl (CB-153) and 1,1-dichloro-2,2-bis (p-chlorophenyl)-ethylene (p,p'-DDE). METHODS: The study included 358 men: Greenlandic Inuit's, Swedish fishermen, and Warsaw (Poland) and Kharkiv (Ukraine) inhabitants. Xenoestrogenicity of serum extracts alone (XER) and XER competitive (XERcomp) effect on 17beta-estradiol induced estrogen receptor (ER) transactivity were assessed in the hormone free, lipophilic serum fraction containing the POPs using the MVLN human breast cancer cell line. RESULTS: No agonistic XER activity was exhibited for Inuit serum samples, while 12 - 24% of the European samples had detectable agonistic XER activity. On the contrary, 71% of Inuit serum samples antagonized XERcomp compared to 7 - 30 % in the other regions. XER and XERcomp were not or weakly correlated to the two POP markers. XER activity of Inuit samples was negatively associated to levels of CB-153 and p,p'-DDE. For the Warsaw group a positive and negative correlation between XER and p,p'-DDE and estradiol equivalence level and CB-153 levels was found. CONCLUSION: No strong consistent association between xenoestrogenic net activity and the two POP markers was found. The results showed that the selected POP markers alone can not predict the integrated xenoestrogenic serum activity. Correlations to the POP markers were found at the extreme edge; the Inuit's and Warsaw study groups eliciting high frequency of samples with ER antagonistic and agonistic activity, respectively. We suggest that the variation in xenoestrogenic serum activity reflects differences in POP exposure mixture, genetic factors and/or life style factors.

Adolescent↗

Dioxin-like activities in serum across European and Inuit populations.

BACKGROUND: Persistent organic pollutants (POPs) such as polychlorinated dibenzo-p-dioxins/furans, polychlorinated biphenyls (PCBs) and organochlorine pesticides can cause a series of adverse effects on e.g. reproduction in animals and humans, many of which involve the aryl hydrocarbon receptor (AhR). The aim of the present study was to compare the integrated serum level of AhR mediated activity among European and Inuit populations, and evaluate whether the activity was associated to the selected POP markers, 2,2',4,4',5,5'-hexachlorobiphenyl (CB-153) and 1,1-dichloro-2,2-bis(p-chlorophenyl)-ethylene (p,p'-DDE). METHODS: The study included 338 males from Greenland (Inuit's), Sweden, Warsaw (Poland) and Kharkiv (Ukraine). The AhR transactivity of serum extracts alone (AhRag) and competitive AhR activity (AhRcomp) upon co-exposure with 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) were determined in the lipophilic serum fraction containing the POPs using the AhR mediated luciferase reporter Hepa1.12cR cell assay. RESULTS: The European groups showed higher median level of AhR-TEQ (TCDD toxic equivalents) compared to the Inuit's, whereas higher incidence of Inuits sample further induced AhRcomp activity. Neither AhRag nor AhR-TEQ were correlated to CB-153 or p,p'-DDE for any of the study groups. Multiple regressions showed a significant heterogeneity of association between the CB-153 and the AhRcomp across the study groups, and accordingly a negative association between AhRcomp and CB-153 was found for the Kharkiv group. CONCLUSION: No consistent correlation between AhR activities and two POP markers was found. Although the difference of AhRag between European and Inuit men could not be explained by CB-153 or p,p'-DDE levels alone, we believe that the variation of AhR serum activity reflects different pattern of POP exposure, genetics and/or life style factors.

Adolescent↗

Inuit exposure to organochlorines through the aquatic food chain in arctic québec.

Inuit people (Eskimos) are likely exposed to persistent organochlorine compounds because their traditional diet includes fatty tissues of the arctic marine biota. Here we present the results of organochlorine compound analysis in milk fat samples from arctic Québec Inuit women and in fat tissues from various animal species inhabiting that region. The total concentration of polychlorinated biphenyl congeners in Inuit milk fat was similar to that of the beluga, while the profile of the 10 congeners resembled that of the polar bear. Mean concentrations of various organochlorines in milk-fat samples from Inuit women were between 2 and 10 times greater than those found in samples previously collected from southern Québec women. The Inuit mothers exhibit the greatest body burden known to occur from exposure to organochlorine residues present in the environment by virtue of their location at the highest trophic level of the arctic food web.

Arctic Regions↗

Cancer in Russian Inuit.

Using the framework of the Native Cancer Registry, cancer morbidity among Russian Inuit can be obtained from 1960 onwards. Earlier data are available, but have not been verified. Unfortunately, the absence of accurate demographic data for the Native population of about 16 000 people, including the increase from 1 149 to 1 452 Inuit between 1970 and 1989 prevents comparison and analysis of morbidity and mortality data with the non-Inuit population. Nevertheless, the number of cancers has risen in the Native population of Chukotka during the last decade (1979-1988), with a predominance of oesophagus, lung and stomach cancer among the Inuit. In contrast, no cases were observed of the salivary gland, nasopharyngeal and cervical cancers common in other Inuit populations.

Arctic Regions↗

Age-related macular degeneration among the Inuit in Greenland.

OBJECTIVES: To investigate the clinical appearance and prevalence of Age-related Macular Degeneration (AMD) among the Inuit in Greenland, to investigate risk factors and to initiate the search for possible genetic markers. STUDY DESIGN: A cross-sectional population study including all individuals older than 60 years of age, born in Greenland and living in the communities of Nuuk and Sisimiut, was performed in 2000 and 2001. METHODS: All participants underwent an ophthalmologic examination, which was complemented by fundus photography and a questionnaire. RESULTS: 689 individuals, or more than 70%, participated in the study. Data are currently being processed. The preliminary data suggest that AMD among the Inuit is characterised by a rather uniform morphology and poor visual outcome. The detection of more cases of AMD in the early and late stages in relation to intermediate stages furthermore indicates a rapid development of AMD among the Inuit. CONCLUSION: The relative homogeneity of the Inuit population of Greenland may represent an opportunity for identifying the aetiological factors responsible for the development of AMD. The future results of this research project will hopefully also contribute towards an increased focus on the growing number of individuals with visual impairment due to AMD among the Inuit.

Cross-Sectional Studies↗

Urbanization, migration and alcohol use in a population of Greenland Inuit.

OBJECTIVE: To analyse the effects of migration and urbanisation on alcohol intake among a population of Greenland Inuit. STUDY DESIGN: Population-based cross-sectional study of 4,139 Inuit randomly selected from Denmark and four areas of western Greenland. Data collection was based on interviews and self-administered questionnaires. METHODS: The association between different aspects of alcohol intake (quantity of intake, occasional heavy drinking, and the modified CAGE questionnaire) and place of living were analysed using a chi-square test and logistic regression analysis. RESULTS: The population living in Denmark had a higher mean alcohol intake than those living in Greenland. Drinking above the sensible drinking limits (21 drinks per week for men and 14 drinks per week for women; where one drink contains 12 g alcohol) was also more prevalent in the population living in Denmark, whereas a higher proportion of those living in Greenland was abstaining. In contrast to the higher alcohol intake in the population living in Denmark, a higher proportion of individuals with episodes of heavy drinking (binge drinking), was observed in both large and small communities in Greenland. A higher proportion of positive results on the modified CAGE test, measuring alcohol dependence, were also seen in large communities in Greenland. We found no statistically significant differences in alcohol intake between Inuit living in large and small communities in Greenland. When comparing Inuit living in Denmark according to length of stay in Denmark, we found a significantly increase in prevalence of binge drinking with length of stay, while no significant variation with length of stay was found for other alcohol parameters. CONCLUSION: Our findings suggest that the alcohol intake among Inuit, living in Denmark and in Greenland respectively, differs in relation to total intake, drinking patterns and a measure of alcohol dependence. Whether this may be attributed to urbanization, or to migration, is not clear.

Adult↗

Preliminary assessment of nutrients in daily diets of a sample of Belcher Island Inuit adults.

In order to describe daily food patterns and nutrient intakes of adults in the Inuit community of Sanikiluaq, 48 adults (young and older men and women, 12 per group, randomly selected from all individuals within their age and sex group) provided two 24-hour recalls of food consumption, once each in two seasons (February/March, October/November). The most frequent Inuit foods were reindeer, seal, and arctic char, while the most frequent market foods were tea, sugar, and bannock. On average 799 grams of Inuit food were consumed per day, providing 47% of daily energy and 65-92% of daily protein, iron, zinc, phosphorus, thiamin, riboflavin, and niacin. Inuit foods are primary sources of many nutrients for the Belcher Island Inuit.

Adult↗

Determining the feasibility of the Canadian First Nations and Inuit regional (longitudinal) health surveys.

The general framework recommended for the First Nations Regional Health Surveys can be summarized as follows: 1. Currently committed funding from Health Canada and Human Resources Development Canada should be used to develop a framework of regional cohort studies for First Nations and Inuit people in the 10 provinces to generate information on community health and the well-being of children. Indian and Northern Affairs should consider participating on an equal basis in this initiative, as long as program dollars are not compromised, in order to assist First Nations and Inuit communities in the documentation of socioeconomic conditions associated with health and the well-being of children. Representatives of these departments should work together with Métis representatives to secure funding for a similar initiative for Métis people in the provinces. 2. National First Nations and Inuit organizations and the major funding departments should be invited to appoint members to First Nations and Inuit National Steering Committees. These Committees will be responsible for the general supervision of the development of the regional cohort studies for their respective communities. 3. Regional (usually provincial) First Nations and Inuit political organizations should be invited to submit letters of intent indicating their interest in developing the longitudinal survey on behalf of all communities in their respective regions. 4. Regional organizations should be asked to propose a research group with which they wish to collaborate in the development of the survey. Research groups should be approved by the national steering committees. 5. National steering committees should appoint a "core questions research group" that will be responsible for the development of comparative "core questions" for the longitudinal surveys. 6. A national Aboriginal technical committee should be established consisting of members of the "core question" research group and one member from all other research groups involved in the longitudinal surveys. 7. National steering committees should approve grants to each regional organization/research group to develop and implement the survey. 8. This initiative should be developed at a pace which is suitable to Aboriginal organizations and communities. It is likely that the first wave of the survey in 1996 will be restricted to several pilot projects in different parts of the country. Other regions and communities may not be ready to participate until 1998.

Canada↗

Inuit write about illness; standing on thin ice.

Although Inuit have a traditional pattern of behaviour for how to die, their culture has not provided a pattern for how to be seriously sick or disabled, since such conditions did not last long in a hunting-gathering society. Tuberculosis provided Canadian Inuit with a harsh and bitter lesson in how to be sick in the twentieth century. The tuberculosis experience is an important part of modern Inuit history and an understanding of how they viewed it goes some way towards explaining some of the attitudes Inuit have toward the health system in the North today. The way Inuit regard illness is evident in their traditional oral literature as well as in more recent written accounts of the disease that devastated their lives only a few decades ago.

Adolescent↗