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At least 19 recordsLinked to original sources
PubMed1994

Amyotrophic lateral sclerosis of Guam: the nature of the neuropathological findings.

To elucidate the fundamental differences and similarities of the neuropathological features and etiopathogenesis of the amyotrophic lateral sclerosis (ALS) and parkinsonism-dementia complex (PDC) of Guam, we conducted a topographic, quantitative and histological investigation of tau-containing neurons, neurofibrillary tangles (NFTs), Bunina bodies and ubiquitinated inclusion bodies in 27 non-ALS non-PDC Guamanian subjects, as well as 10 Guam ALS patients, 28 PDC patients, and 5 patients with combined ALS and PDC (ALS-PDC). The topographic distribution of NFTs was basically the same in each disease and also in the non-ALS non-PDC group. There were relatively few, if any, NFTs in non-ALS non-PDC subjects and ALS patients, but there were many, especially in the frontal and temporal cortex, in Guam PDC and ALS-PDC patients. The histological and ultrastructural features of Bunina bodies in Guam ALS and ALS-PDC patients were similar to those reported in classic ALS. The ratio of occurrence of the inclusion in Guam ALS and ALS-PDC patients was similar to that reported so far in classic ALS. Ubiquitinated skein-like inclusion bodies were observed in the spinal anterior horn cells in Guam ALS and ALS-PDC patients. These findings indicate that classic ALS does exist on Guam, that NFTs in Guam ALS patients are merely a background feature widely dispersed in the population, that the mechanism of neuronal degeneration of Guam ALS is basically different from that of PDC, and that Guam ALS occurs initially are classic ALS.

Adult↗
PubMed1996

Identification of phosphorylation sites in PHF-TAU from patients with Guam amyotrophic lateral sclerosis/parkinsonism-dementia complex.

Guam Amyotrophic Lateral Sclerosis/Parkinsonism-Dementia Complex (Guam ALS/PDC) is a progressive neurodegenerative disorder characterized by abundant neurofibrillary tangles (NFTs) composed of aggregated paired helical filaments (PHFs). These abnormal filaments resemble the PHFs in neurofibrillary lesions of classic Alzheimer's disease (AD), and recent studies demonstrated that tau in Guam ALS/PDC is aberrantly phosphorylated and biochemically similar to the abnormal tau proteins (PHFtau) in classic AD. However, unlike PHFtau in AD, there is little information on the specific sites of phosphorylation in PHFtau from Guam ALS/PDC. Thus, to address this important issue, we examined tangle-rich Guam ALS/PDC and AD brains by Western blot, immunoelectron microscopy and immunohistochemistry using 13 antibodies to defined phosphate-dependent or -independent epitopes distributed throughout AD PHFtau. These studies identified 7 previously unknown sites of phosphorylation in PHFtau from Guam ALS/PDC (i.e. Thr181, Thr231, Ser262, Ser396, Ser404, Ser422, and the site defined by monoclonal antibody AT10), all of which also are found in AD PHFtau. Indeed, the Western blot, light and immunoelectron microscopic data suggest that NFTs, PHFs and PHFtau in Guam ALS/PDC are very similar to their counterparts in classic AD. Thus, insights into mechanisms leading to the accumulation of neurofibrillary lesions in Guam ALS/PDC may advance understanding of the pathogenesis and biological consequences of these lesions in classic AD.

Aged↗
PubMed1980

Amyotrophic lateral sclerosis among Chamorro migrants from Guam.

Amyotrophic lateral sclerosis (ALS), which occurs in unusually high incidence among the Chamorro people on the island of Guam, has developed in 28 Chamorro migrants--24 of whom had onset in the United States, Japan, Germany, or Korea--after periods of absence from Guam of 1 to 34 years. Thus, the latency period for the disease, if caused by environmental factors on Guam, may be over three decades. Four further patients developed ALS within 1 to 14 years of their return to Guam after long-term residence in the continental United States. The minimum exposure time to environmental variables on Guam, based on age at migration, was 18 years, and all patients had spent their childhood and adolescence on Guam. Estimates of crude mortality rates for ALS from these data are considerably higher than for the United States population, and lower than the ALS mortality rates for nonmigrant Chamorros on Guam.

Adult↗
PubMed1989

A retinopathy on Guam with high prevalence in Lytico-Bodig.

A pigmentary retinopathy resembling that sometimes seen in posterior ophthalmomyiasis interna was found in 26 (53.1%) of 49 Chamorro patients from Guam who have Lytico-Bodig (also known as amyotrophic lateral sclerosis-Parkinsonism-dementia complex of Guam). In nine cases, the retinopathy was bilateral. Similar changes were found in 6 (16.2%) of 37 clinically normal individuals from southern villages on Guam that have a high incidence of Lytico-Bodig, and in 1 (3.1%) of 32 individuals from Saipan, an island north of Guam that has a low incidence of the disease. These results indicate the possibility of an association-between Lytico-Bodig and a retinopathy on Guam that may be parasitic in origin. Occurrence of a similar association in other debilitating diseases on Guam and frequency of occurrence of retinopathy in Guamanians with Lytico-Bodig after leaving Guam have yet to be determined.

Adult↗
PubMed1999

Food Sources of Macronutrients in the Diets of Fifth Grade Children on Guam.

PURPOSE. This study was conducted to develop food lists consisting of the top food sources for energy (calories), protein, carbohydrate, fat, cholesterol, and dietary fiber for children in the fifth grade on Guam. METHODS. The food intake of fifth-grade children on Guam, ages 9 through 13, was collected using a one-day food record and computer-analyzed for nutrient content. The 1,006 individual food items from the food records were condensed into 194 food aggregations. Food lists including the 50 major contributors of each nutrient were formulated. Each list represents at least 82% of the total intake per macronutrient. PRINCIPAL FINDINGS. Many of the major contributors of energy, total fat, cholesterol, and protein in the diet of children on Guam are meat dishes, fried chicken, canned corned beef, and whole milk. Rice is consumed frequently and is an important contributor of energy, protien, carbohydrate, and fiber. Sweet beverages provide much of the dietary energy and carbohydrate. Potato and tortilla chips, although low in fiber, are eaten frequently and become major contributors of fiber. CONCLUSIONS. The foods that contribute to macronutrient intake in these fifth graders include many that are high in fat, processed, have low nutrient density, and are unlike foods traditionally consumed on Guam. RELEVANCE. These lists identify foods currently being consumed by children on Guam. These lists can be used to develop culturally specific nutrition education and dietary assessment instruments for children on Guam in an effort to reduce chronic disease risk factors and encourage positive health behaviors in children. KEY WORDS. Macronutrients, Energy, Food, Diet, Children, Guam, Chamorro

Journal Article↗
PubMedDate not supplied

Tobacco use among Pacific Islanders: risk-behavior surveys and data sets for the study of smoking behavior on Guam.

OBJECTIVES: To increase awareness of data resources from the Pacific Island of Guam, and their utility for research investigations of factors that encourage or discourage smoking among Pacific Islanders, and in turn, to produce empirical findings on tobacco use among Pacific Islanders to help fill data gaps on Asian American and Pacific Islander (AAPI) tobacco use for small AAPI populations. METHODS: Guam's 1995 and 1999 Behavioral Risk Factor Surveillance System (BRFSS) data sets were selected, as well as its 1999 Safe and Drug Free Schools and Communities Youth Risk Behavior System (YRBS) study, and a panel study of parental influences on risk behavior of middle school age youth conducted in 2000. Resultant sample sizes were 896 persons in 1995, and 506 in 1999. Guam's YRBS data sets are samples of middle school (grades 6-8) and high school youth (grades 9-12) in classrooms randomly sampled by grade level from both public and private schools. In 1999, a resultant sample of 589 high school students was obtained. In 2000, using the same sampling process as the YRBS studies but limited to public middle schools only, a specialized panel study obtained a sample of 270 middle school youth to study the influences of parents and peers on smoking and other risk behaviors. FINDINGS: Current smoking prevalence among adult Pacific Islanders (38 percent) on Guam is similar to other Pacific islands but comparatively high to US studies. In both 1995 and 1999, Pacific Islanders were more likely to be current smokers than other ethnic communities on island, and among those ever-smoking, they were less likely to have quit (i.e., report being former smokers). The same patterns of ethnic differences between Pacific Islanders, Asians, and non-API persons were consistently found among high school, and also middle school youth. These ethnic differences may implicate factors of tobacco accessibility, cultural definitions of "childhood," and adult role modeling, as contributing forces to smoking behavior on Guam. CONCLUSION: Pacific island communities allow for studies of ethnic-cultural influences that are not masked by factors such as acculturation, socioeconomic status, the intensity of media advertising, or urban life and its attendant conditions of minority status that affect AAPI studies in the US mainland. For tobacco control advocates and AAPI scholars across the nation, data from Guam may prove useful for investigations of differences in lifestyles, cultural beliefs or practices, and environmental exposures that encourage or discourage smoking among AAPIS, and thus help to unravel the compounding interplay between factors.

Adolescent↗
PubMed1991

Neurofibrillary tangle distribution in the cerebral cortex of parkinsonism-dementia cases from Guam: differences with Alzheimer's disease.

Parkinsonism-dementia together with amyotrophic lateral sclerosis is a highly prevalent disorder among the native Chamorro population of Guam and is accompanied by severe widespread neurofibrillary tangle formation. In the present study we compared the regional and laminar distribution of neurofibrillary tangles in the cerebral cortex of 5 Guamanian parkinsonism-dementia cases to 9 Caucasian Alzheimer's disease cases. Although in both diseases the superior frontal and inferior temporal cortex were affected to a comparable degree, there was a striking difference in the laminar distribution of neurofibrillary tangles. Neurofibrillary tangles in Alzheimer's disease are known to be more numerous in layers V-VI than in layers II-III of frontal and temporal cortex, however in the Guam cases, the opposite distribution was observed with most of the tangles located within layer II and the superior part of layer III and relatively low tangle density in layers V-VI. Interestingly, in both conditions, the hippocampal pyramidal layer showed a comparable degree of degeneration. Moreover no amyloid deposits and neuritic plaques were observed in the Guam brains, whereas they were frequent in the Alzheimer's disease cases. Previous studies have suggested that the clinical symptomatology observed in patients suffering from Alzheimer's disease is related to the dramatic loss of specific corticocortically projecting neurons in the neocortex. The present data on Guam parkinsonism-dementia further support this hypothesis, although the set of corticocortical connections affected in Guam cases might differ from that observed in Alzheimer's disease, which may contribute to some extent to the different clinical symptoms of the dementia observed in Guamanian patients.

Aged↗
PubMed2000

Human polyomavirus JC variants in Papua New Guinea and Guam reflect ancient population settlement and viral evolution.

The peopling of the Pacific was a complex sequence of events that is best reconstructed by reconciling insights from various disciplines. Here we analyze the human polyomavirus JC (JCV) in Highlanders of Papua New Guinea (PNG), in Austronesian-speaking Tolai people on the island of New Britain, and in nearby non-Austronesian-speaking Baining people. We also characterize JCV from the Chamorro of Guam, a Micronesian population. All JCV strains from PNG and Guam fall within the broad Asian group previously defined in the VP1 gene as Type 2 or Type 7, but the PNG strains were distinct from both genotypes. Among the Chamorro JCV samples, 8 strains (Guam-1) were like the Type 7 strains found in Southeast Asia, while nine strains (Guam-2) were distinct from both the mainland strains and most PNG strains. We identified three JCV variants within Papua New Guinea (PNG-1, PNG-2 and PNG-3), but none of the Southeast Asian (Type 7) strains. PNG-1 strains were present in all three populations (Highlanders and the Baining and Tolai of New Britain), but PNG-2 strains were restricted to the Highlanders. Their relative lack of DNA sequence variation suggests that they arose comparatively recently. The single PNG-3 strain, identified in an Austronesian-speaking Tolai individual, was closely related to the Chamorro variants (Guam-2), consistent with a common Austronesian ancestor. In PNG-2 variants a complex regulatory region mutation inserts a duplication into a nearby deletion, a change reminiscent of those seen in the brains of progressive multifocal leukoencephalopathy patients. This is the first instance of a complex JCV rearrangement circulating in a human population.

Adult↗
PubMed2001

A clinical and pathological study of motor neurone disease on Guam.

Despite over 40 years of intensive study, the cause of the high incidence of motor neurone disease (MND) on Guam, and the relationship between this disease and MND seen in the rest of the world are still uncertain. We present a series of 45 cases of Guamanian MND, which reaffirm the clinical similarity between this disease and MND seen in other countries. However, the occurrence of MND among the indigenous Chamorros of Guam is distinguished by four factors: (i) high prevalence; (ii) frequent familial occurrence; (iii) co-occurrence with the parkinsonism-dementia complex (PDC); and (iv) association with an unusual and distinctive linear retinopathy termed Guam retinal pigment epitheliopathy (GRPE). These distinguishing factors were not present in four non-Chamorros who resided on Guam when their MND symptoms occurred. Pathologically, the classical features of MND were seen in Guamanian Chamorro cases including ubiquitin inclusions. Neurofibrillary tangles were frequently seen. The neurofibrillary tangles appeared in the same distribution as described in the PDC but, unlike classical PDC, they were not usually associated with cell loss and occurred less frequently. While neurofibrillary tangle formation and the clinicopathological syndrome of MND may occur in parallel, observations from this series suggest that pathologically classical MND on Guam may occur independently of neurofibrillary degeneration and the clinical features of PDC.

Adult↗
PubMed1997

Distinct pathological features of the gallyas- and tau-positive glia in the Parkinsonism-dementia complex and amyotrophic lateral sclerosis of Guam.

We examined 50 patients with parkinsonism-dementia complex of Guam (Guam PDC), 10 Guamanian patients with amyotrophic lateral sclerosis (ALS), 5 patients with combined PDC and ALS (PDC-ALS), and 20 non-PDC non-ALS Guamanians, who had been autopsied between 1979 and 1982, paying special attention to glial inclusions. Gallyas-positive and tau-immunopositive intracytoplasmic inclusions were observed in many of the glial cells, in addition to extensive neurofibrillary tangles (NFTs) in the brains of Guam PDC and PDC-ALS patients. Granular hazy inclusions were seen in the astrocytes, and some crescent/coiled inclusions were observed in the oligodendroglia. Many granular hazy inclusions were observed in the amygdaloid nucleus, inferior olivary nucleus, and lateral funiculus of the spinal cord. The crescent/coiled inclusions were observed predominantly in the anterior nucleus of the thalamus, motor cortex, midbrain tegmentum, pyramids of the medulla oblongata, and lateral funiculus of the spinal cord. The granular hazy inclusions have never been reported previously, and the topographic distribution of the crescent/coiled inclusions in Guam PDC and PDC-ALS differs from those reported previously in other NFT-forming diseases. These findings indicate that Guam PDC and PDC-ALS involve not only neurons but also glia, and that their morphological and topographic differences from other NFT-forming diseases may provide further insights into their distinct etiopathogenesis, and thus prove useful for diagnosis.

Adult↗
PubMed1995

[Disappearance of ALS from Guam: implications for exogenous causes].

The author reports the disappearance of amyotrophic lateral sclerosis (ALS) from Guam over past 30 years, which coincided with rapid changes in the ecology, socioeconomy, and westernization of the life style. This slow but steady decline is believed to be the consequences of radical changes from food collection to wage-based life style and dietary improvement in recent years and elimination of exogenous factors. Those risk factor(s) are believed to be the environmental trace metals which must have triggered the accelerated oxidative stresses in the motor neurons of genetically susceptible population. Changing Epidermiology: 1. The annual incidence of 70/100,000 in 1960s down to 7/100,000 in 1990s, and remained unchanged for past 15 years. 2. Upward shift of age at onset by 10 years and at death by 8 years and even out of sex ratio. 3. Birth cohort analysis showed less risks for those born after 1920. No ALS cases born after 1945. 4. No increase in the incidence of ALS among non-Chamorros transients of Guam and Marianas during W.W.II. 5. Long-term resident non-Charmorro and half-Chamorros on Guam are also affected. 6. Charmorro migrants to U.S. Mainland are affected after long absence from Guam. 7. Incubation period for both ways is estimated to be 18 approximately 20 years. 8. Other forms of dementias like Alzheimer disease (AD) and vascular dementias are on the rise and the leading cause of death is cerebro- and cardiovascular diseases. 9. ALS is also declining in past 10 approximately 15 years in Kii peninsula, and West New Guinea. Changing Ecology of Guam: 1. One third of Island land was used for construction of huge military bases after W.W.II. 2. Urbanization of villages including concrete houses, deep well water supply, sewage, and electrification. 3. Tourism boom: high-rise hotels, development of 7 golf courses and other recreational facilities resulted in loss of flora and erosions of soil. Socioeconomic Changes: 1. Shift in population demography; Efflux of Chamorros and influx of aliens; Chamorros less than 50% by 1990. 2. Tourists passed 1 million in 1994. 3. Automobiles 1 car/1.5 person. 4. Westernization: After W.W.II, almost free access to Military Commissary for imported food and appliances. 5. Life style: from food collection to wage-based society. Genetic Studies: 1. Familial aggregations, but no clear-cut Mendelian inheritance. 2. Segregation analysis: no absolute genetic or environmental cause but additive gene component may play a role in genetic susceptibility and basis for geographical clustering. 3. Absence of Apo-E or Mu/Zn SOD genes. 4. Recent discovery of mtDNA Complex I deficiency in Parkinsonism-dementia cases suggests mitochondrial DNA abnormality. Comparative Environmental Studies: 1. Environmental studies in three hyperendemic areas in the Western Pacific--Kii, Marianas, and west New Guinea, where strikingly high incidences of ALS is known to occur, found the identical geochemical environment--low Ca, Mg, and Zn and high A1, Mn, Fe, Si, in the garden soil and drinking water. 2. Exogenous etiologic factors that are absent from primitive culture of Auyu and Jackai tribes in West New Guinea were eliminated. 3. Cycad neurotoxicity has been excluded. 4. Suspected exogenous agents that are common in these 3 hyperendemic areas are (a) locally grown vegetables, starchy roots, and reef fish; (b) surface water containing soluble organic minerals from red laterites; (c) rain water that is chemically pure and lack of essential minerals. Pathogenic Speculation: Chronic dietary deficiency since birth in Ca, Mg and Zn induced excessive absorption of divalent cations which accelerates oxidant-mediated neuronal degenerations in a genetically susceptible population. The process is probably carried through interactions between cytoskeletal abnormality of the neuron, aging process, abnormal proteins, and mitochondrial dysfunction.

Amyotrophic Lateral Sclerosis↗
PubMed1994

The Influence of Obesity on the Self-Reported Health Status of Chamorros and other Residents of Guam.

PURPOSE OF THE PAPER. We report on an analysis of the relationship of obesity to self-assessments of physical health for a probability sample of Guam's indigenous (Chamorro) and resident populations. Further, we examine whether Guam's populations fit a Western model, in terms of viewing obesity as an unhealthy condition. As background for our analysis, we review the literature on (1) the relationship between obesity and chronic noninfectious diseases; (2) social and behavioral associations of obesity; and (3) the reliability of self-assessed physical health and measures of obesity. METHODS. The data analyzed were taken from a Behavioral Risk Factor Survery (BRFS) conducted on Guam in 1991. We employed various standard univariate (chi-square analysis, ANOVA) and multivariate (OLS regression and logisitic regression analusis) statistical procedures in exploring our data and testing hypotheses on the correlates and associations of self-reported health and obesity. PRINCIPAL FINDINGS. Controlling for ethnicity, age, gender, marital and socioeconomic status, we found that obesity and being Chamorro was associated significantly with low assessments of physical health and that income was a signifcant predictor of higher self-assessments. A small sample of Micronesians, with a slightly greater level of obesity than the Chamorros, did not show the same tendency towards lower self-evaluation of their health. This probably reflects their lesser degree of internalizaition of Western ideas about obesity, appearance and health. When controlling for self-assessments of physical health, obesity was also shown to be related significantly with dieting by Chamorro women but was not a significant predictor of their increased participation in physical exercise. Young males were significantly more likely to report participation in physical exercise regardless of their weight or ethnicity. CONCLUSIONS. We hypothesize that historical (acculturative) changes to the diet and life ways of Chamorros, together with a likely genetic predisposition to store fat, has led to the relatively high levels of obesity seen on Guam today. Because of internalization of Western ideals about obesity and appearance, and increased community awareness of the health perils of obesity, Chamorros are at a public health crossroads. Effective health interventions must reckon with powerful genetic and cultural cross-currents. RELEVANCE TO ASIAN PACIFIC ISLANDER AMERICAN POPULATIONS. Colleagues are encouraged to examine the effects of ethnicity and acculturation on the health attitudes, behaviors, and status of other Pacific Islander and Asian populations. The creation of such a comparative data base will service APIA health interventions. KEY WORDS. Guam, Chamorros, Asian Pacific Islander Americans, survey, obesity, self-evaluated health status, socioeconomic status, cross-cultural comparisons.

Journal Article↗
PubMed1981

Amyotrophic lateral sclerosis and parkinsonism-dementia among Filipino migrants to Guam.

Amyotrophic lateral sclerosis (ALS) has occurred in 9 Filipino migrants to Guam 1 to 29 years after their arrival and parkinsonism-dementia (PD) in 2 migrants 13 and 26 years after arrival. Seven additional Filipino patients developed more classic Parkinson disease (P) 5 to 24 years after their migration to Guam. Furthermore, 10 part-Filipino patients who were born on Guam of Filipino and Chamorro parentage developed ALS, while 6 such part-Filipino patients developed PD. An estimate of the average annual crude mortality rate for ALS among Filipino migrants was approximately six times that of the continental United States, yet half that currently observed among Chamorros living on Guam. A majority of all migrant patients were born in northwestern Luzon in the Philippine Islands, indicating the desirability of an intensive field epidemiological investigation in that area.

Adult↗
PubMed1994

The neostriatum and nucleus accumbens in parkinsonism-dementia complex of Guam: a pathological comparison with Alzheimer's disease and progressive supranuclear palsy.

The neostriatum, nucleus accumbens and basal nucleus of Meynert (bnM) in the parkinsonism-dementia complex of Guam (Guam PDC) were examined immunohistologically, ultrastructurally, quantitatively and topographically, and the results were compared with those in Alzheimer's disease (AD) and progressive supranuclear palsy (PSP). Compared to neurologically normal controls, the number of large neurons in Guam PDC was reduced by approximately 70% in the caudate nucleus and putamen and by more than 90% in the nucleus accumbens. The decreased number of large neurons in the neostriatum was significantly correlated to that in the bnM. The remaining large neurons and many of the medium-sized neurons in the neostriatum and nucleus accumbens were immunopositive for tau protein and contained varying amounts of 21- to 25-nm-wide paired helical filaments (PHFs) admixed with straight tubules. Curly fibers and circularly arranged reactive astrocytes were seen in the nucleus accumbens of many PDC patients. Collectively, these findings, which are similar in part to those of AD and differ from those of PSP, suggest that the large neurons in the neostriatum and nucleus accumbens in Guam PDC degenerate through PHF formation, and that extremely severe loss of large neurons in the nucleus accumbens may be linked to marked degeneration of the limbic and ventral tegmental areas and nucleus dorsal raphe.

Adult↗
PubMed1995

Motor neuron disease on Guam: temporal occurrence, 1941-85.

Using a case registry, we investigated the temporal occurrence of motor neuron disease (MND) on Guam. MND with onset during 1941-85 was documented in 434 Chamorros and 9 non-Chamorro migrants who had lived on Guam before onset. Increased median age at onset and decreased age-adjusted incidence rates (since the early 1960s) were observed for Chamorros of both sexes. Our evidence about MND on Guam is consistent with: 1) The latent period duration has varied from years to decades; 2) With time, the exposure period or latent period, or both, have lengthened; 3) The high risk of acquiring the condition has been reduced since, at least, the early 1950s, and the most recent years of meaningful risk were the early to middle 1960s; 4) The critical age for acquiring the condition is in adolescence and adulthood; 5) Change of environment from Guam to overseas during childhood resulted in decreased risk of acquiring the condition.

Adult↗
PubMed1996

Motor neuron disease on Guam: geographic and familial occurrence, 1956-85.

We investigated the geographic and familial occurrence of motor neuron disease (MND) on Guam, and then considered etiologic hypotheses related to cycad use and metal intoxication. The research was based on 303 Chamorros from Guam and 3 Chamorros from other Mariana Islands, all with MND onset on Guam during 1956-85. Inarajan and Umatac, two southern districts, each had, for both sexes combined, an average incidence rate significantly higher than the corresponding overall rate for Guam. Also, for each sex, geographic patterns of incidence were significantly related to 1) socioeconomic level (men only), 2) cycasin concentrations in cycad flour samples (men and women), 3) iron concentrations in water samples (men and women), 4) silicon concentrations in water samples (men only), and 5) cobalt and nickel concentrations in soil samples (men and women). The MND risk in susceptible sibships was about 7-28 times greater than that in the general population. The cycad hypothesis conforms somewhat better than the metal intoxication hypothesis with the data presented.

Female↗
PubMed1990

2-Amino-3-(methylamino)-propanoic acid (BMAA) in cycad flour: an unlikely cause of amyotrophic lateral sclerosis and parkinsonism-dementia of Guam.

We conducted an investigation of the levels of the neurotoxin 2-amino-3-(methylamino)-propanoic acid (BMAA) in cycad flour. Analysis of 30 flour samples processed from the endosperm of Cycas circinalis seeds collected on Guam indicated that more than 87% of the total BMAA content was removed during processing. Furthermore, in 1/2 the samples almost all (greater than 99%) of the total BMAA was removed. We found no significant regional differences in the BMAA content of flour prepared from cycad seeds collected from several villages on Guam. Testing of different samples prepared by the same Chamorro woman over 2 years suggests that the washing procedure probably varies in thoroughness from preparation to preparation but is routinely efficient in removing at least 85% of the total BMAA from all batches. Analysis of a flour sample that had undergone only 24 hours of soaking indicated that this single wash removed 90% of the total BMAA. We conclude that processed cycad flour as prepared by the Chamorros of Guam and Rota contains extremely low levels of BMAA, which are in the order of only 0.005% by weight (mean values for all samples). Thus, even when cycad flour is a dietary staple and eaten regularly, it seems unlikely that these low levels could cause the delayed and widespread neurofibrillary degeneration of nerve cells observed in amyotrophic lateral sclerosis and the parkinsonism-dementia complex of Guam (ALS-PD).

Amino Acids, Diamino↗
PubMedDate not supplied

Diabetes mellitus as an emerging public health problem on Guam.

The magnitude and impact of diabetes mellitus as a public health problem on Guam was assessed by retrospective analysis of birth and death certificates, as well as chart review of hospital deaths for complications. Non-insulin-dependent diabetes is common on Guam; insulin-dependent diabetes is rare. Diabetes and diabetes-associated mortality rates were similar to those of the general United States population; however, the age-specific rates in persons aged 45 yr and over were two to three times greater. The mean age of the Guam population is only 18.9 yr, about 10 yr younger than the United States mainland. These circumstances could result in the number of persons aged 45 yr and over increasing disproportionately in the future, increasing dramatically the number of persons at risk to develop non-insulin-dependent diabetes. The population found to have the highest rates for diabetes and related complications was the Chamorros (indigenous Guamanians), who comprise the major population group of the Territory. This population experinced most of the complications associated with diabetes, heart disease and hypertension being important causes of morbidity and mortality on Guam. It is likely that many of the complications of pregnancy associated with diabetes go unrecognized. The cost of diabetes to the Territory was estimated to be at least 3 million dollars per year.

Adult↗