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Maple-Brown L.J.,Charles Darwin University | Maple-Brown L.J.,Leadership Sinai Center for Diabetes | Brimblecombe J.,Charles Darwin University | Connelly P.W.,Li Ka Shing Knowledge Institute | And 8 more authors.
Diabetes Research and Clinical Practice

Aim: Indigenous populations of Australia and Canada experience disproportionately high rates of chronic disease. We hypothesized that despite the common outcome of increased diabetes prevalence, differences in cardiometabolic risk profile may exist between these populations. Methods: We compared community-based data on cardiometabolic risks in Aboriginal Australians (n= 297 without, 45 with diabetes), and Aboriginal Canadians (n= 409 without, 87 with diabetes). Results: Despite strikingly lower weight (62 vs 83kg, p<0.0001) and body mass index (BMI, 22 vs 29kg/m2, p<0.0001), Aboriginal Australians without diabetes had similar waist-hip ratio (WHR, 0.91 vs 0.91, p=0.732), lower HDL-cholesterol (0.97 vs 1.25mmol/L, p<0.0001) and higher HbA1c (5.4 vs 5.2%, p<0.0001) than Aboriginal Canadians without diabetes. Waist was the obesity measure most strongly related to diabetes or cardiometabolic risk in Australians while BMI performed similarly to other obesity measures only in Canadians. Multiple regression of HbA1c revealed age and fasting glucose as independent predictors in each study group, with the addition of WHR in Aboriginal Australians. Conclusion: The notable finding was that waist or WHR are preferred obesity measures to appropriately reflect cardiometabolic risk in Aboriginal Australians, who although leaner by BMI criteria, displayed a similarly adverse risk profile to Aboriginal Canadians. Waist or WHR should be routinely included in clinical assessment in these high-risk populations. © 2013 Elsevier Ireland Ltd. Source

Reeds J.,University of Toronto | Mansuri S.,University of Toronto | Mamakeesick M.,Sandy Lake Health and Diabetes Project | Harris S.B.,University of Western Ontario | And 6 more authors.
Canadian Journal of Diabetes

Background: Type 2 diabetes mellitus is a growing concern worldwide, particularly in Indigenous communities, which have undergone a marked nutrition transition characterized by reduced intakes of traditional foods and increased intakes of market foods. Few studies have assessed the relationships between differing dietary patterns and risk for type 2 diabetes in Indigenous communities in Canada. The objective of the study was to characterize dietary patterns using factor analysis (FA) and to relate these patterns to the incidence of type 2 diabetes after 10 years of follow up in a First Nations community in Ontario, Canada. Methods: We conducted a prospective analysis of 492 participants in the SLHDP who did not have diabetes at baseline (1993 to 1995) and were followed for 10 years. A food-frequency questionnaire was administered, and FA was used to identify patterns of food consumption. Multivariate logistic regression analyses determined associations of food patterns with incident type 2 diabetes, adjusting for sociodemographic and lifestyle confounders. Results: At follow up, 86 participants had developed incident type 2 diabetes. FA revealed 3 prominent dietary patterns: Balanced Market Foods, Beef and Processed Foods and Traditional Foods. After adjustment for age, sex, waist circumference, interleukin-6 and adiponectin, the Beef and Processed Foods pattern was associated with increased risk for incident type 2 diabetes (OR=1.38; 95% CI 1.02, 1.86). In contrast, the Balanced Market Foods and Traditional Foods Patterns were not significantly associated with type 2 diabetes. Conclusions: Dietary interventions should encourage reduced consumption of unhealthful market foods, in combination with improvements in local food environments so as to increase access to healthful foods and reduce food insecurity in Indigenous communities. © 2016 Canadian Diabetes Association. Source

Maple-Brown L.J.,Charles Darwin University | Maple-Brown L.J.,Leadership Sinai Center for Diabetes | Cunningham J.,Charles Darwin University | Zinman B.,Leadership Sinai Center for Diabetes | And 9 more authors.
Cardiovascular Diabetology

Background: Indigenous populations of Australia and Canada experience disproportionately high rates of chronic disease. Our goal was to compare cardiovascular (CVD) risk profile and diabetes complications from three recent comprehensive studies of diabetes complications in different Indigenous populations in Australia and Canada.Methods: We compared participants from three recent studies: remote Indigenous Australians (2002-2003, n = 37 known diabetes), urban Indigenous Australians (2003-2005, n = 99 known diabetes), and remote Aboriginal Canadians (2001-2002, n = 188 known diabetes).Results: The three groups were similar for HbA1c, systolic BP, diabetes duration. Although leaner by body-mass-index criteria, remote Indigenous Australians displayed a more adverse CVD risk profile with respect to: waist-hip-ratio (1.03, 0.99, 0.94, remote Indigenous Australians, urban Indigenous Australians, remote Canadians, p < 0.001); HDL-cholesterol (0.82, 0.96, 1.17 mmol/L, p < 0.001); urine albumin-creatinine-ratio (10.3, 2.4, 4.5 mg/mmol); and C-reactive protein. With respect to diabetes complications, microalbuminuria (50%, 25%, 41%, p = 0.001) was more common among both remote groups than urban Indigenous Australians, but there were no differences for peripheral neuropathy, retinopathy or peripheral vascular disease.Conclusions: Although there are many similarities in diabetes phenotype in Indigenous populations, this comparison demonstrates that CVD risk profiles and diabetes complications may differ among groups. Irrespective, management and intervention strategies are required from a young age in Indigenous populations and need to be designed in consultation with communities and tailored to community and individual needs. © 2012 Maple-Brown et al; licensee BioMed Central Ltd. Source

Lahiry P.,University of Western Ontario | Cao H.,University of Western Ontario | Ban M.R.,University of Western Ontario | Pollex R.L.,University of Western Ontario | And 7 more authors.
Journal of Lipid Research

Apolipoprotein (apo) C-I is a constituent of chylomicrons, very low density lipoprotein, and high density lipoprotein. The role of apo C-I in human metabolism is incompletely defi ned. We took advantage of a naturally occurring amino acid polymorphism that is present in aboriginal North Americans, namely apo C-I T45S. We assessed the hypothesis that metabolic traits, including obesity-related and lipoprotein-related traits, would differ between carriers and noncarriers of apo C-I T45S. A genotyping assay was developed for APOC1 T45S and genotypes were determined in a sample of 410 Canadian Oji-Cree subjects. The allele frequency of the apo C-I S45 allele was ∼ 8% in this sample. We observed the apo C-I S45 allele was signifi cantly associated with 1) lower percent body fat (P < 0.05), 2) lower waist circumference (P = 0.058), 3) lower serum leptin levels (P < 0.05), and 4) lower plasma apo C-I levels (P < 0.0001), using a newly developed ELISA-based method. Taken together, these results suggest that at the whole human phenotype level, apo C-I is associated with the complex metabolic trait of obesity as well as with serum leptin levels. Copyright © 2010 by the American Society for Biochemistry and Molecular Biology, Inc. Source

Ley S.H.,University of Toronto | Harris S.B.,University of Western Ontario | Connelly P.W.,University of Toronto | Connelly P.W.,Li Ka Shing Knowledge Institute | And 9 more authors.
Diabetes, Obesity and Metabolism

Aims: Traditional lipid indices have been associated with type 2 diabetes, but limited data are available regarding non-high-density lipoprotein (non-HDL) cholesterol. In view of recent guidelines for the clinical management of dyslipidemia recommending the monitoring of non-HDL cholesterol as a secondary target after achieving the low-density lipoprotein (LDL) cholesterol goal, we aimed to assess the association of non-HDL cholesterol with incident type 2 diabetes and compare its utility as a risk predictor with traditional lipid variables in Aboriginal Canadians. Methods: Of 606 diabetes-free participants at baseline, 540 (89.1%) returned for 10-year follow-up assessments. Baseline anthropometry, blood pressure, fasting insulin and serum lipids were measured. Fasting and 2-h postload glucose were obtained at baseline and follow-up to determine the incidence of type 2 diabetes. Results: The cumulative incidence of type 2 diabetes was 17.5%. Higher non-HDL cholesterol, total-to-HDL cholesterol ratio, apolipoprotein B, triglyceride and LDL cholesterol and lower HDL cholesterol concentrations were individually associated with incident type 2 diabetes in univariate analyses (all p < 0.05). Non-HDL cholesterol was a superior determinant of incident diabetes compared with LDL cholesterol (comparing C-statistics of univariate models p = 0.01) or HDL cholesterol (p = 0.004). With multivariate adjustment including waist circumference, non-HDL cholesterol remained associated with incident diabetes [odds ratio (OR) 1.42 (95% confidence interval, CI 1.07-1.88)], while LDL cholesterol and HDL cholesterol became non-significant. Conclusions: Non-HDL cholesterol was associated with incident type 2 diabetes and was superior to LDL cholesterol as a risk predictor in this population. Further studies are required to establish the utility of non-HDL cholesterol in non-Aboriginal populations. © 2012 Blackwell Publishing Ltd. Source

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