Glycated hemoglobin as an indicator of social environmental stress among indigenous versus westernized populations.
BACKGROUND
This study assessed whether glycated hemoglobin concentration, an indicator of psychogenic stress, differs between indigenous populations and non-indigenous reference groups.


METHODS
Multivariate and stratified analyses were undertaken of cross-sectional data from multi-center community-based diabetes diagnostic and risk factor screening initiatives in Canada and Australia. Population groups were Australian Aborigines (n = 116), Torres Strait Islanders (n = 156), Native Canadians (n = 155), Greek migrants to Australia (n = 117), and Caucasian Australians (n = 67). Measurements included fasting glycated hemoglobin (HbA(1c)) concentration, fasting and 2-h post-load glucose concentrations, body mass index, waist-to-hip ratio, and demographic variables.


RESULTS
Mean HbA(1c) concentrations were greater for indigenous groups than for Greek migrants and Caucasian Australians (P < 0. 0001). The covariate adjusted indigenous versus non-indigenous difference (95% CI) was 0.90 (0.58-1.22) percentage units, 18.2% higher for indigenous people. Stratified analyses indicated greater HbA(1c) for indigenous than for non-indigenous persons with normoglycemia (P = 0.009), impaired glucose tolerance (P = 0.097), and diabetes (P < 0.0001).


CONCLUSIONS
HbA(1c) concentrations are greater for indigenous than for non-indigenous groups. Social changes, low control, and living conditions associated with westernization may be inherently stressful at the biological level for indigenous populations in westernized countries.
Daniel
M
M
Department of Health Behavior & Health Education, School of Public Health, University of North Carolina, Chapel Hill, North Carolina 27599, USA. mdaniel@sph.unc.edu
O'Dea
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Rowley
K G
KG
McDermott
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Kelly
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D000069:Acculturation; D000328:Adult; D000704:Analysis of Variance; D000886:Anthropometry; D001315:Australia; D015415:Biomarkers; D002170:Canada; D003430:Cross-Sectional Studies; D004641:Emigration and Immigration; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006115:Greece / Q000208:ethnology; D006801:Humans; D007198:Indians, North American / Q000523:psychology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D044469:Racial Groups; D013315:Stress, Psychological / Q000097:blood*; D000095283:Australian Aboriginal and Torres Strait Islander Peoples
D015415:Biomarkers; D006442:Glycated Hemoglobin