RESUMEN
BACKGROUND: Market integration (MI), the suite of social and cultural changes that occur with economic development, has been associated with negative health outcomes such as cardiovascular disease; however, key questions remain about how this transition manifests at the local level. AIM: The present paper investigates the effects of MI on health among Shuar, an indigenous lowland Ecuadorian population, with the goal of better understanding the mechanisms responsible for this health transition. SUBJECTS AND METHODS: This study examines associations between measures of MI and several dimensions of cardiovascular and metabolic health (fasting glucose, lipids [LDL, HDL and total cholesterol; triglycerides] and blood pressure) among 348 adults. RESULTS: Overall, Shuar males and females have relatively favourable cardiovascular and metabolic health. Shuar who live closer to town have higher total (p < 0.001) and HDL cholesterol (p < 0.001), while Shuar in more remote regions have higher diastolic blood pressure (p = 0.007). HDL cholesterol is positively associated with consumption of market foods (r = 0.140; p = 0.045) and ownership of consumer products (r = 0.184; p = 0.029). CONCLUSIONS: This study provides evidence that MI among Shuar is not a uniformly negative process but instead produces complex cardiovascular and metabolic health outcomes.
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Glucemia/metabolismo , Presión Sanguínea , Estado de Salud , Lípidos/sangre , Adolescente , Adulto , Anciano de 80 o más Años , Ecuador , Femenino , Humanos , Indígenas Sudamericanos , Masculino , Persona de Mediana Edad , Factores Socioeconómicos , Adulto JovenRESUMEN
OBJECTIVE: Clinical and epidemiological research suggest that bone mineral density (BMD) in women is shaped by various reproductive factors such as parity and lactation patterns. However, the extent of these effects on BMD remains unclear because of contradictory findings and a focus on industrialized populations. Because fertility patterns in these groups are vastly different than those of women from non-Western, subsistence populations, our current understanding of the reproductive effects on skeletal health is incomplete. Using a life history perspective, this study examines the relationship between reproductive factors and bone density among women from the Indigenous Shuar population, an Amazonian Ecuadorian forager-horticulturalist group. METHODS: This preliminary, cross-sectional study included 130 premenopausal and postmenopausal women (14-86 years old) from the Morona-Santiago region of Ecuador. Anthropometrics were recorded, as was estimated BMD using a calcaneal ultrasonometer. A reproductive history questionnaire was administered that included questions regarding menarche, parity, lactation patterns, and menopause. RESULTS: Among postmenopausal women, early menarche and greater stature were significantly associated with higher bone density values. Among premenopausal women, few significant relationships between bone values and reproductive variables were documented; effects of lactation appeared to be transient and restored following weaning. CONCLUSIONS: Although preliminary and not based on longitudinal data, these findings suggest that the effects of reproduction are transient as the system of calcium homeostasis in premenopausal women efficiently restores the bone loss that results from metabolically active reproductive states. Further, this research suggests that the timing of early life history events may canalize bone density phenotype.
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Densidad Ósea , Reproducción , Adolescente , Adulto , Factores de Edad , Anciano de 80 o más Años , Intervalo entre Nacimientos , Estudios Transversales , Ecuador , Femenino , Humanos , Lactancia , Menarquia , Persona de Mediana Edad , Parto , Posmenopausia , Premenopausia , Factores de Tiempo , Adulto JovenRESUMEN
OBJECTIVES: C-reactive protein (CRP) is a central component of innate immune defenses, and high sensitivity CRP has emerged as an important biomarker of chronic inflammation and cardiovascular disease risk. Prior analyses of CRP variability have reported stable between-individual differences in CRP over time, but a limitation of current knowledge is that it is based on research conducted in post-epidemiologic transition populations. METHODS: This study evaluated CRP variability among adults in the southeastern region of the Ecuadorian Amazon where rates of infectious diseases remain high. Blood samples were collected from 52 adults at four weekly sampling intervals and were quantified using a high-sensitivity immunoassay. RESULTS: Median CRP concentration was 0.52 mg/l. About 34.6% of participants had CRP >3 mg/l at one time point, but no individuals had CRP >3 mg/l across two or more sampling intervals, and within-individual correlations revealed low levels of stable, between-individual differences in CRP. The application of current guidelines for the assessment of chronic inflammation failed to detect a single case of "high risk" CRP. CONCLUSIONS: This study is the first to investigate CRP variability in a nonindustrialized, high infectious disease environment. It documents a pattern of variation over time that is distinct from prior research, with no evidence for chronic low-grade inflammation. These results may have substantial implications for research on inflammation and diseases of aging globally, as well as for scientific understandings of the regulation of inflammation.
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Proteína C-Reactiva/metabolismo , Enfermedades Cardiovasculares/epidemiología , Inflamación/sangre , Adulto , Biomarcadores/sangre , Ecuador/epidemiología , Femenino , Humanos , Técnicas para Inmunoenzimas , Indígenas Sudamericanos , Masculino , Persona de Mediana Edad , Estaciones del Año , Adulto JovenRESUMEN
OBJECTIVES: Alterations in thyroid function appear to play a central role in adaptation to Arctic environments. Increased thyroid activity in indigenous circumpolar populations is associated with upregulated metabolism, including elevated basal metabolic rate (BMR); however, little is known about the possible health consequences of these climate-induced changes on thyroid function. The focus of the present study is to determine the prevalence of autoimmune thyroid disorders and their lifestyle and metabolic correlates among a sample of indigenous Yakut adults from northeastern Siberia. METHODS: Anthropometric dimensions, health data, and plasma samples were collected among 281 adults (143 women, 138 men; ≥18 years old) from the rural community of Berdygestiakh (62°N, 127°E; pop. 4,900), Sakha Republic (Yakutia), Russia. BMR measurements were available for 96 women and 98 men. Free triiodothyronine (T(3) ), free thyroxine (T(4) ), thyroid stimulating hormone (TSH), and anti-thyroid peroxidase antibody (TPOAb) levels were determined using enzyme immunoassay. RESULTS: Twenty-two percent of women and 6% of men had clinically elevated (>30 IU/ml) TPOAb. TPOAb was positively correlated with TSH (P < 0.01), T(3) (P < 0.05), and T(4) (P < 0.05) in women and showed a positive trend with T(4) (P = 0.06) in men. Monthly household income was significantly positively correlated with TPOAb in men (P < 0.01) and showed a trend among women (P = 0.06). CONCLUSIONS: Although preliminary, these findings document higher than expected TPOAb levels among Yakut women and suggest possible consequences of increased thyroid activity associated with circumpolar adaptation and social change.
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Enfermedades Autoinmunes/epidemiología , Yoduro Peroxidasa/inmunología , Enfermedades de la Tiroides/epidemiología , Tirotropina/sangre , Aclimatación , Adulto , Enfermedades Autoinmunes/etnología , Metabolismo Basal , Clima Frío , Femenino , Humanos , Técnicas para Inmunoenzimas , Renta , Estilo de Vida/etnología , Masculino , Persona de Mediana Edad , Grupos de Población , Salud Rural/etnología , Siberia/epidemiología , Siberia/etnología , Cambio Social , Enfermedades de la Tiroides/etnología , Tirotropina/inmunología , Tiroxina/sangre , Tiroxina/inmunología , Triyodotironina/sangre , Triyodotironina/inmunologíaRESUMEN
UNLABELLED: Minimal data on bone mineral density changes are available from populations in developing countries. Using calcaneal quantitative ultrasound (QUS) techniques, the current study contributes to remedying this gap in the literature by establishing a normative data set on the indigenous Shuar and non-Shuar Colonos of the Ecuadorian Amazon. PURPOSE: The paucity of bone mineral density (BMD) data from populations in developing countries partially reflects the lack of diagnostic resources in these areas. Portable QUS techniques now enable researchers to collect bone health data in remote field-based settings and to contribute normative data from developing regions. The main objective of this study is to establish normative QUS data for two Ecuadorian Amazonian populations-the indigenous Shuar and non-Shuar Colonos. The effects of ethnic group, sex, age, and body size on QUS parameters are also considered. METHODS: A study cohort consisting of 227 Shuar and 261 Colonos (15-91 years old) were recruited from several small rural Ecuadorian communities in the Upano River Valley. Calcaneal QUS parameters were collected on the right heel of each participant using a Sahara bone sonometer. Three ultrasound generated parameters were employed: broadband ultrasound attenuation (BUA), speed of sound (SOS), and calculated heel BMD (hBMD). RESULTS: In both populations and sexes, all QUS values were progressively lower with advancing age. Shuar have significantly higher QUS values than Colonos, with most pronounced differences found between pre-menopausal Shuar and Colono females. Multiple regression analyses show that age is a key predictor of QUS while weight alone is a less consistent determinant. Both Shuar males and females display comparatively greater QUS parameters than other reference populations. CONCLUSIONS: These normative data for three calcaneal QUS parameters will be useful for predicting fracture risk and determining diagnostic QUS criteria of osteoporosis in non-industrialized populations in South America and elsewhere.