M. Daniel et al., Glycated hemoglobin as an indicator of social environmental stress among indigenous versus westernized populations, PREV MED, 29(5), 1999, pp. 405-413
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-sect
ional data from multi-center community-based diabetes diagnostic and risk f
actor screening initiatives in Canada and Australia. Population groups were
Australian Aborigines (n = 116), Torres Strait Islanders (n = 156), Native
Canadians (n = 155), Creek migrants to Australia (n = 117), and Caucasian
Australians (n = 67). Measurements included fasting glycated hemoglobin (Hb
A(1c)) concentration, fasting and 2-h post-load glucose concentrations, bod
y mass index, waist-to-hip ratio, and demographic variables.
Results. Mean HbA(1c) concentrations were greater for indigenous groups tha
n for Creek migrants and Caucasian Australians (P < 0.0001). The covariate
adjusted indigenous versus non-indigenous difference (95% CI) was 0.90 (0.5
8-1.22) percentage units, 18.2% higher for indigenous people, Stratified an
alyses indicated greater HbA(1c) for indigenous than for non-indigenous per
sons 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 asso
ciated with westernization may be inherently stressful at the biological le
vel for indigenous populations in westernized countries. (C) 1999 American
Health Foundation and Academic Press.