Characterizing cardiovascular risk in a Manitoba First Nation

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Riediger, Natalie
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Preventing Chronic Disease
Background: Prevalence of diabetes and cardiovascular disease among First Nations populations in Canada is higher compared to the non-First Nations population. Consistent monitoring of this epidemic is required. In addition, cardiovascular risk factors derived from research on non-First Nations populations may not be applicable to First Nations populations. Therefore, better understandings of risk factors specific to First Nations populations are required. Purpose: To characterize cardiovascular risk in a Manitoba First Nation population. Methods: Data from the 2002/2003 and 2011/2012 Diabetes Screening Studies in Sandy Bay First Nation were used, including fasting blood, anthropometric, and self-report data. The studies were conducted using a community-based participatory framework. All non-pregnant community members aged ≥18 years old were invited to participate in both study periods. First, using a repeated cross-sectional design, the burden of cardiovascular risk in the community in the 2011/2012 sample (n=482) was compared to the 2002/2003 sample (n=596). Second, by linking 2002/2003 and 2011/2012 data, an eight-year follow-up of participants was developed (n=171). Results: Repeated cross-sectional design. Sex- and age-standardized prevalence of diabetes in the adult population of the community was estimated at 39.2% (95% CI: 35.3, 43.1) in 2011/2012 and was not significantly different from 2002/2003. Significantly higher crude prevalence of obesity, abdominal obesity, dyslipidemia, and metabolic syndrome among women compared to men persisted from 2002/2003 to 2011/2012. At 80.0%, the crude prevalence of current smoking was significantly higher in 2011/2012 compared to 2002/2003. Prospective cohort design. There were 35 (95% CI: 26, 45) new cases of diabetes among 128 participants without diabetes at baseline (27% over 8 years or 3.3% per year). Two-thirds of those with diabetes at follow-up lost weight, including 35.1% of men, and 18.9% of women that lost greater than 10kg. Both men and women lost weight in association with decreases in fasting blood insulin, while men also lost weight in association with uncontrolled blood glucose. Conclusions: This research contributes to the understanding of the diabetes epidemic and how this epidemic has evolved in a high-risk community. Unintentional weight loss related to diabetes is a problem in this population. Further research is needed to better understand how diabetes-related weight loss may contribute to morbidity and mortality.
cardiovascular, diabetes, First Nation, obesity
Riediger, N.D., Lix, L.M., Lukianchuk, V., Bruce, S. (2014). Trends in diabetes and cardiometabolic conditions in a Canadian First Nation community. Preventing Chronic Disease, 11(E198), 1-8.