Marked gender differences in the prevalence of diabetes mellitus among Xavante Indians from Central Brazil

Franco, Laercio

Marked gender differences in the prevalence of diabetes mellitus among Xavante Indians from Central Brazil

Tuesday, 19 August 2014

Exhibit hall (Dena'ina Center)

Laercio J Franco, MD , Ribeirão Preto Medical School - University of São Paulo, Ribeirão Preto, Brazil

Amaury L Dal Fabbro, MD , Ribeirão Preto Medical School - University of São Paulo, Ribeirão Preto, Brazil

Daniela S Sartorelli, PhD , Ribeirão Preto Medical School - University of São Paulo, Ribeirão Preto, Brazil

Anderson S Silva, MD , Ribeirão Preto Medical School - University of São Paulo, Ribeirão Preto, Brazil

Luana P Soares, MPH , Ribeirão Preto Medical School - University of São Paulo, Ribeirão Preto, Brazil

Luciana F Franco, MD , Escola Paulista de Medicina - Federal University of São Paulo, São Paulo, Brazil

Patricia C Kuhn, MD , Escola Paulista de Medicina - Federal University of São Paulo, São Paulo, Brazil

Regina S Moises, MD , Escola Paulista de Medicina - Federal University of São Paulo, São Paulo, Brazil

João Paulo B Vieira-Filho, MD , Escola Paulista de Medicina - Federal University of São Paulo, São Paulo, Brazil

INTRODUCTION: Xavante Indians live in the scrubland of Central Brazil, state of Mato Grosso, and have a low degree of admixture confirmed by genome-wide analysis. Traditionally hunter-gatherers, and due to conflicts with newcomer farmers , started to be settled in delimitated areas in 1957. This new condition produced important changes in their traditional way of life. In spite of these changes, some traditional habits are still preserved, like festivals, seclusion of adolescent boys, young age at marriage, large number of pregnancies and prolonged breast feeding. Aim: To analyze gender differences in diabetes prevalence, by age, nutritional status and leptin levels.

METHODS: Field work was carried out in the Sangradouro and São Marcos reservations from October 2009 to January 2013. Basal capillary glycemia and 2-hour after 75g of glucose load were measured by a portable HemoCue® 201 glucose analyzer. Blood samples were collected for other laboratory tests. Leptin was measured by commercial ELISA kits. Body fat was measured by bioelectric impedance.

RESULTS: From 948 participants (463 men and 485 women) aged ≥20 years, overall age-adjusted prevalence of diabetes (WHO criteria), with 95% confidence intervals was 28.2% (25.3 – 31.1), being 18.4% (14.9 – 22.2) in men and 40.6% (36.2 – 45.1) in women (p<0.001). Prevalence of diabetes was higher among women in all age-groups (20-29 yrs: 14.1 vs. 4.2%; 30-39 yrs: 31.1 vs. 15.2%; 40-49 yrs: 55.5 vs. 32.5%; 50-59 yrs: 63.6 vs. 27.3% and 60 yrs and more: 46.4 vs. 17.8%). The amount of body fat (%) was 32.6 ± 6.0 in women and 22.7 ± 6.0 in men (p<0.001). Leptin levels (ng/ml) were higher in women (24.0 ± 10.5 vs. 7.4 ± 5.9; p<0.05). Xavante women are having less physical activity to carry out their daily activities.

CONCLUSION:The Xavante women have less physical activity to carry out their daily activities and still keeping high fertility and prolonged breast feedings, conditions of leptin resistance that are associated with higher amount of body fat and insulin resistance. As result, women have higher rates of diabetes than men, even at younger ages.