Diabetes mellitus and associated diseases in the adult Bororo population from the Meruri Indian Reservation - MT

• Grant number: 17/20500-9
• Support Opportunities: Regular Research Grants
• Start date: July 01, 2018
• End date: June 30, 2020
• Field of knowledge: Health Sciences - Collective Health - Preventive Medicine
• Principal Investigator: Laercio Joel Franco
• Grantee: Laercio Joel Franco
• Host Institution: Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil
• Associated researchers: Amaury Lelis Dal Fabbro ; Anderson Soares da Silva ; João Paulo Botelho Vieira Filho ; Regina Celia Mello Santiago Moises

Abstract

The epidemics of type 2 diabetes is a world wide phenomenon. Populations from developing countries and from some ethinic groups, particulartly the native American population are of increased risk for diabetes. Reports about the elevated frequency of diabetes in native American Indians focussed mainly the North and Central America. There are few reports about the presence of diabetes among Brazilian Indians and the existing ones report a low prevalence. Study carried out by our group among the Xavante Indians from the Sangradouro/Volta Grande and São Marcos Reservation, that are in in permanente contact with the Brazilian society since 1956, showed a prevalence of diabetes of 28.2% in the adult population, that is a prevalence three fold higher than that found in the general Brazilian population. In an area neighbour to the Xavante territory, in the Meruri Reservation, live the Bororo Indians, that belong to the same linguistic group, the Macro-Jê, and are in permanente contact with the Brazilian society since 1902, and by the existing reports have a frequency of diabetes. The Xavante and Bororo live in constant hostility and are traditional enemies. The existence of two populations, with low degree of admixture, living in the same geographic area, from the same linguistic group and that differ from the duration of the contact with the Brazilian society and diferente pattern of frequency of diabetes, could provide an interesting model to study factors related to the etiology of type 2 diabetes. Objectives: 1-To estimate the prevalence of diabetes, hypertension, dyslipidemia and weight excess in the adult Bororo Indians. 2 - To compare the prevalence of diabetes, hypertension, dyslipidemia and weight excess between the Bororo and Xavante in relation to some variables, as anthropometric, nutritional and metabolic, looking to identify factors associated with the diferences. Methods: A survey will be carried out in the Meruri Reservation, in the Southwest of the state of Mato Grosso, during three or four trips, to examine the adult Bororo population, estimated in 300 individuals. All those that agree to participate, will sign an informed consent form and will undergo to a clinical examination, with measurement of the weight, height, waist, hip and tigh circumferences,blood pressure, bioelectric impedance and collection of blood samples to measure glycemia, lipides, apolipoproteins A and B, leptin, adiponectin, C-reactive protein, C-peptide and HbA1c. The laboratory measurements will be carried out at the Central Laboratory of the São Paulo Hospital - Escola Paulista de Medicina. Initially, a capillary glycemia will be performed with a protable glycosimeter (One Touch); for those without previous history of diabetes or with capillary glycemia d200mg/dl, a 75g glucose load will be performed with measurement of glycemia two hour later. A blood sample will be used for DNA extration, for genoma wide asssociation studies (GWAS) to identify loci of suscetibility to different metabolic traits (glucose intolerance, dyslipidemia, levels of adiponectin and body fat composition). For those with diabetes, a casual urine sample will be taken to measure urinary albumin and creatinine. Data analysis: The initial analysis will consist in the description of frequencies of variables of interest, and in the analysis of association between some risk factors and presence of disease. Due to the cross-sectional design of the study, the multivariated models will be adusted to analyse models of linear regression or multiple logistic. Ethical Aspects: This study was approved by the local (CEP: HCRP-FMRP/USP) and national (CONEP) ethics committee, and also by the National Indian Foundation (FUNAI). The community from the Meruri Reservation was visited by the investigator in the years 2015, 2016 and 2017, when the study was presented and discussed with the local leaders. (AU)