The obesity-associated risk of cardiovascular disease and all-cause mortality is not lower in Inuit compared to Europeans: A cohort study of Greenlandic Inuit, Nunavik Inuit and Danes. (October 2017)

• Record Type: Journal Article
• Authors: Rønn, Pernille Falberg; Lucas, Michel; Laouan Sidi, Elhadji A.; Tvermosegaard, Maria; Andersen, Gregers Stig; Lauritzen, Torsten; Toft, Ulla; Carstensen, Bendix; Christensen, Dirk Lund; Jørgensen, Marit Eika
• Is Part Of: Atherosclerosis. Volume 265(2017)
• Page Start: 207
• Page End: 214
• Publication Date: 2017-10
• Subjects: Obesity -- Epidemiology -- Cardiovascular disease -- Mortality -- Ethnicity -- Inuit; Arteriosclerosis -- Periodicals; Electronic journals; 616.136
• DOI: 10.1016/j.atherosclerosis.2017.08.011
• Languages: English
• ISSNs: 0021-9150

Abstract

Abstract: Background and aims: Inuit populations have lower levels of cardiometabolic risk factors for the same level of body mass index (BMI) or waist circumference (WC) compared to Europeans in cross-sectional studies. We aimed to compare the longitudinal associations of anthropometric measures with cardiovascular disease (CVD) and all-cause mortality in Inuit and Europeans. Methods: Using pooled data from three population-based studies in Canada, Greenland and Denmark, we conducted a cohort study of 10, 033 adult participants (765 Nunavik Inuit, 2960 Greenlandic Inuit and 6308 Europeans). Anthropometric measures collected at baseline included: BMI, WC, waist-to-hip-ratio (WHR), waist-to-height-ratio (WHtR) and a body shape index (ABSI). Information on CVD and death was retrieved from national registers or medical files. Poisson regression analyses were used to calculate incidence rates for CVD and all-cause mortality. Results: During a median follow-up of 10.5 years, there were 642 CVD events and 594 deaths. Slightly higher absolute incidence rates of CVD for a given anthropometric measure were found in Nunavik Inuit compared with Greenlandic Inuit and the Europeans; however, no cohort interactions were observed. For all-cause mortality, all anthropometric measures were positively associated in the Europeans, but only ABSI in the two Inuit populations. In contrast, BMI and WC were inversely associated with mortality in the two Inuit populations. Conclusions: Inuit and Europeans have different absolute incidences of CVD and all-cause mortality, but the trends in the associations with the anthropometric measures only differ for all-cause mortality. Previous findings of a lower obesity-associated cardiometabolic risk among Inuit were not confirmed. Highlights: Similar or higher incidence of CVD and all-cause mortality in Inuit than Europeans. Same trends in the effect of anthropometric measures on CVD across ethnic group. Ethnic differences in the effect of anthropometric measures on all-cause mortality. Cross-sectional evidence of lower obesity-associated CVD risk in Inuit not confirmed.