Contrasting impact of rural, versus urban, living on glucose metabolism and blood pressure in Uganda.

Autor:	Sanya RE; Immunomodulation and Vaccines Programme, Medical Research Council/ Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda.; Department of Internal Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda., Andia Biraro I; Department of Internal Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda., Nampijja M; Immunomodulation and Vaccines Programme, Medical Research Council/ Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda.; Maternal and Child Wellbeing Unit, African Population and Health Research Center, Nairobi, Kenya., Zziwa C; Immunomodulation and Vaccines Programme, Medical Research Council/ Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda., Nanyunja C; Immunomodulation and Vaccines Programme, Medical Research Council/ Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda., Nsubuga D; Immunomodulation and Vaccines Programme, Medical Research Council/ Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda., Kiwanuka S; Immunomodulation and Vaccines Programme, Medical Research Council/ Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda., Tumusiime J; Immunomodulation and Vaccines Programme, Medical Research Council/ Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda., Nassuuna J; Immunomodulation and Vaccines Programme, Medical Research Council/ Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda., Walusimbi B; Immunomodulation and Vaccines Programme, Medical Research Council/ Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda., Cose S; Immunomodulation and Vaccines Programme, Medical Research Council/ Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda.; Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK., Ocama P; Department of Internal Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda., Grencis RK; Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK., Elliott AM; Immunomodulation and Vaccines Programme, Medical Research Council/ Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda.; Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK., Webb EL; MRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
Jazyk:	angličtina
Zdroj:	Wellcome open research [Wellcome Open Res] 2020 Aug 24; Vol. 5, pp. 39. Date of Electronic Publication: 2020 Aug 24 (Print Publication: 2020).
DOI:	10.12688/wellcomeopenres.15616.2
Abstrakt:	Background:  The burden of cardiometabolic diseases, including cardiovascular diseases and diabetes, is increasing in sub-Saharan Africa and this has been linked to urbanisation. Helminths, through their immunomodulatory properties, may protect against these disorders. We hypothesised that the rural environment protects against cardiometabolic diseases and that helminths may influence rural-urban disparity of cardiometabolic disease risk. Methods:  We compared metabolic parameters of individuals aged ≥10 years living in rural, high-helminth-transmission and urban, lower-helminth-transmission settings in Uganda. Cross-sectional surveys were conducted in rural Lake Victoria island fishing communities and in urban sub-wards in Entebbe municipality. Helminth infection and outcomes, including insulin resistance (computed using the homeostatic model assessment of insulin resistance [HOMA-IR]), fasting blood glucose, fasting blood lipids, blood pressure, body mass index (BMI), waist and hip circumference, were assessed. Results:  We analysed 1,898 rural and 930 urban participants. Adjusting for BMI, exercise, smoking, alcohol intake, age and sex, urban residents had lower mean fasting glucose (adjusted mean difference [95%CI] 0.18 [-0.32, -0.05] p=0.01) and HOMA-IR (-0.26 [-0.40, -0.11] p=0.001) but higher blood pressure (systolic, 5.45 [3.75, 7.15] p<0.001; diastolic, 1.93 [0.57, 3.29] p=0.006). Current helminth infection did not explain the observed differences. Conclusions:  In the Ugandan context, living in rural fishing communities may protect against hypertension but worsen glucose metabolism. Competing Interests: No competing interests were disclosed. (Copyright: © 2020 Sanya RE et al.)
Databáze:	MEDLINE
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