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

Wellcome Open Research

article

Josephine Tumusiime¹  Jacent Nassuuna¹  Bridgious Walusimbi¹  Stephen Cose¹  Ponsiano Ocama³  Richard K. Grencis⁴  Alison M. Elliott¹  Emily L. Webb⁵  Richard E. Sanya¹  Irene Andia Biraro³  Margaret Nampijja¹  Christopher Zziwa¹  Carol Nanyunja¹  Denis Nsubuga¹  Samuel Kiwanuka¹ 

[1] Immunomodulation and Vaccines Programme, Medical Research Council/ Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit;Department of Clinical Research, London School of Hygiene and Tropical Medicine;Department of Internal Medicine, School of Medicine, College of Health Sciences, Makerere University;Faculty of Biology, Medicine and Health, University of Manchester;MRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine;Maternal and Child Wellbeing Unit, African Population and Health Research Center

关键词: Rural;    Urban;    Metabolic;    Hypertension;    Diabetes;    Insulin resistance;    Helminths;    Africa;   

DOI  :  10.12688/wellcomeopenres.15616.2

学科分类：内科医学

来源: Wellcome

【 摘 要 】

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.

【 授权许可】

CC BY