Background. Suicide is a serious public health challenge in circumpolar regions, especially among... more Background. Suicide is a serious public health challenge in circumpolar regions, especially among Indigenous youth. Indigenous communities, government agencies and health care providers are making concerted efforts to reduce the burden of suicide and strengthen protective factors for individuals, families and communities. The persistence of suicide has made it clear that more needs to be done. Objective. Our aim was to undertake a scoping review of the peer-reviewed literature on suicide prevention and interventions in Indigenous communities across the circumpolar north. Our objective was to determine the extent and types of interventions that have been reported during past decade. We want to use this knowledge to support community initiative and inform intervention development and evaluation. Design. We conducted a scoping review of online databases to identify studies published between 2004 and 2014. We included articles that described interventions in differentiated circumpolar I...
We undertook studies of the association between common genomic variations in APOC3, APOA5, APOE a... more We undertook studies of the association between common genomic variations in APOC3, APOA5, APOE and PON1 genes and variation in biochemical phenotypes in a sample of Greenlanders. Genetic association study of quantitative lipoprotein traits. In a sample of 1,310 adult Greenlanders, fasting plasma lipid, lipoprotein and apolipoprotein (apo) concentrations were assessed for association with known functional genomic variants of APOC3, APOA5, APOE and PON1. For significantly associated polymorphisms, between-genotype differences were examined in closer detail. We found that (1) the APOE restriction isotype was associated with variation in plasma total and LDL cholesterol and apo B (all p < .0001); (2) the APOC3 promoter genotype was associated with variation in plasma triglycerides, HDL cholesterol and apo A-I (all p < .002); (3) the APOA5 codon 19 genotype was associated with variation in plasma triglycerides (p = .027); and (4) the PON1 codon 192 genotype was associated with var...
The paper aims to explore what knowledge can be obtained about violence through population-based ... more The paper aims to explore what knowledge can be obtained about violence through population-based data and additionally, through inter-country comparisons of violence data. Data on lifetime and 12-month experiences of violence and/or severe threats of violence were obtained from self-administered questionnaires supplementary to nationwide, cross-sectional health interview surveys conducted in Greenland in 1993-94 (N=2,425) and in Denmark in 2000 (N=16,684). The overall response rate achieved for the self-administered questionnaire was 63% (N=1,393) in Greenland and 63% (N=10,458) in Denmark. A comparison of violence data shows that overall, the violence prevalence was significantly higher in Greenland than Denmark. Experienced violence and/or severe threats amongst Greenlandic women was almost as prevalent as amongst Greenlandic men--especially so for severe lifetime violence. This was not the case for the Danish sample. Significantly more Danish men than Danish women reported experi...
The population of Greenland comprises almost 31,000 Inuit Greenlanders aged 20-65. The purpose of... more The population of Greenland comprises almost 31,000 Inuit Greenlanders aged 20-65. The purpose of this study was to estimate trends in expected life years between age 20 and 65 in good and poor health, and to compare changes between men and women since the mid-1990s. Partial life expectancy was calculated and combined with prevalence data on self-rated health, longstanding illness and musculoskeletal diseases derived from health surveys carried out in 1993-94, 1999-2001 and 2005-10. Trends for men and women were compared and changes were decomposed into contributions from changes in mortality and disability. Partial life expectancy increased by 2.2 years for men and 0.8 years for women during the entire period. However, expected lifetime in self-rated good health decreased by 3.3 years for men and by 4.6 years for women (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01). For men, life expectancy without longstanding illness increased by 4.7 years (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). The increase for women by 1.4 years was non-significant (p=0.29). Expected lifetime without musculoskeletal diseases increased significantly by 4.5 years for men and by 1.9 years for women. The development of expected lifetime without longstanding illness supports the theory of compression of morbidity, but as the trend direction differs according to which measure for health is used, a definite conclusion cannot be drawn. The different rate of development of partial life expectancy and expected lifetime in good health between men and women is remarkable, and has reduced the gender gap. The results call for special concern about the women&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s health in Greenland.
Inuit are considered to be vulnerable to cardiovascular disease because their lifestyles are beco... more Inuit are considered to be vulnerable to cardiovascular disease because their lifestyles are becoming more Westernized. During sequence analysis of Inuit individuals at extremes of lipid traits, we identified 2 nonsynonymous variants in low-density lipoprotein receptor (LDLR), namely p.G116S and p.R730W. Genotyping these variants in 3324 Inuit from Alaska, Canada, and Greenland showed they were common, with allele frequencies 10% to 15%. Only p.G116S was associated with dyslipidemia: the increase in LDL cholesterol was 0.54 mmol/L (20.9 mg/dL) per allele (P=5.6×10(-49)), which was >3× larger than the largest effect sizes seen with other common variants in other populations. Carriers of p.G116S had a 3.02-fold increased risk of hypercholesterolemia (95% confidence interval, 2.34-3.90; P=1.7×10(-17)), but did not have classical familial hypercholesterolemia. In vitro, p.G116S showed 60% reduced ligand-binding activity compared with wild-type receptor. In contrast, p.R730W was assoc...
Low vitamin D status may be pronounced in Arctic populations due to limited sun exposure and decr... more Low vitamin D status may be pronounced in Arctic populations due to limited sun exposure and decreasing intake of traditional food. To investigate serum 25(OH)D3 as a measure of vitamin D status among adult Inuit in Greenland, predictors of low serum 25(OH)D3 concentrations and the trend from 1987 to 2005-2010. A total of 2877 randomly selected Inuit (≥ 18 years) from the Inuit Health in Transition study were included. A sub-sample (n = 330) donated a blood sample in 1987 which allowed assessment of time trends in vitamin D status. The geometric mean serum 25(OH)D3 (25[OH]D2 concentrations were negligible and not reported) in 2005-2010 was lowest among the 18-29 year old individuals (30.7 nmol/L; 95% CI: 29.7; 31.7) and increased with age. In all age-groups it decreased from 1987 to 2005-2010 (32%-58%). Low 25(OH)D3 concentrations (<50 nmol/L) were present in 77% of the 18-29 year old and decreased with age. A characteristic seasonal variation in 25(OH)D3 concentrations was obser...
The human intake of lead, cadmium, mercury and selenium from local Greenlandic marine food was es... more The human intake of lead, cadmium, mercury and selenium from local Greenlandic marine food was estimated based on dietary studies and contaminant information. The average lead intake was calculated to be 15 micrograms/person per week, which is very low, whereas the intake of cadmium and mercury was estimated to be very high, on average 1004 micrograms/person per week for cadmium and 846 for mercury, thereby significantly exceeding limits established by FAO/WHO. The main cadmium and mercury source was seal liver. Selenium intake was also high with whale skin as the dominant source.
Traditional Inuit dietary patterns have been found to be beneficial for CVD but have not been inv... more Traditional Inuit dietary patterns have been found to be beneficial for CVD but have not been investigated in relation to glucose intolerance. We examined the association between dietary patterns and type 2 diabetes mellitus (T2DM), impaired glucose tolerance (IGT) and impaired fasting glucose (IFG). Cross-sectional design with a priori derived dietary patterns from an FFQ resulted in five patterns: imported meat (n 196), traditional food (n 601), balanced diet (n 126), unhealthy diet (n 652) and standard diet (n 799). Associations between dietary patterns and glucose-related outcomes were tested by linear and logistic regression analyses. Data included: dietary intake by FFQ, waist circumference, ethnicity, frequency of alcohol intake and smoking, physical activity, and oral glucose tolerance test results. Fasting participants and those without diagnosed T2DM were classified into normal glucose tolerance, IGT, IFG or T2DM. HOMA-IR (homeostatic model assessment-insulin resistance index) and HOMA-β (homeostatic model assessment of β-cell function) were calculated. Data included 2374 Inuit, aged 18+ years. Participants with a traditional dietary pattern had higher fasting plasma glucose (mean 5·73 (95% CI 5·68, 5·78) mmol/l, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0·0001) and lowest HOMA-β (48·66 (95% CI 46·86, 50·40), P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0·0001). The traditional diet gave significantly higher odds for IFG and T2DM than the balanced diet, imported meat diet, standard diet and unhealthy diet. Traditional food was positively associated with T2DM, IFG and fasting plasma glucose, and negatively associated with β-cell function, compared with a standard diet. The imported meat diet seemed the best in relation to glucose intolerance, with lowest fasting plasma glucose and lowest odds for IFG and T2DM.
Exposure to persistent organic pollutants (POPs) is of concern in Arctic populations since these ... more Exposure to persistent organic pollutants (POPs) is of concern in Arctic populations since these contaminants accumulate in fish and marine mammals, which is an important part of the traditional diet of these populations. Epidemiological and experimental studies have reported significant associations between POPs and increased blood pressure (BP) in populations with different degrees of exposure. We aimed to assess the risk of hypertension related to increasing levels of polychlorinated biphenyls (PCBs) and organochlorine (OC) pesticides. Fifteen PCBs and 11 OC pesticides or their metabolites were determined in plasma of 1614 Inuit adults ≥ 18 years living in 9 towns and 13 villages in Greenland. BP was measured using a standardized protocol. The risk of hypertension was estimated through logistic regression using POPs as continuous variables (log-transformed). Hypertension was defined as systolic BP ≥ 140 mm Hg, diastolic BP ≥ 90 mm Hg and/or antihypertensive treatment. Overall, the odd ratios (ORs) of hypertension were not statistically significant for dioxin-like PCBs, non-dioxin-like PCBs and OC pesticides after adjusting for confounders. Once the analyses were stratified by age category (18-39 and ≥ 40 years), increased risk of hypertension was observed for total dioxin-like PCBs among the youngest [OR: 1.34 (95% CI: 1.03-1.74)] while a borderline protective effect was observed for total non-dioxin-like PCBs [OR: 0.81 (95% CI: 0.66-0.99)] among the oldest. Higher risk of hypertension was also associated with increasing p,p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;-dichlorodiphenyltrichloroethane (DDT) concentrations among the youngest [OR: 1.42 (95% CI: 1.08-1.85)]. Overall, no significant associations were observed between PCBs, OC pesticides and blood pressure in this highly exposed population although the associations differed by age category.
Background. Suicide is a serious public health challenge in circumpolar regions, especially among... more Background. Suicide is a serious public health challenge in circumpolar regions, especially among Indigenous youth. Indigenous communities, government agencies and health care providers are making concerted efforts to reduce the burden of suicide and strengthen protective factors for individuals, families and communities. The persistence of suicide has made it clear that more needs to be done. Objective. Our aim was to undertake a scoping review of the peer-reviewed literature on suicide prevention and interventions in Indigenous communities across the circumpolar north. Our objective was to determine the extent and types of interventions that have been reported during past decade. We want to use this knowledge to support community initiative and inform intervention development and evaluation. Design. We conducted a scoping review of online databases to identify studies published between 2004 and 2014. We included articles that described interventions in differentiated circumpolar I...
We undertook studies of the association between common genomic variations in APOC3, APOA5, APOE a... more We undertook studies of the association between common genomic variations in APOC3, APOA5, APOE and PON1 genes and variation in biochemical phenotypes in a sample of Greenlanders. Genetic association study of quantitative lipoprotein traits. In a sample of 1,310 adult Greenlanders, fasting plasma lipid, lipoprotein and apolipoprotein (apo) concentrations were assessed for association with known functional genomic variants of APOC3, APOA5, APOE and PON1. For significantly associated polymorphisms, between-genotype differences were examined in closer detail. We found that (1) the APOE restriction isotype was associated with variation in plasma total and LDL cholesterol and apo B (all p < .0001); (2) the APOC3 promoter genotype was associated with variation in plasma triglycerides, HDL cholesterol and apo A-I (all p < .002); (3) the APOA5 codon 19 genotype was associated with variation in plasma triglycerides (p = .027); and (4) the PON1 codon 192 genotype was associated with var...
The paper aims to explore what knowledge can be obtained about violence through population-based ... more The paper aims to explore what knowledge can be obtained about violence through population-based data and additionally, through inter-country comparisons of violence data. Data on lifetime and 12-month experiences of violence and/or severe threats of violence were obtained from self-administered questionnaires supplementary to nationwide, cross-sectional health interview surveys conducted in Greenland in 1993-94 (N=2,425) and in Denmark in 2000 (N=16,684). The overall response rate achieved for the self-administered questionnaire was 63% (N=1,393) in Greenland and 63% (N=10,458) in Denmark. A comparison of violence data shows that overall, the violence prevalence was significantly higher in Greenland than Denmark. Experienced violence and/or severe threats amongst Greenlandic women was almost as prevalent as amongst Greenlandic men--especially so for severe lifetime violence. This was not the case for the Danish sample. Significantly more Danish men than Danish women reported experi...
The population of Greenland comprises almost 31,000 Inuit Greenlanders aged 20-65. The purpose of... more The population of Greenland comprises almost 31,000 Inuit Greenlanders aged 20-65. The purpose of this study was to estimate trends in expected life years between age 20 and 65 in good and poor health, and to compare changes between men and women since the mid-1990s. Partial life expectancy was calculated and combined with prevalence data on self-rated health, longstanding illness and musculoskeletal diseases derived from health surveys carried out in 1993-94, 1999-2001 and 2005-10. Trends for men and women were compared and changes were decomposed into contributions from changes in mortality and disability. Partial life expectancy increased by 2.2 years for men and 0.8 years for women during the entire period. However, expected lifetime in self-rated good health decreased by 3.3 years for men and by 4.6 years for women (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01). For men, life expectancy without longstanding illness increased by 4.7 years (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). The increase for women by 1.4 years was non-significant (p=0.29). Expected lifetime without musculoskeletal diseases increased significantly by 4.5 years for men and by 1.9 years for women. The development of expected lifetime without longstanding illness supports the theory of compression of morbidity, but as the trend direction differs according to which measure for health is used, a definite conclusion cannot be drawn. The different rate of development of partial life expectancy and expected lifetime in good health between men and women is remarkable, and has reduced the gender gap. The results call for special concern about the women&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s health in Greenland.
Inuit are considered to be vulnerable to cardiovascular disease because their lifestyles are beco... more Inuit are considered to be vulnerable to cardiovascular disease because their lifestyles are becoming more Westernized. During sequence analysis of Inuit individuals at extremes of lipid traits, we identified 2 nonsynonymous variants in low-density lipoprotein receptor (LDLR), namely p.G116S and p.R730W. Genotyping these variants in 3324 Inuit from Alaska, Canada, and Greenland showed they were common, with allele frequencies 10% to 15%. Only p.G116S was associated with dyslipidemia: the increase in LDL cholesterol was 0.54 mmol/L (20.9 mg/dL) per allele (P=5.6×10(-49)), which was >3× larger than the largest effect sizes seen with other common variants in other populations. Carriers of p.G116S had a 3.02-fold increased risk of hypercholesterolemia (95% confidence interval, 2.34-3.90; P=1.7×10(-17)), but did not have classical familial hypercholesterolemia. In vitro, p.G116S showed 60% reduced ligand-binding activity compared with wild-type receptor. In contrast, p.R730W was assoc...
Low vitamin D status may be pronounced in Arctic populations due to limited sun exposure and decr... more Low vitamin D status may be pronounced in Arctic populations due to limited sun exposure and decreasing intake of traditional food. To investigate serum 25(OH)D3 as a measure of vitamin D status among adult Inuit in Greenland, predictors of low serum 25(OH)D3 concentrations and the trend from 1987 to 2005-2010. A total of 2877 randomly selected Inuit (≥ 18 years) from the Inuit Health in Transition study were included. A sub-sample (n = 330) donated a blood sample in 1987 which allowed assessment of time trends in vitamin D status. The geometric mean serum 25(OH)D3 (25[OH]D2 concentrations were negligible and not reported) in 2005-2010 was lowest among the 18-29 year old individuals (30.7 nmol/L; 95% CI: 29.7; 31.7) and increased with age. In all age-groups it decreased from 1987 to 2005-2010 (32%-58%). Low 25(OH)D3 concentrations (<50 nmol/L) were present in 77% of the 18-29 year old and decreased with age. A characteristic seasonal variation in 25(OH)D3 concentrations was obser...
The human intake of lead, cadmium, mercury and selenium from local Greenlandic marine food was es... more The human intake of lead, cadmium, mercury and selenium from local Greenlandic marine food was estimated based on dietary studies and contaminant information. The average lead intake was calculated to be 15 micrograms/person per week, which is very low, whereas the intake of cadmium and mercury was estimated to be very high, on average 1004 micrograms/person per week for cadmium and 846 for mercury, thereby significantly exceeding limits established by FAO/WHO. The main cadmium and mercury source was seal liver. Selenium intake was also high with whale skin as the dominant source.
Traditional Inuit dietary patterns have been found to be beneficial for CVD but have not been inv... more Traditional Inuit dietary patterns have been found to be beneficial for CVD but have not been investigated in relation to glucose intolerance. We examined the association between dietary patterns and type 2 diabetes mellitus (T2DM), impaired glucose tolerance (IGT) and impaired fasting glucose (IFG). Cross-sectional design with a priori derived dietary patterns from an FFQ resulted in five patterns: imported meat (n 196), traditional food (n 601), balanced diet (n 126), unhealthy diet (n 652) and standard diet (n 799). Associations between dietary patterns and glucose-related outcomes were tested by linear and logistic regression analyses. Data included: dietary intake by FFQ, waist circumference, ethnicity, frequency of alcohol intake and smoking, physical activity, and oral glucose tolerance test results. Fasting participants and those without diagnosed T2DM were classified into normal glucose tolerance, IGT, IFG or T2DM. HOMA-IR (homeostatic model assessment-insulin resistance index) and HOMA-β (homeostatic model assessment of β-cell function) were calculated. Data included 2374 Inuit, aged 18+ years. Participants with a traditional dietary pattern had higher fasting plasma glucose (mean 5·73 (95% CI 5·68, 5·78) mmol/l, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0·0001) and lowest HOMA-β (48·66 (95% CI 46·86, 50·40), P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0·0001). The traditional diet gave significantly higher odds for IFG and T2DM than the balanced diet, imported meat diet, standard diet and unhealthy diet. Traditional food was positively associated with T2DM, IFG and fasting plasma glucose, and negatively associated with β-cell function, compared with a standard diet. The imported meat diet seemed the best in relation to glucose intolerance, with lowest fasting plasma glucose and lowest odds for IFG and T2DM.
Exposure to persistent organic pollutants (POPs) is of concern in Arctic populations since these ... more Exposure to persistent organic pollutants (POPs) is of concern in Arctic populations since these contaminants accumulate in fish and marine mammals, which is an important part of the traditional diet of these populations. Epidemiological and experimental studies have reported significant associations between POPs and increased blood pressure (BP) in populations with different degrees of exposure. We aimed to assess the risk of hypertension related to increasing levels of polychlorinated biphenyls (PCBs) and organochlorine (OC) pesticides. Fifteen PCBs and 11 OC pesticides or their metabolites were determined in plasma of 1614 Inuit adults ≥ 18 years living in 9 towns and 13 villages in Greenland. BP was measured using a standardized protocol. The risk of hypertension was estimated through logistic regression using POPs as continuous variables (log-transformed). Hypertension was defined as systolic BP ≥ 140 mm Hg, diastolic BP ≥ 90 mm Hg and/or antihypertensive treatment. Overall, the odd ratios (ORs) of hypertension were not statistically significant for dioxin-like PCBs, non-dioxin-like PCBs and OC pesticides after adjusting for confounders. Once the analyses were stratified by age category (18-39 and ≥ 40 years), increased risk of hypertension was observed for total dioxin-like PCBs among the youngest [OR: 1.34 (95% CI: 1.03-1.74)] while a borderline protective effect was observed for total non-dioxin-like PCBs [OR: 0.81 (95% CI: 0.66-0.99)] among the oldest. Higher risk of hypertension was also associated with increasing p,p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;-dichlorodiphenyltrichloroethane (DDT) concentrations among the youngest [OR: 1.42 (95% CI: 1.08-1.85)]. Overall, no significant associations were observed between PCBs, OC pesticides and blood pressure in this highly exposed population although the associations differed by age category.
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Papers by Peter Bjerregaard