M. Abu Sayeed, Parvin Akter Khanam, Muhammad Tofazzal Hussain, Mir Masudur Rhaman, Shurovi Sayeed, Tanjima Begum, M. Abu Hana Golam Morshed, Akhter Banu

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Department of Community Medicine, Ibrahim Medical College, Dhaka, Bangladesh.
Department of Epidemiology, BIRDEM, Dhaka, Bangladesh.
Institute of Nutrition and Food Science, University of Dhaka, Dhaka, Bangladesh.
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Abstract: BACKGROUND: Santhal (Santals) tribe is one of the oldest and largest aboriginal pre Aryan populations in India and Bangladesh. There was no published report on the prevalence of diabetes and hypertension. OBJECTIVE: To determine the prevalence of type 2 diabetes mellitus (T2DM) and hypertension in a Santhal tribe of Bangladesh. RESEARCH DESIGN AND METHODS: Eight villages inhabited largely by Santhal tribe were purposively selected. All Santhals aged 20 years or more were considered eligible and enlisted for the study. Investigations included socio-demographic information (age, sex, education, income), clinical history (general illness), anthropometry (height, weight, waist-girth, hip-girth) and blood pressure. Body mass index (BMI) and waist-to-hip ration (WHR) were calculated. Blood samples were collected for fasting plasma glucose (FPG), total cholesterol (Chol), triglycerides (TG), urea and creatinine. RESULTS: Thirteen hundred eligible Santhals were enlisted. Of them, 1049 (80.7%) participated in the study. The male and female participants were 40% and 60%, respectively. The prevalence of T2DM was 0.6% and hyperglycemia (FPG > 5.5 mmol/l) was 10.0%. The prevalence of systolic hypertension (sHTN) was 24.4% and diastolic hypertension (dHTN) was 24.6%. Compared with the males the females had significantly higher prevalence of sHTN (OR, 2.20 with 95% CI, 1.62 - 3.02) and dHTN (OR, 1.81 with CI, 1.34 - 2.0); whereas, the prevalence of T2DM and IFG did not differ. Regarding obesity 45% of the participants had BMI < 18.5 and only 5% had BMI > 23.1. Logistic regression estimated that the increasing age, female sex, higher FPG (>5.5 mmol/l) and higher Chol (>160 mg/dl) had independent risk for sHTN and dHTN. CONCLUSIONS: The Santhals had less risk for diabetes but increased risk for hypertension. The Santhal females had excess risk of hypertension. Advancing age, female sex, hyperglycemia and hypercholesterolemia were found to have significant risk for hypertension. Obesity had no effect on diabetes or hypertension. High dietary salt intake among Santhals might have contributed to the development of hypertension. Further study may confirm the study findings and to understand why this tribe is less susceptible to diabetes and more to hypertension.

Keywords: Santhal, Obesity, Diabetes, Hypertension, Lipids

Cite this paper: Sayeed, M. , Khanam, P. , Hussain, M. , Rhaman, M. , Sayeed, S. , Begum, T. , Morshed, M. and Banu, A. (2014) Diabetes and Hypertension in a Santhal Tribe in Bangladesh: A Population Based Study. Journal of Diabetes Mellitus, 4, 133-140. doi: 10.4236/jdm.2014.42020.

References

[1]   King, H. and Rewers, M. (1993) Global Estimates for Prevalence of Diabetes Mellitus and Impaired Glucose Tolerance in Adults. Diabetes Care, 16, 157-177. http://dx.doi.org/10.2337/diacare.16.1.157

[2]   Rock, M. (2003) Sweet Blood and Social Suffering: Rethinking Cause-Effect Relationships in Diabetes, Distress, and Duress. Medical Anthropology, 22, 131-74. http://dx.doi.org/10.1080/01459740306764

[3]   Greenlund, K.J., Valdez, R., Casper, M.L., Rith-Najarian, S. and Croft, J.B. (1999) Prevalence and Correlates of the Insulin Resistance Syndrome among Native Americans. The Inter-Tribal Heart Project. Diabetes Care, 22, 441-447. http://dx.doi.org/10.2337/diacare.22.3.441

[4]   Hoehner, C.M., Greenlund, K.J., Rith-Najarian, S., Casper, M.L. and McClellan, W.M. (2002) Association of the Insulin Resistance Syndrome and Microalbuminuria among Nondiabetic Native Americans. The Inter-Tribal Heart Project. Journal of the American Society of Nephrology, 13, 1626-1634.
http://dx.doi.org/10.1097/01.ASN.0000015762.92814.85

[5]   Burrows, N.R., Geiss, L.S., Engelgau, M.M. and Acton, K.J. (2000) Prevalence of Diabetes among Native Americans and Alaska Natives, 1990-1997: An Increasing Burden. Diabetes Care, 23, 1786-1790. http://dx.doi.org/10.2337/diacare.23.12.1786

[6]   Pioro, M.P., Dyck, R.F. and Gillis, D.C. (1996) Diabetes Prevalence Rates among First Nations Adults on Saskatchewan Reserves in 1990: Comparison by Tribal Grouping, Geography and with Non-First Nations People. Canadian Journal of Public Health, 87, 325-328.

[7]   Rowley, K.G., Iser, D.M., Best, J.D., O’Dea, K., Leonard, D. and McDermott, R. (2000) Albuminuria in Australian Aboriginal People: Prevalence and Associations with Components of the Metabolic Syndrome. Diabetologia, 43, 1397-1403. http://dx.doi.org/10.1007/s001250051545

[8]   Elbagir, M.N., Eltom, M.A., Elmahadi, E.M., Kadam, I.M. and Berne, C. (1998) A High Prevalence of Diabetes Mellitus and Impaired Glucose Tolerance in the Danagla Community in Northern Sudan. Diabetic Medicine, 15, 164-169. http://dx.doi.org/10.1002/(SICI)1096-9136(199802)15:2<164::AID-DIA536>3.0.CO;2-A

[9]   El Mugamer, I.T., Ali Zayat, A.S., Hossain, M.M. and Pugh, R.N. (1995) Diabetes, Obesity and Hypertension in Urban and Rural People of Bedouin Origin in the United Arab Emirates. The Journal of Tropical Medicine and Hygiene, 98, 407-415.

[10]   Chen, H.D., Shaw, C.K., Tseng, W.P., Chen, H.I. and Lee, M.L. (1997) Prevalence of Diabetes Mellitus and Impaired Glucose Tolerance in Aborigines and Chinese in Eastern Taiwan. Diabetes Research and Clinical Practice, 38, 199-205. http://dx.doi.org/10.1016/S0168-8227(97)00104-6

[11]   Sayeed, M.A., Mahtab, H., Khanam, P.A., Ahsan, K.A., Banu, A., Bazlur Rashid, A.N.M. and Azad Khan, A.K. (2004) Diabetes and Impaired Fasting Glycemia in the Tribes of Khagrachari Hill-Tracts of Bangladesh. Diabetes Care, 27, 1054-1059. http://dx.doi.org/10.2337/diacare.27.5.1054

[12]   Santhal Tribe, Art and Culture of Santhal Tribe, Santhal Tribe in India.
http://www.indianmirror.com/tribes/santhaltribes.html

[13]   Guha, B.S. (1944) Racial Elements in the Populations. Oxford University Press, Oxford.

[14]   Ghosh, S. and Malik, S.L. (2007) Sex Differences in Body Size and Shape among Santhals of West Bengal. Anthropologist, 9, 143-149.

[15]   Sayeed, M.A., Mahtab, H., Khanam, P.A., Latif, Z.A., Ali, S.M.K., Banu, A., Ahren, B. and Azad Khan, A.K. (2003) Diabetes and Impaired Fasting Glycemia in a Rural Population of Bangladesh. Diabetes Care, 26, 1034-1039. http://dx.doi.org/10.2337/diacare.26.4.1034

[16]   American Diabetes Association (1997) Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care, 20, 1183-1197.

[17]   Sayeed, M.A., Mahtab, H., Khanam, P.A., Latif, Z.A., Banu, A. and Azad Khan, A.K. (2007) Prevalence of Diabetes and Impaired Fasting Glucose in Urban Population of Bangladesh. Bangladesh Medical Research Council Bulletin, 33, 1-12.

[18]   Sayeed, M.A., Banu, A., Khanam, P.A., Mahtab, H. and Azad Khan, A.K. (2002) Prevalence of Hypertension in Bangladesh: Effect of Socioeconomic Risk on Difference between Rural and Urban Community. Bangladesh Medical Research Council Bulletin, 28, 7-18.

[19]   Lifton, R.P., Hopkins, P.N., Williams, R.R., Hollenberg, N.K., Williams, G.H. and Dluhy, R.G. (1989) Evidence for Heritability of Non-Modulating Essential Hypertension. Hypertension, 13, 884-889.
http://dx.doi.org/10.1161/01.HYP.13.6.884