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Cold climate and unique genetic and environmental factors may influence the prevalence of skin diseases in Greenland. However, there is a lack of epidemiological studies on skin diseases in the adult Greenlandic population. To address this unmet need a cross-sectional study, run by dermatologists from Denmark, the UK, and Switzerland estimated the prevalence and clinical manifestations of skin diseases among adults in East Greenland in May 2022. All adults ≥18 years in the town of Tasiilaq were invited, and 295 individuals aged 18-78 years participated (22.5% of the overall adult population in Tasiilaq). Two-hundred and three participants (69%) had visible signs of current skin disease, and among these, 242 cases of dermatoses were identified. The most common skin diseases were hand eczema (22.4%), lichen simplex (9.5%), discoid eczema (7.1%), psoriasis, atopic dermatitis and acne vulgaris (5.8% each). Scabies was the most frequent infectious skin disease (4.4%). No cases of skin cancer were identified. Atopic dermatitis and psoriasis presented with disease that was of limited extent and different from the classical presentations. Skin diseases showed a high prevalence among adults in East Greenland, and some of them were severe. This indicates a noteworthy public health problem that warrants better access to dermatologist support.
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Dermatopatias , Humanos , Groenlândia/epidemiologia , Adulto , Pessoa de Meia-Idade , Dermatopatias/epidemiologia , Masculino , Feminino , Estudos Transversais , Adulto Jovem , Idoso , Prevalência , AdolescenteRESUMO
Patients with psychotic disorders exhibit elevated mortality and morbidity rates compared to the general population primarily due to comorbid somatic diseases. This study aims to describe the prevalence of selected risk factors and somatic disorders among psychiatric patients with a diagnosis of psychotic disorder. Material and methods: Data were retrieved from Greenland's nationwide electronic medical record. The study population consists of 104 patients diagnosed with a psychotic disorder, encompassing schizophrenia or schizotypal and delusional disorders, residing in Nuuk. The study population comprised 104 patients (68 males and 36 females) with a mean age of 40 years. More than 80% were daily smokers, and 68% had harmful use of cannabis. More than half had dyslipidemia (any imbalance in lipids), while over a quarter were classified as obese with body mass index of 30 kg/m2 or higher. Eighteen percent had hypertension, and six percent suffered from diabetes. This study revealed a notable prevalence of risk factors for somatic diseases, particularly smoking and cannabis use among patients with schizophrenia in Nuuk, indicating that a high prevalence of somatic diseases might be expected as the population gets older and the risk of developing somatic diseases becomes greater. Increased focus on monitoring and preventing those as part of the health care is recommended.
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Estilo de Vida , Transtornos Psicóticos , Esquizofrenia , Transtornos Relacionados ao Uso de Substâncias , Humanos , Groenlândia/epidemiologia , Masculino , Feminino , Adulto , Fatores de Risco , Pessoa de Meia-Idade , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Prevalência , Transtornos Psicóticos/epidemiologia , Esquizofrenia/epidemiologia , Fumar/epidemiologia , Adulto Jovem , Comorbidade , Obesidade/epidemiologia , Dislipidemias/epidemiologia , Diabetes Mellitus/epidemiologia , Hipertensão/epidemiologia , Regiões Árticas/epidemiologia , IdosoRESUMO
Humans are exposed to metals through diet and lifestyle e.g. smoking. Some metals are essential for physiologically body functions, while others are non-essential and can be toxic to humans. This study follows up on metal concentrations in the Greenlandic ACCEPT birth-cohort (mothers and fathers) and compares with other Arctic populations. The data from 2019 to 2020 include blood metal concentrations, lifestyle and food frequency questionnaires from 101 mothers and 76 fathers, 24-55 years, living in Nuuk, Sisimiut, and Ilulissat. A high percentage (25-45%) exceeded international guidance values for Hg. For the mothers, the metal concentrations changed significantly from inclusion at pregnancy to this follow-up 3-5 years after birth; some increased and others decreased. Most metals differed significantly between mothers and fathers, while few also differed between residential towns. Several metals correlated significantly with marine food intake and socio-economic factors, but the direction of the correlations varied. Traditional marine food intake was associated positively with Se, As and Hg. To the best of our knowledge, this study provides the most recent data on metal exposure of both men and women in Greenland, elucidating metal exposure sources among Arctic populations, and documents the need for continuing biomonitoring to follow the exceeding of guidance values for Hg. [Figure: see text].
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Exposição Ambiental , Humanos , Groenlândia/epidemiologia , Feminino , Adulto , Masculino , Regiões Árticas , Pessoa de Meia-Idade , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análise , Adulto Jovem , Metais/sangue , Seguimentos , Fatores Socioeconômicos , Dieta , Estudos de Coortes , Estilo de Vida , Mercúrio/sangueRESUMO
This cross-sectional study sought to assess the prevalence of atrial fibrillation (AF) diagnosis in Greenland among various age groups and examine the corresponding quality of care. We collected data from Greenland's electronic medical records and evaluated the quality of care using six internationally recommended indicators, which are: percentage of AF patients with an assessment of smoking status within the previous year, an assessment of body mass index within the previous year, assessment of blood pressure within the previous year, measurement of thyroid stimulating hormone (TSH), treatment with an anticoagulant and percentage of patients with a measurement of serum-creatinine. We found the prevalence of AF among patients aged 20 years or older in Greenland to be 1.75% (95% CI 1.62-1.88). We found an increasing prevalence of AF with age and a greater proportion of men than women until the age of 74 years. Our study suggests that the associated quality of care could be higher as the requirement of only one of the six quality indicators was met. A lack of registration may partly explain this, and initiatives to improve the quality of care are recommended.
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Fibrilação Atrial , Masculino , Humanos , Feminino , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/epidemiologia , Fibrilação Atrial/terapia , Groenlândia/epidemiologia , Estudos Transversais , Registros Eletrônicos de Saúde , Pressão Sanguínea/fisiologia , PrevalênciaRESUMO
The aim was to test the internal consistency of the Greenlandic version of the COPD Assessment Test (CAT) questionnaire and to estimate the symptom burden in patients with chronic obstructive pulmonary disease (COPD) in Greenland using the CAT questionnaire. A Greenlandic version of the CAT questionnaire was developed including forward translation, reconciliation, backwards translation, and pilot test. Afterwards, a cross-sectional study of patients with COPD was conducted. The internal consistency assessed by the Cronbach α coefficient was 0.823 for the Greenlandic version of the questionnaire (n = 103). The CAT was negatively correlated to spirometry values and current smoking. In the cross-sectional study (n = 250), 81.1% of the patients experienced a high symptom burden (≥10). The main CAT score was 17 (range 0-38). The CAT was used in 9 out of 17 towns in Greenland. The Greenlandic version of the CAT questionnaire demonstrated a good internal consistency. We observed a high burden of symptoms associated with reduced lung function and active smoking status among patient diagnosed with COPD in Greenland. The questionnaire can be used in clinical practice for assessment of symptom burden in patients with COPD in Greenland and may help to increase focus on symptom control and quality of care.
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Doença Pulmonar Obstrutiva Crônica , Humanos , Groenlândia/epidemiologia , Estudos Transversais , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Volume Expiratório Forçado , Fumar/epidemiologia , Inquéritos e QuestionáriosRESUMO
The study evaluates the outcome after surgery for pancreatic and periampullary tumors in Greenlandic Inuit with overall survival (OS) of pancreatic ductal adenocarcinoma (PDAC) as secondary outcome. Results were compared with Danish patients with an identical tumor stage and age operated at the same hospital during the same period from 31. January 1999 to 31. January 2021. Follow up was minimum one year. Preoperative health data shoved a higher rate of smoking among Greenlandic patients, but a lower preoperative comorbidity than in Danish patients. Patients from Greenland had a lower resection rate and a higher rate of palliative operations. Postoperative complications and in-hospital mortality were not significantly different. Adjuvant oncologic treatment was well accepted by Greenlandic patients but less common in a palliative setting than in Danish patients. The one, two, and five-year survival in Greenlandic and Danish patients after radical operation for PDAC was 54.4% vs. 74.6%, 23.4% vs. 48.6%, and 0.0% vs. 23.4%, respectively. The overall survival with non-resectable PDAC was 5.9 and 8.8 months, respectively. It is concluded that although patients from Greenland have the same access to specialized treatment, the outcome after treatment for pancreatic and periampullary cancer is less favorable than in Danish patients.
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Carcinoma Ductal Pancreático , Neoplasias Pancreáticas , Humanos , Groenlândia/epidemiologia , Inuíte , Neoplasias Pancreáticas/cirurgia , Neoplasias Pancreáticas/patologia , Carcinoma Ductal Pancreático/cirurgia , Carcinoma Ductal Pancreático/patologia , Neoplasias PancreáticasRESUMO
Heart Failure (HF) constitutes a significant burden for healthcare around the world. In Greenland, risk factors like smoking, diabetes, and obesity are prevalent. Yet, the prevalence of HF remains unexplored. This register-based cross-sectional study uses data from the national medical record in Greenland to estimate the age- and gender-specific prevalence of HF and to describe the characteristics of patients with HF in Greenland. A total of 507 patients (26% women) with a mean age of 65 years were included based on a diagnosis of HF. The overall prevalence was 1.1% and higher among men compared to women (1.6% vs. 0.6%, p < 0.05). The highest prevalence was among men above 84 years (11.1%). More than half (53%) had a body mass index above 30 kg/m2 and 43% were current daily smokers. The proportion diagnosed with ischaemic heart disease (IHD) was 33%. The overall prevalence of HF in Greenland is consistent with that in other high-income countries, yet high among men in some age groups, compared to Danish men. Almost half the patients were obese and/or smokers. A low prevalence of IHD was observed indicating that other factors may play a role in developing HF among Greenlanders.
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Diabetes Mellitus , Insuficiência Cardíaca , Masculino , Humanos , Feminino , Idoso , Groenlândia/epidemiologia , Estudos Transversais , Prevalência , Diabetes Mellitus/epidemiologia , Obesidade/epidemiologia , Insuficiência Cardíaca/epidemiologiaRESUMO
BACKGROUND: Inflammatory bowel disease (IBD) is sparsely investigated in Arctic populations. The aim of this study was to estimate the prevalence of ulcerative colitis (UC) and Crohn's disease (CD) in Greenland. METHODS: Cross-sectional nationwide data on demography, anthropometry, biochemistry, and pharmacotherapy were extracted from the electronic medical records in Greenland. Diagnoses of UC and CD were based on International Classification of Diseases-Tenth Revision and International Classification of Primary Care-Second Edition coding and treatment with mesalazine. Data from Statistics Greenland were used for prevalence calculations. RESULTS: In total, 254 patients in Greenland experienced IBD, with 214 cases of UC and 40 cases of CD. The overall IBD prevalence was 0.45%, distributed as 0.38% with UC and 0.07% with CD. The IBD prevalence was similar across the 5 regions of Greenland. However, a higher prevalence was observed in the region main towns with the largest populations (0.53%) compared with the small towns along the coastline (0.29%). UC patients were prescribed mesalazine treatment with a frequency of 78%. Furthermore, 10% of all IBD patients received treatment with nonspecific immunomodulators and 7% received biologics. CONCLUSIONS: This study estimates the prevalence and uncovers characteristics of IBD in Greenland. Although CD may be underdiagnosed or less prevalent, the overall prevalence of IBD in Greenland parallels Scandinavian countries and North America. These results boost the knowledge on autoimmune diseases in arctic populations and may guide clinicians in their management of IBD in Greenland. Furthermore, the results may encourage research in IBD across the Arctic regions.
The burden of inflammatory bowel disease has never been investigated in Greenland. This nationwide, cross-sectional, register-based study estimates the prevalence of ulcerative colitis and Crohn's disease in Greenland and reports that the overall prevalence of inflammatory bowel disease in Greenland parallels Western countries.
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Colite Ulcerativa , Doença de Crohn , Doenças Inflamatórias Intestinais , Humanos , Mesalamina/uso terapêutico , Prevalência , Groenlândia/epidemiologia , Estudos Transversais , Doenças Inflamatórias Intestinais/tratamento farmacológico , Doenças Inflamatórias Intestinais/epidemiologia , Colite Ulcerativa/tratamento farmacológico , Colite Ulcerativa/epidemiologia , Colite Ulcerativa/diagnóstico , Doença de Crohn/tratamento farmacológico , Doença de Crohn/epidemiologia , Doença de Crohn/diagnósticoRESUMO
KRAS mutation is one of the most frequent driver mutations in colorectal cancer (CRC) and is also a prognostic biomarker. The aim of the present study was to determine the frequency of KRAS mutations over time in the Greenlandic population diagnosed with CRC. In total, 578 patients with the diagnosis of adenocarcinoma between 1988 and 2017 were identified. The status of KRAS and the mutational subtypes of KRAS mutations were determined in 102 representative samples by the Idylla™ platform in the time periods 1988-1990, 2002-2004, and 2015-2017. The results showed that the frequency of the KRAS mutations increased significantly, from 27% in 1988-1990 to 43% in 2015-2017 (p < 0.001). Furthermore, the most frequent subtypes of KRAS mutations in Greenland were G12D (c.35G > A) with 14%, G12V (c.35G > T) with 7%, and G13D (c.38G > A) with 6%. In conclusion, this study showed that the frequency of KRAS mutations in CRC has been increasing in recent decades in the specific population of Greenland. The results of this study may be used in initiatives related to targeted therapy of CRC in specific ethnicities and in investigations focusing on the environmental factors of cancer-related somatic mutations.
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Adenocarcinoma , Neoplasias Colorretais , Adenocarcinoma/patologia , Neoplasias Colorretais/genética , Neoplasias Colorretais/patologia , Groenlândia/epidemiologia , Humanos , Mutação , Proteínas Proto-Oncogênicas/genética , Proteínas Proto-Oncogênicas p21(ras)/genética , Proteínas ras/genéticaRESUMO
Introduction: For decades, the prevalence of smoking has been high in Greenland. Even so, the prevalence of chronic obstructive pulmonary disease (COPD), a smoking-related disease, remains largely unexplored. This cross-sectional study aimed to estimate the prevalence of COPD and chronic bronchitis (CB) among Inuit workers in the seafood industry in Greenland. Methods: A total of 355 participants, 254 males and 101 females, met the inclusion criteria. Participants had a mean age of 38 years (standard deviation 13.5; range 17-68 years). COPD was diagnosed based on post-bronchodilator ratio between forced expiratory volume within one second and forced vital capacity (FEV1/FVC) below the lower limit of normal (LLN) according to the Global Lung Function Initiative. Participants completed a questionnaire aiming to diagnose CB. Results: The overall prevalence was 9.9% for COPD; 7.4% for CB. Participants were predominantly smokers; 73.2% active smokers, 91.8% active or former smokers. The prevalence of COPD was high, especially among those under 40 years of age. Both COPD and CB were associated with smoking status. Discussion: This study among Greenlandic seafood workers found that smoking was a risk factor for COPD and CB among Greenlanders of Inuit origin. The high prevalence of COPD and the high prevalence of smoking underlines the importance of further initiatives to reduce smoking in Greenland.
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Bronquite Crônica , Doença Pulmonar Obstrutiva Crônica , Adolescente , Adulto , Idoso , Bronquite Crônica/diagnóstico , Bronquite Crônica/epidemiologia , Estudos Transversais , Feminino , Groenlândia/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Alimentos Marinhos/efeitos adversos , Fumar/efeitos adversos , Fumar/epidemiologia , Espirometria , Adulto JovemRESUMO
In-depth reviewing of all medical records and clinical databases concluded a 7-year shorter lifespan among Greenlanders infected with hepatitis B virus (HBV) compared with non-infected. Mortality did not associate with liver disease or any other specific disease entity. A possible mechanism for the reduced lifespan is subclinical inflammation that may be augmented by chronic viral infection. We hypothesized that chronic HBV infection contributes to this process causing a reduced life span. We added measurement of two markers of inflammation to the 10-year follow-up on our study of HBV among 50- through 69-years-old subjects in Greenland. The markers were YKL40 related to liver disease and hsCRP as a global marker of inflammation. Survival was evaluated using Cox regression with time until death entered as dependent variable and age, sex, smoking, alcohol intake, BMI, the presence of HBsAg and one marker of inflammation as explanatory variables. Forty-eight percent of participants with chronic HBV infection were alive after 10 years compared with 65% of participants without infection (p = 0.003). Survival associated with age (p < 0.001), BMI (p = 0.003) and both YKL40 and hsCRP (both, p < 0.001). Harbouring HBV influenced 10-year survival in the Cox regression after adjusting for age, sex, BMI, smoking, alcohol intake and inflammation. In conclusion, chronic low-grade inflammation and being infected with HBV were independent markers of mortality in otherwise healthy subjects. Thus, the 7-year shorter lifespan among Greenlanders with chronic HBV infection seems related to the long-lasting infection. Our findings call for caution in perceiving a chronic infection as benign.
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Hepatite B Crônica , Idoso , Proteína C-Reativa , Proteína 1 Semelhante à Quitinase-3 , DNA Viral , Groenlândia/epidemiologia , Antígenos de Superfície da Hepatite B , Vírus da Hepatite B , Hepatite B Crônica/complicações , Hepatite B Crônica/mortalidade , Humanos , InflamaçãoRESUMO
INTRODUCTION: The seafood industry is the largest industry in Greenland. Work-related diseases and accidents appear to constitute health risks in this sector. The aim was to describe the prevalence of work-related diseases and accidents among workers in the seafood industry in Greenland. METHODS: Data from 311 workers included a questionnaire, lung function measurements, skin prick tests, blood samples, clinical examinations, personal inhalable dust samples and stationary dust measurements. Accident risk was evaluated by work site observations and safety walks. Statistical analyses included mean values and percentage distribution. RESULTS: Exposure levels were highest in shrimp production; 16.1% were sensitised to snow crab, 10.1% to shrimp and 0.3% to fish; 5.2% had probable occupational asthma. Regarding accidents, the annual incidence rate per 100 workers was 10.3%. CONCLUSIONS: Workers in the seafood industry in Greenland have a high prevalence of sensitisation to work-related allergens and occupational asthma closely related to high exposures to shrimp and snow crab allergens. The rate of severe workplace injuries was high. Preventive measures are required. FUNDING: The Health Science Research Council; The Work Environment Council of Greenland; The Greenlandic Workers' Union; Greenland Business Association; Royal Greenland; Polar Seafood; The BANK of Greenland; The Danish Working Environment Research Fund. TRIAL REGISTRATION: The Scientific Ethical Committee for Greenland (2015-11317); The Danish Data Protection Agency, the Central Denmark Region (2012-58-006).
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Doenças Profissionais , Exposição Ocupacional , Acidentes , Animais , Groenlândia/epidemiologia , Humanos , Doenças Profissionais/epidemiologia , Doenças Profissionais/etiologia , Exposição Ocupacional/efeitos adversos , Alimentos Marinhos , Local de TrabalhoRESUMO
PURPOSE: The aim of this study was to compare the consumption of antipsychotic drugs in Denmark and Greenland between 2014 and 2019. We also investigated the use of antipsychotic medication for schizophrenic and non-affective psychotic patients in both countries. METHODS: This study was performed as a register study using data from the medical register in Denmark and Greenland. A cross-sectional study on the prescription of antipsychotic drugs for psychotic patients (F 20-29) in Greenland in September 2020 was also conducted. RESULTS: The prevalence of antipsychotic drug consumption between 2014 and 2019 was higher in Greenland (average 16.9 DDD/1000/day) compared to Denmark (average 9.3 DDD/1000/day) and the consumption increased in Greenland remarkably. Olanzapine was the most widely used drug in both countries and Clozapine consumption was twice as high in Greenland as in Denmark (1.3 versus 0.6 DDD/1000/day). The mean dose of antipsychotics in schizophrenic and non-affective psychotic patients was higher in Greenland than in Denmark and this difference was greatest among institutional residents. In Greenland, 59% of institutional residents received 2 or 3 DDD/day while only 43% in Denmark received it. Polypharmacy was common in both countries. CONCLUSION: The total consumption and the main dose of antipsychotics in schizophrenic patients was higher in Greenland than in Denmark. Factors contributing to the differences noted appear to be a combination of age and gender differences among patients in the two countries. Socio-economic differences, and differences in treatment options can contribute to the differences and must be investigated further.
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Antipsicóticos , Clozapina , Antipsicóticos/uso terapêutico , Clozapina/uso terapêutico , Estudos Transversais , Groenlândia/epidemiologia , Humanos , OlanzapinaRESUMO
BACKGROUND: Greenland is facing an ageing population, and little is known about the characteristics of the elderly population in Greenland. This study offers both a comparison and a description of the demographics, causes of admission, comorbidities and medication of the residents in care homes in the capital, major and minor towns in four of the five administrative regions of Greenland. METHODS: The study was conducted from 2010 to 2016 as a descriptive questionnaire-based cross-sectional study. Data from eligible residents from eight care homes were collected from the regular care staff. Data were categorised into three groups based on town size for analysis. RESULTS: 244 (100 %) of eligible residents participated in the study. Nearly 100 % were of Greenlandic ethnicity based on parents' place of birth, and 62 % were women. The median age at admission/study was 69/71 years for men and 77/79 years for women (both p = 0.001). The median Body Mass Index was 25.6 kg/m2, more than half of the population were previous- or never-smokers and less than ten per cent consumed more than ten drinks of alcohol per week. The most common causes of admission were dementia (25.4 %), stroke (19.3 %) and social causes (11.1 %), while stroke (30.7 %), dementia (29.5 %) and musculoskeletal diseases (25.8 %) were the most common diagnoses at the time of the study. The Barthel Index was used to estimate the residents' level of independence, and residents in smaller towns were found to have a higher level of independence than residents in the capital. The median number of prescribed medications was five, and more residents in the capital were prescribed more than ten medications than elsewhere in Greenland. CONCLUSIONS: This study is the first to describe care home residents in Greenland. We found a population younger than residents in comparable Danish care homes and that women were older than men at admission. In addition, care home residents in the capital had a lower level of independence and a higher number of prescribed medications, which could relate to differences in morbidity, access to health care services and differences in social circumstances influencing the threshold for care home admission.
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Instituição de Longa Permanência para Idosos , Idoso , Estudos Transversais , Feminino , Groenlândia/epidemiologia , Humanos , Masculino , Morbidade , Inquéritos e QuestionáriosRESUMO
The aim of this study was to estimate the age- and gender-specific prevalence and quality of care among patients using medication targeting obstructive lung disease in the five regions of Greenland. The study was designed as a cross-sectional study. Data on patients using medication targeting obstructive lung disease was obtained from the electronically medical record used in Greenland. The prevalence was calculated using the population of Greenland as background population. The quality of care was determined using indicators proposed by international literature and the Steno Diabetes Center Greenland guidelines. The total prevalence of patients using medication targeting obstructive lung disease was 7.5%. The prevalence was significantly higher among women compared to men and differed significantly between the five regions. Smoking status, blood pressure and spirometry were registered within one/two years for 29.8%/43.2%, 29.2%/41.1% and 15.9%/26.0% of the patients, respectively. Regional differences were observed for all indicators.The use of medication targeting obstructive lung disease is common in Greenland. Yet, the quality of care was low and interventions improving the quality of care is recommended.
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Diabetes Mellitus , Pneumopatias Obstrutivas , Estudos Transversais , Feminino , Groenlândia/epidemiologia , Humanos , Inuíte , Pneumopatias Obstrutivas/tratamento farmacológico , Pneumopatias Obstrutivas/epidemiologia , Masculino , PrevalênciaRESUMO
The Inuit in Greenland have gone through dramatic lifestyle changes during the last half century. More time is spent being sedentary and imported foods replaces traditional foods like seal and whale. The population has also experienced a rapid growth in obesity and metabolic disturbances and diabetes is today common despite being almost unknown few decades ago. In this paper, we describe and discuss the role of lifestyle changes and genetics for Inuit metabolic health. Novelty: Cardiometabolic disease risk has increased in Greenland. Lifestyle changes and possibly gene-lifestyle interactions play a role.
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Diabetes Mellitus Tipo 2/epidemiologia , Dieta/métodos , Exercício Físico , Predisposição Genética para Doença/epidemiologia , Inquéritos Epidemiológicos/métodos , Obesidade/epidemiologia , Groenlândia/epidemiologia , Humanos , Inuíte/estatística & dados numéricos , Comportamento SedentárioRESUMO
BACKGROUND: Amongst the indigenous Greenlandic Inuit, the experience of food insecurity has been attributed to a lack of money to buy enough food of sufficient quality to sustain a family, although a preference for alcohol and tobacco over food has also been cited. The purpose of the article was to compare dietary patterns and expenditure on food, alcoholic beverages and tobacco between survey participants who reported food insecurity and those who did not. METHODS: A countrywide cross-sectional health survey was carried out among 1886 adult Greenlandic Inuit in 2018. Diet was estimated by a food frequency questionnaire. Food insecurity status was based on the household hunger scale. Analyses were carried out by univariate general linear models adjusted for age, sex and social position. RESULTS: Nine percent of the participants reported food insecurity. Food insecurity was higher among younger participants, men and participants with low social position. Food insecure participants more often chose an unhealthy dietary pattern (43% vs. 32%) and they reported a higher energy intake. The food insecure spent the same amount of money on food as other participants but less on nutritious food and more on non-nutritious food. The cost per kilojoule (kJ) of the food of the food insecure was lower than that of the food secure (DKK 8.0 and 9.0 per 1000 kJ, respectively). The food insecure participants also spent considerably more on alcohol and tobacco. CONCLUSIONS: The results suggest that it is not only unemployment and lack of money that creates food insecurity and unhealthy dietary patterns in Greenland. Food insecure participants gave higher priority to buying non-nutritious food, alcohol and tobacco than did food secure participants. There seems to be at least two population subgroups in Greenland with poverty and substance use, respectively, as the immediate determinants for food insecurity. The results are important for the design of interventions against food insecurity and unhealthy dietary patterns.
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Nicotiana , Saúde da População , Adulto , Estudos Transversais , Insegurança Alimentar , Abastecimento de Alimentos , Groenlândia/epidemiologia , Gastos em Saúde , Inquéritos Epidemiológicos , Humanos , Inuíte , Masculino , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Hip geometry influences hip fracture risk. Hip fractures are common, and they are associated with pain, disability, premature death and marked costs on society. Osteoporotic fractures are frequent in Arctic populations and increase with advancing age in this society with a steep rise in life expectancy. Greenland Inuit is a distinct ethnic group, and data on hip geometry is missing. We thus aimed to describe hip geometry in 7.7 years of consecutive hip fracture patients in Greenland. METHODS: We evaluated collodiaphysial angle, femoral neck length, the outer and inner diameter of the femur at 2 and 5 centimetres below the centre of the lesser trochanter and the cortical thickness from pelvic and hip radiographs in all patients operated in Greenland over 7.7 years. We included all 84 patients with one non-fractured hip visible for geometric analysis. Analyses were conducted in duplicate. RESULTS: We found a collodiaphysial angle of 134.8/132.6o in men/women (p = 0.06) and a femoral neck length of 38.0/33.9 mm in men/women (p = 0.001). Cortical thickness was affected by sex in the adjusted analysis (p < 0.001). Cortical thickness index at 5 cm below the centre of the lesser trochanter decreased with age (p = 0.026) and may be influenced by height (2 cm below the centre of the lesser trochanter, p = 0.053). CONCLUSION: Our findings differed from European data and suggest a delicate balance in hip geometry in Arctic populations. Ethnic peculiarities influence the structure of the hip and may influence fracture risk. A focus on hip geometry and risk factors for osteoporotic fractures in Arctic populations is warranted.
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Fraturas do Quadril/epidemiologia , Articulação do Quadril/anatomia & histologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Groenlândia/epidemiologia , Fraturas do Quadril/diagnóstico por imagem , Articulação do Quadril/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Fatores de RiscoRESUMO
OBJECTIVE: Dietary transition, obesity and risky use of alcohol and tobacco are challenges to public health among indigenous peoples. The aim of the article was to explore the role of social position in dietary patterns and expenditures on food and other commodities. DESIGN: Countrywide population health survey. SETTING: Greenland. PARTICIPANTS: 2436 Inuit aged 15+ years. RESULTS: Less than half of the expenditures on commodities (43 %) were used to buy nutritious food, and the remaining to buy non-nutritious food (21 %), alcoholic beverages (18 %) and tobacco (18 %). Participants were classified according to five dietary patterns. The cost of a balanced diet and an unhealthy diet was similar, but the cost per 1000 kJ was higher and the energy consumption was lower for the balanced diet. Participants with low social position chose the unhealthy pattern more often than those with high social position (40 % v. 24 %; P < 0·0001), whereas those with high social position more often chose the balanced alternative. Participants with low social position spent less money on the total food basket than those with high social position but more on non-nutritious food, alcohol and tobacco. CONCLUSIONS: Cost seems to be less important than other mechanisms in the shaping of social dietary patterns and the use of alcohol and tobacco among the Inuit in Greenland. Rather than increasing the price of non-nutritious food or subsidising nutritious food, socially targeted interventions and public health promotion regarding food choice and prevention of excessive alcohol use and smoking are needed to change the purchase patterns.
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Inuíte , Nicotiana , Dieta , Groenlândia/epidemiologia , Gastos em Saúde , Humanos , Determinantes Sociais da SaúdeRESUMO
INTRODUCTION: The aim was to describe the treatment-seeking population with alcohol use disorder by means of data from the AUDIT questionnaire at referral and to evaluate and discuss if this information can be of use in treatment and service planning. METHODS: Data from 2016 to 2018 were extracted from the National Database on Substance Abuse Treatment. The sample included 1281 individual treatment seekers from all over Greenland. RESULTS: Mean age was 38.2 years (SD 12.1 years). Only 60.1% had a total AUDIT score suggesting dependency, and 15.5% had a harmful use. While most only drank 2-4 times a month, about 95% binge drank. Half reported loss of control at least weekly, and one of three had been unable to do what was expected of them, or needed a drink first thing in the morning weekly or more often. In two-third others had been concerned about the drinking. Users of cannabis had a higher AUDIT score, while gambling was unassociated to alcohol use. Substantial gender and regional differences were seen. DISCUSSION: The AUDIT screening was found useful in individual and national treatment planning. Data suggested that particular focus should be given to women in treatment, and the service offered to the East Greenlandic population.