Gender differences in the association between westernization and metabolic risk among Greenland Inuit

The Inuit have gone through an accelerated process of modernization especially since 1950. Primarily because of the dietary transition, westernisation is expected to influence the Inuit's metabolic risk in a negative way with respect to cardiovascular risk. The aim was to analyze metabolic risk factors among Inuit in Greenland and Denmark and their relation to westernization. 1173 adult Inuit participated in a health survey in Greenland and Denmark. The examination included a 75 g OGTT. BMI, waist-to-hip ratio, and blood pressure were measured. P-glucose, s-insulin, lipids and urine-albumin/creatinine ratio were analysed. Westernization was estimated by place of residence and language. The prevalence of the metabolic syndrome was 20.3% among men and 19.5% among women (p = 0.73). The association between the metabolic syndrome and westernization was different for men and women. For men there was an increase in prevalence of the metabolic syndrome with westernization within Greenland, but the variation was less pronounced than the difference between the migrants and the Inuit in Greenland. Age, family history of diabetes, and non-smoking were directly associated with the metabolic syndrome, whereas high physical activity was negatively associated with the metabolic syndrome. For women there was a significant negative association between westernization and the metabolic syndrome among the three population groups in Greenland, whereas the prevalence was not significantly lower among female migrants compared with Inuit women in Greenland. Age, family history of diabetes, non-smoking, and low education were associated with the metabolic syndrome. The effect of westernization on metabolic risk was different for men and women. For men physical inactivity due to a decrease in subsistence hunting and fishing seems to increase the metabolic risk; for women higher education is associated with a more favorable risk profile.