Increased risks of cardiovascular diseases and insulin resistance among the Orang Asli in Peninsular Malaysia

Abstract

BackgroundDespite the strategic development plan by the authorities for the Orang Asli, there are six subtribes of which their population numbers are small (less than 700). These minorities were not included in most of the health related studies published thus far. A comprehensive physiological and biomedical updates on these small subtribes in comparison to the larger subtribes and the urban Malay population is timely and important to help provide appropriate measures to prevent further reduction in the numbers of the Orang Asli.MethodsA total of 191 Orang Asli from different villages in Peninsular Malaysia and 115 healthy urban Malays were recruited. Medical examinations and biochemical analyses were conducted. Framingham risk scores were determined. Data was analyzed using IBM SPSS Statistics, Version 20.0.ResultsA higher percentage of the Orang Asli showed high insulin levels and hsCRP compared to the healthy Malays denoting possible risk of insulin resistance. High incidences of low HDL-c levels were observed in all the Orang Asli from the six subtribes but none was detected among the urban Malays. A higher percentage of inlanders (21.1 % of the males and 4.2 % of the females) were categorized to have high Framingham Risk Score.ConclusionsOrang Asli staying both in the inlands and peripheries are predisposed to cardiovascular diseases and insulin resistance diabetes mellitus. The perception of Orang Asli being healthier than the urban people no longer holds. We believed that this information is important to the relevant parties in strategizing a healthier community of the Orang Asli to avoid the vanishing of the vulnerable group(s).

Observational study of the status of coronary risk biomarkers among Negritos with metabolic syndrome in the east coast of Malaysia

“…However, we were unable to observe any statistical difference in the concentrations of biomarkers of inflammation, endothelial activation and prothrombogenesis between MS and non-MS among the Negritos. This contradicts previous reports underscoring enhanced inflammation among OAs 30. These inconsistent findings could be attributed to the small sample size of Negritos in comparing the biomarkers, although the minimum sample size calculated was achieved.…”

“…Furthermore, a previous study conducted to determine the prevalence of MS in an OA population found that the prevalence of MS among inland Negritos to be 12.5%, which is consistent with our findings of 12% among our Negrito population 19. The population differences between the previous study and ours could also have led to these differences, where we recruited mainly inland Negritos in the northern state of Malaysia where majority of them are distributed, while the previous study recruited OAs from a mixture of inland and peripheries of towns where urbanisation could have influenced lifestyle, which could enhance inflammation and insulin resistance 30…”

“…Although several reports highlighted the increasing prevalence of NCDs among the OA in Malaysia, there is scarce research that extended to investigate biomarkers for coronary risk among this population. To the best of our knowledge, there is only one other study which reported the status of inflammatory biomarker among OA in Peninsular Malaysia compared with Malays 30. Our study further explored other biomarkers reflecting atherogenesis such as endothelial activation and prothrombogenesis.…”

“…A larger population study done identified central obesity and hypertension among OA sampled from seven different subtribes and eight settlements 1. What is more alarming is the report by Aziz et al , which highlighted the higher percentage of OA having high insulin levels, hsCRP and higher percentage categorised as high risk by the Framingham Risk Score, which forecasts 10-year risk of CAD 30. These reports strongly imply that NCDs such as hypertension, dyslipidaemia, central obesity and DM, which are clusters of metabolic factors associated with MS, have gradually led to the increase in CAD risk among OA.…”

Health and saliva microbiomes of a semi-urbanized indigenous tribe in Peninsular Malaysia

“…As the OA became more urbanized and by large left their ancestral habitats and practices, they led more sedentary lifestyles. These factors, coupled with loss of access to forest resources and increasing pressures to turn to store-bought food, may largely explain the rise in cardio-metabolic diseases such as hypertension, diabetes and obesity shown in recent studies 1, 3, 4 .…”