Transcript Racial influences on health and diseases: The Tai

Racial influences on health
and diseases:
The Tai-Tai Ahom Connection.
Dr. Hemanta Kumar Gogoi
Simaluguri, Assam, India.
Health is a state of complete physical,
mental and social well being.
• Disease:
evil spirits
»Curse of God
Tai Ahoms
‘Khwan’ the guardian spirit of
the body
‘Rik Khwan’ to call back Khwan.
Modern views about diseases
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Age
Sex
Race
Occupation
Economic status
Environment
Modern views about diseases
• Communicable  bacteria, parasites,
virus
• Non-communicable  Hypertension,
obesity, diabetes, etc.
Modern views about diseases
• Genetic basis for diseases:
genetic disorders, metabolic
diseases, cancers;
Infections susceptibility.
Genetic basis of diseases
• Mendelian Theory:
Augustinian monk
Gregor Mendel
1865
Source: http://en.wikipedia.org/wiki/Mendelian_inheritance
Genetic basis of diseases
• Many diseases cystic fibrosis,
hypertension, obesity, etc. etc. have been
ascribed.
• Oxford geneticist (2004) genes
responsible for metabolic syndrome 
variations in DNA sequence ‘SHIP2’
Metabolic syndrome epidemic
• Developing countries are acquiring this
disease syndrome along with the western
world.
• Under nutrition
over nutrition.
• Diabetes explosion: Asia including India.
Diabetes Mellitus.
• Is a state of chronic hyperglycemia due to
absolute or relative lack of insulin.
• Mainly two types: Type 1 & Type 2 (other
types not elaborated here).
• Morbidity and mortalities are due to
complications of diabetes.
Diabetes Mellitus.
Complications:
• Nephropathy
• Retinopathy
• Neuropathy
• Diabetic foot
• Cardiac complications
Diabetes Mellitus.
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Racial differences in complications:
1.
Asians in UK are higher risk of ESRD (Lanting LC et al
2005).
Asian Americans have a lower prevalence of
hypertension and foot ulcerations than Hispanics,
Native Americans and Pacific Islanders.(McNelley MJ
et al 2003).
People in Asia tend to develop diabetes with a lesser
degree of obesity at younger ages, suffer longer with
complications, and die sooner than people in other
regions. (Ko SH et al 2006).
2.
3.
Our Findings in Assam
• 1986: ‘Impaired Glucose Tolerance
Among Assamese Population in
Simaluguri Area, Assam’- 17th Annual Meeting of the
Endocrine Society of India, Mumbai.
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IGT was a common finding.
No family history of diabetes
Non- obese 74%
63% of patients <40 years.
Our Findings in Assam
• 1991: NIDDM Among Assamese Population
With Special Reference to the Tai-Ahoms. [The
Antiseptic, vol 88(4);186-189].
• Obesity was only 20% among Tai Ahoms
compared to non-Ahom groups 44%, Muslims
33.3%.
• Among the Ahoms, Neuropathy (60%),
Hypertension (52%), IHD (28%), Cardiomegaly
(20%), Retinopathy (16%) and Nephropathy
(8%) were the most common complications of
diabetes.
What do we have in common?
• Diabetes at a lower birth weight.
• Lower incidences of foot ulcers and
Charcot’s foot.
• Higher incidence of End Stage Renal
Diseases (dependent on duration of
diabetes).
• Very low incidence of Type 1 diabetes.
Hemoglobinopathy
• A much talked about genetically abnormal Hemoglobin
of blood common among the Tai and Tai Ahoms.
• HbE first reported by Chatterji (1960) among Toto tribes
of Tibetoburman group, Khasis of Austro-asiatic group
and Ahoms of Tai group.
• The incidence of HbE ranges from around 20% among
Indid Assamese, 57.4% among Ahoms and as high as
80% among Boro-Kacharis (Flatz et al 1972; Das et al ;
Deka & Gogoi 1987).
• The only other area in Southeast area with high HbE is
the ‘HbE triangle’ bordering Laos, Vietnam and
Cambodia.
Our findings
• 2000: Quantitative estimation of HbE
among heterozygotes and their clinical
significance.
• Majority of patients belonged to Tai Ahom
group.
• No race was exempted, except the
Brahmins.
• Result of intermixing by marriage?
Racial distribution of HbE/HbAE/HbAA
70
60
50
40
AE
30
EE
20
AA
10
Ahom
Kachari
Mising Koch ChutiaKalita Jogi BaniaKoibartaOthers
0
Ahom
Mising
Chutia
Jogi
Koibarta
Do we carry a common gene?
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The theories of migration of Tai people:
(Edmondson JA)
1. India
border areas of SE Asia/Yunnan
province China
Laos and Vietnam(810,000 yrs ago). Spread from Guangxi,
Guangdong, Fujian, Zhejiang province up to
the mouth of Yangzi river near Shanghai
2. Tais Direct descent from East African
exodus 80,000 yrs BP. (As evident from M168
mutation in Y chromosome).
Do we carry a common gene?
• Migration of Tai from Yunnan to present day
Thailand, Shan Myanmar, Laos, Vietnam,
Assam, etc are well known.
• HUGO (Human Genome Organization) study
reveals that about 50000 years ago people
originated in Africa migrated to India and from
India to Southeast Asia and Central Asia. The
same people from Central Asia might have
migrated back to India. (Mapping Human Genetic Diversity
in Asia: The HUGO Pan-Asian SNP consortium. Science 11
December 2009. 326. 5959;1541-1545).
Do we carry a common gene?
• The HUGO Theory (2009):
Do we carry a common gene?
Of course, with some mutations.
Peregrinations of the Bai Yue and Tai kindred
http://web.wenxuecity.com/BBSView.php?SubID=memory&MsgID=56818)
Conclusion
• Anthropologically, the Tais carry gene
identifiable to their origin.
• The influence is visible in their phenotype and
genotype.
• It also influences pattern of disease and
complications.
• Further research is needed establish this
connection and identify the aberrations
responsible for diseases and formulate
measures to prevent/treat them.
THANK YOU !