A comparative study of oxidative stress and type 2 diabetes mellitus in rural and urban communities in the Ashanti Region, Ghana

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2012
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BACKGROUND/AIM: A growing area of research is the relationship between oxidative stress and diabetes. Accumulating evidence indicates that oxidative stress, a condition of excessive reactive oxygen species, may play a role in the aetiology of type 2 diabetes mellitus by inducing insulin resistance in the peripheral tissues and impairing insulin secretion from pancreatic beta-cells. However, the link between oxidative stress and the development and progression of diabetes and its complications is still not fully understood. The fast progressive westernization of the Ghanaian society is predisposing increasing numbers of the population to higher rates of oxidative stress and may be the results of the increase in the prevalence of type 2 diabetes and other dysmetabolic conditions. The development of a simple screening tool may help to identify individuals at high risk of development of such dysmetabolic states in the society. METHODOLOGY: 210 adults were recruited from urban Kumasi and 180 adults were recruited from 3 rural villages in the Ashanti region. Sociodemographic data was collected from the subjects. Anthropometric measurements including blood pressure, weight, and height and waist circumference were determined by qualified nurses. Blood samples were collected after 12 hours of overnight fast for the analysis of glucose, lipids, oxidative stress indices and other biochemical parameters. RESULTS: In this study, the prevalence of type 2 diabetes mellitus and IFG were considerably higher among the urban subjects (10.5% and 28.0% respectively for urban subjects and 3.8% and 22.1% respectively for rural subjects). Dyslipidaemia and hypertension were also found to be more prevalent in the urban subjects than the rural population. Plasma antioxidant levels were also higher in the rural population than the urban population whiles malondialdehyde levels were found to be higher in the urban population as compared to the rural population. CONCLUSION: Type 2 diabetes and other dysmetabolic conditions are on the increase in the urban population of the Ashanti. In conclusion, the study hypothesizes that the fast progressive westernization of the Ghanaian culture predisposes individuals to higher rates of systemic oxidative stress as a result of increased exposure to reactive oxidants and this is accelerating the ageing process in the society as evident in the increasing incidence of type 2 diabetes mellitus and other dysmetabolic conditions. Additionally, a simple risk tool like the Ghana Diabetes Risk Score can be used to identify individuals at high risk of development of these dysmetabolic conditions.
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A Thesis submitted to the School of Graduate Studies, Kwame Nkrumah University of Science and Technology, Kumasi, in partial fulfilment of the requirements for the Degree of Doctor of Philosophy,
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