racial influences on health and diseases: the tai-tai ahom connection. dr. hemanta kumar gogoi...

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

• 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:

Source: http://en.wikipedia.org/wiki/Mendelian_inheritance

Augustinian monkGregor Mendel 1865

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.

• Racial differences in complications:1. Asians in UK are higher risk of ESRD (Lanting LC et al

2005).

2. Asian Americans have a lower prevalence of hypertension and foot ulcerations than Hispanics, Native Americans and Pacific Islanders.(McNelley MJ et al 2003).

3. 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).

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.

• 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

Ahom

KachariMisingKochChutiaKalitaJogi BaniaKoibartaOthers0

10

20

30

40

50

60

70

Ahom Mising Chutia Jogi Koibarta

AE

EE

AA

Do we carry a common gene?

• The theories of migration of Tai people: (Edmondson JA)

1. India border areas of SE Asia/Yunnan province China Laos and Vietnam(8-10,000 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).

• 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?

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 kindredhttp://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 !