Abstract:
Ethnic health disparity is a well-established public health issue. In the New Zealand population, certain ethnic groups are over-represented in statistics in diseases of the exocrine pancreas. Māori and Pacific Islanders in particular have some of the highest annual incidence rates of acute pancreatitis (AP). Lifestyle and socioeconomic factors contribute to inequality to an extent, but do not completely explain this disparity. This suggests that underlying differences between ethnic groups may be at play. However, research is limited that investigated this in the context of AP in New Zealand. Two studies were conducted in New Zealand multi-ethnic cohorts that included individuals after AP. The first aim was to investigate ethnic differences in gut and pancreatic hormone profiles by analysing a comprehensive panel of gut hormones, pancreatic hormones, and pro-inflammatory cytokines. The second aim was to assess ethnic differences in abdominal composition by comparing volumes of abdominal compartments using magnetic resonance images. The associations between anthropometric measures and abdominal compartments were also explored to derive ethnicity-specific equations that estimate volumes of abdominal compartments in individuals after AP. The first key finding was that fasting levels of ghrelin, pancreatic polypeptide, interleukin-6, and glicentin were significantly higher in Māori compared to non- Māori. This gives insights into the underlying differences in Māori that may influence the pathogenesis of obesity in this ethnic group that may make them prone to developing AP. The second key finding was that Māori and Pacific Islanders had significantly higher visceral adipose tissue (VAT) volume, compared to the other studied ethnic groups. This suggests that Māori and Pacific Islanders may have a propensity to accumulate VAT, and may contribute to the increased risk of AP observed in this population. Waist circumference and body mass index did not accurately estimate VAT volume for all ethnicities. Therefore, ethnicity-specific equations were constructed to estimate VAT volume using anthropometric measures, demographic factors, and pancreatitis-related factors, with a view to more accurately estimate VAT volume across ethnicities. Identifying ethnicity-specific physiological differences may help towards designing health screening programmes for earlier lifestyle modifications, with the ultimate goal of minimising ethnic health disparity in New Zealand.