Introduction: The lifestyle of Inuit in Greenland and worldwide is undergoing a transition from a fisher-hunter to a westernized society and meanwhile the prevalence of type-2 diabetes (T2D) has increased dramatically. Studies have shown that a common nonsense p.Arg684Ter variant in TBC1D4, which is frequent in Greenland, confers genetic susceptibility towards high risk of T2D. The aim of the study is to investigate whether a traditional marine diet, with high fat and low carbohydrate, will improve glycemic control in Greenland Inuit compared to a western diet. Moreover, we want to examine if the response is more pronounced in carriers of the p.Arg684Ter variant. Materials and methods: We will conduct a randomized, clinical cross-over trial with two dietary intervention periods of four weeks duration. The diet intervention comprise provision of >20E% and instruction for the remaining part of the diet. We expect to include 30 homozygous carriers and 30 homozygous non-carriers of the p.Arg684Ter variant, aged 18–80 years, across three Greenlandic towns. The primary outcome is plasma (p)-glucose 2 h post an oral glucose tolerance test and we aim to have 80% power, at α = 0.05, to detect a difference of 1.1 mmol/L. We will also include supporting measures of glucose homeostasis, assess other markers of the metabolic syndrome and perform metabolome and microbiome profiling. The statistical analysis will be performed as complete case analyses using linear mixed models. Ethics and dissemination: The study received approval by the Ethics Committee of Greenland (KVUG 2018-26) and will be disseminated via international peer-reviewed journal articles and conferences. Trial registration number: Clinicaltrials.gov identifier no. NCT04011904.
Bibliografisk noteFunding Information:
This work was supported by unrestricted grants from The Novo Nordisk Foundation, grant number NNF17OC0028136. Furthermore, Royal Greenland and the supermarket chains Kalaallit Nunaanni Brugseni & Pilersuisoq, provided study products and discounts for study foods as well as helped with logistics and storage of study foods. LL is principal investigator and sponsor. The principle investigator, project managers, or clinical responsible have no personal affiliation with the sponsors, commercial or otherwise and there are no other conflicts of interest to declare.
The work was supported by The Novo Nordisk Foundation , grant number NNF17OC0028136 . Furthermore, Royal Greenland, Pilersuisoq and Kalaallit Nunaanni Brugseni provided sponsorship of food products for the dietary intervention.
MEJ has received funding from AstraZeneca, Sanofi Aventis, Boehringer Ingelheim and AMGEN. MEJ own shares in Novo Nordisk A/S. The other authors have nothing to disclose.
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