A new study from the University of Arkansas for Medical Sciences could play a role in explaining why the Marshallese community faces higher rates of chronic health conditions like type 2 diabetes.
Dr. Sheldon Riklon is a professor at the University of Arkansas for Medical Sciences Institute for Community Health Innovation, as well as a Marshallese person. We spoke over Zoom earlier this week. He says these chronic health conditions affect the community everywhere
Dr. Sheldon Riklon: In the Marshall Islands, in the states and specifically in Northwest Arkansas. That shows that there’s an association between some of these dysregulations of microRNAs with chronic conditions that many of us suffer from.
Matthew Moore: So let’s start by talking about what microRNAs are and why they’re important to our health. I think some of us, perhaps with COVID-19, first heard about RNAs or were reintroduced to it for the first time since maybe like middle school chemistry or biology. So what are microRNAs and why are they important to our health and health research?
Dr. Riklon: Absolutely. MicroRNAs are basically RNA molecules that are noncoding, kind of similar to messenger RNAs, but they’re not the same. But we know that microRNAs have some specific functions, especially when it comes to the health and well-being of different people, and have been associated with certain chronic conditions.
Moore: And so what led you to study microRNAs in the Marshallese community specifically?
Dr. Riklon: Well, if you know, the Marshallese population suffers from disproportionate conditions — high proportions of different conditions, including type 2 diabetes, including hypertension, cardiovascular disease and many other things. And trying to figure out how do we address that need, some thoughts into how you address that is how do we pick it up earlier? What are the different factors that may be incorporated into causing us to have that high rate, and how do we address it? And hopefully that will find some biochemical markers that will help us to treat those different conditions in the future.
Moore: I’ve heard you on a couple of different occasions use “us” language here. Are you a person of Marshallese descent as well?
Dr. Riklon: I am. I was born and raised in the Marshall Islands, and now I’m an Arkansan.
Moore: How does that affect your research — thinking about how you identify and how you think about members of your community, perhaps even family members, who have seen these elevated instances of chronic disease and disorder?
Dr. Riklon: Absolutely. And I think that’s what kind of makes it — brings it home for me. You know, the work that I do with the community is the work I do with family. So whether I’m back in the islands, or I was in Hawaii, or now that I’m in Arkansas, I’m always looking into ways that we can do better for the community members so that they can live healthier lives, find ways that we can take care of them. Because we know that they suffer from so many chronic conditions. There’s got to be better ways because it’s not just the environment.
And you probably know of the history of the nuclear legacy in the Marshall Islands. So even trying to work with our community and taking blood samples or even microRNAs or any kind of genetic — it’s soft grounds to kind of walk through it. But trying to explain to them why we do this work that, in the end, is hopefully for the betterment of their health care in the future. So I’m part of it, but I’m a researcher. But at the same time, I’m deeply devoted to it.
Moore: Do you find that people are more willing to participate when they see someone like you?
Dr. Riklon: Absolutely. You know, I think when they see someone like me or some of my colleagues who work with them closely in the health field, and we explain to them — and so it’s not just translated materials that they have to sign off in terms of informed consent, but actually speaking with them and telling them exactly what is the research, what does the research entail that is free for them to voluntarily do. They don’t have to do it if they don’t want to, even though they had signed somewhere.
And then we explain to them because then they’re comfortable asking questions. You know, ‘Why should I trust you even though you’re Marshallese but you’re working for a U.S. academic research institution?’ But when they see that it is us speaking with them, they trust us more because many of us are related in some form or another, and they know of the kind of work we do in the community, especially in trying to advocate for them out there as well.
Moore: What stood out to you in the results, especially as we think about the differences in gender or the different kinds of conditions, whether it’s diabetes or high blood pressure or something else?
Dr. Riklon: You know, I think the results kind of speak for themselves that there’s definitely this potential that we might have to look into more studies — further studies — that there may be some association with these different microRNAs and the chronic conditions that we all suffer from. We know that definitely the environment plays a role, the kind of medication plays a role, where you were born plays a role, the nuclear legacy plays a role. But at the same time, at least some of the dysregulation of some of these microRNAs kind of confirms that there are certain microRNAs that are associated with these different chronic conditions in the Marshallese population, which is exciting at the same time, because it might help us in diagnosing or even developing different kinds of therapeutic options in the future.
Moore: And we’ve talked about this — we’ve touched on it some here — but are you seeing differences in, say, folks who grew up on the island as opposed to people who were born and raised in the United States?
Dr. Riklon: Well, we definitely see the same chronic disease burdens that we see in the islands here in Northwest Arkansas as well. So regardless of if you’re Marshallese in the Marshall Islands, you’re Marshallese in Hawaii, or you’re Marshallese in Oregon or Marshallese in Arkansas, we come with the same chronic condition, disease states, and we still face challenges in terms of controlling it, maintaining it, making sure that you’re addressing it for different reasons.
This is the first study, I think, that we’ve ever done with the Marshallese community in terms of microRNA. So I don’t have anything to compare when it comes with that aspect of it. But definitely, we see that the chronic conditions that we suffer from, regardless of where you were born, we’re here with it at the same time.
Moore: How can this research help to improve care or maybe even move into a preventative world for Marshallese families?
Dr. Riklon: And I think that’s the exciting part. When we saw some of these results, that there might be certain biomarkers that could be developed in the future, whether it’s for diagnostic purposes or whether it’s for therapeutic purposes. But we know that our study was small — only 50 participants and 47 blood-drawn samples. But at least it opens up that there may be something that we need to do more and further studies that need to be done, because this looks like there are definitely some potentials that we can come up with for better prevention, better diagnostic purposes and definitely better therapeutic options.
Moore: So what’s next? Are you hoping to do a phase two of this to maybe have a larger sample? Are you looking to move forward with the folks that you’ve already had samples from?
Dr. Riklon: Yeah, that’s one of the hopes. We’re looking into that — the folks that were part of this sample or part of this pilot study. And this was exactly that, just a pilot study that maybe we’ll look at them longer in the future if there are any changes that occur. But also it would be nice to have different comparative samples, not just among the Marshallese but non-Marshallese folks, to see if this is really significant, because the numbers look good. But I think we still need to talk among ourselves and see what’s the next step at this point. We haven’t really decided yet.
Moore: Anything I missed? Anything you want to make sure we touch on here?
Dr. Riklon: No, I think you know I appreciate you taking the time to put this to light. Because we’re here in Northwest Arkansas and actually all of Arkansas at this point, definitely there are things that we’re challenged with. We continue to try to address it, try to work with different folks and try to come up with different things. And this is just one of those projects that we’ve been working on. And hopefully there are other projects in the future that will address this further.
Moore: Dr. Sheldon Riklon is a professor at the UAMS Institute for Community Health Innovation, based in Springdale. We spoke over Zoom earlier this week.
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