Distribution Of Rapid Acetylator Phenotype In Myanmar (Burma) And Its Distribution Across The World 1

H Htet1, NHH Win2. 1SEGi University, Kuala Lumpur, Malaysia, 2University of Medicine (1) Yangon, Yangon, Myanmar

Introduction: Pharmacogenetics is an important branch of clinical pharmacology. The beauty of pharmacogenetics is its promise for the identification of the right drug and right dose for the right patient. Acetylation is one of the processes of drug metabolism that is liable to genetic variation. The aim of this study is to investigate the distribution of acetylator phenotypes in Myanmar as well as to develop a map of distribution of rapid acetylator phenotypes across the world.

Several reports have described the frequency of acetylator phenotypes among populations of different ethnic and geographical locations. The regression line called “Asian Fast Acetylator Longitude” displayed a positive correlation between the rapid acetylator phenotype and the median longitude of the corresponding country (1).

Materials and methods: Acetylator phenotyping was done on 63 Myanmar participants using the simplified method of Hasse Schröder (2). Sulphadimidine (10mg/kg orally with 200 mL water) was given and participants were asked to void urine once 4 hours following ingestion. Those urine samples were discarded. Participants were then requested to void urine once between 4 and 6 hours following ingestion. These urine samples were used for identification of acetylator phenotype. Interpretation was determined according to the developed urine colour after addition of a series of chemical reagents and hydrolyzing in the water bath. Each sample was tested for at least three times for confirmation. Analysis was performed using microsoft Excel®.

Results: Among 63 participants (3), 34 (53.97%) were rapid acetylators and 29 (46.03%) were slow acetylators. According to geographical location, Myanmar is at 22°N and 96°E. When our result and previous research on acetylator phenotypes were plotted on a world map, it indicated that Eskimos have highest percentage of rapid acetylators. Rates are lower in the USA and Latin American, then increase along European countries and across the Middle East, gradually increasing in South Asia with highest percentages in Japan and Korea (Fig.1). Conclusion: This finding could contribute to acetylator phenotyping and appears to confirm the “Asian Fast Acetylator Longitude” (1). This might underlie the incidence and prevalence of some diseases in different countries.

Fig.1: Distribution of rapid acetylator phenotype in different countries

(1) Zaid et al. (2004). Biopharmaceutics & Drug Disposition 25: 231-241.

(2) Schröder H (1972). British Medical Journal 3:506-507.

(3) From the Pharmacology 2014 Meeting: Proceedings of the British Pharmacological Society, pa2online.org, volume 12, issue 3, abstract entitled ‘Prevalence Of Rapid Acetylator Phenotype In Myanmar Type 2 Diabetes Mellitus Patients’