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The sexual practices of Asian and Pacific Islander high school students.

PURPOSE: To describe the sexual behaviors, beliefs, and attitudes of Asian and Pacific Islander California high school students and to compare them to other racial/ethnic groups. METHODS: Data were collected from an anonymous self-administered survey of 2026 ninth to 12th graders in a Los Angeles County school district; 186 of the respondents described themselves as Asian and Pacific Islander. The survey was conducted in April 1992. RESULTS: A higher percentage of Asian and Pacific Islander adolescents (73%) compared with African-American (28%, p < .001), Latino (43%, p < .001), white (50%, p < .001), and other (48%, p < .001) adolescents had never had vaginal intercourse. Asian and Pacific Islander adolescents were less likely than other adolescents to report having engaged in heterosexual genital sexual activities during the prior year, including masturbation of or by a partner, fellatio with ejaculation, cunnilingus, and anal intercourse. Few students in any group reported homosexual genital sexual activities. Asians and Pacific Islanders who had had vaginal intercourse were more likely than most other groups to have used a condom at first vaginal intercourse, but Asians and Pacific Islanders had not used condoms more consistently over the prior year. Asians and Pacific Islanders were more likely to expect parental disapproval if they had vaginal intercourse and less likely to think that their peers had had vaginal intercourse. CONCLUSIONS: Asian and Pacific Islander high school students in one California school district appear to be at lower sexual risk than other racial/ethnic groups. However, a large minority are engaging in activities that can transmit disease and lead to unwanted pregnancy. Therefore, current efforts to develop culturally sensitive clinical and community-based approaches to sexual risk prevention should include Asians and Pacific Islanders.

Adolescent↗

Asian subgroups and cancer incidence and mortality rates in California.

The objective of this study was to characterize better the cancer burden among Asian subgroups in California. Nearly 3.7 million Asians reside in California, and no other state has as many Asians. Cancer statistics for Asians often are combined with statistics for Pacific Islanders, and rates for subgroups are not often examined, because most states do not have a large enough population. Asians are affected disproportionately by certain cancers, such as stomach and liver cancers. The California Cancer Registry, a population-based cancer registry, has collected data, including race/ethnicity data, since 1988. The 5-year, average, annual, age-adjusted cancer incidence and mortality rates from 1997 through 2001 were calculated for 5 Asian subgroups: Chinese, Filipino, Japanese, Korean, and Vietnamese. Cancer incidence and mortality varied greatly. Incidence rates for all sites combined among males varied from a low of 318.6 per 100,000 for Chinese to a high of 366.0 per 100,000 among Japanese. For females, rates ranged from 236.6 per 100,000 among Koreans to 302.4 per 100,000 among Japanese. Mortality rates also varied by Asian subgroup. Presenting one statistic for Asian/Pacific Islanders did not provide an accurate depiction of the cancer burden among the different Asian subgroups. Acculturation will continue to affect the patterns of cancer incidence among Asian subgroups in California.

Asian↗

Participation of Asian-American women in cancer chemoprevention research: physician perspectives.

To the authors' knowledge, little is known regarding the participation of Asian Americans in cancer prevention research. In 2002, the authors mailed surveys to primary care physicians in Northern California to assess their knowledge, attitudes, behaviors, and barriers concerning the participation of Asian-American women in breast cancer chemoprevention research. The response rate was 52.3% (n=306 physicians). For physician barriers, most respondents selected lack of study knowledge (73%) and effort required to establish eligibility (75%) and to explain risks and benefits (68%). For patient barriers, most physicians chose the following: physicians did not inform patients about trials (76%), limited English proficiency (78%), researcher-participant language discordance (74%), and complex protocols (69%). Significantly more Asian-American physicians than non-Asian-American physicians (but a majority of each) selected as patient barriers a lack of culturally relevant information on breast cancer, a lack of knowledge about research concepts, and fear of experimentation. A majority of Asian-American physicians also selected the following patient barriers: lack of knowledge of preventive care or breast cancer, work concern, misperception that experimental treatment is inferior, personal modesty, and lack of personal benefit. In multivariate analyses, physicians who were in practice longer, who spent more time with patients, or who knew of tools to estimate breast cancer risk were more likely to discuss such trials with Asian-American women; whereas male physicians and those who believed that Asian-American women's deference to physicians was a barrier were less likely to have discussed such trials with Asian-American women. Efforts to increase research participation among Asian Americans should include physician education and linguistically appropriate recruitment efforts.

Asian↗

Do known risk factors explain the higher coronary heart disease mortality in South Asian compared with European men? Prospective follow-up of the Southall and Brent studies, UK.

AIMS/HYPOTHESIS: We examined prospectively whether measured risk factors can explain the higher CHD mortality in South Asians compared with Europeans. MATERIALS AND METHODS: Conventional CHD risk factors and those associated with insulin resistance were measured in 1,787 European and 1,420 South Asian men aged 40 to 69 years at baseline in the population-based Southall and Brent studies (London) between 1988 and 1990. Participants were followed up for mortality. RESULTS: By February 2006, there were 202 CHD deaths (108 Asian, 94 European). South Asian men had double the CHD mortality of European men in Cox regression analyses adjusted for age, smoking, and cholesterol (hazard ratio [HR] 2.14, 95% CI 1.56-2.94, p<0.001). Nearly half of all South Asian CHD deaths versus 13% of deaths among Europeans were among persons with diabetes. Asian men had greater CHD mortality than Europeans, both in the with- and the without-diabetes categories at baseline. CHD mortality remained significantly higher in South Asian men in multivariable models that adjusted for conventional risk factors and diabetes and/or impaired glucose regulation, features of insulin resistance, or the metabolic syndrome (HR 1.6-1.9). Accounting for co-morbidity and socio-economic status did not materially alter the findings. CONCLUSIONS/INTERPRETATION: These data confirm that South Asian men have significantly higher CHD mortality than their European counterparts, while indicating that neither conventional risk factors, nor insulin resistance parameters or metabolic syndrome criteria as currently defined can account for this excess risk. The contribution of unmeasured factors to the elevated vascular risk in South Asians should be addressed in future studies.

Asian People↗

Testicular cancer patterns in Asian-American males: an opportunity for public health education to impact outcomes.

OBJECTIVES: To examine the racial differences in testicular cancer incidence, pathologic grade, stage, and survival with specific reference to Asian and white Americans and to evaluate the impact of disparities in stage at presentation, if present, on survival. METHODS: Using the Surveillance, Epidemiology, and End Results (SEER) database, we extracted all testicular cancer cases among white and Asian-American males for the years 1973 to 2000. Baseline demographic data included age at diagnosis, year of diagnosis, stage at diagnosis, and histologic features. Survival was examined using the Kaplan-Meier method and Cox proportional hazards modeling. RESULTS: The incidence of testicular cancer is lower among Asian Americans than among whites. However, Asian-American males presented with higher stage disease at diagnosis. Significant differences were noted in the histologic features between the two groups, with Asian Americans presenting with greater rates of seminoma. Asians also demonstrated survival differences, with poorer unadjusted survival compared with whites. However, when the variables of stage at diagnosis and histologic features were included in the analysis, the survival curves became similar. CONCLUSIONS: Asians appeared to present with higher stage disease than do whites. Observed differences in survival for the Asian group relative to whites appeared to be primarily a result of delayed presentation. Cultural perceptions of malignancy and the understanding of cancer screening may be important determinants of later presentation. Healthcare access and education issues, rather than inherent biologic differences, are more likely the primary underlying factors for the observed survival differences in Asian males.

Asian↗

Older Asian Americans and Pacific Islanders dying of cancer use hospice less frequently than older white patients.

PURPOSE: Cancer is the leading cause of death among Asian Americans, yet little is known about their use of hospice care. We examined hospice use by Asian patients compared with white patients, and assessed whether utilization differs among those born in the United States or abroad. METHODS: We studied Asian and white Medicare beneficiaries registered in the Surveillance, Epidemiology, and End Results (SEER) Program who died of primary lung, colorectal, prostate, breast, gastric, or liver cancer between 1988 and 1998. We used logistic regression to determine the effects of race/ethnicity and birthplace on hospice use, adjusting for demographic characteristics, managed care insurance, year of diagnosis, tumor stage at diagnosis, and tumor registry. RESULTS: Of the 184,081 patients, 5% (n = 8614) were Asian Americans, of whom 45% (n = 3847) were foreign born. Compared with whites, Asian Americans were more likely to be male, married, and enrolled in managed care. Compared with U.S.-born Asian Americans, foreign-born Asian Americans were more likely to reside in low-income areas. After adjustment, patients who were Asian American (odds ratio [OR] = 0.67; 95% confidence interval [CI]: 0.62 to 0.73) and born abroad (OR = 0.90; 95% CI: 0.86 to 0.94) were less likely to use hospice care than were white patients. These results were consistent across the six cancer diagnoses that were examined. CONCLUSION: Older Asian Americans dying of cancer, especially those who are born abroad, are less likely than white patients to use hospice care at the end of life. Additional research is needed to understand the reasons for these differences and to eliminate potential barriers to hospice care.

Age Factors↗

Hepatitis A virus infection in people of South Asian origin in England and Wales: analysis of laboratory reports between 1992 and 2004.

The aim of the study was to determine whether rates of hepatitis A infection are higher in people of South Asian origin compared to the general population, to look for evidence of spread to the general population, and to identify ways to improve preventive strategies. Routine laboratory reports of hepatitis A infection in England and Wales in 1992-2004 were analysed. Study participants were patients with confirmed hepatitis A infection reported to the Health Protection Agency by the diagnosing laboratory. Nam Pehchan software was used to identify patients of South Asian ethnicity. Main outcome measures were comparison of incidence of hepatitis A in South Asian and non-South Asian groups, by age and region. Rates of infection were significantly higher in the South Asian group compared to the non-South Asian group (rate ratio 2.68, 95% confidence interval 2.07-3.47). Patients in the South Asian group had a younger age distribution. Travel was an important risk factor with 85% of those of South Asian origin acquiring their infection abroad, most frequently in the Indian subcontinent, compared to less than one third of those in other groups. Health-care professionals should ensure that all travellers to high-risk countries are protected by hepatitis A vaccination. Targeted information campaigns may be indicated in regions of the United Kingdom for people in South Asian minority ethnic groups.

Adolescent↗

Influence of ethnic origin on the incidence of keratoconus and associated atopic disease in Asians and white patients.

PURPOSE: To investigate the influence of ethnic origin on the incidence of keratoconus and the association of atopic diseases in patients with keratoconus. METHODS: Retrospective study of new patients referred to Dewsbury District General Hospital and diagnosed with keratoconus in a 6-year period between 1994 and 2000. The ethnic origin of the patient was defined as white, Asian, or other. Incidence was calculated from the catchment population of 176 774 (82% white people, 17% Asians, 1% others). t-Test, confidence intervals and chi2 tests were used to show statistical significance. RESULTS: A total of 74 cases of keratoconus were diagnosed over this period. Of these patients 29 (39%) were white and 45 (61%) were Asian. This equated to an incidence of keratoconus of 25 per 100 000 (1 in 4000) per year for Asians, compared with 3.3 per 100 000 (1 in 30 000) per year for white people (P<0.001). Asians presented significantly younger than white patients. The incidence of atopic disease was found to be significantly higher in white compared to Asian keratoconic patients. CONCLUSIONS: Asians were significantly more likely to present with keratoconus. The Asian patients were mostly of Northern Pakistani origin. This community has a tradition of consanguineous, especially first-cousin marriages. The higher incidence in this population was highly suggestive of a genetic factor being significant in the aetiology. The incidence was higher than revealed by previous studies. Atopic disease was significantly less common in Asians compared to white people, supporting the theory of a different aetiology in these patients.

Adult↗

Body mass index in a US national sample of Asian Americans: effects of nativity, years since immigration and socioeconomic status.

OBJECTIVE: To examine body mass index (BMI) and the proportion overweight and obese among adults age 18-59 in the six largest Asian American ethnic groups (Chinese, Filipino, Asian Indian, Japanese, Korean, Vietnamese), and investigate whether BMI varies by nativity (foreign-vs native-born), years in US, or socioeconomic status. DESIGN: Cross-sectional interview data were pooled from the 1992-1995 National Health Interview Survey (NHIS). SUBJECTS: 254,153 persons aged 18-59 included in the 1992-1995 NHIS. Sample sizes range from 816 to 1940 for each of six Asian American ethnic groups. MEASUREMENTS: Self-reported height and weight used to calculate BMI and classify individuals as overweight (BMI > or = 25 kg/m2) or obese (BMI > or = 30 kg/m2), age, sex, years in the US, household income and household size. RESULTS: For men, the percentage overweight ranges from 17% of Vietnamese to 42% of Japanese, while the total male population is 57% overweight. For women, the percentage overweight ranges from 9% of Vietnamese and Chinese to 25% of Asian Indians, while the total female population is 38% overweight. The percentage of Asian Americans classified as obese is very low. Adjusted for age and ethnicity, the odds ratio for obese is 3.5 for women and 4.0 for men for US-vs foreign-born. Among the foreign-born, more years in the US is associated with higher risk of being overweight or obese. The association between household income for women is similar for US-born Asian Americans and Whites and Blacks, but is much weaker for foreign-born Asian Americans. CONCLUSIONS: While these data find low proportions of Asian Americans overweight at present, they also imply the proportion will increase with more US-born Asian Americans and longer duration in the US.

Adolescent↗

Diabetes, insulin resistance and vascular disease among Indian Asians and Europeans.

Indian Asians account for one-fifth of all cardiovascular deaths worldwide. Cardiovascular mortality in Indian Asians overseas is higher than in indigenous populations. Diabetes, insulin resistance, and related metabolic disturbances are more common among Indian Asians than Europeans and may account for up to 70% of major Q wave ECG abnormalities in Asians. Previous studies provide evidence that genetic and environmental factors, the latter including intrauterine growth retardation, reduced physical activity, increased weight, and dietary intake, contribute to the high prevalence of diabetes and insulin resistance in Asians. The importance of conventional coronary risk factors is emphasized by studies showing higher prevalence of cigarette smoking, hypertension, and hypercholesterolemia in migrant and urban Indians compared with rural Indians. Recent studies suggest that new risk factors, including C-reactive protein, homocysteine, and lipoprotein(a), are increased among Indian Asians compared with Europeans and may contribute to part of the excess cardiovascular risk in Asians. Further work is needed to identify the precise genetic and environmental mechanisms underlying increased vascular risk in Indian Asians. Clinical strategies must be developed that identify Indian Asians at increased risk and assess the effectiveness of treatment for insulin resistance, and other cardiovascular risk factors, in this racial group.

Asian People↗

Influences of culture on Asian Americans' sexuality.

Asian Americans comprise a population group that is characterized by an enormous demographic, historical, and cultural heterogeneity, yet Asian Americans also share many Asian cultural characteristics such as the primacy of the family and the collective's goals over individual wishes, emphasis on propriety and social codes, the appropriation of sexuality only within the context of marriage, and sexual restraint and modesty. Although there are significant gaps in the scientific literature concerning Asian Americans sexuality, the existing data point to notable differences between Asian Americans and other ethnic groups on major aspects of sexual behavior. For example, relative to other U.S. ethnic group cohorts, Asian American adolescents and young adults tend to show more sexually conservative attitudes and behavior and initiate sexual intercourse at a later age. There are indications that as Asian Americans become more acculturated to the mainstream American culture, their attitudes and behavior become more consistent with the White American norm. Consistent with their more sexually conservative tendencies in normative sexual behavior, Asian American women also appear more reluctant to obtain sexual and reproductive care, which in turn places them at a greater risk for delay in treatment for breast and cervical cancer as well as other gynecological problems. Available data suggest that the prevalence rate of sexual abuse in Asian American communities appear lower than those of other groups, although it is not clear to what extent the low rates are due to cultural reluctance to report shameful experiences.

Adolescent↗

A comparison of Asian and white patients with obstructive sleep apnea syndrome.

OBJECTIVE: To evaluate the possible differences between Asian and white patients with obstructive sleep apnea syndrome. METHODS: A retrospective review of Asian and white patients during a 12-month period was conducted. Patients with respiratory disturbance index (RDI) > or = 15 based on polysomnography were included in the study. Variables examined include age, sex, body mass index (BMI), RDI, lowest oxygen saturation (LSAT), and cephalometric analysis data. RESULTS: Fifty-eight Asian patients (53 men) and 293 white patients (260 men) were studied. The Asians were younger (44.1 +/- 9.8 vs. 47.5 +/- 11.6 y, P = .02), and the mean BMI (kg/m2) was 26.6 +/- 3.7 in the Asians and 30.7 +/- 5.9 in the whites (P < .001). The mean RDI was similar (56.6 +/- 34.9 vs. 55.6 +/- 26.9, P = NS), but the mean LSAT was lower in the whites (77.7 +/- 9.9% vs. 70.0 +/- 15.6%, P < .001). Based on the cephalometric data, the Asians have maxillomandibular protrusion, narrower cranial base angle, larger posterior airway space, and more superiorly positioned hyoid bone compared with the whites. CONCLUSIONS: Although male gender was found to be an important risk factor for obstructive sleep apnea syndrome in both Asian and white patients, obesity may be a less significant risk factor in the Asians because the majority of our Asian patients were nonobese. There was also variability in the craniomandibular factors that contributed to obstructive sleep apnea syndrome in the two groups.

Adolescent↗

Coeliac disease in South Asians resident in Britain: comparison with white Caucasian coeliac patients.

BACKGROUND: The catchment population of our hospital is ethnically diverse and we have seen a number of patients of South Asian origin with coeliac disease. We have suspected that there are differences compared with white Caucasian coeliacs, especially with respect to iron-deficiency anaemia and vitamin D deficiency at presentation. AIMS: To compare the clinical and laboratory features of South Asian adult coeliac patients with adult white Caucasian coeliacs. METHODS: We reviewed the notes of patients attending the adult coeliac clinic over the past 10 years. All patients were older than 16 years at diagnosis. There were 40 South Asians and 90 white Caucasians. Symptoms, haematology, biochemistry, endomysial antibody status, HLA alleles and small bowel histology at presentation were compared between the two racial groups. RESULTS: There were significant differences between the racial groups. South Asians were younger at presentation than the Caucasian patients (mean age 27 years compared with 47 years respectively, P<0.0001); they were less likely to have 'irritable bowel syndrome' symptoms (P<0.01), but more likely to have features of vitamin D deficiency (P<0.03). Their haemoglobin (P<0.05), mean cell volume (P<0.0004), serum iron (P<0.01), transferrin saturation (P<0.05), serum 1,25-dihydroxyvitamin D3 (P<0.002), and levels were lower, while serum alkaline phosphatase levels were higher (P<0.04) than in white Caucasian coeliac patients. There were no differences with respect to serum folate, vitamin B12, serum calcium, alanine aminotransferase and small bowel histology. IgA class endomysial antibody positivity was similar in the two groups (88.5% for South Asians compared with 73.5% for white Caucasians). White Caucasian patients were significantly more likely to be DQ2-positive than the South Asian patients (97.2% compared with 83.3%, P=0.02). CONCLUSION: South Asians with coeliac disease are less likely to present with 'irritable bowel syndrome' symptoms, but more likely to have features of vitamin D deficiency and iron deficiency, and have a higher alkaline phosphatase than white Caucasians. The differences in HLA alleles seen in South Asians with coeliac disease compared with white Caucasian patients suggests that among the South Asians, non-HLA regions may play a stronger role in disease susceptibility and presentation.

Adolescent↗

Renal transplantation in Indo-Asian patients in the UK.

Membership of some ethnic groups has an effect on renal transplant outcome but little is known about the impact of Indo-Asian ethnicity, despite this group's high incidence of renal disease. We compared outcomes in Indo-Asians and Caucasians at the Hammersmith Hospital (Indo-Asians, N = 46; Caucasians, N = 90), in the Long-Term Efficacy and Safety Surveillance (LOTESS) database of cyclosporin-treated renal transplant recipients (Indo-Asians, N = 254; Caucasians, N = 4262) and the National Transplant Database held by UK Transplant (Indo-Asians, N = 459; Caucasians, N = 4831). The baseline demographic and co-morbid characteristics of the two ethnic groups were comparable, save for more diabetes in the Indo-Asian community. Following transplantation, the incidence of delayed graft function and steroid-resistant acute rejection were also comparable, as were graft and patient survival (out to 5 years) and graft function. In addition, post-transplant blood pressure, levels of cholesterol and triglycerides and exposure to corticosteroids and cyclosporin were comparable. However, when patients who were not diabetic before transplantation were studied separately, there was an increased incidence of diabetes in the Indo-Asian community (Hammersmith data: Indo-Asians 10.9% vs. Caucasians 3.3%, p = 0.02; LOTESS data Indo-Asians 5.5% vs. Caucasians 1.6%, p < 0.0001). Subsequent management of this group should pursue immunosuppressive regimens less likely to impair post-transplant glucose tolerance.

Adult↗

Abnormal predicted diffusion capacities in healthy Asians: an inequality with a solution.

BACKGROUND: Asian lung volumes are 10-15% less than those of Caucasians. OBJECTIVES: To test the hypothesis that healthy Asians might be labeled as abnormal using three commonly used Caucasian-derived prediction equation estimates (PEE) of DLCO currently used. In addition, a Chinese-derived PEE of DLCO was tested to determine its validity in non-Chinese Asians. METHODS: Forty-one healthy Asians underwent DLCO testing. Controls consisted of the PEE and 12 healthy Caucasians. Measured DLCO was compared with the Miller, Knudson, Crapo and one Chinese PEE. Abnormal was defined as a DLCO <80% predicted. Gas dilution and plethysmography estimated alveolar volume. Proportions in parentheses in the results below are DLCO adjusted for alveolar volume. RESULTS: The average Asian DLCO was 25.75 +/- 5.55 ml/min/mm Hg, no different than the predicted DLCO of 25.29 +/- 5.53 seen with Chinese PEE. This was different (p < 0.01) than the predicted DLCO of 27.82 +/- 5.09, 33.66 +/- 6.29, and 31.64 +/- 5.33 for the Miller, Knudson, and Crapo equations, respectively. This resulted in 4/41 (0/41), 27/39 (2/39), 21/41 (3/41) and 1/41 (0/41) DLCO measurements being defined as abnormal using Miller, Knudson, Crapo and Chinese PEE, respectively. In Caucasians, the measured DLCO was similar to the Miller but significantly lower than the Knudson and Crapo PEE. Measured lung volumes were significantly smaller compared to predicted for the three Caucasian PEE in Asians, with no difference in Caucasians. There was no difference in measured lung volumes and Chinese PEE. CONCLUSIONS: Current Caucasian PEE for DLCO when used in healthy Asians result in an abnormal reading that is incorrect from 10 to 50% of the time. This PEE failure is related to a reduction in lung volume not accounted for. The Chinese PEE for DLCO works for non-Chinese Asians and should replace Caucasian PEE in the US in all Asians.

Adult↗

Graded testosterone infusions distinguish gonadotropin negative-feedback responsiveness in Asian and white men--a Clinical Research Center study.

Recently, multicenter clinical trials to determine male contraceptive efficacy disclosed that testosterone-induced suppression of spermatogenesis to azoospermia occurred in about 90% of Asian but only 60-70% of white men. To test whether there are ethnic differences in the sensitivity of gonadotropin secretion to suppression by testosterone, we administered constant infusions of testosterone at 0, 7, 14, and 28 mg/1.7 m2 x 24 h i.v. for 48 h to 9 Asian and 8 white normal male volunteers (22-42 yr old). During the last 8 h of each infusion dose, 10-min frequent blood sampling was carried out for later LH and FSH measurements by sensitive fluoroimmunoassays. Analyses of LH secretory pulses showed that LH pulse width, height, area, and total area under the curve (LH concentration vs. time) were significantly more suppressed in Asians than in whites during the lowest infusion dose of testosterone. With increasing testosterone dose, the suppression of pulsatile LH secretion was not different in the two ethnic groups. In contrast to pulsatile LH secretion, the responsiveness of pulsatile FSH secretion to exogenous testosterone infusion was not different between the two ethnic groups. At baseline, Asian men had a significantly higher mean number of FSH pulses and mean incremental pulse heights than did white men. Serum inhibin B levels were not distinguishable in the two ethnic groups, but the FSH profiles were quantifiably more irregular (higher approximate entropy) in the Asian volunteers. Our data suggest that, compared with white men, Asian men respond earlier and with more marked suppression of pulsatile LH secretion to ramped testosterone infusions. The elevated basal serum FSH concentrations (and more irregular FSH release pattern) observed in Asian men may suggest a small relative decrease in spermatogenic reserve and/or gonadal negative feedback. Whether these differences contribute to the observed differences in suppression of spermatogenesis in Asians vs. non-Asians in male contraceptive studies is not yet known.

Adult↗

Sex and race differences in fat distribution among Asian, African-American, and Caucasian prepubertal children.

Sexual dimorphism in fat distribution is thought to emerge during puberty. Truncal or android body fat distribution is characteristic of adult males but is also recognized as a human cardiovascular risk factor. Race differences in truncal fat are clearly evident in adults and have been described in prepubertal children but not between Asians and other race groups. The aim of this study in African-American, Asian, and Caucasian prepubertal children was to evaluate sex differences and race differences in body fat distribution. Analysis of covariance was used to explore fat distribution in 358 prepubertal children (176 girls and 182 boys; 143 Asians, 95 African-Americans, and 120 Caucasians), measured by skinfold thickness and dual-energy x-ray absorptiometry (DXA) in a cross-sectional study. Extremity and gynoid fat masses were evaluated after adjustment for trunk or android fat, respectively, and for covariates including age, weight, height, and interactions. In Asian children, sex differences were present in models for gynoid fat by DXA only (P < 0.001), with girls having greater gynoid fat than boys. In African-American and Caucasian children, sex differences were present in models for extremity and gynoid fat masses, measured by both methods. Among girls, Asians had generally lower adjusted extremity and gynoid fat than Caucasians and African-Americans. Among boys, Asians had lower adjusted extremity fat by DXA than Caucasians (P < 0.01) but greater gynoid fat by skinfolds than African-Americans (P < 0.01). This study of prepubertal children demonstrates that: 1) sex differences in body fat distribution are present in prepubertal children but that the specific characteristics for Asians differ from African-Americans and Caucasians, and 2) differences in body fat distribution in Asian children, compared with African-Americans and Caucasians, are present but vary by sex. This comparison of African-American, Asian, and Caucasian prepubertal children suggests phenotypic differences. Additional studies are needed to explore the metabolic and health risk implications of these findings.

Abdomen↗

Type 2 diabetes prevalence in Asian Americans: results of a national health survey.

OBJECTIVE: Asians are thought to be at high risk for diabetes, yet there is little population-based information about diabetes in Asian Americans. The purpose of this study was to directly compare the prevalence of type 2 diabetes in Asian Americans with other racial and ethnic groups in the U.S. using data from the 2001 Behavioral Risk Factor Surveillance System (BRFSS). RESEARCH DESIGN AND METHODS: The BRFSS is a population-based telephone survey of the health status and health behaviors of Americans in all 50 states, Guam, Puerto Rico, and the U.S. Virgin Islands. Subjects included 3,071 Asians, 12,561 blacks, 12,153 Hispanics, 2,299 Native Americans, 626 Pacific Islanders, and 129,116 non-Hispanic whites aged >/=30 years. Subjects who reported a physician-diagnosis of diabetes were considered to have type 2 diabetes unless they were diagnosed before age 30. RESULTS: Compared with whites, odds ratios (95% CIs) for diabetes, adjusted for age and sex, were 1.0 (0.7-1.4) for Asians, 2.3 (2.1-2.6) for blacks, 2.0 (1.8-2.3) for Hispanics, 2.2 (1.6-2.9) for Native Americans, and 3.1 (1.4-6.8) for Pacific Islanders. Results adjusted for BMI, age, and sex were 1.6 (1.2-2.3) for Asians, 1.9 (1.7-2.2) for blacks, 1.9 (1.6-2.1) for Hispanics, 1.8 (1.3-2.5) for Native Americans, and 3.0 (1.4-6.7) for Pacific Islanders. CONCLUSIONS: Similar proportions of Asian and non-Hispanic white Americans report having diabetes, but after accounting for the lower BMI of Asians, the adjusted prevalence of diabetes is 60% higher in Asian Americans.

Asian↗