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PubMed2001

Adequacy targets of peritoneal dialysis in the Asian population.

End-stage renal disease affects a large number of patients in Asia. The percentage of patients utilizing PD varies significantly in Asian countries. Continuous ambulatory peritoneal dialysis (CAPD) accounts for about 80% of the dialysis population in Hong Kong. In this review, we address several questions related to adequacy targets in Asians: Are Asians different? Is dialysis adequacy important for Asians? What is the magnitude of the benefit and the optimal dose of dialysis prescription? Is the adequacy target realistic? The current international recommendations, including the Dialysis Outcomes Quality Initiative guidelines, are compared with some of our own data for Asian patients. Our published data on dialysis adequacy, nutrition, residual renal function, and peritoneal membrane transport showed that those factors have a significant impact on the morbidity and mortality of PD patients in Hong Kong. Our results show that solute clearance as measured by Kt/V has a significant impact on the outcome of Asian CAPD patients. Although Chinese PD patients have excellent medium-term patient and technique survival despite an apparently lower Kt/V as compared with the CANUSA standard, that favorable outcome should not prevent nephrologists from providing adequate dialysis to Asian patients. From our own data and analysis, we propose a target Kt/V of 1.9 in Asian CAPD populations. Small-volume dialysis (6 L daily) may be an acceptable compromise in some Asian populations with a smaller body size, especially with residual renal function, given the financial constraints in some developing countries. Dialysis adequacy means more than a Kt/V value; other clinical parameters are equally if not more important. Thus we should also aim at achieving adequate fluid removal and volume homeostasis, blood pressure control, good nutrition, normal acid-base balance, normal mineral metabolism, minimal anemia, and normal lipid metabolism.

Asian People↗

PubMed2005

Comparison of high-density and low-density lipoprotein cholesterol subclasses and sizes in Asian Indian women with Caucasian women from the Framingham Offspring Study.

BACKGROUND: Asian Indian women have a higher rate of coronary artery disease (CAD) than do other ethnic groups, despite similar conventional risk factors and lipid profiles. Smaller high-density lipoprotein cholesterol (HDL-C) particle size is associated with reduced cardiac protection or even an increased risk of CAD. Exceptional longevity correlates better with larger HDL-C particle sizes. HYPOTHESIS: Higher rates of CAD among Asian Indian women may partly be explained by the differenes in the prevalence of atherogenic HDL-C and low-density lipoprotein cholesterol (LDL-C) sizes and their subclass concentrations among Asian Indian women compared with Caucasian women. METHODS: We measured HDL-C concentrations and sizes by nuclear magnetic resonance spectroscopy in 119 relatively healthy Asian Indian women and compared them with those of 1752 Caucasian women from the Framingham Offspring Study (FOS). RESULTS: Asian Indian women were significantly younger (47.9 +/- 11.2 vs. 51.0 +/- 10.1 years, p = 0.0001), leaner (body mass index 24.0 +/- 4.7 vs. 26.0 +/- 5.6, p = < 0.0002), less likely to be postmenopausal (32 vs. 54%, p = < 0.0001), or smoke (< 1 vs. 20%, p = < 0.0001); nevertheless, prevalence of CAD was higher in Asian Indian women (4.2 vs. 1%, p = 0.0006). Asian Indian women had similar HDL-C (53 +/- 13 vs. 53 +/- 13 mg/dl, p = 0.99), smaller HDL-C particle size (8.9 +/- 0.35 vs. 9.4 +/- 0.44 nm, p = < 0.0001), higher total cholesterol (209 +/- 40 vs. 199 +/- 42 mg/dl, p = 0.01), and similar triglyceride (120 +/- 77 vs. 108 +/- 110 mg/d, p = 0.24) levels. Low-density lipoprotein cholesterol, particle concentrations and sizes, as well as prevalence of pattern B were similar. CONCLUSIONS: Compared with the FOS, Asian Indian women have significantly smaller overall HDL particle size and similar levels of HDL-C, which may reflect impaired, reverse cholesterol transport. Total cholesterol was higher, whereas triglyceride and LDL-C levels were similar. This may partly explain the higher CAD rates in Asian Indian women. Further large scale, prospective, long-term studies are warranted.

Body Mass Index↗

PubMed2001

Body image and weight consciousness among South Asian, Italian and general population women in Britain.

Italians in Britain have low rates of coronary heart disease while South Asians have high rates, which correspond to a tendency to central abdominal fat deposition and overweight. World variations in attitudes to body size are thought to be related to economic security. This cross-sectional study employed a range of measures including photographic silhouettes of known BMI to investigate the attitudes of 259 South Asian, Italian and general population women (aged 20-42 years) towards body size. Migrants are compared with British-born minority members. Our results indicate that although migrant South Asians were less happy with their weight than migrant Italians, fewer had tried to lose weight in the past or had experienced external pressures to change their bodies. More migrant South Asians than Italians or general population women equated one of the four largest shapes (BMI 28-38) with health and successful reproduction. All groups wanted to resemble one of the two thinnest shapes, equating them with longevity, likelihood of marriage and job success. British-born South Asians generally showed a considerable degree of convergence towards general population women's negative attitudes to large body size, but British-born Italians' attitudes were significantly more negative even than general population women. The study's conclusions were that South Asian health beliefs are an important focus of resistance to slimness. The tendency of migrant South Asians to equate large size with health contrasts with the opposing views of Italian and general population women. British-born South Asians' views are modifying from those of migrants, but significant differences remain when compared with general population women and British-born Italians. Present differences in economic security offer only a partial explanation; South Asian attitudes may be explained by economic insecurity in the past.

Adult↗

PubMed2003

Asian and Siberian ginseng as a potential modulator of immune function: an in vitro cytokine study using mouse macrophages.

BACKGROUND: Ginseng is a widely used herbal product in China, other Asian countries, and in the Unites States. There is a traditional belief that ginseng stimulates immune functions. In this study, the innate effects of Asian and Siberian ginsengs on cytokines and chemokines produced by cultured macrophages were examined. MATERIALS AND METHODS: The effects of Asian and Siberian ginseng on cytokines and chemokines produced by cultured macrophages were examined. Mouse macrophages (J774A.1) were incubated with Asian or Siberian ginseng at varying concentrations (1, 10, 100, and 1000 microg/ml) for 24 h and then harvested for RNA isolation. The expression levels of IL-1beta, IL-12, TNF-alpha, MIP-1 alpha, and MIP-2 mRNA were measured by quantitative PCR. RESULTS: Our data showed that Asian ginseng induced a statistically significant increase in IL-12 expression at both mRNA and protein levels. However, the minor twofold increase is probably biologically insignificant. No significant increase of IL-12 by Siberian ginseng was observed at any dose level studied. No significant change in IL-1beta, IL-15, TNF-alpha, or MIP-1alpha mRNA was observed by either Asian or Siberian ginseng treatment. CONCLUSIONS: Our data showed statistically significant differential regulation of IL-12 by Asian ginseng. Siberian ginseng did not show a statistically significant increase. We conclude that both Asian ginseng and Siberian ginseng cannot significantly stimulate innate macrophage immune functions that influence cellular immune responses. Therefore, contrary to the popular belief, Asian and Siberian ginseng may not stimulate immune function.

Adjuvants, Immunologic↗

PubMed1985

Diet and risk factors for coronary heart disease in Asians in northwest London.

Asian immigrants to England and Wales have high mortality from coronary heart disease but low mortality from colon cancer. A survey of Asians in the London boroughs of Brent and Harrow was undertaken with the object of investigating this. Compared with the British population, the Asians consumed less saturated (S) fat and cholesterol and more polyunsaturated (P) fat and vegetable fibre. The P/S ratio of the Asians' diet was 0.85 compared with 0.28 in the British population: this was reflected in the very high linoleic acid content of their plasma lipids. The plasma total cholesterol and high-density-lipoprotein cholesterol of Asian men was similar to that of a British comparison group; the concentrations in Asian women were much lower than in British women. Smoking rates were low in both Asian men and Asian women. The high rates of coronary heart disease in Asian immigrants are not explained by the levels of these risk factors.

Adult↗

PubMed2002

Elderly suicide rates in Asian and English-speaking countries.

OBJECTIVE: Asian culture venerates elderly people. It was hypothesized that elderly suicides would be proportionately lower in Asian societies than in English-speaking countries (ESC). METHOD: Elderly (i.e. aged 75 years or more) to general population suicide ratios were compared for six Asian societies and six ESC, based upon the latest 5-year suicide rates. RESULTS: Males: The general population suicide rate was highest in rural China (227 per million) and third highest in Japan (217 per million), but other countries with high rates were all ESC (ranging from 224 to 198 per million). Asian countries had the six highest elderly suicide rates, 1327-1373 per million, whilst the highest ESC elderly rate was in the United States (507 per million). Asian societies had the widest range of elderly/general ratios, ranging from 6.62 to 2.6. Females: The overall suicide rates were higher in Asian countries (57-95 per million) than in ESC (40-56 per million). Asian elderly suicide rates differed (932 per million in rural China to 154 per million in Korea) but the highest ESC rate was in Australia (76 per million). The Asian countries elderly/general ratios ranged from 5.82 : 1 to 2.70 : 1, but the widest ESC ratio was 1.71 : 1, in the United Kingdom. CONCLUSION: There is a need for country-specific prevention measures in elderly people, and particularly for older women in Asian countries.

Adolescent↗

PubMed2003

Helicobacter pylori infection, mucosal atrophy and intestinal metaplasia in Asian populations: a comparative study in age-, gender- and endoscopic diagnosis-matched subjects.

BACKGROUND: It is known that the incidence and mortality rate of gastric cancer is high among Japanese and Chinese populations, but extremely low in Thai and Vietnamese populations. The aim of this study was to investigate the prevalence of Helicobacter pylori infection and the differences in the glandular atrophy and intestinal metaplasia scores in stomach specimens of Asian adult subjects of different races. MATERIALS AND METHODS: Chinese, Thai, Vietnamese and Japanese patients were matched by age, gender and endoscopic diagnosis, in order to compare the differences in incidence of H. pylori-related peptic ulcer disease and the prevalence of H. pylori infection among four Asian populations (n = 700). Glandular atrophy scores and intestinal metaplasia scores were also compared among four Asian populations divided into H. pylori-positive cases (n = 120, 109, 145, 80, respectively) and H. pylori-negative cases (n = 55, 66, 30, 95, respectively). RESULTS: Among peptic ulcers, gastric ulcer was more frequently seen in Japanese subjects than in the other Asian populations examined. On the other hand, duodenal ulcer was more frequently seen in other Asian populations than in Japanese subjects. The prevalence of H. pylori infection was similar in the Japanese (Tokyo) and Chinese (Beijing and Fuzhou) populations. It was higher in Thai (Chiang Mai) subjects compared with Japanese subjects. On the other hand, Vietnamese (Ho Chi Minh) subjects had significantly lower rates of H. pylori infection than Japanese subjects. The glandular atrophy and intestinal metaplasia scores in the stomach were significantly higher in the H. pylori-positive Japanese subjects than in H. pylori-positive subjects belonging to other Asian populations, except for the higher glandular atrophy scores in Chinese rather than Japanese subjects. On the other hand, there were no significant differences in the glandular atrophy and intestinal metaplasia scores in the angulus of the stomach among H. pylori-negative subjects belonging to the different Asian populations examined. CONCLUSIONS: Gastric ulcer was more common among Japanese subjects, while duodenal ulcer was more common among the other Asian populations examined. Japanese subjects with H. pylori infection showed more severe atrophic and metaplastic gastritis compared with that in other Asian subjects with H. pylori infection. These results may be related to the higher incidence of gastric cancer noted in Japanese subjects and the lower incidence of the cancer seen in Thai and Vietnamese patients.

Adult↗

PubMed2003

Utilization of papanicolaou smears by South Asian women living in the United States.

OBJECTIVES: Papanicolaou (Pap) smears are an underutilized screening modality among racial and ethnic minorities. However, no data exist on Pap smear utilization among South Asians, a rapidly growing population in the United States, whose country of origin includes India, Pakistan, Bangladesh, and Sri Lanka. We determined rates and identified variables associated with Pap smear receipt by South Asians. DESIGN: A self-administered survey instrument was mailed to a random sample of South Asians nationwide over a 3-month time period. South Asian households were identified by surnames that were used to search white pages in telephone directories, Department of Motor Vehicle records, and voter registries. Questions regarding Pap smear receipt were taken from the 1999 National Health Interview Survey. Sociodemographic information and measures of acculturation were obtained. PARTICIPANTS: A nationwide nonprobability sample of South Asian women. INTERVENTION: Cross-sectional observational study. MEASUREMENTS AND MAIN RESULTS: The overall response rate was 42%. In this sample, South Asians belonged to a high socioeconomic strata (SES), with 45% having a household income of >$80,000 and 42% having a master's degree. Three quarters of the respondents (73%) reported having a Pap smear in the last 3 years. In multivariate logistic regression analysis, South Asian women had greater odds of having had a Pap smear if they were married (P <.001), more educated (P =.004), had a usual source of care (P =.002), and were more acculturated (P =.004). CONCLUSIONS: Despite the high SES of South Asian women, their rates of Pap smear receipt were lower than national recommendations. Marital status, socioeconomic status, and acculturation are all associated with Pap smear receipt. South Asian communities should be targeted for outreach to promote Pap smear utilization.

Adolescent↗

PubMed2003

The utilisation of superficial venous surgery for chronic venous insufficiency by the U.K. Asian population.

BACKGROUND: The epidemiology of superficial venous disease is relatively well defined in the U.K. Caucasian population. By contrast, there are currently no data available for Asians, who comprise 3.6% of the U.K., and 14.1% of this institution's catchment population. The aim of this study was to compare surgery for superficial venous disease in Caucasians and Asians in this institution, in the context of our local population. METHODS: A prospectively gathered database of all 2011 superficial venous operations performed between January 1997 and April 2002 was retrospectively analysed with regard to ethnicity. The ethnic, gender and age composition of our catchment area was determined from U.K. census data. The full institutional records of 100 Asian and 100 randomly selected age and sex-matched Caucasian patients were compared in a case control study. RESULTS: After adjusting for age and gender according to census data, Asians were 40% less likely to undergo superficial venous surgery (SVS). Considering the 2011 operated patients as a whole, Asians were significantly younger and more likely to be male. In the case control study, Asians were significantly less likely to be operated for recurrent disease and significantly more likely to be operated for advanced disease. CONCLUSIONS: Although Asians are significantly less likely to undergo SVS; those that do are more likely to be young, male and operated for skin changes and ulcers. This strongly suggests that the under-representation of Asians is due to cultural, genetic or environmental factors and unmet health care need, rather than a lower prevalence of clinically significant venous disease in the Asian population.

Adult↗

PubMed2003

Social networks and coronary heart disease risk factors in South Asians and Europeans in the UK.

OBJECTIVES: To compare the social networks of South Asian (Indians, Pakistanis and Bangladeshis) and European-origin participants in the Newcastle Heart Project, and to examine the relationships between social network sizes and coronary heart disease (CHD) risk factors in both groups, testing the hypothesis that part of the reason for high rates of CHD in the South Asian UK population may be social isolation. DESIGN: Participants were 684 South Asian (259 Indians, 305 Pakistanis, 120 Bangladeshis) and 825 European men and women aged 25-74 years, who completed a questionnaire and were screened for CHD risk factors in a cross-sectional study. RESULTS: South Asians were more likely to be married than Europeans, had bigger households and were more likely to attend a place of worship regularly. Europeans saw more friends and relatives on a regular basis than did South Asians. There was also some heterogeneity between the South Asian groups. Europeans who reported bigger social networks were less likely to smoke than those with smaller networks, but there was little evidence of an association between social network size and waist circumference, blood pressure or TC:HDL ratio in either Europeans or South Asians. CONCLUSION: The results provided only partial support for the hypothesis that South Asians in the UK are socially isolated, and suggest that South Asians and Europeans in the UK utilise different sources of social support. Future work should acknowledge variation in sources of social support between ethnic groups, and should explore the possibility that different mechanisms link social support and health in different ethnic groups.

Adult↗

PubMed2003

Who is Asian? A category that remains contested in population and health research.

Continuing inconsistent use of the term 'Asian' and its appearance for the first time in the 2001 Census justifies an examination of its utility in population and health research. Given the potential for 'Asian' to describe either persons with origins in the Indian subcontinent or those originating from continental Asia, there is a strong argument in studies employing ethnicity as a measure of broad historical processes of colonialism, migration, and discrimination for privileging 'South Asian' over this contested term. Where the focus is on ethnicity as personal identity, there is some evidence of the emergence of bicultural terms such as 'Asian British' and 'Scottish Asian' and of more limited use regionally of 'Asian' and qualified terms such as 'Hindu Asian'. However, such usage cannot be generalized to the acceptance of a pan-Asian identity. Further, the different meanings that attach to terms such as 'Asian' and 'Indian' in the USA and Canada in terms of the specificity of each country's historical process of ethnogenesis mean that, where international comparisons are being made, accurate description of the population is needed to explain the terminology.

Asia, Western↗

PubMed2002

Nutrition, adequacy of dialysis, and clinical outcome in Indo-Asian and White European patients on peritoneal dialysis.

BACKGROUND: There is a high incidence of end-stage renal disease in Asians originating from the Indian subcontinent living in the UK. Research to date has focused on the cause of renal disease in Indo-Asians, and their outcome on peritoneal dialysis (PD) is less well studied. AIM: To determine whether nutrition, adequacy of dialysis, and outcome of Indo-Asian patients on PD were similar to those of White European patients. DESIGN: Prospective longitudinal observational study over 2 years. METHODS: We enrolled 35 Indo-Asians and 35 White Europeans on peritoneal dialysis, closely matched for age, gender, diabetes and duration of renal replacement therapy. At enrolment (>3 months on PD), demographic data was recorded. From enrolment, and at 6-month intervals, dialysis adequacy, nutritional status, hospitalizations, PD infections, and treatment modality changes were recorded. RESULTS: Dietary protein intake, which was significantly worse in Indo-Asians (particularly vegetarians), declined in all patients over time, along with other measures of nutritional status. Adequacy of dialysis, peritoneal characteristics, and PD infections were similar in Indo-Asian and White patients. Technique failure, and death rate were similar in both groups, but the transplant rate was lower in Indo-Asians. DISCUSSION: Interventions are needed to improve nutritional status in these patients, particularly the Indo-Asian patients. The long-term impact of worse social deprivation and lower transplant rates in Indo-Asians needs to be investigated further.

Africa, Eastern↗

PubMed2002

Early evidence of ethnic differences in cardiovascular risk: cross sectional comparison of British South Asian and white children.

OBJECTIVES: To examine whether British South Asian children differ in insulin resistance, adiposity, and cardiovascular risk profile from white children. DESIGN: Cross sectional study. SETTING: Primary schools in 10 British towns. PARTICIPANTS: British children aged 8 to 11 years (227 South Asian and 3415 white); 73 South Asian and 1287 white children aged 10 and 11 years provided blood samples (half fasting, half after glucose load). MAIN OUTCOME MEASURES: Insulin concentrations, anthropometric measures, established cardiovascular risk factors. RESULTS: Mean ponderal index was lower in South Asian children than in white children (mean difference -0.43 kg/m(3), 95% confidence interval -0.13 kg/m(3) to -0.73 kg/m(3)). Mean waist circumferences and waist:hip ratios were similar. Mean insulin concentrations were higher in South Asian children (percentage difference was 53%, 14% to 106%, after fasting and 54%, 19% to 99%, after glucose load), though glucose concentrations were similar. Mean heart rate and triglyceride and fibrinogen concentrations were higher among South Asian children; serum total, low density lipoprotein, and high density lipoprotein cholesterol concentrations were similar in the two groups. Differences in insulin concentrations remained after adjustment for adiposity and other potential confounders. However, the relations between adiposity and insulin concentrations (particularly fasting insulin) were much stronger among South Asian children than among white children. CONCLUSIONS: The tendency to insulin resistance observed in British South Asian adults is apparent in children, in whom it may reflect an increased sensitivity to adiposity. Action to prevent non-insulin dependent diabetes in South Asian adults may need to begin during childhood.

Adipose Tissue↗

PubMed2003

Elevated plasma high-sensitivity C-reactive protein concentrations in Asian Indians living in the United States.

Proinflammatory state may contribute to the excessive prevalence of type 2 diabetes and cardiovascular disease observed in populations originating from the Indian subcontinent (Asian Indians). This study was conducted to evaluate whether nondiabetic Asian Indian men living in the United States manifest a proinflammatory state when compared with Caucasians of similar age and body fat content. We also compared the relationships between plasma high-sensitivity C-reactive protein (hs-CRP), a marker of low-grade inflammation, and various parameters of body composition and fat distribution and insulin sensitivity in Asian Indians and Caucasians. For this purpose, plasma hs-CRP, oral glucose tolerance test, and anthropometric measurements were conducted in 82 Asian Indian men and 55 Caucasian men of similar age. The two groups had similar body fat content and truncal skinfolds thickness. Asian Indians had higher insulin areas under the curve during oral glucose tolerance tests, indicating a greater insulin resistance. Asian Indians also manifested a significant elevation of plasma hs-CRP. We conclude that young, overtly healthy Asian Indian men have both greater insulin resistance and higher hs-CRP levels than do Caucasians. This difference cannot be explained by greater adiposity in Asian Indians and suggests that many Asian Indians have an underlying proinflammatory state that may contribute to their increased risk for both type 2 diabetes and cardiovascular disease.

Adipose Tissue↗

PubMed1999

Relationship between generalized and upper body obesity to insulin resistance in Asian Indian men.

It has been proposed that excessive insulin resistance in Asian Indians living in urban areas or migrated to western countries is responsible for the higher incidence of type 2 diabetes and coronary heart disease observed in this population. To evaluate whether Asian Indians are more insulin resistant than Caucasians and to define the role of generalized and truncal adiposity, we performed hydrodensitometry, skinfold measurements, and euglycemic-hyperinsulinemic clamps in 21 healthy Asian Indian men and 23 Caucasian men of similar age and body fat content. The glucose disposal rate (Rd) was significantly lower in the Asian Indians than in the Caucasians (3.7+/-1.3 vs. 5.3+/-2.0 mg/min x kg lean body mass, respectively; P = 0.003). Despite similar total body fat content, Asian Indians had higher truncal adiposity than Caucasians (sum of truncal skinfolds, 117+/-37 and 92.4+/-38 mm, respectively). In both Asian Indians and Caucasians, the insulin sensitivity index (Rd/plasma insulin concentrations) was inversely correlated with both total body fat (r = -0.49; P<0.03 and r = -0.67; P<0.001, respectively) and sum of truncal skinfold thickness (r = -0.55; P<0.001 and r = -0.61; P<0.002, respectively). After adjustment for total body fat and truncal skinfold thickness, Asian Indians still had a significantly lower glucose disposal rate (P = 0.04). These results show that Asian Indian men are more insulin resistant than Caucasian men independently of generalized or truncal adiposity. The excessive insulin resistance in Asian Indians is probably a primary metabolic defect and may account for the excessive morbidity and mortality from diabetes and coronary heart disease in this population.

Adult↗

PubMed1993

Pregnancy Outcomes Among Asian Americans.

PURPOSE: The study examines differentials in various measures of pregnancy outcomes among all Asian Americans (N=328, 890) in the United States. METHODS: Cumulative data from the linked birth and infant/fetal death files for the period 198587 were used to study such Asian American and Pacific Islander (AAPI) groups as Chinese, Japanese, Filipino, Hawaiian, and "Other Asian and Pacific Islanders." White and black infants were considered as main comparison groups. Race/ethnic differences in pregnancy outcome measures such as perinatal, neonatal, postneonatal, and infant mortality rates, rates of low birth weight and preterm birth as well as those in maternal characteristics (e.g., maternal age, education, marital status, parity, nativity, and prenatal care) were analyzed. SUMMARY OF IMPORTANT FINDINGS: Results of the descriptive analyses indicate important race/ethnic differences, with Chinese, Japanese, Filipinos, and "Other Asians and Pacific Islanders" showing generally more favorable pregnancy outcomes and lower maternal risk profiles than Whites, Blacks, and Hawaiians. MAJOR CONCLUSIONS: There is substantial heterogeneity among the AAPI groups, with Chinese exhibiting the most favorable and Hawaiians the least favorable pregnancy outcomes. The lower maternal risk profile appears to contribute to the relatively advantageous pregnancy outcomes of the Chinese and Japanese Americans compared to the other groups. The ethnically diverse group "Other Asian and Pacific Islanders" needs to be further subdivided so that specific Asian subgroups within this category, which may be at increased risk for adverse pregnancy outcomes, can be identified. RELEVANCE TO ASIAN PACIFIC ISLANDER AMERICAN POPULATIONS: This study reports comparative analyses of Chinese, Japanese, Filipino, Hawaiian, and "Other Asian and Pacific Islanders." KEY WORDS: Asian Americans/Pacific Islanders, pregnancy, infant, perinatal, preterm, low birth weight

Journal Article↗

PubMed1994

Suicide in the Elderly: Profiles of Asians and Whites.

PURPOSES OF THE PAPER: The theory of acculturation was specifically explored as a possible cause for the increased suicide rate among Japanese and Chinese elderly women as documented by Liu and Yu. SUMMARY OF METHODS UTILIZED: Cultural factors surrounding suicide among Asian and white elderly living in Los Angeles County during the period of 19841989 were examined. Differences in factors contributing to suicide were also compared within specific Asian subgroups, i.e. Japanese, Chinese, Filipino, and Vietnamese. The authors reviewed L.A. County Corloner's investigative reports of 48 Asians and Whites age 65 years and above. PRINCIPAL FINDINGS: Significant differences (p<.05) were found between Asians and Whites in citizenship, number of years in the United States, occupation, living situation, and method of suicide. No significant differences (p>.05) were found for marital status, medical history, reason, previous attempt, or depression. CONCLUSIONS: The majority Asian elderly (50%) were living with their children as compared to White elderly suicide victims (2%), which showed that the Asian tradition of filial piety, as a measure of acculturaltion, was still being obeyed and thus, does not support the theory that acculturation factors cause a higher suicide rate in the Asian elderly population in L.A. County. Suicide is highly prevalent among some elderly Asian Americans and this fact is relevant for health professionals working with them. KEY WORDS: Elderly, Suicide, Asians, Whites, Culture, Male, Female.

Journal Article↗

PubMed2002

An Asian perspective to the problem of osteoporosis.

INTRODUCTION: Most research into the problem of osteoporosis has been carried out in Caucasian populations. This review highlights emerging data from research on osteoporosis among Asians, and some differences from Caucasian data. METHODS: A non-systematic review of the English-language literature on various aspects of osteoporosis among Asian populations was carried out. RESULTS: Compared to Caucasian populations, epidemiological trends in Asian populations appear to be developing along similar lines, although rates of hip fracture do differ by country and ethnicity, and are generally lower. Bone mineral density (BMD) carries similar relevance with regard to fracture risk, although hip geometry is also believed to have some impact. Risk factors for osteoporosis and fractures are somewhat similar, although dietary factors seem to play a larger role as reported in Asian studies. A uniquely Asian self-assessment tool based on clinical factors has been developed to assist in case-finding of osteoporotic patients. The few intervention trials with hormone replacement, alendronate and parathyroid hormone appear to show similar responses between Asians and Caucasians, although the response to vitamin D analogs in Asians appears better. Some differences in gene polymorphisms between Asians and Caucasians exist, and these may impact on BMD and fractures via different gene-environment relationships. CONCLUSIONS: Many aspects of osteoporosis in Asia appear similar to the West, but several interesting differences have emerged. These might lead to refinements in the strategies to manage osteoporosis within the Asian context.

Age Distribution↗