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PubMed2000

Alloimmunization and erythrocyte autoimmunization in transfusion-dependent thalassemia patients of predominantly asian descent.

The development of hemolytic alloantibodies and erythrocyte autoantibodies complicates transfusion therapy in thalassemia patients. The frequency, causes, and prevention of this phenomena among 64 transfused thalassemia patients (75% Asian) were evaluated. The effect of red blood cell (RBC) phenotypic differences between donors (mostly white) and Asian recipients on the frequency of alloimmunization was determined. Additional transfusion and patient immune factors were examined. 14 (22%) of 64 patients (75% Asian) became alloimmunized. A mismatched RBC phenotype between the white population, comprising the majority of the donor pool, and that of the Asian recipients, was found for K, c, S, and Fyb antigens, which accounts for 38% of the alloantibodies among Asian patients. Patients who had a splenectomy had a higher rate of alloimmunization than patients who did not have a splenectomy (36% vs 12.8%; P =.06). Erythrocyte autoantibodies, as determined by a positive Coombs test, developed in 25% or 16 of the 64 patients, thereby causing severe hemolytic anemia in 3 of 16 patients. Of these 16, 11 antibodies were typed immunoglobulin G [IgG], and 5 were typed IgM. Autoimmunization was associated with alloimmunization and with the absence of spleen (44% and 56%, respectively). Transfused RBCs had abnormal deformability profiles, more prominent in the patients without a spleen, which possibly stimulated antibody production. Transfusion of phenotypically matched blood for the Rh and Kell (leukodepleted in 92%) systems compared to blood phenotypically matched for the standard ABO-D system (leukodepleted in 60%) proved to be effective in preventing alloimmunization (2.8% vs 33%; P =.0005). Alloimmunization and autoimmunization are common, serious complications in Asian thalassemia patients, who are affected by donor-recipient RBC antigen mismatch and immunological factors.

Adolescent↗
PubMed2001

Self-reports of stress in Asian immigrants: effects of ethnicity and acculturation.

INTRODUCTION: Although the concept of stress is hard to define or measure, it is a phenomenon associated with a number of health conditions, including hypertension, heart disease, and decreased immunocompetency. Events such as migration are known to create stress; researchers refer to this as acculturative stress. Given that cultural background might influence a patient's recognition, interpretation, and coping mechanisms for stress, we wondered how self-reports of stress by Asian immigrants compare with those of non-Hispanic Whites, and how these self-reports vary with years since immigration, a proxy for acculturation. METHODS: Data from the National Health Information Survey for 1993 and 1995 were analyzed for six groups of Asian national origin, and were compared with non-Hispanic Whites. Using ordered logistic regression, we examined self-reports of stress over two weeks and twelve months, as well as the changes in these self-reports with years since immigration. RESULTS: Adjusted for age, income, educational level, marital status, and gender, Asian immigrants were uniformly less likely to report stress over a two-week period than were non-Hispanic Whites (OR ranges: 0.34[Asian Indian]-0.59[Korean], P values<.05). There were no significant differences in reported stress among Asian ethnic groups. Compared with immigrants who have lived in the United States for at least 15 years, recent immigrants (<1 year) were likely to report less stress over two weeks and twelve months, OR = 0.13 and 0.23, respectively, P values<.005. CONCLUSIONS: Despite their status as immigrants, Asians report less stress than non-Hispanic Whites. These reports of stress increase as years since immigration increase. One potential explanation for these discrepancies is under-reporting, which might reflect underlying cultural differences in the perception or definition of stress, differences that may diminish with "acculturation."

Acculturation↗
PubMed2003

Chronic hepatitis B and hepatitis C in Asian Americans.

Both chronic hepatitis B and hepatitis C are prevalent among the 12 million Asians and Pacific Islanders living in the United States. Significant epidemiological and clinical differences exist between Asian Americans and the general U.S. population, most notably the higher rate of primary liver cancer and the differential response to various antiviral therapies. Perinatal and childhood transmission is common for hepatitis B virus. Transmission of hepatitis C virus probably also occurs early in life and results from nosocomial transmission and person-to-person spread. Asian patients with chronic hepatitis B commonly have hepatitis B e antigen-negative hepatitis B with either the precore or core-promoter mutant hepatitis B virus, which may require long-term antiviral viral therapy because of high rates of relapse following therapy. Asian patients with chronic hepatitis C may have a substantially higher risk of liver cancer but a better response to interferon-based therapy, both in terms of sustained virological response and reduced future incidence of liver cancer. Understanding these differences will lead to improved care for Asian Americans with viral hepatitis and better disease control for hepatitis B and hepatitis C for the entire U.S. population. This review briefly summarizes the major issues in the clinical care of patients with chronic viral hepatitis and focuses on pertinent epidemiological and clinical differences between Asian-American and Caucasian patients.

Adult↗
PubMed2004

Physical activity among Asians and native Hawaiian or other Pacific islanders--50 States and the District of Columbia, 2001-2003.

Data on physical activity participation rates among Asians and Native Hawaiian or Other Pacific Islanders (NHOPIs) in the United States are limited. For example, few studies have measured physical activity prevalence among the diverse Asian population, which was estimated to be 11.9 million in 2000 according to the U.S. Census and is projected to increase to 33.4 million by 2050. One of the broadly defined goals of the 2010 national health objectives is to reduce disparities in health among population groups. To determine the prevalence of recommended levels of lifestyle (i.e., nonoccupational) physical activity (e.g., combined leisure-time, household-related, and transport-related), the prevalence of physical inactivity, and the prevalence of leisure-time physical inactivity among Asians and NHOPIs in the United States, CDC analyzed physical activity data from the Behavioral Risk Factor Surveillance System (BRFSS) surveys from 2001, 2002, and 2003 for the Asian and NHOPI populations from all 50 states and the District of Columbia (DC). This report summarizes the results of that analysis, which indicated that 38.6% of Asians and NHOPIs met recommended levels of lifestyle physical activity, compared with 45.8% of the total U.S. population, and approximately 24% were inactive during their leisure time. To increase physical activity in the Asian and NHOPI populations, state and local health departments and other organizations should adopt evidence-based strategies at the community and individual level to promote and encourage physical activity.

Adult↗
PubMedDate not supplied

Cancer in Asian American males: epidemiology, causes, prevention, and early detection.

OBJECTIVES: The objective of this paper is to discuss the epidemiology, etiology, and cultural phenomena that characterize cancers specific to Asian American males. METHODS: The author reviewed various published literature concerning the health of Asian American males. RESULTS: Data show an epidemiological dichotomy in cancer incidences between Asian American males and the general U.S. male population. First, lung and colorectal cancers are among the top three cancers for most Asian groups, similar to the situation in the White population. Second, prostate cancer is the leading, or second leading, cause of cancer for Chinese, Japanese, and Filipino males -- all groups considered, in U.S. terms, to be more established in their migration patterns. Third, liver and stomach cancer are in the top five cancers for most Asian groups, an incidence not shared by the White population. CONCLUSIONS: The most common cancers in Asian American males involve the interplay of host genetic and environmental factors, and both primary and secondary prevention strategies are necessary to decrease the morbidity and mortality rates of this uniquely diverse population.

Asian↗
PubMed2005

The effect of socio-economic status and ethnicity on the comparative oral health of Asian and White Caucasian 12-year-old children.

OBJECTIVE: To investigate the oral health of 12-year-old children of different deprivation but similar fluoridation status from South Asian and White Caucasian ethnic groups. DESIGN: An epidemiological survey of 12-year-old children using BASCD criteria, with additional tooth erosion, ethnic classification and postcode data. CLINICAL SETTING: Examinations were completed in schools in Leicestershire and Rutland, England, UK. Participants A random sample of 1,753 12-year-old children from all schools in the study area. MAIN OUTCOME MEASURES: Caries experience was measured using the DMFT index diagnosed at the caries into dentine (D3) threshold, and tooth erosion using the index employed in the Children's Dental Health UK study reported in 1993. RESULTS: The overall prevalence of caries was greater in White than Asian children, but varied at different levels of deprivation and amongst different Asian religious groups. There was a significant positive association between caries and deprivation for White children, but the reverse was true for non-Muslim Asians. White Low Deprivation children had significantly less tooth erosion, but erosion experience increased with decreasing deprivation in non-Muslim Asians. CONCLUSIONS: Oral health is associated with ethnicity and linked to deprivation on an ethnic basis. The intra-Asian dental health disadvantage found in the primary dentition of Muslim children is perpetuated into the permanent dentition.

Asian People↗
PubMed2005

Clinical characteristics of South Asian patients hospitalized with heart failure.

Ethnic variations in prevalence, presentation characteristics, and mortality have been identified in Canadian patients with coronary artery disease. Similar data with respect to heart failure do not exist. A retrospective sequential chart review of South Asians and non-South Asian Whites in Canada hospitalized with a primary diagnosis of congestive heart failure between 1997 and 1999 showed South Asians were significantly younger, of lower body mass index, were more often diabetic, and were less often smokers. In-hospital mortality was not different between groups, although South Asians were more likely to experience ventricular arrhythmias. Despite presenting at a younger age, South Asians had more high-risk features at hospital discharge. Since South Asians are at high risk of developing premature coronary artery disease, a more aggressive approach to prevention strategies in this ethnic group may reduce the subsequent burden of heart failure.

Aged↗
PubMed2006

Effective strategies for recruiting of Asian cancer patients in internet research.

This poster is aims to provide directions for effective strategies for recruiting Asian cancer patients in Internet study among Asian American cancer patients. In the study, we used four different strategies to recruit Asian cancer participants: (a) general and ethnic specific Internet cancer support groups; (b) Asian Internet communities/groups; (c) Asian physician clinics, Asian community and culture center; and (d) community consultants. The most effective recruitment strategy among them was the recruitment through community consultant. The findings support the importance of using key persons in ethnic minority communities to recruit ethnic minority participants.

Asian↗
PubMed1991

Correlates of breast-feeding in a low-income population of whites, blacks, and southeast Asians.

Infant feeding was examined in 492 children in a population-based survey conducted in a low-income, urban county of St Paul, Minn. Of 41 Southeast Asian infants who were foreign born, 93% (38) had been breast-fed compared with 10% (12) of Southeast Asian infants born in the United States (n = 116). Among non-Southeast Asian infants, 73% (173) of whites (n = 237), 63% (27) of blacks (n = 43) and 65% (36) of other ethnic groups (n = 55) had been breast-fed. Among the non-Southeast Asian infants, the initiation of breast-feeding was associated with higher parental education and with being married. Ethnic group, level of poverty, and participation in the Supplemental Food Program for Women, Infants, and Children during pregnancy did not appear to influence the initiation of breast-feeding. The findings indicate a higher incidence of breast-feeding than in previous surveys of low-income black and white women; however, this may reflect the higher educational level of the non-Southeast Asian study population. In contrast, the sharp decline in the incidence of breast-feeding among Southeast Asian infants who were born in the United States compared with those who were foreign born indicates the need for public health approaches to strengthen traditional breast-feeding practices.

Black or African American↗
PubMed1991

Dental caries experience and oral cleanliness of Asian and white Caucasian children aged 5 and 6 years attending primary schools in Glasgow and Trafford, UK.

The aim of this study was to compare the dental caries experience and oral cleanliness of Asian and white Caucasian children aged 5 and 6 years attending multi-racial schools in Trafford (Greater Manchester) and Greater Glasgow. In 1989 all schools having at least 25 per cent of per cent of pupils from an Asian background participated in the study. Although the white children in Trafford had a higher caries experience (dmft = 3.29) than those in Glasgow (dmft = 3.02), the difference failed to reach statistical significance. This was also true of the Asian population (Trafford dmft = 4.49. Glasgow dfmt = 4.18). When the Asian population was further divided according to religion and the English-speaking ability of the mother, the non-Muslim children of English-speaking mothers had similar caries levels in both areas (Trafford dmft = 2.28, Glasgow dmft = 2.32), and a better dental health than the rest of the Asian population. Oral cleanliness scores followed a similar pattern to dental caries experience. It is concluded that inequality in dental health between Asian and white schoolchildren exists in both Glasgow and Trafford. In addition, these young children who attended multi-racial schools which were located in deprived areas of Trafford and Glasgow had a similar dental health. This was true of the population as a whole and for each of the major ethnic groups.

Asia↗
PubMed1988

Haloperidol and prolactin concentrations in Asians and Caucasians.

Serum haloperidol and prolactin concentrations were measured in 34 normal male volunteers (12 Caucasians, 11 American-born Asians, and 11 foreign-born Asians) over a 7-hour period after haloperidol administration (0.5 mg given intramuscularly or 1.0 mg given orally). The results were similar between the two Asian groups but significantly different between Caucasians and Asians. After controlling for body surface area, Caucasians still had lower serum haloperidol concentrations and less prominent prolactin responses than did Asians. Furthermore, the ethnic difference in prolactin responses could not be fully accounted for by the differences in serum haloperidol concentrations between the two ethnic groups. These results indicate that both pharmacokinetic factors, including absorption and hepatic first-pass metabolism, and pharmacodynamic factors (dopamine receptor-mediated responses) contribute to the difference in responses between Caucasians and Asians.

Adult↗
PubMed1987

Basal metabolic rate and diet-induced thermogenesis in Asians living in Britain.

The basal metabolic rate (BMR) and diet-induced thermogenesis (DIT) in 11 Asians (4 men, 7 women) who had lived in Britain for longer than 2 years were compared with a matched group of Europeans. The mean basal oxygen consumption was 226 ml O2/min in the Asians and 218 ml O2/min in the Europeans, values not significantly different. When BMR was expressed in absolute terms, per unit body weight, per unit body surface area or lean body mass, still no significant difference was observed. DIT was measured in the two groups fed a mixed meal containing 2800 kJ. The main increase in the metabolic rate over 20-120 min was 19 per cent in the Asians and 20 per cent in the Europeans. These results indicate that, in contrast to Asians living in the tropics, Asians living in Britain show no difference in BMR or DIT. It is concluded that Asians living in the temperature regions behave metabolically differently from those living in the tropics.

Adult↗
PubMed1986

Birth weight, Apgar scores, labor and delivery complications and prenatal characteristics of Southeast Asian adolescents and older mothers.

The study population included 337 adolescents and 876 mothers who delivered live-born, singleton infants in the Maternity and Infant Care Program at the Minneapolis Health Department between 1980-1982. Whites and blacks on the average experienced menarche 1-2 years earlier than the Southeast Asians although age of first pregnancy was 2 years later for the Southeast Asians. In spite of the significantly later ages of entry into prenatal care, lower weight gains, and hematocrits among the Southeast Asians, compared to the white and black populations, overall height-weight status on admission compared favorably with whites and blacks. The virtual absence of alcohol and tobacco consumption among the Southeast Asians may in fact contribute to the generally favorable Apgar scores, length of gestation, and birth weights. The high frequencies of alcohol and tobacco consumption among white adolescents during pregnancy suggest the need for more intervention to discourage smoking in this population. Further, the potential adoption of these substances needs to be discouraged among the Southeast Asian adolescents. While 2-4% of the whites, blacks and Hmong adolescents experienced eclampsia, 1% of the older Hmong mothers and none of the other Southeast Asians experienced eclampsia. The most frequent complication for all groups was perineal laceration.

Adolescent↗
PubMed1994

In search of Asian war brides.

Because of the long presence of U.S. soldiers in Asia, war-bride marriages involving servicemen and Asian women have been formed throughout the century. The literature, however, contains little empirically sound information on Asian war brides. This analysis develops a methodology to identify war brides and applies it to estimate the number of war brides from the six major Asian groups, using the national 1980 Public Use Microdata Sample. Further analysis comparing Asian war brides with other groups of Asian wives tends to support the traditional and lower socioeconomic images commonly associated with Asian war brides.

Acculturation↗
PubMed1995

Glutathione S-transferase M1 genotype affects aminobiphenyl-hemoglobin adduct levels in white, black and Asian smokers and nonsmokers.

Cigarette smoking is the major cause of bladder cancer in men in the United States, and the arylamines contained in cigarettes smoke, including 4-amino-biphenyl (4-ABP), are believed to play an important role in the induction of bladder cancer among smokers. N-acetylation, which is catalyzed by the genetically controlled hepatic N-acetyltransferase enzyme displaying two phenotypes (slow versus rapid), is a detoxification pathway for arylamines with regard to bladder carcinogenesis. In Los Angeles, CA, non-Hispanic white (white), black, and Asian males have comparable smoking habits and yet dramatically different risks of bladder cancer (31 of 100,000 in whites, 16 of 100,000 in blacks, and 13 of 100,000 in Chinese and Japanese). Previously, we have demonstrated that the prevalence of slow acetylators (the high-risk phenotype) was highest in whites (54%), intermediate in blacks (34%), and lowest in Asians (14%). We also showed that mean 3- and 4-ABP hemoglobin adduct levels were significantly higher in cigarette smokers relative to nonsmokers, and that the level increased with increasing number of cigarettes smoke/day. Most importantly, slow acetylators consistently exhibited higher mean levels of ABP hemoglobin adducts relative to rapid acetylators, regardless of race and level of cigarette smoking. We assessed 151 residents of Los Angeles County (CA) who were either white, black, or Asian (Chinese or Japanese) and over the age of 30 years for their glutathione S-transferase M1 (GSTM1) genotype (null versus non-null), acetylator phenotype (slow versus rapid), levels of 3- and 4-ABP hemoglobin adducts, and current use of tobacco products. Whites (27%) had the highest prevalence of the highest risk profile (slow acetylator, GSTM1 null), followed by blacks (15%) and Asians (2.7%), and the difference was statistically significant (P = 0.006). Whites also had less than one-half the prevalence of the "protective" profile (rapid acetylator, GSTM1 non-null) relative to blacks and Asians (23 versus 57%; P = 0.0001). Regardless of race and level of cigarette smoking, mean levels of 3- and 4-ABP hemoglobin adducts were higher in subjects possessing the higher risk (GSTM1/acetylator profile. Mean level of 4-ABP hemoglobin adduct (adjusting for race, cigarette smoking, and acetylator phenotype) was significantly higher in subjects possessing the GSTM1-null versus GSTM1-non-null genotype (46.5 versus 36.0 pg/g Hb; P = 0.037). The comparable difference in mean levels of 3-ABP hemoglobin adduct was borderline significant (1.6 versus 1.1 pg/g Hb; P = 0.07). Thus, our results suggest that GSTM1 is involved in the detoxification of 3- and 4-ABP and may contribute to the racial variation in bladder cancer incidence among white, black, and Asian males in Los Angeles, CA.

Adult↗
PubMed1997

Outcome of hypertension management in Asian Americans.

BACKGROUND: Ethnic and/or racial differences in drug response to antihypertensive agents have been recognized, yet the prescribing practices and the information on efficacy of various agents rely mainly on the response of whites to drugs. OBJECTIVES: To assess the management of hypertension in Asian Americans and to compare it with an age- and sex-matched group of white patients with hypertension. METHODS: The patients' medical records were used as the primary source of information for the data collection. The observational period was a 12-month window and included 200 patients of Asian origin with hypertension and 196 white patients with hypertension whose medical records were randomly selected. RESULTS: The study describes the pattern of use of antihypertensive agents and the differences in response to antihypertensive agents between Asian Americans and whites. The preferred antihypertensive agents in both Asian and white patients included monotherapy with either calcium channel blockers or angiotensin-converting enzyme inhibitors. However, medication changes, dose reduction, and the experience of side effects were all significantly more frequently recorded in Asian patients than in white patients (P < .001, P < .008, and P < .002, respectively). CONCLUSIONS: These findings are supportive of some previous reports on ethnic differences in drug response to antihypertensive agents. The findings also point to the need for further prospective studies on the outcome of hypertension management in Asian American patients.

Aged↗
PubMed1999

The role of ethnicity and parental bonding in the eating and weight concerns of Asian-American and Caucasian college women.

OBJECTIVES: The purpose of this research was to explore the associations among ethnicity, parental bonding, acculturation, and eating disturbance in Asian-American and Caucasian weight-concerned college women. METHODS: Twenty-five Asian-American and 26 Caucasian weight-concerned women were administered the Eating Disorder Examination interview, the Parental Bonding Instrument, and three subscales of the Eating Disorder Inventory. Asian-American subjects also filled out the Suinn-Lew Asian Self-Identity Acculturation Scale questionnaire. RESULTS: Contrary to hypotheses, weight-concerned Asian-American women reported more dissatisfaction with body shape than did Caucasian women. Moreover, in the Asian-American group, acculturation was not associated with level of eating disturbance. In both groups, perceptions of low maternal caring were associated with higher levels of eating problems. In regression analyses, maternal care emerged as a better predictor of eating disturbance than did ethnicity. DISCUSSION: Results suggest that quality of parent-child relations, particularly the mother-daughter relationship, may be important in the etiology of eating problems, irrespective of ethnicity. Longitudinal investigations will be required to test causal relations.

Acculturation↗
PubMed1995

Body shape perception and dieting in preadolescent British Asian girls: links with eating disorders.

Body shape dissatisfaction and dieting have previously been reported in 9-year-old Caucasian girls. As British adolescents of Asian origin appear at least as vulnerable to eating disorders, the present study investigated these issues in preadolescent British Asian girls. Fifty-five Asian and 42 Caucasian 9-year-olds completed assessments of dietary restraint, body esteem, body satisfaction, and body figure preferences. The study revealed a high priority for thinness in both the Asian and Caucasian girls. Their desire for thinness was present even though the Asian girls had a significantly lower body weight than their Caucasian peers. Both groups of high restraint girls expressed body shape discontent and lower body esteem. In addition, an association was found in the Asian sample between reported dieting and the cultural orientation of their family. These results demonstrate the wide appeal of thinness, which in combination with intercultural and intrafamilial conflict, may strongly influence eating and contribute to the development of eating disorders.

Body Image↗