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Concentrations of estrogens and IGFs in umbilical cord blood plasma: a comparison among Caucasian, Hispanic, and Asian-American females.

It has been hypothesized that exposure to elevated levels of estrogens and IGFs before birth may increase breast cancer risk in female offspring. We examined whether the concentrations of estrone, E2, IGF-I, IGF-II, and IGF-binding protein-1 (IGFBP-1), -2, and -3 in umbilical cord blood plasma differed in female neonates of three racial/ethnic groups with contrasting breast cancer risk. The study included 57 Caucasian, 22 Hispanic, and 22 Asian-American subjects. Relative contribution of race/ethnicity to the analyte level variability was the largest for IGFBP-1 (P = 0.06). The only statistically significant (P < 0.05) mean difference was the lower IGFBP-3 levels in Asian than in Caucasian subjects. Adjusted mean levels of estrone and E2 for Asian subjects were 128% and 109% of the Caucasian means, respectively, whereas the Hispanic group showed lower means (85% and 84% of the Caucasian means). IGF-I, IGFBP-1, and IGFBP-3 showed lower adjusted means for both Hispanics and Asians compared with Caucasians. However, these differences were not statistically significant. In summary, we have shown that concentrations of estrogens, IGF-I, IGF-II, and IGFBPs are not different in cord blood samples from Caucasian, Hispanic, and Asian-American subjects. These data do not support a link between antenatal exposure to elevated levels of estrogens and IGFs and breast cancer.

Adult↗

Renin angiotensin aldosterone system blockade and renal disease in patients with type 2 diabetes. An Asian perspective from the RENAAL Study.

OBJECTIVE: Asia is predicted to have the largest population of patients with diabetes who are at high risk for renal disease. In the Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan (RENAAL) study, approximately 17% of patients were Asians. In this subgroup analysis, we examined the characteristics, response, and adherence to treatment of the Asian population, as well as their baseline predictors of risk of renal end points. RESEARCH DESIGN AND METHODS: A total of 252 Asian patients were enrolled in the RENAAL study, which compared losartan (50 mg titrated to 100 mg) to placebo in addition to conventional antihypertensive medications in type 2 diabetic patients with nephropathy. Mean follow-up was 3.2 years. The effect of losartan therapy on renal and cardiovascular outcomes was examined, and baseline predictors of risk were determined using a Cox proportional hazards model with prespecified baseline covariates. RESULTS: Losartan reduced the risk of the primary composite end point composed of a doubling of serum creatinine, end-stage renal disease, or all-cause mortality in Asian patients by 35% (P = 0.02). No difference between losartan and placebo was observed for the cardiovascular composite outcomes. Losartan reduced the level of proteinuria by 47% (P < 0.001) and rate of decrease in renal function by 31% (0.0074). Discontinuations were lower in the losartan-treated patients. The strongest baseline predictors of risk of renal end points were proteinuria (hazard ratio 1.42, P < 0.0001) and low Hb (0.81, P < 0.0001). CONCLUSIONS: In this subgroup analysis of the RENAAL study, losartan conferred significant renal benefits and was well tolerated in Asian patients with type 2 diabetes and clinical nephropathy. Baseline proteinuria and low Hb were strong predictors of risk of renal outcomes.

Antihypertensive Agents↗

Reduced adipocyte insulin sensitivity in Caucasian and Asian subjects with coronary heart disease.

The association between insulin resistance and coronary heart disease (CHD) is strong in the British Indian-Asian population. Adipocyte metabolism may contribute to both insulin resistance and CHD. We examined insulin-stimulated glucose uptake in adipocytes and in vivo insulin sensitivity using the fasting insulin resistance index (FIRI) in 60 subjects (45 Caucasian and 15 Asian) with CHD and 30 Caucasian subjects without CHD. In 25 CHD subjects (18 Caucasian and 7 Asian), the relationship between adipocyte insulin sensitivity and non-esterified fatty acid (NEFA) suppression to oral glucose was examined. Compared with controls, the CHD subjects had higher values of fasting insulin [51 (46 to 54) pmol l(-1) vs 36 (31 to 41) pmol l(-1) p< 0.01] and FIRI [1.65 (1.5 to 1.79) vs 1.06 (0.89 to 1.23), p < 0.01]. Among the CHD subjects, the Asians had higher values than Caucasian [insulin 58 (48 to 67) pmol l(-1) vs 48 (44 to 53) pmol l(-1) p < 0.01, FIRI 1.89 (1.44 to 2.13) vs 1.62 (1.4 to 1.79), p< 0.01)]. Insulin-stimulated glucose uptake in adipocytes was lower in the CHD than control subjects [56 (50 to 62) vs 115 (75 to 132) attomol min(-1).mm2, p < 0.05], being most reduced among the Asians. It was positively correlated with postprandial NEFA suppression and negatively with insulin release. In conclusion, abnormalities of adipocyte function and insulin sensitivity occur in CHD and may contribute to its aetiology.

Adipocytes↗

Sociocultural influences on eating attitudes and behaviors, body image, and psychological functioning: a comparison of African-American, Asian-American, and Caucasian college women.

Eating attitudes and behaviors, body image, and psychological functioning were evaluated in 98 female college students: 36 African-Americans, 34 Asian-Americans, and 28 Caucasians. African-Americans had significantly higher body mass index than either Asian-American or Caucasians. In contrast, Caucasians reported greater levels of disordered eating and dieting behaviors and attitudes and greater body dissatisfaction than did Asian-Americans and African-Americans who differed little on these measures. The nature of variability in these eating behaviors and attitudes and body image was also examined within each of the three groups. A generally consistent pattern emerged within each racial group: low self-esteem and high public self-consciousness were associated with greater levels of problematic eating behaviors and attitudes and body dissatisfaction. A history of being teased about weight and size was associated with problematic eating behaviors and attitudes and body dissatisfaction in African-Americans and Caucasians but not in Asian-Americans. The findings suggest that there exist important racial differences on various aspects of eating, dieting, and body image in college women. Contrary to hypothesis, the degree of acculturation and assimilation within the African-American and Asian-American groups was unrelated to variability in these domains.

Acculturation↗

Acetylation phenotype status in a Bangladeshi population and its comparison with that of other Asian population data.

The objective of the present study was to determine the acetylator status of the Bangladeshi population and to compare the findings with the acetylator status of other Asian populations. The acetylator phenotype was determined in 517 unrelated healthy Bangladeshi subjects. The phenotyping procedure was done according to Price Evans' method using the NAT2 specific probe drug--sulphadimidine. The Bangladeshi population showed a bimodal distribution of fast and slow acetylators. Of a total of 517 healthy Bangladeshi, 79.5% (n=411) were fast acetylators and the rest 20.5% (n=106) were slow acetylators. The high frequency of the fast acetylators in the population of Bangladesh was comparable to other populations in East Asia. When this acetylator status was compared with other Asian data, the Asian population showed a positive correlation between the acetylator status and the geographical longitude (r=0.919; t=7.37; p>0.001; d.f.=10). The regression line of the scatter diagram showed that the frequency of acetylating capacity increasingly occurred in the populations towards eastern Asia (regression coefficient=0.54; constant=52.36). This line was termed as the Asian fast acetylator longitude (AFAL). Thus the AFAL was able to predict the acetylator status of the Asian population by the east-west geographical longitude. The AFAL could be a useful prognosticator in the disposition for the effective and safe use of numerous drugs and xenobiotic compounds in humans.

Acetylation↗

Bone mineral density and mass by total-body dual-photon absorptiometry in normal white and Asian men.

Total body bone mineral density, total body bone mineral mass (TBBM), and bone mineral densities (BMD) in seven different regions of the body were measured in 238 normal men (154 Whites and 84 Asians), age 22-94, using dual-photon absorptiometry. Although Asian men had lower TBBM and BMD in all regions (p less than 0.05) except the arms, when multiple regression was done with body weight, height, and age, no significant differences were found between Asians and Whites for bone measurements. Thus lower bone mineral densities and bone mineral mass in Asian males compared to White males appear to be due to differences in height and weight rather than to ethnic differences. The two groups were combined to derive multiple regression equations for TBBM, total-body BMD, and regional BMD. Age, weight, and height were significant in the multiple regression equations for TBBM, ribs BMD, and legs BMD. Age and weight, but not height, were significant for total-body BMD, trunk BMD, spine BMD, arm BMD, and pelvis BMD. Weight, but neither height nor age, was significant for head BMD. These reference normal bone mineral density and bone mineral mass standards are appropriate for both Asian and White males when adjusted for weight, height, and age.

Absorptiometry, Photon↗

Full-face photorejuvenation of photodamaged skin by intense pulsed light with integrated contact cooling: initial experiences in Asian patients.

BACKGROUND AND OBJECTIVES: For Asian skin, recent "non-ablative" skin rejuvenation techniques have become the focus of attention for darker complected patients. In our earlier research, we have shown that intense pulsed light (IPL) technology can be applied to Asian skin with a high degree of safety and efficacy. In this study, we performed full-face photorejuvenation using a new IPL device incorporating a 560 nm filter and integrated contact cooling system for the improvement of various symptoms associated with photoaging in Asian patients. STUDY DESIGN/MATERIALS AND METHODS: A total of 73 patients were treated with a series of five or more full-face treatments at 3-4 week intervals using IPL with integrated contact cooling. One month after the third and fifth treatments, the patient and the treating physicians subjectively evaluated improvement in five areas-in pigmentation, telangiectasia, fine wrinkles, skin texture, and over-all improvement. In addition, histological changes were evaluated. RESULTS: Pigmentation improvement, telangiectasia reduction, fine wrinkle reduction, smoother skin texture, and over-all improvement were evaluated according to five grades of percentage improvement. In addition, the subjective rating by the patients and the physicians was averaged, and the combined results were evaluated. After the fifth treatment, a combined rating of greater than 60% improvement was given to more than 80% of patients for pigmentation improvement, telangiectasia reduction or removal, smoother skin texture, and overall improvement. Histological evaluations showed strong staining of Type I and Type III collagen. Complications were minor and transitory, with burning sensations and erythema in only two patients. CONCLUSION: Full-face photorejuvenation for Asian patients using this device is not only effective but is also associated with fewer post-treatment complications than other more invasive modalities. We conclude that IPL photorejuvenation can be the basis for safe and effective skin rejuvenation in Asian patients.

Adult↗

Considering context, place and culture: the National Latino and Asian American Study.

This paper provides a rationale for, and overview of, procedures used to develop the National Latino and Asian American Study (NLAAS). The NLAAS is nationally representative community household survey that estimates the prevalence of mental disorders and rates of mental health service utilization by Latinos and Asian Americans in the US. The central aims of the NLAAS are to: 1) describe the lifetime and 12-month prevalence of psychiatric disorders and the rates of mental health services use for Latino and Asian American populations using nationwide representative samples of Latinos and Asian Americans, 2) assess the associations among social position, environmental context, and psychosocial factors with the prevalence of psychiatric disorders and utilization rates of mental health services, and 3) compare the lifetime and 12-month prevalence of psychiatric disorders, and utilization of mental health services of Latinos and Asian Americans with national representative samples of non-Latino whites (from the National Comorbidity Study-Replication) (NCS-R) and African Americans (from the National Survey of American Life) (NSAL). This paper presents new concepts and methods utilized in the development of the NLAAS to capture and investigate ethnic, cultural and environmental considerations that are often ignored in mental health research.

Adolescent↗

Ethnicity and the need for correction of biochemical and ultrasound markers of chromosomal anomalies in the first trimester: a study of Oriental, Asian and Afro-Caribbean populations.

OBJECTIVES: To assess whether there is a need to correct first-trimester biochemical markers (free beta-hCG and pregnancy-associated plasma protein-A (PAPP-A)) or first-trimester fetal nuchal translucency thickness (NT) in different ethnic groups, when screening for Downs syndrome at 11-14 weeks of gestation. METHODS: Free beta-hCG, PAPP-A and fetal NT were measured at 11-14 weeks of gestation in a group of women presenting for first-trimester screening in two OSCAR centres. The group comprised 61 219 sets of data from Caucasian women (the reference group); 4835 sets of data from South Asian women; 3450 sets of data from Oriental women and 2727 sets of data from Afro-Caribbean women. The Oriental data set was supplemented with a further 480 cases collected in Hong Kong and the Afro-Caribbean data set was supplemented with 216 cases collected from Kings College. The difference in marker values between the reference group and the other ethnic groups was compared before and after weight correction for the biochemical markers using standard statistical techniques. A correction factor for ethnic origin was applied for all three markers and the screen-positive rate before and after correction was assessed for the various groups. RESULTS: After maternal weight correction, in Afro-Caribbean women, the median PAPP-A was increased by 55% and the free beta-hCG increased by 11%. In south Asian women, the PAPP-A was increased by 8% and the free beta-hCG decreased by 7.5%. In Oriental women, the PAPP-A was increased by 9% and the free beta-hCG by 6%. For delta NT in Afro-Caribbean women, the values were 0.064 mm lower on average than in Caucasian women and for south Asian women 0.045 mm lower. The difference of -0.012 for Oriental women was not significant. Before correcting for ethnic origin, these changes resulted in the screen-positive rates being lower in the Afro-Caribbean group (3.7% vs 5.6%), the south Asian group (4.3% vs 5.6%) and Oriental group (4.9% vs 5.6%). After correction, the screen-positive rates were largely similar in the four groups. CONCLUSION: Differences in median PAPP-A, free beta-hCG and, to a lesser extent, in NT exist in Afro-Caribbean, South Asian and Oriental women. In populations where the medians and delta NT reference ranges are established in predominantly Caucasian populations, some correction for ethnicity is appropriate and can redress differences in screen-positive rates between these different groups.

Adult↗

Understanding the breast cancer experience of Asian American women.

Breast cancer is the most common form of cancer in women and affects women across all ethnic groups. Although the psychosocial impact of breast cancer is being studied, there is little information on ethnic minorities. To better understand the breast cancer experience of Asian American women, we conducted key informant and focus group interviews. Six professionals participated in the key informant interviews. A total of 34 Asian American breast cancer survivors participated in focus group interviews, including Korean (n=10), Chinese (n=11), and a mixed Asian group (n=13). The common themes identified in this series of qualitative studies included: lack of knowledge about breast cancer; medical care issues such as cost and amount of time spent with physician; cultural factors related to beliefs about illness, gender role and family obligations (e.g. self-sacrifice) and language barriers; the importance of spirituality; and psychosocial concerns related to worry about children, burdening the family, body image and sexual health concerns. A primary source of support and coping for Asian American women with breast cancer was their spiritual beliefs. The results from this qualitative study have been used to prepare a survey instrument to examine these issues in a larger sample of Asian American women.

Adaptation, Psychological↗

The incidence of non-Hodgkin's lymphoma and its histologic subtypes in Asian migrants to the United States and their descendants.

We examined the incidence of non-Hodgkin's lymphoma (NHL) in Chinese, Japanese, and Filipino residents of the United States to obtain further clues about the etiology of the disease. The age, race, and birthplace of residents of Hawaii, San Francisco/Oakland (California), and western Washington who had received a diagnosis of NHL during the period 1973-86 were obtained from population-based cancer registries, and a special tabulation from the 1980 Census was used to estimate the number of person-years at risk for each category of resident. The incidence of NHL in each of the Asian groups examined was 35 to 85 percent that of US-born Whites. However, there was no consistent trend of increasing incidence with increasing generation of residence in any of the groups. In Asian-Americans, the risk of small cell lymphocytic and plasmacytoid lymphoma was 10 to 85 percent that of Whites, although no clear trends of risk with generation of residence in the US were observed. They also were at a reduced risk of follicular lymphoma, and in Chinese and Japanese persons, the risk was lower in first generation than in later generation migrants (Chinese: Asian-born relative risk [RR] = 0.11, US-born, RR = 0.84; Japanese: Asian-born, RR = 0.15, US-born, RR = 0.36). The risk of diffuse lymphoma was similar in Chinese- and Japanese-Americans and US-born Whites. We conclude that, with the exception of follicular lymphoma, the basis for the relatively low incidence of NHL in Asian-Americans does not lie in exposures or characteristics that differ between the migrants themselves and their descendants.

Adolescent↗

Metabolic syndrome and coronary heart disease in South Asians, African-Caribbeans and white Europeans: a UK population-based cross-sectional study.

AIMS/HYPOTHESIS: The aim of this study was to study differences in the prevalence of the metabolic syndrome and its associations with prevalent CHD according to ethnicity and sex. METHODS: We performed a combined analysis of two population-based cross-sectional studies conducted between 1988 and 1991 that followed identical protocols. Participants (aged 40-69 years) comprised 2,346 Europeans (76% male), 1,711 South Asians (83% male) and 803 African-Caribbeans (57% male) resident in west London. Fasting blood, overnight urine collection, clinical and anthropometric measurements were performed. Clinical history or major ECG changes defined prevalent CHD. The metabolic syndrome was defined according to the criteria recommended by the World Health Organization (WHO) and the National Cholesterol Education Programme (NCEP). RESULTS: The prevalence of the metabolic syndrome was highest in South Asians (WHO, men 46%, women 31%; NCEP, men 29%, women 32%) and lowest in European women (WHO, 9%; NCEP, 14%). The prevalence of CHD was 10% in South Asian men, 9% in European men, 5-6% in African-Caribbeans and European women, and 2% in South Asian women. The metabolic syndrome was associated with prevalent CHD in European men [NCEP, odds ratio (OR)=1.6, 95% CI 1.2-2.4; WHO, OR=1.7, 95% CI 1.2-2.5] and South Asian men (NCEP, OR=2.1, 95% CI 1.5-3.1; WHO, OR=1.6, 95% CI 1.1-2.3). Associations with CHD were weaker in African-Caribbeans and were inconsistent among European women. CONCLUSIONS/INTERPRETATION: The current definitions of the metabolic syndrome give an inconsistent picture of cardiovascular disease risk when applied to different ethnic groups within the UK. Prospective studies are needed to validate workable ethnic-specific definitions.

Adult↗

Differences in peak bone mass in women of European and South Asian origin can be explained by differences in body size.

There are few data concerning the occurrence of peak bone mass in women of South Asian origin. The aim of this study was to determine the level of peak bone mass in South Asian women in the UK and to determine whether any observed differences could be explained by differences in body size. Two groups of South Asian women, those of (1) Pakistani Muslim and (2) Gujarati Hindu origin, together with a European group aged 18 to 36 years, were recruited from primary-care population age-sex registers in the Greater Manchester area. They were invited to attend for a detailed interview-assisted lifestyle questionnaire and assessment of height and weight. Bone mass density (BMD) at the hip and lumbar spine was measured by dual energy X-ray absorptiometry (DEXA) scan (Hologic QDR 4500). Volumetric bone density was measured at the distal radius using pQCT (Norland Stratec XCT 2000). Linear regression was used to determine whether any observed differences in the level of bone mass could be explained by differences in body size. A total of 119 European women with a mean age of 30.4 years, 98 Pakistani Muslim women with a mean age of 29.2 years and 20 Gujarati Hindu women with a mean age of 29.2 years had bone density measurements performed. The Europeans were taller and heavier than either South Asian group. Peak BMD was greater among the European than the Pakistani women at all three measuring sites, with the Gujarati women having intermediate values at the hip and lumbar spine. Observed differences disappeared, however, after adjusting for height and weight. There were no differences in volumetric density at the lumbar spine or distal radius between the groups. In summary, there are differences in the level of bone mass between European and South Asian women, though these can be explained by differences in bone size, height or weight.

Absorptiometry, Photon↗

Body size accounts for most differences in bone density between Asian and Caucasian women. The EPIC (Early Postmenopausal Interventional Cohort) Study Group.

We compared bone mineral density (BMD) of the whole body (and subregions: arm, leg, and pelvis), hip, spine, lateral spine, wrist, and forearm among Caucasian and Asian women at four geographic centers (Honolulu, HI; Nottingham, UK; Portland, OR; Copenhagen, Denmark). Data were derived from the baseline examination of 1367 Caucasian and 162 Asian women enrolled in the 1609-subject Early Postmenopausal Interventional Cohort (EPIC) study. After adjusting for age, study site, years postmenopause, and years of estrogen use, BMD was approximately 4-6% lower (P < 0.05) among Asian women at most skeletal sites, but there was no significant difference for wrist or forearm BMD. Adding height, lean body mass, fat mass, and/or quadriceps muscle strength to the regression models reduced the racial differences at most skeletal sites; after these additional adjustments, Asian women had significantly lower BMD only for the lateral spine (-4.4%; P < 0.005), arm (-2.20%; P < 0.05) and leg (-1.65%; P < 0.05), whereas the wrist was significantly greater (4.64%; P < 0.005) for Asian women. Further research is needed to determine why racial differences in BMD persist at certain skeletal sites, but not others, after adjusting for body size.

Anthropometry↗

Lambda-shaped implant for augmentation of anterior nasal spine in Asian rhinoplasty as an ancillary procedure.

There is often a preexisting acute columella-labial angle in Asian noses and in most of these cases, the nasal spine is underdeveloped or sometimes even absent. Moreover, nasal tip projection by a tip graft or cephalic rotation of the nasal tip may get worse at the retracted columella-labial junction in the Asian nose with an underdeveloped anterior nasal spine, thus requiring the use of a maxillary spine graft or an implant. In many instances, however, the ideal source of autogenous tissue may not be available or the donor site for these tissues may be objectionable. So I have designed the lambda-shaped silicone implant for augmenting the underdeveloped anterior nasal spine (ANS) to correct the acute columella-labial angle. From March, 1996 until September, 1999, I have done ANS augmentations using the lambda-shaped silicone implant in Asian rhinoplasty on 37 female patients. The correction of an acute columella-labial angle was readily accomplished by application of the lambda-shaped implant using the unilateral intranasal approach. The author suggests that ANS augmentation with the lambda-shaped implant is a simple and effective method as an ancillary procedure in Asian rhinoplasty providing esthetically pleasing results in properly selected Asian patients.

Adult↗

Parent refugee status, immigration stressors, and Southeast Asian youth violence.

PURPOSE: To assess the effects of parents' experience of traumatic events on violence among Southeast Asian and Chinese youth. The study examines independent effects of parents' refugee camp experiences and immigration stress on serious or family/partner violence among youth. Findings contribute evidence on the intergenerational effects of community-level trauma that can help policy makers better integrate family and community strategies to reduce youth violence. METHODS: Obtained cross-sectional, face-to-face interview data including peer delinquency, parental engagement, parental discipline, serious violence, and family/partner violence from a sample of 329 Chinese and Southeast Asian adolescents. Measures of socioeconomic status, refugee status, and immigration stressors were collected from their respective parents. Data were analyzed using LISREL 8.54 for structural equation modeling. RESULTS: Findings show that parents' refugee status facilitated serious violence, and was fully mediated by peer delinquency and parental engagement, but for Vietnamese only. Parents' refugee status was also significantly related to family/partner violence, and mediated by peer delinquency. This relationship was not observed among the other Asian ethnic groups. The immigration stress variable had no significant effects on either serious violence or family/partner violence. CONCLUSIONS: Refugee communities may not transform easily into stereotypical immigrant Asian communities characterized by little youth violence. Results suggest that the refugee process, as experienced second-hand through the children of refugees, has a strong effect on externally oriented violence (serious violence) and on family/partner violence for particular subgroups. Therefore, community-oriented policy makers should join social workers in developing programs to address youth violence in Southeast Asian families and communities. Findings have implications for other forms of community trauma such as natural disasters.

Adolescent↗

The metabolic syndrome in the asian population.

With the rapid emergence of obesity in Asia, the metabolic syndrome is becoming a clinically important issue. The studies on migrants from Asian countries to Western countries indicate that Asian populations may be more susceptible to the Western diet and lifestyle than whites in developing the metabolic syndrome. The World Health Organization (WHO) Expert Consultation recently reported that the cut-off point for observed risk in Asian populations may be smaller than that for non-Asian populations, varying from 22 kg/m(2) to 25 kg/m(2). This variant susceptibility may be caused by gene-environmental interactions and low birth weight in Asian populations.

Asia↗

Parathyroid hormone and neonatal calcium homeostasis: evidence for secondary hyperparathyroidism in the Asian neonate.

Calcium, 25-hydroxyvitamin D (25 OHD), and parathyroid hormone (PTH) concentrations were measured in 11 Asian and ten Caucasian pregnant women at parturition and in their respective newborns following a full term normal delivery. Maternal calcium and 25 OHD concentrations were significantly lower while PTH concentrations were significantly greater in Asians than those in Caucasians. There was a significant inverse relationship between calcium and PTH and the relationship between 25 OHD and PTH concentrations. Neonatal calcium and 25 OHD concentrations were also significantly lower and PTH concentrations significantly higher in Asians than those in Caucasians. There was a highly significant inverse correlation between neonatal calcium and PTH concentrations. Three of the 11 Asian babies had supranormal concentrations of PTH in their cord blood. We conclude that PTH participates in neonatal calcium homeostasis and Asian newborns have frequent secondary hyperparathyroidism.

Adult↗