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Hyperhomocysteinemia and cobalamin deficiency in young Asian Indians in the United States.

Hyperhomocysteinemia, a risk factor for vascular disease, may be a particular problem in Asian Indians, but information is limited, especially in the U.S., despite its growing Asian population. Moreover, suggestions have been made that folate deficiency is responsible for the hyperhomocysteinemia in Indians. Therefore, we studied homocysteine status in healthy Asian Indians in the U.S. prospectively, determined the frequency of cobalamin and folate deficiency as contributors to it, and examined whether food-cobalamin absorption contributed to cobalamin deficiency. Homocysteine levels were higher in Asian Indian men than in 4 other ethnic groups (P < 0.0001); 10/39 Indian men (25.6%) were hyperhomocysteinemic. Cobalamin levels were lower in Indian men (P = 0.000005) and women (P = 0.03) than in non-Indians; low levels were found more frequently in both Indian men (23/39; 59.0%) and women (5/21; 23.8%) than in others. Measuring methylmalonic acid in 10 selected subjects showed that the low cobalamin levels reflected cobalamin deficiency, and high methylmalonic acid levels were found in some subjects without hyperhomocysteinemia. Evidence of folate deficiency was not found in any subjects. Food-cobalamin absorption was normal in all 13 Indian subjects tested, including those with Helicobacter pylori infection. The results show that hyperhomocysteinemia is strikingly common in apparently healthy, young Asian Indian men. The cause appears to be cobalamin deficiency, which affected more than half of the Indian men, may be largely subclinical, is underestimated by homocysteine levels alone which were not always abnormal, and is probably largely dietary in origin. Folate deficiency is rare. This public health problem is amenable to prevention and treatment in this growing segment of the U.S. population. It was, parenthetically, noteworthy that many of the affected subjects were young physician trainees.

Adult↗

Chromosome painting shows that the proboscis monkey (Nasalis larvatus) has a derived karyotype and is phylogenetically nested within Asian Colobines.

The exceptional diploid number (2n=48) of the proboscis monkey (Nasalis larvatus) has played a pivotal role in phylogenies that view the proboscis monkey as the most primitive colobine, and a long-isolated genus of the group. In this report we used molecular cytogenetic methods to map the chromosomal homology of the proboscis monkey in order to test these hypotheses. Our results reveal that the N. larvatus karyotype is derived and is not primitive in respect to other colobines (2n=44) and most other Old World monkeys. The diploid number of 2n=48 can be best explained by derived fissions of a segment of human chromosomes 14 and 6. The fragmentation and association of human chromosomes 1 and 19 as seen in other Asian colobines, but not in African colobines, is best explained as a derived reciprocal translocation linking all Asian colobines. The alternating hybridization pattern between four segments homologous to human chromosomes 1 and 19 on N. larvatus chromosome 6 is the result of the reciprocal translocation followed by a pericentric inversion. N. larvatus shares this pericentric inversion with Trachypithecus, but not with Pygathrix. This inversion apparently links Nasalis and Trachypithecus after the divergence of Pygathrix. The karyological data support the view that Asian colobines, including N. larvatus, are monophyletic. They share many linking karyological features separating them from the African colobines. The hybridization pattern also suggests that Nasalis is nested within Asian Colobines and shares a period of common descent with other Asian colobines after the divergence of Pygathrix.

Animals↗

Molar size and shape variations among Asian colobines.

Despite decades of research, little is known about morphometric differences within the dentition of Asian colobines. Although some differences, such as the M3 hypoconulid, are often cited as distinct among genera, no comprehensive assessment has been made. The objectives of this study were to document size and shape differences in third molars in eight Asian colobine genera, including Kasi, Nasalis, Presbytis, Pygathrix, Rhinopithecus, Semnopithecus, Simias, and Trachypithecus, and to quantify length differences for all molars in order to understand the potential impact of an occlusal surface area that includes the hypoconulid. To achieve these objectives, the most extensive survey yet published of Asian colobine dentition was conducted. Differences within and among genera for continuous and categorical variables were analyzed using descriptive statistics, chi-square, t-tests, and post hoc comparisons. Results indicate that species of Presbytis differ from all other Asian colobines in both the size and shape of the maxillary and mandibular third molars. Specifically, M3 of Presbytis is relatively shorter in length and less likely to exhibit a hypoconulid optimally positioned for occlusion with M3. Moreover, Presbytis expresses concomitant changes in the maxillary third molar such as absence of a distal shelf and/or a distal cusp with separated crests. We conclude that shape and size changes impact the molar size sequence patterns of Presbytis, setting this genus apart from all other Asian colobine taxa. These differences may reflect variation in overall body size, dietary adaptation, and phylogeny.

Animals↗

Non-fat-phobic anorexia nervosa in British South Asian adolescents.

OBJECTIVE: The current study investigated the clinical features of British South Asian adolescent females presenting with low weight in the absence of organic disease. METHODS: The authors performed a retrospective case note study of South Asian British female adolescents presenting with weight loss/anorexia nervosa to psychiatric clinics and matched White English peers presenting with low weight. RESULTS: South Asian patients presented more frequently with loss of appetite (p = .01) and less frequently with fat phobia (p = .032) and weight preoccupation (p = .001). South Asians also had significantly more satisfactory relationships with their nuclear family and peers (p = .03). DISCUSSION: Differing symptom profiles for anorexia nervosa need to be taken into account when assessing patients from different cultures. South Asian adolescents may present with a non-fat-phobic form of anorexia nervosa. This has clinical and epidemiologic implications. Further investigation is warranted to assess the nosologic status of this group.

Adolescent↗

Body mass index and cardiovascular disease risk factors in seven Asian and five Latin American centers: data from the International Clinical Epidemiology Network (INCLEN).

We have tested the hypothesis that the relationship between body mass index (BMI) and other cardiovascular disease (CVD) risk factors as well as socioeconomic status is different in five Latin American populations (where BMI is high) and seven Asian populations (where BMI is low). Random samples of approximately 200 males aged between 35 and 65 years were selected from 12 general or industrial populations in Latin America and Asia. Standardized measures of height, weight, blood pressure, blood cholesterol, cigarette smoking, highest level of completed education, occupation and income were made. The mean BMI (kg/m2) was 25.3 (SD 3.74) in the five Latin American populations (which were all urban), 22.2 (SD 3.24) in the four Asian urban populations and 21.4 (SD 3.33) in the three Asian rural populations. Despite the differences in mean BMI levels, statistically significant positive relationships of a similar magnitude were seen between BMI and blood pressure levels in Latin America and Asia. Similarly, there was a statistically significant positive relationship found between BMI and total cholesterol in both Latin American and Asian urban samples, but of a higher magnitude in Asian rural samples. Current cigarette smokers had significantly lower BMI than ex-smokers or never smokers in Latin America and Asia. In Asia, there were statistically significant positive associations between BMI and levels of education and income as well as with occupation-these relationships were stronger for education and occupation in rural than in urban samples. There were no statistically significant associations between BMI and these measures of socioeconomic status in Latin America. The similarities of the associations between BMI and blood pressure and cholesterol levels in the two groups suggest that efforts to reduce BMI in all populations is likely to be important in reducing risk of CVD. Preventing the future rise of BMI in populations where BMI is still relatively low is a high priority. The difference in association between BMI and socioeconomic status in the different population groups requires study of the way sociocultural factors influence behavior that determines BMI levels.

Adult↗

Effects of the Asian dust events on daily mortality in Seoul, Korea.

The Korean peninsula has a long history of dust clouds blown by winds from the arid deserts of Mongolia and China in springtime; these are called Asian dust events. Public concern about the possible adverse effects of this dust has increased, because the dust arrives in Korea after having passed over heavily industrialized eastern China. The present study explored the effect of Asian dust events on daily mortality in Seoul, South Korea, during the period 1995-1998. We evaluated the association between daily death counts and the dust events using Poisson regression analysis, adjusted for time trends, weather variables, and the day of the week. Between 1995 and 1998, we identified 28 Asian dust days in Seoul. The estimated percentage increase in the rate of deaths from 3-day moving averages of exposure was 1.7% (95/ confidence interval: -1.6 to 5.3) for all causes, 2.2% (95% confidence interval: -3.5 to 8.3) for deaths of persons aged 65 years and older, and 4.1% (95% confidence interval: -3.8 to 12.6) for cardiovascular and respiratory causes. Our results provide weak evidence that the Asian dust events are associated with risk of death from all causes. However, the association between the dust events and deaths from cardiovascular and respiratory causes was stronger and it suggests that persons with advanced cardiovascular and respiratory disease may be susceptible to the Asian dust events.

Age Factors↗

Multivariate profile of smoking in Southeast Asian men: a biochemically verified analysis.

BACKGROUND: Cigarette smoking prevalence rates among Southeast Asian males are among the highest reported in comparison with other ethnic male groups in the United States. The objective of this study is to profile current smokers, former smokers, and never smokers among Southeast Asian males, based on subject characteristics. METHODS: Southeast Asian (Cambodian, Laotian, and Vietnamese) males residing in the Greater Columbus, Ohio, area were surveyed, utilizing culturally sensitive instruments and interviewers, with respect to demographic and acculturation variables. All subjects were biochemically verified by collecting a saliva sample at the time of the interviews. RESULTS: Those Southeast Asian males who quit smoking tended to be older, employed, more assimilated into the U.S. culture, and of Cambodian ethnicity. The current smokers, relative to never smokers, tended to be older, not in the labor force, traditionally oriented to their native culture, less educated, and of Laotian or Vietnamese ethnicity. CONCLUSIONS: Specific strategies for smoking cessation programs would indicate more intense, and possibly different, efforts be directed at Southeast Asian males of Laotian and Vietnamese ethnicity who are younger, unemployed and less assimilated into the U.S. culture. On the other hand, smoking prevention programs would target those individuals who are at highest risk of smoking.

Acculturation↗

Seasonal changes in affective state in samples of Asian and white women.

Seasonality of the affective state has been reported to vary in direct proportion to latitude in temperate regions. The frequency of seasonal affective disorder (SAD) and the severity of the symptoms associated with it have been reported to be greater in higher than in lower latitudes. In addition, recent research has suggested a genetic loading for SAD. Most of the research on the seasonality of affect has been done in high latitude areas, seasonal mood cycles have been infrequently investigated in tropical areas, and no study has so far measured and compared seasonal changes in affect and behaviour in indigenous and populations non-indigenous to high latitudes. To rule out the biases associated with retrospective designs, a prospective longitudinal study was designed to investigate seasonal mood variations in indigenous white and non-indigenous Asian populations. Since previous research has indicated the excessive vulnerability of women to winter depression, it was decided to measure seasonality of the affective state only in women. To examine the relative effects of genetic predispositions and physical environment, the Asian group was further divided into "Asian" and "Asian-British". The former group comprised women who were living in England but who had been born and had spent considerably more time in their country of origin, while the latter group consisted of women who were born in England and who had lived there all their lives. The three groups of 25 women each were matched for age and socio-economic status, and were interviewed every month for 1 year using the Hospital Anxiety and Depression Scale (HAD), a Behavioural Change Inventory (BCI), the Ladder Scale of General Well-being (LSW) and a Monthly Stress Inventory (MSI). One retrospective scale was administered at the end of the study year to compare the extent of seasonal change in affect with that on the HAD-depression subscale. The results showed that seasonal depression peaked in winter in all three groups, with the incidence of winter depression being highest in the Asian group. Seasonal changes on several dimensions of behaviour were in the direction of winter depression for all three groups. States other than depression (anxiety and general well-being) did not show any seasonal variation. Hours of daylight was found to be the best predictor of seasonal variation in mood among environmental and psychosocial variables. There was no evidence to support a genetic hypothesis for SAD.

Adult↗

Abnormal eating attitudes and behaviours and perceived parental control: a study of white British and British-Asian school girls.

BACKGROUND: Previous studies have found significantly higher scores on the Eating Attitudes Test (EAT-26) which measures eating disorders among second-generation British-Asian schoolgirls in comparison to their White counterparts. Further, high EAT-26 scores (an indication of unhealthy eating attitudes and behaviours) are positively associated with parental overprotection scores on the Parental Bonding Instrument (PBI). This study aimed to replicate and extend previous findings, comparing British-Asian schoolgirls to White schoolgirls and consider 'intra-Asian' differences on the same measures, including factor scores. METHODS: Participants completed three questionnaires: EAT-26, PBI and BSS (Body Satisfaction Scale). There were 168 participants: 46 White, 40 Indian, 44 Pakistani and 38 Bengali. RESULTS: Previous findings were supported; the Asian scores were significantly higher than the White scores on the EAT-26 and PBI, but not the BSS. The Bengali sample had significantly higher EAT-26 total and 'oral control' scores than the other groups. There were no intra-Asian differences for the overprotection scores. PBI scores were not associated with EAT-26 scores. The BSS score was the only significant predictor of EAT scores, when entered into a regression along with PBI scores and the body mass index. CONCLUSION: Results demonstrated sociocultural factors in the development of eating disorders. The results suggest that there are important psychological differences between second-generation migrants from different countries on the Indian subcontinent. In line with previous studies, significant differences were found between the four ethnic groups, parenting styles, but these did not relate to actual eating disorders.

Adolescent↗

Skeletal benefits of two years of alendronate treatment are similar for early postmenopausal Asian and Caucasian women.

Alendronate has been shown to increase bone density among early postmenopausal women. Osteoporosis is common among both Asian and Caucasian women, but most clinical trials have consisted primarily of Caucasian women, and it does not appear that the effectiveness of antiresorptive agents such as alendronate has been compared between the two races. In this study we compared the response of bone density and biochemical markers to alendronate among 136 Asian and 126 Caucasian women who participated in the Early Postmenopausal Interventional Cohort (EPIC) at the Hawaii center. Approximately 40 women of each race were randomly assigned to placebo or to 2.5 mg/day or 5 mg/day alendronate. Bone mineral density (BMD) was measured at the spine, total hip and total body at baseline, 12 months and 24 months; biochemical markers of bone turnover were measured at 6-month intervals. Responses were greater for the 5 mg dose than 2.5 mg, and were similar in the two races. For example, mean (SE) changes in spine BMD at 24 months for Caucasians and Asians, respectively, were -1.9% (0.5%) and -1.9% (0.4%) for the placebo group, 2.0% (0.5%) and 3.4% (0.5%) at 2.5 mg/day and 4.2% (0. 5%) for both races at 5 mg/day. Corresponding changes in urinary N-telopeptide collagen crosslinks were -33.6% (5.6%) and -27.8% (5. 8%) for placebo, -51.4% (4.0%) and -62.1 (4.3%) at 2.5 mg/day and -70.8% (2.4%) and -73.5% (3.1%) at 5 mg/day. We conclude that (1) the rate of bone loss in untreated Asian and Caucasian postmenopausal women is similar, with the possible exception of the hip; (2) 5 mg alendronate daily provides greater skeletal benefits than 2.5 mg/day in both Asian and Caucasian early postmenopausal women; and (3) the response at 5 mg/day is similar in the two races.

Alendronate↗

Three major lineages of Asian Y chromosomes: implications for the peopling of east and southeast Asia.

DNA variation on the non-recombining portion of the Y chromosome was examined in 610 male samples from 14 global populations in north, east, and southeast Asia, and other regions of the world. Eight haplotypes were observed by analyses of seven biallelic polymorphic markers ( DYS257(108), DYS287, SRY(4064), SRY(10831), RPS4Y(711), M9, and M15) and were unevenly distributed among the populations. Maximum parsimony tree for the eight haplotypes showed that these haplotypes could be classified into four distinct lineages characterized by three key mutations: an insertion of the Y Alu polymorphic (YAP) element at DYS287, a C-to-G transversion at M9, and a C-to-T transition at RPS4Y(711). Of the four lineages, three major lineages (defined by the allele of YAP(+), M9-G, and RPS4Y-T, respectively) accounted for 98.6% of the Asian populations studied, indicating that these three paternal lineages have contributed to the formation of modern Asian populations. Moreover, phylogenetic analysis revealed three monophyletic Asian clusters, which consisted of north Asian, Japanese, and Han Chinese/southeast Asian populations, respectively. Coalescence analysis in the haplotype tree showed that the estimated ages for three key mutations ranged from 53,000 to 95,000 years, suggesting that the three lineages were separated from one another during early stages of human evolutionary history. The distribution patterns of the Y-haplotypes and mutational ages for the key markers suggest that three major groups with different paternal ancestries separately migrated to prehistoric east and southeast Asia.

Asia↗

Relationship between angiographically assessed coronary artery disease, plasma insulin levels and lipids in Asians and Caucasians.

In the present study the association between angiographically demonstrated coronary artery disease lipid subfractions and insulin in Caucasians, Asian migrants to the UK and Asians in India was studied. Patients having at least one angiographic lesion of more than 50% were recruited and angiograms scored by two independent observers, blindly. There were 87 Caucasian, 83 British Asian and 30 Indian Asian patients. Lipid subfractions measured were cholesterol, HDL cholesterol, triglyceride, apo A1, apo B, Lp(a). Estimation of glucose and insulin was carried out at fasting and after two hours of oral 75 g glucose. Asians were younger than Caucasians. They did not differ in their body mass index, systolic and diastolic blood pressure or cigarette consumption. In all three ethnic groups cholesterol, LDL cholesterol and apo B showed significant positive association. Insulin levels at fasting or post glucose challenge failed to show any association. Apo B may be an additional marker for coronary artery disease in the ethnic groups studied.

Adult↗

Comparison of strains of Mycobacterium tuberculosis from British, Ugandan and Asian immigrant patients: a study in bacteriophage typing, susceptibility to hydrogen peroxide and sensitivity to thiophen-2-carbonic acid hydrazide.

Strains of Mycobacterium tuberculosis were obtained from 65 patients with pulmonary tuberculosis resident in Uganda, and from pulmonary and extrapulmonary tuberculosis in 42 British patients of European ethnic stock and in 67 Asian immigrants, often from Uganda, resident in Britain. The bacteriophage-type patterns of the African, British and Asian strains were different. The pattern for the Asian strains resembled that found previously in patients from South India, suggesting that there has been little interchange of organisms between the Asian community and the African and British communities alongside whom they have lived. The patterns for pulmonary and extra-pulmonary tuberculosis were similar. Strains of bacteriophage type 1, mainly obtained from Asians, were characterized by a greater susceptibility to the bactericidal activity of hydrogen-peroxide and/or a greater sensitivity to thiophen-2-carbonic acid hydrazide than strains of other types.

Asia↗

Relation of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in South Asians.

The hypothesis that the high mortality from coronary heart disease (CHD) in South Asians settled overseas compared with other populations is due to metabolic disturbances related to insulin resistance was tested in a population survey of 3193 men and 561 women aged 40-69 years in London, UK. The sample was assembled from industrial workforces and general practitioners' lists. In comparison with the European group, the South Asian group had a higher prevalence of diabetes (19% vs 4%), higher blood pressures, higher fasting and post-glucose serum insulin concentrations, higher plasma triglyceride, and lower HDL cholesterol concentrations. Mean waist-hip girth ratios and trunk skinfolds were higher in the South Asian than in the European group. Within each ethnic group waist-hip ratio was correlated with glucose intolerance, insulin, blood pressure, and triglyceride. These results confirm the existence of an insulin resistance syndrome, prevalent in South Asian populations and associated with a pronounced tendency to central obesity in this group. Control of obesity and greater physical activity offer the best chances for prevention of diabetes and CHD in South Asian people.

Adult↗

Glucose tolerance during pregnancy in Asian women.

The present study was aimed at examining differences in gestational diabetes mellitus (GDM) between two ethnic populations (immigrant Asians and indigenous White Caucasians) residing in Leicester, U.K. The study was divided into two parts: to determine the prevalence of GDM and to determine the level at which glycaemia may impose a risk to the mother and the foetus. Of a total of 12,005 pregnancies (4561 Asian and 7444 White Caucasian), over a 3-year period, 314 (6.8%) Asian and 504 (6.7%) White Caucasian were given a 75-g oral glucose tolerance test (OGTT) at 28-32 weeks for indications of 'large for date' pregnancies, hydramnios, glycosuria, a history of previous abortions, stillbirths, congenital abnormalities or glucose intolerance, and family history of diabetes. Abnormal glucose tolerance (AGT) was taken as a 2-h venous plasma glucose greater than or equal to 7.8 mmol/l which reverted to normal when formally tested during the puerperium (WHO criteria, 1985). AGT was found in 1.38% Asian and 0.87% White Caucasian pregnancies (P less than 0.01). This was further divided into impaired glucose tolerance (IGT) (2-h value 7.8-11.1 mmol/l) and gestational diabetes mellitus (GDM) (2-h value greater than or equal to 11.1 mmol/l). IGT was found in 1.2% Asian and 0.84% White Caucasian pregnancies (P less than 0.01), and GDM in 0.18% and 0.02% respectively (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Mycobacterial infection is an important infective complication in British Asian dialysis patients.

To define the extent and nature of mycobacterial infection in patients on an adult dialysis unit whose catchment population contains a large proportion of non-Caucasian subjects, a retrospective survey of all new patients accepted onto our maintenance dialysis programme between January 1987 and December 1989 was carried out. Twenty-six Asian, 13 Afro-Caribbean, two Oriental and 170 Caucasian patients were accepted onto the dialysis programme in the three-year recruitment period. Eight of the 26 Asian patients, but none of the others, had developed mycobacterial infection by the end of December 1990. One patient had a cerebral tuberculoma with miliary mottling on chest X-ray, one pulmonary tuberculosis, one tuberculous adenitis and 5 tuberculous peritonitis (four due to Mycobacterium tuberculosis and one Mycobacterium kansasii). All the patients had been living in the UK for an average of 15 (range 6-24) years, with no known recent exposure to tuberculosis. Five patients are now alive and well, one developed malabsorption following M. kansasii peritonitis, but two with tuberculous peritonitis died before treatment could be instituted. Mycobacterial infections were associated with a high level of mortality and morbidity. No Asian patient developed mycobacterial infection during post-transplant immunosuppressive therapy in the study period, probably because of the routine anti-tuberculous chemoprophylaxis employed in this group of patients. The diagnosis of mycobacterial infection should be suspected when an Asian dialysis patient develops a pyrexia of unknown origin. It is likely, though not proven, that anti-tuberculous chemoprophylaxis might reduce this high incidence of tuberculous infection in Asian dialysis patients.

Adult↗

HLA antigens in Asian Indians: HLA-D-DR relationships.

Fifty-nine Asian Indians were typed for HLA-A, B, D, and DR antigens. Peculiar to the population that we have tested was the absence of HLA-A25, B13, B14, DR1, DW1, LD13 (a DR1-associated HLA-D allele), and LD12 (a DR4-associated HLA-D allele). Certain haplotypes that exhibit high frequencies in Caucasians (such as A2-BW50, AW24-B18, B8-DR3, BW44-DR7, B18-DR5) or in Blacks (such as A29-B7) also show significant delta in Asian Indians. The HLA-D-DR associations previously described in European and North American Caucasians were also found in Asian Indians. Additionally, however, Asian Indians exhibited two new HLA-D antigens, one associated with DR5 and the other with DRw6. The genetic distance between Asian Indians and Caucasians, Blacks, or Mongoloids is of the same order of magnitude.

Alleles↗

Size at birth of Asian and white Caucasian babies born in Leicester: implications for obstetric and paediatric practices.

This investigation extends our knowledge of the size of British born Asian babies compared with those of white Caucasian origin. Seventy Leicester born term Asian babies at birth were lighter, shorter, leaner and had smaller heads than their white Caucasian counterparts. The Asian mothers were shorter and lighter at the start of pregnancy but their weight/height2 index was the same. With the appreciation that the Asian population in Britain is far from homogenous in regard to religion, diet and country of origin, it is concluded that the smaller size at birth of Asian babies is unlikely to be due to undernutrition of their mothers in pregnancy. Genetic factors, as indicated by the shorter stature of the mothers are more likely to be responsible. These findings have implications for obstetric and paediatric practices.

Adult↗