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PubMed1995

Ethnic differences in the biological consequences of alcohol abuse: a comparison between south Asian and European males.

Twenty-two South Asian men and 32 European men who had abused alcohol for at least 1.5 years were studied at the time of admission for detoxification to an Alcohol and Drug Dependency unit. The self-confessed average alcohol consumption during the preceding 3 months was similar in the South Asians (mean 383 g/day) and Europeans (mean 435 g/day) but the total duration of alcohol abuse was significantly shorter in South Asians (geometric mean 7.4 years) than Europeans (geometric mean 13.1 years). The geometric mean values for the concentration of carbohydrate-deficient transferrin in the serum were similar in the two ethnic groups. However, the red cell distribution width, the percentages of HbA1a+b, HbA1c and total HbA1 in red cell lysates and the activities of gamma-glutamyl transpeptidase, aspartate aminotransferase and alanine aminotransferase in the serum were all significantly higher in the South Asians than Europeans. The data suggest that South Asian men who abuse alcohol may be more susceptible to alcohol-related liver damage and acetaldehyde-mediated haemoglobin modification than European men who abuse alcohol to a similar extent for a considerably longer period.

Adult↗
PubMed1996

Body fat distribution in South Asian women and children.

OBJECTIVE: To compare levels of abdominal fatness in South Asian and European mothers and children. SUBJECTS: 49 mothers and children from South Asian backgrounds and 63 mothers and children from European backgrounds who took part in a study on family health behaviours. MEASUREMENTS: Anthropometric measures and abdominal fatness indices, including WHR and conicity. RESULTS: Asian mothers were shorter, and lighter than European mothers, but had a higher WHR and a higher conicity. Among children, boys had a higher WHR and conicity than girls but there were no ethnic differences in fat distribution. CONCLUSION: Different patterns of fat distribution were observed in South Asian and European women, with South Asian women having a relatively large waist circumference, relative either to hip circumference (WHR) or to overall size (conicity). Sex differences in fat distribution, but not ethnic differences, were observed in the children. This suggests that the adult patterns of fat distribution may not be established at this stage.

Abdomen↗
PubMedDate not supplied

Comparison of methods to assess coronary heart disease prevalence in South Asians.

BACKGROUND: Migrants from the Indian subcontinent (South Asian migrants) in the United Kingdom have high mortality from coronary heart disease (CHD) in comparison to the indigenous population. Few studies have assessed the prevalence of CHD in South Asians, and the applicability of conventional survey methods in this population is not known. In this pilot random population survey of South Asian men and women living in West London, the prevalence of CHD as judged by the Rose questionnaire, past cardiac history, cardiologist and resting electrocardiogram were compared. METHODS: Subjects aged 30-64 years from randomly selected households were invited for a cardiological assessment. A lay person administered the Rose questionnaire and recorded the past cardiac history. A cardiologist also made an independent assessment and a 12-lead electrocardiogram was recorded and analysed according to the Minnesota code. RESULTS: Three hundred and seventy-six individuals (192 men and 184 women) were assessed. The prevalence of angina in men and women, respectively, was 3.1% and 4.9% by the Rose questionnaire; 2.6% and 2.2% by past cardiac history; and 4.2% and 0.5% according to the cardiologist. The prevalence of myocardial infarction in men and women, respectively, was 5.2% and 2.2% by the Rose questionnaire, 3.6% and zero by past cardiac history and 3.6% and 0.5% by the cardiologist. Q/QS codes were present in 1.6% men and 0.5% women and ischaemic codes in 13% men and 14% women. Ischaemic changes were not associated with any cardiac history in 72% of men and 92% of women. For a diagnosis of CHD in men, there was poor agreement between the Rose questionnaire and either the past cardiac history or the cardiologist's assessment, but moderate agreement between the past cardiac history and the cardiologist. Agreement was poor between all three methods for a positive diagnosis of CHD in women. CONCLUSION: Current accepted epidemiological methods for assessing CHD prevalence may be inaccurate in South Asians, especially women. Electrocardiogram abnormalities suggestive of ischaemia are common in South Asians and are usually not associated with evidence of CHD. Thus, their value as indicators of CHD is questionable.

Adult↗
PubMed1998

Do GPs prescribe antidepressants differently for South Asian patients?

BACKGROUND: In spite of evidence from controlled trials and published guidelines, general practitioners prescribe antidepressants in lower doses and for shorter courses than are recommended [2]. However, these studies have not examined the effect of ethnicity on antidepressant prescribing by general practitioners. OBJECTIVES: To compare the antidepressant treatment of South Asian patients with White patients. METHODS: Patients, between 16 and 65 years prescribed an antidepressant between November 1993-1995, were selected from an east London training practice by searching the practice computer system EMIS. From a total of 438 patients identified, 40 cases were selected on the basis of their surname [3] as South Asian, and 50 cases formed the White comparison group. Data was collected retrospectively from the computer and paper records and analysed using Stata. The main outcome measures were presenting symptoms, maximum dose of antidepressant prescribed, duration of treatment and continuity of care. RESULTS: Women formed 2/3 of each group, the mean age in both groups being similar. Psychological symptoms were noted in the majority of both groups, but South Asians presented more physical complaints than the White group (67.5% compared to 22%, Chi squared=18.86, P=0.00001). The South Asian group were significantly more likely to be prescribed amitriptyline at doses of 75 mg or less than the White group (Fisher exact 2 tailed test, P=0.008), had significantly shorter median durations of antidepressant treatment (60 days, compared with 160 days for the White group, Mann Whitney test P=0.005). No differences were found between the groups in their continuity of care. CONCLUSION: The results suggest that successful drug treatment of depressed South Asian patients may be less likely than in White patients.

Adolescent↗
PubMed1996

Liver cancer in Asian migrants to the United States and their descendants.

The incidence of primary liver cancer in Chinese, Japanese, and Filipino migrants to the United States and their descendants is compared with that of United States-born Whites. Incident liver cancer cases were ascertained between 1973 and 1986 from population-based cancer registries serving the San Francisco/Oakland (CA) metropolitan area, 13 counties of western Washington, and Hawaii. The population of these three areas, with regard to age, race, and country of birth, was estimated from a special tabulation of the 1980 US census. Rates of primary liver cancer were higher for men born in Asia than Asian men born in the US, who, in turn, had higher rates than did US Whites (respective annual rates per 100,000: Chinese, 26.5 and 9.8; Japanese, 16.5 and 6.6; Filipinos, 11.4 and 6.5; US Whites, 3.4). Among Asian American women, the trends were not as consistent (respective annual rates per 100,000: Chinese, 2.2 and 3.7; Japanese, 1.9 and 1.4; Filipino, 2.6 and 0; US Whites, 1.1). In general, liver cancer incidence among Asian Americans was lower than among residents of Asia. These findings are compatible with substantial variation among Asians in the prevalence of one or more etiologic factors for liver cancer, such as hepatitis-B infection and aflatoxin consumption, in relation to residence and place of birth.

Adolescent↗
PubMed1994

Acetylator phenotype, aminobiphenyl-hemoglobin adduct levels, and bladder cancer risk in white, black, and Asian men in Los Angeles, California.

BACKGROUND: There is a large body of epidemiologic and experimental data that have identified a number of arylamines as human bladder carcinogens. Metabolic activation is required to biotransform these arylamines into their carcinogenic forms, and N-hydroxylation, which is catalyzed by the hepatic cytochrome P4501A2 isoenzyme, is generally viewed as the first critical step. On the other hand, the N-acetylation reaction, catalyzed by the hepatic N-acetyltransferase enzyme, represents a detoxification pathway for such compounds. The N-acetyltransferase enzyme is coded by a single gene displaying two phenotypes, slow and rapid acetylators. In the United States, cigarette smoking is a major cause of bladder cancer in men, and carcinogenic arylamines present in cigarette smoke are believed to be responsible for inducing bladder cancer in smokers. PURPOSE: Our purpose was to test the differences in three ethnic/racial groups for the prevalence of acetylator phenotypes and to ascertain whether slow acetylators actually have higher levels of activated arylamines in comparison with rapid acetylators. METHODS: One hundred thirty-three male residents of Los Angeles County who were either white, black, or Asian (Chinese or Japanese) and over the age of 35 years were assessed for their acetylator phenotype and levels of 3- and 4-aminobiphenyl (ABP) hemoglobin adducts. Subjects were either lifetime nonsmokers (n = 72) or current cigarette smokers of varying intensity (n = 61). RESULTS: The proportion of slow acetylators was highest among whites (54%), intermediate among blacks (34%), and lowest among Asians (14%). Similarly, geometric mean levels of both 3- and 4-ABP-hemoglobin adducts were highest in whites (1.80 and 49.2 pg/g hemoglobin [Hb], respectively), intermediate in blacks (1.54 and 38.5 pg/g Hb), and lowest in Asians (0.73 and 36.0 pg/g Hb). As expected, cigarette smokers had significantly higher mean levels of both 3- and 4-ABP-hemoglobin adducts relative to nonsmokers, and the levels increased with the number of cigarettes smoked per day (P < .0005 for both adducts). Slow acetylators consistently exhibited higher mean levels of ABP-hemoglobin adducts relative to rapid acetylators, independent of race and level of smoking. CONCLUSION: The present cross-sectional survey supports acetylation phenotype as an important determinant of bladder cancer risk and a possible major factor in the varying bladder cancer risk among whites, blacks, and Asians.

Acetylation↗
PubMedDate not supplied

The Asian American Network for Cancer Awareness, Research and Training's role in cancer awareness, research and training.

PURPOSE: The purpose of this paper is to describe the content for the Asian American Network for Cancer Awareness Research and Training (AANCART) with respect to Asian American demographic characteristics and their cancer burden, highlights of accomplishments in various AANCART regions, aspirations for AANCART, and an interim assessment of AANCART's activities to date. METHODS: The author compiled literature and other data references to describe the context for Asian American demographic characteristics and their cancer burden. As the AANCART Principal Investigator, he collected data from internal AANCART reports to depict highlights of accomplishments in various AANCART regions and offer evidence that AANCART's first two specific aims have been attained. PRINCIPAL FINDINGS: With respect to our first specific aim, we have built an infrastructure for cancer awareness, research and training operationally at a Network-wide basis through program directors for biostatistics, community, clinical, and research and in our four original AANCART regions: New York, Seattle, San Francisco, and Los Angeles. With respect to our second specific aim, we have established partnerships as exemplified by working collaboratively with New York's Charles B. Wang Community Health Center in securing external funding with them for a tobacco control initiative and nationally with the American Cancer Society. With respect to our third specific aim, we have been fortunate to assist at least eight junior investigators in receiving NCI-funded pilot studies. The most notable change was the transfer of AANCART's national headquarters from Columbus, Ohio to Sacramento, California along with potentially an increased diversification of Asian American ethnic groups as well as an expansion to Hawaii and Houston. CONCLUSION: As of the end of year 2 of AANCART, AANCART's two specific aims have been achieved. We are focusing on our third specific aim.

Asian↗
PubMed2006

Assessing overweight and obesity risk among Korean Americans in California using World Health Organization body mass index criteria for Asians.

INTRODUCTION: Although it is known that at comparable body mass index (BMI) levels Asian Americans have a higher prevalence of high blood pressure, heart disease, and type 2 diabetes than whites, little is known about the social, behavioral, and cultural factors associated with obesity risk in this population. METHODS: A cross-sectional analysis of the 2003 California Health Interview Survey was performed to estimate overweight and obesity prevalence among Korean Americans using BMI criteria suggested by the World Health Organization for Asian populations worldwide. In addition, associations between demographics, social, behavioral, and cultural factors and the risk of being overweight and obese were examined. RESULTS: Of 492 Korean American respondents, 38% were overweight and 8% were obese according to World Health Organization body mass index criteria for Asians. In a multivariate analysis, sex, marital status, poverty, and length of residence in the United States were associated with BMI. Men were more likely to be overweight or obese than women, and length of residence in the United States was strongly associated with higher body mass index. CONCLUSION: Like other ethnic groups, Korean Americans have a sociodemographic profile that is identified with an increased risk of becoming obese. Considering these factors in developing early diet and physical activity interventions could be an important opportunity to prevent weight gain and diminish disease caused by obesity. This study also suggests how meaningful BMI criteria tailored for Asian Americans could be used to more accurately measure risk of obesity within a heterogeneous population such as the U.S. population.

Adolescent↗
PubMedDate not supplied

Ethnic differences in testicular structure and spermatogenic potential may predispose testes of Asian men to a heightened sensitivity to steroidal contraceptives.

Spermatogenesis in Asian men appears to be more susceptible to suppression by steroidal contraceptives administered in clinical trials than spermatogenesis in Caucasian men. The objective of this study was to determine whether ethnic differences exist in testicular structure and spermatogenic potential that might predispose Asians to a high sensitivity to steroidal contraceptives. Testes from 12 Chinese men were compared to those from 8 Hispanic men and 12 non-Hispanic Caucasian men of ages 29+/-3, 30+/-2, and 29+/-3 years, respectively. Testes were fixed by vascular perfusion with glutaraldehyde, further fixed in osmium, embedded in Epon, and evaluated by stereology using 0.5-microm sections stained with toluidine blue. Homogenates of fixed testes were evaluated for the number of Sertoli cells and the daily sperm production based on pachytene primary spermatocytes (PDSP) or spermatids with spherical nuclei (DSP). Paired parenchymal weight was less (P < 0.05) in Chinese men than in Hispanic or Caucasian men. The PDSP per gram of parenchyma was lower (P < 0.05) and the DSP per gram tended to be lower in Chinese men than in other groups. The histologic appearance, volume density, and length per man of seminiferous tubules were the same among the ethnic groups; however, the diameter of seminiferous tubules was less (P < 0.05) in Chinese than in Hispanic or Caucasian men. The PDSP per man and the DSP per man were lower (P < 0.05) in Chinese than in Hispanic or Caucasian men. The number of Sertoli cells per gram was higher (P < 0.05) in Chinese or Caucasian men than in Hispanic men, but the number of Sertoli cells per man was lower (P < 0.05) in Chinese men than in Hispanic or Caucasian men. Sertoli cell function, measured as the number of germ cells accommodated by a single Sertoli cell, was lower (P < 0.05) in Chinese men than in Caucasian men. The volume density of Leydig cell cytoplasm was greatest (P < 0.05) in Chinese men, but the number of Leydig cells was similar among the ethnic groups. Hence, smaller testes coupled with reduced Sertoli cell number and function and reduced daily sperm production could predispose Asian men to have a heightened negative response of testes to steroidal contraceptives, as compared to Caucasian men. Dampening (by exogenous androgens) of any physiological benefit to spermatogenesis that a high volume density of Leydig cell cytoplasm may bestow on the human testis (that Asian men may have evolved to require) would exacerbate ethnic differences in the spermatogenic response to hormonal contraceptives.

Adult↗
PubMedDate not supplied

Combined silicone and cartilage implants: augmentation rhinoplasty in Asian patients.

Various alloplastic materials are used for nasal augmentation in Asian patients. Of these, silicone is the most prevalent because it is durable and facilitates sculpting. However, silicone grafts have been associated with complications, including tip extrusion, infection, and graft shifting. Often the nasal tip is involved, with skin discoloration and possible implant extrusion due to increased mechanical pressure. Autogenous material provides a safer alternative for nasal augmentation, but the supply of septal or auricular cartilage in Asian patients is limited. To augment optimally and reduce extrusion risk, we use auricular cartilage grafts at the nasal tip and silicone implants for the nasal dorsum in Asian patients. We report the results of this technique in 100 Asian patients with up to 5 years of follow-up. Patients were extremely satisfied, and no implant extrusions resulted. Other complications included further surgical revision due to misalignment of the silicone dorsal implant (5 patients), tip graft shifting (2 patients), and recurrent dorsal edema over the implant requiring removal (1 patient).

Asian People↗
PubMed1985

Westernization of the Asian eyelid.

Westernization of the Asian eyelid has become a topic of considerable interest in the Western world in recent years due to the increasing number of surgeons being consulted to perform this procedure. This demand is attributable to the great influx of Asian immigrants who are influenced by Western culture, design, and esthetics. After performing over 2,000 cases of westernizing Asian eyelids, I have developed a method of surgically creating a "double eyelid" as well as a method for removing the epicanthal web. The techniques result in a marked improvement of the narrow, puffy Asian eye and greater patient satisfaction. With these two separate techniques, improved cosmetic results can be achieved over those techniques that are commonly performed today, either in the Western world or in the Orient.

Asian People↗
PubMed2003

Physical activity and breast cancer risk among Asian-American women in Los Angeles: a case-control study.

BACKGROUND: To the authors' knowledge, there have been few studies published to date regarding physical activity patterns and breast cancer risk in Asian and Asian-American women. METHODS: The authors conducted a population-based case-control study of 501 Asian-American women with incident breast cancer and a control group of 594 Asian-American women in Los Angeles County to evaluate the role of lifetime physical activity on breast cancer risk. Information concerning lifetime recreational physical activity (i.e., type of activity, duration [years], and frequency [average hours per week]) and occupational physical activity was obtained using a structured questionnaire that was administered in person. RESULTS: Increasing years and levels (average metabolic equivalent [MET] hours per week) of lifetime recreational activity were associated with a significantly reduced risk of breast cancer after adjusting for demographic factors, migration history, and menstrual and reproductive factors. Compared with women who had no lifetime recreational physical activity, 3-6 MET hours per week, > 6-12 MET hours per week, and > 12 MET hours per week of activity were associated with significantly reduced risk, with odds ratios (and 95% confidence intervals) of 0.91 (0.55-1.49), 0.65 (0.39-1.10), 0.53 (0.31-0.90), and 0.47 (0.28-0.80), respectively (P value for trend < 0.001). The risk of breast cancer was associated inversely with occupational physical activity, although the result was not statistically significant. CONCLUSIONS: The findings of the current study provide further support for the finding that physical activity has a protective role in breast cancer.

Adult↗
PubMed2005

Highlights/best practices of San Francisco's Asian American Network for Cancer Awareness, Research, and Training (AANCART).

The Asian American Network for Cancer Awareness, Research, and Training in San Francisco (AANCART-SF) consists of two distinct entities, working in cooperation to advance cancer awareness, research, and training among Asian Americans: a university-based group with expertise in the Vietnamese community and a community-based health plan with expertise in the Chinese community. In addition to the goals shared with other AANCART sites, AANCART-SF is a unique effort in capacity building in that it aims to expand and export community-academic research expertise from one Asian population, the Vietnamese, to other Asian populations. It also aims to build the research capability of those serving the Chinese community through a health plan.

Asian↗
PubMed2005

Seizing the moment: California's opportunity to prevent nutrition-related health disparities in low-income Asian American population.

Asian Americans and Pacific Islanders (AAPI) have the fastest growing rate of overweight and obese children. Aggressive programs are urgently needed to prevent unhealthy acculturation-related changes in diet and physical activity and to promote the healthier aspects of traditional lifestyle habits. We conducted focus groups and key informant interviews to explore knowledge, attitudes, dietary practices, and physical activity levels among three low-income Asian American ethnic groups, Chinese, Vietnamese, and Hmong, in California. Content analysis was used to identify similarities and differences among the groups. Several common health beliefs clearly emerged. Participants noted the importance of fresh (not frozen) fruit and vegetable consumption and physical activity for general health. The concept of good health included having a harmonious family, balance, and mental and emotional stability. All groups also expressed the general belief that specific foods have hot or cold properties and are part of the Yin/Yang belief system common to Asian cultures. The lure of fast food, children's adoption of American eating habits, and long work hours were identified as barriers to a healthy, more traditional lifestyle. A California campaign for Asian Americans using multilevel strategies is recommended to counter the alarming rise of obesity among AAPI youth. Strategies directed to individual, community, and policy levels should emphasize maintenance of healthy traditional diets, informed selection of mainstream U.S. foods, and promotion of active lifestyles to prevent an impending burden from cancer and nutrition-related chronic diseases in AAPI populations.

Asian↗
PubMed2005

Stimulating cancer research in Asian communities and training the next generation of scientists.

The landmark Institute of Medicine Report on the "Unequal Burden of Cancer" urgently called for efforts to reduce cancer disparities by conducting research that could rapidly translate laboratory and clinical findings to benefit large segments of society. It also called for intensifying efforts to produce well-trained minority researchers as a way to increase the quantity, quality and community relevance of cancer control research. This manuscript summarized our strategies and successes in these two areas. Over a five year period, the Los Angeles site of the NCI-funded Asian American Network for Cancer Awareness, Research, and Training (AANCART-LA) conducted intensive community based cancer awareness activities through a coalition of over 20 Asian serving community organizations. In addition, a major focus of AANCART-LA was on increasing community-relevant research and on training scientists to conduct research among Asians. Strategies to reach these goals included a focus on pilot studies as a way of introducing the community to research, selection of promising junior scientists to submit applications for pilot funding, and close mentoring of these individuals by seasoned investigators. We describe four pilot project proposals that were selected for funding by the NCI peer review process. In addition, AANCART-LA was able to obtain peer reviewed funding for several other research projects targeting a variety of Asian sub-groups. These projects were the direct outcome of extensive cancer awareness activities in the community, the publicity associated with receiving peer-reviewed pilot project funding, and the collaborations established with multiple community based organizations.

Adult↗
PubMedDate not supplied

Differences in health insurance and health service utilization among Asian Americans: method for using the NHIS to identify unique patterns between ethnic groups.

The purpose of this study is to outline a method to identify the characteristics of socioeconomic variables in determining the differences in health insurance coverage and health services utilization patterns for different ethnic groups, using the behavioural model of health service utilization. A sample drawn from Asian American adult respondents to the 1992, 1993, and 1994 National Health Interview Surveys (NHIS) in the USA formed the data set. The results showed Asian Americans as not being homogeneous. There were distinctly different demographic and socioeconomic characteristics between six Asian American ethnic groups that affect health insurance coverage and health service utilization. The study method is useful for constructing health policy and services to address the general public need without adversely affecting smaller minority groups. Secondary analysis of well-constructed national data sets such as the specific Asian ethnic groups in NHIS, offers a rich method for predicting the differential impact of specific health policies on various ethnic groups.

Adolescent↗
PubMed2005

Effective and safe use of lasers, light sources, and radiofrequency devices in the clinical management of Asian patients with selected dermatoses.

BACKGROUND AND OBJECTIVES: The use of lasers, light sources, and radiofrequency devices in Asian patients differs from their use in Caucasians in several respects. STUDY DESIGN/MATERIALS AND METHODS: The disease spectrum is very different with pigmentary disorders being more commonly encountered in Asian populations. Asian skin, with its higher epidermal melanin content, is more likely to develop adverse reactions, especially post-inflammatory hyperpigmentation (PIH), following treatment. RESULTS AND CONCLUSIONS: The purpose of this article is to discuss the effective and safe use of lasers, light sources, and radiofrequency devices in the clinical management of Asian patients with selected dermatoses.

Acne Vulgaris↗
PubMed2006

Type 2 diabetes and cardiovascular risk in the UK south Asian community.

A popular hypothesis for the greater prevalence of type 2 diabetes and cardiovascular disease in UK south Asians is that they have an increased susceptibility of developing insulin resistance in response to certain environmental factors, including obesity and adoption of a sedentary lifestyle. Insulin resistance is postulated as a central feature of the metabolic syndrome, culminating in type 2 diabetes, atherosclerotic vascular disease and CHD; a pathway potentially accelerated by migration/urbanisation. We describe and compare the prevalence of type 2 diabetes, cardiovascular disease and their associated risk factors in UK south Asian and white Caucasian populations to determine possible reasons for the increased preponderance of these diseases in south Asians, and highlight key evidence for optimal risk factor management. Finally, we describe a UK community-based programme that attempts to reduce the morbidity and mortality from type 2 diabetes and cardiovascular disease in south Asians through a new approach to management.

Adult↗