Search

Background: Insulin resistance and type 2 diabetes are more prevalent in people of South Asian ethnicity than in people of Western European origin. To investigate the source of these differences, we compared insulin sensitivity, insulin secretion, glucose and lipid metabolism in South Asian and Nordic subjects with type 2 diabetes. Methods: Forty-three Nordic and 19 South Asian subjects with type 2 diabetes were examined with intra-venous glucose tolerance test, euglycemic clamp including measurement of endogenous glucose production, indirect calorimetry measuring glucose and lipid oxidation, and dual x-ray absorptiometry measuring body composition. Results: Despite younger mean ± SD age (49.7±9.4 vs 58.3±8.3 years, p = 0.001), subjects of South Asian ethnicity had the same diabetes duration (9.3±5.5 vs 9.6±7.0 years, p = 0.86), significantly higher median [inter-quartile range] HbA1c (8.5 [1.6] vs 7.3 [1.6] %, p = 0.024) and lower BMI (28.7±4.0 vs 33.2±4.7 kg/m2, p<0.001). The South Asian group exhibited significantly higher basal endogenous glucose production (19.1 [9.1] vs 14.4 [6.8] µmol/kgFFM⋅min, p = 0.003). There were no significant differences between the groups in total glucose disposal (39.1±20.4 vs 39.2±17.6 µmol/kgFFM⋅min, p = 0.99) or first phase insulin secretion (AUC0–8 min: 220 [302] vs 124 [275] pM, p = 0.35). In South Asian subjects there was a tendency towards positive correlations between endogenous glucose production and resting and clamp energy expenditure. Conclusions: Subjects of South Asian ethnicity with type 2 diabetes, despite being younger and leaner, had higher basal endogenous glucose production, indicating higher hepatic insulin resistance, and a trend towards higher use of carbohydrates as fasting energy substrate compared to Nordic subjects. These findings may contribute to the understanding of the observed differences in prevalence of type 2 diabetes between the ethnic groups. [ABSTRACT FROM AUTHOR]

A variant (rs3129882) in the genome-wide association study ( GWAS)-linked variant [in the human leukocyte antigen ( HLA) gene region] has been reported to associate with an increased risk of Parkinson's disease ( PD) in Caucasian population. Studies among Chinese are limited. To address this, we analysed rs3129882 in a total of 1312 subjects of Chinese ethnicity from independent Asian centers comprising of 675 controls and 637 PD cases. The rs3129882 variant was associated with a decreased risk in our ethnic Chinese PD patients. Logistic regression analysis taking into consideration variables of age, gender and race showed that allele A reduced the risk of PD via a dominant model [odds ratio ( OR) = 0.77, 95% confidence interval ( CI) = 0.62, 0.96, p = 0.018]. As HLA is a highly polymorphic region, it is possible that ethnic-specific effect or environmental agents may modulate the effect of this GWAS-linked locus in influencing the risk of PD. [ABSTRACT FROM AUTHOR]

Background: The magnitude of racial/ethnic and regional differences in the prevalence of inflammatory bowel disease (IBD) in the United States remains largely unknown. Aims: To estimate differences in the prevalence of IBD by race/ethnicity and region. Methods: The Medical Expenditure Panel Survey, a nationally representative survey of US households and medical conditions, was used. A multivariate logistic model was used in statistical analysis. Results: Among 202,468 individuals surveyed during 1996-2007, 316 were diagnosed with IBD (26 Blacks, 21 Hispanics, and 5 Asians). The prevalence of IBD was higher in Whites [Crohn's disease: 154; ulcerative colitis (UC): 89] than Blacks (Crohn's disease: 68; UC: 25), Hispanics (Crohn's disease: 15; UC: 35), and Asians (Crohn's: 45; UC: 40) (all p < 0.05, except for UC in Asians). The differences in Crohn's disease between Whites and minorities and the difference in UC between Whites and Blacks remained significant in multivariate analysis. In multivariate analysis, there was no regional difference in the prevalence of Crohn's disease, but the prevalence of UC was higher in the Northeast than the South (p < 0.05). Conclusions: There were significant racial/ethnic differences in the prevalence of IBD in the USA. The underlying etiology of these differences warrants additional research. Copyright © 2013 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Hispanics are the largest and fastest growing ethnic group in the United States (US). Aims: We evaluated the incidence and survival of colorectal cancer (CRC) among this population. Methods: Data from the surveillance, epidemiology, and end results program were used to calculate CRC age-adjusted and age-specific incidence rates in Hispanics during 1993-2007. Temporal trends in CRC incidence were examined using annual percent change (APC) and Poisson regression. The 1- and 5-year survival rates were calculated. Results: The annual age-adjusted incidence rates for CRC in Hispanics of all ages declined from 47.4 per 100,000 in 1993-1997 to 43.8 per 100,000 in 2003-2007, with an APC during 1993-2007 equal to −0.8/year. However, there was a 45 % increase in CRC incidence among Hispanic men and women aged 20-49 years that affected both the right and left colon. The proportions of CRC cases with regional (+37 %) and distant (+18 %) spread increased, now constituting 72 % of cases diagnosed at that age. The Poisson model confirmed the increasing CRC incidence in Hispanics aged 20-49 years during 1993-2007 while adjusting for sex and geographic region. The 1-year survival improved in younger Hispanics from approximately 86 % in 1993-1997 to 91 % in 2003-2007 with no significant improvement in 5-year survival. In Hispanics aged >50 years, no significant improvements in survival were observed. Conclusions: The incidence of CRC in young Hispanic men and women has increased in the US. Most are diagnosed with regional or distant disease. No significant improvement in long-term survival was observed in young Hispanics with CRC. [ABSTRACT FROM AUTHOR]

Background:Colorectal cancer (CRC) diagnoses and disease-specific survival (DSS) vary between ethnic groups in the United States. However, few studies have assessed differences among Asian subgroups.Methods:The Surveillance, Epidemiology, and End Results (SEER) database was used to identify patients with invasive CRC between 1988 and 2008. Differences in clinicopathologic features, and DSS rates were compared among Asian subgroups. The California Health Interview Survey was used to examine risk factors and screening patterns for CRC.Results:The study included 359 374 patients with 8.4% Asian. Patients in all Asian subgroups were younger (median: 68 years) at diagnosis than non-Hispanic white (NHW) patients (median: 72 years). Most Asian subgroups, except Hawaiians, had better DSS than NHW patients although Asian subgroups had more advanced disease than NHW. Indian/Pakistani patients had a higher 5-year DSS than other Asian subgroups. Obesity proportions were lower in Asian subgroups (<50.2%) than in NHW (59.8%). Vietnamese men and Korean women had the lowest proportions of CRC screening. Advance tumour stages were highly associated with worse DSS in each ethnicity group. High tumour grades were associated with worse DSS in NHW, Filipino, and Chinese. Older age at diagnosis was associated with worse DSS in most ethnicity groups except Hawaiian and Vietnamese.Conclusion:Disparities exist between Asians and NHW with CRC, and among various Asian subgroups. Differences in cancer clinicopathologic features, patients' behavioural habits, lifestyle, and screening patterns may explain some differences in CRC survival observed among ethnic groups. [ABSTRACT FROM AUTHOR]

Objective Heterocyclic amines (HAA) are animal carcinogens that are present in meat cooked at high temperature and in tobacco smoke. These compounds require activation by cytochrome P450 1A2 (CYP1A2) and N-acetyltransferase-2 (NAT2) before they can damage DNA. This study tested the hypotheses that well-done meat and cigarette smoking increase the risk of adenoma, the precursor to most colorectal cancers, especially in individuals with rapid CYP1A2 and rapid NAT2 activities. Design An endoscopy-based caseecontrol study of adenoma was conducted among Caucasians, Japanese and native Hawaiians to test this hypothesis. The overall diet and consumption of well-done meat cooked by various high-temperature methods were assessed by interview in 1016 patients with a first adenoma and 1355 controls with a normal endoscopy. A caffeine test was used to assess CYP1A2 and NAT2 activities in 635 cases and 845 controls. Logistic regression was used to account for matching factors and potential confounders. Results Smoking was associated with an increased risk of adenoma. Weak non-significant elevated OR were observed for the main effects of HAA intakes or NAT2 activity. However, the combined effects of HAA intakes and NAT2 activity were statistically significant. Subjects in both the upper tertiles of NAT2 activity and HAA intake were at increased risk of adenoma compared with subjects in the lower tertiles of NAT2 activity and exposure (2-amino-3,4,8-dimethylimidazo[4,5-f] quinoxaline intake OR 1.70, 95% CI I 1.06 to 2.75; 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline intake OR 1.91, 95% CI 1.16 to 3.16; and 2-amino-1-methyl-6- phenylimidazo[4,5-b]pyridine intake OR 2.14, 95% CI 1.31 to 3.49). Conclusion The data suggest that rapid N-acetylators with high HAA intake may be at increased risk of adenoma. [ABSTRACT FROM AUTHOR]

Objective: Native Hawaiians and other Pacific Islanders (NHs/PIs) have a high obesity prevalence compared to other ethnic groups. We examined socio-demographic, behavioral, and biological factors related to ≥3% weight loss in 100 overweight/obese NHs/PIs who completed a lifestyle intervention. Design and Methods: Data were from 56 Native Hawaiians, 22 Chuukese, and 22 Other Pacific Islanders who participated in a randomized controlled trial of the Partnership for Improving Lifestyle Intervention (PILI) 'Ohana Project. All completed a 3-month weight loss program (WLP) to initiate weight loss and were then randomized into either a 6-month family/community focused WLP called the PILI Lifestyle Program (PLP; n = 49) or a standard behavior WLP (SBP; n = 51). We collected baseline, 3- and 9-month follow-up data on socio-demographics, weight (kg), a 6-min. walk test, dietary fat, exercise frequency, and blood pressure. Results and Conclusion: Based on ANCOVA or logistic fit, ethnicity, sex, initial weight loss, fat in diet at baseline, change in systolic blood pressure, and intervention type were significantly associated ( P ≤ .05) with ≥3% weight loss at 9-month follow-up. A logistic regression model indicated that Chuukese (OR = 6.04; CI = 1.14-32.17) and participants who had more weight loss in the first 3-months (OR = 1.47; CI = 1.22-1.86) and who were in the PLP (OR = 4.50; CI = 1.50-15.14) were more likely to achieve ≥3% weight loss [model; χ2 (7, N = 100) = 45.50, P < .0001]. The same lifestyle intervention does not benefit all NHs/PIs equally, possibly due to differences in acculturation status and social support. The findings also point to the importance of initial weight loss to sustain motivation toward long-term weight loss maintenance. [ABSTRACT FROM AUTHOR]

Angiotensin II type 1 receptor (AGTR1) has been reported to play a fibrogenic role in non-alcoholic fatty liver disease (NAFLD). In this study, five variants of the AGTR1 gene (rs3772622, rs3772627, rs3772630, rs3772633, and rs2276736) were examined for their association with susceptibility to NAFLD. Subjects made up of 144 biopsy-proven NAFLD patients and 198 controls were genotyped using TaqMan assays. The liver biopsy specimens were histologically graded and scored according to the method of Brunt. Single locus analysis in pooled subjects revealed no association between each of the five variants with susceptibility to NAFLD. In the Indian ethnic group, the rs2276736, rs3772630 and rs3772627 appear to be protective against NAFLD (p = 0.010, p = 0.016 and p = 0.026, respectively). Haplotype ACGCA is shown to be protective against NAFLD for the Indian ethnic subgroup (p = 0.03). Gene-gene interaction between the AGTR1 gene and the patatin-like phospholipase domain-containing 3 (PNPLA3) gene, which we previously reported as associated with NAFLD in this sample, showed a strong interaction between AGTR1 (rs3772627), AGTRI (rs3772630) and PNPLA3 (rs738409) polymorphisms on NAFLD susceptibility (p = 0.007). Further analysis of the NAFLD patients revealed that the G allele of the AGTR1 rs3772622 is associated with increased fibrosis score (p = 0.003). This is the first study that replicates an association between AGTR1 polymorphism and NAFLD, with further details in histological features of NAFLD. There is lack of evidence to suggest an association between any of the five variants of the AGTR1 gene and NAFLD in the Malays and Chinese. In the Indians, the rs2276736, rs3772630 and rs3772627 appear to protect against NAFLD. We report novel findings of an association between the G allele of the rs3772622 with occurrence of fibrosis and of the gene-gene interaction between AGTR1gene and the much-studied PNPLA3 gene. [ABSTRACT FROM AUTHOR]

Common PCSK1 variants (notably rs6232 and rs6235) have been shown to be associated with obesity in European, Asian and Mexican populations. To determine whether common PCSK1 variants contribute to obesity in American population, we conducted association analyses in 8,359 subjects using two multi-ethnic American studies: the Coronary Artery Risk Development in Young Adults (CARDIA) study and the Multi-Ethnic Study of Atherosclerosis (MESA). By evaluating the contribution of rs6232 and rs6235 in each ethnic group, we found that in European-American subjects from CARDIA, only rs6232 was associated with BMI (P = 0.006) and obesity (P = 0.018) but also increased the obesity incidence during the 20 years of follow-up (HR = 1.53 [1.07–2.19], P = 0.019). Alternatively, in African-American subjects from CARDIA, rs6235 was associated with BMI (P = 0.028) and obesity (P = 0.018). Further, by combining the two case-control ethnic groups from the CARDIA study in a meta-analysis, association between rs6235 and obesity risk remained significant (OR = 1.23 [1.05–1.45], P = 9.5×10−3). However, neither rs6232 nor rs6235 was associated with BMI or obesity in the MESA study. Interestingly, rs6232 was associated with BMI (P = 4.2×10−3) and obesity (P = 3.4×10−3) in the younger European-American group combining samples from the both studies [less than median age (53 years)], but not among the older age group (P = 0.756 and P = 0.935 for BMI and obesity, respectively). By combining all the case-control ethnic groups from CARDIA and MESA in a meta-analysis, we found no significant association for the both variants and obesity risk. Finally, by exploring the full PCSK1 locus, we observed that no variant remained significant after correction for multiple testing. These results indicate that common PCSK1 variants (notably rs6232 and rs6235) contribute modestly to obesity in multi-ethnic American population. Further, these results suggest that the association of rs6232 with obesity may be age-dependent in European-Americans. However, multiple replication studies in multi-ethnic American population are needed to confirm our findings. [ABSTRACT FROM AUTHOR]

Background: There is evidence that the outcomes of head and neck surgery may differ across racial and ethnic groups. Vocal changes related to the operation are an anticipated risk of thyroidectomy and parathyroidectomy. Race-specific voice outcomes after thyroid and parathyroid operations have not been reported. Therefore, our aim was to examine the potential disparity in voice outcomes between white and black patients after thyroid or parathyroid operations. Patients and Methods: Eighty-seven patients (59 white and 28 black) were included in a prospective observational trial. Subjects were evaluated before operation, and 2 weeks, 3 months, and 6 months postoperatively using a comprehensive battery of functional voice assessments of voice characteristics. The association of race with voice outcomes over time was evaluated with generalized linear models. Results: Aside from volume of pathologic specimen (black, 117.5 cm3 vs white, 43.2 cm3; P = .004), presence of multinodular goiter (black, 32.1% vs white, 6.8%; P = .004) or Hashimoto''s thyroiditis (black, 3.6% vs white, 28.8%; P = .009), there were no differences between racial groups. Blacks were more likely than whites to have negative voice outcomes (odds ratio, 2.6; 95% confidence interval, 1.1–6.2; P = .034] throughout the postoperative period, especially at 6 months (black, 25% vs white, 4%; P = .018). This finding was related principally to divergent scores on the voice-related quality-of-life scale, the Voice Handicap Index. Conclusion: We observed greater rates of self-reported, negative voice outcomes among blacks than whites after thyroid or parathyroid operations. The precise mechanism for this disparity has not been described. The observed racial disparity in self-perceived voice impairment in this study merits further investigation. [Copyright &y& Elsevier]

Abstract: In 2008 there were 11682 cases of oral cancer in the United Kingdom; this is 16.41/100000 population, and 3.7% of all cancers. Ethnic coding of these data is poor, and so databases were combined to report rates for the incidence of oral cancer in South Asians compared with those among other ethnic groups in West Yorkshire, 2001–2006. A total of 2157 patients with oral cancer were identified in West Yorkshire, 138 of whom were South Asian (6.4%). We analysed them by ethnicity, sex, area in which they lived, and site of cancer. Oral cancer was significantly more common among South Asian women than those from other ethnic groups in England and West Yorkshire, and in England alone it was significantly more common in men of other ethnic groups than those from South Asia. Patients from South Asia were at higher risk of being diagnosed with oral cancer than those of other ethnic groups within West Yorkshire, when data were adjusted for age at diagnosis and sex. In England and in West Yorkshire there was a significantly higher rate of oral cancer among Southern Asian women than among those of other ethnic groups, and men in other ethnic groups had a higher incidence than those from South Asia (England only). The excess of oral cancers gives further weight to the association between smokeless tobacco, smoking, alcohol, and dietary intake by ethnic group. This information is particularly pertinent in areas such as West Yorkshire where there are large groups of Asian people. [Copyright &y& Elsevier]

Vitamin D has been associated with multiple sclerosis (MS) and several markers of disease state in whites. There are limited reports of vitamin D's influence in MS in ethnic groups, such as in Hispanics. In this study, we compared vitamin D levels in Hispanics and whites with MS and tried to determine whether season or increasing disability influence hypovitaminosis D in Hispanics with MS. Serum 25-hydroxyvitamin D [25(OH)D] levels and clinical characteristics were compared in a cross-sectional sample of Hispanics ( n = 80) and whites ( n = 80) with MS recruited from the University of Southern California. Serum 25(OH)D levels were significantly lower in Hispanics than whites with MS (mean and standard deviation 25.1 ± 9.4 and 37.3 ± 19.8 ng/ml, respectively; p < 0.001). Hispanics were significantly more likely than whites to be vitamin D insufficient (≤30 ng/ml; 70 vs. 41 %, respectively; p < 0.001) and deficient (≤20 ng/ml; 40 vs. 14 %, respectively, p < 0.001). In Hispanics, serum 25(OH)D levels were not influenced by season ( p = 0.8) or higher physical disability (EDSS ≥6, p = 0.7). We found that the relationship between vitamin D and MS differs by Hispanic ethnicity. Hypovitaminosis D was significantly more common among Hispanics than among whites with MS, and the majority of Hispanics were vitamin D insufficient. Interestingly, there was no association between vitamin D levels and season or increasing disability in the Hispanics. Our findings imply that factors influencing vitamin D levels and possibly vitamin D requirements may vary by ethnicity in patients with MS. These results should be confirmed in larger, prospective multi-ethnic cohort studies. [ABSTRACT FROM AUTHOR]

The article presents a study concerning the variation of genetic susceptibleness to multiple sclerosis in different individuals with Arab ethnicities. It states that the author adjusted the important findings for using disease modifying therapy and observed that second neurological episodes are seen on Arabic females. It adds that Druze and Muslim females show rapid disease flow compared to Christian females.

Background. Despite reported differences in breastfeeding rates amongst women of different ethnic groups, little research has investigated whether the thoughts and feelings (social cognitions) of women from these different groups during pregnancy influence their later breastfeeding behaviour. Objective. This study investigates the extent to which social cognitions (based on the Theory of Planned Behaviour; TPB) predict differences in breastfeeding intentions, initiation, and maintenance between White British (WB) and South Asian (SA) women. Design and methods. Two hundred and fifty women (predominantly WB or SA) in the last trimester of pregnancy completed a questionnaire based on the TPB. The women were followed up 6 months later and their breastfeeding during the previous 6 months was recorded. Results. The TPB predicted significant variance in breastfeeding across the sample and was able to account for differences between SA and WB women. Affective attitudes (emotional reactions to breastfeeding) and moral norms (reactions about whether breastfeeding is right or wrong) were the strongest predictors of intentions. Intentions and affective attitudes were predictive of breastfeeding initiation, whilst only affective attitudes were predictive of breastfeeding maintenance. Conclusion. Stronger intentions to breastfeed led to higher rates of breastfeeding amongst SA women. In turn, intentions were predicted by emotional and moral beliefs about breastfeeding, beliefs that were less positive amongst a WB sample. This suggests that those tasked with encouraging breastfeeding may need to have a different conversation with women about breastfeeding that goes beyond a focus on costs and benefits. Statement of contribution What is already known on this subject South Asian women living in Britain are more likely to breastfeed their infants than White British women. The constructs of the Theory of Planned Behaviour have been shown to predict breastfeeding initiation and maintenance. However, few studies measure longer term breastfeeding or test whether TPB constructs from the extended TPB measured before the delivery of the baby predict breastfeeding initiation or maintenance. No studies have explored this amongst a British South Asian population. What this study adds This study demonstrates that intentions and affective attitudes are strong predictors of initiation of breastfeeding, but that only affective attitude predicted maintenance of breastfeeding for 6 months. Moreover, we demonstrated that stronger intentions were able to explain the higher breastfeeding initiation rates and affective attitudes were able to explain the greater likelihood of maintenance of breastfeeding amongst South Asian women. [ABSTRACT FROM AUTHOR]

BACKGROUND: It has been established that disparities by ethnicity in the rates of breast cancer diagnoses and disease-specific survival (DSS) exist in the United States. However, few studies have assessed differences specifically between Asians and other ethnic groups or among Asian subgroups. METHODS: The authors used the Surveillance, Epidemiology, and End Results database to identify patients who were diagnosed with invasive breast cancer between 1988 and 2008. Clinicopathologic features, treatment, and DSS rates were compared among broad ethnic groups and among Asian subgroups. RESULTS: In total, there were 658,691 patients in the study, including 511,701 non-Hispanic white (NHW) women (77.7%), 57,890 black women (8.8%), 45,461 Hispanic white (HW) women (6.9%), and 43,639 Asian women (6.6%). The Asian cohort was divided into the following subgroups: Filipino, Chinese, Japanese, Indian/Pakistani, Korean, Vietnamese, Hawaiian/Pacific Islander, and other. Patients in all the Asian subgroups, except Japanese, were younger at diagnosis than NHW patients. After adjustment for disease stage, Japanese patients diagnosed with stage I through III disease had better DSS rates than patients in the NHW group or in the other Asian subgroups. Hawaiian/Pacific Islander patients with stage III or IV disease had worse DSS rates than NHW patients and patients in the other Asian subgroups. All other Asian subgroups had DSS rates similar to the DSS rate in the NHW group. [ABSTRACT FROM AUTHOR]

The prevalence of itch is higher in individuals with darker skin types. In this paper, we review the systems involved in the physiology of itch and how they may differ across the races. Current data point out that the differences may be explained by barrier function, mast cell physiology, and itch receptor polymorphisms. [ABSTRACT FROM AUTHOR]

Studies of ethnic disparities in malignancies have revealed variation in clinical outcomes. In multiple myeloma ( MM), previous literature has focused only on patients of Caucasian and African- American ( AA) descent. We present a Surveillance Epidemiology and End Results ( SEER)-based outcome analysis of MM patients from a broader range of ethnicities, representing current United States demographics. The SEER 17 Registry data was utilized to analyse adult MM patients diagnosed since 1992 ( n = 37 963), as patients of other ethnicities were not well represented prior to that. Overall survival ( OS) and myeloma-specific survival ( MSS) were compared across different ethnicities stratified by year of diagnosis, registry identification, age, sex and marital-status. Hispanics had the youngest median age at diagnosis (65 years) and Whites had the oldest (71 years) ( P < 0·001). Increased age at diagnosis was an independent predictor of decreased OS and MSS. Asians had the best median OS (2·7 years) and MSS (4·1 years), while Hispanics had the worst median OS (2·4 years). These trends were more pronounced in patients ≥75 years. Cumulative survival benefit over successive years was largest among Whites (1·3 years) and smallest among Asians (0·5 years). These disparities may be secondary to multifactorial causes that need to be explored and should be considered for optimal triaging of healthcare resources. [ABSTRACT FROM AUTHOR]

. Neutralizing inhibitors develop in 20-30% of patients with severe factor VIII (FVIII) deficiency. It is well established that Blacks have a higher prevalence of inhibitors than Whites. This is the first study to definitively demonstrate increased inhibitor prevalence in the Hispanic population. We compared inhibitor prevalence among various racial and ethnic groups in a cross-sectional analysis of 5651 males with severe haemophilia A that participated in the Universal Data Collection project sponsored by the Centers for Disease Control and Prevention. We used logistic regression analysis to control for potential confounding variables. We assigned as Hispanic those participants who were white and labelled themselves Hispanic. The prevalence of high-titre inhibitors in the Hispanic participants was 24.5% compared to 16.4% for White non-Hispanic patients (OR 1.4, 95% CI 1.1, 1.7). Possibilities as to the underlying cause of increased inhibitor prevalence in minority ethnic populations include polymorphisms in the FVIII molecule, HLA subtypes and differing inflammatory responses. A better understanding may lead to tailored treatment programmes, or other therapies, to decrease or prevent inhibitor development. [ABSTRACT FROM AUTHOR]

BACKGROUND: Lung cancer is the second most commonly diagnosed cancer and the leading cause of cancer-related death in the United States (US). We examined data from 2004 to 2006 for lung cancer incidence rates by demographics, including race and geographic region, to identify potential health disparities. METHODS: Data from cancer registries affiliated with the Centers for Disease Control and Prevention's (CDC) National Program of Cancer Registries (NPCR), and the National Cancer Institute's (NCI) Surveillance, Epidemiology, and End Results Program (SEER) were used for this study; representing 100% of the US population. Age-adjusted incidence rates and 95% confidence intervals for demographic (age, sex, race, ethnicity, and US Census region), and tumor (stage, grade, and histology) characteristics were calculated. RESULTS: During 2004 to 2006, 623,388 people (overall rate of 68.9 per 100,000) were diagnosed with lung cancer in the US. Lung cancer incidence rates were highest among men (86.2), Blacks (73.0), persons aged 70 to 79 years (431.1), and those living in the South (74.7). Among Whites, the highest lung cancer incidence rate was in the South (75.6); the highest rates among Blacks (88.9) and American Indians/Alaska Natives (65.4) in the Midwest, Asians/Pacific Islanders in the West (40.0), and Hispanics in the Northeast (40.3). CONCLUSIONS: Our findings of racial, ethnic, and regional disparities in lung cancer incidence suggest a need for the development and implementation of more effective culturally specific preventive and treatment strategies that will ultimately reduce the disproportionate burden of lung cancer in the US. Cancer 2012. © 2011 American Cancer Society. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To investigate the prevalence and risk factors of bronchial asthma in the Li ethnic group in Hainan, China. Methods: This study employed a stratified random sample design using custom-designed questionnaires. Subjects with asthma-like symptoms were first identified by two rounds of surveys and then confirmed by respiratory physicians using pulmonary function test, bronchial dilation test and challenge test. Demographic data, information on family history of asthma, history of allergies, smoking habits, domestic cooking fuel and other potential risk factors were collected. Logistic regression was performed to evaluate risk factors for asthma. Results: The prevalence of asthma in the Li ethnic group was 3.38%, much higher than the national average level in China. Aging, agriculture industry (the rubber industry in particular), rural residence, family history of asthma, history of allergies, cold air, inhalation of dust and irritant gases, smoking, domestic cooking fuel and living environment were associated with increased risk of asthma. Conclusions: The high prevalence of asthma in the Li ethnic group highlights the importance of asthma prevention and treatment in this population. Risk factors indentified in this study warrant special attention. Elevating public awareness about asthma in local communities will benefit the prevention of the disease. [Copyright &y& Elsevier]

In this article, author present a method which aims at recording missing data on the ethnicity of cancer patients. It states that the method was developed by a regional cancer registry of Great Britain. It mentions that health service researchers uses this information on ethnicity for planning services, equality of access and epidemiological studies. It further focuses on name recognition software which plays an important role in predicting the ethnicity of cancer patients.

Primary immunodeficiency diseases (PIDs) are a heterogeneous group of inherited disorders that cause individuals to be prone to a variety of clinical manifestations, such as infections, autoimmunity, and malignancies. Early diagnosis and adequate treatment of these disorders can reduce morbidity and mortality and provide a relatively high quality of life. In Iran, recent advances in clinical immunology and in the identification of immunodeficiencies have led to reductions in diagnostic delay and severe complications in patients with PIDs. Autosomal recessive and multifactorial types of PID seem to be more common in Iran because of high rates of consanguine marriages and, probably, the genetic background of its ethnic groups. These facts necessitate special diagnostic and treatment approaches, but at the same time reveal an opportunity to observe novel phenotypes and genetic defects. [ABSTRACT FROM AUTHOR]

Background: During 2001 to 2005, 1-year breast cancer survival was low in ethnically diverse East London. We hypothesised that this was due to low breast cancer awareness and barriers to symptomatic presentation, leading to late stage at diagnosis in women from ethnic minorities. We examined ethnic differences in breast cancer awareness and barriers to symptomatic presentation in East London.Methods: We carried out a population-based survey of 1515 women aged 30+ using the Cancer Research UK Breast Cancer Awareness Measure. We analysed the data using logistic regression adjusting for age group and level of deprivation.Results: South Asian and black women had lower breast cancer awareness than white women. South Asian women, but not black women, reported more emotional barriers to seeking medical help than white women. White women were more likely than non-white women to report worry about wasting the doctor's time as a barrier to symptomatic presentation.Conclusion: Interventions to promote early presentation of breast cancer for South Asian and black women should promote knowledge of symptoms and skills to detect changes, and tackle emotional barriers to symptomatic presentation and for white women tackle the idea that going to the doctor to discuss a breast symptom will waste the doctor's time. [ABSTRACT FROM AUTHOR]

Background. Late diagnosis of human immunodeficiency virus (HIV) infection remains common despite advances in therapy and prognosis. The southeastern United States is a rapidly growing Latino settlement area where ethnic disparities may contribute to late presentation to care. Methods. We assessed demographic and clinical factors between racial/ethnic groups at the time of HIV care initiation in the University of North Carolina Center for AIDS Research Clinical Cohort. We identified independent predictors of late presentation, defined as a CD4+ T lymphocyte (CD4) count <350 cells/mm3 or an AIDS-defining event (ADE), using log-linear binomial regression. Results. During the period 1999-2009, 853 patients initiated HIV care, of whom 11% were Latino, 28% were white, and 61% were black. Median initial CD4 counts were lower for Latino patients (186 cells/mm3) than white patients (292 cells/mm3; P 5 .006) and black patients (302 cells/mm3; P = .02). Latino persons were more likely to be late presenters than white or black persons (76% vs 58%; P < .001) and accounted for 86%, 75%, and 50% of all presenting cases of active tuberculosis, histoplasmosis, and toxoplasmosis, respectively. Latino ethnicity, older age, male sex, and earlier entry year were independently associated with late presentation (P < .05 for all). In multivariable analyses, Latino persons were 1.29 times more likely to present to care late than white or black persons (95% confidence interval, 1.15-1.45). Conclusions. Latinos are more likely to initiate HIV care later in the course of illness than are black and white persons and account for a majority of several ADEs. Strategies to improve earlier HIV testing among Latinos in new settlement areas are needed. [ABSTRACT FROM AUTHOR]

Pediatric obesity threatens the future health of a growing number of children worldwide. An added challenge in identifying the patients at greatest need for intervention due to their elevated risk for future disease is that pediatric obesity and the associated metabolic syndrome manifest differently among different ethnic groups. African-Americans and Hispanics are more likely to exhibit obesity and insulin resistance and are at a higher risk for developing Type 2 diabetes. Nevertheless, using current criteria, African-American adolescents are much less likely to be diagnosed with metabolic syndrome, largely owing to lower rates of dyslipidemia. Further development is needed in ethnicity-inclusive means of risk identification among adolescents to accurately target treatment toward children at highest risk for future disease and to motivate adolescent patients and their families towards lifestyle improvement. Effective targeting and intensive treatment efforts may help in avoiding future sequelae of obesity among all ethnicities. INSET: Key issues. [ABSTRACT FROM AUTHOR]

Li W, Sun L, Corey M, Zou F, Lee S, Cojocaru AL, Taylor C, Blackman SM, Stephenson A, Sandford AJ, Dorfman R, Drumm ML, Cutting GR, Knowles MR, Durie P, Wright FA, Strug LJ. Understanding the population structure of North American patients with cystic fibrosis. It is generally presumed that the cystic fibrosis (CF) population is relatively homogeneous, and predominantly of European origin. The complex ethnic make-up observed in the CF patients collected by the North American CF Modifier Gene Consortium has brought this assumption into question, and suggested the potential for population substructure in the three CF study samples collected from North America. It is well appreciated that population substructure can result in spurious genetic associations. To understand the ethnic composition of the North American CF population, and to assess the need for population structure adjustment in genetic association studies with North American CF patients, genome-wide single-nucleotide polymorphisms on 3076 unrelated North American CF patients were used to perform population structure analyses. We compared self-reported ethnicity to genotype-inferred ancestry, and also examined whether geographic distribution and cystic fibrosis transmembrane regulator (CFTR) mutation type could explain the population structure observed. Although largely Caucasian, our analyses identified a considerable number of CF patients with admixed African-Caucasian, Mexican-Caucasian and Indian-Caucasian ancestries. Population substructure was present and comparable across the three studies of the consortium. Neither geographic distribution nor CFTR mutation type explained the population structure. Given the ethnic diversity of the North American CF population, it is essential to carefully detect, estimate and adjust for population substructure to guard against potential spurious findings in CF genetic association studies. Other Mendelian diseases that are presumed to predominantly affect single ethnic groups may also benefit from careful analysis of population structure. [ABSTRACT FROM AUTHOR]

This paper reports drinking patterns among minority ethnic groups from the UK literature over the past 15 years, and considers the evidence for service provision and support. Findings show that drinking remains low among minority ethnic groups, though with evidence of increases in consumption, particularly among Indian women and Chinese men. South Asian men, particularly Sikh men, are over-represented for liver cirrhosis, and some ethnic groups have higher than national average alcohol-related deaths. People from black and minority ethnic backgrounds have similar rates of alcohol dependency as the white population; however services do not appear to be responsive enough to the needs of minority ethnic groups as they are under-represented in seeking treatment and advice for drinking problems. Help-seeking preferences vary for drinking problems between and within groups suggesting that drinking problems need to be addressed within both mainstream and specialist services. Greater understanding of cultural issues is needed in the development of alcohol services in mainstream and specialist settings. [ABSTRACT FROM AUTHOR]

Several genetic loci (JAZF1, CDC123/CAMK1D, TSPAN8/LGR5, ADAMTS9, VEGFA and HHEX-IDE) were identified to be significantly related to the risk of type 2 diabetes and quantitative metabolic traits in European populations. Here, we aimed to evaluate the impacts of these novel loci on type 2 diabetes risk in a population-based case-control study of Han Chinese (1912 cases and 2041 controls). We genotyped 13 single-nucleotide polymorphisms (SNPs) in/near these genes and examined the differences in allele/genotype frequency between cases and controls. We found that both IDE rs11187007 and HHEX rs1111875 were associated with type 2 diabetes risk (for both variants: odds ratio (OR)=1.15, 95% confidence interval (CI) 1.04-1.28, P=0.009). In a meta-analysis where we pooled our data with the three previous studies conducted in East Asians, we found that the variants of JAZF1 rs864745 (1.09 (1.03-1.16); P=3.49 × 10−3) and TSPAN8/LGR5 rs7961581 (1.11(1.05-1.17); P=1.89 × 10−4) were significantly associated with type 2 diabetes risk. In addition, the meta-analysis (7207 cases and 8260 controls) also showed that HHEX rs1111875 did have effects on type 2 diabetes in Chinese population (OR=1.15(1.10-1.21); P=1.93 × 10−8). This large population-based study and meta-analysis further confirmed the modest effects of the JAZF1, TSPAN8/LGR5 and HHEX-IDE loci on type 2 diabetes in Chinese and other East Asians. [ABSTRACT FROM AUTHOR]

The aim of the study was to compare the prevalence of radiographic hand osteoarthritis (OA) and its association with age, sex, body mass index in two ethnic groups, Russian and Buryats who reside in the same geographic area. It was a cross-sectional observational study. The study population comprised ethnic Russians ( N = 572) and Buryats ( N = 327) from the Barguzinsky District of the Buryat Republic, Russian Federation. OA was evaluated in 14 joints of the left hand according to Kellgren and Lawrence’s grading system. A diagnosis of OA was determined by the number of affected joints and by the presence of at least one affected joint. Statistical analyses included prevalence estimation, linear and logistic regressions, and χ tests. Our major finding was that individuals of different ethnic groups, residing in the same location, have similar prevalence and severity of radiographic hand OA. Considering the results of our previous study, where we found significant differences in the prevalence and severity of hand OA between the Russian samples (same ethnicity) with diverse places of residence, we conclude that environmental factors play an important role in the development of hand OA. [ABSTRACT FROM AUTHOR]

Background: Methylenetetrahydrofolate reductase ( MTHFR) gene variants and hyperhomocysteinemia have been implicated in the pathogenesis of diabetic nephropathy (DN) in various ethnic groups. We investigated the association of C677 T and A1298 C MTHFR gene variants and altered homocysteine concentrations in Lebanese and Bahraini type 2 diabetes (T2DM) DN patients. Methods: Bahraini subjects comprised 224 DN patients and 328 T2DM patients with normal urine albumin [diabetes without nephropathy (DWN)]. Lebanese subjects comprised 252 DN and 309 DWN patients. C677 T and A1298 C genotypes were determined by PCR-restriction fragment length polymorphism (RFLP) analysis, and homocysteine was measured by ELISA. Results: A1298 C allele and genotype distribution were comparable between DN and DWN patients in both communities. However, there was enrichment of the 677 T allele, together with C/ T and T/ T genotypes in Lebanese but not Bahraini DN patients, thereby conferring DN susceptibility [odds ratio (OR) (95% CI)=2.43 (1.89–3.11) and OR (95% CI)=1.15 (0.83–1.61), respectively; heterogeneity Q=12.53, p=0.0004)]. Conclusions: The contribution of C677 T single nucleotide polymorphism to increased risk of DN (presumably by increasing homocysteine concentrations) must be evaluated in the context of the ethnic background. Clin Chem Lab Med 2010;48:1091–4. [ABSTRACT FROM AUTHOR]

Parkinson’s disease (PD) is a common neurodegenerative disorder, for which environmental and/or genetic factors are postulated as possible causes. Over the past decade there has been a substantial increase in the knowledge of the genetics of PD. Mutations in Leucine-rich repeat kinase 2 (LRRK2) are the most frequent genetic causes of PD, and the common G2019S mutation has been identified in various ethnic groups with variable frequency. The aim of this article is to review the literature relating to LRRK2 G2019S in the North African population, which is composed of two main ethnic groups – the Berbers and the Arabs. The frequency of LRRK2 G2019S is 30–41% in familial PD and 30–39% in apparently sporadic PD in North Africa. Within healthy controls, Moroccan Berbers appear to have the highest carrier frequency at 3.3%. The majority of the available studies do not draw a clear distinction between the two ethnic groups, despite the distinct possibility that their ancestral origins are different. Further research looking at the respective prevalences of LRRK2 G2019S in Berbers and Arabs, and in different Arab populations, seems justified. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Objective: To determine the knowledge and cultural beliefs about the etiology and management of orofacial clefts in Nigeria's major ethnic groups. Design: Questionnaires designed to elicit respondents' knowledge and cultural beliefs about the etiology and management of orofacial clefts. Setting: Northern and southern Nigerian communities where the major ethnic groups reside. Participants: Consenting, randomly selected individuals. Results: There were 650 respondents (350 women and 300 men) from 34 of Nigeria's 36 states; 65.5% were aged 21 to 40 years and 52.5% were married. There were Yoruba (33.7%), Igbo/Bini/Urhobo (40.5%), and Hausa/Fulani (25.8%), with most having attained primary and secondary education. Of those responding, 75% had seen an individual with an orofacial cleft. A significant level of ignorance about the cultural beliefs was found. The Hausa/Fulani considered it mostly an act of God; whereas, the Igbo/Bini/Urhobo and Yoruba groups displayed a greater variety of cultural beliefs. The latter groups implicated witchcraft, evil spirit or devil, the mother, and occasionally the child. Of respondents, 40% knew that surgery was a possible solution, and 22% would recommend a visit to the hospital. Respondents with higher educational attainment produced significantly more scientifically related etiologic factors and accurate treatment options. Conclusion: Of respondents, 75% were aware of the existence of orofacial clefts, and a fair knowledge of treatment of orofacial clefts was elicited. Diverse cultural beliefs often may present an obstacle to treatment. Improved awareness about the etiology and management of orofacial clefts is required. [ABSTRACT FROM AUTHOR]

OBJECTIVE-- To derive a 5-year cardiovascular disease (CVD) risk equation from usual-care data that is appropriate for people with type 2 diabetes from a wide range of ethnic groups, variable glycemic control, and high rates of albuminuria in New Zealand. RESEARCH DESIGN AND METHODS-- This prospective open-cohort study used primary-care data from 36,127 people with type 2 diabetes without previous CVD to derive a CVD equation using Cox proportional hazards regression models. Data from 12,626 people from a geographically different area were used for validation. Outcome measure was time to first fatal or nonfatal cardiovascular event, derived from national hospitalization and mortality records. Risk factors were age at diagnosis, diabetes duration, sex, systolic blood pressure, smoking status, total cholesterol-to-HDL ratio, ethnicity, glycated hemoglobin (A1C), and urine albumin-to-creatinine ratio. RESULTS-- Baseline median age was 59 years, 51% were women, 55% were of non-European ethnicity, and 33% had micro- or macroalbuminuria. Median follow-up was 3.9 years (141,169 person-years), including 10,030 individuals followed for at least 5 years. At total of 6,479 first cardiovascular events occurred during follow-up. The 5-year observed risk was 20.8% (95% C120.3-21.3). Risk increased with each 1% A1C (adjusted hazard ratio 1.06 [95% CI 1.05-1.08]), when macroalbuminuria was present (2.04 [1.89-2.21]), and in Indo-Asians (1.29 [1.14-1.46]) and Maori (1.23 [1.14-1.32]) compared with Europeans. The derived risk equations performed well on the validation cohort compared with other risk equations. CONCLUSIONS -- Renal function, ethnicity, and glycemic control contribute significantly to cardiovascular risk prediction. Population-appropriate risk equations can be derived from routinely collected data. [ABSTRACT FROM AUTHOR]

There is a wide variation in the prevalence of various subtypes of non-Hodgkin’s lymphoma worldwide. The aim of this study was to determine the relative frequency of different subtypes of non-Hodgkin’s lymphoma in Kuwait based on the Revised European–American Lymphoma (REAL) classification. From 1998 to 2006, 738 subjects were included that were registered with non-Hodgkin’s lymphoma in the population-based cancer registry at the Kuwait Cancer Control Center. Expert pathologists reviewed histological slides from all subjects. We performed detailed immunohistochemical studies and classified subjects based on the REAL classification. The prevalence of different types of non-Hodgkin's lymphoma was determined based on age, sex, site of disease, and ethnicity. Ethnicity groups comprised Kuwaiti Arabs, non Kuwaiti Arabs, Asians, and others. The prevalence of B- and T-cell lymphomas was 81.8% and 14.2%, respectively. The most common age group was 41–60 years old. The three most common subtypes in Kuwaiti Arabs were diffuse large B-cell lymphoma (46.5%), follicular lymphoma (15.5%), and mycosis fungoides (9.3%). In non-Kuwaiti Arabs, the most common subtypes were diffuse large B-cell lymphoma (48%), B-cell small lymphocytic lymphoma/chronic lymphocytic leukemia (15.8%), and follicular lymphoma (12.7%). Overall, non-Kuwaiti Arabs exhibited the highest prevalence (59%), and 54% of all cases had extranodal presentation. Compared to the Western world, Kuwait had a lower prevalence of follicular lymphoma, a higher prevalence of diffuse large B-cell lymphoma and extranodal presentation, and a high frequency of mycosis fungoides. Compared to other parts of Asia, Kuwait had a lower frequency of peripheral T-cell lymphomas. [ABSTRACT FROM AUTHOR]

Summary: One potential mechanism for reducing racial/ethnic disparities in the receipt of kidney transplants is to enhance minorities'' pursuit of living donor kidney transplantation (LDKT). Pursuit of LDKT is influenced by patients'' personal values, their extended social networks, the health care system, and the community at large. This review discusses research and interventions promoting LDKT, especially for minorities, including improving education for patients, donors, and providers, using LDKT kidneys more efficiently, and reducing surgical and financial barriers to transplant. Future directions to increase awareness of LDKT for more racial/ethnic minorities also are discussed including developing culturally tailored transplant education, clarifying transplant-eligibility practice guidelines, strengthening partnerships between community kidney providers and transplant centers, and conducting general media campaigns and community outreach. [Copyright &y& Elsevier]

Summary: The increased rate of type 2 diabetes among minority ethnic groups compared with Caucasians in the United Kingdom has been well documented. Diabetes complications, such as end-stage renal failure, are much more prevalent among the South Asian and African-Caribbean population in the United Kingdom. Inequalities do currently exist in diabetes and renal services and the solutions to rectifying this situation are complex, focusing both on disease prevention and disease management. However, the financial and human burden of not addressing these inequalities encourage some immediate action. [ABSTRACT FROM AUTHOR]

Background: The inability of aspirin (ASA) to adequately suppress platelet aggregation is associated with future risk of coronary artery disease (CAD). Heritability studies of agonist-induced platelet function phenotypes suggest that genetic variation may be responsible for ASA responsiveness. In this study, we leverage independent information from genome-wide linkage and association data to determine loci controlling platelet phenotypes before and after treatment with ASA. Methods: Clinical data on 37 agonist-induced platelet function phenotypes were evaluated before and after a 2-week trial of ASA (81 mg/day) in 1231 European American and 846 African American healthy subjects with a family history of premature CAD. Principal component analysis was performed to minimize the number of independent factors underlying the covariance of these various phenotypes. Multi-point sib-pair based linkage analysis was performed using a microsatellite marker set, and single-SNP association tests were performed using markers from the Illumina 1 M genotyping chip from deCODE Genetics, Inc. All analyses were performed separately within each ethnic group. Results: Several genomic regions appear to be linked to ASA response factors: a 10 cM region in African Americans on chromosome 5q11.2 had several STRs with suggestive (p-value < 7 × 10-4) and significant (p-value < 2 × 10-5) linkage to post aspirin platelet response to ADP, and ten additional factors had suggestive evidence for linkage (p-value < 7 × 10- 4) to thirteen genomic regions. All but one of these factors were aspirin response variables. While the strength of genome-wide SNP association signals for factors showing evidence for linkage is limited, especially at the strict thresholds of genome-wide criteria (N = 9 SNPs for 11 factors), more signals were considered significant when the association signal was weighted by evidence for linkage (N = 30 SNPs). Conclusions: Our study supports the hypothesis that platelet phenotypes in response to ASA likely have genetic control and the combined approach of linkage and association offers an alternative approach to prioritizing regions of interest for subsequent follow-up. [ABSTRACT FROM AUTHOR]

Background Behçet's disease (BD) is known to be associated with human leucocyte antigen (HLA)-B*51 in many ethnic groups. However, the association of HLA class II gene with BD has been described to be different according to different countries and regions. Objective This study aims to investigate the association between polymorphism of HLA-DRB1 alleles and BD. Methods Forty patients with BD and 100 healthy controls were typed for HLA-DRB1 alleles by the LABTypeTM SSO method. Results The frequency of HLA-DRB1*14 was significantly higher in BD patients than in controls ( P < 0.05), while the frequency of HLA-DRB1*15 was markedly lower in BD patients ( P < 0.05). Regarding clinical manifestations, the frequency of HLA-DRB1*15 was significantly decreased in BD patients with genital ulcerations compared with controls ( P < 0.05); the frequency of HLA-DRB1*14 was significantly increased in BD patients with erythema nodosum–like lesions and in BD patients with folliculitis-like lesions when compared to controls ( P < 0.05, respectively). Moreover, the frequency of HLA-DRB1*14 was significantly increased in BD patients under 20 years of age at the onset of disease ( P < 0.01), while the frequency of HLA-DRB1*15 was significantly decreased in them ( P < 0.05), compared with controls. Conclusion The results suggested that HLA-DRB1 alleles might play an important role in the onset and clinical manifestations of BD. [ABSTRACT FROM AUTHOR]

In 2008, CDC published a supplement to the journal Cancer describing incidence patterns of human papillomavirus (HPV)-associated cancers prior to availability of an HPV vaccine. This report updates the information on HPV-associated female genital cancer incidence with more recent data, adds information on trends, and includes American Indian/Alaska Native (AI/AN) populations. We used combined data from two federal cancer surveillance programs, CDC's National Program of Cancer Registries (NPCR) and NCI's Surveillance, Epidemiology, and End Results (SEER) Program, covering 92% of the U.S. population from 1999 to 2004, to examine recent trends and incidence of invasive cervical carcinoma and vaginal and vulvar squamous cell carcinoma (SCC). Incidence of in situ vaginal and vulvar SCC are also presented. The average annual age-adjusted rate of cervical cancer among women of all races/ethnicities was 8.5/100,000. Annual cervical cancer incidence rates were highest but declined more rapidly among Hispanic and black women compared with non-Hispanic and white women. The rate of vulvar cancer among all women was 1.7/100,000 and was higher among white women than other racial groups. Vulvar cancer rates rose among black women (+2.9% per year) and were relatively stable among all other racial and ethnic groups over the 6-year period. Vaginal cancer was rare (rate 0.5/100,000); the rate was higher among black women than other racial groups and higher among Hispanic women than among non-Hispanic women. A significant decline of vaginal cancer was observed only among black women (−6.2% per year). This article confirms previous findings on racial disparities in HPV-associated female genital cancers. Any post-HPV vaccine declines in these cancers should be interpreted in light of current declines. Enhancing current cancer surveillance systems, combined with special studies to collect data on in situ or precancerous lesions of these cancers, will provide important information in determining the potential impact of the HPV vaccine. [ABSTRACT FROM AUTHOR]

Objectives. We document the extent to which racial and ethnic differences exist in asthma prevalence among US adults, and among asthmatic adults, we document racial differences in asthma problems and asthma-related medical care. We also explore potential explanations for racial and ethnic disparities in each outcome. Design. Using data on a 24-state sample of white, black, Hispanic, Asian, and Native American adults from the 2004 Behavioral Risk Factor Surveillance System, we examine race/ethnic differences in asthma prevalence, problems (had an asthma attack last year; asthma symptoms; sleep difficulties; activities limited because of asthma), and asthma-related medical care (number of routine doctor visits; medication use; urgent doctor visits; visited an emergency room for asthma-related care last year). We then explore whether any observed disparities are due to differences in demographic characteristics, socioeconomic status, health behavior, and environmental conditions across racial/ethnic groups. Results. Asthma prevalence is lowest among Asian and Hispanic adults, and highest among black and Native American adults. Considerable racial/ethnic differences in asthma-related problems and medical care are also present, with Asians doing as well or better than whites, while blacks, Hispanics, and especially Native Americans report more asthma-related problems and medical care use. For some groups (i.e., Asians and Hispanics), we were mostly unable to explain away observed differences with white adults with adjustment for potential explanatory mechanisms, while for other groups (i.e., blacks and Native Americans) adjusting for socioeconomic status and air quality accounted for much of the observed disparity with whites. [ABSTRACT FROM AUTHOR]

Objective: To estimate gestational diabetes mellitus (GDM) prevalence and hyperglycemia in a large multi-ethnic population and evaluate the differences in glucose measures by age and ethnicity. Participants and Setting: All singleton births in Kaiser Permanente Hawaii (KPH) during 1995-2003. Measurements: Ethnicity classifications from birth certificate data were linked to KPH's electronic medical records that included laboratory-screening results. GDM screening was performed using the 50-g, 1-hour oral glucose challenge test (GCT) and the 100-g, 3-hour oral glucose tolerance test (OGTT). GDM was ascertained by both the National Diabetes Data Group (NDDG) and the Carpenter and Coustan (C&C) thresholds. Results: 21,130 (96%) of all pregnant women were screened for GDM using the 1-hour GCT: 21% had glucose levels exceeding the threshold of 140 mg/dL, with the highest rates in Filipinos and Chinese. African American and Caucasian groups had the lowest elevated glucose. Of those with elevated glucose, 1.3% had levels >200 mg/dL, were considered to have GDM, and not tested further; 88% underwent the 3-hour OGTT. Ageadjusted GDM prevalence was 4.4% (NDDG) and 6.6% (C&C). Koreans (6.2%) and Filipinos (6.1%) had the highest age-adjusted NDDG GDM. African Americans (1 .5%), Caucasians (2.5%), and Vietnamese (2.8%) had the lowest. Conclusions: This is the first population-based study to report GDM prevalence in a large group of ethnicities represented in Hawaii. We found very diverse rates of GDM prevalence and elevated glucose among these groups. These findings point to the need for further research along several avenues, such as maternal-child outcome differences and perhaps ethnic-specific guidelines for GDM diagnosis. [ABSTRACT FROM AUTHOR]

In the UK and other developed nations, hypertension and its vascular complications are more common in ethnically African and South-Asian communities compared with Europeans. While these conditions are less common in rural India and Africa, they present a rising problem in expanding cities in all developing countries. Hypertension is, therefore, mainly related to environmental and lifestyle factors rather than genetically determined racial differences. Studies in the USA and elsewhere show that the striking differences in the prevalence of hypertension between people of African and European origin are greatly reduced after adjustment for socio-economic status. One important and probably genuine racial difference between ethnic groups is the significantly suppressed activity of the renin-angiotensin-aldosterone system in African-origin hypertensive patients. As a consequence of this, they are rather more sensitive to a low-salt diet but significantly less sensitive to drugs that block the renin-angiotensin-aldosterone system (angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers) and b-blockers. There is also evidence that renin suppression is common in Japanese and Chinese hypertensive patients as well, although no direct comparisons between these two groups with European-origin patients have been carried out. The management and control of hypertension is unsatisfactory in all ethnic groups and all nations. No one group needs particular targeting; all need better quality systematic care. [ABSTRACT FROM AUTHOR]

Objective To develop and validate a new diabetes risk algorithm (the QDScore) for estimating 10 year risk of acquiring diagnosed type 2 diabetes over a 10 year time period in an ethnically and socioeconomically diverse population. Design Prospective open cohort study using routinely collected data from 355 general practices in England and Wales to develop the score and from 176 separate practices to validate the score. Participants 2 540 753 patients aged 25-79 in the derivation cohort, who contributed 16 436135 person years of observation and of whom 78 081 had an incident diagnosis of type 2 diabetes; 1 232 832 patients (7 643 037 person years) in the validation cohort, with 37 535 incident cases of type 2 diabetes. Outcome measures A Cox proportional hazards model was used to estimate effects of risk factors in the derivation cohort and to derive a risk equation in men and women. The predictive variables examined and included in the final model were self assigned ethnicity, age, sex, body mass index, smoking status, family history of diabetes, Townsend deprivation score, treated hypertension, cardiovascular disease, and current use of corticosteroids; the outcome of interest was incident diabetes recorded in general practice records. Measures of calibration and discrimination were calculated in the validation cohort. Results A fourfold to fivefold variation in risk of type 2 diabetes existed between different ethnic groups. Compared with the white reference group, the adjusted hazard ratio was 4.07 (95% confidence interval 3.24 to 5.11) for Bangladeshi women, 4.53 (3.67 to 5.59) for Bangladeshi men, 2.15 (1.84 to 2.52) for Pakistani women, and 2.54 (2.20 to 2.93) for Pakistani men. Pakistani and Bangladeshi men had significantly higher hazard ratios than Indian men. Black African men and Chinese women had an increased risk compared with the corresponding white reference group. In the validation dataset, the model explained 51.53% (95% confidence interval 50.90 to 52.16) of the variation in women and 48.16% (47.52 to 48.80) of that in men. The risk score showed good discrimination, with a D statistic of 2.11 (95% confidence interval 2.08 to 2.14) in women and 1.97 (1.95 to 2.00) in men. The model was well calibrated. Conclusions The QDScore is the first risk prediction algorithm to estimate the 10 year risk of diabetes on the basis of a prospective cohort study and including both social deprivation and ethnicity. The algorithm does not need laboratory tests and can be used in clinical settings and also by the public through a simple web calculator (www.qdscore.org). [ABSTRACT FROM AUTHOR]

The status of ethnic minority has been reported to be associated with a tendency toward sedentary behavior. The Guadeloupean population is composed of Afro-Caribbeans and an Asian Indian minority. This study examined the association of ethnicity and physical activity on the island. Energy expenditures (EE), energy intakes (EI), and macronutrient intakes of 122 Guadeloupean workers (60 Indians and 62 controls) were assessed by three consecutive 24-h recalls. Two-way analyses of variance were conducted to test the hypothesis of an effect of ethnicity, taking the potential effect of sex into account, on these variables. Asian Indians reported lower EE ( P=0.011), lower EE/EI ratios ( P=0.001), and lower physical activity ( P=0.003) than their Afro-Carribean counterparts. Their food intakes were not different in terms of EI or macronutrient intake. No sex × ethnicity interactions were significant. The present study reports a tendency toward physical inactivity in Asian Indians of Guadeloupe associated with EI similar to those of controls. Sedentary lifestyles and energetic imbalances are well-documented risk factors for several diseases, including type 2 diabetes and cardiovascular disease, both major public health concerns in Guadeloupe. Strategies to prevent sedentary lifestyles should be considered for Asian Indian Guadeloupeans. [ABSTRACT FROM AUTHOR]

The article presents a post hoc analysis of a study on the metabolic effects of aripiprazole versus olanzapine in racial subgroups with schizophrenia conducted from April 2000 to June 2001. The single greatest predictor of endpoint metabolic syndrome was said to be a baseline diagnosis of metabolic syndrome. There was a significant decline in the odds of such syndrome in aripiprazole treatment compared with olanzapine. It emphasizes the need to mitigate risk due to the propensity of Hispanic patients to develop treatment-emergent metabolic effects.

Background: Differences in prevalence of cardiometabolic risk factors between different ethnic groups are largely unknown. We determined the variation in cardiometabolic risk profile according to ethnicity in a cohort overweight/obese Dutch children. Methods: An oral glucose tolerance test was performed in 516 overweight/obese Dutch children of multi-ethnic origin, attending an obesity out-patient clinic of an urban general hospital (mean age 10.6 ± 3.2; 55.2% boys). Anthropometric parameters and blood samples were collected, and the prevalence of (components of) the metabolic syndrome (MetS) and insulin resistance were determined in each ethnic group. Results: Major ethnic groups were Dutch native (18.4%), Turkish (28.1%), and Moroccan (25.8%). The remaining group (27.7%) consisted of children with other ethnicities. Turkish children had the highest mean standardized BMI compared to Dutch native children (P < 0.05). As compared to Moroccan children, they had a higher prevalence of MetS (22.8% vs. 12.8%), low HDL-cholesterol (37.9% vs. 25.8%), hypertension (29.7% vs. 18.0%) and insulin resistance (54.9% vs. 37.4%, all P < 0.05). Although Turkish children also had higher prevalences of forementioned risk factors than Dutch native children, these differences were not statistically significant. Insulin resistance was associated with MetS in the Turkish and Moroccan subgroup (OR 6.6; 95%CI, 2.4-18.3 and OR 7.0; 95%CI, 2.1-23.1, respectively). Conclusion: In a Dutch cohort of overweight/obese children, Turkish children showed significantly higher prevalences of cardiometabolic risk factors relative to their peers of Moroccan descent. The prospective value of these findings needs to be established as this may warrant the need for differential ethnic-specific preventive measures. [ABSTRACT FROM AUTHOR]

Erectile dysfunction (ED) is a common problem in male patients with heart failure (HF). However, no study was found that estimates the prevalence of ED by US ethnic groups with HF. We conducted an observational, cross-sectional study of patients enrolled in a HF disease management program in two sites Louisiana (N=329; 178 white, 99 black) and Florida (N=52; Hispanic). All male patients with an ejection fraction 40% were included. The Sexual Health Inventory for Men was used to estimate the prevalence of ED. Overall prevalence of ED was 89% and ED severity did not vary by race/ethnic group. Race/ethnic group differences were found for age, New York Heart Association functional classification, and blood pressure. Hispanic patients had the lowest unadjusted and adjusted prevalence rate of ED (81, 85%) compared to Black (90, 95%) and White (91, 92%) patients. There is a high prevalence of ED in Hispanic, Black and White ethnic groups with HF.International Journal of Impotence Research (2008) 20, 507–511; doi:10.1038/ijir.2008.35; published online 14 August 2008 [ABSTRACT FROM AUTHOR]

Objective. The age at manifestation of primary hypolactasia varies between ethnic groups. Many people report experiencing the first symptoms of lactose intolerance at adult age. The purpose of this study was to investigate whether primary hypolactasia can appear after the age of 20 among the Finnish population and to investigate the outcome of different diagnostic methods of lactose maldigestion. Material and methods. Lactose digestion status was assessed by the lactose tolerance test with ethanol (LTTE) in 42 subjects (38-71 years) who reported having gastrointestinal symptoms after the ingestion of 20 g or less of lactose and who were diagnosed as lactose digesters in earlier studies. Thirteen of the study subjects underwent upper gastrointestinal endoscopy, and 35 gave a blood sample for DNA analysis. Results. Only one of the 42 subjects studied had the genotype C/C-13910 indicating hypolactasia. Lactase activity was higher in those with the genotype T/T (69.2 U/g protein) than in those with the heterozygous genotype C/T (36.3 U/g protein) (p=0.017). Conclusions. Although primary hypolactasia normally appears before the age of 20 years, the decline in lactase activity may on rare occasions continue after that age. Genotyping of the C/T-13910 variant was found to be a reliable diagnostic approach in defining the lactase persistence/non-persistence status of the study subjects. [ABSTRACT FROM AUTHOR]

Summary: Racial and ethnic variations in the incidence of IgA nephropathy (IgAN) could imply both genetic and environmental influences that exist in a complex and poorly understood interplay to modify the expression of the IgAN clinical phenotype. Progress in identifying genetic factors that influence either susceptibility to IgAN or its progression has been slow. Recent progress using family based approaches (genome-wide scan for linkage and family based genetic association studies) to study the genetic basis for susceptibility to familial and sporadic IgAN strongly point to clinical and genetic heterogeneity in the entity we presently call IgAN. The inconsistent findings reported from case-control genetic association studies may be explained by new understanding of the haplotype block structure of the human genome. Rapid improvements in available and developing technologies in the postgenomic era are needed and are expected to accelerate progress in understanding genetic factors underlying IgAN. [ABSTRACT FROM AUTHOR]

Objectives: This study estimates the prevalence of heart disease among Arab and Chaldean American women and examines the association between Arab and Chaldean ethnicity and heart disease among a sample of women. Methods: This was a cross-sectional study of a convenience sample of 2084 Arab, Chaldean, and African American women aged ≥18 years who completed a survey that was distributed at churches, mosques, and small businesses in southeast Michigans. Logistic regression was used to estimate odds ratios and 95% confidence intervals for the association between ethnicity and self-reported heart disease before and after adjusting for demographic, socioeconomic status, health care, chronic conditions, and health behavior variables. Participants: A sample of 2084 Arab, Chaldean, and African American women 18 years of age and older. Results: The overall prevalence of heart disease was 5.1%. Estimates~were higher for Arabs (7.1%), lower for Chaldeans (6.6%), and lowest among African Americans (1.8%). In the unadjusted model, Chaldeans and Arabs were four times more likely to have heart disease than were African Americans. However, in the fully adjusted model, the association between Chaldean or Arab ethnicity and heart disease was no longer statistically significant. Conclusions: Arab or Chaldean ethnicity was not significantly associated with self-reported heart disease among women, which suggests that other factors account for this relationship. Future studies should collect more detailed socioeconomic status, acculturation, and health behavior information. [ABSTRACT FROM AUTHOR]