Asian Indian Groups Research Articles

The Association Between Body Composition, 25(OH)D, and PTH and Bone Mineral Density in Black African and Asian Indian Population Groups

There are few data on the contribution of body composition to bone mineral density (BMD) in non-Caucasian populations. We therefore studied the contribution of body composition, and possible confounding of 25-hydroxyvitamin D and PTH, to BMD at various skeletal sites in black African (BA) and Asian Indian (AI) subjects. This was a cross-sectional study in Johannesburg, South Africa. BMD, body fat, and lean mass were measured using dual x-ray absorptiometry and abdominal fat distribution by ultrasound in 714 healthy subjects, aged 18-65 years. Whole-body (subtotal), hip, femoral neck, and lumbar spine (lumbar) BMD were significantly higher in BA than AI subjects (P < .001 for all). Whole-body lean mass positively associated with BMD at all sites in both ethnic groups (P < .001 for all) and partially explained the higher BMD in BA females compared with AI females. Whole-body fat mass correlated positively with lumbar BMD in BA (P = .001) and inversely with subtotal BMD in AI subjects (P < .0001). Visceral adiposity correlated inversely with subtotal BMD in the BA (P = .037) and with lumbar BMD in the AI group (P = .005). No association was found between serum 25-hydroxyvitamin D and BMD. PTH was inversely associated with hip BMD in the BA group (P = .01) and with subtotal (P = .002), hip (P = .001), and femoral BMD (P < .0001) in the AI group. Significant differences in whole-body and site-specific BMD between the BA and AI groups were observed, with lean mass the major contributor to BMD at all sites in both groups. The contribution of other components of body composition differed by site and ethnic group.

Racial-ethnic differences in stroke risk factors and subtypes: results of a prospective hospital-based registry

A majority of stroke research in the United States focuses on Caucasian and African-American populations, limiting the amount of comparative stroke data available on other racial and ethnic groups. The purpose of this research was to examine differences in stroke risk factors/subtypes between minority stroke patient groups in the United States (Asian-Indian, African-American, and Hispanic), using a Caucasian reference group. All patients had a comprehensive stroke work-up to ascertain their stroke risk factors and their stroke etiology applying TOAST criteria. Minority groups were younger compared with the white stroke patients, with the mean age significantly lower in the Asian-Indian and the Hispanic groups. The male:female ratio favored males in the Asian-Indian and Hispanic subgroups and females in the Caucasian and African-American groups. Diabetes was more prevalent in the minority subgroups, with a highest prevalence (55%) noted in the Asian-Indian group. The minority groups had lower prevalence of atrial fibrillation, carotid stenosis (≥70%), CAD, PVD, smoking, and alcohol use. The Asian-Indian stroke group had a higher median fasting plasma homocysteine level compared with the reference white group (12.1 vs. 10.4, p = 0.002). Compared to the reference white stroke group, the Asian-Indian stroke group had fewer strokes related to cardioembolism (7% vs. 25%) and a higher number of strokes related to small vessel occlusive disease (25% vs. 11%). There are some similarities in the stroke risk factors between the minority stroke groups, but the data indicate that there are different trends in stroke risk factors and subtypes.

Deprivation and ethnicity impact on diabetes control and use of treatment regimen

Deprivation and/or ethnicity impact on care delivery. We have assessed how these factors influence diabetes care in a paediatric clinic. We related access to care [type of insulin treatment regimen-twice daily, multiple daily injections and insulin pump therapy (continuous subcutaneous insulin infusion)], measures of care process (HbA(1c)) and an approximate measure of satisfaction with the service (clinic attendance rate) in 325 (170 male) children and young people with Type 1 diabetes (mean age 10.6 years, mean duration of diabetes of 4.5 years), with indices of deprivation and ethnicity. Of the 325 children and young people, 2.7% received twice-daily insulin, 48.4% multiple daily injections and 48.9% continuous subcutaneous insulin infusion. Median clinic HbA(1c) was 62 mmol/mol (7.8%) and those receiving the insulin pump therapy had the lowest HbA(1c). Four ethnic groups were represented; White British 81.6%, Asian non-Indian 6.5%, African 8.1% and Asian Indian 3.8%. Mean deprivation score was 21.06. White British and Asian Indian groups were more likely to receive insulin pump therapy (χ(2) = 50.3; P < 0.001). Attendance rates were 94.1% and did not differ across ethnic groups. Deprivation was related to ethnicity and HbA(1c) (R(2) = 0.02; P = 0.02). There was no relationship between clinic attendance and deprivation. Insulin regimen and ethnicity were associated with HbA(1c) (R(2) = 0.096; P < 0.001). Similar findings were obtained when analysis was confined to the White British population. These data suggest that deprivation and ethnicity influence diabetes control and how intensive insulin therapy is utilized. A better consideration of the needs of different ethnic groups is required to ensure equitable care delivery in paediatric diabetes.

Economic Assimilation of Asian Indians in the United States: Evidence from the 1990s

Although Asian Indians constitute one of the largest and fastest-growing immigrant groups in the United States, there has been no systematic examination of their economic performance. This paper studies the relative wage convergence of Asian Indians in the United States, using the 5/100 1990 and 2000 US Censuses. Results from cross-sectional and cohort analyses indicate that, although the recent-arrival cohort of Asian Indian males and females face a wage penalty relative to native-born non-Hispanic whites, there is significant growth in their wages over the decade, suggesting strong economic assimilation. However, overall, the group is not able to reach wage parity with comparable native-born whites even after residing in the country for 20 years. These results are in line with the existing evidence on post-1965 immigrants in the United States. Furthermore, results indicate that Asian Indians experience greater wage assimilation compared with Other Asians, and within the Asian Indian group, females experience greater economic assimilation compared with males.

Abstract 2661: Unique Attributes Of Asian-Indian Stroke/Transient Ischemic Attack (TIA) Patients: Results of a Prospective Multi-ethnic Hospital-based Registry

Introduction: The New Jersey Neuroscience Institute (NJNSI) serves the Middlesex County, NJ which, has a population of 750,000 (68.4% white, 7.3% Asian-Indian, 9.1% African-American, 15.2% others; 13.6% Hispanic of any race, based on 2000 US Census). This prospective multi-ethnic hospital-based registry provides a unique opportunity to study Asian-Indian stroke/TIA patients. Hypothesis: There are differences of stroke risk factors/subtypes between Asian-Indian and Caucasian stroke/TIA patient groups, in light of similar differences noted in the African-American and Hispanic groups individually in relation to the Caucasian group. Methods: Between 1998 and 2009, data on stroke risk factors and stroke subtypes were collected on 1100 consecutive stroke/TIA patients (1037 or 94.3% non-Hispanic; 63 or 5.7% Hispanic) admitted to the NJNSI. Of the non-Hispanics, 768 (74.1%) were Caucasian, 99 (9.6%) Asian-Indian, 139 (13.4%) African-American, 31 (3.0%) were others. Stroke risk factors assessed included age, gender, hypertension, diabetes, atrial fibrillation evaluated by 48-hour Holter monitor, hyperlipidemia evaluated by fasting lipid profile, prevalent coronary artery disease, smoking history, alcohol use, carotid stenosis (&gt;70%) evaluated by duplex ultrasound, fasting homocysteine level and stroke subtypes (using TOAST classification). Asian-Indians, African-American and Hispanic groups were individually compared with the Caucasian group (control) in this study using odds ratio (OR) analyses and X2 test for categorical variables and t-test for continuous variables. Results: The Asian-Indian group was younger (66±12 vs 72±14, p &lt;0.001), higher proportion of males (OR 2.1, p=0.001) and diabetes (OR 2.3, p&lt; 0.001); lower proportion of atrial fibrillation (OR 0.2, p&lt;0.001), smokers (OR 0.3, p&lt;0.001), Alcohol users (OR 0.4, p=0.003) and higher fasting plasma homocysteine level (17.2±20.3 vs 11.9±7.4, p=0.002). There were fewer strokes related to cardioembolism (OR 0.2, p&lt;0.0001) and a higher number of strokes related to small vessel occlusive disease (OR 2.4, p = 0.001). The African-American group had lower proportion of carotid stenosis (OR 0.5, p=0.007) and atrial fibrillation (OR 0.6, p=0.034). African-American group had higher levels of fasting triglyceride level (Median 92 vs 122 mg/dL). The Hispanic group resembled the Asian-Indian group in that they were younger (64±16 vs 72±14, p&lt; 0.001), had a higher proportion of diabetes (OR 1.7, p=0.039), lower proportion of atrial fibrillation (OR 0.5, p=0.037) than the Caucasian group. Conclusions: The Asian-Indian stroke/TIA group in this community has unique attributes in respect to stroke risk factors and stroke subtype. There are few similarities in the stroke risk factors with the Hispanic stroke/TIA group.

Qatari and Indian Asians Type 2 Diabetes in the State of Qatar; IntraCellular Cations and Ultra Structural Study of Platelets

Diabetes mellitus is one of the main causes of cardiovascular diseases in Qatar and platelets play a key role in these events.The aims of this project is to study ultrastructural changes in diabetic platelets, intraplatelets concentration of Ca and Mg and their relation to insulin, and to investigate if there are any racial differences associated with platelets abnormalities. Diabetic groups included 34 Qatari (Q) and 32 Asian Indian (AI). Control groups included 21 (Q) and 13 (AI). The results indicated that intraplatelet Ca was significantly higher in both diabetic (Q &amp; AI) groups compared to corresponding controls (Q; 0.134 ± 0.0728 vs. 0.097 ± 0.034, p&lt; 0.05) and (AI; 0.179 ± 0.0738 vs. 0.117 ± 0.0854, p&lt; 0.01). Comparing to control; a significant decrease in Mg level for the Qatari diabetics (7.4 ± 4.4 vs. 14.4 ± 6.1, p&lt; 0.05) associated with a significant decrease in the insulin level for the same group (26.1 ± 18.2 vs. 21.8 ± 19.6, p&lt; 0.05). The MPV showed significant increase in diabetic groups compared to the controls with (Q; 8.4 ± 1.1 vs. 7.8 ± 0.6, p&lt; 0.05) and (AI; 8.8 ± 0.6 vs. 7.7 ± 0.3, p&lt; 0.05), and a significant increase in (AI) diabetics compared to (Q) diabetics p&lt; 0.05. Abnormal structural characteristics were seen under TEM in both diabetic groups Q &amp; AI with clear evidence of microthrombus in the AI group. This may explain the higher incidence of CV events among the Asian Indians diabetics compared to the other ethnic groups.This project was funded by QU&amp;UREP.

Effect of pioglitazone on insulin sensitivity, vascular function and cardiovascular inflammatory markers in insulin‐resistant non‐diabetic Asian Indians

To determine the effects of pioglitazone (30 mg once daily for 16 weeks) on insulin sensitivity, insulin-mediated vasodilation, vascular inflammatory markers, fat distribution and lipids in Asian Indians and Caucasians of European ancestry. Cross-sectional study. Eighteen non-diabetic Asian Indians and 17 Caucasians of comparable age (34 +/- 3 vs. 36 +/- 3 years) and body mass index (26.0 +/- 1.2 vs. 24.7 +/- 1.0 kg/m(2)) had measurements of insulin sensitivity (M, insulin clamp at 6 pmol/kg per min), abdominal fat (computed tomographic scan at L4-L5), endothelial-dependent (reactive hyperaemia, RH) and -independent (0.4 mg sublingual nitroglycerin, TNG) vasodilation using brachial artery ultrasound before and after the 2-h clamp at baseline and after pioglitazone therapy. Asian Indians were insulin resistant compared with Causasians during the baseline clamp (M = 25.6 +/- 1.7 vs. 41.1 +/- 2.2 micromol/kg per min, P < 0.0001) and improved significantly after pioglitazone (to 33.9 +/- 1.7 micromol/kg per min, P < 0.001). Vasodilatory responses to RH and TNG were similar in Asian Indians and Caucasians at baseline and did not change. Insulin-mediated vasodilation improved after pioglitazone in Asian Indians, but not in Caucasians, and correlated with the change in insulin sensitivity (r = 0.52, P = 0.03). C-reactive protein (CRP) was higher in Asian Indians vs. Caucasians (1.6 +/- 0.4 vs. 0.9 +/- 0.2 mg/l) and was negatively correlated with insulin sensitivity (r = -0.53, P = 0.02). In the Asian Indian group, CRP and plasminogen activator inhibitor-1 decreased and adiponectin increased after pioglitazone, but there were no significant changes in total or visceral fat. These results demonstrate that insulin-resistant Asian Indians respond favourably to an insulin sensitizer with improvements in insulin sensitivity, cardiovascular and inflammatory risk markers, and vascular responses to insulin. These agents may have a role in decreasing the risk of diabetes and cardiovascular disease in this high-risk population.

An Integrative Review on Breast Cancer Screening Practice and Correlates Among Chinese, Korean, Filipino, and Asian Indian American Women

Breast cancer is the leading cancer diagnosed among Chinese, Filipino, and Korean women. Despite the efficacy of breast cancer screening, Asian American women have one of the lowest rates of mammography and clinical breast exam (CBE) of all U.S. ethnic groups. I provided a systematic overview to document factors related to three modalities of breast cancer screening (breast self-exam [BSE], CBE, and mammography) among four subgroups of Asian American women (i.e., Chinese, Korean, Filipino, and Asian Indian). Results showed that the existing studies provided evidence of demographic correlates to screening practice; however, fewer studies focused on cognitive and social–cultural correlates, and limited results were available with Filipino and Asian Indian groups.

High‐Density Lipoprotein Subclass Distribution in Individuals of Asian Indian Descent: The National Asian Indian Heart Disease Project

Individuals of Asian Indian descent have significantly higher cardiovascular event rates as compared with other ethnic groups. The authors investigated the prevalence of metabolic disorders linked to coronary artery disease in an Asian Indian male population compared with non-Asian Indian males. Standard lipid measurements did not discriminate between groups, and the Asian Indian group exhibited less of the high coronary artery disease risk small low-density lipoprotein trait. Despite less of the small low-density lipoprotein trait in the Asian Indian group and no difference in high-density lipoprotein cholesterol, the Asian Indian group had a significantly higher prevalence (p < 0.0002) of low high-density lipoprotein 2b, implying impaired reverse cholesterol transport. This observation remained significant in the subgroup of patients with high-density lipoprotein cholesterol over 40 mg/dL, a region felt not to reflect impaired reverse cholesterol transport. Low high-density lipoprotein 2b combined with the higher lipoprotein(a) in the Asian Indian group may help explain the high prevalence of coronary artery disease in this ethnic population.

Indian Agarwal megalencephalic leukodystrophy with cysts is caused by a common MLC1 mutation

To the Editor: In a recent article, Gorospe et al.1 describe the occurrence of a leukoencephalopathy, commonly called megalencephalic leukoencephalopathy with subcortical cysts (MLC), in an Asian-Indian group, the Agarwals. They describe the clinical and MRI findings in the patients and report on the founder mutation in the MLC1 gene, responsible for the disease in this community, which is an insertion of a cytosine-residue (C-residue) in a stretch of six C-residues in exon 2. The authors refer to …

Evaluation of Lp[a] and other independent risk factors for CHD in Asian Indians and their USA counterparts

Conventional risk factors for coronary heart disease (CHD) do not completely account for the observed increase in premature CHD in people from the Indian subcontinent or for Asian Indians who have immigrated to the USA. The objective of this study was to determine the effect of immigration to the USA on plasma levels of lipoprotein [a] (Lp[a]) and other independent risk factors for CHD in Asian Indians. Three subject groups were studied: group 1, 57 subjects living in India and diagnosed with CHD (CHD patients); group 2, 46 subjects living in India and showing no symptoms of CHD (control subjects); group 3, 206 Asian Indians living in the USA. Fasting blood samples were drawn to determine plasma levels of triglyceride (TG), total cholesterol (TC), low density lipoprotein [LDL cholesterol (LDL-Chol)], high density lipoprotein [HDL cholesterol (HDL-Chol)], apolipoprotein B-100 (apoB-100), and Lp[a]. Apolipoprotein [a] (apo[a]) size polymorphism was determined by immunoblotting. Plasma TG, apoB-100, and Lp[a] concentrations were higher in CHD patients than in control and USA groups. CHD patients had higher levels of TC and LDL-Chol and lower HDL-Chol than control subjects. However, the USA population had higher levels of TC, LDL-Chol, and apoB-100 and lower HDL-Chol than control subjects. Plasma Lp[a] levels were inversely correlated with the relative molecular weight of the more abundant of each subject's two apo[a] isoforms (MAI), and CHD patients showed higher frequencies of lower relative molecular weights among MAI. Our observed changes in lipid profiles suggest that immigrating to the USA may place Asian Indians at increased risk for CHD. This study suggests that elevated plasma Lp[a] confers genetic predisposition to CHD in Asian Indians, and nutritional and environmental factors further increase the risk of CHD. This is the first report implicating MAI size as a predictor for development of premature CHD in Asian Indians. Including plasma Lp[a] concentration and apo[a] phenotype in screening procedures may permit early detection and preventive treatment of CHD in this population.

Ethnic variation in frequency of an allelic polymorphism of human Fcγ RIIA determined with allele specific oligonucleotide probes

We have genotyped 53 individuals from three ethnic groups (Japanese, Chinese, Asian Indian) for an allotypic polymorphism of a widely expressed low affinity Fc receptor for IgG (FcγRIIA). The method, requiring PCR amplification of genomic DNA and Southern analysis with allele specific oligonucleotide probes, detects a single nucleotide difference (G or A) at base 494 which results in an arginine (R) or histidine (H) at amino acid 131 of the FcγRIIA protein. This polymorphism has been shown to determine the affinity of the receptor for hIgG2; FcγRIIA-H131 has a high affinity for hIgG2, while FcγRIIA-R131 binds hIgG2 weakly. We found that the Japanese and Chinese groups have an increased frequency of the H/H131 allotype (61 and 50% respectively) as compared to the Caucasian group (23%), in agreement with previously reported phenotype data. The genotype distribution of the Asian Indian group was not different from our Caucasian group. The shifts in frequency of the R131 and H131 alleles in different populations may have implications for disease susceptibility when the hIgG2 antibody isotype predominates.

Allelic variation adjacent to the human insulin and apolipoprotein C-II genes in different ethnic groups

We have used DNA probes for the human insulin gene and apolipoprotein C-II (apo C-II) gene to determine the extent of allelic variation in different ethnic groups. The distribution of an apo C-II DNA polymorphism revealed by the restriction endonuclease Taq I showed no significant variation amongst racial groups; in contrast, an insulin gene-related DNA polymorphism showed marked variability. In Japanese, Chinese, and Asian Indian groups there was an increased frequency of homozygosity for the class 1 allele compared to Caucasian groups (P less than 0.001, P less than 0.01, and P less than 0.05, respectively). In Caucasian, Japanese, Chinese, and Asian Indian groups no class 2 allele was observed; but in the Negroid populations (African and West Indian) the class 2 allele frequencies were 0.23 and 0.25 respectively. Possible reasons for this variation in allele distribution are considered in relation to disease associations.