Asian Indian Males Research Articles

Indocyanine green angiography reveals choroidal hypoperfusion in subacute sclerosing panencephalitis (SSPE).

We report the choroidal findings on indocyanine green angiography (ICGA) in two cases of subacute sclerosing panencephalitis (SSPE). The two immunocompetent patients (31-year-old and 30-year-old Asian Indian males) presented with acute-onset rapidly progressing vision loss with findings of necrotizing retinitis involving the central macula. Both patients tested negative for serological evidence of herpes or varicella, and toxoplasma antibodies. The patients demonstrated high serum and cerebrospinal fluid titers of anti-measles antibody (and abnormal electroencephalogram in one patient) leading to the diagnosis of SSPE. ICGA of both patients revealed distinct "dark dots" which showed hypofluorescence in the early and late phases suggestive of choroidal involvement/hypoperfusion. Choroidal involvement in SSPE has not been evaluated before and must be considered in the pathological manifestations of the disease.

Abstract 3943: Refined race and ethnicity categories for an EHR-based cohort to study disparities in liver cancer risk

Abstract Purpose: To develop a schema for harmonized, detailed characterization of race and ethnicity data for an electronic health record (EHR)-based cohort linked to cancer registry data to assess disparities in hepatocellular carcinoma (HCC) risk. Methods: We assembled an cohort of adults with 1+ encounter in 2000-2017 by pooling EHR data from three healthcare systems (Kaiser Permanente Hawai’i, Sutter Health, San Francisco Health Network). EHR data to define sociodemographic and clinical factors were linked to population-based state cancer registries for data on incident HCC (ICD-03 site/histology C22.0/8170-8175) through 2017. We extracted, harmonized and developed schemas to characterize multiple response race and ethnicity data across systems. We used Cox proportional hazards regression to examine disparities in HCC risk across racial and ethnic groups, comparing observations across categorization schema. Results: The cohort included 4,248,553 adults; 2,916 had incident HCC. A race and ethnicity schema that prioritized small populations and disaggregation of heterogenous groups defined 16 categories and was used to analyze pooled data from Kaiser Permanente Hawai’i and Sutter Health. With this schema, we observed variation in HCC risk across ethnic groups that are typically aggregated into larger ethno-racial categories (e.g., Asian American). Compared to non-Hispanic (NH) White males, Vietnamese American males had greater risk of HCC (hazard ratio (HR): 7.42; 95% CI: 4.25, 12.96) as did American Indian/Alaska Native, Black, Chinese American, Hispanic, Native Hawaiian, and Pacific Islander males; Asian Indian, Filipino, Japanese, and Korean American males did not. Among females, every group except American Indian/Alaska Native, Asian Indian American, and Pacific Islander females had greater risk of HCC than the NH White group. Due to less granular data from San Francisco Health Network during our study period, we developed a second, grouped schema aggregating categories from the detailed schema; it resulted in seven race and ethnicity categories and was used to analyze pooled data from all three healthcare systems. Compared to the categorization of race and ethnicity used by the US Census, which also has seven categories, we observed different patterns in HCC risk disparities for the smallest groups (i.e., American Indian/Alaska Native and Native Hawaiian). Conclusions: Analysis of a large EHR-based cohort linked to cancer registry data using a race and ethnicity characterization schema that prioritizes small populations yields valuable knowledge on disparities in HCC risk. Thus, to advance research on health disparities using EHR data, researchers must critically assess racial and ethnic categories typically available from healthcare system data repositories. We offer recommendations to operationalize EHR data on race and ethnicity to facilitate its meaningful use in research. Citation Format: Mindy C. DeRouen, Caroline A. Thompson, Alison J. Canchola, Alyssa Cortella, Pushkar Inamdar, Janet Chu, Sixiang Nie, Mai Vu, Ma Somsouk, Michele M. Tana, Anna D. Rubinsky, Iona Cheng, Mi-Ok KIm, Mark Segal, Chanda Ho, Yihe G. Daida, Su-Ying Liang, Hashem B. El-Serag, Scarlett L. Gomez, Salma Shriff-Marco. Refined race and ethnicity categories for an EHR-based cohort to study disparities in liver cancer risk [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3943.

Understanding the predictive accuracy of the InsuTAG index over other surrogate indices in normoglycaemic, non-obese males from Southern India

We aimed to evaluate the predictive accuracy of InsuTAG index against M value of the hyperinsulinaemic-Euglycaemic clamp (HEC) procedure and fasting surrogate indices of insulin sensitivity/resistance in young, normoglycaemic, Asian Indian males. HEC studies were done in young (mean age 19.7 ± 1 years), non-obese (mean BMI 19.2 ± 2.6 kg/m2), normoglycemic Asian Indian males (n = 110) and the M value was calculated. Surrogate indices namely InsuTAG index, HOMA-IR, FG-IR, QUICKI and McAuley index were calculated. Pearson’s correlation and ROC-AUC at 95% CI were applied. Significant negative correlation was observed for InsuTAG index with the M value (r − 0.23, p = 0.01), McAuley index (r − 0.65, p < 0.01), QUICKI (r − 0.34, p < 0.01) and FGIR (r − 0.35, p < 0.01). Significant positive correlations of InsuTAG index were observed for BMI and waist circumference. The ROC-AUC was higher for InsuTAG index (0.75) than FGIR (0.30), QUICKI (0.31), and McAuley index (0.20). The InsuTAG cut-off value ≥ 19.13 showed 66.7% sensitivity and 69.2% specificity in this study group.

Lipid accumulation product (LAP) as a potential index to predict risk of insulin resistance in young, non-obese Asian Indian males from Southern India: observations from hyperinsulinemic-euglycemic clamp studies

IntroductionWe aimed to compare the predictive accuracy of surrogate indices namely the lipid accumulation product (LAP) index, homeostatic model of assessment of insulin resistance (HOMA-IR), fasting glucose-insulin ratio (FG-IR) and...

The waist-height ratio is a potential anthropometric index of insulin resistance: Observations based on oral glucose tolerance test in lean, normo-glycaemic, Asian Indian males from Southern India

AimsTo correlate the waist-to-height ratio (WHt-R) with Matsuda index of the Oral Glucose Tolerance Test (OGTT) and other surrogate indices of fasting insulin resistance/sensitivity and to derive a cut-off value for the WHt-R in lean, normoglycaemic males from Southern India. MethodsA cohort of 105 lean, normoglycaemic males (mean BMI: 19.2 ± 2.6 kg/m2) underwent OGTT. Surrogate indices of insulin resistance viz, the Homeostatic model assessment of Insulin Resistance (HOMA-IR), the Quantitative Insulin sensitivity Check Index (QUICKI), the Fasting glucose to insulin ratio (FG-IR), the McAuley's index and the Triglyceride/HDL-C ratio were correlated with the Matsuda and the Insulinogenic indices. The cut-off value for WHt-R to predict insulin resistance was obtained using Receiver operating characteristics (ROC) with Area under curve (AUC) at 95% confidence interval (CI). The P value < 0.05 was considered statistically significant. ResultsThe ROC analysis at 95% confidence interval (CI), showed an AUC of 0.58 for the WHt-R cut-off value ≥ 0.39 with 69.4% sensitivity and 57.1% specificity. On pooled ROC analysis, significantly higher AUC was observed for the WHt-R (0.90) when compared to BMI (0.83) and waist-to-hip ratio (0.83). Paired wise comparison analysis of ROC curves revealed significant differences for AUC of WHt-R when compared to waist circumference (p < 0.01), but not for BMI and WHR. ConclusionThe WHt-R can be used as a potential anthropometric index to screen for insulin resistance, when compared to BMI and WC in lean, normoglycaemic males from Southern India.

Significance of single and multi-voxel 1H magnetic resonance spectroscopy in the quantification of myocellular lipid in young non-obese Asian Indian males

To prospectively assess intramyocellular lipids (IMCL) and extramyocellular lipids (EMCL) using single voxel spectroscopy (SVS) and multi voxel magnetic resonance spectroscopy (MVS) in soleus muscle and correlate results with metabolic variables in non-obese (BMI < 23 kg/m2) Asian Indian males. Thirty one patients with diabetes (cases) and twelve normoglycaemic subjects (controls) underwent point resolved spectroscopy sequence (PRESS) of soleus muscle using SVS and MVS in a 3 T MRI scanner. Visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were measured from MRI images and body composition was measured from dual-energy x-ray absorptiometry (DXA). The mean IMCL from SVS and MVS were 1.6% and 2.6% in cases and 2.3% and 3.4% in controls respectively. The mean EMCL from SVS and MVS were 1.8% and 3% in cases and 1.5% and 3% respectively in controls. A significant correlation between IMCL and total fat mass (rho = 0.42, p < 0.01) and total body fat (rho = 0.46; p < 0.01) were observed in cases while using the SVS technique and no correlations were found in the MVS technique. The SVS showed significant correlations between total myocellular lipids with VAT and SAT in cases alone. Total myocellular lipids acquired using both techniques showed a significant correlation with BMI, waist circumference, total fat mass, total body fat and truncal fat in cases alone. Quantification of IMCL of soleus muscle using the SVS technique is useful in studying the relationship with metabolic markers in non-obese Asian Indians with diabetes.

The effect of coffee consumption on insulin sensitivity and other biological risk factors for type 2 diabetes: a randomized placebo-controlled trial

In observational studies, coffee consumption has been consistently associated with a lower risk of type 2 diabetes mellitus. Trials examining the effect of coffee consumption on glucose metabolism have been limited by the use of surrogate insulin sensitivity indices, small sample sizes, lack of blinding, and short follow-up duration. We aimed to overcome limitations of previously conducted coffee trials in a randomized placebo-controlled trial of the effect of coffee consumption on insulin sensitivity. We conducted a 24-wk randomized placebo-controlled trial in 126 overweight, non-insulin sensitive (HOMA-IR≥1.30), Chinese, Malay, and Asian-Indian males and females aged 35-69 y. Participants were randomly assigned to receive 4 cups of instant regular coffee (n=62) or 4 cups of a coffee-like placebo beverage (n =64) per day. The primary outcome was the amount of glucose metabolized per kilogram of body weight per minute (Mbw) assessed during steady-state conditions with a hyperinsulinemic euglycemic clamp. Secondary outcomes included other clamp-based insulin sensitivity measures, biological mediators of insulin sensitivity, and measures of fasting glucose metabolism. Coffee consumption did not significantly change insulin sensitivity compared with placebo (percentage mean difference in Mbw = 4.0%; 95% CI: -8.3, 18.0%; P=0.53). Furthermore, no significant differences in fasting plasma glucose (2.9%; 95% CI: -0.4, 6.3%; P=0.09) or biological mediators of insulin resistance, such as plasma adiponectin (2.3%; 95% CI: -1.4, 6.2%; P=0.22), were observed between coffee and placebo groups over 24 wk of intervention. Participants in the coffee arm experienced a loss of fat mass (FM) (-3.7%; 95% CI: -6.3, -1.1%; P=0.006) and reduction in urinary creatinine concentrations (-21.2%; 95% CI: -31.4, -9.5%; P=0.001) compared with participants in the placebo arm over 24 wk of intervention. Consuming 4 cups/d of caffeinated coffee for 24 wk had no significant effect on insulin sensitivity or biological mediatorsof insulin resistance but was associated with a modest lossofFM and reduction in urinary creatinine concentrations.Thistrial was registered at clinicaltrials.gov as NCT01738399. Registered on November 28, 2012. Trial sponsor: Nestlé Research, Lausanne, Switzerland. Trial site: National University of Singapore.

Orlistat therapy for children with type 1 hyperlipoproteinemia: a randomized clinical trial

Context Patients with type 1 hyperlipoproteinemia (T1HLP), a rare genetic disorder, have extreme chylomicronemia and recurrent episodes of acute pancreatitis. Currently, the only therapeutic option is to consume an extremely low-fat diet because the triglyceride-lowering medications are not efficacious. Objective To determine the efficacy of orlistat, a gastric and pancreatic lipase inhibitor, in reducing serum triglyceride levels in patients with T1HLP. Design and setting We conducted a randomized, open-label, clinical trial with a four-period, two-sequence (orlistat and for 3 months), crossover study design. Patients Two unrelated young Asian Indian males (11 and 9 years old) with T1HLP due to homozygous large GPIHBP1 deletions were enrolled at the UT Southwestern Medical Center. The patients were randomized to receive 3 months of orlistat or no therapy (off), then crossed over to the other arm, and this sequence was then repeated. Fasting serum triglyceride levels, fat-soluble vitamins, and gastrointestinal side effects were assessed. Results Compared with the two off periods, orlistat therapy reduced serum triglycerides by 53.3% and 53.0% in patient 1 and 45.8% and 62.2% in patient 2. There was no deficiency of fat-soluble vitamin levels, and their growth continued. There were no serious adverse effects of orlistat; patient 1 had a mild increase in passage of gas and bloating, and patient 2 had constipation with mild stool leakage. Conclusion Orlistat is safe and highly efficacious in lowering serum triglycerides in children with T1HLP and should be the first-line therapy in conjunction with an extremely low-fat diet.

Allometric scaling of weight to height and resulting body mass index thresholds in two Asian populations

BackgroundBody mass index (BMI) represents a normalization of weight to height and is used to classify adiposity. While the capacity of BMI as an adiposity index has been experimentally validated in Caucasians, but there has been little testing Asian populations.MethodsTo determine whether weight scales to height squared in Asian Indians across the general population and in Asian Indian tribes an allometric analysis on the power law model, W = αHβ, where W is weight (kg) and H is height (m) was performed on cross-sectional weight and height data from India (N = 43,880) collected through the Anthropological Survey of India. The database contained males 18–84 years of age spanning 161 districts of 14 states and including 33 different tribes (N = 5,549). Models were developed that were unadjusted and adjusted for tribe membership. The Korean National Health and Nutrition Examination Survey (KNHANES) was used to compare to height–weight data from the Anthropological Survey of India and to calculate BMI thresholds for obesity status using a receiver operating characteristic.ResultsThe unadjusted power was β = 2.08 (s = 0.02). The power for the general population (non-tribal) was β = 2.11 (s = 0.02). Powers when adjusted for tribe ranged from 1.87 to 2.35 with 24 of the 33 tribes resulting in statistically significant (p < 0.05) differences in powers from the general population. The coefficients of the adjusted terms ranged from −0.22 to 0.26 and therefore the scaling exponent does not deviate far from 2. Thresholds for BMI classification of overweight in the KNHANES database were BMI = 21 kg/m2 (AUC = 0.89) for males 18 kg/m2 (AUC = 0.97) for females. Obesity classification was calculated as BMI = 26 kg/m2 (AUC = 0.81) and 23 kg/m2 (AUC = 0.83) for females.ConclusionsOur study confirms that weight scales to height squared in Asian Indian males even after adjusting for tribe membership. We also demonstrate that optimal BMI thresholds are lower in a Korean population in comparison to currently used BMI thresholds. These results support the application of BMI in Asian populations with potentially lower thresholds.

Bioimpedance analysis with a novel predictive equation - A reliable technique to estimate fat free mass in birth weight based cohorts of Asian Indian males

AimTo validate bioimpedance based predictive equations for fat free mass (FFM) against DEXA and to derive a novel birth weight based predictive equation for FFM in a birth weight based cohort of healthy Asian Indian men. MethodologyWhole body composition was done using DEXA and bioimpedance in 117 young Asian Indian men, born of normal birth weight (n = 59, birth weight ≥2.5 kg) or low birth weight (n = 58, birth weight < 2.5 kg). Predictive accuracy of 11 different bioimpedance based equations for FFM was evaluated using Pearson's correlation analysis and the root of mean squared prediction error (RMSE) analysis. ResultsThe mean FFM (on DEXA) and total lean mass & impedance index (on bioimpedance) were significantly higher in the low birth weight cohort. Significantly higher body fat percentage was noted on bioimpedance, for the normal birth weight cohort, but not on DEXA. In addition, the mean values of predicted FFM were significantly higher in the low birth weight cohort for 9 different predictive equations. Specifically, the mean FFM values obtained using the predictive equations of Schaefer et al., Hoot cooper et al. and Hughes et al. were in close agreement with the actual FFM values on DEXA. A novel predictive equation (CMC equation) for FFM based on birth weight was derived. FFM = 32.637 + (−0.222*age) + (−32.51*waist-to-hip ratio) + (0.33*body mass index) + (1.58 * 1 or 2 (1 = normal birth weight, 2 = low birth weight) + (0.510*waist circumference). ConclusionsOur study findings substantiate the validity of Bio-impedance analysis (BIA) as a reliable and noninvasive tool for estimating body composition measures in birth-weight based cohorts of Asian Indian males. Further, we have devised a novel BIA-based predictive equation that can be useful in larger epidemiological studies to look at alterations in body fat in this cohort.

Differential performance of surrogate indices of fasting insulin resistance in low-birthweight and normal-birth weight cohorts: Observations from Hyperinsulinaemic-Euglycaemic clamp studies in young, Asian Indian males

AimTo evaluate the predictive accuracy of surrogate measures of fasting insulin resistance/sensitivity like the Homeostasis model assessment for insulin resistance (HOMA –IR), Fasting glucose/insulin ratio (FG-IR), Quantitative insulin sensitivity check index (QUICKI), and the 20/fasting C peptide x fasting plasma glucose [20/(FCP × FPG)] index in comparison to M value derived from hyperinsulinaemic-euglycaemic clamp (HEC) studies in two birth weight based cohorts of Asian Indian males. MethodsHEC studies were performed in non-diabetic Asian Indian males (n = 117), born of normal birth weight (n = 59, birth weight > 2.5 kgs) and low birth weight (n = 58, birth weight < 2.5 kgs). Anthropometry and biochemical analysis were done. Surrogate indices of fasting insulin resistance were calculated and data were analysed by Pearson's correlation and Random calibration model analysis. ResultsAmongst surrogate indices of fasting insulin resistance/sensitivity, the mean values for HOMA-IR, QUICKI, FG-IR, 20/(FCP × FPG) index and M value were similar between the two groups. Significant positive correlation was observed for FG-IR and QUICKI with M value (the gold standard measure of insulin sensitivity derived from HEC procedure) in the low birth weight cohort in contrast to the normal birth weight cohort, wherein no significant correlation was observed for any of the indices. Random calibration model analysis showed highest predictive accuracy for QUICKI in both the study groups. ConclusionThe QUICKI index showed highest predictive accuracy in the normal birth weight and the low birth weight cohorts of Asian Indian males.

Alcohol use disorder and risk of sensitization to environmental allergens in Sub-Continental Asian Indian males

Alcohol is known to cause elevation of serum total IgE (tIgE). Whether it can predispose to allergic disorders, however, is not clear. To assess whether alcohol can cause sensitization to allergens, we analyzed 100 individuals with alcohol use disorder (AUD) and 50 matched healthy controls. Serum tIgE and specific IgE against environmental allergens were measured. We found 93% of individuals with AUD had raised tIgE compared to only 48% of healthy controls (p < 0.0001). Sensitization to aeroallergens was noted in 68% drinkers compared to 24% of controls (p < 0.0001). The degree of sensitization was directly proportional to the amount and duration of alcohol intake. There is a possibility of a link between alcohol abuse and allergic sensitization.

Orlistat Therapy for Children With Type 1 Hyperlipoproteinemia: A Randomized Clinical Trial

Patients with type 1 hyperlipoproteinemia (T1HLP), a rare genetic disorder, have extreme chylomicronemia and recurrent episodes of acute pancreatitis. Currently, the only therapeutic option is to consume an extremely low-fat diet because the triglyceride-lowering medications are not efficacious. To determine the efficacy of orlistat, a gastric and pancreatic lipase inhibitor, in reducing serum triglyceride levels in patients with T1HLP. We conducted a randomized, open-label, clinical trial with a four-period, two-sequence ("orlistat" and "off orlistat" for 3 months), crossover study design. Two unrelated young Asian Indian males (11 and 9 years old) with T1HLP due to homozygous large GPIHBP1 deletions were enrolled at the UT Southwestern Medical Center. The patients were randomized to receive 3 months of orlistat or no therapy (off), then crossed over to the other arm, and this sequence was then repeated. Fasting serum triglyceride levels, fat-soluble vitamins, and gastrointestinal side effects were assessed. Compared with the two off periods, orlistat therapy reduced serum triglycerides by 53.3% and 53.0% in patient 1 and 45.8% and 62.2% in patient 2. There was no deficiency of fat-soluble vitamin levels, and their growth continued. There were no serious adverse effects of orlistat; patient 1 had a mild increase in passage of gas and bloating, and patient 2 had constipation with mild stool leakage. Orlistat is safe and highly efficacious in lowering serum triglycerides in children with T1HLP and should be the first-line therapy in conjunction with an extremely low-fat diet.

Abstract 040: The Effects of Coffee Consumption on Insulin Sensitivity and Other Risk Factors for Type 2 Diabetes

Background: In observational studies, coffee consumption has been consistently associated with a lower risk of type 2 diabetes mellitus. Trials examining the effect of coffee consumption on glucose metabolism have been limited by the use of surrogate insulin sensitivity indices, small sample sizes, lack of blinding, and short follow-up duration. We aimed to overcome these limitations in a randomized placebo-controlled trial examining the effects of coffee consumption on insulin sensitivity. Methodology: We conducted a 24-week randomized placebo-controlled trial in 126 overweight, insulin-resistant (HOMA-IR ≥ 1.30), Chinese, Malay and Asian-Indian males and females aged 35-69 years. Participants were randomly assigned to receive 4 cups of instant regular coffee (n=62) or 4 cups of a coffee-like placebo beverage (n=64) per day. The primary outcome was bodyweight-standardized M-value (M bw ) assessed with a hyperinsulinemic euglycemic clamp. Secondary outcomes included other clamp-based insulin sensitivity measures, biological mediators of insulin sensitivity, and measures of fasting glucose metabolism, body weight and composition. Results: Coffee consumption did not significantly change insulin sensitivity as compared with placebo [% mean difference in M bw : 0.3% (95% CI: -12.0% to 14.2%), P =0.97]. Furthermore, no significant differences in fasting plasma glucose [3.0% (-1.1% to 7.3%), P =0.16] or biological mediators of insulin resistance, such as plasma adiponectin [1.5% (-3.4% to 6.6%), P =0.55], were observed between coffee and placebo groups after 24 weeks of intervention. Coffee consumption led to a loss of body weight as compared with placebo [-1.2% (-2.3% to -0.1%), P =0.03] resulting from a decrease in fat mass [-3.7% (-7.1% to -0.2%), P =0.04] . Conclusions: Consuming 4 cups per day of caffeinated coffee for 24 weeks had no significant effect on insulin sensitivity or biological mediators of insulin resistance. Coffee consumption led to a modest decrease in body fat as compared with coffee abstinence. Trial Registration: ClinicalTrials.gov identifier: NCT01738399. Registered on 28 November 2012. Trial Sponsor: Nestlé Research Center, Lausanne, Switzerland. Trial Site: National University of Singapore.

High Plasma Glucagon Levels Correlate with Waist-to-Hip Ratio, Suprailiac Skinfold Thickness, and Deep Subcutaneous Abdominal and Intraperitoneal Adipose Tissue Depots in Nonobese Asian Indian Males with Type 2 Diabetes in North India.

We aimed to correlate plasma glucagon levels with anthropometric measures and abdominal adipose tissue depots. Nonobese males (n = 81; BMI < 25 kg/m2) with T2DM of less than one-year duration and nonobese males without diabetes (n = 30) were evaluated for the following: anthropometry (BMI, waist circumference, W-HR, and truncal skinfolds), whole-body DEXA (for body fat and fat-free mass), and MRI scan (for volumes of subcutaneous abdominal adipose tissue (SCAT) including superficial and deep, intra-abdominal visceral adipose tissue (including intraperitoneal adipose tissue (IPAT), retroperitoneal adipose tissue, liver span and fatty liver, and pancreatic volume)). Plasma glucose and glucagon, serum insulin, hepatic transaminases, and lipid profile were measured. Significantly higher levels of fasting and postprandial glucagon (p < 0.001) and fasting and postprandial insulin (p < 0.001) were seen in patients with T2DM. The mean values of fasting and postprandial plasma glucagon levels were higher in T2DM patients with NAFLD (n = 37) as compared to T2DM patients without NAFLD (n = 44). Four independent predictors were derived for fasting glucagon levels in patients with T2DM, namely, W-HR, suprailiac skinfold thickness, IPAT, and deep SCAT (p < 0.05; r2 = 0.84). These observations in Asian Indians may have significance for diabetes therapies which impact glucagon levels.

Vitamin D-binding protein, vitamin D status and serum bioavailable 25(OH)D of young Asian Indian males working in outdoor and indoor environments.

Urban Asian Indians generally have low serum 25(OH)D. Information on serum bioavailable 25(OH)D and the effect of prolonged sun-exposure in them is not known. We assessed serum 25(OH)D and bioavailable 25(OH)D in males with varying durations of sun-exposure in Delhi during August-September. Serum 25(OH)D, vitamin D-binding protein (DBP), bioavailable 25(OH)D, free 25(OH)D index, iPTH, ionized calcium and sun-index were assessed in outdoor, mixed outdoor-indoor and indoor workers (n=88, 32 and 74, respectively). The mean sun-index (12.0±6.25, 4.3±2.20 and 0.7±0.62, respectively; P<0.001) was highest outdoors and lowest indoors. Serum 25(OH)D (29.0±8.61, 19.1±5.73 and 10.9±4.19ng/ml, respectively; P<0.001), bioavailable 25(OH)D and free 25(OH)D index were maximum in outdoor workers followed by mixed-exposure and indoor workers. Their mean serum DBP levels (241.2±88.77, 239.3±83.40 and 216.6±63.93µg/ml, respectively; P=0.12) were comparable. Mean serum iPTH was significantly lower in outdoor than indoor workers and showed inverse correlations with serum 25(OH)D, bioavailable 25(OH)D and free 25(OH)D index (r=-0.401, -0.269 and -0.236, respectively; P<0.001 in all). Daily dietary-calorie intake was higher and calcium lower in outdoor than indoor workers. On regression analysis, sun-exposure was the only significant variable, increasing serum 25(OH)D by 2.03ng/ml per hour of sun-exposure (95% confidence interval 1.77-2.28; P<0.001). Outdoor workers with prolonged sun-exposure were vitamin D-sufficient, with higher serum bioavailable 25(OH)D than the indoor workers during summer. Use of serum DBP levels did not affect the interpretation of their vitamin D status.

Leading Causes of Death among Asian American Subgroups (2003-2011).

BackgroundOur current understanding of Asian American mortality patterns has been distorted by the historical aggregation of diverse Asian subgroups on death certificates, masking important differences in the leading causes of death across subgroups. In this analysis, we aim to fill an important knowledge gap in Asian American health by reporting leading causes of mortality by disaggregated Asian American subgroups.Methods and FindingsWe examined national mortality records for the six largest Asian subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese) and non-Hispanic Whites (NHWs) from 2003-2011, and ranked the leading causes of death. We calculated all-cause and cause-specific age-adjusted rates, temporal trends with annual percent changes, and rate ratios by race/ethnicity and sex. Rankings revealed that as an aggregated group, cancer was the leading cause of death for Asian Americans. When disaggregated, there was notable heterogeneity. Among women, cancer was the leading cause of death for every group except Asian Indians. In men, cancer was the leading cause of death among Chinese, Korean, and Vietnamese men, while heart disease was the leading cause of death among Asian Indians, Filipino and Japanese men. The proportion of death due to heart disease for Asian Indian males was nearly double that of cancer (31% vs. 18%). Temporal trends showed increased mortality of cancer and diabetes in Asian Indians and Vietnamese; increased stroke mortality in Asian Indians; increased suicide mortality in Koreans; and increased mortality from Alzheimer’s disease for all racial/ethnic groups from 2003-2011. All-cause rate ratios revealed that overall mortality is lower in Asian Americans compared to NHWs.ConclusionsOur findings show heterogeneity in the leading causes of death among Asian American subgroups. Additional research should focus on culturally competent and cost-effective approaches to prevent and treat specific diseases among these growing diverse populations.

Male Attitudes Towards Children, Fatherhood, and Childrearing: A Descriptive Profile from South African Social Attitudes Survey (SASAS)

South African male attitudes towards children, fatherhood and childrearing remain an important topic for research and policy development given concerns about men’s engagement with children and the family. This study utilizes a subsample of males from the national South African Social Attitudes Survey to profile attitudes of males cross analyzed by survey designated racial groups. Results show that males in general, have a positive attitude towards having children and feel that they are not a burden. A greater number of Black African males than the other racial groups believe children are a financial burden and restrict employment choices. Most males believe that men want to have a loving relationship with children and perform best as fathers if married to the mother. The majority of them believe that it is a crisis in the country that many fathers do not co-reside with their children. Consistent across racial groups, most males are split about discipline with half believing in spanking, and that it teaches children right from wrong. Most males believe that it is better to talk to children than spank them. In examining responses to survey questions, Black African males trended away from the prevalent attitudes more than Colored, Asian Indian, and White males. Family service providers can utilize these attitudes of men in planning intervention programs and policy development.

Abstract P157: Leading Causes of Death Among Asian Americans

Background: Asian Americans are one of the fastest growing racial/ethnic groups in the United States (U.S). Our current understanding of Asian American mortality patterns have been distorted by the aggregation of distinct subgroups, which masks the heterogeneity of the leading causes of death among diverse Asian American subgroups. There is currently a knowledge gap on the health of these rapidly expanding populations with little evidence to recommend research agendas, create public health policy, and offer clinical guidelines. In this analysis, we examined the leading causes of death among Asian American subgroups to determine racial/ethnic differences in mortality within the U.S. Methods: We examined national mortality rates for the six largest Asian American subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese) from 2003-2010. U.S. death records from 34 U.S. states and the District of Columbia were used to identify race/ethnicity and cause of death by ICD-10 coding. Standardized mortality ratios (SMR), were calculated for each sex and racial/ethnic group relative to Non-Hispanic Whites (NHW), adjusting for age. Mortality counts were used to rank the top ten causes of death among Asian Americans and the leading causes of death, death counts, and overall death percentage for each Asian American subgroup by sex were determined. Results: We examined 15,943,806 U.S. death records. SMRs were lower for all Asian subgroups compared to NHWs (0.52 female, 0.5 male vs. 1.0 male and female) for all causes of mortality. There was heterogeneity in mortality rates across Asian subgroups. Filipino (0.59) and Japanese men (0.63) and women (0.58) had the highest SMRs compared to other Asian subgroups. Cancer is the leading cause of death for all Asian women (27.6% of all Asian deaths), except Asian Indian women with cardiovascular disease (CVD) as the leading cause of death (28% of all deaths). The leading cause of death varies among Asian subgroups for men. Aggregate data for Asian men indicates cancer as the leading cause of death (27.4% of all Asian deaths), however this is only true for Chinese (31.9%), Korean (33.9%) and Vietnamese men (32.4%). CVD is the leading cause of death for Filipino (28.5%), Japanese (26.5%), and Asian Indian (31.8%) men. Proportions of death among Asian Indian males due to CVD (31.8%) are nearly double that of cancer (17.7%). CVD is the leading cause of death for NHWs (25.9% females, 26.9% males) followed by cancer (21.9% females, 24.9% males). Conclusions: There is significant heterogeneity in mortality patterns among Asian American subgroups. While Asian Americans in general have lower rates of mortality, CVD is an important cause of death for some subgroups. This heterogeneity calls to attention the need for more research in the distinct subgroups to help direct treatment and prevention efforts to reduce health disparities for this rapidly growing population.

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.