Asian-Pacific Population Research Articles

Growth differentiation factor-15 and metabolic features in chronic heart failure: Insights from the SUPPORT Trial -GDF15 across the BMI spectrum

BackgroundGDF15 plays pivotal metabolic roles in nutritional stress and serves as a physiological regulator of energy balance. However, the patterns of GDF15 levels in underweight or obese patients with chronic heart failure (CHF) are not well-understood. MethodsWe assessed serum GDF15 levels at baseline and 3 years and the temporal changes in 940 Japanese patients (642 paired samples), as a sub-analysis of the SUPPORT trial (age 65.9 ± 10.1 years). The GDF15 levels were analyzed across BMI groups (underweight [<18.5 kg/m2; n = 50], healthy weight [18.5–22.9; n = 27 5], overweight [23–24.9; n = 234], and obese [≥25; n = 381]), following WHO recommendations for the Asian-Pacific population. Landmark analysis at 3 years assessed the association between GDF15 levels and HF hospitalization or all-cause death. ResultsCompared to the healthy weight group, the underweight group included more females (54.0%) with advanced HF (NYHA class III; 20.0%) and exhibited increased GDF15 level (1764 pg/mL [IQR 1067-2633]). Obese patients, younger (64.2 years) and diabetic (53%), had a similar GDF15 level to the healthy weight group. A higher baseline GDF15 level was associated with worse outcomes across the BMI spectrum. GDF15 increased by 208 [21–596] pg/mL over 3 years, with the most substantial increase observed in the underweight group (by +28.9% [6.2–81.0]). Persistently high GDF15 levels (≥1800 pg/mL) was independently associated with worse outcomes after 3 years (adjusted HR 1.8 [95%CI 1.1–2.9]). ConclusionsIn underweight patients with CHF, GDF15 level was elevated at baseline and experienced the most significant increase over 3 years. Its consistent elevation suggested a worse outcome.

Total Wrist Replacement Outcomes in the Asian Pacific Population - A Single-Centre Result.

Background: Total wrist replacement (TWR) is rarely done in the Asia-Pacific region. The aim of this study is to report the surgical outcomes and experience of TWR in patients with advanced arthritis. Methods: This is a retrospective review of all TWR patients in the Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Hong Kong, which is a university tertiary centre, from January 2004 to March 2023. Recorded demographic parameters include gender, age upon surgery, pathology, types of implants and follow-up period. The surgical outcome parameters include range of motion, grip strength, wrist function assessment, radiological and clinical complications and any related secondary operations. Postoperative X-ray and clinical notes were reviewed. All wrist function assessments were performed by specialised occupational therapists according to protocol. Results: The study included a total of 12 wrists of 10 patients, all Chinese-Asian, with a mean age of 61.4 years at surgery. Larsen grade V arthritis constituted 50% and grade IV 16.7% of the patients, amongst which 33% had volar subluxation. The mean follow-up period was 97.4 months (21-205 months). The mean grip strength was 64.2% of the unaffected side. The mean postoperative Disabilities of Arm, Shoulder and Hand (DASH) score was 41.12% and patient-rated wrist/hand evaluation (PRWE) score 18.0. Complication incidence was 16.67% for loosening, 8.3% for metallosis and 8.3% for infection. One patient required conversion to total wrist arthrodesis due to metallosis. No patient suffered from dislocation, periprosthetic fracture and infection. Conclusions: TWR is an effective and safe alternative to total wrist arthrodesis with comparable outcomes. Our series outcomes are satisfactory and in line with literature. With meticulous soft tissue release and balancing, volar subluxation can also be corrected and may not be a contraindication. Level of Evidence: Level IV (Therapeutic).

Prognostic significance of growth differentiation factor-15 across the BMI spectrum in patients with chronic heart failure: Insights from the SUPPORT trial

Abstract Background Obesity is a risk factor for cardiovascular diseases including heart failure (HF), yet patients with obesity have better outcomes than their leaner counterparts in HF (i.e. the obesity paradox). We sought to investigate whether growth differentiation factor-15 (GDF15), an emerging biomarker in HF reflecting inflammation and oxidative stress, is a prognostic indicator across the body mass index (BMI) spectrum in chronic heart failure (CHF). Methods Serum levels of GDF15 and its prognostic significance across BMI were examined in a total of 1,040 Japanese patients with CHF enrolled in a randomized clinical trial of the SUPPORT trial (supplemental benefit of an angiotensin receptor blocker in hypertensive patients with stable heart failure using olmesartan) (mean age 66.0±9.9 years, 26% female). Patients were categorized into four groups: underweight (BMI &amp;lt;18.5 kg/m2; n = 56), normal (BMI 18.5-22.9; n = 304), overweight (BMI 23-24.9; n = 257), and obese (BMI ≥25; n = 423) defined based on the WHO recommendation for Asian-Pacific population. Results The underweight group consisted of older patients with a higher prevalence of NYHA class III and reduced left ventricular ejection fraction (LVEF) compared to obese patients (mean age 69.0 vs 64.7 years, NYHA class III 17.9 vs 5.9%, and mean LVEF 49.3 vs 55.5%; all p&amp;lt;0.05). Median GDF15 level in the underweight group was higher (1,864 pg/mL [IQR 1,070-2,626]) but was similar in overweight and obese groups (1,285 [953, 1772] and 1,220 [888-1,789], respectively) compared to normal BMI group (1,276 [879-2,018]). During follow-up (median 10.3 years), 540 composite events of HF hospitalization or all-cause death occurred. The risk was higher in the underweight group (adjusted HR 1.8, 95%CI [1.3-2.5]) and lower in the obesity group (adjusted HR 0.8 [95% CI 0.6-0.9]) compared to the normal BMI group. An increased GDF15 incurred a consistently higher risk from underweight to obese groups; per unit increase in logGDF15 (pg/mL) was associated with 4.1, 2.4, 1.7 and 2.4 times higher risk, respectively. The optimal cut-off point for discriminating those with and without the composite events was 1,343 pg/mL in overall patients. This cut-off value performed well as a prognostic indicator across the continuous BMI spectrum including those with higher BMI (Figure). Conclusions The prognostic significance of GDF15 persisted across the BMI spectrum in patients with CHF. GDF15 may be useful for providing prognostic information across patients with a diverse range of BMI even in those with modest outcomes.HF events in high GDF15 across BMI

Trends in State-Level Maternal Mortality by Racial and Ethnic Group in the United States

Evidence suggests that maternal mortality has been increasing in the US. Comprehensive estimates do not exist. Long-term trends in maternal mortality ratios (MMRs) for all states by racial and ethnic groups were estimated. To quantify trends in MMRs (maternal deaths per 100 000 live births) by state for 5 mutually exclusive racial and ethnic groups using a bayesian extension of the generalized linear model network. Observational study using vital registration and census data from 1999 to 2019 in the US. Pregnant or recently pregnant individuals aged 10 to 54 years were included. MMRs. In 2019, MMRs in most states were higher among American Indian and Alaska Native and Black populations than among Asian, Native Hawaiian, or Other Pacific Islander; Hispanic; and White populations. Between 1999 and 2019, observed median state MMRs increased from 14.0 (IQR, 5.7-23.9) to 49.2 (IQR, 14.4-88.0) among the American Indian and Alaska Native population, 26.7 (IQR, 18.3-32.9) to 55.4 (IQR, 31.6-74.5) among the Black population, 9.6 (IQR, 5.7-12.6) to 20.9 (IQR, 12.1-32.8) among the Asian, Native Hawaiian, or Other Pacific Islander population, 9.6 (IQR, 6.9-11.6) to 19.1 (IQR, 11.6-24.9) among the Hispanic population, and 9.4 (IQR, 7.4-11.4) to 26.3 (IQR, 20.3-33.3) among the White population. In each year between 1999 and 2019, the Black population had the highest median state MMR. The American Indian and Alaska Native population had the largest increases in median state MMRs between 1999 and 2019. Since 1999, the median of state MMRs has increased for all racial and ethnic groups in the US and the American Indian and Alaska Native; Asian, Native Hawaiian, or Other Pacific Islander; and Black populations each observed their highest median state MMRs in 2019. While maternal mortality remains unacceptably high among all racial and ethnic groups in the US, American Indian and Alaska Native and Black individuals are at increased risk, particularly in several states where these inequities had not been previously highlighted. Median state MMRs for the American Indian and Alaska Native and Asian, Native Hawaiian, or Other Pacific Islander populations continue to increase, even after the adoption of a pregnancy checkbox on death certificates. Median state MMR for the Black population remains the highest in the US. Comprehensive mortality surveillance for all states via vital registration identifies states and racial and ethnic groups with the greatest potential to improve maternal mortality. Maternal mortality persists as a source of worsening disparities in many US states and prevention efforts during this study period appear to have had a limited impact in addressing this health crisis.

IGlarLixi provides a higher derived time-in-range versus insulin glargine 100 U/mL or lixisenatide in Asian Pacific people with type 2 diabetes: A post hoc analysis.

To evaluate the efficacy of iGlarLixi in Asian Pacific (AP) population with type 2 diabetes (T2D) using derived time-in-ranges calculated from seven-point self-measured blood glucose. Two phase III trials were analyzed. LixiLan-O-AP was performed in insulin-naive T2D patients (n=878) randomized to iGlarLixi, glargine 100 units/mL (iGlar), or lixisenatide (Lixi). LixiLan-L-CN was performed in insulin-treated T2D patients (n=426) randomized to iGlarLixi or iGlar. Changes in derived time-in-ranges from baseline to end-of-treatment (EOT) and estimated treatment differences (ETDs) were analyzed. The proportions of patients achieving ≥70% derived time-in-range (dTIR), ≥5% dTIR improvement, and the composite triple target (≥70% dTIR, <4% derived time-below-the-range [dTBR], and <25% derived time-above-the-range [dTAR]) were calculated. The changes from baseline to EOT in dTIR with iGlarLixi were greater versus iGlar (ETD1 : 11.45% [95% CI, 7.66 to 15.24]) or Lixi (ETD2 : 20.54% [95% CI, 15.74 to 25.33]) in LixiLan-O-AP, and versus iGlar (ETD: 16.59% [95% CI, 12.09 to 21.08]) in LixiLan-L-CN. In LixiLan-O-AP, the proportions of patients achieving ≥70% dTIR or ≥5% dTIR improvement at EOT with iGlarLixi were 77.5% and 77.8%, respectively, higher than with iGlar (61.1% and 75.3%) or Lixi (47.0% and 53.0%). In LixiLan-L-CN, the proportions of patients achieving ≥70% dTIR or ≥5% dTIR improvement at EOT were 71.4% and 59.8% with iGlarLixi, greater than with iGlar (45.4% and 39.5%). More patients achieved the triple target with iGlarLixi compared with iGlar or Lixi. iGlarLixi achieved greater improvements in dTIR parameters vs. iGlar or Lixi in insulin-naïve and insulin-experienced AP people with T2D. This article is protected by copyright. All rights reserved.

Morphometric study of tibial condylar area in Rajasthan population

Background: Indians are the part of Asian-pacific population and they have a smaller build and stature in comparison of western population. The prosthesis for knee replacement surgeries which are presently being used are best suited for the western population therefore leading to implant size incompatibility with the resected bony surfaces. Aim of the study: To perform morphometric study of tibial condylar area in Rajasthan population. Materials and methods: The present study was conducted in the Department of Anatomy, S.M.S. Medical College, Jaipur. The study period was from approval of plan till 15th December 2019. The study is a descriptive type of observational study. 120 dry tibiae (60 right sided and 60 left sided) were required as sample size. The ethical clearance for the study was approved from the ethical committee of the hospital. Results: The mean AP diameter of the total tibial condyle was 45.28±2.93 mm on the right side and 44.68±4.29 mm on the left side and the total mean AP diameter of total tibial condyle was 44.98±3.67 mm. The difference in the mean AP diameter values between right and left side was found to be statistically not significant.

Off-the-Shelf, Immune-Compatible Human Embryonic Stem Cells Generated Via CRISPR-Mediated Genome Editing

Human embryonic stem cells (hESCs) hold promise in regenerative medicine but allogeneic immune rejections caused by highly polymorphic human leukocyte antigens (HLAs) remain a barrier to their clinical applications. Here, we used a CRISPR/Cas9-mediated HLA-editing strategy to generate a variety of HLA homozygous-like hESC lines from pre-established hESC lines. We edited four pre-established HLA-heterozygous hESC lines and created a mini library of 14 HLA-edited hESC lines in which single HLA-A and HLA-B alleles and both HLA-DR alleles are disrupted. The HLA-edited hESC derivatives elicited both low T cell- and low NK cell-mediated immune responses. Our library would cover about 40% of the Asian-Pacific population. We estimate that HLA-editing of only 19 pre-established hESC lines would give rise to 46 different hESC lines to cover 90% of the Asian-Pacific population. This study offers an opportunity to generate an off-the-shelf HLA-compatible hESC bank, available for immune-compatible cell transplantation, without embryo destruction.Graphical

Off-the-Shelf, Immune-Compatible Human Embryonic Stem Cells Generated Via CRISPR-Mediated Genome Editing

Human embryonic stem cells (hESCs) hold promise in regenerative medicine but allogeneic immune rejections caused by highly polymorphic human leukocyte antigens (HLAs) remain a barrier to their clinical applications. Here, we used a CRISPR/Cas9-mediated HLA-editing strategy to generate a variety of HLA homozygous-like hESC lines from pre-established hESC lines. We edited four pre-established HLA-heterozygous hESC lines and created a mini library of 14 HLA-edited hESC lines in which single HLA-A and HLA-B alleles and both HLA-DR alleles are disrupted. The HLA-edited hESC derivatives elicited both low T cell- and low NK cell-mediated immune responses. Our library would cover about 40% of the Asian-Pacific population. We estimate that HLA-editing of only 19 pre-established hESC lines would give rise to 46 different hESC lines to cover 90% of the Asian-Pacific population. This study offers an opportunity to generate an off-the-shelf HLA-compatible hESC bank, available for immune-compatible cell transplantation, without embryo destruction.

Effect of obesity on cardiometabolic risk factors in Asian Indians

ObjectivesTo determine the prevalence of overweight and obesity and their effects on cardiometabolic risk factors in a representative sample of urban population in Eastern India. Materials and methodsA population-based survey was conducted among a randomly selected study population aged 20–80 years in an urban population of Berhampur city of Eastern India. Both anthropometric and biochemical information were collected, in addition to detailed information on classical cardiometabolic risk factors. Both descriptive and inferential statistical analyses were performed. Obesity and overweight were defined based on the revised Asian–Pacific population criteria (Body mass index [BMI] ≥25 kg/m2 and ≥23 kg/m2, respectively). ResultsThe age-standardized rates of obesity and overweight are 36.8% (Males: 33.2%; Females: 40.8%) and 17.6%, (Males: 20.4%; Females: 15.1%) respectively, i.e., over half are either obese or overweight in this study population. Compared to the World Health Organization (WHO) standard cutoff criteria of overweight [BMI ≥25 kg/m2] and obesity [BMI >30 kg/m2], the cardiometabolic risk factors studied showed a significant incremental rise even with the lower cutoffs of the revised Asia–Pacific criteria. Older age, female gender, family history of diabetes, being hypertensive, hypertriglyceridemia, hypercholesterolemia, physical inactivity and middle to higher socioeconomic status significantly contributed to increased obesity risk among this urban population. ConclusionOne-third of the urban populations are obese in Eastern India – an underestimate compared to the standard BMI cutoff criteria. Nevertheless, significant associations of the classical cardiometabolic risk factors with obesity were observed using the revised Asia–Pacific criteria clearly indicating a more aggressive cardiovascular prevention strategy for Asian Indians.

Los primeros pobladores de América y sus relaciones con poblaciones del Océano Pacífico según los genes HLA

HLA allele frequencies were compared with those of other First American Natives and also those of other worldwide populations in order to clarify the still unclear peopling of the Americas and the origins of Amerindians. All possible HLA data already obtained on early Native American populations are used. Genetic distances and N-J dendrogram methods are applied. Results and discussion have led to the following conclusions: 1) North West Canadian Athabaskans have had gene flow with close neighbouring populations, Amerindians, Pacific Islanders, including East Australians, and Siberians, since they share DRB1-DQB1 haplotypes with these populations (i.e.: DRB1*14:01-DQB1*05:03, DRB1*09:01-DQB1*03:03); 2) Amerindians entrance to America may have been different to that of Athabaskans, Aleuts and Eskimos; Amerindians may have been in their lands long before Athabaskans and Eskimos as they present an altogether different set of HLA-DRB1 allele frequencies; 3) Amerindians show very few “particular” single-locus alleles (i.e.: DRB1*04:11, DRB1*04:17), but have unique extended haplotypes (i.e.: A*02-B*35-DRB1*04:07-DQB1*03:02, A*02-B*35-DRB1*08:02-DQB1*04:02); 4) Our results do not support the three-wave model of American peopling but another model, where the Pacific Coast is also an entrance point. Pacific Ocean sea voyages may have contributed to the HLA genetic American profile. Reverse migration (America to Asia) is not discarded, and different movements of people in either direction in different times are supported by the Athabaskan population admixture with Asian-Pacific population and with Amerindians.

Nasal allergies in the Asian-Pacific population: Results from the Allergies in Asia-Pacific Survey.

The Allergies in Asia-Pacific Survey describes the symptoms, impact, and treatment of allergic rhinitis (AR) across Australia, China, Hong Kong, Malaysia, Singapore, Taiwan, Vietnam, and the Philippines. The Allergies in Asia-Pacific Survey was undertaken to further clarify the prevalence of physician-diagnosed nasal allergies (NAs), impact on quality-of-life (QOL), existing treatment paradigms and gaps, and NA medications currently used in treatment. Thirty-three thousand three hundred seventy-eight households were screened for individuals, ≥4 years old, with a physician diagnosis of AR or NA and either symptoms or treatment in the past 12 months. Standardized questionnaires were used to make comparisons across regions. A total of 1043 adults and 192 children were included in the survey. Nine percent of participants were diagnosed with AR with two of three responding that their NAs were seasonal in nature. Nasal congestion was the most common and bothersome symptom of AR. Most participants reported that AR impacted their QOL with nearly one-half citing impairments in school/work performance/productivity. Sleep disturbances, secondary to AR, were also shown to be appreciable. Two-thirds of patients took medication for their AR. Less than one-quarter of survey respondents reported taking an intranasal corticosteroid and the satisfaction rate was similar to that of over-the-counter medications. The most common reasons cited for dissatisfaction were related to inadequate efficacy and bothersome side effects. AR appears to be extremely common across Asia-Pacific nations. Many individuals with AR suffer from symptoms that reduce QOL and treatment gaps exist with current therapies. Through identification of disease impact and highlighting treatment gaps, clinicians may better understand and treat AR, leading to improvements in overall patient satisfaction and QOL.

Nasal allergies in the Asian-Pacific population: Results from the Allergies in Asia-Pacific Survey

Nasal allergies in the Asian-Pacific population: Results from the Allergies in Asia-Pacific Survey

Body Mass Index, Initial Neurological Severity and Long-Term Mortality in Ischemic Stroke

Background: Obesity is believed to increase the risks of ischemic stroke or coronary heart disease; however, regarding outcome after established vascular diseases, recent unexpected evidence has suggested that an increased body mass index (BMI) might have beneficial effects (obesity paradox). The aim of this study was to evaluate the independent association between BMI and long-term mortality after ischemic stroke. Methods: A total of 1,592 consecutive patients with ischemic stroke were prospectively included through our stroke cohort. In this study, the levels of BMI were classified based on guidelines for the Asian-Pacific population. Initial neurological severity was estimated by the National Institutes of Health Stroke Scale (NIHSS) score. Information on mortality was collected until the end of 2009, and the median follow-up period was 4 years. To examine the association between BMI and long-term mortality, we used Cox’s proportional regression analysis. Results: During follow-up, 23% of patients died. Linear regression analysis showed that the level of BMI was inversely related to initial neurological severity (p = 0.002). In the model of adjustment of age and gender using Cox’s proportional regression analysis, this inverse trend was also significant (reference, normal weight; hazard ratio of underweight, 2.45; overweight, 0.77; obesity, 0.60). However, after adjustment of all covariates, including initial neurological severity, only the harmful effect of underweight remained significant (2.79; 95% CI, 1.92–4.05); however, beneficial effects of overweight and obesity did not. Conclusion: Our study showed that an independent association between BMI and long-term mortality after ischemic stroke was found only in underweight patients. The obesity paradox phenomenon seems to be limited, and might not be interpreted as a direct causal relationship due to a strong association with initial neurological severity.

Original Synthetic Report: The peopling of the Americas: a complex issue for Amerindian, Na-Dene, Aleut and Eskimo first inhabitants

Aim: To compare the Amerindians HLA allele frequencies with those of other First American Natives and also those of other worldwide populations in order to clarify the still unclear peopling of the Americas and the origins of Amerindians. Subjects and methods: All possible HLA data already obtained about early Native American populations are used. Genetic distances and N-J dendrogram method are applied. Results and conclusions: Results and discussion have given to the following conclusions: 1) Pacific Ocean boat trips may have contributed to the HLA genetic American profile (or vice versa); 2) North West Canadian Athabaskans have had gene flow with close neighboring populations, Amerindians, Pacific Islanders including East Australians, and Siberians; 3) Amerindians entrance to America may have been different to that of Athabaskans, Aleuts and Eskimos; Amerindians may have been in their lands long before Athabaskans and Eskimos because they present and altogether different set of HLA-DRB1 allele frequencies; 4) Amerindians show very few ―particular‖ single-locus alleles, but have unique extended haplotypes; 5) Our results do not support the three-wave model of American peopling, but another model where the Pacific Coast is also an entrance point. Reverse migration (America to Asia) is not discarded and different movements of people in either direction in different times are supported by the Athabaskan population admixture with Asian-Pacific population and with Amerindians. Key words: Aleuts, Amerindians, Athabaskans, Eskimo, HLA, peopling of America.

The Origin of Amerindians and the Peopling of the Americas According to HLA Genes: Admixture with Asian and Pacific People

The classical three-waves theory of American peopling through Beringia was based on a mixed anthropological and linguistic methodology. The use of mtDNA, Y chromosome and other DNA markers offers different results according to the different markers and methodologies chosen by different authors. At present, the peopling of Americas remains uncertain, regarding: time of population, number of peopling waves and place of peopling entrance among other related issues. In the present review, we have gathered most available HLA data already obtained about First Native American populations, which raise some doubts about the classical three waves of American peopling hypothesis. In summary, our conclusions are: 1) North West Canadian Athabaskans have had gene flow with: a) close neighboring populations, b) Amerindians, c) Pacific Islanders including East Australians and d) Siberians; 2) Beringia was probably not the only entrance of people to America: Pacific Ocean boat trips may have contributed to the HLA genetic American profile (or the opposite could also be true); 3) Amerindians entrance to America may have been different to that of Athabaskans and Eskimos and Amerindians may have been in their lands long before Athabaskans and Eskimos because they present and altogether different set of HLA-DRB1 allele frequencies; 4) Amerindians show very few “particular alleles”, almost all are shared with other Amerindians, Athabaskans and Pacific Islanders, including East Australians and Siberians; 5) Our results do not support the three waves model of American peopling, but another model where the people entrance is not only Beringia, but also Pacific Coast. Reverse migration (America to Asia) is not discarded and different movements of people in either direction in different times are supported by the Athabaskan population admixture with Asian-Pacific population and with Amerindians, 6) HLA variability is more common than allele veriability in Amerindians. Finally, it is shown that gene genealogy analises should be completed with allele frequency analyses in population relatednes and migrations studies.

Prevalence and factor analysis of metabolic syndrome in an urban Korean population.

The aim of this study was to explore the prevalence and pattern of the metabolic syndrome and its association with hyperinsulinemia in an urban Korean population of 269 men and 505 women. The National Cholesterol Education Program Adult Treatment Panel (ATP) III guidelines were used to calculate the sex-specific prevalence of the metabolic syndrome. After excluding individuals taking medication for hypertension, diabetes, or dyslipidemia, we used factor analysis to examine the pattern of the metabolic syndrome in 206 men and 449 women. The prevalence of metabolic syndrome was 16.0% in men and 10.7% in women aged 30-80 years. However, ATP III criteria for central obesity are not optimal for an Asian-Pacific population; when waist circumference is reduced from 102 to 90 cm in men and 88 to 80 cm in women, the prevalence of the metabolic syndrome increased to 29.0 and 16.8%, respectively. Sex-specific factor analysis showed four factors in men (obesity, glucose intolerance, hypertension, and dyslipidemia) and three in women (obesity-hypertension, glucose intolerance, and obesity-dyslipidemia). Insulin resistance estimated from fasting insulin levels clustered with three of the four factors in men and two of the three factors in women. By ATP III or Asian-Pacific waist circumference criteria, the prevalence of the metabolic syndrome increased with increasing tertiles of insulin resistance, which was estimated by a homeostasis model assessment. The metabolic syndrome is common in an urban Korean population when using Asian-Pacific waist criteria. The prevalence of the metabolic syndrome increased with increasing tertiles of insulin resistance.

Anthropometry of the proximal tibia to design a total knee prosthesis for the Japanese population

Anthropometric data on proximal tibiae of 100 knees in 80 Japanese patients undergoing total knee arthroplasty were obtained. Anterior-posterior (AP) and medial-lateral (ML) lengths of the tibia were measured on computed tomography scans and intraoperatively on tibial resection surfaces. A special small component is unnecessary, and size variation should focus on ML length of 65 to 75 mm because this includes 90% of women's knees. AP-to-ML ratio had a negative correlation with ML length, indicating that small knees were longer in the AP direction. Most prostheses had AP mismatch up to 5 mm for small women's knees. These data could provide the basis for designing the optimal tibial component for most of the Asian-Pacific population. Copyright 2002, Elsevier Science (USA). All rights reserved.

Recounting the wages of self-appraised sinfulness: a research note on divorce, cohabitation, and guilt

This study examines the conditional effects of self-appraised sinfulness for divorce and cohabitation on feelings of guilt among Guam's predominantly Roman Catholic, Asian-Pacific population. Self-appraised sinfulness is a form of stigma resulting from one's internalization of religious doctrine and also indicates the strength of an individual's theological belief. Due to Guam's apparent acceptance of cohabitation and the non-acceptance of divorce by the Catholic Church, we predicted that the effects of sinful self-appraisal would result in greater feelings of guilt for divorced respondents and significantly lower feelings of guilt for cohabiting respondents. Our tests supported our predictions. The implications of our findings for theory and future research are also discussed.

Anthropometric measurements to design total knee prostheses for the Indian population

An anthropometric computed tomography scan study was undertaken to design femoral components in 86 knees (47 osteoarthritic Indians—21 men, 26 women) who matched standards suggested by the Indian Council of Medical Research 1990. Patients were classified into 3 random groups based on anteroposterior diameter (<55 mm, 55–59 mm, >59 mm). Most Indian men (86.8%) could have the femoral component satisfactorily replaced by available designs. A statistically significant number of women (60.4%, P < .001) had femoral anteroposterior diameters smaller than the smallest available (55 mm) femoral component. Splaying in mediolateral dimension (> 10 mm) in a given anteroposterior size was noted in all 3 groups. This pilot study representative of the Indian population can be used to manufacture prosthetic inventories suitable for most of the Asian-Pacific population having smaller anthropometric measurements than Western populations.

Cigarette smoking among Vietnamese immigrants in California.

In the 18 years since 1975, more than 600,000 Vietnamese have arrived in the United States from Vietnam. Census figures for 1990 show that Vietnamese are the fastest-growing Asian/Pacific Islander ethnic group in the United States, with a growth rate of 135% in the decade since 1980.1 Population projections show that by 2030 they will vie with Filipinos to be the largest Asian-Pacific Islander population in the country. 2 In previous research conducted in 1987, we found a high cigarette-smoking prevalence rate of 56% among Vietnamese men. ~ Concern about this high prevalence led us to develop and evaluate an antitobacco program targeting this population in the San Francisco Bay area, To assess preintervention baseline smoking behavior, we conducted a survey of Vietnamese in the San Francisco/Oakland (intervention) and Los Angeles (control) areas in the spring of 1989. This article reports the survey results.