Ethnic Differences In Association Research Articles

Social inequalities in pregnancy metabolic profile: findings from the multi-ethnic Born in Bradford cohort study.

Lower socioeconomic position (SEP) associates with adverse pregnancy and perinatal outcomes and with less favourable metabolic profile in nonpregnant adults. Socioeconomic differences in pregnancy metabolic profile are unknown. We investigated association between a composite measure of SEP and pregnancy metabolic profile in White European (WE) and South Asian (SA) women. We included 3,905 WE and 4,404 SA pregnant women from a population-based UK cohort. Latent class analysis was applied to nineteen individual, household, and area-based SEP indicators (collected by questionnaires or linkage to residential address) to derive a composite SEP latent variable. Targeted nuclear magnetic resonance spectroscopy was used to determine 148 metabolic traits from mid-pregnancy serum samples. Associations between SEP and metabolic traits were examined using linear regressions adjusted for gestational age and weighted by latent class probabilities. Five SEP sub-groups were identified and labelled 'Highest SEP' (48% WE and 52% SA), 'High-Medium SEP' (77% and 23%), 'Medium SEP' (56% and 44%) 'Low-Medium SEP' (21% and 79%), and 'Lowest SEP' (52% and 48%). Lower SEP was associated with more adverse levels of 113 metabolic traits, including lower high-density lipoprotein (HDL) and higher triglycerides and very low-density lipoprotein (VLDL) traits. For example, mean standardized difference (95%CI) in concentration of small VLDL particles (vs. Highest SEP) was 0.12 standard deviation (SD) units (0.05 to 0.20) for 'Medium SEP' and 0.25SD (0.18 to 0.32) for 'Lowest SEP'. There was statistical evidence of ethnic differences in associations of SEP with 31 traits, primarily characterised by stronger associations in WE women e.g., mean difference in HDL cholesterol in WE and SA women respectively (vs. Highest-SEP) was -0.30SD (-0.41 to -0.20) and -0.16SD (-0.27 to -0.05) for 'Medium SEP', and -0.62SD (-0.72 to -0.52) and -0.29SD (-0.40 to -0.20) for 'Lowest SEP'. We found widespread socioeconomic differences in metabolic traits in pregnant WE and SA women residing in the UK. Further research is needed to understand whether the socioeconomic differences we observe here reflect pre-conception differences or differences in the metabolic pregnancy response. If replicated, it would be important to explore if these differences contribute to socioeconomic differences in pregnancy outcomes.

Ethnic differences in depression and anxiety among adults with atopic eczema: Population-based matched cohort studies within UK primary care.

Evidence demonstrates that individuals with atopic eczema (eczema) have increased depression and anxiety; however, the role of ethnicity in these associations is poorly understood. We aimed to investigate whether associations between eczema and depression or anxiety differed between adults from white and minority ethnic groups in the UK. We used UK Clinical Practice Research Datalink GOLD to conduct matched cohort studies of adults (≥18years) with ethnicity recorded in primary care electronic health records (April 2006-January 2020). We matched (age, sex, practice) adults with eczema to up to five adults without. We used stratified Cox regression with an interaction between eczema and ethnicity, to estimate hazard ratios (HRs) for associations between eczema and incident depression and anxiety in individuals from white ethnic groups and a pooled minority ethnic group (adults from Black, South Asian, Mixed and Other groups). We identified separate cohorts for depression (215,073 with eczema matched to 646,539 without) and anxiety (242,598 with eczema matched to 774,113 without). After adjusting for matching variables and potential confounders (age, sex, practice, deprivation, calendar period), we found strong evidence (p<0.01) of ethnic differences in associations between eczema and depression (minority ethnic groups: HR=1.33, 95% CI=1.22,1.45; white ethnic groups: HR=1.15, 95% CI=1.12,1.17) and anxiety (minority ethnic groups: HR=1.41, 95% CI=1.28,1.55; white ethnic groups: HR=1.17, 95% CI=1.14,1.19). Adults with eczema from minority ethnic groups appear to be at increased depression and anxiety risk compared with their white counterparts. Culturally adapted mental health promotion and prevention strategies should be considered in individuals with eczema from minority ethnic groups.

Ethnic differences in the relationship between step cadence and physical function in older adults

ABSTRACT This study investigated associations between step cadence and physical function in healthy South Asian (SA) and White European (WE) older adults, aged ≥60. Participants completed the 60-s Sit-to-Stand (STS-60) test of physical function. Free-living stepping was measured using the activPAL3™. Seventy-one WEs (age = 72 ± 5, 53% male) and 33 SAs (age = 71 ± 5, 55% male) were included. WEs scored higher than SAs in the STS-60 (23 vs 20 repetitions, p = 0.045). Compared to WEs, SAs had significantly lower total and brisk (≥100 steps/min) steps (total: 8971 vs 7780 steps/day, p = 0.041; brisk: 5515 vs 3723 steps/day, p = 0.001). In WEs, 1000 brisk steps and each decile higher proportion of steps spent brisk stepping were associated with STS-60 (β = 0.72 95% CI 0.05, 1.38 and β = 1.01 95% CI 0.19, 1.82, respectively), with associations persisting across mean peak 1 min (β = 1.42 95% CI 0.12, 2.71), 30 min (β = 1.71 95% CI 0.22, 3.20), and 60 min (β = 2.16 95% CI 0.62, 3.71) stepping periods. Associations were not observed in SAs. Ethnic differences in associations between ambulation and physical function may exist in older adults which warrant further investigationi.

Early Pregnancy Blood Pressure Patterns Identify Risk of Hypertensive Disorders of Pregnancy Among Racial and Ethnic Groups.

Hypertensive disorders of pregnancy are a leading cause of severe maternal morbidity and mortality and confer 4-fold higher perinatal mortality in Black women. Early pregnancy blood pressure patterns may differentiate risk of hypertensive disorders of pregnancy. This study identified distinct blood pressure trajectories from 0 to 20 weeks' gestation to evaluate subsequent pregnancy-related hypertension in a retrospective cohort of 174 925 women with no prior hypertension or history of preeclampsia, prenatal care entry ≤14 weeks, and a stillborn or live singleton birth delivered at Kaiser Permanente Northern California hospitals in 2009 to 2019. We used electronic health records to obtain clinical outcomes, covariables, and longitudinal outpatient blood pressure measurements ≤20 weeks' gestation (mean 4.1 measurements). Latent class trajectory modeling identified 6 blood pressure groups: ultra-low-declining(referent), low-declining, moderate-fast-decline, low-increasing, moderate-stable, and elevated-stable. Multivariable logistic regression evaluated trajectory group-associations with the odds of preeclampsia/eclampsia and gestational hypertension' and effect modification by race-ethnicity and prepregnancy body size. Compared with ultra-low-declining, adjusted odds ratios (95% confidence intervals [CIs]) for low-increasing, moderate-stable, and elevated-stable groups were 3.25 (2.7-3.9), 5.3 (4.5-6.3), and 9.2 (7.7-11.1) for preeclampsia/eclampsia' and 6.4 (4.9-8.3), 13.6 (10.5-17.7), and 30.2 (23.2-39.4) for gestational hypertension. Race/ethnicity, and prepregnancy obesity modified the trajectory-group associations with preeclampsia/eclampsia (interaction P<0.01), with highest risks for Black, then Hispanic and Asian women for all blood pressure trajectories, and with increasing obesity class. Early pregnancy blood pressure patterns revealed racial and ethnic differences in associations with preeclampsia/eclampsia risk within equivalent levels and patterns. These blood pressure patterns may improve individual risk stratification permitting targeted surveillance and early mitigation strategies.

Abstract 842: Ethnic differences in association of behavioral risk factors with gastric precancerous lesions in Inner Mongolia, China

Abstract Background: The prevalence of Gastric precancerous lesion (GPL) exists ethnic differences, however, little evidence exists to clarify whether preventable behavioral risk factors lead to these differences. Objectives: To investigate the ethnic-difference of associations between GPL and behavioral risk factors in Mongol and Han Chinese population. Methods: The study included participants aged 36-75 years enrolling in the Cancer Screening Program during 2016-2017 from Hohhot and Tongliao City in Inner Mongolia. GPL defined as gastric ulcer, atrophic gastritis, intestinal metaplasia and dysplasia. Results: A total of 61638 participants were included, of whom 6863(11.1%) were Mongolians. The prevalence of GPL for Mongolians (13.6%) was significantly higher than that of Han (10.2%). Compared with Han: (1) Mongolians have significantly higher proportion of alcohol consumption (23.1% vs 18.8%), along with a larger positive association for alcohol consumption with GPL, and a higher population attributable fraction (PAF) (P&amp;lt;0.05); (2) Mongolians have significantly lower proportion of irregular physical activity (60.1% vs 62.3%), but with a larger positive association for irregular physical activity with GPL, and a higher PAF (P&amp;lt;0.05). (3) Mongolians have significantly lower proportion of insufficient vegetables and fruits intake (80.6% vs 82.2%), the significant association for insufficient vegetable and fruit intake with GPL was observed only in Mongolians (P &amp;lt; 0.05). (4) Mongolians have significantly higher proportion of smoking (23.1%), as the association for light smoking with GPL in Mongolians were lower than that in Han, resulting into similar PAF in two population. Conclusion: Mongolians should pay more attention to the intervention of behavioral risk factors. Additionally, the result may also reflect a different GPL pathogenesis in Mongolians. Association between behavioral risk factors and GPL in study populationBehavioral risk factorsExposure ratio (%) (95%CI)P for chi-square testOdd Ratio (95%CI )P for interactionPopulation attributable fraction (95%CI )Smoking (cigarettes/d)&amp;lt;0.01&amp;lt;0.01Han18.8 (18.5, 19.1)46.3 (44.6, 47.8)&amp;lt;104.9 (4.7, 5.1)5.2 (4.7, 5.9)11-207.8 (7.6, 8.0)8.2 (7.5, 9.0)≥216.1 (5.9, 6.3)7.1 (6.4, 7.8)Mongol23.1 (22.1, 24.1)43.4 (39.1, 47.4)&amp;lt;105.9 (5.3, 6.5)3.0 (2.2, 4.0)11-2010.9 (10.2, 11.7)6.2 (5.0, 7.7)≥216.3 (5.7, 6.9)7.0 (5.5, 9.1)Alcohol consumption&amp;lt;0.010.015Han18.8 (18.5, 19.2)5.6 (5.3, 6.0)43.7 (42.1, 45.3)Mongol25.1 (24.0, 26.1)6.9 (5.8, 8.3)53.2 (49.0, 57.0)irregular physical activity0.001&amp;lt;0.01Han62.3 (61.9, 62.7)1.1 (1.0, 1.2)5.6 (1.3, 9.8)Mongol60.1 (59.0, 61.3)2.0 (1.7,2.4)38.8 (30.5, 46.1)Insufficient vegetables and fruits intake0.0010.06Han82.2 (81.9, 82.5)1.0 (0.9,1.1)3.0 (-3.9, 9.5)Mongol80.6 (79.6, 81.5)1.3 (1.0,1.6)18.1 (2.5, 31.1) Citation Format: Weiqi Dong, Liying Qiao, Buqi Na, Weiwei Kang, Shengfeng Wang, Wenrui Wang, Yunfeng Xi. Ethnic differences in association of behavioral risk factors with gastric precancerous lesions in Inner Mongolia, China [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 842.

Ethnic differences in association of outcomes with trimethylamine N-oxide in acute heart failure patients.

AimsThe aim of this study was to investigate whether ethnicity influences the associations between trimethylamine N‐oxide (TMAO) levels and heart failure (HF) outcomes.Methods and resultsTrimethylamine N‐oxide levels were measured in two cohorts with acute HF at two sites. The UK Leicester cohort consisted mainly of Caucasian (n = 842, 77%) and South Asian (n = 129, 12%) patients, whereas patients in the Japanese cohort (n = 116, 11%) were all Japanese. The primary endpoint was the measurement of all‐cause mortality and/or HF rehospitalization within 1 year post‐admission. Association of TMAO levels with outcome was compared in the entire population and between ethnic groups after adjustment for clinical parameters. TMAO levels were significantly higher in Japanese patients [median (interquartile range): 9.9 μM (5.2–22.8)] than in Caucasian [5.9 μM (3.6–10.8)] and South Asian [4.5 μM (3.1–8.4)] (P < 0.001) patients. There were no differences in the rate of mortality and/or HF rehospitalization between the ethnic groups (P = 0.096). Overall, higher TMAO levels showed associations with mortality and/or rehospitalization after adjustment for confounders ( P = 0.002). Despite no differences between ethnicity and association with mortality/HF after adjustment (P = 0.311), only in Caucasian patients were TMAO levels able to stratify for a mortality/HF event (P < 0.001).ConclusionsDifferences were observed in the association of mortality and/or rehospitalization based on circulating TMAO levels. Elevated TMAO levels in Caucasian patients showed increased association with adverse outcomes, but not in non‐Caucasian patients.

Impact of Kidney Function on Cardiovascular Risk and Mortality: A Comparison of South Asian and European Cohorts

Background: Evidence is limited on ethnic differences in associations between kidney function markers and mortality or cardiovascular disease (CVD). Methods: Baseline cross-sectional analysis and longitudinal follow-up study of a UK population-based cohort of 1,116 Europeans and 1,104 South Asians of predominantly Indian descent, age 52 ± 7 years at baseline (1988–1991). Kidney function was estimated using Cystatin C and creatinine-based chronic kidney disease (CKD) Epidemiology Collaboration estimated glomerular filtration rate (eGFR) equations, and urinary albumin-creatinine ratio (ACR). Mortality was captured at 27 years, and incident CVD at 22 years, from death certification, medical records and participant report. Longitudinal associations between eGFR/ACR and mortality/incident CVD were examined using Cox models. Results: eGFR_cys was lower and ACR higher in South Asians than Europeans. eGFR_cys and ­eGFR_creat were more strongly associated with outcomes in Europeans than South Asians. Conversely, associations between ACR and outcomes were greater in South Asians than Europeans, for example, for CVD mortality: HRs (95% CI) adjusted for CVD risk factors and ACR/eGFR_cys as appropriate, p for ethnicity interaction: eGFR_cys: Europeans: 0.76 (0.62–0.92), South Asians: 0.92 (0.78–1.07), p = 0.05, eGFR_creat: Europeans 0.81 (0.67–0.99), South Asians 1.18 (0.97–1.41), p = 0.002, ACR: ­Europeans: 1.24 (1.08–1.42), South Asians: 1.39 (1.25–1.57), p= 0.23. Addition of all CKD measures to a standard CVD risk factor model modestly improved prediction capability in ­Europeans; in South Asians only ACR contributed to improvement. Conclusions: Strong associations between ACR and outcomes in South Asians of predominantly Indian origin, and null associations for eGFR_cys and eGFR_creat, suggest that ACR may have greater utility in CVD risk prediction in South Asians. Further work is needed to validate these ­findings.

Racial and ethnic differences in associations of community violence with self-harm: a population-based case–control study

Racial and ethnic differences in associations of community violence with self-harm: a population-based case–control study

WHITE MATTER VULNERABILITY AND CARDIOVASCULAR RISK IN OLDER HISPANICS/LATINOS: EVIDENCE FOR EARLIER NEURODEGENERATION?

Hispanics 65 years and older are one of the fastest growing minority populations in the US and also one of the most medically underserved. For example, when compared to non-Hispanic whites, Hispanics have higher rates of uncontrolled cardiovascular disease risk factors (CVD-RFs) including hypertension and diabetes and twice the risk of dementia including Alzheimer's disease. Evidence suggests that cardiovascular disease risk factors may contribute to the earlier development of cognitive (i.e., executive functioning and information processing speed) and cerebral white matter alterations (i.e., white matter hyperintensities; WMH) in Hispanics. Overt white matter damage including WMHs may be driven, in part, by alterations in myelin integrity. We quantified myelin integrity using multicomponent relaxometry (MCR) in Hispanics and non-Hispanic Whites to explore for ethnic differences in associations to cardiovascular disease risk factors in these groups. We obtain the risk of stroked based on cardiovascular disease risk factors using the Framingham Stroke Risk Profile Score and acquired MCR data using a 3T GE MRI. 15 Hispanics (x̅age=62.7 years & FSRP=7.5; 66% women) and 15 non-Hispanic Whites (x̅age=69.7 years & FSRP=11.1; 40% women) with documented cardiovascular risk factor burden were compared to a group of 11 non-Hispanic whites (x̅age=71.0 years) without any cardiovascular risk factors. Figure 4 shows comparable differences in myelin degradation between Hispanics (yellow) and non-Hispanic whites (green) despite the fact that Hispanics were significantly younger (mean age=62.7 versus non-Hispanic whites mean age=69.7; p<0.001) with significantly lower cardiovascular disease scores as measured by the Framingham Stroke Risk Profile (FSRP) Score (FSRP=7.5 versus non-Hispanic whites’ mean=11.1; p<0.01). This preliminary study suggests that myelin degradation, associated with even mild vascular disease burden, is detectable using MCR. Furthermore, despite being significantly younger with less stroke risk associated with cardiovascular disease risk factors, Hispanics displayed comparable myelin degradation to older non-Hispanic whites with greater cardiovascular risk. Myelin integrity associated with cardiovascular disease risk burden was greater for Hispanics (yellow) than non-Hispanic whites (green) when compared to healthier controls.

Ethnic differences in association of high body mass index with early onset of Type 1 diabetes - Arab ethnicity as case study.

ObjectiveThe “accelerator hypothesis” predicts early onset of Type 1 diabetes (T1D) in heavier children. Studies testing direction of correlation between body mass index (BMI) and age at onset of T1D in different continental populations have reported differing results–inverse, direct, and neutral. Evaluating the correlation in diverse ethnic populations is required to generalize the accelerator hypothesis.MethodsThe study cohort comprised 474 Kuwaiti children of Arab ethnicity diagnosed with T1D at age 6 to 18 years during 2011–2013. Age- and sex-adjusted BMI z-scores were calculated by comparing the BMI measured at diagnosis with Kuwaiti pediatric population reference data recorded during comparable time-period. Multiple linear regression and Pearson correlation analyses were performed.ResultsBMI z-score was seen inversely associated with onset age (r,-0.28; p-value<0.001). Children with BMI z-score>0 (i.e. BMI >national average) showed a stronger correlation (r,-0.38; p-value<0.001) than those with BMI z-score<0 (r,-0.19; p-value<0.001); the former group showed significantly lower mean onset age than the latter group (9.6±2.4 versus 10.5±2.7; p-value<0.001). Observed inverse correlation was consistent with that seen in Anglo-saxon, central european, caucasian, and white children while inconsistent with that seen in Indian, New Zealander, and Australian children.ConclusionsThe accelerator hypothesis generalizes in Arab pediatric population from Kuwait.

Racial and Ethnic Differences in Socioeconomic Position and Risk of Childhood Acute Lymphoblastic Leukemia.

Racial and ethnic differences in associations between socioeconomic position (SEP) and risk of childhood acute lymphoblastic leukemia (ALL) were investigated using data from population-based cancer registries in the Surveillance, Epidemiology, and End Results Program in the United States. The study included 8,383 ALL cases diagnosed at age ≤19 years in 2000-2010. Census tract-level composite SEP index in quintiles was assigned based on residence at the time of diagnosis. Incidence rate ratios and 95% confidence intervals associated with SEP and race/ethnicity, adjusted for sex, age, and year of diagnosis, were estimated using Poisson regression models. The incidence rate of childhood ALL was negatively associated with SEP among Hispanics but was positively associated among children of other races/ethnicities. As compared with the lowest SEP, the adjusted incidence rate ratios for children with the highest SEP were 1.29 (95% confidence interval (CI): 1.15, 1.44) for non-Hispanic whites, 1.67 (95% CI: 1.20, 2.34) for non-Hispanic blacks, 1.57 (95% CI: 1.17, 2.09) for Asians/Pacific Islanders, 2.33 (95% CI: 0.93, 5.83) for American Indians/Alaska Natives, and 0.70 (95% CI: 0.60, 0.81) for Hispanics. The findings of a reverse association in Hispanics need to be confirmed and further explained in future studies using different measures of SEP.

Ethnic Differences in Association of Vitamin D Levels with Incident Stroke Cases between Ethnic Chinese and South Asians

Ethnic Differences in Association of Vitamin D Levels with Incident Stroke Cases between Ethnic Chinese and South Asians

Racial and ethnic differences in associations between psychological distress and the presence of binge drinking: Results from the California health interview survey

IntroductionRacial and ethnic minorities often suffer from poorer health than Whites given their exposure to more stressors and fewer resources that buffer the effects of stress. Given that alcohol is often consumed to alleviate the negative moods, the present study hypothesized that psychological distress may impact the involvement in binge drinking differently across racial and ethnic groups. MethodsWe used data from the California Health Interview Survey (CHIS) from 2007 to 2012. The sample consisted of 130,556 adults including African Americans (N=6541), Asians (N=13,508), Latinos (N=18,128), and Whites (N=92,379). Binary logistic regression analysis was used with consideration for complex survey design. ResultsThe results indicated that psychological distress was significantly associated with binge drinking across all racial and ethnic groups. However, this association differed by race and ethnicity adjusting for age, gender, marital status, education, poverty, and employment status. The results revealed that psychological distress had the largest effect on binge drinking for Asian Americans, particularly Filipinos and South Asians, compared to Whites. ConclusionsThis study highlights the importance of examining racial and ethnic differences in the impacts of psychological distress on alcohol consumption. Future research is needed to better understand the potential factors that mediate the effects of psychological distress on binge drinking specific to each racial and ethnic group in order to develop culturally sensitive interventions and hence decrease the alcohol-related racial health disparities.

Objectively measured physical activity and sedentary time: cross-sectional and prospective associations with adiposity in the Millennium Cohort Study

ObjectiveTo examine whether physical activity (PA) and sedentary time (ST) in primary school-aged children are associated with adiposity at the start of secondary school, and whether these associations differ by...

Abstract C51: Ethnic differences in the relationship between diabetes, early age adiposity, and mortality among breast cancer survivors: The Breast Cancer Health Disparities Study

Abstract Hispanic women have a high prevalence of type 2 diabetes and obesity. Breast cancer (BC) has become the leading cause of death among Hispanic women. Limited information exists on the relationship between diabetes, obesity, and mortality in Hispanic women diagnosed with BC. In a multicenter study we examined the associations between diabetes, obesity measures and survival outcomes. The study included 1,180 Hispanic and 1,298 non-Hispanic white (NHW) women who were diagnosed with incident invasive BC from the San Francisco Bay Area, New Mexico, Utah, Colorado and Arizona. Adjusted hazard ratios (HR) and 95% confidence intervals (CI) were calculated by Cox proportional hazards regression models. The median follow-up time from BC diagnosis to death was 10.8 years and 267 of 466 deaths that occurred were from BC. Diabetes was significantly associated with BC-specific mortality (HR, 1.63 95% CI 1.08-2.47), with a stronger association among Hispanics (HR, 1.85 95% CI 1.11-3.09) compared to NHWs (HR, 1.33 95% CI 0.67-2.62). Among diabetic Hispanic women with estrogen receptor negative tumors, BC-specific mortality was increased three-fold (HR, 2.93 95% CI 1.09-7.88). In contrast, obesity at age 30 years was positively associated with BC-specific mortality in NHW women after adjusting for diabetes and known prognostic factors (HR, 2.33 95% CI 1.36-3.97, p interaction&amp;lt; 0.05), but not in Hispanics. In conclusion, we observed differences in the prognostic significance of diabetes and obesity by ethnicity among women with BC. Larger prospective studies are needed to evaluate ethnic differences in associations between diabetes and mortality for less common BC subtypes. Citation Format: Avonne E. Connor, Kala Visvanathan, Kathy B. Baumgartner, Richard N. Baumgartner, Stephanie D. Boone, Lisa M. Hines, Anna R, Giuliano, Roger K. Wolff, Esther M. John, Martha L. Slattery. Ethnic differences in the relationship between diabetes, early age adiposity, and mortality among breast cancer survivors: The Breast Cancer Health Disparities Study. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr C51.

Red meat, poultry, and fish intake and breast cancer risk among Hispanic and Non-Hispanic white women: The Breast Cancer Health Disparities Study

There is suggestive but limited evidence for a relationship between meat intake and breast cancer (BC) risk. Few studies included Hispanic women. We investigated the association between meats and fish intake and BC risk among Hispanic and NHW women. The study included NHW (1,982 cases and 2,218 controls) and the US Hispanics (1,777 cases and 2,218 controls) from two population-based case-control studies. Analyses considered menopausal status and percent Native American ancestry. We estimated pooled ORs combining harmonized data from both studies, and study- and race-/ethnicity-specific ORs that were combined using fixed or random effects models, depending on heterogeneity levels. When comparing highest versus lowest tertile of intake, among NHW we observed an association between tuna intake and BC risk (pooled OR 1.25; 95 % CI 1.05-1.50; trend p = 0.006). Among Hispanics, we observed an association between BC risk and processed meat intake (pooled OR 1.42; 95% CI 1.18-1.71; trend p < 0.001), and between white meat (OR 0.80; 95% CI 0.67-0.95; trend p = 0.01) and BC risk, driven by poultry. All these findings were supported by meta-analysis using fixed or random effect models and were restricted to estrogen receptor-positive tumors. Processed meats and poultry were not associated with BC risk among NHW women; red meat and fish were not associated with BC risk in either race/ethnic groups. Our results suggest the presence of ethnic differences in associations between meat and BC risk that may contribute to BC disparities.

Sex and ethnic differences in the associations between lipoprotein(a) and peripheral arterial disease in the Multi-Ethnic Study of Atherosclerosis

Higher lipoprotein(a) [Lp(a)] has been linked with peripheral arterial disease (PAD). Also, elevated Lp(a) serum levels have been observed in women and African Americans (AAs). It remains uncertain if sex and ethnicity modify the association between Lp(a) and PAD. Lp(a) mass concentration was measured with a latex-enhanced turbidimetric immunoassay, from blood collected at baseline clinic visits after a 12-hour fast, in a multiethnic cohort. Also at baseline, the ankle-brachial index was measured. PAD was defined as an ankle-brachial index <1.0. Multivariable logistic regression was used to determine sex and ethnic differences in associations of log-transformed Lp(a) and the presence of PAD. In 4618 participants, the mean age was 62 ± 10 years; Lp(a) mean was 30 ± 32 mg/dL and median (interquartile range) was 18 (8-40 mg/dL); 48% were male; 36% were European American, 29% were AA, 23% were Hispanic American (HA), and 12% were Chinese American; and 11% had PAD. Across all ethnic groups, serum Lp(a) was higher among women compared with men and highest among AAs compared with other ethnicities. After adjustments for traditional cardiovascular disease risk factors (age, sex, ethnicity, hypertension, diabetes, smoking, total cholesterol, and high-density lipoprotein cholesterol) as well as interleukin-6, fibrinogen, D-dimer, and homocysteine levels, one log unit increase in Lp(a) was associated with greater odds for PAD (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.01-1.25). In fully adjusted models, significant gender(∗)ln[Lp(a)] and ethnicity(∗)ln[Lp(a)] interactions were observed (P = .08 for both). The association between higher Lp(a) and PAD was strongest in HA men (OR, 1.73; 95% CI, 1.07-2.80) and HA women (OR, 1.49; 95% CI, 1.07-2.08). Nonsignificant associations were observed for European American, AA, and Chinese American men and women. We observed a significant and independent association between elevated Lp(a) and PAD only among HA women and men, despite higher serum Lp(a) levels among AAs. Future studies are needed to determine the role that lowering of Lp(a) may have on the burden of PAD in HAs.

Ethnic Differences in Associations Between Blood Pressure and Stroke in South Asian and European Men.

It is unknown whether associations between blood pressure (BP) and stroke vary between Europeans and South Asians, despite higher stroke rates in the latter. We report findings from a UK cohort study of 1375 European and 1074 South Asian men, not receiving antihypertensive medication, aged 40 to 69 years at baseline (1988-1991). Assessment included BP, blood tests, anthropometry, and questionnaires. Incident stroke was established at 20 years from death certification, hospital and primary care records, and participant report. South Asians had higher systolic BP, diastolic BP, and mean arterial pressure than Europeans, and similar pulse pressure. Associations between systolic BP or diastolic BP and stroke were stronger in South Asians than Europeans, after adjustment for age, smoking status, waist/hip ratio, total/high-density lipoprotein-cholesterol ratio, diabetes mellitus, fasting glucose, physical activity, and heart rate (systolic BP: Europeans [odds ratio, 1.22; 95% confidence interval, 0.98-1.51], South Asians [1.56; 1.24-1.95]; ethnic difference P=0.04; diastolic BP: Europeans [0.90; 0.71-1.13], South Asians [1.68; 1.32-2.15]; P<0.001). Hemodynamic correlates of stroke risk differed by ethnicity: in combined models, mean arterial pressure but not pulse pressure was detrimentally associated with stroke in South Asians, whereas the converse was true for Europeans. The combination of hyperglycemia and hypertension appeared particularly detrimental for South Asians. There are marked ethnic differences in associations between BP parameters and stroke. Undue focus on systolic BP for risk prediction, and current age and treatment thresholds may be inappropriate for individuals of South Asian ancestry.

Ethnic differences in associations between fat deposition and incident diabetes and underlying mechanisms: the SABRE study.

ObjectiveTo examine ethnic differences in ectopic fat and associations with incident diabetes.MethodsIn a UK cohort study, 1338 Europeans, 838 South Asians, and 330 African Caribbeans living in London were aged 40-69 years at baseline. Baseline assessment included blood tests, anthropometry, and questionnaires. Anthropometry-based prediction equations estimated baseline visceral adipose tissue (VAT). Incident diabetes was ascertained from record review, self-report, or oral glucose tolerance testing.ResultsSouth Asians had more and African Caribbeans less estimated VAT than Europeans. Both ethnic minorities had larger truncal skinfolds than Europeans. In men, adjustment for risk factors (BMI, smoking, systolic blood pressure, and HDL-cholesterol) markedly attenuated the association between estimated VAT and diabetes in Europeans (standardized subhazard ratios [95% CI]: from 1.74 [1.49, 2.03] to 1.16 [0.77, 1.76]) and African Caribbeans (1.72 [1.26, 2.35] to 1.44 [0.69, 3.02]) but not South Asians (1.60 [1.38, 1.86] to 1.90 [1.37, 2.64]). In women, attenuation was observed only for South Asians (1.80 [1.01, 3.23] to 1.07 [0.49, 2.31]). Associations between truncal skinfolds and diabetes appeared less affected by multivariable adjustment in South Asians and African Caribbeans than Europeans (1.24 [0.97, 1.57] and 1.28 [0.89, 1.82] versus 1.02 [0.77, 1.36] in men; 1.91 [1.03, 3.56] and 1.42 [0.86, 2.34] versus 1.23 [0.74, 2.05] in women).ConclusionsDifferences in overall truncal fat, as well as VAT, may contribute to the excess of diabetes in South Asian and African Caribbean groups, particularly for women.

Abstract T P151: Ethnic Differences in Associations Between Short-Term Exposures to Ambient Air Pollution and the Risk of Acute Ischemic Stroke

Background: Air pollution may contribute to ethnic differences in stroke risk, but little research has been conducted in diverse US populations. We investigated the association between daily changes in ambient pollution (PM2.5 and ozone (O3)) and the risk of ischemic stroke among individuals living in a biethnic community and whether the association differed by ethnicity. Methods: We identified incident ischemic stroke cases from the population-based Brain Attack Surveillance in Corpus Christi (BASIC) project between 2000 and 2012. Air pollutant data were obtained from a state website. The association between average daily levels of PM2.5 and O3, measured on the same-day and lags of 1-3 days, and odds of ischemic stroke was assessed using a time-stratified case-crossover study design. We explored race/ethnicity of Mexican American (MA) and non-Hispanic white (NHW) as an interaction of the associations between air pollution and stroke. Results: There were 2,948 ischemic strokes during the study period. Median age was 71 years (interquartile range: 59-80); 51% were women and 56% were MA. In models combining ethnic groups, an association between lag 1 O3 and stroke was found (OR: 1.05, 95% CI: 1.00-1.10); no other significant associations were noted. Ethnic differences in the associations between PM2.5 and O3 with stroke were suggested (Figure). When stratified by ethnicity, increases in O3 were consistently associated with increased odds of stroke for NHWs, but not for MAs. Increases in same-day PM2.5 were marginally associated with increases in the odds of stroke in MAs (OR: 1.12, 95% CI: 0.98-1.27), but not for NHWs. Conclusion: We observed an association between previous-day O3 and ischemic stroke, but found little evidence of an association between PM2.5 and ischemic stroke. Ethnic differences in the associations with both O3 and PM2.5 and stroke were also noted, suggesting that further study of environmental influences on stroke in diverse populations is warranted.