Ethnic Differences In Prevalence Research Articles

Trends and disparities in prevalence of cardiometabolic diseases by food security status in the United States

BackgroundPrevious studies have demonstrated the association between food security and cardiometabolic diseases (CMDs), yet none have investigated trends in prevalence of CMDs by food security status in the United States (US).MethodsSerial cross-sectional analysis of the US nationally representative data from National Health and Nutrition Examination Survey (1999–2018) was conducted among adults aged 20 years or older. Food security status was defined by the US Household Food Security Survey Module (full, marginal, low, and very low food security). We estimated the age-adjusted prevalence of CMDs including obesity, hypertension, diabetes, and coronary heart disease by food security status. Racial and ethnic disparities in age-adjusted prevalence of CMDs by food security status were also assessed.ResultsA total of 49,738 participants were included in this analysis (weighted mean age 47.3 years; 51.3% women). From 1999 to 2018, the age-adjusted prevalence of CMDs was lower in full food secure group as compared with other groups. For example, trends in hypertension decreased from 49.7% (47.5-51.8%) to 45.9% (43.8-48.0%) (P-trend = 0.002) among the full and from 54.2% (49.9-58.5%) to 49.7% (46.8-52.6%) (P-trend = 0.02) among the marginal but remained stable among the low at 49.7% (47.9-51.6%) and among the very low at 51.1% (48.9-53.3%) (P-interaction = 0.02). Prevalence of diabetes increased from 8.85% (8.15-9.60%) to 12.2% (11.1-13.5%) among the full (P-trend < 0.001), from 16.5% (13.2-20.4%) to 20.9% (18.6-23.5%) (P-trend = 0.045) among the marginal and from 14.6% (11.1-19.0%) to 20.9% (18.8-23.3%) (P-trend = 0.001) among the low but remained stable at 18.8% (17.0-20.9) among the very low (P-trend = 0.35) (P-interaction = 0.03). Racial and ethnic differences in prevalence of CMD by food security status were observed. For example, among individuals with full food secure status, the prevalence of diabetes was 9.08% (95% CI, 8.60-9.59%) for non-Hispanic whites, 17.3% (95% CI, 16.4-18.2%) for non-Hispanic blacks, 16.1% (95% CI, 15.0-17.4%) for Hispanics and 14.9% (95% CI, 13.3-16.7%) for others.Conclusions and relevancePrevalence of CMDs was greatest among those experiencing food insecurity, and food insecurity disproportionately affected racial/ethnic minorities. Disparities in CMD prevalence by food security status persisted or worsened, especially among racial/ethnic minorities.

Pelvic girdle pain in pregnancy and early postpartum – prevalence and risk factors in a multi-ethnic cohort

BackgroundPelvic girdle pain (PGP) is common during and after pregnancy. It has been assumed that Scandinavian women report more PGP than women of other ethnicities. However, there are few population-based studies on ethnic differences and few with ethnicity as risk factor for PGP. The purposes of the present study were: To examine the prevalence of self-reported PGP through pregnancy and early postpartum in a multi-ethnic cohort. To investigate how ethnicity and patient characteristics were associated with risk of PGP during pregnancy and early postpartum. To investigate if clinical and personal factors obtained in gestation week (GW) 15 were associated with PGP in GW28 and postpartum week (PPW) 14.MethodsThis study analyzed questionnaire data from 823 women from the Stork - Groruddalen mult-iethnic cohort study in Norway. Chi-square tests were used to investigate ethnic differences in prevalence of self-reported PGP, and logistic regression analyses to identify factors associated with self-reported PGP.ResultsWomen from South-Asia and Middle East reported 10-20% higher prevalence of self-reported PGP at all time points compared with Western women. Ethnicity was associated with PGP in GW15 and PPW14, adjusted for parity. Pain locations in pelvic area (PGP locations) in GW15, especially combined symphysis and posterior PGP, gave the highest risk (OR=7.4) for PGP in GW28 and in PPW14 (OR = 3.9). Being multiparous was a risk for PGP in PPW14 (OR=1.9).ConclusionsWomen of South Asian and Middle Eastern background had higher risk of self-reported PGP than Western women. Ethnicity was associated with PGP in GW15 and PPW14, after adjustments for parity. PGP locations in GW15 was the most prominent risk factor for PGP in GW28 and PPW14, whilst ethnicity was not significant in multivariable analyses.

Comparison between UK Biobank and Shanghai Changfeng suggests distinct hip morphology may contribute to ethnic differences in the prevalence of hip osteoarthritis

ObjectsJoint morphology is a risk factor for hip osteoarthritis (HOA) and could explain ethnic differences in HOA prevalence. Therefore, we aimed to compare the prevalence of radiographic HOA (rHOA) and hip morphology between the predominantly White UK Biobank (UKB) and exclusively Chinese Shanghai Changfeng (SC) cohorts. MethodsLeft hip iDXA scans were used to quantify rHOA, from a combination of osteophytes (grade>1) and joint space narrowing (grade>1), and hip morphology. Using an 85-point Statistical Shape Model (SSM) we evaluated cam (alpha angle (AA) ≥60°) and pincer (lateral centre edge angle (LCEA) ≥45°) morphology and acetabular dysplasia (LCEA <25°). Diameter of the femoral head (DFH), femoral neck width (FNW) and hip axis length (HAL) were also obtained from these points. Results were adjusted for differences in age, height and weight and stratified by sex. ResultsComplete data were available for 5,924 SC and 39,020 White UKB participants with mean ages of 63.4 and 63.7 years old. rHOA prevalence was considerably lower in female (2.2% versus 13.1%) and male (12.0% and 25.1%) SC compared to UKB participants. Cam morphology, rarely seen in females, was less common in SC compared with UKB males (6.3% versus 16.5%). Composite SSM modes, scaled to the same overall size, revealed SC participants to have a wider femoral head compared to UKB participants. FNW and HAL were smaller in SC compared to UKB, whereas DFH/FNW ratio was higher in SC. ConclusionsrHOA prevalence is lower in Chinese compared with White individuals. Several differences in hip shape were observed, including frequency of cam morphology, FNW and DFH/FNW ratio. These characteristics have previously been identified as risk factors for HOA and may contribute to observed ethnic differences in HOA prevalence.

Abstract 15197: Trends in Prevalence and Treatment of Metabolic Syndrome and Individual Components by Race/Ethnicity, 1999-2020

Introduction: Nationally representative data evaluating recent trends in racial and ethnic differences in prevalence and treatment of metabolic syndrome (MetS) are sparse. Methods: We evaluated 21-year trends in the prevalence and treatment of MetS and individual components in 21,602 adults, using data from the National Health and Nutrition Examination Surveys (NHANES) from 1999 to 2020. We used weighted linear regression to estimate time trends and compared these trends by race and ethnicity. Results: Among participants, the mean age was 47.7 (SD, 2.2) years; 51 % were female; 78 %, 12.7%, and 9.3% were White, Black, and Hispanic. From 1999 to 2020, the prevalence of MetS as well as the prevalences of elevated waist circumference and elevated fasting glucose increased significantly for Black, Hispanic, and White individuals (P&lt;0.01 for all). The prevalences of elevated blood pressure and elevated triglyceride increased among Black individuals but did not change among Hispanic and White individuals. The use of antihypertensive, antihyperglycemic, and lipid-modifying medications also increased for all racial/ethnic subgroups. Racial/ethnic disparities in prevalence and treatment of MetS and individual components persisted throughout the study period. Compared with White individuals, Black individuals had higher use of antihypertensive medications but lower use of lipid-modifying medications (P&lt;0.01 for all). Hispanic individuals had lower use of antihypertensive medications and lipid-modifying medications (P&lt;0.01 for all). Across all racial/ethnic subgroups, less than 60% and 30% of people with medication indications received lipid-modifying and antihyperglycemic medications, respectively. Conclusions: Temporal trends suggest an increase in prevalence of MetS. There were persistent racial/ethnic disparities in use of antihypertensive, antihyperglycemic, and lipid-modifying medications among people with medication indications.

High prevalence and significant ethnic differences in actionable HbA1C after gestational diabetes mellitus in women living in Norway

BackgroundThe type 2 diabetes risk after gestational diabetes mellitus (GDM) is twice as high in South Asian compared to European women. Current guidelines differ regarding which test to use as a screening-tool post-GDM. We aimed to identify ethnic differences in the prevalence rates and early predictors for actionable HbA1c (defined as prediabetes and diabetes) short time after GDM.MethodsThis cross-sectional study, enrolling South Asian and Nordic women 1–3 years after a diagnosis of GDM, was undertaken at three hospitals in Norway. We performed a clinical and laboratory evaluation including an oral glucose tolerance test (OGTT). Medical records were used to retrieve data during pregnancy. Prediabetes was classified with HbA1c alone or combined with OGTT glucose measurements according to the WHO, WHO-IEC, and ADA criteria (fasting plasma glucose (FPG) 6.1–6.9 mmol/L, FPG 6.1–6.9 mmol/L and/or HbA1c 42-47 mmol/mol (6.0-6.4%), and FPG 5.6–6.9 mmol/L and/or HbA1c 39-47 mmol/mol (5.7-6.4%)). Ethnic differences in prevalence and predictors of glucose deterioration were assed by χ2 (Pearson) tests and logistic regression models.ResultsWe included 163 South Asian and 108 Nordic women. Actionable HbA1c levels were highly prevalent and more so among South Asian than Nordic women (WHO-IEC-HbA1c: 25.8% vs. 6.5% (p ≤ 0.001), ADA-HbA1c: 58.3% vs. 22.2% (p ≤ 0.001)). Although adding OGTT-data gave higher combined prevalence rates of prediabetes and diabetes (WHO: 65.6% vs. 47.2% (p ≤ 0.05), WHO-IEC: 70.6% vs. 47.2% (p ≤ 0.001), ADA: 87.8% vs. 65.7% (p ≤ 0.001)), the excess risk in the South Asian women was best captured by the HbA1c. Important predictors for glucose deterioration after GDM were: South Asian ethnicity, GDM before the index pregnancy, use of glucose-lowering drugs in pregnancy, higher age, and higher in-pregnancy fasting glucose levels.ConclusionsIn women with GDM 1–3 year previously, we found high prevalence and significant ethnic differences in actionable ADA-HbA1c levels, with South Asian ethnicity, GDM before the index pregnancy, and the use of glucose-lowering drugs in pregnancy as the most important risk factors. This study reinforces the importance of annual screening—preferably with HbA1c measurements—to facilitate early intervention after GDM.

Epidemiological, clinical, pathological and genetic characteristics of epidermolysis bullosa in New Zealand.

To establish the epidemiological, clinical, pathological and genetic characteristics of epidermolysis bullosa (EB) in New Zealand (NZ). Participants were recruited through the Dystrophic Epidermolysis Bullosa Research Association of New Zealand (DEBRA NZ). Dedicated EB nurse medical records, Genetic Health Service NZ (GHSNZ) records and, where available, public hospital records were manually reviewed for relevant clinical data. Ninety-two participants took part in the study (56% participation rate). Forty-nine (53%) participants had EB simplex (EBS), 40 (43%) had dystrophic EB (DEB), and 3 (3%) had junctional EB (JEB). Point prevalence for EB of all types was 19.5 per million, and 10.4, 8.6 and 0.9 per million for EBS, DEB and JEB, respectively. Thirty-four participants had intermediate or severe EB. There were 29 paediatric cases and almost even numbers of males and females. Compared to NZ European and Māori, prevalence rates were lower for Pacific and Asian people and higher in the Middle Eastern/Latin American/African population. Eight out of 14 skin biopsy results were informative, and 14 of 15 genetic test results were informative. New Zealand has similar prevalence rates of EB compared with other national cohorts. This is likely to be an underestimate due to methodological limitations. Recent advancements in genomic testing have resulted in an improved diagnostic rate in our population. Further research into ethnic differences in prevalence, and exploring the characteristics of lethal forms of EB, is warranted. A dynamic registry may be helpful for the EB community in NZ.

Differential discordance of informant‐ and self‐rated depression and apathy in Black, Hispanic, and White participants in the NACC dataset

AbstractBackgroundEvidence points to racial and ethnic differences in prevalence of neuropsychiatric syndromes (NPS) and interpretation of symptoms by patients and family. Although Alzheimer’s and related dementia (ADRD) research and clinical assessment relies heavily on family report, agreement of self and informant NPS ratings has not been examined in racially diverse cohorts. We used cross‐sectional data from the National Alzheimer’s Coordinating Center (NACC) Uniform Dataset to assess concordance in depression and apathy by race/ethnicity, across cognitive status categories.MethodsThe analytic dataset included 28,165 non‐Hispanic Whites (NHW), 5177 non‐Hispanic Blacks (NHB), and 2943 Hispanics age 45 and older, with baseline cognitive status of normal cognition, mild cognitive impairment (MCI), impaired‐not‐MCI, or dementia. Rates of depression and apathy were calculated using self‐report (Geriatric Depression Scale; GDS‐12 and GDS‐3 subscales) and informant report (Neuropsychiatric Inventory‐Questionnaire (NPI‐Q)). Next, using previously‐validated cutpoints on GDS subscales, concordance of dichotomously‐coded self‐ and informant ratings was examined by race/ethnicity within each cognitive status category.ResultsHispanics were slightly younger and reported fewer years of formal education, while NHB were more likely to be female (Table 1). Self‐rated apathy and depression levels were higher in Hispanic participants compared to their non‐Hispanic counterparts (p&lt;.0001). NHB and NHW did not differ on apathy scores, but NHW endorsed more depression compared to NHB (p=.0006). Rates of informant‐rated apathy and depression were highest in the Hispanic group and lowest in NHB (all comparisons p&lt;.0001). Across cognitive status categories, informants were more likely to identify depression compared to self‐ratings (Figure 1). However, self‐reported rates of apathy were higher than informant report, except in the dementia group (Figure 2). Overall, discordance of report was statistically significant in all race/ethnic groups. Interestingly, reports of depression in Hispanic participants (n=198) adjudicated as impaired/not MCI were not discordant.ConclusionsIn this diverse NACC cohort, discordance between informant and self‐report of depression and apathy was revealed across race/ethnicity and cognitive status, but the direction of discordance differed by symptom. Future research should examine the impact of other demographic characteristics on observed differences, explore use of different cutpoints, and examine neuropsychiatric symptoms in additional racial groups.

Contrasting Narratives of Race and Fatness in Covid-19

The slogan that ‘the virus doesn’t discriminate’ has been belied by the emergence of stark and persistent disparities in rates of infection, hospitalisation, and death from Covid-19 between various social groups. I focus on two groups that have been disproportionately affected, and that have been constructed or designated as particularly ‘at-risk’ during the Covid-19 pandemic: racial or ethnic minorities and fat people. I trace the range of narratives that have arisen in the context of explaining these disparities, in both the scientific literature and wider expert and public discourse. I show that the scientific and public narratives around these groups have differed significantly, revealing contested and competing conceptions of the basis of these categories themselves. These different conceptions have important impacts on the kinds of interventions that become possible or desirable. I show that in the case of racial or ethnic disparities, genetic narratives have been combatted by a strong focus on structural racism as a driver of pandemic inequalities. However, in the case of fatness, individualising and stigmatising narratives have dominated discussions. I suggest that, given racial or ethnic differences in prevalence of fatness, and scholarship casting anti-fatness as historically racialised, the stigmatisation of fatness disproportionately affects racial or ethnic minorities in terms of placing individual blame or responsibility for the increased burden of Covid-19 on these groups. Despite widespread acknowledgement of the role of structural racism in driving racial inequalities in the burden of Covid-19, anti-obesity rhetoric and research provides a ‘backdoor’ to placing blame on individuals from racial minorities.

Racial disparities in clinical trials of biologic treatments for psoriatic arthritis

To the Editor: Psoriatic arthritis affects 20% to 30% of patients with psoriasis; however, little is known about racial and ethnic differences in prevalence.1 Limited knowledge regarding disease manifestations in non-White races is exacerbated by an underrepresentation of non-White participants in clinical trials.2 To determine the extent of underrepresentation, a cross-sectional study was performed assessing differences in patient race and ethnicity in completed phase III clinical trials for biologic agents used to treat psoriatic arthritis.

Ethnic differences in prevalence of actionable HbA1c levels in UK Biobank: implications for screening

IntroductionEarly detection and treatment of diabetes as well as its prevention help lessen longer-term complications. We determined the prevalence of pre-diabetes and undiagnosed diabetes in the UK Biobank and standardized...

Hypertension Editors' Picks: Hyperaldosteronism.

Hypertension Editors' Picks: Hyperaldosteronism.

Racial Differences in Isolated Aortic, Concomitant Aortoiliac, and Isolated Iliac Aneurysms: This is a Retrospective Observational Study.

Our aim was to describe the racial and ethnic differences in presentation, baseline and operative characteristics, and outcomes after aortoiliac aneurysm repair. Previous studies have demonstrated racial and ethnic differences in prevalence of abdominal aortic aneurysms and showed more complex iliac anatomy in Asian patients. We identified all White, Black, Asian, and Hispanic patients undergoing aortoiliac aneurysm repair in the VQI from 2003 to 2019. We compared baseline comorbidities, operative characteristics, and perioperative outcomes by race and ethnicity. In our 60,435 patient cohort, Black patients, followed by Asian patients, were most likely to undergo repair for aortoiliac (W:23%, B:38%, A:31%, H:22%, P < 0.001) and isolated iliac aneurysms (W:1.0%, B:3.1%, A:1.5%, H:1.6%, P < 0.001), and White and Hispanic patients were most likely to undergo isolated aortic aneurysm repair (W:76%, B:59%, A:68%, H:76%, P < 0.001). Black patients were more likely to undergo symptomatic repair and underwent rupture repair at a smaller aortic diameter. The iliac aneurysm diameter was largest in Black and Asian patients. Asian patients were most likely to have aortic neck angulation above 60 degree, graft oversizing above 20%, and completion endoleaks. Also, Asian patients were more likely to have a hypogastric artery aneurysm and to undergo hypogastric coiling. Asian and Black patients were more likely to undergo repair for aortoiliac and isolated iliac aneurysms compared to White and Hispanic patients who were more likely to undergo repair for isolated aortic aneurysms. Moreover, there were significant racial differences in the demographics and anatomic characteristics that could be used to inform operative approach and device development.

Racial and Ethnic Differences in Multigene Hereditary Cancer Panel Test Results for Women With Breast Cancer.

To evaluate the racial and ethnic differences in prevalence of germline pathogenic variants (PVs) and the effect of race and ethnicity on breast cancer (BC) risk among carriers, results of multigene testing of 77 900 women with BC (non-Hispanic White [NHW] = 57 003; Ashkenazi-Jewish = 4798; Black = 6722; Hispanic = 5194; and Asian = 4183) were analyzed, and the frequency of PVs in each gene were compared between BC patients (cases) and race- and ethnicity-matched gnomAD reference controls. Compared with NHWs, BRCA1 PVs were enriched in Ashkenazi-Jews and Hispanics, whereas CHEK2 PVs were statistically significantly lower in Blacks, Hispanics, and Asians (all 2-sided P < .05). In case-control studies, BARD1 PVs were associated with high risks (odds ratio > 4.00) of BC in Blacks, Hispanics, and Asians; ATM PVs were associated with increased risk of BC among all races and ethnicities except Asians, whereas CHEK2 and BRIP1 PVs were associated with increased risk of BC among NHWs and Hispanics only. These findings suggest a need for personalized management of BC risk in PV carriers based on race and ethnicity.

Racial differences in urinary incontinence prevalence and associated bother: the Multi-Ethnic Study of Atherosclerosis

Urinary incontinence is influenced by multiple factors, and the prevalence of urinary incontinence subtypes may differ by race and ethnicity. This study aimed to determine the prevalence of urinary incontinence subtypes and associated bother among women by race and ethnicity. This cross-sectional analysis used data from the Multi-Ethnic Study of Atherosclerosis, an observational cohort study of 4 racial and ethnic groups recruited from 6 communities from the United States. At the sixth follow-up examination, urinary symptoms were ascertained with the International Consultation on Incontinence Questionnaire. The prevalence rate ratios of stress urinary incontinence, urgency urinary incontinence, and mixed urinary incontinence by race and ethnicity were calculated using generalized linear models for the binomial family while adjusting for covariates. The degree of bother was based on a scale of 0 (none) to 10 (greatest bother), and presence of any bother was defined as a score of ≥3. Among the 1749 female participants in the Multi-Ethnic Study of Atherosclerosis who completed the sixth follow-up examination, 1628 (93%) completed the questionnaire. Women who did not complete the questionnaire were older than those who completed the questionnaire (average age, 82.2 [standard deviation, 9.5] vs 73.7 [standard deviation, 8.4] years; P<.01) and more likely to use diuretics (29.8% vs 18.9%; P<.01). Among those who completed the questionnaire (n=1628), 39.4% were white, 12.5% were Chinese, 27.2% were black, and 20.9% were Hispanic. After adjusting for covariates, stress urinary incontinence (prevalence rate ratio, 0.47; 95% confidence interval, 0.25-0.86) and mixed urinary incontinence (prevalence rate ratio, 0.58; 95% confidence interval, 0.38-0.89) regardless of bother scores were significantly less prevalent among black vs white women, although no significant racial and ethnic differences in stress or mixed urinary incontinence prevalence were noted for Chinese or Hispanic women vs white women. No racial and ethnic differences in the prevalence of urgency urinary incontinence were noted after the adjustment for covariates. Most women with urinary incontinence reported bother scores of ≥3 regardless of race and ethnicity and urinary incontinence subtype, and bother scores did not differ significantly by race and ethnicity. Frequency of urinary incontinence subtypes may differ by race and ethnicity, but older women who report urinary incontinence are likely to have associated bother regardless of race and ethnicity.

Ethnic differences in atrial fibrillation among patients with heart failure in Asia.

AimsWe aimed to characterize ethnic differences in prevalence, clinical correlates, and outcomes of atrial fibrillation (AF) in heart failure (HF) with preserved and reduced ejection fraction (HFpEF and HFrEF) across Asia.Methods and resultsAmong 5504 patients with HF prospectively recruited across 11 Asian regions using identical protocols in the Asian Sudden Cardiac Death in Heart Failure study (mean age 61 ± 13 years, 27% women, 83% HFrEF), 1383 (25%) had AF defined as a history of AF and/or AF/flutter on baseline electrocardiogram. Clinical correlates of AF were similar across ethnicities and included older age, prior stroke, higher NT‐proBNP, and larger left atria. Diabetes was associated with lower odds of AF in HFrEF [adjusted odds ratio (AOR) 0.79, 95% CI 0.66–0.95] and HFpEF (AOR 0.58, 95% CI 0.39–0.84) regardless of ethnicity. Compared with Chinese ethnicity, Japanese/Koreans had higher odds of AF in HFrEF (AOR 1.76, 95% CI 1.40–2.21), while Indians had lower odds in HFrEF (AOR 0.18, 95% CI 0.13–0.24) and HFpEF (AOR 0.28, 95% CI 0.16–0.49) even after adjusting for clinical covariates. Interaction between ethnicity and region was observed among Indians, with Southeast Asian Indians having higher odds of AF (AOR 3.01, 95% CI 1.60–5.67) compared with South Asian Indians. AF was associated with poorer quality of life and increased risk of 1 year all‐cause mortality or HF hospitalisation (adjusted hazard ratio 1.39, 95% CI 1.18–1.63) regardless of ethnicity.ConclusionsAmong patients with HF across Asia, clinical correlates and adverse outcomes associated with AF are similar across ethnicities; however, there are striking ethnic variations in the prevalence of AF that are not accounted for by known risk factors.

Serum carotenoid concentrations and their association with ethnic differences in type 2 diabetes within the Healthy Life in an Urban Setting (HELIUS) study.

Studies have reported an inverse association between a diet rich in fruits and vegetables and type 2 diabetes (T2D), but data on high-risk ethnic minority groups is limited. We investigated whether serum carotenoids, as biomarkers for fruit and vegetable intake, mediate ethnic differences in the prevalence of T2D. Age-adjusted serum carotenoid concentrations were compared using ANCOVA. A cross-sectional analysis was performed using Cox regression to estimate prevalence ratios (PR) and their 95 % CI of the association between serum carotenoid concentrations and T2D. To study whether serum carotenoids potentially mediate the differences in the prevalence of T2D across ethnic groups, we compared PR of the model including known risk factors and the model additionally adjusted for serum carotenoid concentrations using the Dutch group as reference. A study among six ethnic groups living in Amsterdam, the Netherlands. Data on 204 Dutch, 203 South Asian Surinamese, 204 African Surinamese, 203 Turkish and 200 Moroccan-origin participants from the Healthy Life in an Urban Setting (HELIUS) study were used. Serum carotenoid concentrations differed across ethnic groups. After adjusting for confounders, the serum concentrations of total carotenoids (PR 0·67, 95 % CI 0·54, 0·84), α-carotene (PR 0·57, 95 % CI 0·42, 0·77), β-carotene (PR 0·45, 95 % CI 0·32, 0·63) and β-cryptoxanthin (PR 0·73, 95 % CI 0·58, 0·92) were inversely associated with T2D. Despite the associations, serum carotenoids did not mediate the ethnic differences in the prevalence of T2D. The limited contribution of serum carotenoids to ethnic differences in T2D suggests that a focus on increasing fruit and vegetable intake alone will not likely eliminate ethnic differences in T2D prevalence.

Ethnic differences in prevalence of Dupuytren disease can partly be explained by known genetic risk variants

Dupuytren disease (DD), a fibroproliferative disorder of the palmar fascia that causes flexion contractures in the fingers, is prevalent in people of North-Western European descent and less so in other ethnicities. DD is a complex disorder, influenced by genetic risk variants. We aimed to study if the marked differences in prevalences in DD between ethnic (sub)groups could be explained by differences in allele frequencies of the 26 known genetic risk variants of DD. Therefore, genetic risk scores (GRS) composed of the 26 DD risk variants were calculated for the 26 populations from the 1000 Genomes database and correlated to observed DD prevalences from literature. For comparison, GRSs were generated for 10,000 sets of 26 random SNPs and also correlated to the observed DD prevalences to determine the significance of the observed correlation. To determine whether differences in allele frequencies between ethnicities were caused by natural selection, fixation indices (Fst) were calculated from the 26 SNPs and from the sets of 26 random SNPs for comparison. Observed prevalences could be determined from literature for 10 populations. Their correlation with the GRS composed of DD SNPs proved to be 0.60 (p = 0.0003). The Fsts between British and other populations were low for European, ad mixed American, and South-Asian populations, and moderate for East-Asians. African populations were significantly different from expected values determined from the random sets. In conclusion, the 26 known genetic risk variants associated with DD explain for a substantial part (R2 = 0.36) the differing DD prevalences observed between ethnicities.

Ethnic differences in prevalence, risk factors, and perinatal outcomes of gestational diabetes mellitus: A comparison between immigrant ethnic Chinese women and Australian-born Caucasian women in Australia.

The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide. Ethnic differences in risk factors and perinatal outcomes are clinically important. Chinese women constitute approximately 10% of the world's population, and are an increasing migrant population, yet prevalence, risk factors, and outcomes of GDM in this population are insufficiently explored. A retrospective study of a large pregnancy dataset comparing GDM prevalence, risk factors, and perinatal outcomes between immigrant ethnic Chinese women and Australian-born Caucasian women was conducted using logistic regression. Overall, 73 517 births were extracted from the pregnancy databases of two of Australia's largest maternity services. Chinese women (n = 3419) had a 4-fold higher risk of GDM than Caucasians (n = 28 594) after adjusting for risk factors of GDM. A past history of GDM (adjusted odds ratio [aOR] 5.24; 95% confidence interval [95% CI] 2.91-9.42] was the main GDM risk factor in both groups. Other GDM risk factors varied between groups. Perinatal outcomes in Chinese women with and without GDM were similar, except for neonatal hypoglycemia (aOR 2.01; 95% CI 1.14-3.56]. Caucasian women with GDM had more adverse perinatal outcomes than women without GDM. After adjusting for confounders, Chinese women with GDM had a lower risk of labor induction, large-for-gestational-age babies, neonatal hypoglycemia, respiratory distress, and low Apgar scores than Caucasian women with GDM. Differences in prevalence, risk profile, and adverse outcomes in GDM were evident between ethnic Chinese and Caucasian women. A precision medicine approach to GDM may be warranted considering ethnicity and individual risk profiles rather than a one-size-fits-all approach.

Effect of neighbourhood socioeconomic status on overweight and obesity in children 2-15 years of different ethnic groups.

Studies on the influence of neighbourhood socioeconomic status (N-SES) on overweight and obesity rates in children from different ethnic backgrounds are scarce. This study investigated the differential effect of N-SES on overweight (including obesity) and obesity prevalence in different ethnic groups, and if N-SES explains ethnic differences in the prevalence of overweight and obesity. A population based study of 109 766 body mass index (BMI) measurements of 86 209 children 2-15 years of Dutch, Turkish, Moroccan and South Asian descent. BMI class was determined with The International Obesity Task Force, and South Asian specific BMI cut-offs. WHO BMI criteria were applied for reference purposes. The effect of N-SES on prevalence rates was studied with generalized linear mixed models. Neighbourhood SES was negatively associated with overweight and obesity. However, the effect of N-SES on overweight was stronger in Dutch children (OR 0.75, 95% CI 0.73-0.77) than in Turkish (OR 0.86, 95% CI 0.82-0.90), Moroccan (OR 0.91, 95% CI 0.86-0.97) and South Asian (OR 0.90, 95% CI 0.84-0.96) children. The influence of N-SES on obesity showed a similar pattern, except for Moroccan children in whom obesity prevalence remained stable over the whole N-SES range. At the same N-SES, overweight and obesity prevalence was significantly higher in Turkish, Moroccan and especially South Asian children compared with Dutch children. Adjusting for N-SES attenuated the ethnic differences. Neighbourhood SES was negatively associated with overweight and obesity rates in all ethnic groups, but only partly explained the ethnic differences in overweight and obesity prevalence.

Trans-ethnic kidney function association study reveals putative causal genes and effects on kidney-specific disease aetiologies

Chronic kidney disease (CKD) affects ~10% of the global population, with considerable ethnic differences in prevalence and aetiology. We assemble genome-wide association studies of estimated glomerular filtration rate (eGFR), a measure of kidney function that defines CKD, in 312,468 individuals of diverse ancestry. We identify 127 distinct association signals with homogeneous effects on eGFR across ancestries and enrichment in genomic annotations including kidney-specific histone modifications. Fine-mapping reveals 40 high-confidence variants driving eGFR associations and highlights putative causal genes with cell-type specific expression in glomerulus, and in proximal and distal nephron. Mendelian randomisation supports causal effects of eGFR on overall and cause-specific CKD, kidney stone formation, diastolic blood pressure and hypertension. These results define novel molecular mechanisms and putative causal genes for eGFR, offering insight into clinical outcomes and routes to CKD treatment development.