South Asian Men Research Articles

Ethnic Differences in Sexual Dysfunction among Diabetic and Nondiabetic Males: The Oxford Sexual Dysfunction Study

Erectile dysfunction (ED), premature ejaculation (PE), and reduced libido are common yet poorly investigated complications of diabetes especially among South Asians (SA). To determine possible variations in prevalence and interassociations of ED, PE, and reduced libido among SA and Europids with and without diabetes. Men with diabetes and a randomly selected sample of age-matched nondiabetic men from 25 general practitioners in eight primary care trusts in the United Kingdom were invited to participate in a linguistically validated questionnaire-based study in English, Hindi, Urdu, Panjabi, Tamil, and Sinhala languages. ED, assessed by International Index of Erectile Function (IIEF-5), PE, evaluated using the Premature Ejaculation Diagnostic Tool, and libido, assessed by asking participants to grade their desire for sexual activity. Sample size was 510 (SA: 184, Europid: 326). Mean age was 56.9 ± 9.7 years. There was no difference in erectile function when assessed by IIEF between SA and Europids with diabetes (84.8% and 84.1%, respectively). The overall prevalence of PE was 28.8% (32.6% and 25.8% in those with and without diabetes, respectively, P = NS). Among men with diabetes, the prevalence of PE was 45.8% and 22.4% for SA and Europids, respectively (P < 0.001). In those without diabetes, this figure was 41.9% in SA and 20.2% in Europids (P < 0.001). There was a significant trend of increasing prevalence of PE with increasing severity grade of ED (P < 0.001). Reduced libido was reported by 26.9% men (32.8% and 22.0% in those with and without diabetes, respectively, P < 0.01), with no significant ethnic difference. The association between reduced libido and increasing severity grades of ED was also significant (P < 0.001). No significant difference was observed in the prevalence of ED between SA and Europid men with diabetes. PE was significantly more common in the SA men irrespective of their diabetes status.

Prostate cancer disease characteristics for foreign-born South Asian men living in the United States

We report the largest known cohort of South Asian (SA) men treated by radical prostatectomy living in the United States. Our objective was to characterize this sub-population and compare them to our wider cohort of prostate cancer patients treated with radical prostatectomy in the United States. All patients who underwent radical prostatectomy at two high-volume United States academic institutions at separate geographic locations between 1990 and 2011 were identified. Demographic data, pre-operative Prostate Specific Antigen (PSA), biopsy Gleason score, pathology Gleason score, pathology Stage, margin status, and node status were collected. In addition to SA men, African American (AA) men were identified and used for comparative analysis as a high-risk cohort. A total of 69 SA men were identified in Cohort 1 and 24 men were identified in Cohort 2. When comparing SA men against the entire cohort, no significant difference was found for age, year of surgery, biopsy Gleason score, or path Gleason score for either cohort. However, significant differences were found in pre-operative PSA (P = 0.01), pathologic stage (P<0.01), and positive node status (P = 0.04) for SA men in Cohort 1. Whereas in Cohort 2, SA men had a significantly higher proportion of positive surgical margins (P = 0.04). In all significant comparisons, characteristics were worse in SA men and similar to that of AA men. SA men have worse pathologic disease profiles when compared to the general population of men undergoing radical prostatectomy. SA men living in the United States have pathologic disease profiles that are comparable to AA men.

Adipocytokine Associations with Insulin Resistance in British South Asians

Aims. Adipocytokines are implicated in the pathogenesis of type 2 diabetes and may represent identifiable precursors of metabolic disease within high-risk groups. We investigated adiponectin, leptin, and TNF-α and assessed the contribution of these molecules to insulin resistance in south Asians. Hypothesis. South Asians have adverse adipocytokine profiles which associate with an HOMA-derived insulin resistance phenotype. Methods. We measured adipocytokine concentrations in south Asians with newly diagnosed impaired glucose tolerance or Type 2 Diabetes Mellitus in a case-control study. 158 (48.5% males) volunteers aged 25–75 years with risk factors for diabetes but no known vascular or metabolic disease provided serum samples for ELISA and bioplex assays. Results. Total adiponectin concentration progressively decreased across the glucose spectrum in both sexes. A reciprocal trend in leptin concentration was observed only in south Asian men. Adiponectin but not leptin independently associated with HOMA-derived insulin resistance after logistic multivariate regression. Conclusion. Diasporic south Asian populations have an adverse adipocytokine profile which deteriorates further with glucose dysregulation. Insulin resistance is inversely associated with adiponectin independent of BMI and waist circumference in south Asians, implying that adipocytokine interplay contributes to the pathogenesis of metabolic disease in this group.

Ethnic differences in sports participation in England

Aim: to provide a detailed picture of ethnic differences in sports participation in England. Design: Health Survey for England data is used. Percentages and age-standardised logistic regression models compare participation in ten separate sports for eight ethnic groups. Logistic regression models explore ethnic differences in regular sporting activity allowing for a range of explanatory variables (for all respondents and for White, South Asian and Black respondents separately). Results: There is major variation in levels and types of sports participation for different ethnic groups. Sports participation of ethnic minority men is depressed by their socio-economic disadvantage and migrant status. Participation is low for South Asian and Black African women after controlling for socio-economic status and migration. First generation South Asian men and women are less likely to participate than second generation. Conclusion: Sports sociologists and policy makers should distinguish between different ethnic groups and between genders within ethnic groups. Policy makers should consult with BME communities/organisations to explore culturally appropriate ways of increasing participation among targeted groups. Sporting facilities should be made available for all income groups and particularly in areas of high deprivation. Sports promotion in schools is important.

The Association of the Triglyceride-to-HDL Cholesterol Ratio with Insulin Resistance in White European and South Asian Men and Women

IntroductionThere is recent interest surrounding the use of the triglyceride-to-HDL cholesterol ratio as a surrogate marker of insulin resistance in clinical practice, as it may identify people at high risk of developing diabetes or its complications. However, it has been suggested using this lipid ratio may not be appropriate for measuring insulin resistance in African-Americans, particularly women. We investigated if this inconsistency extended to South Asian women in a UK multi-ethnic cohort of White Europeans and South Asians.MethodsCross-sectional analysis was done of 729 participants from the ADDITION-Leicester study from 2005 to 2009. The association between tertiles of triglyceride-to-HDL cholesterol ratio to fasting insulin, homeostatic model of assessment for insulin resistance (HOMA1-IR), quantitative insulin sensitivity check index (QUICKI) and glucose: insulin ratio was examined with adjustment for confounding variables.ResultsIncremental tertiles of the triglyceride-to-HDL cholesterol ratio demonstrated a significant positive association with levels of fasting insulin, HOMA1-IR, glucose: insulin ratio and a negative association with QUICKI in White European men (n = 255) and women (n = 250) and South Asian men (n = 124) (all p<0.05), but not South Asian women (n = 100). A significant interaction was demonstrated between sex and triglyceride-to-HDL cholesterol ratio tertiles in South Asians only (p<0.05). The area under the receiver operating characteristic curve for triglyceride-to-HDL cholesterol ratio to detect insulin resistance, defined as the cohort HOMA1-IR≥75th percentile (3.08), was 0.74 (0.67 to 0.81), 0.72 (0.65 to 0.79), 0.75 (0.66 to 0.85) and 0.67 (0.56 to 0.78) in White European men and women, South Asian men and women respectively. The optimal cut-points for detecting insulin resistance were 0.9–1.7 in mmol/l (2.0–3.8 in mg/dl) for the triglyceride-to-HDL ratio.ConclusionIn South Asian women the triglyceride-to-HDL cholesterol ratio was not associated with insulin resistance; therefore there may be limitations in its use as a surrogate marker in this group.

Rumour and Myth in the labour camps of Qatar (Respond to this article at http://www.therai.org.uk/at/debate)

The petroleum‐rich states of the Arabian Peninsula comprise one of the principal transnational destinations for the global movement of labour. In the Gulf States, much of that labour force comes from South Asia. Legions of unskilled male labourers are typically housed in labor camps, a nomenclature that masks a wide variety of both formal and informal accommodation that, in spatial terms, is a fundamental mechanism for the social segregation of this foreign labor force from the citizenry. Building upon recent fieldwork in Doha, Qatar, this paper examines the myths and narratives that proliferate amongst the South Asian men in these labor camps – men who, often despite years of experience in the Gulf States, typically have little or no interaction with the native citizenry. This paper suggests that these myths and stories can be understood as instruments of governance in that they portray the collectively‐established boundaries of appropriate behavior in a culture foreign to these unskilled laborers. A close analysis of the content of these myths and rumors, however, also helps us grapple with the connections and contradictions between power, race, class, ethnicity, nationality, religion, gender and sexuality in the extraordinarily heterogeneous context of the contemporary Gulf State. As such, the analysis not only sheds light on the experiences of these foreign men and women, but also their collective understanding of that experience and of the society that hosts them.

Abstract 11404: MicroRNA Associated with Atherogenic Dyslipidemia In South Asian Men

Elena Flowers, 2012 Finalist and Presenting Author

Influence of Upper and Lower Body Adipose Tissue on Insulin Sensitivity in South Asian Men

BackgroundSouth Asians have a high prevalence of insulin resistance, which predisposes to type 2 diabetes.RationaleIn the current study, we examined whether insulin sensitivity in South Asian men and men of...

Circulating IL-6 concentrations and associated anthropometric and metabolic parameters in South Asian men and women in comparison to European whites

ObjectiveTo determine any ethnic differences in circulating interleukin (IL)-6 concentrations among SAs and Europeans, and to assess their relationship with body composition and insulin resistance measures. MethodsBody composition was assessed among 80 SA and European men and women using anthropometry, dual-energy X-ray absorptiometry and abdominal CT scan. Oral glucose tolerance tests with insulin response were performed to assess insulin resistance measures. IL-6 levels were measured by high sensitivity ELISA. ResultsMedian IL-6 values were higher in SA compared with European women: 1.94mg/l versus 1.51mg/l, p=0.041, but not so in men (1.56mg/l versus 1.57mg/l). Only measures of obesity, in particular percentage fat area (r=0.6, p=0.003), were positively correlated with IL-6 in SAs. Differences in body fat percentage (visceral and total) could explain up to 30% of the IL-6 difference between Asian and European women. ConclusionSA women have elevated circulating IL-6 levels, in part due to greater visceral and percent fat levels compared with European women. This observation may in part explain why Asians are at elevated cardiovascular disease risk. Future studies should address the effects of lifestyle factors (physical activity, diet) on plasma IL-6 concentrations in SA women.

Working with South Asian male perpetrators of intimate partner violence in British Columbia, Canada

This article outlines effective intervention strategies for probation officers working with South Asian men in British Columbia, Canada, who have assaulted their partners. It is part of a larger qualitative research study aimed at determining effective intervention strategies for frontline personnel that work with South Asian men, as well as determining effective prevention strategies aimed at policy makers and members of South Asian communities. Seventeen in-depth interviews were conducted with South Asian frontline workers that included police officers, probation officers, counsellors, child protection workers and victim service workers. The audio-taped data was transcribed and analysed by identification of themes and subthemes. Probation officers need to respect their clients’ cultural values while still holding these men accountable for their behaviour. Interventions that address patriarchal attitudes, the stressors arising out of immigration/acculturation, influence of extended family, and substance abuse were identified as being key factors in changing behaviour.

HIV Infection Among Ethnic Minority and Migrant Men Who Have Sex With Men in Britain

To examine human immunodeficiency virus (HIV) infection among men who have sex with men (MSM) from different ethnic and migrant groups living in Britain. In 2007-2008, a diverse national sample of MSM living in Britain was recruited through Web sites, in sexual health clinics, bars, clubs, and other venues. Men completed an online survey that included questions on HIV testing, HIV status, and sexual behavior. Nine hundred and ninety-one ethnic minority MSM, 207 men born in Central or Eastern Europe (CEE), 136 men born in South or Central America, and 11,944 white British men were included in the analysis. Self-reported HIV seropositivity was low for men of South Asian, Chinese, and "other Asian" ethnicity (range, 0.0%-5.8%) and for men born in CEE (4.5%) but elevated for men born in South or Central America (18.7%), compared with white British men (13.1%) (P < 0.001). There were no significant differences between these groups in high-risk sexual behavior (P = 0.8). After adjusting for confounding factors in a multivariable model, substantial differences in the odds of HIV infection remained for South Asian and Chinese MSM as well as for migrants from CEE, but not for other groups, compared with white British men; for example, South Asian men, adjusted odds ratio 0.43, 95% confidence interval 0.23, 0.79, P = 0.007. There were marked differences in self-reported HIV seropositivity between ethnic minority, key migrant, and white British MSM in this study but not in high-risk sexual behavior. This highlights the importance of health promotion targeting MSM from all ethnic and migrant groups in Britain.

Correlation of serum free thyroxine with components of metabolic syndrome in euthyroid South Asian men and women

Metabolic syndrome is a combination of risk factors for cardiovascular disease, whose prevalence is rising rapidly. Recently, a few studies have suggested that serum thyroxine, even in the reference range, may be associated with components of metabolic syndrome. However, this issue remains to be settled and has not been explored in the Pakistani population. So, we aimed to determine serum free thyroxine level and its relationship, if any, with components of metabolic syndrome in a euthyroid local population. This analytical, cross-sectional study included 130 euthyroid subjects (age range of 45 to 55 years). The subjects had their history taken and underwent clinical examination, after which, fasting blood was analysed for free thyroxine and thyroid stimulating hormone (chemiluminescence), along with glucose, triglycerides and high density lipoprotein cholesterol (using enzymatic methods). Free thyroxine showed a positive correlation with systolic and diastolic blood pressure in all subjects and with serum glucose in males, which was statistically significant (p = 0.022, p = 0.005 and p = 0.032, respectively). However, the correlation of serum free thyroxine with waist circumference, serum triglycerides and high-density lipoprotein cholesterol in males and with all components of metabolic syndrome in females was not significant. These results indicate that high-normal free thyroxine may be associated with raised blood pressure in all subjects and with raised glucose in males. Larger studies need to be done in Pakistani population to confirm our findings. Key words: Free thyroxine, metabolic syndrome, correlation, euthyroid

The Gendered Suspect: Women at the Canada-U.S. Border after September 11

Crossing the border is a gendered and racialized act. Considering the experiences of South Asian women at the border deemed "Suspect," this article examines the ways that discourses of "saving Muslim women" get mobilized at the border. While much has been written on the racial profiling that happens to South Asian men, for South Asian women there is a corresponding phenomenon that draws on popular images of "Other" women. At the border, categories of "victim" and "terrorist" become mutually constitutive and importantly gendered. This article is based on ethnographic fieldwork conducted in Toronto, Canada and Lahore and Karachi Pakistan between 2002 and 2010.

Health risks in south Asian men: heightening awareness

AbstractAlthough south Asian men have higher rates of coronary heart disease and diabetes than the general population, there are some health benefits for this ethnic group. Copyright © 2012 John Wiley &amp; Sons

A Gene-based restoration of Akt activity in endothelial progenitor cells from human subjects at high cardiovascular risk rescues vascular reparative capacity

Introduction Late-outgrowth endothelial progenitor cells (LEPC) are putative mediators of endogenous vascular repair, and represent an attractive tool for future cell-based cardiovascular repair strategies. However, progenitor function may be impaired in high cardiovascular risk populations, such as those of South Asian (SA) ethnicity, in whom cell based therapies are likely to offer most benefit. Methods Detailed analysis of in vitro LEPC function (abundance, proliferation, migration, angiogenesis and senescence) was performed in 12 SA men and 12 matched White European (WE) controls. Molecular abnormalities within the Akt/eNOS signalling axis were analysed with PCR and western blotting. LEPC were transfused into immunodeficient mice subsequent to femoral artery injury to assess in vivo reparative function. In vitro and in vivo studies were repeated after lentiviral gene delivery of constitutively active Akt1 (E17K) or control (EGFP) to SA LEPC; augmented Akt activity was confirmed using a Glycogen Synthase Kinase phosphorylation assay. Data are expressed as mean [SEM] and compared with t tests as appropriate; statistical significance is defined as p Results The two groups were matched for age and cardiovascular risk factors, although the SA group was comparatively insulin resistant (HOMA-IR 1.2 [0.2] vs 0.5 [0.1] au*). SA LEPC exhibited impaired colony formation (0.06 [0.02] vs 0.19 [0.03] colonies/ml blood*), migration to vascular endothelial growth factor (5 [0.7] vs 10 [1.7] cells/microscopic field*) and in vitro angiogenesis (1.9 [0.6] vs 3.8 [0.5] tubular structures/microscopic field*), associated with markedly decreased abundance of the phosphorylated forms of the pro-angiogenic molecules S473-Akt (0.14 [0.05] vs 0.81 [0.2] au*) and S1177-eNOS (0.05 [0.02] vs 0.15 [0.01] au*). Transfusion of WE LEPC into immunodeficient mice after wire-induced femoral artery luminal injury augmented re-endothelialisation; however, neither SA LEPC, nor vehicle, augmented re-endothelialisation (WE: 54.2 [6.4], SA: 36.9 [3.4], vehicle: 31.1 [2.4] % re-endothelialised; WE vs SA*; SA vs vehicle p=0.2). Lentiviral gene delivery of a E17K, but not EGFP control, to SA LEPC was associated with augmented Akt1 activity and rescue of in vivo re-endothelialisation capacity (E17K: 55.2 [4.4] vs EGFP 24.1 [1.3] % re-endothelialised; E17K vs EGFP*; E17K vs WE non-transduced cells p=0.9). Conclusions These data provide proof of principle for human LEPC based vascular repair therapy, and demonstrate a mechanism by which to rescue marked progenitor dysfunction in a group at high risk of cardiovascular events, whom are likely to benefit from cardiovascular repair therapies.

All‐cause cancer mortality over 15 years in multi‐ethnic Mauritius: The impact of diabetes and intermediate forms of glucose tolerance

There are accumulating data describing the association between diabetes and cancer mortality from Westernised populations. There are no data describing the relationship between diabetes and cancer mortality in African or South Asian populations from developing countries. We explored the relationship of abnormal glucose tolerance and diabetes on cancer mortality risk in a large, multi-ethnic cohort from the developing nation of Mauritius. Population-based surveys were undertaken in 1987, 1992 and 1998. The 9559 participants comprised 66% of South Asian (Indian), 27% of African (Creole), and 7% of Chinese descent. Cox's proportional hazards model with time varying covariates was used to obtain hazard ratios (HRs) and 95% confidence intervals (95% CI) for risk of cancer mortality, after adjustment for confounding factors. In men, but not women, cancer mortality risk increased with rising 2h-PG levels with HR for the top versus bottom quintile of 2.77 (95%CI: 1.28 to 5.98). South Asian men with known diabetes had a significantly greater risk of cancer mortality than those with normal glucose tolerance (NGT) HR: 2.74 (95%CI: 1.00-7.56). Overall, impaired glucose tolerance was associated with an elevated risk of cancer mortality compared to NGT (HR: 1.47, 95% CI: 0.98-2.19), though this was not significant. We have shown that the association between abnormal glucose tolerance and cancer extends to those of African and South Asian descent. These results highlight the importance of understanding this relationship in a global context to direct future health policy given the rapid increase in type 2 diabetes, especially in developing nations.

Validity of self‐assessed waist circumference in a multi‐ethnic UK population

Diabet. Med. 29, 404–409 (2012)AbstractAims To investigate validity of waist circumference measurements obtained by self‐report and self‐measurement with non‐verbal pictorial instructions among a multi‐ethnic population.Methods Five hundred and twenty‐six individuals aged 40–75 years (91 South Asian, 430 White European and five other), who attended a screening programme for Type 2 diabetes, estimated their waist circumference and measured their waist with a paper tape measure. Participants were also provided with simple pictorial instructions for measurement of waist circumference in their preferred language and remeasured their waist circumference. We calculated 95% limits of agreement with measures undertaken by a healthcare professional unaware of prior measures.Results Mean age was 56.8 years (sd 9.0), mean BMI 30.0 kg/m2 (sd 5.6) and mean waist circumference 98.4 cm (sd 14.1). Seventy‐nine per cent had high waist circumference according to International Diabetes Federation criteria. The mean of participants’ self‐reported value was 6.8 cm lower than the healthcare professional measure (sd 8.8; 95% limits of agreement −10.4 to 24.0 cm), with significant differences by sex and ethnicity (South Asian men 7.5 cm, South Asian women 0.1 cm, White European men 7.8 cm, White European women 7.0 cm, P &lt; 0.001). Compared with healthcare professional measures, mean self‐measured waist circumference was very similar, both with instructions (0.4 cm higher; sd 5.5 cm; −11.1 to 10.4 cm) and without instructions (0.5 cm lower; sd 5.6; −10.4 to 11.4 cm), but with significant differences by sex and ethnicity (P &lt; 0.001).Conclusions There was systematic underestimation of self‐reported waist circumference in this multi‐ethnic UK population. The magnitude of underestimation might reduce the performance of risk scores; however, this can be corrected through self‐measurement with pictorial instructions.

Body mass index and waist circumference associate to a comparable degree with insulin resistance and related metabolic abnormalities in South Asian women and men

The aim of this study was to test the hypothesis that body mass index (BMI) and waist circumference (WC) associate to a comparable degree with insulin resistance and cardiometabolic risk factors in South Asians. We measured blood pressure and fasting glucose, insulin, triglyceride, high-density lipoprotein cholesterol (HDL-C), high-sensitivity C-reactive protein (hs-CRP), and fibrinogen and calculated the homeostasis model assessment of insulin resistance (HOMA-IR) in a community-based sample of 923 nondiabetic South Asians. BMI and WC were highly correlated in both genders (r = 0.82 and 0.87). The relationship between BMI and values of blood pressure, glucose, insulin, HOMA-IR, triglyceride, HDL-C, hs-CRP, and fibrinogen was comparable to that between WC and these variables. Fasting insulin and HOMA-IR correlated most strongly with BMI (r = 0.49 to 0.56) and WC (r = 0.52 to 0.59). These results show that BMI and WC associate to a comparable degree with estimates of insulin resistance and related metabolic abnormalities in South Asians.

Spectacular Urbanization amidst Variegated Geographies of Globalization: Learning from Abu Dhabi's Trajectory through the Lives of South Asian Men

AbstractThe world city aspirations and spectacular urbanization of Gulf cities such as Abu Dhabi rest on the combination of petrodollars, connections and labour. Drawing on interviews with South Asian men working there, this article reports their lives and labour as a mirror to the development of Abu Dhabi. This requires and invites an investigation of spaces of social reproduction, raising broader theoretical and comparative issues about these in the context of Gulf cities and other sites of rapid urbanization and migration. Transnational categories and connections are thereby opened up in ways that have implications for the study of other cities.RésuméLes aspirations à devenir ville mondiale et la spectaculaire urbanisation des grandes villes du Golfe, comme Abou Dhabi, s'appuient sur les atouts combinés que sont les pétrodollars, les capacités de connexion et la main‐d'œuvre. À partir d'entretiens auprès de travailleurs venus d'Asie du Sud, cet article relate leur vie et leur travail en les rapprochant du développement d'Abou Dhabi. Cette démarche exige et suggère une étude des espaces de reproduction sociale, soulevant à leur propos des problèmes théoriques et comparatifs plus vastes, dans le cadre des villes du Golfe ou d'autres lieux d'urbanisation et de migration accélérées. Il en résulte des connexions et des catégories transnationales dont l'étude d'autres villes doit tenir compte.

Politics of desire: Exploring the ethnicity/sexuality intersectionality in South and East Asian men who have sex with men (MSM)

‘Intersectionality’ has been used to interrupt dominant discourse surrounding LGB experiences, and has exposed their heterogeneity. Complexities of negotiating desire within a matrix of race/ethnicity and sexuality in South and East Asian men who have sex with men (MSM) has been under-explored in Black and Minority Ethnic LGB research. Our internet survey found discordance between sexual identities and sexual practices amongst Asian MSM. Many did not access LGB physical and cyberspaces, and some experienced abuse attributed to their race/ethnicity. Feeling undesired was read as a function of racism, but racism from Asian MSM, manifesting as dispreference for certain races/ethnicities, was also found. We also explored intersections between internalised racism and homophobia which affect the lived experience of diasporic Asian MSM.