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1.
Nature ; 596(7872): 393-397, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34349265

RESUMO

Reproductive longevity is essential for fertility and influences healthy ageing in women1,2, but insights into its underlying biological mechanisms and treatments to preserve it are limited. Here we identify 290 genetic determinants of ovarian ageing, assessed using normal variation in age at natural menopause (ANM) in about 200,000 women of European ancestry. These common alleles were associated with clinical extremes of ANM; women in the top 1% of genetic susceptibility have an equivalent risk of premature ovarian insufficiency to those carrying monogenic FMR1 premutations3. The identified loci implicate a broad range of DNA damage response (DDR) processes and include loss-of-function variants in key DDR-associated genes. Integration with experimental models demonstrates that these DDR processes act across the life-course to shape the ovarian reserve and its rate of depletion. Furthermore, we demonstrate that experimental manipulation of DDR pathways highlighted by human genetics increases fertility and extends reproductive life in mice. Causal inference analyses using the identified genetic variants indicate that extending reproductive life in women improves bone health and reduces risk of type 2 diabetes, but increases the risk of hormone-sensitive cancers. These findings provide insight into the mechanisms that govern ovarian ageing, when they act, and how they might be targeted by therapeutic approaches to extend fertility and prevent disease.


Assuntos
Envelhecimento/genética , Ovário/metabolismo , Adulto , Alelos , Animais , Osso e Ossos/metabolismo , Quinase 1 do Ponto de Checagem/genética , Quinase do Ponto de Checagem 2/genética , Diabetes Mellitus Tipo 2 , Dieta , Europa (Continente)/etnologia , Extremo Oriente/etnologia , Feminino , Fertilidade/genética , Proteína do X Frágil de Retardo Mental/genética , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Envelhecimento Saudável/genética , Humanos , Longevidade/genética , Menopausa/genética , Menopausa Precoce/genética , Camundongos , Camundongos Endogâmicos C57BL , Pessoa de Meia-Idade , Insuficiência Ovariana Primária/genética , Útero
2.
Diabetes Res Clin Pract ; 176: 108848, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33945841

RESUMO

AIMS: To evaluate efficacy and safety of Gla-300 with Gla-100 in a patient-level meta-analysis among large East Asian patients with type 2 diabetes mellitus (T2DM). METHODS: A patient level meta-analysis of three EDITION studies with similar design and endpoints were conducted over 6-months treatment period. The analysis included 547 patients treated with Gla-300 and 348 patients treated with Gla-100. RESULTS: Over 6-month treatment period, mean change in HbA1c was similar for Gla-300 [Least square (LS) mean, (SE): -1.13 (0.05) % and Gla-100: -1.14 (0.05) %], showing non-inferiority of Gla-300 to Gla-100 (LS mean difference: 0.02%, 95% CI: -0.08 to 0.11). Gla-300 was associated with reduced risk of hypoglycemic event (confirmed ≤ 3.9 mmol/L or severe) vs Gla-100 at any time of day or at night (00:00-05:59 h). The event rates of hypoglycemia were consistently lower with Gla-300 than Gla-100. Severe hypoglycemia was rare in both treatment groups. Weight gain was minimal in both treatment groups. CONCLUSION: Gla-300 provides comparable glycemic control to Gla-100 in East Asian patients with broad clinical spectrum of T2DM, with consistently less hypoglycemia at any time of the day and night.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Controle Glicêmico/métodos , Insulina Glargina/administração & dosagem , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático , Ensaios Clínicos Fase III como Assunto/estatística & dados numéricos , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/etnologia , Relação Dose-Resposta a Droga , Extremo Oriente/etnologia , Feminino , Hemoglobina A Glicada/análise , Hemoglobina A Glicada/efeitos dos fármacos , Hemoglobina A Glicada/metabolismo , Controle Glicêmico/efeitos adversos , Humanos , Hipoglicemia/induzido quimicamente , Hipoglicemia/epidemiologia , Hipoglicemiantes/administração & dosagem , Hipoglicemiantes/efeitos adversos , Insulina Glargina/efeitos adversos , Masculino , Pessoa de Meia-Idade , Estudos Multicêntricos como Assunto/estatística & dados numéricos , Ensaios Clínicos Controlados Aleatórios como Assunto/estatística & dados numéricos , Ganho de Peso/efeitos dos fármacos , Ganho de Peso/etnologia
3.
Mol Genet Genomics ; 296(4): 783-797, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34037863

RESUMO

East Asia, geographically extending to the Pamir Plateau in the west, to the Himalayan Mountains in the southwest, to Lake Baikal in the north and to the South China Sea in the south, harbors a variety of people, cultures, and languages. To reconstruct the natural history of East Asians is a mission of multiple disciplines, including genetics, archaeology, linguistics, and ethnology. Geneticists confirm the recent African origin of modern East Asians. Anatomically modern humans arose in Africa and immigrated into East Asia via a southern route approximately 50,000 years ago. Following the end of the Last Glacial Maximum approximately 12,000 years ago, rice and millet were domesticated in the south and north of East Asia, respectively, which allowed human populations to expand and linguistic families and ethnic groups to develop. These Neolithic populations produced a strong relation between the present genetic structures and linguistic families. The expansion of the Hongshan people from northeastern China relocated most of the ethnic populations on a large scale approximately 5300 years ago. Most of the ethnic groups migrated to remote regions, producing genetic structure differences between the edge and center of East Asia. In central China, pronounced population admixture occurred and accelerated over time, which subsequently formed the Han Chinese population and eventually the Chinese civilization. Population migration between the north and the south throughout history has left a smooth gradient in north-south changes in genetic structure. Observation of the process of shaping the genetic structure of East Asians may help in understanding the global natural history of modern humans.


Assuntos
Cromossomos Humanos Y/genética , Civilização/história , Grupos Étnicos/história , Antropologia Cultural , Grupo com Ancestrais do Continente Asiático/classificação , Grupo com Ancestrais do Continente Asiático/etnologia , Grupo com Ancestrais do Continente Asiático/genética , China/etnologia , Grupos Étnicos/classificação , Grupos Étnicos/genética , Extremo Oriente/etnologia , Fluxo Gênico , Genética Populacional/história , História Antiga , Humanos , Linguística/classificação , Linguística/história , Filogenia
4.
Nature ; 592(7853): 253-257, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33828320

RESUMO

Modern humans appeared in Europe by at least 45,000 years ago1-5, but the extent of their interactions with Neanderthals, who disappeared by about 40,000 years ago6, and their relationship to the broader expansion of modern humans outside Africa are poorly understood. Here we present genome-wide data from three individuals dated to between 45,930 and 42,580 years ago from Bacho Kiro Cave, Bulgaria1,2. They are the earliest Late Pleistocene modern humans known to have been recovered in Europe so far, and were found in association with an Initial Upper Palaeolithic artefact assemblage. Unlike two previously studied individuals of similar ages from Romania7 and Siberia8 who did not contribute detectably to later populations, these individuals are more closely related to present-day and ancient populations in East Asia and the Americas than to later west Eurasian populations. This indicates that they belonged to a modern human migration into Europe that was not previously known from the genetic record, and provides evidence that there was at least some continuity between the earliest modern humans in Europe and later people in Eurasia. Moreover, we find that all three individuals had Neanderthal ancestors a few generations back in their family history, confirming that the first European modern humans mixed with Neanderthals and suggesting that such mixing could have been common.


Assuntos
DNA Antigo/análise , Genoma Humano/genética , Homem de Neandertal/genética , Alelos , América/etnologia , Animais , Arqueologia , Bulgária/etnologia , Cavernas , Extremo Oriente/etnologia , Feminino , História Antiga , Humanos , Masculino , Filogenia
5.
Nutrients ; 13(3)2021 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-33803731

RESUMO

The rising incidence of cardiometabolic diseases and chronic kidney disease (CKD) is a leading public health problem in East Asia. Diet is an important modifiable risk factor; thus, adopting a healthy diet such as the Dietary Approaches to Stop Hypertension (DASH) diet may help combat these chronic diseases. The DASH diet was originally developed in a U.S. population, and East Asia is demographically and culturally different from the U.S. Therefore, it is important to examine the evidence regarding the DASH diet and chronic disease in this unique population. This narrative review summarizes the evidence on the DASH diet and cardiometabolic health and CKD in East Asia. Culturally-modified DASH diets have been developed in some East Asian countries. Studies suggest the DASH diet is effective at lowering blood pressure in this population, though the long-term benefits remain unclear. Evidence also suggests the DASH diet may reduce the risk of type 2 diabetes and metabolic syndrome. Further research indicates the DASH diet and its components may reduce CKD risk. However, recommending the DASH diet in those who already have CKD is controversial, as it conflicts with current CKD dietary guidelines, especially in advanced CKD. Notably, current intakes in the general population differ from the DASH dietary pattern, suggesting public health efforts would be needed to encourage adoption of the DASH diet.


Assuntos
Abordagens Dietéticas para Conter a Hipertensão/etnologia , Síndrome Metabólica/etnologia , Síndrome Metabólica/prevenção & controle , Insuficiência Renal Crônica/etnologia , Insuficiência Renal Crônica/prevenção & controle , Adulto , Fatores de Risco Cardiometabólico , Extremo Oriente/epidemiologia , Extremo Oriente/etnologia , Feminino , Humanos , Incidência , Masculino , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Insuficiência Renal Crônica/epidemiologia
6.
Circ Heart Fail ; 14(3): e007537, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33724884

RESUMO

BACKGROUND: Clinical studies of hypertrophic cardiomyopathy are over-represented by individuals of European ethnicity, with less known about other ethnic groups. We investigated differences between patients in a multiethnic Australian hypertrophic cardiomyopathy population. METHODS: We performed a retrospective cohort study of 836 unrelated hypertrophic cardiomyopathy probands attending a specialized clinic between 2002 and 2020. Major ethnic groups were European (n=611), East Asian (n=75), South Asian (n=58), and Middle Eastern and North African (n=68). The minor ethnicity groups were Oceanian (n=9), People of the Americas (n=7), and African (n=8). One-way ANOVA with Dunnett post hoc test and Bonferroni adjustment were performed. RESULTS: Mean age of the major ethnic groups was 54.9±16.9 years, and 527 (65%) were male. Using the European group as the control, East Asian patients had a lower body mass index (29 versus 25 kg/m2, P<0.0001). South Asians had a lower prevalence of atrial fibrillation (10% versus 31%, P=0.024). East Asians were more likely to have apical hypertrophy (23% versus 6%, P<0.0001) and Middle Eastern and North African patients more likely to present with left ventricular outflow tract obstruction (46% versus 34%, P=0.0003). East Asians were less likely to undergo genetic testing (55% versus 85%, P<0.0001) or have an implantable cardioverter-defibrillator implanted (19% versus 36%, P=0.037). East Asians were more likely to have a causative variant in a gene other than MYBPC3 or MYH7, whereas Middle Eastern and North African and South Asians had the highest rates of variants of uncertain significance (27% and 21%, P<0.0001). CONCLUSIONS: There are few clinical differences based on ethnicity, but importantly, we identify health disparities relating to access to genetic testing and implantable cardioverter-defibrillator use. Unless addressed, these gaps will likely widen as we move towards precision-medicine-based care of individuals with hypertrophic cardiomyopathy.


Assuntos
Cardiomiopatia Hipertrófica/fisiopatologia , Grupos Étnicos/genética , Disparidades em Assistência à Saúde/etnologia , Adulto , África do Norte/etnologia , Grupo com Ancestrais do Continente Africano/genética , Idoso , Ásia/etnologia , Ásia Ocidental/etnologia , Grupo com Ancestrais do Continente Asiático/genética , Austrália , Miosinas Cardíacas/genética , Cardiomiopatia Hipertrófica/etnologia , Cardiomiopatia Hipertrófica/genética , Cardiomiopatia Hipertrófica/terapia , Proteínas de Transporte/genética , Desfibriladores Implantáveis/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/genética , Extremo Oriente/etnologia , Feminino , Testes Genéticos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Oriente Médio/etnologia , Cadeias Pesadas de Miosina/genética , Grupo com Ancestrais Oceânicos/genética , Estudos Retrospectivos
7.
Ethn Dis ; 30(4): 553-562, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32989355

RESUMO

Objective: Although the fastest growing minority group, Asian Americans receive little attention in mental health research. Moreover, aggregated data mask further diversity within Asian Americans. This study aimed to examine depression risk by detailed Asian American subgroup, and further assess determinants within and between three Asian ethnic subgroups. Methods: Needs assessment surveys were collected in 16 Asian American subgroups (six Southeast Asian, six South Asian, and four East Asian) in New York City from 2013-2016 using community-based sampling strategies. A final sample of N=1,532 completed the PHQ-2. Bivariate comparisons and multivariable logistic models explored differences in depression risk by subgroup. Results: Southeast Asians had the greatest depression risk (19%), followed by South Asians (11%) and East Asians (9%). Among Southeast Asians, depression risk was associated with lacking health insurance (OR=.2, 95% CI: 0-.6), not having a provider who speaks the same language (OR=3.2, 95% CI: 1.3-8.0), and lower neighborhood social cohesion (OR= .94, 95% CI: .71-.99). Among South Asians, depression risk was associated with greater English proficiency (OR=3.9, 95% CI: 1.6-9.2); and among East Asians, depression risk was associated with ≤ high school education (OR=4.2, 95% CI: 1.2-14.3). Additionally, among Southeast Asians and South Asians, the highest depression risk was associated with high levels of discrimination (Southeast Asian: OR=9.9, 95% CI: 1.8-56.2; South Asian: OR=7.3, 95% CI: 3.3-16.2). Conclusions: Depression risk and determinants differed by Asian American ethnic subgroup. Identifying factors associated with depression risk among these groups is key to targeting limited public health resources for these underserved communities.


Assuntos
Americanos Asiáticos/estatística & dados numéricos , Barreiras de Comunicação , Depressão/etnologia , Adolescente , Adulto , Idoso , Ásia Sudeste/etnologia , Escolaridade , Extremo Oriente/etnologia , Feminino , Humanos , Seguro Saúde , Idioma , Masculino , Pessoa de Meia-Idade , Cidade de Nova Iorque/epidemiologia , Racismo/psicologia , Características de Residência , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
9.
Nature ; 582(7811): 240-245, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32499647

RESUMO

Meta-analyses of genome-wide association studies (GWAS) have identified more than 240 loci that are associated with type 2 diabetes (T2D)1,2; however, most of these loci have been identified in analyses of individuals with European ancestry. Here, to examine T2D risk in East Asian individuals, we carried out a meta-analysis of GWAS data from 77,418 individuals with T2D and 356,122 healthy control individuals. In the main analysis, we identified 301 distinct association signals at 183 loci, and across T2D association models with and without consideration of body mass index and sex, we identified 61 loci that are newly implicated in predisposition to T2D. Common variants associated with T2D in both East Asian and European populations exhibited strongly correlated effect sizes. Previously undescribed associations include signals in or near GDAP1, PTF1A, SIX3, ALDH2, a microRNA cluster, and genes that affect the differentiation of muscle and adipose cells3. At another locus, expression quantitative trait loci at two overlapping T2D signals affect two genes-NKX6-3 and ANK1-in different tissues4-6. Association studies in diverse populations identify additional loci and elucidate disease-associated genes, biology, and pathways.


Assuntos
Grupo com Ancestrais do Continente Asiático/genética , Diabetes Mellitus Tipo 2/genética , Predisposição Genética para Doença , Aldeído-Desidrogenase Mitocondrial/genética , Alelos , Anquirinas/genética , Índice de Massa Corporal , Estudos de Casos e Controles , Europa (Continente)/etnologia , Proteínas do Olho/genética , Extremo Oriente/etnologia , Feminino , Estudo de Associação Genômica Ampla , Proteínas de Homeodomínio/genética , Humanos , Masculino , Proteínas do Tecido Nervoso/genética , RNA Mensageiro/análise , Fatores de Transcrição/genética , Transcrição Genética
10.
Bioethics ; 34(6): 570-577, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32488873

RESUMO

This paper aims to evoke an alternative viewpoint on surrogacy, moving beyond popular Western feminist beliefs on the practice, by introducing the history and current context of East Asian surrogacy. To elaborate a different cultural perspective on surrogacy, this paper first introduces the East Asian history of contract pregnancy systems, prior to the emergence of the American invention of 'modern' surrogacy practice. Then, it examines Japanese mass media portrayals of cross-border surrogacy in which white women have become 'convenient' entities. The results of the analysis show how Japanese culture has adopted a rhetoric about the use of white women as convenient surrogate mothers in the global commercial surrogacy market. An essential aspect of surrogacy is the premise that a woman's reproductive function should be accessible to others. Past discussions among feminists have neglected this important point. Moreover, they share the assumption that white surrogacy clients are exploiters, who take advantage of women of colour as surrogate mothers. The current situation in Asia flips this perspective-with white women regarded as easier targets for exploitation by wealthy people of colour. For Asian clients, Westerners can be easily regarded as 'others' whom they can use for their reproductive needs. In today's globalized era, the surrogacy industry is no longer for affluent Westerners only. Considering this change, it is crucial to discuss surrogacy issues by reconstructing feminist perspectives with a globalized view, to help protect women's bodies, regardless of nationality, ethnicity, skin colour, or religion.


Assuntos
Mercantilização , Características Culturais/história , Mães Substitutas , Extremo Oriente/etnologia , Feminino , História do Século XV , História do Século XVI , História do Século XVII , História do Século XVIII , História do Século XIX , História do Século XX , Humanos , Japão , Meios de Comunicação de Massa , Motivação , Gravidez , Comportamento Estereotipado , Estados Unidos
11.
Am J Hum Genet ; 106(6): 805-817, 2020 06 04.
Artigo em Inglês | MEDLINE | ID: mdl-32442408

RESUMO

Despite strong transethnic genetic correlations reported in the literature for many complex traits, the non-transferability of polygenic risk scores across populations suggests the presence of population-specific components of genetic architecture. We propose an approach that models GWAS summary data for one trait in two populations to estimate genome-wide proportions of population-specific/shared causal SNPs. In simulations across various genetic architectures, we show that our approach yields approximately unbiased estimates with in-sample LD and slight upward-bias with out-of-sample LD. We analyze nine complex traits in individuals of East Asian and European ancestry, restricting to common SNPs (MAF > 5%), and find that most common causal SNPs are shared by both populations. Using the genome-wide estimates as priors in an empirical Bayes framework, we perform fine-mapping and observe that high-posterior SNPs (for both the population-specific and shared causal configurations) have highly correlated effects in East Asians and Europeans. In population-specific GWAS risk regions, we observe a 2.8× enrichment of shared high-posterior SNPs, suggesting that population-specific GWAS risk regions harbor shared causal SNPs that are undetected in the other GWASs due to differences in LD, allele frequencies, and/or sample size. Finally, we report enrichments of shared high-posterior SNPs in 53 tissue-specific functional categories and find evidence that SNP-heritability enrichments are driven largely by many low-effect common SNPs.


Assuntos
Grupos Étnicos/genética , Estudo de Associação Genômica Ampla , Herança Multifatorial/genética , Polimorfismo de Nucleotídeo Único/genética , Teorema de Bayes , Europa (Continente)/etnologia , Extremo Oriente/etnologia , Frequência do Gene , Humanos , Desequilíbrio de Ligação , Especificidade de Órgãos/genética
12.
Can J Diabetes ; 44(5): 394-400, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32241753

RESUMO

OBJECTIVE: Although national guidelines advocate for earlier diabetes screening in high-risk ethnic groups, little evidence exists to guide clinicians on the age at which screening should commence. The purpose of this study was to determine age equivalency thresholds for diabetes risk across a broad range of ethnic populations. METHODS: This population-based, retrospective cohort study used linked administrative health and immigration records for 592,376 individuals in Ontario, Canada. Adjusted incidence rates by ethnicity, sex and age were used to derive ethnic-specific age thresholds for risk. RESULTS: Diabetes incidence rates in South Asians reached an equivalent risk as that experienced by a 40-year-old Western European man (3.7 per 1,000 person-years) by 25 years of age. For all other non-European ethnic groups, the equivalent risk was experienced between 30 and 35 years of age. These risk differentials persisted despite controlling for covariates. CONCLUSIONS: We found a 15-year difference in age equivalency of risk across ethnic groups.


Assuntos
Diabetes Mellitus Tipo 2/etnologia , Emigrantes e Imigrantes/estatística & dados numéricos , Adulto , África ao Sul do Saara/etnologia , África do Norte/etnologia , Grupo com Ancestrais do Continente Africano , Distribuição por Idade , Idoso , Ásia Central/etnologia , Ásia Sudeste/etnologia , Ásia Ocidental/etnologia , Grupo com Ancestrais do Continente Asiático , Região do Caribe/etnologia , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/prevenção & controle , Europa Oriental/etnologia , Grupo com Ancestrais do Continente Europeu , Extremo Oriente/etnologia , Feminino , Humanos , Incidência , América Latina/etnologia , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Oriente Médio/etnologia , Ontário/epidemiologia , Estudos Retrospectivos , Adulto Jovem
13.
J Immigr Minor Health ; 22(1): 182-211, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31152303

RESUMO

The number of female marriage migrants in East and Southeast Asia has grown significantly over the past three decades. However, little is known about the health of this population. Following Arksey and O'Malley's (Int J Soc Res Methodol 8(1):19-32, 2005) framework, a scoping review of English language research databases was used to synthesize knowledge on the health of Asian marriage migrants. This will be used to inform recommendations for health care practice and research. Fifty-five eligible studies were included and presented using five identified categories-mental health, women's health and maternal-child health, public health, general well-being, and social challenges. Overall, studies consistently document that marriage migrants experience worse health outcomes, multiple barriers to health care services, and multilevel social challenges compared with the native population in the receiving countries.


Assuntos
Nível de Saúde , Casamento/estatística & dados numéricos , Saúde Mental/etnologia , Migrantes/estatística & dados numéricos , Saúde da Mulher , Ásia Sudeste/etnologia , Grupo com Ancestrais do Continente Asiático , Saúde da Criança , Extremo Oriente/etnologia , Feminino , Acesso aos Serviços de Saúde , Humanos , Meio Social
14.
J Gerontol B Psychol Sci Soc Sci ; 75(3): 504-512, 2020 02 14.
Artigo em Inglês | MEDLINE | ID: mdl-29788464

RESUMO

OBJECTIVES: Research has shown that stereotype threat can impair older adults' memory in Western cultures. We tested whether this also occurs for older adults from the East Asian Chinese culture. We also tested whether an intervention that highlighted Confucian principles would protect Chinese older adults from stereotype threat's detrimental effects. METHOD: Culturally-Chinese older adults residing in the United States completed a memory test either under age-based stereotype threat about cognitive decline or not. Prior to this, some participants were also reminded of Confucian traditions of filial piety and were assured these values had been transmitted to the younger generation. RESULTS: Stereotype threat impaired Chinese older adults' memory performance. However, our intervention was effective in eliminating this deficit. When the Chinese participants were reminded of the Confucian principle of filial piety they did not exhibit stereotype threat effects. DISCUSSION: Confirming that younger adults have an obligation to respect their elders can eliminate the social-evaluative pressure of stereotype threat for Chinese older adults. These findings are noteworthy since population aging is happening at an unprecedented pace in East Asia. Although our results suggest that stereotype threat can adversely affect older adults' cognitive performance in these societies, we also identify a culturally-based intervention to alleviate this impairment.


Assuntos
Ageismo/etnologia , Envelhecimento/etnologia , Americanos Asiáticos , Disfunção Cognitiva/etnologia , Confucionismo , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Religião e Psicologia , Estereotipagem , Idoso , Idoso de 80 Anos ou mais , Extremo Oriente/etnologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Distribuição Aleatória , Estados Unidos/etnologia
15.
Am J Cardiol ; 124(7): 1012-1019, 2019 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-31351575

RESUMO

Recent evidence suggests plaque morphology evaluated on coronary computed tomography angiography has prognostic implications. East Asians have a lower prevalence of myocardial infarction and cardiovascular mortality compared with European-origin Caucasians. We aimed to compare coronary atherosclerotic burden and plaque composition in a matched cohort of Caucasian and East Asians patients with stable chest pain who underwent computed tomography angiography. Two-hundred symptomatic patients (age 58.8 ± 7.9, male 51%) were matched for age, gender, body mass index, and diabetes (100 each ethnic group). A blinded core-laboratory quantified calcified and noncalcified plaque (NCP) volume and burden. Components of NCP were differentiated by plaque hounsfield unit (HU) thresholds which defined high-risk necrotic core (-30 to 30HU), fibrofatty plaque (31 to 130HU); and low-risk fibrous plaque (131 to 350HU). Composition of NCP components was derived as (NCP component volume/total NCP volume) × 100%. Segment Involvement Score, percent diameter and area stenosis were comparable in both groups. Similarly, there was no difference in the volume and burden of total, calcified and NCP. Compared with Caucasians, East Asians demonstrated lower composition of plaque attenuation corresponding to necrotic core (3.5 vs 5.1%; p = 0.004) and fibrofatty plaque (29.6 vs 37.3%; p = 0.005), and higher fibrous plaque (65.7 vs 57.6%; p = 0.004). On multivariable analysis East Asian ethnicity was independently associated with lower composition of high-risk plaque after adjustment for risk factors and scan parameters. These findings were consistent in a propensity-matched sensitivity-analysis. In conclusion, based on this matched cohort, East Asian ethnicity is associated with significantly less composition of high-risk NCP (necrotic core and fibrofatty plaque) and a higher composition of low-risk fibrous plaque compared with Caucasians; which may confer a lower risk of cardiovascular events.


Assuntos
Grupo com Ancestrais do Continente Asiático , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/etnologia , Grupo com Ancestrais do Continente Europeu , Placa Aterosclerótica/diagnóstico por imagem , Placa Aterosclerótica/etnologia , Idoso , Austrália , Angiografia por Tomografia Computadorizada , Angiografia Coronária , Doença da Artéria Coronariana/patologia , Extremo Oriente/etnologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Placa Aterosclerótica/patologia , Estudos Retrospectivos
16.
Am J Hum Biol ; 31(5): e23263, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31197927

RESUMO

OBJECTIVES: The distribution of hypertension, type 2 diabetes, dyslipidemia, and obesity variables were studied among tribal and non-tribal populations with East Asian ancestry from northeast India. METHODS: Data pertaining to somatometric measurements, blood pressure, lipid profile, and fasting blood glucose were collected from 1916 participants (Mizo-422, Liangmai-352, and Meitei-1142) of both sexes older than 18 years. Two-way ANOVA and chi square analysis were done to understand the inter-population prevalence differences. RESULTS: Differential distribution of obesity variables, hypertension, type 2 diabetes, and dyslipidemia was observed among the three populations. CONCLUSIONS: Population-specific prevalence studies need to be conducted to develop population-specific health strategies, specifically in countries like India with huge diversity.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Dislipidemias/epidemiologia , Hipertensão/epidemiologia , Obesidade/epidemiologia , Diabetes Mellitus Tipo 2/etnologia , Diabetes Mellitus Tipo 2/etiologia , Dislipidemias/etnologia , Dislipidemias/etiologia , Extremo Oriente/etnologia , Hipertensão/etnologia , Hipertensão/etiologia , Índia/epidemiologia , Obesidade/etnologia , Obesidade/etiologia , Prevalência , Fatores de Risco
17.
J Natl Cancer Inst ; 111(12): 1298-1306, 2019 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-31093668

RESUMO

BACKGROUND: The incidence of breast cancer among younger East Asian women has been increasing rapidly over recent decades. This international collaborative study systemically compared the differences in age-specific incidences and pathological characteristics of breast cancer in East Asian women and women of predominantly European ancestry. METHODS: We excerpted analytic data from six national cancer registries (979 675 cases) and eight hospitals (18 008 cases) in East Asian countries and/or regions and, for comparisons, from the US Surveillance, Epidemiology, and End Results program database. Linear regression analyses of age-specific incidences of female breast cancer and logistic regression analyses of age-specific pathological characteristics of breast cancer were performed. All statistical tests were two-sided. RESULTS: Unlike female colorectal cancer, the age-specific incidences of breast cancer among East Asian women aged 59 years and younger increased disproportionally over recent decades relative to rates in US contemporaries. For years 2010-2014, the estimated age-specific probability of estrogen receptor positivity increased with age in American patients, whereas that of triple-negative breast cancer (TNBC) declined with age. No similar trends were evident in East Asian patients; their probability of estrogen receptor positivity at age 40-49 years was statistically significantly higher (odd ratio [OR] = 1.50, 95% confidence interval [CI] = 1.36 to 1.67, P < .001) and of TNBC was statistically significantly lower (OR = 0.79, 95% CI = 0.71 to 0.88, P < .001), whereas the probability of ER positivity at age 50-59 years was statistically significantly lower (OR = 0.88, 95% CI = 0.828 to 0.95, P < .001). Subgroup analyses of US Surveillance, Epidemiology, and End Results data showed similarly distinct patterns between East Asian American and white American patients. CONCLUSIONS: Contrasting age-specific incidences and pathological characteristics of breast cancer between East Asian and American women, as well as between East Asian Americans and white Americans, suggests racial differences in the biology.


Assuntos
Neoplasias da Mama/epidemiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Americanos Asiáticos/estatística & dados numéricos , Neoplasias da Mama/química , Intervalos de Confiança , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Extremo Oriente/epidemiologia , Extremo Oriente/etnologia , Feminino , Humanos , Imunofenotipagem , Incidência , Modelos Lineares , Pessoa de Meia-Idade , Razão de Chances , Receptor ErbB-2 , Receptores de Estrogênio , Sistema de Registros/estatística & dados numéricos , República da Coreia/epidemiologia , Programa de SEER/estatística & dados numéricos , Singapura/epidemiologia , Singapura/etnologia , Neoplasias de Mama Triplo Negativas/epidemiologia , Estados Unidos/epidemiologia
18.
Lancet Glob Health ; 7(2): e236-e248, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30683241

RESUMO

BACKGROUND: Global migration from regions where strongyloidiasis and schistosomiasis are endemic to non-endemic countries has increased the potential individual and public health effect of these parasitic diseases. We aimed to estimate the prevalence of these infections among migrants to establish which groups are at highest risk and who could benefit from screening. METHODS: We did a systematic review and meta-analysis of strongyloidiasis and schistosomiasis prevalence among migrants born in endemic countries. Original studies that included data for the prevalence of Strongyloides or Schistosoma antibodies in serum or the prevalence of larvae or eggs in stool or urine samples among migrants originating from countries endemic for these parasites and arriving or living in host countries with low endemicity-specifically the USA, Canada, Australia, New Zealand, Israel, and 23 western European countries-were eligible for inclusion. Pooled estimates of the prevalence of strongyloidiasis and schistosomiasis by stool or urine microscopy for larvae or eggs or serum antibodies were calculated with a random-effects model. Heterogeneity was explored by stratification by age, region of origin, migrant class, period of study, and type of serological antigen used. FINDINGS: 88 studies were included. Pooled strongyloidiasis seroprevalence was 12·2% (95% CI 9·0-15·9%; I2 96%) and stool-based prevalence was 1·8% (1·2-2·6%; 98%). Migrants from east Asia and the Pacific (17·3% [95% CI 4·1-37·0]), sub-Saharan Africa (14·6% [7·1-24·2]), and Latin America and the Caribbean (11·4% [7·8-15·7]) had the highest seroprevalence. Pooled schistosomiasis seroprevalence was 18·4% (95% CI 13·1-24·5; I2 97%) and stool-based prevalence was 0·9% (0·2-1·9; 99%). Sub-Saharan African migrants had the highest seroprevalence (24·1·% [95% CI 16·4-32·7]). INTERPRETATION: Strongyloidiasis affects migrants from all global regions, whereas schistosomiasis is focused in specific regions and most common among sub-Saharan African migrants. Serological prevalence estimates were several times higher than stool estimates for both parasites. These data can be used to inform screening decisions for migrants and support the use of serological screening, which is more sensitive and easier than stool testing. FUNDING: None.


Assuntos
Emigrantes e Imigrantes/estatística & dados numéricos , Esquistossomose/epidemiologia , Estrongiloidíase/epidemiologia , África ao Sul do Saara/etnologia , Austrália/epidemiologia , Canadá/epidemiologia , Região do Caribe/etnologia , Doenças Endêmicas , Europa (Continente)/epidemiologia , Extremo Oriente/etnologia , Fezes/parasitologia , Humanos , Israel/epidemiologia , América Latina/etnologia , Programas de Rastreamento , Nova Zelândia/epidemiologia , Ilhas do Pacífico/etnologia , Prevalência , Esquistossomose/sangue , Esquistossomose/diagnóstico , Esquistossomose/urina , Estudos Soroepidemiológicos , Testes Sorológicos , Estrongiloidíase/sangue , Estrongiloidíase/diagnóstico , Estrongiloidíase/urina , Estados Unidos/epidemiologia
19.
J Obstet Gynaecol Can ; 41(1): 21-28, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30316709

RESUMO

BACKGROUND: The risk of invasive cervical cancer (ICC) varies throughout the world. We aimed to compare the risk of this invasive disease among immigrants arriving in Ontario with that of the general female population of Ontario. METHODS: We used an exposure-control matched design. We identified females from the Immigration, Refugees, and Citizenship Canada (IRCC) database with arrival in Ontario, and whose first eligibility for the Ontario Health Insurance Plan according to its Registered Persons Database fell between July 1, 1991, and June 30, 2008, at age 20 years or older, and matched two female controls on year of birth. We identified cases of ICC between the index date and December 31, 2014. Crude rates and relative rates of ICC were calculated. Multivariable extended Cox regression models were then implemented. RESULTS: The crude rate of ICC was 0.032 per 100 000 person-years for immigrants and 0.037 for controls. Immigrants who were born in certain countries showed a higher risk of ICC; Russia had a relative rate of 1.736 compared with a relative rate of 0.221 among those born in Iran. Among immigrants, the age-adjusted HR was 0.76 (95% CI 0.63-0.92) after 10 years of residency when compared with controls. Immigrants aged 20 to 39 years had a lower risk of ICC compared with controls of equivalent age, and immigrants aged ≥40 years had a higher risk of ICC. CONCLUSIONS: The risk of ICC among immigrants in Ontario varies by age, country of birth, and time since immigration.


Assuntos
Carcinoma/epidemiologia , Emigrantes e Imigrantes/estatística & dados numéricos , Neoplasias do Colo do Útero/epidemiologia , Adulto , África ao Sul do Saara/etnologia , África do Norte/etnologia , Idoso , Ásia Central/etnologia , Carcinoma/patologia , Região do Caribe/etnologia , Estudos de Casos e Controles , Europa (Continente)/etnologia , Extremo Oriente/etnologia , Feminino , Humanos , América Latina/etnologia , Pessoa de Meia-Idade , Oriente Médio/etnologia , Análise Multivariada , Invasividade Neoplásica , Ontário/epidemiologia , Modelos de Riscos Proporcionais , Neoplasias do Colo do Útero/patologia , Adulto Jovem
20.
J Autism Dev Disord ; 49(4): 1665-1685, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30569408

RESUMO

Families play a crucial role in determining the mental health of the autistic individual(s) they are caring for. However, the stigma associated with autism can impair caregiver health. To investigate this, empirical evidence pertaining to stigma's impact on informal caregivers' mental health was systematically reviewed. All twelve included studies (n = 1442 informal caregivers) consistently reported the impact of autism related stigma upon caregiver mental health to be significant, meaningful and complex. A new theoretical framework describing the relationship between stigma and caregiver mental health is constructed. Moderating variables include those both changeable through intervention (e.g. hopelessness, self-esteem, self-compassion) and not changeable (gender, culture, financial burden and time since diagnosis). Implications and recommendations for professionals, interventions and future research are proposed.


Assuntos
Transtorno Autístico/psicologia , Transtorno Autístico/terapia , Cuidadores/psicologia , Saúde Mental , Estigma Social , Transtorno Autístico/etnologia , Empatia/fisiologia , Extremo Oriente/etnologia , Humanos , Saúde Mental/etnologia , Saúde Mental/tendências , Oriente Médio/etnologia , Estados Unidos/etnologia
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