Diabetes and Diabetes Care among Nonobese Japanese-Americans: Findings from a Population-Based Study.

OBJECTIVES: The objectives of this study are as follows: (1) to determine the prevalence of diabetes among nonobese Japanese-Americans and to determine the adjusted odds of diabetes among nonobese Japanese-Americans compared to non-Hispanic Whites (NHWs); (2) to identify the risk factors associated with having diabetes in a large sample of nonobese Japanese-Americans; and (3) to determine the prevalence and adjusted odds of diabetes management behaviors among nonobese Japanese-Americans with diabetes in comparison to NHWs with diabetes. METHODS: The combined 2007-2016 waves of the adult California Health Interview Survey (CHIS) were used to analyze a nonobese (BMI<30) sample of 2,295 Japanese-Americans and 119,651 NHWs. Chi-square and logistic regression analyses were performed using Stata. RESULTS: The findings of this representative community study of nonobese Californians indicate that the prevalence of diabetes among Japanese-American respondents was higher than their NHW counterparts (8.0% versus 4.5%). Prevalence increased markedly with age; one-quarter of nonobese Japanese Americans aged 80 and older had diabetes. CONCLUSIONS: The prevalence of diabetes among nonobese Japanese-Americans is significantly higher than that among NHWs. There is an urgent need to develop appropriate intervention and prevention approaches with lifestyle modification specifically targeted towards nonobese Japanese-Americans.

Diabetes Care of Non-obese Korean Americans: Considerable Room for Improvement.

BACKGROUND: Family doctors are increasingly managing the diabetes care of Korean-Americans. Little is known about the prevalence of diabetes among non-obese Korean-Americans, or the extent to which they receive timely and appropriate diabetes care. The purpose of this investigation is to: (1) identify the prevalence of diabetes and to determine the adjusted odds of diabetes among non-obese Korean-Americans compared to non-Hispanic White (NHW) Americans, (2) examine the factors associated with having diabetes in a large sample of non-obese KoreanAmericans, and (3) determine the prevalence and adjusted odds of optimal frequency of eye care, foot care and A1C blood glucose level monitoring among non-obese Korean-Americans with diabetes in comparison to NHWs with diabetes. METHODS: Secondary analysis of population-based data from the combined 2007, 2009, and 2011 adult California Health Interview Survey. The sample included 74,361 respondents with body mass index (BMI) <30 kg/m2 (referred to as 'non-obese BMI'), of whom 2,289 were Korean-Americans and 72,072 were NHWs, and 4,576 had diabetes. RESULTS: The prevalence and adjusted odds of diabetes among non-obese Korean-Americans are significantly higher than among their NHW peers. More than 90% of Korean-Americans with diabetes were non-obese. NHWs had substantially higher odds of having optimal frequency of eye care, foot care and A1C glucose level monitoring, even after adjusting for insulin dependence, sex, age, education, income, and BMI. CONCLUSION: Non-obese Korean-Americans are at higher risk for diabetes and are much less likely to receive optimal diabetes care in comparison to NHWs. Targeted outreach is necessary.

Arsenic exposure alters lung function and airway inflammation in children: A cohort study in rural Bangladesh.

Exposure to arsenic has been associated with increased risk of reduced lung function in adults, but the adverse impacts in early life are unclear. We aim to examine whether prenatal and childhood arsenic exposure is associated with reduced lung function and increased airway inflammation in school-aged children. Children born in the MINIMat cohort in rural Bangladesh were evaluated at 9years of age (n=540). Arsenic exposure was assessed in urine (U-As) that was collected from mothers during early pregnancy and their children aged 4.5 and 9years. In the 9-year-old children, lung function was assessed using spirometry and airway inflammation was assessed by the NIOX MINO system. C-reactive protein (CRP) and Clara cell secretory protein (CC16) concentrations were measured in plasma by immunoassays. The U-As concentrations in 9-year-old children were lower (median 53µg/l) compared to their mothers (median 76µg/l). Maternal U-As (log2 transformed) was inversely associated with forced vital capacity (FVC) and forced expiratory volume at 1s (FEV1) (ß=-12; 95% CI: -22, -1.5; p=0.031 and ß=-12; 95% CI: -22, -1.9; p=0.023, respectively) in all children, and the associations were stronger in boys and among children with adequate height and weight, as well as among those whose mothers had higher percentages of methylarsonic acid (MMA) and lower percentages of dimethylarsinic acid (DMA). U-As (log2 transformed) at 4.5 and 9years was positively associated with fractional exhaled nitric oxide (FENO) concentrations in boys (ß=0.89; 95% CI: 0.13, 1.66; p=0.022 and ß=0.88; 95% CI: 0.16, 1.61; p=0.017, respectively) but not in girls. Increased CC16 concentrations were associated with higher lung function indices. In conclusion, our findings suggest that prenatal arsenic exposure is related to impaired lung function, while childhood exposure may increase airway inflammation, particularly in boys.

Diabetes among non-obese Filipino Americans: Findings from a large population-based study.

OBJECTIVES: Filipino Americans form the second-largest Asian American and Pacific Islanders subgroup. Growing evidence suggests that Filipino Americans have higher rates of diabetes than non-Hispanic whites. The key objectives of this study are 1) to determine the prevalence of diabetes in non-obese Filipino Americans compared to non-obese non-Hispanic whites, and 2) to identify risk factors for diabetes in non-obese Filipino men and women. METHODS: Secondary analysis of population-based data from combined waves (2007, 2009 and 2011) of the adult California Health Interview Survey (CHIS). The study sample was restricted to non-obese Filipino Americans (n = 1629) and non-Hispanic whites (n = 72 072). RESULTS: Non-obese Filipino Americans had more than twice the odds of diabetes compared to non-Hispanic whites, even after correcting for several known risk factors (OR = 2.80, p < 0.001). For non-obese Filipino men, older age, poverty, cigarette smoking, and being overweight are associated with increased odds for diabetes, while older age was the only factor associated with diabetes among Filipina women. DISCUSSION: Diabetes prevention approaches need to be targeted towards non-obese Filipino Americans, due to their high risk of diabetes.

Maternal Micronutrient Supplementation and Long Term Health Impact in Children in Rural Bangladesh.

BACKGROUND: Limited data is available on the role of prenatal nutritional status on the health of school-age children. We aimed to determine the impact of maternal micronutrient supplementation on the health status of Bangladeshi children. METHODS: Children (8.6-9.6 years; n = 540) were enrolled from a longitudinal mother-child cohort, where mothers were supplemented daily with either 30mg iron and 400µg folic acid (Fe30F), or 60mg iron and 400µg folic acid (Fe60F), or Fe30F including 15 micronutrients (MM), in rural Matlab. Blood was collected from children to determine the concentration of hemoglobin (Hb) and several micronutrients. Anthropometric and Hb data from these children were also available at 4.5 years of age and mothers at gestational week (GW) 14 and 30. RESULTS: MM supplementation significantly improved (p≤0.05) body mass index-for-age z-score (BAZ), but not Hb levels, in 9 years old children compared to the Fe30F group. MM supplementation also reduced markers of inflammation (p≤0.05). About 28%, 35% and 23% of the women were found to be anemic at GW14, GW30 and both time points, respectively. The prevalence of anemia was 5% and 15% in 4.5 and 9 years old children, respectively. The adjusted odds of having anemia in 9 year old children was 3-fold higher if their mothers were anemic at both GW14 and GW30 [Odds Ratio (OR) = 3.05; 95% Confidence Interval (CI) 1.42, 6.14, P = 0.002] or even higher if they were also anemic at 4.5 years of age [OR = 5.92; 95% CI 2.64, 13.25; P<0.001]. CONCLUSION: Maternal micronutrient supplementation imparted beneficial effects on child health. Anemia during pregnancy and early childhood are important risk factors for the occurrence of anemia in school-age children.