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1.
Cultural Factors Influencing Osteoarthritis Care in Asian Communities: A Review of the Evidence.
Sathiyamoorthy, T, Ali, SA, Kloseck, M
Journal of community health. 2018;(4):816-826
Abstract
With the prevalence of osteoarthritis (OA) increasing internationally, there is a need to study the impact of this disease on culturally diverse populations. Individuals of Asian descent make up more than 60% of the world population, yet comprehensive information on the cultural factors that impact OA care is not available. Scoping review methodology using directed content analysis was employed to identify and analyze existing research on OA care for Asians. A categorization matrix was developed using the six care areas from the OA clinical practice guidelines along with an additional three non-clinical areas (cross-cultural adaptation of clinical tools; psychological well-being; family systems and informal care) identified in an initial scan resulting in a total of nine OA care areas to guide initial coding. A full scoping review was conducted across five databases resulting in 656 abstracts screened. All text was coded using the categorization matrix and resulting subthemes were identified. A total of 74 articles were analyzed with 23 subthemes identified across the nine categories. Four new perspectives emerged to support OA care for Asian populations: (1) the importance of family and peer assistance, (2) the importance of culturally specific activities, (3) distrust in western medicine, and (4) impact of positive coping mechanisms on health appraisals. While Asians are more susceptible to knee and hand OA because of their cultural lifestyle factors (e.g. squatting for chores, hygiene and religious activities), and traditional beliefs on OA management (e.g. traditional diet, topical oils, physical therapy), many do not present themselves for conventional treatments (e.g. surgery) until all traditional treatments are exhausted. The results suggest that cultural factors influence the uptake of OA management practices among Asians. Greater awareness of these cultural factors may improve diagnosis, treatment, and management of OA among Asian patients.
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2.
Impact of preoperative anemia on outcomes in patients undergoing curative resection for gastric cancer: a single-institution retrospective analysis of 2163 Chinese patients.
Liu, X, Qiu, H, Huang, Y, Xu, D, Li, W, Li, Y, Chen, Y, Zhou, Z, Sun, X
Cancer medicine. 2018;(2):360-369
Abstract
We sought to evaluate whether preoperative anemia was an important determinant of survival in gastric cancer (GC). A single institution cohort of 2163 GC patients who underwent curative resection were retrospectively analyzed. Anemia was defined as a preoperative hemoglobin level <120 g/L in males and <110 g/L in females. Overall survival (OS) was analyzed using the Kaplan-Meier method, and a multivariate Cox proportional hazards model was performed to identify the independent prognostic factor. Anemic patients had a poorer OS compared with nonanemic patients after resection for tumor-nodes-metastasis (TNM) stage III tumors (5-year OS rate: 32.2% vs. 45.7%, P < 0.001) but not stage I (P = 0.480) or stage II (P = 0.917) tumors. Multivariate analysis revealed that preoperative anemia was an independent prognostic factor in TNM stage III (hazard ratio [HR], 1.771; 95% CI, 1.040-3.015; P = 0.035). In a stage-stratified analysis, preoperative anemia was still independently associated with OS in TNM stages IIIa through IIIc (P < 0.001, P = 0.075, and P = 0.012, respectively), though the association was only marginal in stage IIIb. Of note, preoperative mild anemia had a similar prognostic value in TNM stage III GC. Furthermore, preoperative anemia was significantly associated with more perioperative transfusions, postoperative complications and several nutritional-based indices, including the prognostic nutritional index (PNI), preoperative weight loss and performance status (all P < 0.05). Preoperative anemia, even mild anemia, was an important predictor of postoperative survival for TNM stage III GC.
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3.
The Association of Acylcarnitines and Amino Acids With Age in Dutch and South-Asian Surinamese Living in Amsterdam.
Muilwijk, M, Vaz, FM, Celis-Morales, C, Peters, RJG, van Valkengoed, IGM
The Journal of clinical endocrinology and metabolism. 2018;(10):3783-3791
Abstract
CONTEXT Type 2 diabetes and cardiovascular disease occur more frequently and at a younger age in South-Asians than Europeans. This may be related to differences in regulation of the fatty acid metabolism during aging. We compared age-related acylcarnitine and amino acid concentrations in Dutch and South-Asian Surinamese study participants. METHODS We measured types of acylcarnitine and amino acid concentrations in plasma (by tandem mass spectrometry) in a random subsample of 350 Dutch and 350 South-Asian Surinamese origin participants of the Healthy Life in an Urban Setting study (Amsterdam, Netherlands). We derived principal components (PCs) from the metabolites. Linear regression was used to assess differences in PCs and individual metabolite concentrations, and their age trends between the groups by sex. We adjusted for body mass index and intake of fat and total energy. RESULTS Mean age was 44.8 (SD, 13.3) years. Amino acid concentrations were higher among South-Asian Surinamese women compared with Dutch women; acylcarnitine and amino acid levels were higher among South-Asian Surinamese men than Dutch men. Metabolite levels increased similarly with age in both ethnic groups. Results remained similar after adjustment. CONCLUSION Ethnic differences in metabolite concentrations suggest that fatty acid and amino acid metabolism are more dysregulated among South-Asian Surinamese compared with Dutch from a young age. During adulthood, metabolites increase similarly in both ethnic groups.
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4.
Higher serum zinc levels may reduce the risk of cervical cancer in Asian women: A meta-analysis.
Xie, Y, Wang, J, Zhao, X, Zhou, X, Nie, X, Li, C, Huang, F, Yuan, H
The Journal of international medical research. 2018;(12):4898-4906
Abstract
OBJECTIVE This meta-analysis was conducted to examine the possible association between serum zinc concentration and cervical cancer risk. METHODS PubMed, WanFang, China National Knowledge Infrastructure, and SinoMed databases were searched for relevant articles published between January 1980 and September 2017. Results were combined using a random-effects model, and pooled standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated to compare serum zinc levels in patients with cervical cancer versus controls. Publication bias was evaluated using Begg's funnel plot and Egger's regression asymmetry test. RESULTS Twelve articles regarding serum zinc levels and cervical cancer were included in this meta-analysis. Combined results showed that serum zinc levels in cervical cancer cases were significantly lower than in controls without cervical cancer (summary SMD -1.379, 95% CI -1.527, -1.231), with high heterogeneity ( I2 = 98.8%). Analysis of data stratified by geographic location showed a significant association between serum zinc levels and cervical cancer risk in Asian populations (summary SMD -1.391, 95% CI -1.543, -1.239). CONCLUSIONS Higher serum zinc levels may be a protective factor for cervical cancer in Asian women.
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5.
The "T" allele of apolipoprotein A5 rs2075291 is significantly associated with higher total cholesterol and triglyceride and lower high-density lipoprotein cholesterol levels in Asians: a meta-analysis.
Qian, X, Li, Y, Liu, X, Li, L, Yang, K, Liu, R, Zhang, H, Shi, Y, Yu, F, Mao, Z, et al
Nutrition research (New York, N.Y.). 2018;:11-22
Abstract
Previous studies have discussed the association between apolipoprotein A5 (APOA5) gene rs2075291 polymorphism and lipid levels, but the results were inconsistent. The meta-analysis was performed to evaluate the reported effects of rs2075291 polymorphism on blood lipid levels, including total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) in Asians. A literature search was performed in six databases from January 1, 2001 to March 1, 2017. A standardized mean difference (SMD) with 95% confidence interval (95% CI) was computed to estimate the effect value. Overall, 10 articles with 19 reports were included and most of them were from Chinese institutions. Pooled results indicated significant effects of rs2075291 on lipid levels in Asians; the carriers of T allele had higher TC and TG levels but lower HDL-C level than the non-carriers, and the corresponding SMD (95% CI) were 0.20 (0.04-0.36), 0.74 (0.54-0.94), and -0.17 (-0.33 to -0.00), respectively. No significant difference was found for the LDL-C level: P = .172. Although results from the meta-analysis suggest that the T allele of the APOA5 rs2075291 is associated with higher TC and TG levels and lower HDL-C levels, large-scale studies considering the gene-gene and gene-environment interaction are needed to further explore the effects of rs2075291 polymorphism on blood lipid levels in different ethnicities.
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6.
Clinical management of type 2 diabetes in south Asia.
Misra, A, Sattar, N, Tandon, N, Shrivastava, U, Vikram, NK, Khunti, K, Hills, AP
The lancet. Diabetes & endocrinology. 2018;(12):979-991
Abstract
Compared with other ethnic groups, south Asian people with type 2 diabetes tend to develop the disease at a younger age and manifest with higher glycaemia, dyslipidaemia, nephropathy, and cardiovascular diseases. Additionally, specific issues that can affect treatment of type 2 diabetes in south Asia include poor awareness of the disease, delay in diagnosis, inadequate treatment, the use of ineffective and often harmful alternative medicines, and frequent non-compliance with lifestyle recommendations and drug treatment. Disease development at younger ages, delayed diagnosis, and inadequate management result in early development of severe complications and premature mortality. In this Series paper, we describe the challenges associated with the increasing burden of type 2 diabetes in south Asia and discuss ways to improve clinical care of people with the disorder in the region (defined to include Bangladesh, Bhutan, India, Nepal, Pakistan, and Sri Lanka). Treatment of diabetes in south Asia needs to be individualised on the basis of diverse and heterogeneous lifestyle, phenotype, environmental, social, cultural, and economic factors. Aggressive management of risk factors from diagnosis is necessary to reduce the risk of microvascular and macrovascular complications, focusing on provision of basic treatments (eg, metformin, low-cost statins, and blood pressure-lowering drugs) and other interventions such as smoking cessation. Strengthening of the primary care model of care, better referral linkages, and implementation of rehabilitation services to care for patients with chronic complications will be important. Finally, improvement of physicians' skills, provision of relevant training to non-physician health-care workers, and the development and regular updating of national clinical management guidelines will also be crucial to improve diabetes care in the region.
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7.
Long-term follow-up in a Chinese child with congenital lipoid adrenal hyperplasia due to a StAR gene mutation.
Zhao, X, Su, Z, Liu, X, Song, J, Gan, Y, Wen, P, Li, S, Wang, L, Pan, L
BMC endocrine disorders. 2018;(1):78
Abstract
BACKGROUND Congenital lipoid adrenal hyperplasia (CLAH) is an extremely rare and the most severe form of congenital adrenal hyperplasia. Typical features include disorder of sex development, early-onset adrenal crisis and enlarged adrenal glands with fatty accumulation. CASE PRESENTATION We report a case of CLAH caused by mutations in the steroidogenic acute regulatory protein (StAR) gene. The patient had typical early-onset adrenal crisis at 2 months of age. She had normal-appearing female genitalia and a karyotype of 46, XY. The serum cortisol and adrenal steroids levels were always nearly undetectable, but the adrenocorticotropic hormone levels were extremely high. Genetic analysis revealed compound heterozygous mutations at c. 229C > T (p.Q77X) in exon 3 and c. 722C > T (p.Q258X) in exon 7 of the StAR gene. The former mutation was previously detected in only two other Chinese CLAH patients. Both mutations cause truncation of the StAR protein. The case reported here appears to be a classic example of CLAH with very small adrenal glands and is the second reported CLAH case with small adrenal glands thus far. In a 15-year follow-up, the patient's height was approximately average for females before age 4 and fell to - 1 SDS at 10 years of age. Her bone age was similar to her chronological age from age 4 to age 15 years. CONCLUSIONS In conclusion, this is a classic case of CLAH with exceptionally small adrenal glands. Q77X mutation seems to be more common in Chinese CLAH patients. Additionally, this is the first report of the growth pattern associated with CLAH after a 15-year follow-up.
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8.
[Meta-analysis on relationship between the Chinese maternal MTHFR gene polymorphism(C677T) and neural tube defects in offspring].
Zhang, C, Huo, J, Sun, J, Huang, J, Piao, W, Yin, J
Wei sheng yan jiu = Journal of hygiene research. 2018;(2):312-317
Abstract
OBJECTIVE To explore the association between maternal MTHFR gene polymorphism( C677T) and neural tube defects in offspring through Meta-analysis in China. METHODS CNKI, Pub Med, Web of Science, Chinese Wan Fang Data databases, CBM, VIP for published articles were searched from the time of Database establishment to July 5 th 2017. The search strategy was based on combinations of the English and/or Chinese keywords, 'MTHFR'and 'folate pathway'and 'polymorphism'or 'SNP'and'NTDs or Neural Tube Defects'. References of reviews and retrieved studies were also scanned. All the case-control studies about MTHFR gene C677T polymorphism and susceptibility of neural tube defect were collected, which were fulfilled the followinginclusion criteria: case-control study and cohort study design, presentation of data necessary for calculating odds ratios( ORs). Data were extracted from studies and analyzed by Rev Man 5. 3 software. RESULTS A total of 13 papers were selected, including1500 patients and 1654 controls. Meta-analysis result showed that the combined odds ratio values of neural tube defect for offspring with maternal TT, TT + CT and T allele genotypes were 1. 94, 1. 65 and 1. 39, respectively. CONCLUSION The present Meta-analysis suggests that MTHFR C677T is significantly associated with maternal risk for NTDs in the Chinese population, supplemental folic acid supplementation based on MTHFR polymorphisms will be an important means to further reduce the birth defects of newborns.
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9.
A Meta-Analysis of the Associations Between the ATP-Binding Cassette Transporter ABCA1 R219K (rs2230806) Polymorphism and the Risk of Type 2 Diabetes in Asians.
Jung, D, Cao, S, Liu, M, Park, S
Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme. 2018;(4):308-316
Abstract
Asians have relatively low insulin secretion capacity and readily develop type 2 diabetes mellitus (T2DM) when insulin resistant. For that reason, insufficient insulin secretion is critical factor for Asians at the early stage of T2DM. ATP-binding cassette transporter1 (ABCA1) is a membrane protein responsible for cholesterol efflux and its function is also important for secreting insulin in pancreatic β-cells. Given the importance of its role, different polymorphisms of ABCA1 gene might contribute differently to the development of T2DM. Here, we analyzed the association between a variant form of ABCA1 gene called ABCA1 rs2230806 and the prevalence of T2DM in a large sample size by pooling all of the case-control studies published. Relevant case-control studies were identified by searching PubMed, EMBASE, Cochrane Library, Korean scientific database, Chinese medical databases, and the Indian medical database. The association was evaluated using five genetic models such as the allelic (AG), recessive (RG), dominant (DG), homozygous (HMG), and heterozygous (HTG) genetic models. Heterogeneity of each genetic model was determined by the I2 test. A total of eight studies (7 published studies and one data set from the Korean Genetic Epidemiology Study) were eligible, satisfying Hardy-Weinberg equilibrium and included 2755 T2DM patients (case) and 16 635 nondiabetic subjects (control). All subjects in the studies were Asians. Each genetic model exhibited heterogeneity. In all genetic models, ABCA1 rs2230806 had a significant association with prevalence of T2DM: AG (OR=0.78, 95% CI: 0.61-0.98), RG (OR=0.72, 95% CI: 0.51-1.03), DG (OR=0.73, 95% CI: 0.55-0.97), HMG (OR=0.62, 95% CI: 0.41-0.96), and HTG (OR=0.78, 95% CI: 0.61-0.99). There was no single study that changed the overall effects in allelic genetic model with random effects. No publication bias existed in any models except the RG model. In conclusion, middle-aged and elderly adults with the minor allele of ABCA1 rs2230806 will have a lower risk of T2DM. This is the first meta-analysis to evaluate the association in Asians.
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10.
Identification of CDAN1, C15ORF41 and SEC23B mutations in Chinese patients affected by congenital dyserythropoietic anemia.
Wang, Y, Ru, Y, Liu, G, Dong, S, Li, Y, Zhu, X, Zhang, F, Chang, YZ, Nie, G
Gene. 2018;:73-78
Abstract
Congenital dyserythropoietic anaemias (CDAs) are a group of rare haematological disorders characterized by ineffective erythropoiesis and dyserythropoiesis and reduced numbers of red cells, often with an abnormal morphology. Pathogenic defects in CDAN1, C15ORF41, SEC23B, KIF23, KLF1 and GATA1 genes have been identified in CDAs patients. In this study, we described 13 unrelated Chinese CDAs patients and identified 21 mutations, including 5 novel mutations in CDAN1 gene, and 5 novel mutations in SEC23B gene. Additionally, we predicted the molecular consequence of these missense mutations with Polymorphism Phenotyping v2 (Polyphen), Sorting Intolerant From Tolerant (SIFT), MutPred (http://mutpred1.mutdb.org/) and Protein Variation Effect Analyzer (Provean, http://provean.jcvi.org/seq_submit.php) and analyzed the conservation of the mutated amino acid among proteins from several mammalian species.