Identifying Disparities in Type 2 Diabetes Among Asian Americans: The Pan Asian C

确定亚裔美国人 2 型糖尿病的差异：泛亚裔 C

• 批准号: 7755901
• 负责人: Latha P Palaniappan
• 金额: $ 48.4万
• 依托单位: PALO ALTO MEDICAL FOUNDATION RES INST
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-01-15 至 2013-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7755901
• 关键词: Address; Adherence; Affect; Age; American; Asian Americans; Asian Indian; Asians; Attenuated; Body mass index; California; Cardiovascular Diseases; Caring; Chinese People; Clinical; Comorbidity; Complications of Diabetes Mellitus; Data; Databases; Demographic Factors; Diabetes Mellitus; Electronic Health Record; Environment; Epidemiologic Studies; Ethnic group; Filipino; Goals; Health; Healthcare; Healthcare Systems; Hypertension; Immigrant; Incidence; Individual; Japanese Population; Knowledge; Koreans; Language; Life; Link; Measures; Medical; Medicare; Minority Groups; Natural History; Non-Insulin-Dependent Diabetes Mellitus; Not Hispanic or Latino; Obesity; Outcome; Overweight; Patient Self-Report; Patients; Physicians; Play; Population; Prediabetes syndrome; Preferred Provider Organizations; Prevalence; Preventive; Public Health; Research; Risk; Risk Factors; Role; Sampling; Screening procedure; Subgroup; Targeted Research; Testing; Time; World Health Organization; base; care seeking; clinical decision-making; cohort; comparison group; cost efficient; diabetes risk; diabetic; ethnic minority population; follow-up; health disparity; macrovascular disease; obesity risk; population based; prospective; public health relevance; racial/ethnic difference; sex

DESCRIPTION (provided by applicant): Although the Asian American population has grown dramatically in size and diversity in recent decades, there are wide gaps in our knowledge of health and healthcare for this population. Asian subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese) are often aggregated in clinical and population-based studies because of small numbers in any one subgroup. In particular, data are lacking on Type 2 diabetes and obesity for Asian Americans, suggested to have increased risk of Type 2 diabetes. Moreover, no data explains whether this applies equally for all Asian American subgroups. The prevalence of obesity, pre-diabetes, diabetes and the diabetic complications of diabetes are largely unknown in specific Asian subgroups. There is also a controversy about how obesity should be defined for Asians. In 2004, the World Health Organization recommended lower body mass index (BMI) cut points to define overweight and obesity for people of Asian descent worldwide. However the evidence on which this is based is debatable, and it is possible that this association will be different in Asian subgroups living in the U.S. It is also unknown if risk factors for diabetes are similarly predictive for Asian American subgroups and Non-Hispanic Whites (NHWs). Better information is needed concerning screening, incidence, prevalence, risk factors, natural history of obesity and diabetes, and healthcare and patient factors that affect treatment disparities for Asian American subgroups. This application aims to examine diabetes screening, risk and care both to fill gaps in knowledge of diabetes disparities and to inform clinical decision making regarding screening and healthcare for Asian Americans. We propose to construct a mixed historical and prospective longitudinal cohort by linking existing clinical databases in a large (20,000), multiethnic sample of contemporary Asians in California. We will define Asian subgroups through self-report, and will include a sample of NHWs for comparison. Use of electronic health records in this epidemiologic study will allow highly cost efficient assembly and follow-up of this cohort. The overall goal of this application is to address a substantial gap in existing knowledge regarding diabetes risk in Asian racial/ethnic minorities. This study will provide a greater understanding of diabetes among Asian ethnic minorities in a comparable environment, and would contribute both to a global understanding of risk for Asian populations and to more targeted research, public health and clinical efforts throughout the U.S. PUBLIC HEALTH RELEVANCE Limited information is available about diabetes among Asians, one of the nation's fastest growing minority groups. The overall goal of this application is to address a substantial gap in existing knowledge about diabetes in Asians. This application will provide a greater understanding of diabetes among Asian racial/ethnic minorities and would contribute to targeted research, public health, and clinical efforts throughout the U.S.

描述（由申请人提供）：尽管近几十年来亚裔美国人人口的规模和多样性急剧增长，但我们对该人群的健康和医疗保健知识仍存在巨大差距。在临床和基于人群的研究中，亚洲亚组（亚洲印度人、中国人、菲律宾人、日本人、韩国人和越南人）经常被汇总，因为任何一个亚组的数量都很少。特别是，缺乏关于亚裔美国人 2 型糖尿病和肥胖的数据，这表明亚裔美国人患 2 型糖尿病的风险增加。此外，没有数据解释这是否同样适用于所有亚裔美国人亚群体。在特定的亚洲亚群体中，肥胖、糖尿病前期、糖尿病和糖尿病并发症的患病率在很大程度上是未知的。关于如何定义亚洲人的肥胖也存在争议。 2004 年，世界卫生组织建议采用较低的体重指数 (BMI) 切点来定义全世界亚裔人群的超重和肥胖。然而，这一结论所依据的证据是有争议的，而且这种关联在居住在美国的亚裔亚群中可能会有所不同。目前还不清楚糖尿病的危险因素是否对亚裔美国人亚群和非西班牙裔白人具有类似的预测作用。 NHW）。需要更好的信息，包括筛查、发病率、患病率、危险因素、肥胖和糖尿病的自然史，以及影响亚裔美国人亚群体治疗差异的医疗保健和患者因素。该应用程序旨在检查糖尿病筛查、风险和护理，以填补糖尿病差异知识的空白，并为亚裔美国人的筛查和医疗保健方面的临床决策提供信息。我们建议通过连接加州当代亚洲人的大型（20,000）多种族样本中的现有临床数据库来构建一个混合的历史和前瞻性纵向队列。我们将通过自我报告定义亚洲亚组，并将纳入 NHW 样本进行比较。在这项流行病学研究中使用电子健康记录将能够以高成本效益的方式对该群体进行组装和随访。该应用程序的总体目标是解决有关亚洲少数族裔糖尿病风险的现有知识的巨大差距。这项研究将在可比较的环境中更好地了解亚洲少数民族的糖尿病，并将有助于全球对亚洲人群风险的了解，以及整个美国更有针对性的研究、公共卫生和临床工作。 公共卫生相关性 有限信息有关亚洲人糖尿病的信息，亚洲人是美国增长最快的少数群体之一。该应用程序的总体目标是解决亚洲人关于糖尿病的现有知识的巨大差距。该应用程序将加深对亚洲少数族裔糖尿病的了解，并将有助于整个美国的有针对性的研究、公共卫生和临床工作。