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Tseng M , Fang CY
Acculturation and Insulin Resistance among US Chinese Immigrant Women
Ethn Dis. 2015 Autumn;25(4) :443-50
PMID: 26672487    PMCID: PMC4671435    URL: http://www.ncbi.nlm.nih.gov/pubmed/26672487
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OBJECTIVE: Chinese immigrants in the United States undergo a transition to increased chronic disease risk commonly attributed to acculturative changes. Longitudinal data to confirm this are lacking. We examined acculturation in relation to insulin resistance in a sample of Chinese immigrant women to determine differences by level of education and possible mediation by anthropometry and diet. DESIGN: Longitudinal study. SETTING: Philadelphia, Pennsylvania. PARTICIPANTS: 305 Chinese immigrant women recruited October 2005 to April 2008 and followed until April 2010. MAIN OUTCOME MEASURES: Association of acculturation, measured using the General Ethnicity Questionnaire - American version (GEQA), with homeostasis model assessment (HOMA) score as an indicator of insulin resistance, modeled using generalized estimating equations to account for repeated measures over time. RESULTS: GEQA was associated with log HOMA score, but only in women with <9 years of education (beta [SE] = .09 [.04], P=.02; interaction P=.02). The association persisted with adjustment for body mass index, waist circumference, and dietary variables. CONCLUSIONS: These findings provide longitudinal evidence that insulin resistance increases with acculturation. However, the association was apparent only in less-educated immigrants and may be mediated by a pathway other than changes in anthropometry and diet.
Tseng, Marilyn Fang, Carolyn Y P30 CA006927/CA/NCI NIH HHS/United States R01 CA106606/CA/NCI NIH HHS/United States Research Support, N.I.H., Extramural United States Ethn Dis. 2015 Nov 5;25(4):443-50. doi: 10.18865/ed.25.4.443.