The causes of hypercalcemia in Okinawan patients: an international comparison.
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OBJECTIVE: Our objective was to determine the causes and relative prevalence of hypercalcemia in patients at a major community hospital in Okinawa, Japan. Additionally, we compared these causes of hypercalcemia with the previously published international data. MATERIALS AND METHODS: We analyzed all patients with hypercalcemia in a community teaching hospital in Okinawa, Japan, from 1999 to 2002 and determined the cause of hypercalcemia in each patient. We also performed a literature review of the original articles describing causes of hypercalcemia in patients from Eastern as well as Western countries. RESULTS: We identified 145 patients with hypercalcemia (median age, 69; range, 22 to 97). Major causes included malignant disorders (n=100; 69%), primary hyperparathyroidism (n=31; 21%), vitamin D-induced (n=4; 3%), and miscellaneous or unknown cause in 11 (8%). Among malignant disorders, adult T cell leukemia was the most frequent (n=35), being followed by lung cancer (n=25). Breast carcinoma was less prevalent (n=4). CONCLUSION: The major causes of hypercalcemia are malignancy and primary hyperparathyroidism in Okinawan Japanese patients. Adult T cell leukemia and lung carcinoma are among the top leading malignancies, while breast carcinoma is less frequent in this patient population. The etiologic prevalence of hypercalcemia in the Eastern population including Okinawans is significantly different from that in the Western population. (+info)
Genetic studies of human diversity in East Asia.
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East Asia is one of the most important regions for studying evolution and genetic diversity of human populations. Recognizing the relevance of characterizing the genetic diversity and structure of East Asian populations for understanding their genetic history and designing and interpreting genetic studies of human diseases, in recent years researchers in China have made substantial efforts to collect samples and generate data especially for markers on Y chromosomes and mtDNA. The hallmark of these efforts is the discovery and confirmation of consistent distinction between northern and southern East Asian populations at genetic markers across the genome. With the confirmation of an African origin for East Asian populations and the observation of a dominating impact of the gene flow entering East Asia from the south in early human settlement, interpretation of the north-south division in this context poses the challenge to the field. Other areas of interest that have been studied include the gene flow between East Asia and its neighbouring regions (i.e. Central Asia, the Sub-continent, America and the Pacific Islands), the origin of Sino-Tibetan populations and expansion of the Chinese. (+info)
Evidence of divergence with duration of residence in circulatory disease mortality in migrants to Australia.
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BACKGROUND: Very little is known about how acculturation affects health in different societal settings. Using duration of residence, this study investigates acculturation and circulatory disease mortality among migrants in Australia. METHODS: Data from death records, 1998-2002, and from 2001 Census data were extracted for seven migrant groups [New Zealand; United Kingdom (UK)/Ireland; Germany; Greece; Italy; China/Singapore/Malaysia/Vietnam (East Asia); and India/Sri Lanka (South Asia)] aged 45-64 years. Poisson regression models were fitted to estimate the duration of residence effect (categorized in 5-year bands and also as having arrived 2-16, 17-31 and 32 years ago or more), adjusted for sex, 5-year age group and year of death, then additionally for occupational class and marital status (SES) on relative risks (RR) of CVD mortality. RESULTS: Compared with the Australia-born population, CVD mortality was generally lower in each migrant group. Decreasing mortality with increasing duration of residence was observed for migrants from New Zealand (RR 0.95, 95% Confidence Interval 0.92-0.98, P<0.01, per 5-year increase), Greece (0.90, 0.86-0.94, P<0.01), Italy (0.94, 0.91-0.97, P<0.01) and South Asia (0.95, 0.91-0.99, P<0.01), mainly in older age groups. Trends remained after SES adjustment and also when broader categories of duration of residence were used. CVD mortality among migrants from the UK/Ireland appeared to converge towards those of the Australian-born. CONCLUSIONS: These results show divergence in CVD mortality compared with the Australian rate for New Zealanders, Greeks, Italians and South Asians. Sustained cardio-protective behavioural practices in the Australian setting is a potential explanation. (+info)
Metabolic syndrome: recent prevalence in East and Southeast Asian populations.
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BACKGROUND: The prevalence of the metabolic syndrome among a number of Asian populations as defined by several current criteria has been increasing rapidly and appears to resemble that among Western populations. METHODS: We review 25 surveys of the metabolic syndrome in Asian populations (PR China, Hong Kong, Taiwan, Japan, Philippines, Singapore) that report adequate information published during the last 5 years. RESULTS: Using Asian-adapted definitions of obesity (BMI > or = 25 kg/m(2)) and increased waist circumference (for male > or = 90 cm; for female > or =80 cm) prevalence appears to be between 10 to 30%. Those with the syndrome are more likely to have a history of diabetes and cardiovascular disease. The risk of developing Type 2 diabetes is 10 times higher among middle-aged Japanese men with the metabolic syndrome compared to healthy subjects. In Chinese and Japanese populations, people who have the metabolic syndrome are 3 to 10 times more likely to develop cardiovascular disease. Variance in prevalence estimates of the metabolic syndrome even within the same country result from differences in sampling and possibly from definitions. CONCLUSIONS: The outstanding conclusion from recent surveys across the Asian-Pacific region is that of a consistent increase in the prevalence of the metabolic derangements associated with abdominal adiposity that lead to high risk of morbidity and mortality. (+info)
Evidence that the spread of Mycobacterium tuberculosis strains with the Beijing genotype is human population dependent.
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This study describes a comparative analysis of the Beijing mycobacterial interspersed repetitive unit types of Mycobacterium tuberculosis isolates from Cape Town, South Africa, and East Asia. The results show a significant association between the frequency of occurrence of strains from defined Beijing sublineages and the human population from whom they were cultured (P < 0.0001). (+info)
The role of lifestyle risk factors on mortality from colorectal cancer in populations of the Asia-Pacific region.
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Although colorectal cancer is one of the leading malignancies worldwide, there are few data on aetiological relationships from the Asia-Pacific region. Therefore, a collaborative study was conducted involving over half a million subjects from 33 cohort studies in the region. Age-adjusted death rates from colorectal cancer, over an average of 6.8 years follow-up, were 12 and 14 per 100,000 person-years among Asian women and men, respectively; corresponding values in Australasia were 31 and 41. Height was strongly associated with death from colorectal cancer: an extra 5 cm of height was associated with 10% (95%confidence interval, 3% - 18% additional risk, after adjustment for other factors. Smoking increased risk by 43% (9% - 88%), although no significant dose-response relationship was discerned (p>0.05). Other significant (p <0.05) risk factors were body mass index and lack of physical activity. There was no significant effect on colorectal cancer mortality for alcohol consumption, waist circumference, fasting blood glucose or diabetes, although the latter conferred a notable 26% additional risk. Height may be a biomarker for some currently unknown genetic, or environmental, risk factors that are related both to skeletal growth and mutanogenesis. Understanding such mechanisms could provide opportunities for novel preventive and therapeutic intervention. (+info)
The impact of modifiable risk factors on mortality from prostate cancer in populations of the Asia-Pacific region.
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Mortality from cancer of the prostate is increasing in the Asia-Pacific, when much of this region is undergoing a transition to a Western lifestyle. The role that lifestyle factors play in prostate cancer appears limited, but existing data mainly are from the West. We conducted an individual participant data analysis of 24 cohort studies involving 320,852 men (83% in Asia). Cox proportional hazard models were used to quantify associations between risk factors and mortality from prostate cancer. There were 308 deaths from prostate cancer (14% in Asia) during 2.1 million person-years of follow-up. The age-adjusted hazard ratio (95% confidence interval; CI) for men with body mass index (BMI) 28 kg/m2 or more, compared with below 25, was 1.55 (1.12 - 2.16); no such significant relationship was found for height or waist circumference. The BMI result was unchanged after adjustment for other variables, was consistent between Asia and Australia/New Zealand (ANZ) and did not differ with age. There was no significant relationship with diabetes, glucose or total cholesterol (p > or = 0.18). Smoking, alone, showed different effects in the two regions, possibly due to the relative immaturity of the smoking epidemic in Asia. In ANZ, the multiple-adjusted hazard ratio for an extra 5 cigarettes per day was 1.12 (95%CI: 1.03 - 1.22), whereas in Asia it was 0.77 (0.56 - 1.05). Body size is an apparently important determinant of prostate cancer in the Asia-Pacific. Evidence of an adverse effect of smoking is conclusive only in the predominantly Caucasian parts of the region. (+info)
Genetic divergence and phylogenetic independence of Far Eastern species in subfamily Leuciscinae (Pisces: Cyprinidae) inferred from mitochondrial DNA analyses.
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Classification of freshwater fish in the subfamily Leuciscinae, Cyprinidae is hampered by complexity or lack of morphological diversity. In this study, analyses based on mtDNA sequences were undertaken to clarify phylogenetic relationships among Far Eastern, North American and European species in the Leuciscinae. Evolutionary rate in cytochrome b gene (Cyt-b) and D-loop sequences appear to be almost constant in Leuciscinae. The topology of phylogenetic trees generated by neighbor-joining (NJ) and maximum likelihood (ML) methods based on Cyt-b gene and D-loop sequences was similar. Five major clades, designated clades 1-5, and a minor clade were discriminated. Most of the Far Eastern, North American and European species were included in the major clades. Clade 1, comprised almost entirely of Far Eastern phoxinins, is monophyletic and greatly diverged from the other species of Leuciscinae. From the present phylogenetic relationships and the previous studies, we present the following hypotheses with respect to the evolutionary history of the Far Eastern phoxinins. The Far Eastern species should be classified into Far Eastern-specific genera, although ichthyologists have still insisted that the species should be included in the European genera. The Far Eastern clade 1 consists of two subclades, including genera Pseudaspius-Tribolodon and Far Eastern Phoxinus species. According to our phylogenetic analyses, Pseudaspius leptocephalus and Tribolodon species should be reclassified into the same genus. On the basis of evolutionary rate in Cyt-b gene in Cyprinidae, it is estimated that the Far Eastern lineage diverged approximately 10-14 million years ago (mya) from the common ancestor of Leuciscinae. It is deduced that speciation of the Far Eastern species occurred until approximately 4 mya, in relation to the formation of the Sea of Japan and the Japanese Islands. (+info)