(1/998) Associations of anti-beta2-glycoprotein I autoantibodies with HLA class II alleles in three ethnic groups.

OBJECTIVE: To determine any HLA associations with anti-beta2-glycoprotein I (anti-beta2GPI) antibodies in a large, retrospectively studied, multiethnic group of 262 patients with primary antiphospholipid antibody syndrome (APS), systemic lupus erythematosus (SLE), or another connective tissue disease. METHODS: Anti-beta2GPI antibodies were detected in sera using an enzyme-linked immunosorbent assay. HLA class II alleles (DRB1, DQA1, and DQB1) were determined by DNA oligotyping. RESULTS: The HLA-DQB1*0302 (DQ8) allele, typically carried on HLA-DR4 haplotypes, was associated with anti-beta2GPI when compared with both anti-beta2GPI-negative SLE patients and ethnically matched normal controls, especially in Mexican Americans and, to a lesser extent, in whites. Similarly, when ethnic groups were combined, HLA-DQB1*0302, as well as HLA-DQB1*03 alleles overall (DQB1*0301, *0302, and *0303), were strongly correlated with anti-beta2GPI antibodies. The HLA-DR6 (DR13) haplotype DRB1*1302; DQB1*0604/5 was also significantly increased, primarily in blacks. HLA-DR7 was not significantly increased in any of these 3 ethnic groups, and HLA-DR53 (DRB4*0101) was increased in Mexican Americans only. CONCLUSION: Certain HLA class II haplotypes genetically influence the expression of antibodies to beta2GPI, an important autoimmune response in the APS, but there are variations in HLA associations among different ethnic groups.  (+info)

(2/998) A genome search identifies major quantitative trait loci on human chromosomes 3 and 4 that influence cholesterol concentrations in small LDL particles.

Small, dense LDL particles are associated with increased risk of cardiovascular disease. To identify the genes that influence LDL size variation, we performed a genome-wide screen for cholesterol concentrations in 4 LDL size fractions. Samples from 470 members of randomly ascertained families were typed for 331 microsatellite markers spaced at approximately 15 cM intervals. Plasma LDLs were resolved by using nondenaturing gradient gel electrophoresis into 4 fraction sizes (LDL-1, 26.4 to 29.0 nm; LDL-2, 25.5 to 26.4 nm; LDL-3, 24.2 to 25.5 nm; and LDL-4, 21.0 to 24.2 nm) and cholesterol concentrations were estimated by staining with Sudan Black B. Linkage analyses used variance component methods that exploited all of the genotypic and phenotypic information in the large extended pedigrees. In multipoint linkage analyses with quantitative trait loci for the 4 fraction sizes, only LDL-3, a fraction containing small LDL particles, gave peak multipoint log10 odds in favor of linkage (LOD) scores that exceeded 3.0, a nominal criterion for evidence of significant linkage. The highest LOD scores for LDL-3 were found on chromosomes 3 (LOD=4.1), 4 (LOD=4.1), and 6 (LOD=2.9). In oligogenic analyses, the 2-locus LOD score (for chromosomes 3 and 4) increased significantly (P=0.0012) to 6.1, but including the third locus on chromosome 6 did not significantly improve the LOD score (P=0.064). Thus, we have localized 2 major quantitative trait loci that influence variation in cholesterol concentrations of small LDL particles. The 2 quantitative trait loci on chromosomes 3 and 4 are located in regions that contain the genes for apoD and the large subunit of the microsomal triglyceride transfer protein, respectively.  (+info)

(3/998) Serum and red blood cell folate concentrations, race, and education: findings from the third National Health and Nutrition Examination Survey.

BACKGROUND: Little is known about the relations between race or ethnicity, educational attainment, and serum and red blood cell folate concentrations. OBJECTIVE: We examined the relation between educational attainment and serum and red blood cell folate concentrations in 8457 white, African American, and Mexican American men and women aged > or = 17 y. DESIGN: We performed a cross-sectional analysis using data from Phase 1 of the third National health and Nutrition Examination Survey (1988-1991). RESULTS: White men had significantly higher adjusted serum and red blood cell folate concentrations (16.9 and 502.6 nmol/L, respectively) than did African American men (15.6 and 423.3 nmol/L, respectively) or Mexican American men (16.0 and 457.0 nmol/L, respectively); white women had significantly higher concentrations (18.4 and 515.9 nmol/L, respectively) than did African American women (16.3 and 415.4 nmol/L, respectively) or Mexican American women (15.9 and 455.7 nmol/L, respectively). For the entire sample, rank correlation coefficients between educational attainment and serum and red blood cell folate were 0.11 and 0.12, respectively, and were larger in white participants than in other participants. No significant linear trends between adjusted serum or red blood cell folate and educational attainment were found. Among participants with > 12 y of education, the mean adjusted concentrations of serum folate were 15% and 18% lower and those of red blood cell were 18% and 22% lower in African American men and women than in white men and women, respectively. CONCLUSIONS: African Americans and Mexican Americans could benefit most from public health programs to boost folate intakes by encouraging increased intake of folate-rich foods and vitamin supplements.  (+info)

(4/998) Serum total homocysteine concentrations in adolescent and adult Americans: results from the third National Health and Nutrition Examination Survey.

BACKGROUND: The elevation of circulating total homocysteine concentrations in a fasting state is associated with an increased risk of occlusive vascular disease. OBJECTIVE: The primary goals of this study were to describe the distribution of serum total homocysteine concentrations in the United States and to test for differences in homocysteine concentrations among sex, age, and race-ethnicity categories. DESIGN: Using surplus sera from phase 2 of the third National Health and Nutrition Examination Survey, we measured serum total homocysteine concentrations for a nationally representative sample of 3766 males and 4819 females aged > or = 12 y. RESULTS: Age-adjusted geometric mean total homocysteine concentrations were 9.6 and 7.9 mmol/L in non-Hispanic white males and females, 9.8 and 8.2 mmol/L in non-Hispanic black males and females, and 9.4 and 7.4 mmol/L in Mexican American males and females, respectively. Age-adjusted geometric mean total homocysteine concentrations were significantly lower in females than in males in each race-ethnicity group (P < 0.01) and were significantly lower in Mexican American females than in non-Hispanic white and non-Hispanic black females (P < 0.01). There was a significant age-sex interaction (P < 0.01), reflecting the fact that homocysteine concentrations in females tended to diverge from those in males at younger ages and converge with those in males at older ages. CONCLUSIONS: The first data on homocysteine concentrations in a nationally representative sample of Americans confirm the age and sex differences reported previously in nonrepresentative samples. These data also indicate that differences between Mexican American and non-Hispanic females may influence circulating homocysteine concentrations.  (+info)

(5/998) Mediators of ethnic-associated differences in infant birth weight.

PURPOSE: To examine whether ethnic differences in low birth weight babies of low-income women may be explained in part by group differences in prenatal health behaviors and psychosocial factors. METHODS: A prospective, survey of 1,071 low-income, primiparous African-American and Mexican-origin women was conducted in Los Angeles County, California. In face-to-face interviews, data were obtained on substance use, prenatal stress, social support, attitudes toward pregnancy, initiation of prenatal care, and medical risk. Medical chart data were abstracted regarding medical risk factors and labor, delivery, and neonatal data. Interview data were linked with birth outcome data retrieved from maternal medical records. Structural equation modeling was used to test a hypothesized model in which differences in birth weight were expected to be mediated by ethnic differences in substance use, psychosocial factors, and medical risk. RESULTS: As expected, African-American women delivered babies of earlier gestational age and lower birth weight than did women of Mexican origin. Direct predictors of low birth weight were use of drugs and cigarettes, prenatal stress, and positive attitudes toward pregnancy; together, these factors accounted for the observed ethnic differences in birth weight. CONCLUSION: These data contribute to our understanding of the factors that may account for ethnic-associated differences in low birth weight.  (+info)

(6/998) Racial and ethnic differences in glycemic control of adults with type 2 diabetes.

OBJECTIVE: To evaluate glycemic control in a representative sample of U.S. adults with type 2 diabetes. RESEARCH DESIGN AND METHODS: The Third National Health and Nutrition Examination Survey included national samples of non-Hispanic whites, non-Hispanic blacks, and Mexican Americans aged > or = 20 years. Information on medical history and treatment of diabetes was obtained to determine those who had been diagnosed with type 2 diabetes by a physician before the survey (n = 1,480). Fasting plasma glucose and HbA1c were measured, and the frequencies of sociodemographic and clinical variables related to glycemic control were determined. RESULTS: A higher proportion of non-Hispanic blacks were treated with insulin and a higher proportion of Mexican Americans were treated with oral agents compared with non-Hispanic whites, but the majority of adults in each racial or ethnic group (71-83%) used pharmacologic treatment for diabetes. Use of multiple daily insulin injections was more common in whites. Blood glucose self-monitoring was less common in Mexican Americans, but most patients had never self-monitored. HbA1c values in the nondiabetic range were found in 26% of non-Hispanic whites, 17% of non-Hispanic blacks, and 20% of Mexican Americans. Poor glycemic control (HbA1c > 8%) was more common in non-Hispanic black women (50%) and Mexican-American men (45%) compared with the other groups (35-38%), but HbA1c for both sexes and for all racial and ethnic groups was substantially higher than normal levels. Those with HbA1c > 8% included 52% of insulin-treated patients and 42% of those taking oral agents. There was no relationship of glycemic control to socioeconomic status or access to medical care in any racial or ethnic group. CONCLUSIONS: These data indicate that many patients with type 2 diabetes in the U.S. have poor glycemic control, placing them at high risk of diabetic complications. Non-Hispanic black women, Mexican-American men, and patients treated with insulin and oral agents were disproportionately represented among those in poor glycemic control. Clinical, public health, and research efforts should focus on more effective methods to control blood glucose in patients with diabetes.  (+info)

(7/998) The prevalence and health burden of self-reported diabetes in older Mexican Americans: findings from the Hispanic established populations for epidemiologic studies of the elderly.

OBJECTIVES: The prevalence and health burden of self-reported adult-onset diabetes mellitus were examined in older Mexican Americans. METHODS: Data from the Hispanic Established Populations for Epidemiologic Studies of the Elderly were used to assess the prevalence of self-reported diabetes and its association with other chronic conditions, disability, sensory impairments, health behaviors, and health service use in 3050 community-dwelling Mexican Americans 65 years and older. RESULTS: The prevalence of self-reported diabetes in this sample was 22%, and there were high rates of obesity, diabetes-related complications, and diabetic medication use. Myocardial infarction, stroke, hypertension, angina, and cancer were significantly more common in diabetics than in nondiabetics, as were high levels of depressive symptoms, low perceived health status, disability, incontinence, vision impairment, and health service use. Many of the rate differences found in this sample of older Mexican Americans were higher than those reported among other groups of older adults. CONCLUSIONS: Our findings indicate that the prevalence and health burden of diabetes are greater in older Mexican Americans than in older non-Hispanic Whites and African Americans, particularly among elderly men.  (+info)

(8/998) The dynamics of mass migration.

We specify a set of equations defining a dynamic model of international migration and estimate its parameters by using data specially collected in Mexico. We then used it to project the a hypothetical Mexican community population forward in time. Beginning with a stable population of 10,000 people, we project ahead 50 years under three different assumptions: no international migration; constant probabilities of in- and out-migration, and dynamic schedules of out- and in-migration that change as migratory experience accumulates. This exercise represents an attempt to model the self-feeding character of international migration noted by prior observers and theorists. Our model quantifies the mechanisms of cumulative causation predicted by social capital theory and illustrates the shortcomings of standard projection methodologies. The failure to model dynamically changing migration schedules yields a 5% overstatement of the projected size of the Mexican population after 50 years, an 11% understatement of the total number of U.S. migrants, a 15% understatement of the prevalence of U.S. migratory experience in the Mexican population, and an 85% understatement of the size of the Mexican population living in the United States.  (+info)