Subclinical Coronary Atherosclerosis in Asymptomatic Filipino and White Women

Abstract

Background-Coronary heart disease (CHD) is the leading cause of morbidity and mortality in persons with type 2 diabetes mellitus (T2DM). Electron-beam computed tomography (EBCT) detects coronary artery calcium (CAC), a marker of atherosclerotic plaque. Few studies have described EBCT-defined CHD among ethnic minorities with elevated T2DM prevalence. ) and lower HDL cholesterol levels (54 versus 66 mg/dL) than whites. Exercise frequency, body mass index, and waist girth did not differ by ethnicity. Nevertheless, extensive (CAC score Ն400; 9% versus 9%) and moderate (CAC score 150 to 399; 13% versus 11%) atherosclerotic plaque did not differ by ethnicity, even after adjustment for age, T2DM, hypertension, estrogen use, statin use, smoking, lipids, and visceral fat. Conclusions-Filipinas had no excess of subclinical atherosclerosis despite their significantly higher prevalence of T2DM, the metabolic syndrome, hypertension, and visceral adiposity.

Probable NAFLD, by ALT levels, and diabetes among Filipino-American Women

“…Although liver diseases including Hepatitis B and Hepatitis C were not assessed, our cohort of women did not consume alcohol and have displayed NAFLD-associated comorbidities including metabolic syndrome, diabetes, and hypertension [4,5,27] which may allow elevated ALT levels to reflect NAFLD. Measuring liver enzymes is an inexpensive, convenient tool for routine clinical practice that may be used to assess premature liver disease and identify other associated comorbidities and macrovascular complications of diabetes.…”

“…Convenience-based sampling was necessary since Filipinos were not identified separately in the 1990 census. Recruitment, published previously [27], included tests for various chronic diseases to reduce self-selection bias for participants with known diabetes. All participants spoke functional English and provided written informed consent; a Philippine-born native Tagalog speaker translated when necessary.…”

“…Visceral adiposity was measured in women without known coronary heart disease by electron beam computed tomography [27]. A single-slice CT scan of the abdomen (at the umbilicus) was obtained using an Imatron C-150 ultra-fast CT scanner to measure visceral and subcutaneous adipose tissue volume.…”

Does using ethnic specific criteria improve the usefulness of the term metabolic syndrome? controversies and suggestions

“…The Chinese population, for example, has been found to have a low prevalence of hypertension when compared to their North American Caucasian cohort, but the CVD risk associated with increases in blood pressure is proportionally greater in the Chinese. 69 Similarly, Filipino females with a higher prevalence of both hypertension and the MetS than their white Caucasian counterparts had no excess of subclinical atherosclerosis, 70 suggesting that the MetS hypertension criteria inadequately characterize CVD risk in this population. In the UK, multiple researchers have noted higher prevalence rates of hypertension in populations of African ancestry but lower rates of CVD mortality when compared to their hypertensive white and South Asian cohorts.…”

Diabetes and Coronary Heart Disease in Filipino-American Women

“…Most lived in north San Diego County, primarily Mira Mesa, a middleclass community with a high proportion of Filipino residents (all participants, except for four women, were born in the Philippines). Random sampling of the entire county was not feasible because Filipinos are not identified separately in the San Diego census, and recruitment strategies have previously been described in detail (5,17).…”