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

描述(由申请人提供)：尽管近几十年来亚裔美国人的人口规模和多样性都有了显著的增长，但我们对这一群体的健康和保健知识仍存在很大差距。亚洲亚组(亚裔印度人、中国人、菲律宾人、日本人、韩国人和越南人)在临床和基于人群的研究中经常被聚集，因为任何一个亚组中的人数都很少。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，没有数据说明这是否同样适用于所有亚裔美国人亚裔群体。在特定的亚洲亚群中，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。关于应该如何定义亚洲人的肥胖，也存在争议。2004年，世界卫生组织建议用较低的身体质量指数(BMI)切点来定义全球亚裔人群的超重和肥胖。然而，这一结论所基于的证据是值得商榷的，而且这种关联在居住在美国的亚裔群体中可能会有所不同。糖尿病的风险因素是否对亚裔美国人亚群和非西班牙裔白人(NHW)具有类似的预测作用也是未知的。在筛查、发病率、患病率、风险因素、肥胖和糖尿病的自然病史以及影响亚裔美国人亚群治疗差异的医疗保健和患者因素方面，需要更好的信息。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，并为有关亚裔美国人筛查和医疗保健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样本(20,000个)、多种族样本的现有临床数据库，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来定义亚洲亚群，并将包括卫生保健工作者的样本以供比较。在这项流行病学研究中使用电子健康记录将使这一队列的组装和后续工作具有极高的成本效益。这项申请的总体目标是解决亚洲少数民族对糖尿病风险的现有知识存在的重大差距。这项研究将使亚洲少数民族在可比环境中更好地了解糖尿病，并将有助于全球了解亚洲人群的风险，并有助于整个美国的更有针对性的研究、公共卫生和临床努力。亚洲人是美国增长最快的少数群体之一，目前有关于糖尿病的有限信息。这项应用的总体目标是解决亚洲人对糖尿病现有知识的巨大差距。这项应用将使亚裔少数族裔对糖尿病有更好的了解，并将有助于全美的有针对性的研究、公共卫生和临床工作。

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.