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在规模和多样性上都有了显著增长，但我们对这一人群的健康和医疗保健知识仍存在很大差距。亚洲亚群（亚洲印度人、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汇总，因为任何一个亚群的人数都很少。特别是，缺乏关于2型糖尿病和肥胖的亚裔美国人的数据，表明他们患2型糖尿病的风险增加。此外，没有数据解释这是否同样适用于所有亚裔美国人。亚洲特定亚群的肥胖、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。关于亚洲人应该如何定义肥胖，也存在争议。2004年，世界卫生组织（World Health Organization）推荐了较低的身体质量指数（BMI）分界点，以界定全球亚裔的超重和肥胖。然而，这一结论所依据的证据是有争议的，而且这种关联可能在生活在美国的亚洲亚群中有所不同。糖尿病的危险因素是否在亚裔美国人亚群和非西班牙裔白人（nhw）中具有类似的预测性也尚不清楚。我们需要更好的信息，包括筛查、发病率、流行率、危险因素、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保健和患者因素。本应用程序旨在研究糖尿病筛查，风险和护理，以填补糖尿病知识差距，并为亚裔美国人的筛查和医疗保健提供临床决策。我们建议通过连接现有的临床数据库，建立一个混合的历史和前瞻性纵向队列，在加利福尼亚的一个大型（20,000），多种族的当代亚洲人样本中。我们将通过自我报告定义亚洲亚组，并将包括nhw样本进行比较。在本流行病学研究中使用电子健康记录将使该队列的收集和随访具有很高的成本效益。本应用程序的总体目标是解决关于亚洲种族/少数民族糖尿病风险的现有知识的实质性差距。这项研究将在可比的环境中提供对亚洲少数民族糖尿病的更深入的了解，并将有助于全球对亚洲人群风险的了解，以及在整个美国开展更有针对性的研究、公共卫生和临床工作。公共卫生相关有限公司提供了关于亚洲人糖尿病的信息，亚洲人是美国增长最快的少数民族之一。该应用程序的总体目标是解决亚洲糖尿病现有知识的实质性差距。该应用程序将提供对亚洲种族/少数民族糖尿病的更深入的了解，并将有助于有针对性的研究，公共卫生和临床工作在整个美国

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.