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Health disparities between Whites and Japanese in measures of diabetes and subclinical atherosclerosis in an international population-based study

Ahuja, Vasudha (2015) Health disparities between Whites and Japanese in measures of diabetes and subclinical atherosclerosis in an international population-based study. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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This dissertation includes three manuscripts focusing on health disparities between whites and Japanese with regard to measures of diabetes and subclinical atherosclerosis in the EBCT and Risk Factor Assessment among Japanese and U.S. Men in the Post World War II Birth Cohort (ERA JUMP) study. The first manuscript compares markers of insulin resistance and insulin secretion between white men in the United States and Japanese men in Japan, adjusting for visceral adipose tissue and other covariates. Whites had significantly higher HOMA-IR, HOMA-β%, and disposition index (DI) than Japanese in Japan. The better compensation of insulin resistance by increased insulin secretion in whites as shown by higher DI may partly explain lower susceptibility of whites to developing type 2 diabetes than Japanese in Japan at similar levels of body-mass index.
The second manuscript compares progression of intima-media thickness of the carotid artery (CIMT) between middle-aged Japanese American men and white men, adjusting for baseline cardiovascular risk factors. Japanese Americans had greater progression of CIMT than whites. The third manuscript compares progression of coronary artery calcium (CAC) between Japanese American men and white men. Japanese Americans had similar progression of CAC as whites.
This work contributes uniquely to public health significance. Future studies exploring reasons of poorer compensation of increasing insulin resistance by enhanced insulin secretion in Japanese in Japan may help to prevent earlier onset of type 2 diabetes in Japanese than whites at a given level of BMI. The second and third manuscripts identify increasing subclinical atherosclerosis in Japanese Americans that may translate into increased risk of CHD in Japanese Americans in the future. The second and third manuscripts identify Japanese American as a target group for prevention of CHD.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Ahuja, Vasudhavaa15@pitt.eduVAA15
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairSekikawa, Akiraakira@pitt.eduAKIRA
Committee MemberBarinas-Mitchell, Emmabarinas@edc.pitt.eduEJB4
Committee MemberChang, Joycechangj@pitt.eduCHANGJ
Committee MemberSonger, Thomastjs@pitt.eduTJS
Committee MemberWassel, ChristinaCWASSEL@pitt.eduCWASSEL
Date: 28 September 2015
Date Type: Publication
Defense Date: 23 July 2015
Approval Date: 28 September 2015
Submission Date: 20 July 2015
Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
Number of Pages: 125
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Health disparities, race, HOMA-IR, disposition index, subclinical vascular disease
Date Deposited: 28 Sep 2015 18:56
Last Modified: 01 Sep 2020 05:15


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