Surprise! Turns out ethnicity alone really does have an impact on cardiometabolic risk factors, a study Rick and I discuss on PodMed this week and published in Annals of Internal Medicine reveals. And in the short term, that means that as part of the prescription of personalized medicine, ethnicity needs to be considered in determining someone's risk for cardiovascular outcomes, perhaps even as the primary reason for screening for risk factors. What did the study show?
The authors examined data from a couple of longitudinal studies: " 2622 white, 803 Chinese American, 1893 African American, and 1496 Hispanic persons from MESA (Multi-Ethnic Study of Atherosclerosis) and 803 South Asian participants in the MASALA (Mediators of Atherosclerosis in South Asians Living in America) study." Basically, the relationship between high fasting glucose, low levels of HDL, high triglycerides and high blood pressure, so-called cardiometabolic risk factors, and body weight was examined. The authors coin a term "metabolic abnormality but normal weight (MAN)," to describe the results, revealing that for various ethnicities, even those of normal weight had 2 or more cardiometabolic risk factors.
Twenty-one percent of whites in this study met the MAN criteria, compared to 32% of Chinese Americans, 31% of African Americans, almost 39% of Hispanics, and almost 44% of South Asians. Wow! It would be possible to miss a screening opportunity in almost half of one's patients if only obesity or overweight was the criterion that tipped the scales in favor of a closer look, something that those in primary care might want to keep in mind.
Other topics this week include another from Annals:Weight History and All-Cause and Cause-Specific Mortality in Three Prospective Cohort Studies, one from Pediatrics: Influenza Vaccine Effectiveness Against Pediatric Deaths: 2010–2014, and one from JAMA: Trends in Thyroid Cancer Incidence and Mortality in the United States, 1974-2013. Until next week, y'all live well.