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Acculturation and Insulin Resistance among US Chinese Immigrant Women
Marilyn Tseng1, Carolyn Y Fang2
11. Kinesiology Department, California Polytechnic State University, San Luis Obispo, Calif.
Objective:
Chinese immigrants in the United States undergo a transition to increased chronic disease risk commonly attributed to acculturative changes. Longitudinal data to confirm this are lacking. We examined acculturation in relation to insulin resistance in a sample of Chinese immigrant women to determine differences by level of education and possible mediation by anthropometry and diet.
Design:
Longitudinal study.
Setting:
Philadelphia, Pennsylvania.
Participants:
305 Chinese immigrant women recruited October 2005 to April 2008 and followed until April 2010.
Main Outcome Measures:
Association of acculturation, measured using the General Ethnicity Questionnaire - American version (GEQA), with homeostasis model assessment (HOMA) score as an indicator of insulin resistance, modeled using generalized estimating equations to account for repeated measures over time.
Results:
GEQA was associated with log HOMA score, but only in women with <9 years of education (beta [SE] = .09 [.04], P=.02; interaction P=.02). The association persisted with adjustment for body mass index, waist circumference, and dietary variables.
Conclusions:
These findings provide longitudinal evidence that insulin resistance increases with acculturation. However, the association was apparent only in less-educated immigrants and may be mediated by a pathway other than changes in anthropometry and diet.
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