BackgroundEthnic differences in the progression and outcome of diabetic kidney disease (DKD) remain to be elucidated. MRI-quantified renal sinus fat volume could be a potential biomarker to help... Show moreBackgroundEthnic differences in the progression and outcome of diabetic kidney disease (DKD) remain to be elucidated. MRI-quantified renal sinus fat volume could be a potential biomarker to help investigate the changes of DKD risk in response to glucose regulation.PurposeTo evaluate whether the effect of glucose-lowering treatment on renal sinus fat volume differed in West Europeans (WE) compared to South Asians (SA), and whether ethnic-related difference exists regarding the effect of liraglutide on renal sinus fat.Study TypeRetrospective.PopulationNinety-three patients with type 2 diabetes mellitus, including 47 WE (27 males) aged 59.3 +/- 6.5 years, and 46 SA (19 males) aged 54.4 +/- 9.8 years.Field Strength/Sequence3.0 T dual-echo fast gradient-echo pulse sequence using two-point Dixon technique with a phase-correction algorithm.AssessmentChanges of renal sinus fat volume were measured by a radiologist (LL) with 4-years' experience, and were compared between the two ethnic groups, together with glycemic level, metabolic risk factors and renal function. The effects of liraglutide were assessed.Statistical TestsNormality of the data was visually evaluated by histograms and Q-Q plots. Within-group and between-group differences were analyzed using paired t-tests and analysis of covariance. Associations were analyzed by person's correlation and multiple linear regression models.ResultsRenal sinus fat decreased in SA patients (Delta% = -7.6% +/- 14.8%), but increased in WE patients (Delta% = 5.0% +/- 13.1%), with a significant difference between the two ethnic groups. In the WE group, the increase of sinus fat volume was significant in the placebo subgroup (Delta% = 6.8% +/- 12.5%), in contrast to the nonsignificant increase in the liraglutide subgroup (Delta% = 3.0% +/- 13.8%, P = 0.444).Data ConclusionRenal sinus fat accumulation responds differently to glucose regulation, showing a reduction in SA patients in contrast to a persistent accumulation in WE patients. A trend of less accumulation of sinus fat in WE patients receiving liraglutide has been observed.Evidence Level4Technical EfficacyStage 4 Show less
Velden, A.I.M. van der; Berg, B.M. van den; Born, B.J. van den; Galenkamp, H.; Ijpelaar, D.H.T.; Rabelink, T.J. 2022
Introduction We aimed to investigate ethnic differences in two urinary inflammatory markers in participants with type 2 diabetes mellitus (T2DM). Research design and methods: We included 55 Dutch,... Show moreIntroduction We aimed to investigate ethnic differences in two urinary inflammatory markers in participants with type 2 diabetes mellitus (T2DM). Research design and methods: We included 55 Dutch, 127 South-Asian Surinamese, 92 African Surinamese, 62 Ghanaian, 74 Turkish and 88 Moroccan origin participants with T2DM from the HEalthy LIfe in an Urban Setting study. Using linear regression analyses, we investigated differences in urinary monocyte chemoattractant protein-1 (MCP-1) and heparanase-1 (HPSE-1) levels across ethnic minorities compared with Dutch. Associations between the urinary markers and albuminuria (albumin:creatinine ratio (ACR)) was investigated per ethnicity. Results: Urinary MCP-1 levels were higher in the Moroccan participants (0.15 log ng/mmol, 95% CI 0.05 to 0.26) compared with Dutch after multiple adjustments. Urinary HPSE-1 levels were lower in the African Surinamese and Ghanaian participants compared with the Dutch, with a difference of -0.16 log mU/mmol (95% CI -0.29 to -0.02) in African Surinamese and -0.16 log mU/mmol (95% CI -0.31 to -0.00) in Ghanaian after multiple adjustments. In all ethnic groups except the Dutch and Ghanaian participants, MCP-1 was associated with ACR. This association remained strongest after multiple adjustment in South-Asian and African Surinamese participants, with an increase in log ACR of 1.03% (95% CI 0.58 to 1.47) and 1.23% (95% CI 0.52 to 1.94) if log MCP-1 increased 1%. Only in the Dutch participants, an association between HPSE-1 and ACR was found, with increase in log ACR of 0.40% (95% CI 0.04 to 0.76) if log HPSE-1 increased 1%. Conclusions: We found ethnic differences in urinary MCP-1 and HPSE-1 levels, in a multi-ethnic cohort of participants with T2DM. In addition, we found ethnic differences in the association of MCP-1 and HPSE-1 levels with albuminuria. These findings suggest differences in renal inflammation across ethnic groups. Show less
Context: South Asian individuals are more prone to develop type 2 diabetes (T2D) coinciding with earlier complications than Europids. While inflammation plays a central role in the development and... Show moreContext: South Asian individuals are more prone to develop type 2 diabetes (T2D) coinciding with earlier complications than Europids. While inflammation plays a central role in the development and progression of T2D, this factor is still underexplored in South Asians. Objective: This work aimed to study whether circulating messenger RNA (mRNA) transcripts of immune genes are different between South Asian compared with Europid patients with T2D. Methods: A secondary analysis was conducted of 2 randomized controlled trials of Dutch South Asian (n = 45; age: 55 +/- 10 years, body mass index [BMI]: 29 +/- 4 kg/m(2)) and Dutch Europid (n = 44; age: 60 +/- 7 years, BMI: 32 +/- 4 kg/m(2)) patients with T2D. Main outcome measures included mRNA transcripts of 182 immune genes (microfluidic quantitative polymerase chain reaction; Fluidigm Inc) in fasted whole-blood, ingenuity pathway analyses (Qiagen). Results: South Asians, compared to Europids, had higher mRNA levels of B-cell markers (CD19, CD79A, CD79B, CR2, CXCR5, IGHD, MS4A1, PAX5; all fold change > 1.3, false discovery rate [FDR] < 0.008) and interferon (IFN)-signaling genes (CD274, GBP1, GBP2, GBP5, FCGR1A/B/CP, IFI16, IFIT3, IFITM1, IFITM3, TAP1; all FC > 1.2, FDR < 0.05). In South Asians, the IFN signaling pathway was the top canonical pathway (z score 2.6; P < .001) and this was accompanied by higher plasma IFN-gamma levels (FC = 1.5, FDR = 0.01). Notably, the ethnic difference in gene expression was larger for women (20/182 [11%]) than men (2/182 [1%]). Conclusion: South Asian patients with T2D show a more activated IFN-signaling pathway compared to Europid patients with T2D, which is more pronounced in women than men. We speculate that a more activated IFN-signaling pathway may contribute to the more rapid progression of T2D in South Asian compared with Europid individuals. Show less
A substantial body of research has found that social desirability motivates respondents to overstate support for immigration when asked directly, but when provided an unobtrusive means of... Show moreA substantial body of research has found that social desirability motivates respondents to overstate support for immigration when asked directly, but when provided an unobtrusive means of expressing preferences, support declines. In this paper, we ask whether South Koreans follow this pattern, especially with regards to co-ethnic migrants from North Korea and China. We use list experiments to determine whether observed levels of support for general immigration and co-ethnic migration are biased by social desirability. We find that generally respondents overstate their support for co-ethnics from North Korea by a significant amount when asked directly, but not for the other groups, although college-educated respondents overstate their support for general immigration. Social desirability bias with respect to co-ethnics from North Korea is particularly evident in older respondents and males. These findings challenge the notion that native-born citizens prefer co-ethnic immigrants. Show less
Background: It has been suggested that children and infants can develop multisystem inflammatory syndrome in children (MIS-C) in response to a SARS-CoV-2 infection and that Black children are... Show moreBackground: It has been suggested that children and infants can develop multisystem inflammatory syndrome in children (MIS-C) in response to a SARS-CoV-2 infection and that Black children are overrepresented among cases. The aim of the current study was to quantify the association between Black, Asian, or other non-White genetic background and COVID-19-related MIS-C in children and infants.Methods: Eight different research groups contributed cases of MIS-C, potentially related to SARS-CoV-2 infection. Several sensitivity analyses were performed, including additional data available from the literature. Analyses were stratified by geographical region.Results: Seventy-three cases from nine distinct geographical regions were included in the primary analyses. In comparison to White children, the relative risk for developing MIS-C after SARS-CoV-2 infection was 15 [95% confidence interval (CI): 7.1 to 32] for Black children, 11 (CI: 2.2 to 57) for Asian, and 1.6 (CI: 0.58 to 4.2) for other ethnic background.Conclusion: Pediatricians should be aware of the fact that the risk of COVID-19-related MIS-C is severely increased in Black children. Show less
Background: Socioeconomic status and ethnicity are not incorporated as predictors in country-level cardiovascular risk charts on mainland Europe. The aim of this study was to quantify the sex... Show moreBackground: Socioeconomic status and ethnicity are not incorporated as predictors in country-level cardiovascular risk charts on mainland Europe. The aim of this study was to quantify the sex-specific cardiovascular death rates stratified by ethnicity and socioeconomic factors in an urban population in a universal healthcare system. Methods: Age-standardized death rates (ASDR) were estimated in a dynamic population, aged 45-75 in the city of The Hague, the Netherlands, over the period 2007-2018, using data of Statistics Netherlands. Results were stratified by sex, ethnicity (country of birth) and socioeconomic status (prosperity) and compared with a European cut-off for high-risk countries (ASDR men 225/100,000 and women 175/100,000). Findings: In total, 3073 CVD deaths occurred during 1 cent 76 million person years follow-up. Estimated ASDRs (selected countries of birth) ranged from 126 (95%CI 89-174) in Moroccan men to 379 (95%CI 272-518) in Antillean men, and from 86 (95%CI 50-138) in Moroccan women to 170 (95%CI 142-202) in Surinamese women. ASDRs in the highest and lowest prosperity quintiles were 94 (95%CI 90-98) and 343 (95%CI 334-351) for men, and 43 (95%CI 41-46) and 140 (95%CI 135-145), for women, respectively. Interpretation: In a diverse urban population, large health disparities in cardiovascular ASDRs exists across ethnic and socioeconomic subgroups. Identifying these high-risk subgroups followed by targeted preventive efforts, might provide a basis for improving cardiovascular health equity within communities. Instead of classifying countries as high-risk or low-risk, a shift towards focusing on these subgroups within countries might be needed. Funding: Leiden University Medical Center and Leiden University (c) 2021 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/) Show less
Background Early prehospital recognition of critical conditions such as ST-segment-elevation myocardial infarction (STEMI) has prognostic relevance. Current international electrocardiographic STEMI... Show moreBackground Early prehospital recognition of critical conditions such as ST-segment-elevation myocardial infarction (STEMI) has prognostic relevance. Current international electrocardiographic STEMI thresholds are predominantly based on individuals of Western European descent. However, because of ethnic electrocardiographic variability both in health and disease, there is a need to reevaluate diagnostic ST-segment elevation thresholds for different populations. We hypothesized that fulfillment of ST-segment elevation thresholds of STEMI criteria (STE-ECGs) in apparently healthy individuals is ethnicity dependent.Methods and Results HELIUS (Healthy Life in an Urban Setting) is a multiethnic cohort study including 10 783 apparently healthy subjects of 6 different ethnicities (African Surinamese, Dutch, Ghanaian, Moroccan, South Asian Surinamese, and Turkish). Prevalence of STE-ECGs across ethnicities, sexes, and age groups was assessed with respect to the 2 international STEMI thresholds: sex and age specific versus sex specific. Mean prevalence of STE-ECGs was 2.8% to 3.4% (age/sex-specific and sex-specific thresholds, respectively), although with large ethnicity-dependent variability. Prevalences in Western European Dutch were 2.3% to 3.0%, but excessively higher in young (<40 years) Ghanaian males (21.7%-27.5%) and lowest in older (40 years) Turkish females (0.0%). Ethnicity (sub-Saharan African origin) and other variables (eg, younger age, male sex, high QRS voltages, or anterolateral early repolarization pattern) were positively associated with STE-ECG occurrence, resulting in subgroups with >45% STE-ECGs.Conclusions The accuracy of diagnostic tests partly relies on background prevalence in healthy individuals. In apparently healthy subjects, there is a highly variable ethnicity-dependent prevalence of ECGs with ST-segment elevations exceeding STEMI thresholds. This has potential consequences for STEMI evaluations in individuals who are not of Western European descent, putatively resulting in adverse outcomes with both over- and underdiagnosis of STEMI. Show less
Contestation over land is at the core of the prolonged political conflicts that mark the recent history of India’s North Eastern region. The rural areas of India’s North East, erstwhile marginal to... Show moreContestation over land is at the core of the prolonged political conflicts that mark the recent history of India’s North Eastern region. The rural areas of India’s North East, erstwhile marginal to the ‘modern’ state, are increasingly integrated in a monetized market-oriented economy. Confronted with dominant regimes of development, mobility and citizenship, it is imperative to recognize that increasingly unequal land relations are a main reason for broadening social fissures within and among communities. This volume critically engages with questions such as: How do contestations over the ownership and usage of land challenge customary interpretations of gender? And in what ways can the importance attributed to land, in a symbolic sense, contribute to the redefinition of coordinates of identity, community and belonging? Combining perspectives from political science, social geography, social history, sociology and anthropology, this volume critically engages with received notions of the customary. Presenting case studies by both senior and emerging scholars, it makes mandatory reading for anyone interested in the challenges of governance, citizenship and development faced by the people of India’s North East. Show less
As in many countries in Asia, the concept “indigenous” is a highly contested term in Indonesia. The government is of the opinion that Indonesia is a nation that has no indigenous peoples, or that... Show moreAs in many countries in Asia, the concept “indigenous” is a highly contested term in Indonesia. The government is of the opinion that Indonesia is a nation that has no indigenous peoples, or that all Indonesians are equally indigenous. The article aims to analyse the role and the paradox of using ethnic narratives, i.e. distinct social, economic or political systems, as well as language, culture and beliefs as their material and political basis, in the articulation of indigenous rights. Upon discussing a case study from Papua, Indonesia, it is observed that the use of ethnic narratives does create opportunity structures necessary for the struggles of indigenous rights. However, the salience of these endeavours is shaped by how these groups, their autonomy and marginalisation are positioned in the wider context of development, sovereignty and territoriality, which make them also dependent on the design and orientation of the state. Show less
This essay investigates the historical background of ethnic disunity in today’s Western Uganda as part of the Great Lakes Region of East Africa. In general, there are two opposing views with... Show moreThis essay investigates the historical background of ethnic disunity in today’s Western Uganda as part of the Great Lakes Region of East Africa. In general, there are two opposing views with respect to the existence of ethnicity in precolonial times. On the one hand, social scientists state that the existence of ethnic groups is an invention of the joint work of colonial administrators and professional ethnologists. On the other hand, several scholars argue that ethnicity is an ancient phenomenon predating colonial times. In the past decades, the study into the ancient history of the Great Lakes Region has made great progress. The interdisciplinary approach of historical linguistics, history and anthropology revealed a fascinating and complex history of languages and cultures. However, the history of the different peoples who spoke these languages and built up these cultures is much less known, in particular about how they interacted with each other and how they judged socio-cultural differences. For example, what names they gave each other. This essay tries to give an impetus for further interdisciplinary research about the existence of ethnicity in precolonial times. Identity formation within and between groups is related to power structures in societies. Therefore, investigating ethnicity in precolonial times has to be carried out in the context of developing power structures. Show less
Beukel, T.O. van den; Hommel, K.; Kamper, A.L.; Heaf, J.G.; Siegert, C.E.H.; Honig, A.; ... ; Norredam, M. 2016
Comment imaginer la forme de l'Etat dans sa gestion de la cohabitation ethnique sous un angle positif pour l'Afrique aujourd'hui et demain? Telle est la question thématique fondamentale de... Show moreComment imaginer la forme de l'Etat dans sa gestion de la cohabitation ethnique sous un angle positif pour l'Afrique aujourd'hui et demain? Telle est la question thématique fondamentale de Pascal Touoyem de Cameroon. La réalité ethnique en Afrique continue d'être déterminante comme dimension absolue de l'existence individuelle et collective au point de constituer une hypothèque grave pour ce qui est du fonctionnement normal de ces Etats. C'est pourquoi le continent noir est riche en Etats faillis, effondrés, ou en passe de le devenir. A l'ère globale, le modèle politique de l'Etat multi-ethnique doit permettre la mise en perspective d'un néo-constitutionnalisme démotique (de 'demos' ou peuple) permettant de restituer aux ethnies, leur statut de nations sociologiques. L'enjeu étant celui de jeter les bases d'une renaissance politique africaine adossée sur la nature plurinationale des sociétés africaines par-delà le multipartisme. Le nouveau pacte social et politique qui fonde l'Etat multi-ethnique permettrait ainsi aux pays d'Afrique noire de se doter d'une démocratie fondée sur le principe 'gagnant-gagnant'. La théorie de l'Etat multinational ouvre la perspective d'une innovation constitutionnelle, politique et conceptuelle des sociétés plurinationales au XXIe siècle: celle d'une refondation de notre imaginaire pour une réorientation globale de la pensée politique africaine dans ses besoins, ses désirs, ses quêtes, ses attentes et ses espérances. Show less
