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Differences in Clinical Outcomes Between Non-Obese Caucasian and African American Populations Who Have Diabetes, A Nation-Wide Study
DM is a metabolic disease that is closely linked with ethnicity. There is limited data on its outcomes in different racial groups. Controlling DM will mitigate the risks of atherosclerotic cardiovascular disease. The purpose of this study is to compare differences in clinical outcomes in non-obese Caucasian and African American (AA) populations with DM. Conducted as an observational study, it utilized data from the National Inpatient Sample from 2017 to 2020 focusing on non-obese adults over 18 years, with a BMI <30 kg/m^2, and DM diagnosis, excluding those under 18, obese or without DM. Primary outcome was in-hospital mortality. Secondary outcomes were cardiogenic shock, cardiac arrest, GIB, mechanical ventilation, length of stay, and total cost. Multivariable logistic and Poisson regression analyses determined the clinical outcomes, considering a p-value <0.05 significant. Among 22,300,000 non-obese adults with DM, 64.2% were Caucasians, 18.8% were AA, 13.3% were Hispanics, 3.5% were Asians, and the remaining population belonged to other ethnicities. This study revealed higher rates in the Caucasians for conditions like metabolic syndrome, dyslipidemia, HTN, A.fib, PVD, ACS, severe sepsis, and COPD. The AA were seen to have a higher incidence of anemia, DKA, pHTN, HF, AKI, CKD, stroke, and PE. In terms of the primary outcome, Caucasians had more in-hospital mortality than the AA, but the results were not statistically significant. Results for the secondary outcomes were variable as seen in Table 1. The findings undermine the importance of racial differences in such conditions and more in-depth studies are needed to extrapolate the gaps in care.
Journal Article
Clinical Outcomes in Non-Obese Caucasian and Hispanic Populations with DM, a Nation-Wide Study
The global prevalence of DM is approximately 10.5% and is expected to rise in the next few years. There is limited data on its outcomes stratified by race. Controlling DM will mitigate the risks of atherosclerotic cardiovascular disease. The purpose of this study is to compare differences in clinical outcomes in non-obese Caucasian and Hispanic populations with DM. Conducted as an observational study, it utilized data from the National Inpatient Sample from 2017 to 2020 focusing on non-obese adults over 18 years, with a BMI <30 kg/m^2, and DM diagnosis, excluding those under 18, obese or without DM. Primary outcome was in-hospital mortality. Secondary outcomes were cardiogenic shock, cardiac arrest, GIB, mechanical ventilation, length of stay, and total cost. Multivariable logistic and Poisson regression analyses determined the clinical outcomes, considering a p-value <0.05 significant. Among 22,300,000 non-obese adults with DM, 64.2% were Caucasians, 13.3% were Hispanics, 3.5% were Asians, 18.8% were AA, and the remaining population belonged to other ethnicities. This study revealed higher rates in the Caucasians for conditions like metabolic syndrome, dyslipidemia, HTN, pHTN, HF, PVD, A.fib, ACS, AKI, stroke, PE, and COPD. The Hispanics were seen to have a higher incidence of anemia, CKD, and severe sepsis. In terms of primary and secondary outcomes, Hispanics were higher. The findings undermine the importance of racial differences in such conditions and more in-depth studies are needed to extrapolate the gaps in care.
Journal Article
Variation in the α
Sympathetic activation suppresses insulin secretion via pancreatic ADRA2A. Because sympathetic activity and insulin demand increase during pregnancy, we tested the hypothesis that
variants are associated with gestational diabetes (GDM).
Among Caucasian pregnant women without pre-existing diabetes, we genotyped 458 who had GDM and 1537 without GDM for seven
variants.
rs1800038 (OR: 2.34; p = 0.020) and rs3750625 (OR: 1.56; p = 0.010) increased the risk of GDM, and rs11195418 decreased it (OR: 0.62; p = 0.025). The associations remained significant after adjustment for maternal age, maternal BMI, parity and a genetic risk score that included variants previously associated with Type 2 diabetes mellitus and GDM.
genetic variation contributes independently to the risk of GDM in Caucasian women.
Journal Article
On the Issue of the Caucasian Union in the 1920s-1930s
The paper analyses the futile attempts of the political elites of the independent Caucasus states created at the end of the First World War (Georgia, Azerbaijan, Armenia, and the Mountainous Republic of the Northern Caucasus) to create the united Caucasus during their presence in power and then in political emigration in the 1920s and 1930s, and also the attitude of influential European politicians towards this matter. The merits of the ‘main dreamers’ fighting for the integrity of the Caucasus – Akaki Chkhenkeli, Ali Mardan Bek Topchibashev, and Haidar Bamatov (Bamat) – have been outlined. The article discusses the factors that created fertile ground for the existence of their dream, on the one hand, and examines the real circumstances and objective reasons that hindered the realization of the ideas and actions of the historical figures working in the period under the lens. The work emphasises that, despite separate impediments (especially disagreement over boundaries and the annexationist policy of Turkey and Russia), the idea of Caucasian unity in the 1920s was based on the solid background created by the three main cultures that coexisted harmoniously over the centuries: 1. Religion - Judaism, Christianity, Islam; 2. Caucasian rule of thinking and 3. Caucasian mentality. Based on the research, we conclude that the happy future of the Caucasian people is linked to the unity of the Caucasus as it was in the case of the European Union.
Journal Article
Comparative Effectiveness of Calcium‐Channel Blockers, Angiotensin‐Converting Enzyme/Angiotensin Receptor Blockers and Diuretics on Cardiovascular Events Likelihood in Hypertensive African‐American and Non‐Hispanic Caucasians: A Retrospective Study Across HCA Healthcare
Background Hypertension, a leading global risk factor for mortality and disability, disproportionately affects racial and ethnic minorities. Our study investigates the association between the type of prior antihypertensive medication use and the likelihood of cardiovascular events (CVE) and assesses whether the patient's race influences this relationship. Methods A retrospective study of 14 836 hypertension cases aged ≥ 40 years was conducted using data from HCA Healthcare between 2017 and 2023. Logistic regression was employed to predict the likelihood of CVE and mortality at admission, adjusting for baseline comorbidities, with Race added as an effect modifier. Interaction analysis was performed among races based on antihypertensive medication types. Results African American patients on ACE inhibitors (ACE) or angiotensin receptor blockers (ARBs) were 1.7 times more likely to have cardiovascular events (CVE) compared to those on calcium channel blockers (CCBs) and 0.66 times as likely compared to diuretics. CCB users had a lower CVE risk than diuretic users. Among White patients, ACE/ARB users had a 1.18 times higher CVE risk than CCB users and 0.45 times lower compared to diuretics, while CCBs offered a 0.38 times lower risk than diuretics. Only ACE/ARB use showed significantly higher CVE odds for African Americans compared to White patients, with similar risks across racial groups for CCBs and diuretics. Conclusion Prior antihypertensive type significantly influenced CVE risk, with race as an effect modifier. CCB users had lower CVE odds than ACE/ARBs or diuretics, and ACE/ARBs showed reduced CVE likelihood compared to diuretics in both racial groups.
Journal Article
Progression of initially unilateral Moyamoya angiopathy in Caucasian Europeans
Background
Moyamoya angiopathy (MMA) is a rare cause of stroke in Caucasians, but it is much more frequent in East Asia. Since 2021, diagnostic criteria not only comprise bilateral, but also unilateral MMA. Hitherto, progression of unilateral MMA has predominantly been described in East Asians. Our study aimed to analyze the occurrence and characteristics of progression of initially unilateral MMA in Caucasian Europeans.
Methods
By retrospective analysis of medical records of 200 European Caucasians with MMA, admitted to our German center between 2010 and 2022, cases of unilateral MMA and its progression, i.e. progressive ipsi- or novel contralateral arterial stenosis, during follow-up were identified. Kruskal Wallis Test and Fisher’s Exact Test were used to identify statistically significant differences between progressive and stable patients concerning demographic, clinical, laboratory, and radiographic features.
Results
Our cohort comprised 63 patients with initially unilateral MMA. Fourteen (22.2%) had an ipsi- (
n
= 3, 21.4%) or contralateral (
n
= 11, 78.6%) progression. Mean age of patients with progressive MMA at symptom onset was 32 ± 14.1 years. The ratio of women to men in this subgroup was 2.5:1. Mean follow-up period was 5.4 ± 3.7 years, mean age at progression was 39.9 ± 12.7 years. Mean time interval between penultimate follow-up and progression was 4.8 ± 4.5 years. Patients with progression showed affection of the posterior cerebral artery (
p
= 0.009) and suffered from vertigo (
p
= 0.009) significantly more often.
Conclusion
Unilateral MMA progresses in a substantial proportion in European Caucasians. Long-term follow-up is required due to potential late progression with consecutive symptoms and the need for bypass surgery.
Journal Article
The Rise and Fall of the Caucasian Race
The term Caucasian is a curious invention of the modern age. Originating in 1795, the word identifies both the peoples of the Caucasus Mountains region as well as those thought to be Caucasian. Bruce Baum explores the history of the term and the category of the Caucasian race more broadly in the light of the changing politics of racial theory and notions of racial identity. With a comprehensive sweep that encompasses the understanding of \"race\" even before the use of the term Caucasian, Baum traces the major trends in scientific and intellectual understandings of race from the Middle Ages to the present day. Baum's conclusions make an unprecedented attempt to separate modern science and politics from a long history of racial classification. He offers significant insights into our understanding of race and how the Caucasian race has been authoritatively invented, embraced, displaced, and recovered throughout our history.
eBook
Anthropometry and Current Aesthetic Concept of the Lower Third of the Face and Lips in Caucasian Adult Population: A Systematic Review and Meta-Analysis
Background
The lack of standardization of the norms and aesthetic concept of the lower third of the face and lips creates challenges in reconstructive surgery and aesthetic procedures. A large-scale, anthropometric measurements summary poses an alternative for establishing universal patterns.
Methods
A systematic review was conducted by searching PubMed, Embase, Google Scholar and Web of Science using keywords: lip, face, aesthetics, beauty, anthropometry and Caucasian. Seventy records were included in the review and checked in detail in terms of available data.
Results
The study contains a meta-analysis of twelve parameters with sufficient quantitative data—lip width, nose width, facial width, lower third of the face height, midline mandible height, total height of the upper and lower lip, upper and lower vermilion height, cutaneous upper lip height and nasolabial and mentolabial angle.
Conclusions
The review provides a detailed database of primary anthropometric studies of lips and perioral regions of the healthy Caucasian population. The attractiveness of the region is focused on uniformity of proportions. Notably, results acquired with different methods of measurement are not interchangeable. Despite many published anthropometric studies, systems for conducting the measurements and reporting the results are not sufficiently unified to quantitatively assess meticulous key aesthetic clinical parameters.
Level of Evidence I
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors
www.springer.com/00266
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Journal Article