title: Acculturation and Insulin Resistance among US Chinese Immigrant Women.
abstract: 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.
  
  
  METHODS
  Longitudinal study.
  
  
  METHODS
  Philadelphia, Pennsylvania.
  
  
  METHODS
  305 Chinese immigrant women recruited October 2005 to April 2008 and followed until April 2010.
  
  
  METHODS
  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.
authors.affiliation: 1. Kinesiology Department, California Polytechnic State University, San Luis Obispo, Calif.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Tseng
authors.affiliation: 2. Cancer Prevention & Control Program, Fox Chase Cancer Center, Philadephia, Penn.
authors.forename: Carolyn Y
authors.initials: CY
authors.lastname: Fang
mesh_terms: D000069:Acculturation; D000328:Adult; D000886:Anthropometry; D044466:Asian People / Q000523:psychology*; D015992:Body Mass Index; D002681:China / Q000208:ethnology; D004032:Diet / Q000208:ethnology; D004522:Educational Status; D054242:Emigrants and Immigrants / Q000523:psychology*; D005247:Feeding Behavior / Q000208:ethnology; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000208:ethnology*; D008137:Longitudinal Studies; D008875:Middle Aged; D010414:Pennsylvania; D011795:Surveys and Questionnaires; D014481:United States
keywords: Acculturation; Chinese; Immigrants; Insulin Resistance