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Modesti PA, Marzotti I, Calabrese M, Stefani L, Toncelli L, Modesti A, Galanti G, Boddi M. Gender differences in acculturation and cardiovascular disease risk-factor changes among Chinese immigrants in Italy: Evidence from a large population-based cohort. Int J Cardiol Cardiovasc Risk Prev 2021; 11:200112. [PMID: 34746933 PMCID: PMC8561312 DOI: 10.1016/j.ijcrp.2021.200112] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/11/2021] [Accepted: 10/19/2021] [Indexed: 11/28/2022]
Abstract
Background In recent decades, the Chinese presence in Southern Europe has grown rapidly but no data is available on the influence that residing in Mediterranean countries has on Chinese immigrants. In this study, we aim to examine the association between acculturation and cardiovascular risk factors among first-generation Chinese immigrants in Italy. Design Population-based, cross-sectional study. Methods A sample of 2589 Chinese first-generation immigrants (1599 women and 990 men) living in Prato, Italy, underwent blood pressure measurement, blood tests (with measurement of glucose, cholesterol, and triglycerides), and anthropometric measurements. The influence of length of residence (dependent variable) on hypertension, type 2 diabetes, overweight/obesity, and hyperlipidemia (high cholesterol) (independent variables) was investigated with multivariable logistic regression adjusted for age, sex, education and urban/rural home area in China before migration. Results Mean age of Chinese participants was 47.2 ± 10.7 years and 61.7% were women. Immigrants residing in Italy for ≥20 years were more likely to be hypertensive [odd ratio (OR) 1.84; 95% confidence interval (CI) 1.33 to 2.59], or diabetic (1.91; 1.26 to 2.86) than those residing in Italy for <10 years. Differently, prevalence of hypercholesterolemia (total cholesterol≥240 mg/dl) was lower in immigrants residing in Italy for ≥20 years than in those with <10 years of residence (0.52; 0.32 to 0.83). The association between indicators of acculturation and cardiovascular risk factors appeared to differ by sex. Conclusion Acculturation of Chinese immigrants in Italy was associated with hypertension and type 2 diabetes whereas a favorable effect on hypercholesterolemia was observed.
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Affiliation(s)
- Pietro Amedeo Modesti
- Dipartimento di Medicina Sperimentale e Clinica, Universita degli Studi di Firenze, Florence, Italy.,Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Ilaria Marzotti
- Dipartimento di Medicina Sperimentale e Clinica, Universita degli Studi di Firenze, Florence, Italy
| | - Maria Calabrese
- UO Diabetologia, Ospedale Misericordia e Dolce, Prato, Italy
| | - Laura Stefani
- Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Loira Toncelli
- Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Alessandra Modesti
- Dipartimento di Scienze Biomediche, Sperimentali e Cliniche Mario Serio, Universita degli Studi di Firenze, Florence, Italy
| | - Giorgio Galanti
- Dipartimento di Medicina Sperimentale e Clinica, Universita degli Studi di Firenze, Florence, Italy.,Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Maria Boddi
- Dipartimento di Medicina Sperimentale e Clinica, Universita degli Studi di Firenze, Florence, Italy.,Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
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Modesti PA, Marzotti I, Pellegrino A, Ermini E, Bartoletti A, Mascherini G, Galanti G. LACK OF CHANGES IN FOOD BEHAVIOUR OF FIRST-GENERATION CHINESE MIGRANTS THROUGH THE YEARS OF RESIDENCE IN ITALY. J Hypertens 2021. [DOI: 10.1097/01.hjh.0000748188.48045.c8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Modesti PA, Wang J, Damasceno A, Agyemang C, Van Bortel L, Persu A, Zhao D, Jarraya F, Marzotti I, Bamoshmoosh M, Parati G, Schutte AE. Indirect implications of COVID-19 prevention strategies on non-communicable diseases : An Opinion Paper of the European Society of Hypertension Working Group on Hypertension and Cardiovascular Risk Assessment in Subjects Living in or Emigrating from Low Resource Settings. BMC Med 2020; 18:256. [PMID: 32795303 PMCID: PMC7426897 DOI: 10.1186/s12916-020-01723-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 07/27/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND After its outbreak in China, the novel COronaVIrus Disease 19 is spreading across the globe. It is an emergency the world has never seen before. MAIN TEXT The attention of health systems is mainly focused on COronaVIrus Disease 19 patients and on the risk that intensive care units might be overwhelmed by the serious pulmonary complications. Different countries are also attempting to establish infection prevention and control strategies which proved effective in China where the outbreak was initially reported. We reflect on important lessons to be learnt from different countries. The effects that infection prevention and control strategies, such as social distancing or isolation, can have on the care of millions of patients with non-communicable diseases, who may be indirectly affected, have not been taken into consideration so much. CONCLUSIONS When dealing with COronaVIrus Disease 19, policy makers and healthcare personnel should consider the indirect effects on the treatment of non-communicable diseases.
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Affiliation(s)
- Pietro A Modesti
- Department of Experimental and Clinical Medicine, School of Medicine, Universita' degli Studi di Firenze, Azienda Ospedaliero Universitaria Careggi, Largo Brambilla 3, 50134, Florence, Italy.
| | - Jiguang Wang
- The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Albertino Damasceno
- Department of Cardiology, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - Charles Agyemang
- Department of Public & Occupational Health, Amsterdam Public Health (APH) Research Institute, Amsterdam University Medical Centres, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105 AZ, the Netherlands
| | - Luc Van Bortel
- Division of Clinical Pharmacology, Department of Basic and Applied Medical Sciences, Ghent University, Ghent, Belgium
| | - Alexandre Persu
- Division of Cardiology, Cliniques Universitaires Saint-Luc and Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Brussels, Belgium
| | - Dong Zhao
- Department of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Faical Jarraya
- Université de Sfax, Laboratoire de Recherche LR19ES11 (Ex. UR12ES14), Faculté de Médecine, Avenue M. Boulila, Sfax, 3029, Tunisie
| | - Ilaria Marzotti
- Department of Experimental and Clinical Medicine, School of Medicine, Universita' degli Studi di Firenze, Azienda Ospedaliero Universitaria Careggi, Largo Brambilla 3, 50134, Florence, Italy
| | | | - Gianfranco Parati
- Department of Medicine and Surgery, University of Milano-Bicocca, Department of Cardiology, S. Luca Hospital, IRCCS Istituto Auxologico Medicine and Surgery, Milan, Italy
| | - Aletta E Schutte
- Hypertension in Africa Research Team, North-West University, Potchefstroom, South Africa
- School of Public Health & Community Medicine, Faculty of Medicine, University of New South Wales and the George Institute for Global Health, Sydney, Australia
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Modesti PA, Scali E, Marzotti I, Ulivi N, Boddi M, Galanti G, Pellegrino A, Macrí R. Blood pressure and fasting glucose changes in male migrants waiting for an asylum decision in Italy. A pilot study. Int J Cardiol 2020; 309:110-114. [PMID: 31884005 DOI: 10.1016/j.ijcard.2019.12.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 11/27/2019] [Accepted: 12/12/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Central Mediterranean route from Libya to Italy has been for years the major port of entry from Africa to Europe. However, information on the early effects of permanence in Italy on cardiovascular risk factors is limited. Therefore, the association between length of stay in Italy and blood pressure or blood glucose was explored in young asylum seekers. METHODS Cross-sectional study performed on male asylum seekers (aged 18-40 years), hosted for 0-30 months in Prato, Italy. Blood pressure and blood glucose, measured with validated instruments, were classified according to European Society of Hypertension and American Diabetes Association guidelines respectively. The relationship of quartiles of months of stay in Italy (independent variable) with blood pressure and fasting glucose was investigated with multivariate linear regression adjusted for years of age, world area of origin, education level, travel duration in months, smoking habit, alcohol use, body mass index, triglycerides. RESULTS On average, the 217 asylum seekers lived in Italy for 8.4 months (95% CI 7.5-9.3; range 0-30 months). At multivariate adjusted linear regression analysis, quartiles of months in Italy were associated with a forward shift in the blood pressure categories of the European Society of Hypertension (B = 0.396; 95% CI 0.190 to 0.602) and in the categories fasting glucose levels of the American Diabetes Association (B = 0.450; 95% CI 0.023 to 0.876). CONCLUSIONS When considering the importance of high blood pressure and type 2 diabetes for ethnic minorities living in Europe, changes of cardiovascular risk factors in the new environment probably need more attention.
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Affiliation(s)
| | | | - Ilaria Marzotti
- Dept. Experimental and Clinical Medicine, University of Florence, Italy
| | | | - Maria Boddi
- Dept. Experimental and Clinical Medicine, University of Florence, Italy
| | - Giorgio Galanti
- Dept. Experimental and Clinical Medicine, University of Florence, Italy
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Modesti PA, Marzotti I, Rapi S, Rogolino A, Cappuccio FP, Zhao D, Costanzo G, Galanti G, Boddi M. Daily urinary sodium and potassium excretion in Chinese first-generation migrants in Italy. Int J Cardiol 2018; 286:175-180. [PMID: 30583922 DOI: 10.1016/j.ijcard.2018.12.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 10/04/2018] [Accepted: 12/10/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND China has one of the highest salt intake levels in the world, and Chinese people form one of the largest foreign-born communities now living in Europe. The present study was performed to assess 24-hour urinary sodium and potassium excretion in Chinese migrants in Italy and to explore possible associations with hypertension, hypertension awareness, and length of residence in Italy. METHODS A cross-sectional evaluation was conducted on 319 first-generation Chinese migrants (154 women and 165 men) aged 18-70 years. Subjects were asked to do a 24-hour urine collection and the relationships of urinary sodium and potassium and arterial blood pressure, hypertension (BP ≥ 140/90 mmHg or anti-hypertensive drug use), hypertension awareness, and years of residence in Italy were investigated with linear or logistic regression analysis. RESULTS Sodium excretion was 145.2 mmol/day (95%CI 138.0-152.3) in men, and 134.7 (95%CI 127.6-141.8) in women corresponding to a dietary salt intake of 9.4 g/day (95%CI 9.0-9.9) and 8.8 (95%CI 8.3-9.2) respectively. Potassium excretion was 35.1 mmol/day (95%CI 33.6-36.5), with no significant difference by gender. At multivariable adjusted linear regression analysis body mass index, low education level, and hypertension were positive predictors of sodium urinary excretion; gender (women), and body mass index were positive predictors of potassium excretion. Sodium and potassium excretion were unaffected by hypertension awareness or years of residence in Italy. CONCLUSIONS Sodium excretion in Chinese workers is higher than recommended and in line with high salt intake in Italy. Potassium consumption remains low.
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Affiliation(s)
| | - Ilaria Marzotti
- Dept. Experimental and Clinical Medicine, University of Florence, Italy
| | - Stefano Rapi
- Dept. Experimental and Clinical Medicine, University of Florence, Italy
| | - Angela Rogolino
- Dept. Experimental and Clinical Medicine, University of Florence, Italy
| | - Francesco P Cappuccio
- University of Warwick, Warwick Medical School, Coventry, UK; University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
| | - Dong Zhao
- Department of Epidemiology, Capital Medical University Beijing Anzhen Hospital, and National Institute of Heart, Lung & Blood Disease, Beijing, China
| | | | - Giorgio Galanti
- Dept. Experimental and Clinical Medicine, University of Florence, Italy
| | - Maria Boddi
- Dept. Experimental and Clinical Medicine, University of Florence, Italy
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