Acculturation and Insulin Resistance Among US Chinese Immigrant Women

<p class="Pa7"><strong>Objective: </strong>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.</p><p class="Pa7"><strong>Design: </strong>Longitudinal study.</p><p class="Pa7"><strong>Setting</strong><em>: </em>Philadelphia, Pennsylvania.</p><p class="Pa7"><strong>Participants: </strong>305 Chinese immigrant women recruited October 2005 to April 2008 and followed until April 2010.</p><p class="Pa7"><strong>Main Outcome Measures</strong><em>: </em>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.</p><p class="Pa7"><strong>Results: </strong>GEQA was associated with log HOMA score, but only in women with &lt;9 years of education (beta [SE] = .09 [.04], <em>P</em>=.02; interaction <em>P</em>=.02). The association persisted with adjustment for body mass index, waist circumference, and dietary variables.</p><p><strong>Conclusions: </strong>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. <em>Ethn Dis. </em>2015;25(4):443-450; doi:10.18865/ed.25.4.443</p>