The Hispanic paradox further unraveled?
نویسندگان
چکیده
In their cross-sectional study, Powell et al found no evidence that genetic ancestry or self-reported ethnicity effected lung function among US smokers, in particular no evidence of a reduced risk of COPD in Hispanics (Hispanic paradox) previously described in a prospective study by Bruse et al. This observation might be due, in part, to the definition of Hispanic and lighter smoking histories in the Powell study. In the Powell study, only 51% of those defined as Hispanic were Mexican while the rest were predominantly of Caribbean ancestry. This is important because the Mexican Hispanics are of European and American Indian ancestry, whereas the Caribbean Hispanics also have African ancestry and a greater risk for COPD compared with Mexicans (http://www.cdc.gov/nchs/data/ databriefs/db63.pdf) Significantly in the study by Powell et al, smoking exposure was much lower than that of Bruse et al (16 vs 34 pack years respectively in Hispanic men). 2 Given that the smoking and lung function relationship is nonlinear and the ‘ancestral effects’ may be subject to different smoking exposure history, we suggest a further analysis be done by Powell including only Mexican Hispanics stratified by matching pack-year exposure. While the Bruse et al study suggests that American Indian genetic ancestry confers a reduced risk of COPD, potentially accounting for the Hispanic paradox, it remains a possibility that there exists a non-genetic basis to this phenomenon. Interestingly, the Hispanic paradox extends to lung cancer, another smoking-related lung disease where pulmonary and systemic inflammation has been implicated. We suggest that it is possible that cultural differences may account for the Hispanic paradox, in particular the effect of diet. It is noteworthy that the Mexican (and American Indian) diet is
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ورودعنوان ژورنال:
- Thorax
دوره 69 2 شماره
صفحات -
تاریخ انتشار 2014