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. 2015 Apr 7;10(4):e0123599.
doi: 10.1371/journal.pone.0123599. eCollection 2015.

Asthma, type 1 and type 2 diabetes mellitus, and inflammatory bowel disease amongst South Asian immigrants to Canada and their children: a population-based cohort study

Eric I Benchimol  1 , Douglas G Manuel  2 , Teresa To  3 , David R Mack  4 , Geoffrey C Nguyen  5 , Jennifer L Gommerman  6 , Kenneth Croitoru  7 , Nassim Mojaverian  8 , Xuesong Wang  8 , Pauline Quach  9 , Astrid Guttmann  10
Affiliations

Asthma, type 1 and type 2 diabetes mellitus, and inflammatory bowel disease amongst South Asian immigrants to Canada and their children: a population-based cohort study

Eric I Benchimol et al. PLoS One. .

Abstract

Background: There is a high and rising rate of immune-mediated diseases in the Western world. Immigrants from South Asia have been reported to be at higher risk upon arrival to the West. We determined the risk of immune-mediated diseases in South Asian and other immigrants to Ontario, Canada, and their Ontario-born children.

Methods: Population-based cohorts of patients with asthma, type 1 diabetes (T1DM), type 2 diabetes (T2DM), and inflammatory bowel disease (IBD) were derived from health administrative data. We determined the standardized incidence, and the adjusted risk of these diseases in immigrants from South Asia, immigrants from other regions, compared with non-immigrant residents of Ontario. The risk of these diseases in the Ontario-born children of immigrants were compared to the children of non-immigrants.

Results: Compared to non-immigrants, adults from South Asia had higher risk of asthma (IRR 1.56, 95%CI 1.51-1.61) and T2DM (IRR 2.59, 95%CI 2.53-2.65). Adults from South Asia had lower incidence of IBD than non-immigrants (IRR 0.32, 95%CI 0.22-0.49), as did immigrants from other regions (IRR 0.29, 95%CI 0.20-0.42). Compared to non-immigrant children, the incidence of asthma (IRR 0.66, 95%CI 0.62-0.71) and IBD (IRR 0.47, 95%CI 0.33-0.67) was low amongst immigrant children from South Asia. However, the risk in Ontario-born children of South Asian immigrants relative to the children of non-immigrants was higher for asthma (IRR 1.75, 95%CI 1.69-1.81) and less attenuated for IBD (IRR 0.90, 95%CI 0.65-1.22).

Conclusion: Early-life environmental exposures may trigger a genetic predisposition to the development of asthma and IBD in South Asian immigrants and their Canada-born children.

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Conflict of interest statement

Competing Interests: All authors have completed the ICMJE uniform disclosure form at (www.icmje.org/coi_disclosure.pdf) and declare no support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

Figures

Fig 1
Fig 1. Incidence of asthma in (A) children and (B) adults 1996–2008.
Fig 2
Fig 2. Incidence of (A) type 1 diabetes in children and (B) type 2 diabetes in adults 1994–2008.
Fig 3
Fig 3. Incidence of inflammatory bowel disease in (A) children 1994–2008 and (B) adults 1999–2008.
See this image and copyright information in PMC

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