Gender differences in acculturation and cardiovascular disease risk-factor changes among Chinese immigrants in Italy: Evidence from a large population-based cohort

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.