
Gigantic study of Chinese babies yields slew of health data - okket
https://www.nature.com/articles/d41586-018-05522-1
======
faitswulff
I wonder how much of the data generated isn't true of non-Chinese people. NPR
goes into detail on why diverse clinical trials are necessary:
[https://www.npr.org/sections/health-
shots/2015/12/16/4596667...](https://www.npr.org/sections/health-
shots/2015/12/16/459666750/clinical-trials-still-dont-reflect-the-diversity-
of-america)

> The blood thinner clopidogrel, or Plavix, doesn't work in the 75 percent of
> Pacific Islanders whose bodies don't produce the enzyme required to activate
> the drug. For them, taking the medication is like taking a placebo.

> People with epilepsy who are of Asian descent are supposed to get genetic
> testing before being prescribed the seizure medication carbamazepine,
> because the drug can damage the skin and internal organs of patients with a
> certain gene variant.

> And, says Oh, "African-Americans and Puerto Ricans don't respond as well to
> some of the most common asthma controller medications, and that's really a
> tragedy since these two groups are the most affected by asthma in the United
> States."

~~~
vancan1ty
Race does not exist... therefore there won't be a genetic difference in
average outcomes between different people groups. It is useful to think of
variation from person-to-person but it is impossible to make comparisons
between ethnic groups/races because no substantive differences exist among the
various human populations. Probably the study results you reference are a
result of different environments...

~~~
entee
Race is often shorthand for ethnicity, and it's true that to a certain extent
different ethnic groups have genetic differences of medical relevance. While
variation within groups is generally larger than that between groups, that
doesn't mean ethnicity is medically useless as data point. Classic examples
are among those the OP listed. The most visible are probably lactose tolerance
(significantly more common in Europe and cattle-herding populations) and
alcohol dehydrogenase (also know as Alcohol Flush Reaction). There are many
others and we're likely to find many more.

Medically important genetic differences between ethnicities exist, but it's
important to note the limits of this analysis. Usually these are fairly low-
level traits, i.e. different enzyme activity, and it's critical not not over-
extend the logic to more complex emergent traits such as intelligence or
others where clean biochemical links are suspect. Saying a certain set of
constraints changed the way certain enzymes work in a given population is not
the same as saying this group is better than another group.

~~~
lgessler
> Race is often shorthand for ethnicity

Huh? In medical contexts I've always understood race as a person's genetic
background and ethnicity as a person's cultural background. The two often
don't align as many might expect: an adopted child, for example, could be
racially South Asian but ethnically French because they speak French, enjoy
French food and culture, perceive their self as French, etc.

~~~
entee
That's maybe true but in that case also quite incomplete and doesn't actually
conflict with my point. Ethnicity is a readout of where that person grew up,
those cultural touchtones reflect that you have a bunch of people living in
the same geographical area. These people scramble their genes together, but
because they're in the same area, they would naturally begin to diverge
genetically from those in other areas.

You're right that ethnicity and the common definitions of race (i.e. skin
tone, hair color/texture, dominant facial features) don't always correlate as
well as expected, but that doesn't stop it from being used that way. Another
example in addition to yours would be someone who is north african and someone
who is south african may have quite different tolerance to lactose because of
different prevalences of cattle herding in those regions of the world (Lactose
tolerance arises very quickly when humans raise cattle). Still an outside
observer would label them both "Black", despite their ethnicities and genetic
makeups being different.

In short, ethnicity/race/genetics are all correlates but not absolutes. You
have to do a follow-up test, you have to be careful in your assumptions or
you'll make a mistake.

------
dokein
When I first started evaluating research, I was able to deconstruct studies
and show why they were bad left and right. I thought I was so smart, but then
when I started trying to do my own research it became obvious that we operate
under the same limitations as everyone else -- how do we design the best
imperfect study given the limitations of money, time, people, and geography?

In that context, I think this study is great. It is always true that the
results of a study in a narrow group do not extrapolate to a larger group and
it is good to be aware. However, that doesn't mean it can't generate
hypotheses for a larger group (which can then be studied). The researchers
likely would not have had the pull to generate an equivalent amount of data
and follow-up data for a world-wide population, but I'm glad they did the best
they could rather than spend their day posting criticisms on HackerNews.

------
sparrish
"The cohort’s leaders recruit babies born at the Guangzhou Women and
Children’s Medical Center. Only families planning to live in the southern
Chinese city for a long time have been recruited"

Limited ethnic and geographical selection of participants means this 'slew' of
data will likely be less valuable than this article lets on. Helpful to that
immediate area? yes.

~~~
relenzo
I have to say, the impressive scale of this data collection probably means it
will still have some uses. And for Chinese health & medicine, it's simply a
massive deal, if everything was done correctly.

------
forkLding
Heres the study details: [https://www.semanticscholar.org/paper/The-Born-in-
Guangzhou-...](https://www.semanticscholar.org/paper/The-Born-in-Guangzhou-
Cohort-Study-\(BIGCS\)-Qiu-Lu/9b6800246e0b757c397c695d48f71e0ba4d48a2b)

with references.

------
HillaryBriss
The progesterone finding is particularly interesting. I wonder if it's common
in the US to prescribe progesterone before 14 weeks gestation.

~~~
tathougies
It's commonly given to women who have had repeat miscarriages, like my wife.
However, her doctor also prescribes it after birth for women with PPD, because
it has been shown to alleviate the symptoms, and I imagine that if my wife
were to present with that, she would be put on it.

It's also common to give it to women who have short luteal phases and want to
conceive.

------
pnathan
These sorts of broad cohort studies wind up being _enormously_ useful. The
Scandinavian study keeps returning good results even today.

I would, mildly speculatively, hazard that enormous cost overruns are
permissible and acceptable to the tune of 1000% if we could execute a similar
cohort study in the entire United States for 30-50 years. The wealth of
knowledge they can reveal is absolutely astounding and informs post/ante/neo-
natal care to the point of redefining key practices.

------
greymeister
I was very disappointed when I realized this wasn't the study of giant Chinese
babies.

