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The British Journal of Diabetes & Vascular Disease
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Reviews

Review: Diabetes and cardiac disease in South Asians

Babulayeb Mukhopadhyay

Department of Diabetes, Glasgow Royal Infirmary, Glasgow, G4 0SF, UK, neel64{at}hotmail.com

Naveed Sattar

Division of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow Royal Infirmary, Glasgow, G4 0SF, UK

Miles Fisher

Department of Diabetes, Glasgow Royal Infirmary, Glasgow, G4 0SF, UK

South Asians have a higher prevalence of diabetes, coronary heart disease and cardiovascular death. Their predisposition to insulin resistance partly explains this excess risk. After immigration, the adoption of a western diet allied to increased sedentary behaviour leads to weight gain, hypertension and hyperlipidaemia, factors which in turn combine to amplify the chances of getting heart disease. Further contributory factors are increased sub-clinical inflammation, increased thrombogenic tendency and higher serum homocysteine levels. South Asians with diabetes might do as well as White people with respect to intensive glycaemic and blood pressure control. However, there is little evidence for measures to reduce cardiovascular risk as South Asians have not been included as a subgroup in most large trials. Future prospective studies, including studies on the prevention of diabetes and cardiovascular disease in this high-risk population, are therefore urgently required.

Key Words: diabetes • South Asians • cardiovascular risk.

References

  • Mather H., Keen H. The Southall Diabetes survey: prevalence of known diabetes in Asians and Europeans. BMJ (Clin Res Ed) 1985;291:1081-4.[Abstract/Free Full Text]
  • Samanta A., Burden AC, Fent B. Comparative prevalence of non-insulin dependant diabetes mellitus in Asian and white Caucasian adults. Diabetes Res Clin Pract 1987;4:1-6.[Medline] [Order article via Infotrieve]
  • Ramachandran A., Snehalata C., Kapur A. et al. High prevalence of diabetes and impaired glucose tolerance in India: National Urban Diabetes Survey. Diabetologia 2001;44:1094-101.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Gupta R., Gupta VP Meta-analysis of coronary heart disease prevalence in India. Indian Heart J 1996;48:241-5.[Medline] [Order article via Infotrieve]
  • Wild S., McKeigue P. Cross-sectional analysis of mortality by country of birth in England and Wales, 1970-92. BMJ 1997;314:705-10.[Abstract/Free Full Text]
  • Sheth T., Nair C., Nargundkar M., Anand S., Yusuf S. Cardiovascular and cancer mortality among Canadians of European, south Asian and Chinese origin from 1979 to 1993: an analysis of 1.2 million deaths. CMAJ 1999;161:132-8.[Abstract/Free Full Text]
  • McKeigue PM, Ferrie JE, Marmot MG Association of early-onset Coronary Heart Disease in south Asian men with glucose intolerance and hyperinsulinaemia. Circulation 1993;87:152-61.[Abstract/Free Full Text]
  • Mather HM, Chaturvedi N., Fuller JH Mortality and morbidity from diabetes in south Asians and Europeans: 11-year follow-up of the Southall Diabetes Survey, London, UK. Diabet Med 1998;15:53-9.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • UK Prospective Diabetes Study Group. The incidence of myocardial infarction in White, south Asian and Afro-Caribbean patients with type 2 diabetes (UKPDS 32). Diabetes Care 1998;21:1271-7.[Abstract]
  • Davis TME, Cull CA, Holman RR for the UKPDS group. Relationship between ethnicity and glycaemic control, lipid profiles and blood pressure during the first 9 years of type 2 diabetes. Diabetes Care 2001; 24:1167-74.[Abstract/Free Full Text]
  • UK Prospective Diabetes Study Group. UK Prospective Diabetes Study XII: Differences between Asian, AfroCaribbean and White Caucasian type 2 diabetic patients at diagnosis of diabetes. Diabet Med 1994;11:670-7.[Web of Science][Medline] [Order article via Infotrieve]
  • Wilkinson P., Sayer J., Koorithottumkal L. et al. Comparison of case fatality in south Asian and white patients after acute myocardial infarction: observational study. BMJ 1996;312:1330-3.[Abstract/Free Full Text]
  • Bhopal R., Unwin N., White M. et al. Heterogeneity of coronary heart disease risk factors in Indian, Pakistani, Bangladeshi and European origin populations: cross sectional study. BMJ 1999;319:215-20.[Abstract/Free Full Text]
  • Yusuf S., Hawken S., Ounpuu S., Dans T. et al. on behalf of INTERHEART Study Investigators. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 2004;364:937-52.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Sniderman AD, Furberg CD, Keech A. et al. Apoproteins versus lipids as indices of coronary risk and as targets for statin therapy: analysis of the evidence. Lancet 2003;36:777-80.
  • Williams K., Sniderman AD, Sattar N., D'Agostino R. Jr, Wagenknecht LE, Haffner SM Comparison of the associations of apolipoprotein B and low-density lipoprotein cholesterol with other cardiovascular risk factors in the Insulin Resistance Atherosclerosis Study (IRAS). Circulation 2003;108:2312-16.[Abstract/Free Full Text]
  • Bhatnagar D., Anand IS, Durrington PN et al. Coronary risk factors in people from the Indian subcontinent living in west London and their siblings in India. Lancet 1995;345:405-09.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • McKeigue PM, Shah B., Marmot MG Relation of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in south Asians. Lancet 1991;337:382-6.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Pan CY, So WY, Khalid BAK et al. on behalf of the ASDIAB Study Group. Metabolic, immunological and clinical characteristics in newly diagnosed Asian diabetes patients aged 12-40 years. Diabet Med 2004;21:1007-13.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Whincup PH, Gilg JA, Papacosta O. et al. Early evidence of ethnic differences in cardiovascular risk: cross sectional comparison of British South Asian and white children. BMJ 2002;324:635-8.[Abstract/Free Full Text]
  • Yajnik CS, Lubree HG, Rege SS et al. Adiposity and hyperinsulinaemia in Indians are present at birth. J Clin Endocrinol Metab 2002;87:5575-80.[Abstract/Free Full Text]
  • Lydakis C., Lip G. Microalbuminuria and cardiovascular risk. QJM 1998;91: 381-91.[Abstract/Free Full Text]
  • Fischbacher CM, Bhopal R., Rutter MK et al. Microalbuminuria is more frequent in south Asian than in European origin populations: a comparative study in Newcastle UK. Diabet Med 2003;20:31-6.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Anand SS, Yusuf S., Vuksan V. et al. for the SHARE investigators. Differences in risk factors, atherosclerosis and cardiovascular disease between ethnic groups in Canada: the Study of Health Assessment and Risk in Ethnic groups. Lancet 2000;356:279-84.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Festa A., D'gostino R. Jr, Tracy RP, Haffner SM Elevated levels of acute-phase proteins and plasminogen activator inhibitor-1 predict the development of type 2 diabetes: the insulin resistance atherosclerosis study. Diabetes 2002;51:1131-7.[Abstract/Free Full Text]
  • Kain K., Catto AJ, Grant PJ Impaired fibrinolysis and increased fibrinogen levels in south Asian subjects. Atherosclerosis 2001;156:457-61.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Kain K., Catto AJ, Grant PJ Associations between insulin resistance and thrombotic risk factors in high-risk south Asian subjects. Diabet Med 2003;20:651-5.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Forouhi NG, Rumley A., Lowe GD, McKeigue P., Sattar N. Specific elevation in plasma tissue plasminogen activator antigen concentrations in South Asians relative to Europeans. Blood Coagul Fibrinolysis 2003;14: 755-60.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Eliasson MC, Jansson JH, Lindahl B., Stegmayr B. High levels of tissue plasminogen activator (tPA) antigen precede the development of type 2 diabetes in a longitudinal population study. The Northern Sweden MON-ICA Study. Cardiovasc Diabetol 2003;2:19.
  • Lowe GD, Danesh J., Lewington S. et al. Tissue plasminogen activator antigen and coronary heart disease. Prospective study and meta-analysis. Eur Heart J 2004;25:252-9.[Abstract/Free Full Text]
  • Velmurugan K., Deepa R., Ravikumar R. et al. Relationship of lipoprotein(a) with intimal medial thickness of the carotid artery in type 2 diabetic patients in south India. Diabet Med 2003;20:455-61.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Danesh J., Collins R., Peto R. Lipoprotein(a) and coronary heart disease. Meta-analysis of prospective studies. Circulation 2000;102:1082-5.[Abstract/Free Full Text]
  • Lindsay RS, Funahashi T., Matsuzawa Y. et al. Adiponectin Protects Against Development of Type 2 Diabetes in the Pima Indian Population. Lancet 2002;360:57-8.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Pischon T., Girman CJ, Hotamisligil GS, Rifai N., Hu FB, Rimm EB Plasma adiponectin levels and risk of myocardial infarction in men. JAMA 2004;291:1730-7.[Abstract/Free Full Text]
  • Zoccali C., Mallamaci F., Tripepi G. et al. Adiponectin, metabolic risk factors, and cardiovascular events among patients with end-stage renal disease. J Am Soc Nephrol 2002;13:134-41.[Abstract/Free Full Text]
  • Retnakaran R., Hanley AJG, Raif N., Connelly PW, Sermer M., Zinman B. Hypoadiponectinaemia in south Asian women during pregnancy: evidence of ethnic variation in adiponectin concentration. Diabet Med 2004;21:388-92.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Valsamakis G., Chetty R., McTernan PG, Al-Daghri NM, Barnett AH, Kumar S. Fasting serum adiponectin concentration is reduced in IndoAsian subjects and related to HDL-cholesterol. Diabetes Obes Metab 2003;5:131-5.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Abate N., Chandalia M., Snell PG, Grundy SM Adipose tissue metabolites and insulin resistance in nondiabetic Asian Indian men. J Clin Endocrinol Metab 2002;89:2750-5.[CrossRef]
  • Ridker PM, Rifai N., Rose L., Buring JE, Cook NR Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events. New Engl J Med 2002;347:1557-65.[Abstract/Free Full Text]
  • Forouhi NG, Sattar N., McKeigue PM Relation of C-reactive protein to body fat distribution and features of the metabolic syndrome in Europeans and South Asians. Int J Obes Relat Metab Disord 2001;25: 1327-31.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • 1. Chandalia M., Cabo-Chan A., Devaraj S., Jialal I., Grundy SM, Abate N. Elevated plasma high-sensitivity C-reactive protein concentrations in Asian Indians living in the United States. J Clin Endocrinol Metab 2003; 88:3773-6.[Abstract/Free Full Text]
  • Klerk M., Verhoef P., Clarke R., Blom HJ, Kok FJ, Schouten EG; MTHFR Studies Collaboration Group. MTHFR 677C-->T polymorphism and risk of coronary heart disease: a meta-analysis. JAMA 2002;288:2023-31.[Abstract/Free Full Text]
  • Chambers JC, Obeid OA, Refsum H. et al. Plasma homocysteine concentrations and risk of coronary heart disease in UK Indian Asian and European men. Lancet 2000;355:523-7.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Wannamethee S., Lowe GD, Whincup PH, Rumley A., Walker M., Lennon L. Physical activity and hemostatic and inflammatory variables in elderly men. Circulation 2002;105:1785-90.[Abstract/Free Full Text]
  • Dhawan J., Bray CL Asian Indians, coronary artery disease and physical exercise. Heart 1997;78:550-4.[Abstract/Free Full Text]
  • Lean ME, Han TS, Bush H., Anderson AS, Bradby H., Williams R. Ethnic differences in anthropometric and lifestyle measures related to coronary heart disease risk between south Asian, Italian and general population British women living in the west of Scotland. Int J Obes Relat Metab Disord 2001;25:1800-05.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Barnett AH, Grant PJ, Hitman GA et al. on behalf of the Indo-Asian Trial Investigators. Rosiglitazone in type 2 diabetes mellitus: an evaluation in British Indo-Asian patients. Diabet Med 2003;20:387-93.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Ammari F., Davies M., Koppiker N., Gregory R., Burden AC The effect of gliclazide on plasma insulin, intact and 32/33 split proinsulin in south Asian subjects with type 2 diabetes mellitus. Diabet Med 1999;16:142-6.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • The DECODA study group on behalf of the International Diabetes Epidemiology Group. Cardiovascular risk profile assessment in glucose-intolerant Asian individuals - an evaluation of the World Health Organization two-step strategy: the DECODA study (Diabetes Epidemiology: Collaborative Analysis of Diagnostic Criteria in Asia). Diabet Med 2002;19:549-57.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002;346:393-403.[Abstract/Free Full Text]
  • Pais P., Pogue J., Gerstein H. et al. Risk factors for acute myocardial infarction in Indians: a case-control study. Lancet 1996;348:358-63.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • McKeigue PM, Marmot MG, Adelstein AM et al. Diet and risk factors for coronary heart disease in Asians in northwest London. Lancet 1985;2: 1086-90.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Gupta R., Gupta VP, Ahluwalia NS Educational status, coronary heart disease, and coronary risk factor prevalence in a rural population of India. BMJ 1994;309:1332-6.[Abstract/Free Full Text]
  • Diabetes in minority ethnic groups in Scotland. A Report by the National Resource Centre for Ethnic Minority health in collaboration with the Scottish Diabetes Group. 2004. Health Scotland, Glasgow.
  • Mukhopadhyay B., Forouhi N., Fisher BM, Kesson C., Sattar N. South Asians have a more rapid deterioration in glycaemic control relative to Europeans: results from follow up in a routine diabetes clinic. Diabet Med (in press).

The British Journal of Diabetes & Vascular Disease, Vol. 5, No. 5, 253-259 (2005)
DOI: 10.1177/14746514050050050301
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