Abstract
Cardiovascular disease (CVD) is an important global health problem causing significant morbidity, disability, and premature mortality. The overall impact of CVD on the society is enormous – chronic disease burden, frequent hospitalizations, loss of productivity, and impairment of quality of life. While multiple individual risk factors such as hypertension, diabetes, hyperlipidemia, obesity, and tobacco consumption can cause CVD, it is the constellation of these risk factors (termed metabolic syndrome) which creates the milieu for atherosclerosis and other manifestations of CVD. The problem of metabolic syndrome is escalating all over the world irrespective of cultural, genetic, gender, and geographical differences. Thus, metabolic syndrome can be labeled as a merciless equal opportunity killer. This chapter covers the epidemiology of metabolic syndrome in South Asians and the implications for the society. The escalating prevalence and degree of metabolic syndrome in South Asians required applicable public health interventions at the societal level to decrease chronic disease burden.
References
Abate N, et al. Genetic polymorphism PC-1 K121Q and ethnic susceptibility to insulin resistance. J Clin Endocrinol Metab. 2003;88(12):5927-5934.
Abbasi F, et al. Relationship between obesity, insulin resistance, and coronary heart disease risk. J Am Coll Cardiol. 2002;40(5):937-943.
Alberti KG, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009;120(16):1640-1645.
Ballantyne CM, et al. Influence of low high-density lipoprotein cholesterol and elevated triglyceride on coronary heart disease events and response to simvastatin therapy in 4S. Circulation. 2001;104(25):3046-3051.
Basit A, Shera AS. Prevalence of metabolic syndrome in Pakistan. Metab Syndr Relat Disord. 2008;6:171-175.
Bhalodkar NC, et al. Comparison of levels of large and small high-density lipoprotein cholesterol in Asian Indian men compared with Caucasian men in the Framingham Offspring Study. Am J Cardiol. 2004;94(12):1561-1563.
Bhalodkar NC, Blum S, Enas EA. Accuracy of the ratio of triglycerides to high-density lipoprotein cholesterol for predicting low-density lipoprotein cholesterol particle sizes, phenotype B, and particle concentrations among Asian Indians. Am J Cardiol. 2006;97(7):1007-1009.
Bhopal RS. Heterogeneity among Indians, Pakistanis, and Bangladeshis is key to racial inequities. BMJ. 2002;325(7369):903.
Cappuccio FP, et al. Prevalence, detection, and management of cardiovascular risk factors in different ethnic groups in south London. Heart. 1997;78(6):555-563.
Chambers JC, et al. Abnormalities of vascular endothelial function may contribute to increased coronary heart disease risk in UK Indian Asians. Heart. 1999;81(5):501-504.
Chiu KC, et al. Hepatic glucokinase promoter polymorphism is associated with hepatic insulin resistance in Asian Indians. BMC Genet. 2000;1:2.
Cromwell WC. High-density lipoprotein associations with coronary heart disease: does measurement of cholesterol content give the best result? J Clin Lipidol. 2007;1(1):57-64.
Donati MB. The “common soil hypothesis”: evidence from population studies? Thromb Res. 2010;125(Suppl 2):S92-S95.
Eckel RH, et al. The metabolic syndrome. Lancet. 2010;375(9710):181-183.
Enas EA, et al. Coronary heart disease and its risk factors in first-generation immigrant Asian Indians to the United States of America. Indian Heart J. 1996;48(4):343-353.
Enas EA, et al. Elevated lipoprotein(a) – a genetic risk factor for premature vascular disease in people with and without standard risk factors: a review. Dis Mon. 2006;52(1):5-50.
Farmer JA, Liao J. Evolving concepts of the role of high-density lipoprotein in protection from atherosclerosis. Curr Atheroscler Rep. 2011;13(2):107-114.
Ferrannini E, et al. Hyperinsulinaemia: the key feature of a cardiovascular and metabolic syndrome. Diabetologia. 1991;34(6):416-422.
Ghosh A. Effects of socio-economic and behavioural characteristics in explaining central obesity – a study on adult Asian Indians in Calcutta. India Coll Antropol. 2006;30(2):265-271.
Grundy SM, et al. Definition of metabolic syndrome: Report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation. 2004;109(3):433-438.
Grundy SM, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005;112(17):2735-2752.
Gupta R. Meta-analysis of prevalence of hypertension in India. Indian Heart J. 1997;49(1):43-48.
Gupta A, et al. Prevalence of diabetes, impaired fasting glucose and insulin resistance syndrome in an urban Indian population. Diabetes Res Clin Pract. 2003;61(1):69-76.
Joseph A, Kutty VR, Soman CR. High risk for coronary heart disease in Thiruvananthapuram city: a study of serum lipids and other risk factors. Indian Heart J. 2000;52(1):29-35.
Kain K, Catto AJ, Grant PJ. Associations between insulin resistance and thrombotic risk factors in high-risk South Asian subjects. Diabet Med. 2003;20:651-655.
Keech A, et al. Effects of long-term fenofibrate therapy on cardiovascular events in 9795 people with type 2 diabetes mellitus (the FIELD study): randomised controlled trial. Lancet. 2005;366(9500):1849-1861.
King H, Aubert RE, Herman WH. Global burden of diabetes, 1995–2025: prevalence, numerical estimates, and projections. Diabetes Care. 1998;21(9):1414-1431.
Knowler WC, et al. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet. 2009;374(9702):1677-1686.
Krentz AJ, Bailey CJ. Oral antidiabetic agents: current role in type 2 diabetes mellitus. Drugs. 2005;65(3):385-411.
Liu J, et al. Joint distribution of non-HDL and LDL cholesterol and coronary heart disease risk prediction among individuals with and without diabetes. Diabetes Care. 2005;28(8):1916-1921.
Loke YK, Kwok CS, Singh S. Comparative cardiovascular effects of thiazolidinediones: systematic review and meta-analysis of observational studies. BMJ. 2011;342:d1309.
Manttari M, et al. Lipoproteins and coronary heart disease in the Helsinki Heart Study. Eur Heart J. 1990;11(Suppl H):26-31.
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(8738):382-386.
Miller M, et al. APOC3 promoter polymorphisms C-482T and T-455C are associated with the metabolic syndrome. Arch Med Res. 2007;38(4):444-451.
Misra A. Revisions of cutoffs of body mass index to define overweight and obesity are needed for the Asian-ethnic groups. Int J Obes Relat Metab Disord. 2003;27(11):1294-1296.
Misra A, Khurana L. Obesity and the metabolic syndrome in developing countries. J Clin Endocrinol Metab. 2008;93(11 Suppl 1):S9-S30.
Misra A, Khurana L. The metabolic syndrome in South Asians: epidemiology, determinants, and prevention. Metab Syndr Relat Disord. 2009;7(6):497-514.
Misra A, Misra R, Wijesuriya M. The metabolic syndrome in South Asians. In: Mohan V, Rao GHR, eds. Type 2 Diabetes in South Asians. Epidemiology, Risk Factors and Prevention. Jaypee Bros; 2007:76-96.
Misra A, et al. Consensus statement for diagnosis of obesity, abdominal obesity and the metabolic syndrome for Asian Indians and recommendations for physical activity, medical and surgical management. J Assoc Physicians India. 2009a;57:163-170.
Misra A, et al. South Asian diets and insulin resistance. Br J Nutr. 2009b;101(4):465-473.
Mohan B, et al. Prevalence of sustained hypertension and obesity in urban and rural school going children in Ludhiana. Indian Heart J. 2004;56(4):310-314.
Murphy C, et al. Vascular dysfunction and reduced circulating endothelial progenitor cells in young healthy UK South Asian men. Arterioscler Thromb Vasc Biol. 2007;27(4):936-942.
Nissen SE, Wolski K. Rosiglitazone revisited: an updated meta-analysis of risk for myocardial infarction and cardiovascular mortality. Arch Intern Med. 2010;170(14):1191-1201.
Popkin BM, et al. Trends in diet, nutritional status, and diet-related noncommunicable diseases in China and India: the economic costs of the nutrition transition. Nutr Rev. 2001;59(12):379-390.
Radhika G, et al. Dietary salt intake and hypertension in an urban south Indian population – [CURES – 53]. J Assoc Physicians India. 2007;55:405-411.
Ramachandran A, Snehalatha C, Kapur A, et al. High prevalence of diabetes and impaired glucose tolerance in India: National Urban Diabetes Survey. Diabetologia. 2001;44:1094-1101.
Ramachandran A, et al. Metabolic syndrome in urban Asian Indian adults – a population study using modified ATP III criteria. Diabetes Res Clin Pract. 2003;60(3):199-204.
Reaven GM. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes. 1988;37(12):1595-1607.
Reaven GM. The metabolic syndrome: time to get off the merry-go-round? J Intern Med. 2011;269(2):127-136.
Reddy KS, Yusuf S. Emerging epidemic of cardiovascular disease in developing countries. Circulation. 1998;97(6):596-601.
Scanu AM. Lp(a) lipoprotein – coping with heterogeneity. N Engl J Med. 2003;349(22):2089-2090.
Schernthaner G, Chilton RJ. Cardiovascular risk and thiazolidinediones – what do meta-analyses really tell us? Diabetes Obes Metab. 2010;12(12):1023-1035.
Sirtori CR, et al. Effect of statins on LDL particle size in patients with familial combined hyperlipidemia: a comparison between atorvastatin and pravastatin. Nutr Metab Cardiovasc Dis. 2005;15(1):47-55.
Sleight P, et al. Blood-pressure reduction and cardiovascular risk in HOPE study. Lancet. 2001;358(9299):2130-2131.
Smelt AH, de Beer F. Apolipoprotein E and familial dysbetalipoproteinemia: clinical, biochemical, and genetic aspects. Semin Vasc Med. 2004;4(3):249-257.
Superko HR, et al. Gemfibrozil reduces small low-density lipoprotein more in normolipemic subjects classified as low-density lipoprotein pattern B compared with pattern A. Am J Cardiol. 2005;96(9):1266-1272.
Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002;106(25):3143-421.
Vikram NK, et al. Non-obese (body mass index < 25 kg/m2) Asian Indians with normal waist circumference have high cardiovascular risk. Nutrition. 2003;19(6):503-509.
Wasir JS, Misra A. The Metabolic Syndrome in Asian Indians: Impact of Nutritional and Socio-economic Transition in India. Metab Syndr Relat Disord. 2004;2(1):14-23.
Wasir JS, Misra A, Vikram NK, et al. C-reactive protein, obesity, and insulin resistance in postmenopausal women in urban slums of North India. Diabet Metab Syndr Clin Res Rev. 2007;1:83-89.
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Wali, M., Ram, C.V.S. (2016). Metabolic Syndrome in South Asians. In: Ahima, R.S. (eds) Metabolic Syndrome. Springer, Cham. https://doi.org/10.1007/978-3-319-11251-0_7
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