Login Register Cart 0
Generic placeholder image

Current Diabetes Reviews

Editor-in-Chief

ISSN (Print): 1573-3998
ISSN (Online): 1875-6417

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Review Article

Pathophysiological Mechanisms Underlying Excess Risk for Diabetes and Cardiovascular Disease in South Asians: The Perfect Storm

Author(s): Anurag Mehta, Sumitabh Singh, Anum Saeed, Dhruv Mahtta, Vera A. Bittner, Laurence S. Sperling and Salim S. Virani*

Volume 17, Issue 9, 2021

Published on: 03 July, 2020

Article ID: e070320183447 Pages: 12

DOI: 10.2174/1573399816666200703182458

Price: $65

Open Access Journals Promotions 2
Abstract

Background: South Asians are at a significantly increased risk of type 2 diabetes (T2D) and cardiovascular disease (CVD), are diagnosed at relatively younger ages, and exhibit more severe disease phenotypes as compared with other ethnic groups. The pathophysiological mechanisms underlying T2D and CVD risk in South Asians are multifactorial and intricately related.

Methods: A narrative review of the pathophysiology of excess risk of T2D and CVD in South Asians.

Results: T2D and CVD have shared risk factors that encompass biological factors (early life influences, impaired glucose metabolism, and adverse body composition) as well as behavioral and environmental risk factors (diet, sedentary behavior, tobacco use, and social determinants of health). Genetics and epigenetics also play a role in explaining the increased risk of T2D and CVD among South Asians. Additionally, South Asians harbor several lipid abnormalities including high concentration of small-dense low-density lipoprotein (LDL) particles, elevated triglycerides, low high-density lipoprotein (HDL)- cholesterol levels, dysfunctional HDL particles, and elevated lipoprotein(a) that predispose them to CVD.

Conclusion: In this comprehensive review, we have discussed risk factors that provide insights into the pathophysiology of excess risk of T2D and CVD in South Asians.

Keywords: South Asia, type 2 diabetes, atherosclerosis, pathophysiology, risk factors, prevention.

[1]
United Nations Statistics Division. Geographic Regions https://unstats.un.org/unsd/methodology/m492020.
[2]
United Nations World Population Prospects. 2019.https://population.un.org/wpp
[3]
India State-Level Disease Burden Initiative Collaborators. Nations within a nation: variations in epidemiological transition across the states of India, 1990-2016 in the Global Burden of Disease Study. Lancet 2017; 390(10111): 2437-60.
[http://dx.doi.org/10.1016/S0140-6736(17)32804-0] [PMID: 29150201]
[4]
Misra A, Tandon N, Ebrahim S, et al. Diabetes, cardiovascular disease, and chronic kidney disease in South Asia: current status and future directions. BMJ 2017; 357: j1420.
[http://dx.doi.org/10.1136/bmj.j1420] [PMID: 28400361]
[5]
I nstitute for Health Metrics and Evaluation. Global Burden of Disease Compare https://vizhub.healthdata.org/gbd-compare2020.
[6]
Hills AP, Arena R, Khunti K, et al. Epidemiology and determinants of type 2 diabetes in south Asia. Lancet Diabetes Endocrinol 2018; 6(12): 966-78.
[http://dx.doi.org/10.1016/S2213-8587(18)30204-3] [PMID: 30287102]
[7]
Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular diseases: Part II: variations in cardiovascular disease by specific ethnic groups and geographic regions and prevention strategies. Circulation 2001; 104(23): 2855-64.
[http://dx.doi.org/10.1161/hc4701.099488] [PMID: 11733407]
[8]
Sattar N, Gill JM. Type 2 diabetes in migrant south Asians: mechanisms, mitigation, and management. Lancet Diabetes Endocrinol 2015; 3(12): 1004-16.
[http://dx.doi.org/10.1016/S2213-8587(15)00326-5] [PMID: 26489808]
[9]
Gujral UP, Pradeepa R, Weber MB, Narayan KM, Mohan V. Type 2 diabetes in South Asians: similarities and differences with white Caucasian and other populations. Ann N Y Acad Sci 2013; 1281: 51-63.
[http://dx.doi.org/10.1111/j.1749-6632.2012.06838.x] [PMID: 23317344]
[10]
Shah A, Kanaya AM. Diabetes and associated complications in the South Asian population. Curr Cardiol Rep 2014; 16(5): 476.
[http://dx.doi.org/10.1007/s11886-014-0476-5] [PMID: 24643902]
[11]
Joshi P, Islam S, Pais P, et al. Risk factors for early myocardial infarction in South Asians compared with individuals in other countries. JAMA 2007; 297(3): 286-94.
[http://dx.doi.org/10.1001/jama.297.3.286] [PMID: 17227980]
[12]
Ahmed ST, Rehman H, Akeroyd JM, et al. Premature Coronary Heart Disease in South Asians: Burden and Determinants. Curr Atheroscler Rep 2018; 20(1): 6.
[http://dx.doi.org/10.1007/s11883-018-0706-1] [PMID: 29374801]
[13]
Prabhakaran D, Jeemon P, Roy A. Cardiovascular Diseases in India: Current Epidemiology and Future Directions. Circulation 2016; 133(16): 1605-20.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.114.008729] [PMID: 27142605]
[14]
Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2018; 73(24): 3168-209.
[http://dx.doi.org/10.1016/j.jacc.2018.11.002] [PMID: 30423391]
[15]
Gholap N, Davies M, Patel K, Sattar N, Khunti K. Type 2 diabetes and cardiovascular disease in South Asians. Prim Care Diabetes 2011; 5(1): 45-56.
[http://dx.doi.org/10.1016/j.pcd.2010.08.002] [PMID: 20869934]
[16]
Martín-Timón I, Sevillano-Collantes C, Segura-Galindo A, Del Cañizo-Gómez FJ. Type 2 diabetes and cardiovascular disease: Have all risk factors the same strength? World J Diabetes 2014; 5(4): 444-70.
[http://dx.doi.org/10.4239/wjd.v5.i4.444] [PMID: 25126392]
[17]
Bhopal RS. A four-stage model explaining the higher risk of Type 2 diabetes mellitus in South Asians compared with European populations. Diabet Med 2013; 30(1): 35-42.
[http://dx.doi.org/10.1111/dme.12016] [PMID: 22998210]
[18]
Hayman LL, Helden L, Chyun DA, Braun LT. A life course approach to cardiovascular disease prevention. J Cardiovasc Nurs 2011; 26(4)(Suppl.): S22-34.
[http://dx.doi.org/10.1097/JCN.0b013e318213ef7f] [PMID: 21659809]
[19]
WHO. Life course perspectives on coronary heart disease, stroke and diabetes : key issues and implications for policy and research https://apps.who.int/iris/handle/10665/671732020.
[20]
Sharma D, Shastri S, Sharma P. Intrauterine Growth Restriction: Antenatal and Postnatal Aspects. Clin Med Insights Pediatr 2016; 10: 67-83.
[http://dx.doi.org/10.4137/CMPed.S40070] [PMID: 27441006]
[21]
Stein CE, Fall CH, Kumaran K, Osmond C, Cox V, Barker DJ. Fetal growth and coronary heart disease in south India. Lancet 1996; 348(9037): 1269-73.
[http://dx.doi.org/10.1016/S0140-6736(96)04547-3] [PMID: 8909379]
[22]
Vaag AA, Grunnet LG, Arora GP, Brøns C. The thrifty phenotype hypothesis revisited. Diabetologia 2012; 55(8): 2085-8.
[http://dx.doi.org/10.1007/s00125-012-2589-y] [PMID: 22643933]
[23]
Prentice AM, Rayco-Solon P, Moore SE. Insights from the developing world: thrifty genotypes and thrifty phenotypes. Proc Nutr Soc 2005; 64(2): 153-61.
[http://dx.doi.org/10.1079/PNS2005421] [PMID: 15960860]
[24]
Tillin T, Hughes AD, Mayet J, et al. The relationship between metabolic risk factors and incident cardiovascular disease in Europeans, South Asians, and African Caribbeans: SABRE (Southall and Brent Revisited) -- a prospective population-based study. J Am Coll Cardiol 2013; 61(17): 1777-86.
[http://dx.doi.org/10.1016/j.jacc.2012.12.046] [PMID: 23500273]
[25]
Moussouttas M, Aguilar L, Fuentes K, et al. Cerebrovascular disease among patients from the Indian subcontinent. Neurology 2006; 67(5): 894-6.
[http://dx.doi.org/10.1212/01.wnl.0000233923.63869.8c] [PMID: 16966562]
[26]
Gunarathne A, Patel JV, Gammon B, Gill PS, Hughes EA, Lip GY. Ischemic stroke in South Asians: a review of the epidemiology, pathophysiology, and ethnicity-related clinical features. Stroke 2009; 40(6): e415-23.
[http://dx.doi.org/10.1161/STROKEAHA.108.535724] [PMID: 19390072]
[27]
Mohan V, Sharp PS, Cloke HR, Burrin JM, Schumer B, Kohner EM. Serum immunoreactive insulin responses to a glucose load in Asian Indian and European type 2 (non-insulin-dependent) diabetic patients and control subjects. Diabetologia 1986; 29(4): 235-7.
[http://dx.doi.org/10.1007/BF00454882] [PMID: 3519338]
[28]
Sharp PS, Mohan V, Levy JC, Mather HM, Kohner EM. Insulin resistance in patients of Asian Indian and European origin with non-insulin dependent diabetes. Horm Metab Res 1987; 19(2): 84-5.
[http://dx.doi.org/10.1055/s-2007-1011745] [PMID: 3549505]
[29]
Abdul-Ghani MA, Tripathy D, DeFronzo RA. Contributions of beta-cell dysfunction and insulin resistance to the pathogenesis of impaired glucose tolerance and impaired fasting glucose. Diabetes Care 2006; 29(5): 1130-9.
[http://dx.doi.org/10.2337/dc05-2179] [PMID: 16644654]
[30]
Narayan KMV, Kanaya AM. Why are South Asians prone to type 2 diabetes? A hypothesis based on underexplored pathways. Diabetologia 2020; 63(6): 1103-9.
[http://dx.doi.org/10.1007/s00125-020-05132-5] [PMID: 32236731]
[31]
Motala AA, Omar MA. Evidence for impaired pancreatic beta cell function in South African Indians with impaired glucose tolerance. Diabet Med 1994; 11(5): 437-44.
[http://dx.doi.org/10.1111/j.1464-5491.1994.tb00303.x] [PMID: 8088120]
[32]
Staimez LR, Weber MB, Ranjani H, et al. Evidence of reduced β-cell function in Asian Indians with mild dysglycemia. Diabetes Care 2013; 36(9): 2772-8.
[http://dx.doi.org/10.2337/dc12-2290] [PMID: 23596180]
[33]
Ikehara S, Tabák AG, Akbaraly TN, et al. Age trajectories of glycaemic traits in non-diabetic South Asian and white individuals: the Whitehall II cohort study. Diabetologia 2015; 58(3): 534-42.
[http://dx.doi.org/10.1007/s00125-014-3448-9] [PMID: 25431266]
[34]
Gujral UP, Narayan KM, Kahn SE, Kanaya AM. The relative associations of β-cell function and insulin sensitivity with glycemic status and incident glycemic progression in migrant Asian Indians in the United States: the MASALA study. J Diabetes Complications 2014; 28(1): 45-50.
[http://dx.doi.org/10.1016/j.jdiacomp.2013.10.002] [PMID: 24211090]
[35]
Staimez LR, Deepa M, Ali MK, Mohan V, Hanson RL, Narayan KMV. Tale of two Indians: Heterogeneity in type 2 diabetes pathophysiology. Diabetes Metab Res Rev 2019; 35(8)e3192
[http://dx.doi.org/10.1002/dmrr.3192] [PMID: 31145829]
[36]
Yajnik CS, Lubree HG, Rege SS, et al. Adiposity and hyperinsulinemia in Indians are present at birth. J Clin Endocrinol Metab 2002; 87(12): 5575-80.
[http://dx.doi.org/10.1210/jc.2002-020434] [PMID: 12466355]
[37]
Bavdekar A, Yajnik CS, Fall CH, et al. Insulin resistance syndrome in 8-year-old Indian children: small at birth, big at 8 years, or both? Diabetes 1999; 48(12): 2422-9.
[http://dx.doi.org/10.2337/diabetes.48.12.2422] [PMID: 10580432]
[38]
Ramachandran A, Snehalatha C, Yamuna A, Murugesan N, Narayan KM. Insulin resistance and clustering of cardiometabolic risk factors in urban teenagers in southern India. Diabetes Care 2007; 30(7): 1828-33.
[http://dx.doi.org/10.2337/dc06-2097] [PMID: 17416794]
[39]
Chowdhury TA, Lasker SS. Complications and cardiovascular risk factors in South Asians and Europeans with early-onset type 2 diabetes. QJM 2002; 95(4): 241-6.
[http://dx.doi.org/10.1093/qjmed/95.4.241] [PMID: 11937651]
[40]
Gunarathne A, Patel JV, Kausar S, Gammon B, Hughes EA, Lip GY. Glycemic status underlies increased arterial stiffness and impaired endothelial function in migrant South Asian stroke survivors compared to European Caucasians: pathophysiological insights from the West Birmingham Stroke Project. Stroke 2009; 40(7): 2298-306.
[http://dx.doi.org/10.1161/STROKEAHA.109.548388] [PMID: 19520993]
[41]
Kain K, Catto AJ, Grant PJ. Clustering of thrombotic factors with insulin resistance in South Asian patients with ischaemic stroke. Thromb Haemost 2002; 88(6): 950-3.
[PMID: 12529744]
[42]
Deepa R, Mohan V, Premanand C, et al. Accelerated platelet activation in Asian Indians with diabetes and coronary artery disease--The Chennai Urban Population Study (CUPS-13). J Assoc Physicians India 2006; 54: 704-8.
[PMID: 17212017]
[43]
Narne P, Ponnaluri KC, Singh S, Siraj M, Ishaq M. Relationship between NADPH oxidase p22phox C242T, PARP-1 Val762Ala polymorphisms, angiographically verified coronary artery disease and myocardial infarction in South Indian patients with type 2 diabetes mellitus. Thromb Res 2012; 130(5): e259-65.
[http://dx.doi.org/10.1016/j.thromres.2012.09.012] [PMID: 23040216]
[44]
Hsu WC, Araneta MR, Kanaya AM, Chiang JL, Fujimoto W. BMI cut points to identify at-risk Asian Americans for type 2 diabetes screening. Diabetes Care 2015; 38(1): 150-8.
[http://dx.doi.org/10.2337/dc14-2391] [PMID: 25538311]
[45]
Misra A. Ethnic-Specific Criteria for Classification of Body Mass Index: A Perspective for Asian Indians and American Diabetes Association Position Statement. Diabetes Technol Ther 2015; 17(9): 667-71.
[http://dx.doi.org/10.1089/dia.2015.0007] [PMID: 25902357]
[46]
Misra A, Vikram NK. Insulin resistance syndrome (metabolic syndrome) and obesity in Asian Indians: evidence and implications. Nutrition 2004; 20(5): 482-91.
[http://dx.doi.org/10.1016/j.nut.2004.01.020] [PMID: 15105039]
[47]
Misra A, Khurana L. Obesity and the metabolic syndrome in developing countries. J Clin Endocrinol Metab 2008; 93(11)(Suppl. 1): S9-S30.
[http://dx.doi.org/10.1210/jc.2008-1595] [PMID: 18987276]
[48]
Misra A, Jayawardena R, Anoop S. Obesity in South Asia: Phenotype, Morbidities, and Mitigation. Curr Obes Rep 2019; 8(1): 43-52.
[http://dx.doi.org/10.1007/s13679-019-0328-0] [PMID: 30729382]
[49]
Kahn BB, Flier JS. Obesity and insulin resistance. J Clin Invest 2000; 106(4): 473-81.
[http://dx.doi.org/10.1172/JCI10842] [PMID: 10953022]
[50]
Ye J. Mechanisms of insulin resistance in obesity. Front Med 2013; 7(1): 14-24.
[http://dx.doi.org/10.1007/s11684-013-0262-6] [PMID: 23471659]
[51]
Rodríguez-Hernández H, Simental-Mendía LE, Rodríguez-Ramírez G, Reyes-Romero MA. Obesity and inflammation: epidemiology, risk factors, and markers of inflammation. Int J Endocrinol 2013; 2013678159
[http://dx.doi.org/10.1155/2013/678159] [PMID: 23690772]
[52]
Ellulu MS, Patimah I, Khaza’ai H, Rahmat A, Abed Y. Obesity and inflammation: the linking mechanism and the complications. Arch Med Sci 2017; 13(4): 851-63.
[http://dx.doi.org/10.5114/aoms.2016.58928] [PMID: 28721154]
[53]
Golia E, Limongelli G, Natale F, et al. Inflammation and cardiovascular disease: from pathogenesis to therapeutic target. Curr Atheroscler Rep 2014; 16(9): 435.
[http://dx.doi.org/10.1007/s11883-014-0435-z] [PMID: 25037581]
[54]
Lopez-Candales A, Hernández Burgos PM, Hernandez-Suarez DF, Harris D. Linking Chronic Inflammation with Cardiovascular Disease: From Normal Aging to the Metabolic Syndrome. J Nat Sci 2017; 3(4)e341
[PMID: 28670620]
[55]
Volgman AS, Palaniappan LS, Aggarwal NT, et al. American Heart Association Council on Epidemiology and Prevention; Cardiovascular Disease and Stroke in Women and Special Populations Committee of the Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; Council on Quality of Care and Outcomes Research; and Stroke Council. Atherosclerotic Cardiovascular Disease in South Asians in the United States: Epidemiology, Risk Factors, and Treatments: A Scientific Statement From the American Heart Association. Circulation 2018; 138(1): e1-e34.
[http://dx.doi.org/10.1161/CIR.0000000000000580] [PMID: 29794080]
[56]
Unnikrishnan R, Anjana RM, Mohan V. Diabetes in South Asians: is the phenotype different? Diabetes 2014; 63(1): 53-5.
[http://dx.doi.org/10.2337/db13-1592] [PMID: 24357697]
[57]
Patel SA, Shivashankar R, Ali MK, et al. Is the "South Asian Phenotype" Unique to South Asians?: Comparing Cardiometabolic Risk Factors in the CARRS and NHANES Studies Glob Heart 2016; 11(1): 89-96.
[58]
Sniderman AD, Bhopal R, Prabhakaran D, Sarrafzadegan N, Tchernof A. Why might South Asians be so susceptible to central obesity and its atherogenic consequences? The adipose tissue overflow hypothesis. Int J Epidemiol 2007; 36(1): 220-5.
[http://dx.doi.org/10.1093/ije/dyl245] [PMID: 17510078]
[59]
Krishnaveni GV, Hill JC, Veena SR, et al. Truncal adiposity is present at birth and in early childhood in South Indian children. Indian Pediatr 2005; 42(6): 527-38.
[PMID: 15995269]
[60]
Yajnik CS, Fall CH, Coyaji KJ, et al. Neonatal anthropometry: the thin-fat Indian baby. The Pune Maternal Nutrition Study. Int J Obes Relat Metab Disord 2003; 27(2): 173-80.
[http://dx.doi.org/10.1038/sj.ijo.802219] [PMID: 12586996]
[61]
Misra A, Khurana L, Isharwal S, Bhardwaj S. South Asian diets and insulin resistance. Br J Nutr 2009; 101(4): 465-73.
[http://dx.doi.org/10.1017/S0007114508073649] [PMID: 18842159]
[62]
Satija A, Hu FB, Bowen L, et al. Dietary patterns in India and their association with obesity and central obesity. Public Health Nutr 2015; 18(16): 3031-41.
[http://dx.doi.org/10.1017/S1368980015000312] [PMID: 25697609]
[63]
Safdar NF, Bertone-Johnson E, Cordeiro L, Jafar TH, Cohen NL. Dietary patterns of Pakistani adults and their associations with sociodemographic, anthropometric and life-style factors. J Nutr Sci 2014; 2: e42-2.
[http://dx.doi.org/10.1017/jns.2013.37] [PMID: 25191598]
[64]
Mohan V, Radhika G, Sathya RM, Tamil SR, Ganesan A, Sudha V. Dietary carbohydrates, glycaemic load, food groups and newly detected type 2 diabetes among urban Asian Indian population in Chennai, India (Chennai Urban Rural Epidemiology Study 59). Br J Nutr 2009; 102(10): 1498-506.
[http://dx.doi.org/10.1017/S0007114509990468] [PMID: 19586573]
[65]
Popkin BM, Adair LS, Ng SW. Global nutrition transition and the pandemic of obesity in developing countries. Nutr Rev 2012; 70(1): 3-21.
[http://dx.doi.org/10.1111/j.1753-4887.2011.00456.x] [PMID: 22221213]
[66]
Anand SS, Hawkes C, de Souza RJ, et al. Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System: A Report From the Workshop Convened by the World Heart Federation. J Am Coll Cardiol 2015; 66(14): 1590-614.
[http://dx.doi.org/10.1016/j.jacc.2015.07.050] [PMID: 26429085]
[67]
Trichopoulou A, Martínez-González MA, Tong TY, et al. Definitions and potential health benefits of the Mediterranean diet: views from experts around the world. BMC Med 2014; 12: 112.
[http://dx.doi.org/10.1186/1741-7015-12-112] [PMID: 25055810]
[68]
Ranasinghe CD, Ranasinghe P, Jayawardena R, Misra A. Physical activity patterns among South-Asian adults: a systematic review. Int J Behav Nutr Phys Act 2013; 10: 116.
[http://dx.doi.org/10.1186/1479-5868-10-116] [PMID: 24119682]
[69]
Hu FB. Sedentary lifestyle and risk of obesity and type 2 diabetes. Lipids 2003; 38(2): 103-8.
[http://dx.doi.org/10.1007/s11745-003-1038-4] [PMID: 12733740]
[70]
Rastogi T, Vaz M, Spiegelman D, et al. Physical activity and risk of coronary heart disease in India. Int J Epidemiol 2004; 33(4): 759-67.
[http://dx.doi.org/10.1093/ije/dyh042] [PMID: 15044412]
[71]
Yusuf S, Hawken S, Ounpuu S, et al. 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(9438): 937-52.
[http://dx.doi.org/10.1016/S0140-6736(04)17018-9] [PMID: 15364185]
[72]
Celis-Morales CA, Ghouri N, Bailey ME, Sattar N, Gill JM. Should physical activity recommendations be ethnicity-specific? Evidence from a cross-sectional study of South Asian and European men. PLoS One 2013; 8(12)e82568
[http://dx.doi.org/10.1371/journal.pone.0082568] [PMID: 24349313]
[73]
Duong M, Rangarajan S, Zhang X, et al. Effects of bidi smoking on all-cause mortality and cardiorespiratory outcomes in men from south Asia: an observational community-based substudy of the Prospective Urban Rural Epidemiology Study (PURE). Lancet Glob Health 2017; 5(2): e168-76.
[http://dx.doi.org/10.1016/S2214-109X(17)30004-9] [PMID: 28104186]
[74]
Maddatu J, Anderson-Baucum E, Evans-Molina C. Smoking and the risk of type 2 diabetes. Transl Res 2017; 184: 101-7.
[http://dx.doi.org/10.1016/j.trsl.2017.02.004] [PMID: 28336465]
[75]
Gupta R, Gupta N, Khedar RS. Smokeless tobacco and cardiovascular disease in low and middle income countries. Indian Heart J 2013; 65(4): 369-77.
[http://dx.doi.org/10.1016/j.ihj.2013.06.005] [PMID: 23992997]
[76]
Sreeramareddy CT, Pradhan PMS, Mir IA, Sin S. Smoking and smokeless tobacco use in nine South and Southeast Asian countries: prevalence estimates and social determinants from Demographic and Health Surveys. Popul Health Metr 2014; 12(1): 22.
[http://dx.doi.org/10.1186/s12963-014-0022-0] [PMID: 25183954]
[77]
Hosseinpoor AR, Parker LA, Tursan d’Espaignet E, Chatterji S. Socioeconomic inequality in smoking in low-income and middle-income countries: results from the World Health Survey. PLoS One 2012; 7(8)e42843
[http://dx.doi.org/10.1371/journal.pone.0042843] [PMID: 22952617]
[78]
Palipudi KM, Gupta PC, Sinha DN, Andes LJ, Asma S, McAfee T. GATS Collaborative Group. Social determinants of health and tobacco use in thirteen low and middle income countries: evidence from Global Adult Tobacco Survey. PLoS One 2012; 7(3)e33466
[http://dx.doi.org/10.1371/journal.pone.0033466] [PMID: 22438937]
[79]
WHO. World Health Organization Global Ambient Air Quality Database https://www.who.int/airpollution/data/cities/en/2020.
[80]
Stafoggia M, Cesaroni G, Peters A, et al. Long-term exposure to ambient air pollution and incidence of cerebrovascular events: results from 11 European cohorts within the ESCAPE project. Environ Health Perspect 2014; 122(9): 919-25.
[http://dx.doi.org/10.1289/ehp.1307301] [PMID: 24835336]
[81]
Shah AS, Lee KK, McAllister DA, et al. Short term exposure to air pollution and stroke: systematic review and meta-analysis. BMJ 2015; 350: h1295.
[http://dx.doi.org/10.1136/bmj.h1295] [PMID: 25810496]
[82]
Balti EV, Echouffo-Tcheugui JB, Yako YY, Kengne AP. Air pollution and risk of type 2 diabetes mellitus: a systematic review and meta-analysis. Diabetes Res Clin Pract 2014; 106(2): 161-72.
[http://dx.doi.org/10.1016/j.diabres.2014.08.010] [PMID: 25262110]
[83]
He D, Wu S, Zhao H, et al. Association between particulate matter 2.5 and diabetes mellitus: A meta-analysis of cohort studies. J Diabetes Investig 2017; 8(5): 687-96.
[http://dx.doi.org/10.1111/jdi.12631] [PMID: 28122165]
[84]
Cosselman KE, Navas-Acien A, Kaufman JD. Environmental factors in cardiovascular disease. Nat Rev Cardiol 2015; 12(11): 627-42.
[http://dx.doi.org/10.1038/nrcardio.2015.152] [PMID: 26461967]
[85]
Marmot M, Friel S, Bell R, Houweling TA, Taylor S. Commission on Social Determinants of Health. Closing the gap in a generation: health equity through action on the social determinants of health. Lancet 2008; 372(9650): 1661-9.
[http://dx.doi.org/10.1016/S0140-6736(08)61690-6] [PMID: 18994664]
[86]
Havranek EP, Mujahid MS, Barr DA, et al. American Heart Association Council on Quality of Care and Outcomes Research, Council on Epidemiology and Prevention, Council on Cardiovascular and Stroke Nursing, Council on Lifestyle and Cardiometabolic Health, and Stroke Council. Social Determinants of Risk and Outcomes for Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation 2015; 132(9): 873-98.
[http://dx.doi.org/10.1161/CIR.0000000000000228] [PMID: 26240271]
[87]
Walker RJ, Smalls BL, Campbell JA, Strom Williams JL, Egede LE. Impact of social determinants of health on outcomes for type 2 diabetes: a systematic review. Endocrine 2014; 47(1): 29-48.
[http://dx.doi.org/10.1007/s12020-014-0195-0] [PMID: 24532079]
[88]
Clark ML, Utz SW. Social determinants of type 2 diabetes and health in the United States. World J Diabetes 2014; 5(3): 296-304.
[http://dx.doi.org/10.4239/wjd.v5.i3.296] [PMID: 24936251]
[89]
Kreatsoulas C, Anand SS. The impact of social determinants on cardiovascular disease Can J Cardiol 2010; 26C: 8C.: 13C.
[http://dx.doi.org/10.1016/S0828-282X(10)71075-8]
[90]
Thresia CU. Health Inequalities in South Asia at the Launch of Sustainable Development Goals: Exclusions in Health in Kerala, India Need Political Interventions. Int J Health Serv 2018; 48(1): 57-80.
[http://dx.doi.org/10.1177/0020731417738222] [PMID: 29086619]
[91]
Hackett RA, Steptoe A. Psychosocial Factors in Diabetes and Cardiovascular Risk. Curr Cardiol Rep 2016; 18(10): 95.
[http://dx.doi.org/10.1007/s11886-016-0771-4] [PMID: 27566328]
[92]
Everson-Rose SA, Lewis TT. Psychosocial factors and cardiovascular diseases. Annu Rev Public Health 2005; 26: 469-500.
[http://dx.doi.org/10.1146/annurev.publhealth.26.021304.144542] [PMID: 15760298]
[93]
Williams ED, Steptoe A, Chambers JC, Kooner JS. Psychosocial risk factors for coronary heart disease in UK South Asian men and women. J Epidemiol Community Health 2009; 63(12): 986-91.
[http://dx.doi.org/10.1136/jech.2008.084186] [PMID: 19622519]
[94]
Nair M, Ali MK, Ajay VS, et al. CARRS Surveillance study: design and methods to assess burdens from multiple perspectives. BMC Public Health 2012; 12: 701.
[http://dx.doi.org/10.1186/1471-2458-12-701] [PMID: 22928740]
[95]
Li H, Kilpeläinen TO, Liu C, et al. Association of genetic variation in FTO with risk of obesity and type 2 diabetes with data from 96,551 East and South Asians. Diabetologia 2012; 55(4): 981-95.
[http://dx.doi.org/10.1007/s00125-011-2370-7] [PMID: 22109280]
[96]
Sanghera DK, Ortega L, Han S, et al. Impact of nine common type 2 diabetes risk polymorphisms in Asian Indian Sikhs: PPARG2 (Pro12Ala), IGF2BP2, TCF7L2 and FTO variants confer a significant risk. BMC Med Genet 2008; 9: 59.
[http://dx.doi.org/10.1186/1471-2350-9-59] [PMID: 18598350]
[97]
Yajnik CS, Janipalli CS, Bhaskar S, et al. FTO gene variants are strongly associated with type 2 diabetes in South Asian Indians. Diabetologia 2009; 52(2): 247-52.
[http://dx.doi.org/10.1007/s00125-008-1186-6] [PMID: 19005641]
[98]
Chauhan G, Spurgeon CJ, Tabassum R, et al. Impact of common variants of PPARG, KCNJ11, TCF7L2, SLC30A8, HHEX, CDKN2A, IGF2BP2, and CDKAL1 on the risk of type 2 diabetes in 5,164 Indians. Diabetes 2010; 59(8): 2068-74.
[http://dx.doi.org/10.2337/db09-1386] [PMID: 20424228]
[99]
Kooner JS, Saleheen D, Sim X, et al. DIAGRAM; MuTHER. Genome-wide association study in individuals of South Asian ancestry identifies six new type 2 diabetes susceptibility loci. Nat Genet 2011; 43(10): 984-9.
[http://dx.doi.org/10.1038/ng.921] [PMID: 21874001]
[100]
Rees SD, Hydrie MZ, Shera AS, et al. Replication of 13 genome-wide association (GWA)-validated risk variants for type 2 diabetes in Pakistani populations. Diabetologia 2011; 54(6): 1368-74.
[http://dx.doi.org/10.1007/s00125-011-2063-2] [PMID: 21350842]
[101]
Frayling TM, Timpson NJ, Weedon MN, et al. A common variant in the FTO gene is associated with body mass index and predisposes to childhood and adult obesity. Science 2007; 316(5826): 889-94.
[http://dx.doi.org/10.1126/science.1141634] [PMID: 17434869]
[102]
Bravard A, Lefai E, Meugnier E, et al. FTO is increased in muscle during type 2 diabetes, and its overexpression in myotubes alters insulin signaling, enhances lipogenesis and ROS production, and induces mitochondrial dysfunction. Diabetes 2011; 60(1): 258-68.
[http://dx.doi.org/10.2337/db10-0281] [PMID: 20943749]
[103]
Chambers JC, Loh M, Lehne B, et al. Epigenome-wide association of DNA methylation markers in peripheral blood from Indian Asians and Europeans with incident type 2 diabetes: a nested case-control study. Lancet Diabetes Endocrinol 2015; 3(7): 526-34.
[http://dx.doi.org/10.1016/S2213-8587(15)00127-8] [PMID: 26095709]
[104]
Saleheen D, Zaidi M, Rasheed A, et al. The Pakistan Risk of Myocardial Infarction Study: a resource for the study of genetic, lifestyle and other determinants of myocardial infarction in South Asia. Eur J Epidemiol 2009; 24(6): 329-38.
[http://dx.doi.org/10.1007/s10654-009-9334-y] [PMID: 19404752]
[105]
Chowdhury R, Alam DS, Fakir II, et al. Cardiology Research Group. The Bangladesh Risk of Acute Vascular Events (BRAVE) Study: objectives and design. Eur J Epidemiol 2015; 30(7): 577-87.
[http://dx.doi.org/10.1007/s10654-015-0037-2] [PMID: 25930055]
[106]
Howson JMM, Zhao W, Barnes DR, et al. CARDIoGRAMplusC4D; EPIC-CVD. Fifteen new risk loci for coronary artery disease highlight arterial-wall-specific mechanisms. Nat Genet 2017; 49(7): 1113-9.
[http://dx.doi.org/10.1038/ng.3874] [PMID: 28530674]
[107]
Golbus JR, Stitziel NO, Zhao W, et al. CARDIoGRAMplusC4D, Myocardial Infarction Genetics (MIGen), Exome Sequencing Project and Early-Onset Myocardial Infarction (ESP EOMI), and the Pakistan Risk of Myocardial Infarction Study (PROMIS) Consortia*. Common and Rare Genetic Variation in CCR2, CCR5, or CX3CR1 and Risk of Atherosclerotic Coronary Heart Disease and Glucometabolic Traits. Circ Cardiovasc Genet 2016; 9(3): 250-8.
[http://dx.doi.org/10.1161/CIRCGENETICS.115.001374] [PMID: 27013693]
[108]
Khan S, Phulukdaree A, Ramkaran P, Moodley D, Chuturgoon AA. The Arg72 variant of the p53 functional polymorphism (rs1042522) is associated with coronary artery disease in young South Africans of Indian ancestry. Gene 2016; 593(2): 261-4.
[http://dx.doi.org/10.1016/j.gene.2016.07.040] [PMID: 27436625]
[109]
Chowdhury R, Narayan KM, Zabetian A, Raj S, Tabassum R. Genetic studies of type 2 diabetes in South Asians: a systematic overview. Curr Diabetes Rev 2014; 10(4): 258-74.
[http://dx.doi.org/10.2174/1573399810666140707101325] [PMID: 25001234]
[110]
Enas EA, Chacko V, Pazhoor SG, Chennikkara H, Devarapalli HP. Dyslipidemia in South Asian patients. Curr Atheroscler Rep 2007; 9(5): 367-74.
[http://dx.doi.org/10.1007/s11883-007-0047-y] [PMID: 18001619]
[111]
Bilen O, Kamal A, Virani SS. Lipoprotein abnormalities in South Asians and its association with cardiovascular disease: Current state and future directions. World J Cardiol 2016; 8(3): 247-57.
[http://dx.doi.org/10.4330/wjc.v8.i3.247] [PMID: 27022456]
[112]
Enas EA, Garg A, Davidson MA, Nair VM, Huet BA, Yusuf S. 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): 343-53.
[PMID: 8908818]
[113]
Cappuccio FP, Cook DG, Atkinson RW, Strazzullo P. Prevalence, detection, and management of cardiovascular risk factors in different ethnic groups in south London. Heart 1997; 78(6): 555-63.
[http://dx.doi.org/10.1136/hrt.78.6.555] [PMID: 9470870]
[114]
Sewdarsen M, Desai RK, Vythilingum S, Shah N, Rajput MC. Serum lipoproteins and apolipoproteins in young normocholesterolaemic, non-diabetic Indian men with myocardial infarction. Postgrad Med J 1991; 67(784): 159-64.
[http://dx.doi.org/10.1136/pgmj.67.784.159] [PMID: 2041847]
[115]
Bhalodkar NC, Blum S, Rana T, 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): 1561-3.
[http://dx.doi.org/10.1016/j.amjcard.2004.08.040] [PMID: 15589018]
[116]
Superko HR, Enas EA, Kotha P, Bhat NK, Garrett B. High-density lipoprotein subclass distribution in individuals of Asian Indian descent: the National Asian Indian Heart Disease Project. Prev Cardiol 2005; 8(2): 81-6.
[http://dx.doi.org/10.1111/j.1520-037X.2005.3766.x] [PMID: 15860982]
[117]
Karthikeyan G, Teo KK, Islam S, et al. Lipid profile, plasma apolipoproteins, and risk of a first myocardial infarction among Asians: an analysis from the INTERHEART Study. J Am Coll Cardiol 2009; 53(3): 244-53.
[http://dx.doi.org/10.1016/j.jacc.2008.09.041] [PMID: 19147041]
[118]
Anand SS, Yusuf S, Vuksan V, et al. Differences in risk factors, atherosclerosis and cardiovascular disease between ethnic groups in Canada: the study of health assessment and risk in ethnic groups (SHARE). Indian Heart J 2000; 52(7)(Suppl.): S35-43.
[PMID: 11339439]
[119]
Gupta R, Gupta VP, Sarna M, et al. Prevalence of coronary heart disease and risk factors in an urban Indian population: Jaipur Heart Watch-2. Indian Heart J 2002; 54(1): 59-66.
[PMID: 11999090]
[120]
Sekhri T, Kanwar RS, Wilfred R, et al. Prevalence of risk factors for coronary artery disease in an urban Indian population. BMJ Open 2014; 4(12)e005346
[http://dx.doi.org/10.1136/bmjopen-2014-005346] [PMID: 25488095]
[121]
Chow CK, McQuillan B, Raju PK, et al. Greater adverse effects of cholesterol and diabetes on carotid intima-media thickness in South Asian Indians: comparison of risk factor-IMT associations in two population-based surveys. Atherosclerosis 2008; 199(1): 116-22.
[http://dx.doi.org/10.1016/j.atherosclerosis.2007.10.008] [PMID: 18083174]
[122]
Dodani S, Henkhaus R, Wick J, et al. Metabolic syndrome in South Asian immigrants: more than low HDL requiring aggressive management. Lipids Health Dis 2011; 10: 45.
[http://dx.doi.org/10.1186/1476-511X-10-45] [PMID: 21410987]
[123]
Dodani S, Dong L, Guirgis FW, Reddy ST. Carotid intima media thickness and low high-density lipoprotein (HDL) in South Asian immigrants: could dysfunctional HDL be the missing link? Arch Med Sci 2014; 10(5): 870-9.
[http://dx.doi.org/10.5114/aoms.2014.46208] [PMID: 25395937]
[124]
Ouimet M, Barrett TJ, Fisher EA. HDL and Reverse Cholesterol Transport. Circ Res 2019; 124(10): 1505-18.
[http://dx.doi.org/10.1161/CIRCRESAHA.119.312617] [PMID: 31071007]
[125]
Tsimikas S. A Test in Context: Lipoprotein(a): Diagnosis, Prognosis, Controversies, and Emerging Therapies. J Am Coll Cardiol 2017; 69(6): 692-711.
[http://dx.doi.org/10.1016/j.jacc.2016.11.042] [PMID: 28183512]
[126]
Isser HS, Puri VK, Narain VS, Saran RK, Dwivedi SK, Singh S. Lipoprotein (a) and lipid levels in young patients with myocardial infarction and their first-degree relatives. Indian Heart J 2001; 53(4): 463-6.
[PMID: 11759936]
[127]
Anand SS, Enas EA, Pogue J, Haffner S, Pearson T, Yusuf S. Elevated lipoprotein(a) levels in South Asians in North America. Metabolism 1998; 47(2): 182-4.
[http://dx.doi.org/10.1016/S0026-0495(98)90217-7] [PMID: 9472967]
[128]
Palaniappan L, Anthony MN, Mahesh C, et al. Cardiovascular risk factors in ethnic minority women aged < or =30 years. Am J Cardiol 2002; 89(5): 524-9.
[http://dx.doi.org/10.1016/S0002-9149(01)02291-3] [PMID: 11867035]
[129]
Gupta R, Vasisht S, Bahl VK, Wasir HS. Correlation of lipoprotein (a) to angiographically defined coronary artery disease in Indians. Int J Cardiol 1996; 57(3): 265-70.
[http://dx.doi.org/10.1016/S0167-5273(96)02800-8] [PMID: 9024915]
[130]
Gambhir JK, Kaur H, Gambhir DS, Prabhu KM. Lipoprotein(a) as an independent risk factor for coronary artery disease in patients below 40 years of age. Indian Heart J 2000; 52(4): 411-5.
[PMID: 11084781]
[131]
Chopra V, Vasisht S, Gulati S, Manchanda SC. Serum levels of lipoprotein (a) and other lipids in angiographically defined coronary artery disease patients and healthy blood bank donors. Indian J Med Sci 2000; 54(7): 284-9.
[PMID: 11143848]
[132]
Paré G, Çaku A, McQueen M, et al. INTERHEART Investigators. Lipoprotein(a) Levels and the Risk of Myocardial Infarction Among 7 Ethnic Groups. Circulation 2019; 139(12): 1472-82.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.118.034311] [PMID: 30667276]
[133]
Saleheen D, Haycock PC, Zhao W, et al. Apolipoprotein(a) isoform size, lipoprotein(a) concentration, and coronary artery disease: a mendelian randomisation analysis. Lancet Diabetes Endocrinol 2017; 5(7): 524-33.
[http://dx.doi.org/10.1016/S2213-8587(17)30088-8] [PMID: 28408323]
[134]
Makaryus AN, Dhama B, Raince J, et al. Coronary artery diameter as a risk factor for acute coronary syndromes in Asian-Indians. Am J Cardiol 2005; 96(6): 778-80.
[http://dx.doi.org/10.1016/j.amjcard.2005.05.018] [PMID: 16169359]
[135]
Tillin T, Dhutia H, Chambers J, et al. South Asian men have different patterns of coronary artery disease when compared with European men. Int J Cardiol 2008; 129(3): 406-13.
[http://dx.doi.org/10.1016/j.ijcard.2007.07.129] [PMID: 18022712]
[136]
Hasan RK, Ginwala NT, Shah RY, Kumbhani DJ, Wilensky RL, Mehta NN. Quantitative angiography in South Asians reveals differences in vessel size and coronary artery disease severity compared to Caucasians. Am J Cardiovasc Dis 2011; 1(1): 31-7.
[PMID: 22254183]
[137]
Patel JV, Vyas A, Cruickshank JK, et al. Impact of migration on coronary heart disease risk factors: comparison of Gujaratis in Britain and their contemporaries in villages of origin in India. Atherosclerosis 2006; 185(2): 297-306.
[http://dx.doi.org/10.1016/j.atherosclerosis.2005.06.005] [PMID: 16005463]
[138]
Gujral UP, Narayan KM, Pradeepa RG, et al. Comparing Type 2 Diabetes, Prediabetes, and Their Associated Risk Factors in Asian Indians in India and in the U.S.: The CARRS and MASALA Studies. Diabetes Care 2015; 38(7): 1312-8.
[http://dx.doi.org/10.2337/dc15-0032] [PMID: 25877810]

Rights & Permissions Print Cite
Article Metrics
49
1
Wayfinder Image
Open Access Journals Promotions
World Diabetes Day
© 2024 Bentham Science Publishers | Privacy Policy