Insulin resistance, high prevalence of diabetes, and cardiovascular risk in immigrant Asians. Genetic or environmental effect?

Dhawan, J; Bray, Colin; Warburton, Rod R.; Ghambhir, D S; Morris, Jonathan

doi:10.1136/hrt.72.5.413

Cited by 104 publications

(82 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We extended this previous observation in a much younger patient population and demonstrated that Indians have a 3-fold risk of developing premature AMI in comparison to the other ethnic groups. Prior studies [18][19][20][21][22] have shown that Indians have at least double the risk of CAD than than of white patients after adjustment of risk factors. The causes of this ethnic predisposition to CAD are likely to be multi-factorial ie interaction between genetic and environmental factors.…”

Section: Discussionmentioning

confidence: 99%

Acute myocardial infarction: Clinical features and outcomes in young adults in Singapore

Wong

Loh²,

Loh³

et al. 2012

WJC

View full text Add to dashboard Cite

AIM:To investigate the clinical features and in-hospital outcomes of young adults with acute myocardial infarction (AMI) in Singapore. METHODS:Between January 2005 to September 2010, 333 consecutive patients aged ≤ 45 years old were diagnosed to have AMI at our institution. As Singapore is a multi-ethnic society, we also analysed whether ethnic differences exist between the three dominant ethnic groups, Malay, Chinese and Indian with regards to the clinical features. Clinical data was collected retrospectively on demographic characteristics, presenting signs and symptoms, blood investigation, angiographic findings and in-hospital clinical outcomes. RESULTS:The mean age at presentation was 40.2 ± 4.0 years with male predominance (94%). The majority of patients were Chinese (51%) followed by Indians (31%) and Malays (18%). The most common risk factor was smoking (74%) followed by hypertension (28.5%) and hyperlipidemia (20.0%). 37% of patients were obese. The majority of patients had single vessel disease (46%) on coronary angiography. The mean total cholesterol, low-density lipoprotein and highdensity lipoprotein levels were 5.6 ± 1.2 mmol/L, 3.8 ± 1.1 mmol/L and 0.93 ± 0.25 mmol/L respectively. The mean left ventricular function was 44% ± 10% with the incidence of heart failure 3% and cardiogenic shock 4.5%. Overall in-hospital mortality was low with 4 deaths (1.2%). For ethnic subgroup analysis, Indians have a 3-fold risk of developing premature AMI when compared to other ethnic groups. CONCLUSION:Young AMI patients in Singapore are characterized by male predominance, high incidence of smoking and obesity. Overall in-hospital clinical outcomes are favourable. Among the 3 ethnic groups, Indians have the highest risk of developing premature AMI.

show abstract

Section: Discussionmentioning

confidence: 99%

Acute myocardial infarction: Clinical features and outcomes in young adults in Singapore

Wong

Loh²,

Loh³

et al. 2012

WJC

View full text Add to dashboard Cite

show abstract

“…34 Asians tend to have higher levels of microalbuminuria, 35 which has been associated with diabetic retinopathy. 36 Higher total plasma insulin concentration has been reported, [37][38][39] which seems to be genetically predetermined 40 and which is a risk factor for retinopathy. Other reasons may include increased vitamin D deficiency in Asians 41 which has been shown to affect diabetic retinopathy, 42 earlier changes required in treatment in Asians 37 which is considered a risk factor, 43 and heath care access which will invariably affect control, diagnosis, and progression and eventually make an impact on diabetic retinopathy.…”

Section: Discussionmentioning

confidence: 99%

Impact of age and duration on sight–threatening retinopathy in South Asians and Caucasians attending a diabetic clinic

Pardhan

Gilchrist

Mahomed

2004

Eye

View full text Add to dashboard Cite

Aims To examine diabetic retinopathy in Asians and Caucasians attending a hospital diabetic clinic and to evaluate the impact of the significant risk factors on the probability of sight-threatening retinopathy. Methods A total of 500 diabetic patients (268 Asians, 232 Caucasians) who attended a diabetic clinic within a defined time period were examined for severity of diabetic retinopathy. The existence of sight-threatening retinopathy (STR) was compared in the two groups. Significant risk factors such as age, duration and hypertension were analysed against the probability of STR in each of the two races. Results Asians demonstrated significantly higher rates of STR. Univariate analysis showed age, duration, race, gender, and insulin-requiring status to be significantly associated with STR. Multivariate logistic regression showed a significant association of STR with race, age and duration of diabetes, with no significant interaction effects between variables. The logistic regression model predicted STR in Asians to be matched to that in Caucasians by a 12.5-year difference factor; that is, Caucasians were older by 12.5 years or had a 12.5-year longer duration than Asians for the same level of STR. Conclusions After adjusting for age and duration of diabetes, the probability of STR in Asian diabetic patients attending the diabetic clinics in Bradford is significantly higher than that in Caucasians (odds ratio ¼ 3.184, Po0.05). The impact of age and duration was significantly higher in patients of South Asian origin compared to Caucasians.

show abstract

“…High levels of CHD and of coronary and diabetic risk factors have been consistently noted among South Asians overseas communities (McKeigue et al, 1989;Vardan et al, 1995;Balarajan, 1996;Wild & McKeigue, 1997). This has been demonstrated in areas as diverse as Trinidad (Beckles et al, 1986), the UK (Dhawan et al, 1994), Singapore (Hughes et al, 1990), Figi (Sorokin, 1973) and Uganda (Shaper & Jones, 1959). Risk of CHD among South Asians has been demonstrated to be higher than that of the host society to which they have migrated (Balarajan, 1991).…”

Section: Introductionmentioning

confidence: 97%

Risk factors for coronary heart disease in two similar Indian population groups, one residing in India, and the other in Sydney, Australia

Mahajan

Bermingham

2004

Eur J Clin Nutr

View full text Add to dashboard Cite

Objective: To identify the prevalence of coronary risk factors among South Asian Indians in Australia and India. Design: Cross-sectional intercountry comparison. Subjects: Healthy volunteers aged 23-75 y recruited from the Indian community in Sydney Australia (n¼125), and their nominated relatives in India, (n¼125). Results: The two groups were of similar background with over 90% of the group in India being siblings, parents or relatives of the group in Australia. There was no difference in the populations between India and Australia with regard to mean age (40711.5 vs 39710. Conclusion:The group in Australia (especially women) have a more favourable disease risk profile than those in India. The fact that the groups are of such similar background and partly related, make it unlikely that changes due to migration have a strong genetic bias. In contrast to other studies, the absence here of excessive weight gain on migration may be a key factor in disease risk prevention.

show abstract

Insulin resistance, high prevalence of diabetes, and cardiovascular risk in immigrant Asians. Genetic or environmental effect?

Cited by 104 publications

References 21 publications

Acute myocardial infarction: Clinical features and outcomes in young adults in Singapore

Acute myocardial infarction: Clinical features and outcomes in young adults in Singapore

Impact of age and duration on sight–threatening retinopathy in South Asians and Caucasians attending a diabetic clinic

Risk factors for coronary heart disease in two similar Indian population groups, one residing in India, and the other in Sydney, Australia

Contact Info

Product

Resources

About