Insulin resistance, diabetes, and risk markers for ischaemic heart disease in Asian men and non-Asian in Bradford.

Abstract

Objective-To examine the hypothesis, in a community not studied before, that insulin resistance associated with centralised adiposity is the mechanism underlying the predisposition of Asian immigrant communities to both ischaemic heart disease and diabetes mellitus.Design-Cross sectional study within one socioeconomic stratum.Setting-Two factories in the textile sector in Bradford, West Yorkshire.Subjects-Male manual workers of Asian (110) and non-Asian origin (156) aged 20-65 years.Results-Diabetes was almost three times more prevalent in the Asian group. Two hours after an oral glucose load Asian men had double the serum insulin concentrations of non-Asian men (p < 0 0001). Asian men also had significantly lower concentrations of plasma total cholesterol (p < 0 03), high density lipoprotein cholesterol (HDL) (HDL2, p < 0-0001; HDL3, p < 0-0001), and apolipoprotein AI (p < 0 0001). Fasting plasma triglyceride concentrations were slightly higher (p = 0 072) in the Asian men; thus the ratio of triglyceride cholesterol was higher (p = 0 006). The interrelation between serum insulin and plasma lipid concentrations indicated metabolic differences between the ethnic groups. Insulin concentrations were associated with cholesterol concentrations in the Asian men only and there was a lack of association between triglyceride, low density lipoprotein cholesterol, and HDL cholesterol in this group. The risk marker profile in the Asian men was therefore quite different to that of their non-Asian counterparts and was associated with a greater tendency to centralised adiposity.Conclusion-These data support the insulin resistance hypothesis and thus have important implications for

Is the blood pressure of South Asian adults in the UK higher or lower than that in European white adults? A review of cross-sectional data

“…[4][5][6][7]10,12 Four study [4][5][6]10 samples were based on general practices lists. Two studies 3,8 were factory based, two were from the health surveys for England, 13,14 one was based on postcode sectors, 9 one was based on office staff, 12 one was based on a health authority register used for a health and lifestyle survey, 11 and one was general practice and factory based. 7 Most studies had broad aims relating to a range of cardiovascular risk factors.…”

“…7 Most studies had broad aims relating to a range of cardiovascular risk factors. Name analysis, [7][8][9][10][11] selfreported origin, 3,6,8,11,13,14 country of birth, [5][6][7] and parental origin 6,11 were the usual indicators of ethnicity. The age range varied widely.…”

“…Most studies assessed blood pressure levels and prevalence of hypertension in men and women separately, but a few only studied men. 3,5,8 Response rates varied widely from 60 14 to 83.4%. 8 The largest, most representative and most up-to-date study was the Health Survey for England 1999.…”

“…3,5,8 Response rates varied widely from 60 14 to 83.4%. 8 The largest, most representative and most up-to-date study was the Health Survey for England 1999. 14 Table 2 shows that blood pressure was measured in three studies in hospital clinics, 4,10,11 one study in a health center, 6 four studies in participants' own homes, 5,9,13,14 one study in a work place and hospital clinic, 7 and three studies in a workspace.…”

“…Totally, 12 studies were examined. [3][4][5][6][7][8][9][10][11][12][13][14] One author 10 supplied unpublished data.…”