Lipid Profile, Plasma Apolipoproteins, and Risk of a First Myocardial Infarction Among Asians

Abstract

The preserved association of LDL-C with risk of AMI among Asians, despite the lower baseline levels, suggests the need to rethink treatment thresholds and targets in this population. The low HDL-C level among South Asians requires further study and targeted intervention.

Ethnic Difference in Lipid Profiles

“…The Current guideline, mainly based on the data of Whites, consistently recommend that LDL-C < 2.6 mmol/l should be the primary target of therapy in patients with diabetes. As shown in our study and others' (Mulukutla et al 2008;Karthikeyan et al 2009), the Asian Indian population had significantly lower TC and LDL-C than did Whites. The threshold of LDL-C for treatment target for Whites may be too high for Asian Indians.…”

“…Mean total cholesterol and LDL-C levels are lower in American Indians compared with the US average, and levels of Lp(a) are reported to be lower than in Whites (Wang W 2002). East Asians tend to have lower LDL-C, HDL-C and TG as compared with non-Asians (Karthikeyan et al 2009). East Asians have been reported to have low Lp(a) levels, whereas south Asians have higher mean Lp(a) levels (Geethanjali FS 2003;Berglund L 2004).…”

“…It is clear that certain ethnic groups have differences in lipid profiles in general. Elevated TG and reduced HDL-C, as the components of the metabolic syndrome and atherogenic dyslipidaemia, was seen more common in Asian Indians than in the Whites (Anand et al 2000;Razak et al 2005;Chandalia et al 2008;Mulukutla et al 2008), Chinese (Tan et al 1999;Anand et al 2000;Razak et al 2005; The DECODA Study Group 2007; Karthikeyan et al 2009), Japanese (The DECODA Study Group 2007;Karthikeyan et al 2009) or Africans (Mulukutla et al 2008). In a nationally representative sample of seven ethnic groups in the UK (Zaninotto et al 2007), the prevalence of low HDL-C was highest in south Asian groups such as Bangladeshi, Indian and Pakistani, followed by Chinese, Irish and those from the general population living in private households; In contrast, the lowest prevalence was seen in Black Caribbean.…”

Association of Serum Lipids with High Blood Pressure and Hypertensionamong Diabetic Patients. Mathematical Regression Models to PredictBlood Pressure from Lipids. An Experience from 12-year Follow Up ofmore than 9000 Patients' Cohort

“…Free fatty acid-induced insulin resistance is associated with activation of protein kinase C-theta (C-ɵ) and alterations in the insulin signaling cascade. Aggressive treatment should be initiated if dyslipidemia is detected with statins [54][55][56][57][58][59][60][61][62]. Furthermore, during management of diabetes in diabetology clinics, diabetologist should consider options for the management of type-1 and type-2 diabetic patients.…”

ApoA1 and ApoA1-specific self-antibodies in cardiovascular disease

“…Plasma HDL cholesterol and ApoA1 levels are associated with lower CVD risk, especially MI risk. 23,24 However, atherosclerosis-related oxidative stress and inflammation lead to oxidation and other modifications of mature ApoA1, a phenomenon that can switch atheroprorective properties of native apoA1 to proatherogenic properties of modified ApoA1. 25 ApoA1 modification could induce formation of ApoA1-specific IgG antibodies that exhibit pro-inflammatory properties.…”