Type 2 diabetes and cardiovascular disease in South Asians

Gholap, Nitin; Davies, Melanie J.; Patel, Kiran; Sattar, Naveed; Khunti, Kamlesh

doi:10.1016/j.pcd.2010.08.002

Cited by 183 publications

(158 citation statements)

References 112 publications

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“…We found that the metabolic activity of BAT was not different between South Asians and Europids. We did not expect this finding, as both the tendency of South Asians to develop abdominal obesity and type 2 diabetes [1,2,4] and the ontogenetic superfluity of the presence of BAT in the warm sub-Indian continent suggest BAT activity would be lower in South Asians than in Europids. As nine out of ten South Asians in our study were born in the Netherlands, it is unlikely that environmental factors influenced our results.…”

Section: Discussionmentioning

confidence: 91%

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Cold-induced activity of brown adipose tissue in young lean men of South-Asian and European origin

et al. 2013

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Aims/hypothesis South Asians have a disproportionately high risk of developing abdominal obesity, insulin resistance and type 2 diabetes. Brown adipose tissue (BAT) has been identified as a possible target to fight obesity and protect against metabolic disturbance. We explored whether lower BAT activity in South Asians compared with Europids may contribute to the high risk of metabolic disturbance. Methods We studied 20 healthy men (ten Europids/ten South Asians, BMI 19-25 kg/m 2 , age 18-32 years). Following 2 h of cold exposure (16-18°C) after an overnight fast, 18 F-fluorodeoxyglucose ( 18 F-FDG) positronemission tomography-computed tomography (CT) and 123 I-metaiodobenzylguanidine ( 123 I-MIBG) single-photon emission computed tomography-CT were performed to visualise metabolic BAT activity and sympathetic stimulation of BAT. Metabolic BAT activity was defined as maximal standardised uptake value (SUV max ) of 18 F-FDG, and sympathetic stimulation of BAT as semiquantitative uptake value (SQUV) of 123 I-MIBG. We performed hyperinsulinaemic-euglycaemic clamps to assess insulin sensitivity. Spearman's correlations for SUV max of 18 F-FDG and both SQUV of 123 I-MIBG and insulin sensitivity were determined. Results The median (interquartile range) SUV max of 18 F-FDG in South Asians (7.5 [2.2-10.6] g/ml) was not different from the median SUV max obtained in Europids (4.5 [2.2-8.4] g/ml; p=0.59). There was no correlation between BAT activity and insulin sensitivity. Correlations between SQUV of 123 I-MIBG and SUV max of 18 F-FDG were positive, both in the total population (ρ=0.80, p<0.001) and after stratification by ethnicity (Europids, ρ =0.65, p = 0.04; South Asians, ρ=0.83, p=0.01). Conclusions/interpretation This is the first study to prospectively investigate ethnic differences in metabolic BAT activity during cold exposure. We did not find differences in BAT activity between South Asians and Europids. Therefore, it seems unlikely that BAT plays an important role in the development of unfavourable metabolic profiles in South Asians.

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Section: Discussionmentioning

confidence: 91%

“…Several studies have shown that South Asians have a disproportionately high risk of developing abdominal obesity, insulin resistance and type 2 diabetes [1][2][3][4]. Next to the higher prevalence, these metabolic disturbances also seem to develop at an earlier age in South Asians than in populations of European origin.…”

Section: Introductionmentioning

confidence: 99%

Cold-induced activity of brown adipose tissue in young lean men of South-Asian and European origin

et al. 2013

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“…Although there were participants included from other ethnicities in both data sets (such as Chinese, Caribbean and African) there was not sufficient data to model separate scores for each ethnicity. South Asians are known to have a high level of risk [29], and therefore assuming the same level of risk for all black and minority ethnic groups may overestimate the risk for some, but this was thought to be preferential to underestimating risk or estimating risk based on insufficient data. In summary we have developed a valid and sensitive score for identifying those at the highest risk of prevalent IGR or type 2 diabetes mellitus within a multiethnic UK population.…”

Section: Score Developmentmentioning

confidence: 99%

Detection of impaired glucose regulation and/or type 2 diabetes mellitus, using primary care electronic data, in a multiethnic UK community setting

et al. 2012

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Aims/hypothesis The aim of this study was to develop and validate a score for detecting the glycaemic categories of impaired glucose regulation (IGR) and type 2 diabetes using the WHO 2011 diagnostic criteria. Methods We used data from 6,390 individuals aged 40-75 years from a multiethnic population based screening study. We developed a logistic regression model for predicting IGR and type 2 diabetes (diagnosed using OGTT or HbA 1c ≥6.5% [48 mmol/mol]) from data which are routinely stored in primary care. We developed the score by summing the β coefficients. We externally validated the score using data from 3,225 participants aged 40-75 years screened as part of another study. Results The score includes age, ethnicity, sex, family history of diabetes, antihypertensive therapy and BMI. Fifty per cent of a population would need to be invited for testing to detect type 2 diabetes mellitus on OGTT with 80% sensitivity; this is slightly raised to 54% that need to be invited if using HbA 1c . Inviting the top 10% for testing, 9% of these would have type 2 diabetes mellitus using an OGTT (positive predictive value [PPV]

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“…People in South Asian countries have earlier incidence and greater premature mortality from cardiovascular disease (CVD) than people in Western countries, a disparity that persists for South Asian immigrants in developed countries [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. A case-control comparison of age of first acute myocardial infarction between five South Asian countries and 47 other countries concluded that the observed disparities could be attributed to higher levels of standard risk factors at earlier ages in South Asians compared to citizens of other countries [5].…”

Section: Introductionmentioning

confidence: 99%

The Association of Duration of Residence in the United States with Cardiovascular Disease Risk Factors Among South Asian Immigrants

Bharmal

Kaplan

Shapiro

et al. 2014

J Immigrant Minority Health

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Type 2 diabetes and cardiovascular disease in South Asians

Cited by 183 publications

References 112 publications

Cold-induced activity of brown adipose tissue in young lean men of South-Asian and European origin

Cold-induced activity of brown adipose tissue in young lean men of South-Asian and European origin

Detection of impaired glucose regulation and/or type 2 diabetes mellitus, using primary care electronic data, in a multiethnic UK community setting

The Association of Duration of Residence in the United States with Cardiovascular Disease Risk Factors Among South Asian Immigrants

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