Metabolic syndrome in South Asian immigrants: more than low HDL requiring aggressive management.
Metabolic syndrome in South Asian immigrants: more than low HDL requiring aggressive management.
复制标题
DOI：
10.1186/1476-511x-10-45
复制
发表时间：
2011-03-16
影响因子：
4.5
通讯作者：
Butler MG
中科院分区：
文献类型：
--
作者：
Dodani S;Henkhaus R;Wick J;Vacek J;Gupta K;Dong L;Butler MG
积极的临床和公共卫生干预已导致世界范围内冠状动脉疾病(CAD)的显著减少。然而，与其他民族相比，南亚移民(SAI)表现出更高的冠心病患病率及其危险因素。本研究的目的是评估代谢综合征(MS)的患病率及其与高密度脂蛋白(HDL)功能、载脂蛋白A-I(APOA1)基因多态性的关系，以及以颈总动脉内中膜厚度(CCA-IMT)作为替代标记物的亚临床冠心病。对35-65岁的SAI患者进行了一项基于社区的横断面研究。采用新型无细胞比色法和高密度脂蛋白炎症指数(Dys-HDLI)测定Dys-HDL值。DNA测序分析6个内含子APOA1基因的多态性。根据国际糖尿病联合会的定义，在没有冠心病的SAI中，MS的患病率为29.7%，26%的人有高密度脂蛋白炎症指数≥1，提示高密度脂蛋白是促炎性的。对6个新发现的载脂蛋白A1单核苷酸多态(SNPs)进行Logistic回归分析，发现G2、G3和G5三个SNP与MS显著相关(p=0.039，p=0.038，p=0.054)。在多变量分析中，MS与BMI&Gt；23(P=0.005)、Apo-A-I水平(P=0.01)和Lp[a](P<；0.0001)显著相关。众所周知，SAI对冠心病的风险高得不成比例，这可能归因于MS的高负担。需要探索和了解非传统风险因素，尤其是Dys-HDLs，因为SAI的高密度脂蛋白水平较低。需要进行更大规模的前瞻性研究，以进一步加强目前的研究结果。
Aggressive clinical and public health interventions have resulted in significant reduction in coronary artery disease (CAD) worldwide. However, South Asian immigrants (SAIs) exhibit the higher prevalence of CAD and its risk factors as compared with other ethnic populations. The objective of the current study is to assess the prevalence of metabolic syndrome (MS), its association with high density Lipoprotein (HDL) function, Apo lipoprotein A-I (APOA1) gene polymorphisms, and sub-clinical CAD using common carotid intima-media thickness (CCA-IMT) as a surrogate marker. A community-based cross-sectional study was conducted on SAIs aged 35-65 years. Dysfunctional/pro-inflammatory (Dys-HDL) was determined using novel cell free assay and HDL inflammatory index. Six intronic APOA1 gene polymorphisms were analyzed by DNA sequencing. According to the International Diabetes Federation definition, MS prevalence was 29.7% in SAIs without CAD and 26% had HDL inflammatory index ≥ 1 suggesting pro-inflammatory Dys-HDL. Six novel APOA1 single nucleotide polymorphisms (SNPs) were analyzed with logistic regression, three SNPs (G2, G3, and G5) were found to be significantly associated with MS (p = 0.039, p = 0.038, p = 0.054). On multi-variate analysis, MS was significantly associated with BMI > 23 (P = 0.005), Apo-A-I levels (p = 0.01), and Lp [a] (p < 0.0001). SAIs are known to be at a disproportionately high risk for CAD that may be attributed to a high burden for MS. There is need to explore and understand non-traditional risk factors with special focus on Dys-HDL, knowing that SAIs have low HDL levels. Large prospective studies are needed to further strengthen current study results.