The metabolic syndrome and dyslipidemia among Asian Indians: a population with high rates of diabetes and premature coronary artery disease.
The metabolic syndrome and dyslipidemia among Asian Indians: a population with high rates of diabetes and premature coronary artery disease.
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DOI：
10.1111/j.1559-4564.2007.07392.x
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发表时间：
2007-01-01
期刊：
影响因子：
--
通讯作者：
Chennikkara, Hancy
中科院分区：
文献类型：
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作者：
Enas, Enas A;Mohan, Vishwanathan;Chennikkara, Hancy
南亚人的糖尿病发病率很高，而且早发冠状动脉疾病的发病率是世界上最高的，两者的发生时间都比其他人群早约 10 年。代谢综合征（MS）似乎是这两种疾病的前身或“共同土壤”，在南亚人中也很常见。由于南亚人出现代谢异常的体重指数和腰围低于其他群体，因此传统标准低估了 MS 的患病率 25% 至 50%。拟议的南亚改良国家胆固醇教育计划标准将腹部肥胖作为可选组成部分，而国际糖尿病联盟推荐的南亚特定腰围似乎更适合该人群。此外，即使根据糖尿病和多发性硬化症的存在情况进行调整，亚裔印度人患冠状动脉疾病的风险至少是白人的两倍。这种风险增加似乎是由于南亚血脂异常所致，其特点是载脂蛋白 B、脂蛋白 (a) 和甘油三酯的血清水平较高，而载脂蛋白 A1 和高密度脂蛋白 (HDL) 胆固醇水平较低。此外，HDL 颗粒小、致密且功能失调。需要认识到多发性硬化症对南亚人来说是一种迫在眉睫的危险，并从儿童时期开始积极改变生活方式，并以比其他人群更低的阈值进行治疗。
South Asians have high rates of diabetes and the highest rates of premature coronary artery disease in the world, both occurring about 10 years earlier than in other populations. The metabolic syndrome (MS), which appears to be the antecedent or "common soil" for both of these conditions, is also common among South Asians. Because South Asians develop metabolic abnormalities at a lower body mass index and waist circumference than other groups, conventional criteria underestimate the prevalence of MS by 25% to 50%. The proposed South Asian Modified National Cholesterol Education Program criteria that use abdominal obesity as an optional component and the South Asian-specific waist circumference recommended by the International Diabetes Federation appear to be more appropriate in this population. Furthermore, Asian Indians have at least double the risk of coronary artery disease than that of whites, even when adjusted for the presence of diabetes and MS. This increased risk appears to be due to South Asian dyslipidemia, which is characterized by high serum levels of apolipoprotein B, lipoprotein (a), and triglycerides and low levels of apolipoprotein A1 and high-density lipoprotein (HDL) cholesterol. In addition, the HDL particles are small, dense, and dysfunctional. MS needs to be recognized as a looming danger to South Asians and treated with aggressive lifestyle modifications beginning in childhood and at a lower threshold than in other populations.