Metabolic syndrome in South Asian immigrants: more than low HDL requiring aggressive management

Lipids in Health and Disease

Research

Sunita Dodani¹  Jo Wick²  Lei Dong²  Rebecca Henkhaus³  Merlin G Butler³  James Vacek⁴  Kamal Gupta⁴ 

[1] Center for Post Polio Rehabilitation, 2308 W, 127 street, 66209, Leawood, KS, USA;Department of Biostatistics, School of Medicine, University of Kansas Medical Center, 3910 Rainbow Blvd, 66160, Kansas City, Kansas, USA;Departments of Psychiatry & Behavioral Sciences and Pediatrics, University of Kansas Medical Center, 3910 Rainbow Blvd, 66160, Kansas City, Kansas, USA;Mid America Cardiology, University of Kansas Medical Center, 3910 Rainbow Blvd, 66160, Kansas City, Kansas, USA;

关键词: Metabolic Syndrome;    Coronary Artery Disease Risk;    International Diabetes Federation;    APOA1 Gene;    Coronary Artery Disease Risk Factor;   

DOI  :  10.1186/1476-511X-10-45

 received in 2011-02-03, accepted in 2011-03-16,  发布年份 2011

来源: Springer

【 摘 要 】

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.

【 授权许可】

CC BY   
© Dodani et al; licensee BioMed Central Ltd. 2011