The metabolic basis of increased coronary risk attributed to people from the Indian subcontinent

摘要

People originating from the Indian subcontinent living abroad are reported to have a higher prevalence of coronary heart disease (CHD) compared to indigenous populations in the countries they reside. Recently there have been reports of increases in prevalence of CHD from India also. Initial reports indicate that people of Indo-origin may be more prone to CHD due to a metabolic syndrome which comprises of resistance to insulin-mediated glucose uptake, serum triglycerides that are at the upper end of normal, a low level of high density lipoprotein (HDL) cholesterol and blood glucose values in the pre-diabetic range. In addition, people of Indo-origin have increased concentrations of lipoprotein (a), a particle that is associated with increased propensity to CHD. Both insulin resistance and lipoprotein (a) are genetically determined, but the increased CHD risk related to them seems to come into play when environmental factors such as diet and physical inactivity lead to obesity and/or increases in serum cholesterol. Alterations in traditional lifestyles due to migration from rural areas to urban areas in India and or on migration abroad to more prosperous conditions may explain why people of Indo-origin are at an increased risk of CHD. There is a need for more studies in India and cross-country studies of Indians abroad to clarify some of these issues. The results of these studies will help put into place health promotion strategies to prevent CHD which often affects people when they are most productive. [References: 99]