Jha Prabhat, Enas Enas, Yusuf Salim
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
Asian Am Pac Isl J Health. 1993 Autumn;1(2):163-175.
The purpose of this study is to describe the prevalence of coronary artery disease (CAD) and provide a review of the risk factors associated with CAD in Asian Indians. SEARCH METHODS USED: The authors extensively reviewed numerous British and international studies and the more limited number of studies in India and the US. SUMMARY OF IMPORTANT FINDINGS: Asian Indians have one of the highest rates of CAD. Conventional risk factors such as high blood pressure, high serum total cholesterol level, cigarette smoking, high fat diet, and obesity consistently fail to fully explain these high rates. There appears to be a strong role of insulin resistance and abdominal obesity, both of which have a high prevalence in Asian Indians. Various dyslipidemic disorders in Asian Indians such as low levels of HDL cholesterol, elevation of triglyceride, elevation of LDL cholesterol and elevation of lipoprotein (a) may also have a role. CONCLUSIONS: We hypothesize that against a background of higher susceptibility to CAD among Asian Indians, as characterized by insulin resistance, abdominal obesity and dyslipidemic disorders, conventional risk factors for CAD are also important. A genetic predisposition to CAD is suggested by high levels of lipoprotein (a) in Asian Indians. This would suggest that more aggressive identification and modulation of all known risk factors are necessary among Asian Indians along with a compelling need for further epidemiological studies in this population. RELEVANCE TO ASIAN PACIFIC ISLANDER AMERICAN POPULATIONS: The marked differences in the rates of CAD among Asian Indians, compared with Chinese, Japanese, Filipino, other Asians and Whites are discussed. KEY WORDS: Asian Indians, coronary artery disease, epidemiology, disease prevalence, risk factors, insulin resistance, dyslipidemic disorders, triglycedide, high density lipoprotein; lipoprotein (a)
本研究旨在描述冠状动脉疾病（CAD）的患病率，并综述与亚洲印度人CAD相关的危险因素。
作者广泛查阅了众多英国及国际研究，以及印度和美国数量有限的研究。
亚洲印度人是CAD发病率最高的群体之一。高血压、血清总胆固醇水平高、吸烟、高脂肪饮食和肥胖等传统危险因素始终无法充分解释这些高发病率。胰岛素抵抗和腹型肥胖似乎起到了重要作用，这两者在亚洲印度人中的患病率都很高。亚洲印度人存在的各种血脂异常紊乱，如高密度脂蛋白胆固醇水平低、甘油三酯升高、低密度脂蛋白胆固醇升高和脂蛋白（a）升高，可能也有影响。
我们推测，在亚洲印度人对CAD易感性较高的背景下，以胰岛素抵抗、腹型肥胖和血脂异常紊乱为特征，CAD的传统危险因素也很重要。亚洲印度人脂蛋白（a）水平高提示存在CAD的遗传易感性。这表明，在亚洲印度人中，更积极地识别和调节所有已知危险因素是必要的，同时迫切需要对该人群进行进一步的流行病学研究。
讨论了亚洲印度人与中国人、日本人、菲律宾人、其他亚洲人和白人相比，CAD发病率的显著差异。
亚洲印度人；冠状动脉疾病；流行病学；疾病患病率；危险因素；胰岛素抵抗；血脂异常紊乱；甘油三酯；高密度脂蛋白；脂蛋白（a）
