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黑人和白人在心血管疾病及2型糖尿病风险因素方面的差异:剖析代谢综合征的种族悖论

Disparities in Cardiovascular Disease and Type 2 Diabetes Risk Factors in Blacks and Whites: Dissecting Racial Paradox of Metabolic Syndrome.

作者信息

Osei Kwame, Gaillard Trudy

机构信息

Professor Emeritus of Medicine and Exercise Physiology, Division of Endocrinology, Diabetes and Metabolism, The Ohio State University, Columbus, OH, United States.

College of Nursing, University of Cincinnati, Cincinnati, OH, United States.

出版信息

Front Endocrinol (Lausanne). 2017 Aug 31;8:204. doi: 10.3389/fendo.2017.00204. eCollection 2017.

Abstract

Cardiovascular diseases (CVD) remain as the leading cause of mortality in the western world and have become a major health threat for developing countries. There are several risk factors that account for the CVD and the associated mortality. These include genetics, type 2 diabetes (T2DM), obesity, physical inactivity, hypertension, and abnormal lipids and lipoproteins. The constellation of these risk factors has been termed (MetS). MetS varies among racial and ethnic populations. Thus, race and ethnicity account for some of the differences in the MetS and the associated CVD and T2DM. Furthermore, the relationships among traditional metabolic parameters and CVD differ, especially when comparing Black and White populations. In this regard, the greater CVD in Blacks than Whites have been partly attributed to other non-traditional CVD risk factors, such as subclinical inflammation (C-reactive protein), homocysteine, increased low-density lipoprotein oxidation, lipoprotein a, adiponectin, and plasminogen activator inhibitor-1, etc. Thus, to understand CVD and T2DM differences in Blacks and Whites with MetS, it is essential to explore the contributions of both traditional and non-traditional CVD and T2DM risk factors in Blacks of African ancestry and Whites of Europoid ancestry. Therefore, in this mini review, we propose that non-traditional risk factors should be integrated in defining MetS as a predictor of CVD and T2DM in Blacks in the African diaspora in future studies.

摘要

心血管疾病(CVD)仍然是西方世界的主要死因,并已成为发展中国家的重大健康威胁。有几个危险因素可导致心血管疾病及其相关死亡率。这些因素包括遗传因素、2型糖尿病(T2DM)、肥胖、缺乏体育锻炼、高血压以及血脂和脂蛋白异常。这些危险因素的集合被称为代谢综合征(MetS)。代谢综合征在不同种族和族裔人群中有所不同。因此,种族和族裔是代谢综合征以及相关心血管疾病和2型糖尿病存在一些差异的原因之一。此外,传统代谢参数与心血管疾病之间的关系也有所不同,尤其是在比较黑人和白人人群时。在这方面,黑人比白人患心血管疾病的几率更高,部分原因可归结于其他非传统的心血管疾病危险因素,如亚临床炎症(C反应蛋白)、同型半胱氨酸、低密度脂蛋白氧化增加、脂蛋白a、脂联素和纤溶酶原激活物抑制剂-1等。因此,为了解患有代谢综合征的黑人和白人在心血管疾病和2型糖尿病方面的差异,有必要探究传统和非传统的心血管疾病及2型糖尿病危险因素对非洲裔黑人及欧洲裔白人的影响。所以,在本综述中,我们建议在未来的研究中,应将非传统危险因素纳入代谢综合征的定义中,作为散居非洲的黑人患心血管疾病和2型糖尿病的预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/335c/5583515/dd6373eb2851/fendo-08-00204-g001.jpg

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