Centre of Nutrition & Metabolic Research (C-NET), National Diabetes, Obesity and Cholesterol Foundation (N-DOC), SDA, New Delhi, India; Diabetes Foundation (India), SDA, New Delhi, India; Fortis C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, Chirag Enclave, Nehru Place, New Delhi, India.
School of Public Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.
J Diabetes Complications. 2018 Nov;32(11):1068-1075. doi: 10.1016/j.jdiacomp.2018.08.001. Epub 2018 Aug 4.
The prevalence of overweight and obesity is escalating in South Asian countries. South Asians display higher total and abdominal obesity at a lower BMI when compared to Whites. Consequently, metabolic dysfunction leading to metabolic syndrome (MetS) and type 2 diabetes mellitus (T2DM) will account for a majority of the health burden of these countries. In this review, we discuss those factors that contribute to MetS and T2DM in South Asians when compared to whites, focusing on adiposity. Abdominal obesity is the single-most important risk factor for MetS and its predisposition to T2DM. Excessive ectopic fat deposition in the liver (non-alcoholic fatty liver disease) has been linked to insulin resistance in Asian Indians, while the effects of ectopic fat accumulation in pancreas and skeletal muscle need more investigation. South Asians also have lower skeletal muscle mass than Whites, and this may contribute to their higher risk T2DM. Lifestyle factors contributing to MetS and T2DM in South Asians include inadequate physical activity and high intakes of refined carbohydrates and saturated fats. These are reflective of the recent but rapid economic transition and urbanization of the South Asian region. There is need to further the research into genetic determinants of dysmetabolism as well as gene x environment interactions. Collectively, MetS and T2DM have multi-factorial antecedents in South Asians and efforts to combat it through low-cost and socio-culturally appropriate lifestyle interventions need to be supported.
南亚国家超重和肥胖的患病率正在不断上升。与白人相比，南亚人在 BMI 较低的情况下，总肥胖和腹部肥胖的程度更高。因此，导致代谢综合征（MetS）和 2 型糖尿病（T2DM）的代谢功能障碍将成为这些国家健康负担的主要原因。在这篇综述中，我们讨论了与白人相比，导致南亚人出现 MetS 和 T2DM 的因素，重点讨论了肥胖。腹部肥胖是 MetS 的最重要单一风险因素，也是其导致 T2DM 的倾向。亚洲印第安人中，肝脏（非酒精性脂肪性肝病）中过多的异位脂肪沉积与胰岛素抵抗有关，而脂肪在胰腺和骨骼肌中的积累的影响需要更多的研究。南亚人的骨骼肌量也低于白人，这可能导致他们患 T2DM 的风险更高。导致南亚人出现 MetS 和 T2DM 的生活方式因素包括体力活动不足、精制碳水化合物和饱和脂肪摄入过多。这反映了南亚地区最近快速的经济转型和城市化。需要进一步研究代谢紊乱的遗传决定因素以及基因与环境的相互作用。总的来说，南亚人出现 MetS 和 T2DM 的因素有多种，需要通过低成本和适合社会文化的生活方式干预来支持对抗这种疾病。
