Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA, Georgia.
Division of Endocrinology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, United States.
Curr Diabetes Rev. 2021;17(9):e070320183447. doi: 10.2174/1573399816666200703182458.
South Asians are at a significantly increased risk of type 2 diabetes (T2D) and cardiovascular disease (CVD), are diagnosed at relatively younger ages, and exhibit more severe disease phenotypes as compared with other ethnic groups. The pathophysiological mechanisms underlying T2D and CVD risk in South Asians are multifactorial and intricately related.
A narrative review of the pathophysiology of excess risk of T2D and CVD in South Asians.
T2D and CVD have shared risk factors that encompass biological factors (early life influences, impaired glucose metabolism, and adverse body composition) as well as behavioral and environmental risk factors (diet, sedentary behavior, tobacco use, and social determinants of health). Genetics and epigenetics also play a role in explaining the increased risk of T2D and CVD among South Asians. Additionally, South Asians harbor several lipid abnormalities including high concentration of small-dense low-density lipoprotein (LDL) particles, elevated triglycerides, low high-density lipoprotein (HDL)- cholesterol levels, dysfunctional HDL particles, and elevated lipoprotein(a) that predispose them to CVD.
In this comprehensive review, we have discussed risk factors that provide insights into the pathophysiology of excess risk of T2D and CVD in South Asians.
南亚人患 2 型糖尿病（T2D）和心血管疾病（CVD）的风险显著增加，他们的诊断年龄相对较小，且与其他族裔相比，疾病表型更为严重。南亚人 T2D 和 CVD 风险增加的病理生理学机制是多因素的，且相互关联。
对南亚人 T2D 和 CVD 风险增加的病理生理学进行了叙述性综述。
T2D 和 CVD 具有共同的危险因素，包括生物学因素（生命早期影响、葡萄糖代谢受损和不良的身体成分）以及行为和环境危险因素（饮食、 sedentary behavior、吸烟和健康的社会决定因素）。遗传学和表观遗传学也在解释南亚人 T2D 和 CVD 风险增加方面发挥了作用。此外，南亚人还存在几种脂质异常，包括小而密的低密度脂蛋白（LDL）颗粒浓度升高、甘油三酯升高、高密度脂蛋白（HDL）-胆固醇水平降低、HDL 颗粒功能障碍和脂蛋白（a）升高，这些都会使他们易患 CVD。
在这篇全面的综述中，我们讨论了风险因素，这些因素为理解南亚人 T2D 和 CVD 风险增加的病理生理学提供了深入了解。
