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南亚人群心血管疾病的遗传和非遗传决定因素。

Genetic and Non-genetic Determinants of Cardiovascular Disease in South Asians.

机构信息

Department of Pediatrics, Section of Genetics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States.

出版信息

Curr Diabetes Rev. 2021;17(9):e011721190373. doi: 10.2174/1573399817666210118103022.

Abstract

South Asians (SAs), people from the Indian subcontinent (e.g., India, Pakistan, Bangladesh, Sri Lanka, and Nepal) have a higher prevalence of cardiovascular disease (CVD) and suffer from a greater risk of CVD-associated mortality compared to other global populations. These problems are compounded by the alterations in lifestyles due to urbanization and changing cultural, social, economic, and political environments. Current methods of CV risk prediction are based on white populations that under-estimate the CVD risk in SAs. Prospective studies are required to obtain actual CVD morbidity/mortality rates so that comparisons between predicted CVD risk can be made with actual events. Overwhelming data support a strong influence of genetic factors. Genome-Wide Association Studies (GWAS) serve as a starting point for future genetic and functional studies since the mechanisms of action by which these associated loci influence CVD is still unclear. It is difficult to predict the potential implication of these findings in clinical settings. This review provides a systematic assessment of the risk factors, genetics, and environmental causes of CV health disparity in SAs, and highlights progress made in clinical and genomics discoveries in the rapidly evolving field, which has the potential to show clinical relevance in the near future.

摘要

南亚人(SAs),来自印度次大陆(如印度、巴基斯坦、孟加拉国、斯里兰卡和尼泊尔)的人,心血管疾病(CVD)的患病率较高,与其他全球人群相比,死于 CVD 相关疾病的风险更高。城市化以及文化、社会、经济和政治环境的变化导致生活方式的改变,使这些问题更加复杂。目前的 CV 风险预测方法基于白人人群,低估了南亚人患 CVD 的风险。需要进行前瞻性研究以获得实际的 CVD 发病率/死亡率,以便可以将预测的 CVD 风险与实际事件进行比较。大量数据支持遗传因素的强烈影响。全基因组关联研究(GWAS)为未来的遗传和功能研究提供了起点,因为这些相关位点影响 CVD 的作用机制尚不清楚。很难预测这些发现对临床环境的潜在影响。本综述系统评估了南亚人 CV 健康差异的危险因素、遗传学和环境原因,并强调了在快速发展的领域中临床和基因组学发现所取得的进展,这些进展有可能在不久的将来显示出临床相关性。

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