Begom R, Singh R B
Department of Home Science, College for Women, Medical Hospital and Research Centre, Moradabad, India.
Acta Cardiol. 1995;50(3):227-40.
There is scanty evidence on prevalence of coronary artery disease (CAD) in the urban population of India and it is not clear why South Indians have higher prevalence than North Indians. Of 506 subjects between 25-65 years of age selected for this study from 234 randomly selected households from 2 randomly selected streets, 46 (9.0%) were non-responders and 460 (response rate 91%) volunteered to participate in the study. Dietary intakes, anthropometric and laboratory data, prevalence of risk factors and CAD were obtained and compared with 152 North Indian subjects reported earlier. In comparison with North Indians, the prevalence of CAD was 61.6% higher in South Indians (13.9 vs 8.6%). The prevalence of possible evidence of CAD in South Indians was 139 per 1000 (95% confidence limits 112 to 178). While prevalence of diabetes mellitus, glucose intolerance, hypertension, hypercholesterolemia, hypertriglyceri-demia were comparable between North and South Indians in both sexes, the prevalence of smoking in South Indians males (44.6%) was significantly higher than North Indian. The prevalence of passive smoking in females (45.3%) was significantly higher in South Indian females which may be the cause of higher CAD among them. While total fat intake in North and South Indians were comparable, the intake of saturated fat and cholesterol were higher and P/S ratio was lower than North Indians, although these levels of fat intake are considered safe in British who have 26.4% less prevalence of CAD than South Indians. Among smokers, those subjects eating low saturated fat diet had less CAD compared to those smokers eating higher fat diet. It is clear that smoking, saturated fat, cholesterol, hypertension, diabetes, central obesity and glucose intolerance alone can not explain the cause of all of the higher CAD among South Indians. Study of other risk factors such as insulin resistance and antioxidant vitamins may be necessary.
关于印度城市人口中冠状动脉疾病（CAD）的患病率，现有证据不足，而且尚不清楚为何南印度人的患病率高于北印度人。从随机抽取的2条街道的234个随机选取的家庭中挑选出506名年龄在25至65岁之间的受试者参与本研究，其中46名（9.0%）未作出回应，460名（回应率91%）自愿参与研究。获取了饮食摄入量、人体测量和实验室数据、危险因素和CAD的患病率，并与之前报道的152名北印度受试者进行比较。与北印度人相比，南印度人CAD的患病率高出61.6%（13.9%对8.6%）。南印度人CAD可能证据的患病率为每1000人中有139例（95%置信区间为112至178）。虽然糖尿病、葡萄糖耐量异常、高血压、高胆固醇血症、高甘油三酯血症在北印度人和南印度人的男女患病率中相当，但南印度男性吸烟率（44.6%）显著高于北印度男性。南印度女性被动吸烟率（45.3%）显著高于北印度女性，这可能是她们中CAD患病率较高的原因。虽然北印度人和南印度人的总脂肪摄入量相当，但饱和脂肪和胆固醇的摄入量更高，P/S比值低于北印度人，尽管这些脂肪摄入水平在CAD患病率比南印度人低26.4%的英国人中被认为是安全的。在吸烟者中，与食用高脂肪饮食的吸烟者相比，食用低饱和脂肪饮食的受试者患CAD的几率更低。显然，仅吸烟、饱和脂肪、胆固醇、高血压、糖尿病、中心性肥胖和葡萄糖耐量异常并不能解释南印度人CAD患病率较高的所有原因。研究其他危险因素，如胰岛素抵抗和抗氧化维生素可能是必要的。
