PMID- 19900153
OWN - NLM
STAT- MEDLINE
DCOM- 20100304
LR  - 20220410
IS  - 1557-8518 (Electronic)
IS  - 1540-4196 (Linking)
VI  - 7
IP  - 6
DP  - 2009 Dec
TI  - The metabolic syndrome in South Asians: epidemiology, determinants, and 
      prevention.
PG  - 497-514
LID - 10.1089/met.2009.0024 [doi]
AB  - BACKGROUND: The prevalence of obesity and the metabolic syndrome is rapidly 
      increasing in India and other south Asian countries, leading to increased 
      morbidity and mortality due to type 2 diabetes mellitus (T2DM) and cardiovascular 
      disease (CVD). METHODS: The literature search has been carried out using the key 
      words "insulin resistance, the metabolic syndrome, cardiovascular risk, diabetes, 
      obesity, Asian Indians, and South Asians" in the medical search engine Pubmed 
      (National Library of Medicine, Bethesda, MD) from 1966 to September 2009. 
      RESULTS: A high prevalence of the metabolic syndrome and associated 
      cardiovascular risk factors has been observed not only in urban South Asian/Asian 
      Indian adults and children but also in economically disadvantaged people residing 
      in urban slums and rural areas. The main drivers are rapid nutrition, lifestyle, 
      and socioeconomic transitions, consequent to increasing affluence, urbanization, 
      mechanization, and rural-to-urban migration. Less investigated determinants of 
      the metabolic syndrome include psychological stress in urban setting, genetic 
      predisposition, adverse perinatal environment, and childhood "catch up" obesity. 
      Data show atherogenic dyslipidemia, glucose intolerance, thrombotic tendency, 
      subclinical inflammation, and endothelial dysfunction are higher in South Asians 
      than Caucasians. Many of these manifestations are more severe and are seen at an 
      early age (childhood) in South Asians than Caucasians. Metabolic syndrome and 
      cardiovascular risk in South Asians is also heightened by their higher body fat, 
      truncal subcutaneous fat, intra-abdominal fat, and ectopic fat deposition (liver 
      fat, etc.). Further, cardiovascular risk cluster manifests at a lower level of 
      adiposity and abdominal obesity. The cutoffs of body mass index and waist 
      circumference for defining obesity and abdominal obesity, respectively, have been 
      lowered and the definition of the metabolic syndrome has been revised for Asian 
      Indians in a recent consensus statement, so that physicians could intervene early 
      with lifestyle management. Data from a major intervention program conducted by us 
      on urban adolescent schoolchildren in north India for prevention of obesity (the 
      MARG project) has shown encouraging results, making it a model for any future 
      intervention program in South Asians. CONCLUSIONS: Cardiometabolic risk is high 
      in South Asians, starting at an early age. Increasing awareness of cluster of 
      risk factors and how to prevent them should be emphasized in population-wide 
      prevention strategies in South Asian countries, primarily focusing on children.
FAU - Misra, Anoop
AU  - Misra A
AD  - Department of Diabetes and Metabolic Diseases, Fortis Hospital, Vasant Kunj, 
      Delhi, India. anoopmisra@metabolicresearchindia.com
FAU - Khurana, Lokesh
AU  - Khurana L
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - United States
TA  - Metab Syndr Relat Disord
JT  - Metabolic syndrome and related disorders
JID - 101150318
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Asia/epidemiology
MH  - Cardiovascular Diseases/etiology
MH  - Child
MH  - Diabetes Mellitus, Type 2/etiology
MH  - Emigrants and Immigrants
MH  - Female
MH  - Humans
MH  - India/epidemiology
MH  - Life Style
MH  - Male
MH  - Metabolic Syndrome/*epidemiology/etiology/prevention & control
MH  - Obesity/epidemiology/etiology
MH  - Phenotype
MH  - Risk Factors
MH  - Rural Population
MH  - Socioeconomic Factors
MH  - Urbanization
RF  - 192
EDAT- 2009/11/11 06:00
MHDA- 2010/03/05 06:00
CRDT- 2009/11/11 06:00
PHST- 2009/11/11 06:00 [entrez]
PHST- 2009/11/11 06:00 [pubmed]
PHST- 2010/03/05 06:00 [medline]
AID - 10.1089/met.2009.0024 [doi]
PST - ppublish
SO  - Metab Syndr Relat Disord. 2009 Dec;7(6):497-514. doi: 10.1089/met.2009.0024.