Diabetes in South Asians: Uncovering Novel Risk Factors With Longitudinal Epidemiologic Data: Kelly West Award Lecture 2023

IF 14.8 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Diabetes Care Pub Date : 2023-12-20 DOI:10.2337/dci23-0068
Alka M. Kanaya
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Abstract

South Asian populations have a higher prevalence and earlier age of onset of type 2 diabetes and atherosclerotic cardiovascular diseases than other race and ethnic groups. To better understand the pathophysiology and multilevel risk factors for diabetes and cardiovascular disease, we established the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study in 2010. The original MASALA study cohort (n = 1,164) included 83% Asian Indian immigrants, with an ongoing expansion of the study to include individuals of Bangladeshi and Pakistani origin. We have found that South Asian Americans in the MASALA study had higher type 2 diabetes prevalence, lower insulin secretion, more insulin resistance, and an adverse body composition with higher liver and intermuscular fat and lower lean muscle mass compared with four other U.S. race and ethnic groups. MASALA study participants with diabetes were more likely to have the severe hyperglycemia subtype, characterized by β-cell dysfunction and lower body weight, and this subtype was associated with a higher incidence of subclinical atherosclerosis. We have found several modifiable factors for cardiometabolic disease among South Asians including diet and physical activity that can be influenced using specific social network members and with cultural adaptations to the U.S. context. Longitudinal data with repeat cardiometabolic measures that are supplemented with qualitative and mixed-method approaches enable a deeper understanding of disease risk and resilience factors. Studying and contrasting Asian American subgroups can uncover the causes for cardiometabolic disease heterogeneity and reveal novel methods for prevention and treatment.
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南亚人的糖尿病:利用纵向流行病学数据发现新的风险因素:凯利-韦斯特奖讲座 2023
与其他种族和族裔群体相比,南亚人 2 型糖尿病和动脉粥样硬化性心血管疾病的发病率更高,发病年龄更早。为了更好地了解糖尿病和心血管疾病的病理生理学和多层次风险因素,我们于 2010 年建立了 "生活在美国的南亚人动脉粥样硬化介导因素"(MASALA)研究。最初的 MASALA 研究队列(n = 1,164)包括 83% 的亚裔印度移民,目前正在扩大研究范围,将孟加拉和巴基斯坦裔纳入其中。我们发现,与美国其他四个种族和族裔群体相比,MASALA 研究中的南亚裔美国人 2 型糖尿病患病率更高、胰岛素分泌更低、胰岛素抵抗更强,而且身体成分不利,肝脏和肌间脂肪更高,瘦肌肉质量更低。MASALA研究中的糖尿病患者更有可能属于严重高血糖亚型,其特征是β细胞功能障碍和体重较轻,这种亚型与亚临床动脉粥样硬化的发生率较高有关。我们在南亚人中发现了几种可改变心脏代谢疾病的因素,包括饮食和体育锻炼,这些因素可以通过特定的社会网络成员和对美国文化的适应来影响。纵向数据与重复的心脏代谢测量方法,再辅以定性和混合方法,可以更深入地了解疾病风险和恢复因素。对亚裔美国人亚群进行研究和对比,可以发现心脏代谢疾病异质性的原因,并揭示新的预防和治疗方法。
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来源期刊
Diabetes Care
Diabetes Care 医学-内分泌学与代谢
CiteScore
27.80
自引率
4.90%
发文量
449
审稿时长
1 months
期刊介绍: The journal's overarching mission can be captured by the simple word "Care," reflecting its commitment to enhancing patient well-being. Diabetes Care aims to support better patient care by addressing the comprehensive needs of healthcare professionals dedicated to managing diabetes. Diabetes Care serves as a valuable resource for healthcare practitioners, aiming to advance knowledge, foster research, and improve diabetes management. The journal publishes original research across various categories, including Clinical Care, Education, Nutrition, Psychosocial Research, Epidemiology, Health Services Research, Emerging Treatments and Technologies, Pathophysiology, Complications, and Cardiovascular and Metabolic Risk. Additionally, Diabetes Care features ADA statements, consensus reports, review articles, letters to the editor, and health/medical news, appealing to a diverse audience of physicians, researchers, psychologists, educators, and other healthcare professionals.
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