Metabolic Syndrome in Indian Diasporas
- Approximately 27 million Indians live outside India in more than 100 countries. The prevalence of metabolic syndrome (MS) among the Indian Diasporas varies widely depending upon the criteria used and the countries studied. Using NCEP criteria, prevalence of MS ranges from 12% in Mauritius, to 26% in Canada, to 34% in the United States.1-3
- Prevalence of MS is 50% to 100% higher among Indian Diasporas than in Europids.4-6 Studies in UK have shown a prevalence of 28-39% in men and 32-38% in women compared to18-20% in white men and 14-20% in white women.4, 5
- The prevalence of MS using IDF definition, was double (44% vs.23%) and diabetes 3 times higher among South Asians in UK despite a lower age and lower BMI.7
- Compared with whites, MS develops 10 years earlier among South Asian men and 20 years earlier among South Asian women. The prevalence of MS increases from 10% at age 20 to 29 years to 53% by age 60 years.5
- To address the issue of high risk of metabolic abnormalities at low level of obesity in South Asians, several expert societies, organizations and consensus groups have recommended lower thresholds for waist circumference for South Asians (men >90cm and female >80cm).8 9
- The use of these lower WC cut-points could increase the prevalence of metabolic syndrome by 20-50%.8
Sources
1. Misra KB, Endemann SW, Ayer M. Leisure time physical activity and metabolic syndrome in Asian Indian immigrants residing in northern California. Ethn Dis. Autumn 2005;15(4):627-634.
2. Anand SS, Yi Q, Gerstein H, et al. Relationship of metabolic syndrome and fibrinolytic dysfunction to cardiovascular disease. Circulation. Jul 29 2003;108(4):420-425.
3. DECODA Study Group. Prevalence of the metabolic syndrome in populations of Asian origin. Comparison of the IDF definition with the NCEP definition. Diabetes Res Clin Pract. Apr 2007;76(1):57-67.
4. Tillin T, Forouhi N, Johnston DG, McKeigue PM, Chaturvedi N, Godsland IF. Metabolic syndrome and coronary heart disease in South Asians, African-Caribbeans and white Europeans: a UK population-based cross-sectional study. Diabetologia. Apr 2005;48(4):649-656.
5. Chambers J. The age and gender relted prevalence of the metabolic syndrome among UK Indian Asians and European whites:First results from the LondonLife Sciences Population (LOLIPOP) Study. Heart (British Cardiac Society). 2006;92(suppl):A11 (abstract).
6. Ajjan R, Carter AM, Somani R, Kain K, Grant PJ. Ethnic differences in cardiovascular risk factors in healthy Caucasian and South Asian individuals with the metabolic syndrome. J Thromb Haemost. Apr 2007;5(4):754-760.
7. Gholap N, Davies M, Patel K, Sattar N, Khunti K. Type 2 diabetes and cardiovascular disease in South Asians. Prim Care Diabetes. Sep 23 2010.
8. Enas EA, Mohan V, Deepa M, Farooq S, Pazhoor S, Chennikkara H. The metabolic syndrome and dyslipidemia among Asian Indians: a population with high rates of diabetes and premature coronary artery disease. Journal of the cardiometabolic syndrome. Fall 2007;2(4):267-275.
9. Alberti KG, Eckel RH, Grundy SM, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and international association for the Study of Obesity. Circulation. Oct 20 2009;120(16):1640-1645.