Disentangling Dual Threats: Premature Coronary Artery Disease and Early-Onset Type 2 Diabetes Mellitus in South Asians

Abstract South Asian individuals (SAs) face heightened risks of premature coronary artery disease (CAD) and early-onset type 2 diabetes mellitus (T2DM), with grave health, societal, and economic implications due to the region's dense population. Both conditions, influenced by cardiometabolic ri...

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Published in:Journal of the Endocrine Society 2023-12, Vol.8 (1), p.bvad167-bvad167
Main Authors: Muniyappa, Ranganath, Narayanappa, Satish Babu K
Format: Article
Language:English
Subjects:
Asians
Atherosclerosis
Australia
Bangladesh
Coronary heart disease
Development and progression
Dextrose
Epidemics
Epidemiology
Glucose
Hypertension
Insulin resistance
Lipoprotein A
Low density lipoproteins
Medical research
Medicine, Experimental
Mini-Review
Pakistan
Prediabetic state
Risk factors
South Asia
Type 2 diabetes
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Narayanappa, Satish Babu K
description Abstract South Asian individuals (SAs) face heightened risks of premature coronary artery disease (CAD) and early-onset type 2 diabetes mellitus (T2DM), with grave health, societal, and economic implications due to the region's dense population. Both conditions, influenced by cardiometabolic risk factors such as insulin resistance, hypertension, and central adiposity, manifest earlier and with unique thresholds in SAs. Epidemiological, demographic, nutritional, environmental, sociocultural, and economic transitions in SA have exacerbated the twin epidemic. The coupling of premature CAD and T2DM arises from increased obesity due to limited adipose storage, early-life undernutrition, distinct fat thresholds, reduced muscle mass, and a predisposition for hepatic fat accumulation from certain dietary choices cumulatively precipitating a decline in insulin sensitivity. As T2DM ensues, the β-cell adaptive responses are suboptimal, precipitating a transition from compensatory hyperinsulinemia to β-cell decompensation, underscoring a reduced functional β-cell reserve in SAs. This review delves into the interplay of these mechanisms and highlights a prediabetes endotype tied to elevated vascular risk. Deciphering these mechanistic interconnections promises to refine stratification paradigms, surpassing extant risk-prediction strategies.
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Both conditions, influenced by cardiometabolic risk factors such as insulin resistance, hypertension, and central adiposity, manifest earlier and with unique thresholds in SAs. Epidemiological, demographic, nutritional, environmental, sociocultural, and economic transitions in SA have exacerbated the twin epidemic. The coupling of premature CAD and T2DM arises from increased obesity due to limited adipose storage, early-life undernutrition, distinct fat thresholds, reduced muscle mass, and a predisposition for hepatic fat accumulation from certain dietary choices cumulatively precipitating a decline in insulin sensitivity. As T2DM ensues, the β-cell adaptive responses are suboptimal, precipitating a transition from compensatory hyperinsulinemia to β-cell decompensation, underscoring a reduced functional β-cell reserve in SAs. This review delves into the interplay of these mechanisms and highlights a prediabetes endotype tied to elevated vascular risk. 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subjects Asians
Atherosclerosis
Australia
Bangladesh
Coronary heart disease
Development and progression
Dextrose
Epidemics
Epidemiology
Glucose
Hypertension
Insulin resistance
Lipoprotein A
Low density lipoproteins
Medical research
Medicine, Experimental
Mini-Review
Pakistan
Prediabetic state
Risk factors
South Asia
Type 2 diabetes
title Disentangling Dual Threats: Premature Coronary Artery Disease and Early-Onset Type 2 Diabetes Mellitus in South Asians
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