Lipoprotein abnormalities in South Asians and its association with cardiovascular disease:Current state and future directions

作     者：Ozlem Bilen Ayeesha Kamal Salim S Virani 

作者机构：Department of MedicineBaylor College of Medicine Section of NeurologyDepartment of MedicineAga Khan University Hospital 

出 版 物：《World Journal of Cardiology》 (世界心脏病学杂志（英文版）（电子版）)

年 卷 期：2016年第8卷第3期

页      面：247-257页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：Supported by The American Heart Association Beginning Grant--in--Aid,No.14BGIA20460366 the American Diabetes Association Clinical Science and Epidemiology award,No.1-14-CE-44 the Baylor College of Medicine Center for Globalization Award 

主　　题：Dyslipidemia South Asians Asian Indians Cardiovascular disease 

摘      要：South Asians have a high prevalence of coronary heart disease(CHD) and suffer from early-onset CHD compared to other ethnic groups. Conventional risk factors may not fully explain this increased CHD risk in this population. Indeed, South Asians have a unique lipid profile which may predispose them to premature CHD. Dyslipidemia in this patient population seems to be an important contributor to the high incidence of coronary atherosclerosis. The dyslipidemia in South Asians is characterized by elevated levels of triglycerides, low levels of high-density lipoprotein(HDL) cholesterol, elevated lipoprotein(a) levels, and a higher atherogenic particle burden despite comparable low-density lipoprotein cholesterol levels compared with other ethnic subgroups. HDL particles also appear to be smaller, dysfunctional, and proatherogenic in South Asians. Despite the rapid expansion of the current literature with better understanding of the specific lipid abnormalities in this patient population, studies with adequate sample sizes are needed to assess the significance and contribution of a given lipid parameter on overall cardiovascular risk in this population. Specific management goals and treatment thresholds do not exist for South Asians because of paucity of data. Current treatment recommendations are mostly extrapolated from Western guidelines. Lastly, large, prospective studies with outcomes data are needed to assess cardiovascular benefit associated with various lipid-lowering therapies(including combination therapy) in this patient population.