Mediators of Atherosclerosis in South Asians Living in America

生活在美国的南亚人动脉粥样硬化的介质

基本信息

批准号：
7779527
负责人：
ALKA M. KANAYA
金额：
$ 71.71万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-04-01 至 2014-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7779527
关键词：
Abdomen Adipose tissue Adult African American Age Alcohol consumption Americas Ankle Anthropometry Area Asian Indian Atherosclerosis Bangladesh Behavioral Blood Blood Pressure Body Weight Body mass index C-reactive protein Calcium California Cardiac Cardiovascular Diseases Cardiovascular system Cause of Death Chicago Chinese American Cohort Studies Communities Coronary artery Cross-Sectional Studies Data Collection Diabetes Mellitus Disease Outcome Disease Progression Enrollment Ethnic group Etiology Event Fasting Funding Future Glucose tolerance test High Density Lipoprotein Cholesterol High Prevalence Homocysteine Homocystine Hour Hypertension India Individual Insulin Resistance Latino Life Link Lipoprotein (a)Longitudinal Studies Mails Measures Mediator of activation protein Medical Records Metabolic Methods Microalbuminuria Minority Groups Modeling Nepal Obesity Pakistan Participant Pathogenesis Phenotype Pilot Projects Plasminogen Activator Inhibitor 1 Population Prevalence Reporting Research Personnel Risk Factors Sampling San Francisco Site Smoking Socioeconomic Factors South Asian Sri Lanka Telephone Testing Thick Ultrasonography United States Universities Urine Visceral Visit Woman X-Ray Computed Tomography adiponectin adjudicate base cardiovascular disorder risk cardiovascular risk factor diet and exercise ethnic minority population factor C follow-up high risk indexing insight interest intima media men novel population based prevent prognostic prospective public health relevance sex social socioeconomics waist circumference

项目摘要

DESCRIPTION (provided by applicant): South Asians (individuals from India, Pakistan, Nepal, Bangladesh, and Sri Lanka) represent a quarter of the world's population and are one of the fasting growing ethnic groups in the United States. Several cross-sectional studies conducted worldwide have reported a high prevalence of atherosclerosis, diabetes, hypertension, and cardiovascular disease in this ethnic group, despite low body mass index. However, there are no longitudinal studies of South Asians to determine other risk factors that may explain the high prevalence of cardiovascular disease. We performed a pilot community-based cross-sectional study of South Asian men and women in the San Francisco Bay Area. We collaborated with investigators involved with the Multi-Ethnic Study of Atherosclerosis (MESA), an NHLBI-supported prospective cohort study of four U.S. ethnic groups (Whites, African Americans, Latinos, and Chinese Americans). We used identical methods and measures for data collection to efficiently compare the South Asian sample with the MESA ethnic groups. We found that South Asians had higher socioeconomic attainment, lower smoking and alcohol use, relatively low BMI and waist circumference, and higher hypertension and diabetes prevalence. Common carotid intima media thickness was significantly higher in the South Asians compared to all ethnic groups in MESA, but coronary artery calcium scores were similar to all other ethnic groups. We now propose a prospective cohort study of 900 South Asian individuals to determine other risk factors linked to atherosclerosis and disease progression. We will conduct a two-center prospective cohort study of 900 South Asian adults between the ages of 40 and 79 years without cardiovascular disease from the San Francisco Bay Area and Chicago area to determine etiologic associations and prognostic significance of subclinical atherosclerosis and to compare these findings with other U.S. ethnic groups in MESA. Our specific aims are to determine whether (1) traditional, social/cultural/behavioral and novel risk factors are associated with subclinical atherosclerosis measures; (2) South Asians have higher prevalence of subclinical atherosclerosis than the four ethnic groups in the MESA 5th examination after adjusting for traditional, social/behavioral, and novel risk factors. In an exploratory aim, we will determine whether measures of subclinical atherosclerosis are associated with incident cardiovascular events after 2 years of follow-up. Understanding the antecedents of atherosclerosis in this high-risk ethnic population may lend insight into the pathogenesis of cardiovascular disease in general. The identification of key risk factors that are linked to atherosclerosis will provide targets for future therapies to prevent or cure the leading cause of death worldwide - cardiovascular disease. PUBLIC HEALTH RELEVANCE: South Asian (Indian, Pakistani, Bangladeshi, Nepali, and Sri Lankan) individuals have high rates of cardiovascular disease that is not explained by traditional cardiovascular risk factors. Though South Asians represent over one-quarter of the world's population, there are no longitudinal studies in this high-risk ethnic group. We aim to establish a longitudinal study of South Asians at two U.S. centers to identify risk factors linked to subclinical atherosclerosis and incident cardiovascular disease. These will provide targets for future therapies to prevent or cure the leading cause of death worldwide, cardiovascular disease.

描述（由申请人提供）：南亚人（来自印度、巴基斯坦、尼泊尔、孟加拉国和斯里兰卡的人）占世界人口的四分之一，是美国快速增长的族裔群体之一。世界范围内进行的几项横断面研究报告称，尽管该族群的体重指数较低，但动脉粥样硬化、糖尿病、高血压和心血管疾病的患病率很高。然而，目前还没有针对南亚人的纵向研究来确定可能解释心血管疾病高患病率的其他危险因素。我们对旧金山湾区的南亚男性和女性进行了一项基于社区的试点横断面研究。我们与参与动脉粥样硬化多种族研究 (MESA) 的研究人员合作，这是一项由 NHLBI 支持的针对美国四个族裔（白人、非裔美国人、拉丁裔和华裔美国人）的前瞻性队列研究。我们使用相同的数据收集方法和措施来有效地将南亚样本与 MESA 族群进行比较。我们发现南亚人的社会经济成就较高，吸烟和饮酒较少，体重指数和腰围相对较低，高血压和糖尿病患病率较高。与 MESA 的所有种族相比，南亚人的颈总动脉内膜中层厚度显着较高，但冠状动脉钙评分与所有其他种族相似。我们现在提议对 900 名南亚人进行一项前瞻性队列研究，以确定与动脉粥样硬化和疾病进展相关的其他危险因素。我们将对来自旧金山湾区和芝加哥地区的 900 名年龄在 40 岁至 79 岁之间、无心血管疾病的南亚成年人进行一项两中心前瞻性队列研究，以确定亚临床动脉粥样硬化的病因关联和预后意义，并比较这些研究结果与 MESA 的其他美国族裔群体。我们的具体目标是确定（1）传统、社会/文化/行为和新的危险因素是否与亚临床动脉粥样硬化措施相关； (2) 在调整传统、社会/行为和新的危险因素后，在 MESA 第五次检查中，南亚人的亚临床动脉粥样硬化患病率高于四个民族。在探索性目标中，我们将在两年的随访后确定亚临床动脉粥样硬化的测量是否与心血管事件相关。了解这一高危种族人群中动脉粥样硬化的前因可能有助于深入了解心血管疾病的发病机制。识别与动脉粥样硬化相关的关键危险因素将为未来预防或治愈全球主要死亡原因——心血管疾病的治疗提供目标。公共卫生相关性：南亚人（印度、巴基斯坦、孟加拉国、尼泊尔和斯里兰卡）的心血管疾病发病率很高，而传统的心血管危险因素无法解释这一点。尽管南亚人占世界人口的四分之一以上，但目前还没有针对这一高风险族群的纵向研究。我们的目标是在美国两个中心对南亚人进行纵向研究，以确定与亚临床动脉粥样硬化和心血管疾病相关的危险因素。这些将为未来预防或治疗全球主要死因心血管疾病的治疗提供目标。