Metabolic syndrome and the Asian Indian diaspora

Objective: Asian Indians experience a disproportionate burden of diabetes and heart disease as compared to other racial ethnic groups in the U.S. Metabolic syndrome [MetS] is a clustering of risk factors and has been implicated for enhanced susceptibility to diabetes and CVD. The objective of this study was to compare the prevalence of MetS among Asian Indians [AIs] in the US and Urban/Rural Indians in India using the ethnic specific International Diabetes Federation (IDF) criteria. A bi-national comparative study allowed the examination of multiple determinants of metabolic syndrome while controlling for ethnic and genetic origin. Method: The sample comprised of 1038 randomly selected Asian Indians (>18 years of age) in seven US site, 508 urban Indians in New Delhi and 599 rural Indians in Tami Nadu. Data collection involved survey interviews and clinical and anthropometric information. Results: Mean age was 39.48±13.86 years, 42.65±11.78 years and 45.7±12.8 years for rural, urban and immigrant AIs. The age-adjusted prevalence of MetS was 38.2% among Indian Americans and 39.2% and 10.5% among urban and rural Indians. The most frequent contributing components of MetS in the immigrant AIs were high triglyceride, impaired blood glucose, abdominal obesity and low HDL. Urban Indians had higher blood pressure, triglyceride, low HDL, and abdominal obesity; rural Indians had low levels of HDL and higher triglycerides. There were significant gender differences in the prevalence of MetS and four of the five individual components of metabolic syndrome. Females had a higher frequency of abdominal obesity and low HDL-C levels, while males had a higher frequency of hypertriglyceridemia and hypertension. Conclusion: The higher prevalence of MetS in immigrant AIs/urban Indians is fuelled by obesity, higher triglycerides and low HDL, possibly resulting from altered lifestyle and diet related to urbanization. Population-based and gender-specific prevention strategies are necessary for this ethnic group.