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      Adult nontwin sib concordance rates for type 2 diabetes, hypertension and metabolic syndrome among Asian Indians: The Indian Atherosclerosis Research Study

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          Abstract

          Diabetes (DM), hypertension (HTN), and metabolic syndrome (MS) are established cardiovascular risk factors with a complex etiology. The aim of the present study was to estimate the rates of concordance for the above coronary risk factors between siblings in Asian Indian families with premature coronary artery disease (CAD). Spouse concordance rates were used to evaluate the relative contribution of shared genes and lifestyle towards these traits. A total of 508 families comprising of 1250 sib-pairs and 463 corresponding spouse-pairs were analyzed. Concordance rates were manually determined. Plasma lipids were estimated by standard enzymatic assay. The concordance rates among sib-pairs for DM, HTN, and MS was 11% (N = 136), 14% (N = 174), and 23% (N = 287), while the corresponding concordance for spouse-pairs was 2.8% (N = 13), 6.3% (N = 29), and 28.1% (N = 130), respectively. Employing Chi-square test, sib-pairs showed significantly higher concordance for diabetes (p ≤ 0.0001) and hypertension (p < 0.0001) while spouse-pairs had higher concordance for metabolic syndrome (p = 0.033) in our study. These findings suggest a probable dominant genetic component in the causation of DM and HTN and a predominantly nongenetic component for metabolic syndrome among Asian Indians.

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          Genomewide association analysis of coronary artery disease.

          Nilesh J. Samani, Jeanette Erdmann, Alistair S. Hall … (2007)
          Modern genotyping platforms permit a systematic search for inherited components of complex diseases. We performed a joint analysis of two genomewide association studies of coronary artery disease. We first identified chromosomal loci that were strongly associated with coronary artery disease in the Wellcome Trust Case Control Consortium (WTCCC) study (which involved 1926 case subjects with coronary artery disease and 2938 controls) and looked for replication in the German MI [Myocardial Infarction] Family Study (which involved 875 case subjects with myocardial infarction and 1644 controls). Data on other single-nucleotide polymorphisms (SNPs) that were significantly associated with coronary artery disease in either study (P 80%) of a true association: chromosomes 1p13.3 (rs599839), 1q41 (rs17465637), 10q11.21 (rs501120), and 15q22.33 (rs17228212). We identified several genetic loci that, individually and in aggregate, substantially affect the risk of development of coronary artery disease. Copyright 2007 Massachusetts Medical Society.
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            Trends in hypertension epidemiology in India.

            R. Gupta (2004)
            Cardiovascular diseases caused 2.3 million deaths in India in the year 1990; this is projected to double by the year 2020. Hypertension is directly responsible for 57% of all stroke deaths and 24% of all coronary heart disease deaths in India. Indian urban population studies in the mid-1950s used older WHO guidelines for diagnosis (BP > or =160 and/or 95 mmHg) and reported hypertension prevalence of 1.2-4.0%. Subsequent studies report steadily increasing prevalence from 5% in 1960s to 12-15% in 1990s. Hypertension prevalence is lower in the rural Indian population, although there has been a steady increase over time here as well. Recent studies using revised criteria (BP > or =140 and/or 90 mmHg) have shown a high prevalence of hypertension among urban adults: men 30%, women 33% in Jaipur (1995), men 44%, women 45% in Mumbai (1999), men 31%, women 36% in Thiruvananthapuram (2000), 14% in Chennai (2001), and men 36%, women 37% in Jaipur (2002). Among the rural populations, hypertension prevalence is men 24%, women 17% in Rajasthan (1994). Hypertension diagnosed by multiple examinations has been reported in 27% male and 28% female executives in Mumbai (2000) and 4.5% rural subjects in Haryana (1999). There is a strong correlation between changing lifestyle factors and increase in hypertension in India. The nature of genetic contribution and gene-environment interaction in accelerating the hypertension epidemic in India needs more studies. Pooling of epidemiological studies shows that hypertension is present in 25% urban and 10% rural subjects in India. At an underestimate, there are 31.5 million hypertensives in rural and 34 million in urban populations. A total of 70% of these would be Stage I hypertension (systolic BP 140-159 and/or diastolic BP 90-99 mmHg). Recent reports show that borderline hypertension (systolic BP 130-139 and/or diastolic BP 85-89 mmHg) and Stage I hypertension carry a significant cardiovascular risk and there is a need to reduce this blood pressure. Population-based cost-effective hypertension control strategies should be developed.
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              Cutoff values for normal anthropometric variables in asian Indian adults.

              Chamukuttan Snehalatha, Ambady Ramachandran, Vijay Viswanathan (2003)
              Asian Indians have a high risk of developing glucose intolerance with small increments in their BMI. They generally have high upper-body adiposity, despite having a lean BMI. Therefore, this analysis was performed to find out the normal cutoff values for BMI and upper-body adiposity (waist circumference [WC] or waist-to-hip ratio [WHR]) by computing their risk associations with diabetes. The risk of diabetes with stratified BMI, WC, or WHR was computed in 10,025 adults aged > or =20 years without a history of diabetes, and they were tested by oral glucose tolerance tests, using World Health Organization criteria. The calculations were performed separately in men and women using diabetes as the dependent variable versus normoglycemia (normal glucose tolerance) in multiple logistic regression analyses. Age-adjusted and stratified BMI, WC, or WHR were used as the independent variables, using the first stratum as the reference category. The upper limit of the stratum above which the risk association became statistically significant (P < 0.05) was considered to be the cutoff for normal values. Normal cutoff values for BMI was 23 kg/m(2) for both sexes. Cutoff values for WC were 85 and 80 cm for men and women, respectively; the corresponding WHRs were 0.88 and 0.81, respectively. Optimum sensitivity and specificity obtained from the receiver operator characteristic curve corresponded to these cutoff values. The cutoff value for normal BMI for men and women was 23 kg/m(2). The cutoff values for WC and WHR were lower in women than in men. The values were significantly lower compared with the corresponding values in white populations.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Vasc Health Risk Manag
                Journal ID (publisher-id): Therapeutics and Clinical Risk Management
                Title: Vascular Health and Risk Management
                Publisher: Dove Medical Press
                ISSN (Print): 1176-6344
                ISSN (Electronic): 1178-2048
                Publication date (Print): December 2007
                Volume: 3
                Issue: 6
                Pages: 1063-1068
                Affiliations
                [1 ]Mary and Garry Weston Functional Genomics Unit, Thrombosis Research Institute Bangalore, India
                [2 ]Tata Proteomics and Coagulation Unit, Thrombosis Research Institute Bangalore, India
                [3 ]Cardiology Division, St. Johns’ Medical College and Hospital Bangalore, India
                [4 ]University Department of Chemical Technology Mumbai, India
                [5 ]Founder Chairman, Thrombosis Research Institute London, UK
                Author notes
                Correspondence: Jayashree Shanker 258/A, Narayana Hrudayalaya, Bommasandra Industrial area, Anekal Taluk, Bangalore 560099, India Tel +91 80 7835 3030 Fax +91 80 7835 3020, Email jayashreeshanker@ 123456triindia.org.in
                Article
                PMC ID: 2350127
                PubMed ID: 18200825
                SO-VID: ddf0857b-bb93-4069-a819-6873a087d9a8
                Copyright © © 2007 Shanker et al, publisher and licensee Dove Medical Press Ltd.
                History
                Categories
                Subject: Original Research

                ScienceOpen disciplines: Cardiovascular Medicine
                Keywords: type 2 diabetes,metabolic syndrome,cad,hypertension,concordance,spouse-pairs,sib-pairs,asian indians
                Data availability:
                ScienceOpen disciplines: Cardiovascular Medicine
                Keywords: type 2 diabetes, metabolic syndrome, cad, hypertension, concordance, spouse-pairs, sib-pairs, asian indians

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