South Asian individuals (SAs) are one of the fastest-growing minority groups in the U.S., and have been found to have markedly increased risk of atherosclerotic cardiovascular disease (ASCVD) compared with most other groups. SAs often present with heart disease at a much younger age (7-10 years younger than white persons) and with much more extensive disease. South Asian ethnicity is now recognized as a “risk enhancing factor” in the 2018 ACC/AHA prevention guidelines, and South Asian country of origin is part of the QRISK2/3 risk calculator used in the U.K. Reducing morbidity and mortality in SAs is a clear priority and unmet need.
Excess cardio-metabolic dysfunction differentiates SAs vs. non-SAs, characterized primarily by premature insulin resistance, increased ectopic fat, and higher risk of type 2 diabetes (T2DM). The etiology of excess cardiometabolic dysfunction in SAs is not well differentiated and likely multifactorial. The various pathways linked to this excess risk must be explored, such as lifestyle, genetics, body composition, and lipoprotein metabolism. Elucidating these pathways will facilitate improved identification of risk factors and potential therapeutic targets to reduce this excess risk.
Our present study aims to assess cardiometabolic risk in South Asians as it relates to lifestyle, genetics, body composition, and lipoprotein metabolism. We hope to determine the contribution of these risk factors to a wide range of cross-sectional and longitudinal cardiometabolic phenotypes in SAs compared to non-SAs. The anticipated duration of this project is 12 months from data collection.