Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Aug 26, 2022; 14(8): 462-472
Published online Aug 26, 2022. doi: 10.4330/wjc.v14.i8.462
Cardiometabolic risk factors in young Indian men and their association with parameters of insulin resistance and beta-cell function
Yashdeep Gupta, Alpesh Goyal, Mani Kalaivani, Nikhil Tandon
Yashdeep Gupta, Alpesh Goyal, Nikhil Tandon, Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi 110029, Delhi, India
Mani Kalaivani, Department of Biostatistics, All India Institute of Medical Sciences, New Delhi 110029, Delhi, India
Author contributions: Gupta Y conceived the idea and wrote the manuscript; Goyal A, Kalaivani M, and Tandon N read and edited the manuscript; Kalaivani M did the statistical analysis; all authors approved the final version of this manuscript.
Institutional review board statement: This is a post-hoc analysis of the data collected in two previously published studies that primarily evaluated the concordance of cardiometabolic risk factors among spouses of women with hyperglycaemia in pregnancy. Both studies were approved by the institutional ethics committee, and written informed consent was obtained from all participants.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: Yashdeep Gupta, Alpesh Goyal, Mani Kalaivani, and Nikhil Tandon have nothing to disclose for this article.
Data sharing statement: Data can be shared on reasonable request to the corresponding author
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yashdeep Gupta, MD, Additional Professor, Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, Delhi, India. yash_deep_gupta@yahoo.co.in
Received: March 1, 2022
Peer-review started: March 1, 2022
First decision: April 17, 2022
Revised: April 29, 2022
Accepted: July 20, 2022
Article in press: July 20, 2022
Published online: August 26, 2022
Processing time: 170 Days and 9.7 Hours
ARTICLE HIGHLIGHTS
Research background

Existing data suggest significant beta cell dysfunction and insulin resistance (IR) in Asian Indians, even in the absence of diabetes. This dual pathophysiological defect, manifested at a lower body mass index (BMI) and younger age, explains the huge burden of dysglycaemia in South Asians. Importantly, most studies on this subject were performed in a relatively older population (mean age in 40s or 50s), in those at high risk for diabetes, screened and selected for clinical trials, or in individuals of this ethnicity residing outside South Asia. Thus, there is an unmet need to evaluate the burden of cardiometabolic risk factors in young South Asian adults, who are not preselected for glycaemia.

Research motivation

There is an unmet need to evaluate the burden of cardiometabolic risk factors in young South Asian adults, who are not preselected for glycaemia.

Research objectives

To evaluate young North Indian men (aged 20-50 years) for: (1) Burden of glycemic and cardiometabolic traits; and (2) Their relation to parameters of insulin action and beta-cell function.

Research methods

Study participants were invited in a fasting state. Sociodemographic, anthropometric, and medical data were collected, and 75 g oral glucose tolerance test was performed with serum insulin and plasma glucose estimation at 0, 30, and 120 min. Participants were divided into quartiles for homeostatic model assessment for IR (HOMA-IR) and oDI (category 1: Best HOMA-IR/oDI quartile; category 3: Worst HOMA-IR/oDI quartile) and composite HOMA-IR/oDI phenotypes (phenotype 1: Best quartile for both HOMA-IR and oDI; phenotype 4: Worst quartile for both HOMA-IR and oDI) were derived.

Research results

We evaluated a total of 635 men at a mean (± SD) age of 33.9 ± 5.1 years and BMI of 26.0 ± 3.9 kg/m2. Diabetes and prediabetes were present in 34 (5.4%) and 297 (46.8%) participants, respectively. Overweight/obesity, metabolic syndrome, and hypertension were present in 388 (61.1%), 258 (40.6%), and 123 (19.4%) participants, respectively. The prevalence of dysglycaemia, metabolic syndrome, and hypertension was significantly higher in participants belonging to the worst HOMA-IR and oDI quartiles, either alone (category 3 vs 1) or in combination (phenotype 4 vs 1). The adjusted odds ratios for dysglycaemia (6.5 to 7.0-fold), hypertension (2.9 to 3.6-fold), and metabolic syndrome (4.0 to 12.2-fold) were significantly higher in individuals in the worst quartile of HOMA-IR and oDI (category 3), compared to those in the best quartile (category 1). The adjusted odds ratios further increased to 21.1, 5.6, and 13.7, respectively, in individuals with the worst, compared to the best composite HOMA-IR/oDI phenotypes (phenotype 4 vs 1).

Research conclusions

The burden of cardiometabolic risk factors is high among young Asian Indian men. Our findings highlight the importance of using parameters of IR and beta-cell function in phenotyping individuals for cardiometabolic risk.

Research perspectives

We evaluated a large cohort of young Asian India men for the burden of cardiometabolic risk factors in relation to parameters of IR and beta-cell function. Apart from the traditional risk factors such as age and BMI, across which abnormal cardiometabolic traits increased, we found that individuals in the most severely affected quartiles of IR (HOMA-IR), beta-cell function (oDI), and a combination of both had a significantly higher burden of dysglycaemia, hypertension, metabolic syndrome, and adverse lipid parameters. These findings highlight the importance of using parameters of IR and beta-cell function in phenotyping individuals for cardiometabolic risk.