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Vascular dysfunction and reduced circulating endothelial progenitor cells in young healthy UK South Asian men
Cliona Murphy1, Gajen S Kanaganayagam, Benyu Jiang
1Cardiovascular Division, Kings College London, London, UK.
Insights
South Asian men have higher insulin resistance, impaired vascular function, and fewer endothelial progenitor cells (EPCs) compared to Caucasian men, increasing their coronary artery disease (CAD) risk.
Area of Science:
- Cardiovascular Research
- Vascular Biology
- Ethnic Health Disparities
Background:
- Coronary artery disease (CAD) risk is elevated in UK South Asians compared to UK Caucasians.
- Understanding the underlying determinants of this disparity is crucial for targeted prevention strategies.
Purpose of the Study:
- To investigate the factors contributing to excess CAD risk in UK South Asians.
- To compare risk factors, vascular function, and endothelial progenitor cell (EPC) characteristics between South Asian and Caucasian men.
Main Methods:
- A comparative study involving healthy, age-matched, non-smoking South Asian (n=24) and Caucasian (n=25) men.
- Vascular function assessed via flow-mediated dilation (FMD), GTN response, and responses to acetylcholine (ACh), SNP, and L-NMMA infusions.
- EPCs quantified using flow cytometry and assessed for function via CFU/migration assays.
Main Results:
- South Asians exhibited higher fasting insulin levels and significantly lower FMD, L-NMMA response, and SNP response.
- Reduced EPC number and impaired EPC colony-forming (CFU) ability were observed in South Asians.
- EPC number was the strongest predictor of FMD, while ethnicity was the strongest predictor of EPC number.
Conclusions:
- Healthy South Asian men present with increased insulin resistance, endothelial dysfunction, and diminished EPC quantity and function compared to Caucasians.
- These physiological differences likely contribute to the heightened CAD risk observed in the South Asian population.
Objectives:
The objective of this study was to examine determinants of excess coronary artery disease risk in UK South Asians, more prevalent in this population than UK Caucasians, by examining differences in risk factors, vascular function, and endothelial progenitor cells (EPCs).
Methods And Results:
24 South Asian and 25 Caucasian healthy age-matched nonsmoking men were studied. Vascular function was assessed by flow-mediated and GTN brachial artery dilatation and blood flow responses to infusion of ACh, SNP, and L-NMMA. EPC number and function were measured by flow cytometry (CD34, CD133, and KDR positive cells), and CFU/migration assays. Traditional risk factors and anthropometric measurements were similar in the groups. South Asians had higher fasting insulin levels (6.01 versus 3.62 microU/mL; P = 0.02). South Asians had lower FMD (6.9 versus 8.5%; P = 0.003), L-NMMA response (0.8 versus 1.3 mL/min/100 mL; P = 0.03), mean SNP response (9.5+/-0.6 versus 11.6+/-0.6; P = 0.02), EPC number (0.046+/-0.005% versus 0.085+/-0.009%; P = < 0.001), and CFU ability (CFU 4.29+/-1.57 versus 18.86+/-4.00; P = 0.005). EPC number was the strongest predictor of FMD. Ethnicity was the strongest predictor of EPC number.
Conclusions:
Healthy South Asian men are more insulin resistant, and demonstrate endothelial dysfunction and reduced EPC number and function compared with Caucasians. These abnormalities may contribute to their increased CAD risk.
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