Cardiovascular disease risk factors in 2 distinct ethnic groups: Indian and Pakistani compared with American premenopausal women

Background: Although people from the Indian subcontinent have high rates of cardiovascular disease (CVD), studies of such in Indian and Pakistani wome n living in the United States are lacking. Objective: This study accounted for variability in serum lipid (total chole sterol and triacylglycerol) and lipoprotein [LDL cholesterol, lipoprotein(a ), and HDL cholesterol] concentrations in Indian and Pakistani compared wit h American premenopausal women in the United States. Body composition, regi onal fat distribution, dietary intake, and energy expenditure were compared between groups. Design: The 2 groups were 47 Indian and Pakistani and 47 American women. He alth was assessed via medical history, physical activity, body composition (via anthropometry and dual-energy X-ray absorptiometry), dietary intake (v ia 7-d food records), and serum lipids. Results: Serum total cholesterol, triacylglycerol, LDL cholesterol, lipopro tein(a), the ratio of total to HDL cholesterol, and the ratio of LDL to HDL cholesterol were greater (P < 0.03), whereas HDL-cholesterol values were l ower (P = 0.011) in Indians and Pakistanis than in Americans. Multiple regr ession analysis indicated that approximate to 18% of the variance in total cholesterol (P = 0.0010) and LDL cholesterol (P = 0.0009) was accounted for by ethnicity, energy expenditure, and the ratio of the sum of central to t he sum of peripheral skinfold thicknesses. Ethnicity, sum of central skinfo ld thicknesses, ratio of polyunsaturated to saturated fat, and monounsatura ted fat intake accounted for approximate to 43% of the variance in triacylg lycerol concentration (P less than or equal to 0.0001). Monounsaturated fat , percentage body fat, and alcohol intake accounted for approximate to 26% of variance in HDL cholesterol. Ethnicity contributed approximate to 22% of the 25% overall variance in lipoprotein(a). Conclusions: Results suggest that these Indian and Pakistani women are at h igher CVD risk than their American counterparts, but that increasing their physical activity is likely to decrease overall and regional adiposity, the reby improving their serum lipid profiles.