Abstract
Inflammation, a vascular risk factor, is more pronounced among ethnic South Asians
compared to ethnic Chinese in the general population. We compared serum erythrocyte
sedimentation rate (ESR) levels between ethnic South Asian and Chinese acute ischemic
stroke patients, and further investigated if metabolic syndrome or central obesity
could account for any difference detected. We prospectively recruited consecutive
ischemic stroke patients within seven days of onset. Measurement of serum ESR was
performed within two days of admission. Median serum ESR was higher among the 55 ethnic
South Asian (16 mm/h IQR 3–35) compared to the 165 ethnic Chinese patients (9 mm/h
IQR 4–19), p=0.004). Serum ESR was correlated with age. Higher serum ESR was associated with female
gender, non-smokers, patients with central obesity and low high-density lipoprotein
(HDL) cholesterol. Using regression analysis, South Asian ethnicity remained significantly
associated with serum ESR, independent of age, gender, smoking status, metabolic syndrome,
central obesity and low HDL. Ethnic South Asian ischemic stroke patients have a higher
inflammatory state compared to ethnic Chinese patients. As the higher inflammatory
state is independent of demographic and risk factors, we propose an underlying genetic
or cultural basis for the ethnic difference.
Keywords
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References
www.international.ucla.edu/eas/statistics/wb-population.html: Accessed 18 November 2007.
- The global burden of disease.in: World Health Organisation. Harvard University Press, Massachusetts1996
- Evidence-based health policy — lessons from the global burden of disease study.Science. 1996; 274: 740-743
- Ethnic differences in acute myocardial infarction in Singapore.Eur Heart J. 2003; 24: 151-160
- Antecedent risk factors and their control in young patients with a first myocardial infarction.Singap Med J. 2006; 47: 27-30
- Premature myocardial infarction in Singapore — risk factor analysis and clinical features.Singap Med J. 1996; 37: 31-33
- Young ischaemic stroke patients in Singapore General Hospital.J of Clin Neurosci. 2004; 11: S34
- Low grade inflammation and coronary heart disease: prospective study and updated meta-analyses.BMJ. 2000; 321: 199-204
- C-reactive protein as a screening test for cardiovascular risk in a multiethnic population.Arterioscler Thromb Vasc Biol. 2004; 24: 1509-1515
- C-reactive protein, insulin resistance, central obesity, and coronary heart disease risk in Indian Asians from the United Kingdom compared with European whites.Circulation. 2001; 104: 145-150
- High-sensitivity C-reactive protein is predictive of medium-term cardiac outcome in high-risk Asian patients presenting with chest pain syndrome without myocardial infarction.Ann Acad Med Singap. 2004; 33: 407-412
- Metabolic syndrome among ethnic South Asian patients with ischemic stroke and comparison with ethnic Chinese patients: the Singapore General Hospital experience.J Stroke Cerebrovasc Dis. 2007; 16: 119-121
- Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAT. Trial of org 10172 in acute stroke treatment.Stroke. 1993; 24: 35-41
- Executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III).JAMA. 2001; 285: 2486-2497
- Steering committee of the World Health Organisation western pacific region, internal association of the study of obesity and international obesity task force: the Asia-Pacific perspective.in: Redefining obesity and its treatment. Health Communications, Sydney2000
- Inflammation and atherosclerosis.Annu Rev Pathol. 2006; 1: 297-329
- Role of inflammation in stroke and atherothrombosis.Cerebrovasc Dis. 2004; 17: 1-5
- Applicability of biomarkers in ischemic stroke.Cerebrovasc Dis. 2007; 24: 7-15
- Proinflammatory cytokines in serum of patients with acute cerebral ischemia: kinetics of secretion and relation to the extent of brain damage and outcome of disease.J Neurol Sci. 1994; 122: 135-139
- The gene encoding 5-lipoxygenase activating protein confers risk of myocardial infarction and stroke.Nat Genet. 2004; 36: 233-239
- A variant of the gene encoding leukotriene A4 hydrolase confers ethnicity-specific risk of myocardial infarction.Nat Genet. 2006; 38: 68-74
- Dietary fat interacts with the -514c>t polymorphism in the hepatic lipase gene promoter on plasma lipid profiles in a multiethnic Asian population: the 1998 Singapore national health survey.J Nutr. 2003; 133: 3399-3408
- Vitamins, selenium, iron, and coronary heart disease risk in Indians, Malays, and Chinese in Singapore.J Epidemiol Community Health. 1998; 52: 181-185
- Levels of cardiovascular disease risk factors in Singapore following a national intervention programme.Bull World Health Organ. 2001; 79: 908-915
- Association between C-reactive protein and features of the metabolic syndrome: a population-based study.Diabetes Care. 2000; 23: 1835-1839
Article info
Publication history
Accepted:
September 16,
2008
Received in revised form:
September 10,
2008
Received:
June 9,
2008
Identification
Copyright
© 2008 Elsevier B.V. Published by Elsevier Inc. All rights reserved.