Inflammation in Relation to Cardiovascular Disease Risk: Comparison of Black and White Women in the United States, Unite
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Inflammation in Relation to Cardiovascular Disease Risk: Comparison of Black and White Women in the United States, United Kingdom, and South Africa Juliet Evans & Julia H. Goedecke
Published online: 18 March 2011 # Springer Science+Business Media, LLC 2011
Abstract Ethnic differences in the prevalence of cardiovascular disease and type 2 diabetes mellitus and associated metabolic risk factors have been shown in both developed and developing countries. This review explores the hypothesis that ethnic differences in the inflammatory response are associated with the disparities in disease risk in black and white women from South Africa, the United States of America, and the United Kingdom. Higher inflammatory profiles at the genetic, adipose tissue, and circulating level have been reported in black compared to white women but do not explain the disparity in disease risk between black and white women. Ethnic differences in inflammation and their association with disease risk have been shown to be partly mediated by differences in underlying genetic variation, body fat and its distribution, socioeconomic status and lifestyle factors, as well as their interactions. Keywords High-sensitivity C-reactive protein . Interleukin-6 . Interleukin-18 . Tumor necrosis factor-alpha . Ethnicity . Race . Adipose tissue distribution . Visceral adipose tissue . Subcutaneous adipose tissue . Genetics . Type 2 diabetes . Cardiovascular disease . Metabolic risk J. Evans : J. H. Goedecke (*) UCT/MRC Research Unit for Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, 3rd Floor Sports Science Institute of South Africa, Boundary Road, Newlands 7700, South Africa e-mail: [email protected] J. Evans e-mail: [email protected] J. H. Goedecke South African Medical Research Council, Parow, South Africa
factors . Socioeconomic status . Lifestyle factors . Insulin resistance . Dyslipidemia . Hypertension . Circulating inflammatory markers
Introduction Ethnic differences in the prevalence of non-communicable diseases and associated metabolic risk factors occur in both developed and developing countries. Data from the United States of America (USA), United Kingdom (UK), and South Africa (SA) show that white individuals have a higher prevalence of acute coronary syndromes, atherogenic dyslipidemia, and ischemic heart disease, whereas black individuals have a higher prevalence of insulin resistance, type 2 diabetes mellitus (T2DM), hypertension, and stroke [1–4]. Although these differences are likely related to differential clustering of risk factors [5•, 6] and socioeconomic status (SES) variables [7••] between these populations, it has recently been hypothesised that ethnic differences in the inflammatory response may explain ethnic disparities in the risk for cardiovascular disease (CVD) and T2DM [8]. It is established that a state of chronic low-grade inflammation is present in obesity, T2DM, and CVD [9]. Increased circulating levels of inflammatory proteins, such as proinflammatory cytokines, acu
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