Pathogenesis of type 2 diabetes and cardiovascular disease in South Asians: effects of dietary interventions on metabolism and cardiovascular function

Bakker, L.E.H. (2015)

Doctoral Thesis

People of South Asian origin have an increased risk of developing type 2 diabetes (T2D) and cardiovascular disease (CVD) compared to people of Western European descent. Not only is the prevalence of these diseases higher in South Asians, they also occur at a younger age and lower BMI, and have a more severe course. The high prevalence of T2D and CVD in South Asians, who comprise one fifth of the total world__s population, poses a major health and socioeconomic burden worldwide. The underlying cause of this excess risk is, however, still poorly understood. The studies described in this thesis were performed to gain more insight in the pathogenesis of T2D and CVD in South Asians and to provide new leads for preventive strategies and treatment options. For this purpose sophisticated techniques were used such as hyperinsulinemic-euglycemic clamp with stable isotopes, indirect calorimetry, skeletal muscle biopsies, MRI and spectroscopy, and brown fat quantification using PET-CT-imaging, combined with short-term dietary interventions, in healthy lean young adult men and overweight adult men. These studies have led to a number of promising areas for further research. It seems that not one, but multiple metabolic mechanisms have been affected, most likely due to gene-environment interactions.

• Cardiovascular function
• MRI
• Clamp
• HDL function
• Brown adipose tissue
• mTOR
• Metabolic flexibility
• Insulin resistance
• Ethnicity
• South Asian

• All authors: Bakker, L.E.H.
• Supervisor: Meinders, A.E.; Pijl, H.
• Co-supervisor: Jazet, I.M.
• Qualification: Doctor (dr.)
• Awarding Institution: Leiden University Medical Center (LUMC), Leiden University
• Date: 2015-02-18
• ISBN (print): 9789461696137