Association of Acculturation and Cardiometabolic Disease Incidence Among Immigrants of South Asian Ancestry in a National Biobank

BackgroundIndividuals of South Asian ancestry experience higher risk of cardiometabolic disease compared with most other groups, and the impact of acculturation on this risk warrants further study. MethodsWe studied individuals of South Asian (n=8,420) and European (n=441,696) ancestry free of baseline cardiometabolic disease in the UK Biobank prospective cohort. South Asians were divided into 3 acculturation groups based on time lived in UK: born in UK (n=801); born abroad, in UK >5yrs (n=7213), and born abroad, in UK [&le;]5yrs (n=406). We estimated the risk for incident coronary artery disease (CAD), type 2 diabetes mellitus, chronic kidney disease, ischemic stroke, and non-alcoholic fatty liver disease, comparing South Asian acculturation groups vs. European ancestry individuals using Cox proportional hazards regression. ResultsOver a median follow-up of 12 yrs, individuals of South Asian ancestry, regardless of acculturation group, had a higher risk of cardiometabolic disease when compared with European ancestry individuals. After adjusting for age and sex, the HR for CAD was 1.76 (95%CI 1.26-2.45;p=0.001) for UK-born South Asians; 2.00 (95%CI 1.86-2.16;p<0.001) for South Asians born abroad, in UK >5 yrs; and 2.03 (95%CI 1.42-2.91;p<0.001) for South Asians born abroad, lived in UK [&le;]5 yrs. Similarly elevated risk across groups was observed for DM and CKD. ConclusionIn a large prospective study, we show that individuals of South Asian (vs. European) ancestry are at higher risk for cardiometabolic disease, regardless of time lived in UK.