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Objectives— The objective of this study was to examine determinants of excess coronary artery disease risk in UK South Asians, more prevalent in this population than UK Caucasians, by examining differences in risk factors, vascular function, and endothelial progenitor cells (EPCs). Methods and Results— 24 South Asian and 25 Caucasian healthy age-matched nonsmoking men were studied. Vascular function was assessed by flow-mediated and GTN brachial artery dilatation and blood flow responses to infusion of ACh, SNP, and L-NMMA. EPC number and function were measured by flow cytometry (CD34, CD133, and KDR positive cells), and CFU/migration assays. Traditional risk factors and anthropometric measurements were similar in the groups. South Asians had higher fasting insulin levels (6.01 versus 3.62 μU/mL; P =0.02). South Asians had lower FMD (6.9 versus 8.5%; P =0.003), L-NMMA response (0.8 versus 1.3 mL/min/100 mL; P =0.03), mean SNP response (9.5±0.6 versus 11.6±0.6; P =0.02), EPC number (0.046±0.005% versus 0.085±0.009%; P =< 0.001), and CFU ability (CFU 4.29±1.57 versus 18.86±4.00; P =0.005). EPC number was the strongest predictor of FMD. Ethnicity was the strongest predictor of EPC number. Conclusions— Healthy South Asian men are more insulin resistant, and demonstrate endothelial dysfunction and reduced EPC number and function compared with Caucasians. These abnormalities may contribute to their increased CAD risk.

Objective— Autopsy studies show that intimal lipid accumulations in arteries are often present at birth, suggesting that the prenatal environment plays a role in the pathogenesis of atherosclerosis. In animal models, a restricted or unbalanced maternal diet during gestation can influence susceptibility to atherosclerosis, but the relation in humans between maternal diet during pregnancy and atherogenesis is unknown. Methods and Results— We measured carotid intima–media thickness (IMT) in 216 nine-year-old children whose mothers had participated in a study of nutrition during pregnancy. IMT was greater in boys, in children who were heavier, in those with higher systolic blood pressure, and in those who took less exercise. Increased IMT was associated with a lower maternal energy intake in early ( P =0.029) or late ( P =0.006) pregnancy, after adjustment for these factors. Mean IMT of children whose mothers were in the lowest quarter of the distribution of energy intake in late pregnancy was 0.027 mm (95% confidence interval, 0.004 to 0.049) greater than that of those whose mothers were in the highest quarter of the distribution. Conclusion— Lower maternal energy intake during pregnancy may increase the susceptibility to atherogenesis of the child.