When it comes to heart and metabolic health, South Asians carry unique risks that routine lab work can often miss. Genetics, lifestyle, and diet patterns combine to create higher rates of diabetes and heart disease, sometimes at younger ages and with fewer obvious warning signs. Paying closer attention to certain labs can make all the difference in catching risks early and preventing complications. Here are the top three areas to focus on.
1. Cholesterol Beyond LDL: ApoB and Lipoprotein(a)
Most standard blood tests measure LDL cholesterol, but for South Asians, this doesn’t tell the full story. Two important markers to ask about are Apolipoprotein B (ApoB) and Lipoprotein(a), often written as Lp(a). ApoB reflects the total number of cholesterol-carrying particles in the blood, which drives plaque buildup in arteries. Lp(a) is a genetic cholesterol particle that can sharply increase heart disease risk, even if LDL looks normal. Both are simple blood tests but need to be ordered separately. If either is elevated, your doctor may recommend earlier lifestyle changes or medication to reduce risk.
2. Glucose Control: A1c and Early Diabetes Screening
South Asians are at higher risk of type 2 diabetes at younger ages and lower body weights. A hemoglobin A1c test measures average blood sugar over three months and can pick up early changes before full diabetes develops. Current guidelines suggest considering screening as early as age 35, but for South Asians, many experts recommend starting in the late 20s or early 30s, especially if there is family history. Even a “borderline” A1c (5.7–6.4%) deserves attention, since it can progress quickly if not managed.
3. Triglycerides and Metabolic Syndrome
Triglycerides are another type of cholesterol in the blood that often run high in South Asians, even when LDL looks fine. Elevated triglycerides can signal insulin resistance, which can influence belly fat, diabetes, and heart disease. In fact, many South Asians have a pattern called “atherogenic dyslipidemia”: normal LDL, but high triglycerides and low HDL (the “good” cholesterol). Tracking triglycerides along with waist circumference and blood pressure can help identify metabolic syndrome early, which is a red flag for both diabetes and heart disease.
Final Thoughts
For South Asians, paying attention to more than the standard cholesterol and sugar panel is essential. Ask your doctor about ApoB, Lp(a), triglycerides, and A1c testing. Together, these give a clearer picture of your metabolic and cardiovascular risk, and they can guide early steps to protect long-term health.
