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Das TK, Kar P, Panchali T, Khatun A, Dutta A, Ghosh S, Chakrabarti S, Pradhan S, Mondal KC, Ghosh K. Anti-obesity potentiality of Lactiplantibacillus plantarum E2_MCCKT isolated from a fermented beverage, haria: a high fat diet-induced obese mice model study. World J Microbiol Biotechnol 2024; 40:168. [PMID: 38630156 DOI: 10.1007/s11274-024-03983-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 04/04/2024] [Indexed: 04/19/2024]
Abstract
Obesity is a growing epidemic worldwide. Several pharmacologic drugs are being used to treat obesity but these medicines exhibit side effects. To find out the alternatives of these drugs, we aimed to assess the probiotic properties and anti-obesity potentiality of a lactic acid bacterium E2_MCCKT, isolated from a traditional fermented rice beverage, haria. Based on the 16S rRNA sequencing, the bacterium was identified as Lactiplantibacillus plantarum E2_MCCKT. The bacterium exhibited in vitro probiotic activity in terms of high survivability in an acidic environment and 2% bile salt, moderate auto-aggregation, and hydrophobicity. Later, E2_MCCKT was applied to obese mice to prove its anti-obesity potentiality. Adult male mice (15.39 ± 0.19 g) were randomly divided into three groups (n = 5) according to the type of diet: normal diet (ND), high-fat diet (HFD), and HFD supplemented with E2_MCCKT (HFT). After four weeks of bacterial treatment on the obese mice, a significant reduction of body weight, triglyceride, and cholesterol levels, whereas, improvements in serum glucose levels were observed. The bacterial therapy led to mRNA up-regulation of lipolytic transcription factors such as peroxisome proliferator-activated receptor-α which may increase the expression of fatty acid oxidation-related genes such as acyl-CoA oxidase and carnitine palmitoyl-transferase-1. Concomitantly, both adipocytogenesis and fatty acid synthesis were arrested as reflected by the down-regulation of sterol-regulatory element-binding protein-1c, acetyl-CoA carboxylase, and fatty acid synthase genes. In protein expression study, E2_MCCKT significantly increased IL-10 expression while decreasing pro-inflammatory cytokine (IL-1Ra and TNF-α) expression. In conclusion, the probiotic Lp. plantarum E2_MCCKT might have significant anti-obesity effects on mice.
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Affiliation(s)
- Tridip Kumar Das
- Department of Biological Sciences, Midnapore City College, Midnapore, 721129, West Bengal, India
- Biodiversity and Environmental Studies Research Center, Midnapore City College Affiliated to Vidyasagar University, Midnapore, West Bengal, India
| | - Priyanka Kar
- Department of Biological Sciences, Midnapore City College, Midnapore, 721129, West Bengal, India
- Biodiversity and Environmental Studies Research Center, Midnapore City College Affiliated to Vidyasagar University, Midnapore, West Bengal, India
| | - Titli Panchali
- Department of Biological Sciences, Midnapore City College, Midnapore, 721129, West Bengal, India
- Biodiversity and Environmental Studies Research Center, Midnapore City College Affiliated to Vidyasagar University, Midnapore, West Bengal, India
| | - Amina Khatun
- Department of Biological Sciences, Midnapore City College, Midnapore, 721129, West Bengal, India
- Biodiversity and Environmental Studies Research Center, Midnapore City College Affiliated to Vidyasagar University, Midnapore, West Bengal, India
| | - Ananya Dutta
- Department of Biological Sciences, Midnapore City College, Midnapore, 721129, West Bengal, India
- Biodiversity and Environmental Studies Research Center, Midnapore City College Affiliated to Vidyasagar University, Midnapore, West Bengal, India
| | - Smita Ghosh
- Department of Biological Sciences, Midnapore City College, Midnapore, 721129, West Bengal, India
- Biodiversity and Environmental Studies Research Center, Midnapore City College Affiliated to Vidyasagar University, Midnapore, West Bengal, India
| | - Sudipta Chakrabarti
- Department of Biological Sciences, Midnapore City College, Midnapore, 721129, West Bengal, India
| | - Shrabani Pradhan
- Department of Biological Sciences, Midnapore City College, Midnapore, 721129, West Bengal, India
| | - Keshab Chandra Mondal
- Department of Microbiology, Vidyasagar University, Midnapore, 721102, West Bengal, India
| | - Kuntal Ghosh
- Department of Biological Sciences, Midnapore City College, Midnapore, 721129, West Bengal, India.
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Cp G. A structural equation modeling examining the influence of body mass index on the lipid profile of type II diabetes patients. Nutr Health 2024; 30:121-127. [PMID: 35581729 DOI: 10.1177/02601060221101715] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: High Body Mass Index (BMI) has a two times greater risk of developing type II diabetes compared to low BMI. The results showed that general obesity had a risk of 2.24 times while abdominal obesity had a risk of 2.44 times for the occurrence of diabetes. Aim: Based on the background described, the researcher was interested in examining the influence of BMI on the lipid profile of type II diabetes patients. Methods: A considerably large sample of 500 type II diabetes patients who attended the outpatient department of Endocrinology wing of NIMS Medicity (NICER-Noorul Islam Centre for Endocrinology Research), Kerala, India were selected to the macrosample pool following purposive random sampling method. Height and weight of the patients were taken following standard methods and BMI of the patients was computed. Biochemical investigations such as their lipid profile along with Fasting, Post Prandial Blood Glucose values and HbA1C were obtained from patients' medical records. Finally, the hypothesized model was developed and tested by Structural Equation Modeling (SEM) technique using SPSS AMOS 22.0. Results: The results show that height and weight highly influenced the BMI, among which weight, as shown by Standardized Regression Weights (SRW) Estimate- 1.102, Statistically Significant) influenced more than height (SRW Estimate:-0.683, Statistically Significant), weight had a positive influence, whereas height had a negative influence in selected Type II Diabetes patients. The model could not establish any relationship between BMI and lipid profile (SRW Estimate:-0.037, Statistically not Significant). Conclusion: The findings suggest that in diabetes patients increase in BMI alone does not lead to any alterations in their lipid profile.
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Affiliation(s)
- Gayathry Cp
- Department of Home Science HHMSPB NSS College for Women (Affiliated to University of Kerala), Neeramankara, Thiruvananthapuram, Kerala, India
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Kaur P, Yadav AK, Pal A, Jassal RS, Shafiq N, Sahni N, Kumar V, Jha V. Estimation of dietary intake of sodium, potassium, phosphorus and protein in healthy Indian population and patients with chronic kidney disease. Front Nutr 2024; 11:1312581. [PMID: 38487633 PMCID: PMC10937368 DOI: 10.3389/fnut.2024.1312581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 02/19/2024] [Indexed: 03/17/2024] Open
Abstract
Introduction Poor nutritious diet is a major risk element for non-communicable diseases (NCD), which are of considerable public health concern. Given the diverse dietary patterns in India, precise determination of nutrient consumption is crucial for disease management. The present study assessed the dietary intake of sodium, potassium, protein, and phosphorus among North Indians. Methods This cross-sectional study included healthy adults and adults with stage 2 to 4 chronic kidney disease (CKD). We analysed sodium, protein, potassium and phosphorus intakes using one-time 24-h urinary excretion. Dietary intake was also analysed in subgroups based on sex, body mass index, blood pressure and abdominal obesity. We evaluated the performance of various equations available to estimate sodium intake using a spot urine sample with respect to the sodium excretion measured in a 24-h urine sample. Descriptive statistics was used along with t-test for statistical significance. Results A total of 404 subjects (182 adult healthy subjects and 222 adults with CKD) with a mean age of 47.01 ± 11.46 years were studied. Mean dietary intakes of sodium, salt, potassium, protein and phosphorus were 2.94 ± 1.68 g/day, 7.42 ± 4.24 g/day, 1.43 ± 0.59 g/day, 47.67 ± 14.73 g/day and 0.86 ± 0.39 g/day, respectively. There were no differences in nutrient consumption between adults who were healthy and those with CKD. Consumption of sodium, salt, protein, potassium, and phosphorus among healthy population vs. those with CKD were 2.81 ± 1.60 vs. 3.05 ± 1.73 g/day (p = 0.152), 7.08 ± 4.04 vs. 7.70 ± 4.37 g/day (p = 0.143), 47.16 ± 14.59 vs. 48.08 ± 14.86 g/day (p = 0.532), 1.38 ± 0.59 vs. 1.48 ± 0.58 g/day (p = 0.087) and 0.86 ± 0.41 vs. 0.87 ± 0.37 g/day (p = 0.738), respectively. Men had higher consumption of these nutrients than women. Compared to non-hypertensives, hypertensive subjects had higher consumption of salt (8.23 ± 4.89 vs. 6.84 ± 3.59 g/day, p = 0.002) and potassium (1.51 ± 0.63 vs. 1.38 ± 0.55 g/day, p = 0.024), however, no difference were found in protein and phosphorus intakes. In terms of performance of equations used to estimate 24-h sodium intake from spot urinary sodium concentration against the measured 24-h urinary sodium excretion, INTERSALT 2 equation exhibited the least bias [1.08 (95% CI, -5.50 to 7.66)]. Conclusion The study shows higher-than-recommended salt and lower-than-recommended potassium intake in the north Indian population compared to those recommended by guidelines. The dietary protein intake is below the recommended dietary allowance. These findings help the development of targeted policies for dietary modification to reduce the risk of the development and progression of CKD.
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Affiliation(s)
- Prabhjot Kaur
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ashok Kumar Yadav
- Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Arnab Pal
- Department of Biochemistry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ravjit Singh Jassal
- Department of Biochemistry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Nusrat Shafiq
- Department of Pharmacology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Nancy Sahni
- Department of Dietetics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vivek Kumar
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vivekanand Jha
- The George Institute for Global Health, UNSW, New Delhi, India
- School of Public Health, Imperial College, London, United Kingdom
- Manipal Academy of Higher Education, Manipal, India
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Arumugaswamy PR, Chumber S, Rathore YS, Maitra S, Bhattacharjee HK, Bansal VK, Aggarwal S, Dhar A, Asuri K, Kataria K, Ranjan P. Low-pressure pneumoperitoneum with deep neuromuscular blockade versus standard pressure pneumoperitoneum in patients undergoing laparoscopic cholecystectomy for gallstone disease: a non-inferiority randomized control trial. Surg Endosc 2024; 38:449-459. [PMID: 38012441 DOI: 10.1007/s00464-023-10558-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 10/22/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Low-pressure pneumoperitoneum (LPP) is an attempt at improving laparoscopic surgery. However, it has the issue of poor working space for which deep neuromuscular blockade (NMB) may be a solution. There is a lack of literature comparing LPP with deep NMB to standard pressure pneumoperitoneum (SPP) with moderate NMB. METHODOLOGY This was a single institutional prospective non-inferiority RCT, with permuted block randomization of subjects into group A and B [Group A: LPP; 8-10 mmHg with deep NMB [ Train of Four count (TOF): 0, Post Tetanic Count (PTC): 1-2] and Group B: SPP; 12-14 mmHg with moderate NMB]. The level of NMB was monitored with neuromuscular monitor with TOF count and PTC. Cisatracurium infusion was used for continuous deep NMB in group A. Primary outcome measures were the surgeon satisfaction score and the time for completion of the procedure. Secondarily important clinical outcomes were also reported. RESULTS Of the 222 patients screened, 181 participants were enrolled [F: 138 (76.2%); M: 43 (23.8%); Group A n = 90, Group B n = 91]. Statistically similar surgeon satisfaction scores (26.1 ± 3.7 vs 26.4 ± 3.4; p = 0.52) and time for completion (55.2 ± 23.4 vs 52.5 ± 24.9 min; p = 0.46) were noted respectively in groups A and B. On both intention-to-treat and per-protocol analysis it was found that group A was non-inferior to group B in terms of total surgeon satisfaction score, however, non-inferiority was not proven for time for completion of surgery. Mean pain scores and incidence of shoulder pain were statistically similar up-to 7 days of follow-up in both groups. 4 (4.4%) patients in group B and 2 (2.2%) in group A had bradycardia (p = 0.4). Four (4.4%) cases of group A were converted to group B. One case of group B converted to open surgery. Bile spills and gallbladder perforations were comparable. CONCLUSION LPP with deep NMB is non-inferior to SPP with moderate NMB in terms of surgeon satisfaction score but not in terms of time required to complete the procedure. Clinical outcomes and safety profile are similar in both groups. However, it could be marginally costlier to use LPP with deep NMB.
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Affiliation(s)
- Prasanna Ramana Arumugaswamy
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Sunil Chumber
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Yashwant Singh Rathore
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
| | - Souvik Maitra
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Hemanga Kumar Bhattacharjee
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Virinder Kumar Bansal
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Sandeep Aggarwal
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Anita Dhar
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Krishna Asuri
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Kamal Kataria
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Piyush Ranjan
- Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
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Kumar S. Profile of type 2 diabetes mellitus patients attending family medicine clinic in a rural tribal locality in India. J Family Med Prim Care 2023; 12:3242-3248. [PMID: 38361905 PMCID: PMC10866235 DOI: 10.4103/jfmpc.jfmpc_2114_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 04/03/2023] [Accepted: 07/27/2023] [Indexed: 02/17/2024] Open
Abstract
Objective Diabetes prevalence has been predicted to reach 578 million worldwide in 2030 and is estimated to increase by 51% (700 million) in 2045. Type 2 diabetes mellitus (T2DM) is frequently associated with various cardiovascular (CV) risk factors secondary to associated dyslipidemias and good glycemic control is key for the prevention of long-term CV complications; this study was conducted to assess present glycemic status and lipid profile of the population residing in a rural tribal locality of Jharkhand (India). Materials and Methods This cross-sectional study was conducted as a project for Fellowship in diabetes course by the Department of Endocrinology, DEDU, CMC Vellore. Whole blood and sera were analyzed for fasting blood sugar (FBS), glycated-hemoglobin (HbA1c), total cholesterol (CH), triglycerides (TGs), high-density-lipoprotein-cholesterol (HDL-C), low-density-lipoprotein-cholesterol (LDL-C), and very-low-density-lipoprotein-cholesterol (VLDL-C). A correlation test of HbA1c with lipid ratios and individual lipid indexes was done. Results The mean Hb1Ac level was uncontrolled as 7.24 ± 1.80 and, interestingly, was marginally higher [7.31 ± 1.92 Vs 6.92 ± 1.16] in patients with T2DM <5 years as compared to those with T2DM >5 years. Mixed dyslipidemias were common with abnormal TG, LDL, VLDL, HDL, and total CH values. Hb1Ac levels showed a significant positive correlation with serum CH, TG, LDL, and VLDL levels, while a significant negative correlation with HDL levels in the study. Conclusion Apart from being a reliable indicator of long-term glycemic control, HbA1c can also be used as a surrogate marker of dyslipidemia, and thus early diagnosis and treatment of dyslipidemia can prevent life-threatening cardiovascular complications that can be particularly useful in resource-poor rural tribal locality settings.
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Affiliation(s)
- Sumit Kumar
- Department of Physiology, Government Medical College, Datia, Madhya Pradesh, India
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Bhagadurshah RR, Eagappan S, Kasthuri Santharam R, Subbiah S. The Impact of Body Mass Index, Residual Beta Cell Function and Estimated Glucose Disposal Rate on the Development of Double Diabetes and Microvascular Complications in Patients With Type 1 Diabetes Mellitus. Cureus 2023; 15:e48979. [PMID: 38111445 PMCID: PMC10726016 DOI: 10.7759/cureus.48979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2023] [Indexed: 12/20/2023] Open
Abstract
Background The clinical impact of body mass index (BMI), residual beta cell function and estimated glucose disposal rate (eGDR) in the development of double diabetes (DD) and microvascular complications are largely unknown. We aimed to assess whether BMI, residual beta cell function measured by plasma "C" peptide and insulin resistance measured by eGDR have any impact on the development of DD and microvascular complications in patients with type 1 diabetes mellitus (T1DM). Methods It is a cross-sectional observational study involving 113 T1DM patients of more than five years duration who were classified into two groups: normal BMI (18.5-22.9 kg/m2) and overweight/obese group (≥ 23kg/m2) based on Asian BMI classification. Based on their eGDR values, they were grouped into four categories: ≥ 8, 6-7.99, 4-5.99, and < 4 mg/kg/min. The prevalence of DD based on eGDR values was determined. Their BMI and different eGDR categories were compared with the prevalence of diabetic retinopathy and nephropathy and their odds ratio (OR) was calculated. Results The median and interquartile range (IQR) of the eGDR of the overweight/obese group was significantly lower than the normal BMI group (5.3 [3.96-8.15] vs 8.72 [6.50-9.77 mg/kg/min], p < 0.001). The prevalence of DD in the overweight/obese T1DM group and normal BMI group was 75% and 33.3% respectively. The OR of retinopathy and nephropathy in the overweight/obese group was 3.28 (p = 0.007) and 3.01 (p = 0.015) respectively when compared to the normal BMI group. The OR of retinopathy and nephropathy in T1DM patients with eGDR < 4 mg/kg/min was 17.13 (p = 0.001) and 18.5 (p = 0.001) respectively. The lower the eGDR values, the higher the prevalence of retinopathy and nephropathy regardless of HbA1c levels. Conclusion As overweight and obesity are increasingly becoming more prevalent in T1DM, the eGDR will better predict the development of DD and microvascular complications irrespective of HbA1c levels. It is more useful as a variable and easily inducted into routine clinical practice. However, residual beta cell function was not useful in predicting the development of microvascular complications.
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Affiliation(s)
- Rameez Raja Bhagadurshah
- Department of Endocrinology and Diabetology, Madurai Medical College and Government Rajaji Hospital, Madurai, IND
| | - Subbiah Eagappan
- Department of Endocrinology and Diabetology, Madurai Medical College and Government Rajaji Hospital, Madurai, IND
| | - Raghavan Kasthuri Santharam
- Department of Endocrinology and Diabetology, Madurai Medical College and Government Rajaji Hospital, Madurai, IND
| | - Sridhar Subbiah
- Department of Endocrinology and Diabetology, Madurai Medical College and Government Rajaji Hospital, Madurai, IND
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Azam M, Sakinah LF, Kartasurya MI, Fibriana AI, Minuljo TT, Aljunid SM. Prevalence and determinants of obesity among individuals with diabetes in Indonesia. F1000Res 2023; 11:1063. [PMID: 37928804 PMCID: PMC10624955 DOI: 10.12688/f1000research.125549.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/12/2023] [Indexed: 11/07/2023] Open
Abstract
Background: Obesity and diabetes mellitus (DM), both individually or simultaneously, increase the risk of morbidity and mortality. The present study aimed to determine the prevalence and determinants of obesity among diabetic individuals in Indonesia. Methods: Data were extracted based on 2018 Indonesian Basic Health Survey (Riset Kesehatan Dasar=RISKESDAS). This study involved all individuals with DM and categorized obesity based on body mass index. After data clearing, this study analyzed 3911 DM subjects of the 33.905 subjects acquired from the 2018 RISKESDAS. The study also observed demographic data, diabetes control parameters, history of hypertension, lipid profiles, and food consumption patterns. These variables were involved in a Chi-square test, and related variables were then involved in the Binary logistic regression to define the independent determinants of obesity among DM subjects. Results: Of the 3911 DM subjects included, the study found an obesity prevalence of 32.9%. This study found that female (prevalence odds ratio [POR]=2.15; 95% CI: 1.76-2.62), age 15-44 years (POR=2.46; 95% CI: 1.83-3.33), urban residence (POR=1.49; 95% CI: 1.25-1.77), history of hypertension (POR=1.25; 95% CI: 1.04-1.51), high diastolic blood pressure (POR=1.90; 95% CI: 1.58-2.29), high LDL (POR=1.44; 95% CI: 1.13-1.84), high HDL (POR=0.60; 95% CI: 0.46-0.78, and high triglycerides (POR=1.27; 95% CI: 1.07-1.50) were the risk factor of obesity among DM subjects; while higher education (POR=0.64; 95% CI: 0.53-0.78) and married (POR=0.73; 95% CI: 0.59-0.90) were protective factors of obesity among DM subjects. Conclusions: The study concluded that almost one-third of DM subjects in Indonesia were obese. Female, age, urban residence, education level, history of hypertension, diastolic blood pressure, and lipid profiles were all associated with obesity among DM subjects in Indonesia. These findings suggest that monitoring and controlling of related determinants is needed to prevent complications caused by the doubled burden of diabetes and obesity.
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Affiliation(s)
- Mahalul Azam
- Department of Public Health, Faculty of Sports Science, Universitas Negeri Semarang, Semarang, Jawa Tengah, 50229, Indonesia
| | - Luluk Fadhoh Sakinah
- Department of Public Health, Faculty of Sports Science, Universitas Negeri Semarang, Semarang, Jawa Tengah, 50229, Indonesia
| | - Martha Irene Kartasurya
- Department of Public Health Nutrition, Faculty of Public Health, Diponegoro University, Semarang, Jawa Tengah, 50275, Indonesia
| | - Arulita Ika Fibriana
- Department of Public Health, Faculty of Sports Science, Universitas Negeri Semarang, Semarang, Jawa Tengah, 50229, Indonesia
| | - Tania Tedjo Minuljo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Dr. Kariadi General Hospital, Semarang, Jawa Tengah, 50244, Indonesia
| | - Syed Mohamed Aljunid
- Department of Health Policy and Management, Faculty of Public Health, Kuwait University, Kuwait City, 11311, Kuwait
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Singh S, Vemireddy V. Transitioning diets: a mixed methods study on factors affecting inclusion of millets in the urban population. BMC Public Health 2023; 23:2003. [PMID: 37833667 PMCID: PMC10576316 DOI: 10.1186/s12889-023-16872-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 10/01/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND The increasing health challenge in urban India has led to consumers to change their diet preferences by shifting away from staple cereals and making way for healthier foods such as nutri-cereals like millets and other diverse food groups. Taking the case of millets, this study seeks to uncover the exact drivers for this shift of consumers away from a traditional cereal dense diet to a nutritionally more diverse diet that includes nutri-cereal. We also look at deterrents that dissuade consumers from shifting to millets. METHOD We use primary data by surveying respondents through interviews and focused group discussions and online questionnaires. A total of 20 personal consumer interviews and 4 focus group discussions having 8-12 members each were conducted to arrive at the measures for the study. We use logistic regression and Structural Equation Modeling for data analysis. Responses were obtained across major metropolitan cities and tier 2 cities of India thus ensuring representation of geographical, cultural and diet diversity. 875 participants' responses were analysed for results. RESULTS Health reasons and social networks are the major drivers for shift to millets while lack of awareness, lack of easy availability, high prices, lack of branded products, family being averse to switching to millets and lack of attractive promotional cashbacks and discounts are major deterrents to trying out millets. CONCLUSIONS Diet focussed interventions are urgently needed to curb rising diet related non communicable diseases. Government policies aimed at greater production of millets, running awareness campaigns on mass media and private sector initiatives aimed at generating better value added market offerings could lead the way.
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Affiliation(s)
- Suruchi Singh
- Centre for Management in Agriculture, Indian Institute of Management Ahmedabad, Ahmedabad, India.
| | - Vidya Vemireddy
- Centre for Management in Agriculture, Indian Institute of Management Ahmedabad, Ahmedabad, India
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Ambade M, Kim R, Subramanian SV. Socio-economic distribution of modifiable risk factors for cardiovascular diseases: An analysis of the national longitudinal ageing study in India. Prev Med 2023; 175:107696. [PMID: 37666306 DOI: 10.1016/j.ypmed.2023.107696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 07/13/2023] [Accepted: 09/01/2023] [Indexed: 09/06/2023]
Abstract
The association of socioeconomic status (SES) with modifiable risk factors for cardiovascular diseases (CVDs) is unclear in developing nations. We studied SES variations in major risk factors and their percentage distribution for adults aged 45 years or above in India. Using individual records of 59,672 individuals aged 45 years or above from the Longitudinal Ageing Study in India Wave 1 (cross-sectional study design), 2017-18, we chart age-and-sex-adjusted prevalence of clinical risk factors such as measured high blood pressure, hypertension, overweight, obesity, central adiposity and self-reported high blood glucose; and lifestyle risk factors such as excessive use of alcohol, current use of smoking and smokeless tobacco and physical inactivity across SES variables of education, quintiles of mean per capita expenditure and social caste. Multivariable analysis was used to explore the SES gradient of risk factors. The sample used in the study is predominantly rural (69.9%), illiterate (50.7%), has more females (54.2%), and belongs to other backward classes (45.6%). Prevalence of high blood pressure, overweight, obesity, central adiposity, high blood glucose, and physical inactivity increased; and excessive alcohol consumption and current use of smoking/smokeless tobacco decreased with income, education, and social caste. However, no significant income gradient was noted for lifestyle risk factors except the use of smokeless tobacco. The income gradient was largest for central adiposity (waist-circumference) with a difference of 23.4 percentage points as it increased from 38.7% among the poorest to 62.1% among the richest. The major burden of CVDs risk factors among older adults aged 45+ years falls among high SES.
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Affiliation(s)
- Mayanka Ambade
- Indian Institute of Technology Mandi, Himachal Pradesh, India.
| | - Rockli Kim
- Division of Health Policy and Management, College of Health Science, Korea University, Seoul, South Korea; Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea.
| | - S V Subramanian
- Harvard Center for Population and Development Studies, 9 Bow Street, Cambridge, MA 02138, USA; Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
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Suri TM, Ghosh T, Mittal S, Hadda V, Madan K, Mohan A. Systematic review and meta-analysis of the prevalence of obstructive sleep apnea in Indian adults. Sleep Med Rev 2023; 71:101829. [PMID: 37517357 DOI: 10.1016/j.smrv.2023.101829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 07/18/2023] [Accepted: 07/18/2023] [Indexed: 08/01/2023]
Abstract
Obstructive sleep apnea (OSA) is a common sleep disorder associated with considerable morbidity. However, there is an underrepresentation of data from India and other developing countries in global reviews of OSA prevalence. This systematic review and meta-analysis examined the prevalence of OSA in India. The MEDLINE, Embase, and Scopus databases were searched for articles that reported the prevalence of OSA in the general Indian adult population using sleep studies. Eight studies were included comprising 11,009 subjects with mean age ranging from 35.5 to 47.8 years. On the Joanna Briggs Institute (JBI) checklist for prevalence studies, the study quality ranged from 3/9 to 9/9. Meta-analysis was performed using the random-effects model. The pooled prevalence of OSA (AHI ≥5 events/hour) was 11% overall (95% CI: 7%-15%; I2 = 98.0%, p<0.001), 13% in males (95% CI: 7%-18%; I2 = 96.0%, p<0.001), and 5% in females (95% CI: 3%-7%; I2 = 73.3%, p = 0.01). The pooled prevalence of moderate-to-severe OSA (AHI ≥15 events/hour) was 5% (95% CI: 2%-8%, I2 = 95.3%; p = 0.01). Based on these findings, approximately 104 million Indians of working age suffer from OSA, of whom 47 million have moderate-to-severe OSA. This represents a major public health problem in India with important implications for the global burden of the disease.
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Affiliation(s)
- Tejas Menon Suri
- Department of Pulmonary, Critical Care & Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Tamoghna Ghosh
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Saurabh Mittal
- Department of Pulmonary, Critical Care & Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Vijay Hadda
- Department of Pulmonary, Critical Care & Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Karan Madan
- Department of Pulmonary, Critical Care & Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Anant Mohan
- Department of Pulmonary, Critical Care & Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India.
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Das S, Goswami V, Chandel S. Normal weight central obesity and hypertension in India: Cross-sectional finding from LASI, 2017-19. Nutr Metab Cardiovasc Dis 2023; 33:1888-1898. [PMID: 37544873 DOI: 10.1016/j.numecd.2023.06.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/14/2023] [Accepted: 06/30/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND AND AIM The current public health guidelines for preventing and managing obesity still emphasize the importance of maintaining a normal Body Mass Index, while paying little attention to central obesity, which is common among the general population. Normal Weight Central Obesity (NWCO) is a less explored risk factor for hypertension in India. Therefore, this study aims to investigate the prevalence of NWCO and its association with hypertension in India. METHODS AND RESULTS The cross-sectional study used data from the Longitudinal Aging Study in India (LASI), 2017-19, which included 54,016 participants (22,438 men and 31,578 women). Hypertension was evaluated following the JNC-VIII guidelines for the detection, evaluation, and treatment of hypertension. Anthropometric measurements were taken to identify NWCO. The study found that NWCO was more prevalent among women (33.9%) than men (17.8%), while men had a higher prevalence of hypertension (47.6%) than women (43.8%). In India, the state of Haryana had the highest proportion of NWCO among men (26.4%), while Kerala had the highest proportion among women (39.1%). Binary logistic regression analysis showed that NWCO was significantly associated with an increased risk of hypertension. The odds ratio (aOR) was 1.57 (95% CI 1.45-1.67, p < 0.001) in men and 1.53 (95% CI 1.43-1.63, p < 0.001) in women, compared to normal-weight study participants. CONCLUSIONS The study emphasizes the importance of considering central obesity in individuals with a normal BMI when assessing cardiovascular risk, particularly for hypertension. State-specific data can help identify high-risk areas and facilitate targeted prevention and treatment strategies.
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Affiliation(s)
- Sayani Das
- Department of Health Research, International Institute of Health Management Research, New Delhi 110075, India.
| | - Vaidehi Goswami
- Department of Anthropology, University of Delhi, Delhi 110007, India
| | - Shivani Chandel
- Department of Anthropology, University of Delhi, Delhi 110007, India
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Naz S, Haider KA, Jaffar A, Khan U, Azam I, Siddiqui AR, Iqbal R. Feasibility of a peer-supported, WhatsApp-assisted, lifestyle modification intervention for weight reduction among adults in an urban slum of Karachi, Pakistan: a mixed-methods, single-group, pretest-post-test, quasi-experimental study. BMJ Open 2023; 13:e070913. [PMID: 37527890 PMCID: PMC10394542 DOI: 10.1136/bmjopen-2022-070913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 07/24/2023] [Indexed: 08/03/2023] Open
Abstract
OBJECTIVES This pilot study assessed whether a peer-supported, WhatsApp-assisted lifestyle modification intervention for weight reduction is feasible to execute a definitive trial. DESIGN A mixed-methods, single group, pretest and post-test, quasi-experimental study. SETTING Azam Basti, an urban slum in Karachi, Pakistan. PARTICIPANTS Fifty participants (males and females aged 20-60) with a body mass index of >23 kg/m2, along with their nominated peers from the same family. INTERVENTION Using motivational interviewing techniques, a trained nutritionist delivered the lifestyle modification intervention to the participants and peers for 3 days after the baseline assessment and then once monthly for 1 year. The intervention was delivered in groups using WhatsApp voice calls. The education sessions mainly focused on dietary modifications, physical activity advice and peer-support assignments to achieve a 5% wt loss from the participant's initial body weight. OUTCOMES The feasibility measures included screening, recruitment, retention and monthly interview response rates. At 1 year, in-depth interviews (IDIs) with participants and peers were conducted to explore the facilitators, barriers, acceptability and experiences of the intervention. Changes in weight, calorie intake/day and calorie expenditure/day were also assessed. RESULTS The recruitment and retention rates were 32% (n=50/156) and 78% (n=39/50), respectively, while the response rate for monthly interviews ranged between 66% (n=33) and 94% (n=47). The mean weight loss at 1 year was 2.2 kg, and the reduction in mean calorie intake was 386 kcal/day. There were no changes in the mean calorie expenditure. During the IDIs, participants and peers reported intervention via WhatsApp and peer support as convenient, flexible and supportive. CONCLUSIONS The quantitative and qualitative findings of the current pilot study support the scale-up of this work with minor modifications to the screening method as well as close monitoring and motivational interviewing to improve adherence in terms of physical activity. TRIAL REGISTRATION NUMBER NCT05928338.
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Affiliation(s)
- Sabahat Naz
- Community Health Sciences Department, The Aga Khan University, Karachi, Pakistan
| | - Kaniz Amna Haider
- Pediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Ali Jaffar
- Pediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Umber Khan
- Community Health Sciences Department, The Aga Khan University, Karachi, Pakistan
| | - Iqbal Azam
- Community Health Sciences Department, The Aga Khan University, Karachi, Pakistan
| | - Amna Rehana Siddiqui
- Community Health Sciences Department, The Aga Khan University, Karachi, Pakistan
| | - Romaina Iqbal
- Department of Community Health Sciences and Medicine, The Aga Khan University, Karachi, Pakistan
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Anjana RM, Unnikrishnan R, Deepa M, Pradeepa R, Tandon N, Das AK, Joshi S, Bajaj S, Jabbar PK, Das HK, Kumar A, Dhandhania VK, Bhansali A, Rao PV, Desai A, Kalra S, Gupta A, Lakshmy R, Madhu SV, Elangovan N, Chowdhury S, Venkatesan U, Subashini R, Kaur T, Dhaliwal RS, Mohan V. Metabolic non-communicable disease health report of India: the ICMR-INDIAB national cross-sectional study (ICMR-INDIAB-17). Lancet Diabetes Endocrinol 2023; 11:474-489. [PMID: 37301218 DOI: 10.1016/s2213-8587(23)00119-5] [Citation(s) in RCA: 75] [Impact Index Per Article: 75.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 04/10/2023] [Accepted: 04/12/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Non-communicable disease (NCD) rates are rapidly increasing in India with wide regional variations. We aimed to quantify the prevalence of metabolic NCDs in India and analyse interstate and inter-regional variations. METHODS The Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) study, a cross-sectional population-based survey, assessed a representative sample of individuals aged 20 years and older drawn from urban and rural areas of 31 states, union territories, and the National Capital Territory of India. We conducted the survey in multiple phases with a stratified multistage sampling design, using three-level stratification based on geography, population size, and socioeconomic status of each state. Diabetes and prediabetes were diagnosed using the WHO criteria, hypertension using the Eighth Joint National Committee guidelines, obesity (generalised and abdominal) using the WHO Asia Pacific guidelines, and dyslipidaemia using the National Cholesterol Education Program-Adult Treatment Panel III guidelines. FINDINGS A total of 113 043 individuals (79 506 from rural areas and 33 537 from urban areas) participated in the ICMR-INDIAB study between Oct 18, 2008 and Dec 17, 2020. The overall weighted prevalence of diabetes was 11·4% (95% CI 10·2-12·5; 10 151 of 107 119 individuals), prediabetes 15·3% (13·9-16·6; 15 496 of 107 119 individuals), hypertension 35·5% (33·8-37·3; 35 172 of 111 439 individuals), generalised obesity 28·6% (26·9-30·3; 29 861 of 110 368 individuals), abdominal obesity 39·5% (37·7-41·4; 40 121 of 108 665 individuals), and dyslipidaemia 81·2% (77·9-84·5; 14 895 of 18 492 of 25 647). All metabolic NCDs except prediabetes were more frequent in urban than rural areas. In many states with a lower human development index, the ratio of diabetes to prediabetes was less than 1. INTERPRETATION The prevalence of diabetes and other metabolic NCDs in India is considerably higher than previously estimated. While the diabetes epidemic is stabilising in the more developed states of the country, it is still increasing in most other states. Thus, there are serious implications for the nation, warranting urgent state-specific policies and interventions to arrest the rapidly rising epidemic of metabolic NCDs in India. FUNDING Indian Council of Medical Research and Department of Health Research, Ministry of Health and Family Welfare, Government of India.
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Affiliation(s)
- Ranjit Mohan Anjana
- Department of Diabetology, Madras Diabetes Research Foundation and Dr Mohan's Diabetes Specialities Centre, Chennai, Tamil Nadu, India.
| | - Ranjit Unnikrishnan
- Department of Diabetology, Madras Diabetes Research Foundation and Dr Mohan's Diabetes Specialities Centre, Chennai, Tamil Nadu, India
| | - Mohan Deepa
- Department of Epidemiology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Rajendra Pradeepa
- Department of Research Operations & Diabetes Complications, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Nikhil Tandon
- Department of Endocrinology & Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Ashok Kumar Das
- Department of General Medicine & Endocrinology, Pondicherry Institute of Medical Sciences, Puducherry, India
| | - Shashank Joshi
- Department of Diabetology & Endocrinology, Lilavati Hospital and Research Centre, Mumbai, Maharashtra, India
| | - Sarita Bajaj
- Department of Medicine, Moti Lal Nehru Medical College, Prayagraj, Uttar Pradesh, India
| | | | | | - Ajay Kumar
- Department of Diabetology, Diabetes Care and Research Centre, Patna, Bihar, India
| | | | - Anil Bhansali
- Department of Endocrinology, Gini Health, Mohali, Punjab, India
| | - Paturi Vishnupriya Rao
- Department of Endocrinology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Ankush Desai
- Department of Endocrinology, Goa Medical College, Bambolim, Goa, India
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India
| | - Arvind Gupta
- Department of Diabetology, Jaipur Diabetes Research Centre, Jaipur, Rajasthan, India
| | - Ramakrishnan Lakshmy
- Department of Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Sri Venkata Madhu
- Department of Endocrinology, University College of Medical Sciences and GTB Hospital, New Delhi, India
| | - Nirmal Elangovan
- Department of Research Operations & Diabetes Complications, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Subhankar Chowdhury
- Department of Endocrinology & Metabolism, Institute of Post Graduate Medical Education & Research (IPGMER) & SSKM Hospital, Kolkata, West Bengal, India
| | | | - Radhakrishnan Subashini
- Department of Biostatistics, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Tanvir Kaur
- Non-Communicable Disease Division, Indian Council of Medical Research, New Delhi, India
| | | | - Viswanathan Mohan
- Department of Diabetology, Madras Diabetes Research Foundation and Dr Mohan's Diabetes Specialities Centre, Chennai, Tamil Nadu, India
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Chaudhary M, Sharma P. Abdominal obesity in India: analysis of the National Family Health Survey-5 (2019-2021) data. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2023; 14:100208. [PMID: 37492420 PMCID: PMC10363491 DOI: 10.1016/j.lansea.2023.100208] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 12/15/2022] [Accepted: 04/24/2023] [Indexed: 07/27/2023]
Abstract
Background The ever-growing trend of abdominal obesity worldwide has garnered global attention over the past three decades. In India, BMI has conventionally been used to measure obesity. National Family Health Survey (NFHS) is the largest demographic and health survey (DHS) in India. For the first time, the NFHS conducted the fifth round in 2019-21 which assessed abdominal obesity through waist circumference. The objective of the current study was to determine the prevalence of abdominal obesity and explore the associated socioeconomic factors. Methods The prevalence of abdominal obesity in India was determined using the NFHS-5 dataset, where waist circumference was used as a measure. Multivariable binary logistic regression was then employed to examine the association of different socioeconomic factors with abdominal obesity. Findings The prevalence of abdominal obesity in the country was found to be 40% in women and 12% in men. The findings show that 5-6 out of 10 women between the ages of 30-49 are abdominally obese. The association of abdominal obesity in women is stronger with older age groups, urban residents, wealthier sections, and non-vegetarians. For those practising the Sikh religion, the prevalence is higher in both men and women. Abdominal obesity is also on the rise in rural areas and is penetrating lower and middle socioeconomic sections of society. Interpretation The findings of the current study highlight the need for the government and other stakeholders to proactively design targeted interventions for abdominal obesity, especially for women in their thirties and forties in India. Further research is recommended to understand the driving factors of abdominal obesity, their inter-operability, and the disease risk associated with this type of obesity. Funding None.
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Affiliation(s)
- Monika Chaudhary
- IIHMR University, Jaipur, India
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
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15
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Getahun MS, Deybasso HA, Komicha MA, Gurara AM. Magnitude of central obesity and associated factors among adult patients attending public health facilities in Adama town, Oromia region, Ethiopia, 2022. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:57. [PMID: 37330577 PMCID: PMC10276422 DOI: 10.1186/s41043-023-00397-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 06/04/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Central obesity is excessive accumulation of fat around the abdomen, which is associated with the risk of coronary heart and cerebrovascular diseases. This study determined the magnitude of central obesity among adult patients using the waist-to-hip ratio, which has a superior capacity to measure the risk of developing non-communicable diseases compared to the body mass index used in previous studies in Ethiopia. METHODS Institutional-based cross-sectional study was conducted among a sample of 480 adults from April 1 to May 30, 2022. A systematic random sampling technique was used to select the study participants. Data were collected by using interviewer-administered structured questionnaires and anthropometric measurements. The data were entered into EPI INFO version 7 and analyzed by Statistical Software for Social Science Version 25. The associations between independent and dependent variables were checked using bivariate and multivariate logistic regression analyses. Adjusted odds ratio and 95% confidence interval were used to measure the strengths of the association. Statistical significance was declared at a P value of less than 0.05. RESULTS The magnitude of central obesity in this study was 40% (51.2% and 27.4% among females and males, respectively (95% CI 36-44%)). Being a female (AOR = 9.5, 95% CI 5.22-17.9), age range 35-44 (AOR = 7.0, 95% CI 2.9-16.7), 45-64 years (AOR = 10.1, 95% CI4.0-15.2), married (AOR = 2.5, 95% CI 1.3-4.7), high monthly income (AOR = 3.3, 95% CI 1.5-7.3), high consumption of milk and milk products (AOR = 0.3, 95% CI 0.1-0.6), family history of obesity (AOR = 1.8, 95% CI 1.1-3.2) were significantly associated with central obesity among the study participants. CONCLUSION The magnitude of central obesity was higher in the study area. Sex, age, marital status, monthly income, consumption of milk and milk products, and family history of obesity were independent determinants of central obesity. Therefore, it is important to raise awareness about central obesity through behavior change communication that targets the high-risk population.
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Affiliation(s)
| | - Haji Aman Deybasso
- Public Health Department, Adama Hospital Medical College, Adama, Ethiopia.
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16
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Yadav U, Kumar N, Sarvottam K. Role of obesity related inflammation in pathogenesis of peripheral artery disease in patients of type 2 diabetes mellitus. J Diabetes Metab Disord 2023; 22:175-188. [PMID: 37255816 PMCID: PMC10225462 DOI: 10.1007/s40200-023-01221-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 03/29/2023] [Indexed: 06/01/2023]
Abstract
Objective Type 2 diabetes mellitus (T2DM) has emerged as one of the greatest global health challenges of twenty-first century. Visceral obesity is one of the most important determinant of insulin resistance (IR) as well as T2DM complications. Therefore this review focuses on the molecular mechanism of obesity induced inflammation, signaling pathways contributing to diabetes, as well as role of lifestyle interventions and medical therapies in the prevention and management of T2DM. Method Articles were searched on digital data base PubMed, Cochrane Library, and Web of Science. The key words used for search included Type 2 diabetes mellitus, obesity, insulin resistance, vascular inflammation and peripheral arterial disease. Result Visceral obesity is associated with chronic low grade inflammation and activation of immune systems which are involved in pathogenesis of obesity related IR and T2DM. Conclusion Metabolic dysregulation of adipose tissue leads to local hypoxia, misfolded/unfolded protein response and increased circulating free fatty acids, which in turn initiate inflammatory signaling cascades in the population of infiltrating cells. Mechanism that relates the role of adipocytokines with insulin sensitivity and glucose homeostasis might throw a light on the development of therapeutic interventions and subsequently might result in the reduction of vascular complications.
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Affiliation(s)
- Umashree Yadav
- Department of Physiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh 221005 India
| | - Nilesh Kumar
- Department of General Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005 India
| | - Kumar Sarvottam
- Department of Physiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh 221005 India
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Gupta RD, Tamanna N, Siddika N, Haider SS, Apu EH, Haider MR. Obesity and Abdominal Obesity in Indian Population: Findings from a Nationally Representative Study of 698,286 Participants. EPIDEMIOLOGIA 2023; 4:163-172. [PMID: 37218876 DOI: 10.3390/epidemiologia4020017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/30/2023] [Accepted: 05/05/2023] [Indexed: 05/24/2023] Open
Abstract
This study aims to determine and compare the prevalence and correlates of obesity and abdominal obesity in India among participants aged 18-54 years. Data were acquired from the nationally representative National Family Health Survey 2019-21. Age and sex standardized descriptive analyses were conducted to determine the prevalence of obesity and abdominal obesity, and multivariable multilevel logistic regression was performed to identify the factors associated with these conditions. Gender-specific analyses were also conducted. The sample weight was adjusted throughout. The final sample size for this study was 698,286. The prevalence of obesity and abdominal obesity was 13.85% and 57.71%, respectively. Older age, being female, increased educational status and increased wealth index, being married at any point, and residing in an urban area all increased the odds of both obesity and abdominal obesity. Being a resident of the North zone and having a current alcohol intake increased the odds of abdominal obesity. On the other hand, being a resident of the South zone of India increased the odds of obesity. Targeting these high-risk groups can be a strategy for public health promotion programs.
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Affiliation(s)
- Rajat Das Gupta
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29028, USA
| | - Nowrin Tamanna
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29028, USA
| | - Nazeeba Siddika
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI 48824, USA
- Centre for International Public Health and Environmental Research, Bangladesh (CIPHER,B), Dhaka 1207, Bangladesh
| | - Shams Shabab Haider
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., Baltimore, MD 21205, USA
| | - Ehsanul Hoque Apu
- Centre for International Public Health and Environmental Research, Bangladesh (CIPHER,B), Dhaka 1207, Bangladesh
- Department of Biomedical Engineering, Institute for Quantitative Health Science and Engineering (IQ), Michigan State University, East Lansing, MI 48824, USA
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, 90220 Oulu, Finland
| | - Mohammad Rifat Haider
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA 30602, USA
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18
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Ong J, Alswat K, Hamid S, El-Kassas M. Nonalcoholic Fatty Liver Disease in Asia, Africa, and Middle East Region. Clin Liver Dis 2023; 27:287-299. [PMID: 37024208 DOI: 10.1016/j.cld.2023.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease worldwide. The global prevalence of the disease varies according to the geographical region. Despite having distinct models for the western patterns of NAFLD, Africa, Asia, and the Middle East regions exhibited varying prevalence rates of NAFLD. The disease burden is anticipated to significantly increase in these areas. Furthermore, with an increase in NAFLD risk factors in these regions, the disease burden is expected to rise even more. Policies at the regional and international levels are required to address such growing burden of NAFLD consequences.
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Affiliation(s)
- Janus Ong
- College of Medicine, University of the Philippines, Manila, Philippines
| | - Khalid Alswat
- Department of Medicine, Liver Disease Research Centre, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Saeed Hamid
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Mohamed El-Kassas
- Endemic Medicine Department, Faculty of Medicine, Helwan University, Ain Helwan, Cairo 11795, Egypt.
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19
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Gade S, Sahasrabuddhe AV, Mohite KA, Bankar NJ, Chaudhary SS, Muley PA, Muley PP. Effect of Obesity on Left Ventricular Systolic and Diastolic Functions Based on Echocardiographic Indices. Cureus 2023; 15:e37232. [PMID: 37168145 PMCID: PMC10166396 DOI: 10.7759/cureus.37232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 04/06/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Left ventricular systolic and diastolic functions are known prognosticators for cardiovascular morbidity. One of the significant risk factors for cardiovascular diseases is obesity. The objective of this study is to determine the effect of obesity on the systolic and diastolic functions of the left ventricle on the basis of echocardiographic indices. METHODS 75 obese and 75 averagely built subjects were studied. They had no other comorbidities. The indices of echocardiography of systolic and diastolic function were taken and assessed using recent recommendations from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. RESULTS The volume indices of systolic and diastolic function (ejection diastolic volume (EDV) and ejection systolic volume (ESV)) and iso-volumetric relaxation time (IVRT) showed a significant increase in obese subjects (p<0.05); however, the relative thickness of the wall and internal diameter were comparable to non-obese subjects. The indices of contractility like ejection fraction, early diastolic filling velocity and late diastolic filling velocity (E/A) ratio, and mitral annular velocity were significantly lower in the obese subjects as compared to non-obese subjects. It was also found that left atrial diameter in systole and diastole had a moderate association (r=0.48, P<0.0001; r=0.35, P<0.0005) while mitral inflow E/A ratio had a negative association with body mass index (BMI) (r=-0.26, P=0.0166). CONCLUSIONS Volumetric changes and ejection are significantly altered by increased BMI. More comprehensive studies in the future are recommended to assess the same.
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Affiliation(s)
- Shubhda Gade
- Physiology, Datta Meghe Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Anagha V Sahasrabuddhe
- Physiology, Datta Meghe Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Kajal A Mohite
- Physiology, Datta Meghe Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Nandkishor J Bankar
- Microbiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Shilpa S Chaudhary
- Radiology, Datta Meghe Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Parikshit A Muley
- Physiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Pranjali P Muley
- Physiology, Datta Meghe Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
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20
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Singh SK, Singh R, Singh SK, Iquebal MA, Jaiswal S, Rai PK. Prevalence of Obesity in Newly Onset Diabetes Mellitus and Its Relationship with Uric Acid: An Indian Cross-Sectional Study. Int J Gen Med 2023; 16:1217-1226. [PMID: 37057053 PMCID: PMC10086392 DOI: 10.2147/ijgm.s402683] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 03/13/2023] [Indexed: 04/09/2023] Open
Abstract
Introduction Prevalence of obesity is high in diabetes mellitus (DM) and is associated with hyperuricemia (HU), hypertension, metabolic syndrome, cardiovascular disease and dyslipidemia. In obesity, elevated serum uric acid (SUA) has been shown to be associated in many studies from different countries, but data from India are lacking. The aim of the present study is to know the prevalence of obesity and to know the relationship between obesity and SUA in newly onset DM. Methods In this cross-sectional study from India, 402 consecutive newly onset diabetic patients (male: 284; female: 118) were enrolled. All patients were grouped into four based on BMI (body mass index): underweight (<18.5 kg/m2), normal weight (18.5-23 kg/m2), overweight (>23-27.5 kg/m2), and obese (>27.5 kg/m2). All participants were grouped into four quartiles based on SUA (Q1: <4.23; Q2: ≥4.24-5.19; Q3: ≥5.20-6.16; Q4: >6.16). Results The mean age, BMI and SUA of the participants were 46.20±0.52 years, 26.35±0.21 kg/m2 and 5.24±0.007 mg/dl, respectively. Overall prevalence of generalized obesity, central obesity and hyperuricemia (HU) were 35.07%, 85.82% and 13.43%, respectively. The prevalence of generalized obesity increased across the SUA quartile. A multinomial logistic regression analysis showed that serum uric acid level was independently associated with generalized obesity (p<0.001). Conclusion This first report from India shows a significant positive association between SUA and generalized obesity among newly onset DM. Therefore, routine estimation of SUA is recommended in newly onset DM to prevent and treat HU and its related complications.
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Affiliation(s)
- Shailendra Kumar Singh
- Department of Endocrine, Endocrine Clinic, Varanasi, Uttar Pradesh, India
- Correspondence: Shailendra Kumar Singh, Department of Endocrine, Endocrine Clinic, Varanasi, Uttar Pradesh, India, Email
| | - Rina Singh
- Department of Endocrine, Endocrine Clinic, Varanasi, Uttar Pradesh, India
| | | | - Mir Asif Iquebal
- Division of Agriculture Bioinformatics, ICAR-IASRI, New Delhi, India
| | - Sarika Jaiswal
- Division of Agriculture Bioinformatics, ICAR-IASRI, New Delhi, India
| | - Pradeep Kumar Rai
- Department of Nephrology, Opal Hospital, Varanasi, Uttar Pradesh, India
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Anjana RM, Deepa M, Pradeepa R. The ICMR-INDIAB Study: Results from the National Study on Diabetes in India. J Indian Inst Sci 2023. [DOI: 10.1007/s41745-023-00359-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
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22
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Narra LK, Ghate J, Sinha M, Sinha R. Assessment of visual and auditory evoked potentials in young obese males. Med J Armed Forces India 2023; 79:136-140. [PMID: 36969112 PMCID: PMC10037068 DOI: 10.1016/j.mjafi.2020.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/28/2020] [Indexed: 11/25/2022] Open
Abstract
Background Obesity is a chronic condition, affecting central and peripheral nervous system. Studies on cranial nerve conduction in obesity are scarce and unclear; therefore, we planned this study. The aim of this study was to evaluate optic and auditory nerve conductions in obesity. Methods It was a case-control study, with inclusion of 40 young males (20 obese and 20 controls) in age group of 18-30 years. We recorded pattern reversal visual evoked potential (PRVEP) and brainstem auditory evoked potential (BAEP). The PRVEP P100 latency and BAEP absolute and interpeak latencies were analyzed. Results In obese individuals, BAEP absolute latencies of wave V were significantly prolonged in both the ears and wave I in left ear. In addition, significant prolongation of interpeak latency III-V was observed in both the ears and I-V latency, in right ear among obese cases. A positive correlation was seen between body mass index and interpeak latency I-V. In PRVEP recordings, P100 latency did not show any significant difference in both the groups. Conclusion Therefore, we can conclude that obesity does not affect optic nerve conduction, but auditory nerve conduction is affected. BAEP I-V interpeak latency may be an indicator of subclinical auditory conduction defects in young obese males.
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Affiliation(s)
| | - Jayshri Ghate
- Associate Professor (Physiology), AIIMS Raipur, India
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Shanmugasundaram K, Bade G, Sampath M, Talwar A. Effect of Obesity on Airway Mechanics. Indian J Endocrinol Metab 2023; 27:161-166. [PMID: 37292068 PMCID: PMC10245307 DOI: 10.4103/ijem.ijem_363_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 01/15/2023] [Accepted: 01/27/2023] [Indexed: 06/10/2023] Open
Abstract
Background Obesity is known to induce lung function impairment. Previous studies of decline in lung function associated with obesity are well established. Materials and Methods In this cross-sectional study, to evaluate the effects of different obesity indices on lung mechanics, healthy subjects (males-23 and females-22) were recruited. Anthropometric parameters like body mass index (BMI), waist circumference (WC), hip circumference (HC) and neck circumference (NC) were measured and waist-hip ratio (WHR) was derived. Spirometry, impulse oscillometry (IOS) and fractional exhaled nitric oxide (FeNO) measurements were performed to assess lung function. Subgroups were divided and analysed. Results In males, increased WHR is associated with increased total airway resistance (R5). BMI correlates positively with R5, R5% predicted, resistance at 20 Hz (R20) and R20% predicted; likewise, WHR shows a positive correlation with R5. In females, increased WHR has significantly higher R5, R5% predicted, R20, R20% predicted, area of reactance (Ax), resonant frequency (Fres) and decreased reactance at 5 Hz (X5), reactance at 20 Hz (X20), X20% predicted. The female group with higher WC shows significantly increased R5, R5% predicted, R20, R20% predicted, Ax, Fres and lower fixed ratio of forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC), X5, X20, X20% predicted. The group with higher NC has a lower FEV1/FVC ratio. WHR positively correlated with R5% predicted and Fres while WC correlated positively with R5, R5% predicted, Ax and Fres; same way, NC with X5% predicted. Conclusion Obesity/overweight causes significant changes in lung volumes, capacity and airway mechanics, Higher WC and WHR are associated with significant changes in lung mechanics, which are more prominent in females than in males. NC is not associated with changes in lung mechanics.
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Affiliation(s)
| | - Geetanjali Bade
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Meghashree Sampath
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Anjana Talwar
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
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Mohan V, Sudha V, Shobana S, Gayathri R, Krishnaswamy K. Are Unhealthy Diets Contributing to the Rapid Rise of Type 2 Diabetes in India? J Nutr 2023; 153:940-948. [PMID: 36858259 DOI: 10.1016/j.tjnut.2023.02.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 02/18/2023] [Accepted: 02/22/2023] [Indexed: 03/03/2023] Open
Abstract
The prevalence of diabetes is increasing at an alarming rate globally, particularly in India. In the urban areas, the prevalence of diabetes among adults aged ≥20 y, which was around 2% in the early 1970's, has increased by >20% in 50 y. The rapid nutrition transition due to high economic growth rates increased urbanization and globalization has resulted in higher intakes of processed refined grain staples, mainly white rice in Southern and Eastern India and refined wheat in Northern and Western India. This coupled with inadequate quantity and quality of protein; unhealthy fats; lower intake of vegetables, fruits, and fiber; and a sedentary lifestyle are the main drivers of the diabetes epidemic in India. This review attempts to discuss both the quality and quantity of Indian diets with specific reference to macronutrients. This review also outlines some of the strategies that can be employed to slow down the diabetes epidemic in this region. We believe that the lessons learned from India would be applicable to other developing nations as well, particularly to the South East Asian region. J Nutr 2023;xx:xxx.
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Affiliation(s)
- Viswanathan Mohan
- Department of Diabetology, Madras Diabetes Research Foundation, Dr. Mohan's Diabetes Specialties Centre, IDF Centre of Diabetes Education, Chennai, Tamil Nadu, India.
| | - Vasudevan Sudha
- Department of Foods, Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Shanmugam Shobana
- Department of Diabetes Food Technology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Rajagopal Gayathri
- Department of Foods, Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Kamala Krishnaswamy
- Department of Foods, Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
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Gupta RD, Haider SS, Nishat MNS, Dey S, Akonde M, Haider MR. Prevalence and associated factors of abdominal obesity in the South Asian population: findings from nationally representative surveys. J Public Health (Oxf) 2023. [DOI: 10.1007/s10389-023-01846-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
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Sharma S, Matheson A, Lambrick D, Faulkner J, Lounsbury DW, Vaidya A, Page R. Dietary practices, physical activity and social determinants of non-communicable diseases in Nepal: A systemic analysis. PLoS One 2023; 18:e0281355. [PMID: 36745612 PMCID: PMC9901760 DOI: 10.1371/journal.pone.0281355] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 01/20/2023] [Indexed: 02/07/2023] Open
Abstract
Unhealthy dietary habits and physical inactivity are major risk factors of non-communicable diseases (NCDs) globally. The objective of this paper was to describe the role of dietary practices and physical activity in the interaction of the social determinants of NCDs in Nepal, a developing economy. The study was a qualitative study design involving two districts in Nepal, whereby data was collected via key informant interviews (n = 63) and focus group discussions (n = 12). Thematic analysis of the qualitative data was performed, and a causal loop diagram was built to illustrate the dynamic interactions of the social determinants of NCDs based on the themes. The study also involved sense-making sessions with policy level and local stakeholders. Four key interacting themes emerged from the study describing current dietary and physical activity practices, influence of junk food, role of health system and socio-economic factors as root causes. While the current dietary and physical activity-related practices within communities were unhealthy, the broader determinants such as socio-economic circumstances and gender further fuelled such practices. The health system has potential to play a more effective role in the prevention of the behavioural and social determinants of NCDs.
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Affiliation(s)
- Sudesh Sharma
- DIYASU Community Development Centre, Biratnagar, Morang, Nepal,Massey University, Wellington, Wellington Region, New Zealand,* E-mail:
| | - Anna Matheson
- Victoria University of Wellington, Wellington, Wellington Region, New Zealand
| | | | - James Faulkner
- University of Winchester, Winchester, Hampshire, United Kingdom
| | - David W. Lounsbury
- Albert Einstein College of Medicine, Bronx, New York, United States of America
| | | | - Rachel Page
- Massey University, Wellington, Wellington Region, New Zealand
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Nathan K, E M, Jabaris S SL, Visweswaraiah NK. Effect of abrupt and gradual calorie restriction regimens on biochemical and behavioral markers in obese mice model. Nutr Health 2023:2601060221131726. [PMID: 36650659 DOI: 10.1177/02601060221131726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Background: Although Calorie Restriction (CR) is primarily considered in obesity management, behavioral studies of CR and its methodology of implementation are not well-defined. Objective: The study aimed to determine the efficacy of the extensively researched method of CR-abrupt calorie restriction (ACR) and a newly proposed gradual calorie restriction (GCR) in terms of body weight, behavioral and biochemical parameters in the obese animal model-C57BL/6J mice. Design: Male obese mice were subjected to GCR regimen for 14 weeks which was compared and evaluated for anxiety-like behavior and stress levels with ACR. Plasma corticosterone was measured before initiation of CR and every three weeks following GCR and ACR, whereas plasma insulin was measured twice-after obesity induction and post 14 weeks of CR. The behavioral assessments were conducted before inducing CR and every three weeks following ACR and GCR. Results: A significant anxiety-like behavior and an increase in plasma corticosterone were observed in mice on GCR during the critical initial six weeks of CR (p < 0.05). Both groups showed a decrease in plasma glucose levels; however, the GCR group showed a significant reduction (p < 0.01). There was a significant decrease in social interaction in both groups with an increase in the latency period and a decrease in time spent with the stranger animal during the social interaction test (p < 0.05). Conclusion: The mice on GCR regimen demonstrated lesser anxiety-like behavior and low plasma corticosterone levels compared to those on ACR. This gives us a new avenue in CR research to evaluate the methodologies of implementing CR.
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Affiliation(s)
- Kousalya Nathan
- Department of Biochemistry, 77239Chettinad Academy of Research and Education, Kanchipuram District, Tamil Nadu, India
| | - Malligai E
- Department of Biochemistry, 77239Chettinad Academy of Research and Education, Kanchipuram District, Tamil Nadu, India
| | - Sugin Lal Jabaris S
- Department of Pharmacology, Siddha Central Research Institute, 390302Central Council for Research in Siddha, Anna Govt. Hospital Campus, Chennai, India
| | - Naveen K Visweswaraiah
- Australian Research Council for Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology, Sydney, Australia
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Suresh C, Govindasamy K, KS S, Anand M, Kaur D, Anitha JB, Aloui A, Boughanmi H, Achouri I. Role of aerobics exercise and kettlebell training improving on selected health related physical fitness parameters in obese male adults. HEALTH, SPORT, REHABILITATION 2022. [DOI: 10.34142/hsr.2022.08.04.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background: Aerobics exercise training and kettlebell training is recommended to prevent and control overweight/obesity.
Purpose: The aim of the this research is to assess the improvement in various variables related to health fitness among obese adults on administrating a twelve weeks aerobics exercise training and kettlebell training.
Materials and Methods: Total sixty male adults with obese (Mean ± SD; age: 18.92 ± 1.54 yrs.; height: 172.4 ± 5.4 cm.; weight: 84.4 ± 6.3 kg) were randomly allocated into three equal (n = 20) groups: Aerobic Exercise Training (AET), Kettlebell Training (KBT) and a control group. The AET & KBT training protocol was performed three days per week for 12 weeks. All the selected variables of physical fitness has been examined at baseline and 12 weeks. Control group does not perform any exercise.
Analysis and findings: There were significant difference in terms of Flexibility (F), Muscular Endurance (ME), Muscular Strength (MS) and Cardiovascular Endurance (CE), between the AETG & KBTG have been compared with control group (p < 0.05). Body Composition (BF) significant reductions in AET & KBT groups have been compared with control group (p < 0.05).
Conclusion: Our findings suggest that AET & KBT protocols have greater effects than control group on health related physical fitness variables in obese male adult individuals. It is recommended that schools and colleges should administrate the aerobic exercise session and kettlebell training among adults for better health perspectives.
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Kaur H, Bains V, Sharma T, Badaruddoza. Relationship between leptin gene variants (–2548G>A and 19A>G) and obesity among north Indian Punjabi population. J Genet 2022. [DOI: 10.1007/s12041-022-01401-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Sinha A, Puri P, Pati S. Social determinants of diabesity and its association with multimorbidity among older adults in India: a population-based cross-sectional study. BMJ Open 2022; 12:e061154. [PMID: 36424108 PMCID: PMC9693658 DOI: 10.1136/bmjopen-2022-061154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES India, a major contributor to the global diabetes burden, is witnessing a simultaneous epidemic of obesity leading to rise in diabesity. Diabesity, the coexistence of diabetes and obesity in an individual, has emerged as a risk factor for other morbidities and hence, multimorbidity. Although diabesity has long been recognised, still, there is a poor understanding of its social determinants in India, necessary for its control. We aimed to estimate and compare the prevalence and identify social determinants of obesity, diabetes and diabesity; explore their association with other selected non-communicable diseases (NCDs) multimorbidity; and assess its outcomes among adults aged ≥45 years. DESIGN AND SETTING We undertook an observational analyses employing nationally representative data from Longitudinal Ageing Study in India, 2017-2018. PARTICIPANTS This study was conducted among n=59 073 respondents. OUTCOME MEASURES Descriptive analysis was conducted among n=59 073 respondents to determine prevalence of diabetes, obesity and diabesity. The social determinants were assessed using multinomial regression, reported as adjusted relative risk ratio (RRR). A multiple correspondence analysis generated life satisfaction. RESULTS The prevalence of obesity, diabetes, and diabesity was 21.2%, 6%, and 5.8%, respectively. We identified women (RRR: 2.16 (1.72 to 2.71)), urban residents (RRR: 3.73 (3.07 to 4.54)) and affluent groups (RRR: 3.60 (2.46 to 4.58)) had a higher likelihood of having diabesity. The association with various NCDs showed multimorbidity to be akin to the diabesity group. We observed inferior life satisfaction and significantly higher healthcare utilisation among participants with diabesity as compared with other two groups. CONCLUSION Increased obesity prevalence has led to the rise in diabesity in India. Additionally, the level of multimorbidity in this group cannot be overlooked. Rather than focusing on individual conditions, an in toto approach to multimorbidity is warranted.
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Affiliation(s)
- Abhinav Sinha
- ICMR-Regional Medical Research Centre Bhubaneswar, Bhubaneswar, Odisha, India
| | - Parul Puri
- Department of Survey Research and Data Analytics, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Sanghamitra Pati
- ICMR-Regional Medical Research Centre Bhubaneswar, Bhubaneswar, Odisha, India
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Salis S. Effects of Intermittent Fasting on Weight Loss in Asian Indian Adults with Obesity. JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 2022; 70:11-12. [DOI: 10.5005/japi-11001-0098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Pawalia A, Yadav VS, Pawalia K. Effect of an exercise intervention during pregnancy on metabolic health parameters and delivery outcomes in Indian women. COMPARATIVE EXERCISE PHYSIOLOGY 2022. [DOI: 10.3920/cep220034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Moderate physical activity is important during pregnancy. However, this concept is new in India. This study reported the effect of an exercise intervention on weight changes and delivery outcomes in pregnant Indian women. 60 pregnant women in two groups underwent a pregnancy intervention between 20 weeks of gestation till delivery. Group 1 attended a supervised prenatal weekly exercise session with diet advise & walking for 30 min/day from 20 weeks of gestation till delivery. Group 2 received regular prenatal care at the hospital with general advice on physical activity during pregnancy. Outcome variables-body weight, body mass index (BMI), waist & hip circumference, gestational weight gain (GWG), post-partum weight retention (PPWR) and 2 delivery outcomes, i.e. mode of delivery and prolonged labour. The readings were taken at baseline, at delivery and at 2 months post-delivery. Intervention group retained less PPWR than the control at 2 months post-delivery. Similar results were found for various obesity parameters, waist (5.60±4.96 and 9.46±4.64, P=0.003) and hip (4.33±4.25 and 7.70±7.46, P=0.036) circumference and BMI at 2 months post-partum (2.41±1.65 and 4.28±3.75, P=0.015). Incidence of caesarean section and prolonged labour was less in intervention group too (P=0.012). The pregnancy lifestyle intervention significantly reduced weight retention, obesity parameters, and reduced pregnancy complications, in Indian women. Clinical Trial Registry India no. CTRI/2017/04/008322
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Affiliation(s)
- A. Pawalia
- Department of Physiotherapy, Guru Jambheshwar University of Science & Technology, Hisar, Haryana, India
| | - V. Singh Yadav
- College of Physiotherapy, Pt. B.D Sharma University of Health Sciences, PGIMS, Rohtak 124001, Haryana, India
| | - K. Pawalia
- National Health Systems Resource Centre, NHM, MoHFWF, GOI, New Delhi 110067, India
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Hulkoti V, Acharya S, Shukla S, Kumar S, Kabra R, Dubey A, Lahane V, Giri A. Visceral Adiposity Index in Type 2 Diabetes Mellitus (DM) and Its Correlation With Microvascular Complications. Cureus 2022; 14:e31279. [DOI: 10.7759/cureus.31279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 11/09/2022] [Indexed: 11/11/2022] Open
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Paul B, Acharya S. Measurement of association between malocclusion, nutritional status, and dental trauma in adolescents: A cross-sectional study. Med J Armed Forces India 2022; 78:S232-S237. [PMID: 36147399 PMCID: PMC9485745 DOI: 10.1016/j.mjafi.2020.10.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 10/27/2020] [Indexed: 11/22/2022] Open
Abstract
Background With the decrease in the incidence of dental caries globally, traumatic dental injury (TDI) has emerged as a major cause of morbidity and distress among adolescents. The aim of this study was to assess the prevalence of TDI and explore its association with malocclusion and nutritional status among adolescent population of Udupi taluk, Karnataka state, India. Methods The sample consisted of 770 children, from randomly selected schools in Udupi taluk. An anthropometric measurement was done to record the "body mass index", an oral examination was done to record the "Dental Aesthetic Index" for malocclusion and "Andreasen classification" for TDI. Statistical analysis included chi-square test and bivariate and multivariate binary logistic regression. A p value of ≤0.05 was considered statistically significant. Results The prevalence of TDI was 11.8%. The prevalence of overweight and obesity was 20.3%. The prevalence of malocclusion recorded in the study population was 49.8%. When prevalence of TDI was compared against gender, the type of school attended, and presence/absence of malocclusion, it was found that there was a statistically significant difference in prevalence of trauma between the aforementioned parameters (p ≤ 0.05). Results of the multivariate analysis through logistic regression indicated that being a male [3.87 (3.21-4.72)], attending a public school [1.41 (1.19-1.63)], and having malocclusion [1.55 (1.32-1.71)] significantly increased the odds of sustaining TDI. Conclusion The results indicated a strong association between TDI, gender, the type of school attended, and malocclusion, and they have important implications toward the health and well-being of the individual communities.
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Affiliation(s)
- Budhaditya Paul
- DO & MDS (Public Health Dentistry), 320 Field Hospital, 903320, C/o 99 APO, India
| | - Shashidhar Acharya
- Professor & Head (Public Health Dentistry), Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India
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Yang X, Ouyang Y, Zhang X, Su C, Bai J, Zhang B, Hong Z, Du S, Wang H. Waist Circumference of the Elderly over 65 Years Old in China Increased Gradually from 1993 to 2015: A Cohort Study. BIOMEDICAL AND ENVIRONMENTAL SCIENCES : BES 2022; 35:604-612. [PMID: 35945175 PMCID: PMC10023151 DOI: 10.3967/bes2022.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/14/2022] [Indexed: 06/15/2023]
Abstract
Objective This study aimed to analyze the temporal trends and characteristics associated with waist circumference (WC) among elderly Chinese people. Methods We used data from 3,096 adults ≥ 65 years who participated in the China Health and Nutrition Survey (CHNS), an ongoing cohort study, between 1993 and 2015. We used longitudinal quantile regression models to explore the temporal trends and characteristics associated with WC. Results WC increased gradually among the elderly Chinese population during the survey. The WC curves shifted to the right with wider distributions and lower peaks in men and women. All WC percentile curves shifted upward with similar growth rates in the 25th, 50th, and 75th percentiles. The WC means increased from 78 cm to 86 cm during the 22 years of our study. WC significantly increased with age and body mass index and decreased with physical activity (PA). These associations were stronger in the higher percentiles than in the lower percentiles. Conclusions WC is rising among Chinese adults ≥ 65 years. Factors affecting WC in elderly people may have different effects on different percentiles of the WC distribution, and PA was the most important protective factor in the higher percentiles of the WC distribution. Thus, different interventional strategies are needed.
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Affiliation(s)
- Xinli Yang
- Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yifei Ouyang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaofan Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chang Su
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jing Bai
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Bing Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhongxin Hong
- Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Shufa Du
- Department of Nutrition and Carolina Population Center University of North Carolina at Chapel Hill, the United States
| | - Huijun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
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Sridhar S, Nazirudeen R, Ramasamy S, Natarajan V, Thiagarajan K, Karthika LN. Clinical Profile and Molecular Genetic Analysis of Prader - Willi Syndrome: A Single Center Experience. Indian J Endocrinol Metab 2022; 26:384-388. [PMID: 36185961 PMCID: PMC9519837 DOI: 10.4103/ijem.ijem_122_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 05/31/2022] [Accepted: 07/21/2022] [Indexed: 11/04/2022] Open
Abstract
AIM The prevalence of childhood and adolescent obesity is increasing worldwide as well as in India. Prader--Willi syndrome (PWS) is one of the most common causes of syndromic obesity with varied clinical manifestations across different lifespan. Herewith, we describe clinical and molecular characteristics of eight PWS who were diagnosed in an obesity clinic of tertiary care hospital. MATERIALS AND METHODS Clinically suspected cases of PWS were screened between January 2014 and January 2022. Detailed history and clinical examination were done to look for typical features of PWS like characteristic facial appearance, short stature, obesity, hyperphagia, delayed puberty or hypogonadism, diabetes mellitus, developmental delay, cognitive dysfunction, learning disabilities or abnormal behavior. All were evaluated, with 75 g oral glucose tolerance tests (GTT), HbA1c, Free T4, TSH, LH, FSH, testosterone, and growth hormone level. Intelligent quotient (IQ) of each patient was assessed by a psychiatrist using Binet-Kamat test. Molecular confirmation of clinically suspected PWS was done by either Methylation-specific polymerase chain reaction (MS-PCR) or Fluorescence in situ Hybridization (FISH) methods. RESULTS Based on clinical and molecular characteristics, eight were diagnosed as PWS. Except one, all were male with characteristic facies, mean age of study cohort was 12 years and mean BMI of 44.58. Obesity, short stature, hyperphagia, hypotonia, and mild to moderate mental retardation were noted in entire (100%) PWS study population. All male PWS patients had cryptorchidism, which was bilateral in six patients and unilateral (right undescended testes) in one. Apart from obesity, short stature, other endocrine associations noted were diabetes mellitus in 50% and subclinical hypothyroidism in 37% of PWS. Molecular characteristics of PWS were confirmed by Methylation-specific PCR in seven and by FISH method in one. CONCLUSION Prader-Willi syndrome should be kept in mind in case of childhood or adolescent obesity with short stature, hypotonia, cryptorchidism, and developmental delay or cognitive dysfunction. Judicious use of molecular diagnostic testing should be made in all clinically suspected cases. Early diagnosis and appropriate management of this complex disorder by a multidisciplinary team will improve the quality of life and treatment outcome.
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Affiliation(s)
- Subbiah Sridhar
- Department of Endocrinology, Madurai Medical College and Govt. Rajaji Hospital, Madurai, Tamil Nadu, India
| | - Roshan Nazirudeen
- Department of Endocrinology, Madurai Medical College and Govt. Rajaji Hospital, Madurai, Tamil Nadu, India
| | - Suresh Ramasamy
- Institute of Paediatrics and Child Health, Madurai Medical College, Madurai, Tamil Nadu, India
| | - Vasanthiy Natarajan
- Department of Endocrinology, Madurai Medical College and Govt. Rajaji Hospital, Madurai, Tamil Nadu, India
| | - Kumanan Thiagarajan
- Department of Psychiatry, Madurai Medical College, Madurai, Tamil Nadu, India
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Madhu SV. The Changing Paradigm of Obesity Care. Indian J Endocrinol Metab 2022; 26:293-294. [PMID: 36185957 PMCID: PMC9519842 DOI: 10.4103/2230-8210.356237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- S. V. Madhu
- Department of Endocrinology, Centre for Diabetes, Endocrinology and Metabolism, University College of Medical Sciences, Delhi, India
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S.V M, Nitin K, Sambit D, Nishant R, Sanjay K. ESI Clinical Practice Guidelines for the Evaluation and Management of Obesity In India. Indian J Endocrinol Metab 2022; 26:295-318. [PMID: 36185955 PMCID: PMC9519829 DOI: 10.4103/2230-8210.356236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Madhu S.V
- Department of Endocrinology, Centre for Diabetes, Endocrinology and Metabolism, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, India
| | - Kapoor Nitin
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, Tamil Nadu, India
| | - Das Sambit
- Department of Endocrinology, Hi Tech Medical College and Hospital, Bhubaneshwar, Odisha, India
| | - Raizada Nishant
- Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India
| | - Kalra Sanjay
- Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India
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Wuni R, Adela Nathania E, Ayyappa AK, Lakshmipriya N, Ramya K, Gayathri R, Geetha G, Anjana RM, Kuhnle GGC, Radha V, Mohan V, Sudha V, Vimaleswaran KS. Impact of Lipid Genetic Risk Score and Saturated Fatty Acid Intake on Central Obesity in an Asian Indian Population. Nutrients 2022; 14:2713. [PMID: 35807893 PMCID: PMC9269337 DOI: 10.3390/nu14132713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 11/22/2022] Open
Abstract
Abnormalities in lipid metabolism have been linked to the development of obesity. We used a nutrigenetic approach to establish a link between lipids and obesity in Asian Indians, who are known to have a high prevalence of central obesity and dyslipidaemia. A sample of 497 Asian Indian individuals (260 with type 2 diabetes and 237 with normal glucose tolerance) (mean age: 44 ± 10 years) were randomly chosen from the Chennai Urban Rural Epidemiological Study (CURES). Dietary intake was assessed using a previously validated questionnaire. A genetic risk score (GRS) was constructed based on cholesteryl ester transfer protein (CETP) and lipoprotein lipase (LPL) genetic variants. There was a significant interaction between GRS and saturated fatty acid (SFA) intake on waist circumference (WC) (Pinteraction = 0.006). Individuals with a low SFA intake (≤23.2 g/day), despite carrying ≥2 risk alleles, had a smaller WC compared to individuals carrying <2 risk alleles (Beta = −0.01 cm; p = 0.03). For those individuals carrying ≥2 risk alleles, a high SFA intake (>23.2 g/day) was significantly associated with a larger WC than a low SFA intake (≤23.2 g/day) (Beta = 0.02 cm, p = 0.02). There were no significant interactions between GRS and other dietary factors on any of the measured outcomes. We conclude that a diet low in SFA might help reduce the genetic risk of central obesity confirmed by CETP and LPL genetic variants. Conversely, a high SFA diet increases the genetic risk of central obesity in Asian Indians.
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Affiliation(s)
- Ramatu Wuni
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Reading RG6 6DZ, UK; (R.W.); (G.G.C.K.)
| | - Evelyn Adela Nathania
- Indonesia International Institute for Life Sciences, JI. Pulomas Barat Kav. 88, Jakarta Timur 13210, Indonesia;
| | - Ashok K. Ayyappa
- Department of Molecular Genetics, Madras Diabetes Research Foundation, ICMR Centre for Advanced Research on Diabetes, Chennai 603103, India; (A.K.A.); (K.R.); (R.M.A.); (V.R.); (V.M.)
| | - Nagarajan Lakshmipriya
- Department of Food, Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai 600086, India; (N.L.); (R.G.); (G.G.); (V.S.)
| | - Kandaswamy Ramya
- Department of Molecular Genetics, Madras Diabetes Research Foundation, ICMR Centre for Advanced Research on Diabetes, Chennai 603103, India; (A.K.A.); (K.R.); (R.M.A.); (V.R.); (V.M.)
| | - Rajagopal Gayathri
- Department of Food, Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai 600086, India; (N.L.); (R.G.); (G.G.); (V.S.)
| | - Gunasekaran Geetha
- Department of Food, Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai 600086, India; (N.L.); (R.G.); (G.G.); (V.S.)
| | - Ranjit Mohan Anjana
- Department of Molecular Genetics, Madras Diabetes Research Foundation, ICMR Centre for Advanced Research on Diabetes, Chennai 603103, India; (A.K.A.); (K.R.); (R.M.A.); (V.R.); (V.M.)
- Department of Food, Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai 600086, India; (N.L.); (R.G.); (G.G.); (V.S.)
- Dr. Mohan’s Diabetes Specialties Centre, IDF Centre of Excellence in Diabetes Care, Gopalapuram, Chennai 600086, India
| | - Gunter G. C. Kuhnle
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Reading RG6 6DZ, UK; (R.W.); (G.G.C.K.)
| | - Venkatesan Radha
- Department of Molecular Genetics, Madras Diabetes Research Foundation, ICMR Centre for Advanced Research on Diabetes, Chennai 603103, India; (A.K.A.); (K.R.); (R.M.A.); (V.R.); (V.M.)
| | - Viswanathan Mohan
- Department of Molecular Genetics, Madras Diabetes Research Foundation, ICMR Centre for Advanced Research on Diabetes, Chennai 603103, India; (A.K.A.); (K.R.); (R.M.A.); (V.R.); (V.M.)
- Department of Food, Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai 600086, India; (N.L.); (R.G.); (G.G.); (V.S.)
- Dr. Mohan’s Diabetes Specialties Centre, IDF Centre of Excellence in Diabetes Care, Gopalapuram, Chennai 600086, India
| | - Vasudevan Sudha
- Department of Food, Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai 600086, India; (N.L.); (R.G.); (G.G.); (V.S.)
| | - Karani Santhanakrishnan Vimaleswaran
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Reading RG6 6DZ, UK; (R.W.); (G.G.C.K.)
- The Institute for Food, Nutrition, and Health (IFNH), University of Reading, Reading RG6 6AP, UK
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Anjana RM, Unnikrishnan R, Deepa M, Venkatesan U, Pradeepa R, Joshi S, Saboo B, Das AK, Bajaj S, Bhansali A, Madhu SV, Dhandhania VK, Jabbar PK, Jain SM, Gupta A, Chowdhury S, Ali MK, Nirmal E, Subashini R, Kaur T, Dhaliwal RS, Tandon N, Mohan V. Achievement of guideline recommended diabetes treatment targets and health habits in people with self-reported diabetes in India (ICMR-INDIAB-13): a national cross-sectional study. Lancet Diabetes Endocrinol 2022; 10:430-441. [PMID: 35461575 DOI: 10.1016/s2213-8587(22)00072-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 02/10/2022] [Accepted: 02/16/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND There is little information on comprehensive diabetes care comprising glycaemic, lipid, and blood pressure control in India; therefore, we aimed to assess the achievement of treatment targets among adults with self-reported diabetes. METHODS The Indian Council of Medical Research (ICMR)-India Diabetes (INDIAB) study is a cross-sectional, population-based survey of adults aged 20 years or older in all 30 states and union territories of India. We used a stratified multistage sampling design, sampling states in a phased manner, and selected villages in rural areas and census enumeration blocks in urban areas. We used a three-level stratification method on the basis of geography, population size, and socioeconomic status for each state. For the outcome assessment, good glycaemic control was defined as HbA1c of less than 7·0% (A), blood pressure control was defined as less than 140/90 mm Hg (B), and the LDL cholesterol target was defined as less than 100 mg/dL (C). ABC control was defined as the proportion of individuals meeting glycaemic, blood pressure, and LDL cholesterol targets together. We also performed multiple logistic regression to assess the factors influencing achievement of diabetes treatment targets. FINDINGS Between Oct 18, 2008, and Dec 17, 2020, 113 043 individuals (33 537 from urban areas and 79 506 from rural areas) participated in the ICMR-INDIAB study. For this analysis, 5789 adults (2633 in urban areas and 3156 in rural areas) with self-reported diabetes were included in the study population. The median age was 56·1 years (IQR 55·7-56·5). Overall, 1748 (weighted proportion 36·3%, 95% CI 34·7-37·9) of 4834 people with diabetes achieved good glycaemic control, 2819 (weighted proportion 48·8%, 47·2-50·3) of 5698 achieved blood pressure control, and 2043 (weighted proportion 41·5%, 39·9-43·1) of 4886 achieved good LDL cholesterol control. Only 419 (weighted proportion 7·7%) of 5297 individuals with self-reported diabetes achieved all three ABC targets, with significant heterogeneity between regions and states. Higher education, male sex, rural residence, and shorter duration of diabetes (<10 years) were associated with better achievement of combined ABC targets. Only 951 (weighted proportion 16·7%) of the study population and 227 (weighted proportion 36·9%) of those on insulin reported using self-monitoring of blood glucose. INTERPRETATION Achievement of treatment targets and adoption of healthy behaviours remains suboptimal in India. Our results can help governments to adopt policies that prioritise improvement of diabetes care delivery and surveillance in India. FUNDING Indian Council of Medical Research and Department of Health Research, Ministry of Health and Family Welfare.
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Affiliation(s)
- Ranjit Mohan Anjana
- Department of Diabetology, Madras Diabetes Research Foundation, Indian Council of Medical Research Centre for Advanced Research on Diabetes and Dr Mohan's Diabetes Specialities Centre, Chennai, India
| | - Ranjit Unnikrishnan
- Department of Diabetology, Madras Diabetes Research Foundation, Indian Council of Medical Research Centre for Advanced Research on Diabetes and Dr Mohan's Diabetes Specialities Centre, Chennai, India
| | - Mohan Deepa
- Department of Epidemiology, Madras Diabetes Research Foundation, Indian Council of Medical Research Centre for Advanced Research on Diabetes and Dr Mohan's Diabetes Specialities Centre, Chennai, India
| | - Ulagamathesan Venkatesan
- Department of Biostatistics, Madras Diabetes Research Foundation, Indian Council of Medical Research Centre for Advanced Research on Diabetes and Dr Mohan's Diabetes Specialities Centre, Chennai, India
| | - Rajendra Pradeepa
- Department of Research Operations, Madras Diabetes Research Foundation, Indian Council of Medical Research Centre for Advanced Research on Diabetes and Dr Mohan's Diabetes Specialities Centre, Chennai, India
| | - Shashank Joshi
- Department of Diabetology and Endocrinology, Lilavati Hospital and Research Centre, Mumbai, India
| | - Banshi Saboo
- Dia Care, Diabetes Care and Hormone Clinic, Ahmedabad, India
| | - Ashok Kumar Das
- Department of General Medicine and Endocrinology, Pondicherry Institute of Medical Sciences, Puducherry, India
| | - Sarita Bajaj
- Department of Medicine, Moti Lal Nehru Medical College, Prayagraj, India
| | - Anil Bhansali
- Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sri Venkata Madhu
- Department of Endocrinology, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, India
| | | | | | - Sunil M Jain
- TOTALL, Diabetes Thyroid Hormone Research Institute, Indore, India
| | | | - Subhankar Chowdhury
- Department of Endocrinology and Metabolism, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, India
| | - Mohammed K Ali
- Department of Epidemiology, Madras Diabetes Research Foundation, Indian Council of Medical Research Centre for Advanced Research on Diabetes and Dr Mohan's Diabetes Specialities Centre, Chennai, India; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Elangovan Nirmal
- Department of Research Operations, Madras Diabetes Research Foundation, Indian Council of Medical Research Centre for Advanced Research on Diabetes and Dr Mohan's Diabetes Specialities Centre, Chennai, India
| | - Radhakrishnan Subashini
- Department of Biostatistics, Madras Diabetes Research Foundation, Indian Council of Medical Research Centre for Advanced Research on Diabetes and Dr Mohan's Diabetes Specialities Centre, Chennai, India
| | - Tanvir Kaur
- Division of Non-Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | | | - Nikhil Tandon
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Viswanathan Mohan
- Department of Diabetology, Madras Diabetes Research Foundation, Indian Council of Medical Research Centre for Advanced Research on Diabetes and Dr Mohan's Diabetes Specialities Centre, Chennai, India.
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Venkatesan V, Lopez-Alvarenga JC, Arya R, Ramu D, Koshy T, Ravichandran U, Ponnala AR, Sharma SK, Lodha S, Sharma KK, Shaik MV, Resendez RG, Venugopal P, R P, Saju N, Ezeilo JA, Bejar C, Wander GS, Ralhan S, Singh JR, Mehra NK, Vadlamudi RR, Almeida M, Mummidi S, Natesan C, Blangero J, Medicherla KM, Thanikachalam S, Panchatcharam TS, Kandregula DK, Gupta R, Sanghera DK, Duggirala R, Paul SFD. Burden of Type 2 Diabetes and Associated Cardiometabolic Traits and Their Heritability Estimates in Endogamous Ethnic Groups of India: Findings From the INDIGENIUS Consortium. Front Endocrinol (Lausanne) 2022; 13:847692. [PMID: 35498404 PMCID: PMC9048207 DOI: 10.3389/fendo.2022.847692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 02/21/2022] [Indexed: 01/14/2023] Open
Abstract
To assess the burden of type 2 diabetes (T2D) and its genetic profile in endogamous populations of India given the paucity of data, we aimed to determine the prevalence of T2D and estimate its heritability using family-based cohorts from three distinct Endogamous Ethnic Groups (EEGs) representing Northern (Rajasthan [Agarwals: AG]) and Southern (Tamil Nadu [Chettiars: CH] and Andhra Pradesh [Reddys: RE]) states of India. For comparison, family-based data collected previously from another North Indian Punjabi Sikh (SI) EEG was used. In addition, we examined various T2D-related cardiometabolic traits and determined their heritabilities. These studies were conducted as part of the Indian Diabetes Genetic Studies in collaboration with US (INDIGENIUS) Consortium. The pedigree, demographic, phenotypic, covariate data and samples were collected from the CH, AG, and RE EEGs. The status of T2D was defined by ADA guidelines (fasting glucose ≥ 126 mg/dl or HbA1c ≥ 6.5% and/or use of diabetes medication/history). The prevalence of T2D in CH (N = 517, families = 21, mean age = 47y, mean BMI = 27), AG (N = 530, Families = 25, mean age = 43y, mean BMI = 27), and RE (N = 500, Families = 22, mean age = 46y, mean BMI = 27) was found to be 33%, 37%, and 36%, respectively, Also, the study participants from these EEGs were found to be at increased cardiometabolic risk (e.g., obesity and prediabetes). Similar characteristics for the SI EEG (N = 1,260, Families = 324, Age = 51y, BMI = 27, T2D = 75%) were obtained previously. We used the variance components approach to carry out genetic analyses after adjusting for covariate effects. The heritability (h2) estimates of T2D in the CH, RE, SI, and AG were found to be 30%, 46%, 54%, and 82% respectively, and statistically significant (P ≤ 0.05). Other T2D related traits (e.g., BMI, lipids, blood pressure) in AG, CH, and RE EEGs exhibited strong additive genetic influences (h2 range: 17% [triglycerides/AG and hs-CRP/RE] - 86% [glucose/non-T2D/AG]). Our findings highlight the high burden of T2D in Indian EEGs with significant and differential additive genetic influences on T2D and related traits.
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Affiliation(s)
- Vettriselvi Venkatesan
- Department of Human Genetics, Faculty of Biomedical Sciences and Technology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, India
| | - Juan Carlos Lopez-Alvarenga
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Brownsville, TX, United States
| | - Rector Arya
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Brownsville, TX, United States
| | - Deepika Ramu
- Department of Human Genetics, Faculty of Biomedical Sciences and Technology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, India
| | - Teena Koshy
- Department of Human Genetics, Faculty of Biomedical Sciences and Technology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, India
| | - Umarani Ravichandran
- Department of Medicine, Rajah Muthiah Medical College Hospital, Annamalai University, Chidambaram, India
| | - Amaresh Reddy Ponnala
- Department of Endocrinology, Krishna Institute of Medical Sciences (KIMS) Hospital, Nellore, India
| | | | - Sailesh Lodha
- Departments of Preventive Cardiology, Internal Medicine and Endocrinology, Eternal Heart Care Centre and Research Institute, Mount Sinai New York Affiliate, Jaipur, India
| | - Krishna K. Sharma
- Department of Pharmacology, Lal Bahadur Shastri College of Pharmacy, Rajasthan University of Health Sciences, Jaipur, India
| | - Mahaboob Vali Shaik
- Department of Endocrinology, Narayana Medical College and Hospital, Nellore, India
| | - Roy G. Resendez
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Brownsville, TX, United States
| | - Priyanka Venugopal
- Department of Human Genetics, Faculty of Biomedical Sciences and Technology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, India
| | - Parthasarathy R
- Department of Human Genetics, Faculty of Biomedical Sciences and Technology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, India
| | - Noelta Saju
- Department of Human Genetics, Faculty of Biomedical Sciences and Technology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, India
| | - Juliet A. Ezeilo
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Brownsville, TX, United States
| | - Cynthia Bejar
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Gurpreet S. Wander
- Hero Dayanand Medical College (DMC) Heart Institute, Dayanand Medical College and Hospital, Ludhaina, India
| | - Sarju Ralhan
- Hero Dayanand Medical College (DMC) Heart Institute, Dayanand Medical College and Hospital, Ludhaina, India
| | - Jai Rup Singh
- Honorary or Emeritus Faculty, Central University of Punjab, Bathinda, India
| | - Narinder K. Mehra
- Honorary or Emeritus Faculty, All India Institute of Medical Sciences and Research, New Delhi, India
| | | | - Marcio Almeida
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Brownsville, TX, United States
| | - Srinivas Mummidi
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Brownsville, TX, United States
| | - Chidambaram Natesan
- Department of Medicine, Rajah Muthiah Medical College Hospital, Annamalai University, Chidambaram, India
| | - John Blangero
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Brownsville, TX, United States
| | | | - Sadagopan Thanikachalam
- Department of Cardiology, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, India
| | | | | | - Rajeev Gupta
- Departments of Preventive Cardiology, Internal Medicine and Endocrinology, Eternal Heart Care Centre and Research Institute, Mount Sinai New York Affiliate, Jaipur, India
| | - Dharambir K. Sanghera
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- Department of Physiology, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Ravindranath Duggirala
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Brownsville, TX, United States
| | - Solomon F. D. Paul
- Department of Human Genetics, Faculty of Biomedical Sciences and Technology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, India
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The Prevalence of Overweight Status among Early Adolescents from Private Schools in Indonesia: Sex-Specific Patterns Determined by School Urbanization Level. Nutrients 2022; 14:nu14051001. [PMID: 35267976 PMCID: PMC8912438 DOI: 10.3390/nu14051001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 02/24/2022] [Accepted: 02/25/2022] [Indexed: 02/04/2023] Open
Abstract
(1) Background: Few studies have investigated (demographic) correlates of (prevalent) overweight rates among early adolescents, especially from higher socioeconomic positions (SEP) in developing countries, such as Indonesia. The current study aims to fill this gap. (2) Methods: Participants included 411 adolescents from five private schools in Indonesia. Adolescents’ weight and height were measured, and adolescents completed questionnaires on demographic factors (i.e., sex, school area, ethnicity, pocket money) and previous year dieting. (3) Results: Results showed that more than one-third of the sample was overweight, with higher rates among adolescent males (47%) than females (24%). Moreover, adolescents attending schools in urban areas (compared with suburban areas), and those reporting past dieting (compared with those reporting no dieting) had higher overweight rates. Ethnicity and the amount of pocket money were not related to overweight status. Finally, a clear sex-specific interaction was found involving school area, showing that males in urban areas had a significantly higher risk to be overweight, whereas this did not apply to females. (4) Conclusions: males from urban area private schools in Indonesia may be an important target group for future preventive overweight interventions.
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Deepa M, Anjana RM, Unnikrishnan R, Pradeepa R, Das AK, Madhu SV, Rao PV, Joshi S, Saboo B, Kumar A, Bhansali A, Gupta A, Bajaj S, Elangovan N, Venkatesan U, Subashini R, Kaur T, Dhaliwal RS, Tandon N, Mohan V. Variations in glycated haemoglobin with age among individuals with normal glucose tolerance: Implications for diagnosis and treatment-Results from the ICMR-INDIAB population-based study (INDIAB-12). Acta Diabetol 2022; 59:225-232. [PMID: 34596779 DOI: 10.1007/s00592-021-01798-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 09/05/2021] [Indexed: 10/20/2022]
Abstract
AIM To report on glycated haemoglobin (HbA1c) values among individuals with normal glucose tolerance (NGT) at different age groups, using data acquired from a large national survey in India. MATERIALS AND METHODS Data on glycaemic parameters at different age groups were obtained from the Indian Council of Medical Research-INdia DIABetes (ICMR-INDIAB) study, in adults aged ≥ 20 years representing all parts of India. Age-wise distribution of HbA1c was assessed among individuals with NGT (n = 14,222) confirmed by an oral glucose tolerance test using the World Health Organization (WHO) criteria. Results were validated in another large epidemiological study (n = 1077) conducted in Chennai, India. RESULTS Among NGT individuals, HbA1c increased gradually with age from 5.16 ± 0.71% (33 mmol/mol) in the age group of 20-29 years to 5.49 ± 0.69% (37 mmol/mol) in those aged 70 + years. In the validation study, conducted in another study population, HbA1c was 5.35 ± 0.43% (35 mmol/mol) in age group of 20-29 years and 5.74 ± 0.50% (39 mmol/mol) in those aged 70 and above. In the INDIAB study, for every decadal increase in age, there is a 0.08% increase in HbA1c and this increase was more significant in females (females: 0.10% vs. males: 0.06%) and in urban (urban: 0.10% vs. rural: 0.08%) population. CONCLUSIONS HbA1c levels increase steadily with age. This suggests that age-specific cutoffs be used while utilizing HbA1c to diagnose diabetes and prediabetes, so as to minimize the risk of overdiagnosis and unnecessary initiation of treatment in elderly people who could have physiological increase in HbA1c levels.
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Affiliation(s)
- Mohan Deepa
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, ICMR Centre for Advanced Research On Diabetes, No 4, Conran Smith Road, Gopalapuram, Chennai, India
| | - Ranjit Mohan Anjana
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, ICMR Centre for Advanced Research On Diabetes, No 4, Conran Smith Road, Gopalapuram, Chennai, India
| | - Ranjit Unnikrishnan
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, ICMR Centre for Advanced Research On Diabetes, No 4, Conran Smith Road, Gopalapuram, Chennai, India
| | - Rajendra Pradeepa
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, ICMR Centre for Advanced Research On Diabetes, No 4, Conran Smith Road, Gopalapuram, Chennai, India
| | - Ashok Kumar Das
- Pondicherry Institute of Medical Sciences, Puducherry, India
| | - Sri Venkata Madhu
- University College of Medical Sciences and GTB Hospital, Delhi, New Delhi, India
| | | | - Shashank Joshi
- Lilavati Hospital and Research Centre, Mumbai, Maharashtra, India
| | - Banshi Saboo
- Dia Care-Diabetes Care and Hormone Clinic, Ahmedabad, Gujarat, India
| | - Ajay Kumar
- Diabetes Care and Research Centre, Patna, Bihar, India
| | - Anil Bhansali
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Sarita Bajaj
- Moti Lal Nehru Medical College, Allahabad, India
| | - Nirmal Elangovan
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, ICMR Centre for Advanced Research On Diabetes, No 4, Conran Smith Road, Gopalapuram, Chennai, India
| | - Ulagamathesan Venkatesan
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, ICMR Centre for Advanced Research On Diabetes, No 4, Conran Smith Road, Gopalapuram, Chennai, India
| | - Radhakrishnan Subashini
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, ICMR Centre for Advanced Research On Diabetes, No 4, Conran Smith Road, Gopalapuram, Chennai, India
| | - Tanvir Kaur
- Indian Council of Medical Research, Delhi, New Delh, India
| | - R S Dhaliwal
- Indian Council of Medical Research, Delhi, New Delh, India
| | - Nikhil Tandon
- All India Institute of Medical Sciences, Delhi, New Delhi, India
| | - Viswanathan Mohan
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, ICMR Centre for Advanced Research On Diabetes, No 4, Conran Smith Road, Gopalapuram, Chennai, India.
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Jayant SS, Gupta R, Rastogi A, Agrawal K, Sachdeva N, Ram S, Dutta P, Bhadada SK, Bhansali A. Abdominal obesity and incident cardio-metabolic disorders in Asian-Indians: A 10-years prospective cohort study. Diabetes Metab Syndr 2022; 16:102418. [PMID: 35123378 DOI: 10.1016/j.dsx.2022.102418] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/23/2022] [Accepted: 01/25/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIMS To estimate the strength of association between abdominal obesity and incident cardio-metabolic diseases. METHODS A subset of Chandigarh Urban Diabetes study cohort (n = 543) was followed after a mean of 10.7 years for development of diabetes, prediabetes, dysglycaemia (either prediabetes or diabetes), hypertension and atherosclerotic cardiovascular disease (ASCVD). Diabetes and prediabetes were defined as per American Diabetes Association consulting group criteria, hypertension as blood pressure of ≥140/90 mmHg and ASCVD after review of medical records. Abdominal obesity was defined as waist circumference of ≥80 cm and ≥90 cm in females and males, respectively. RESULTS As compared to non-obese (n = 209), abdominally obese individuals (n = 334) had a higher risk of diabetes [RR:1.82(1.28-2.57)], prediabetes [RR:1.40(1.05-1.85)], dysglycaemia [ RR:1.38(1.07-1.78)], hypertension [RR: 1.84(1.30-2.59)] and ASCVD [RR:2.12(1.02-4.4)]. The optimal cut-off of waist circumference for detecting incident diabetes, hypertension and ASCVD in females was 88 cm, 85 cm and 91 cm, respectively; while in males it was 90 cm, 87 cm and 94 cm, respectively. CONCLUSION In Asian-Indians, abdominal obesity as defined by waist circumference of ≥90 cm and ≥80 cm in males and females, respectively is associated with a twofold higher risk of diabetes, hypertension and ASCVD. In addition, the current-cut-offs of waist circumference to define abdominal obesity need reconsideration to optimally identify individuals at a higher risk of cardio-metabolic diseases. However, a high attrition rate represents a major limitation.
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Affiliation(s)
- Satyam Singh Jayant
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Rahul Gupta
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Ashu Rastogi
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
| | - Kanhaiya Agrawal
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Naresh Sachdeva
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Sant Ram
- Department of Biochemistry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Pinaki Dutta
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Sanjay Kumar Bhadada
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Anil Bhansali
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Sangu PV, Balakrishna N, Challapalli B, Ravikanti K. Mini Female Health Program for detection of non-communicable diseases in Women – In a urban teaching hospital in India. WOMEN'S HEALTH 2022; 18:17455057221135493. [DOI: 10.1177/17455057221135493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: Prevalence of non-communicable diseases (NCDs) is increasing with women affected at an early age. The Mini Female Health Program (MFHP) is a simple screening package to detect NCDs in women. Objective: Determine the prevalence of selected NCDs in a hospital-based outpatient setting using MFHP. Methods: A cross-sectional observational study was conducted in an urban teaching hospital in India. MFHP included medical history, physical examination and investigations. NCDS of interest included anaemia, thyroid disorders, hypertension, diabetes, and obesity. Analysis was performed on groups stratified by age groups (18–30, 31–40 and > 41 years). Between group comparison and association of hypertension with other variables was undertaken. Results: Final analysis included 468 women, of whom 49.8%, 29.9%, and 20.3% were between 18–30, 31–40, and >41 years, respectively. Central obesity was most common NCD (waist to height ratio (WHR) > 0.5 (72.7%), waist circumference (WC) > 80 cm (62.7%)) followed by generalized obesity (body mass index (BMI) > 25 kg/m2 (52.4%)), anaemia (52.6%), thyroid disorders (27.4%), hypertension (14.1%) and diabetes (5.1%). Half of the women between 18 and 30 years were either overweight (BMI: 23–25 kg/m2) or obese. Increasing age was associated with a significant increase in the prevalence of hypertension, diabetes, thyroid disorders and obesity, but not anaemia. Only 9.8% of women were without an NCD with 17.3% having one NCD and 72.8% reporting multiple NCDs. Hypertension was strongly associated with age and WHR in multivariate regression analysis. Conclusion: The MFHP has highlighted the high prevalence of NCDs in women, particularly in young women demonstrating the value of simple screening programme in routine clinical care.
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Ghosh J, Chaudhuri D, Saha I, Chaudhuri AN. Association of Conicity Index with Different Cardiovascular Disease Risk Factors among Rural Elderly Women of West Bengal, India. Indian J Community Med 2022; 47:18-22. [PMID: 35368493 PMCID: PMC8971865 DOI: 10.4103/ijcm.ijcm_595_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 12/09/2021] [Indexed: 11/05/2022] Open
Abstract
Introduction: In menopause, changes in body fat distribution lead to increasing risk of cardiovascular and metabolic diseases. Therefore, the prediction of cardiovascular disease (CVD) by the presence of risk factors is of importance in elderly women. Objective: To find out the conicity index (CI) and its association with different CVD risk factors among rural elderly women of West Bengal. Materials and Methods: The study was conducted among 236 rural elderly women, selected randomly from 30 villages of Amdanga block, West Bengal. Components of metabolic syndrome (MS), body fat percentage, different lipid profile fractions, CI, and body mass index (BMI) were measured. Statistical tests were calculated using SPSS software version 20.0. P ≤ 0.05 was considered statistically significant. Results: High CI (median 1.25 and interquartile range 1.05–1.45) was found. The proportion of participants with high CI were significantly higher among those with MS (87.95%), waist circumference having 80 cm or more (99.09%), blood pressure having ≥ 130/85 mm of Hg (75.66%), body fat percentage ≥25% (80.14%), and BMI ≥23 (93.18%). Conclusion: High prevalence of CI existed among rural elderly women. Significant correlation existed between CI and different CVD risk factors as well as some of the components of MS indicating a possible coexistence of different CVD risks.
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Affiliation(s)
- Joyeta Ghosh
- Department of Dietetics and Nutrition, NSHM Knowledge Campus, Kolkata, West Bengal, India.,Department of Microbiology, Lady Brabourne College, University of Calcutta, Kolkata, West Bengal, India
| | | | - Indranil Saha
- Scientist E, ICMR-Centre for Ageing and Mental Health (I-CAM), Indian Council of Medical Research, Kolkata, West Bengal, India
| | - Aditi Nag Chaudhuri
- Department of Microbiology, Lady Brabourne College, University of Calcutta, Kolkata, West Bengal, India
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Tegegne KD, Wagaw GB, Gebeyehu NA, Yirdaw LT, Shewangashaw NE, Mekonen NA, Kassaw MW. Prevalence of central obesity and associated factors in Ethiopia: A systematic review and meta-analysis. Front Endocrinol (Lausanne) 2022; 13:983180. [PMID: 36111291 PMCID: PMC9468774 DOI: 10.3389/fendo.2022.983180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/12/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Obesity is a global public health concern that is now on the rise, especially in low- and middle-income nations. Despite the fact that there are several studies reporting the prevalence of central obesity among adults in Ethiopia, there is a lack of a systematic review and meta-analysis synthesizing the existing observational studies. Therefore, this systematic review and meta-analysis aimed to determine the prevalence of central obesity and its associated factors in Ethiopia. METHODS Online libraries such as PubMed, Google Scholar, Scopus, Science Direct, and Addis Ababa University were searched. Data were extracted using Microsoft Excel and analyzed using STATA statistical software (v. 16). Forest plots, Begg's rank test, and Egger's regression test were all used to check for publication bias. To look for heterogeneity, I2 was computed, and an overall estimated analysis was carried out. Subgroup analysis was done by region and study setting. In addition, the pooled odds ratio for related covariates was calculated. RESULTS Out of 685 studies assessed, 20 met our criteria and were included in the study. A total of 12,603 people were included in the study. The prevalence of central obesity was estimated to be 37.31% [95% confidence interval (CI): 29.55-45.07]. According to subgroup analysis by study region and setting, the highest prevalence was observed in the Dire Dawa region (61.27%) and community-based studies (41.83%), respectively. Being a woman (AOR = 6.93; 95% CI: 3.02-10.85), having better socioeconomic class (AOR = 5.45; 95% CI: 0.56-10.34), being of age 55 and above (AOR = 5.23; 95% CI: 2.37-8.09), being physically inactive (AOR = 1.80; 95% CI: 1.37-2.24), being overweight (AOR = 4.00; 95% CI: 2.58-5.41), being obese (AOR = 6.82; 95% CI: 2.21-11.43), and having hypertension (AOR = 3.84; 95% CI: 1.29-6.40) were the factors associated with central obesity. CONCLUSION The prevalence of central obesity was high in Ethiopia. Being a woman, having a higher socioeconomic class, being older, being physically inactive, being overweight or obese, and having hypertension were all associated. Therefore, it is vital for the government and health organizations to design and implement preventive measures like early detection, close monitoring, and positive reversal of central obesity in all patients and the general population. High-quality investigations on the prevalence of central obesity in the Ethiopian people are required to better understand the status of central obesity in Ethiopia. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/PROSPERO, identifier: CRD42022329234.
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Affiliation(s)
- Kirubel Dagnaw Tegegne
- Department of Comprehensive Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
- *Correspondence: Kirubel Dagnaw Tegegne,
| | - Gebeyaw Biset Wagaw
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Natnael Atnafu Gebeyehu
- Department of Midwifery, College of Medicine and Health Science, Wolaita Sodo University, Sodo, Ethiopia
| | - Lehulu Tilahun Yirdaw
- Department of Emergency Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | | | - Nigusie Abebaw Mekonen
- Department of Midwifery, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Mesfin Wudu Kassaw
- School of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia
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Ningombam SS, Newmei MK, Chhungi V, Mondal PR, Devi NK, Saraswathy KN. Obesity, dyslipidaemia and candidate gene polymorphisms: a cross-sectional study among the Liangmai and Mizo tribes of Manipur, India. Ann Med 2021; 53:1438-1446. [PMID: 34414818 PMCID: PMC8381916 DOI: 10.1080/07853890.2021.1969034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 08/11/2021] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND The prevalence of obesity and dyslipidaemia was observed to be increased among the tribal populations, due to globalization. MATERIALS AND METHODS In the present study, data on demographic, somatometric and blood samples were collected from 613 participants of both sex, age 18-60 years, further lipid profiling and genotyping was executed. Multifactor dimensionality reduction (MDR) software was used for gene-gene interactions analysis. RESULTS Significantly differences were observed with respect to the general characteristic and selected gene polymorphisms in both the tribes. Among the Liangmai tribe, MC4R gene was found to pose significant decreased risk for waist-height ratio (WHtR) (OR = 0.56; 95% confidence interval (CI)= 0.32-0.99; p value = .04) and HDL (OR = 0.58; 95% CI = 0.36-0.92; p value = .02). Similar trends of significant decreased risk (OR = 0.39; 95% CI = 0.20-0.76; p value=.006) for BMI were observed among the Mizo tribe. The gene-gene interaction revealed the combined model of FTO+MC4R genes shows an increased risk for BMI in both the tribes. The independent significant increased risk posed by FTO gene was moderated by interaction with MC4R gene. CONCLUSIONS The observed differences can possibly attribute to both their respective ancestries resulting in different gene pools and the physical environment. The results of the study highlight the importance of gene-gene and gene-environment interactions in adverse phenotype groups.KEY MESSAGEAmong the tribal population, the prevalence of obesity and dyslipidaemia has been increased.Differential distribution and associations of selected markers hint towards differential genetic architecture in these populations.MC4R rs17782313 polymorphism was found to show a significantly decreased risk for WHtR and low HDL among the Liangmai tribe and BMI among the Mizo tribe.Significant increased risk posed by FTO rs9939609 gene polymorphism was moderated by the interaction with MC4R rs17782313.
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Affiliation(s)
- Somorjit Singh Ningombam
- Laboratory Oncology Unit, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Masan Kambo Newmei
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Varhlun Chhungi
- National Family Health Survey-5, ICMR-National Institute of Malaria Research, New Delhi, India
| | - Prakash Ranjan Mondal
- Department of Anthropology, Laboratory of Biological and Molecular Anthropology, University of Delhi, New Delhi, India
| | - Naorem Kiranmala Devi
- Department of Anthropology, Laboratory of Biological and Molecular Anthropology, University of Delhi, New Delhi, India
| | - Kallur Nava Saraswathy
- Department of Anthropology, Laboratory of Biological and Molecular Anthropology, University of Delhi, New Delhi, India
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Pradeepa R, Subashini R, Venkatesan U, Ningombam S, Purty A, John M, Reang T, Luaia R, Tripathy SK, Modi S, Mokta JK, Desai A, Dash K, Deepa M, Nirmal E, Unnikrishnan R, Anjana RM, Kaur T, Dhaliwal RS, Mohan V. Effect of internal migration on diabetes and metabolic abnormalities in India - The ICMR-INDIAB study. J Diabetes Complications 2021; 35:108051. [PMID: 34607777 DOI: 10.1016/j.jdiacomp.2021.108051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 11/26/2022]
Abstract
AIMS To assess the effect of migration (rural-to-urban and vice versa) on prevalence of diabetes and metabolic disorders in Asian Indians participating in the Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) study. MATERIALS AND METHODS The ICMR-INDIAB study is a national study on diabetes and associated cardiometabolic disorders in individuals aged ≥20 years from 28 states and 2 union territories of India. Individuals who moved to a different place from their place of birth and had resided in the new location for at least one year were considered as migrants. Anthropometric measurements, blood pressure estimation and a capillary oral glucose tolerance test were performed. RESULTS Of the 113,043 participants, 66.4% were non-migrant rural dwellers, 19.4% non-migrant urban dwellers, 8.4% rural-urban migrants, 3.8% multiple migrants and 2.0% urban-rural migrants. Weighted prevalence of diabetes was highest in rural-urban migrants followed by urban dwellers, urban-rural migrants and rural dwellers [14.7%, 13.2%, 12.7% and 7.7% respectively (p < 0.001)]. Rural-urban migrants had highest prevalence of abdominal obesity (50.5%) compared to the other three groups. The risk for diabetes was 1.9 times higher in rural-urban migrants than among rural dwellers. Five risk factors [hypertension, abdominal and generalized obesity, physical inactivity and low fruit and vegetable intake] together explained 69.8% (partial population attributable risk) of diabetes among rural-urban migrants and 66.4% among non-migrant urban dwellers. CONCLUSIONS Rural-to-urban migration is associated with increased risk of developing diabetes and other cardiometabolic abnormalities. Adoption of healthier lifestyle patterns among migrants could help prevent/delay onset of these abnormalities in this population.
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Affiliation(s)
- Rajendra Pradeepa
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, ICMR Centre for Advanced Research on Diabetes, Chennai, India.
| | - Radhakrishnan Subashini
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, ICMR Centre for Advanced Research on Diabetes, Chennai, India
| | - Ulagamathesan Venkatesan
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, ICMR Centre for Advanced Research on Diabetes, Chennai, India
| | | | - Anil Purty
- Pondicherry Institute of Medical Sciences, Puducherry, India
| | - Mary John
- Christian Medical College & Hospital, Ludhiana, India
| | | | | | | | - Sagar Modi
- Himalayan Institute of Medical Sciences, Dehradun, India
| | | | | | | | - Mohan Deepa
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, ICMR Centre for Advanced Research on Diabetes, Chennai, India
| | - Elangovan Nirmal
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, ICMR Centre for Advanced Research on Diabetes, Chennai, India
| | - Ranjit Unnikrishnan
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, ICMR Centre for Advanced Research on Diabetes, Chennai, India
| | - Ranjit Mohan Anjana
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, ICMR Centre for Advanced Research on Diabetes, Chennai, India
| | - Tanvir Kaur
- Non-Communicable Disease Division, Indian Council of Medical Research, New Delhi, India
| | | | - Viswanathan Mohan
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, ICMR Centre for Advanced Research on Diabetes, Chennai, India
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Jain N, Pathania M, Bahurupi Y. Assessment of Sleep Quality and Quality of Life in Hypertensive Subjects at a Tertiary Care Hospital in Uttarakhand, India. Int J Prev Med 2021; 12:158. [PMID: 35070191 PMCID: PMC8724674 DOI: 10.4103/ijpvm.ijpvm_465_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 01/21/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Hypertension is a leading risk factor for cardiovascular diseases with prevalence of 33% in urban and 25% in rural population in India. Studies have suggested that hypertension significantly affects the sleep quality and quality of life of subjects. Therefore, this study aimed to establish a correlation between sleep quality, quality of life, and hypertension in Uttarakhand. METHODS This observational cross-sectional study was carried out on hypertensive subjects at a tertiary care hospital in Uttarakhand following ethics approval. After taking consent from participants, blood pressure and anthropometric measurements were recorded. Then, their sleep quality and quality of life was assessed using Pittsburgh sleep quality index (PSQI) and WHO-QOL BREF questionnaire respectively. Statistical analysis was then carried out to correlate these parameters. RESULTS 168 participants were recruited for this study, with 43.5% males and 56.5% females. It was found that 77.4% of these subjects were having poor sleep quality with the mean global PSQI score as 7.90 ± 3.713. These subjects assessed their Quality of life to be worst in physical domain (12.68 ± 3.13), followed by psychological, social relationship domain and environment domain. A significant association was found between sleep quality and different stages of hypertension (P value = 0.039) but quality of life and stages of hypertension have no significant association (P value > 0.05). CONCLUSIONS Sleep quality, quality of life and blood pressure are correlated. So, clinicians should also focus on improving their patient's sleep quality and quality of life besides pharmacological treatment.
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Affiliation(s)
- Neha Jain
- Department of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Monika Pathania
- Department of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India,Address for correspondence: Dr. Monika Pathania, Department of Medicine, AIIMS Rishikesh, Uttarakhand, India. E-mail:
| | - Yogesh Bahurupi
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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