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Trabecular Bone Score and Bone Mineral Density in Postmenopausal Women with Morbid Obesity-A Clinical Paradox. Med Sci (Basel) 2021; 9:medsci9040069. [PMID: 34842748 PMCID: PMC8628953 DOI: 10.3390/medsci9040069] [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: 07/21/2021] [Revised: 10/19/2021] [Accepted: 11/07/2021] [Indexed: 11/22/2022] Open
Abstract
Obesity has long been considered to have a protective effect on bone, but specific complications in those with morbid obesity are known to have a detrimental impact on bone architecture. We aimed to study the bone microarchitecture (TBS—trabecular bone score) and bone mineral density (BMD) in postmenopausal women with morbid obesity compared to obese and non-obese age-matched women. Eighty-five consecutive postmenopausal women with morbid obesity (body mass index (BMI) ≥ 35 kg/m2) were enrolled and compared to age-matched obese (n = 80) and non-obese postmenopausal controls (n = 85). The BMD and TBS were assessed in all subjects using a Hologic-QDR 4500-W Discovery-A DXA scanner. The mean BMD (gm/cm2) at the femoral neck in women with morbid obesity was found to be significantly lower as compared to the age-matched postmenopausal obese controls (0.723 versus 0.762, p-value = 0.002). The BMD at the lumbar spine and hip showed similar trends but were not statistically significant. The bone microarchitecture was found to be significantly lower in those with morbid obesity (1.205) as compared to the other two groups (obesity 1.244; non-obese 1.228) (p < 0.013). Though obesity was associated with a better bone density and bone microarchitecture in postmenopausal women, a paradoxical lower value was seen in those with morbid obesity.
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Mahajan SK, Verma BS, Sharma S, Mahajan K, Singh B. Prevalence of obstructive sleep apnoea among patients admitted with acute coronary syndrome in a hill state of northern India. THE NATIONAL MEDICAL JOURNAL OF INDIA 2021; 34:337-340. [PMID: 35818095 DOI: 10.25259/nmji_413_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Background Obstructive sleep apnoea (OSA) is one of the emerging non-traditional cardiovascular risk factors. Studying OSA may contribute towards a better understanding of current concepts of atherogenesis and in guiding therapy. Methods We conducted this cross-sectional study among 66 patients with acute coronary syndrome (ACS) in a tertiary care hospital from 1 January 2019 to 30 June 2020. We included patients of ST elevation myocardial infarction (STEMI)/ non-STEMI (on achieving Killip class I/II) and unstable angina and performed in-hospital overnight polysomnography (PSG) within 8 weeks of index event. Apnoea-hypoapnoea index (AHI) value 5-<15 was defined as mild OSA, AHI 15-<30 as moderate OSA and AHI >30 as severe OSA. We analysed data using Epi Info version 7.2.4 for Windows. Results The 66 patients had a mean (SD) age of 57.7 (11.1) years and 54 (81.8%) were men. Forty-three (65.1%) patients had STEMI, 19 (28.7%) had non-STEMI and 4 (6%) had unstable angina. On PSG, the prevalence of OSA (AHI>5) was 78.8% (95% CI 67.0-87.9). Of these, AHI >15 was significantly associated with diabetes, hypertension and different measures of obesity (p<0.05). Conclusions This study, conducted in a hill state of northern India, showed a high prevalence of OSA in patients with ACS. Obesity, diabetes mellitus and hypertension were significantly associated with severity of OSA (AHI>15).
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Affiliation(s)
- Sanyam K Mahajan
- Department of Medicine, Indira Gandhi Medical College, Shimla 171001, Himachal Pradesh, India
| | - Balbir S Verma
- Department of Medicine, Indira Gandhi Medical College, Shimla 171001, Himachal Pradesh, India
| | - Sunil Sharma
- Department of Pulmonary Medicine, Critical Care and Sleep Medicine, Shimla 171001, Himachal Pradesh, India
| | - Kunal Mahajan
- Department of Cardiology, Critical Care and Sleep Medicine, Shimla 171001, Himachal Pradesh, India
| | - Balraj Singh
- Department of Community Medicine, Critical Care and Sleep Medicine, Shimla 171001, Himachal Pradesh, India
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Golabi P, Paik JM, AlQahtani S, Younossi Y, Tuncer G, Younossi ZM. Burden of non-alcoholic fatty liver disease in Asia, the Middle East and North Africa: Data from Global Burden of Disease 2009-2019. J Hepatol 2021; 75:795-809. [PMID: 34081959 DOI: 10.1016/j.jhep.2021.05.022] [Citation(s) in RCA: 95] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 04/23/2021] [Accepted: 05/02/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND & AIM Non-alcoholic fatty liver disease (NAFLD) has become a major cause of chronic liver disease (CLD) worldwide. Our aim was to assess the burden of liver complications (LC, cirrhosis and liver cancer) related to NAFLD (LC-NAFLD) between 2009-2019 in Asia and the Middle East and North Africa (MENA) region. METHODS We used Global Burden of Disease data to assess incidence, mortality, and disability-adjusted life years (DALYs) for LC-NAFLD from Asia and the MENA region. Annual % change (APC) in rates were computed using a joinpoint regression model. Associations of LC-NAFLD with low physical activity, diet and metabolic risks were determined by partial Spearman correlation coefficients (ρ). RESULTS Globally in 2019, there were 170,000 incident cases of LC-NAFLD, accounting for 6.6% of LC incident cases from all CLDs. There were 168,969 deaths related to LC-NAFLD, accounting for 8.6% of LC deaths from all CLDs. Asia accounted for 48.3% of the global incidence of LC-NAFLD and for 46.2% of deaths attributable to LC-NAFLD, while MENA accounted for 8.9% and 8.6%, respectively. There were 2.08 million DALYs in Asia and 340,000 DALYs in MENA. From 2009 to 2019, regions in Asia and MENA experienced a rise in DALYs attributable to LC-NAFLD (compared to LC from other CLDs), ranging from South Asia (APC = +2.12% vs. -0.94%) to high-income Asia Pacific (APC = -0.07%, p = 0.646 vs. -0.97%). In Asia, NAFLD-related DALYs were significantly correlated with dietary risks (95% CI 0.280-0.763, p = 0.004), metabolic risks (0.341-0.790, p <0.001) and tobacco use (0.134-0.691, p = 0.007). In MENA, low physical activity (0.557-0.918, p <0.001), metabolic risks (0.432-0.888, p = 0.001), and dietary risks (0.315-0.855, p = 0.001) correlated with DALYs. CONCLUSIONS NAFLD is posing a substantial burden in Asia and MENA. About half of the global burden of LC-NAFLD is accounted for by these regions. LAY SUMMARY Non-alcoholic fatty liver disease (NAFLD) has emerged as one of the most common causes of chronic liver disease worldwide. We used Global Burden of Disease data to assess the incidence, mortality, and disability-adjusted life years attributable to NAFLD-related liver complications in Asia, the Middle East and North Africa. NAFLD is poised to contribute to a substantial liver disease burden in these regions. Regional and global policies are needed to address the increasing burden of complications of NAFLD.
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Affiliation(s)
- Pegah Golabi
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States
| | - James M Paik
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States; Center for Liver Disease, Department of Medicine, Inova Fairfax Medical Campus, Falls Church, VA, United States
| | - Saleh AlQahtani
- Johns Hopkins Medical Center, Baltimore, MD, United States; Center for Outcomes Research in Liver Diseases, Washington DC, United States
| | - Youssef Younossi
- Center for Outcomes Research in Liver Diseases, Washington DC, United States
| | - Gabriela Tuncer
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States
| | - Zobair M Younossi
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States; Johns Hopkins Medical Center, Baltimore, MD, United States; Inova Medicine, Inova Health System, Falls Church, VA, United States.
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Sengupta P, Tiwari N, Bhatt T, Paul AT. Mechanistically acting anti-obesity compositions/formulations of natural origin: a patent review (2010-2021). Expert Opin Ther Pat 2021; 32:29-46. [PMID: 34236914 DOI: 10.1080/13543776.2021.1954161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Introduction: Current health trends indicate that the rate of incidence of obesity has risen considerably. According to the World Health Organization (WHO) report 2017, the issue of obesity has grown to an epidemic proportion, with over 4 million people dying every year. Orlistat, a potent pancreatic lipase (PL) inhibitor for long-term treatment of obesity has been recently reported to cause hepatic and renal toxicities. Hence, there is a need to develop newer, safer and efficacious therapeutics that targets obesity and its associated disorders.Areas covered: The present article attempts to review patents on compositions of natural origin that include either combination of two or more lead NPs/whole extract(s)/ mixture of one or more NPs/extracts from various plants and micro-organisms. Patents that were granted during the period 2010 to 2021 have been considered.Expert opinion: The article highlights the recent trends in the rise of the global obesity population. Patents are classified based on the mechanism of action of extracts/NPs. It has been observed that in the years 2013, 2017 and 2019 maximum number of patents from China, South Korea, United States and Japan have been filed for the anti-obesity compositions.
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Affiliation(s)
- Pracheta Sengupta
- Laboratory of Natural Product Chemistry, Department of Pharmacy, Birla Institute of Technology and Sciences, Pilani (BITS Pilani), Pilani Campus, Rajasthan, India
| | - Niyati Tiwari
- Laboratory of Natural Product Chemistry, Department of Pharmacy, Birla Institute of Technology and Sciences, Pilani (BITS Pilani), Pilani Campus, Rajasthan, India
| | - Tanya Bhatt
- Department of Pharmaceutical Sciences, State University of New York, Buffalo, NY, USA
| | - Atish T Paul
- Laboratory of Natural Product Chemistry, Department of Pharmacy, Birla Institute of Technology and Sciences, Pilani (BITS Pilani), Pilani Campus, Rajasthan, India
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Kumar P, Srivastava S, Mishra PS, Mooss ETK. Prevalence of pre-diabetes/type 2 diabetes among adolescents (10-19 years) and its association with different measures of overweight/obesity in India: a gendered perspective. BMC Endocr Disord 2021; 21:146. [PMID: 34233661 PMCID: PMC8261995 DOI: 10.1186/s12902-021-00802-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 06/21/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The International Diabetes Federation (IDF) estimated that 1.1 million children and adolescents aged 14-19 years are living with diabetes. Diabetes is a chronic, progressive disease characterized by elevated levels of blood glucose. It is also recognized as a complex disease that affects people of different ages due to different causes. The present study aims to estimate the prevalence of pre-diabetes/diabetes at the national level. Additionally, the respective study determines the factors associated with pre-diabetes/diabetes conditions among adolescents at the national level. METHODS The data for this study was carried out from the Comprehensive National Nutrition Survey (CNNS), the first-ever nationally representative nutrition survey of children and adolescents in India. The study used a sample size of 17,865 adolescent boys and 17,965 adolescent girls for the analysis. Descriptive statistics, bivariate analysis, and logistic regression analysis were done to carve out the results. RESULTS The prevalence of pre-diabetes/diabetes was 12.3% and 8.4% among adolescent boys and girls in India, respectively. Body mass index and Subscapular skinfold thickness were the two most important predictors of pre-diabetes/diabetes among adolescents. Further, physical activities show a negative association with pre-diabetes/diabetes. Moreover, interaction models in the present study clearly reveal the fact that adolescent girls were less likely to suffer from pre-diabetes/diabetes than adolescent boys. Additionally, it was found that the prevalence of pre-diabetes/diabetes was high among adolescent girls from lower socio-economic strata. CONCLUSION The high prevalence of pre-diabetes and diabetes among adolescents portrayed serious public health concern in India. As body mass index and Subscapular skinfold thickness were positively associated with pre-diabetes/diabetes conditions among adolescents. Therefore, effective approaches are needed to be taken to tackle these pre-diabetes/diabetes conditions among adolescents and especially among adolescent boys.
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Affiliation(s)
- Pradeep Kumar
- International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - Shobhit Srivastava
- International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
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Gangwar SK, Verma SK, Modi S. Frequency and Correlates of Hypogonadism in Adult Males with Type 2 Diabetes Mellitus. Indian J Endocrinol Metab 2021; 25:320-325. [PMID: 35136739 PMCID: PMC8793960 DOI: 10.4103/ijem.ijem_239_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/24/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND AND AIMS There is increasing awareness about an association between type 2 diabetes mellitus (T2DM) and male hypogonadism. However, data are sparse and less uniform with respect to factors associated with hypogonadism in males with T2DM. This study aimed to assess the frequency and correlates of hypogonadism in these subjects. MATERIALS AND METHODS This cross-sectional study included 130 males with T2DM, age 25-60 years. Study subjects were screened for hypogonadal symptoms using androgen deficiency in aging male (ADAM) questionnaire. Serum total testosterone was measured in subjects with positive ADAM score. Hypogonadism was defined as the presence of positive ADAM score and low serum total testosterone (<3 ng/mL). Clinical and biochemical variables were compared between T2DM subjects with and without hypogonadism. RESULTS Hypogonadism was observed in 26.9% of the study subjects. Hypogonadal symptoms most frequently observed in patients with T2DM and hypogonadism were erectile dysfunction (96.4%), reduced libido (64.3%) and deterioration in work performance (53.6%). Group with T2DM and hypogonadism had higher (i) duration of T2DM (8.9 ± 5.03 vs. 4.8 ± 4.76 years; P = .001), (ii) frequency of diabetic retinopathy (58.3% vs. 27.3%; P = .008), (iii) frequency of diabetic neuropathy (42.9% vs. 19.7%; P = .024), (iv) proportion of subjects on insulin therapy (46.4% vs. 22.4%; P = .027), and (v) HbA1c (10.9 ± 2.63% vs. 9.3 ± 2.42%; P = .006), compared to group without hypogonadism. CONCLUSION Hypogonadism was present in nearly one-fourth of the study subjects with T2DM. Compared to the subjects without hypogonadism, group with hypogonadism had longer duration of diabetes, higher HbA1c, greater frequencies of diabetic retinopathy and diabetic neuropathy, and more subjects on insulin therapy.
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Affiliation(s)
- Saurabh K. Gangwar
- Department of General Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
| | - Sanjiv K. Verma
- Department of General Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
| | - Sagar Modi
- Department of General Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
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Obesity and dyslipidemia among Bhil tribal population: A cross-sectional study from India. Int J Diabetes Dev Ctries 2021. [DOI: 10.1007/s13410-021-00962-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Ghimire U, Vatsa R. Spatial distribution of various forms of malnutrition among reproductive age women in Nepal: A Bayesian geoadditive quantile regression approach. SSM Popul Health 2021; 14:100781. [PMID: 33997241 PMCID: PMC8099780 DOI: 10.1016/j.ssmph.2021.100781] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 02/21/2021] [Accepted: 03/23/2021] [Indexed: 01/21/2023] Open
Abstract
Addressing both the under-and over-nutritional status of women is an eminent challenge for developing countries like Nepal. This paper examined a critical analysis of factors associated with various forms of malnutrition using Bayesian geoadditive quantile regression approach and assessed spatial variations of malnutrition among Nepalese women using Asian cut-off values. Data drawn from the 2016 Nepal Demographic and Health Survey was utilized to assess the spatial distributions of underweight, overweight and obesity at the provincial level. Spatial and nonlinear components were estimated using Markov random fields and Bayesian P-splines, respectively. The analysis of 4,338 women confirmed that women living in extremely urbanized areas and in Province 1, Province 3, and Province 4 were more likely to be overweight/obese. Similarly, the likelihood of being underweight was prominently high among women residing in rural municipality and women residing in Province 2 and Province 7. Women from the richest and richer quintiles, and with primary education were more likely to be obese. Furthermore, currently-working women and women having access to protected water source were less likely to be obese while improved toilet and access to electricity facility were associated with obesity. Women with access to newspaper and radio were less prone to obesity. Inconsistent distribution of under- and over-nutrition existed in Nepal, given that the high prevalence of overweight/obesity among women living in metropolitan and undernutrition among rural women. Specific intervention measures, addressing location-specific nutrition issues are urgent. Rigorous implementation of strategies incorporated in the national nutrition plan is called for to curb the burden of overweight/obesity. Involving mass media to promote healthier lifestyle and nutritious food could be advantageous at the population level, especially in rural municipalities.
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Affiliation(s)
- Umesh Ghimire
- New ERA, Rudramati Marga, Kalopul, Kathmandu, 44600, Nepal
| | - Richa Vatsa
- Central University of South Bihar, SH-7, Gaya Panchanpur Road, Village – Karhara, Post. Fatehpur, Gaya, 824236, Bihar, India
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Budi Mulia EP, Fauzia KA, Atika A. Abdominal Obesity is Associated with Physical Activity Index in Indonesian Middle-Aged Adult Rural Population: A Cross-Sectional Study. Indian J Community Med 2021; 46:317-320. [PMID: 34321751 PMCID: PMC8281867 DOI: 10.4103/ijcm.ijcm_947_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 03/31/2021] [Indexed: 11/04/2022] Open
Abstract
Background Obesity is one of the significant health problems. Physical activity includes a potential modifier in the development of abdominal obesity. Objective The objective of the study is to analyze the association between physical activity and abdominal obesity in middle-aged adults in the Indonesian rural population. Methods A community-based study was conducted in a rural area of Malang, Indonesia. Data were collected using interviews to obtain sociodemographic and physical activity index (PAI). Waist circumference was measured using a tape measure. Data were analyzed using one-way ANOVA and logistic regression. Results A total of 75 adults (62.7% were female) was included in this study. Mean waist circumference was 88.18 ± 9.21 cm. Total prevalence of abdominal obesity was 69.3%. Among the total of participants, 29.3% were inactive. A significant association was found between physical activity and abdominal obesity. Participants with inactive PAI have a higher risk of suffering from abdominal obesity than those with active PAI with odds ratio = 7.04; 95% confidence interval: 1.55-31.99. Conclusion In middle-aged adults living in a rural area of Indonesia, physical activity was associated with a lower risk of abdominal obesity. Strategies for preventing and reducing abdominal obesity in rural areas should consider improving physical activity.
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Affiliation(s)
- Eka Prasetya Budi Mulia
- Departments of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Kartika Afrida Fauzia
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Atika Atika
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
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Walia GK, Saini S, Vimal P, Bhatia K, Kumar A, Singh R, Prabhakaran D, Gupta V. Association of MC4R (rs17782313) gene polymorphism with obesity measures in Western India. Diabetes Metab Syndr 2021; 15:661-665. [PMID: 33813238 DOI: 10.1016/j.dsx.2021.03.013] [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: 07/07/2020] [Revised: 03/08/2021] [Accepted: 03/15/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS The association of melanocortin receptor 4 (MC4R) gene with adiposity measures is widely studied in European populations. Only six studies have investigated the role of MC4R gene with adiposity measures among Indian populations. We have evaluated the role of MC4R (rs17782313) gene polymorphism in influencing adiposity measures in India among children and adults. MATERIALS AND METHODS The present population based cross sectional study was conducted among 303 individuals (208 children and 95 adults) of age group 10-30 years, belonging to Rajasthan. Somatometric measurements (standing height, weight, and waist and hip girths) and blood samples were taken after obtaining written informed consent. Genotyping of MC4R rs17782313 single nucleotide polymorphism was done using restriction fragment length polymorphism method for polymerase chain reaction amplified fragments. We examined association between rs17782313 and different adiposity measures (height, weight, BMI, WHR, and waist and hip girths) using linear regression models. RESULTS The MC4R variant (rs17782313) predicted increased body weight (0.15 kg, S.E ± 0.076, P = 0.043) among children. In combined population, the rs17782313 variant was moderately associated with body weight (0.13 kg, S.E ± 0.070, P = 0.057). This variant was not found to be associated with any other adiposity measure. CONCLUSION Further studies are needed to evaluate the association of MC4R variants through sequencing and functional genomics with different adiposity measures in Indian populations for understanding the genetic underpinnings of adiposity in India.
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Affiliation(s)
| | - Simmi Saini
- Department of Anthropology, University of Delhi, India.
| | - Pradeep Vimal
- Indian Institute of Public Health- Delhi, Public Health Foundation of India, Gurugram, India.
| | | | - Arun Kumar
- Department of Anthropology, University of Delhi, India.
| | - Ranjana Singh
- Indian Institute of Public Health- Delhi, Public Health Foundation of India, Gurugram, India.
| | | | - Vipin Gupta
- Department of Anthropology, University of Delhi, India.
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Bevinakoppamath S, Saleh Ahmed AM, Ramachandra SC, Vishwanath P, Prashant A. Chemopreventive and Anticancer Property of Selenoproteins in Obese Breast Cancer. Front Pharmacol 2021; 12:618172. [PMID: 33935708 PMCID: PMC8087246 DOI: 10.3389/fphar.2021.618172] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 03/05/2021] [Indexed: 12/24/2022] Open
Abstract
Obesity is a significant risk factor for various cancers including breast cancer resulting in an increased risk of recurrence as well as morbidity and mortality. Extensive studies on various pathways have been successful in establishing a biological relationship between obesity and breast cancer. The molecular classification of breast cancer includes five groups each having different responses to treatment. Increased levels of inflammatory cytokines seen in obese conditions drive the pro-proliferative pathways, such as the influx of macrophages, angiogenesis, and antiapoptotic pathways. Increased peripheral aromatization of androgens by aromatase increases the circulating estrogen levels which are also responsible for the association of obesity with breast cancer. Also, increased oxidative stress due to chronic low-grade inflammation in obese women plays an important role in carcinogenesis. Despite the availability of safe and effective treatment options for breast cancer, obese women are at increased risk of adverse outcomes including treatment-related toxicities. In the recent decade, selenium compounds have gained substantial interest as chemopreventive and anticancer agents. The chemical derivatives of selenium include inorganic and organic compounds that exhibit pro-oxidant properties and alter cellular redox homeostasis. They target more than one metabolic pathway by thiol modifications, induction of reactive oxygen species, and chromatin modifications to exert their chemopreventive and anticancer activities. The primary functional effectors of selenium that play a significant role in human homeostasis are selenoproteins like glutathione peroxidase, thioredoxin reductase, iodothyronine deiodinases, and selenoprotein P. Selenoproteins play a significant role in adipose tissue physiology by modulating preadipocyte proliferation and adipogenic differentiation. They correlate negatively with body mass index resulting in increased oxidative stress that may lead to carcinogenesis in obese individuals. Methylseleninic acid effectively suppresses aromatase activation thus reducing the estrogen levels and acting as a breast cancer chemopreventive agent. Adipose-derived inflammatory mediators influence the selenium metabolites and affect the proliferation and metastatic properties of cancer cells. Recently selenium nanoparticles have shown potent anticancer activity which may lead to a major breakthrough in the management of cancers caused due to multiple pathways. In this review, we discuss the possible role of selenoproteins as chemopreventive and an anticancer agent in obese breast cancer.
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Affiliation(s)
- Supriya Bevinakoppamath
- Center of Excellence in Molecular Biology and Regenerative Medicine, Department of Biochemistry, JSS Medical College, JSS Academy of Higher Education & Research, Mysore, India
| | - Adel Mohammed Saleh Ahmed
- Center of Excellence in Molecular Biology and Regenerative Medicine, Department of Biochemistry, JSS Medical College, JSS Academy of Higher Education & Research, Mysore, India
| | - Shobha Chikkavaddaraguddi Ramachandra
- Center of Excellence in Molecular Biology and Regenerative Medicine, Department of Biochemistry, JSS Medical College, JSS Academy of Higher Education & Research, Mysore, India
| | - Prashant Vishwanath
- Center of Excellence in Molecular Biology and Regenerative Medicine, Department of Biochemistry, JSS Medical College, JSS Academy of Higher Education & Research, Mysore, India
| | - Akila Prashant
- Center of Excellence in Molecular Biology and Regenerative Medicine, Department of Biochemistry, JSS Medical College, JSS Academy of Higher Education & Research, Mysore, India
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Mutations in two component system (PhoPQ and PmrAB) in colistin resistant Klebsiella pneumoniae from North Indian tertiary care hospital. J Antibiot (Tokyo) 2021; 74:450-457. [PMID: 33820943 DOI: 10.1038/s41429-021-00417-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 02/20/2021] [Accepted: 02/27/2021] [Indexed: 11/08/2022]
Abstract
Colistin resistance in Gram negative bacteria is mainly attributed to chromosomal mutations in Two Component Systems(TCS) PhoPQ and PmrAB and plasmid-borne genes(mcr and its variants). The aim of this study was to understand the molecular basis of colistin resistance in Klebsiella pneumoniae and determine clonal transmission, in a North Indian tertiary care hospital over a 2.5 year period. Antimicrobial susceptibility was determined by Vitek and colistin resistance was confirmed by broth microdilution. Carbapenemases(blaKPC, blaVIM, blaIMP, blaNDM, blaOXA-48) and mcr-1 screening was done by PCR. Mutations in chromosomal genes mgrB, phoP, phoQ, pmrA, pmrB were analysed. Sequence typing was performed by Multilocus sequence typing(MLST). OXA-48 was detected in thirteen isolates while three isolates co-expressed OXA-48 and NDM. The mcr-1 gene was absent in all 16 isolates. Deleterious mutations in mgrB included insertion sequences IS903 and ISkpn26 and a premature stop codon. A total of 18 point mutations were identified in PhoPQ and PmrAB TCS; of which, novel mutations were reported in phoQ (K46E, L322V, D152N, F373L, R249G), pmrB (P159R) and pmrA (D149L). Six different sequence types ST231, ST147, ST395, ST42, ST14 and ST101 were identified. Phylogenetic analysis showed that sequence types ST14, ST395 and ST147 are closely related to ST101 and all identified sequence types had a common ancestor ST231. Colistin resistance in K. pneumoniae was attributed to mutations in PhoPQ and PmrAB TCS, while location specific distribution of strains indicates clonal transmission. The results of this study will help in formulation of effective infection prevention and antimicrobial development strategies.
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AlShahrani MS. Prevalence of obesity and overweight among type 2 diabetic patients in Bisha, Saudi Arabia. J Family Med Prim Care 2021; 10:143-148. [PMID: 34017717 PMCID: PMC8132811 DOI: 10.4103/jfmpc.jfmpc_1349_20] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 09/13/2020] [Accepted: 10/12/2020] [Indexed: 11/19/2022] Open
Abstract
Context: Obesity is a significant worldwide public health issue and one of the significant risk factors for type 2 diabetes and cardiovascular diseases. Aims: This study aims to determine the prevalence of obesity and overweight among type 2 diabetic patients, and explore the association between Body Mass Index (BMI), social demographics and time since diagnosis. Settings and Design: This study followed a cross-sectional study design in Bisha, Saudi Arabia. Methods and Material: Participants were identified by convenience sampling from 6 Primary Health Care Centers (PHCC) over a period of two weeks from March 16 to March 28, 2020. Statistical Analysis Used: Frequency and percentage were used to report the obesity prevalence. Chi-Square test was used to test the association between social demographics and time since diagnosis with BMI. Results: Obesity and overweight prevalence was 85.8% (n = 525), among which 27.9% (n = 171) were overweight, 57.8% were obese (n = 354), and only 13.2% (n = 81) had normal weight. A statistically significant difference between BMI and age was observed (P = 0.01). Differences between BMI and time since obesity diagnosis were statistically significant (P < 0.0001). Differences between BMI and time since type 2 diabetes diagnosis were not found to be statistically significant. Conclusion: There is a high prevalence of obesity and overweight among type 2 diabetic patients in Bisha. Differences in BMI were found to be statistically significant according to age, gender, education level and time since obesity diagnosis. Patient education programs and public health awareness about diabetes and obesity are highly recommended.
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Affiliation(s)
- Mohammad S AlShahrani
- Department of Family Medicine, College of Medicine, University of Bisha, Bisha, Saudi Arabia
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Padmavati R, Kantipudi SJ, Balasubramanian S, Raghavan V. Cardiovascular Diseases and Schizophrenia in India: Evidence, Gaps, and Way Forward. Front Psychiatry 2021; 12:639295. [PMID: 34248694 PMCID: PMC8264419 DOI: 10.3389/fpsyt.2021.639295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 05/03/2021] [Indexed: 11/18/2022] Open
Abstract
Background: The importance of physical health among persons with schizophrenia is well-established. Studies from developed and developing countries indicated a strong association between cardiovascular diseases and schizophrenia, while evidence from India is scattered and in its infancy. Hence, the aims of the study were to collate available studies from India on cardiovascular diseases among persons with schizophrenia, identify knowledge gaps and challenges, and discuss recommendations to improve clinical care and research on cardiovascular diseases among persons with schizophrenia in India. Materials and methods: A comprehensive literature review of Indian studies on cardiovascular diseases and schizophrenia was conducted to collate and synthesise available knowledge. Results: Several risk factors for cardiovascular disease predominated among persons with schizophrenia. Metabolic syndrome and obesity were the key factors that were reported. Knowledge gaps were identified with respect to the prevalence of cardiovascular diseases among persons with schizophrenia. Sparse research in interventions to prevent and reduce the impact of cardiovascular diseases among persons with schizophrenia was noted. Conclusion: Targeted efforts are needed at the clinic, community, and policy levels to understand the impact of cardiovascular diseases among persons with schizophrenia. Robust and feasible interventions targeting cardiovascular diseases and its varied risk factors in persons with schizophrenia, that can be implemented in tertiary mental health services, need to be developed and tested.
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Affiliation(s)
| | - Suvarna Jyothi Kantipudi
- Department of Psychiatry, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
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Baharudin@Shaharuddin A, Abdul Aziz NS, Ahmad MH, Manjit Singh JS, Chan YY, Palaniveloo L, Kee CC, Zulkafly N, Ibrahim Wong N, Salleh R, Selamat R. Abdominal obesity and its associated factors among older adults in Malaysia. Geriatr Gerontol Int 2020; 20 Suppl 2:68-72. [DOI: 10.1111/ggi.13962] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 04/30/2020] [Accepted: 05/16/2020] [Indexed: 02/02/2023]
Affiliation(s)
- Azli Baharudin@Shaharuddin
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia Selangor Malaysia
| | - Nur Shahida Abdul Aziz
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia Selangor Malaysia
| | - Mohamad Hasnan Ahmad
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia Selangor Malaysia
| | | | - Ying Ying Chan
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia Selangor Malaysia
| | - Lalitha Palaniveloo
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia Selangor Malaysia
| | - Chee Cheong Kee
- Sector for Biostatistics & Data Repository, Research Policy and Planning Division, National Institutes of Health, Ministry of Health Malaysia Selangor Malaysia
| | - Norlida Zulkafly
- Nutrition Division Ministry of Health Malaysia Putrajaya Malaysia
| | - Norazizah Ibrahim Wong
- Sector for Biostatistics & Data Repository, Research Policy and Planning Division, National Institutes of Health, Ministry of Health Malaysia Selangor Malaysia
| | - Ruhaya Salleh
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia Selangor Malaysia
| | - Rusidah Selamat
- Nutrition Division Ministry of Health Malaysia Putrajaya Malaysia
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Basit A, Askari S, Zafar J, Riaz M, Fawwad A. NDSP 06: Prevalence and risk factors for obesity in urban and rural areas of Pakistan: A study from second National Diabetes Survey of Pakistan (NDSP), 2016-2017. Obes Res Clin Pract 2020; 15:19-25. [PMID: 33281110 DOI: 10.1016/j.orcp.2020.11.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 10/03/2020] [Accepted: 11/25/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To study the pattern and prevalence of obesity in a large representative sample of Pakistani population aged 20 years and above. METHODOLOGY This study is a sub analysis of the second National Diabetes Survey of Pakistan (NDSP) 2016-2017, a large community-based epidemiological survey carried out from February 2016 to August 2017 in all 4 provinces of Pakistan. An estimated sample size of 10,834 people was calculated using a multistage sampling technique. Out of 213 clusters, Twenty-seven clusters were selected from all four provinces of Pakistan. Households were identified and selected members of every 10th household were advised to come to the campsite after an overnight fast. All the study participants underwent anthropometric measurements including height, weight, and waist circumference by using standardized techniques and oral glucose tolerance tests were done. Data were analyzed on the statistical package for social sciences (SPSS), version 20. RESULTS Overall weighted prevalence of generalized obesity was 57.9% (42% in males and 58% in females) and central obesity 73.1% (37.3% in males and 62.7% in females) as per WHO Asia pacific cutoffs. The highest prevalence of generalized obesity was found in Punjab 60%, followed by Khyber, Pakhtunkhwa 59.2%. Moreever, highest prevalence of abdominal obesity was observed in Baluchistan 82.1%, followed by Punjab 73.3%. Obesity (generalized and abdominal) was found significantly associated with diabetes, hypertension, and dyslipidemia. CONCLUSION The prevalence of obesity is at epidemic proportions in Pakistan, calling for urgent lifestyle intervention strategies to prevent and manage this important cardiometabolic risk factor.
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Affiliation(s)
- Abdul Basit
- Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Pakistan.
| | - Saima Askari
- Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Pakistan.
| | - Jamal Zafar
- Yashfeen Trust Hospital, Islamabad, Pakistan.
| | - Musarrat Riaz
- Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Pakistan.
| | - Asher Fawwad
- Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Pakistan.
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67
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Chandrupatla SG, Khalid I, Muthuluri T, Dantala S, Tavares M. Diabetes and prediabetes prevalence among young and middle-aged adults in India, with an analysis of geographic differences: findings from the National Family Health Survey. Epidemiol Health 2020; 42:e2020065. [PMID: 32972049 PMCID: PMC7871157 DOI: 10.4178/epih.e2020065] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 09/13/2020] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES This study aimed to approximate the prevalence of hyperglycemia in India. METHODS The study was conducted using the Demographic and Health Survey 2015-16 (also known as the National Family Health Survey-4), which surveyed 811,808 individuals using a stratified, multistage, cluster sampling design. This cross-sectional survey recorded socio-demographic and anthropometric data, including blood glucose levels, of adults aged 18 years to 54 years. RESULTS The final analysis included 718,597 individuals, of whom 49.90% (weighted) were males. The overall prevalence of diabetes was 6.65% and that of prediabetes was 5.57%. A positive association was seen with urban residence, geographic region, sex, age, body mass index, socioeconomic status, and hypertension. Approximately two-thirds of individuals with diabetes lived in urban areas, and about half of the urban population was considered overweight/obese. South India showed a higher prevalence of diabetes (prevalence ratio, 2.01; p<0.001) than northern India. CONCLUSIONS Hyperglycemia (diabetes and prediabetes) has a high prevalence in India and is a major public health issue. Diabetes is unevenly distributed based on geographic location and urbanization. Prevention, early detection, and treatment strategies should consider this uneven distribution of diabetes.
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Affiliation(s)
- Siddardha G. Chandrupatla
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA, USA
| | - Isma Khalid
- Department of Pediatric Dentistry, Boston University, Boston, MA, USA
| | - Tejdeep Muthuluri
- Deptartment of Oral Surgery, SVS Dental College, Mehboobnagar, India
| | | | - Mary Tavares
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA, USA
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68
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Srivastav P, Broadbent S, K V, Nayak B, Bhat HV. Prevention of adolescent obesity: The global picture and an indian perspective. Diabetes Metab Syndr 2020; 14:1195-1204. [PMID: 32673840 DOI: 10.1016/j.dsx.2020.06.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 06/17/2020] [Accepted: 06/18/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND AIMS Adolescent obesity is an increasing health burden with a growing prevalence in low- and middle-income countries. The aim of this review is to assess and compare current best practice obesity prevention interventions for adolescents in developed nations and in India METHODS: Medline (PubMed), CINAHL, Scopus and Google Scholar electronic databases from 2000 to 2020 were searched using the key terms obesity, overweight, child and adolescent obesity, child and adolescent overweight, interventions for childhood and adolescent obesity and dietary interventions for adolescents, developed countries, and India. RESULTS Developed nations worldwide have formed and implemented policies and programs at national and local levels to attempt to minimize and manage adolescent obesity. In 2019, scientific and government consultation groups in India have recommended national cross-sectoral structures to action interventions to restrict high-fat food intake, increase physical activity in children and adolescents and to link current research and school-based interventions in a national framework. CONCLUSIONS Obesity is a multifactorial problem, and multimodal interventions involving all Indian stakeholders, combined with government policy reform, are urgently needed.
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Affiliation(s)
- Prateek Srivastav
- Department of Physiotherapy, Manipal college of health professions, Manipal Academy of Higher Education, Manipal, India.
| | - Suzanne Broadbent
- School of Health & Sports Science, University of the Sunshine Coast, Queensland, Australia
| | - Vaishali K
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Baby Nayak
- Department of Child Health Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
| | - H Vinod Bhat
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
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Tesfaye TS, Zeleke TM, Alemu W, Argaw D, Bedane TK. Dietary diversity and physical activity as risk factors of abdominal obesity among adults in Dilla town, Ethiopia. PLoS One 2020; 15:e0236671. [PMID: 32730320 PMCID: PMC7392300 DOI: 10.1371/journal.pone.0236671] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 07/10/2020] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Globally, the prevalence of obesity is on the rise and has nearly tripled since 1975. In Ethiopia, despite not having well-documented evidence, abdominal obesity has been increasing dramatically, particularly in urban settings. Therefore, this study is intended to determine the prevalence and risk factors of abdominal obesity among adults in Dilla town, Ethiopia. METHODS A community-based cross-sectional study was conducted between January and February 2018 in Dilla Town. A multi-stage sampling technique was employed to recruit 663 adults. The study was conducted in accordance with the World Health Organization (WHO) STEP wise approach. Waist circumference was measured using a flexible metric tape mid-way between the lowest rib and iliac crest with the participant standing at the end of gentle expiration. Abdominal obesity was determined using the International Diabetes Federation cutoff. A logistic regression model was fitted to identify risk factors of abdominal obesity. Adjusted odds ratio (AOR) with corresponding 95% confidence interval (CI) was calculated to show the strength of association. RESULTS A total of 634 adults participated in the study with a response rate of 95.6%. This study revealed that 155 (24.4%) [95% CI: (21.50, 27.80)] adults were abdominally obese. Higher odds of being abdominally obese were noted among adults with a high [AOR = 4.61, 95% CI: (2.51-8.45)] and middle [AOR = 3.22, 95% CI: (1.76-5.88)] wealth rank, consuming less diversified diet [AOR = 2.05, 95% CI: (1.31-3.19)], physical inactivity [AOR = 2.68, 95% CI: (1.70-4.22)] and being female [AOR = 1.92, 95% CI: (1.13-3.28)]. CONCLUSIONS The prevalence of abdominal obesity among adults in Dilla town is considerably high, and became an emerging nutrition related problem. Being in the middle and high wealth rank, physical inactivity, consuming less diversified diet, and being female were the risk factors of abdominal obesity.
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Affiliation(s)
- Tinsae Shemelise Tesfaye
- Public Health Department, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
| | - Tadesse Mekonen Zeleke
- Food Science and Nutrition Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Wagaye Alemu
- Public Health Department, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
| | - Dirshaye Argaw
- Public Health Department, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
| | - Tadesse Kebebe Bedane
- Food Science and Nutrition Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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Solanki DK, Walia R, Gautam A, Misra A, Aggarwal AK, Bhansali A. Prevalence of abdominal obesity in non-obese adolescents: a North Indian adolescent study. J Pediatr Endocrinol Metab 2020; 33:853-858. [PMID: 32621730 DOI: 10.1515/jpem-2019-0026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 03/21/2020] [Indexed: 11/15/2022]
Abstract
Context Childhood obesity is defined based on body mass index (BMI) criteria. Asian adults have more abdominal adiposity as compared to Western people for an equivalent BMI. Similarly, children who are non-obese/overweight by BMI criteria may have abdominal obesity. It is important to identify and target this population to reduce future cardiovascular risk. Objective To evaluate and inter-relate the prevalence of obesity subtypes (generalized and abdominal) in school going adolescents. Methods A randomized cross-sectional community based study was conducted, which was carried out in 13 schools of Chandigarh, a North Indian city. 10,037 school going adolescents of age 10-18 years were evaluated. Results The prevalence of overweight and generalized obesity in present study was 9.3 and 4.9% respectively. Generalized obesity was observed in 4.2% of males and 5.7% of females (p-Value = 0.001). The abdominal obesity was noted in 5.4% of children and its prevalence increased progressively with age. The prevalence was highest in 16-18 years age-group (7.6%, p<0.001). 39.3% of abdominally obese subjects were not obese by BMI criteria, while prevalence of abdominal obesity in nonobese adolescents was 2.24%. It was more prevalent in females (3.7%) than males (3%, p=0.025). Prevalence of obesity was 7.9 and 1.8% in private and government schools respectively (p<0.001). Conclusions Abdominal obesity is more prevalent than generalized obesity and shows increasing trend with age. Interestingly, over one third of centrally obese adolescents are not obese by BMI criteria. This underlines the importance of waist circumference measurement in addition to BMI while assessing obesity.
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Affiliation(s)
- Dhiraj Kumar Solanki
- Department of Endocrinology, Post-Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rama Walia
- Department of Endocrinology, Post-Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Akanksha Gautam
- Department of Endocrinology, Post-Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Anoop Misra
- Department of Diabetes and Metabolic Diseases, Fortis Hospital, New Delhi, India
| | - Arun Kumar Aggarwal
- Department of Community Medicine, Post-Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Anil Bhansali
- Department of Endocrinology, Post-Graduate Institute of Medical Education and Research, Chandigarh, India
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Chawla R, Madhu SV, Makkar BM, Ghosh S, Saboo B, Kalra S. RSSDI-ESI Clinical Practice Recommendations for the Management
of Type 2 Diabetes Mellitus 2020. Int J Diabetes Dev Ctries 2020. [PMCID: PMC7371966 DOI: 10.1007/s13410-020-00819-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Rajeev Chawla
- North Delhi Diabetes Centre Rohini, New Delhi, India
| | - S. V. Madhu
- Centre for Diabetes, Endocrinology & Metabolism, UCMS-GTB Hospital, Delhi, India
| | - B. M. Makkar
- Dr Makkar’s Diabetes & Obesity Centre Paschim Vihar, New Delhi, India
| | - Sujoy Ghosh
- Department of Endocrinology & Metabolism, Institute of Post Graduate Medical Education & Research, Kolkata, West Bengal India
| | - Banshi Saboo
- DiaCare - A Complete Diabetes Care Centre, Ahmedabad, India
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, Haryana India
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Venkatrao M, Nagarathna R, Majumdar V, Patil SS, Rathi S, Nagendra H. Prevalence of Obesity in India and Its Neurological Implications: A Multifactor Analysis of a Nationwide Cross-Sectional Study. Ann Neurosci 2020; 27:153-161. [PMID: 34556954 PMCID: PMC8455012 DOI: 10.1177/0972753120987465] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 10/07/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND India is undergoing a rapid epidemiological transition, from underweight to overweight/obese population. Obesity is a major risk factor in type 2 diabetes and cardiovascular diseases, and is also implicated as a factor in neurological diseases such as Alzheimer's disease. A robust, pan-Indian estimate of obesity is not yet available. PURPOSE This study estimates the pan-Indian prevalence of obesity, stratified across nonmodifiable (age and gender) and modifiable (education and physical activity levels) factors, and across zones and urban/rural. METHODOLOGY Data for 1,00,531 adults from a nationwide randomized cluster sample survey (Niyantrita Madhumeha Bharata 2017, phase 1) were analyzed. Obesity was determined using body mass index, and cross-tabulations were calculated across zones, age, gender, education, physical activity, and area. To determine statistical significance, t-tests were used. The odds of obesity within each category of the various factors were calculated using binary logistic regression. RESULTS Prevalence of obesity in India is 40.3%. Zonal variations were seen as follows: south highest at 46.51% and east lowest at 32.96%. Obesity was higher among women than men (41.88% vs. 38.67%), urban than rural (44.17% vs. 36.08%), and over 40 than under 40 (45.81% vs. 34.58%). More education implied a higher obesity (44.6% college vs. 38% uneducated), as did lowered physical activity (43.71% inactive vs. 32.56% vigorously active). The odds ratio for physical activity was 3.83, stronger than age (1.58), education (1.4), urban (1.3), and gender (1.2). CONCLUSION Obesity levels in India are very high, across all zones. The odds of being obese increases with age, and is higher among women and among urban dwellers. Obesity is the highest among aging urban men and women who are college educated and are sedentary. Physical activity and aging are the strongest determinants of obesity. Given the high cost of obesity in terms of type 2 diabetes, cardiovascular diseases, and Alzheimer's disease, urgent public health measures are necessary to reduce its impact.
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Affiliation(s)
- Murali Venkatrao
- Division of Yoga and Life Sciences, SVYASA University, Prashanti Kutiram, Jigani, Bengaluru, Karnataka, India
| | - Raghuram Nagarathna
- Division of Yoga and Life Sciences, SVYASA University, Prashanti Kutiram, Jigani, Bengaluru, Karnataka, India
| | - Vijaya Majumdar
- Division of Yoga and Life Sciences, SVYASA University, Prashanti Kutiram, Jigani, Bengaluru, Karnataka, India
| | - Suchitra S. Patil
- Division of Yoga and Life Sciences, SVYASA University, Prashanti Kutiram, Jigani, Bengaluru, Karnataka, India
| | - Sunanda Rathi
- Division of Yoga and Life Sciences, SVYASA University, Prashanti Kutiram, Jigani, Bengaluru, Karnataka, India
| | - Hongasandra Nagendra
- Division of Yoga and Life Sciences, SVYASA University, Prashanti Kutiram, Jigani, Bengaluru, Karnataka, India
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Beneficial effect of phospholipase A2 group IIA inhibitors from Acacia suma in obesity: an in silico and in vitro study. ADVANCES IN TRADITIONAL MEDICINE 2020. [DOI: 10.1007/s13596-020-00456-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Mandal SK, Mitra A, Alok Y, Gupta S, Majumdar A. Awareness and perceptions regarding taxation and health warnings related to sugar-sweetened beverages and the factors associated with these among visitors of a general out-patient clinic in Bhopal, India. J Family Med Prim Care 2020; 9:2350-2358. [PMID: 32754500 PMCID: PMC7380747 DOI: 10.4103/jfmpc.jfmpc_226_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 03/13/2020] [Accepted: 03/23/2020] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Although increased taxation on sugar-sweetened beverages (SSBs) and warning labels on their packaging have been successful in other countries, India has not implemented these. It is imperative to understand the user perspectives before implementation, regarding which almost no information exists. OBJECTIVES To assess the awareness and perceptions of people regarding taxation and health warnings on SSB packaging, and to determine the factors associated with these. METHODOLOGY This cross-sectional study was conducted in the general out-patient clinic of a public tertiary care hospital in Bhopal, India, between April and November 2018. Patients and accompanying persons ≥15 years of age and attending the clinic were included. Severely ill patients were excluded. Exit interviews were conducted after the clinical consultation using a pre-tested semi-structured interview schedule. Data were analyzed using IBM SPSS version 21. RESULTS Out of the 503 participants interviewed, three-fourths had never heard of taxes on SSBs and had never seen any health warning on SSB packaging. Most participants (96.6%) wanted some health warning to be present on the packaging. Majority of them (69.3%) wanted both textual and pictorial warnings. Close to half of those who wanted a pictorial warning to be present opined that it should occupy <25% of the surface area of the packaging. Multivariable analysis showed that participants aged <25 years and females were not in favor of tax increment. CONCLUSION Government policies should also focus on user perspectives and preferences before deciding to increase tax on SSBs or introducing mandatory health warnings on SSBs.
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Affiliation(s)
- Soumya K Mandal
- All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India
| | - Arun Mitra
- Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India
| | - Yash Alok
- Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India
| | - Shubhanshu Gupta
- Department of Community Medicine, Datia Medical College, Datia, Madhya Pradesh, India
| | - Anindo Majumdar
- Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India
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Bhasker AG, Prasad A, Raj PP, Wadhawan R, Khaitan M, Agrawal AJ, Tantia O, Baig SJ, Palaniappan R, Shivaram HV, Shah S, Soni V, Bhandari M, Shivhare R, Dhorepatil S, Chowbey P, Narwaria M, Shah S, Khullar R. Trends and progress of bariatric and metabolic surgery in India. Updates Surg 2020; 72:743-749. [DOI: 10.1007/s13304-020-00774-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 04/16/2020] [Indexed: 12/18/2022]
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Kalyan M, Dhore P, Purandare V, Deshpande S, Unnikrishnan AG. Obesity and its Link to Undiagnosed Diabetes Mellitus and Hypertension in Rural Parts of Western India. Indian J Endocrinol Metab 2020; 24:155-159. [PMID: 32699782 PMCID: PMC7333747 DOI: 10.4103/ijem.ijem_582_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 12/26/2019] [Accepted: 02/06/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Obesity and overweight are becoming major health concerns worldwide. Hence, we studied the association between overweight and obesity with new-onset diabetes and hypertension in a selected rural population. METHODOLOGY Community health workers made house-to-house visits, inviting adults >20 years of age who were at a higher risk of diabetes, from a predefined rural area of Maharashtra, to visit a mobile diabetes clinic operating in a hub and spoke manner. Sociodemographic data and anthropometric measurements were recorded. BMI and waist circumference was classified according to the WHO recommended cutoffs for Asians. Subjects with capillary blood fasting glucose of ≥126 mg/dL or random glucose of ≥200 mg/dL by glucometer were diagnosed as diabetes and blood pressure of ≥140/90 mmHg by sphygmomanometer were diagnosed as hypertension. Subjects with a known history of diabetes mellitus and hypertension were excluded. RESULTS Out of 29,324 total population, 16.5% of subjects were overweight and 26.4% were obese. Mean ± SD of BMI of the participants was 22.9 ± 4.1 kg/m2 in males and 22.4 ± 4.2 kg/m2 in females. Around 35% of males and 30.5% of females had a high waist circumference of ≥90 cm and ≥80 cm, respectively, 20.5% of subjects had newly diagnosed hypertension, and 11.4% of subjects had newly diagnosed diabetes mellitus. The occurrence of newly diagnosed hypertension and diabetes showed an increasing trend with increasing BMI. CONCLUSION Our community-based screening suggested a high prevalence of overweight and obesity in rural India. There was a high prevalence of newly diagnosed hypertension and diabetes in this population.
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Affiliation(s)
- Meenakshi Kalyan
- Department of Endocrinology and Diabetes, Chellaram Diabetes Institute, Pune, Maharashtra, India
| | - Prasanna Dhore
- Department of Education and outreach, Chellaram Diabetes Institute, Pune, Maharashtra, India
| | - Vedavati Purandare
- Department of Endocrinology and Diabetes, Chellaram Diabetes Institute, Pune, Maharashtra, India
| | - Shailesh Deshpande
- Department of Education and outreach, Chellaram Diabetes Institute, Pune, Maharashtra, India
| | - A. G. Unnikrishnan
- Department of Endocrinology and Diabetes, Chellaram Diabetes Institute, Pune, Maharashtra, India
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Girish P, Jayanthi M, Gitanjali B, Manikandan S, Rajan S. Screening of Weight-Loss Herbal Products for Synthetic Anti-Obesity Adulterants: A Target-Oriented Analysis by Liquid Chromatography-Tandem Mass Spectrometry. J Diet Suppl 2020; 18:92-104. [PMID: 32081055 DOI: 10.1080/19390211.2020.1723774] [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: 10/25/2022]
Abstract
BACKGROUND The medical and social impact of being overweight, as well as the difficulty in making long-term changes in diet, physical activity, and pitfalls associated with allopathic management, lure obese individuals to over-the-counter weight-loss herbal products (WHPs). However, the safety of herbals is questionable, as reports from all over the world suggest adulteration with synthetic weight loss agents. Objective: The present study was carried out to develop a rapid and sensitive method to screen potential weight loss adulterants in WHPs. Methodology: We procured 33 licensed brands of WHPs that are available in Puducherry (India) and through web stores. Drug-free spiked herbal matrices were used for internal proficiency testing. Spiked herbal matrices and samples were extracted and centrifuged. The supernatant was collected and subjected to liquid chromatography-tandem mass spectrometry analyses. Isocratic elution was carried out by the mobile phase of methanol: 0.1% v/v formic acid (70%:30% v/v) through a C18 column. Analytes were monitored in electrospray ionization positive and negative modes, and an multiple reaction monitoring (MRM) scan was used. Results: Run time was 12 min. Intra- and inter-day precision was < 15% and recoveries were in the range of 99% to 115%. Limit of quantification (LOQ) of the analytes were in the range of 0.1 to 0.3 ng/ml. Conclusion: We developed a sensitive and rapid validated method for the detection of potential adulterants in WHPs. None of the WHPs analyzed were found to contain adulterants. The proposed method will be useful for routine monitoring. WHPs analyzed in this study were not adulterated indicating that WHPs from licensed sources are reliable.
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Affiliation(s)
- P Girish
- Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India
| | - M Jayanthi
- Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India
| | - B Gitanjali
- Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India.,All India Institute of Medical Sciences, Bhubaneswar, India
| | - S Manikandan
- Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India
| | - S Rajan
- Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India
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78
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Sreeniwas Kumar A, Sinha N. Cardiovascular disease in India: A 360 degree overview. Med J Armed Forces India 2020; 76:1-3. [PMID: 32020960 DOI: 10.1016/j.mjafi.2019.12.005] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- A Sreeniwas Kumar
- Director (Cardiology & Clinical Research), Apollo Hospitals, Apollo Health City, Hyderabad, India
| | - Nakul Sinha
- Cardiologist, Sahara Hospital, Lucknow, India
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79
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Ranzani OT, Milà C, Sanchez M, Bhogadi S, Kulkarni B, Balakrishnan K, Sambandam S, Sunyer J, Marshall JD, Kinra S, Tonne C. Association between ambient and household air pollution with carotid intima-media thickness in peri-urban South India: CHAI-Project. Int J Epidemiol 2020; 49:69-79. [PMID: 31605119 PMCID: PMC7124504 DOI: 10.1093/ije/dyz208] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2019] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Evidence linking ambient air pollution with atherosclerosis is lacking from low- and middle-income countries. Additionally, evidence regarding the association between household air pollution and atherosclerosis is limited. We evaluated the association between ambient fine particulate matter [particulate matter with an aerodynamic diameter of ≤2.5 µm (PM2.5)] and biomass fuel use on carotid intima-media thickness (CIMT), a surrogate of atherosclerosis, in India. METHODS We analysed the third follow-up of the Andhra Pradesh Children and Parent Study cohort (2010-2012), which recruited participants from 28 peri-urban villages. Our primary outcome was mean CIMT, measured using a standardized protocol. We estimated annual average PM2.5 outdoors at residence using land-use regression. Biomass cooking fuel was self-reported. We fitted a within-between linear-mixed model adjusting for potential confounders. RESULTS Among 3278 participants (48% women, mean age 38 years), mean PM2.5 was 32.7 [range 24.4-38.2] µg/m3, and 60% used biomass. After confounder adjustment, we observed positive associations between within-village variation in PM2.5 and CIMT in all participants [1.79%, 95% confidence interval (CI), -0.31 to 3.90 per 1 µg/m3 of PM2.5] and in men (2.98%, 95% CI, 0.23-5.72, per 1 µg/m3 of PM2.5). Use of biomass cooking fuel was associated with CIMT in all participants (1.60%, 95% CI, -0.46 to 3.65), especially in women with an unvented stove (6.14%, 95% CI, 1.40-10.89). The point-estimate for the PM2.5 association was larger in sub-groups with higher cardiometabolic risk profile. CONCLUSIONS Ambient and household air pollution were positively associated with CIMT in a peri-urban population of India, although with limited precision for some estimates. We observed differences in the association between ambient and household air pollution and CIMT by gender.
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Affiliation(s)
- Otavio T Ranzani
- Barcelona Institute for Global Health, Universitat Pompeu Fabra, CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Carles Milà
- Barcelona Institute for Global Health, Universitat Pompeu Fabra, CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Margaux Sanchez
- Barcelona Institute for Global Health, Universitat Pompeu Fabra, CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | | | - Bharati Kulkarni
- National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, India
| | - Kalpana Balakrishnan
- Department of Environmental Health Engineering, Sri Ramachandra University (SRU), Chennai, India
| | - Sankar Sambandam
- Department of Environmental Health Engineering, Sri Ramachandra University (SRU), Chennai, India
| | - Jordi Sunyer
- Barcelona Institute for Global Health, Universitat Pompeu Fabra, CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Julian D Marshall
- Department of Civil and Environmental Engineering, University of Washington, Seattle, WA, USA
| | - Sanjay Kinra
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Cathryn Tonne
- Barcelona Institute for Global Health, Universitat Pompeu Fabra, CIBER Epidemiología y Salud Pública, Barcelona, Spain
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Gadekar T, Dudeja P, Basu I, Vashisht S, Mukherji S. Correlation of visceral body fat with waist-hip ratio, waist circumference and body mass index in healthy adults: A cross sectional study. Med J Armed Forces India 2020; 76:41-46. [PMID: 32020967 PMCID: PMC6994756 DOI: 10.1016/j.mjafi.2017.12.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Accepted: 12/01/2017] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Visceral Fat (VF) is the underlying culprit for cardiovascular diseases, type 2 diabetes, breast cancer, etc. VF can be estimated at present only by using expensive instruments as Bio Impedance Analyzer (BIA), DEXA scanner, etc. Measurement of Waist-Hip Ratio (WHR) can be used as a proxy for VF. Hence, the present study was done to assess the role of WHR as appropriate technology for assessment of VF. The aim of this study was to find correlation of Visceral Fat Area (VFA) with (WHR), Waist Circumference (WC) and Body Mass Index (BMI) in young healthy adults. METHODS It was a descriptive cross-sectional study conducted on 215 healthy adults over one year in Western Maharashtra. Biospace 720 was used to assess VF. Data was analyzed by using software SPSS version 20.0. In body 720 was used to assess VF of subjects. RESULTS Majority 155 (73%) were males and 57 (27%) were females. Nearly half (42% of males, 49% of females) had VFA above cut off value (i.e. 100 cm2) and 42% of males had WHR >0.9 and 56% of females had WHR >0.8. We found a very strong correlation between VFA and WHR (r = 0.936, p < 0.05) among males and females (r = 0.920, p < 0.05) and correlation between WC and BMI with VFA (r = 0.739, r = 0.758) for males, (r = 0.774, r = 0.605) for females was modest. CONCLUSION There is a strong correlation between VF and WHR. Measurement of WHR is simple, handy, and inexpensive tool which can be used as a surrogate to measure VF.
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Affiliation(s)
- Tukaram Gadekar
- Resident, Department of Community Medicine, Armed Forces Medical College, Pune 411040, India
| | - Puja Dudeja
- Associate Professor, Department of Community Medicine, Armed Forces Medical College, Pune 411040, India
| | - Ipsita Basu
- Intern, Command Hospital (Eastern Commnad), Kolkata, India
| | - Shruti Vashisht
- Clinical Tutor, Department of Community Medicine, Armed Forces Medical College, Pune 411040, India
| | - Sandip Mukherji
- PMO, HQ Central Air Command, Indian Air Force, Allahabad, India
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81
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Marjot T, Moolla A, Cobbold JF, Hodson L, Tomlinson JW. Nonalcoholic Fatty Liver Disease in Adults: Current Concepts in Etiology, Outcomes, and Management. Endocr Rev 2020; 41:5601173. [PMID: 31629366 DOI: 10.1210/endrev/bnz009] [Citation(s) in RCA: 119] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 10/14/2019] [Indexed: 02/06/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is a spectrum of disease, extending from simple steatosis to inflammation and fibrosis with a significant risk for the development of cirrhosis. It is highly prevalent and is associated with significant adverse outcomes both through liver-specific morbidity and mortality but, perhaps more important, through adverse cardiovascular and metabolic outcomes. It is closely associated with type 2 diabetes and obesity, and both of these conditions drive progressive disease toward the more advanced stages. The mechanisms that govern hepatic lipid accumulation and the predisposition to inflammation and fibrosis are still not fully understood but reflect a complex interplay between metabolic target tissues including adipose and skeletal muscle, and immune and inflammatory cells. The ability to make an accurate assessment of disease stage (that relates to clinical outcome) can also be challenging. While liver biopsy is still regarded as the gold-standard investigative tool, there is an extensive literature on the search for novel noninvasive biomarkers and imaging modalities that aim to accurately reflect the stage of underlying disease. Finally, although no therapies are currently licensed for the treatment of NAFLD, there are interventions that appear to have proven efficacy in randomized controlled trials as well as an extensive emerging therapeutic landscape of new agents that target many of the fundamental pathophysiological processes that drive NAFLD. It is highly likely that over the next few years, new treatments with a specific license for the treatment of NAFLD will become available.
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Affiliation(s)
- Thomas Marjot
- Translational Gastroenterology Unit, NIHR Oxford Biomedical Research Centre, University of Oxford, John Radcliffe Hospital, Oxford, UK.,Oxford Centre for Diabetes, Endocrinology and Metabolism, NIHR Oxford Biomedical Research Centre, University of Oxford, Churchill Hospital, Oxford, UK
| | - Ahmad Moolla
- Oxford Centre for Diabetes, Endocrinology and Metabolism, NIHR Oxford Biomedical Research Centre, University of Oxford, Churchill Hospital, Oxford, UK
| | - Jeremy F Cobbold
- Translational Gastroenterology Unit, NIHR Oxford Biomedical Research Centre, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Leanne Hodson
- Oxford Centre for Diabetes, Endocrinology and Metabolism, NIHR Oxford Biomedical Research Centre, University of Oxford, Churchill Hospital, Oxford, UK
| | - Jeremy W Tomlinson
- Oxford Centre for Diabetes, Endocrinology and Metabolism, NIHR Oxford Biomedical Research Centre, University of Oxford, Churchill Hospital, Oxford, UK
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82
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RAUTELA Y, REDDY B, SINGH A, GUPTA A. Smoking and alcoholism among adult population and its association with outlet density in a hilly area of North India. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2019; 60:E361-E367. [PMID: 31967094 PMCID: PMC6953459 DOI: 10.15167/2421-4248/jpmh2019.60.4.1341] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 11/20/2019] [Indexed: 11/16/2022]
Abstract
Background The rising burden of non-communicable diseases is a threat to India. The behavioural risk factors having largest contribution to NCDs. Neighbourhood retailing of tobacco products, and alcohol are important risk factors. The objectives of the present study were to determine the prevalence of smoking and alcoholism among adults of Srikot, Uttarakhand, and to determine its relationship with tobacco, and alcohol retail outlet density. Materials and methods The study design was a community based cross sectional study, which was done in Srikot, Uttarakhand among adults aged above 20 years, selected by systematic sampling. A semi-structured questionnaire was used. The outlet density was measured mapped using android application. Results A total of 155 were enrolled in the study of which 61.3% were females. A total of 11.6% of the study participants were smokers. On multivariate analysismale gender, and alcohol use was significantly associated with increased risk of smoking (p < 0.05). A total of 16.8% of the study participants were alcohol user. On multivariate analysis it was found male gender, and smoking was significantly associated with increased risk of alcohol use (p < 0.05). On mapping the study area, it was found that total tobacco selling outlets were 40. There was no alcohol-selling outlet in the study area. Conclusion The community is in an early stage of urbanization as evident from the burden of smoking, and alcohol use. This burden of smoking might be worsened by outlet density of tobacco seller.
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Affiliation(s)
- Y.S. RAUTELA
- Veer Chandra Singh Garhwali Government Medical Sciences and Research Institute, Uttarakhand, India
| | - B.V. REDDY
- Department of Community Medicine, NRI Academy of Medical Sciences Andhra Pradesh, India
| | - A.K. SINGH
- Department of Community Medicine, Veer Chandra Singh Garhwali Government Medical Sciences and Research Institute, Uttarakhand, India
| | - A. GUPTA
- Department of Community and Family Medicine, All India Institute of Medical Sciences Mangalagiri, Andhra Pradesh, India
- Correspondence: Arti Gupta, Department of Community and Family Medicine, All India Institute of Medical Sciences Mangalagiri, Andhra Pradesh, India - Tel. +91 9013902976 - E-mail:
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83
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Esakkimuthu S, Nagulkumar S, Darvin SS, Buvanesvaragurunathan K, Sathya TN, Navaneethakrishnan KR, Kumaravel TS, Murugan SS, Shirota O, Balakrishna K, Pandikumar P, Ignacimuthu S. Antihyperlipidemic effect of iridoid glycoside deacetylasperulosidic acid isolated from the seeds of Spermacoce hispida L. - A traditional antiobesity herb. JOURNAL OF ETHNOPHARMACOLOGY 2019; 245:112170. [PMID: 31434002 DOI: 10.1016/j.jep.2019.112170] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 08/12/2019] [Accepted: 08/15/2019] [Indexed: 06/10/2023]
Abstract
ETHNOBOTANICAL RELEVANCE The interest on herbal health supplements for obesity is increasing globally. Our previous ethnobotanical survey in Tiruvallur district, Tamil Nadu, India indicated the use of Spermacoce hispida L. seeds for the treatment of obesity. AIM OF THE STUDY This study was aimed to validate the traditional claim and to identify the antihyperlipidemic principle in the seeds of Spermacoce hispida using bioassay guided fractionation method. METHODS Bioassay monitored fractionation of the aqueous extract from Spermacoce hispida seeds was carried out using triton WR 1339 induced hyperlipidemic animals. It yielded deacetylasperulosidic acid (DAA) as the active ingredient. Pharmacokinetic properties of DAA were predicted using DataWarrior and SwissADME tools. In vitro antiobesity and antihyperlipidemic effects of DAA were evaluated in 3T3L1 preadipocytes and HepG2 cells, respectively. The chronic antihyperlipidemic efficacy of DAA was evaluated in high fat diet fed rats. RESULTS DAA did not show any mutagenic and tumorigenic properties. It bound with PPARα with comparable ligand efficiency as fenofibrate. The treatment with DAA significantly lowered the proliferation of matured adipocytes, but not preadipocytes. The treatment of steatotic HepG2 cells with DAA significantly decreased the LDH leakage by 43.03% (P < 0.05) at 50 μM concentration. In triton WR 1339 induced hyperlipidemic animals, the treatment with 50 mg/kg dose significantly lowered the TC, TG and LDL-c levels by 40.27, 46.00 and 63.65% respectively. In HFD fed animals, the treatment at 10 mg/kg decreased BMI and AC/TC ratio without altering SRBG. It also improved serum lipid, transaminases and phosphatases levels of HFD fed animals. The treatment lowered adipocyte hypertrophy and steatosis of hepatocytes. CONCLUSION This preliminary report supported the traditional use of Spermacoce hispida for the treatment of obesity. Further detailed investigations on the long term safety, efficacy and molecular mode of action of Spermacoce hispida and DAA will throw more light on their usefulness for the management of obesity.
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Affiliation(s)
- S Esakkimuthu
- Division of Ethnopharmacology, Entomology Research Institute, Loyola College (University of Madras), Chennai, Tamil Nadu, 600034, India
| | - S Nagulkumar
- Division of Ethnopharmacology, Entomology Research Institute, Loyola College (University of Madras), Chennai, Tamil Nadu, 600034, India
| | - S Sylvester Darvin
- Division of Ethnopharmacology, Entomology Research Institute, Loyola College (University of Madras), Chennai, Tamil Nadu, 600034, India
| | - K Buvanesvaragurunathan
- Division of Ethnopharmacology, Entomology Research Institute, Loyola College (University of Madras), Chennai, Tamil Nadu, 600034, India
| | - T N Sathya
- GLR Laboratories Private Limited, Mathur, Chennai, 600068, India
| | | | - T S Kumaravel
- GLR Laboratories Private Limited, Mathur, Chennai, 600068, India
| | - S S Murugan
- GLR Laboratories Private Limited, Mathur, Chennai, 600068, India
| | - Osamu Shirota
- Laboratory of Pharmacognosy and Natural Products Chemistry, Kagawa School of Pharmaceutical Sciences, Tokushima Bunri University, Kagawa, 769-2193, Japan.
| | - K Balakrishna
- Division of Ethnopharmacology, Entomology Research Institute, Loyola College (University of Madras), Chennai, Tamil Nadu, 600034, India.
| | - P Pandikumar
- Division of Ethnopharmacology, Entomology Research Institute, Loyola College (University of Madras), Chennai, Tamil Nadu, 600034, India.
| | - S Ignacimuthu
- Division of Ethnopharmacology, Entomology Research Institute, Loyola College (University of Madras), Chennai, Tamil Nadu, 600034, India; St. Xavier Research Foundation, St. Xavier's College, High Ground Road, Palayamkottai, Tirunelveli, Tamil Nadu, 627002, India.
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84
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Dubey AK, Priyamvada PS, Sahoo J, Vairappan B, Haridasan S, Parameswaran S. Reliability of Anthropometry-Based Equations Compared to Dual Energy Absorptiometry for Assessing Body Composition in Predialysis Chronic Kidney Disease-A Longitudinal Study. J Ren Nutr 2019; 30:216-222. [PMID: 31679965 DOI: 10.1053/j.jrn.2019.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 07/29/2019] [Accepted: 08/25/2019] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES Skinfold thickness measurements for assessing body composition are reported to have good reproducibility compared to the reference method of dual energy absorptiometry (DXA). In the current study, we compared the level of agreement between body composition measured with DXA and skinfold thickness (SFT) in CKD Stage 3 and 4, at 2 occasions, 6 months apart. METHODS Body composition was assessed in 177 Indian patients with CKD Stage 3 and 4 using DXA and anthropometry (SFT). The body fat mass obtained by the 2 methods was compared by paired t-test, intraclass correlation coefficients, regression analysis, and Bland-Altman plots. A linear regression analysis was done to identify the patient-related parameters which would account for the intermethod differences between DXA and SFT. RESULTS Compared to DXA, SFT underestimated the fat mass at baseline as well as 6 months [DXA vs. SFT at entry: 15.85 kg (95% confidence interval, CI 15.07-16.65) vs. 13.71 kg (95% CI 13.21-14.32), P < .001; at 6 months: 16.13 (95% CI 15.33-16.93) vs. 13.85 (95% CI 13.25-14.45), P < .001]. The intraclass correlation coefficients at entry and 6 months were 0.894 (0.857-0.921) and 0.896 (0.860-0.923), respectively. The intermethod differences between DXA and SFT at baseline and 6 months were comparable: 2.08 kg (95% CI 1.66-2.5) at baseline versus 2.27 kg (95% CI 1.83-2.71) at 6 months, P = 0.200. Gender and body mass index turned out to be the significant predictors of intermethod differences at base line and exit (P < .001). CONCLUSIONS SFT-based measurements show good reproducibility compared to DXA over a period of 6 months. However, SFT systematically underestimates the fat mass by 2 Kg compared to DXA.
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Affiliation(s)
- Avinash Kumar Dubey
- Department of Nephrology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - P S Priyamvada
- Department of Nephrology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
| | - Jayaprakash Sahoo
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Balasubramaniyan Vairappan
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Satish Haridasan
- Department of Nephrology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Sreejith Parameswaran
- Department of Nephrology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Chaurasiya D, Gupta A, Chauhan S, Patel R, Chaurasia V. Age, period and birth cohort effects on prevalence of obesity among reproductive-age women in India. SSM Popul Health 2019; 9:100507. [PMID: 31998829 PMCID: PMC6978492 DOI: 10.1016/j.ssmph.2019.100507] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 10/24/2019] [Accepted: 10/26/2019] [Indexed: 12/12/2022] Open
Abstract
Cohort effect shows that obesity for recent cohort has narrowed down. Our study shows as age increases the risk of obesity also increases. Cohort relative risk is higher among women in rural area than women in urban area.
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Affiliation(s)
- Dinesh Chaurasiya
- Department of Mathematical Demography and Statistics, International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai, 400088, India
| | - Ajay Gupta
- Department of Mathematical Demography and Statistics, International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai, 400088, India
| | - Shekhar Chauhan
- Department of Population Policies and Programs, International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai, 400088, India
- Corresponding author.
| | - Ratna Patel
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai, 400088, India
| | - Vaishali Chaurasia
- Department of Mathematical Demography and Statistics, International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai, 400088, India
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Kedar A, Hariprasad R, Kumar V, Dhanasekaran K, Mehrotra R. Association of metabolic NCD risk factors with oral, breast and cervical precancers and cancers in India. Fam Med Community Health 2019; 7:e000180. [PMID: 32148727 PMCID: PMC6910767 DOI: 10.1136/fmch-2019-000180] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 09/15/2019] [Accepted: 09/19/2019] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To find an association between metabolic non-communicable disease (NCD) risk factors (high blood pressure (BP), high random blood sugar (RBS) and overweight /obesity) and oral, breast, cervical cancers/precancerous or potentially malignant conditions. DESIGN This is an observational study using convenience sampling. The participants were screened through opportunistic or population-based screening. SETTING The study was conducted at a health promotion clinic (HPC) located in Northern India under the Indian Council of Medical Research. HPC is a screening clinic where screening is done for hypertension (HT), diabetes mellitus (DM), obesity, and oral, breast and cervical cancers. The study was conducted between December 2016 and January 2019. PARTICIPANT The number of participants screened was 8352 (6712 women and 1640 men). All consenting men and women above 18 years were included. All participants were screened for oral cancer, DM, HT and obesity. All women were also screened for breast and cervical cancers. Cervical screening was done for non-pregnant women 21 years and above with history of sexual activity. RESULT Oral potentially malignant disease (OPMD) was the most prevalent, followed by breast cancer, oral cancer, cervical cancer and cervical precancer. High RBS had a strong association with oral cancer (OR=2.29, 95% CI 1.09 to 4.82, p=0.03) and breast cancer (OR=1.95, 95% CI 1.01 to 3.76, p=0.05). High BP had a strong association with breast cancer (OR=2.50, 95% CI 1.43 to 4.35, p<0.0001). An inverse association was noted between oral cancer and overweight/obesity (OR=0.20, 95% CI 0.08 to 0.48, p<0.0001). Current tobacco use was strongly associated with oral cancer (OR=6.51, 95% CI 3.63 to 11.67, p<0.0001) and OPMD (OR=9.82, 95% CI 8.13 to 11.86, p<0.0001). No association was elicited between the metabolic NCD risk factors and cervical cancer/precancer. CONCLUSIONS The study reaffirms that NCD metabolic risk factors determine oral and breast cancers. Besides NCD risk factors, current tobacco use was a strong determinant of OPMD and oral cancer. Hence, primary and primordial prevention measures to control NCD metabolic risk factors and tobacco use should move along with secondary prevention of breast and oral cancers.
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Affiliation(s)
- Ashwini Kedar
- Department of Clinical Oncology, National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India
| | - Roopa Hariprasad
- Department of Clinical Oncology, National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India
| | - Vipin Kumar
- Department of Clinical Oncology, National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India
| | - Kavitha Dhanasekaran
- Department of Clinical Oncology, National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India
| | - Ravi Mehrotra
- Department of Clinical Oncology, National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India
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87
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Kaur P, Ramachandra Rao S, Venkatachalam R, Kangusamy B, Radhakrishnan E, Kaliaperumal K, Thota V, Gupte MD. Risk factors for cardiovascular disease in rural South India: cohort study. BMJ Open 2019; 9:e029759. [PMID: 31662362 PMCID: PMC6830617 DOI: 10.1136/bmjopen-2019-029759] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Cardiovascular diseases (CVD) accounted for one-third of the deaths in India. We conducted a cohort study to estimate the incidence of CVD and the association of established risk factors with the incident CVD in a rural population in South India. DESIGN, SETTING AND PARTICIPANTS We conducted a community-based cohort study among 6026 adults aged 25-64 years in five villages in Tiruvallur, Tamil Nadu. We did baseline (2005-2007) and two follow-up surveys in 2008-2009 and 2013-2015. Risk factors studied were tobacco, alcohol, hypertension, self-reported diabetes and central obesity. OUTCOME MEASURES Outcome measures were fatal or non-fatal ischaemic heart disease or cerebrovascular event. We estimated HRs for the risk factors and population attributable fraction (PAF). RESULTS We followed up 5641 (94.4%) subjects, and follow-up duration was 33 371 person years. The overall incidence of cardiovascular event or death was 4.6 per 1000 person years. Current smoking (HR 1.6, 95% CI 1.1 to 2.6) and hypertension (HR 2.2, 95% CI 1.5 to 3.4) were the risk factors among men and accounted for 47% of the PAF. Among women, hypertension (HR 1.8, 95% CI 1.0 to 3.4), self-reported diabetes (HR 4.3, 95% CI 2.2 to 8.1) and central obesity (HR 2.2, 95% CI 1.2 to 4.0) were associated with CVD and accounted for more than half of the PAF. CONCLUSIONS We described the high burden of fatal CVD and identified the role of CVD risk factors such as hypertension, self-reported diabetes, smoking and central obesity. There is an urgent need to implement low-cost interventions such as smoking cessation and treat hypertension and diabetes in primary care settings.
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Affiliation(s)
- Prabhdeep Kaur
- Division of Noncommunicable Diseases, ICMR-National Institute of Epidemiology, Chennai, India
| | - Sudha Ramachandra Rao
- Division of Noncommunicable Diseases, ICMR-National Institute of Epidemiology, Chennai, India
| | | | - Boopathi Kangusamy
- Division of Heath Systems Research, ICMR-National Institute of Epidemiology, Chennai, India
| | - Ezhil Radhakrishnan
- Division of Noncommunicable Diseases, ICMR-National Institute of Epidemiology, Chennai, India
| | - Kanagasabai Kaliaperumal
- Division of Computing and Information Science, ICMR-National Institute of Epidemiology, Chennai, India
| | - Venkatarao Thota
- Division of Noncommunicable Diseases, ICMR-National Institute of Epidemiology, Chennai, India
| | - Mohan D Gupte
- Former Director, ICMR-National Institute of Epidemiology, Chennai, India
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88
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The Prevalence of Overweight, Obesity, Hypertension, and Diabetes in India: Analysis of the 2015-2016 National Family Health Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203987. [PMID: 31635366 PMCID: PMC6843936 DOI: 10.3390/ijerph16203987] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 10/10/2019] [Accepted: 10/16/2019] [Indexed: 02/06/2023]
Abstract
Overweight, obesity, hypertension, and diabetes increase the risk of non-communicable diseases and all-cause mortality worldwide. Previous studies have not determined the prevalence of these conditions/diseases throughout India. Therefore, this study was aimed to address this limitation. Data on these conditions/diseases among men and women aged ≥ 18 years were obtained from the fourth National Family Health Survey conducted throughout India between January 2015 and December 2016. The prevalence and prevalence rate per 100,000 population were calculated at the national level and by age group, sex, and type of residence for each state and union territory. The national prevalence of overweight, obesity, hypertension, and diabetes were 14.6%, 3.4%, 5.2%, and 7.1%, respectively. The highest prevalence of these conditions/diseases at the national level was seen among those aged 35–49 years (54 years for men), especially women living in urban areas. In India, 1 out of every 7, 29, 19, and 14 individuals at the national level had overweight, obesity, hypertension, and diabetes, respectively—between 2015 and 2016. These results are important for the healthcare system and government policies in the future. Moreover, targeted efforts are required to establish public health strategies for the prevention, management, and treatment of these conditions/diseases throughout India.
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89
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Central obesity and hypertension among rural adults of Paschim Medinipur, West Bengal, India. ANTHROPOLOGICAL REVIEW 2019. [DOI: 10.2478/anre-2019-0017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Obesity is generally classified into generalized obesity (BMI ≥30 kg/m2) and abdominal or central obesity (WC ≥90 cm for men and WC ≥80 cm for women) based on World Health Organization recommendation for Asians. Hypertension is one of the most common obesity-related complications, and about 30% of hypertensive individuals can be classified as being obese. The present study aimed to investigate the effect of different age groups (years) on the anthropometric and derived variables. It determined the correlation between anthropometric and derived variables and also estimated the frequency of central obesity and hypertension. Finally, it investigated the relationship between central obesity and blood pressure among rural Bengalee adults of Dirghagram village of Ghatal Block, Paschim Medinipur, West Bengal, India. The present cross-sectional study was undertaken among 310 rural adults (154 males; 156 females) aged over 18 years. Our study was carried out during March, 2017. Height (cm), weight (kg), waist circumference (cm), hip circumference (cm) and blood pressure (systolic and diastolic) were measured using standard procedures. One way ANOVA analysis on most of the anthropometric and derived variables showed a statistically significant increase from younger to older age group in both sexes (p<0.001;p<0.01; p<0.05). In addition to that, more females had central obesity using waist circumference (55.8% vs. 19.5%), waist hip ratio (87.2% vs. 35.7%), waist height ratio (73.7% vs. 44.2%), and conicity index (87.2% vs. 57.8%) criteria, and hypertension (52.5% vs. 27.3%). The prevalence of central obesity was much higher in case of hypertensive individuals. Therefore, the present study showed a high prevalence of central obesity among the rural adults of Dirghagram village. Furthermore, central obesity contributed in increasing hypertension among the villagers.
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90
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Abstract
Background: Inconsistent evidence exists regarding the strength, direction, and moderators in the relationship between obesity and psychiatric disorders. Aim: This study aims to summarize the evidence on the association between psychiatric illness and obesity with particular attention to the strength and direction of association and also the possible moderators in each postulated link. Materials and Methods: Systematic electronic searches of MEDLINE through PubMed, ScienceDirect, PsycINFO, and Google Scholar were carried out from inception till October 2016. Generated abstracts were screened for eligibility to be included in the review. Study designs that evaluated the strength of relationship between obesity and psychiatric disorders were included in the study. Quality assessment of included studies was done using the Newcastle–Ottawa checklist tool. Results: From a total of 2424 search results, 21 eligible articles were identified and reviewed. These included studies on obesity and depression (n = 15), obesity and anxiety (four) and one each on obesity and personality disorders, eating disorder (ED), attention deficit hyperactivity disorder, and alcohol use. Maximal evidence existed for the association between depression and obesity with longitudinal studies demonstrating a bidirectional link between the two conditions. The odds ratios (ORs) were similar for developing depression in obesity (OR: 1.21–5.8) and vice versa (OR: 1.18–3.76) with a stronger association observed in women. For anxiety disorders, evidence was mostly cross-sectional, and associations were of modest magnitude (OR: 1.27–1.40). Among other disorders, obesity, and EDs appear to have a close link (OR: 4.5). Alcohol use appears to be a risk factor for obesity and not vice versa but only among women (OR: 3.84). Conclusion: Obesity and depression have a significant and bidirectional association. Evidence is modest for anxiety disorders and inadequate for other psychiatric conditions. Gender appears to be an important mediator in these relationships.
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Affiliation(s)
- T M Rajan
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - V Menon
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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91
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Parajuli K, Shivaswamy M, Narasannavar A, Dahal M. WITHDRAWN: Obesity and overweight among medical college students in Belagavi, Karnataka. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2019. [DOI: 10.1016/j.cegh.2019.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Kumar A, Shariff M. Atherosclerostic cardiovascular disease risk score: Are Indians underestimating the risk of cardiovascular disease? Indian Heart J 2019; 71:364-365. [PMID: 31779868 PMCID: PMC6890962 DOI: 10.1016/j.ihj.2019.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/20/2019] [Accepted: 08/13/2019] [Indexed: 12/21/2022] Open
Affiliation(s)
- Ashish Kumar
- Resident, Department of Critical Care Medicine, St John's Medical College Hospital, Bangalore, India.
| | - Mariam Shariff
- Resident, Department of Critical Care Medicine, St John's Medical College Hospital, Bangalore, India
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93
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Importance of the Madras Diabetes Research Foundation-Indian Diabetes Risk Score (MDRF-IDRS) for mass screening of type 2 diabetes and its complications at primary health care centers of North India. Int J Diabetes Dev Ctries 2019. [DOI: 10.1007/s13410-018-0710-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Krishnaswamy K, Gayathri R. Nature's bountiful gift to humankind: Vegetables & fruits & their role in cardiovascular disease & diabetes. Indian J Med Res 2019; 148:569-595. [PMID: 30666984 PMCID: PMC6366266 DOI: 10.4103/ijmr.ijmr_1780_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Fruits and vegetables (FVs) are recognized as healthy constituents of diet and a sustainable solution to the existing twin burden of micronutrient deficiencies and non-communicable diseases in developing and developed countries. In general, FVs are nutrient dense foods low in energy, containing varying amounts of vitamins and minerals including carotenoids, B vitamins, vitamin C, iron, zinc, potassium, calcium, magnesium and fibre. These are abundantly rich in phytochemicals that function as antioxidants, anti-atherosclerotic and anti-inflammatory agents. This review summarizes some epidemiological, prospective cohort and intervention studies on the health benefits of FVs in relation to cardiovascular disease, obesity and diabetes. The rich varieties of FVs available, their composition, production scenario in India, dietary intake and trends over time, barriers to sufficient intake mainly sociocultural, economic and horticulture environment, policies for promotion and prevention of diseases are considered.
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Affiliation(s)
| | - Rajagopal Gayathri
- Department of Foods Nutrition & Dietetics Research, Madras Diabetes Research Foundation, Chennai, India
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95
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Kolhe KM, Amarapurkar A, Parikh P, Chaubal A, Chauhan S, Khairnar H, Walke S, Ingle M, Pandey V, Shukla A. Aspartate transaminase to platelet ratio index (APRI) but not FIB-5 or FIB-4 is accurate in ruling out significant fibrosis in patients with non-alcoholic fatty liver disease (NAFLD) in an urban slum-dwelling population. BMJ Open Gastroenterol 2019; 6:e000288. [PMID: 31275584 PMCID: PMC6577364 DOI: 10.1136/bmjgast-2019-000288] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 04/17/2019] [Accepted: 04/23/2019] [Indexed: 12/11/2022] Open
Abstract
Background and aims Non-invasive assessment of fibrosis in patients with non-alcoholic fatty liver disease (NAFLD) is challenging, especially in resource-limited settings. MR or transient elastography and many patented serum scores are costly and not widely available. There are limited data on accuracy of serum-based fibrosis scores in urban slum-dwelling population, which is a unique group due to its dietary habits and socioeconomic environment. We did this study to compare the accuracy of serum-based fibrosis scores to rule out significant fibrosis (SF) in this population. Methods Histological and clinical data of 100 consecutive urban slum-dwelling patients with NAFLD were analysed. Institutional ethics committee permission was taken. Aspartate transaminase (AST) to platelet ratio index (APRI), fibrosis-4 index (FIB-4) and FIB-5 scores were compared among those with non-significant fibrosis (METAVIR; F0 to F1; n=73) and SF (METAVIR; F2 to F4; n=27). Results AST (IU/mL) (68.3±45.2 vs 23.9±10.9; p<0.0001), alanine transaminase (IU/mL) (76.4±36.8 vs 27.9±11.4; p<0.0001), FIB-4 (2.40±2.13 vs 0.85±0.52; p<0.0001) and APRI (1.18±0.92 vs 0.25±0.16; p<0.0001) were higher and platelets (100 000/mm3) (1.8±0.8 vs 2.6±0.7; p<0.0001), albumin (g/dL) (3.4±0.50 vs 3.7±0.4; p<0.0001), alkaline phosphatase (IU/L) (60.9±10.2 vs 76.4±12.9; p<0.0001) and FIB-5 (−1.10±6.58 vs 3.79±4.25; p<0.0001) were lower in SF group. APRI had the best accuracy (area under the receiver operating characteristic curve=0.95) followed by FIB-4 (0.78) and FIB-5 (0.75) in ruling out SF. Conclusions APRI but not FIB-5 or FIB-4 is accurate in ruling out SF in patients with NAFLD in an urban slum-dwelling population.
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Affiliation(s)
- Kailash Marotrao Kolhe
- Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India
| | - Anjali Amarapurkar
- Pathology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India
| | - Pathik Parikh
- Gastroenterology, Zydus Hospitals, Ahmedabad, Gujarat, India
| | - Alisha Chaubal
- Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India
| | - Shamsher Chauhan
- Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India
| | - Harshad Khairnar
- Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India
| | - Swapnil Walke
- Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India
| | - Meghraj Ingle
- Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India
| | - Vikas Pandey
- Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India
| | - Akash Shukla
- Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India
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Qian X, Su C, Zhang B, Qin G, Wang H, Wu Z. Changes in distributions of waist circumference, waist-to-hip ratio and waist-to-height ratio over an 18-year period among Chinese adults: a longitudinal study using quantile regression. BMC Public Health 2019; 19:700. [PMID: 31170949 PMCID: PMC6555739 DOI: 10.1186/s12889-019-6927-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 04/30/2019] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Little is known about the long-term shifts in distributions of three abdominal-obesity-related indicators, waist circumference (WC), waist-to-hip ratio (WHpR) and waist-to-height ratio (WHtR) among Chinese adults. Traditional mean regression models used in the previous analyses were limited in their ability to capture cross-distribution among effects. The current study aims to describe the shift in distribution of WC, WHpR, and WHtR over a period of 18 years (1993-2011) in China, and to reveal quantile-specific associations of the three indicators with key covariates. METHODS Longitudinal data from seven waves of the China Health and Nutrition Surveys (CHNS) in 1993, 1997, 2000, 2004, 2006, 2009 and 2011 were analyzed. The LMS method was used to illustrate the gender-specific quantile curves of WC, WHtR and WHpR over age. Separate gender-stratified longitudinal quantile regressions were employed to investigate the effect of important factors on the trends of the three indicators. RESULTS A total of 11,923 participants aged 18-65 years with 49,507 observations were included in the analysis. The density curves of WC, WHtR and WHpR shifted to right and became wider. The three outcomes all increased with age and increased more at upper percentiles. From the multivariate quantile regression, physical activity was negatively associated in both genders; smoking only had a negative effect on male indicators. Education and drinking behavior both had opposite effects on the three indicators between men and women. Marital status and income were positively associated with the shifts in WC, WHtR and WHpR in male and female WC, while urbanicity index had a positive effect on three outcomes in men but inconsistent effect among female outcomes. CONCLUSIONS The abdominal-obesity related indicators of the Chinese adults experienced rapid growth according to our population-based, age- and gender-specific analyses. Over the 18-year study period, major increases in WC, WHtR and WHpR were observed among Chinese adults. Specifically, these increases were greater at upper percentiles and in men. Age, physical activity, energy intake, drinking, smoking, education, income and urbanicity index were associated with elevated abdominal obesity indicators, and the effects differed among percentiles and between genders.
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Affiliation(s)
- Xiwen Qian
- Department of Biostatistics, School of Public Health, Key Laboratory of Public Health Safety and Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, 200032, People's Republic of China
| | - Chang Su
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 29 Nanwei Road, Xicheng District, Beijing, 100050, People's Republic of China
| | - Bing Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 29 Nanwei Road, Xicheng District, Beijing, 100050, People's Republic of China
| | - Guoyou Qin
- Department of Biostatistics, School of Public Health, Key Laboratory of Public Health Safety and Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, 200032, People's Republic of China
| | - Huijun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 29 Nanwei Road, Xicheng District, Beijing, 100050, People's Republic of China.
| | - Zhenyu Wu
- Department of Biostatistics, School of Public Health, Key Laboratory of Public Health Safety and Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, 200032, People's Republic of China.
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Verma M, Rajput M, Kishore K, Kathirvel S. Asian BMI criteria are better than WHO criteria in predicting Hypertension: A cross-sectional study from rural India. J Family Med Prim Care 2019; 8:2095-2100. [PMID: 31334186 PMCID: PMC6618189 DOI: 10.4103/jfmpc.jfmpc_257_19] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 03/29/2019] [Accepted: 04/15/2019] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND International Obesity Task Force proposed lower body mass index (BMI) cut-off values for defining overweight and obesity in Asian population. However, there is an absence of unanimity regarding the definition of overweight and obesity that is confusing while estimating disease burden, resource allocation, and priority setting. Therefore, the primary aim of the study was to assess the prevalence of overweight and obesity and its predictors as per different criteria (WHO criteria, Modified Asian criteria of BMI classification and BF% estimation by bioelectric impedance analysis technique). The secondary aim was to assess the concordance of overweight and obesity as diagnosed using these three methods. METHODOLOGY A community-based cross-sectional study was conducted in a rural area of Rohtak, north India over a period of 1 year with a sample size of 1080. Anthropometric measurements including height, weight, blood pressure, body fat % analysis were recorded using standard protocols. RESULTS The prevalence of overweight and obesity were observed to be 49.62% (N = 536) as per the modified criteria for the Asian Indians (BMI ≥23 kg/m2) and 34.62% (N = 374) according to WHO criteria (BMI ≥25 kg/m2). A total of 18.3% of the study population were hypertensive. Modified criteria of BMI classification for Asian Indians had high sensitivity (67%) as compared to WHO criteria (55%) in predicting, diagnosing hypertension, and resembled sensitivity estimate obtained through direct body fat percentage estimation (69%). CONCLUSION Modified criteria of overweight and obesity classification are better in terms of reducing comorbid dysmetabolic conditions, as exemplified by hypertension.
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Affiliation(s)
- Madhur Verma
- Department of Community Medicine, Kalpana Chawla Government Medical College, Karnal, Haryana, India
| | - Meena Rajput
- Department of Community Medicine, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India
| | - Kamal Kishore
- Department of Biostatistics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Soundappan Kathirvel
- Department of Community Medicine & School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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99
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Oruganti A, Kavi A, Walvekar PR. Risk of developing Diabetes Mellitus among urban poor South Indian population using Indian Diabetes Risk Score. J Family Med Prim Care 2019; 8:487-492. [PMID: 30984660 PMCID: PMC6436280 DOI: 10.4103/jfmpc.jfmpc_388_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: Diabetes mellitus is increasing its share of burden to the health-related problems in developing countries such as India. Urban slum residents constitute the “vulnerable population” who lack the basic health amenities. Lack of effective screening for primary prevention has been one of the reasons for the rising burden. Materials and Methods: The cross-sectional study was conducted among 400 adults aged between 30 and 60 years residing in a settled slum of Rukmini Nagar area of Belagavi city, Karnataka. Data were collected after taking written informed consent from each participant using a pretested questionnaire that included demographic information and details of the risk factors. Risk of developing diabetes was assessed by using Indian Diabetes Risk Score. Results are expressed as proportions, and analysis was done using Chi-square test and multiple logistic regression analysis. Results: The mean age of participants was 44.3 ± 8.7 years. The proportion of low, moderate, and high risk of developing diabetes mellitus was 7%, 63%, and 30%, respectively. The prevalence of newly diagnosed cases was 10.25%. Moreover, 57.1% of them with positive family history were in the high risk category; 76.9% of the sedentary workers were at higher risk; overweight and obese individuals had higher proportion of the high and moderate risk (P < 0.0001). Correlation coefficient (R) was 0.782, and coefficient of determination (R2) was 0.61. Conclusions: Our study demonstrated that advancing age, low physical activity, family history, overweight, and obesity were the prominent factors that predicted the risk of diabetes in the near future. Hence, focused interventions for urban slum dwellers are imperative and draw special attention.
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Affiliation(s)
- Aditya Oruganti
- Department of Community Medicine, Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research, Nehru Nagar, Belagavi, Karnataka, India
| | - Avinash Kavi
- Department of Community Medicine, Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research, Nehru Nagar, Belagavi, Karnataka, India
| | - Padmaja R Walvekar
- Department of Community Medicine, Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research, Nehru Nagar, Belagavi, Karnataka, India
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Palo SK, Swain S, Priyadarshini S, Behera B, Pati S. Epidemiology of obesity and its related morbidities among rural population attending a primary health centre of Odisha, India. J Family Med Prim Care 2019; 8:203-208. [PMID: 30911507 PMCID: PMC6396592 DOI: 10.4103/jfmpc.jfmpc_255_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Context: Overweight and obesity has become a major contributor to global burden of chronic diseases and disability. Obesity among rural India is emerging as a major health problem because of change in lifestyle and food habits, thereby increases the risk of multiple morbid conditions among rural population. Aims: This study aims to find out the association of overweight/obesity with different socio-demographic factors and explore the co-morbidities among overweight and obese in a rural setting. Settings and Design: A cross-sectional study was done in a randomly selected primary health centre of Khurda district, Odisha for 4 months. Materials and Methods: This study was done among 183 patients aged >20 years with BMI >25 kg/m2 after taking their consent. Anthropometric measurements were done and data were collected using a semi-structured questionnaire. Statistical Analysis Used: Descriptive statistics such as proportion, mean and standard deviation were calculated and inferential statistics such as Chi-square test, univariate and multivariate regression was done using the SPSS version 20.0. Results: Mean age of participants was 45.7 (±13.8) years. About 93.4% were Grade II obese while 51.9% were at risk according to their waist–hip ratio. Around 53.6% of participants had multi-morbidity. Age, occupation and number of children were significantly associated with obesity. Morbidity was significantly associated with age, occupation, marital status and number of children. Increased grade in obesity the more is the probability of having morbidity. Conclusions: There is an urgent need to screen for obesity at rural health facility and early management for prevention from co-morbidities.
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Affiliation(s)
| | - Swagatika Swain
- Technical Assistant Nursing, ICMR-RMRC, Bhubaneswar, Odisha, India
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