Prevalence, patterns, and associations of dyslipidemia among Sri Lankan adults-Sri Lanka Diabetes and Cardiovascular Study in 2005-2006

Insulin Resistance-Related Cardiometabolic Risk Among Nondiabetic Childbearing Age Females

Background: This study evaluates insulin resistance prevalence in young females without diabetes, assessing risk factors and adiposity indices for early detection of cardiometabolic disorders. Methods: A cross-sectional study was conducted, involving 282 females aged 18-35 years from suburban and rural areas of Sri Lanka. Anthropometric measurements [height, weight, waist circumference (WC)] were obtained and biochemical parameters [fasting glucose, insulin, insulin resistance (IR), total cholesterol, high-density lipoproteins, (HDL), low-density lipoproteins, triglycerides] were measured. The anthropometric and biochemical data were compared between the groups of normal weight controls and overweight/obese cases, as well as between females with or without IR. Results: The prevalence of IR in controls and cases were 48.6% and 57.1%, respectively. Both groups had mean Homeostasis Model Assessment-IR values greater than the normal cutoff value of 2.5. Females with IR showed higher prevalence of dyslipidemia than those without IR. Compared to the controls (2.81%), the prevalence of metabolic syndrome (MetS) was substantially greater among cases (46.42%). Both groups showed a statistically significant association between IR and MetS, but the association was considerably stronger in cases [r = 0.616, odds ratio (OR) >8] than in controls (r = 0.175, OR >1). Controls exhibited lower HDL levels, hypertriglyceridemia, and elevated IR levels (P < 0.05), and their ORs for acquiring MetS were >2, <1, and >3, respectively. Importantly, overweight/obese cases exhibited a significant association (P < 0.05) with all the MetS risk variables. Visceral adiposity index (VAI) proves to be a precise measurement for identifying IR and cardiovascular disease (CVD) among young females (Z = -3.651), surpassing the accuracy of other indices. Body mass index, body round index, a body shape index, and WC were also reliable measurements to assess IR and the risk of CVD (P < 0.05). Conclusion: The study underscores the importance of assessing IR in nondiabetic young females to identify early cardiometabolic risks. VAI emerges as a precise measurement for identifying IR and CVD risk, surpassing the accuracy of other indices.

Development and validation of predictive model based on deep learning method for classification of dyslipidemia in Chinese medicine

Backgrounds

Dyslipidemia is a prominent risk factor for cardiovascular diseases and one of the primary independent modifiable factors of diabetes and stroke. Statins can significantly improve the prognosis of dyslipidemia, but its side effects cannot be ignored. Traditional Chinese Medicine (TCM) has been used in clinical practice for more than 2000 years in China and has certain traits in treating dyslipidemia with little side effect. Previous research has shown that Mutual Obstruction of Phlegm and Stasis (MOPS) is the most common dyslipidemia type classified in TCM. However, how to compose diagnostic factors in TCM into diagnostic rules relies heavily on the doctor's experience, falling short in standardization and objectiveness. This is a limit for TCM to play its advantages of treating dyslipidemia with MOPS.

Methods

In this study, the syndrome diagnosis in TCM was transformed into the prediction and classification problem in artificial intelligence The deep learning method was employed to build the classification prediction models for dyslipidemia. The models were built and trained with a large amount of multi-centered clinical data on MOPS. The optimal model was screened out by evaluating the performance of prediction models through loss, accuracy, precision, recall, confusion matrix, PR and ROC curve (including AUC).

Results

A total of 20 models were constructed through the deep learning method. All of them performed well in the prediction of dyslipidemia with MOPS. The model-11 is the optimal model. The evaluation indicators of model-11 are as follows: The true positive (TP), false positive (FP), true negative (TN) and false negative (FN) are 51, 15, 129, and 9, respectively. The loss is 0.3241, accuracy is 0.8672, precision is 0.7138, recall is 0.8286, and the AUC is 0.9268. After screening through 89 diagnostic factors of TCM, we identified 36 significant diagnosis factors for dyslipidemia with MOPS. The most outstanding diagnostic factors from the importance were dark purple tongue, slippery pulse and slimy fur, etc.

Conclusions

This study successfully developed a well-performing classification prediction model for dyslipidemia with MOPS, transforming the syndrome diagnosis problem in TCM into a prediction and classification problem in artificial intelligence. Patients with dyslipidemia of MOPS can be accurately recognized through limited information from patients. We also screened out significant diagnostic factors for composing diagnostic rules of dyslipidemia with MOPS. The study is an avant-garde attempt at introducing the deep-learning method into the research of TCM, which provides a useful reference for the extension of deep learning method to other diseases and the construction of disease diagnosis model in TCM, contributing to the standardization and objectiveness of TCM diagnosis.

The impact of the Sri Lankan economic crisis on medication adherence: An online cross-sectional survey

Background

The economic crisis in Sri Lanka has disarrayed the country's healthcare services, posing a challenge to people with chronic diseases on routine care. This study investigated the changes in medication adherence during the economic crisis.

Methods

A web-based cross-sectional survey was undertaken in July-August 2022. It assessed socio-demographics, diseases, medication adherence, and reasons for changes in compliance of respondents and their family members during the economic crisis. Descriptive statistics and multivariable logistic regression analysis were used.

Findings

A total of 1214 respondents, aged ≥18 years were included in the survey. The majority were females (60%). The main finding was that 39%, 41%, and 37% of participants, their family members, or children respectively have changed medication use during the crisis. Among those who changed their medication practices, the most significant change was the change in the brand, reported by 44.7% of the respondents. A similar pattern was observed among other family members, with 61.3% of adults and 53.8% of children switching brands. Respondents who lived outside the Colombo district had a significantly increased risk of changing medication (OR = 1.425, 95% CI = 1.020-1.992, P = 0.038). Respondents with monthly incomes of less than 100,000 LKR had a twofold greater risk of medication nonadherence compared to participants who earned more than 100,000 LKR per month (OR = 2.278, 95% CI = 1.37-3.78, P = 0.001). The most stated reason for changing medication among adults was the high cost of drugs, whereas among, children, the lack of access to drugs in the public or private sector was the leading cause of non-compliance.

Interpretation

The population's adherence to medication is negatively impacted by the economic crisis in Sri Lanka.

Prevalence, pattern, and correlates of dyslipidemia in Bangladeshi individuals

BACKGROUND

The burden of dyslipidemia in Bangladesh remains inadequately characterized.

OBJECTIVES

To determine and describe the prevalence and pattern of dyslipidemia and its associated risk factors among an adult Bangladeshi population.

DESIGN

Population-based, cross-sectional study. Participants were adults living in all eight administrative divisions of Bangladesh. The total sample size was 7084 (53.1 % women, 46.9% urban residents). Primary outcome measures were triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and the use of lipid lowering medication. In addition, control of LDL-C and control of non high-density lipoprotein cholesterol (non-HDL-C) were investigated.

RESULTS

The overall dyslipidemia prevalence was 76.7%, with 35.7% showing a high TG level, 18.5% showing a high LDL-C level, 63.8% showing a low HDL-C level, and 7.2% of the participants showing all three lipid abnormalities. Sylhet division had the highest prevalence (83.8%) of overall dyslipidemia, while Rangpur had the lowest prevalence (69.3%). The control of LDL-C (<50 mg/dL) and non-HDL-C (<80 mg/dL) among adults with a previous history of atherosclerotic cardiovascular diseases (ASCVD) were 5.1% and 6.9% respectively. The regression models showed that male sex and age 45-59 years were significant predictors of overall dyslipidemia. Both smokers and smokeless tobacco users were significant factors for overall dyslipidemia and high TG. A high waist-hip ratio was associated with overall dyslipidemia and all other subtypes of dyslipidemia.

CONCLUSION

The high prevalence of dyslipidemia in Bangladesh necessitates lifestyle interventions to prevent and control this cardiovascular risk factor.

Trajectories of 24-Hour Physical Activity Distribution and Relationship with Dyslipidemia

The association between physical activity (PA) and dyslipidemia is well known, but the relationship between a temporal pattern of PA and dyslipidemia remain unknown. Here, we aimed to identify the intensity and temporal patterns of PA clustered by the trajectory model and their relationship with dyslipidemia. The participants were 701 adults (305 males) aged 18−60 years undergoing continuous measurement of PA with Actigraph GT3X+ accelerometers for at least 3 days. A trajectory analysis was applied based on moderate-to-vigorous intensity physical activity (MVPA) accumulated values over every period per day. The association between PA and dyslipidemia was estimated using a logistic regression model. Four distinct PA trajectory groups in the population were identified (continued low, stable and moderate, late increasing, and early increasing). Specifically, the “moderate and stable group” was associated with a decreased rate of high TG (p < 0.05) and the “moderate and stable group” and “late increasing group” were associated with decreased rates of low HDL-C (p < 0.05). In conclusion, there were four activity trajectory groups in this population and the continued low PA trajectory was associated with a high prevalent rate of an abnormal lipid profile, and continued and moderate activity or late afternoon increasing activity might have lower HDL-C distribution.

Effects of commercial non-dairy tea whitener consumption in comparison to milk on lipid profile, histopathology, and liver enzymes in animal model

The pandemic of obesity and other diet-related non-communicable diseases are serious threats to the wellbeing and financial prosperity around the globe. It has been documented that the consumption of processed foods with high levels of refined sugars and fats are the main cause contributing to this phenomenon. The present work was therefore conducted to assess the effects of the consumption of non-dairy tea whiteners (NDTW’s) on lipid profile, histopathology, and liver enzymes of rats for a period of three months. To this end, 30 albino Wister rats (7 weeks old, 130 ± 5 g) was divided into five groups namely control (G1), fed with whole milk (G2), and groups fed with defined dose of commercial NDTW’s (G3, G4, and G5). All rats were provided feed and water ad libitum during the experimental period. At trial completion, the rats were decapitated, and samples (blood, liver) were collected and subjected to blood chemistry (lipid profile) and liver histopathological analyses. Results indicated that as compared to milk, powder NDTW consumption increased the level of cholesterol (69%), triglycerides (98%), and LDL (84%), whereas HDL was non-significantly affected. On the other hand, liquid NDTW consumption led to the increase in triglyceride levels for all NDTW, and yielded 130% increase as compared to milk, which might have been attributed to composition of NDTW. Additionally, liver and renal functional tests yielded non-significant results. The present work concluded that the consumption of NDTW contributed towards derangement and elevation in lipid profile parameters as compared to milk, particularly if consumed for longer period of time.

Prevalence of cardiovascular diseases and risk factors in adult patients with haemophilia: a cross-sectional study in a tertiary care hospital clinic in Sri Lanka

Background

Management of cardiovascular disease (CVD) in patients with haemophilia is extremely challenging. Therefore, knowing the prevalence of CVD and risk factors in this population is imperative.

Methods

All consented patients ≥ 18 years of age attending the haemophilia clinic at a tertiary care centre were recruited to the study. Data were collected using a pretested, investigator administered questionnaire. Seated blood pressure, anthropometric measurements and blood samples were obtained using standard techniques. Lipid profile and fasting plasma glucose were estimated. Prevalence of risk factors for CVD was compared with those of age matched males in the general population. P values < 0.05 were considered significant.

Results

Of the total 109 participants, 92 (84.4%) had haemophilia A. The median age of the study group was 36 years. Three (2.8%) had at least one cardiovascular disease. There were 10 (9.2%), 30 (27.5%), 13 (11.9%) and 4 (3.7%) participants with diabetes, hypertension, current smoking and obesity (Body Mass Index (BMI) ≥ 30 kg/m²) respectively. 32 (29.4%) and 37 (33.9%) participants had waist circumference ≥ 90 cm and waist hip ratio ≥ 0.9 respectively. 38 (34.9%) had total cholesterol ≥ 200 mg/dl, 43 (39.5%) had low density lipoprotein (LDL) cholesterol ≥ 130 mg/dl, 25 (22.9%) had triglycerides (TG) ≥ 150 mg/dl and 58 (53.2%) had High density lipoprotein (HDL) cholesterol < 40 mg/dl. Diabetes was significantly associated with factor levels below 5% (p = 0.038). BMI, waist circumference and dyslipidaemia in the study were significantly higher compared to the general population.

Conclusion

The study signifies an increased prevalence of risk factors for CVD among patients with haemophilia and the need for preventive measures.

Derivation and validation of sex-specific continuous metabolic syndrome scores for the Mexican adult population

Traditionally the diagnosis of Metabolic syndrome (MetS) is binary (present/absent). The goal of this work is to propose a sex-specific continuous score to measure the severity of MetS in Mexican adults using waist circumference and body mass index as adiposity measures. MetSx-WC and MetSx-BMI indexes by sex were derived by confirmatory factor analysis (CFA) using data for 6567 adult participants of the National Health and Nutrition Survey 2018. The overall fit of the two proposed CFA models was excellent. We then validated these scores using a community-based health study of 862 university participants and determined that the reliability and strength of agreement between the MetSx-WC and MetSx-BMI scores were excellent. The ROC analysis of the resulting indexes indicates that they have excellent ability to discriminate a MetS classification according to the different criteria. The correlations of MetSx scores and surrogate markers of insulin resistance and obesity ranged from weak to strong. Subsequently, a retrospective study of 310 hospitalized patients with COVID-19 was used to determined that MetSx-BMI score was associated with the mortality of patients with COVID-19. The proposed indices provide a continuous measure in the identification of MetS risk in Mexican adults.

Obesity and Dyslipidemia in Chinese Adults: A Cross-Sectional Study in Shanghai, China

This study examined the association of obesity and dyslipidemia according to body measurements among Chinese adults in Shanghai, a place in the process of rapid urbanization. Using the baseline data of the Shanghai Suburban Adult Cohort and Biobank study (SSACB), the subjects completed questionnaires and physical examinations, and fasting blood was collected for biochemical assays. We estimated the odds ratios (OR) and 95% confidence interval (CI) by multivariable logistic regression. The prevalence was 12.9% and 28.8% in both general and central obesity, respectively. Compared with the non-obese, the general or central obesity participants had a higher level of TC, TG, LDL-C and lower level of HDL-C. The OR (95%CI) for dyslipidemia was 1.79 (1.69–1.91) and 1.91 (1.83–2.00) in general or central obesity, respectively. Positive associations were also observed between obesity and high TC, high LDL-C, low HDL-C and high TG, with the adjusted OR ranging from 1.11 to 2.00. Significant modifying effect of gender, age, hypertension, and diabetes were found in the association of obesity and different forms of dyslipidemia. The findings of our study indicated that participants with obesity, including general or central obesity, have a higher prevalence of dyslipidemia and gender, age, hypertension, and diabetes might be potential modifiers of the association. More effective attention and interventions should be directed to managing body weight to reduce the prevalence of dyslipidemia.

The effects of dyslipidemia on noise-induced hearing loss in a petrochemical workers in the Southwest of Iran

BACKGROUND

Research has shown that the decrease in the inner diameter of vessels caused by hyperlipidemia lowers the capacity for blood oxygen delivery to the cochlea. This leads to impaired cochlear metabolism and causes hearing problems.

OBJECTIVE

The effects of dyslipidemia on noise-induced hearing loss in workers were examined.

METHODS

This descriptive cross-sectional study was performed on 692 male employees in a petrochemical industry in the southwest of Iran exposed to 85 dB noise. Clinical audiometry and blood sample tests were used to evaluate the hearing and prevalence indices of dyslipidemia (cholesterol, triglyceride, HDL and LDL). The data were analyzed using SPSS software version 25 (p = 0.05).

RESULTS

The results showed that the prevalence of dyslipidemia was 24.5%with abnormal relative triglyceride frequency of 49.5%, HDL of 28%, LDL of 33%, and total blood cholesterol level of 37.8%. There was no significant relationship between NIHL and dyslipidemia (p >  0.09). However, the major NIHL drops at different frequencies were in the individuals with dyslipidemia. The parameters age and dyslipidemia increased NIHL odds ratio (95%C.I.). by 1.130 (1.160-1.100) and 1.618 (2.418-1.082) respectivelyCONCLUSION:The rate of hearing loss in individuals with dyslipidemia increases at different frequencies and it leads to an increase of the OR of NIHL in individuals with dyslipidemia. We can control dyslipidemia and its effective factors. The NIHL is more common in people exposed to noise.

Association between Dietary Patterns and Low HDL-C among Community-Dwelling Elders in North China

We aimed to investigate the association between dietary patterns and low HDL-C among the elderly population living in North China. The data were from a national cross-sectional survey conducted in 2015. General information in terms of living habits, health status, and food intake using 24 h dietary recall for three consecutive days was procured, and the weight of edible oil and condiments recorded. Anthropometric index, blood pressure, and fasting serum lipids were measured using standard methods. Dietary patterns were derived from food categories by exploratory factor analysis, and multivariate logistic regression was used to estimate the odds ratios of low HDL-C across quartiles of dietary patterns. Among 3387 elderly participants, 21.9% had low HDL-C levels. After adjusting for potential confounding factors, participants with highest score versus lowest score in the balanced dietary pattern had a decreased risk of low HDL-C (OR = 0.38, 95% CI: 0.16-0.88, p for trend = 0.013) in the group with a BMI of 27.1 kg/m² and above. Compared to the lowest quartile, there was a statistically significant negative association between the highest scores of the Western dietary pattern and low HDL-C (OR = 0.37, 95% CI: 0.17-0.82, p for trend = 0.018) in the group with a BMI of 21.6-24.8 kg/m². However, greater adherence to a thrifty dietary pattern (highest quartiles vs. lowest quartiles) was associated with increased risk of low HDL-C (OR = 3.31, 95% CI: 1.05-10.40, p for trend = 0.044), especially in the subgroup with a BMI of 21.6 kg/m² and below. The study revealed that it is urgent to develop district-specific dietary improvement plans for dyslipidemia based on the nutritional status of the elderly population in North China.

Prevalence of dyslipidemia and associated risk factors among newly diagnosed Type-2 Diabetes Mellitus (T2DM) patients in Kushtia, Bangladesh

Dyslipidemia is considered a significant modifiable risk factor for type-2 diabetes mellitus (T2DM) and has become one of the emerging health problems throughout the world. In Bangladesh, data on dyslipidemia among newly diagnosed T2DM patients are comparatively inadequate. This study aimed to evaluate the prevalence of dyslipidemia and its associated risk factors in newly diagnosed T2DM patients. This cross-sectional study was conducted by a well-structured questionnaire from 132 newly diagnosed type-2 diabetic patients attending the Mujibur Rahman Memorial Diabetic Hospital in Kushtia, Bangladesh. Data regarding socio-demographic, anthropometric, fasting blood glucose, total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) were collected from all the respondents. The association between dyslipidemia and its associated factors was analyzed using the multivariate logit regression model. The findings suggest that the prevalence rate of dyslipidemia was 75.7% in female and 72.6% in male T2DM patients. The odds of having dyslipidemia were 1.74 (95% Cl: 1.58-1.87) times significantly higher in female (p<0.001). The other factors associated with dyslipidemia encompassed age between 30-39 years (OR: 2.32, 95% CI: 1.97-2.69), obesity (OR: 2.63, 95% CI: 2.27-2.90), waist circumferences of male ≥90 and female ≥80 (OR: 1.65, 95% CI: 1.59-1.89), hypertensive patients (OR: 1.51, 95% CI: 1.45-1.74), physically inactive (OR: 3.25, 95% CI: 1.84-4.68), and current smoker or tobacco user (OR: 1.93, 95% CI: 1.85-2.13). This study concluded that the high prevalence of dyslipidemia was found among newly diagnosed type-2 diabetes patients and associated with gender, age, BMI, waist circumference, poor physical activity, and smoking, or tobacco use. This result will support increase awareness of dyslipidemia and its associated risk factors among type-2 diabetes patients.

Evaluation of biochemical profile of Chronic Kidney Disease of uncertain etiology in Sri Lanka

Chronic Kidney Disease of uncertain etiology (CKDu) is an endemic, disease that mostly affects young agricultural workers in the rural dry zone of Sri Lanka. This study was designed to identify specific biochemical manifestations of CKDu cases. All (119) non-dialysis definite CKDu patients in Girandurukotte and Wilgamuwa were selected. Blood and urine samples were collected and measured biochemical parameters. All analyses were performed in IBM SPSS statistics version 23 (IBM Corp, USA). The median blood pressure was normal though nearly half of the patients (45.4%) who were in the advanced stages (Stage 3b, 4 and 5) of CKDu. Patients without a history of hypertension before the diagnosis of CKDu (100%) and minimal proteinuria (26%) are similar to the previous findings. Patients without a history of diabetes before the CKDu diagnosis had high percentages of diabetes (15.7%) and pre-diabetes (59.8%) and hence indicated the possibility of uremia induced impaired glucose intolerance in the rural areas of the country. There were 62.2% patients who had low vitamin D and only a minority had evidence of bone mineral diseases. Out of liver disease markers serum glutamic pyruvic transaminases (SGPT), serum glutamic oxaloacetic transaminases (SGOT), gamma-glutamyl transferase (GGT), and Lactic acid degydrogenase (LDH) had an inverse correlation with the advancement of the disease indicating subclinical liver disease. Osmolality in serum and urine showed a discrepancy despite > 50% of CKDu patients had increased their serum osmolality. The current study supports most of the previously described manifestations of CKDu. Moreover, some specific patterns have been identified which need to be validated in a larger group.

Associations between age and dyslipidemia are differed by education level: The Cardiovascular and Metabolic Diseases Etiology Research Center (CMERC) cohort

Background

Dyslipidemia is a multifactorial disorder, which arises from complex interactions among genetic and environmental risk factors. Previous studies have established the deteriorating effect of aging on lipid profiles. However, little is known about the role of education level, a stable marker of socioeconomic status, which reflect modifiability of lifestyle risk factors. Therefore, we examined the association between age and individual dyslipidemia parameter across education level among healthy, middle-aged Korean women.

Methods

From 2049 middle-aged women, education attainment was classified into completion of elementary school or below, middle school, high school, college or above. Dyslipidemia was assessed in adherence to the 2018 Korean Dyslipidemia Treatment Guideline. Multivariable logistic regression and generalized linear model tested for associations between age and dyslipidemia parameter across education level and other known risk factors, including menopause, obesity, and current drinking and smoking.

Results

In this cross-sectional analysis, the prevalence of each dyslipidemia parameter was significantly different by age and education level. The odds ratio (OR) for dyslipidemia was higher among participants who were older and had received higher education (OR = 2.31, p for interaction = 0.008) than younger and low education counterpart. The interaction between age and education level remained significant for hypercholesterolemia (p for interaction = 0.003) and hyper-LDL-cholesterolemia (p for interaction = 0.002).

Conclusions

Separate examination of individual dyslipidemia parameter indicated varying degree of interaction with age and education level. Such results imply that each type of lipid abnormality may arise from and be exacerbated by heterogeneous composition of biological and lifestyle risk factors, which may be reflected by education level.

Association Between Obesity Type and Common Vascular and Metabolic Diseases: A Cross-Sectional Study

Background: The association between different types of obesity and some chronic diseases in Dehui, Jilin province, China, is still unclear. The aim of our study was to clarify the association between different types of obesity and chronic diseases. Methods: Residents aged 40 years or older were randomly selected using a multistage stratified cluster sampling method. Data were collected by means of face-to-face interview, physical examination, and laboratory examination. Descriptive data analyses were performed, and multiple logistic regression analyses were used to explore the adjusted association between different types of obesity and common vascular and metabolic diseases. Results: The prevalence of general obesity alone, central obesity alone and compound obesity were 0.15, 54.29, and 14.36%, respectively. The prevalence of coronary heart disease, stroke, hypertension, dyslipidemia, and diabetes mellitus was highest in the compound obesity group, and lowest in the non-obesity group. Hypertension, dyslipidemia, and diabetes mellitus were associated with compound obesity and central obesity alone [compound obesity (OR = 4.703, 95% CI: 3.714-5.956 for hypertension; OR = 4.244, 95% CI: 3.357-5.365 for dyslipidemia; OR = 4.575, 95% CI: 3.194-6.552 for diabetes mellitus); central obesity alone (OR = 2.210, 95% CI: 1.901-2.570 for hypertension; OR = 2.598, 95% CI: 2.241-3.012 for dyslipidemia; OR = 2.519, 95% CI: 1.834-3.459 for diabetes mellitus)]. Coronary heart disease was associated with compound obesity (OR = 1.761, 95% CI: 1.141-2.719) but not central obesity alone (OR = 1.409, 95% CI: 0.986-2.013). Stroke was associated with neither compound obesity (OR = 1.222, 95% CI: 0.815-1.833) nor associated with central obesity alone (OR = 1.080, 95% CI: 0.786-1.485). Conclusions: Central obesity alone and compound obesity are associated with the risk of hypertension, hyperlipidemia, and diabetes mellitus. Compound obesity but not central obesity alone is associated with the risk of coronary heart disease, but further research is needed to confirm it. There are no significant relationship between stroke and central obesity alone or compound obesity.

Assessment of Nutritional Status and Dietary Pattern of a Rural Adult Population in Dry Zone, Sri Lanka

The objective of this work was to describe average dietary intake, physical activity (PA) and nutritional status of the adult population of Girandurukotte, Sri Lanka. A cross-sectional survey, including one 24-h dietary recall, international physical activity questionnaire and anthropometric measurements was conducted in a representative sample of 120 adults. Mean (SD) for body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR) and waist to height ratio (WHtR) were 23.06(4.20) kg/m2, 85.6(9.5) cm, 0.95(0.05) and 0.55(0.07), respectively. Significant differences were observed in height, body fat %, body muscle %, hip circumference, WHR, WHtR, fat mass index and hand grip strength between men and women (p < 0.05). Among the study group, 35.8% were overweight, 13.3% were obese and 11.7% were underweight. Central obesity was observed in 59.2%, 97.5% and 74.2% of adults by WC, WHR and WHtR, respectively. Mean (SD) dietary diversity score and dietary diversity score with portions were 4.77(1.28) and 4.09(1.32), respectively. Mean daily intake of protein, fruits, vegetables and dairy were well below the national recommendations. Despite the higher PA level, nearly half the population was overweight and obese and the majority was centrally obese. None of the dietary diversity scores met the optimal levels, suggesting poor quality and quantity of the diet.

mHealth nutrition and lifestyle intervention (mHENAL) to reduce cardiovascular disease risk in a middle-aged, overweight and obese population in Sri Lanka: Study protocol for a randomized controlled trial

Mobile phone-based health interventions (mHealth) are viewed as an attractive approach to foster behaviour change, and found to be effective in promoting physical activity and healthy diets. The present study aims to investigate whether mHealth with advice for dietary and lifestyle modifications would reduce 10-year cardio vascular disease (CVD) risk among overweight or obese adults aged 35-64 years in Sri Lanka. A two-group parallel-arm randomized controlled trial (RCT) was conducted in Colombo district, recruiting 1200 individuals aged 35-64 years with a body mass index (BMI) of ≥25 kgm-2. Participants were randomly assigned either to mHealth package (intervention arm, n = 600) or usual care (control arm, n = 600). The intervention package contains a series of dietary and lifestyle improvement messages, a mobile application to register participants, and a web application to deliver these messages. Participants in the intervention arm receive 2 voice and 2 text messages per week to their mobile phones for a period of 12 months. The primary outcome (10-year CVD risk) will be assessed according to sex, age, smoking status, blood pressure, serum cholesterol and glycaemic status. Data are collected at enrollment and after 12 months of intervention on: dietary practices, physical activity, smoking, anthropometry, body composition, blood pressure, fasting plasma glucose, HbA1c and lipid profile. Analysis of effect will be performed by intention-to-treat principle, comparing the outcomes between intervention and control arms. The study resulted in a comprehensive mHealth nutrition and lifestyle package (mHENAL) and successfully completed recruitment and baseline assessment of participants. The message delivery is in progress.

Prevalence of dyslipidemia among the diabetic patients in southern Bangladesh: A cross-sectional study

AIM

Diabetic dyslipidemia is one of the major risk factors for cardiovascular disease which has a vast mortality rate throughout the world. Early detection and treatment of dyslipidemia can avoid risk for cardiovascular disorder in diabetic patients. This study was conducted to determine the prevalence of and pattern of dyslipidemia in diabetic patients.

MATERIALS AND METHODS

This cross sectional study was performed in several specialized diabetic hospital of Noakhali, a southern district of Bangladesh. All known cases of diabetes mellitus were evaluated for their lipid profile. A total number of 1008 patients were included in the study having 683 (67.8%) female and 325 (32.2%) male subjects.

RESULTS

The prevalence of dyslipidemia among the male subjects was 73% while among female subjects 71%. Among diabetic males the percentage of high serum Cholesterol, high serum TG (Triglyceride), low HDL (High density cholesterol) and high LDL (Low density cholesterol) was 35.69%, 44.31%, 50.15% and 72.92% respectively, whereas the female had the percentage at 35.29%, 40.85%, 49.49% and 70.57% respectively.

CONCLUSION

Majority portion of the study subjects were dyslipidemic. The most prevalent pattern among both male and female was high level of LDL and low level of HDL. The prevalence of dyslipidemia in Bangladesh is significantly high, which indicates the urgency of lifestyle intervention strategies to prevent and manage this important health problem and risk factor.