Contribution of modifiable risk factors on the burden of diabetes among women in reproductive age-group in India: a population based cross-sectional study

Prevalence of metabolic disorders among women in reproductive age group in hilly rural area of North India

Background

Metabolic syndrome consists of cardiometabolic risk factors that promote the development of atherosclerotic cardiovascular disease, type 2 'DM' and obesity. These are associated with increased cardiovascular mortality and morbidity. Metabolic disorders (MD) are becoming more prevalent both in developing countries and developed countries and are now considered as lifestyle diseases. In women of reproductive age group, especially pregnancy, the blood glucose level is increasing which adversely affects the health of mother and child. Similarly, high blood pressure also precipitates the problems. This study was carried out to find the prevalence of hypertension, diabetes mellitus, obesity and 'MD' among the women living in remote rural set-up.

Materials and Methods

This cross-sectional study was done among women of reproductive age group in 15 villages from 5 panchayats of field practice area of Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan. They were screened for 'MD' through investigative procedures (weight, height, BMR, abdominal girth, blood pressure through sphygmomanometer, blood glucose through the glucometer method), serum HDL and triglycerides. Respondents from the family were asked about the common/general information of house. The tool used for collecting general and relevant information from the respondent was a questionnaire, which was pretested for validity before being used in the field.

Results

Four-hundred and sixty-seven women of reproductive age group participated in the study. Half of the participants were with qualification of matriculate and 9.2% participants were illiterate. Three-fourths of the participants were married women and 89% were vegetarian. Sixty-four per cent of participants were housewives. Half of the participants had a normal BMI, whereas 28.9% were overweight and 10% were obese. The prevalence of hypertension and diabetes among the participants were 12.5% and 9.8%, respectively. Forty-seven per cent participants had a waist circumference above 80 cm.

Conclusion

The level of non-communicable diseases is related with the MD which has the adverse effect on the various systems and organs of the subjects. The MD can be controlled with the certain changes in the life style pattern. The GOI is also concerned with such scenarios in the country. It is recommended that women of reproductive age group undergo regular blood pressure and blood sugar screenings to detect hypertension and diabetes early and take appropriate measures to manage them.

Chronic non-communicable disease burden among reproductive-age women in India: evidence from recent demographic and health survey

BACKGROUND

Chronic disease burden among women leads to various detrimental consequences, impacting women's health throughout their life course and off-springs. The present study explores the chronic disease profile among reproductive-aged women and analyzes the effects of various covariates on multimorbidity among reproductive-aged women in India. Here, multimorbidity is defined as an individual suffering from two or more chronic conditions.

METHODS

The present study employed the most recent National Family Health Survey round, 2019-2021. The study utilized information on 695,707 non-pregnant women aged 15-49 years. The study used descriptive, bivariate, and multivariable ordered logistic regression analysis to explore the burden of chronic non-communicable diseases and multimorbidity.

RESULTS

The mean age of women with single chronic condition-related morbidity is 30 years, whereas it was 35 years for those with multimorbidity. Approximately 28% of urban women suffered from multimorbidity. Further, significant factors that affect multimorbidity include age, educational attainment, working status, marital status, parity, menopause, religion, region, wealth index, tobacco use, alcohol consumption, and dietary patterns.

CONCLUSIONS

The present study hints that women in the reproductive age group are at very high risk of developing multimorbidity in India. Most of the programs and policies are focused on the elderly population in terms of awareness and facilitating them with better health services. However, right now, one should also prioritize the emerging chronic condition related to chronic conditions other than hypertension, diabetes, and cancer among the study population, which is escalating as soon as women reach 30 years of age.

Early Marriage in Adolescence and Risk of High Blood Pressure and High Blood Glucose in Adulthood: Evidence from India

Adolescence, the transition phase to adulthood, is a critical period for physical and psychological development. Disruptions during this period, such as getting married, could result in various adverse short- and long-term health outcomes. This study aimed to assess the differential risk of two common chronic conditions—high blood pressure and high blood glucose—in adult women (20–49 years) who were married during different stages of adolescence (10–19 years) compared to women who were married in their youth (20–24 years). Using the most recent nationally representative data from India, we separately assessed the odds in favor of having the two chronic conditions for women who were married during early (10–14 years), middle (15–17 years), and late (18–19 years) adolescence. We found that an earlier age at marriage during adolescence was associated with a higher risk of chronic conditions later in life. Women who were married during early adolescence were respectively 1.29 and 1.23 times more likely (p < 0.001) to have high blood pressure and high blood glucose compared to women who were married in their youth. These findings highlight the importance of preventing underage marriage among adolescent females to address the risk of downstream chronic health consequences as adults.

Identifying non-communicable disease multimorbidity patterns and associated factors: a latent class analysis approach

OBJECTIVE

In the absence of adequate nationally-representative empirical evidence on multimorbidity, the existing healthcare delivery system is not adequately oriented to cater to the growing needs of the older adult population. Therefore, the present study identifies frequently occurring multimorbidity patterns among older adults in India. Further, the study examines the linkages between the identified patterns and socioeconomic, demographic, lifestyle and anthropometric correlates.

DESIGN

The present findings rest on a large nationally-representative sample from a cross-sectional study.

SETTING AND PARTICIPANTS

The study used data on 58 975 older adults (45 years and older) from the Longitudinal Ageing Study in India, 2017-2018.

PRIMARY AND SECONDARY OUTCOME MEASURES

The study incorporated a list of 16 non-communicable diseases to identify commonly occurring patterns using latent class analysis. The study employed multinomial logistic regression models to assess the association between identified disease patterns with unit-level socioeconomic, demographic, lifestyle and anthropometric characteristics.

RESULTS

The present study demonstrates that older adults in the country can be segmented into six patterns: 'relatively healthy', 'hypertension', 'gastrointestinal disorders-hypertension-musculoskeletal disorders', 'musculoskeletal disorders-hypertension-asthma', 'metabolic disorders' and 'complex cardiometabolic disorders'. Additionally, socioeconomic, demographic, lifestyle and anthropometric factors are significantly associated with one or more identified disease patterns.

CONCLUSIONS

The identified classes 'hypertension', 'metabolic disorders' and 'complex cardiometabolic disorders' reflect three stages of cardiometabolic morbidity with hypertension as the first and 'complex cardiometabolic disorders' as the last stage of disease progression. This underscores the need for effective prevention strategies for high-risk hypertension group. Also, targeted interventions are essential to reduce the burden on the high-risk population and provide equitable health services at the community level.