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Gnanaraj JP, Jaganathan V, Asaithambi N, Sekar R, Chandrasekaran E, Elangovan EM, Srinivasan K, Ganesan M, Mohandoss NP, Gorijavaram PK, Ramesh R, Raji R, Kunjitham T, Kaliamoorthy T, Sangareddi V, Mohanan N. Fibrinolysis and clinical outcomes in acute pulmonary embolism. Madras medical college pulmonary embolism (M-PER) registry from India. Indian Heart J 2024; 76:172-181. [PMID: 38878966 DOI: 10.1016/j.ihj.2024.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 03/27/2024] [Accepted: 06/12/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Acute pulmonary embolism (APE) is the third most common cause of vascular death. Data on APE from India and other low-and middle-income countries is sparse. OBJECTIVES Study the clinical characteristics, prognostic factors, in-hospital mortality (IMH) and 12 months mortality of patients with APE in India. METHODS We prospectively enrolled 186 consecutive patients diagnosed with APE between November 2016 and November 2021 in Madras Medical College Pulmonary Embolism Registry (M-PER). All patients had electrocardiography and echocardiography. High risk patients and selected intermediate risk patients underwent fibrinolysis. RESULTS 75 % of our patients were below 50 years of age. 35 % were women. The mean time to presentation from symptom onset was 6.04 ± 10.01 days. 92 % had CT pulmonary angiography. Intermediate risk category (61.3 %) was the more common presentation followed by high risk (26.9 %). Electrocardiography showed S1Q3T3 pattern in 56 %. 76 % had right ventricular dysfunction and 12.4 % had right heart thrombi(RHT) by echocardiography. 50.5 % received fibrinolysis. Patients with RHT received fibrinolysis more frequently (78.3 % vs 46.6 %; p = 0.007). In-hospital mortality (IHM) was 15.6 %. Systemic arterial desaturation and need for mechanical ventilation independently predicted IHM. Ten patients (5.3 %) were lost to follow up. One year mortality was 26.7 % (47/176). One year mortality of patients discharged alive was similar among high, intermediate and low risk groups(14.8 % vs 1.9 % vs 10.5 %; p = 0.891). CONCLUSIONS Patients with PE are often young and present late in India. The in-hospital and 12 months mortality were high. Low and intermediate risk groups had a high post discharge mortality similar to high risk patients.
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Affiliation(s)
- Justin Paul Gnanaraj
- Institute of Cardiology, Madras Medical College and Rajiv Gandhi Government General Hospital, Park Town, Chennai, 600002, India; The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, 600032, India.
| | - Vivek Jaganathan
- Institute of Cardiology, Madras Medical College and Rajiv Gandhi Government General Hospital, Park Town, Chennai, 600002, India; The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, 600032, India
| | - Nilavan Asaithambi
- Institute of Cardiology, Madras Medical College and Rajiv Gandhi Government General Hospital, Park Town, Chennai, 600002, India; The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, 600032, India
| | - Rajesh Sekar
- Institute of Cardiology, Madras Medical College and Rajiv Gandhi Government General Hospital, Park Town, Chennai, 600002, India; The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, 600032, India
| | - Elangovan Chandrasekaran
- Institute of Cardiology, Madras Medical College and Rajiv Gandhi Government General Hospital, Park Town, Chennai, 600002, India; The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, 600032, India
| | - Elavarasi Manimegalai Elangovan
- Institute of Cardiology, Madras Medical College and Rajiv Gandhi Government General Hospital, Park Town, Chennai, 600002, India; The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, 600032, India
| | - Kumaran Srinivasan
- Institute of Cardiology, Madras Medical College and Rajiv Gandhi Government General Hospital, Park Town, Chennai, 600002, India; The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, 600032, India
| | - Manohar Ganesan
- Institute of Cardiology, Madras Medical College and Rajiv Gandhi Government General Hospital, Park Town, Chennai, 600002, India; The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, 600032, India
| | - Nageswaran Piskala Mohandoss
- Institute of Cardiology, Madras Medical College and Rajiv Gandhi Government General Hospital, Park Town, Chennai, 600002, India; The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, 600032, India
| | - Pratap Kumar Gorijavaram
- Institute of Cardiology, Madras Medical College and Rajiv Gandhi Government General Hospital, Park Town, Chennai, 600002, India; The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, 600032, India
| | - Rajasekar Ramesh
- Institute of Cardiology, Madras Medical College and Rajiv Gandhi Government General Hospital, Park Town, Chennai, 600002, India; The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, 600032, India
| | - Ravindran Raji
- Institute of Cardiology, Madras Medical College and Rajiv Gandhi Government General Hospital, Park Town, Chennai, 600002, India; The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, 600032, India
| | - Tamilselvan Kunjitham
- Institute of Cardiology, Madras Medical College and Rajiv Gandhi Government General Hospital, Park Town, Chennai, 600002, India; The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, 600032, India
| | - Thiyagarjan Kaliamoorthy
- Institute of Cardiology, Madras Medical College and Rajiv Gandhi Government General Hospital, Park Town, Chennai, 600002, India; The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, 600032, India
| | - Venkatesan Sangareddi
- Institute of Cardiology, Madras Medical College and Rajiv Gandhi Government General Hospital, Park Town, Chennai, 600002, India; The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, 600032, India
| | - Nandakumaran Mohanan
- Institute of Cardiology, Madras Medical College and Rajiv Gandhi Government General Hospital, Park Town, Chennai, 600002, India; The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, 600032, India
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Rao S, Basu S, Nandi K, Singh MM, Lalwani H, Maheshwari V, Borle A, Sharma N. Metabolic syndrome burden, determinants and treatment status in an urban slum resettlement colony in Delhi, India. Int Health 2024:ihae024. [PMID: 38517308 DOI: 10.1093/inthealth/ihae024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 11/10/2023] [Accepted: 03/08/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) in low-resource settings contributes to accentuated risk of cardiovascular disease, including stroke. The study objective was to estimate the prevalence, determinants and treatment status of MetS in an urban slum resettlement population in Delhi, India. METHODS This study was conducted from February to May 2023. Multiphase sampling was conducted with 1910 individuals screened for abdominal obesity (AO), with 996 detected as having AO, of which, 400 were selected by simple random sampling and further evaluated for triglycerides (TGs), high-density lipoprotein (HDL) and fasting glucose levels. RESULTS Among the 400 participants detected as having AO, 211 had evidence of MetS (52.75% [95% confidence interval 47.83 to 57.62]). The most prevalent combination of MetS clustering was for all five components (AO, diabetes mellitus [DM], hypertension [HTN], low HDL and high TGs; 14.69%), followed by AO, DM and HTN (12.32%). On adjusted analysis, the odds of having MetS was found to be independently associated with increasing age (≥40 y) but not sex. CONCLUSIONS A high burden of MetS and suboptimal treatment status is prevalent in urban slum populations. Screening of individuals with AO, especially in those >40 y of age, can be an effective programmatic strategy for early diagnosis and management of MetS and its underlying components.
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Affiliation(s)
- Shivani Rao
- Department of Community Medicine, Maulana Azad Medical College, New Delhi 110002, India
| | - Saurav Basu
- Indian Institute of Public Health - Delhi, Public Health Foundation of India, Haryana 122102, India
| | - Kajal Nandi
- Department of Biochemistry, Maulana Azad Medical College, New Delhi 110002, India
| | - M M Singh
- Department of Community Medicine, Maulana Azad Medical College, New Delhi 110002, India
| | - Heena Lalwani
- Department of Community Medicine, Maulana Azad Medical College, New Delhi 110002, India
| | - Vansh Maheshwari
- Indian Institute of Public Health - Delhi, Public Health Foundation of India, Haryana 122102, India
| | - Amod Borle
- Department of Community Medicine, Maulana Azad Medical College, New Delhi 110002, India
| | - Nandini Sharma
- Department of Community Medicine, Maulana Azad Medical College, New Delhi 110002, India
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Moradpour F, Karimi Z, Fatemi Z, Moradi Y, Khosravi MR, Shokri A, Karimzadeh M. Prevalence of metabolic syndrome and its association with oral health: First results from the Kurdish cohort study. Health Sci Rep 2023; 6:e1602. [PMID: 37841941 PMCID: PMC10568541 DOI: 10.1002/hsr2.1602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/05/2023] [Accepted: 09/18/2023] [Indexed: 10/17/2023] Open
Abstract
Aims Investigate the association between oral and dental health (ODH) and metabolic syndrome (MetS) in adults aged 35-70 years. Methods The study utilized data from the enrollment phase of Dehgolan prospective cohort study in the west of Iran. A cross-sectional assessment was conducted on a total of 3996 participants, involving a comprehensive oral examination and the assessment of their oral hygiene behavior (ODH). MetS was defined according to the updated National Cholesterol Education Program Adult Treatment Panel III. Logistic regression used to calculate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for sociodemographic characteristics. Results MetS was more prevalent among those who not daily brushing and flossing. Participants with missing teeth (MT) show higher prevalent of MetS. Being female, lower age, illiteracy, family history of diabetes, low physical activity, and salt at table were independently associated with increase odds of MetS (p < 0.05). Odds of MetS were significantly decreased with use flossing (OR = 0.75; CI = 0.60-0.93), decayed (OR = 0.83; CI = 0.72-0.97), filled (OR = 0.84; CI = 0.71-0.99), and increased with MT (OR = 1.45; CI = 1.16-1.81) as long as adjusted for ODH factors. When other potential confounder such as sociodemographic, personal and nutritional habits were adjusted, daily flossing was the only factor that still statistically decreased (OR = 0.79; CI = 0.62-0.99) the odds of MetS. Conclusion Daily flossing was the only factor that independently associated with MetS. Relationship of other ODH factors with Mets were confounded by sociodemographic characteristics of the participants.
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Affiliation(s)
- Farhad Moradpour
- Social Determinants of Health Research Center, Research Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
| | - Zahra Karimi
- Vice Chancellor for Research and TechnologyKurdistan University of Medical SciencesSanandajIran
| | - Zeinab Fatemi
- Vice Chancellor for Health AffairsKurdistan University of Medical SciencesSanandajIran
| | - Yousef Moradi
- Department of Epidemiology and Biostatistics, Faculty of MedicineKurdistan University of Medical SciencesSanandajIran
| | | | - Azad Shokri
- Social Determinants of Health Research Center, Research Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
| | - Mohammad Karimzadeh
- Department of Epidemiology and Biostatistics, Faculty of MedicineKurdistan University of Medical SciencesSanandajIran
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Choi S, Park NJ, Kim M, Song K, Choi J. Comparison of cardiovascular disease risk in women with and without breast cancer: secondary data analysis with the 2014-2018 korean national health and nutrition examination survey. BMC Public Health 2023; 23:1158. [PMID: 37322518 PMCID: PMC10268351 DOI: 10.1186/s12889-023-16063-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 06/06/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Aging breast cancer survivors may be at an elevated risk of cardiovascular disease (CVD), but little is known about CVD risk assessment and breast cancer in Korean women. We hypothesized that Korean breast cancer survivors would have higher risks of future CVD within the next 10 years (i.e., Framingham Risk Score [FRS]) than women without cancer. OBJECTIVES (1) To compare FRS-based CVD risks in women with and without breast cancer based on propensity score matching; and (2) To explore adiposity-related measures in relation to FRS in Korean women with breast cancer. METHODS Using the cross-sectional data from the 2014-2018 Korean National Health and National Survey (KNHANES), we identified 136 women with breast cancer aged 30-74 years who had no other cancer and no CVD. The comparison group of 544 women with no cancer were selected by 1:4 nearest-neighbor propensity score matching based on breast cancer diagnosis. CVD risk was assessed by FRS based on multiple traditional risk factors (e.g., cholesterol, blood pressure, diabetes, and smoking). Adiposity was measured by physical examination, including body mass index (BMI) and waist-to-height ratio (WHtR). Physical activity and health behaviors were assessed by self-reports. RESULTS Women with breast cancer (mean age of 57 years) had similar FRS levels at a low-risk category (< 10%) to women with no cancer (4.9% vs. 5.5%). Breast cancer survivors (mean 8.5 survival years) presented at significantly lower levels of total cholesterol, BMI, and WHtR (all p values < 0.05) than their counterpart. Within the breast cancer group, WHtR ≥ 0.5 was associated with higher FRS, compared to WHtR < 0.5. FRS was not different by survival < 5 years or ≥ 5 years after breast cancer diagnosis. CONCLUSIONS FRS-based CVD risks were not different in Korean, mostly postmenopausal, women by breast cancer status. Whereas breast cancer survivors had even lower levels of lipid and adiposity measures than women without cancer, those values indicating borderline cardiometabolic risk suggest continued screening and management efforts for these aging women. Future studies are needed to examine longitudinal trajectories of CVD risk factors and CVD outcomes among Korean breast cancer survivors.
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Affiliation(s)
- Seongmi Choi
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, 03722, South Korea
| | - Na-Jin Park
- University of Pittsburgh School of Nursing, Pittsburgh, PA, 15261, USA
| | - Mihui Kim
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, 03722, South Korea
- Department of Nursing Science, Jeonju University, Jeonju-si, 55069, Jeollabuk-do, South Korea
| | - Kijun Song
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, 03722, South Korea
| | - JiYeon Choi
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, 03722, South Korea.
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Oza C, Mondkar S, Shah N, More C, Khadilkar V, Khadilkar A. A Pilot Study to Assess Effect of Metformin Therapy on Prevention of Double Diabetes in Indian Adolescents with Type-1 Diabetes. Indian J Endocrinol Metab 2023; 27:201-207. [PMID: 37583410 PMCID: PMC10424107 DOI: 10.4103/ijem.ijem_46_23] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/08/2023] [Accepted: 03/21/2023] [Indexed: 08/17/2023] Open
Abstract
Introduction Increased prevalence of metabolic syndrome in Indian adolescents owing to the obesity epidemic leads to double diabetes (DD), which is associated with an increased risk of complications in type-1 diabetes (T1D). Metformin may be a useful intervention for the prevention and treatment of insulin resistance in T1D. We conducted this pilot randomized controlled trial with the objective of investigating the effect of metformin on insulin sensitivity in Indian adolescents with T1D. Method This pilot randomized controlled trial was performed on 59 participants with T1D aged 10-19 years distributed uniformly by gender and puberty across two groups with a 3-month intervention period. The intervention group received metformin (weight less than 60 kg received 500 mg twice daily and more than 60 kg received 1 gm twice daily) and non-metformin group received standard of care for diabetes. Anthropometric, clinical details, biochemistry and insulin sensitivity indices (ISI) were evaluated using standard protocols at baseline and endline. Result 22.2% of subjects from non-metformin group and 12.5% from metformin group were at the risk of the development of DD. The odds ratio and relative risk for the development of DD in non-metformin subjects were 2.0 and 1.4, respectively, as compared to participants in metformin group. The mean improvement in ISI ranged from 1.4% to 4.6% in participants on metformin as opposed to deterioration of -2% to -14.1% in non-metformin group. On performing the paired sample t-test, the reduction in ISI in non-metformin group was significant. Conclusion Metformin may prevent deterioration in insulin sensitivity in Indian adolescents with T1D.
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Affiliation(s)
- Chirantap Oza
- Department of Growth and Pediatric Endocrinology, Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, India
| | - Shruti Mondkar
- Department of Growth and Pediatric Endocrinology, Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, India
| | - Nikhil Shah
- Department of Growth and Pediatric Endocrinology, Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, India
- Department of Paediatrics, Cloudnine Hospital, Mumbai, Maharashtra, India
| | - Chidvilas More
- Department of Growth and Pediatric Endocrinology, Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, India
| | - Vaman Khadilkar
- Department of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, India
- Department of Growth and Pediatric Endocrinology, Senior Paediatric Jehangir Hospital, Pune, Maharashtra, India
| | - Anuradha Khadilkar
- Department of Growth and Pediatric Endocrinology, Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, India
- Department of Growth and Pediatric Endocrinology, Senior Paediatric Jehangir Hospital, Pune, Maharashtra, India
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Jayasinghe IU, Agampodi TC, Dissanayake AK, Agampodi SB. Early pregnancy metabolic syndrome and risk for adverse pregnancy outcomes: findings from Rajarata Pregnancy Cohort (RaPCo) in Sri Lanka. BMC Pregnancy Childbirth 2023; 23:231. [PMID: 37020187 PMCID: PMC10074348 DOI: 10.1186/s12884-023-05548-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 03/25/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND Despite the intergenerational effects of metabolic disorders, evidence is greatly lacking on early pregnancy metabolic syndrome (MetS) and its effects on pregnancy outcomes from low- and middle-income countries. Thus, this prospective cohort of South Asian pregnant women aimed to evaluate how early pregnancy MetS would affect pregnancy outcomes. METHODS A prospective cohort study was conducted among first-trimester (T1) pregnant women of Anuradhapura district, Sri Lanka recruited to the Rajarata Pregnancy Cohort in 2019. MetS was diagnosed by the Joint Interim Statement criteria before 13 weeks of gestational age (GA). Participants were followed up until their delivery, and the major outcomes measured were large for gestational age (LGA), small for gestational age (SGA), preterm birth (PTB) and miscarriage (MC). Gestational weight gain, gestational age at delivery and neonatal birth weight were used as measurements to define the outcomes. Additionally, outcome measures were re-assessed with adjusting fasting plasma glucose (FPG) thresholds of MetS to be compatible with hyperglycemia in pregnancy (Revised MetS). RESULTS 2326 T1 pregnant women with a mean age of 28.1 years (SD-5.4), and a median GA of 8.0 weeks (IQR-2) were included. Baseline MetS prevalence was 5.9% (n = 137, 95%CI-5.0-6.9). Only 2027 (87.1%) women from baseline, had a live singleton birth, while 221(9.5%) had MC and 14(0.6%) had other pregnancy losses. Additionally, 64(2.8%) were lost to follow-up. A higher cumulative incidence of LGA, PTB, and MC was noted among the T1-MetS women. T1-MetS carried significant risk (RR-2.59, 95%CI-1.65-3.93) for LGA, but reduced the risk for SGA (RR-0.41, 95%CI-0.29-0.78). Revised MetS moderately increased the risk for PTB (RR-1.54, 95%CI-1.04-2.21). T1-MetS was not associated (p = 0.48) with MC. Lowered FPG thresholds were significantly associated with risk for all major pregnancy outcomes. After adjusting for sociodemographic and anthropometric confounders, revised MetS remained the only significant risk predictor for LGA. CONCLUSION Pregnant women with T1 MetS in this population are at an increased risk for LGA and PTB and a reduced risk for SGA. We observed that a revised MetS definition with lower threshold for FPG compatible with GDM would provide a better estimation of MetS in pregnancy in relation to predicting LGA.
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Affiliation(s)
- Imasha Upulini Jayasinghe
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka.
| | - Thilini Chanchala Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - Ajith Kumara Dissanayake
- Department of Gynaecology and Obstetrics, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - Suneth Buddhika Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
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Babahajiani M, Zarepur E, Khosravi A, Mohammadifard N, Noohi F, Alikhasi H, Nasirian S, Moezi Bady SA, Janjani P, Solati K, Lotfizadeh M, Ghaffari S, Javanmardi E, Salari A, Gholipour M, Dehghani M, Cheraghi M, Assareh A, Haybar H, Namayandeh SM, Madadi R, Kojuri J, Mansourian M, Sarrafzadegan N. Ethnic differences in the lifestyle behaviors and premature coronary artery disease: a multi-center study. BMC Cardiovasc Disord 2023; 23:170. [PMID: 36991315 PMCID: PMC10061766 DOI: 10.1186/s12872-023-03192-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 03/21/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Diverse ethnic groups that exist in Iran may differ regarding the risk factors such as hypertension, hyperlipidemia, dyslipidemia, diabetes mellitus, and family history of non-communicable disease. Premature Coronary Artery Disease (PCAD) is more endemic in Iran than before. This study sought to assess the association between ethnicity and lifestyle behaviors in eight major Iranian ethnic groups with PCAD. METHODS In this study, 2863 patients aged ≤ 70 for women and ≤ 60 for men who underwent coronary angiography were recruited in a multi-center framework. All the patients' demographic, laboratory, clinical, and risk factor data were retrieved. Eight large ethnicities in Iran, including the Farses, the Kurds, the Turks, the Gilaks, the Arabs, the Lors, the Qashqai, and the Bakhtiari were evaluated for PCAD. Different lifestyle components and having PCAD were compared among the ethnical groups using multivariable modeling. RESULTS The mean age of the 2863 patients participated was 55.66 ± 7.70 years. The Fars ethnicity with 1654 people, was the most subject in this study. Family history of more than three chronic diseases (1279 (44.7%) was the most common risk factor. The Turk ethnic group had the highest prevalence of ≥ 3 simultaneous lifestyle-related risk factors (24.3%), and the Bakhtiari ethnic group had the highest prevalence of no lifestyle-related risk factors (20.9%). Adjusted models showed that having all three abnormal lifestyle components increased the risk of PCAD (OR = 2.28, 95% CI: 1.04-1.06). The Arabs had the most chance of getting PCAD among other ethnicities (OR = 2.26, 95%CI: 1.40-3.65). While, the Kurds with a healthy lifestyle showed the lowest chance of getting PCAD (OR = 1.96, 95%CI: 1.05-3.67)). CONCLUSIONS This study found there was heterogeneity in having PACD and a diverse distribution in its well-known traditional lifestyle-related risk factors among major Iranian ethnic groups.
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Affiliation(s)
- Media Babahajiani
- Student Research Committee, Vice Chancellor for Research and Technology, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ehsan Zarepur
- Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Cardiology, Medicine School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Khosravi
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
- The Iranian Network of Cardiovascular Research (INCVR), Isfahan, Iran
| | - Noushin Mohammadifard
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Feridoun Noohi
- The Iranian Network of Cardiovascular Research (INCVR), Isfahan, Iran
- Shahid Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hasan Alikhasi
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shima Nasirian
- Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Ali Moezi Bady
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
- Clinical Research Development Unit, Imam Reza Hospital, Birjand University of Medical Sciences, Birjand, Iran
| | - Parisa Janjani
- Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Kamal Solati
- Department of Psychiatry, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Masoud Lotfizadeh
- Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Samad Ghaffari
- The Iranian Network of Cardiovascular Research (INCVR), Isfahan, Iran
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elmira Javanmardi
- Department of Cardiovascular Medicine, Amiralmomenin Hospital, Maragheh University Medical Sciences, Maragheh, Iran
| | - Arsalan Salari
- Department of cardiology, Healthy heart research center, Heshmat hospital, School of medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Mahboobeh Gholipour
- Department of Cardiology, Healthy Heart Research Center, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Mostafa Dehghani
- Department of Cardiovascular research Center, Shahid Rahimi Hospital, Lorestan university of Medical Science, Khorramabad, Iran
| | - Mostafa Cheraghi
- Department of Cardiovascular Research Center, Shahid Rahimi Hospital, Lorestan university of Medical Science, Khorramabad, Iran
| | - Ahmadreza Assareh
- The Iranian Network of Cardiovascular Research (INCVR), Isfahan, Iran
- Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Habib Haybar
- Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Reza Madadi
- Zanjan University of Medical Sciences, Zanjan, Iran
| | - Javad Kojuri
- The Iranian Network of Cardiovascular Research (INCVR), Isfahan, Iran
- Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marjan Mansourian
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Nizal Sarrafzadegan
- The Iranian Network of Cardiovascular Research (INCVR), Isfahan, Iran
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
- Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, Canada
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Tkachenko K, Esteban-Díez I, González-Sáiz JM, Pérez-Matute P, Pizarro C. Dual Classification Approach for the Rapid Discrimination of Metabolic Syndrome by FTIR. BIOSENSORS 2022; 13:15. [PMID: 36671850 PMCID: PMC9855898 DOI: 10.3390/bios13010015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/12/2022] [Accepted: 12/21/2022] [Indexed: 06/17/2023]
Abstract
Metabolic syndrome is a complex of interrelated risk factors for cardiovascular disease and diabetes. Thus, new point-of-care diagnostic tools are essential for unambiguously distinguishing MetS patients, providing results in rapid time. Herein, we evaluated the potential of Fourier transform infrared spectroscopy combined with chemometric tools to detect spectra markers indicative of metabolic syndrome. Around 105 plasma samples were collected and divided into two groups according to the presence of at least three of the five clinical parameters used for MetS diagnosis. A dual classification approach was studied based on selecting the most important spectral variable and classification methods, linear discriminant analysis (LDA) and SIMCA class modelling, respectively. The same classification methods were applied to measured clinical parameters at our disposal. Thus, the classification's performance on reduced spectra fingerprints and measured clinical parameters were compared. Both approaches achieved excellent discrimination results among groups, providing almost 100% accuracy. Nevertheless, SIMCA class modelling showed higher classification performance between MetS and no MetS for IR-reduced variables compared to clinical variables. We finally discuss the potential of this method to be used as a supportive diagnostic or screening tool in clinical routines.
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Affiliation(s)
| | | | | | - Patricia Pérez-Matute
- Infectious Diseases, Microbiota and Metabolism Unit, Infectious Diseases Department, Center for Biomedical Research of La Rioja (CIBIR), 26006 Logroño, Spain
| | - Consuelo Pizarro
- Department of Chemistry, University of La Rioja, 26006 Logroño, Spain
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9
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Virmani A, Brink SJ, Middlehurst A, Mohsin F, Giraudo F, Sarda A, Ajmal S, von Oettingen JE, Pillay K, Likitmaskul S, Calliari LE, Craig ME. ISPAD Clinical Practice Consensus Guidelines 2022: Management of the child, adolescent, and young adult with diabetes in limited resource settings. Pediatr Diabetes 2022; 23:1529-1551. [PMID: 36537524 DOI: 10.1111/pedi.13456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/24/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- Anju Virmani
- Department of Pediatrics, Max Super Specialty Hospital, New Delhi, India.,Department of Endocrinology, Madhukar Rainbow Children's Hospital, New Delhi, India
| | - Stuart J Brink
- New England Diabetes and Endocrinology Center, Boston, Massachusetts, USA.,New England Diabetes and Endocrinology Center, Newton, Massachusetts, USA.,Harvard School of Medicine, Tufts School of Medicine, Boston, Massachusetts, USA
| | - Angela Middlehurst
- ISPAD & International Volunteer Pediatric Diabetes Educator, Sydney, Australia
| | - Fauzia Mohsin
- Pediatric Endocrinology and Metabolism Unit, Dept of Pediatrics, BIRDEM General Hospital, Dhaka, Bangladesh
| | - Franco Giraudo
- Institute of Maternal and Child Research (IDIMI), School of Medicine, University of Chile, Santiago, Chile.,San Borja Arriarán Clinical Hospital, Santiago, Chile
| | - Archana Sarda
- UDAAN, NGO for Persons with Diabetes, Aurangabad, India
| | - Sana Ajmal
- Meethi Zindagi, Not-for-Profit Community Organisation for Persons with Diabetes, Rawalpindi, Pakistan
| | - Julia E von Oettingen
- Dept of Pediatrics, Division of Endocrinology, Montreal Children's Hospital, Quebec, Canada
| | | | - Supawadee Likitmaskul
- Siriraj Diabetes Center, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | - Maria E Craig
- The Children's Hospital at Westmead, Sydney, New South Wales, Australia.,The University of Sydney Children's Hospital, Westmead Clinical School, Sydney, New South Wales, Australia.,School of Women's and Children's Health, University of NSW, Sydney, New South Wales, Australia
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10
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Zhang GH, Yuan TH, Yue ZS, Wang L, Dou GR. The presence of diabetic retinopathy closely associated with the progression of non-alcoholic fatty liver disease: A meta-analysis of observational studies. Front Mol Biosci 2022; 9:1019899. [PMID: 36458094 PMCID: PMC9706004 DOI: 10.3389/fmolb.2022.1019899] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 11/01/2022] [Indexed: 07/30/2023] Open
Abstract
Background and Objective: Although growing evidence indicates that non-alcoholic fatty liver disease is related to diabetic retinopathy (DR), research results significantly vary. Therefore, we conducted a meta-analysis to assess the association between the progression of non-alcoholic fatty liver disease and the onset of DR. Methods: PubMed, Embase, and Cochrane databases were searched until 7 November 2021. Combined odds ratios (ORs) and 95% confidence intervals (CIs) were used to assess the association. Results: We identified 18 studies involving 12,757 patients. The pooled effect assessment showed that liver fibrosis was positively correlated with DR (OR = 1.69, 95%CI 1.30-2.20; p < 0.0001); non-alcoholic fatty liver disease was not associated with the risk of DR (OR = 1.15, 95%CI 0.75-1.76; p = 0.51); non-alcoholic fatty liver disease was positively correlated with DR in patients with type 1 diabetes (OR = 2.96, 95%CI 1.48-5.94; p = 0.002). In patients with type 2 diabetes, there was no association between non-alcoholic fatty liver disease and DR (OR = 0.92, 95%CI 0.59-1.43; p = 0.70). Subgroup analysis showed no correlation in both Asian and Caucasian races. Conclusion: There is a significant correlation between liver fibrosis and DR. This suggests that the ocular examination of DR could be helpful in predicting whether patients with non-alcoholic fatty liver disease would progress to liver fibrosis.
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Affiliation(s)
- Guo-heng Zhang
- Department of Ophthalmology, Eye Institute of Chinese PLA, Xijing Hospital, Fourth Military Medical University, Xi’an, China
- Department of Ophthalmology, 942 Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army, Yin’chuan, China
| | - Tian-hao Yuan
- Department of Ophthalmology, Eye Institute of Chinese PLA, Xijing Hospital, Fourth Military Medical University, Xi’an, China
- Department of The Cadet Team 6 of School of Basic Medicine, Fourth Military Medical University, Xi’an, China
| | - Zhen-sheng Yue
- Department of Ophthalmology, Eye Institute of Chinese PLA, Xijing Hospital, Fourth Military Medical University, Xi’an, China
- Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Lin Wang
- Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Guo-Rui Dou
- Department of Ophthalmology, Eye Institute of Chinese PLA, Xijing Hospital, Fourth Military Medical University, Xi’an, China
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11
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Singh SK, Taillie LS, Gupta A, Bercholz M, Popkin B, Murukutla N. Front-of-Package Labels on Unhealthy Packaged Foods in India: Evidence from a Randomized Field Experiment. Nutrients 2022; 14:nu14153128. [PMID: 35956305 PMCID: PMC9370292 DOI: 10.3390/nu14153128] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/09/2022] [Accepted: 06/11/2022] [Indexed: 02/01/2023] Open
Abstract
Policies to require front-of-package labels (FOPLs) on packaged foods may help Indian consumers to better identify foods high in nutrients of concern, including sugar, saturated fat, and sodium, and discourage their consumption, which are outcomes that are critical for preventing rises in diet-related non-communicable disease. The objective was to test whether FOPLs helped Indian consumers identify “high-in” packaged foods and reduce intentions to purchase them. We conducted an in-person randomized experiment (n = 2869 adults between ages 18 and 60 years old) in six states of India in 2022. Participants were randomized to one of five FOPLs: a control label (barcode), warning label (octagon with “High in [nutrient]”), Health Star Rating (HSR), Guideline Daily Amount (GDA), or traffic light label. Participants then viewed a series of packaged foods high in sugar, saturated fat, or sodium with the assigned FOPL, and rated product perceptions and label reactions. Fewer than half of participants in the control group (39.1%) correctly identified all products high in nutrient(s) of concern. All FOPLs led to an increase in this outcome, with the biggest differences observed for the warning label (60.8%, p < 0.001), followed by the traffic light label (54.8%, p < 0.001), GDA (55.0%, p < 0.001), and HSR (45.0%, p < 0.01). While no FOPLs led to a reduction in intentions to purchase the packaged foods, the overall pattern of results suggested that warning labels are the most effective FOPL to help Indian consumers identify unhealthy foods.
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Affiliation(s)
- S. K. Singh
- Department of Survey Research and Data Analytics, International Institute for Population Sciences, Deemed University, Mumbai 400088, India
- Correspondence: (S.K.S.); (L.S.T.)
| | - Lindsey Smith Taillie
- Department of Nutrition, Gillings School of Global Public Health, Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27516, USA;
- Correspondence: (S.K.S.); (L.S.T.)
| | - Ashish Gupta
- Vital Strategies, New York, NY 27599, USA; (A.G.); (N.M.)
| | - Maxime Bercholz
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27516, USA;
| | - Barry Popkin
- Department of Nutrition, Gillings School of Global Public Health, Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27516, USA;
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12
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Sluyter JD, Plank LD, Rush EC. Identifying metabolic syndrome in migrant Asian Indian adults with anthropometric and visceral fat action points. Diabetol Metab Syndr 2022; 14:96. [PMID: 35841020 PMCID: PMC9284905 DOI: 10.1186/s13098-022-00871-4] [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: 04/22/2022] [Accepted: 06/24/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is a clustering of metabolic risk factors, including large waist circumference (WC). Other anthropometric parameters and visceral fat mass (VFM) predicted from these may improve MetS detection. Our aim was to assess the ability of such parameters to predict this clustering in a cross-sectional, diagnostic study. METHOD Participants were 82 males and 86 females, aged 20-74 years, of Asian Indian ethnicity. VFM was estimated by dual-energy X-ray absorptiometry (DXA) through identification of abdominal subcutaneous fat layer boundaries. Non-anthropometric metabolic risk factors (triglycerides, HDL cholesterol, blood pressure and glucose) were defined using MetS criteria. We estimated the ability of anthropometry and VFM to detect ≥ 2 of these factors by receiver operating characteristic (ROC) and precision-recall curves. RESULTS Two or more non-anthropometric metabolic risk factors were present in 45 (55%) males and 29 (34%) females. The area under the ROC curve (AUC) to predict ≥ 2 of these factors using WC was 0.67 (95% confidence interval: 0.55-0.79) in males and 0.65 (0.53-0.77) in females. Optimal WC cut-points were 92 cm for males (63% accuracy) and 79 cm for females (53% accuracy). VFM, DXA-measured sagittal diameter and suprailiac skinfold thickness yielded higher AUC point estimates (by up to 0.06), especially in females where these measures improved accuracy to 69%, 69% and 65%, respectively. Pairwise combinations that included WC further improved accuracy. CONCLUSION Our findings indicate that cut-points for readily obtained measures other than WC, or in combination with WC, may provide improved detection of MetS risk factor clusters.
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Affiliation(s)
- John D. Sluyter
- Section of Epidemiology and Biostatistics, Faculty of Medical and Health Sciences, University of Auckland, 28 Park Road, Auckland, 1023 New Zealand
| | - Lindsay D. Plank
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Elaine C. Rush
- School of Sport and Recreation, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
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13
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Disparity in association of obesity measures with ankle and brachial systolic blood pressures in Europeans and South Asians. Sci Rep 2022; 12:9174. [PMID: 35655080 PMCID: PMC9163110 DOI: 10.1038/s41598-022-13372-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 05/17/2022] [Indexed: 11/22/2022] Open
Abstract
Obesity causes increases in brachial systolic-blood-pressures (SBP), risks of type 2 diabetes (T2DM) and cardiovascular diseases (CVD). Brachial and ankle SBPs have differential relationship with T2DM and CVD. Our objective was to study the relationship of obesity measures with brachial and ankle SBPs. A population of 1098 adults (South Asians n = 699; 41.70% male and 58.3% female) were recruited over 5 years from primary care practices in England. Their four limbs SBPs were measured using Doppler machine and body-mass-index (BMI) and waist-to-height-ratio (WHtR) calculated. Linear regressions were performed between SBPs and obesity measures, after adjustments for sex, age, ethnicity, T2DM and CVD. The mean age of all participants was 51.3 (SD = 17.2), European was 57.7 (SD 17.2) and South Asian was 47.8 (SD = 16.1). The left posterior tibial [Beta = 1.179, P = 4.559 × 10−15] and the right posterior tibial SBP [Beta = 1.178, P = 1.114 × 10−13] most significantly associated with the BMI. In South Asians, although the left brachial [Beta = 25.775, P = 0.032] and right brachial SBP [Beta = 22.792, P = 0.045] were associated to the WHtR, the left posterior tibial SBP [Beta = 39.894, P = 0.023], association was the strongest. For the first time, we have demonstrated that ankle SBPs had significant association with generalised obesity than brachial systolic blood pressures (SBP), irrespective of ethnicity. However, with respect to visceral obesity, the association with ankle SBP was more significant in South Asians compared to Europeans.
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Rawal T, van Schayck OC, Willeboordse M, Arora M, Bhaumik S, Bhagra A, Bhagra S, Muris JW, Tandon N. How to promote a healthy lifestyle among schoolchildren: Development of an intervention module (i-PROMISe). PUBLIC HEALTH IN PRACTICE 2022; 3:100262. [PMID: 36101760 PMCID: PMC9461553 DOI: 10.1016/j.puhip.2022.100262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 04/02/2022] [Accepted: 04/22/2022] [Indexed: 11/30/2022] Open
Abstract
Objective Lifestyle preferences are inculcated in childhood and once established, persist into adulthood. The Project PROMoting Health LIteracy in School (i-PROMISe) aims to promote a healthy lifestyle among students for the universal prevention of non-communicable diseases (NCDs) like diabetes. Study design Qualitative study using focus-group-discussions (FGDs) and In-Depth Interviews (IDI). Method Project was undertaken in two-phases in two private schools in New Delhi, India. In phase-one, FGDs with students (grades IV to VIII) and IDIs with teachers were conducted to ascertain their perceptions of diabetes prevention and management according to the Health Belief Model. The data was analyzed using a thematic framework method. In phase-two, the resources were pre-tested and participants’ feedback was requested on the duration, quality, and understanding of the resources. Results In total, 89 students and 17 teachers participated in phase-one (n = 54 [in FGDs] and n = 5 [in IDIs]) and phase-two (n = 35 students and n = 12 teachers in FGDs). In phase-one, themes that emerged included: diabetes was considered a disease of the elderly; misconceptions about susceptibility to these diseases were common; children were largely aware of measures to prevent these diseases, but barriers to adopting a healthy lifestyle existed. Based on the findings, a comprehensive module was developed, which consisted of a teacher's manual with interactive activities and short films. The resources (teacher's manual and short films) were well received and contributed to a better understanding of diabetes and other NCDs; myths/misconceptions were clarified. Conclusion Development of resources using participatory approach can be effective in promoting and reinforcing healthy behaviours among school going children to prevent and control NCDs in schools.
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Affiliation(s)
- Tina Rawal
- Health Promotion Division, Public Health Foundation of India, Gurgaon, India
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
- Corresponding author. Health Promotion Division, Public Health Foundation of India (PHFI), Plot No. 47, Sector 44, Gurgaon (Haryana) 122002, India.
| | - Onno C.P. van Schayck
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Maartje Willeboordse
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Monika Arora
- Health Promotion Division, Public Health Foundation of India, Gurgaon, India
| | - Soumyadeep Bhaumik
- Health Promotion Division, Public Health Foundation of India, Gurgaon, India
| | - Anjali Bhagra
- Mayo Clinic, Mayo Clinic, World India Diabetes Foundation, Rochester, United States
| | - Sumit Bhagra
- Mayo Clinic, Mayo Clinic, World India Diabetes Foundation, Rochester, United States
| | - Jean W.M. Muris
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Nikhil Tandon
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
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Koralegedara IS, Warnasekara JN, Dayaratne KG, De Silva FN, Premadasa JK, Agampodi SB. Non-alcoholic fatty liver disease (NAFLD): a significant predictor of gestational diabetes mellitus (GDM) and early pregnancy miscarriages-prospective study in Rajarata Pregnancy Cohort (RaPCo). BMJ Open Gastroenterol 2022; 9:bmjgast-2021-000831. [PMID: 35193889 PMCID: PMC8867246 DOI: 10.1136/bmjgast-2021-000831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 01/31/2022] [Indexed: 12/29/2022] Open
Abstract
Background and aims Non-alcoholic fatty liver disease (NAFLD) is increasing globally with a mounting body of evidence on various adverse effects on pregnancy. Yet, prospective studies, especially from low-income and middle-income countries, are lacking in examining the impact of NAFLD in pregnancy. In this study, we explored the effect of NAFLD on the development of gestational diabetes mellitus (GDM) and early pregnancy miscarriages. Methods A population-based prospective cohort study was conducted among first-trimester pregnant women who registered in the national pregnancy care programme during July–September 2019 in Anuradhapura district, Sri Lanka. Baseline clinical–biochemical parameters and ultrasound scan (USS) of the liver were done to assess fatty liver. Those who were normoglycaemic based on WHO criteria were followed up, and a repeat oral glucose tolerance test was performed between 24 and 28 weeks of gestation. Results Of the 632 pregnant women studied, 90 (14%) and 234 (37%) were diagnosed as having fatty liver grade (FLG) II and I, respectively. The cumulative incidence of GDM in FLG 0, I, and II were 11, 44, and 162 per 1000 pregnancies, respectively. After adjusting for age and other known risk factors, women with FLG II had a relative risk (RR) of 12.5 (95% CI 2.2 to 66.4) for developing GDM compared with FLG 0. In addition, women with FLG I (RR 2.1, 95% CI 1.01 to 4.64) and FLG II (RR 4.5, 95% CI 2.1 to 9.9) were significant risk factors for early pregnancy miscarriages, and FLG II remained as the only independent predictor of miscarriages after adjusting for age, parity, body mass index, blood sugar, blood pressure, and haemoglobin level (adjusted OR 4.2 (95% CI 1.9 to 9.1)). Conclusion In this rural south Asian community, NAFLD is shown to be a major risk factor for GDM and early pregnancy miscarriages. Therefore, routine identification of NAFLD through a simple USS may help in the early identification of high-risk mothers.
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Affiliation(s)
- Iresha Sandamali Koralegedara
- Department of Anatomy, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, North Central, Sri Lanka .,Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, North Central, Sri Lanka.,Maternal and Child Health Research Unit, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, North Central, Sri Lanka
| | - Janith Niwanthaka Warnasekara
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, North Central, Sri Lanka.,Maternal and Child Health Research Unit, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, North Central, Sri Lanka
| | - Korale Gedara Dayaratne
- Department of Radiology, Teaching Hospital Anuradhapura, Anuradhapura, North Central, Sri Lanka
| | - Farika Nirmani De Silva
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, North Central, Sri Lanka.,Maternal and Child Health Research Unit, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, North Central, Sri Lanka
| | - Jagath Keerthi Premadasa
- Department of Obstetrics and Gynaecology, Teaching Hospital Anuradhapura, Anuradhapura, North Central, Sri Lanka
| | - Suneth Buddhika Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, North Central, Sri Lanka.,Maternal and Child Health Research Unit, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, North Central, Sri Lanka
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16
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Rougeaux E, Miranda JJ, Fewtrell M, Wells JCK. Maternal internal migration and child growth and nutritional health in Peru: an analysis of the demographic and health surveys from 1991 to 2017. BMC Public Health 2022; 22:37. [PMID: 34991546 PMCID: PMC8734138 DOI: 10.1186/s12889-021-12452-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 12/13/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Peru has historically experienced high rural-to-urban migration. Despite large reductions in undernutrition, overweight is increasing. Elsewhere, internal migration has been associated with differences in children's growth and nutritional health. We investigated how child growth and nutritional status in Peru varied over time and in association with maternal internal migration. METHODS Using data from Demographic & Health Surveys from 1991 to 2017, we assessed trends in child growth (height-for-age [HAZ], weight-for-age [WAZ], weight-for-height [WHZ] z scores) and nutritional health (stunting, underweight, overweight) by maternal adult internal migration (urban [UNM] or rural non-migrant [RNM], or urban-urban [UUM], rural-urban [RUM], rural-rural [RRM], or urban-rural migrant [URM]). Using 2017 data, we ran regression analyses, adjusting for confounders, to investigate associations of maternal migration with child outcomes and the maternal and child double burden of malnutrition. We further stratified by timing of migration, child timing of birth and, for urban residents, type of area of residence. Results are given as adjusted predictive margins (mean z score or %) and associated regression p-values [p]. RESULTS In 1991-2017, child growth improved, and undernutrition decreased, but large differences by maternal migration persisted. In 2017, within urban areas, being the child of a migrant woman was associated with lower WHZ (UUM = 0.6/RUM = 0.5 vs UNM = 0.7; p = 0.009 and p < 0.001 respectively) and overweight prevalence ((RUM 7% vs UNM = 11% [p = 0.002]). Results however varied both by child timing of birth (birth after migration meant greater overweight prevalence) and type of area of residence (better linear growth in children of migrants [vs non-migrants] in capital/large cities and towns but not small cities). In rural areas, compared to RNM, children of URM had higher HAZ (- 1.0 vs - 1.2; p < 0.001) and WAZ (- 0.3 vs - 0.4; p = 0.001) and lower stunting (14% vs 21%; [p < 0.001]). There were no differences by timing of birth in rural children, nor by time since migration across all children. The mother and child double burden of malnutrition was higher in rural than urban areas but no differences were found by maternal internal migration. CONCLUSIONS Migration creates a unique profile of child nutritional health that is not explained by maternal ethnic and early life factors, but which varies depending on the pathway of migration, the child timing of birth in relation to migration and, for urban dwellers, the size of the place of destination. Interventions to improve child nutritional health should take into consideration maternal health and migration history.
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Affiliation(s)
- Emeline Rougeaux
- Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, London, UK.
| | - J Jaime Miranda
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Mary Fewtrell
- Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Jonathan C K Wells
- Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, London, UK
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Zhang R, Viswambharan H, Cheng CW, Garstka MA, Kain K. Inter-ankle Systolic Blood Pressure Difference Is a Marker of Increased Fasting Blood-Glucose in Asian Pregnant Women. Front Endocrinol (Lausanne) 2022; 13:842254. [PMID: 35712250 PMCID: PMC9195077 DOI: 10.3389/fendo.2022.842254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 04/15/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE This cross-sectional study aimed to determine the relationship between clinical blood pressures and blood pressures measured using Doppler with blood glucose in pregnancy by ethnicity. METHODS We recruited 179 (52% White European, 48% Asian) pregnant women at 24-28 weeks of gestation who underwent a glucose tolerance test in an antenatal clinic in Bradford Royal Infirmary, the UK, from 2012 to 2013. Systolic blood pressures in the arm (left and right brachial) and ankle [left and right posterior tibial (PT) and dorsalis pedalis (DP)] blood pressures were measured using a Doppler probe. The inter-arm (brachial) and inter-ankle (PT and DP) systolic blood pressure differences were obtained. A multivariate linear regression model adjusted for age, body mass index, and diabetes risk was used to assess the relationship between blood pressures and blood glucose. RESULTS Asian pregnant women had higher blood glucose but lower ankle blood pressures than White Europeans. In White Europeans, brachial blood pressures and clinical blood pressures were positively associated with fasting blood glucose (FBG), but brachial blood pressures did not perform better as an indicator of FBG than clinical blood pressures. In Asians, increased inter-ankle blood pressure difference was associated with increased FBG. For each 10 mmHg increase in the inter-ankle blood pressure difference, FBG increased by 0.12 mmol/L (Beta=0.12, 95%CI: 0.01-0.23). CONCLUSION The relationship between blood pressures with blood glucose differed by ethnicity. In Asians, inter-ankle systolic blood pressure difference was positively associated with blood glucose. This is first ever report on ankle blood pressures with blood glucose in pregnancy which suggests future potential as a non-invasive gestational diabetes risk screening tool.
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Affiliation(s)
- Ruo Zhang
- Department of Endocrinology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Hema Viswambharan
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom
| | - Chew Weng Cheng
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom
- *Correspondence: Malgorzata Anna Garstka, ; Chew Weng Cheng,
| | - Malgorzata Anna Garstka
- Core Research Laboratory, Department of Endocrinology, Department of Tumor and Immunology, Precision Medical Institute, Western China Science and Technology Innovation Port, The Second Affiliated Hospital, Health Science Center, Xi’an Jiaotong University, Xi’an, China
- *Correspondence: Malgorzata Anna Garstka, ; Chew Weng Cheng,
| | - Kirti Kain
- NHS England & NHS Improvement (North East and Yorkshire), Leeds, United Kingdom
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Senarathne R, Hettiaratchi U, Dissanayake N, Hafiz R, Zaleem S, Athiththan L. Metabolic syndrome in hypertensive and non-hypertensive subjects. Health Sci Rep 2021; 4:e454. [PMID: 34938898 PMCID: PMC8670729 DOI: 10.1002/hsr2.454] [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: 05/04/2021] [Revised: 10/07/2021] [Accepted: 10/11/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND AIMS Hypertension is a major risk factor of cardiovascular diseases (CVDs), which attributes to one-third of all deaths worldwide. It is also considered as a key feature of metabolic syndrome (MetS). The aim of the present study was to compare the presence of characteristic features of MetS in hypertensive and non-hypertensive males and females and find out the percentages of MetS in hypertensive and non-hypertensive adults. METHODS This was a cross-sectional study, involving 120 participants that included 60 hypertensives and 60 non-hypertensives (35-55 years). Data were obtained through an interviewer-administered questionnaire. Fasting blood sugar (FBS) and lipid parameters [triglyceride-(TG), high density lipoprotein (HDL)] were analyzed, and waist circumference (WC) was measured. Percentages of MetS among hypertensive and non-hypertensive groups were determined according to both modified Adult Treatment Panel III (ATP III) and new International Diabetes Federation (IDF) criteria. Results were analyzed using SPSS version 21. RESULTS Among the characteristic features of MetS, mean FBS and WC were significantly higher in hypertensive males compared with non-hypertensive males (P < .001 and P = .002 respectively), while mean value of TG was significantly higher (P = .005) in hypertensive females compared with non-hypertensive females. Further, the percentage of subjects in the total hypertensive group with increased FBS and increased WC was significantly higher than the non- hypertensive group. The percentage of subjects with MetS was significantly (P < .001) higher in hypertensive group (68%) compared with non-hypertensive group (20%) according to modified ATP III criteria. When compared with new IDF criteria, it was 63% and 20%, respectively. CONCLUSION The percentage of subjects with increased FBS, WC, and MetS was significantly higher in the hypertensive group compared with non-hypertensives group. These findings emphasize the urgent need to develop national strategies for early detection, and to take preventive measures to make people aware of the impact of metabolic syndrome.
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Affiliation(s)
- Roshali Senarathne
- Faculty of Allied Health SciencesUniversity of Sri JayewardenepuraNugegodaColomboSri Lanka
| | - Usha Hettiaratchi
- Department of Biochemistry, Faculty of Medical SciencesUniversity of Sri JayewardenepuraNugegodaColomboSri Lanka
| | - Nirodha Dissanayake
- Faculty of Allied Health SciencesUniversity of Sri JayewardenepuraNugegodaColomboSri Lanka
| | - Riyaza Hafiz
- Faculty of Allied Health SciencesUniversity of Sri JayewardenepuraNugegodaColomboSri Lanka
| | - Sumara Zaleem
- Faculty of Allied Health SciencesUniversity of Sri JayewardenepuraNugegodaColomboSri Lanka
| | - Lohini Athiththan
- Department of Biochemistry, Faculty of Medical SciencesUniversity of Sri JayewardenepuraNugegodaColomboSri Lanka
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Zhu L, Yang WJ, Spence CB, Bhimla A, Ma GX. Lean Yet Unhealthy: Asian American Adults Had Higher Risks for Metabolic Syndrome than Non-Hispanic White Adults with the Same Body Mass Index: Evidence from NHANES 2011-2016. Healthcare (Basel) 2021; 9:healthcare9111518. [PMID: 34828564 PMCID: PMC8618667 DOI: 10.3390/healthcare9111518] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/05/2021] [Accepted: 11/05/2021] [Indexed: 01/22/2023] Open
Abstract
(1) Background: Despite having consistently lower rates of obesity than other ethnic groups, Asian Americans (AAs) are more likely to be identified as metabolically obese, suggesting an ethnic-specific association between BMI and cardiometabolic outcomes. The goal of this study was to provide an estimate of metabolic syndrome (MetS) prevalence among AAs using national survey data and to compare this rate to that of non-Hispanic Whites (NHWs) over the BMI continuum. (2) Methods: Using the NHANES 2011–2016 data, we computed age-adjusted, gender-specific prevalence of MetS and its individual components for three BMI categories. Furthermore, we conducted multivariate binary logistic regression to examine the risk of MetS in AAs compared to NHWs, controlling for sociodemographic and lifestyle factors. The analysis sample consisted of 2121 AAs and 6318 NHWs. (3) Results: Among AAs, the prevalence of MetS and its components increased with higher BMI levels, with overall prevalence being 5.23% for BMI < 23, 38.23% for BMI of 23–27.4, and 77.68% for BMI ≥ 27.5 in men; and 18.61% for BMI < 23, 47.82% for BMI of 23–27.4, and 67.73% for BMI ≥ 27.5 in women. We also found that for those with a BMI > 23, AAs had a higher predicted risk of MetS than their NHW counterparts of the same BMI level, in both men and women. (4) Conclusions: Our findings support the use of lower BMI ranges for defining overweight and obesity in Asian populations, which would allow for earlier and more appropriate screening for MetS and may better facilitate prevention efforts.
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Affiliation(s)
- Lin Zhu
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, 3440 N. Broad St., Philadelphia, PA 19140, USA; (W.J.Y.); (A.B.); (G.X.M.)
- Correspondence:
| | - Wei J. Yang
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, 3440 N. Broad St., Philadelphia, PA 19140, USA; (W.J.Y.); (A.B.); (G.X.M.)
| | - Cody B. Spence
- Department of Sociology, College of Liberal Arts, Temple University, 1114 W. Berks St., Philadelphia, PA 19122, USA;
| | - Aisha Bhimla
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, 3440 N. Broad St., Philadelphia, PA 19140, USA; (W.J.Y.); (A.B.); (G.X.M.)
| | - Grace X. Ma
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, 3440 N. Broad St., Philadelphia, PA 19140, USA; (W.J.Y.); (A.B.); (G.X.M.)
- Department of Clinical Sciences, Lewis Katz School of Medicine, Temple University, 3440 N. Broad St., Philadelphia, PA 19140, USA
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Jayawardena R, Sooriyaarachchi P, Misra A. Abdominal obesity and metabolic syndrome in South Asians: prevention and management. Expert Rev Endocrinol Metab 2021; 16:339-349. [PMID: 34586004 DOI: 10.1080/17446651.2021.1982381] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/15/2021] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The prevalence of metabolic syndrome (MetS) and abdominal obesity are escalating in South Asian countries. It is well established that MetS is associated with increased risk for both Type 2 diabetes mellitus and cardiovascular diseases. South Asians have an increased risk of MetS due to a variety of factors including unhealthy lifestyle and their unique body composition. AREAS COVERED In this review, we discuss the prevalence, associated risk factors, and evidence-based preventive and curative strategies for MetS and abdominal obesity in South Asians. A literature search through PubMed®, Web of Science®, and Scopus® was performed for studies published before 31st April 2021. A combination of the following keywords was used with the names of the individual South Asian countries: 'metabolic syndrome,' 'syndrome X,' 'abdominal obesity,' 'central obesity,' 'visceral obesity,' 'prevention,' and 'management.' EXPERT OPINION According to current evidence, MetS and abdominal obesity are highly prevalent among South Asians. Several risk factors, such as lifestyle, socio-demography, cultural, and body composition, are associated with MetS. Limited research shows culturally tailored lifestyle interventions are effective in preventing and managing MetS and abdominal obesity among South Asians.
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Affiliation(s)
- Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
- School of Exercise & Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Piumika Sooriyaarachchi
- School of Exercise & Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Anoop Misra
- Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, Chirag Enclave, New Delhi, India
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Aldhafiri FK, Abdelgawad FE, Bakri GMM, Saber T. Thyroid Function Assessment in Saudi Males with Metabolic Syndrome. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2021; 13:352-359. [PMID: 35399801 PMCID: PMC8985841 DOI: 10.4103/jpbs.jpbs_745_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 12/06/2021] [Accepted: 12/14/2021] [Indexed: 11/04/2022] Open
Abstract
Background Metabolic Syndrome (MetS) is a multifactor condition associated with cardiovascular risk. Thyroid hormones regulate MetS components via controlling energy homeostasis, lipids, and glucose metabolism. The risk ratio for MetS and related disorders changes between males and females. Aim and Objectives: Study aim to access thyroid functions in Saudi population with metabolic syndrome. Materials and Methods The current study sought to evaluate the impact of thyroid stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) in predicting the risk of MetS. A total of 200 (MetS 100 and control 100) Saudi Arabian males were enrolled for the study, and after applying eligibility criteria, the eligible study size was examined for the physical test (chest, abdominal, and general examination with stress on blood pressure measurement) and anthropometric parameters (bodyweight, body mass index, and waist circumference). Results In the present study, the biochemical parameters, such as TSH, FT3, FT4, total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), high-density lipoprotein (LDL), fasting glucose, and fasting insulin were measured in the study group, and statistical analysis was also performed. The results revealed that the MetS and control differ in terms of physical, anthropometric, and biochemical markers. The study showed that thyroid dysfunction (TD) and MetS are closely associated with the difference in physical, anthropometric, and metabolic characteristics. Conclusion The result demonstrated hypothyroidism major risk factor due to TD in MetS. These findings provide a scientific basis for diagnosis and the management of TD, associated MetS, and cardiovascular disease (CVD).
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Affiliation(s)
- Fahad Khalid Aldhafiri
- Department of Public Health, College of Applied Medical Sciences, Majmaah University, Al Majmaah, Saudi Arabia
| | - Fathy Elsayed Abdelgawad
- Medical Biochemistry Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
- Department of Chemistry, Faculty of Science, Islamic University of Madinah, Madinah, KSA
| | | | - Tamer Saber
- Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Sharma AK, Baig VN, Ahuja J, Sharma S, Panwar RB, Katoch VM, Gupta R. Efficacy of IVRS-based mHealth intervention in reducing cardiovascular risk in metabolic syndrome: A cluster randomized trial. Diabetes Metab Syndr 2021; 15:102182. [PMID: 34330073 DOI: 10.1016/j.dsx.2021.06.019] [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: 11/27/2020] [Revised: 06/17/2021] [Accepted: 06/18/2021] [Indexed: 11/26/2022]
Abstract
AIMS Efficacy of mobile-phone based intervention for reducing cardiovascular risk in metabolic syndrome (MetSyn). METHODS We screened adults 20-60 years in 10 villages in India for MetSyn using stratified cluster sampling. Lifestyle and biochemical risk factors were assessed. International Harmonized Criteria were used for diagnosis. Villages were randomized with 5 each in control and intervention groups. Interactive voice response system (IVRS) in Hindi was developed. In intervention clusters two messages for promotion of healthy lifestyle and medical treatment were broadcast daily over 12-months and risk factors reassessed. RESULTS 1012/1200(84%) persons were screened and MetSyn diagnosed in 286(28.3%). Villages were divided into 5 control(n = 136) and 5 intervention(n = 147) clusters. Baseline characteristics in both clusters were similar. Acceptability of intervention was >60% in 80% participants. At 12 months, significantly greater participants in intervention vs control clusters had healthier lifestyle (healthy diet 28.8vs14.7%, physical activity 25.9vs13.1%, tobacco 13.7vs32.5%), anthropometry (waist circumference 85.7 ± 6.3vs88.6 ± 14.0 cm, body mass index 21.9 ± 2.8vs23.1 ± 2.9 kg/m2), systolic BP 123.6 ± 7.7vs128.6 ± 14.1 mmHg, fasting glucose 95.6 ± 19.4vs109.4 ± 43.7 mg/dl, cholesterol 175.5 ± 36.5vs186.4 ± 43.3 mg/dl, and triglycerides 147.6 ± 48.3vs159.5 ± 60.7 mg/dl (p < 0.01). Prevalence of metabolic syndrome declined in intervention group by 22.3%vs3.9%, p < 0.001). CONCLUSION An interactive voice response system based technology significantly reduced multiple cardiovascular risk factors and prevalence of metabolic syndrome.
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Affiliation(s)
- Arvind K Sharma
- Departments of Community Medicine, RUHS College of Medical Sciences, Jaipur, 302033, India.
| | - Vaseem Naheed Baig
- Departments of Community Medicine, RUHS College of Medical Sciences, Jaipur, 302033, India
| | - Jitendra Ahuja
- Departments of Biochemistry, RUHS College of Medical Sciences, Jaipur, 302033, India
| | - Sonali Sharma
- Departments of Biochemistry, RUHS College of Medical Sciences, Jaipur, 302033, India
| | - Raja Babu Panwar
- Academic Research Development Unit, Rajasthan University of Health Sciences, 302033, Jaipur, India
| | - Vishwa Mohan Katoch
- Academic Research Development Unit, Rajasthan University of Health Sciences, 302033, Jaipur, India
| | - Rajeev Gupta
- Academic Research Development Unit, Rajasthan University of Health Sciences, 302033, Jaipur, India
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Rodríguez-Vera D, Vergara-Castañeda A, Lazcano-Orozco DK, Ramírez-Vélez G, Vivar-Sierra A, Araiza-Macías MJ, Hernández-Contreras JP, Naranjo-Navarro CR, Salazar JR, Loza-Mejía MA, Pinto-Almazán R. Inflammation Parameters Associated with Metabolic Disorders: Relationship Between Diet and Microbiota. Metab Syndr Relat Disord 2021; 19:469-482. [PMID: 34402660 DOI: 10.1089/met.2021.0022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The metabolic syndrome (MetS) includes numerous interrelated clinical, anthropometric, biochemical, and metabolic components and has become a public health problem due to its impact on morbimortality. Inflammation is a central mechanism underlying the etiology and clinical manifestations of MetS, contributing to its related pathological outcomes. Dietary patterns have been associated with the promotion of the diversity of microbiota in the digestive tract. Recently, research has focused on the importance of microbiota changes associated with MetS and inflammation. Other studies have been performed to understand the impact of prebiotics, probiotics, and synbiotics as allies on diet, inflammation, and MetS parameters. This review analyses the correlation between metabolic disorders, inflammation parameters, gut microbiota, and how diet has been involved as treatment of MetS and the modulation of inflammation and microbiota.
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Affiliation(s)
- Diana Rodríguez-Vera
- Molecular Biology in Metabolic and Neurodegenerative Diseases Laboratory, Research Unit, High Specialty Regional Hospital of Ixtapaluca (HRAEI), Ixtapaluca, México.,Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional. Mexico City, Mexico
| | - Arely Vergara-Castañeda
- Basic and Clinical Health Sciences Research Group, Chemical Sciences School, Universidad La Salle-México, México City, Mexico
| | - Diana K Lazcano-Orozco
- Molecular Biology in Metabolic and Neurodegenerative Diseases Laboratory, Research Unit, High Specialty Regional Hospital of Ixtapaluca (HRAEI), Ixtapaluca, México
| | - Gabriela Ramírez-Vélez
- Design, Isolation, and Synthesis of Bioactive Molecules Research Group, Chemical Sciences School, Universidad La Salle-México, Mexico City, Mexico
| | - Alonso Vivar-Sierra
- Design, Isolation, and Synthesis of Bioactive Molecules Research Group, Chemical Sciences School, Universidad La Salle-México, Mexico City, Mexico
| | - María José Araiza-Macías
- Design, Isolation, and Synthesis of Bioactive Molecules Research Group, Chemical Sciences School, Universidad La Salle-México, Mexico City, Mexico
| | - José Patricio Hernández-Contreras
- Design, Isolation, and Synthesis of Bioactive Molecules Research Group, Chemical Sciences School, Universidad La Salle-México, Mexico City, Mexico
| | - Carlos Rogelio Naranjo-Navarro
- Design, Isolation, and Synthesis of Bioactive Molecules Research Group, Chemical Sciences School, Universidad La Salle-México, Mexico City, Mexico
| | - Juan Rodrigo Salazar
- Design, Isolation, and Synthesis of Bioactive Molecules Research Group, Chemical Sciences School, Universidad La Salle-México, Mexico City, Mexico
| | - Marco A Loza-Mejía
- Design, Isolation, and Synthesis of Bioactive Molecules Research Group, Chemical Sciences School, Universidad La Salle-México, Mexico City, Mexico
| | - Rodolfo Pinto-Almazán
- Molecular Biology in Metabolic and Neurodegenerative Diseases Laboratory, Research Unit, High Specialty Regional Hospital of Ixtapaluca (HRAEI), Ixtapaluca, México.,Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional. Mexico City, Mexico
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Obesity and Metabolic Care of Children of South Asian Ethnicity in Western Society. CHILDREN-BASEL 2021; 8:children8060447. [PMID: 34070381 PMCID: PMC8228459 DOI: 10.3390/children8060447] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/13/2021] [Accepted: 05/22/2021] [Indexed: 11/17/2022]
Abstract
South Asians constitute one-fourth of the world’s population and are distributed significantly in western countries. With exponentially growing numbers, childhood obesity is of global concern. Children of South Asian ancestry have a higher likelihood of developing obesity and associated metabolic risks. The validity of commonly used measures for quantifying adiposity and its impact on metabolic outcomes differ by race and ethnicity. In this review we aim to discuss the validity of body mass index (BMI) and other tools in screening for adiposity in South Asian children. We also discuss the prevalence of overweight and obesity amongst South Asian children in western countries and the differences in body fat percentage, adiposity distribution, and metabolic risks specific to these children compared to Caucasian children. South Asian children have a characteristic phenotype: lower lean mass and higher body fat percentage favoring central fat accumulation. Hence, BMI is a less reliable predictor of metabolic status in these children than it is for Caucasian children. Furthermore, the relatively lower birth weight and rapid growth acceleration in early childhood of South Asian children increase the risk of their developing cardiometabolic disorders at a younger age than that of Caucasians. We emphasize the need to use modified tools for assessment of adiposity, which take into consideration the ethnic differences and provide early and appropriate intervention to prevent obesity and its complications.
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Das RR, Mangaraj M, Nayak S, Satapathy AK, Mahapatro S, Goyal JP. Prevalence of Insulin Resistance in Urban Indian School Children Who Are Overweight/Obese: A Cross-Sectional Study. Front Med (Lausanne) 2021; 8:613594. [PMID: 33644095 PMCID: PMC7907002 DOI: 10.3389/fmed.2021.613594] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 01/19/2021] [Indexed: 02/06/2023] Open
Abstract
Background: Limited data are available for insulin resistance (IR) in over-weight/obese children from the Indian subcontinent. Identifying predictors of IR in this population is important, as they may be used as a screening tool for future metabolic complications. Materials and Methods: This school-based cross-sectional study was conducted in an Eastern Indian city. Anthropometry and blood pressure measurements were carried out as per the published guidelines. Venous blood samples were taken in a fasting state to measure plasma glucose, insulin, and lipid profile. IR was measured quantitatively by a homeostatic model of assessment (HOMA-IR). Results: A total of 545 (28.2%) children who were overweight or obese were included. The male:female ratio was 1:1.27. The overall prevalence of metabolic syndrome (MS) in these children was 21.8%. Around 32.3% of children had HOMA-IR of ≥2.5, and 22.2% had HOMA-IR of ≥3.16. The mean HOMA-IR in children with MS was 5.46 compared to 2.18 in those without MS. An increased risk of IR with low HDL, high triglyceride, increased waist circumference, and increased BP (both systolic and diastolic) was found. This means that insulin resistance was more common in children who were overweight or obesity and had underlying MS. Conclusions: The present school-based study found a high prevalence of insulin resistance among children who were overweight or obese. This could predict an increased risk of future adverse cardio-vascular events in the studied children. The findings of this study would help in planning and implementing primary prevention programs targeting weight management and lifestyle change in schoolchildren.
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Affiliation(s)
- Rashmi Ranjan Das
- Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, India
| | - Manaswini Mangaraj
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, India
| | - Saurav Nayak
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, India
| | - Amit Kumar Satapathy
- Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, India
| | - Samarendra Mahapatro
- Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, India
| | - Jagdish Prasad Goyal
- Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
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Concise perspectives on some synthetic thiazolidine-2,4-dione derivatives and their specific pharmacodynamic aspects. Life Sci 2021; 271:119182. [PMID: 33577851 DOI: 10.1016/j.lfs.2021.119182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 01/28/2021] [Accepted: 02/01/2021] [Indexed: 12/21/2022]
Abstract
Glitazones are synthetic derivatives of thiazolidinedione, and are designated as oral anti-diabetic agents, primarily acting on peroxisome proliferator-activated receptor-gamma (PPAR-γ) receptors and driving some crucial metabolic pathways linked to glucose and lipid metabolism at transcriptional level. Despite presenting adverse effects, including weight gain, fluid retention, prostate hyperplasia, hyperinsulinemia, and myocardial infarction, they are still preferred in clinical settings due to their utmost efficacy and selectivity. However, these complications kept glitazones restrained for long-term usage. The present review briefly highlights some important synthetic derivatives of thiazolidine2,4-dione and emphasizes the influence of various structural manipulations on their bio-efficacy.
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Meher T, Sahoo H. The epidemiological profile of metabolic syndrome in Indian population: A comparative study between men and women. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2020.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Balanova YA, Imaeva AE, Kutsenko VA, Kapustina AV, Muromtseva GA, Evstifeeva SE, Maksimov SA, Karamnova NS, Yarovaya EB, Shalnova SA, Drapkina OM. Metabolic syndrome and its associations with socio-demographic and behavioral risk factors in the Russian population aged 25-64 years. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2020. [DOI: 10.15829/1728-8800-2020-2600] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Aim. To assess the associations of metabolic syndrome (MS) with sociodemographic and behavioral factors in the Russian population aged 25-64 years.Material and methods. As part of the ESSE-RF 2 study, representative samples of the population of four Russian regions (Krasnodar Krai, Omsk and Ryazan Oblasts, Republic of Karelia) were examined: men (n=3011) and women (n=3721) aged 25-64 years. The response rate was approximately 80%. The study was approved by the Independent Ethics Committee of National Medical Research Center for Therapy and Preventive Medicine. All subjects were interviewed using a standard questionnaire. We analyzed the region and type of residence (urban/ rural area), age, educational level, marital and economic status, behavioral habits, and medical history data. Anthropometric measurements were performed. Blood pressure (BP) was measured with an Omron BP monitor. Lipid profile were assessed. MS was diagnosed according to the IDF criteria (2006). Statistical analysis was performed using the R 3.6.1 software package.Results. Abdominal obesity (AO) was found in 49,7% of men and 61,6% of women. Obesity according to body mass index was noted in 31,6% of subjects (men — 28,6% and women — 34%). MS prevalence in the entire sample was 33,0% and increased with age. In the group of subjects 35-44 years old, the prevalence of MS was significantly higher among men, and among those 55-64 years old — among women. We also found that AO in combination with two MS components was observed in 17,2% of participants; AO with three components — in 11,8%, AO with four components — in 4%. The highest prevalence of MS was noted in theRyazan region (men — 42,0%, women — 37,4%), the lowest — in theRepublic ofKarelia (men — 25,8%, women — 29,6%). In men, age-adjusted univariate logistic regression revealed significant associations of MS with former smoking, low physical activity, and alcohol abuse. Elevated BP and lipid profile abnormalities were significantly associated with low income level. AO was significantly associated with marriage. Similarly, the risk of diabetes and elevated blood glucose levels was lower in single men. Among women, the risk of MS was higher in those without higher education, with low income, smoking, and low consumption of vegetables and fruits. Women living in rural areas have a higher risk of AO and high BP. The risk of lipid metabolism disorders was higher among women with secondary education. Most of these associations were confirmed by multivariate analysis.Conclusion. MS was diagnosed in 33% of Russians aged 25-64 years. The proportion of people with MS increases with age, which, due to the life expectancy increase, suggests an increase in the total number of MS people. Risk factors associated with MS in women are smoking, insufficient consumption of vegetables and fruits, no higher education, and low income. In men, MS are associated with excessive alcohol consumption, smoking, and low physical activity. MS prevalence can be reduced by changing the lifestyle and habits, and if necessary, in combination with drug therapy.
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Affiliation(s)
- Yu. A. Balanova
- National Medical Research Center for Therapy and Preventive Medicine
| | - A. E. Imaeva
- National Medical Research Center for Therapy and Preventive Medicine
| | - V. A. Kutsenko
- National Medical Research Center for Therapy and Preventive Medicine;
Lomonosov Moscow State University
| | - A. V. Kapustina
- National Medical Research Center for Therapy and Preventive Medicine
| | - G. A. Muromtseva
- National Medical Research Center for Therapy and Preventive Medicine
| | - S. E. Evstifeeva
- National Medical Research Center for Therapy and Preventive Medicine
| | - S. A. Maksimov
- National Medical Research Center for Therapy and Preventive Medicine
| | - N. S. Karamnova
- National Medical Research Center for Therapy and Preventive Medicine
| | - E. B. Yarovaya
- National Medical Research Center for Therapy and Preventive Medicine;
Lomonosov Moscow State University
| | - S. A. Shalnova
- National Medical Research Center for Therapy and Preventive Medicine;
Lomonosov Moscow State University
| | - O. M. Drapkina
- National Medical Research Center for Therapy and Preventive Medicine
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Mahajan N, Kshatriya GK. Prevalence of metabolic syndrome and associated risk factors among tribal adolescents of Gujarat. Diabetes Metab Syndr 2020; 14:995-999. [PMID: 32622209 DOI: 10.1016/j.dsx.2020.06.040] [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: 08/31/2019] [Revised: 06/17/2020] [Accepted: 06/18/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND AIM Metabolic syndrome is rising at an alarming rate in developing countries. In India, increasing influence of urbanization in the rural areas is responsible for transition in lifestyle and diet of the indigenous people. Therefore, this study aims to estimate the prevalence of metabolic syndrome and the associated risk factors among the adolescents of Kukana tribe of Valsad district, Gujarat. METHODS A cross-sectional study was conducted on 296 adolescents (128 boys and 168 girls) aged 14-19 years. Semi-structure interview schedule including demographic characteristics like age, sex, clan, native village was administered. Anthropometric measurements (height, body weight, waist circumference), systolic and diastolic blood pressure, biochemical tests were recorded. Data was entered in MS-Excel, and SPSS was used to analyse descriptive statistics (mean and standard deviations), frequencies and test of significance such t-test and chi-square. Prevalence of metabolic syndrome and associated risk factors was determined by National Cholesterol Education Program Adult Treatment Panel III modified for adolescents by Cook's criteria. RESULTS Overall prevalence of metabolic syndrome was estimated as 3.8%, with sex-wise prevalence found to be 3.9% and 3.6% in boys and girls, respectively. Low High-Density Lipoprotein Cholesterol was the most prevalent individual risk factor observed in the present study. CONCLUSION This study is the first study which assessed metabolic syndrome and its components in tribal adolescents in India. Tribal communities are susceptible a triple burden of diseases. Micro-level and grassroot community-based studies should be designed and carried out in tribal communities, in order to provide better healthcare deliveries.
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Affiliation(s)
- Nupur Mahajan
- Department of Anthropology, University of Delhi, 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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Prasad M, Sawant S, Dhir AA. Comment on: Nutritional concerns of survivors of childhood cancer: A "First World" perspective; perspective from a low/middle-income country. Pediatr Blood Cancer 2020; 67:e28362. [PMID: 32386098 DOI: 10.1002/pbc.28362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 04/06/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Maya Prasad
- Division of Pediatric Oncology, Tata Memorial Centre, Mumbai, India.,Homi Bhabha National Institute, Mumbai, India
| | - Sheela Sawant
- Department of General Medicine, Tata Memorial Centre, Mumbai, India.,Homi Bhabha National Institute, Mumbai, India
| | - Aruna Alahari Dhir
- Department of General Medicine, Tata Memorial Centre, Mumbai, India.,Homi Bhabha National Institute, Mumbai, India
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Chowdhury MZI, Rahman M, Akter T, Akhter T, Ahmed A, Shovon MA, Farhana Z, Chowdhury N, Turin TC. Hypertension prevalence and its trend in Bangladesh: evidence from a systematic review and meta-analysis. Clin Hypertens 2020; 26:10. [PMID: 32514373 PMCID: PMC7262759 DOI: 10.1186/s40885-020-00143-1] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 03/26/2020] [Indexed: 02/08/2023] Open
Abstract
Background Hypertension, itself being a major chronic condition, is one of the most significant risk factors for premature cardiovascular diseases and mortality. Hypertension is responsible for 13% of global deaths and three-quarters of the world’s hypertensive population reside in low- and middle-income countries. Bangladesh is one of those countries that experiencing an epidemiological transition from communicable to non-communicable diseases, a nutritional transition from a traditional diet to process and fast food, and an increase in a sedentary lifestyle, resulting in increased hypertension prevalence. We carried out a systematic review and meta-analysis to identify existing research on hypertension prevalence in Bangladesh, summarize findings and assess its temporal change. Methods We searched MEDLINE, EMBASE and PubMed and relevant references to identify studies on the prevalence of hypertension in Bangladesh. We used Random-effects meta-analysis to pool the prevalence estimates and performed subgroup analyses. We assessed heterogeneity, a trend in prevalence of hypertension and publication bias in selected studies. Results Our search initially identified 735 articles and after removing duplicates, reviewing titles and abstracts, and screening full texts, 53 studies were finally selected. The studies comprised 305,432 subjects and reported overall, gender-specific, geographical location specific and criteria specific prevalence of hypertension. We identified the range of hypertension prevalence is from 1.10% to 75.0% and the overall weighted pooled prevalence of hypertension is 20.0%. An extremely high heterogeneity (I2 = 99.53%; Cochran Q-statistic p < 0.001) was observed in the prevalence of hypertension. Consequently, we performed subgroup analysis based on gender, age group and geographical location of the study participants, the cut-off level used to define hypertension, and the types of hypertension reported and presented our findings accordingly. An overall increasing trend of hypertension prevalence is also observed. Conclusions The prevalence of hypertension is high and rising in Bangladesh. Strategies targeting prevention are required to mitigate a further increase in the prevalence and reduce the morbidity and mortality associated with it.
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Affiliation(s)
- Mohammad Ziaul Islam Chowdhury
- Department of Community Health Sciences, University of Calgary, TRW Building (3rd Floor), 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6 Canada
| | - Meshbahur Rahman
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Tanjila Akter
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Tania Akhter
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Arifa Ahmed
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Minhajul Arifin Shovon
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Zaki Farhana
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Nashit Chowdhury
- Department of Family Medicine, University of Calgary, Calgary, Alberta Canada
| | - Tanvir C Turin
- Department of Family Medicine, University of Calgary, Calgary, Alberta Canada
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Dudi P, Goyal B, Saxena V, Rabari K, Mirza AA, Naithani M, Kumar T, Goyal R. Single point insulin sensitivity estimator as an index for insulin sensitivity for metabolic syndrome: A study in North Indian population. J Lab Physicians 2020; 11:244-248. [PMID: 31579190 PMCID: PMC6771329 DOI: 10.4103/jlp.jlp_163_18] [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] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND: Various indices for estimating insulin sensitivity, based on glucose tolerance test and fasting insulin levels, have been devised. However, they are laborious, time-consuming, and costly. Recently, a new index, single point insulin sensitivity estimator (SPISE) based on TG, high-density lipoproteins (HDL), and body mass index (BMI) was proposed in the European population and was found comparable to gold standard test. Decreased insulin sensitivity is a hallmark of metabolic syndrome (MetS). Hence, the current study was planned to determine the optimal cutoff of SPISE with high sensitivity and specificity in MetS patients of the North Indian population. MATERIALS AND METHODS: A community-based cross-sectional study including 229 MetS cases and 248 controls was conducted. MetS was defined according to the South Asian Modified National Cholesterol Education Program criteria. SPISE index was calculated for cases and controls using the formula devised by Paulmichl et al.: SPISE = 600 × HDL-C0.185/(TG0.2 × BMI1.338). Receiver operating characteristic (ROC) curve was plotted for determining optimal cutoff for SPISE in MetS. RESULTS: SPISE was significantly lower in MetS patients (5.35 ± 1.35) than that for controls (7.45 ± 2) with P < 0.05 (confidence interval [CI]: 1.79–2.41). ROC curve showed area under the curve = 0.83 for SPISE (P < 0.05, CI: 0.79–0.86), showing SPISE to have good predictive ability to discriminate MetS cases from controls. The cutoff value of SPISE index for predicting insulin sensitivity in MetS was found out to be 5.82 with sensitivity and specificity of 73% and 80%, respectively. This cutoff is lower than the European population (6.61), indicating higher insulin resistance (IR) in the study population. CONCLUSION: SPISE could be a useful potential low-cost indicator with high sensitivity and specificity for predicting IR in MetS.
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Affiliation(s)
- Parmila Dudi
- Department of Biochemistry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Bela Goyal
- Department of Biochemistry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Vartika Saxena
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Kamlesh Rabari
- Department of Biochemistry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Anissa Atif Mirza
- Department of Biochemistry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Manisha Naithani
- Department of Biochemistry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Tarun Kumar
- Department of Biochemistry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Rajeev Goyal
- Department of Biochemistry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.,Department of Biochemistry, Lady Hardinge Medical College, New Delhi, India
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Deng X, Wang P, Yuan H. Epidemiology, risk factors across the spectrum of age-related metabolic diseases. J Trace Elem Med Biol 2020; 61:126497. [PMID: 32247247 DOI: 10.1016/j.jtemb.2020.126497] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 02/13/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Population aging is dynamic process of increasing proportion of older adults in the total population, which is an inescapable result of decline in fertility rate and extension in life expectancy. Inevitably, age-related metabolic diseases, for example obesity, type 2 diabetes, metabolic syndrome, dyslipidemia, and nonalcoholic fatty liver disease, are becoming epidemic globally along with the demographic transition. CONTENT The review examines the literatures related to: 1) the epidemiology of age related metabolic diseases including obesity, type 2 diabetes, metabolic syndrome, dyslipidemia, and nonalcoholic fatty liver disease; and 2) the risk factors of age related metabolic diseases including genetic factors, diet, smoking, Physical activity, intestinal microbiota and environmental factors. CONCLUSION Population aging is becoming epidemic worldwide, resulting in increasing incidence and prevalence of a serious of age-related metabolic diseases. Both genetic and environmental factors contribute to the diseases, thus interventions targeting on these factors may have beneficial effect on the development of age-related metabolic diseases.
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Affiliation(s)
- Xinru Deng
- Department of Endocrinology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, 450003, China
| | - Pengxu Wang
- Department of Endocrinology, Henan University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, 450003, China
| | - Huijuan Yuan
- Department of Endocrinology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, 450003, China.
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Gomes SV, Dias BV, Pereira RR, de Pádua Lúcio K, de Souza DMS, Talvani A, Brandão GC, Cosenza GP, de Queiroz KB, Costa DC. Different source of commercial vegetable oils may regulate metabolic, inflammatory and redox status in healthy rats. J Funct Foods 2020. [DOI: 10.1016/j.jff.2020.103780] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
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Kulshreshtha B, Sharma N, Pant S, Prasad A, Chitkara A, Pahuja B, Pahuja I. Predictors of Metabolic Syndrome among Polycystic Ovary Syndrome Sisters. J Hum Reprod Sci 2020; 12:334-340. [PMID: 32038085 PMCID: PMC6937762 DOI: 10.4103/jhrs.jhrs_172_18] [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: 12/31/2018] [Revised: 04/15/2019] [Accepted: 09/24/2019] [Indexed: 11/04/2022] Open
Abstract
Aims Metabolic syndrome among PCOS sisters may vary depending on the phenotype. The aim of the present study was to analyze the prevalence of metabolic syndrome among different phenotypes of PCOS sisters. Design Case control study. Materials and Methods Two hundred sisters of PCOS patients and 99 age matched healthy controls underwent history, clinical examination, biochemical parameters for metabolic syndrome and hormonal assessment. Results Of 200 sisters, 85 were unaffected (UA group), 21 sisters had hyperandrogenemia (HA group), and 94 sisters had irregular periods or hyperandrogenemia. We observed that the frequency of metabolic syndrome among PCOS sisters was comparable to age and weight matched controls (30% vs 27%). The prevalence of metabolic syndrome was higher in HA and AFFECTED sisters (around 30% in both) compared to UA sisters (20%). The presence of metabolic syndrome was significantly associated with age, BMI, HOMA-IR and free testosterone. After correction for age and BMI, metabolic syndrome was significantly associated with HOMA-IR (P - 0.05) and free testosterone (P - 0.03). Conclusion Based on above findings, we conclude that affected sisters and those with higher age, BMI and hyperandrogenemia have a high risk of metabolic syndrome compared to unaffected sisters.
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Affiliation(s)
| | - Neera Sharma
- Department of Biochemistry, PGIMER, Dr. RML Hospital, New Delhi, India
| | - Shubhi Pant
- Department of Endocrinology, PGIMER, Dr. RML Hospital, New Delhi, India
| | - Akhila Prasad
- Department of Radiodiagnosis, PGIMER, Dr. RML Hospital, New Delhi, India
| | - Anubhuti Chitkara
- Department of Biochemistry, PGIMER, Dr. RML Hospital, New Delhi, India
| | - Bhawna Pahuja
- Department of Endocrinology, PGIMER, Dr. RML Hospital, New Delhi, India
| | - Isha Pahuja
- Department of Endocrinology, PGIMER, Dr. RML Hospital, New Delhi, India
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Sinha N, Mukhopadhyay S, Sau M. Metabolic syndrome is not uncommon among lean non-alcoholic fatty liver disease patients as compared with those with obesity. Indian J Gastroenterol 2020; 39:75-83. [PMID: 32314167 DOI: 10.1007/s12664-020-01020-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 02/04/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is associated with obesity, which is known to be associated with metabolic syndrome (MS). However, the risk factors for NAFLD in absence of obesity (leanness) is not well-studied. This study aimed to investigate and compare the clinical characteristics, metabolic associations, and cardiovascular risk factors among patients having NAFLD with (body mass index [BMI] ≥ 23 kg/m2) or without obesity (BMI < 23 kg/m2). METHODS The cross-sectional study was conducted among the outdoor and indoor patients diagnosed as NAFLD by ultrasonography in a tertiary care teaching hospital in eastern India. Relevant anthropometric measurements, laboratory investigations, and imaging were performed. Metabolic syndrome was classified by the "International Diabetes Federation, 2005" criteria. RESULTS Among 120 NAFLD patients, 37 (30.8%) were lean, while 83 (69.2%) were obese. The components of MS such as systolic blood pressure (lean, 138.0 ± 17.6 mmHg; obese, 137.9 ± 15.3 mmHg), diastolic blood pressure (lean, 88.9 ± 6.5 mmHg; obese, 87.3 ± 6.1 mmHg), fasting blood sugar (lean, 127.8 ± 30.8 mg/dL; obese, 135.1 ± 29.5 mg/dL), and serum triglyceride (lean, 170.5 ± 34.2 mg/dL; obese, 186.4 ± 43.8 mg/dL) were comparable among patients with obese and lean NAFLD and were more often abnormal among both the groups of NAFLD as compared with controls. CONCLUSION The overall prevalence of MS among NAFLD study population was 64.2%. Lean NAFLD was also associated with the component of MS like obese NAFLD.
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Affiliation(s)
- Nirmalya Sinha
- Community Medicine, Midnapore Medical College, Midnapore, 721 101, India
| | - Saptarshi Mukhopadhyay
- Department of General Medicine, Ramakrishna Mission Seva Pratishthan, Vivekananda Institute of Medical Sciences, Kolkata, 700 026, India
| | - Manabendra Sau
- Community Medicine, Midnapore Medical College, Midnapore, 721 101, 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. Indian J Endocrinol Metab 2020; 24:1-122. [PMID: 32699774 PMCID: PMC7328526 DOI: 10.4103/ijem.ijem_225_20] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- Rajeev Chawla
- North Delhi Diabetes Centre, Rohini, New Delhi, India
| | - S. V. Madhu
- Centre for Diabetes, Endocrinology and Metabolism, UCMS-GTB Hospital, New Delhi, India
| | - B. M. Makkar
- Dr. Makkar's Diabetes and Obesity Centre, Paschim Vihar, New Delhi, India
| | - Sujoy Ghosh
- Department of Endocrinology and Metabolism, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Banshi Saboo
- DiaCare - A Complete Diabetes Care Centre, Ahmedabad, Gujarat, India
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India
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Gill G, Lancki N, Randhawa M, Mann SK, Arechiga A, Smith RD, Soret S, Kanaya AM, Kandula N. Linkage between Neighborhood Social Cohesion and BMI of South Asians in the Masala Study. J Obes 2020; 2020:7937530. [PMID: 31998534 PMCID: PMC6969985 DOI: 10.1155/2020/7937530] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 08/11/2019] [Accepted: 08/20/2019] [Indexed: 11/17/2022] Open
Abstract
UNLABELLED Introduction. South Asians in the United States have a high prevalence of obesity and an elevated risk for cardiometabolic diseases. Yet, little is known about how aspects of neighborhood environment influence cardiometabolic risk factors such as body mass index (BMI) in this rapidly growing population. We aimed to investigate the association between perceived neighborhood social cohesion and BMI among South Asians. METHODS We utilized cross-sectional data from the MASALA study, a prospective community-based cohort of 906 South Asian men and women from the San Francisco Bay area and the greater Chicago area. Multivariable linear regression models, stratified by sex, were used to examine the association between perceived level of neighborhood social cohesion and individual BMI after adjusting for sociodemographics. RESULTS Participants were 54% male, with an average age of 55 years, 88% had at least a bachelor's degree, and the average BMI was 26.0 kg/m2. South Asian women living in neighborhoods with the lowest social cohesion had a significantly higher BMI than women living in neighborhoods with the highest cohesion (β coefficient = 1.48, 95% CI 0.46-2.51, p=0.02); however, the association was not statistically significant after adjusting for sociodemographic factors (β coefficient = 1.48, 95% CI 0.46-2.51, p=0.02); however, the association was not statistically significant after adjusting for sociodemographic factors (. CONCLUSION Perceived neighborhood social cohesion was not significantly associated with BMI among South Asians in our study sample. Further research is recommended to explore whether other neighborhood characteristics may be associated with BMI and other health outcomes in South Asians and the mechanisms through which neighborhood may influence health.
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Affiliation(s)
- Gagandeep Gill
- School of Public Health, Loma Linda University, Loma Linda, CA, USA
| | - Nicola Lancki
- Northwestern University Feinberg School of Medicine, Departments of Medicine and Preventive Medicine, Chicago, IL, USA
| | | | - Semran K. Mann
- School of Behavioral Health, Loma Linda University, Loma Linda, CA, USA
| | - Adam Arechiga
- School of Behavioral Health, Loma Linda University, Loma Linda, CA, USA
| | - Robin D. Smith
- School of Public Health, Loma Linda University, Loma Linda, CA, USA
| | - Samuel Soret
- School of Public Health, Loma Linda University, Loma Linda, CA, USA
| | | | - Namratha Kandula
- Northwestern University Feinberg School of Medicine, Departments of Medicine and Preventive Medicine, Chicago, IL, USA
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Malik MS, Qayyum W, Farooq A, Waqas A, Sukhera AB, Khalid MA, Baig AA. Dietary Patterns, Exercise, and the Metabolic Syndrome Among Young People in Urban Pakistan (Lahore). Metab Syndr Relat Disord 2019; 18:56-64. [PMID: 31638468 DOI: 10.1089/met.2019.0021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background: Increasing urbanization, mechanization, and rural-to-urban migration has led to deranged sleeping patterns, surplus energy intake, and sedentary lifestyles in South Asian young people. This shift poses an insidious health risk for the development of metabolic syndrome (MetS). Early detection is needed because in the South Asian population, this syndrome carries an increased risk of comorbidities compared to people without the syndrome. This study was designed to elucidate the prevalence of MetS and its risk factors in young people in urban areas of Pakistan. Methods: A cross-sectional study was conducted in four undergraduate institutions in Lahore, Pakistan. Five hundred and nine young people participated, and each provided their informed consent for the collection of data on their demographic, physical, and biochemical characteristics along with information on their dietary, sleep, and physical activity habits. Results: Most participants reported consuming greater-than-recommended amounts of protein and smaller-than-recommended amounts of vegetables and fruits. The International Diabetes Federation criteria for MetS were fulfilled by 6.1% of the students. Hypertension (67.7%) and hypo-HDL-emia (64.5%) were the most common risk factors. More than 50% of the respondents slept fewer hours per day than recommended, and 33% had a sedentary lifestyle. Men, participants with a family history of metabolic illness and those with low physical activity levels had higher odds of a positive result on screening for MetS. Conclusions: The early detection of MetS and early identification of probable risk factors may make beneficial contributions to both public health and clinical interventions directed at high-risk individuals. Establishing and using cutoff values for modified waist circumference and specific body mass index in Asian populations may aid in early detection.
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Affiliation(s)
| | - Wahhaj Qayyum
- Combined Military Hospital, Lahore, Punjab, Pakistan
| | - Ayesha Farooq
- Combined Military Hospital, Lahore, Punjab, Pakistan
| | - Ahmed Waqas
- Combined Military Hospital, Lahore, Punjab, Pakistan
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Lee CH, Kuo FC, Tang WH, Lu CH, Su SC, Liu JS, Hsieh CH, Hung YJ, Lin FH. Serum E-selectin concentration is associated with risk of metabolic syndrome in females. PLoS One 2019; 14:e0222815. [PMID: 31550292 PMCID: PMC6759160 DOI: 10.1371/journal.pone.0222815] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 09/06/2019] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES Traits of metabolic syndrome (MetS) and biomarkers of inflammation and endothelial dysfunction were examined. We investigated the differences of various biomarkers among individuals with or without Mets in a gender-specific manner. The gender-specific associations between E-selectin and MetS were further evaluated. METHODS A total of 205 patients were recruited from the outpatient clinics of Tri-Service General Hospital, Taipei, Taiwan. Inclusion criteria were age between 20-75 years and BMI < 35 kg/m2. Demographic, anthropometric and MetS index data were compared between genders. Markers of inflammation and endothelial dysfunction were compared between individuals with or without MetS by gender. RESULTS Age-adjusted E-selectin values showed significant positive correlations with BMI, waist-hip ratio, fasting plasma glucose, systolic and diastolic blood pressure, triglycerides, TNF-α, hsCRP and ICAM-1, and inverse correlation with HDL cholesterol. E-selectin levels were positively correlated with numbers of MetS components in females (P < 0.001) but not in males (P = 0.125). CONCLUSIONS Increased E-selectin levels are significantly associated with increased MetS risk in females, but not in males.
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Affiliation(s)
- Chien-Hsing Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Feng-Chih Kuo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Wen-Hao Tang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, Song Shan Branch, Taipei, Taiwan, ROC
| | - Chieh-Hua Lu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Sheng-Chiang Su
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Jhih-Syuan Liu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Chang-Hsun Hsieh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Yi-Jen Hung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, Song Shan Branch, Taipei, Taiwan, ROC
| | - Fu-Huang Lin
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC
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Akbarzadeh M, Naderi T, Dabbaghmanesh MH. The glucose metabolism disorder and dyslipidemia among girls with different phenotype polycystic ovary syndrome. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2019; 24:72. [PMID: 31523258 PMCID: PMC6734671 DOI: 10.4103/jrms.jrms_804_16] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 05/23/2018] [Accepted: 05/01/2019] [Indexed: 12/13/2022]
Abstract
Background: This study aimed to determine the prevalence of glucose metabolism disorder and dyslipidemia in 14–18-year-old girls with different phenotype polycystic ovary syndrome (PCOS). Materials and Methods: This descriptive, cross-sectional study was conducted on 3200 high-school adolescents aged 14–18 years in Shiraz in 2010. Selected parameters of metabolic syndrome (fasting blood glucose, glucose tolerance test [GTT], insulin level, triglyceride (TG), cholesterol, and high-density lipoprotein [HDL]), based on adult treatment panel Ш definition criteria, were compared between the “PCOS” and control groups. Results: Results were compared at four main phenotypes. The level of serum TG was increased in the Phenotype B (P = 0.03) and Phenotype D (P = 0.01), compared to the control group. Cholesterol and low-density lipoprotein levels (P < 0.05) and GTT (P > 0.05) were increased, and HDL was decreased (was below 50) in all the four phenotypes and the control group (P > 0.05). Conclusion: The risk of metabolic alterations of glucose metabolism disorder and dyslipidemia in PCOS adolescents was more than non-PCOS counterparts.
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Affiliation(s)
- Marzieh Akbarzadeh
- Department of Midwifery, Maternal-Fetal Medicine Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Tahereh Naderi
- Community Based Psychiatric Care Research Centre, Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad H Dabbaghmanesh
- Department of Internal Medicine, Endocrine and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Wells JC, Saunders MA, Lea AS, Cortina-Borja M, Shirley MK. Beyond Bergmann's rule: Global variability in human body composition is associated with annual average precipitation and annual temperature volatility. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2019; 170:75-87. [PMID: 31318051 DOI: 10.1002/ajpa.23890] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 06/11/2019] [Accepted: 06/15/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Human populations exhibit substantial geographical variability in body size and shape. However, the ecological stresses underlying this morphological variability remain poorly understood. The prevailing evolutionary explanation, "Bergmann's rule" assumes that morphological variability represents an adaptive response to average thermal conditions. We hypothesized that other climate factors-annual average precipitation, a marker of ecological productivity and inter-annual temperature volatility, a marker of infectious disease spikes-may also contribute to variability in body composition. MATERIALS AND METHODS We explored this hypothesis by examining associations between these climate factors and geographic variability in body composition across 133 male and 105 female populations from nonindustrialized settings. We used monthly climate data over 113 years (1901-2013) to develop new climate indices for all worldwide land areas. We stratified our analyses by hot/cold setting (>/<20°C). RESULTS In hot environments, lean mass increased as predicted in association with ecological productivity, and decreased in association with ecological volatility. Conversely, levels of body fat increased in association with temperature volatility and precipitation. However, in cold settings, equivalent associations were only partially consistent with our hypotheses, and there was suggestive evidence of sex differences in these associations. DISCUSSION Beyond associations with mean annual temperature predicted by Bergmann's rule, variability in human body composition is also associated with mean annual temperature and inter-annual temperature volatility, with these associations further differing between hot and cold settings. Collectively, our results suggest that associations of human body composition with climate are complex for both physique (fat-free mass) and energy stores (adiposity).
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Affiliation(s)
- Jonathan C Wells
- Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Mark A Saunders
- Department of Space and Climate Physics, University College London, Surrey, UK
| | - Adam S Lea
- Department of Space and Climate Physics, University College London, Surrey, UK
| | - Mario Cortina-Borja
- Population, Policy & Practice Programme, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Meghan K Shirley
- Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, London, UK.,Nutrition Department, University of São Paulo, São Paulo, Brazil
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Rajput R, Rajput M, Mishra S, Ahlawat P. Prevalence of Metabolic Syndrome in Prediabetes. Metab Syndr Relat Disord 2019; 17:406-410. [PMID: 31305207 DOI: 10.1089/met.2019.0010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Aims: To study the prevalence of metabolic syndrome and its components in prediabetes and to compare the anthropometric indices [waist circumference (WC), hip circumference, waist-hip ratio, waist-height ratio] as predictors of metabolic syndrome in prediabetes. Methods: A total of 300 subjects (200 prediabetic cases and 100 matched normoglycemic controls) in the age group of 18-70 years were recruited for the study. Among the cases, there were 38% of males and 62% of females; and there were 33% of males and 67% of females in the control group. Prediabetes was diagnosed using the American Diabetic Association (ADA) criteria, and metabolic syndrome was diagnosed using the International Diabetes Federation criteria. Results: Prevalence of metabolic syndrome was 63% among the cases and 26% among the normoglycemic controls. Among cases, 56.5% of males and 66.9% of females, and among the controls, 36.3% of males and 20.9% of females had metabolic syndrome. The prevalence of metabolic syndrome increased with age and increasing body mass index among both the cases and controls. Central obesity was found to be the most common component of metabolic syndrome among prediabetic males (80.2%) and females (82.2%). The most common cluster of abnormality among the cases and controls was found to be increased WC plus low high-density lipoprotein plus increased triglycerides. Logistic regression analysis was applied to anthropometric indices, and it was found that increased WC had the maximum predictive power for metabolic syndrome among the subjects with prediabetes. Conclusion: Metabolic syndrome was more prevalent in the prediabetic population in comparison to the normoglycemic individuals with increased WC being the most prevalent component. Increased WC had the maximum predictive power for occurrence of metabolic syndrome among prediabetic subjects.
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Affiliation(s)
- Rajesh Rajput
- Department of Endocrinology, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
| | - Meena Rajput
- Department of Social and Preventive Medicine, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
| | - Sanat Mishra
- Department of Medicine, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
| | - Parul Ahlawat
- Department of Medicine, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
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Paudel S, Owen AJ, Owusu-Addo E, Smith BJ. Physical activity participation and the risk of chronic diseases among South Asian adults: a systematic review and meta-analysis. Sci Rep 2019; 9:9771. [PMID: 31278314 PMCID: PMC6611898 DOI: 10.1038/s41598-019-46154-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 06/24/2019] [Indexed: 01/05/2023] Open
Abstract
South Asia specific reviews on the role of physical activity (PA) domains on chronic disease prevention are lacking. This study aimed to systematically review published literature to identify the association between PA domains and chronic diseases and to provide summary estimates of the strength of association. Nine electronic databases were searched using the predefined inclusion criteria which included population (South Asian adults 40 years or older), exposure (PA or sedentary behaviour) and outcome (type 2 diabetes mellitus, breast cancer, colorectal cancer, coronary heart disease, stroke, vascular disease and musculoskeletal diseases and their markers). A random-effects meta-analysis was carried out for cardiometabolic outcomes whereas narrative synthesis was completed for other outcome variables. Inactive or less active South Asian adults were at 31% higher risk of being hypertensive. Likewise, the risk of cardiometabolic outcomes was 1.34 times higher among inactive adults. Household PA was found to have a protective effect on breast cancer risk. Total and leisure time PA had a protective effect on osteoporosis among males and females respectively. Contemporary studies with a longitudinal design, representative samples, valid and reliable assessment of different domains are needed to establish the role of PA in chronic disease prevention in the region.
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Affiliation(s)
- Susan Paudel
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Alice J Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Ebenezer Owusu-Addo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Bureau of Integrated Rural Development, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana
| | - Ben J Smith
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
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Bhosale VV, Singh S, Srivastava M, Pathak P, Prakash S, Sonkar S, Misra AK, Misra R, Ghatak A. A case control study of clinical and biochemical parameters of metabolic syndrome with special attention among young and middle aged population. Diabetes Metab Syndr 2019; 13:2653-2659. [PMID: 31405690 DOI: 10.1016/j.dsx.2019.07.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 07/10/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Metabolic syndrome (MS) increases the risk of heart disease, stroke, and other complications. AIM The aim of this study was to assess the clinical and biochemical parameters of MS and its complications (cerebrovascular accidents, cardiovascular accidents, DN or chronic kidney disease (CKD) compared with healthy controls especially among the younger population in Northern India. MATERIAL AND METHODS A total of 245 (healthy, MS and it's complicated) aged 18-70 years participated in the Open-Label, Single Centered; hospital-based random selection case-control comparative study. All anthropometric and biochemical assessment was done after proper consent. The metabolic syndrome was determined by IDF criteria. RESULTS The key risk parameters in three groups i.e. Control, Metabolic syndrome, and Complicated was TG (96.5 ± 46.9, 194.1 ± 87.8, 148.0 ± 102.2). LDL (91.2 ± 27.2, 114.0 ± 31.8, 69.1 ± 42.5, BP (120.1 ± 9.9, 139.3 ± 13.3, 132.1 ± 15.0) and high fasting glucose (81.1 ± 13.7, 164.5 ± 84.3, 138.0 ± 74.5). The hs-CRP is also significantly increased in the complicated group. The subanalysis of data also indicates that younger middle age (36-55 years) group both male and female is obese, hypertensive, diabetic with lipid abnormality according to IDF criteria. CONCLUSION The risk factors like high TG, low HDL, high BP, and high fasting glucose were found higher particularly in younger population which may lead to diagnosis & complications of diabetes, hypertension and lipid abnormality. Due to changing physiology in young and middle age population these individuals are moving towards metabolic syndrome easily and needs frequent monitoring, preventive checkups, and lifestyle changes to prevent complications.
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Affiliation(s)
- Vivek V Bhosale
- Department of Toxicology and Experimental Medicine, CSIR-Central Drug Research Institute, Sector 10, Jankipuram Vistar, Lucknow, 226031, India.
| | - Shail Singh
- Department of Toxicology and Experimental Medicine, CSIR-Central Drug Research Institute, Sector 10, Jankipuram Vistar, Lucknow, 226031, India
| | - Mukesh Srivastava
- Department of Toxicology and Experimental Medicine, CSIR-Central Drug Research Institute, Sector 10, Jankipuram Vistar, Lucknow, 226031, India
| | - Priyanka Pathak
- Department of Toxicology and Experimental Medicine, CSIR-Central Drug Research Institute, Sector 10, Jankipuram Vistar, Lucknow, 226031, India
| | - Shakti Prakash
- Department of Toxicology and Experimental Medicine, CSIR-Central Drug Research Institute, Sector 10, Jankipuram Vistar, Lucknow, 226031, India
| | - Satyendra Sonkar
- Department of Medicine, King George Medical University, Chowk, Lucknow, 226003, India.
| | - Arvind K Misra
- Department of Medicine, King George Medical University, Chowk, Lucknow, 226003, India
| | - Ravi Misra
- Department of Medicine, King George Medical University, Chowk, Lucknow, 226003, India
| | - Ashim Ghatak
- Division of Clinical and Experimental Medicine, CSIR-Central Drug Research Institute, Sector 10, Jankipuram Vistar, Lucknow, 226031, India
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Vendhan R, Amutha A, Anjana RM, Unnikrishnan R, Mohan V. Clinical profile of nonalcoholic Fatty liver disease among young patients with type 1 diabetes mellitus seen at a diabetes speciality center in India. Endocr Pract 2019; 20:1249-57. [PMID: 25100370 DOI: 10.4158/ep14044.or] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To estimate the prevalence and clinical profile of nonalcoholic fatty liver disease (NAFLD) among young type 1 diabetes mellitus (T1DM) patients at a tertiary care diabetes center in India. METHODS Electronic medical records of T1DM patients (age at first diagnosis of T1DM ≤25 years) registered between January 1992 and May 2013 who had undergone ultrasonography and denied history of any alcohol intake (n = 736) were reviewed. NAFLD was diagnosed if there was any degree of fatty liver. Retinopathy was initially assessed by direct and indirect ophthalmoscopy and later by retinal photography. Nephropathy was diagnosed if urine protein excretion was >500 mg/day, and neuropathy was diagnosed if a patient's vibration perception threshold on biothesiometry was ≥20 V. RESULTS A total of 204/736 (27.7%) T1DM patients had NAFLD. Compared to T1DM subjects without NAFLD those with NAFLD had higher body mass index (BMI) (18.9 ± 4.2 vs. 20.2 ± 4.7 kg/m2, P<.001), waist circumference (67.9 ± 13.2 vs. 71.9 ± 13.3 cm, P<.05), systolic blood pressure (110 ± 15 vs. 116 ± 18 mm Hg, P<.001) and diastolic blood pressure (72 ± 9 vs. 74 ± 10 mm Hg, P<.05), while fasting blood glucose (201 ± 101 vs. 183 ± 101 mg/dL, P<.05) and alkaline phosphatase (419 [12.5] vs. 315 [15.8], P<.001) levels were lower in patients with T1DM with NAFLD. Multiple logistic regression analysis showed a significant association between NAFLD and retinopathy (odds ratio [OR]: 2.01, 95% confidence interval [CI]: 1.13-3.43; P = .017, after adjusting for sex, duration of diabetes, overweight/obesity, hypertension, fasting plasma glucose, nephropathy, and nephropathy (OR: 1.89, 95% CI: 1.02-3.50; P = .042), after adjusting for sex and fasting plasma glucose. CONCLUSIONS This study suggests that NAFLD is also seen among T1DM patients and that it has an independent and significant association with retinopathy and nephropathy.
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Affiliation(s)
- Ramanujam Vendhan
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, Gopalapuram, Chennai, India
| | - Anandakumar Amutha
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, Gopalapuram, Chennai, India
| | - Ranjit Mohan Anjana
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, Gopalapuram, Chennai, India
| | - Ranjit Unnikrishnan
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, Gopalapuram, Chennai, India
| | - Viswanathan Mohan
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, Gopalapuram, Chennai, India
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Kant R, Khapre M. Profile of Metabolic Syndrome in Newly Detected Hypertensive Patients in India: An Hospital-Based Study. Int J Appl Basic Med Res 2019; 9:32-36. [PMID: 30820417 PMCID: PMC6385532 DOI: 10.4103/ijabmr.ijabmr_108_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Metabolic syndrome (MetS) is recognized as an emerging threat and interest of public health because the factors defining syndrome are associated with increased risk of mortality and morbidity. Hypertension further adds to risk factor leading to target organ damage. Recognizing the MetS in patients with hypertension provides a great opportunity for more aggressive treatment. Objective The objective of the study is to estimate the prevalence and evaluate the metabolic profile of MetS in newly diagnosed adult hypertensive participants. Methodology This is an hospital-based cross-sectional study. A total of 400 participants with newly detected essential hypertension were included in the study after detailed medical and laboratory investigations done to exclude the secondary hypertension. After the informed consent, a structured proforma was filled containing the demographic data; medical history; physiological parameters such as blood pressure, height, weight, and waist circumference; some laboratory investigations such as lipid profile and fasting blood glucose. Descriptive statistics such as mean and proportion were used. To compare the proportions, Chi-square test was used. Kappa agreement was utilized to know the level of agreement between various criteria defining MetS. Results The prevalence of MetS according to the International Diabetes Federation criteria in the new hypertensive study participants was 50.5% more common in females. One-fourth of young hypertensives was having MetS. Hypertensive patients with MetS show risk factors at significantly higher range than their counterparts. High-density lipoprotein was the most common risk factor present apart from increased waist circumference. There was a wide variation in the prevalence of MetS in the Indian population by different criteria. Conclusion Half of the new hypertensive patients had MetS and thus it becomes very important to screen all the hypertensives at the onset for MetS and treat them aggressively to decrease the cardiovascular events.
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Affiliation(s)
- Ravi Kant
- Department of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Meenakshi Khapre
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Viswanathan V, Krishnan D, Kalra S, Chawla R, Tiwaskar M, Saboo B, Baruah M, Chowdhury S, Makkar BM, Jaggi S. Insights on Medical Nutrition Therapy for Type 2 Diabetes Mellitus: An Indian Perspective. Adv Ther 2019; 36:520-547. [PMID: 30729455 PMCID: PMC6824451 DOI: 10.1007/s12325-019-0872-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Indexed: 02/07/2023]
Abstract
It is critical to integrate medical nutrition therapy (MNT) provided by a registered dietician (RD) into primary care of type 2 diabetes mellitus (T2DM). This is necessary to achieve the goals of improving overall metabolic measures beyond calorie restriction and weight loss. Misconceptions about nutrition in T2DM add to the challenges of executing MNT in a culturally sensitive population. The current review provides insights into MNT for the prevention and management of T2DM in India, based on both evidence and experience. It revisits historical Indian studies and provides information on appropriate dietary intake of carbohydrates (60-70%), proteins (~ 20%) and fats (10%) that will be acceptable and beneficial in an Indian T2DM population. It discusses nuances of types of carbohydrates and fats and explains associations of increased dietary fiber intake, balanced intake of low and high glycemic index foods and substitution of saturated fats with plant-based polyunsaturated fats in improving outcomes of T2DM and attenuating risk factors. The article also deliberates upon special patient populations with comorbid conditions and diseases and the necessary adjustments needed in their nutritional care. It outlines a step-wise approach to MNT involving a careful interplay of nutrition assessment, diagnosis, individualization and patient counseling. Overall, the success of MNT relies on providing accurate, acceptable and appropriate dietary choices for continued patient adherence. Collaborative efforts from diabetologists, endocrinologists, internists and RDs are required to prioritize and implement MNT in diabetes practice in India.Funding: Signutra Inc.
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Affiliation(s)
- Vijay Viswanathan
- M.V. Hospital for Diabetes and Prof. M. Viswanathan Diabetes Research Centre (WHO Collaborating Centre for Research, Education and Training in Diabetes), Chennai, Tamil Nadu, India
| | | | - Sanjay Kalra
- Bharti Research Institute of Diabetes & Endocrinology (BRIDE), Karnal, Haryana, India.
| | | | | | - Banshi Saboo
- Dia Care-Diabetes and Hormone Centre, Ahmedabad, Gujarat, India
| | | | - Subhankar Chowdhury
- Institute of Postgraduate Medical Education and Research/SSKM Hospital, Kolkata, India
| | - B M Makkar
- Diabetes and Obesity Center, New Delhi, India
| | - Shalini Jaggi
- Dr. Mohan's Diabetes Specialties Centre, New Delhi, India
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50
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Sadananthan SA, Tint MT, Michael N, Aris IM, Loy SL, Lee KJ, Shek LPC, Yap FKP, Tan KH, Godfrey KM, Leow MKS, Lee YS, Kramer MS, Gluckman PD, Chong YS, Karnani N, Henry CJ, Fortier MV, Velan SS. Association Between Early Life Weight Gain and Abdominal Fat Partitioning at 4.5 Years is Sex, Ethnicity, and Age Dependent. Obesity (Silver Spring) 2019; 27:470-478. [PMID: 30707510 PMCID: PMC6392178 DOI: 10.1002/oby.22408] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 11/28/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the independent associations between age-specific annual weight gain from birth to age 4 years and fat deposition in metabolically distinct compartments at age 4.5 years in a South Asian longitudinal birth cohort. METHODS Volumetric abdominal magnetic resonance imaging with comprehensive segmentation of deep and superficial subcutaneous adipose tissue (SAT) and visceral adipose tissues (VAT) was performed in 316 children (150 boys and 166 girls in three ethnic groups; 158 Chinese, 94 Malay, and 64 Indian) aged 4.5 years. Associations between fat volumes and annual relative weight gain conditional on past growth were assessed overall and stratified by sex and ethnicity. RESULTS Conditional relative weight gain had stronger associations with greater SAT and VAT at age 4.5 years in girls than boys and in Indians compared with Malay and Chinese. Overall, the magnitude of association was the largest during 2 to 3 years for SAT and 1 to 2 years for VAT. Despite similar body weight, Indian children and girls had the highest deep and superficial SAT volumes at age 4.5 years (all interactions P < 0.05). No significant sex or ethnic differences were observed in VAT. With increasing BMI, Indian children had the highest tendency to accumulate VAT, and girls accumulated more fat than boys in all depots (all interactions P < 0.001). CONCLUSIONS Indian ethnicity and female sex predisposed children to accumulate more fat in the VAT depot with increasing conditional relative weight gain in the second year of life. Thus, 1 to 2 years of age may be a critical window for interventions to reduce visceral fat accumulation.
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Affiliation(s)
- Suresh Anand Sadananthan
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
| | - Mya Thway Tint
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Navin Michael
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
| | - Izzuddin M Aris
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
| | - See Ling Loy
- Department of Reproductive Medicine, KK Women’s and Children’s Hospital, Singapore
- Duke-NUS Medical School, Singapore
| | - Kuan Jin Lee
- Singapore BioImaging Consortium, Agency for Science Technology and Research, Singapore
| | - Lynette Pei-Chi Shek
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Fabian Kok Peng Yap
- Duke-NUS Medical School, Singapore
- Department of Paediatric Endocrinology, KK Women’s and Children’s Hospital, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Kok Hian Tan
- Duke-NUS Medical School, Singapore
- Department of Obstetrics and Gynaecology, KK Women’s and Children’s Hospital, Singapore
| | - Keith M. Godfrey
- MRC Lifecourse Epidemiology Unit & NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Melvin Khee-Shing Leow
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science Technology and Research and National University Health System, Singapore
- Department of Endocrinology, Tan Tock Seng Hospital, Singapore
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Michael S. Kramer
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Departments of Pediatrics and of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, Canada
| | - Peter D. Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Neerja Karnani
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
| | - Christiani Jeyakumar Henry
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science Technology and Research and National University Health System, Singapore
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Marielle Valerie Fortier
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
- Department of Diagnostic and Interventional Imaging, KK Women’s and Children’s Hospital, Singapore
| | - S. Sendhil Velan
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
- Singapore BioImaging Consortium, Agency for Science Technology and Research, Singapore
- Corresponding author: S. Sendhil Velan, Singapore Institute for Clinical Sciences and Singapore Bioimaging Consortium, 11 Biopolis Way, #02-02, Singapore 138667. Phone: +65 64788757,
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