Anthropometric indicators as predictor of pre-diabetes in Indian adolescents

Lifestyle practices predisposing adolescents to non communicable diseases in Delhi

Background

Globally the prevalence of non- communicable diseases is on a rise. Adolescents are vulnerable to such diseases later on in life because of the susceptibility to behavioural risk factors like insufficient physical activity, unhealthy dietary practices and tobacco and alcohol consumption during this transition stage of their life. Adolescents who are from low-income families are also at increased risk of dual states of malnutrition such as underweight and obesity. So, this study aimed to estimate the prevalence of such behavioural risk factors among adolescents of low-income urban areas of Delhi.

Methodology

A cross-sectional study was conducted among 264 adolescents (10-19 years) of low-income Urban areas of Delhi.

Results

A total of 122 (46.2%) boys and 142 (53.8%) girls were enrolled in the study. The mean age of adolescents were 14.2 ± 2.4 years. The most prevalent NCD risk factor was physical inactivity (98.1% [96.4-99.7])). The screen time for television was significantly higher among boys than girls (p value 0.022). An age stratified analysis of risk factors showed that the intake of carbonated drinks (p value 0.026) and social media utilisation time (p value 0.037) was significantly higher among late adolescent boys (≥15 years) compared to early adolescents.

Conclusion

There is high prevalence of physical inactivity and unhealthy dietary behaviours among adolescents which could be a warning sign for prompt actions as they are at risk of NCD in future. Hence healthier practices should be promoted among adolescents at community level.

A Mediterranean-Diet-Based Nutritional Intervention for Children with Prediabetes in a Rural Town: A Pilot Randomized Controlled Trial

Prediabetes is a pathological condition in which the blood glucose concentration is higher than normal concentrations but lower than those considered necessary for a type 2 diabetes mellitus diagnosis. Various authors have indicated that the Mediterranean Diet is one of the dietary patterns with the most healthy outcomes, reducing high levels of HbA1c, triglycerides, BMI, and other anthropometric parameters. The main objective of this study was to determine the efficacy of the nutritional intervention for children with prediabetes, including the effectiveness of this nutritional education regarding anthropometric parameters. A randomized pilot trial with two groups, an experimental group (EG) and a control group (CG), using intervention in dietary habits with nutritional reinforcement was carried out on 29 children with prediabetes from a rural area. The nutritional intervention was analyzed through astrophotometric and glycemic measurements and validated surveys. Results: The results indicated improvement in eating habits, adherence to the Mediterranean diet, anthropometric measurements, mainly body mass index and perimeters, and analytical parameters, with a significant decrease in glycated hemoglobin in the EG compared to the CG (p < 0.001). Although the results showed that both groups’ anthropometric parameters improved, a more significant decrease was observed in the experimental group compared to the control.

Body impedance analyzer and anthropometric indicators; predictors of metabolic syndrome

Aim

Metabolic syndrome is one of the outcomes of a sedentary lifestyle in the modern world. In this study, we want to introduce the predictors of metabolic syndrome using anthropometric indices and Bio-Electrical Impedance Analysis (BIA) test values.

Method

This cross-sectional study was performed on 2284 employees of Tehran University of Medical Sciences in different job categories. Metabolic syndrome was determined according to IDF criteria. Anthropometric dimensions, para-clinical tests, basic information were collected from the participants. Also, the body analysis of the participants was performed using a BIA method.

Result

The prevalence of metabolic syndrome in this study was 23.2% based on IDF criteria, which was 21% and 26.6% in men and women, respectively. The most important factor among the components of IDF criteria was HDL deficiency. In this study, neck circumference, fat mass, visceral fat, muscle mass percentage and waist to height ratio were observed as predictors of metabolic syndrome.

Conclusion

This study realized that there is association between fat mass, fat-free mass, visceral fat and muscle mass which all are some elements of body composition analysis and metabolic syndrome as a major health issue.

Baseline risk factor prevalence among adolescents aged 15-17 years old: findings from National Non-communicable Disease Monitoring Survey (NNMS) of India

OBJECTIVE

To generate national estimates of key non-communicable disease (NCD) risk factors for adolescents (15-17 years) identified in the National NCD Monitoring Framework and, study the knowledge, attitudes and practices towards NCD risk behaviours among school-going adolescents.

DESIGN AND SETTING

A community-based, national, cross-sectional survey conducted during 2017-2018. The survey was coordinated by the Indian Council of Medical Research-National Centre for Disease Informatics and Research with 10 reputed implementing research institutes/organisations across India in urban and rural areas.

PARTICIPANTS

A multistage sampling design was adopted covering ages between 15 and 69 years-adolescents (15-17 years) and adults (18-69 years). The sample included 12 000 households drawn from 600 primary sampling units. All available adolescents (15-17 years) from the selected households were included in the survey.

MAIN OUTCOME MEASURES

Key NCD risk factors for adolescents (15-17 years)-current tobacco and alcohol use, dietary behaviours, insufficient physical activity, overweight and obesity.

RESULTS

Overall, 1402 households and 1531 adolescents completed the survey. Prevalence of current daily use of tobacco was 3.1% (95% CI: 2.0% to 4.7%), 25.2% (95% CI: 22.2% to 28.5%) adolescents showed insufficient levels of physical activity, 6.2% (95% CI: 4.9% to 7.9%) were overweight and 1.8% (95% CI: 1.0% to 2.9%) were obese. Two-thirds reported being imparted health education on NCD risk factors in their schools/colleges.

CONCLUSION

The survey provides baseline data on NCD-related key risk factors among 15-17 years in India. These national-level data fill information gaps for this age group and help assess India's progress towards NCD targets set for 2025 comprehensively. Though the prevalence of select risk factors is much lower than in many developed countries, this study offers national evidence for revisiting and framing appropriate policies, strategies for prevention and control of NCDs in younger age groups.

Anthropometry did not approach adequate predictive accuracies for detecting elevated fasting plasma glucose or hemoglobin A1c levels among Chinese children aged 7-9 years

AIMS/INTRODUCTION

Elevated concentrations of fasting plasma glucose (FPG) or hemoglobin A1c (HbA1c) are well-established independent risk factors for progression to diabetes, cardiovascular comorbidities and mortality. Most previous studies on the relationships of anthropometric measures with hyperglycemia were carried out among adults and adolescents, but few data are available for the performance predication of the predictors for diagnosing elevated FPG or HbA1c among young children.

MATERIALS AND METHODS

Involving 5,556 students of aged 7-9 years, a school-based cross-sectional survey was carried out between March and June 2019 in Shenzhen, China. Receiver operating characteristic curve analysis was utilized.

RESULTS

The median was 4.6 (interquartile range [IQR] 4.3-4.8) mmol/L for FPG and 5.3% (IQR 5.1-5.5%) for HbA1c levels for all participants. For detecting elevated FPG, weight (0.651, IQR 0.583-0.719) and waist circumference (0.650, IQR 0.584-0.717) showed the highest area under the curve and 95% confidence interval, followed by body mass index and the z-score of body mass index (both 0.635, IQR 0.567-0.703); other anthropometric measures showed poorer diagnostic efficiencies or no ability. For detecting elevated HbA1c, lower efficiencies for the Conicity Index (0.651, IQR 0.583-0.719), waist-to-height ratio, waist-to-hip ratio and waist-to-chest ratio were shown. The correlations of FPG and HbA1c levels with anthropometric indices were weak (Spearman's r ≤ 0.179).

CONCLUSIONS

None of the evaluated anthropometric indicators approached an adequate predictive accuracy for the detection of elevated FPG or HbA1c levels in Shenzhen children aged 7-9 years. The current study did not recommend anthropometry screening for prediabetes in young children.

Effectiveness of Anthropometric Measurements for Identifying Diabetes and Prediabetes among Civil Servants in a Regional City of Northern Ethiopia: A Cross-Sectional Study

Methods

The study involved a cross-sectional survey carried out from October 2015 to February 2016 among 1504 subjects aged from 18 to 75 years of age. Receiver operating characteristic (ROC) was used to select the most effective anthropometric cut-off point among waist circumference, waist-to-hip ratio, waist-to-height ratio, and BMI for identifying prediabetic and diabetes. Statistical significance was declared at p value of ≤0.05.

Results

Waist circumference was found better for identifying diabetes (AUC = 0.69) and prediabetes (AUC = 0.63) in women, respectively. Waist-to-hip ratio was better identifying diabetes (AUC = 0.67) while waist circumference-to-height ratio was better identifying prediabetes (AUC = 0.63) in men compared to body mass index. The optimal cut-off point with maximum sensitivity and specificity of waist circumference for identifying diabetes and prediabetes was 83.5 cm and 82.9 cm in women, respectively. The optimal ut-off point with maximum sensitivity and specificity of waist-to-hip ratio for identifying diabetes and prediabetes was 0.97 and 0.82 in men, respectively.

Conclusion

Waist circumference and waist-to-hip ratio exhibited better discriminate performance than BMI for identifying prediabetes and diabetes in women and men, respectively.

Impaired fasting glucose prevalence surge among Iranian adolescents in a decade: The Tehran Lipid and Glucose Study

PURPOSE

Impaired fasting glucose (IFG) is associated with incident diabetes, cardiovascular risk, and markers of atherosclerosis in early adulthood. We aimed to explore the 10-year change in IFG prevalence among adolescent participants of the Tehran Lipid and Glucose Study, a population-based study from Iran.

METHODS

For our study, we used data on fasting plasma glucose (FPG), anthropometric, and demographic information of 11 to 19-year-old adolescents in study periods I (1999-2005; 1415 boys, 1583 girls) and II (2011-2014; 477 boys, 469 girls). Sex-adjusted and sex-stratified multivariable logistic regression models were used to assess the relationship of the study period (reference: study period I) with IFG.

RESULTS

The prevalence of IFG, general obesity, and central obesity increased from 7%, 13.3%, and 18.8% in study period I to 16.6%, 24%, and 37.4% in study period II; while a favorable trend was seen for blood pressure, triglycerides, and high-density lipoprotein cholesterol. In the fully adjusted model, being older (age group 15-19 vs 11-14 years) and female sex were associated with lower risk. Being overweight and obese increased the risk by risk ratios (confidence interval) of 1.57 (1.17-2.11) and 1.63 (1.15-2.30), respectively. Central adiposity did not remain as an independent risk factor. Nevertheless, study period persisted as a significant factor despite all adjustments [2.20 (1.81-2.68)]. Results in the sex-stratified models were generally the same.

CONCLUSION

Our results demonstrated that the over 2-fold rise in IFG prevalence among adolescents was not solely dependent on general and central obesity.