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Munjal S, Sharma A, Chhabra N, Panda N. Perceptual, Aerodynamic and Acoustic Evaluation of Vocal Characteristics in Subjects With Obesity. J Voice 2024; 38:660-665. [PMID: 34969555 DOI: 10.1016/j.jvoice.2021.10.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 10/23/2021] [Accepted: 10/28/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Obesity has tripled since 1975 and affects health across many domains. Increasing body mass index increases the risk to the obese subject of many non-communicable diseases. The study evaluated the perceptive, aerodynamic, and acoustic parameters that characterize the voice of the obese population. METHODOLOGY Eighty adult subjects (40 participants in each obese and control group) aged 18-50 years were enrolled. The perceptual voice analysis was performed using the Consensus Auditory Perceptual Evaluation of Voice. The aerodynamic and acoustic voice analyses were performed using the MIR Spiro lab instrument and Doctor's Speech software. A digital stopwatch was also used to measure maximum phonation time. RESULTS Statistical analysis revealed a significant difference (P-value <0.05 and t value >2) between two groups on acoustic parameters, specifically Normalized noise energy and fundamental frequency tremor (F0 tremor). Normalized noise energy and fundamental frequency tremor were greater in the obese group. Moreover, maximum phonation time and expiratory reserve volume were significantly reduced in the obese group. DISCUSSION AND CONCLUSION Results of the present study showed poor voice quality and reduced expiratory reserve volume in obese individuals. This could be credited to the adverse effects of accrued adipose on the functioning of the laryngeal and respiratory systems. Increasing body mass index escalates the risk to the obese subjects of many non-communicable diseases.
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Affiliation(s)
- Sanjay Munjal
- Department of Otolaryngology, Post Graduate Institute of Medical Education and Research, New OPD, Chandigarh, India; Department of Otolaryngology, Speech and Hearing Unit, New OPD, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Anuradha Sharma
- Department of Otolaryngology, Post Graduate Institute of Medical Education and Research, New OPD, Chandigarh, India; Department of Otolaryngology, Speech and Hearing Unit, New OPD, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
| | - Neha Chhabra
- Department of Otolaryngology, Post Graduate Institute of Medical Education and Research, New OPD, Chandigarh, India; Department of Otolaryngology, Speech and Hearing Unit, New OPD, Post Graduate Institute of Medical Education and Research, Chandigarh, India; Post Graduate Institute of Medical Education and Research, New OPD, Chandigarh, India
| | - Naresh Panda
- Department of Otolaryngology, Post Graduate Institute of Medical Education and Research, New OPD, Chandigarh, India; Department of Otolaryngology, Speech and Hearing Unit, New OPD, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
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Hua S, Yao D, Wu S, Chen M, Li L, Li B. Association between visceral fat area and diabetic retinopathy among people with type 2 diabetes mellitus: a cross-sectional study in Ningbo, Zhejiang Province, China. Front Med (Lausanne) 2024; 11:1327805. [PMID: 38414615 PMCID: PMC10897001 DOI: 10.3389/fmed.2024.1327805] [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: 10/25/2023] [Accepted: 02/01/2024] [Indexed: 02/29/2024] Open
Abstract
Aim The objective of this study is to investigate the relationship between visceral fat area (VFA) and diabetic retinopathy (DR) in the context of type 2 diabetes mellitus (T2DM) within Ningbo, China. Methods The data of a total of 3,707 subjects with T2DM treated at The First Affiliated Hospital of Ningbo University were enrolled. The existence and severity of diabetic retinopathy were assessed by employing the 45° two-field stereoscopic digital photography. Subjects were categorized into four distinct groups: those without DR (NDR), individuals with mild non-proliferative DR (mild NPDR), people with moderate non-proliferative DR (moderate NPDR), and those suffering from vision-threatening DR (VTDR). Bio-electrical impedance was employed to estimate the Visceral fat area (VFA). Multinomial logistic regression models were utilized to evaluate the association between VFA and DR. Results The mean VFA in patients without diabetic retinopathy (NDR) was notably lower compared to that of patients with diabetic retinopathy (DR) (85.21 ± 37.78 vs. 97.37 ± 44.58 cm2, p < 0.001). As the severity of DR increased, VFA increased gradually but insignificantly (94.41 ± 43.13 cm2, 96.75 ± 40.82 cm2, 100.84 ± 49.34 cm2, p = 0.294). After adjusting the confounding factors, there was an association identified between VFA and the occurrence of DR (OR = 1.020, 95% CI = 1.016-1.024). It showed that regardless of BMI, whether it's less than 25 kg/m2 or greater than or equal to 25 kg/m2, a higher VFA (≥100 cm2) level came with a higher prevalence of DR (p < 0.001). Conclusion The outcomes of this research indicate a modest association between VFA and the incidence of DR among Chinese patients who have been diagnosed with T2DM in Ningbo.
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Affiliation(s)
- Shanshan Hua
- Department of Ophthalmology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Dongwei Yao
- Department of Ophthalmology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Siteng Wu
- Department of Ophthalmology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Miao Chen
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Li Li
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Bo Li
- Department of Ophthalmology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
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Getahun MS, Deybasso HA, Komicha MA, Gurara AM. Magnitude of central obesity and associated factors among adult patients attending public health facilities in Adama town, Oromia region, Ethiopia, 2022. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:57. [PMID: 37330577 PMCID: PMC10276422 DOI: 10.1186/s41043-023-00397-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 06/04/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Central obesity is excessive accumulation of fat around the abdomen, which is associated with the risk of coronary heart and cerebrovascular diseases. This study determined the magnitude of central obesity among adult patients using the waist-to-hip ratio, which has a superior capacity to measure the risk of developing non-communicable diseases compared to the body mass index used in previous studies in Ethiopia. METHODS Institutional-based cross-sectional study was conducted among a sample of 480 adults from April 1 to May 30, 2022. A systematic random sampling technique was used to select the study participants. Data were collected by using interviewer-administered structured questionnaires and anthropometric measurements. The data were entered into EPI INFO version 7 and analyzed by Statistical Software for Social Science Version 25. The associations between independent and dependent variables were checked using bivariate and multivariate logistic regression analyses. Adjusted odds ratio and 95% confidence interval were used to measure the strengths of the association. Statistical significance was declared at a P value of less than 0.05. RESULTS The magnitude of central obesity in this study was 40% (51.2% and 27.4% among females and males, respectively (95% CI 36-44%)). Being a female (AOR = 9.5, 95% CI 5.22-17.9), age range 35-44 (AOR = 7.0, 95% CI 2.9-16.7), 45-64 years (AOR = 10.1, 95% CI4.0-15.2), married (AOR = 2.5, 95% CI 1.3-4.7), high monthly income (AOR = 3.3, 95% CI 1.5-7.3), high consumption of milk and milk products (AOR = 0.3, 95% CI 0.1-0.6), family history of obesity (AOR = 1.8, 95% CI 1.1-3.2) were significantly associated with central obesity among the study participants. CONCLUSION The magnitude of central obesity was higher in the study area. Sex, age, marital status, monthly income, consumption of milk and milk products, and family history of obesity were independent determinants of central obesity. Therefore, it is important to raise awareness about central obesity through behavior change communication that targets the high-risk population.
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Affiliation(s)
| | - Haji Aman Deybasso
- Public Health Department, Adama Hospital Medical College, Adama, Ethiopia.
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Verma A, Jha A, Alagorie AR, Sharma R. Association of anthropometric parameters as a risk factor for development of diabetic retinopathy in patients with diabetes mellitus. Eye (Lond) 2023; 37:303-308. [PMID: 35058601 PMCID: PMC9873787 DOI: 10.1038/s41433-022-01934-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 12/15/2021] [Accepted: 01/11/2022] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To study the relationship of body fat distribution in patients with diabetes mellitus (DM), and its long-term complications like diabetic retinopathy (DR), in Indian population. METHODS This was a prospective, cross-sectional observational study involving 1773 subjects diagnosed with DM and 1778 age and gender-matched individuals. The patients with DM were assessed for the presence and severity of DR. Severe non-proliferative DR and proliferative DR were categorised as sight threatening DR (STDR). Anthropometric parameters, i.e., neck circumference (NC); mid-upper arm circumference (MAC); waist circumference (WC); hip circumference (HC); mid-thigh circumference (MTC) and body mass index (BMI) were measured using standardised technique. RESULTS The mean age was 59.33 ± 9.32 for DM group, and 66.03 ± 11.04 for non-DM group. DM group showed significantly greater NC, WC, and MTC and significantly reduced MAC and weight. HC and BMI were comparable between the groups. There was a significant positive correlation of MAC and WC (with any level of DR) and MAC, WC, and weight (for STDR); and a significant negative correlation of HC and MTC (with any level of DR) and NC, HC, MTC, and BMI (for STDR). Multiple logistic regression analysis confirmed that WC was the single most important predictor for any level of DR and STDR. CONCLUSIONS Association of body fat distribution with DM and DR appears multifactorial. However, central obesity signified by waist circumference appears to be the significant risk related to the development of DR and STDR in Indian population.
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Affiliation(s)
- Aditya Verma
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, College Road 18, Chennai, 600006, India
| | - Ashok Jha
- Department of Ophthalmology, Military Hospital, Gaya, Bihar, 823005, India.
| | | | - Rishi Sharma
- Department of Ophthalmology, Military Hospital, Yol, Himachal Pradesh, 176052, India
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Endukuru CK, Gaur GS, Yerrabelli D, Sahoo J, Vairappan B, Goud AC. Correlation among Poincare plot and traditional heart rate variability indices in adults with different risk levels of metabolic syndrome: a cross-sectional approach from Southern India. J Basic Clin Physiol Pharmacol 2023:jbcpp-2022-0208. [PMID: 36626361 DOI: 10.1515/jbcpp-2022-0208] [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: 08/04/2022] [Accepted: 12/24/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVES Heart rate variability (HRV) is an important marker of cardiac autonomic modulation. Metabolic syndrome (MetS) can alter cardiac autonomic modulation, raising the risk of cardiovascular disease (CVD). Poincaré plot analysis (PPA) is a robust scatter plot-based depiction of HRV and carries similar information to the traditional HRV measures. However, no prior studies have examined the relationship between PPA and traditional HRV measures among different risk levels of MetS. We evaluated the association between the Poincare plot and traditional heart rate variability indices among adults with different risk levels of MetS. METHODS We measured anthropometric data and collected fasting blood samples to diagnose MetS. The MetS risk was assessed in 223 participants based on the number of MetS components and was classified as control (n=64), pre-MetS (n=49), MetS (n=56), and severe MetS (n=54). We calculated the Poincaré plot (PP) and traditional HRV measures from a 5 min HRV recording. RESULTS Besides the traditional HRV measures, we found that various HRV indices of PPA showed significant differences among the groups. The severe MetS group had significantly lower S (total HRV), SD1 (short-term HRV), SD2 (long-term HRV), and higher SD2/SD1. The values of S, SD1, SD2, and SD2/SD1 were significantly correlated with most traditional HRV measures. CONCLUSIONS We found gradual changes in HRV patterns as lower parasympathetic and higher sympathetic activity alongside the rising number of MetS components. The HRV indices of PPA integrating the benefits of traditional HRV indices distinguish successfully between different risk levels of MetS and control subjects.
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Affiliation(s)
- Chiranjeevi Kumar Endukuru
- Department of Physiology, Sri Siddhartha Institute of Medical Sciences & Research Centre, Bengaluru, India
| | - Girwar Singh Gaur
- Department of Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Dhanalakshmi Yerrabelli
- Department of Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Jayaprakash Sahoo
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Balasubramaniyan Vairappan
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Alladi Charanraj Goud
- Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
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Mohammed RA, Danda AK, Kotakadi SM, Nannepaga JS. Anti-obesity Effect of Bioengineered Silver Nanoparticles Synthesized from Persea americana on Obese Albino Rats. Pharm Nanotechnol 2023; 11:433-446. [PMID: 37106516 DOI: 10.2174/2211738511666230427145944] [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: 09/29/2022] [Revised: 12/28/2022] [Accepted: 01/09/2023] [Indexed: 04/29/2023]
Abstract
BACKGROUND Obesity is an immoderate or abnormal accretion of fat or adipose tissue in the body that is prone to damage the health of mankind. Persea americana (Avocados) is a nutritious fruit known for its several health benefits. The current research was planned to evaluate the anti-obesity activity of bioengineered Silver Nanoparticles (AgNPs) against a high-fat diet (HFD) treated obese albino rats. METHODS AgNPs were synthesized and characterized for the Phytochemical constituents, UV-vis Spectroscopy, FTIR, SEM and XRD. Furthermore, the lipid profile in serum, biochemical parameters and histopathological changes in tissues of albino rats were determined. RESULTS The present study revealed the presence of tannins, flavonoids, steroids and saponins, carbohydrates, alkaloids, phenols and glycosides. The peak was disclosed at 402 nm in UV-vis spectroscopy, confirming the synthesis of AgNPs. FTIR analysis showed two peaks at 3332.25 cm-1 which correspond to the O-H stretch of the carboxylic acid band, and 1636.40 cm-1 represents the N-H stretch of the amide of proteins, respectively. This result confirms their contribution to the capping and stabilization of AgNPs. The XRD results confirm the crystalline nature of AgNPs, and SEM results indicated that the synthesized AgNPs were spherical. Further, the results of the current study showed the improved lipid profile and biochemical parameters in rats supplemented with methanolic pulp extract of Persea americana AgNPs when compared with other experimental groups. The histopathological findings displayed improved results with reduced hepatocyte degradation under the influence of AgNPs treatment. CONCLUSION All the experimental evidence indicated the possible anti-obesity effect of silver nanoparticles synthesized from the methanolic pulp extract of Persea americana.
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Affiliation(s)
- Reshma Anjum Mohammed
- Department of Biotechnology, Sri Padmavati Mahila Visvavidyalayam (Women's University), Tirupati, 517 502, Andhra, India
| | - Aruna Kumari Danda
- Department of Zoology, Government Degree College, Anantapur, 515001, Andhra Pradesh, India
| | - Sai Manogna Kotakadi
- Department of Biotechnology, Sri Padmavati Mahila Visvavidyalayam (Women's University), Tirupati, 517 502, Andhra, India
| | - John Sushma Nannepaga
- Department of Biotechnology, Sri Padmavati Mahila Visvavidyalayam (Women's University), Tirupati, 517 502, Andhra, India
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Suresh C, Govindasamy K, KS S, Anand M, Kaur D, Anitha JB, Aloui A, Boughanmi H, Achouri I. Role of aerobics exercise and kettlebell training improving on selected health related physical fitness parameters in obese male adults. HEALTH, SPORT, REHABILITATION 2022. [DOI: 10.34142/hsr.2022.08.04.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background: Aerobics exercise training and kettlebell training is recommended to prevent and control overweight/obesity.
Purpose: The aim of the this research is to assess the improvement in various variables related to health fitness among obese adults on administrating a twelve weeks aerobics exercise training and kettlebell training.
Materials and Methods: Total sixty male adults with obese (Mean ± SD; age: 18.92 ± 1.54 yrs.; height: 172.4 ± 5.4 cm.; weight: 84.4 ± 6.3 kg) were randomly allocated into three equal (n = 20) groups: Aerobic Exercise Training (AET), Kettlebell Training (KBT) and a control group. The AET & KBT training protocol was performed three days per week for 12 weeks. All the selected variables of physical fitness has been examined at baseline and 12 weeks. Control group does not perform any exercise.
Analysis and findings: There were significant difference in terms of Flexibility (F), Muscular Endurance (ME), Muscular Strength (MS) and Cardiovascular Endurance (CE), between the AETG & KBTG have been compared with control group (p < 0.05). Body Composition (BF) significant reductions in AET & KBT groups have been compared with control group (p < 0.05).
Conclusion: Our findings suggest that AET & KBT protocols have greater effects than control group on health related physical fitness variables in obese male adult individuals. It is recommended that schools and colleges should administrate the aerobic exercise session and kettlebell training among adults for better health perspectives.
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Kaur H, Bains V, Sharma T, Badaruddoza. Relationship between leptin gene variants (–2548G>A and 19A>G) and obesity among north Indian Punjabi population. J Genet 2022. [DOI: 10.1007/s12041-022-01401-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Monu M, Gandhi G. Association of Indices of Adiposity with Lipoprotein Sub-fractions in the general Population of Amritsar City. PROCEEDINGS OF THE INDIAN NATIONAL SCIENCE ACADEMY 2022. [DOI: 10.1007/s43538-022-00090-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Manabe N, Matsueda K, Haruma K. Epidemiological Review of Gastroesophageal Junction Adenocarcinoma in Asian Countries. Digestion 2022; 103:29-36. [PMID: 34718236 DOI: 10.1159/000519602] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 09/13/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Similar trends in the prevalence of gastroesophageal reflux disease (GERD), obesity, and Helicobacter pylori infection have been observed in Asian and Western countries despite their time differences. However, it is unclear whether the prevalence of gastroesophageal junction adenocarcinomas in Asian countries is increasing. In this review, we discuss the epidemiological trends of gastroesophageal junction adenocarcinoma in Asian countries. SUMMARY The prevalence of GERD is increasing in Asian countries, but most cases are considered mild. Obesity is a serious problem worldwide, but it is considered less serious in Asia than in Western countries. In Asian countries where gastric cancer is common, both cardiac and noncardiac cancers are associated with high rates of H. pylori infection, which is considered a carcinogenic risk factor for both sites of cancer. The widespread use of H. pylori eradication therapy for chronic gastritis in several Asian countries has not directly led to an increased prevalence of esophageal adenocarcinoma. One of the originating sites of junctional adenocarcinoma in most Asian countries is Barrett's esophagus, with short-segment Barrett's esophagus having much lower carcinogenicity than long-segment Barrett's esophagus. Key Messages: Considering the future trends of several risk factors for gastroesophageal junction adenocarcinoma in Asian countries, it is likely that the incidence of gastroesophageal junction adenocarcinoma will gradually increase, but not at a rate that exceeds that of squamous cell carcinoma, as in Western countries.
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Affiliation(s)
- Noriaki Manabe
- Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School, Okayama, Japan
| | - Kazuhiro Matsueda
- Department of Gastroenterology and Hepatology, Kurashiki Central Hospital, Kurashiki, Japan
| | - Ken Haruma
- Department of General Internal Medicine 2, Kawasaki Medical School, Okayama, Japan
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Sangu PV, Balakrishna N, Challapalli B, Ravikanti K. Mini Female Health Program for detection of non-communicable diseases in Women – In a urban teaching hospital in India. WOMEN'S HEALTH 2022; 18:17455057221135493. [DOI: 10.1177/17455057221135493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: Prevalence of non-communicable diseases (NCDs) is increasing with women affected at an early age. The Mini Female Health Program (MFHP) is a simple screening package to detect NCDs in women. Objective: Determine the prevalence of selected NCDs in a hospital-based outpatient setting using MFHP. Methods: A cross-sectional observational study was conducted in an urban teaching hospital in India. MFHP included medical history, physical examination and investigations. NCDS of interest included anaemia, thyroid disorders, hypertension, diabetes, and obesity. Analysis was performed on groups stratified by age groups (18–30, 31–40 and > 41 years). Between group comparison and association of hypertension with other variables was undertaken. Results: Final analysis included 468 women, of whom 49.8%, 29.9%, and 20.3% were between 18–30, 31–40, and >41 years, respectively. Central obesity was most common NCD (waist to height ratio (WHR) > 0.5 (72.7%), waist circumference (WC) > 80 cm (62.7%)) followed by generalized obesity (body mass index (BMI) > 25 kg/m2 (52.4%)), anaemia (52.6%), thyroid disorders (27.4%), hypertension (14.1%) and diabetes (5.1%). Half of the women between 18 and 30 years were either overweight (BMI: 23–25 kg/m2) or obese. Increasing age was associated with a significant increase in the prevalence of hypertension, diabetes, thyroid disorders and obesity, but not anaemia. Only 9.8% of women were without an NCD with 17.3% having one NCD and 72.8% reporting multiple NCDs. Hypertension was strongly associated with age and WHR in multivariate regression analysis. Conclusion: The MFHP has highlighted the high prevalence of NCDs in women, particularly in young women demonstrating the value of simple screening programme in routine clinical care.
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Venkatesan V, Lopez-Alvarenga JC, Arya R, Ramu D, Koshy T, Ravichandran U, Ponnala AR, Sharma SK, Lodha S, Sharma KK, Shaik MV, Resendez RG, Venugopal P, R P, Saju N, Ezeilo JA, Bejar C, Wander GS, Ralhan S, Singh JR, Mehra NK, Vadlamudi RR, Almeida M, Mummidi S, Natesan C, Blangero J, Medicherla KM, Thanikachalam S, Panchatcharam TS, Kandregula DK, Gupta R, Sanghera DK, Duggirala R, Paul SFD. Burden of Type 2 Diabetes and Associated Cardiometabolic Traits and Their Heritability Estimates in Endogamous Ethnic Groups of India: Findings From the INDIGENIUS Consortium. Front Endocrinol (Lausanne) 2022; 13:847692. [PMID: 35498404 PMCID: PMC9048207 DOI: 10.3389/fendo.2022.847692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 02/21/2022] [Indexed: 01/14/2023] Open
Abstract
To assess the burden of type 2 diabetes (T2D) and its genetic profile in endogamous populations of India given the paucity of data, we aimed to determine the prevalence of T2D and estimate its heritability using family-based cohorts from three distinct Endogamous Ethnic Groups (EEGs) representing Northern (Rajasthan [Agarwals: AG]) and Southern (Tamil Nadu [Chettiars: CH] and Andhra Pradesh [Reddys: RE]) states of India. For comparison, family-based data collected previously from another North Indian Punjabi Sikh (SI) EEG was used. In addition, we examined various T2D-related cardiometabolic traits and determined their heritabilities. These studies were conducted as part of the Indian Diabetes Genetic Studies in collaboration with US (INDIGENIUS) Consortium. The pedigree, demographic, phenotypic, covariate data and samples were collected from the CH, AG, and RE EEGs. The status of T2D was defined by ADA guidelines (fasting glucose ≥ 126 mg/dl or HbA1c ≥ 6.5% and/or use of diabetes medication/history). The prevalence of T2D in CH (N = 517, families = 21, mean age = 47y, mean BMI = 27), AG (N = 530, Families = 25, mean age = 43y, mean BMI = 27), and RE (N = 500, Families = 22, mean age = 46y, mean BMI = 27) was found to be 33%, 37%, and 36%, respectively, Also, the study participants from these EEGs were found to be at increased cardiometabolic risk (e.g., obesity and prediabetes). Similar characteristics for the SI EEG (N = 1,260, Families = 324, Age = 51y, BMI = 27, T2D = 75%) were obtained previously. We used the variance components approach to carry out genetic analyses after adjusting for covariate effects. The heritability (h2) estimates of T2D in the CH, RE, SI, and AG were found to be 30%, 46%, 54%, and 82% respectively, and statistically significant (P ≤ 0.05). Other T2D related traits (e.g., BMI, lipids, blood pressure) in AG, CH, and RE EEGs exhibited strong additive genetic influences (h2 range: 17% [triglycerides/AG and hs-CRP/RE] - 86% [glucose/non-T2D/AG]). Our findings highlight the high burden of T2D in Indian EEGs with significant and differential additive genetic influences on T2D and related traits.
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Affiliation(s)
- Vettriselvi Venkatesan
- Department of Human Genetics, Faculty of Biomedical Sciences and Technology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, India
| | - Juan Carlos Lopez-Alvarenga
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Brownsville, TX, United States
| | - Rector Arya
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Brownsville, TX, United States
| | - Deepika Ramu
- Department of Human Genetics, Faculty of Biomedical Sciences and Technology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, India
| | - Teena Koshy
- Department of Human Genetics, Faculty of Biomedical Sciences and Technology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, India
| | - Umarani Ravichandran
- Department of Medicine, Rajah Muthiah Medical College Hospital, Annamalai University, Chidambaram, India
| | - Amaresh Reddy Ponnala
- Department of Endocrinology, Krishna Institute of Medical Sciences (KIMS) Hospital, Nellore, India
| | | | - Sailesh Lodha
- Departments of Preventive Cardiology, Internal Medicine and Endocrinology, Eternal Heart Care Centre and Research Institute, Mount Sinai New York Affiliate, Jaipur, India
| | - Krishna K. Sharma
- Department of Pharmacology, Lal Bahadur Shastri College of Pharmacy, Rajasthan University of Health Sciences, Jaipur, India
| | - Mahaboob Vali Shaik
- Department of Endocrinology, Narayana Medical College and Hospital, Nellore, India
| | - Roy G. Resendez
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Brownsville, TX, United States
| | - Priyanka Venugopal
- Department of Human Genetics, Faculty of Biomedical Sciences and Technology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, India
| | - Parthasarathy R
- Department of Human Genetics, Faculty of Biomedical Sciences and Technology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, India
| | - Noelta Saju
- Department of Human Genetics, Faculty of Biomedical Sciences and Technology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, India
| | - Juliet A. Ezeilo
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Brownsville, TX, United States
| | - Cynthia Bejar
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Gurpreet S. Wander
- Hero Dayanand Medical College (DMC) Heart Institute, Dayanand Medical College and Hospital, Ludhaina, India
| | - Sarju Ralhan
- Hero Dayanand Medical College (DMC) Heart Institute, Dayanand Medical College and Hospital, Ludhaina, India
| | - Jai Rup Singh
- Honorary or Emeritus Faculty, Central University of Punjab, Bathinda, India
| | - Narinder K. Mehra
- Honorary or Emeritus Faculty, All India Institute of Medical Sciences and Research, New Delhi, India
| | | | - Marcio Almeida
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Brownsville, TX, United States
| | - Srinivas Mummidi
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Brownsville, TX, United States
| | - Chidambaram Natesan
- Department of Medicine, Rajah Muthiah Medical College Hospital, Annamalai University, Chidambaram, India
| | - John Blangero
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Brownsville, TX, United States
| | | | - Sadagopan Thanikachalam
- Department of Cardiology, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, India
| | | | | | - Rajeev Gupta
- Departments of Preventive Cardiology, Internal Medicine and Endocrinology, Eternal Heart Care Centre and Research Institute, Mount Sinai New York Affiliate, Jaipur, India
| | - Dharambir K. Sanghera
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- Department of Physiology, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Ravindranath Duggirala
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Brownsville, TX, United States
| | - Solomon F. D. Paul
- Department of Human Genetics, Faculty of Biomedical Sciences and Technology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, India
- *Correspondence: Solomon F. D. Paul,
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Khan M, Khan M, Ahmad M, Alam R, Khan S, Jaiswal G. Association of circulatory adiponectin with the parameters of Madras Diabetes Research Foundation-Indian Diabetes Risk Score. JOURNAL OF DIABETOLOGY 2022. [DOI: 10.4103/jod.jod_86_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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14
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Mukesh S, Lavanya ML, Sathya M, Tejaswi P. Concised 9-year data of cancer patient's body mass index: An institutional study. JOURNAL OF RADIATION AND CANCER RESEARCH 2022. [DOI: 10.4103/jrcr.jrcr_45_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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15
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Estrogen Impairs Adipose Tissue Expansion and Cardiometabolic Profile in Obese-Diabetic Female Rats. Int J Mol Sci 2021; 22:ijms222413573. [PMID: 34948369 PMCID: PMC8705713 DOI: 10.3390/ijms222413573] [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: 10/30/2021] [Revised: 12/10/2021] [Accepted: 12/14/2021] [Indexed: 11/20/2022] Open
Abstract
It has been reported that 17β-estradiol (E2) can exert beneficial effects against the development of obesity, providing women with a healthier metabolic profile and conferring cardiovascular protection. However, a growing body of evidence questions this role in the context of obesity and diabetes. We focus on the adipose tissue–heart axis to address the question of whether E2 can have metabolically detrimental effects in an obese-diabetic rat model. Female Zucker Diabetic Fatty rats were used: LEAN, fa/+; SHAM, sham-operated fa/fa; OVA, ovariectomized fa/fa, and OVA+E2, ovariectomized and E2 treated fa/fa. The secretory expression profile, tissue expansion parameters and composition of visceral adipose tissue, as well as systemic and cardiac parameters related to insulin resistance, fibrosis, and inflammation were analyzed. Ovariectomy induced an attenuation of both diabetic condition and metabolic dysfunction of adipose tissue and cardiac muscle in fa/fa rats, suggesting that E2, in the context of diabetes and obesity, loses its cardioprotective role and could even contribute to greater metabolic alterations. Adipose tissue from OVA rats showed a healthier hyperplastic expansion pattern, which could help maintain tissue function, increase adiponectin expression, and decrease pro-inflammatory adipokines. These findings should be taken into account when considering hormone replacement therapy for obese-diabetic women.
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Sarna A, Porwal A, Acharya R, Ashraf S, Ramesh S, Khan N, Sinha S, Sachdev HS. Waist circumference, waist-to-height ratio and BMI percentiles in children aged 5 to 19 years in India: A population-based study. Obes Sci Pract 2021; 7:392-404. [PMID: 34401198 PMCID: PMC8346379 DOI: 10.1002/osp4.493] [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: 07/28/2020] [Revised: 01/25/2021] [Accepted: 01/29/2021] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE Nationally representative percentiles for waist circumference (WC), waist-to-height-ratio (WHtR), and body mass index (BMI) are not available for children and adolescents in India. METHODS Using LMS method, age- and gender-specific reference growth charts were constructed for WC (n = 68,261), WHtR (n = 68,261), and BMI (n = 67,741) from children/adolescents aged 5-19 years who participated in a nationally representative survey. General obesity, indicating overall obesity, was defined as age-sex-specific BMI z-scores ≥ 95th percentile. Central obesity was defined in three ways: WC ≥ 90th percentile, WHtR ≥ 0.5, and both WC ≥ 90th percentile and WHtR ≥ 0.5. FINDINGS WC and BMI percentiles for boys and girls are lower than those previously reported from India and several other countries. The BMI percentiles are lower than the WHO 2007 reference population. The prevalence of general obesity using India specific BMI centiles was 2.9% (95% CI: 2.6-3.2). The prevalence of central obesity was 6.1% (95% CI: 5.7-6.6) using WC ≥ 90th percentile, 5.3% (95% CI: 5.0-5.7) using WHtR ≥ 0.5, and 3.6% using both criteria. Three-fourth of children with general obesity also had central obesity based on WC ≥ 90th. CONCLUSIONS Indian children are thinner than Caucasian and other Asian children, and the global WHO reference population. Using India specific reference, the prevalence of central obesity is higher than general obesity with a significant overlap between the two.
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Affiliation(s)
- Avina Sarna
- Population CouncilZone 5AGround Floor India Habitat CentreNew DelhiIndia
| | - Akash Porwal
- Population CouncilZone 5AGround Floor India Habitat CentreNew DelhiIndia
| | - Rajib Acharya
- Population CouncilZone 5AGround Floor India Habitat CentreNew DelhiIndia
| | - Sana Ashraf
- Population CouncilZone 5AGround Floor India Habitat CentreNew DelhiIndia
| | - Sowmya Ramesh
- Population CouncilZone 5AGround Floor India Habitat CentreNew DelhiIndia
| | - Nizamuddin Khan
- Population CouncilZone 5AGround Floor India Habitat CentreNew DelhiIndia
| | | | - Harshpal Singh Sachdev
- Pediatrics and Clinical EpidemiologySitaram Bhartia Institute of Science and ResearchNew DelhiIndia
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Obesity and dyslipidemia among Bhil tribal population: A cross-sectional study from India. Int J Diabetes Dev Ctries 2021. [DOI: 10.1007/s13410-021-00962-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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18
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Thakkar H, Vincent V, Shukla S, Sra M, Kanga U, Aggarwal S, Singh A. Improvements in cholesterol efflux capacity of HDL and adiponectin contribute to mitigation in cardiovascular disease risk after bariatric surgery in a cohort with morbid obesity. Diabetol Metab Syndr 2021; 13:46. [PMID: 33865458 PMCID: PMC8053301 DOI: 10.1186/s13098-021-00662-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/30/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Bariatric surgery can alleviate cardiovascular risk via effects on cardiovascular disease (CVD) risk factors such as diabetes mellitus, hypertension, and dyslipidemia. Our study aimed to assess the cholesterol efflux capacity (CEC) of HDL as a negative risk factor for CVD in individuals with obesity and identify the factors associated with improvement in CEC 3 months following bariatric surgery. METHODS We recruited 40 control individuals (mean BMI of 22.2 kg/m2) and 56 obese individuals (mean BMI of 45.9 kg/m2). The biochemical parameters, inflammatory status and CEC of HDL was measured for the obese individuals before bariatric surgery and at 3 months after surgery. The CEC was measured using a cell-based cholesterol efflux system of BODIPY-cholesterol-labelled THP-1 macrophages. RESULTS A significant reduction in BMI (- 17%, p < 0.001), resolution of insulin sensitivity (HOMA2-IR = - 23.4%, p = 0.002; Adipo IR = - 16%, p = 0.009) and inflammation [log resistin = - 6%, p = 0.07] were observed 3 months post-surgery. CEC significantly improved 3 months after surgery [Pre: 0.91 ± 0.13; Post: 1.02 ± 0.16; p = 0.001] despite a decrease in HDL-C levels. The change in CEC correlated with the change in apo A-I (r = 0.39, p = 0.02) and adiponectin levels (r = 0.35, p = 0.03). CONCLUSION The results suggest that improvements in CEC, through improvement in adipose tissue health in terms of adipokine secretion and insulin sensitivity could be an important pathway in modulating obesity-related CVD risk.
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Affiliation(s)
- Himani Thakkar
- Department of Biochemistry, All India Institute of Medical Sciences, Room No. 3044, New Delhi, 110029, India
| | - Vinnyfred Vincent
- Department of Biochemistry, All India Institute of Medical Sciences, Room No. 3044, New Delhi, 110029, India
| | - Sakshi Shukla
- Department of Biochemistry, All India Institute of Medical Sciences, Room No. 3044, New Delhi, 110029, India
| | - Manraj Sra
- All India Institute of Medical Sciences, New Delhi, India
| | - Uma Kanga
- Department of Transplant Immunology and Immunogenetics, All India Institute of Medical Sciences, New Delhi, India
| | - Sandeep Aggarwal
- Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India
| | - Archna Singh
- Department of Biochemistry, All India Institute of Medical Sciences, Room No. 3044, New Delhi, 110029, India.
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Srinivasan S, Singh P, Kulothungan V, Sharma T, Raman R. Relationship between triglyceride glucose index, retinopathy and nephropathy in Type 2 diabetes. Endocrinol Diabetes Metab 2021; 4:e00151. [PMID: 33532603 PMCID: PMC7831221 DOI: 10.1002/edm2.151] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 04/18/2020] [Accepted: 05/02/2020] [Indexed: 12/16/2022] Open
Abstract
Aims To explore the relationship between TyG index, diabetic retinopathy (DR) and nephropathy. Methods This was a cross-sectional observational study that examined 1413 subjects with type 2 diabetes (both known and newly diagnosed). Subjects underwent a detailed standard evaluation to detect diabetic retinopathy (fundus photography) and nephropathy (defined as urinary albumin excretion ≥ 30 mg/24 h). The TyG index was calculated as ln (fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2) and stratified into 4 quartiles (TyG-Q). The baseline characteristics of the study population in the four TyG-Q (Q1 (≤7.3) n = 349, Q2 (>7.3 to ≤ 7.5) n = 358, Q3 (>7.5 to ≤ 8.0) n = 354, and Q4 (>8.0) n = 352) were analysed. Variables associated with the presence of DR and nephropathy were assessed using a stepwise binary logistic regression analysis. Results The presence of DR was associated with higher TyG index (OR = 1.453, P =.001) and longer duration of diabetes (OR = 1.085, P < .001). The presence of nephropathy was associated with a higher TyG index (OR = 1.703, P < .001), greater age (OR = 1.031, P < .001), use of insulin (OR = 1.842, P = .033), higher systolic BP (OR = 1.015, P < .001), and the presence of DR (OR = 3.052, P < .001). Higher TyG-Q correlated with the severity of DR (P = .024), presence of nephropathy (P = .001), age (P < .001) and diastolic blood pressure (P = .006). Conclusions A higher TyG index is associated with the presence of retinopathy and nephropathy in individuals with diabetes and could be used for monitoring metabolic status in clinical settings.
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Affiliation(s)
| | - Pallavi Singh
- Shri Bhagwan Mahavir Vitreoretinal ServicesMedical Research FoundationChennaiIndia
| | | | - Tarun Sharma
- Shri Bhagwan Mahavir Vitreoretinal ServicesMedical Research FoundationChennaiIndia
| | - Rajiv Raman
- Shri Bhagwan Mahavir Vitreoretinal ServicesMedical Research FoundationChennaiIndia
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Prasad DS, Kabir Z, Revathi Devi K, Peter PS, Das BC. Gender differences in central obesity: Implications for cardiometabolic health in South Asians. Indian Heart J 2020; 72:202-204. [PMID: 32768024 PMCID: PMC7411104 DOI: 10.1016/j.ihj.2020.04.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 12/29/2019] [Accepted: 04/26/2020] [Indexed: 10/27/2022] Open
Abstract
This study estimates the prevalence of central obesity in South Asian adults and examines gender differences in central obesity across cardiometabolic determinants. An urban community-based survey was conducted using multi-stage random sampling. Asia-Pacific criterion for waist circumference (WC) was used to measure central obesity. Amongst 1178 participants, females had a higher age-adjusted central obesity (48%), and more than two-fold increased odds of central obesity. Increased prevalence of central obesity and female preponderance are indicative for a gender-sensitive population-level intervention to tackle cardiometabolic risk. WC may be an effective population-level measurement tool for cardiometabolic risk assessment in South Asian adults.
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Affiliation(s)
- D S Prasad
- Consultant Cardiologist, Sudhir Heart Centre, Berhampur, 760002, Odisha State, India.
| | - Zubair Kabir
- School of Public Health, University College Cork, Cork, Ireland.
| | - K Revathi Devi
- Sudhir Heart Centre, Berhampur, Odisha State, 760002, India.
| | - Pearline Suganthy Peter
- Australian Medical Research Foundation, Fresh Start Recovery Program, Perth, WA, 6008, Australia.
| | - B C Das
- Kalinga Institute of Medical Sciences, KIIIT University, Bhubaneswar, 751024, India.
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21
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Solanki DK, Walia R, Gautam A, Misra A, Aggarwal AK, Bhansali A. Prevalence of abdominal obesity in non-obese adolescents: a North Indian adolescent study. J Pediatr Endocrinol Metab 2020; 33:853-858. [PMID: 32621730 DOI: 10.1515/jpem-2019-0026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 03/21/2020] [Indexed: 11/15/2022]
Abstract
Context Childhood obesity is defined based on body mass index (BMI) criteria. Asian adults have more abdominal adiposity as compared to Western people for an equivalent BMI. Similarly, children who are non-obese/overweight by BMI criteria may have abdominal obesity. It is important to identify and target this population to reduce future cardiovascular risk. Objective To evaluate and inter-relate the prevalence of obesity subtypes (generalized and abdominal) in school going adolescents. Methods A randomized cross-sectional community based study was conducted, which was carried out in 13 schools of Chandigarh, a North Indian city. 10,037 school going adolescents of age 10-18 years were evaluated. Results The prevalence of overweight and generalized obesity in present study was 9.3 and 4.9% respectively. Generalized obesity was observed in 4.2% of males and 5.7% of females (p-Value = 0.001). The abdominal obesity was noted in 5.4% of children and its prevalence increased progressively with age. The prevalence was highest in 16-18 years age-group (7.6%, p<0.001). 39.3% of abdominally obese subjects were not obese by BMI criteria, while prevalence of abdominal obesity in nonobese adolescents was 2.24%. It was more prevalent in females (3.7%) than males (3%, p=0.025). Prevalence of obesity was 7.9 and 1.8% in private and government schools respectively (p<0.001). Conclusions Abdominal obesity is more prevalent than generalized obesity and shows increasing trend with age. Interestingly, over one third of centrally obese adolescents are not obese by BMI criteria. This underlines the importance of waist circumference measurement in addition to BMI while assessing obesity.
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Affiliation(s)
- Dhiraj Kumar Solanki
- Department of Endocrinology, Post-Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rama Walia
- Department of Endocrinology, Post-Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Akanksha Gautam
- Department of Endocrinology, Post-Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Anoop Misra
- Department of Diabetes and Metabolic Diseases, Fortis Hospital, New Delhi, India
| | - Arun Kumar Aggarwal
- Department of Community Medicine, Post-Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Anil Bhansali
- Department of Endocrinology, Post-Graduate Institute of Medical Education and Research, Chandigarh, India
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Jain S, Joshi M. Endoscopy-guided intragastric balloon. MGM JOURNAL OF MEDICAL SCIENCES 2020. [DOI: 10.4103/mgmj.mgmj_71_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Wells JCK. The diabesity epidemic in the light of evolution: insights from the capacity-load model. Diabetologia 2019; 62:1740-1750. [PMID: 31451870 PMCID: PMC6731192 DOI: 10.1007/s00125-019-4944-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Accepted: 05/21/2019] [Indexed: 12/21/2022]
Abstract
The global nutrition transition, which embraces major changes in how food is produced, distributed and consumed, is associated with rapid increases in the prevalence of obesity, but the implications for diabetes differ between populations. A simple conceptual model treats diabetes risk as the function of two interacting traits: 'metabolic capacity,' which promotes glucose homeostasis, and 'metabolic load', which challenges glucose homoeostasis. Population variability in diabetes prevalence is consistent with this conceptual model, indicating that the effect of obesity varies by ethnicity. Evolutionary life history theory can help explain why variability in metabolic capacity and metabolic load emerges. At the species level (hominin evolution), across human populations and within individual life courses, phenotypic variability emerges under selective pressure to maximise reproductive fitness rather than metabolic health. Those exposed to adverse environments may express or develop several metabolic traits that are individually beneficial for reproductive fitness, but which cumulatively increase diabetes risk. Public health interventions can help promote metabolic capacity, but there are limits to the benefits that can emerge within a single generation. This means that efforts to curb metabolic load (obesity, unhealthy lifestyles) must remain at the forefront of diabetes prevention. Such efforts should go beyond individuals and target the broader food system and socioeconomic factors, in order to maximise their efficacy.
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Affiliation(s)
- Jonathan C K Wells
- Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK.
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Abstract
Background: Inconsistent evidence exists regarding the strength, direction, and moderators in the relationship between obesity and psychiatric disorders. Aim: This study aims to summarize the evidence on the association between psychiatric illness and obesity with particular attention to the strength and direction of association and also the possible moderators in each postulated link. Materials and Methods: Systematic electronic searches of MEDLINE through PubMed, ScienceDirect, PsycINFO, and Google Scholar were carried out from inception till October 2016. Generated abstracts were screened for eligibility to be included in the review. Study designs that evaluated the strength of relationship between obesity and psychiatric disorders were included in the study. Quality assessment of included studies was done using the Newcastle–Ottawa checklist tool. Results: From a total of 2424 search results, 21 eligible articles were identified and reviewed. These included studies on obesity and depression (n = 15), obesity and anxiety (four) and one each on obesity and personality disorders, eating disorder (ED), attention deficit hyperactivity disorder, and alcohol use. Maximal evidence existed for the association between depression and obesity with longitudinal studies demonstrating a bidirectional link between the two conditions. The odds ratios (ORs) were similar for developing depression in obesity (OR: 1.21–5.8) and vice versa (OR: 1.18–3.76) with a stronger association observed in women. For anxiety disorders, evidence was mostly cross-sectional, and associations were of modest magnitude (OR: 1.27–1.40). Among other disorders, obesity, and EDs appear to have a close link (OR: 4.5). Alcohol use appears to be a risk factor for obesity and not vice versa but only among women (OR: 3.84). Conclusion: Obesity and depression have a significant and bidirectional association. Evidence is modest for anxiety disorders and inadequate for other psychiatric conditions. Gender appears to be an important mediator in these relationships.
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Affiliation(s)
- T M Rajan
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - V Menon
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Zhang Y, Guo Y, Shen X, Zhao F, Yan S. Lower body mass index is not of more benefit for diabetic complications. J Diabetes Investig 2019; 10:1307-1317. [PMID: 30628186 PMCID: PMC6717826 DOI: 10.1111/jdi.13003] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 12/13/2018] [Accepted: 01/09/2019] [Indexed: 12/14/2022] Open
Abstract
AIMS/INTRODUCTION To investigate the relationship between different body mass index (BMI) levels and vascular complications in type 2 diabetes mellitus patients. MATERIALS AND METHODS Data were collected from 3,224 individuals with type 2 diabetes mellitus (male/female: 1,635/1,589; age 61.31 ± 11.45 years), using a retrospective case study design. The association of BMI quintiles and diabetes mellitus vascular complications was assessed using multiple logistic regression models adjusting for age, sex, diabetes duration, smoking status, drinking and other confounders, using those with the lowest quintile of BMI as the reference group. RESULTS With increasing BMI, the detection rate of diabetic peripheral neuropathy and peripheral arterial disease initially decreased and then it increased, whereas the detection rate of diabetic kidney disease and carotid atherosclerotic plaques showed an upward trend; however, diabetic retinopathy was irregular. The odds ratios of diabetic peripheral neuropathy decreased as BMI increased from the 21st percentile to the 80th percentile initially, and increased when BMI was in >80th percentile. The same result was shown in peripheral arterial disease. BMI >80th percentile showed a 1.426-fold risk of diabetic kidney disease and a 1.336 -fold risk of carotid atherosclerotic plaque. CONCLUSIONS In patients with type 2 diabetes mellitus, the relationship between different BMIs and vascular complications varies. A U-shaped relationship was observed between BMI and diabetic peripheral neuropathy, as well as BMI and peripheral arterial disease. BMI is positively correlated with diabetic kidney disease and carotid atherosclerotic plaque; however, it is not correlated with diabetic retinopathy.
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Affiliation(s)
- Yongze Zhang
- Department of Endocrinologythe First Affiliated Hospital of Fujian Medical UniversityFuzhouFujianChina
- Diabetes Research Institute of Fujian ProvinceFuzhouFujianChina
| | - Yangyang Guo
- Department of Endocrinologythe First Affiliated Hospital of Fujian Medical UniversityFuzhouFujianChina
- Diabetes Research Institute of Fujian ProvinceFuzhouFujianChina
- Present address:
Graduate student of Department of Endocrinology, the First Affiliated Hospital of Fujian Medical, now working at SanMing First Hospital (Teaching Hospital of Fujian Medical University)SanmingFujianChina
| | - Ximei Shen
- Department of Endocrinologythe First Affiliated Hospital of Fujian Medical UniversityFuzhouFujianChina
- Diabetes Research Institute of Fujian ProvinceFuzhouFujianChina
| | - Fengying Zhao
- Department of Endocrinologythe First Affiliated Hospital of Fujian Medical UniversityFuzhouFujianChina
- Diabetes Research Institute of Fujian ProvinceFuzhouFujianChina
| | - Sunjie Yan
- Department of Endocrinologythe First Affiliated Hospital of Fujian Medical UniversityFuzhouFujianChina
- Diabetes Research Institute of Fujian ProvinceFuzhouFujianChina
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Association of SNP rs7181866 in the nuclear respiratory factor-2 beta subunit encoding GABPB1 gene with obesity and type-2 diabetes mellitus in South Indian population. Int J Biol Macromol 2019; 132:606-614. [DOI: 10.1016/j.ijbiomac.2019.03.125] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 01/12/2019] [Accepted: 03/19/2019] [Indexed: 01/22/2023]
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Importance of the Madras Diabetes Research Foundation-Indian Diabetes Risk Score (MDRF-IDRS) for mass screening of type 2 diabetes and its complications at primary health care centers of North India. Int J Diabetes Dev Ctries 2019. [DOI: 10.1007/s13410-018-0710-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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28
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Kim JJ. Epidemiology of Gastroesophageal Junction Adenocarcinoma in Korea. J Gastric Cancer 2018; 18:328-338. [PMID: 30607296 PMCID: PMC6310763 DOI: 10.5230/jgc.2018.18.e38] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 12/04/2018] [Accepted: 12/04/2018] [Indexed: 12/20/2022] Open
Abstract
The incidence of gastroesophageal junction adenocarcinoma (GEJAC) in Western countries has increased in recent decades, in addition to a rise in the incidence of esophageal adenocarcinoma (EAC). Gastroesophageal reflux disease (GERD), obesity, smoking, alcohol consumption, and low Helicobacter pylori (HP) infection rate have been nominated as risk factors for such cancers. Among these risk factors, the increased prevalence of GERD and obesity and the decreased prevalence of HP infection are of special interest owing to the currently increasing prevalence of GEJAC in Western countries. Although similar trends in the prevalence of GERD, obesity, and HP infection are observed in Asian countries after a time lag from Western countries, it is still uncertain if the prevalence of GEJAC in Asian countries is increasing, especially in Korea. The incidence of GERD in Korea is currently increasing; it was below 3% in the 1990s. The incidence of obesity in the Korean population is increasing owing to the adoption of westernized lifestyles, including food preferences, and the HP infection rate in Korea is known to be decreasing. Therefore, based on logical extrapolation of observations of Western countries, the incidence of GEJAC will increase in Korea. However, the proportion of GEJAC among other upper gastrointestinal malignancies in Korea appears to be currently unchanged compared with that in the 1990s. Presently, there is a lack of epidemiologic studies on this issue in this region; therefore, more studies are needed to clarify the characteristics of these tumors and to improve clinical outcomes for patients with these tumors.
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Affiliation(s)
- Jin-Jo Kim
- Division of Gastrointestinal Surgery, Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
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Rawal LB, Kanda K, Mahumud RA, Joshi D, Mehata S, Shrestha N, Poudel P, Karki S, Renzaho A. Prevalence of underweight, overweight and obesity and their associated risk factors in Nepalese adults: Data from a Nationwide Survey, 2016. PLoS One 2018; 13:e0205912. [PMID: 30399189 PMCID: PMC6219769 DOI: 10.1371/journal.pone.0205912] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 10/03/2018] [Indexed: 11/29/2022] Open
Abstract
Introduction Over the past few decades, the total population of Nepal has increased substantially with rapid urbanization, changing lifestyle and disease patterns. There is anecdotal evidence that non-communicable diseases (NCDs) and associated risk factors are becoming key public health challenges. Using nationally representative survey data, we estimated the prevalence of underweight, overweight and obesity among Nepalese adults and explored socio-demographic factors associated with these conditions. Materials and methods We used the Nepal Demographic Health Survey 2016 data. Sample selection was based on stratified two-stage cluster sampling in rural areas and three stages in urban areas. Weight and height were measured in all adult women and men. Body mass index (BMI) was calculated using Asian specific BMI cut-points. Results A total of 13,542 adults aged 18 years and above (women 58.19%) had their weight and height measured. The mean (±SD) age was 40.63±16.82 years (men 42.75±17.27, women 39.15±16.34); 41.13% had no formal education and 60.97% lived in urban areas. Overall, 17.27% (95% CI: 16.64–17.91) were underweight; 31.16% (95% CI: 30.38–31.94) overweight/obese. The prevalence of both underweight (women 18.30% and men 15.83%, p<0.001) and overweight/obesity (women 32.87% and men 28.77%, p<0.001) was higher among women. The older adults (≥65 years) (aOR: 2.40, 95% CI: 1.92–2.99, p<0.001) and the adults of poorest wealth quintile (aOR: 2.05, 95% CI: 1.62–2.59, p<0.001) were more likely to be underweight. The younger age adults (36–45 years) (aOR: 3.05, 95% CI: 2.61–3.57, p<0.001) and women (aOR: 1.53, 95% CI 1.39–1.68, p<0.001) were more likely to be overweight or obese. Also, all adults were twice likely to overweight/obese (p<0.001). No significant difference was observed for overweight/obesity by ecological regions and place of residence (urban vs. rural). Conclusion These findings confirm co-existence of double burden of underweight and overweight/obesity among Nepalese adults. These conditions are associated with increased risk of developing NCDs. Therefore, effective public health intervention approaches emphasizing improved primary health care systems for NCDs prevention and care and using multi-sectoral approach, is essential.
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Affiliation(s)
- Lal B. Rawal
- Western Sydney University, Sydney, Australia
- * E-mail: ,
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Ashraf H, Laway BA, Afroze D, Wani AI. Evaluation of Proinflammatory Cytokines in Obese vs Non-obese Patients with Metabolic Syndrome. Indian J Endocrinol Metab 2018; 22:751-756. [PMID: 30766812 PMCID: PMC6330875 DOI: 10.4103/ijem.ijem_206_18] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Obesity is one of the most common yet neglected public health problems in both the developed and developing countries. Metabolic syndrome (MS) is a multiplex of risk factor for the development of type 2 diabetes (T2D) and cardiovascular disease (CVD) and it reflects the clustering of multiple risk factors resulting from obesity and insulin resistance. Despite its predominance in obese individuals, MS does occur in non-obese individuals. Many individuals characterised as normal weight as per their body mass index (BMI), have increased visceral adiposity thereby leading to an unfavourable inflammatory cytokine profile. There are limited studies from India with respect to inflammatory cytokines in obesity and MS in general and non-obese patients with MS in particular. MATERIALS AND METHODS An observational cross-sectional study was carried out in patients with MS with or without obesity. Anthropometric parameters such as height, weight and waist girth were measured and BMI was calculated. Serum levels of TNF-α, IL-6 and adiponectin were measured by using the enzyme-linked immunosorbent assay. RESULTS A significant proportion of individuals categorised as normal weight had an increased waist circumference which correlated with BMI, acanthosis nigricans (AN) and fatty liver. There was no statistically significant difference in the cytokine levels in obese and non-obese patients with MS; similarly among non-obese patients with MS, cytokine levels were comparable in patients with or without abdominal obesity. However, triglycerides inversely correlated with adiponectin levels and there was no significant correlation between the cytokines and other parameters of MS. CONCLUSION There was no significant difference in various metabolic and inflammatory parameters between obese and non-obese patients with MS. Even in non-obese group, there were no differences in metabolic and inflammatory markers between individuals with or without abdominal obesity. This finding indicates that apart from adipose tissue, other factors are also responsible for the development of MS and its associated proinflammatory profile. There could be a significant contribution of genetic and epigenetic factors which needs to be further explored.
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Affiliation(s)
- Hamid Ashraf
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India
| | - Bashir Ahmad Laway
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India
| | - Dil Afroze
- Department of Immunology and Molecular Medicine, Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India
| | - Arshad Iqbal Wani
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India
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Wells JCK, Wibaek R, Poullas M. The Dual Burden of Malnutrition Increases the Risk of Cesarean Delivery: Evidence From India. Front Public Health 2018; 6:292. [PMID: 30386761 PMCID: PMC6199394 DOI: 10.3389/fpubh.2018.00292] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Accepted: 09/24/2018] [Indexed: 11/23/2022] Open
Abstract
Background: Among contemporary human populations, rates of cesarean delivery vary substantially, making it difficult to know if the procedure is inadequately available, or used excessively relative to medical need. A much-cited evolutionary hypothesis attributed birth complications to an “obstetric dilemma,” resulting from antagonistic selective pressures acting on maternal pelvic dimensions and fetal brain growth during hominin evolution. However, the childbirth challenges experienced by living humans may not be representative of those in the past, and may vary in association with trends in ecological conditions. We hypothesized that variability in maternal phenotype (height and nutritional status) may contribute to the risk of cesarean delivery. In many populations, high levels of child stunting contribute to a high frequency of short adult stature, while obesity is also becoming more common. The combination of short maternal stature and maternal overweight or obesity may substantially increase the risk of cesarean delivery. Methods: Using data from two large Indian health surveys from 2005–6 to 2015–2016, we tested associations of maternal somatic phenotype (short stature, overweight) with the risk of cesarean delivery, adjusting for confounding factors such as maternal age, birth order, rural/urban location, wealth and offspring sex. Results: Secular trends in maternal body mass index between surveys were greater than trends in height. Maternal short stature and overweight both increased the risk of cesarean delivery, most strongly when jointly present within individual women. These associations were independent of birth order, wealth, maternal age and rural/urban location. Secular trends in maternal phenotype explained 18% of the increase in cesarean rate over 10 years. Conclusion: Our results highlight how the emerging dual burden of malnutrition (persisting short adult stature which reflects persistent child stunting; increasing overweight in adults) is likely to impact childbirth in low and middle-income countries.
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Affiliation(s)
- Jonathan C K Wells
- Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Rasmus Wibaek
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.,Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Marios Poullas
- Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
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Kaur H, Badaruddoza B, Bains V, Kaur A. Genetic association of ADIPOQ gene variants (-3971A>G and +276G>T) with obesity and metabolic syndrome in North Indian Punjabi population. PLoS One 2018; 13:e0204502. [PMID: 30265726 PMCID: PMC6161880 DOI: 10.1371/journal.pone.0204502] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Accepted: 09/10/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND AND AIMS At present obesity and metabolic syndrome (MetS) in India are the most challenging health problems. It is also well accepted that obesity is a significant risk factor for the development of metabolic syndrome and other degenerative diseases. Many studies have reported that single-nucleotide polymorphisms (SNPs) of the adiponectin (ADIPOQ) gene have been associated with obesity and its related disorders. Here, we aimed to investigate the association of two intronic variants in ADIPOQ gene, -3971A>G (rs822396) and +276G>T (rs1501299) with obesity and metabolic syndrome. METHODS Biochemical and anthropometric measurements were obtained from a total of 550 unrelated subjects (obese = 250 and non-obese = 300) of North Indian Punjabi population. Genotyping for the intron variants were performed by polymerase chain reaction based restriction fragment length polymorphism (PCR-RFLP) methods. After genotyping, as a quality control measure 10% of the samples for each polymorphism were confirmed by Sanger Sequencing method. The distributions of genotypic and allelic frequencies among obese and non-obese groups were compared by chi-square test and the corresponding risk was calculated using binary logistic regression. The effects of multiple testing were controlled by applying Bonferroni corrections. RESULTS All the anthropometric and biochemical parameters except triglycerides (TG) and very low-density lipoproteins cholesterol (VLDL-C) have shown significant association with both GG and TT genotypes of -3971A>G (rs822396) and +276G>T (rs1501299) polymorphisms respectively. The frequencies of GG (-3971A>G) and TT (+276G>T) genotypes were higher among obese cases (p = 0.008 and p = 0.035 respectively). However, no significant association was found between allelic frequencies of ADIPOQ rs822396 and obesity, whereas the association of ADIPOQ rs1501299 attenuated and became marginally significant after Bonferroni correction (p>0.025). Both the variant genotypes of ADIPOQ gene polymorphisms (-3971GG and +276TT) significantly increased the risk of development of obesity (OR: 1.52, p = 0.03; OR: 1.58, p = 0.04 respectively) and MetS (OR: 1.42, p = 0.03; OR: 1.57, p = 0.01 respectively) in the present population, after adjusting the various covariates. The G-T haplotype model (possessing -3971G and +276T alleles) was shown toprovide ~ 3 fold risk towards the obesity susceptibility (OR: 2.69, p = 0.009) and MetS risk (OR: 2.73, p = 0.009) and the association persisted after adjusting for different confounding variables. CONCLUSION The present study has confirmed that ADIPOQ -3971A>G (rs822396) and +276G>T (rs1501299) polymorphism may be clinically helpful to estimate obesity and MetS risk in North Indian Punjabi population.
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Affiliation(s)
- Harjit Kaur
- Department of Human Genetics, Guru Nanak Dev University, Amritsar, Punjab, India
| | | | - Veena Bains
- Department of Human Genetics, Guru Nanak Dev University, Amritsar, Punjab, India
| | - Anupam Kaur
- Department of Human Genetics, Guru Nanak Dev University, Amritsar, Punjab, India
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Rautela YS, Reddy BV, Singh AK, Gupta A. The prevalence of obesity among adult population and its association with food outlet density in a hilly area of Uttarakhand. J Family Med Prim Care 2018; 7:809-814. [PMID: 30234058 PMCID: PMC6132005 DOI: 10.4103/jfmpc.jfmpc_161_17] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background The rising burden of obesity is a threat to both developed and developing countries. Obesity is a killer lifestyle disease. Different aspects of the local environment play a key role in the occurrence of obesity. The present study was conducted to determine the prevalence of obesity among adult, its associated factors, and its relationship with retail food outlet density in Srikot, Uttarakhand. Materials and Methods This study was a community-based cross-sectional study, carried out in Srikot, Uttarakhand, in 2016 among 155 adults systematically sampled, aged above 20 years. A semi-structured pretested questionnaire was used to interview the participants, and anthropometry measurements were done. The details regarding the geographic location and count of outlets were carried out. Obesity was considered body mass index ≥25 kg/m2. Results In the present study, 61.3% were females. The mean age of the study participants was 38.3 (±13.6) years. The prevalence of overweight was 14.8% and obesity was 55.5%. A total of 92.9% of the study participants reported consumption of junk food. On mapping the study area, it was found that the total number of food outlets were 116. It was found that density of any food outlet per study participant was 0.7. Conclusion The Srikot in Uttarakhand is in an early stage of urbanization as evident from the burden of obesity, and this might worsen by prevalent outlet density of food in the environment.
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Affiliation(s)
- Yashneel Singh Rautela
- Department of Community Medicine, Veer Chandra Singh Garhwali Government Institute of Medical Science and Research, Srinagar, Uttarakhand, India
| | - B Venkatashiva Reddy
- Department of Community Medicine, Veer Chandra Singh Garhwali Government Institute of Medical Science and Research, Srinagar, Uttarakhand, India
| | - Amit Kumar Singh
- Department of Community Medicine, Veer Chandra Singh Garhwali Government Institute of Medical Science and Research, Srinagar, Uttarakhand, India
| | - Arti Gupta
- Department of Community Medicine, Veer Chandra Singh Garhwali Government Institute of Medical Science and Research, Srinagar, Uttarakhand, India
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Zhou Y, Wang C, Shi K, Yin X. Relation of metabolic syndrome and its components with risk of diabetic retinopathy: A meta-analysis of observational studies. Medicine (Baltimore) 2018; 97:e12433. [PMID: 30235724 PMCID: PMC6160146 DOI: 10.1097/md.0000000000012433] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Emerging studies have reported the effects of metabolic syndrome (MetS) and its components on risk of diabetic retinopathy (DR), but the results remain controversial. Therefore, we performed a meta-analysis to evaluate the relationship between MetS and risk of DR.A meta-analysis of observational studies.Studies were searched from PubMed, Cochrane Library, and Elsevier databases from the start of the database up until November 30, 2017. Adjusted odds ratios (ORs) and its corresponding 95% confidence intervals (CIs) were extracted and pooled by using a random effects model.A total of 12 observational studies were included in this meta-analysis. When the MetS as a full syndrome, MetS was not associated with increased risks of type 1 (OR = 1.47, 95% CI 0.67-3.24; P = .34) or type 2 (OR = 1.34, 95% CI 0.91-1.98; P = .14) DR. In addition, none of single component of MetS was associated with the risk of DR, including body mass index/waist circumference (BMI/WC) (OR = 0.92, 95% CI 0.75-1.13; P = .41), blood pressure (OR = 1.37, 95% CI 0.96-1.95; P = .08), high density lipoprotein (OR = 0.97, 95% CI 0.93-1.01; P = .19), and triglyceride (OR = 0.85, 95% CI 0.63-1.15; P = .29). In the sensitivity analysis, the pooled OR values were not changed after we removed the included studies one by one.Based on recent published data, neither MetS nor its components are associated with an increased risk of DR.
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Affiliation(s)
- Yue Zhou
- The Children's Department of Ophthalmology
| | - Changyun Wang
- Department of Ophthalmology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Ke Shi
- Department of Ophthalmology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
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Ayisi Addo S, Steiner-Asiedu M. Telephone based weight loss intervention: Relevance for developing countries. Crit Rev Food Sci Nutr 2018; 59:2095-2101. [PMID: 29420054 DOI: 10.1080/10408398.2018.1437536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Obesity is a major public health challenge not only for developed but developing countries as well. The World Health Organization recommends the immediate use of effective, efficient and widely accessible weight loss interventions. Telephone based weight loss intervention could provide a cheaper and wider reach of obese participants. Previous systematic reviews on telephone based weight loss interventions either excluded studies that had obese participants with co-morbidities or were silent on their inclusion. Obese/overweight individuals with co-morbidities constitute an important population in any weight loss intervention study due to the strong association of obesity with major chronic health conditions. This paper, reviews the efficacy of telephone based weight loss intervention solely in overweight/obese individuals with obesity related diseases and discusses its relevance for developing countries.
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Affiliation(s)
- Sandra Ayisi Addo
- a Department of Nutrition and Food Science , University of Ghana , Legon , Accra , Ghana
| | - Matilda Steiner-Asiedu
- a Department of Nutrition and Food Science , University of Ghana , Legon , Accra , Ghana
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Babu GR, Murthy GVS, Ana Y, Patel P, Deepa R, Benjamin-Neelon SE, Kinra S, Reddy KS. Association of obesity with hypertension and type 2 diabetes mellitus in India: A meta-analysis of observational studies. World J Diabetes 2018; 9:40-52. [PMID: 29359028 PMCID: PMC5763039 DOI: 10.4239/wjd.v9.i1.40] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Revised: 10/09/2017] [Accepted: 11/20/2017] [Indexed: 02/05/2023] Open
Abstract
AIM To perform a meta-analysis of the association of obesity with hypertension and type 2 diabetes mellitus (T2DM) in India among adults.
METHODS To conduct meta-analysis, we performed comprehensive, electronic literature search in the PubMed, CINAHL Plus, and Google Scholar. We restricted the analysis to studies with documentation of some measure of obesity namely; body mass index, waist-hip ratio, waist circumference and diagnosis of hypertension or diagnosis of T2DM. By obtaining summary estimates of all included studies, the meta-analysis was performed using both RevMan version 5 and “metan” command STATA version 11. Heterogeneity was measured by I2 statistic. Funnel plot analysis has been done to assess the study publication bias.
RESULTS Of the 956 studies screened, 18 met the eligibility criteria. The pooled odds ratio between obesity and hypertension was 3.82 (95%CI: 3.39 to 4.25). The heterogeneity around this estimate (I2 statistic) was 0%, indicating low variability. The pooled odds ratio from the included studies showed a statistically significant association between obesity and T2DM (OR = 1.14, 95%CI: 1.04 to 1.24) with a high degree of variability.
CONCLUSION Despite methodological differences, obesity showed significant, potentially plausible association with hypertension and T2DM in studies conducted in India. Being a modifiable risk factor, our study informs setting policy priority and intervention efforts to prevent debilitating complications.
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Affiliation(s)
- Giridhara R Babu
- Public Health Foundation of India, IIPH-H, Bangalore Campus, SIHFW Premises, Beside Leprosy Hospital, Bangalore 560023, India
| | - G V S Murthy
- Indian Institute of Public Health-Hyderabad, Plot # 1, A.N.V.Arcade, Amar Co-op Society, Kavuri Hills, Madhapur, Hyderabad 500033, India
- London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom
| | - Yamuna Ana
- Public Health Foundation of India, IIPH-H, Bangalore Campus, SIHFW Premises, Beside Leprosy Hospital, Bangalore 560023, India
| | - Prital Patel
- Indian School of Business, Hyderabad 500111, India
| | - R Deepa
- Public Health Foundation of India, IIPH-H, Bangalore Campus, SIHFW Premises, Beside Leprosy Hospital, Bangalore 560023, India
| | | | - Sanjay Kinra
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine and University College London Hospital, London WC1E 7HT, United Kingdom
| | - K Srinath Reddy
- Public Health Foundation of India, ISID Campus, 4 Institutional Area Vasant Kunj, New Delhi 110070, India
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Patel SA, Deepa M, Shivashankar R, Ali MK, Kapoor D, Gupta R, Lall D, Tandon N, Mohan V, Kadir MM, Fatmi Z, Prabhakaran D, Narayan KMV. Comparison of multiple obesity indices for cardiovascular disease risk classification in South Asian adults: The CARRS Study. PLoS One 2017; 12:e0174251. [PMID: 28448582 PMCID: PMC5407781 DOI: 10.1371/journal.pone.0174251] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 03/06/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND We comparatively assessed the performance of six simple obesity indices to identify adults with cardiovascular disease (CVD) risk factors in a diverse and contemporary South Asian population. METHODS 8,892 participants aged 20-60 years in 2010-2011 were analyzed. Six obesity indices were examined: body mass index (BMI), waist circumference (WC), waist-height ratio (WHtR), waist-hip ratio (WHR), log of the sum of triceps and subscapular skin fold thickness (LTS), and percent body fat derived from bioelectric impedance analysis (BIA). We estimated models with obesity indices specified as deciles and as continuous linear variables to predict prevalent hypertension, diabetes, and high cholesterol and report associations (prevalence ratios, PRs), discrimination (area-under-the-curve, AUCs), and calibration (index χ2). We also examined a composite unhealthy cardiovascular profile score summarizing glucose, lipids, and blood pressure. RESULTS No single obesity index consistently performed statistically significantly better than the others across the outcome models. Based on point estimates, WHtR trended towards best performance in classifying diabetes (PR = 1.58 [1.45-1.72], AUC = 0.77, men; PR = 1.59 [1.47-1.71], AUC = 0.80, women) and hypertension (PR = 1.34 [1.26,1.42], AUC = 0.70, men; PR = 1.41 [1.33,1.50], AUC = 0.78, women). WC (mean difference = 0.24 SD [0.21-0.27]) and WHtR (mean difference = 0.24 SD [0.21,0.28]) had the strongest associations with the composite unhealthy cardiovascular profile score in women but not in men. CONCLUSIONS WC and WHtR were the most useful indices for identifying South Asian adults with prevalent diabetes and hypertension. Collection of waist circumference data in South Asian health surveys will be informative for population-based CVD surveillance efforts.
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Affiliation(s)
- Shivani A. Patel
- Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- Centre for Control of Chronic Conditions, Gurgaon, Haryana, India
- * E-mail:
| | - Mohan Deepa
- Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Roopa Shivashankar
- Centre for Control of Chronic Conditions, Gurgaon, Haryana, India
- Public Health Foundation of India, Gurgaon, Haryana, India
| | - Mohammed K. Ali
- Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- Centre for Control of Chronic Conditions, Gurgaon, Haryana, India
| | - Deksha Kapoor
- All India Institute of Medical Sciences, New Delhi, India
| | - Ruby Gupta
- Centre for Control of Chronic Conditions, Gurgaon, Haryana, India
- Public Health Foundation of India, Gurgaon, Haryana, India
| | - Dorothy Lall
- Institute of Public Health Bengaluru, Bengaluru, Karnataka, India
| | - Nikhil Tandon
- Centre for Control of Chronic Conditions, Gurgaon, Haryana, India
- All India Institute of Medical Sciences, New Delhi, India
| | | | | | - Zafar Fatmi
- Aga Khan University, Karachi, Sindh, Pakistan
| | - Dorairaj Prabhakaran
- Centre for Control of Chronic Conditions, Gurgaon, Haryana, India
- Public Health Foundation of India, Gurgaon, Haryana, India
| | - K. M. Venkat Narayan
- Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- Centre for Control of Chronic Conditions, Gurgaon, Haryana, India
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Khan MM, Sonkar GK, Alam R, Mehrotra S, Khan MS, Kumar A, Sonkar SK. Validity of Indian Diabetes Risk Score and its association with body mass index and glycosylated hemoglobin for screening of diabetes in and around areas of Lucknow. J Family Med Prim Care 2017; 6:366-373. [PMID: 29302549 PMCID: PMC5749088 DOI: 10.4103/2249-4863.220010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVES The present study aimed to assess the validity of Indian Diabetes Risk Score (IDRS) and its association with body mass index (BMI) and glycosylated hemoglobin (HbA1c) for screening of diabetes and obesity. METHODOLOGY A cross-sectional study was designed, and samples were randomly enrolled from Lucknow and its adjoining areas. Totally, 405 subjects were included in the study. We used diabetes risk factors (age, waist circumference, physical activity, and family history of diabetes) for screening of diabetes and abdominal obesity (AO) and BMI for screening of general obesity. HbA1c was used for confirming the diabetes patients in this population. Statistical analysis was applied to all data using SPSS software (version 20.0). P < 0.05 was considered statistically significant. RESULTS All 405 subjects were assessed for diabetic risk factors, BMI, and glycated hemoglobin. Of these, 56.3% subjects were aged ≥50 years. 1° and 2° AO was found in 47.9% and 40% subjects, respectively. About 27.1% subjects were found to have sedentary lifestyle, and 72.6% were found to have no family history of diabetes. According to IDRS, 272 subjects (67.2%) were found at high risk of diabetes (score ≥60). Based on BMI calculation, 198 subjects were obese, of which 79.3% were found at high risk for diabetes. A significant association was found between subjects with higher risk score and BMI (P < 0.001). Assessment of HbA1c showed that 97 (23.9%) were prediabetic and 204 (50.4%) were diabetic, of which 63.9% and 77%, respectively was at high risk for diabetes as per IDRS. A significant association was found between subjects with higher risk score and HbA1c (P < 0.001). CONCLUSION Our study fully supports the validity of IDRS, as it can be used as a cost-effective tool for primary mass screening of diabetes. Moreover, its combination with BMI value and HbA1c can be used for strict monitoring for diabetes and obesity at primary health care centers to reduce the early development of diabetes complications and severe obesity comorbidities.
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Affiliation(s)
- Mohammad Mustufa Khan
- Department of Biochemistry, Integral Institute of Medical Sciences and Research, Integral University, Lucknow, Uttar Pradesh, India
| | - Gyanendra Kumar Sonkar
- Department of Biochemistry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Roshan Alam
- Department of Biochemistry, Integral Institute of Medical Sciences and Research, Integral University, Lucknow, Uttar Pradesh, India
| | - Sudhir Mehrotra
- Department of Medicine, Integral Institute of Medical Sciences and Research, Integral University, Lucknow, Uttar Pradesh, India
| | - M. Salman Khan
- Department of Biosciences, Integral University, Lucknow, Uttar Pradesh, India
| | - Ajay Kumar
- Department of Biochemistry, Integral Institute of Medical Sciences and Research, Integral University, Lucknow, Uttar Pradesh, India
| | - Satyendra Kumar Sonkar
- Department of Medicine, Hemodialysis Unit, King George's Medical University, Lucknow, Uttar Pradesh, India
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Jayawardana NWIA, Jayalath WATA, Madhujith WMT, Ralapanawa U, Jayasekera RS, Alagiyawanna SASB, Bandara AMKR, Kalupahana NS. Lifestyle factors associated with obesity in a cohort of males in the central province of Sri Lanka: a cross-sectional descriptive study. BMC Public Health 2017; 17:27. [PMID: 28056898 PMCID: PMC5217224 DOI: 10.1186/s12889-016-3963-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 12/20/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Obesity has become a global epidemic. The prevalence of obesity has also increased in the South Asian region in the last decade. However, dietary and lifestyle factors associated with obesity in Sri Lankan adults are unclear. The objective of the current study was to investigate the association of dietary and lifestyle patterns with overweight and obesity in a cohort of males from the Central Province of Sri Lanka. METHODS A total of 2469 males aged between 16 and 72 years ([Formula: see text]) were included in the study. The sample comprised individuals who presented for a routine medical examination at the National Transport Medical Institute, Kandy, Sri Lanka. The Body Mass Index (BMI) cutoff values for Asians were used to categorize the participants into four groups as underweight, normal weight, overweight or obese. The data on dietary and lifestyle patterns such as level of physical activity, smoking, alcohol consumption, sleeping hours and other socio demographic data were obtained using validated self-administered questionnaires. Multinomial logistic regression model was fitted to assess the associations of individual lifestyle patterns with overweight and obesity. RESULTS The mean BMI of the study group was 22.7 kg m-2 and prevalence rates of overweight and obesity were 31.8 and 12.3%, respectively. Mean waist circumference of the participants was 78.6 cm with 17.1% of them being centrally obese. After adjusting for potential confounders, weight status was associated with older age (P < 0.0001), ethnicity (P = 0.0033) and higher income (P = 0.0006). While higher physical activity showed a trend for being associated with lower odds of being obese (odds ratio: 0.898 - confidence interval: 0.744-1.084), alcohol intake, consumption of fruits, level of education, sleeping hours, smoking, consumption of fish, meat, dairy, sweets or fried snacks were not significantly associated with the weight status. CONCLUSION The high prevalence rates of overweight and obesity in working-age males is a threatening sign for Sri Lanka. Since the prevalence rate is higher in certain ethnic groups and higher-income groups, targeted interventions for these groups may be necessary.
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Affiliation(s)
- N W I A Jayawardana
- Department of Animal and Food Sciences, Faculty of Agriculture, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - W A T A Jayalath
- Department of Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - W M T Madhujith
- Department of Food Science and Technology, Faculty of Agriculture, University of Peradeniya, Peradeniya, Sri Lanka
| | - U Ralapanawa
- Department of Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | | | - S A S B Alagiyawanna
- Department of Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - A M K R Bandara
- Department of Agricultural Systems, Faculty of Agriculture, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - N S Kalupahana
- Department of Physiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.
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Rshikesan PB, Subramanya P, Nidhi R. Yoga Practice for Reducing the Male Obesity and Weight Related Psychological Difficulties-A Randomized Controlled Trial. J Clin Diagn Res 2016; 10:OC22-OC28. [PMID: 28050422 DOI: 10.7860/jcdr/2016/22720.8940] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 08/20/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Obesity is a health disorder and increasing all over the world. It is also a cause for many non-communicable diseases. Yoga practice reduces the stress level which may improve the eating habits and help in weight reduction. AIM To assess the final outcome of the effects after 3 months of the 14 weeks yoga training on obesity of adult male in an urban setting. MATERIALS AND METHODS This was a randomized controlled trial with parallel groups (Yoga and Control groups) on male obese. Total 80 subjects with Body Mass Index (BMI) between 25 to 35 kg/cm2 were enrolled and randomized into two equal groups in which 72 subjects (yoga n = 37 and control n=35) completed the trial. Yoga group mean age ± SD was 40.03±8.74 and Control group mean age±SD was 42.20±12.06. A 14 weeks special IAYT (Integrated Approach of Yoga Therapy) yoga training was given to the Yoga group and no specific activity was given to Control group. The interim results of this study at 14 weeks were covered in another article which is under process. After the 14 weeks of yoga training the Yoga group was asked to continue the yoga practice for the next 3 months and the Control group was not given any physical activity. The final outcome is covered in this paper. The assessments were anthropometric parameters of body weight (Wt), BMI (Body Mass Index), MAC (Mid-upper Arm Circumferences of left and right arm), WC (Waist Circumference), HC (Hip Circumference), WHR (Waist Hip Ratio), SKF (Skin Fold Thickness) of biceps, triceps, sub scapular, suprailiac and cumulative skin fold thickness value), Percentage body fat based on SKF and Psychological questionnaires of PSS (Perceived Stress Scale) and AAQW (Acceptance and Action Questionnaire for Weight related difficulty). Assessments were taken after 3 months of yoga training, for both Yoga and Control groups. Within group, between group and correlation analyses were carried out using SPSS 21. RESULTS Improvement in anthropometric and psychological parameters such as Wt, Percentage body fat, PSS were observed in the final outcome. Also, some of the improvements such as AAQW score were lost in the final outcome, compared to interim results. CONCLUSION The yoga practice is effective for obesity control for adult male in an urban setting.
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Affiliation(s)
- P B Rshikesan
- Research Scholar, Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana , Bengaluru, Karnataka, India
| | - Pailoor Subramanya
- Associate Professor, Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana , Bengaluru, Karnataka, India
| | - Ram Nidhi
- Assistant Professor, Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana , Bengaluru, Karnataka, India
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Rshikesan PB, Subramanya P. Effect of Integrated Approach of Yoga Therapy on Male Obesity and Psychological Parameters-A Randomised Controlled Trial. J Clin Diagn Res 2016; 10:KC01-KC06. [PMID: 27891357 DOI: 10.7860/jcdr/2016/21494.8727] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 08/01/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Obesity is a growing global epidemic and cause of non-communicable diseases. Yoga is one of the effective ways to reduce stress which is one of the causes of obesity. AIM To assess the effect of Integrated Approach of Yoga Therapy (IAYT) yoga module on adult male obesity in an urban setting. MATERIALS AND METHODS RCT (Randomized Controlled Trial) was conducted for 14 weeks on obese male subjects with yoga and control groups. Total number of subjects were 72 and they were randomized into two groups (Yoga n=37, Control n=35). The subjects were from an urban setting of Mumbai and were doing yoga for the first time. Special yoga training of IAYT was given to yoga group for one and half hour for 5 days in a week for 14 weeks. The control group continued regular physical activities and no specific physical activity was given. The assessments were anthropometric parameters of weight, Body Mass Index (BMI), MAC (Mid Upper Arm Circumferences) of Left and Right Arm, Waist Circumference (WC), HC (Hip Circumference), WHR (Waist Hip Ratio), SKF(Skin Fold Thickness of Biceps, Triceps, Sub scapular, suprailiac and cumulative), Percentage body fat based on SKF and Psychological Questionnaires of Perceived Stress Scale (PSS) and AAQW (Acceptance and Action Questionnaire for Weight Related Difficulty). These were taken before and after intervention for both yoga and control groups. Within and between group analysis & correlation of differences from post to pre readings among the variables, were carried out using SPSS 21. RESULTS The anthropometric and psychological parameters were improved in both the groups but changes were significant in yoga group. CONCLUSION Incorporating the IAYT for obese male in urban setting will be effective for obesity treatment and for reducing the obesity related problems.
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Affiliation(s)
- P B Rshikesan
- Research Scholar, Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana , Bengaluru, Karnataka, India
| | - Pailoor Subramanya
- Associate Professor, Division of Yoga and Life Sciences, 19 S- VYASA Yoga University , Gavipuram Circle, K.G. Nagar, Bengaluru, Karnataka, India
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Mondal N, Sen J, Bose K, Timungpi R, Kathar M, Hanse S. Neck circumference as a screening measure of overweight/obesity among Indian adults. ANTHROPOLOGICAL REVIEW 2016. [DOI: 10.1515/anre-2016-0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Neck circumference (NC) is an anthropometric measurement of differentiating body fat distributions and a marker of upper subcutaneous adiposity. The present study highlights the association and importance of NC as a suitable proxy screening measure of overweight/obesity as compared to the conventional anthropometric variables used among Indian adults. The present community based cross-sectional study was undertaken among 1169 Karbi adults (males: 625; females: 544) residing in Karbi Anglong district of Assam, Northeast India, who were selected through a multistage stratified random sampling method. Height, weight, waist circumference (WC), hip circumference (HC) and NC were recorded using standard procedures. The body mass index (BMI) was calculated and prevalence of overweight/obesity was assessed using standard cut-offs. The prevalence of obesity using BMI (≥25.00 kg m-2) was 15.52% and 15.26% among males and females, respectively (p≥0.05).The prevalence of obesity using NC was observed to be significantly higher among males (48.80%) than females (19.12%) (p<0.01). The binary logistic regression analysis showed that NC predicted obesity over the conventional anthropometric variables with reasonable accuracy (p<0.01). The ROC-AUC analysis showed a relatively greater significant association between BMI, WC and HC and NC for obesity (p<0.01). Thus, NC appears to be a potentially simple, easyto- use screening measure for predicting obesity among adults. Further studies are required to validate its use for screening of obesity among other ethnic populations in India.
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Srivastava A, Mittal B, Prakash J, Srivastava P, Srivastava N, Srivastava N. A multianalytical approach to evaluate the association of 55 SNPs in 28 genes with obesity risk in North Indian adults. Am J Hum Biol 2016; 29. [PMID: 27650258 DOI: 10.1002/ajhb.22923] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 07/13/2016] [Accepted: 08/20/2016] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES The aim of the study was to investigate the association of 55 SNPs in 28 genes with obesity risk in a North Indian population using a multianalytical approach. METHODS Overall, 480 subjects from the North Indian population were studied using strict inclusion/exclusion criteria. SNP Genotyping was carried out by Sequenom Mass ARRAY platform (Sequenom, San Diego, CA) and validated Taqman® allelic discrimination (Applied Biosystems® ). Statistical analyses were performed using SPSS software version 19.0, SNPStats, GMDR software (version 6) and GENEMANIA. RESULTS Logistic regression analysis of 55 SNPs revealed significant associations (P < .05) of 49 SNPs with BMI linked obesity risk whereas the remaining 6 SNPs revealed no association (P > .05). The pathway-wise G-score revealed the significant role (P = .0001) of food intake-energy expenditure pathway genes. In CART analysis, the combined genotypes of FTO rs9939609 and TCF7L2 rs7903146 revealed the highest risk for BMI linked obesity. The analysis of the FTO-IRX3 locus revealed high LD and high order gene-gene interactions for BMI linked obesity. The interaction network of all of the associated genes in the present study generated by GENEMANIA revealed direct and indirect connections. In addition, the analysis with centralized obesity revealed that none of the SNPs except for FTO rs17818902 were significantly associated (P < .05). CONCLUSIONS In this multi-analytical approach, FTO rs9939609 and IRX3 rs3751723, along with TCF7L2 rs7903146 and TMEM18 rs6548238, emerged as the major SNPs contributing to BMI linked obesity risk in the North Indian population.
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Affiliation(s)
- Apurva Srivastava
- Department of Medical Genetics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Rae Bareli Road, Lucknow, Uttar Pradesh, 226014, India
| | - Balraj Mittal
- Department of Medical Genetics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Rae Bareli Road, Lucknow, Uttar Pradesh, 226014, India
| | - Jai Prakash
- Department of Physiology, King George's Medical University, Chowk, Lucknow, Uttar Pradesh, 226003, India
| | - Pranjal Srivastava
- Darbhanga Medical College and Hospital Near Karpuri Chowk Benta Laheriasarai Darbhanga, Bihar, 846003, India
| | - Nimisha Srivastava
- Sikkim Manipal Institute of Medical Sciences (SMIMS), National Highway 31A, Upper Tadong, Gangtok, 737102, Sikkim
| | - Neena Srivastava
- Department of Medical Genetics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Rae Bareli Road, Lucknow, Uttar Pradesh, 226014, India
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Tripathy JP, Thakur JS, Jeet G, Chawla S, Jain S, Prasad R. Urban rural differences in diet, physical activity and obesity in India: are we witnessing the great Indian equalisation? Results from a cross-sectional STEPS survey. BMC Public Health 2016; 16:816. [PMID: 27538686 PMCID: PMC4989330 DOI: 10.1186/s12889-016-3489-8] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 08/11/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The rising morbidity and mortality due to non-communicable diseases can be partly attributed to the urbanized lifestyle leading to unhealthy dietary practices and increasing physical levels of inactivity. The demographic and nutrition transition in India has also contributed to the emerging epidemic of non-communicable diseases in this country. In this context, there is limited information in India on dietary patterns, levels of physical activity and obesity. The aim of the present study was thus to assess the urban rural differences in dietary habits, physical activity and obesity in India. METHODS A household survey was done in the state of Punjab, India in a multistage stratified sample of 5127 individuals using the WHO STEPS questionnaire. RESULTS No rural urban difference was found in dietary practices and prevalence of overweight and obesity except the fact that a significantly higher proportion of respondents belonging to rural area (15.6 %) always/often add salt before/when eating as compared to urban area (9.1 %). Overall 95.8 % (94.6-97.0) of participants took less than 5 servings of fruits and/or vegetables on average per day. No significant urban rural difference was noted in both sexes in all three domains of physical activity such as work, transport and recreation. However, rural females (19.1 %) were found to be engaged in vigorous activity more than the urban females (6.3 %). Males reported high levels of physical activity in both the settings. Absence of recreational activity was reported by more than 95 % of the subjects. Higher prevalence of obesity (asian cut offs used) was seen among urban females (34.3 %) as compared to their rural counterparts (23.2 %). Abdominal obesity was found to be significantly higher among females in both the settings compared to males (p < 0.001). CONCLUSIONS Poor dietary practices and physical inactivity seems to fuel the non-communicable disease epidemic in India. Non communicable disease control strategy need to address these issues with a gender equity lens. Rapid urbanization of rural India might be responsible for the absence of a significant urban rural difference.
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Affiliation(s)
- Jaya Prasad Tripathy
- International Union Against Tuberculosis and Lung Disease, The Union South East Asia Office, New Delhi, India
| | - J S Thakur
- Department of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
| | - Gursimer Jeet
- Department of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sohan Chawla
- Department of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sanjay Jain
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rajender Prasad
- Department of Biochemistry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Wells JCK, Pomeroy E, Walimbe SR, Popkin BM, Yajnik CS. The Elevated Susceptibility to Diabetes in India: An Evolutionary Perspective. Front Public Health 2016; 4:145. [PMID: 27458578 PMCID: PMC4935697 DOI: 10.3389/fpubh.2016.00145] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 06/24/2016] [Indexed: 01/11/2023] Open
Abstract
India has rapidly become a "diabetes capital" of the world, despite maintaining high rates of under-nutrition. Indians develop diabetes at younger age and at lower body weights than other populations. Here, we interpret these characteristics in terms of a "capacity-load" model of glucose homeostasis. Specifically, we assume that glycemic control depends on whether the body's "metabolic capacity," referring to traits, such as pancreatic insulin production and muscle glucose clearance, is able to resolve the "metabolic load" generated by high levels of body fat, high dietary glycemic load, and sedentary behavior. We employ data from modern cohorts to support the model and the interpretation that elevated diabetic risk among Indian populations results from the high metabolic load imposed by westernized lifestyles acting on a baseline of low metabolic capacity. We attribute this low metabolic capacity to the low birth weight characteristic of Indian populations, which is associated with short stature and low lean mass in adult life. Using stature as a marker of metabolic capacity, we review archeological and historical evidence to highlight long-term declines in Indian stature associated with adaptation to several ecological stresses. Underlying causes may include increasing population density following the emergence of agriculture, the spread of vegetarian diets, regular famines induced by monsoon failure, and the undermining of agricultural security during the colonial period. The reduced growth and thin physique that characterize Indian populations elevate susceptibility to truncal obesity, and increase the metabolic penalties arising from sedentary behavior and high glycemic diets. Improving metabolic capacity may require multiple generations; in the meantime, efforts to reduce the metabolic load will help ameliorate the situation.
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Affiliation(s)
- Jonathan C K Wells
- Childhood Nutrition Research Centre, UCL Institute of Child Health , London , UK
| | - Emma Pomeroy
- McDonald Institute for Archaeological Research, University of Cambridge , Cambridge , UK
| | | | - Barry M Popkin
- Nutrition Department, Gillings Global School of Public Health, University of North Carolina School of Public Health , Chapel Hill, NC , USA
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Pradeepa R, Anjana RM, Joshi SR, Bhansali A, Deepa M, Joshi PP, Dhandania VK, Madhu SV, Rao PV, Geetha L, Subashini R, Unnikrishnan R, Shukla DK, Kaur T, Mohan V, Das AK. Prevalence of generalized & abdominal obesity in urban & rural India--the ICMR-INDIAB Study (Phase-I) [ICMR- NDIAB-3]. Indian J Med Res 2016; 142:139-50. [PMID: 26354211 PMCID: PMC4613435 DOI: 10.4103/0971-5916.164234] [Citation(s) in RCA: 151] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND & OBJECTIVES Overweight and obesity are rapidly increasing in countries like India. This study was aimed at determining the prevalence of generalized, abdominal and combined obesity in urban and rural India. METHODS Phase I of the ICMR-INDIAB study was conducted in a representative population of three States [Tamil Nadu (TN), Maharashtra (MH) and Jharkhand (JH)] and one Union Territory (UT)[Chandigarh (CH)] of India. A stratified multi-stage sampling design was adopted and individuals ≥ 20 yr of age were included. WHO Asia Pacific guidelines were used to define overweight [body mass index (BMI) ≥ 23 kg/m [2] but < 25 kg/m [2]], generalized obesity (GO, BMI ≥ 25 kg/m [2], abdominal obesity (AO, waist circumference ≥ 90 cm for men and ≥ 80 cm for women) and combined obesity (CO, GO plus AO). Of the 14,277 participants, 13,800 subjects (response rate, 96.7%) were included for the analysis (urban: n = 4,063; rural: n = 9737). RESULTS The prevalence of GO was 24.6, 16.6, 11.8 and 31.3 per cent among residents of TN, MH, JH and CH, while the prevalence of AO was 26.6, 18.7, 16.9 and 36.1 per cent, respectively. CO was present in 19.3, 13.0, 9.8 and 26.6 per cent of the TN, MH, JH and CH population. The prevalence of GO, AO and CO were significantly higher among urban residents compared to rural residents in all the four regions studied. The prevalence of overweight was 15.2, 11.3, 7.8 and 15.9 per cent among residents of TN, MH, JH and CH, respectively. Multiple logistic regression analysis showed that female gender, hypertension, diabetes, higher socio-economic status, physical inactivity and urban residence were significantly associated with GO, AO and CO in all the four regions studied. Age was significantly associated with AO and CO, but not with GO. INTERPRETATION & CONCLUSIONS Prevalence of AO as well as of GO were high in India. Extrapolated to the whole country, 135, 153 and 107 million individuals will have GO, AO and CO, respectively. However, these figures have been estimated from three States and one UT of India and the results may be viewed in this light.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Viswanathan Mohan
- Department of Epidemiology & Diabetology, Madras Diabetes Research Foundation & Dr Mohan's Diabetes Specialities Centre, Chennai, India
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Parikesit D, Mochtar CA, Umbas R, Hamid ARAH. The impact of obesity towards prostate diseases. Prostate Int 2015; 4:1-6. [PMID: 27014656 PMCID: PMC4789344 DOI: 10.1016/j.prnil.2015.08.001] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 08/13/2015] [Indexed: 12/21/2022] Open
Abstract
Evidence has supported obesity as a risk factor for both benign prostate hyperplasia (BPH) and prostate cancer (PCa). Obesity causes several mechanisms including increased intra-abdominal pressure, altered endocrine status, increased sympathetic nervous activity, increased inflammation process, and oxidative stress, all of which are favorable in the development of BPH. In PCa, there are several different mechanisms, such as decreased serum testosterone, peripheral aromatization of androgens, insulin resistance, and altered adipokine secretion caused by inflammation, which may precipitate the development of and even cause high-grade PCa. The role of obesity in prostatitis still remains unclear. A greater understanding of the pathogenesis of prostate disease and adiposity could allow the development of new therapeutic markers, prognostic indicators, and drug targets. This review was made to help better understanding of the association between central obesity and prostate diseases, such as prostatitis, BPH, and PCa.
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Affiliation(s)
- Dyandra Parikesit
- Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Chaidir Arief Mochtar
- Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Rainy Umbas
- Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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Srivastava A, Mittal B, Prakash J, Srivastava P, Srivastava N, Srivastava N. Association of FTO and IRX3 genetic variants to obesity risk in north India. Ann Hum Biol 2015; 43:451-6. [DOI: 10.3109/03014460.2015.1103902] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Apurva Srivastava
- Department of Physiology, King George’s Medical University, Chowk, Lucknow, Uttar Pradesh, India,
- Department of Medical Genetics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India,
| | - Balraj Mittal
- Department of Medical Genetics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India,
| | - Jai Prakash
- Department of Physiology, King George’s Medical University, Chowk, Lucknow, Uttar Pradesh, India,
| | - Pranjal Srivastava
- Darbhanga Medical College and Hospital, Karpuri Chowk, Benta Laheriasarai, Darbhanga, Bihar, India, and
| | - Nimisha Srivastava
- Sikkim Manipal Institute of Medical Sciences (SMIMS), Upper Tadong, Tadong, Gangtok, Sikkim, India
| | - Neena Srivastava
- Department of Physiology, King George’s Medical University, Chowk, Lucknow, Uttar Pradesh, India,
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Parikesit D, Mochtar CA, Umbas R, Hamid AR. WITHDRAWN: The impact of obesity towards prostate diseases. Prostate Int 2015. [DOI: 10.1016/j.prnil.2015.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Anjana RM, Sudha V, Nair DH, Lakshmipriya N, Deepa M, Pradeepa R, Shanthirani CS, Subhashini S, Malik V, Unnikrishnan R, Binu VS, Patel SA, Hu FB, Mohan V. Diabetes in Asian Indians-How much is preventable? Ten-year follow-up of the Chennai Urban Rural Epidemiology Study (CURES-142). Diabetes Res Clin Pract 2015; 109:253-61. [PMID: 26044609 DOI: 10.1016/j.diabres.2015.05.039] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Revised: 03/26/2015] [Accepted: 05/13/2015] [Indexed: 11/23/2022]
Abstract
We sought to evaluate the contribution of various modifiable risk factors to the partial population attributable risk (PARp) for diabetes in an Asian Indian population. Of a cohort of 3589 individuals, representative of Chennai, India, followed up after a period of ten years, we analyzed data from 1376 individuals who were free of diabetes at baseline. A diet risk score was computed incorporating intake of refined cereals, fruits and vegetables, dairy products, and monounsaturated fatty acid. Abdominal obesity was found to contribute the most to incident diabetes [Relative Risk (RR) 1.63(95%CI 1.21-2.20)]; (PARp 41.1% (95%CI 28.1-52.6)]. The risk for diabetes increased with increasing quartiles of the diet risk score [highest quartile RR 2.14(95% CI 1.26-3.63)] and time spent viewing television [(RR 1.84(95%CI 1.36-2.49] and sitting [(RR 2.09(95%CI 1.42-3.05)]. The combination of five risk factors (obesity, physical inactivity, unfavorable diet risk score, hypertriglyceridemia and low HDL cholesterol) could explain 80.7% of all incident diabetes (95%CI 53.8-92.7). Modifying these easily identifiable risk factors could therefore prevent the majority of cases of incident diabetes in the Asian Indian population. Translation of these findings into public health practice will go a long way in arresting the progress of the diabetes epidemic in this region.
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Affiliation(s)
- Ranjit Mohan Anjana
- Departments of Epidemiology, Diabetology, Nutrition and Biostatistics, Madras Diabetes Research Foundation & Dr Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, International Diabetes Federation (IDF) Centre of Education, Gopalapuram, Chennai, India.
| | - Vasudevan Sudha
- Departments of Epidemiology, Diabetology, Nutrition and Biostatistics, Madras Diabetes Research Foundation & Dr Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, International Diabetes Federation (IDF) Centre of Education, Gopalapuram, Chennai, India
| | - Divya H Nair
- Departments of Epidemiology, Diabetology, Nutrition and Biostatistics, Madras Diabetes Research Foundation & Dr Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, International Diabetes Federation (IDF) Centre of Education, Gopalapuram, Chennai, India
| | - Nagarajan Lakshmipriya
- Departments of Epidemiology, Diabetology, Nutrition and Biostatistics, Madras Diabetes Research Foundation & Dr Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, International Diabetes Federation (IDF) Centre of Education, Gopalapuram, Chennai, India
| | - Mohan Deepa
- Departments of Epidemiology, Diabetology, Nutrition and Biostatistics, Madras Diabetes Research Foundation & Dr Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, International Diabetes Federation (IDF) Centre of Education, Gopalapuram, Chennai, India
| | - Rajendra Pradeepa
- Departments of Epidemiology, Diabetology, Nutrition and Biostatistics, Madras Diabetes Research Foundation & Dr Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, International Diabetes Federation (IDF) Centre of Education, Gopalapuram, Chennai, India
| | - Coimbatore S Shanthirani
- Departments of Epidemiology, Diabetology, Nutrition and Biostatistics, Madras Diabetes Research Foundation & Dr Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, International Diabetes Federation (IDF) Centre of Education, Gopalapuram, Chennai, India
| | - Sivasankaran Subhashini
- Departments of Epidemiology, Diabetology, Nutrition and Biostatistics, Madras Diabetes Research Foundation & Dr Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, International Diabetes Federation (IDF) Centre of Education, Gopalapuram, Chennai, India
| | - Vasanti Malik
- Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, MA, USA
| | - Ranjit Unnikrishnan
- Departments of Epidemiology, Diabetology, Nutrition and Biostatistics, Madras Diabetes Research Foundation & Dr Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, International Diabetes Federation (IDF) Centre of Education, Gopalapuram, Chennai, India
| | | | - Shivani A Patel
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Frank B Hu
- Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, MA, USA
| | - Viswanathan Mohan
- Departments of Epidemiology, Diabetology, Nutrition and Biostatistics, Madras Diabetes Research Foundation & Dr Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, International Diabetes Federation (IDF) Centre of Education, Gopalapuram, Chennai, India
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