Effect of obesity on cardiovascular risk factors in urban population in South India

Association of anthropometric measures of obesity and physical activity with cardio-vascular diseases among older adults: Evidence from a cross-sectional survey, 2017-18

BACKGROUND

With the increase in elderly population, the risk of cardiovascular diseases (CVD) among Indian older adults is also increasing. The present paper tries to assess how different anthropometric measures of obesity and physical activity affects cardiovascular disease risk among older adults in India.

METHODS

The data from Longitudinal Ageing Study in India (LASI) has been used. The total sample size for the present study is 31,464 older adults aged 60 years and above. Chi-square test and binary logistic regression has been used to measure the association of obesity measures and CVD prevalence.

RESULTS

About 35.2% (n = 11,058) of the older adults suffered from CVD. Moreover, 22.2% (n = 6,217) of the older adults were obese/overweight, 23.7% (n = 6,651) had high risk waist circumference and 77.0% (n = 21,593) had high risk waist-Hip ratio. The likelihood of CVD was 60%, 50%, and 34% significantly higher among older adults who were obese/overweight [Adjusted odds ratio (AOR): 1.60; CI: 1.48-1.72], had high risk waist circumference [AOR: 1.50; CI: 1.39-1.62] and high risk waist-Hip ratio [AOR: 1.34; CI: 1.25-1.44], respectively compared to older adults with normal BMI and those who do not have a high risk waist circumference and high risk waist hip ratio. Moreover, older adults who never did physical activity had 22 per cent higher risk of CVD than those who did frequent [AOR: 1.22; CI: 1.13-1.32] physical activity.

CONCLUSION

The burden of overweight and obesity along with physical inactivity increases the risk of CVD in older adults. These findings highlight the urgent need for framing direct and indirect strategies to control obesity in order to reduce the burden of CVD among older adults in India.

Prevalence of metabolic syndrome among adult population in India: A systematic review and meta-analysis

OBJECTIVE

This review was done to determine the prevalence of metabolic syndrome (MS) among adult general population in India. We also wanted to find the gender, setting, and region-wide distribution of MS in India.

METHODS

We conducted systematic searches in various databases including Medline, ScienceDirect, Cochrane library and Google Scholar from inception until August 2019. We included studies conducted in India reporting the prevalence of MS among adults aged 18 years or more. We used the Newcastle Ottawa scale to assess the quality of included studies. We carried out a meta-analysis with random-effects model and reported pooled prevalence with 95% confidence intervals (CIs). We used the Funnel plot to assess publication biases.

RESULTS

In total, we analysed 113 data from 111 studies with 133,926 participants. Majority of the included studies (76 out of 111) had low risk of bias. We found significant heterogeneity among the included studies (p<0.001). We also found a symmetrical funnel plot indicating an absence of publication bias. The prevalence of MS among adult population in India was 30% (95%CI: 28%-33%). There was a steady increase in the burden across the age groups from 13% (18-29 years group) to 50% (50-59 years). We also found that people living in urban areas (32%; 95%CI: 29%-36%) had higher prevalence when compared to tribal (28%; 95%CI: 21%-36%) or rural adults (22%; 95%CI: 20%-25%). Gender distribution of MS showed that the females had higher prevalence (35%; 95%CI: 31%-38%) when compared to males 26% (95%CI: 22%-29%).

CONCLUSION

Almost one in three adults in India suffer from MS. Females, people living in urban areas and in northeast region had higher prevalence of MS. Development and implementation of policies and protocols for the screening of MS would enable us in early diagnosis and treatment with special focus towards the vulnerable and high-risk groups.

Prevalence of metabolic syndrome crossing 40% in Northern India: Time to act fast before it runs out of proportions

Background:

Metabolic syndrome (MetS) is a constellation of high blood pressure, hyperglycemia, obesity, and dyslipidemia. Its presence makes the patient more prone for cardiovascular events. Its prevalence has been documented as 11%–41%. The present study was undertaken to find out the demographic profile of the MetS in Kanpur region of northern India.

Materials and Methods:

This is a hospital based, cross-sectional study with adequate sample size.

Results:

Out of the randomly selected 420 patients (232 males and 188 females), 172 cases (61 males and 111 females) were found to have MeTS adopting the National Cholesterol Education Program Adult Treatment Panel III criteria. The overall prevalence of MeTS was found to be 40.9% (26.2% of total males and 59% of total females). Among the 172 cases of MeTS, females were more than males (64.5% vs. 35.4%). Maximum numbers of MeTS cases were in the age range of 50–59 years (55/172 = 31.9%) followed by 40–49 years (50/172 = 29%), >60 years (35/172 = 20.3%), 30–39 years (30/172 = 17.4%), and <30 years (2/172 = 1.1%). In the total study population of 420 cases, hyperglycemia was the most common (29.2%) and hyperglycemia, obesity, and high triglyceride were significantly higher prevalence in females. Among the participants of 111 cases of MeTS, hyperglycemia was the most common (71.5%) and high blood pressure, and low high density lipoprotein was significantly higher among males.

Conclusion:

The prevalence of MetS was more than 40% and its prevalence in <40 years age group is rapidly increasing. Its high time to be more active physically, before fatal cardiovascular events.

Prevalence of Cardio-metabolic Risk Factors: A Cross-sectional Study among Employed Adults in Urban Delhi, India

INTRODUCTION

Many studies have shown increasing prevalence of Cardiovascular Diseases (CVD) among employed adults. Metabolic Syndrome (MS) which is a predictor of increasing CVD is a cluster of risk factors like central obesity, dyslipidemia, hyperglycaemia and hypertension. Heredity, poor dietary choice, unhealthy lifestyle, job stress are some of the causes responsible for increased prevalence of cardiovascular risk among employed adults.

AIM

To measure the prevalence of cardio-metabolic risk factors among employed adults in urban Delhi, India.

MATERIALS AND METHODS

Study design was cross-sectional with purposive sampling of 200 apparently healthy adults (both males and females) working in urban Delhi, India. Sociodemographic profile, anthropometric measurements (height, weight and waist circumference) and biochemical measurements (lipid profile and fasting glucose) and blood pressure were documented. Physical activity pattern was assessed using WHO Global Physical Activity Questionnaire (GPAQ). Univariate and multivariate regression analysis for associating cardio-metabolic risk factors among adults were performed using the SPSS 18.0 software.

RESULTS

High prevalence of metabolic syndrome among males (66.6%) and females (57.2%) of 25 to 45 years of age was reported. Overall prevalence of MS was 62% among the study population. Central obesity (50.5%, p<0.04), low HDL (62%, p<0.05), hypertriglyceridemia (56.5%, p<0.00), hypertension (39%, p<0.00) and high fasting glucose (10.5%, p<0.76) were the most common abnormalities among males and females. Incidence of high BMI (54.5%, p<0.05) was positively correlated with MS risk factors. Associated cardio-metabolic risk factors besides MS were family history (43.5%, p<0.72), smoking (17.6%, p<0.001), drinking (18%, p<0.001) and physical inactivity. It was found that 32.8% of the subjects had low, 60.4% had moderate and only 7.0% had high physical activity.

CONCLUSION

Employed adults in urban Delhi, India are at high risk of developing CVD due to high prevalence of MS and high Body Mass Index (BMI).

Effect of obesity on cardiometabolic risk factors in Asian Indians

OBJECTIVES

To determine the prevalence of overweight and obesity and their effects on cardiometabolic risk factors in a representative sample of urban population in Eastern India.

MATERIALS AND METHODS

A population-based survey was conducted among a randomly selected study population aged 20-80 years in an urban population of Berhampur city of Eastern India. Both anthropometric and biochemical information were collected, in addition to detailed information on classical cardiometabolic risk factors. Both descriptive and inferential statistical analyses were performed. Obesity and overweight were defined based on the revised Asian-Pacific population criteria (Body mass index [BMI] ≥25 kg/m(2) and ≥23 kg/m(2), respectively).

RESULTS

The age-standardized rates of obesity and overweight are 36.8% (Males: 33.2%; Females: 40.8%) and 17.6%, (Males: 20.4%; Females: 15.1%) respectively, i.e., over half are either obese or overweight in this study population. Compared to the World Health Organization (WHO) standard cutoff criteria of overweight [BMI ≥25 kg/m(2)] and obesity [BMI >30 kg/m(2)], the cardiometabolic risk factors studied showed a significant incremental rise even with the lower cutoffs of the revised Asia-Pacific criteria. Older age, female gender, family history of diabetes, being hypertensive, hypertriglyceridemia, hypercholesterolemia, physical inactivity and middle to higher socioeconomic status significantly contributed to increased obesity risk among this urban population.

CONCLUSION

One-third of the urban populations are obese in Eastern India - an underestimate compared to the standard BMI cutoff criteria. Nevertheless, significant associations of the classical cardiometabolic risk factors with obesity were observed using the revised Asia-Pacific criteria clearly indicating a more aggressive cardiovascular prevention strategy for Asian Indians.

Prevalence and risk factors for metabolic syndrome in Asian Indians: A community study from urban Eastern India

OBJECTIVES

To determine the prevalence of metabolic syndrome and to identify predictors for the same, specific to an underdeveloped urban locale of Eastern India.

MATERIALS AND METHODS

STUDY DESIGN

Population-based cross-sectional study, with multistage random sampling technique.

SETTING

Urban city-dwellers in Orissa one of the poorest states of Eastern India bordering a prosperous state of Andhra Pradesh of Southern India.

PARTICIPANTS

1178 adults of age 20-80 years randomly selected from 37 electoral wards of the urban city. Definition of Metabolic Syndrome: We followed a unified definition of the metabolic syndrome by joint interim statement of five major scientific organizations - the International Diabetes Federation, the National Heart, Lung, and Blood Institute, the American Heart Association, the World Heart Federation, the International Atherosclerosis Society, and the International Association of the Study of Obesity. Individuals who meet at least three of five clinical criteria of abdominal obesity, hypertriglyceredimia, low HDL, hypertension, and hyperglycemia are diagnosed as having the condition; presence of none of these criteria is mandatory. Explicit cut points are defined for all criteria, except elevated waist circumference, which must rely on population and country-specific definitions.

MAIN OUTCOME MEASURE

Prevalence and significant predictors of metabolic syndrome.

STATISTICAL ANALYSIS

Both descriptive and multivariable logistic regression analyses.

RESULTS

Age-standardized prevalence rates of metabolic syndrome were 33.5% overall, 24.9 % in males and 42.3% in females. Older age, female gender, general obesity, inadequate fruit intake, hypercholesterolemia, and middle-to-high socioeconomic status significantly contributed to increased risk of metabolic syndrome.

CONCLUSION

Metabolic syndrome is a significant public health problem even in one of the poorest states of India that needs to be tackled with proven strategies.

Cardiovascular risk factors in middle age obese Indians: a cross-sectional study on association of per cent body fat and intra-abdominal fat mass

OBJECTIVES

To determine the association of per cent total body fat (TBF), intra-abdominal fat (IAF) mass and subcutaneous abdominal fat with cardiovascular risk factors in middle age obese Indians.

DESIGN

Cross-sectional study.

SETTING

Hydrostatic Laboratory, Department of Sports Medicine and Physiotherapy, Guru Nanak Dev University, India.

PARTICIPANTS

51 subjects aged 30-55 years with a body mass index value 23 and above.

METHODOLOGY

In all the participants, TBF was estimated by underwater weighing machine and IAF and subcutaneous fat were measured by ultrasonography. Lipid profile was determined by a semiautomated analyser. Main outcome measures were: IAF, per cent body fat to TBF ratio, lipid profile and risk of developing cardiovascular diseases.

RESULTS

IAF was found to be significantly associated with lipid variables (95% CI, p<0.01) and risk of developing cardiovascular diseases (95% CI, p≤0.05) in both male and female subjects. TBF and subcutaneous fat thickness showed no significant results (95% CI, p>0.05) with either lipid variables or risk of developing cardiovascular diseases (tables 1 and 2). IAF mass showed significant association with age (95% CI, p<0.01) and significant negative association with physical activity (95% CI, p<0.05) in male subjects (tables 3 and 4).

CONCLUSION

An ultrasonic measurement of IAF is a better predictor of the risk of developing cardiovascular diseases in middle aged Indian population. In male subjects, physical activity of 5 or more days a week showed lesser amount of IAF as compared with those with physical activity <5 days a week.