Pregnancy complications and calculated cardiovascular risk in urban women: do we envisage an association?

Most researches related to pregnancy complications and future cardiovascular disease, and their risk factors have been equivocal. Existence and extent of these complications, as a contributing factor to CVD risks, with underlying mechanisms of these associations, still remain uncertain. Hence, the current study tends to examine associations between "complicated pregnancies" with obesity markers known to be coherent reflections of cardiovascular health in urban women. A cross-sectional sample of 631 Punjabi Khatri (mean age: 33 ± 5.58 years) urban women was studied for associations of pregnancy diabetes mellitus, hypertensive disorders, preterm delivery, and size for GA with calculated 10-year CVD risk (based on the Framingham score). A wide range of obesity markers (BMI, waist circumference (WC), WHR, and WHtR) were measured 3-8 years postpregnancy to determine its association with complications during pregnancy. The association with the calculated 10-year CVD risk (≥10 %) based on the Framingham prediction score was 3.01 OR (2.11-3.72 CI) for pregnancy DM, 4.52 (3.68-4.93 CI) for preeclampsia/gestational hypertension, 2.16 (2.01-2.79 CI) for size at GA (SGA and LGA), 2.25 (1.91-2.85 CI) for preterm births, and 2.48 (2.08-3.98 CI) for abnormal birth weight when compared with women without pregnancy diabetes mellitus, preeclampsia/gestational hypertension, appropriate gestational age, full-term babies, and normal birth weight, respectively, in completely adjusted models. Therefore, HDP, pregnancy diabetes mellitus, and pregnancy outcomes are all associated with an increased risk of CVD 10 years later. Pregnancy may provide an opportunity to identify women at increased risk of CVD relatively early in life.

Efficacy of obesity indices and age in predicting diabetes: study on a transitional tribe of Northeast India.

OBJECTIVE: To evaluate the association between blood sugar level and obesity, and the interplay of socioeconomic change, and to investigate the efficacy of different obesity indices and age in predicting diabetes. METHODS: Cross-sectional study was carried out among 603 adult Tangkhul Nagas of NE India. Anthropometric measurements, random blood sugar level, general and regional obesity indices were evaluated along with their information on socioeconomic and lifestyle factors. RESULTS: Socioeconomic change observed among the Tangkhuls influence the rise of overweight/obesity and blood sugar level. Obesity and elevated blood sugar level were highly prevalent and interrelated. Diabetes and obesity were also found to be associated with age. Central obesity indices were highly associated with blood sugar level. Odds ratio showed the likelihood of developing prediabetes/diabetes among centrally obese participants. Correlation between blood sugar level, age and obesity indices showed that waist hip ratio had the highest correlation with blood sugar. It implies the higher reliability of central obesity than general obesity or age in determining blood sugar level. CONCLUSION: The transition of the Tangkhul Naga tribe in terms of socioeconomic and lifestyle factors contributes to the escalating prevalence of overweight/obesity and diabetes. The rising epidemic is not restricted to highly urbanized societies but now has penetrated even to traditional and transitional tribes owing to their changing lifestyle. Different facets of the complex associations between obesity, age, diabetes and socioeconomic change were observed. Central obesity indicator, waist hip ratio emerge as the paramount predictors of prediabetes/diabetes.

Genetic and environmental influences on blood pressure in an urban Indian population.

Aggarwal Baniyas were found to have a high prevalence of high blood pressure. Genetic and environmental influences may be implicated for this risk factor of cardiovascular disease. The aim of this study was to investigate the potential for common genetic and environmental influences on blood pressure measures (systolic and diastolic blood pressure (SBP, DBP)). The population-based sample was comprised of 309 Aggarwal Baniya families, including 1214 individuals (271 fathers, 307 mothers, 311 sons and 325 daughters) from New Delhi, India. The prevalence of obesity in this community was found to be high (BMI: fathers, 26.1 kg/m2; mothers, 29.4 kg/m2; sons, 16.9-22.4 kg/m2; and daughters, 16.3-22.7 kg/m2). Correlation and heritability were estimated. Most sibling-sibling correlations were larger than the parent-offspring correlations, and all parent-offspring and sibling-sibling correlations were larger than the corresponding spouse correlation (SBP=0.026; DBP=0.029). The maximum heritability was estimated as 44.6% for SBP and 62.8% for DBP. The lack of a significant spouse correlation is consistent with little or no influence of the common familial environment. However, the high heritability estimate for both SBP and DBPs reinforces the importance of the non-shared environmental effect.

Optimal cut-off values of anthropometric markers to predict hypertension in North Indian population.

The aim of the study was to determine the cut-offs of anthropometric markers for detecting hypertension in an endogamous North Indian population. A cross-sectional study was carried out to collect data from 578 adult Aggarwal Baniya subjects (271 men and 307 women, mean age: 43.4 ± 5.3 and 38.7 ± 4.9 respectively) using multistage, stratified sampling method. Individual body weight, height, waist circumference (WC), hip circumference, blood pressure were assessed. Receiver operating characteristic (ROC) analysis was used to find out the optimal cut-off values of various anthropometric markers to predict hypertension. The likelihood ratios for having hypertension in subjects with various cut-off values were calculated. Logistic regression analysis was used to examine the independent relationship between the anthropometric markers and odds of having hypertension. The BMI cut-off to predict hypertension was 22.8 kg/m(2) in men and 28.8 kg/m(2) in women. The optimal WC cut-offs varied from 91-92 cm in both men and women. The WHR cut-off was about 0.90 in men and 0.78 in women respectively, and the optimal WHtR cut-off was 0.56 in men and 0.43 in women. The cut-off levels for BMI, WC and WHtR corresponded to the inflexion points in the likelihood ratio graphs. The area under curve (AUC) and odds ratios showed that the risk of having hypertension was highest with respect to increased BMI and that BMI is the best predictor of having hypertension. The cut-off points for detecting cardiovascular risk factors among our population are lower than the criteria by the World Health Organization. Although these results may not be readily applied to the rest of the Indian populations due to the multiethnic composition, they point to the necessity of similar studies with large randomized samples to find the cut-off levels for chronic conditions in different populations.

Sex-dependent effects of the UCP1 -3826 A/G polymorphism on obesity and blood pressure.

OBJECTIVE: To ascertain the association of -3826 A/G polymorphism with blood pressure and different obesity markers. DESIGN AND SUBJECTS: A total of 96 adult participants (49 males, 47 females) were studied. Anthropometric measurements and blood pressure were taken using standardized techniques. Obesity indices of body mass index (BMI), waist hip ratio (WHR), waist height ratio (WHtR) and grand mean thickness (GMT) were computed. For genetic analysis, DNA was extracted from 50 microL blood. RESULTS: A statistically significant difference between various genotypes of UCP1 and BMI, GMT, systolic blood pressure, diastolic blood pressure was found among females. In GGC homozygote, blood pressure showed positive and significant association with fat percentage and GMT (P < .001). Waist circumference, WHR, WHtR and BMI also showed positive association with blood pressure in heterozygous and homozygous GG form. CONCLUSION: This study links the GG homozygous form of UCP1 with obesity and blood pressure among females only.

Covariates and prevalence of obesity among adult North Indian population.

The present study was aimed to investigate the prevalence of obesity and its covariates including age among adult Khatri males and females. A total of 805 subjects (male = 381, female = 424) between age of 18 yr to 71 + yr residing in Shahjahanpur city, Uttar Pradesh, India were studied cross sectionally. The study highlights the trend of obesity in the population and also discusses in detail, the factors that cause it. An inverse relationship was obtained between level of physical activity and different relative weight categories based on body mass index in both the sexes. Similar association was observed in case of television watching time and overweight/obesity. With increase in hours of television watching the prevalence of overweight/obese also increased among both Khatri males and females.

Sex differences in blood pressure levels and its association with obesity indices: who is at greater risk.

OBJECTIVE: The aim of our study was to investigate blood pressure (BP) levels and their association with different indices of body fat in adult Baniyas. DESIGN AND SETTING: A cross-sectional survey was carried out on an endogamous group of 577 adults (307 females and 270 males) aged 25-60 years in Delhi, India. METHODS: Data were collected for weight, height, waist circumference and blood pressure using standardized procedure. Body mass index (BMI), waist to hip ratio (WHR), waist to height ratio (WHtR) and grand mean thickness (GMT) were calculated to assess obesity. Also, the sex-specific prevalence estimates for various BP categories was calculated. Correlation was calculated between systolic and diastolic BP and various indices of obesity. Odds ratios for association of hypertension with obesity indices were obtained using multiple logistic regression. RESULTS: Prevalence of prehypertension and hypertension was higher among males and prevalence of obesity was higher in females. Correlations of BP with all indices of obesity were significant. Odds ratio of hypertension was higher in males than in females for all the indices of obesity at 95% CI. CONCLUSION: Although obesity was found to be higher among females, males were found to be at higher risk of hypertension. High odds ratios of obesity indicate that the optimum cut-off should be calculated for screening those who are at-risk of becoming hypertensive and thus are at the greater risk of developing cardiovascular diseases.

Socioeconomic changes as covariates of overweight and obesity among Tangkhul Naga tribal women of Manipur, north-east India.

The prevalence of overweight/obesity is increasing worldwide. Although countries like India are typically thought of as having a high prevalence of undernutrition, significant proportions of overweight/obese now co-exist with the undernourished. This study aims to find the prevalence of overweight/obesity, and its association with socioeconomic change, among Tangkhul women in India. The cross-sectional study was carried out among 346 Tangkhul women aged 20-70 years, who were divided into five 10-year age groups. Mean BMI was found to be lowest among the youngest age group, and it increased with age until the age of 59 and then declined. The prevalence of overweight and obesity was found to be 27.1%, as assessed from the Asian cut-off point. Although the prevalence of obesity (2.0%) was low when compared with Indian non-tribal female populations, the prevalence of overweight (25.1%) was not far behind. Overweight and obesity were found to be associated with age, marital status, physical activity level, lifestyle and improvement in socioeconomic status, especially occupation and income. When compared with urban non-tribal Indian females, who have a higher socioeconomic status, the prevalence of overweight/obesity among Tangkhul females is lower, indicating its association with socioeconomic status. Tangkhul Naga is a population where the majority are believed to be thin traditionally owing to the difficult hilly terrain and their physically active lifestyle. With urbanization and economic development, nutritional transition, improved socioeconomic status and an increasingly sedentary lifestyle have been observed, which have contributed to the increasing prevalence of overweight/obesity among Tangkhul Naga women.

Fat distribution pattern as a risk factor for chronic disease among the tribals of northeast India.

The objective of this study was to investigate the effect of pulmonary tuberculosis on the body fat distribution pattern and the sensitivity of different skinfold sites with disease and treatment among the adult tribals of Manipur, Northeast India. A total of four anthropometric measurements and skinfold thickness at five different sites were taken for the study. The indices of adiposity like body mass index, waist hip ratio and grand mean thickness were computed. The cross sectional sample included tuberculosis (TB) patients (n=167) at different stages of treatment and healthy non patients as controls (n=80). The subjects ranged in age from 20-40 years. Wasting of muscle mass and decrease in fat mass because of chronic disease (TB) and overall improvement in these components along with redistribution of fat with TB treatment was observed.

Lifestyle and diabetes among Muslim population of Manipur.

OBJECTIVES: This study aims to find out the association of lifestyle with adiposity markers among the patients with diabetes. MATERIALS AND METHODS: 200 diabetic participants of both sexes were enrolled in the present study. Age group of the participants ranged from 20 years to 45 years. A cross sectional study was conducted for the present study. Data was collected from Imphal East district and Thoubal district of Manipur. OBSERVATIONS: The study reported maximum percentage of overweight BMI among diabetic females as compared to diabetic males. Spending long hours at work place was positively associated with body mass index among diabetic participants. CONCLUSIONS: This study informs the need of physical activity for those individuals who were physically inactive and had diabetes, as increasing BMI may lead to other non-communicable diseases.

Adiposity markers and its association with age at menarche: A comparative study among rural and urban Meitei females of Manipur, North-East India.

BACKGROUND: Menarche is a critical biomarker in the reproductive life of females. Early age at menarche may represent an indicator of adult adiposity. The study examines the association of various adiposity markers with age at menarche in rural and urban Meitei females of Manipur, India. METHODS: A cross-sectional study was conducted among rural and urban Meitei females of Manipur of age 18-45 years. Detailed information of the participants was taken with the help of proforma. Various anthropometric and physiological measurements were also recorded. RESULTS: Mean age at menarche was 12.5 years for urban females and 13.1 years for rural females. Females of urban and rural areas under overweight category of BMI had higher odds of attaining early menarche. Odds of having early menarche were found to be highest among those with risk category of waist hip ratio, waist height ratio and waist circumference in both rural and urban females. CONCLUSION: Females with higher body mass index, high waist-to-hip ratio and waist height ratio were found to be at risk of early menarche.

Hypertension and its correlate with general and central adiposity: A study among urban population of Delhi.

AIM: Study aims to assess the association of various adiposity markers with blood pressure levels. STUDY DESIGN: The present study was a cross-sectional study conducted in Delhi. A total of 568 (males- 250, females- 318) participants aged 20-55 years were enrolled for the study. RESULT: Mean height (167.35 ±â€¯7.59) and weight (73.76 ±â€¯15.08) was found to be significantly higher in males. Mean values of minimum waist circumference (183.80 ±â€¯12.24), maximum hip circumference (100.90 ±â€¯12.811), body mass index (27.93 ±â€¯5.76), and conicity index (1.25 ±â€¯0.12) were found to be significantly higher in females. Correlation showed significant positive associations of body mass index (p < 0.01) and waist circumference (p < 0.01) with blood pressure in both males and females. Odds ratios showed strong association of hypertension (both SBP and DBP) with adiposity indices as measured by body mass index, waist circumference and conicity index. CONCLUSION: Adiposity markers such as BMI, WC and CI could be effective predictors of hypertension.

Nutrition, physical activity and psychological status during lockdown due to Covid-19

Aim of the present study was to assess physical activity, nutrition and psychological status of the population during lockdown due to covid-19. Online survey was conductedamong 534 participants within the age range of 16-78 years using convenient sampling. Participantsfrom varied regions within India and abroad were enrolled for the present study. Volunteered participants were solicited to take part in a survey that has to be carried out by filling an online questionnaire form available to them as a URL link in the invitation through WhatsApp/Messenger. The gathered data has been compiled, coded and cleaned using Microsoft Excel. Analysis has been carried out employing descriptive and inferential statistics in SPSS 17.0.Majority of participants in the studied population showed significant change in their nutrition and physical activity status due to lockdown. Covid-19 lockdown did limit their daily activities. It also had impacted their psychological status.The current investigation accentuates the need to pursue suitable life style for the maintenance of optimum metabolism and physiology. Sticking to more regular timetable of meals, effective management of stress levels and continued physical activity during the quarantine and in all the following phases of living is desirable.

Parent-child correlation for various indices of adiposity in an endogamous Indian population.

The study was conducted on 1,042 Punjabi adults and adolescent boys and girls (11-17 years) belonging to middle class families residing in Delhi, India. To study the relative influence of genetic and environmental factors on various fat measures, a set of 7 body measurements namely weight, stature and skinfold thickness at biceps, triceps, subscapular, suprailiac and medial calf measurements was taken on each subject. There was a redistribution of fat away from extremity towards the trunk, a rapid occurring process in males than in females. Increase in body mass index (BMI) with age was more pronounced in females than in males, both at adolescence and adult stage. There was an increase in grand mean thickness (GMT) calculated as mean of all five skinfold thicknesses, in adolescent girls where as in adolescent boys it fluctuated with age. The trunk/extremity ratios reflected a trend in favor of increase in trunk fat, more marked in boys than in girls. The correlations were of low magnitude, however, some skin folds displayed relatively higher value of correlation indicating that these could be determinant of adult obesity.

Pattern of socio-economic and health aspects among TB patients and controls.

BACKGROUND: Socio-economic and health-related factors have a significant impact on tuberculosis (TB) incidence among population residing in resource-scare settings. OBJECTIVE: To evaluate the pattern of socio-economic and health-related factors among TB patients and control in Delhi, India. METHODS: The present cross-sectional study was performed among 893 TB patients (or cases) and 333 healthy disease-free controls. The data for the present study was obtained from several district TB centres in north, west and south Delhi. The collected data was edited, coded and statistical analysed with the help of SPSS 20.0 version. RESULTS: Illiteracy and primary education were significant risk factors being associated with a TB. Rented housing condition had an odds ratio (OR) of 1.4 (95% confidence interval [CI]: 1.09-1.89) compared to owned housing condition. 3-5 individuals per room were 3 times more likely to be associated with a case of TB (95% CI: 2.49-4.41). Migrant individuals were 13 times more likely to be associated with a case of TB (95% CI: 8.77-19.78) in comparison to settled population. Daily consumption of non-vegetarian food also significantly contributed to case of TB with an OR of 3.4 (95% CI: 2.51-4.72). Loss of appetite and family TB served as significant health-related factors associated with TB risk. CONCLUSION: Lower educational status, rented household, individuals per room (as a measure of overcrowding) and migratory status served as prominent risk factors for TB disease. Preference and frequency of non-vegetarian food being consumed, night sweating, weight loss, loss of appetite, earlier TB and family TB were principle health-related risk factors associated with TB disease.

Body structure and respiratory efficiency among high altitude Himalayan populations.

To understand the morphological and physiological variations among the temporary and permanent residents of high altitude, this study was undertaken at Leh, Ladakh. It is situated at 3500 m (11500 feet) above sea level, the mean barometric pressure was 500 tors and air temperature varied from 2 degrees C to 20 degrees C. The highland Tibetans showed broadest chest and most developed musculature closely followed by Ladakhi Bods. These high altude natives also displayed significantly higher value of vital capacity, forced vital capacity, and inspiratory capacity. The better respiratory efficiency observed among high altitude residents indicates higher degree of adaptation to high altitude hypoxia. Temporary residents were observed to be tallest and fattest with lower trunk fat predominance of all the four groups and showed narrowest chest and lower respiratory efficiency as compared to high altitude natives. The duration of stay at high altitude has clearly brought about a perceptible difference in body dimensions and respiratory functions of various groups of adult males studied at same altitude.

Body composition and fat distribution pattern of urban elderly females, Delhi, India.

The present study was conducted on females (n = 279) in the age range of 51-89 year, living in the urban dwellings of Delhi, India. Another group of 21-25 years old young adult females was taken as a control group. A total of 14 anthropometric measurements were taken: stature, sitting height, weight, skinfold thickness at nine different sites over the body and body girths such as upper arm, waist and hip circumference. Indices like body mass index, grand mean thickness, waist-hip ratio were computed to assess the body composition. Fat profile and responsiveness of different skinfold sites towards fat accumulation were studied to find out the regional fat distribution with advancing age. Redistribution of body fat was found to take place with increasing age. A relative preponderance of upper body fat was visible among elderly subjects. However, a clear reverse trend was observed in the young control group females. Significant differences were observed with regards to the body composition and fat profile between young adult females and test group females. Abdomen and the sub-scapular area were reported to be the most sensitive sites for fat deposition as the age advanced. The stature and sitting height showed significant decline with age. All the indices of adiposity i.e. grand mean thickness, waist-hip ratio and body mass index revealed significant changes in elderly females when compared with young adult control group females.

Impact of consanguinity on cardio-metabolic health and other diseases: findings from an Afro-Indian tribal community.

Numerous anthropological reports have indicated consanguineous marriage in populous Asian countries, but the overall impact of first cousin marriage on survival and health of specific communities has rarely been reported. The aim of the study was to estimate risks for various complex diseases in the progeny of consanguineous parents. A cross-sectional study was conducted among 222 women among Siddis, a particularly vulnerable tribal group in the state of Gujarat, India, who are Sunni Muslims by faith. The Siddis are not part of the original Negrito element of India. They are descendants of Africans from Northeast and East Africa who were brought to India as slaves, soldiers, or servants. The degree of consanguinity between each female and her spouse and the degree of consanguinity between their parents and proband's grandparents were recorded with the help of pedigrees. The results showed that the rate of consanguinity in the present generation was 49 % (N = 109), higher than preceding generations. A significant association was observed between women's age, educational level, occupational status, consanguineous parents, and consanguinity. Socioeconomic status and consanguinity showed U-shaped associations. Nearly three times odds for cardio-metabolic risks (2.65 odds ratio (OR) for heart diseases, 2.44 OR for diabetes mellitus, and 2.62 OR for hypertension) have been contracted in the progeny of consanguineous marriage in the parental generation. The risk of cardio-metabolic diseases is higher in offspring of consanguineous couples, and there is a significant increase in the prevalence of common adult diseases.

Secular trend in stature and age at menarche among Punjabi Aroras residing in New Delhi, India.

The study was conducted on Punjabi Arora girls (n = 159) and their mothers to see the phenomenon of secular trend in stature and age at menarche. An increase in stature and decrease in age at menarche was reported when the data of daughters was compared with that of their mothers thereby indicating secular trend in these two parameters. Better living conditions, improved nutrition and medical facilities, changes in environmental and socio-economic factors may account for increase in stature and early biological maturation.

Body adiposity index: its relevance and validity in assessing body fatness of adults.

Background. One of the limitations of body mass index is its accuracy to assess body fatness. To address this limitation, a new index, body adiposity index, has been developed. However its validity needs to ascertained. Objective. Our aim was to investigate sex-specific relationship between BAI, BMI, and percent body fat in an endogamous population of Delhi, India. Method. Data was collected from 578 adults on bodyweight, height, skinfold thicknesses, hip circumference, waist circumference, and systolic and diastolic blood pressure. Pearson's correlations were calculated for BAI and BMI with PBF. Differences in the correlation coefficients were examined using Fisher's z tests. Receiver operating characteristic analysis was used to compare the predictive validity and to determine optimal cut-off values. Odds ratios were calculated to assess the risk of having hypertension using the proposed cut-off points. Results. The correlations of PBF with BMI (men: r = 0.83; women: r = 0.71) were stronger than those with BAI (men: r = 0.66; women: r = 0.58). In men, the sensitivity and specificity of BAI to predict hypertension were higher than other anthropometric markers but lower than BMI. In women, the sensitivity of BAI was higher than BMI and WC. Conclusions. BAI can be used as an additional marker for screening population; however its validity needs to be demonstrated on other populations too.