Magnoflorine-Loaded Chitosan Collagen Nanocapsules Ameliorate Cognitive Deficit in Scopolamine-Induced Alzheimer's Disease-like Conditions in a Rat Model by Downregulating IL-1ß, IL-6, TNF-α, and Oxidative Stress and Upregulating Brain-Derived Neurotrophic Factor and DCX Expressions.

Dementia or the loss of cognitive functioning is one of the major health issues in elderly people. Alzheimer's disease (AD) is one of the common forms of dementia. Treatment chiefly involves the use of acetylcholinesterase (AChE) inhibitors in AD. However, oxidative stress has also been found to be involved in the proliferation of the disease. Magnoflorine is one of the active compounds of Coptidis Rhizoma and has high anti-oxidative properties. Active principle-loaded nanoparticles have shown increased efficiency for neurodegenerative diseases due to their ability to cross the blood-brain barrier more easily. An in vitro study involving magnoflorine-loaded chitosan collagen nanocapsules (MF-CCNc) has shown them to possess inhibitory effects against oxidative stress and to some extent on AChE as well. In the current study, both nootropic and anti-amnesic effects of magnoflorine and MF-CCNc on scopolamine-induced amnesia in rats were evaluated. The treatment was done intraperitoneally (i.p.) once daily for 17 consecutive days with MF-CCNc (0.25, 0.5, and 1 mg), magnoflorine (1 mg), and donepezil (1 mg). To induce amnesia, hence, cognitive deficit rats were induced with scopolamine (1 mg/kg) daily for the last 9 days. Novel object recognition (NOR) and elevated plus maze (EPM) behavioral analysis were done to assess memory functioning. Hippocampal tissues were extracted to study the effect on biochemicals (AChE, MDA, SOD, and CAT), pro-inflammatory cytokines (IL-1ß, IL-6, and TNF-α), and immunohistochemistry (brain-derived neurotrophic factor (BDNF) and DCX). MF-CCNc showed memory-enhancing effects in nootropic as well as chronic scopolamine-treated rats in NOR and an increase in inflexion ratio in EPM. MF-CCNc reduced the levels of AChE and MDA while increasing SOD and CAT levels in the hippocampus. MF-CCNc further lowered the levels of pro-inflammatory cytokines IL-1ß, IL-6, and TNF-α. These nanocapsules further increased the expression of BDNF and DCX that are necessary for adult neurogenesis. From the research findings, it can be concluded that MF-CCNc has high anti-amnesic properties and could be a promising candidate for the treatment of AD.

Interceptive orthodontic management of mandibular lateral incisor-canine transposition using simplified and efficient biomechanical approach: A case report.

PURPOSE: Ectopic eruption anomaly, manifesting as tooth transposition, often presents a complex therapeutic challenge. Mandibular lateral incisor- canine transposition, although observed with rarity, tends to have major impact on development of proper dentition and adversely influence physical, nutritional, aesthetic and overall psychosocial well being of the patient. This report chronicles individualized one-phase orthodontic management of the case of incomplete transposition between mandibular right lateral incisor and canine in a 9-year-old boy during mixed dentition period. METHODS: Interceptive orthodontic treatment was initiated with placement of 2×4 fixed appliance in lower arch. A combination of continuous arch wire technique involving the use of improved superelastic nickel-titanium wire in conjunction with TMA rectangular wire loop was utilized to achieve biomechanically efficient mesial movement of mandibular lateral incisor. Treatment continued with sequential bonding of brackets to the rest of the mandibular dentition until the levelling and alignment of the buccal segment dentition was achieved. RESULTS: Well-timed early interceptive treatment involving simplified and controlled movements helped reinstate tooth order, promote free eruption of buccal segment teeth, reduce anchorage burden and achieve predictable and biologically compatible outcome without the use of lingual arch as an additional source of reinforcing anchorage. CONCLUSION: From an aesthetic, occlusal and functional standpoint, the treatment approach used in the reported case and the therapeutic outcome proved to be highly satisfactory. By optimizing the eruption and alignment patterns of the permanent teeth, preadolescent interceptive orthodontic treatment helps mitigate the burden of malocclusion and risks of complex orthodontic treatment in permanent dentition.

Resveratrol-Loaded Glutathione-Coated Collagen Nanoparticles Attenuate Acute Seizures by Inhibiting HMGB1 and TLR-4 in the Hippocampus of Mice.

Epilepsy is a relatively complicated neurological disorder that results in seizures. The use of resveratrol in treating seizures has been reported in recent studies. However, the low bioavailability of resveratrol and the difficulty of reaching the targeted location in the brain reduce its efficacy considerably. The side effects due to the higher concentration of drugs are another matter of concern. The purpose of the present study is to enhance the antiepileptic potential of resveratrol by delivering it to the brain's targeted location by encapsulating it in glutathione-coated collagen nanoparticles. The collagen nanoparticles increase the bioavailability of resveratrol, while the transport of resveratrol to its target location in the brain is facilitated by glutathione. By encapsulating resveratrol in glutathione-coated collagen nanoparticles, the concentration also substantially decreases. Resveratrol encapsulated in synthesized nanoparticles is referred to as nanoresveratrol. In the present study, nanoresveratrol effectiveness was studied through PTZ-induced seizures (PTZ-IS) and the increasing current electroshock (ICES) test. The efficacy of nanoresveratrol was further established using biochemical analysis, histopathological examinations, ELISA and real-time-PCR tests, and immunohistochemistry examination of the hippocampus of mice. Hence, this study is unique in the sense that it synthesized nanoresveratrol by using glutathione-coated collagen nanoparticles, followed by its application to treating seizures. On the basis of the study results, nanoresveratrol was found to be effective in preventing cognitive impairment in the mice and controlling epilepsy seizures to a greater extent than resveratrol. The proposed nanoformulation also reduces the concentration of resveratrol considerably. The present study results show that even 0.4 mg/kg of nanoresveratrol outperforms 40 mg/kg of resveratrol.

Nanonization of Magnoflorine-Encapsulated Novel Chitosan-Collagen Nanocapsules for Neurodegenerative Diseases: In Vitro Evaluation.

Neurodegeneration is one of the most common diseases in the aged population, characterized by the loss in the function of neuronal cells and their ultimate death. One of the common features in the progression of this type of diseases is the oxidative stress. Drugs which are currently being used have been found to show lateral side effects, which is partly due to their inefficiency to cross blood-brain barrier. Nanoencapsulation of bioactive compounds is a profound approach in this direction and has become a method of choice nowadays. This study involved the evaluation of the anti-oxidative properties of magnoflorine (MF), which is an aporphine quaternary alkaloid, and synthesis of MF-loaded chitosan-collagen nanocapsules (MF-CCNc) for its better efficacy as a potent anti-oxidant. Physiochemical characterization of the synthesized nanocapsules was done by using dynamic light scattering and transmission electron microscopy. It revealed that the synthesized nanocapsules are of small size range, as small as 12 ± 2 nm, and are more or less of spherical shape. Sustained release was shown by MF in the in vitro drug release studies. Both MF and MF-CCNc were found to have good anti-oxidant potential with IC50 < 25 µg/mL. No major cytotoxicity was shown by the synthesized nanocapsules on SH-SY5Y cells. In silico anti-acetylcholinesterase (AChE) studies were also done, and they revealed that MF can be a potent inhibitor of AChE.

Resveratrol loaded nanoparticles attenuate cognitive impairment and inflammatory markers in PTZ-induced kindled mice.

Resveratrol has been found to exert protective effects in neurological disorders, including epilepsy. However, its poor bioavailability and difficulty in reaching the brain's targeted location reduce resveratrol's efficacy substantially. The side effects due to the higher concentration of drugs are another matter of concern. The objective of the present study is to propose solutions to these issues by encapsulating resveratrol in glutathione-coated collagen nanoparticles' core. The collagen nanoparticles increase the resveratrol's bioavailability, and glutathione helps in the passage of the encapsulated resveratrol to the target location in the brain. The concentration also substantially reduces due to resveratrol's encapsulation in glutathione-coated collagen nanoparticles. The encapsulated resveratrol is termed nanoresveratrol. The effectiveness of nanoresveratrol on epilepsy seizures was evaluated through histopathological examinations, ELISA tests, and qRT-PCR tests on the hippocampus of the kindled mice. The novelty of the present study thus lies in (i) the synthesis of nanoresveratrol using glutathione-coated collagen nanoparticles and (ii) the application of synthesized nanoresveratrol in the treatment of epilepsy. The study's outcome shows that nanoresveratrol has a favorable impact in reducing cognitive impairment in kindled mice, and it is more effective in controlling epilepsy seizures than resveratrol. The p-values of all the nanoresveratrol-given groups of mice (compared with the diseased group) were substantially smaller (∼10-4 to 10-2) than the significance level (0.05), indicating that the nanoresveratrol-given groups are significantly different from the diseased group, i.e., the nanoresveratrol has a significant effect on the mice. The concentration of resveratrol also decreases substantially in the proposed nanoformulation. It was observed that even 0.4 mg/kg of nanoformulation of resveratrol is performing better than 40 mg/kg of resveratrol.

Determinants of socio-demographic and environmental barriers in prevention of COVID-19 pandemic.

Aim and Objectives: This study assessed the knowledge, attitude, and practice of patients with ESIC, who are insured patients with the public health sector about COVID-19. Materials and Method: This was a cross-sectional observational study that used a questionnaire developed for the purpose of the survey. The questionnaire was divided into five parts including the demographic variables and environmental variables that are enablers for positive preventive practices of COVID-19, knowledge, attitude, and preventive practices followed with respect to COVID-19. Results: The mean age of the study population was 36.96 ± 13.05 (18-73) years with almost an equal proportion of males and females. The knowledge about measures to be taken for prevention of corona infection such as Balanced diet, Lockdown, Social distance, frequently wash hands often, using face mask and regularly cleaning with disinfectant surfaces was significantly better among females. Majority of the subjects displaying good attitude toward the corona disease prevention. Preventive practices were found to be satisfactory among the study population. Use of soap and handwashing was more than the use of sanitizer. Hand washing, use of mouth mask, and taking bath after returning home from outside was significantly better among males. Conclusion: There are increased worries and apprehensions among the public regarding acquiring the COVID-19 infection. People have higher perceived needs to deal with their anxiety towards acquiring the infection.

Collagen Nanoparticle-Mediated Brain Silymarin Delivery: An Approach for Treating Cerebral Ischemia and Reperfusion-Induced Brain Injury.

Silymarin is a bioactive constituent isolated from milk thistle (Silybum marinum). Since its discovery, silymarin has been considered a gold standard drug in treating ailments related to the liver, resulting from alcohol consumption and viral hepatitis. This hepatoprotective nature of silymarin arises out of antioxidative and tissue-regenerating properties of silymarin. However, several recent studies have established the neuroprotective link of silymarin, too. Thus, the current investigation was aimed at exploring the neuroprotective effect of nanosilymarin (silymarin encapsulated inside collagen-based polymeric nanoparticulate drug delivery system). The study aimed at bringing out the role of nanoparticles in enhancing the therapeutic effect of silymarin against neuronal injury, originating out of oxidative-stress-related brain damages in focal cerebral ischemia. Collagen-based micellar nanoparticles were prepared and stabilized using 3-ethyl carbodiimide-hydrochloride (EDC-Hcl) and malondialdehyde (MDA) as crosslinkers. Nanoparticles were characterized using dynamic light scattering (DLS), transmission electron microscopy (TEM), and Fourier transform infrared (FT-IR) spectroscopy techniques, and the size of nanoparticles was found to be around 48 nm. Male albino Wistar rats were pretreated with three different doses of nanosilymarin of 10, 100, and 1,000 µg/kg b.wt and a dose of free silymarin of 100 mg/kg b.wt intraperitoneally (i.p.) for 7 days. Focal cerebral ischemia was induced using the middle cerebral artery occlusion (MCAO) model on the eighth day for 1 h followed by 24 h reperfusion. The animals were then evaluated for neurobehavioral, infarct analysis, biochemical, histopathological, and immunohistochemical studies. All the above parameters showed remarkable improvement in nanosilymarin-treated groups in comparison to the silymarin-treated group. Nanoparticle encapsulation of drug enhanced neuroprotection by increasing drug bioavailability and targeting. Thus, the present study concluded with satisfactory results, showing the critical role played by nanoparticles in improving the neuroprotection at very low drug doses.

Collagen-curcumin nanocomposites showing an enhanced neuroprotective effect against short term focal cerebral ischemia.

The effectiveness of curcumin in treating cerebral ischemia has been reported in recent studies. However, its mode of action is still not defined. The objective of the present study is to formulate collagen-curcumin nanocomposites which will work effectively against cerebral ischemia/reperfusion injury. Ischemic injury is followed by inflammatory damage and oxidative stress, which together contribute a lot in the pathogenesis of cerebral ischemia and may be considered a good target for treatment. The present study focused on examining the effectiveness of collagen-curcumin nanocomposites stabilized by increasing the degree of crosslinking in reducing oxidative stress associated with brain injury resulting from cerebral ischemia. The collagen nanoparticles were prepared by conjugating collagen on the surface of Tween©80 micelles, and further stabilizing them using crosslinkers. The effectiveness of the prepared nanocomposite was validated by performing infarct analysis followed by biochemical, behavioral, histopathological and immunohistochemical studies. The outcomes of this study are promising for the use of collagen-curcumin nanocomposites in showing neuroprotective potential in treating ischemic injury.

Size- and shape-dependent clinical and mycological efficacy of silver nanoparticles on dandruff.

Dandruff is a prominent scalp problem caused by the growth of fungus Malassezia furfur, potentially cascading into dermal inflammation, itching, and tissue damage. The present work outlines a detailed analysis of the treatment of scalp infection using silver nanomaterials (Ag NMs), and focuses on biocidal activity owing to manipulation of size, shape, and structure. Monodisperse silver spherical nanoparticles (NPs) and nanorods (NRs) were synthesized by chemical routes that were characterized using analytical and spectroscopic techniques. Ag NMs demonstrated enhanced biocidal tendencies compared to market available drugs, itracanozole and ketoconazole, showing greater zones of inhibition. The obtained 20 nm and 50 nm spherical-shaped NPs and 50 nm NRs showed concentration-, size-, and shape-dependent antifungal activity, with 20 nm spherical-shaped NPs exhibiting excellent potency. Minimum inhibitory concentration for 20 nm was lowest at 0.2 mg/mL in comparison to 0.3 mg/mL for NRs. Primary irritation index was 0.33 and 0.16 for 20 nm and 50 nm spherical-shaped NPs, respectively, while 50 nm rod-shaped NMs exhibited negligible redness. An in vivo model for M. furfur infection was generated by passing fungi subcutaneously in rats' skin. Again, 20 nm particles showed best normalization of skin after 10 days on regular dosing, in comparison with bigger and rod-shaped particles. The statistical clinical score was highest for Ag nanorods, followed by 50 nm Ag NPs-treated animals. It was observed that 20 nm spherical particles exhibited the lowest score (0) compared with others as well as with antifungal drugs. Biochemical analysis performed by checking antioxidant enzymatic activities indicated tissue repair and normalization of enzymes and protein concentration by Ag NPs.

Modulation of liver and kidney toxicity by herb Withania somnifera for silver nanoparticles: a novel approach for harmonizing between safety and use of nanoparticles.

In the present study, toxicity of nanoparticles is evaluated for assessing their effect on liver and kidney. We have synthesized highly mono-disperse spherical and rod-shaped silver nanoparticles using reverse microemulsion and aqueous phase methods. These were characterized by UV-vis spectrophotometer, dynamic light scattering, and transmission electron microscope confirming the formation of different sizes of spherical-shaped and rod-shaped silver nanoparticles (Ag NPs). Acute toxicity of different shapes and sizes of Ag NPs and their modulations by using Withania somnifera were evaluated through biochemical and histopathological changes in liver and kidney tissues of Wistar rats. We also evaluated cytotoxicity in specific murin macrophages through confocal microscopy. Cytotoxicity analysis indicates that median lethal dose (LD50) for 20, 50, and 100-nm size spherical and 100-nm rod-shaped Ag NPs was 0.25, 0.35, 0.35, and 0.35 mg/ml, respectively. We also calculated clinically important protein concentration to illustrate the efficacy of Ag nanomaterials. These studies indicated that 20, 50, and 100-nm spherical Ag NPs (35 mg/kg, 23 days) increased the biochemically important enzymes and substrate levels glutamate oxaloacetate transaminase (GOT), glutamate pyruvate transaminase (GPT), alkaline phosphatase (ALP), creatinine, and urea concentration in serum, showing liver and kidney tissue damage. After 23 days of treatment of Ag NPs (20, 50, and 100 nm spherical), along with W. somnifera, toxicity of Ag NPs significantly decreased and marginalized. However, no significant changes were observed for 100-nm rod-shaped Ag NPs on normal liver and kidney architecture. Given their low toxic effects and high uptake efficiency, these have a promising potential as to lower the toxicity of Ag NPs.

Cholinergic immunotoxin 192 IgG-SAPORIN alters subicular theta-gamma activity and impairs spatial learning in rats.

Subiculum is an important structure of hippocampal formation and is a part of intra hippocampal network involved in spatial information processing. However, relatively very few studies are available in literature demonstrating the explicit role of subiculum in spatial information processing. The present study investigated the cholinergic modulation of subicular theta-gamma activity on spatial learning and memory functions in rats. The cholinergic projections to ventral subiculum were selectively eliminated using 192 IgG-SAPORIN. Eliminations of cholinergic inputs to ventral subiculum significantly reduced the subicular theta and enhanced the gamma activity during active wake and REM sleep states. In addition, the spatial learning was severely impaired following cholinergic elimination of ventral subiculum. The ChAT immunocytochemical studies showed sparse distribution of cholinergic fibers in the ventral subiculum confirming the cholinergic elimination to ventral subiculum. Cholinotoxic infusions to ventral subiculum did not alter the hippocampal cholinergic innervations and retained the hippocampal theta and gamma activities. The present findings support that cholinergic modulation of subicular theta-gamma oscillations is crucial for spatial information processing.

Nanothymoquinone, a novel hepatotargeted delivery system for treating CCl4 mediated hepatotoxicity in rats.

Thymoquinone (TQ) is the major active principle of Nigella sativa (N. sativa) which is widely being used as a hepatoprotective agent nowadays. However, toxicity at high doses with poor water solubility limit its usage as a therapeutic agent. The idea behind the present study is to design a nanocarrier that exploits the benefit of the antioxidant property of TQ without any toxicity. For this purpose, PAG (p-aminophenyl-1-thio-ß-d-galactopyranoside) coated NIPAAM (N-isopropyl acrylamide) nanoparticles are synthesized followed by encapsulation of TQ (NTQ) in their hydrophobic core. PAG is a ligand which directly interacts with asialoglycoprotein receptors (ASGP-R) present on the surface of hepatocytes and delivers the drug directly to the liver. NTQ have a size of ∼100 nm and were characterized using IR, NMR, DLS, and TEM. The drug was given in two modes: one as NTQ (3 groups: 0.125 (NTQL), 1.25 (NTQM) and 12.5 (NTQH) µg kg-1 body weight, intraperitoneal (i.p.)) and the other as TQ (12 500 µg kg-1 body weight, i.p.). The best results were obtained with NTQH which is around 1000 times lower than TQ in concentration. Serum and biochemical parameters followed by restoration of histopathology supported this. Expression of inflammatory enzyme COX-2 and NF-kB also gave evidence in support.

Prevalence of metabolic syndrome in an Indian urban population.

OBJECTIVES: To determine prevalence of the metabolic syndrome using United States Adult Treatment Panel-3 (ATP-3) guidelines in an urban Indian population. METHODS: Randomly selected adults >20 years were studied using stratified sampling. Target study sample was 1800 with population proportionate distribution (men 960, women 840). Evaluation of anthropometric variables, blood pressure, fasting blood glucose and lipids was performed. Subjects (1123; response 62.4%) were examined, fasting blood samples were available in 1091 (532 men, 559 women) and analysed for prevalence of metabolic syndrome. Atherosclerosis risk factors were determined using the current guidelines. Metabolic syndrome was diagnosed when any three of the following were present: central obesity, raised triglycerides >/=150 mg/dl (>/=1.7 mmol/l), low high-density lipoprotein (HDL) cholesterol, blood pressure >/=130/>/=85 mm Hg, and diabetes or fasting glucose >110 mg/dl (>6.1 mmol/l). Intergroup comparisons were performed using t-test or chi-square test. RESULTS: Metabolic syndrome was present in 345 (31.6%) subjects; prevalence was 122 (22.9%) in men and 223 (39.9%) in women (p<0.001); the age-adjusted prevalence was 24.9%, 18.4% in men and 30.9% in women. There was a significant age-related increase in its prevalence (Mantel-Haenzel chi(2) for trend p<0.05). Prevalence of components of metabolic syndrome in men and women was: central obesity (waist, men >102 cm, women >88 cm) in 116 (25.6%) and 246 (44.0%); low HDL cholesterol (men<40 mg/dl, <1.0 mmol/l), women<50 mg/dl, <1.3 mmol/l) in 292 (54.9%) and 504 (90.2%); high triglycerides >/=150 mg/dl (>/=1.7 mmol/l) in 172 (32.3%) and 160 (28.6%); and impaired fasting glucose or diabetes in 90 (16.9%) and 90 (16.1%). The prevalence of physical inactivity, hypertension, hypercholesterolemia (>/=200 mg/dl, >/=5.2 mmol/l) and high LDL cholesterol (>/=130 mg/dl, >/=3.4 mmol/l) was greater in the metabolic syndrome group in both men and women (p<0.05). CONCLUSIONS: There is a high prevalence of metabolic syndrome in an urban Indian population. Focus of cardiovascular prevention should be at this high-risk group.

Serial epidemiological surveys in an urban Indian population demonstrate increasing coronary risk factors among the lower socioeconomic strata.

OBJECTIVE: To determine trends of coronary risk factors in an Indian urban population and their association with educational level as marker of socioeconomic status. METHODS: Two successive coronary risk factor surveys were performed in randomly selected individuals. In the first study (in 1995) 2212 subjects (1415 men, 797 women) and in the second (in 2002) 1123 subjects (550 men, 573 women) were studied. Details of smoking, physical activity, hypertension, diabetes, coronary heart disease, body-mass index, waist-hip ratio, blood pressure and electrocardiography were evaluated. Fasting blood was examined for lipid levels in 297 (199 men, 98 women) in the first and in 1082 (532 men, 550 women) in the second study. Educational status was classified into Group 0: no formal education, Group I: 1-10 years, Group II: 11-15 years, and Group III: > 16 years. Current definitions were used for risk factors in both the studies. RESULTS: Prevalence of coronary risk factors, adjusted for age and educational status, in the first and second study in men was smoking/tobacco in 38.7 vs. 40.5%, leisure time physical inactivity in 70.8 vs. 66.1%, hypertension (> or = 140 and/or 90 mm Hg) in 29.5 vs. 33.7%, diabetes history in 1.1 vs. 7.8%, obesity (body-mass index > or = 25 Kg/m2) in 20.7 vs. 33.0%, and truncal obesity (waist:hip > 0.9) in 54.7 vs. 54.4%. In women, tobacco use was in 18.7 vs. 20.5%, leisure time physical inactivity in 72.4 vs. 75.3%, hypertension in 36.9 vs. 33.7%, diabetes history in 1.0 vs. 7.3%, obesity in 19.9 vs. 39.4%, and truncal obesity (waist:hip > 0.8) in 70.1 vs. 69.2%. In men, high total cholesterol > or = 200 mg/dl was in 24.6 vs. 37.4%, high LDL cholesterol > or = 130 mg/dl in 22.1 vs. 37.0%, high triglycerides > or = 150 mg/dl in 26.6 vs. 30.6% and low HDL cholesterol < 40 mg/dl in 43.2 vs. 54.9%; while in women these were in 22.5 vs. 43.1%, 28.6 vs. 45.1%, 28.6 vs. 28.7% and 45.9 vs. 54.2% respectively. In the second study there was a significant increase in diabetes, obesity, hypertension (men), total- and LDL cholesterol and triglycerides and decrease in HDL cholesterol (p < 0.05). In the first study with increasing educational status a significant increase of obesity, total cholesterol, LDL cholesterol and triglycerides and decrease in smoking was observed. In the second study increasing education was associated with decrease in smoking, leisure-time physical inactivity, total and LDL cholesterol, and triglycerides and increase in obesity, truncal obesity and hypertension (Least-squares regression p < 0.05). Increase in smoking, diabetes and dyslipidaemias was greater in the less educated groups. CONCLUSIONS: Significant increase in coronary risk factors--obesity, diabetes, total-, LDL-, and low HDL cholesterol, and triglycerides is seen in this urban Indian population over a seven year period. Smoking, diabetes and dyslipidaemias increased more in low educational status groups.

Prevalence of diabetes, impaired fasting glucose and insulin resistance syndrome in an urban Indian population.

OBJECTIVE: Epidemiological study among urban subjects in western India to determine prevalence of diabetes, insulin resistance syndrome (IRS) and their risk factors. METHODS: Randomly selected adults > or =20 years were studied using stratified sampling. Target sample was 1,800 (men 960, women 840). 1123 subjects (response 62.4%) were evaluated and blood samples were available in 532 men and 559 women (n=1091, 60.6%). Measurement of anthropometric variables, blood pressure, fasting blood glucose and lipids was performed. Atherosclerosis risk factors were determined using current guidelines. Diabetes was diagnosed when the subject was a known diabetic or fasting blood glucose was > or =126 mg/dl, impaired fasting glucose (IFG) diagnosed when fasting glucose was 110-125 mg/dl. IRS was diagnosed when any three of-IFG, high triglycerides >150 mg/dl, low HDL cholesterol (men<40 mg/dl, women<50 mg/dl), central obesity (men>102 cm, women>88 cm), or high normal blood pressure (>130/>85 mmHg) or hypertension-were present. RESULTS: Diabetes was present in 70 men (13.2%) and 64 women (11.5%). Age-adjusted prevalence of diabetes was 9.3% in men (95% confidence intervals (CI) 6.7-11.8), 8.1% in women (CI 5.8-10.4) and 8.6% overall (CI 6.9-10.3). IFG was in 28 men (5.3%) and 29 women (5.2%). IRS was present in 52 men (9.8%) and 114 women (20.4%) with age-adjusted prevalence of 7.9% in men (CI 6.7-9.1) and 17.5% in women (CI 14.4-20.6) with an overall prevalence of 12.8% (CI 10.8-14.8). Other metabolic abnormalities of IRS in men and women were high triglycerides in 32.1 and 28.6%, low HDL cholesterol in 54.9 and 90.2%; central obesity in 21.8 and 44.0%, and high normal blood pressure or hypertension in 35.5 and 32.4%. IFG subjects had similar atherosclerosis risk factor profile as normal subjects while those with IRS and diabetes had significantly greater prevalence of obesity, central obesity, hypertension, high triglycerides and low HDL (P<0.01). CONCLUSIONS: There is s significant prevalence of diabetes and IRS in this urban Indian population. Subjects with diabetes as well as IRS have greater prevalence of obesity, central obesity, hypertension, hypertriglyceridemia and low HDL as compared with normal subjects.