Musculoskeletal manifestations in type-2 diabetic patients attending a tertiary care hospital in a North-Eastern city of India-A cross-sectional observational study.

Background: Musculoskeletal manifestations of diabetes are common and not life threatening, but these are an important cause of morbidity, pain and disability among diabetic patients. In 2004, the National Health Interview Survey determined that 58% of diabetic patients would have musculoskeletal functional disability. This study was designed to estimate the proportion of musculoskeletal manifestations among Type 2 diabetic patients attending a tertiary care hospital in Tripura and also to determine the association of various musculoskeletal manifestations with glycaemic status, body mass index and duration of diabetes mellitus. Methods: This hospital-based cross-sectional study was carried out in a tertiary care hospital in a northeastern state of India from December 2020 to November 2021. All the diabetic patients attending diabetes nutrition clinic of a tertiary care hospital for a period of one year were considered for this study. Diagnosis of musculoskeletal disorder was made based on history, physical examination, laboratory test and imaging test. Quantitative data were expressed as mean and standard deviation. Descriptive data was expressed in percentages and frequencies using charts and tables. Chi-square test was applied to explore any association between variables. Ethical approval for the study was obtained from the institutional ethics committee. Results: Out of four hundred and forty-two diabetic cases and two hundred and thirty-four (52.9%) patients were found with musculoskeletal manifestations, 55% of which belong to 45-59 age group. Conclusion: Physicians treating diabetic patients should be encouraged for regular examination for musculoskeletal complaints. Early diagnosis will facilitate appropriate treatment and thus prevents further complications.

Assessment of serum nitric oxide level and its correlation with anthropometric parameters and lipid profile in diabetic patients: A hospital-based study from Tripura.

Background: Endothelial dysfunction is a well-known finding in hyper-cholesterolaemic patients. Multiple factors including increased inactivation of nitric oxide by radicals and inhibition of nitric oxide formation by different mechanisms contribute to this. Objectives: (i) To estimate serum nitric oxide (NO) levels among diabetic and non-diabetic subjects attending a tertiary care hospital of Tripura and (ii) to determine the correlation of serum nitric oxide with different anthropometric parameters and lipid profile among the study subjects. Methods: This cross-sectional study was conducted during June 2019 to May 2020 among 227 subjects. Anthropometric measurements like weight, body mass index (BMI), body fat percentage, visceral fat percentage were measured by using OMRON Body Composition Monitor (HBF 701). Serum NO levels were measured using standard NO colorimetric assay kit and HbA1C and lipid profile were analyzed by using a Biochemical Autoanalyser. Statistical analysis was performed by using SPSS software version 25. Result: One hundred fifteen (115) diabetics were considered as test group whereas One hundred twelve (112) non-diabetic subjects were included as control. The mean serum level of NO in the diabetic group was 86.91 ± 14.13 mmoles/L whereas in the non-diabetic group it was 33.23 ± 12.90 mmoles/L which is statistically significant. Significant correlation is also found between serum NO level and different anthropometric parameters, namely, age, BMI and visceral fat percentage. Conclusion: In this study, positive correlation is found between serum NO, BMI, and body visceral fat. As NO is considered as a potential biomarker for diabetic patients developing hypertension, BMI, and body visceral fat may be considered as a good prognostic parameter in future development of diabetic complications. While dealing with diabetic patients the family physicians should be aware of these two parameters and besides treating them, physicians should convince the diabetic patients to maintain ideal BMI and body visceral fat by following proper life style.

Hypovitaminosis D, Dyslipidemia, and Thyroid Dysfunction among Adolescents and Their Associations with Blood Pressure in a Northeastern City of India.

BACKGROUND: Blood pressure (BP) is associated with serum levels of Vitamin D3, lipid profile, and thyroid hormones among adults. However, limited information is available regarding such associations in adolescents. OBJECTIVES: The objectives of this study were to estimate the prevalence of Vitamin D3 deficiency, dyslipidemia, and thyroid dysfunction among secondary school students of Agartala and to determine their associations with BP. METHODOLOGY: This cross-sectional study was conducted from April 1, 2018, to December 31, 2018, among 1000 secondary-level school students of Agartala municipal corporation area, chosen by multistage sampling ensuring proportionate representation. RESULTS: The prevalence of Vitamin D3 deficiency, thyroid dysfunction, and dyslipidemia was found to be 79.4%, 62.8%, and 37.5%, respectively. Among the respondents, 58.1% had raised BP, 16.7% were overweight, 5.3% were obese, and 48.3% had high waist-hip ratio (WHR). Among them, 70.97% of the fatty participants, 82.27% with high body mass index (BMI), and 69.05% with either low or normal WHR had significantly raised BP (P < 0.05). Out of total, 58.26% of the participants with normal serum D3 level, 59.95% with either euthyroid or hyperthyroid status, and 62.13% with dyslipidemia had raised BP, though these were not significant (P > 0.05). Binary logistic regression model has identified higher BMI, higher body fat content, high WHR, habit of consuming extra salt, and fast food on a regular basis as significant determinants of raised BP in this population (P < 0.05). CONCLUSION: Hypovitaminosis D, thyroid dysfunction, and dyslipidemia are prevalent among adolescents of Northeast India, but they did not emerge as significant determinants of BP in this population.

Role of body visceral fat in hypertension and dyslipidemia among the diabetic and nondiabetic ethnic population of Tripura-A comparative study.

BACKGROUND: Excess fat in the upper part of human body correlates with increased mortality and risk for diabetes, dyslipidemia, and hypertension. In India, there are very limited data available on the association of excess body visceral fat with hypertension and dyslipidemia independent of obesity and diabetes. OBJECTIVE: The objective of this study is to assess the role of body visceral fat percentage in hypertension and dyslipidemia among diabetic and nondiabetic indigenous ethnic population of Tripura. METHODS: Random blood sugar test was done for each of the study subjects with the help of a standard and validated glucometer. Then, blood samples were obtained after an 8-12-h overnight fast using vacutainer. Later on, all the blood samples were transported to the MRU laboratory at Agartala Government Medical College maintaining cold chain for following investigations: (1) FBS, PP by GOD-POD method; (2) HbA1c by immunoturbidimetric method; (3) cholesterol estimation by CHOD-PAP method; and (4) triglyceride estimation by glycerol phosphate oxidase method. RESULTS: In this study, it has been found that 62.5% diabetic subjects having high body visceral fat are suffering from Dyslipidemia, whereas only 42.9% nondiabetic subjects with high body visceral fat percentage are having dyslipidemia. Fisher's exact test showed association between diabetes status and body visceral fat (P = 0.048). It has been also observed that there was significant (P < 0.05) association between hypertension and body visceral fat among local indigenous ethnic population of Tripura. CONCLUSION: Body visceral fat percentage is significantly associated with hypertension, dyslipidemia, and type-2 diabetes among indigenous ethnic population of Tripura.

Associations of obesity and serum leptin level with elevated blood pressure among urban secondary school students of a northeastern city of India: A baseline observation.

BACKGROUND: Elevated blood pressure has been found to be associated with body mass index (BMI) and serum leptin levels among adults. But there is a paucity of reports regarding such associations among adolescents. OBJECTIVES: To estimate the prevalence of prehypertension and hypertension and its associations with BMI and serum leptin levels among the secondary school going students of the Agartala Municipal Corporation area. MATERIALS AND METHODS: This school-based cross-sectional study was conducted from 1st April 2018 to 31st December 2018, among 1,000 students studying in different secondary level schools located in Agartala municipal corporation area chosen by multistage sampling ensuring proportionate representation in the sample. RESULT: Prevalence of prehypertension and hypertension were found to be 42.40% and 15.70%, respectively, 55.20% had normal, 22.80% had low, and 22.00% had high BMI. Serum leptin levels were found to be normal among 54.70% of the students, whereas, 36.70% had high and 8.60% had low levels, respectively. Logistic regression analysis has identified male sex (OR = 0.231, 95% CI = 0.172-0.310, P = 0.000) and high BMI (OR = 4.289, 95% CI = 2.857-6.440, P = 0.000) as the significant determinants of elevated blood pressure, but the effect of serum leptin level and family history of hypertension did not attain the level of statistical significance. CONCLUSION: Prevalence of prehypertension and hypertension among urban school-going adolescents were found to be 42.40% and 15.70%, respectively and were significantly associated with their sex and BMI and serum leptin level, but regression analysis failed to detect any significant effect of serum leptin level in determining the blood pressure of the study subjects.