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Objective: Increasing evidence revealed the role of adipokines in carbohydrates and fat metabolism. The present study was designed to evaluate the adiponectin, leptin, and resistin levels in prediabetes subjects and evaluate the relationship between these adipokines and insulin resistance. Methods: A hospital-based descriptive study was conducted for one year. 200 individuals who met the inclusion criteria were enrolled in the study. Based on the oral glucose tolerance test, the study subjects were grouped into healthy controls (n = 100), prediabetic non-obese (n = 61), and prediabetic obese (n = 39). Blood glucose estimation was done by the glucose oxidase peroxidase method. Chemiluminescent immunoassay was used for the measurement of insulin level and homeostasis model assessment-estimated insulin resistance was used for the assessment of insulin resistance. Serum adipokines levels were determined by ELISA. Statistical analysis was performed by using SPSS Software. Results: Serum adiponectin levels decreased significantly in obese prediabetes (7.21 ± 2.15 µg/ml) when compared to non-obese prediabetes (7.28 ± 2.41 µg/ml) and healthy control subjects (13.64 ± 2.88 µg/ml, p < 0.001). Serum leptin levels increased significantly in obese prediabetes (13.59 ± 2.59 ng/ml) when compared to non-obese prediabetes (9.84 ± 2.66 ng/ml) and healthy control subjects (12.28 ± 2.65 ng/ml, p < 0.001). Serum resistin levels increased significantly in obese prediabetes (17.67 ± 3.60 ng/ml) when compared to non-obese prediabetes (17.2 ± 3.93 ng/ml) and healthy control subjects (14.46 ± 4.16 ng/ml, p < 0.001). Adiponectin-leptin ratio decreased significantly in obese prediabetes (0.56 ± 0.22) when compared to non-obese prediabetes (0.79 ± 0.4) and healthy control subjects (1.15 ± 0.37; p < 0.001). Fasting insulin resistance was statistically significant (p < 0.001) in all groups. Conclusion: The present study strongly suggests that the adipokine profile is an ideal diagnostic tool to predict prediabetes and metabolic syndrome, especially among those with insulin resistance. [ABSTRACT FROM AUTHOR]

Introduction: Type 2 diabetes mellitus (T2DM) and abdominal obesity are the principal foundation for the development and progression of cardiovascular disease (CVD) and its associated mortality. This study is aimed to analyse the utility of Madras Diabetes Research Foundation-Indian diabetes risk score (MDRF-IDRS) for the screening of T2DM and CVD. Methodology: In this cross-sectional study, total 300 samples were randomly included from the OPD (outdoor patient department), University Medical College, in and around areas of Lucknow. The parameters of MDRF-IDRS include age, waist circumference (WC), physical activity and family history of T2DM, and these were recorded for each subject. Glycated haemoglobin (HbA1c) and electrocardiogram (ECG) were also measured for the confirmation of T2DM and CVD. For statistical analysis, the p < 0.05 was considered as statistically significant. Results: In this study subjects, 135 (45%) were ≥ 50 years old, 124 (41.3%) have 1° abdominal obesity and 67 (22.3%) have 2° abdominal obesity, 91 (30.3%) were physically inactive and 101 (33.6%) have family history of either parent having diabetes, and 76 (25.3%) have family history of both the parent diabetic. According to MDRF-IDRS, 165 (55%) subjects were at high risk of T2DM (score ≥ 60). Based on HbA1c, 76 (25.3%) subjects were pre-diabetic and 165 (55%) subjects were found T2DM, of which 41 (53.9%) and 102 (61.8%) were at high risk of T2DM, respectively. Based on ECG, 147 (49%) subjects have normocardia, 58 (19%) subjects have bradycardia and 95 (31.6%) subjects have tachycardia, of which 55 (37.4%), 35 (60.3%) and 75 (78.9%) were at high risk of T2DM, respectively. A significant association was found between subjects with high risk of T2DM, elevated HbA1c and abnormal heart rate (p = 0.001, p = 0.003, respectively). Sensitivity (88%), specificity (64%), positive predictive value and negative predictive value for MDRF-IDRS validity are calculated. Receiver operator characteristic curve (ROC) has been drawn and area under the curve (AUC) (0.780) is estimated. Conclusion: Result showed that the MDRF-IDRS is an efficient and cost-effective tool for the screening of abdominal obesity, T2DM and CVD. Presently, the MDRF-IDRS is necessity for bulk screening of disease at early stage in primary public healthcare centres to reduce the prevalence of T2DM, abdominal obesity and CVD and its associated mortality. [ABSTRACT FROM AUTHOR]

Background: The aim was to investigate: (a) whether there is an association between the maternal double burden of overweight and short stature and the risk of cesarean delivery and (b) whether socioeconomic status (SES) acts as a moderator in the association between the maternal double burden of overweight and short stature and the risk of cesarean birth (CB). Materials and methods: The data for this study were obtained from the nationally representative Demographic and Health Survey databases of five South Asian countries. The analyses were based on responses from married women between 15 and 49 years of age. The risk of CB was the primary outcome, while the maternal double burden of overweight and short stature (coexistence of overweight and short stature) was the exposure of interest. Results: Maternal double burden of overweight and short stature was significantly associated with 179% higher likelihood of undergoing CB in South Asia (SA), with 304%, 200%, 167%, 155%, and 125% higher likelihood of undergoing CB in Nepal, Pakistan, India, Maldives, and Bangladesh, respectively. Findings also demonstrated that mothers belonging to low SES groups with a double overweight and short stature burden were not uniquely disadvantaged. Conclusions: A significant marker in SA of higher risk of CB is the maternal double burden of overweight and short stature. The negative effect of the maternal double burden of overweight and short stature extends across all economic backgrounds in relation to the risk of CB. It is not limited to poor mothers who suffer from the double burden of overweight and short stature. [ABSTRACT FROM AUTHOR]

Introduction: Vitamin B12 is essential for the normal functioning of the nervous system and for the formation of red blood cells. Vegetarian diet, low socioeconomic status, and social and religious reasons are known risk factors of its deficiency. Pregnant women, children, and the elderly are vulnerable groups. Indians have the highest prevalence, but the data among pregnant women in the rural setting is lacking. Objectives: The objective of this study is to assess the prevalence of Vitamin B12 deficiency and its associated factors among pregnant women of rural South India. Materials and Methods: A cross-sectional study was conducted to recruit consecutive 120 multigravida women with ≤20 weeks of gestation, attending the mobile doctor run clinic of Kaniyambadi block, Vellore. A structured questionnaire was administered, and blood samples were collected. Results: The prevalence of Vitamin B12 deficiency (<200 pgm/ml) and anemia (Hb ≤10.5 g/dL) was 55% and 17.5%, respectively. Only 11.7% were B12 deficient and anemic. Past history of abortion (odds ratio [OR] = 0.5), fatigue (OR = 0.4), and low B12 intake (OR = 2) was associated only in the bivariate analysis. First trimester (OR = 3.9) and obesity (OR = 9.6) were found to be independent risk factors of Vitamin B12 deficiency. Conclusion: Our study showed a high prevalence of Vitamin B12 deficiency in pregnancy in rural India. Some risk factors were identified. However, studies with a higher sample size will be beneficial to study the associated risk factors better. [ABSTRACT FROM AUTHOR]

Background: Early detection of Pre-diabetes and controlling the risk factors may delay the development of Diabetes and related complications. Objectives: To estimate the prevalence of Pre-diabetes in West Tripura district of India and to study it's associations with selected risk factors. Methods: This community based cross-sectional study was conducted in West Tripura district of India, during 1st January 2018 to 31st December 2019 among 320 individuals selected by multistage sampling. Fasting blood sugar was tested for diagnosing Pre-diabetes. Data entry and analysis were performed using SPSS-24. Result: Prevalence of Pre-diabetes in West Tripura district was 19.4%, 28.1% were hypertensive and 32.5% had high BMI. Multivariable logistic regression has identified age ≥40 yr (OR: 20.62, 95% CI: 4.97 -- 85.49) higher socioeconomic status (OR: 4.99, 95% CI: 1.95 -- 12.72), family history of diabetes (OR: 9.72, 95% CI: 2.51 -- 37.61), higher BMI (OR: 2.79, 95% CI: 1.32 -- 5.89) and physical inactivity (OR: 3.52, 95% CI: 1.66 -- 7.46) as the predictors of Pre-diabetes. Conclusion: West Tripura district of India has higher prevalence of pre-diabetes than the national average. Age ≥40 yr, higher socioeconomic status, family history of diabetes, higher BMI and physical inactivity were identified as significant predictors of Pre-diabetes in this region. [ABSTRACT FROM AUTHOR]

Introduction: Anticipation of difficulties in airway management is of prime importance in avoiding potential catastrophies. Obese patients form part of a population that is believed to have difficult airway. Ultrasound imaging has recently come forth as a simple, portable, noninvasive adjunct for bedside assessment. We hypothesized that there is an association between ultrasonographic measurements of the anterior neck soft-tissue thickness at level of vocal cords (VCs) and hyoid bone (HB) in predicting difficult laryngoscopy in the obese patients and evaluated the feasibility of ultrasound in predicting difficult laryngoscopy in Indian population. Materials and Methods: A total of 70 obese patients with body mass index >30 kg/m2 and American Society of Anesthesiologists Grade I and II undergoing elective surgeries and receiving general anesthesia were enrolled in the study. Ultrasound quantification of the anterior neck soft tissue was performed using a high-frequency (13-6 MHz) linear transducer. The distance from the skin to the anterior aspect of the trachea was measured at two levels: VCs and HB. Results: The incidence of difficult laryngoscopy (III and IV) in our study population was 24.3% (17 of 70 cases). The sonographic measurements of the skin thickness of the anterior neck were greater at the level of VCs in the difficult laryngoscopy group at 13.5 ± 1.5 mm as compared to the easy laryngoscopy group at 10.2 ± 1.6 mm, with the difference being statistically significant, P < 0.001. The soft-tissue thickness at the level of HB was also greater in the difficult laryngoscopy group in contrast to the easy laryngoscopy group (16.4 ± 1.9 mm vs. 12.4 ± 2.0 mm; P < 0.001). Conclusions: Ultrasonographically measured skin thickness at the level of HB and VCs has got a good correlation with difficult intubation. [ABSTRACT FROM AUTHOR]

Coronary artery disease (CAD) is a significant cause of mortality in women. Risk factors for CAD may vary in different populations. We assessed the risk factors for angiographically proven CAD in women in India in this case-control study. Women with normal coronary arteries served as controls. High prevalence of conventional CAD risk factors was seen in women with CAD, but significant association with CAD was not present for all risk factors. Oral contraceptive pill use and family history of CAD were important risk factors for CAD in premenopausal women, while reproductive span was an additional factor influencing premature CAD. [ABSTRACT FROM AUTHOR]

Objective: Obesity is one of the modifiable risk factors of type 2 diabetes mellitus. Adiposity causes insulin resistance and diabetes by various mechanisms. This study was undertaken to determine diabetogenic effect of adiposity in relation to age for identification of vulnerable age groups. Methods: This prospective study included 370 healthy adult non-diabetic individuals. Height and weight were recorded to calculate body mass index (BMI). Fasting blood sugar (FBS) was estimated by glucose oxidase method. Results: A stepwise increase in magnitude of BMI was observed with increase of age in decades. Although increase in mean FBS was observed with age, statistically significant (p = 0.00093) increase in mean FBS was observed only in 4th decade of life. Positive correlation was observed (Pearson's correlation coefficient r = + 0.26) between BMI and FBS. Conclusion: With increasing age, BMI and FBS increase, especially during 4th decade of life. This emphasizes the need to target the vulnerable age group (30-40 years) for creating awareness about maintenance of ideal body weight to prevent early onset of type 2 diabetes. Positive correlation between BMI and FBS reiterates diabetogenic effect of adipose tissue and emphasizes importance of maintenance of normal BMI. [ABSTRACT FROM AUTHOR]

Background: In developing countries, obesity is the most prevalent metabolic disease and leads to an important cardiovascular and global mortality rate, either directly or indirectly through cardiovascular risk factors. Aim: We sought to study the prevalence of impaired glucose tolerance (IGT), dyslipidemia, metabolic syndrome (MS), and cardiovascular risk (CVR) in a south Indian population. Setting and Design: A cross-sectional, single-center observational study in a cohort of 96 healthy male subjects. Materials and Methods: Age, body mass index (BMI), blood pressure (BP), total lipid profiles, fating plasma glucose (FPG), post lunch plasma glucose (PLPG), glycated hemoglobin (HbA1c), creatinine and insulin were measured by standard methods. Statistical Analysis: Student's t-test and Chi-square test were used to determine differences between mean and frequency values of continuous and categorical variables. Results: Significant differences were observed in the means of BMI (28.89 kg/m2) (P<0.0001), FPG (102.41 mg/dL) (P<0.0001), insulin (18.1 μU/L) (P<0.0001), PLPG (149.05 mg/dL) (P<0.0001), diastolic BP (84.41 mmHg) (P<0.01), total cholesterol (166.72 mg/dL) (P<0.001), lowdensity lipoprotein (90.65 mg/dL) (P<0.0001) in overweight subjects when compared to normal subjects . The prevalence of dyslipidemia, IGT, MS and CVR was significantly higher in younger (<45years) than middle-aged (46-55years) subjects. Conclusions: The condition of being overweight, expressed as BMI, appears to be a good indicator of risk for IGT, MS, and CVR, particularly in young non-obese subjects (BMI<30). [ABSTRACT FROM AUTHOR]

Objectives To assess the differences in risk perceptions of overweight/obese and normal-weight adolescents about obesity and associated risk factors. Design Qualitative study using focus group discussions (FGDs). Settings Five randomly selected schools from the South Indian city of Hyderabad. Participants Seventy-nine adolescents (ages 11–14 years) participated in 10 FGDs (5 each with overweight/obese and normal-weight groups). Phenomenon of Interest Whether obesity-related risk perceptions differ with actual weight status or not. Analysis FGDs were recorded, transcribed, and manually coded for thematic analysis. Results were presented according to 6 themes. At each stage of coding and analysis, reports were read independently by 2–3 researchers and the inter-coder reliability was high (ratio of number of agreements against the sum of agreements plus disagreements was over 90%). Results Adolescents across the groups had limited understanding of nutrition during adolescence as well as causes and consequences of obesity. The optimistic bias that they were less vulnerable compared to others to the risks of obesity was evident from perceptions of overweight groups. While overweight adolescents argued that obesity was hereditary, the normal-weight participants perceived “faulty food habits” and laziness as the reasons. Adolescents across the groups considered fruits and vegetables as healthy foods. Conclusions and Implications There were clear differences in perceptions of adolescents of different weight status. Employing the risk perception analysis framework, this study identified the following adolescent traits: responsive, avoidance, and indifference, which may be useful for developing nutrition communication programs. [ABSTRACT FROM AUTHOR]