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Objective: The aim of the present study was to evaluate polymorphisms of fat mass and obesity (FTO; rs9939609) and vitamin D receptor (VDR, FokI (rs2228570), BsmI (rs1544410), ApaI (rs7975232), and TaqI (rs731236)] genes on weight loss after lifestyle interventions in Asian Indians.Methods: In this 6-month pre-post intervention trial, 110 overweight/obese men and women underwent diet and exercise interventions for 180 days resulting in reduction in body weight, (5.1 kg, p < 0.001), waist circumference, and skinfolds.Results: Association of the following genotypes was seen in those with ≥5% weight loss: TT of FTO polymorphism; 35 (81.4%) [OR (95% CI) AT, 2.5 (0.6, 10.9); TT, 6.9 (1.6, 28.2); with reference to AA], tt of VDR TaqI polymorphism, 12 (92.3%) [OR (95% CI); tt, 32.2 (2.4, 436.4); TT, 0.5 (0.08, 3.1); all with reference to Tt], bb of VDR BsmI polymorphism; 27 (65.8%) [OR (95% CI) Bb, 0.2 (0.04, 0.9); bb, 10.6 (0.9, 120.3); all with reference to BB] after adjusting for other genotypes. Further, analysis of combined influence of genotypes conferring maximum weight loss showed that the following had high odds of ≥5% weight loss: (1) TT of FTO gene in combination with BB/Bb of VDR BsmI and TT/Tt of VDR TaqI [OR (95% CI) 5.1 (1.5, 17.4)], (2) bb of BsmI and AA/AT of FTO and tt of TaqI [OR (95% CI) 3.2 (0.3, 31.7)], and (3) bb of BsmI plus TT of FTO and tt of TaqI.Conclusions: The above observations suggest a significant and independent role of the genotypes of FTO and VDR in influencing weight loss after lifestyle intervention in Asian Indians. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular diseases are more prevalent and severe in Asian Indians. Simple diet-based strategies are important for prevention of cardiovascular diseases. The aim of the present study was to evaluate the effects of oats consumption on lipid parameters in mildly hypercholesterolemic Asian Indians living in India. Methods: A short-term, prospective, open-labeled, randomized controlled, parallel group study was conducted. Mildly hypercholesterolemic (total cholesterol >200 mg/dL and <240 mg/dL) subjects (n = 80) were randomized into two groups: intervention (n = 40) and usual diet (n = 40). Sample size was calculated for a two-group parallel superiority randomized control trial. Out of 80 enrolled subjects 69 subjects completed the study; 33 in the control group and 36 in the intervention group. In the intervention group, patients were served 70 g of oats twice a day in the form of porridge and upma (A thick porridge from oats with seasonings and vegetables) under observation at the study site. Lipid parameters were assessed at baseline and after 4 weeks of intervention. Results: There was a reduction of 3.1% in total cholesterol levels in the control group as against 8.1% reduction in the intervention group (p < 0.02). Greater reductions were also seen in low-density lipoprotein cholesterol in the intervention group (11.6%) as compared to control group (4.1%, p < 0.04) over a period of 28 days. Conclusion: Daily consumption of 3 g of soluble fiber from 70 g of oats leads to beneficial effects on the lipid parameters, specifically total cholesterol and low-density lipoprotein cholesterol in hypercholesterolemic Asian Indians. Large scale studies over a longer period of intervention are required to further establish the cholesterollowering effect of oat fiber. [ABSTRACT FROM AUTHOR]

Background: Enlargement of adipocyte is associated with their dysfunction and alterations in metabolic functions. Objectives: We evaluated the association of adipocyte size of subcutaneous and omental adipose tissue with body composition and cardiovascular risk factors in Asian Indians. Methodology: Eighty (40 males and 40 females) non-diabetic adult subjects undergoing elective abdominal surgery were included. Pre-surgery evaluation included anthropometric measurements, % body fat by bioimpedance, abdominal fat area at L2–3 level (computed tomography) and biochemical investigations (fasting blood glucose and insulin, lipids and hsCRP). During surgery, about 5 grams each of omental and subcutaneous adipose tissue was obtained for adipocyte size determination. Results: Females had higher BMI, % body fat, skinfold thickness, total and subcutaneous abdominal fat area as compared to males. Overweight was present in 42.5% and 67.5%, and abdominal obesity in 5% and 52.5% males and females, respectively. Subcutaneous adipocyte size was significantly higher than omental adipocyte size. Omental adipocyte size correlated more strongly than subcutaneous adipocyte size with measures of adiposity (BMI, waist circumference, %BF), total and subcutaneous abdominal fat area and biochemical measures (fasting glucose, total cholesterol, triglycerides and HOMA-IR), the correlations being stronger in females. The correlation of adipocyte size with metabolic parameters was attenuated after adjusting for measures of adiposity. Conclusion: Omental adipocyte size, though smaller than the subcutaneous adipocyte size, was more closely related to measures of adiposity and metabolic parameters. However, the relationship was not independent of measures of adiposity. [ABSTRACT FROM AUTHOR]

The present study examines the secular trends in prevalence of overweight and obesity among urban Asian Indian adolescents in New Delhi (North India). The data were derived fromcross-sectional sampling of children, 3493 in year 2006 and 4908 in year 2009, aged 14-17 years studying in privately-funded and government-funded schools. Age, gender and Asian Indian-specific cut offs of body mass index (BMI) were used to define overweight and obesity. The prevalence of obesity increased significantly from 9.8% in 2006 to 11.7% in 2009 (p<0.01), whereas underweight decreased from 11.3% to 3.9% (p<0.001). There was a significantly higher risk of being overweight (OR 1.28; 95% CI, 1.15-1.42) and obese (OR 1.44; 95% CI, 1.24-1.66) in year 2009 than 2006, after adjusting for age, gender and type of school. Males and privately-funded school children had significantly higher increase in prevalence and risk of being overweight and obese over the three years. In conclusion, this study showed an increasing trend in prevalence of overweight and obesity in urban Asian Indian adolescents. More specifically, the study showed the association of this increasing trend of overweight and obesity prevalence with male gender and high socio-economic status, calling for an urgent need for immediate and targeted preventive measures. [ABSTRACT FROM AUTHOR]

There is paucity of data on the association of various risk factors of the metabolic syndrome in urban Asian Indian adolescents. This cross-sectional study included 948 subjects (527 males; 421 females) aged 14-19 y, selected randomly from New Delhi, India. Principal component factor analysis included variables such as: body mass index (BMI), waist circumference (WC), triceps (TR) and subscapular (SS) skinfold thickness, systolic and diastolic blood pressures, fasting blood glucose, serum triglycerides, high-density lipoprotein cholesterol and fasting insulin. Factor scores were used to generate a cumulative risk scale and identify independent correlates of high cumulative risk. Three factors namely: obesity/insulin factor (BMI, WC, TR, SS and fasting insulin) explained 40.9% and 35.5%, 'blood pressure' factor explained 14.1% and 14.2%, and the 'metabolic' factor (glucose/triglycerides) explained 10.4% and 10.8% of the variance data in males and females, respectively. Overweight and hyperinsulinemia in both genders and high SS in males were independently associated with high cumulative risk. More than one factor is associated with the metabolic syndrome in Asian Indian adolescents. Obesity (generalized, abdominal and truncal sub-cutaneous) accounts for the maximum variance in clustering and appears to be the stronger correlate of high cumulative risk rather than hyperinsulinemia. [ABSTRACT FROM AUTHOR]

Objective Biochemical measures for assessment of insulin resistance are not cost-effective in resource-constrained developing countries. Using classification and regression tree (CART) and multivariate logistic regression, we aimed to develop simple predictive decision models based on routine clinical and biochemical parameters to predict insulin resistance in apparently healthy Asian Indian adolescents. Design Community based cross-sectional study. Subjects and patients Data of apparently healthy 793 adolescents (aged 14–19 years) were used for analysis. WHO's multistage cluster sampling design was used for data collection. Methods and measurements Homeostasis Model of Assessment value > 75th centile was used as cut-off for defining the main outcome variable insulin resistance. CART was used to develop the decision tree models and multivariate logistic regression used to develop the clinical prediction score. Results Three classification trees and an equation for prediction score were developed and internally validated. The three decision trees were termed as CART I, CART II and CART III, respectively. CART I based on anthropometric parameters alone has sensitivity 88·2%, specificity 50·1% and area under receiver operating characteristic curve (aROC) 77·8%. CART II based on anthropometric and routine biochemical parameters has sensitivity 94·5%, specificity 38·3% and aROC 73·6%. CART III based on all anthropometric, biochemical and clinical parameters together has sensitivity 70·7%, specificity 79·2% and aROC 77·4%. Prediction score for insulin resistance = 1 × (waist circumference) + 1·1 × (percentage body fat) + 1·6 × (triceps skin-fold thickness) – 1·9 × (gender). A score cut-off of > 0 (using values marked for each) was a marker of insulin resistance in the study population (sensitivity 82·4%, specificity 56·7%, and aROC 73·4%). Conclusion These simple and cost-effective classification rules may be used to predict insulin resistance and implement population based preventive interventions in Asian Indian adolescents. [ABSTRACT FROM AUTHOR]

Background: Asian Indians have a high prevalence of insulin resistance that may underlie their higher tendency to develop type 2 diabetes mellitus and early-onset atherosclerosis. Objective: To investigate the relationship between dietary nutrients and insulin resistance in Asian Indian adolescents and young adults. Design: Dietary nutrient intake values (24-hour dietary recall and monthly consumption data) and fasting serum insulin levels were studied in 352 (311 males and 41 females) healthy adolescents and young adults (mean age 18.0 ± 2.3 years; range 14–25 years). Bivariate and multivariate logistic regression analyses were performed with hyperinsulinemia as the outcome variable and various dietary nutrients and anthropometric variables as covariates. Results: Mean fasting serum insulin levels were 107.4 ± 35.0 pmol/l (36.5–230.4 pmol/l). The intake of polyunsaturated fatty acids (PUFAs) was higher, saturated fat and the ω–6 to ω–3 PUFA ratio were in the upper limit, and ω–3 PUFAs (% caloric intake, En) were lower than the recommended dietary allowance for Asian Indians. The PUFAs (% En), BMI, percent body fat and waist circumference were significantly higher in the hyperinsulinemic group compared with the normoinsulinemic group (p = 0.021, 0.0021, 0.0006, and 0.0041, respectively). Multiple regression analysis showed that the lowest tertile of ω–6 (<3% En) PUFA intake [adjusted OR (95% CI) = 0.3 (0.1–0.7)] and BMI [adjusted OR (95% CI) = 2.9 (1.4–6.0)] were the significant independent predictors of fasting hyperinsulinemia. Conclusion: For prevention and amelioration of insulin resistance in Asian Indian adolescents and young adults, it is prudent to have normal BMI and low intake of ω–6 PUFAs. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The article discusses a study which aims to develop predictive equations to quantify body fat and abdominal adipose tissue sub-compartments with dual-energy X-ray absorptiometry (DXA) and magnetic resonance imaging as reference in healthy Asian Indians. It hypothesized that equations developed from simple anthropometric measures would have a fair degree of accuracy in predicting percentage of total body fat (%BF), total abdominal fat (TAF), subcutaneous abdominal adipose tissue (SCAT), and intra-abdominal adipose tissue (IAAT).

Background: Reference data for plasma lipids and blood pressure are not available for Asian Indian adolescents. This study aimed to develop representative age- and sex- specific percentile reference data for serum lipids [total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), non-HDL cholesterol] and blood pressure for urban Asian Indian adolescents aged 14-18 years. The sample consisted of 680 boys and 521 girls aged 14-18 years from the cross-sectional population survey, Epidemiological Study of Adolescents and Young Adults (ESAY) for whom the data for serum lipid levels and blood pressure were recorded. Smoothed age- and sex- specific 5th, 10th, 25th, 50th, 75th, 85th, 90th and 95th percentiles where derived using LMS regression. Results: Percentile-based reference data for serum lipids and blood pressure are presented for adolescent Asian Indian boys and girls for the first time. Asian Indian adolescents had lower levels of serum TC, LDL-C and HDL-C and higher TG than their counterparts in the USA. Interesting trends in TC and HDL-C levels where observed, which might reflect changes in dietary pattern and physical activity in this age group in India. Conclusion: These reference data could be used to identify adolescents with an elevated risk of developing dyslipidemia, hypertension and cardiovascular disorders, to plan and implement preventive policies, and to study temporal trends. [ABSTRACT FROM AUTHOR]

Abstract: Objective: We examined the association of subclinical atherosclerosis and endothelial dysfunction with nonalcoholic fatty liver disease (NAFLD) in Asian Indians. Methods: This study included 40 non-diabetic subjects with NAFLD and 40 apparently healthy controls without NAFLD with similar age, gender and body mass index. Measurements included anthropometric parameters, oral glucose tolerance test, fasting and 2 h insulin, lipid profile, C-reactive protein, sICAM-1, VCAM-1, carotid intima-media thickness (CIMT) and brachial artery flow mediated dilatation (FMD). Results: Subjects with NAFLD had higher average and maximum CIMT (0.6 ± 0.12 and 0.684 ± 0.16 mm, respectively, vs 0.489 ± 0.1 and 0.523 ± 0.1 mm, respectively; p < 0.05), and had higher prevalence of atherosclerotic plaques (20% vs 5%, p < 0.05) than controls. Significantly greater degree of impairment in FMD and higher levels of hs-CRP and sICAM-1 were observed in NAFLD patients than controls. The presence of NAFLD was observed to be the independent predictor of having high average CIMT (OR 4.8; 95% CI: 1.8–12.8), high maximum CIMT (OR 5.4; 95% CI: 2.0–14.4) and impaired FMD (OR 11.7; 95% CI: 1.4–96.5) even after adjusting for obesity, metabolic syndrome, insulin resistance and lipid parameters. Conclusion: In Asian Indians NAFLD is significantly associated with subclinical atherosclerosis and endothelial dysfunction independent of obesity and metabolic syndrome. Elevated levels of hs-CRP and sICAM-1 may be useful as indicators of liver injury in NAFLD. [Copyright &y& Elsevier]

Abstract: We report the determination of intramyocellular lipids (IMCLs) of the soleus muscle of patients with type 2 diabetes mellitus (T2DM) using proton magnetic resonance spectroscopy. In addition, the various anthropometric and biochemical profiles of these patients were determined, including estimation of C-reactive protein (CRP), an inflammatory marker of coronary heart disease, and insulin resistance [Homeostasis Model Assessment (HOMA-IR)]. The estimated CRP level and the IMCL content in these patients were correlated with body mass index, percentage of body fat, other measures of abdominal obesity, serum lipoproteins, fasting and post-oral glucose load serum insulin levels and other surrogate markers of insulin resistance. The IMCL content (P=.04), CRP (P=.008) and insulin resistance (P=.0007) were significantly higher in T2DM patients compared to healthy controls. However, IMCL content did not correlate with values of fasting insulin, HOMA-IR or CRP in either group. These findings have strong implications of increased cardiovascular risk in Asian Indians with T2DM. The absence of relationship between CRP and IMCL needs to be explored further in a study using a large sample size. [Copyright &y& Elsevier]