Water-pipe (WP) smoking has significantly increased in the last decade worldwide. Compelling evidence suggests that the toxicants in WP smoke are similar to that of cigarette smoke. The WP smoking in a single session could have acute harmful health effects even worse than cigarette smoking. However, there is no evidence as such on long term WP smoking and its impact on chronic health conditions particularly cardiovascular and metabolic conditions. Therefore, we conducted this study to investigate the relationship between WP smoking and metabolic syndrome (MetS). This was a cross-sectional study carried out in Punjab province of Pakistan using the baseline data of a population-based study – Urban Rural Chronic Diseases Study (URCDS). Information was collected by trained nurses regarding the socio-demographic profile, lifestyle factors including WP smoking, current and past illnesses. A blood sample was obtained for measurement of complete blood count, lipid profile and fasting glucose level. MetS was ascertained by using the International Diabetic Federation’s criteria. We carried out multiple logistic regressions to investigate the association between WP smoking and MetS. Final sample included 2,032 individuals – of those 325 (16.0%) were current WP smokers. Age adjusted-prevalence of MetS was significantly higher among current WP smokers (33.1%) compared with non-smokers (14.8%). Water-pipe smokers were three times more likely to have MetS (OR 3.21, 95% CI 2.38–4.33) compared with non-smokers after adjustment for age, sex and social class. WP smokers were significantly more likely to have hypertriglyceridemia (OR 1.63, 95% CI 1.25–2.10), hyperglycaemia (OR 1.82, 95% CI 1.37–2.41), Hypertension (OR 1.95, 95% CI 1.51–2.51) and abdominal obesity (OR 1.93, 95% CI 1.52–2.45). However, there were no significant differences in HDL level between WP smokers and non-smokers. This study suggests that WP smoking has a significant positive (harmful) relationship with MetS and its components.

Purpose. The study was aimed to investigate the frequency of diabetes mellitus type 2 in patients infected with chronic hepatitis C virus and its association with cirrhosis. Patients and Methods. This prospective case series was conducted at Section of Gastroenterology and Hepatology, Isra University Hospital, Hyderabad, over a period of 4 months from June 2009 to October 2009. Hepatitis C virus seropositive patients who were older than 18 years, diabetic or nondiabetic, were included. Basic demographic data collected by questionnaire and laboratory investigations including fasting blood glucose levels, serum cholesterol, and liver function tests were done. A logistic regression model was used to explore the association between diabetic and nondiabetic HCV seropositives and type 2 diabetes mellitus with cirrhosis. Results. A total of 361 patients with hepatitis C were analyzed; the prevalence of type 2 diabetes mellitus in HCV patients was 31.5%. Out of the total number of the participants, 58.4% (n = 211) were cirrhotics, while 41.6% (n = 150) were noncirrhotic HCV seropositives. In multivariate analysis, cirrhotic patients appeared significantly more likely (P = 0.01) to be diabetic as compared with noncirrhotic patients (OR = 2.005, 95% CI: 1.15, 3.43). Conclusion. Advancing age, increased weight, and HCV genotype 3 are independent predictors of type 2 diabetes in HCV seropositive patients, and there is a statistically significant association of cirrhosis observed with type 2 diabetes mellitus.

Objective This study aims to describe the relationship between body mass index (BMI) and blood pressure in three distinct Peruvian populations. Methods Three population groups were recruited: Rural (born and remained in Ayacucho), Migrant (born in Ayacucho and migrated to Lima), and Urban (born in Lima). Systolic blood pressure (SBP) and diastolic blood pressure were measured using oscillometric devices (Omron M5-i, Japan) and standardised techniques. BMI was calculated from standardised measurements. ANOVA was used to test differences between groups. Multi-variable linear regression was used to describe the relationship between BMI and blood pressure, adjusting for potential confounders. Results SBP was similar in the rural (120.9618.7) and migrant groups (119.9616.4), but higher in the urban group (128.2622.9). BMI was significantly lower in the rural group (23.262.7), but similar in the migrant (27.064.3) and urban groups (28.365.4). There was a positive relationship between BMI and SBP (slope 0.81; 95% CI 0.59 to 1.03) after adjustment for age, sex, height and haemoglobin. A positive relationship was observed in urban residents (0.61; 0.04e1.18), but the gradient of the relationship was steeper in the migrant group (0.75, 0.48e1.02). Similar results were found for diastolic blood pressure. Conclusions The relationship between BMI and blood pressure differed between our three study populations, with blood pressure rising at lower values of BMI in migrants. Migrant population in transitional countries may be at greater risk of developing hypertension, and the effect of BMI as a predictor is not uniform in migrant and urban-born residents. Background Prevalence of cardiovascular disease and the risk factors associated with it are increasing globally and in particular throughout the developing world. The south Asian region is especially at risk because of the increasing prevalence of the said risk factors. The study was undertaken to investigate the impact of social class and area of residence in distribution of cardiovascular risk factors mainly hypertension and diabetes mellitus in Pakistan. Methods A cross-sectional study on 2495 subjects aged between 30 and 75 years was conducted in the Punjab province covering both the urban and rural areas. A detailed questionnaire was completed; anthropometric measurements and blood samples from the chosen subjects were taken after a written informed consent was obtained. Participants were categorised into urban and rural, and assigned a social class by occupation. A logistic regression model was used to explore the association between social class and the area of residence Results Overall prevalence of hypertension and diabetes was 24.21% and 16.63% respectively. Out of the total number of participants, 56.79% (n¼1417) were rural area residents while 43.21% (n¼1078) were urban. Urban individuals appeared significantly more likely (p<0.001) to be hypertensive (OR¼3.03, 95% CI 2.41 to 4.82) and more likely (p<0.001) to be diabetic (OR¼1.77, 95% CI 1.37 to 2.29) than rural ...

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The prevalence of cardiovascular disease and associated risk factors are increasing globally, particularly in the developing world. Those in the South Asian region are especially at risk of cardiovascular disease due to an increasing prevalence of its risk factors. This study was undertaken to investigate the association of social class with location of residence in the distribution of cardiovascular risk factors (mainly hypertension and diabetes mellitus) in Pakistan. Methods:A cross-sectional study of 2495 subjects aged between 30-75 years was conducted in Punjab Province, which includes urban and rural areas. Subjects completed a detailed questionnaire, and anthropometric measurements and blood samples were taken after a written informed consent. Participants were categorized as urban or rural and assigned a social class according to their occupation. A logistic regression model was used to explore the association between social class and location of residence © MF Tareen, K Shafique, SS Mirza, ZI Arain, I Ahmad, P Vart, 2011. A licence to publish this material has been given to James Cook University, http://www.rrh.org.au 2Results: The overall prevalence of hypertension and diabetes was 24.2% and 16.6%, respectively. Of the total number of participants, 56.8% (n=1417) were rural residents and 43.2% (n=1078) were urban. Urban individuals were significantly more likely (p<0.001) to be hypertensive (OR=3.03, 95% CI 2.14-4.30) and more likely (p<0.001) to be diabetic (OR=1.77, 95% CI 1.29-2.42) than rural dwellers, after multivariate adjustments for age, sex, BMI and social class. Social class was not significantly associated with the prevalence of either hypertension or diabetes. Conclusions:In the Pakistani population, rural or urban location of residence is a more powerful determinant of cardiovascular risk factors than social class.