High Prevalence of Diabetes and Cardiovascular Risk Factors Associated With Urbanization in India

Abstract

OBJECTIVE -To compare prevalence of diabetes, impaired glucose tolerance (IGT), impaired fasting glucose (IFG), and cardiovascular risk factors between a city, a town, and periurban villages (PUVs) in southern India and to look for temporal changes in the city and PUVs.RESEARCH DESIGN AND METHODS -Subjects aged Ն20 years were studied in Tamilnadu, India, in Chennai (city, n ϭ 2,192; 1,053 men and 1,138 women), Kanchipuram (town, n ϭ 2,290; 988 men and 1,302 women), and Panruti (PUVs, n ϭ 2,584; 1,280 men and 1,304 women) in 2006. Demographic, socioeconomic, and anthropometric details; blood pressure; physical activity; diet habits; and lipids were studied. Risk associations with diabetes were analyzed using multiple logistic regression analyses. Present and previous data in the city and the PUVs were compared.RESULTS -Mean BMI, waist circumference, and family history of diabetes were significantly lower in the PUVs. The PUVs had a lower prevalence of diabetes (9.2 [95% CI 8.0 -10.5], P Ͻ 0.0001) than the city (18.6 [16.6 -20.5]) and town (16.4 [14.1-18.6]). Approximately 40% of subjects were newly diagnosed. Prevalence of impaired glucose tolerance (IGT) was higher (P Ͻ 0.0001) in the city (7.4 [6.2-8.5]) than in the town (4.3 [3.3-5.3]) and the PUVs (5.5 [4.6 -6.5]). Prevalence of IFG was generally low. Age, family history, and waist circumference were significantly associated with diabetes, while physical activity was not. Overweight, elevated waist circumference, hypertension, and dyslipidemia were more prevalent in the city.CONCLUSIONS -In the city, diabetes increased from 13.9 to 18.6% in 6 years and IGT decreased significantly. The town and city had similar prevalences; the PUVs had lower diabetes prevalence, but prevalence had increased compared with that in a previous survey. Cardiometabolic abnormalities were more prevalent in urban populations.

Cardiovascular risk factors in the normoglycaemic Asian-Indian population—influence of urbanisation

“…Abdominal obesity was the most common abnormality in the different groups. Several epidemiological studies in native Asian-Indians [4,8] and migrant Indians [9] have shown a higher occurrence of upper body adiposity than general adiposity (BMI).…”

“…Normoglycaemic individuals were selected from the database of a diabetes survey conducted by us in 2006 in a city, a town and villages [4]. In brief, an epidemiological survey of diabetes and prediabetic states (impaired glucose tolerance and impaired fasting glucose) was performed in the city of Chennai, Kanchipuram town, and villages of Panruti (19 villages randomly selected out of 42) in Tamil Nadu, India.…”

“…Diabetes and cardiovascular disease share several common aetiological factors, and India has the largest number of diabetic individuals in the world [1]. The prevalence of diabetes is rapidly increasing among the urban [4,5] and urbanising rural populations in India [4]. Cardiovascular risk increases with increasing blood glucose levels [6].…”

“…Cardiovascular risk increases with increasing blood glucose levels [6]. Recently, we noted a high prevalence of cardiovascular risk factors in southern India, and this increased with the degree of urbanisation [4]. The objective of this analysis was to study the prevalence of cardiovascular risk factors in normoglycaemic individuals and to investigate whether this is correlated with urbanisation and blood glucose level.…”

Association of High Sensitivity C-Reactive Protein with the Components of Metabolic Syndrome in Diabetic and Non-Diabetic Individuals

“…The level of this marker, however, is known to vary among populations, influenced by gender, age, and obesity [7]. South east Asians are known to be at a high risk for T2DM, CVD, and MetS [8,9]. There has been a paucity of evidence from this part of world including Nepal regarding hsCRP level in health and diseases.…”