Indian Phenotype Characteristics Among Patients with Type 2 Diabetes Mellitus: Insights from a Non-interventional Nationwide Registry in India

Kalra, Sanjay; Mithal, Ambrish; Zargar, Abdul Hamid; Sethi, Bipin; Dharmalingam, Mala; Ghosh, Sujoy; Sen, Ranjini

doi:10.17925/ee.2022.18.1.63

Cited by 4 publications

References 50 publications

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A Systematic Review of the Effect of Gene–Lifestyle Interactions on Metabolic-Disease-Related Traits in South Asian Populations

Bineid,

Ventura,

Samidoust

et al. 2024

Nutrition Reviews

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Context Recent data from the South Asian subregion have raised concern about the dramatic increase in the prevalence of metabolic diseases, which are influenced by genetic and lifestyle factors. Objective The aim of this systematic review was to summarize the contemporary evidence for the effect of gene–lifestyle interactions on metabolic outcomes in this population. Data sources PubMed, Web of Science, and SCOPUS databases were searched up until March 2023 for observational and intervention studies investigating the interaction between genetic variants and lifestyle factors such as diet and physical activity on obesity and type 2 diabetes traits. Data extraction Of the 14 783 publications extracted, 15 were deemed eligible for inclusion in this study. Data extraction was carried out independently by 3 investigators. The quality of the included studies was assessed using the Appraisal Tool for Cross-Sectional Studies (AXIS), the Risk Of Bias In Non-randomized Studies—of Interventions (ROBINS-I), and the methodological quality score for nutrigenetics studies. Data analysis Using a narrative synthesis approach, the findings were presented in textual and tabular format. Together, studies from India (n = 8), Pakistan (n = 3), Sri Lanka (n = 1), and the South Asian diaspora in Singapore and Canada (n = 3) reported 543 gene–lifestyle interactions, of which 132 (∼24%) were statistically significant. These results were related to the effects of the interaction of genetic factors with physical inactivity, poor sleep habits, smoking, and dietary intake of carbohydrates, protein, and fat on the risk of metabolic disease in this population. Conclusions The findings of this systematic review provide evidence of gene–lifestyle interactions impacting metabolic traits within the South Asian population. However, the lack of replication and correction for multiple testing and the small sample size of the included studies may limit the conclusiveness of the evidence. Note, this paper is part of the Nutrition Reviews Special Collection on Precision Nutrition. Systematic Review Registration PROSPERO registration No. CRD42023402408.

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A Systematic Review of the Effect of Gene–Lifestyle Interactions on Metabolic-Disease-Related Traits in South Asian Populations

Bineid,

Ventura,

Samidoust

et al. 2024

Nutrition Reviews

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Dual Metrics of Obesity: Evaluating BMI and Central Obesity as Indicators of Cardiometabolic Risk in Rural India

Prasad,

Sagiraju,

Chatterjee

et al. 2024

Preprint

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PurposeIndians face a higher risk of cardiometabolic diseases (CMDs) at the same BMI compared to Caucasians. This study explored the use of the Dual Metric Obesity Criteria (DMOC), combining central obesity (CO) indices with BMI, to assess sex-specific associations with CMDs in rural Indians.MethodsBaseline cross-sectional data from 3,397 participants aged ≥45 from the Centre for Brain Research-Srinivaspura Aging, Neuro Senescence and COGnition (CBR-SANSCOG) study were analysed. Five obesity indices were examined: BMI, Waist Circumference, Waist-Hip Ratio (WHR), Waist-Height Ratio (WHtR), and Visceral Fat Percentage. Cohen’s Kappa assessed the agreement between BMI and CO indices. Participants were classified based on BMI and CO status: NWNC (Normal Weight No CO), AWNC (Abnormal Weight No CO), NWCO (Normal Weight CO), and AWCO (Abnormal Weight CO). Multinomial logistic regression models evaluated associations between DMOC groups and CMDs. Interaction analyses explored CO and CMD relationships across sex, BMI categories, and age groups. The mediation effect of CO indices on the relationship between BMI and cardiometabolic risk factors was investigated.ResultsBMI showed a slight to fair agreement with WHR and moderate agreement with WHtR. Individuals with AWCO had the highest odds for all CMDs (p<0.001). Males with NWCO had a 3.51 (2.14,6.04) times increased odds times for diabetes and 2.04 (1.22,3.37) times odds for dyslipidemia. Individuals < 58 years and males had stronger associations with CMDs.ConclusionCombining CO indices with BMI effectively identifies high-risk CMD groups in rural Indians, including those with NWCO a previously overlooked group.

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Exploring the silent epidemic: investigating the hidden burden of normal weight obesity in type 2 Diabetes Mellitus in India - a cross-sectional study

Yogesh,

Mody,

Makwana

et al. 2024

Clin Diabetes Endocrinol

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Objective This study aimed to determine the prevalence of Normal Weight Obesity (NWO) and evaluate its association with cardiometabolic risk factors among patients with Type 2 Diabetes Mellitus (T2DM) in Gujarat, India. Methods This cross-sectional study included 432 adults with T2DM attending a Non-Communicable Disease clinic. Anthropometric measurements, body composition analysis using bioelectrical impedance, and clinical parameters were assessed. NWO was defined as normal BMI (18.5–24.9 kg/m²) with high body fat percentage (≥ 25% for men, ≥ 32% for women). Cardiometabolic risk factors, including blood glucose, blood pressure, and lipid profile, were evaluated. Statistical analyses included descriptive statistics, correlation analysis, and multivariate logistic regression. Results The prevalence of NWO was 33% among the study population. Significant discordance was observed between BMI classification and body fat percentage, with 91% of males and 51.8% of females with normal BMI having obese levels of body fat. Individuals with NWO demonstrated higher cardiometabolic risk profiles compared to non-obese counterparts, including elevated random blood glucose levels (290 ± 110 mg/dL vs. 180 ± 80 mg/dL, p < 0.001), higher systolic (148.8 ± 25.4 mmHg vs. 122.5 ± 19.5 mmHg, p < 0.001) and diastolic blood pressure (98.5 ± 55.6 mmHg vs. 78.6 ± 36.6 mmHg, p < 0.001), and increased prevalence of hypertension (61% vs. 15%, p < 0.001). A moderate positive correlation was found between body fat percentage and random blood sugar levels ( r = 0.504, p < 0.001). Multivariate analysis identified age, duration of diabetes, blood glucose levels, and blood pressure as independent factors associated with NWO. Conclusion The high prevalence of NWO and its significant association with adverse cardiometabolic risk factors in T2DM patients underscores the limitations of using BMI alone for obesity assessment. These findings highlight the need for incorporating body composition analysis in routine clinical practice to improve risk stratification and management strategies in T2DM patients, particularly in the Asian Indian population.

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Indian Phenotype Characteristics Among Patients with Type 2 Diabetes Mellitus: Insights from a Non-interventional Nationwide Registry in India

Cited by 4 publications

References 50 publications

A Systematic Review of the Effect of Gene–Lifestyle Interactions on Metabolic-Disease-Related Traits in South Asian Populations

A Systematic Review of the Effect of Gene–Lifestyle Interactions on Metabolic-Disease-Related Traits in South Asian Populations

Dual Metrics of Obesity: Evaluating BMI and Central Obesity as Indicators of Cardiometabolic Risk in Rural India

Exploring the silent epidemic: investigating the hidden burden of normal weight obesity in type 2 Diabetes Mellitus in India - a cross-sectional study

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