Social determinants of common metabolic risk factors (high blood pressure, high blood sugar, high body mass index and high waist-hip ratio) of major non-communicable diseases in South Asia region: a systematic review protocol

Abstract

BackgroundPrevalence of non-communicable diseases has been increasing at a greater pace in developing countries and, in particular, the South Asia region. Various behavioral, social and environmental factors present in this region perpetuate common metabolic risk factors of non-communicable diseases. This study will identify social determinants of common metabolic risk factors of major non-communicable diseases in the context of the South Asian region and map their causal pathway.MethodsA systematic review of selected articles will be carried out following Cochrane guidelines. Review will be guided by Social Determinants of Health Framework developed by the World Health Organization to extract social determinants of metabolic risk factors of non-communicable diseases from studies. A distinct search strategy will be applied using key words to screen relevant studies from online databases. Primary and grey literature published from the year 2000 to 2016 and studies with discussion on proximal and distal determinants of non-communicable risk factors among adults of the South Asia region will be selected. They will be further checked for quality, and a matrix illustrating contents of selected articles will be developed. Thematic content analysis will be done to trace social determinants and their interaction with metabolic risk factors. Findings will be illustrated in causal loop diagrams with social determinants of risk factors along with their interaction (feedback mechanism).DiscussionThe review will describe the interplay of social determinants of common NCD metabolic risk factors in the form of causal loop diagram. Findings will be structured in two parts: the first part will explain the linkage between proximal determinants with the metabolic risk factors and the second part will describe the linkage among the risk factors, proximal determinants and distal determinants. Evidences across different regions will be discussed to compare and validate and/or contrast the findings. Possible bias and limitations of this study will also be discussed.Systematic review registrationPROSPERO CRD42017067212 Electronic supplementary materialThe online version of this article (10.1186/s13643-017-0576-6) contains supplementary material, which is available to authorized users.

Cardio-metabolic disease risk factors among South Asian labour migrants to the Middle East: a scoping review and policy analysis

“…We used a causal loop diagram (CLD)—a tool based on System Dynamics -- to further expand on our analysis of CMD epidemiology and migration policies in South Asia [12]. The authors (SRM, SRS) have used CLD in NCD context before [13]. The CLD shows the linkages between social determinants of CMD risk factors, and how these determinants reinforce or balance each other under a prevailing policy context.…”

“…‘R’ denotes a reinforcing loop and ‘B’ denotes a balancing loop. More description about them is available in reference [12] and [13]. Abbreviations: CMD: cardio metabolic disease;’ SE: socio-economic…”

Astragalus polysaccharides protect renal function and affect the TGF-β/Smad signaling pathway in streptozotocin-induced diabetic rats

“…17,18 Studies have shown that when the mesangial cells are stimulated by hyperglycemia, TGF-b1 synthesis is increased and extracellular matrix is deposited by induction. 19 Smad protein is the only substrate of TGF-b1 signaling pathway; when expression of TGF-b1 is upregulated, expression of Smad protein is increased correspondingly, which may lead to transduction of the TGF-b1 signal from the receptor to the nucleus, accelerating the process of tissue fibrosis. 20 Studies have shown that expression of Smad3 in fibrotic kidney tissue is significantly upregulated 21 and that when the Smad3 gene is knocked out from renal tubular epithelial cells, Ang II-induced matrix is significantly reduced and renal fibrosis process may be stopped.…”

Transforming Nepal’s primary health care delivery system in global health era: addressing historical and current implementation challenges

“…Thematic analysis and brainstorming with authors’ own reflexivity helped in constructing these causal loop diagrams (CLDs). More description about causal loop diagrams and its application in decision making is available in the reference [ 47 – 49 ]. For further information in CLDs, please follow the online resource from the John Hopkins University ( https://www.coursera.org/learn/systems-thinking ) …”