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High prevalence of diabetes, obesity and dyslipidaemia in urban slum population in northern India

International Journal of Obesity volume 25, pages 1722–1729 (2001)Cite this article

A Corrigendum to this article was published on 21 August 2002

Abstract

BACKGROUND AND AIMS: In this study, a prevalence survey of various atherosclerosis risk factors was carried out on hitherto poorly studied rural–urban migrants settled in urban slums in a large metropolitan city in northern India, with the aim of studying anthropometric and metabolic characteristics of this population in socio-economic transition.

DESIGN: A cross-sectional epidemiological descriptive study.

SUBJECTS: A total of 532 subjects (170 males and 362 females) were included in the study (response rate approximately 40%).

METHODS AND RESULTS: In this study, diabetes mellitus was recorded in 11.2% (95% CI 6.8–16.9) of males and 9.9% (95% CI 7.0–13.5) of females, the overall prevalence being 10.3% (95% CI 7.8–13.2). Based on body mass index (BMI), obesity was more prevalent in females (15.6%; 95% CI 10.7–22.3) than in males (13.3%; 95% CI 8.5–19.5). On the other hand, classifying obesity based on percentage body fat (%BF), 10.6% (95% CI 6.4–16.2) of males and 40.2% (95% CI 34.9–45.3) of females were obese. High waist–hip ratio (WHR) was observed in 9.4% (95% CI 5.4–14.8) of males and 51.1% (95% CI 45.8–56.3) of the females. All individual skinfolds and sum of skinfolds were significantly higher in females (P<0.001). In both males and females above 30 y of age, there was a steep increase in the prevalence of high WHR, and in females, %BF was very high (particularly in %BF quartile>30%). Furthermore, total cholesterol and low-density lipoprotein cholesterol were high in both males and females. Stepwise multiple linear regression analysis showed that for both males and females BMI, WHR and %BF were positive predictors of biochemical parameters, except for HDL-c, for which these parameters were negatively associated.

CONCLUSIONS: Appreciable prevalence of obesity, dyslipidaemia, diabetes mellitus, substantial increase in body fat, generalised and regional obesity in middle age, particularly in females, need immediate attention in terms of prevention and health education in such economically deprived populations.

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References

  1. McKeigue PM, Shah B, Marmot MG . Relation of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in South Asians Lancet 1991 337: 382–388.

    Article  CAS  PubMed  Google Scholar 

  2. Ramaiya K, Kodali VRR, Alberti, KGMM . Epidemiology of diabetes in Asians of the Indian Subcontinent Diabetes Metab Rev 1990 6: 125–146.

    Article  CAS  PubMed  Google Scholar 

  3. Ramachandran A, Jali MV, Mohan V, Snehalatha C . High prevalence of diabetes in an urban population in South India Br Med J 1986 297: 587–590.

    Article  Google Scholar 

  4. Varma NPS, Mehta SP, Madhu SV, Mather HM, Keen H . Prevalence of known diabetes in an urban Indian environment: the Darya Ganj diabetes survey Br Med J 1986 293: 423–424.

    Article  Google Scholar 

  5. King H, Aubert RE, Herman WH . Global burden of diabetes, 1995–2025: prevalence, numerical estimates, and projections Diabetes Care 1998 21: 1414–1431.

    Article  CAS  PubMed  Google Scholar 

  6. Ramachandran A, Snehalatha C, Latha E, Vijay V, Viswanathan M . Rising prevalence of NIDDM in an urban population in India Diabetologia 1997 40: 232–237.

    Article  CAS  PubMed  Google Scholar 

  7. Gupta OP, Joshi MH, Dave SK . Prevalence of diabetes in India Adv Metab Disord 1978 9: 147–165.

    Article  CAS  PubMed  Google Scholar 

  8. Millar WJ, Wigle DT . Socio-economic disparities in risk factors for cardiovascular diseases CMAJ 1986 134: 127–132.

    CAS  PubMed  PubMed Central  Google Scholar 

  9. Connolly V, Unwin N, Sherriff P, Bilous R, Kelly W . Diabetes prevalence and socioeconomic status: a population based study showing increased prevalence of type II diabetes in the deprived areas J Epidemiol Community Health 2000 54: 173–177.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Bunnag SC, Amorn SC, Chandraprasert S . The prevalence of obesity, risk factors and associated disease in Klong Toey slum and Klong Toey government apartment houses Diabetes Res Clin Pract 1990 10: (Suppl 1): S81–87.

    Article  PubMed  Google Scholar 

  11. Sitthi-Amorn C, Chandraprasert S, Bunnag SC, Plengvidhya SC . The prevalence and risk factors of hypertension in Klon Toey slum and Klong Toey government apartment houses Int J Epidemiol 1989 18: 89–94.

    Article  CAS  PubMed  Google Scholar 

  12. Akatsu H, Aslam A . Prevalence of hypertension and obesity among women over age 25 in a low income area in Karachi, Pakistan J Pak Med Assoc 1996 46: 191–193.

    CAS  PubMed  Google Scholar 

  13. Sawaya AL, Dallal G, Solymos G et al. Obesity and malnutrition in a shantytown population in the city of Sao Paulo, Brazil Obes Res 1995 3: (suppl 2): 135s–143s.

    Article  Google Scholar 

  14. Durnin JVGA, Womersely J . Body fat assessed from total body density and its estimation from skinfold thickness: measurements on 481 men and women aged from 16 to 72 y Br J Nutr 1974 32: 77–97.

    Article  CAS  PubMed  Google Scholar 

  15. Kuriyan R, Petracchi C, Ferro-Luzzi A, Shetty PS, Kurpad AV . Validation of expedient methods for measuring body composition in Indian adults Ind J Med Res 1998 107: 37–45.

    CAS  Google Scholar 

  16. Chiamori N, Henry RJ . Study of the ferric chloride method for determination of total cholesterol and cholesterol esters Am J Clin Pathol 1959 31: 305–309.

    Article  CAS  PubMed  Google Scholar 

  17. Rosenberg SP, Gottfried A . Improved manual spectrophotometric procedure for determination of triglycerides Clin Chem 1973 9: 1077–1078.

    Google Scholar 

  18. World Health Organization . The Asia-Pacific perspective. Redefining obesity and its treatment International Diabetes Institute. February 2000

  19. Hortobagyi T, Israel RG, O'Brien KF . Sensitivity and specificity of the Quetelet index to assess obesity in men and women Eur J Clin Nutr 1994 48: 769–775.

    Google Scholar 

  20. Pollock ML, Wilmore JH . Exercise in health and disease WB Saunders: Philadelphia, PA 1990

    Google Scholar 

  21. Willett WC, Dietz WH, Colditz GA . Guidelines for healthy weight New Engl J Med 1999 341: 427–434.

    Article  CAS  PubMed  Google Scholar 

  22. Dudeja V, Misra A, Pandey RM, Devina G, Kumar G, Vikram NK . Body mass index does not accurately predict overweight in Asian Indians in Northern India Br J Nutr (in press).

  23. National Cholesterol Education Panel . Second report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Pressure in Adults (Adult Treatment Panel II) Circulation 1994 89: 1329–1445.

    Google Scholar 

  24. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus: report of the Expert Committee on Diagnosis and Classification of Diabetes Mellitus . Diabetes Care 1997 20: 1183–1197.

  25. Gopinath N, Chadha SL, Jain P, Shekhawat S, Tandon R . An epidemiological study of obesity in adults in the urban population of Delhi J Assoc Phys Ind 1994 42: 212–215.

    CAS  Google Scholar 

  26. Tripathy BB, Panda NC, Tej SC, Sahoo GN, Kar BN . Survey for the detection of glycocusira, hyperglycemia, and diabetes mellitus in urban and rural areas of Cuttak district J Assoc Phys Ind 1971 19: 681–692.

    CAS  Google Scholar 

  27. Patandin S, Bots ML, Abel R, Valkenburg HA . Impaired glucose intolerance and diabetes mellitus in a rural population in South India Diabetes Res Clin Pract 1994 24: 47–53.

    Article  CAS  PubMed  Google Scholar 

  28. Wander GS, Khurana SB, Gulati R, Sachar RK, Gupta RK, Khurana S, Anand IS . Epidemiology of coronary heart disease in a rural Punjab population-prevalence and correlation with various risk factors Indian Heart J 1994 46: 319–323.

    CAS  PubMed  Google Scholar 

  29. Zargar AH, Khan AK, Masoodi SR, Laway BA, Wani AI, Bashir MI, Dar FA . Prevalence of type 2 diabetes mellitus and impaired glucose tolerance in the Kashmir Valley of the Indian subcontinent Diabetes Res Clin Pract 2000 47: 135–146.

    Article  CAS  PubMed  Google Scholar 

  30. Hales CN, Barker DJ, Clark PM, Cox LJ, Fall C, Osmond C, Winter PD . Fetal and infant growth and impaired glucose tolerance at age 64 Br Med J 1991 303: 1019–1022.

    Article  CAS  Google Scholar 

  31. Barker DJ, Hales CN, Fall CH, Osmond C, Phipps K, Clark PM . Type 2 (non-insulin-dependent) diabetes mellitus, hypertension and hyperlipidemia (syndrome X): relation to reduced fetal growth Diabetologia 1993 36: 62–67.

    Article  CAS  PubMed  Google Scholar 

  32. Fall CH, Stein CE, Kumaran K, Cox V, Osmond C, Barker DJ, Hales CN . Size at birth, maternal weight, and type 2 diabetes in South India Diabetic Med 1998 15: 220–227.

    Article  CAS  PubMed  Google Scholar 

  33. Yajnik CS, Fall CH, Vaidya U, Pandit AN, Bavdekar A, Bhat DS, Osmond C, Hales CN, Barker DJ . Fetal growth and glucose and insulin metabolism in four-year-old Indian children Diabetic Med 1995 12: 330–336.

    Article  CAS  PubMed  Google Scholar 

  34. Bjorntorp P . Behavior and metabolic disease Int J Behav Med 1996 3: 285–302.

    Article  CAS  PubMed  Google Scholar 

  35. Bjorntorp P . Visceral fat accumulation: the missing link between psychosocial factors and cardiovascular disease? J Intern Med 1991 230: 195–201.

    Article  CAS  PubMed  Google Scholar 

  36. Brunner EJ, Marmot MG, Nanchahal K, Shipley MJ, Stansfeld SA, Juneja M, Alberti KG . Social inequality in coronary risk: central obesity and the metabolic syndrome: evidence from the Whitehall II study Diabetologia 1997 40: 1341–1349.

    Article  CAS  PubMed  Google Scholar 

  37. Tribhuvan RD, Kelkar A . Health issues of slum women. In: Tribhuvan RD (ed.). Social problems and development issues in slum women Amruta: Pune 1997 pp 66–75.

    Google Scholar 

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Acknowledgements

The study was fully supported by financial grant from Science and Society Division, Department of Science and Technology, Ministry of Science and Technology, Government of India. The authors express their appreciation to the staff of SRB Centre of Clinical Pharmacology, Department of Medicine, All India Institute of Medical Sciences, New Delhi including Mr Ramesh Giri, Mr Inder Taneja, Mr Gian Chand and Mrs Alice Jacob for performing various investigations, Mr RL Taneja for performing quality control of various biochemical tests, Mrs Jyoti for typing and Miss Kajal for editing the manuscript. Help and voluntary services provided from the volunteers, in particular the late Mr Jaipal, and the population of the slum community is appreciated.

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Authors and Affiliations

  1. Department of Medicine, All India Institute of Medical Sciences, New Delhi, India

    A Misra, J Rama Devi & NK Vikram

  2. Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India

    RM Pandey

  3. Department of Dietetics, All India Institute of Medical Sciences, New Delhi, India

    R Sharma & Nidhi Khanna

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  1. A Misra
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Correspondence to A Misra.

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Misra, A., Pandey, R., Rama Devi, J. et al. High prevalence of diabetes, obesity and dyslipidaemia in urban slum population in northern India. Int J Obes 25, 1722–1729 (2001). https://doi.org/10.1038/sj.ijo.0801748

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