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Published in: BMC Public Health 1/2014

Open Access 01-12-2014 | Research article

Is vulnerability to cardiometabolic disease in Indians mediated by abdominal adiposity or higher body adiposity

Authors: Hannah Kuper, Amy Taylor, Kankipati Vijay Radha Krishna, Yoav Ben-Shlomo, Ruby Gupta, Bharati Kulkarni, Dorairaj Prabhakaran, George Davey Smith, Jonathan Wells, Shah Ebrahim, Sanjay Kinra

Published in: BMC Public Health | Issue 1/2014

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Abstract

Background

Indians may be particularly vulnerable to cardiometabolic disease, potentially due to higher body fat for a given BMI, or a tendency towards depositing abdominal adiposity. The aim of the study is to assess whether different measures of the distribution of adiposity (abdominal versus whole body) or amount of adiposity (DXA versus traditional anthropometric) are better at predicting prevalent cardiometabolic risk markers in an Indian population.

Methods

Participants were recruited from the Indian Migration Study (IMS) and the Andhra Pradesh Children and Parent Study (APCAPS). Participants attended a clinic in Hyderabad, India, January 2009-December 2010. Adiposity was measured by conventional anthropometry (including weight, height, waist) and DXA scanning (whole body and abdominal). Blood samples were taken and assessed for fasting plasma glucose, insulin, cholesterol, and triglycerides and blood pressure was measured. Lifestyle data were collected by questionnaire.

Results

We invited 4 617 participants to the clinic (1 995 IMS; 2 622 APCAPS) and examined 918 from IMS (46%) and 1 451 from APCAPS (55%). There were strong and consistent relationships between adiposity and cardiometabolic risk factors. Cardiometabolic risk factors did not appear to be more strongly associated with DXA measures as opposed to BMI, or skinfold measures of body fat. There was some evidence that WHR was more closely related to diabetes than total body adiposity, but this was not apparent for the other measures of abdominal adiposity (DXA measures, waist circumference) or other cardiometablic risk factors.

Conclusions

No strong evidence supports that DXA measures or abdominal measures of adiposity are better at predicting the prevalence of cardiometabolic risk factors in comparison to BMI.
Appendix
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Literature
1.
go back to reference Danaei G, Finucane MM, Lu Y, Singh GM, Cowan MJ, Paciorek CJ, Lin JK, Farzadfar F, Khang YH, Stevens GA, Rao M, Ali MK, Riley LM, Robinson CA, Ezzati M: National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants. Lancet. 2011, 378 (9785): 31-40. 10.1016/S0140-6736(11)60679-X.CrossRefPubMed Danaei G, Finucane MM, Lu Y, Singh GM, Cowan MJ, Paciorek CJ, Lin JK, Farzadfar F, Khang YH, Stevens GA, Rao M, Ali MK, Riley LM, Robinson CA, Ezzati M: National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants. Lancet. 2011, 378 (9785): 31-40. 10.1016/S0140-6736(11)60679-X.CrossRefPubMed
2.
go back to reference Agrawal S, Ebrahim S: Prevalence and risk factors for self-reported diabetes among adult men and women in India: findings from a national cross-sectional survey. Public Health Nutr. 2012, 15 (6): 1065-1077. 10.1017/S1368980011002813.CrossRefPubMed Agrawal S, Ebrahim S: Prevalence and risk factors for self-reported diabetes among adult men and women in India: findings from a national cross-sectional survey. Public Health Nutr. 2012, 15 (6): 1065-1077. 10.1017/S1368980011002813.CrossRefPubMed
3.
go back to reference Ramachandran A, Ma RC, Snehalatha C: Diabetes in Asia. Lancet. 2010, 375 (9712): 408-418. 10.1016/S0140-6736(09)60937-5.CrossRefPubMed Ramachandran A, Ma RC, Snehalatha C: Diabetes in Asia. Lancet. 2010, 375 (9712): 408-418. 10.1016/S0140-6736(09)60937-5.CrossRefPubMed
4.
go back to reference Patel V, Chatterji S, Chisholm D, Ebrahim S, Gopalakrishna G, Mathers C, Mohan V, Prabhakaran D, Ravindran RD, Reddy KS: Chronic diseases and injuries in India. Lancet. 2011, 377 (9763): 413-428. 10.1016/S0140-6736(10)61188-9.CrossRefPubMed Patel V, Chatterji S, Chisholm D, Ebrahim S, Gopalakrishna G, Mathers C, Mohan V, Prabhakaran D, Ravindran RD, Reddy KS: Chronic diseases and injuries in India. Lancet. 2011, 377 (9763): 413-428. 10.1016/S0140-6736(10)61188-9.CrossRefPubMed
5.
go back to reference Ramachandran A, Mary S, Yamuna A, Murugesan N, Snehalatha C: High prevalence of diabetes and cardiovascular risk factors associated with urbanization in India. Diabetes Care. 2008, 31 (5): 893-898. 10.2337/dc07-1207.CrossRefPubMed Ramachandran A, Mary S, Yamuna A, Murugesan N, Snehalatha C: High prevalence of diabetes and cardiovascular risk factors associated with urbanization in India. Diabetes Care. 2008, 31 (5): 893-898. 10.2337/dc07-1207.CrossRefPubMed
6.
go back to reference Ebrahim S, Kinra S, Bowen L, Andersen E, Ben-Shlomo Y, Lyngdoh T, Ramakrishnan L, Ahuja RC, Joshi P, Das SM, Mohan M, Davey Smith G, Prabhakaran D, Reddy KS, Indian Migration Study group: The effect of rural-to-urban migration on obesity and diabetes in India: a cross-sectional study. PLoS Med. 2010, 7 (4): e1000268-10.1371/journal.pmed.1000268.CrossRefPubMedPubMedCentral Ebrahim S, Kinra S, Bowen L, Andersen E, Ben-Shlomo Y, Lyngdoh T, Ramakrishnan L, Ahuja RC, Joshi P, Das SM, Mohan M, Davey Smith G, Prabhakaran D, Reddy KS, Indian Migration Study group: The effect of rural-to-urban migration on obesity and diabetes in India: a cross-sectional study. PLoS Med. 2010, 7 (4): e1000268-10.1371/journal.pmed.1000268.CrossRefPubMedPubMedCentral
7.
go back to reference Bowen L, Ebrahim S, De Stavola B, Ness A, Kinra S, Bharathi AV, Prabhakaran D, Reddy KS: Dietary intake and rural-urban migration in India: a cross-sectional study. PLoS One. 2011, 6 (6): e14822-10.1371/journal.pone.0014822.CrossRefPubMedPubMedCentral Bowen L, Ebrahim S, De Stavola B, Ness A, Kinra S, Bharathi AV, Prabhakaran D, Reddy KS: Dietary intake and rural-urban migration in India: a cross-sectional study. PLoS One. 2011, 6 (6): e14822-10.1371/journal.pone.0014822.CrossRefPubMedPubMedCentral
8.
go back to reference Sullivan R, Kinra S, Ekelund U, Bharathi AV, Vaz M, Kurpad A, Collier T, Reddy KS, Prabhakaran D, Ben-Shlomo Y, Davey Smith G, Ebrahim S, Kuper H: Socio-demographic patterning of physical activity across migrant groups in India: results from the Indian Migration Study. PLoS One. 2011, 6 (10): e24898-10.1371/journal.pone.0024898.CrossRefPubMedPubMedCentral Sullivan R, Kinra S, Ekelund U, Bharathi AV, Vaz M, Kurpad A, Collier T, Reddy KS, Prabhakaran D, Ben-Shlomo Y, Davey Smith G, Ebrahim S, Kuper H: Socio-demographic patterning of physical activity across migrant groups in India: results from the Indian Migration Study. PLoS One. 2011, 6 (10): e24898-10.1371/journal.pone.0024898.CrossRefPubMedPubMedCentral
9.
go back to reference Yoon KH, Lee JH, Kim JW, Cho JH, Choi YH, Ko SH, Zimmet P, Son HY: Epidemic obesity and type 2 diabetes in Asia. Lancet. 2006, 368 (9548): 1681-1688. 10.1016/S0140-6736(06)69703-1.CrossRefPubMed Yoon KH, Lee JH, Kim JW, Cho JH, Choi YH, Ko SH, Zimmet P, Son HY: Epidemic obesity and type 2 diabetes in Asia. Lancet. 2006, 368 (9548): 1681-1688. 10.1016/S0140-6736(06)69703-1.CrossRefPubMed
10.
go back to reference Huxley R, James WP, Barzi F, Patel JV, Lear SA, Suriyawongpaisal P, Janus E, Caterson I, Zimmet P, Prabhakaran D, Reddy S, Woodward M, Obesity in Asia Collaboration: Ethnic comparisons of the cross-sectional relationships between measures of body size with diabetes and hypertension. Obes Rev. 2008, 9 (Suppl 1): 53-61.CrossRefPubMed Huxley R, James WP, Barzi F, Patel JV, Lear SA, Suriyawongpaisal P, Janus E, Caterson I, Zimmet P, Prabhakaran D, Reddy S, Woodward M, Obesity in Asia Collaboration: Ethnic comparisons of the cross-sectional relationships between measures of body size with diabetes and hypertension. Obes Rev. 2008, 9 (Suppl 1): 53-61.CrossRefPubMed
11.
go back to reference Lee JW, Brancati FL, Yeh HC: Trends in the prevalence of type 2 diabetes in Asians versus whites: results from the United States National Health Interview Survey, 1997-2008. Diabetes Care. 2011, 34 (2): 353-357. 10.2337/dc10-0746.CrossRefPubMedPubMedCentral Lee JW, Brancati FL, Yeh HC: Trends in the prevalence of type 2 diabetes in Asians versus whites: results from the United States National Health Interview Survey, 1997-2008. Diabetes Care. 2011, 34 (2): 353-357. 10.2337/dc10-0746.CrossRefPubMedPubMedCentral
12.
go back to reference Raji A, Gerhard-Herman MD, Warren M, Silverman SG, Raptopoulos V, Mantzoros CS, Simonson DC: Insulin resistance and vascular dysfunction in nondiabetic Asian Indians. J Clin Endocrinol Metab. 2004, 89 (8): 3965-3972. 10.1210/jc.2004-0087.CrossRefPubMed Raji A, Gerhard-Herman MD, Warren M, Silverman SG, Raptopoulos V, Mantzoros CS, Simonson DC: Insulin resistance and vascular dysfunction in nondiabetic Asian Indians. J Clin Endocrinol Metab. 2004, 89 (8): 3965-3972. 10.1210/jc.2004-0087.CrossRefPubMed
13.
go back to reference Chandalia M, Abate N, Garg A, Stray-Gundersen J, Grundy SM: Relationship between generalized and upper body obesity to insulin resistance in Asian Indian men. J Clin Endocrinol Metab. 1999, 84 (7): 2329-2335.PubMed Chandalia M, Abate N, Garg A, Stray-Gundersen J, Grundy SM: Relationship between generalized and upper body obesity to insulin resistance in Asian Indian men. J Clin Endocrinol Metab. 1999, 84 (7): 2329-2335.PubMed
14.
go back to reference Raji A, Seely EW, Arky RA, Simonson DC: Body fat distribution and insulin resistance in healthy Asian Indians and Caucasians. J Clin Endocrinol Metab. 2001, 86 (11): 5366-5371. 10.1210/jcem.86.11.7992.CrossRefPubMed Raji A, Seely EW, Arky RA, Simonson DC: Body fat distribution and insulin resistance in healthy Asian Indians and Caucasians. J Clin Endocrinol Metab. 2001, 86 (11): 5366-5371. 10.1210/jcem.86.11.7992.CrossRefPubMed
15.
go back to reference Misra A, Vikram NK, Arya S, Pandey RM, Dhingra V, Chatterjee A, Dwivedi M, Sharma R, Luthra K, Guleria R, Talwar KK: High prevalence of insulin resistance in postpubertal Asian Indian children is associated with adverse truncal body fat patterning, abdominal adiposity and excess body fat. Int J Obes Relat Metab Disord. 2004, 28 (10): 1217-1226. 10.1038/sj.ijo.0802704.CrossRefPubMed Misra A, Vikram NK, Arya S, Pandey RM, Dhingra V, Chatterjee A, Dwivedi M, Sharma R, Luthra K, Guleria R, Talwar KK: High prevalence of insulin resistance in postpubertal Asian Indian children is associated with adverse truncal body fat patterning, abdominal adiposity and excess body fat. Int J Obes Relat Metab Disord. 2004, 28 (10): 1217-1226. 10.1038/sj.ijo.0802704.CrossRefPubMed
16.
go back to reference Forouhi NG: Ethnicity and The Metabolic Syndrome. The Metabolic Syndrome. Edited by: Byrne CD, Wild SH. 2005, London: John Wiley and Sons Forouhi NG: Ethnicity and The Metabolic Syndrome. The Metabolic Syndrome. Edited by: Byrne CD, Wild SH. 2005, London: John Wiley and Sons
17.
go back to reference Bhat DS, Yajnik CS, Sayyad MG, Raut KN, Lubree HG, Rege SS, Chougule SD, Shetty PS, Yudkin JS, Kurpad AV: Body fat measurement in Indian men: comparison of three methods based on a two-compartment model. Int J Obes (Lond). 2005, 29 (7): 842-848. 10.1038/sj.ijo.0802953.CrossRef Bhat DS, Yajnik CS, Sayyad MG, Raut KN, Lubree HG, Rege SS, Chougule SD, Shetty PS, Yudkin JS, Kurpad AV: Body fat measurement in Indian men: comparison of three methods based on a two-compartment model. Int J Obes (Lond). 2005, 29 (7): 842-848. 10.1038/sj.ijo.0802953.CrossRef
18.
go back to reference Yajnik CS, Lubree HG, Rege SS, Naik SS, Deshpande JA, Deshpande SS, Joglekar CV, Yudkin JS: Adiposity and hyperinsulinemia in Indians are present at birth. J Clin Endocrinol Metab. 2002, 87 (12): 5575-5580. 10.1210/jc.2002-020434.CrossRefPubMed Yajnik CS, Lubree HG, Rege SS, Naik SS, Deshpande JA, Deshpande SS, Joglekar CV, Yudkin JS: Adiposity and hyperinsulinemia in Indians are present at birth. J Clin Endocrinol Metab. 2002, 87 (12): 5575-5580. 10.1210/jc.2002-020434.CrossRefPubMed
19.
go back to reference Banerji MA, Faridi N, Atluri R, Chaiken RL, Lebovitz HE: Body composition, visceral fat, leptin, and insulin resistance in Asian Indian men. J Clin Endocrinol Metab. 1999, 84 (1): 137-144.PubMed Banerji MA, Faridi N, Atluri R, Chaiken RL, Lebovitz HE: Body composition, visceral fat, leptin, and insulin resistance in Asian Indian men. J Clin Endocrinol Metab. 1999, 84 (1): 137-144.PubMed
20.
go back to reference Janssen I, Katzmarzyk PT, Ross R: Waist circumference and not body mass index explains obesity-related health risk. Am J Clin Nutr. 2004, 79 (3): 379-384.PubMed Janssen I, Katzmarzyk PT, Ross R: Waist circumference and not body mass index explains obesity-related health risk. Am J Clin Nutr. 2004, 79 (3): 379-384.PubMed
21.
go back to reference Canoy D, Boekholdt SM, Wareham N, Luben R, Welch A, Bingham S, Buchan I, Day N, Khaw KT: Body fat distribution and risk of coronary heart disease in men and women in the European Prospective Investigation into cancer and nutrition in Norfolk cohort: a population-based prospective study. Circulation. 2007, 116 (25): 2933-2943. 10.1161/CIRCULATIONAHA.106.673756.CrossRefPubMed Canoy D, Boekholdt SM, Wareham N, Luben R, Welch A, Bingham S, Buchan I, Day N, Khaw KT: Body fat distribution and risk of coronary heart disease in men and women in the European Prospective Investigation into cancer and nutrition in Norfolk cohort: a population-based prospective study. Circulation. 2007, 116 (25): 2933-2943. 10.1161/CIRCULATIONAHA.106.673756.CrossRefPubMed
22.
go back to reference Yusuf S, Hawken S, Ounpuu S, Bautista L, Franzosi MG, Commerford P, Lang CC, Rumboldt Z, Onen CL, Lisheng L, Tanomsup S, Wangai P, Razak F, Sharma AM, Anand SS, INTERHEART Study Investigators: Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case-control study. Lancet. 2005, 366 (9497): 1640-1649. 10.1016/S0140-6736(05)67663-5.CrossRefPubMed Yusuf S, Hawken S, Ounpuu S, Bautista L, Franzosi MG, Commerford P, Lang CC, Rumboldt Z, Onen CL, Lisheng L, Tanomsup S, Wangai P, Razak F, Sharma AM, Anand SS, INTERHEART Study Investigators: Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case-control study. Lancet. 2005, 366 (9497): 1640-1649. 10.1016/S0140-6736(05)67663-5.CrossRefPubMed
23.
go back to reference Chan JC, Malik V, Jia W, Kadowaki T, Yajnik CS, Yoon KH, Hu FB: Diabetes in Asia: epidemiology, risk factors, and pathophysiology. JAMA. 2009, 301 (20): 2129-2140. 10.1001/jama.2009.726.CrossRefPubMed Chan JC, Malik V, Jia W, Kadowaki T, Yajnik CS, Yoon KH, Hu FB: Diabetes in Asia: epidemiology, risk factors, and pathophysiology. JAMA. 2009, 301 (20): 2129-2140. 10.1001/jama.2009.726.CrossRefPubMed
24.
go back to reference Gupta V, Vinay DG, Rafiq S, Kranthikumar MV, Janipalli CS, Giambartolomei C, Evans DM, Mani KR, Sandeep MN, Taylor AE, Kinra S, Sullivan RM, Bowen L, Timpson NJ, Smith GD, Dudbridge F, Prabhakaran D, Ben-Shlomo Y, Reddy KS, Ebrahim S, Chandak GR, ndian Migration Study Group: Association analysis of 31 common polymorphisms with type 2 diabetes and its related traits in Indian sib pairs. Diabetologia. 2012, 55 (2): 349-357. 10.1007/s00125-011-2355-6.CrossRefPubMed Gupta V, Vinay DG, Rafiq S, Kranthikumar MV, Janipalli CS, Giambartolomei C, Evans DM, Mani KR, Sandeep MN, Taylor AE, Kinra S, Sullivan RM, Bowen L, Timpson NJ, Smith GD, Dudbridge F, Prabhakaran D, Ben-Shlomo Y, Reddy KS, Ebrahim S, Chandak GR, ndian Migration Study Group: Association analysis of 31 common polymorphisms with type 2 diabetes and its related traits in Indian sib pairs. Diabetologia. 2012, 55 (2): 349-357. 10.1007/s00125-011-2355-6.CrossRefPubMed
25.
go back to reference Taylor AE, Sandeep MN, Janipalli CS, Giambartolomei C, Evans DM, Kranthi Kumar MV, Vinay DG, Smitha P, Gupta V, Aruna M, Kinra S, Sullivan RM, Bowen L, Timpson NJ, Davey Smith G, Dudbridge F, Prabhakaran D, Ben-Shlomo Y, Reddy KS, Ebrahim S, Chandak GR: Associations of FTO and MC4R variants with obesity traits in Indians and the role of rural/urban environment as a possible effect modifier. J Obes. 2011, 2011: 307542-CrossRefPubMedPubMedCentral Taylor AE, Sandeep MN, Janipalli CS, Giambartolomei C, Evans DM, Kranthi Kumar MV, Vinay DG, Smitha P, Gupta V, Aruna M, Kinra S, Sullivan RM, Bowen L, Timpson NJ, Davey Smith G, Dudbridge F, Prabhakaran D, Ben-Shlomo Y, Reddy KS, Ebrahim S, Chandak GR: Associations of FTO and MC4R variants with obesity traits in Indians and the role of rural/urban environment as a possible effect modifier. J Obes. 2011, 2011: 307542-CrossRefPubMedPubMedCentral
26.
go back to reference Rafiq S, Venkata KKM, Gupta V, Vinay DG, Spurgeon CJ, Parameshwaran S, Madana SN, Kinra S, Bowen L, Timpson NJ, Smith GD, Dudbridge F, Prabhakaran D, Ben-Shlomo Y, Reddy KS, Ebrahim S, Chandak GR, Indian Migration Study Group: Evaluation of seven common lipid associated loci in a large Indian sib pair study. Lipids Health Dis. 2012, 11: 155-10.1186/1476-511X-11-155.CrossRefPubMedPubMedCentral Rafiq S, Venkata KKM, Gupta V, Vinay DG, Spurgeon CJ, Parameshwaran S, Madana SN, Kinra S, Bowen L, Timpson NJ, Smith GD, Dudbridge F, Prabhakaran D, Ben-Shlomo Y, Reddy KS, Ebrahim S, Chandak GR, Indian Migration Study Group: Evaluation of seven common lipid associated loci in a large Indian sib pair study. Lipids Health Dis. 2012, 11: 155-10.1186/1476-511X-11-155.CrossRefPubMedPubMedCentral
27.
go back to reference Tabassum R, Chauhan G, Dwivedi OP, Mahajan A, Jaiswal A, Kaur I, Bandesh K, Singh T, Mathai BJ, Pandey Y, Chidambaram M, Sharma A, Chavali S, Sengupta S, Ramakrishnan L, Venkatesh P, Aggarwal SK, Ghosh S, Prabhakaran D, Srinath RK, Saxena M, Banerjee M, Mathur S, Bhansali A, Shah VN, Madhu SV, Marwaha RK, Basu A, Scaria V, McCarthy MI: Genome-wide association study for type 2 diabetes in Indians identifies a new susceptibility locus at 2q21. Diabetes. 2013, 62 (3): 977-986. 10.2337/db12-0406.CrossRefPubMedPubMedCentral Tabassum R, Chauhan G, Dwivedi OP, Mahajan A, Jaiswal A, Kaur I, Bandesh K, Singh T, Mathai BJ, Pandey Y, Chidambaram M, Sharma A, Chavali S, Sengupta S, Ramakrishnan L, Venkatesh P, Aggarwal SK, Ghosh S, Prabhakaran D, Srinath RK, Saxena M, Banerjee M, Mathur S, Bhansali A, Shah VN, Madhu SV, Marwaha RK, Basu A, Scaria V, McCarthy MI: Genome-wide association study for type 2 diabetes in Indians identifies a new susceptibility locus at 2q21. Diabetes. 2013, 62 (3): 977-986. 10.2337/db12-0406.CrossRefPubMedPubMedCentral
28.
go back to reference Kooner JS, Saleheen D, Sim X, Sehmi J, Zhang W, Frossard P, Been LF, Chia K-S, Dimas AS, Hassanali N, Jafar T, Jowett JB, Li X, Radha V, Rees SD, Takeuchi F, Young R, Aung T, Basit A, Chidambaram M, Das D, Grundberg E, Hedman AK, Hydrie ZI, Islam M, Khor CC, Kowlessur S, Kristensen MM, Liju S, Lim WY, et al: Genome-wide association study in individuals of South Asian ancestry identifies six new type 2 diabetes susceptibility loci. Nat Genet. 2011, 43 (10): 984-989. 10.1038/ng.921.CrossRefPubMedPubMedCentral Kooner JS, Saleheen D, Sim X, Sehmi J, Zhang W, Frossard P, Been LF, Chia K-S, Dimas AS, Hassanali N, Jafar T, Jowett JB, Li X, Radha V, Rees SD, Takeuchi F, Young R, Aung T, Basit A, Chidambaram M, Das D, Grundberg E, Hedman AK, Hydrie ZI, Islam M, Khor CC, Kowlessur S, Kristensen MM, Liju S, Lim WY, et al: Genome-wide association study in individuals of South Asian ancestry identifies six new type 2 diabetes susceptibility loci. Nat Genet. 2011, 43 (10): 984-989. 10.1038/ng.921.CrossRefPubMedPubMedCentral
31.
go back to reference Kinra S, Radhakrishna KV, Kuper H, Rameshwar Sarma K, Prabhakaran P, Gupta V, Walia G, Bhogadi S, Kulkarni B, Kumar A, Aggarwal A, Gupta R, Prabhakaran D, Reddy KS, Davey Smith G, Ben-Shlomo Y, Ebrahim S: Cohort Profile: Andhra Pradesh Children and Parents Study (APCAPS). Int J Epidemiol. 2013, 43 (5): 1417-1424.CrossRefPubMedPubMedCentral Kinra S, Radhakrishna KV, Kuper H, Rameshwar Sarma K, Prabhakaran P, Gupta V, Walia G, Bhogadi S, Kulkarni B, Kumar A, Aggarwal A, Gupta R, Prabhakaran D, Reddy KS, Davey Smith G, Ben-Shlomo Y, Ebrahim S: Cohort Profile: Andhra Pradesh Children and Parents Study (APCAPS). Int J Epidemiol. 2013, 43 (5): 1417-1424.CrossRefPubMedPubMedCentral
32.
go back to reference Kinra S, Rameshwar Sarma KV, Mendu VV, Ravikumar R, Mohan V, Wilkinson IB, Cockcroft JR, Davey Smith G, Ben-Shlomo Y, Ghafoorunissa: Effect of integration of supplemental nutrition with public health programmes in pregnancy and early childhood on cardiovascular risk in rural Indian adolescents: long term follow-up of Hyderabad nutrition trial. BMJ. 2008, 337: a605-10.1136/bmj.a605.CrossRefPubMedPubMedCentral Kinra S, Rameshwar Sarma KV, Mendu VV, Ravikumar R, Mohan V, Wilkinson IB, Cockcroft JR, Davey Smith G, Ben-Shlomo Y, Ghafoorunissa: Effect of integration of supplemental nutrition with public health programmes in pregnancy and early childhood on cardiovascular risk in rural Indian adolescents: long term follow-up of Hyderabad nutrition trial. BMJ. 2008, 337: a605-10.1136/bmj.a605.CrossRefPubMedPubMedCentral
33.
go back to reference Durnin JV, Womersley 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 years. Br J Nutr. 1974, 32 (1): 77-97. 10.1079/BJN19740060.CrossRefPubMed Durnin JV, Womersley 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 years. Br J Nutr. 1974, 32 (1): 77-97. 10.1079/BJN19740060.CrossRefPubMed
34.
go back to reference Alberti KGMM, Zimmet PZ, Consultation W: Definition, Diagnosis, and Classification of Diabetes Mellitus and its Complications. Report of a WHO Consultation. Part 1: Diagnosis and Classification of Diabetes Mellitus. 2002, Geneva: World Health Organization Alberti KGMM, Zimmet PZ, Consultation W: Definition, Diagnosis, and Classification of Diabetes Mellitus and its Complications. Report of a WHO Consultation. Part 1: Diagnosis and Classification of Diabetes Mellitus. 2002, Geneva: World Health Organization
35.
go back to reference Levy JC, Matthews DR, Hermans MP: Correct homeostasis model assessment (HOMA) evaluation uses the computer program. Diabetes Care. 1998, 21 (12): 2191-2192. 10.2337/diacare.21.12.2191.CrossRefPubMed Levy JC, Matthews DR, Hermans MP: Correct homeostasis model assessment (HOMA) evaluation uses the computer program. Diabetes Care. 1998, 21 (12): 2191-2192. 10.2337/diacare.21.12.2191.CrossRefPubMed
36.
go back to reference International Institute for Population Sciences (IIPS) and ORC Macro: National Family Health Survey (NFHS-2), 1998-99. 2000, Mumbai: International Institute for Population Sciences International Institute for Population Sciences (IIPS) and ORC Macro: National Family Health Survey (NFHS-2), 1998-99. 2000, Mumbai: International Institute for Population Sciences
37.
go back to reference Wiklund P, Toss F, Jansson JH, Eliasson M, Hallmans G, Nordstrom A, Franks PW, Nordstrom P: Abdominal and gynoid adipose distribution and incident myocardial infarction in women and men. Int J Obes (Lond). 2010, 34 (12): 1752-1758. 10.1038/ijo.2010.102.CrossRef Wiklund P, Toss F, Jansson JH, Eliasson M, Hallmans G, Nordstrom A, Franks PW, Nordstrom P: Abdominal and gynoid adipose distribution and incident myocardial infarction in women and men. Int J Obes (Lond). 2010, 34 (12): 1752-1758. 10.1038/ijo.2010.102.CrossRef
38.
go back to reference Sun Q, van Dam RM, Spiegelman D, Heymsfield SB, Willett WC, Hu FB: Comparison of dual-energy x-ray absorptiometric and anthropometric measures of adiposity in relation to adiposity-related biologic factors. Am J Epidemiol. 2010, 172 (12): 1442-1454. 10.1093/aje/kwq306.CrossRefPubMedPubMedCentral Sun Q, van Dam RM, Spiegelman D, Heymsfield SB, Willett WC, Hu FB: Comparison of dual-energy x-ray absorptiometric and anthropometric measures of adiposity in relation to adiposity-related biologic factors. Am J Epidemiol. 2010, 172 (12): 1442-1454. 10.1093/aje/kwq306.CrossRefPubMedPubMedCentral
39.
go back to reference Ito H, Nakasuga K, Ohshima A, Maruyama T, Kaji Y, Harada M, Fukunaga M, Jingu S, Sakamoto M: Detection of cardiovascular risk factors by indices of obesity obtained from anthropometry and dual-energy X-ray absorptiometry in Japanese individuals. Int J Obes Relat Metab Disord. 2003, 27 (2): 232-237. 10.1038/sj.ijo.802226.CrossRefPubMed Ito H, Nakasuga K, Ohshima A, Maruyama T, Kaji Y, Harada M, Fukunaga M, Jingu S, Sakamoto M: Detection of cardiovascular risk factors by indices of obesity obtained from anthropometry and dual-energy X-ray absorptiometry in Japanese individuals. Int J Obes Relat Metab Disord. 2003, 27 (2): 232-237. 10.1038/sj.ijo.802226.CrossRefPubMed
40.
go back to reference Shen W, Punyanitya M, Chen J, Gallagher D, Albu J, Pi-Sunyer X, Lewis CE, Grunfeld C, Heshka S, Heymsfield SB: Waist circumference correlates with metabolic syndrome indicators better than percentage fat. Obesity (Silver Spring). 2006, 14 (4): 727-736. 10.1038/oby.2006.83.CrossRef Shen W, Punyanitya M, Chen J, Gallagher D, Albu J, Pi-Sunyer X, Lewis CE, Grunfeld C, Heshka S, Heymsfield SB: Waist circumference correlates with metabolic syndrome indicators better than percentage fat. Obesity (Silver Spring). 2006, 14 (4): 727-736. 10.1038/oby.2006.83.CrossRef
41.
go back to reference Lee K, Song YM, Sung J: Which obesity indicators are better predictors of metabolic risk?: healthy twin study. Obesity (Silver Spring). 2008, 16 (4): 834-840. 10.1038/oby.2007.109.CrossRef Lee K, Song YM, Sung J: Which obesity indicators are better predictors of metabolic risk?: healthy twin study. Obesity (Silver Spring). 2008, 16 (4): 834-840. 10.1038/oby.2007.109.CrossRef
42.
go back to reference Wells JC: Commentary: the paradox of body mass index in obesity assessment: not a good index of adiposity, but not a bad index of cardio-metabolic risk. Int J Epidemiol. 2014, 43 (3): 672-674. 10.1093/ije/dyu060.CrossRefPubMedPubMedCentral Wells JC: Commentary: the paradox of body mass index in obesity assessment: not a good index of adiposity, but not a bad index of cardio-metabolic risk. Int J Epidemiol. 2014, 43 (3): 672-674. 10.1093/ije/dyu060.CrossRefPubMedPubMedCentral
43.
go back to reference Taylor AE, Ebrahim S, Ben-Shlomo Y, Martin RM, Whincup PH, Yarnell JW, Wannamethee SG, Lawlor DA: Comparison of the associations of body mass index and measures of central adiposity and fat mass with coronary heart disease, diabetes, and all-cause mortality: a study using data from 4 UK cohorts. Am J Clin Nutr. 2010, 91 (3): 547-556. 10.3945/ajcn.2009.28757.CrossRefPubMed Taylor AE, Ebrahim S, Ben-Shlomo Y, Martin RM, Whincup PH, Yarnell JW, Wannamethee SG, Lawlor DA: Comparison of the associations of body mass index and measures of central adiposity and fat mass with coronary heart disease, diabetes, and all-cause mortality: a study using data from 4 UK cohorts. Am J Clin Nutr. 2010, 91 (3): 547-556. 10.3945/ajcn.2009.28757.CrossRefPubMed
44.
go back to reference Vazquez G, Duval S, Jacobs DR, Silventoinen K: Comparison of body mass index, waist circumference, and waist/hip ratio in predicting incident diabetes: a meta-analysis. Epidemiol Rev. 2007, 29: 115-128. 10.1093/epirev/mxm008.CrossRefPubMed Vazquez G, Duval S, Jacobs DR, Silventoinen K: Comparison of body mass index, waist circumference, and waist/hip ratio in predicting incident diabetes: a meta-analysis. Epidemiol Rev. 2007, 29: 115-128. 10.1093/epirev/mxm008.CrossRefPubMed
45.
go back to reference Qiao Q, Nyamdorj R: Is the association of type II diabetes with waist circumference or waist-to-hip ratio stronger than that with body mass index?. Eur J Clin Nutr. 2010, 64 (1): 30-34. 10.1038/ejcn.2009.93.CrossRefPubMed Qiao Q, Nyamdorj R: Is the association of type II diabetes with waist circumference or waist-to-hip ratio stronger than that with body mass index?. Eur J Clin Nutr. 2010, 64 (1): 30-34. 10.1038/ejcn.2009.93.CrossRefPubMed
46.
go back to reference Nyamdorj R, Qiao Q, Lam TH, Tuomilehto J, Ho SY, Pitkaniemi J, Nakagami T, Mohan V, Janus ED, Ferreira SR: BMI compared with central obesity indicators in relation to diabetes and hypertension in Asians. Obesity (Silver Spring). 2008, 16 (7): 1622-1635.CrossRef Nyamdorj R, Qiao Q, Lam TH, Tuomilehto J, Ho SY, Pitkaniemi J, Nakagami T, Mohan V, Janus ED, Ferreira SR: BMI compared with central obesity indicators in relation to diabetes and hypertension in Asians. Obesity (Silver Spring). 2008, 16 (7): 1622-1635.CrossRef
Metadata
Title
Is vulnerability to cardiometabolic disease in Indians mediated by abdominal adiposity or higher body adiposity
Authors
Hannah Kuper
Amy Taylor
Kankipati Vijay Radha Krishna
Yoav Ben-Shlomo
Ruby Gupta
Bharati Kulkarni
Dorairaj Prabhakaran
George Davey Smith
Jonathan Wells
Shah Ebrahim
Sanjay Kinra
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2014
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-14-1239

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