Skeletal and muscle health among rural south indian older population

India is at early stages of demographic transition to an aging society, but little is known about musculoskeletal health. Mobility and Independent Living among Elders’ Study (MILES), a rural south Indian older adults’ cohort, provides an opportunity to expand our musculoskeletal health understanding. This dissertation goal was to compare peripheral quantitative computed tomography (pQCT) parameters of Indian population with other ethnic groups and, assess its associations with mortality and physical performance. We observed Indian men compared to US Caucasians had significantly lower trabecular volumetric bone mineral density (vBMD), cortical thickness and higher endosteal circumference, suggesting higher risk of osteoporotic fractures. Over an average follow up of 64.2 months, among 499 MILES participants, 123 died (73 men; 50 women). Among men, trabecular vBMD (radius and tibia), cortical vBMD (radius and tibia), cortical thickness (radius and tibia), polar strength strain index (SSIp) of tibia and muscle density were inversely associated and, endosteal circumference (radius and tibia) were positively associated with mortality. Among women cortical vBMD (radius and tibia), cortical thickness (radius and tibia), SSIp (radius and tibia) were inversely associated, and endosteal circumference (radius and tibia) were positively associated with mortality. Gait speed among men mediated the muscle density and mortality association. On cross sectional analysis; among men, muscle density was associated with grip strength; cortical vBMD (radius), trabecular vBMD (tibia), cortical thickness (tibia), endosteal circumference (tibia) and muscle density were associated with short physical performance battery (SPPB); cortical thickness (tibia) was associated with 400-meter walk. Among women, trabecular vBMD (radius and tibia), cortical thickness (radius and tibia), SSIp (radius) and muscle density were associated with grip strength; cortical vBMD and SSIp of tibia and muscle density were associated with SPPB and; trabecular vBMD (tibia) was associated with 400-meter walk. These dissertation findings have public health importance; as it suggests Indian older population have lower bone strength indices. It presents for the first time mortality and physical performance associations with bone and muscle measures. These findings indicate the vulnerability of older population in India, and calls attention of policy makers for musculoskeletal health research and inclusion in national programs

Dengue serotype-specific seroprevalence among 5- to 10-year-old children in India: a community-based cross-sectional study

Background: Dengue surveillance data in India are limited and probably substantially underestimate the burden of disease. A community-based study was undertaken to assess the prevalence of dengue-specific immunoglobulin G (IgG) antibodies in children across India and to examine historical dengue exposure rates. Potential associations between socio-economic factors and dengue seroprevalence were also assessed (registered at ctri.nic.in: CTRI/2011/12/002243). Methods: A convenience sample of 2609 healthy children aged 5–10 years was enrolled; these children were registered at or were living in the vicinity of eight centres located at six geographically distinct sites across India. Blood samples were drawn to test for the presence of dengue IgG antibodies using ELISA. Serotype-specific neutralizing antibody titres were measured in dengue IgG-positive children using dengue plaque reduction neutralization tests. Socio-demographic and household information was collected using a questionnaire. Results: Overall, 2558/2609 children had viable samples with laboratory results for dengue IgG. Dengue IgG seroprevalence across all sites was 59.6% (95% confidence interval 57.7–61.5%): the lowest (23.2%) was in Kalyani, West Bengal, and the highest (80.1%) was in Mumbai. Seroprevalence increased with age. Multivariate analysis suggested associations with household water storage/supply and type of housing. Half of the subjects with positive IgG results presented a multitypic profile, indicating previous exposure to more than one serotype. Conclusions: The overall dengue seroprevalence suggests that dengue endemicity in India is comparable to that in highly endemic countries of Southeast Asia. Additional prospective studies are required to fully quantify the disease burden, in order to support evidence-based policies for dengue prevention and control in India

Hazard ratios (95% CI) for mortality per SD increase in the pQCT bone measures and muscle density among 254 women of MILES.

Hazard ratios (95% CI) for mortality per SD increase in the pQCT bone measures and muscle density among 254 women of MILES.</p

Kaplan Meir curves of quartiles of pQCT parameters and log rank test in men.

Kaplan Meir curves of quartiles of pQCT parameters and log rank test in men.</p

Kaplan Meir curves of quartiles of pQCT parameters and log rank test in women.

Kaplan Meir curves of quartiles of pQCT parameters and log rank test in women.</p

Impact of prepregnancy body mass index on adverse pregnancy outcomes: analysis from the Longitudinal Indian Family hEalth cohort studyAJOG MFM at a Glance

BACKGROUND: Both high and low maternal prepregnancy body mass index can lead to suboptimal fetal growth and risk of pregnancy complications. In developed countries, nearly half of all women of childbearing age are either overweight or obese, and most data linking maternal body mass index and adverse pregnancy complications are limited to these populations. OBJECTIVE: This study aimed to prospectively evaluate the relationships between prepregnancy body mass index and adverse pregnancy outcomes using the Longitudinal Indian Family hEalth (LIFE) study. STUDY DESIGN: We modeled the relationships between prepregnancy body mass index and adverse pregnancy outcomes such as low birthweight, preterm birth, cesarean delivery, intrauterine growth restriction, miscarriage, and fetal death among 675 women aged 15 to 35 years with singleton pregnancies in the Longitudinal Indian Family hEalth study, a population-based prospective pregnancy cohort study conducted in Telangana, India. Prepregnancy body mass index was calculated as weight in kilograms divided by height in meters squared and was classified into 4 categories using the World Health Organization recommendations for Asian adults. Prepregnancy body mass index was assessed at a mean of 12.3 months before pregnancy. Odds ratios and 95% confidence intervals of adverse pregnancy outcomes were modeled and adjusted for confounders. RESULTS: Obese women had a 3-fold increased risk of cesarean delivery (odds ratio, 3.13; 95% confidence interval, 1.56–6.29) compared with normal-weight women. Those who were overweight also had a marginally increased risk of cesarean delivery, albeit not statistically significant (odds ratio, 1.17; 95% confidence interval, 0.61–2.24). Underweight women had a modestly increased risk of low birthweight, compared with normal-weight women (odds ratio, 1.12; 95% confidence interval, 0.71–1.77), although results were not significant. Conversely, obese (odds ratio, 0.71; 95% confidence interval, 0.28–1.77) and overweight (odds ratio, 0.61; 95% confidence interval, 0.24–1.51) women had a marginally decreased risk of low birthweight. CONCLUSION: Our data suggest that women with elevated prepregnancy body mass index may have a higher risk of adverse pregnancy outcomes, especially cesarean delivery. Although this study has limited generalizability, our findings are generalizable to rural to periurban regions of India. Further studies exploring the translatability of these findings to other populations are needed. In addition, targeted prepregnancy intervention studies and programs that include counseling on optimization of preconception health and lifestyle modification for improvement of subsequent pregnancy outcomes among overweight and obese women are needed