The original version of this article unfortunately contained a mistake. The name of the author "Kavitha Shivakumar" should be changed as "Kavitha Sivakumar".The original article has been corrected.
Rheumatic heart disease (RHD) is one of the common heart disease acquired in children in many regions of the world, mainly in developing and underprivileged countries. This heart condition occurs following rheumatic fever caused by streptococcal infection. It affects the functionality of heart valves. When untreated it may lead to medical complications and even death. The disease mainly targeting children and young adults is responsible for cardiovascular morbidity and mortality in people. Prevention and treatment of acute rheumatic fever plays an important role in controlling the disease. Diagnosis of the disease is critically important because misdiagnosis of acute rheumatic fever can lead to worsening of damage caused to heart valves and may also lead to premature death. This being a preventable problem, it can be managed through surgeries to repair functions of cardiac valves. Alcohol consumption and tobacco smoking has shown synergistic effect which may prove detrimental to cardiovascular health.
To address the public health issue of type 2 diabetes (T2D) and its genetic profile in India, we aimed to evaluate genetic determinants of T2D using family-based cohorts from four distinct Endogamous Ethnic Groups (EEGs) representing two Northern (Punjab [Sikhs: SI] and Rajasthan [Agarwals: AG]) and two Southern (Tamil Nadu [Chettiars: CH] and Andhra Pradesh [Reddys: RE]) states of India, and to examine whether genetic variants found through targeted sequencing of the previously established 8 South Asian T2D risk loci (including the one from the Sikh population) are relevant to the AG, CH, and RE EEGs. In this study, we report the findings of T2D occurrence and genetic basis of T2D/related traits from the EEGs, as part of the INDIGENIUS (Indian Diabetes Genetic Studies in collaboration with U.S.) consortium studies, supported by an Indo-U.S. Collaborative Research Partnership on T2D. Data and samples were collected from three EEGs: AG (N=530, Families=25, mean age=43y, mean BMI=27, T2D=37%); CH (N=518, families=21, Age=47y, BMI=27, T2D=33%), and RE (N=500, Families=22, Age=46y, BMI=27, T2D=36%). Each of the families from an EEG was ascertained by a proband with T2D. The status of T2D was defined by ADA 2018 guidelines (fasting glucose≥126 mg/dl or HbA1c≥6.5% and/or use of diabetes medication/history). Similar characteristics for the SI EEG (N=1260, Families=324, Age=51y, BMI=27, T2D=75%) were obtained previously. We used the variance components method as implemented in the program SOLAR to carry out genetic analyses. All analyses were adjusted for age and sex effects. In all cohorts, T2D heritability (h2) (p<0.05) ranged from 30% (CH) to 81% (AG). Other T2D-related traits (e.g., BMI, lipids, blood pressure, insulin, glucose) in AG, CH, and RE EEGs exhibited strong genetic influences (h2 range: 15% [triglycerides] - 90% [glucose; non-T2D]). Our findings highlight high burden of T2D in Indian EEGs with significant additive genetic influences on T2D and its related traits. Disclosure V. Venkatesan: None. J.C. Lopez-Alvarenga: None. R. Arya: None. T. Koshy: None. U. Ravichandran: None. S. Sharma: None. S. Lodha: None. A.R. Ponnala: None. K.K. Sharma: None. M.V. Shaik: None. R.G. Resendez: None. D. Ramu: None. P. Venugopal: None. P. R.: None. N. S.: None. J.A. Ezeilo: None. C.A. Bejar: None. S. Mummidi: None. C. Natesan: None. J. Blangero: None. K.M. Medicherla: None. S. Thanikachalam: None. T. Sadras Panchatcharam: None. D. K.: None. R. Gupta: None. D.K. Sanghera: None. R. Duggirala: None. S.F. Paul: None. Funding Indian Council of Medical Research (55/6/2/Indo-US/2014-NCD-II); National Institute of Diabetes and Digestive and Kidney Diseases (R21DK105913)
Higher education levels are known to be associated with better understanding and awareness of type 2 diabetes (T2D) and its complications. Given the diverse ethnic and socio-cultural characteristics of Indian populations, we aimed to study the effect of educational status on fasting glucose (FG) and HbA1c from three distinct Endogamous Ethnic Groups (EEGs) in India, which are part of the INDIGENIUS consortium, supported by an Indo-U.S. Collaborative Research Partnership on T2D. We obtained data from 1,548 individuals from 68 families (Mean age: 45.5(16)y, 51% men, BMI 26.7(5.2)), representing the communities of Chettiar (34%) from Tamil Nadu state, Agarwal (34%) from Rajasthan state, and Reddy (32%) from Andhra Pradesh state with different levels of income (Low, Middle, High) and education (Uneducated [UE], High School [HS], Graduate [GD], and Postgraduate [PG]). We rank-normalized FG and HbA1c by Van der Waerden's method and performed MANCOVA adjusting for covariates (age, sex, BMI, T2D and income). The main effects were EEG and education level. Data were standardized. Reddys exhibited the lowest value of FG [(-0.05 (SE: 0.06)] compared with Chettiars [0.48 (0.14)] and Agarwals [0.4 (0.04)] p<0.001; for HbA1c, Reddys [0.18 (0.14)] were different from Agarwals [0.35 (0.04)] p< 0.001, but not with Chettiars [0.18 (0.14)]. Once adjusted for confounders, education levels (UE, HS, GD, PG) showed association with FG as follows, respectively: 0.6 (0.1)a, 0.25 (0.06)b, 0.13 (0.06)c and 0.05 (0.08)c; and for HbA1c as follows: 0.37 (0.1)a, 0.23 (0.06)b, 0.1 (0.06)c and 0.1 (0.07)c. The letters a, b and c refer to homogenous groups p<0.1. Education had significant effect on FG (and HbA1c) (p< 0.003), but its interaction with sex was found only for FG (p<0.036). In conclusion, fasting glucose and HbA1c concentrations are influenced by education level independent of income status and population background in the ethnically diverse Indian populations. Disclosure T. Koshy: None. R. Arya: None. J.C. Lopez-Alvarenga: None. V. Venkatesan: None. U. Ravichandran: None. S. Sharma: None. S. Lodha: None. A.R. Ponnala: None. K.K. Sharma: None. M.V. Shaik: None. R.G. Resendez: None. D. Ramu: None. P. Venugopal: None. P. R.: None. N. S.: None. J.A. Ezeilo: None. C.A. Bejar: None. S. Mummidi: None. C. Natesan: None. J. Blangero: None. K.M. Medicherla: None. S. Thanikachalam: None. T. Sadras Panchatcharam: None. D. K.: None. R. Gupta: None. R. Duggirala: None. D.K. Sanghera: None. S.F. Paul: None. Funding Indian Council of Medical Research (55/6/2/Indo-US/2014-NCD-II); National Institute of Diabetes and Digestive and Kidney Diseases (R21DK105913)
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