Context:Hypertension in youth is increasing, but there is a dearth of data about the knowledge of risk factors in this age group.Aims:To assess the knowledge of risk factors of hypertension among university students and associate it with the blood pressure, physical activity, family history of cardiovascular disease (CVD), and sociodemographic variables.Materials and Methods:A cross-sectional survey among students enrolled in the first year, in the four academic programs, with the use of a validated, self-administered questionnaire on physical activity in the past 30 days and knowledge of risk factors of hypertension. A score of 6 on 11 was considered as good knowledge for modifiable risk factors. Blood pressure was also measured. The data was analyzed using PASW-17, Chi square test, and binary logistic regression analysis was done.Results:Of the 110 participants, 69.2% were < 20 years of age, 76.4% were females, and 40% were Arabs. Stress, high cholesterol, obesity, and smoking were identified as risk factors by 75.5, 73.6, 77.6, and 71.8%, respectively; 69.1% considered high salt intake and 62.7% considered high calorie diet as risk factors. Energy drink was considered as a risk factor by 64.5%, coffee consumption 35.5%, physical inactivity 47%, and oral contraceptives 13.6%. Half the group did not consider a family history of CVD as a risk factor, 60% did not consider older age as a risk factor, and 88% did not think male gender was a risk factor. Knowledge of modifiable risk factors was better than that of non-modifiable risk factors. Although nationality, course of study, raised blood pressure, and history of diabetes showed significant association with good knowledge, their net effect was not significant by the Adjusted Odd's Ratio.Conclusions:The study identified some gaps in knowledge regarding both modifiable and non-modifiable risk factors of hypertension among students. A larger study would enable health promotion activities tailored to the needs of this age group.

There was significant concordance of abnormal glycaemia among non-diabetic women with diabetic husbands. The spouses of diabetic patients may therefore be a target population for regular hyperglycaemia and DM screening.

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Background: Excess adiposity is associated with an increased risk of cardiovascular disease due to metabolic changes in the body. Visceral obesity increases the risk of diabetes mellitus through adipocytokines and hence the effective targeting therapies are essential to control obesity in high-risk individuals. The study's main objective was to evaluate the effect of add-on therapy of sodium-glucose cotransporter 2 (SGLT2) inhibitors and dipeptidyl peptidase 4 (DPP4) inhibitors on visceral fat-associated serum adipokines. Methods:The study included 90 subjects diagnosed with type 2 diabetes mellitus. The blood samples were taken before starting first-line therapy with metformin, 12 weeks after starting metformin therapy and 12 weeks after starting add-on therapy. Serum adipokines were analyzed with enzyme-linked immunosorbent assay (ELISA). Hemoglobin A1c (HbA1c) level was estimated with high-performance liquid chromatography (HPLC). The biochemical variables were measured using Cobas ® 6000 analyzer. Results:The mean adiponectin level was significantly elevated with add-on therapy using SGLT2 inhibitors and DPP4 inhibitors (P < 0.001). The mean retinol binding protein 4 (RBP4), fatty acid binding protein 4 (FABP4) and visfatin levels were reduced considerably (P < 0.001). The SGLT2 inhibitors are more effective on serum FABP4 in patients with type 2 diabetes (P = 0.038). The mean fasting plasma glucose (FPG), postprandial blood glucose (PPBG) and HbA1c levels were reduced significantly with add-on therapy (P < 0.001). Lipid pro-file was also altered significantly with this add-on therapy (P < 0.001). Conclusions:The results indicate that add-on therapy exerts a beneficial effect in type 2 diabetic patients insufficiently controlled with metformin only by altering the visceral fat-associated adipokine levels and controlling the metabolic activities.

BackgroundYouth is a vulnerable group for developing almost all life-style related diseases. The present cross-sectional study was conducted to assess the determinants of blood pressure among entry year students in a medical university in Ajman, United Arab Emirates.Materials and Methods  One hundred and ten students from Gulf Medical University, Ajman, UAE participated in the study. A pretested structured questionnaire was used for data collection. Predictive Analytic Software 17 was used for data analysis. Chi-square test, Univariate and multivariate logistic regression were used.ResultsVariables such as tobacco use, duration of sleep, Body Mass Index and gender were considered to assess the association with blood pressure. The mean age of the students was 19 years with a SD of 1.9 years. The mean systolic and diastolic blood pressure was 113.5 (SD 12.0) and 73.7 (SD 11.2) respectively with mean BMI of 24.9 (SD 5.7). A statistically significant association was observed between gender and blood pressure (p<0.05). The crude Odds Ratio (OR) observed for sleep duration and blood pressure was found statistically significant (p<0.05), but the adjusted OR was not statistically significant. Of the participants who sleep for more than 6 hours, majority (70%) have normal blood pressure. Nearly half of the participants who slept for less than 6 hours have pre-hypertension and/ or hypertension. There was statistically significant (p<0.005) association between Body Mass Index (BMI) and blood pressure (BP). The mean BMI among those with normal BP was 23.25 kg/m2 with a SD of 4.6 and those with pre-hypertension and/ or hypertension was 27.6 kg/m2 with a SD of 6.5.ConclusionGender and BMI are the significant factors associated with Blood pressure. The findings may be used to create strategies to impart awareness of the dangers of increased blood pressure among obese and non obese students.Key Words: Body Mass Index; Blood Pressure; UAEDOI: 10.3126/nje.v1i1.4107Nepal Journal of Epidemiology 2010;1 (1):17-21

Background:The alteration of adipokine secretion leads to the development of insulin resistance or impaired function of insulin in type 2 diabetes with obesity. The main objective of the study was to evaluate the effect of add-on therapy of dapagliflozin and empagliflozin on visceral fat-associated adipokines in inadequately controlled overweight and obese type 2 diabetic patients on metformin monotherapy. Methods:The study included 60 participants diagnosed with type 2 diabetes mellitus with overweight or obesity. The blood samples were taken before starting first-line therapy with metformin, 12 weeks after starting metformin therapy and 12 weeks after starting add-on therapy. The biochemical variables were analyzed using Cobas ® 6000 analyzer. Hemoglobin A1c (HbA1c) level was measured with highperformance liquid chromatography (HPLC). Serum adipokines were estimated with enzyme-linked immunosorbent assay (ELISA). Results:The mean adiponectin level was significantly elevated with add-on therapy using dapagliflozin and empagliflozin (P < 0.001). The mean fatty-acid binding protein 4 (FABP4), retinol-binding protein 4 (RBP4) and visfatin levels were reduced considerably (P < 0.001). The mean HbA1c, fasting plasma glucose (FPG) and postprandial blood glucose (PPBG) levels were reduced significantly with add-on therapy (P < 0.001). Lipid profile and creatinine were also altered significantly with the add-on therapy (P < 0.001).Conclusions: Add-on therapy of dapagliflozin and empagliflozin are beneficial to control the adipokines that regulate the visceral fat in overweight and obese type 2 diabetic patients. The effective therapeutic target to control adipokines with metabolic variables reduces body weight, obesity, cardiovascular risk and renal disease in type 2 diabetes.

Background Elevated blood pressure has been identified as a silent killer contributing to mortality and morbidity worldwide, hence it is essential to identify the high risk individuals at an early age to prevent the progress of the disease and its co-morbid conditions. Objective The objective of the present cross-sectional study was to assess the pattern of blood pressure distribution among students of medical and allied health professions at Gulf Medical University (GMU) Ajman, United Arab Emirates (UAE). Methods The study was conducted from November 2009 to February 2010. GMU has academic programmes such as Bachelor of Medicine, Physical therapy, Pharm D and Dental Medicine with a multiethnic student population. A pretested structured instrument used for data collection and blood pressure was measured using mercury sphygmomanometer. Descriptive statistics such as means and standard deviation were used to summarize the quantitative variables. The association of age, gender and nationality with systolic and diastolic blood pressure was determined by Pearson's correlation coefficient and a p-value ≤ 0.05 was considered statistically significant. Results The systolic and diastolic blood pressures were evenly distributed across all students irrespective of their age. A significantly higher systolic blood pressure in males was observed when compared to females, but the difference was not significant in diastolic blood pressure. In the present study among medical and allied health science students, the distribution of blood pressure was not associated with age. The mean systolic blood pressure and diastolic blood pressure were seen to be higher among Arabs when compared to Non-Arabs though not statistically significant. Family history of metabolic diseases did not show any association with the mean blood pressure. Conclusion There was a strong association for developing hypertension among male when compared to female gender. Key Words: University students; Age; Gender; Nationality; Systolic blood pressure; Diastolic blood pressureDOI: http://dx.doi.org/10.3126/nje.v1i3.5572 Nepal Journal of Epidemiology 2011;1(3) 86-89

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