High Prevalence of Cardio-Metabolic Risk Factors in a Young Urban Sri-Lankan Population

Abstract

BackgroundSouth-Asian's are predisposed to early onset type 2 diabetes (T2DM). The prevalence of cardio-metabolic risk-factors in young Sri-Lankans is unknown.Methodology/Principal FindingsTo determine by questionnaire and anthropometry the prevalence of first degree family history (FH) of T2DM, physical inactivity, raised waist circumference (WC) and raised body mass index (BMI) in a representative healthy urban population selected by cluster sampling. Those with ≥2 risk-factors were evaluated for metabolic syndrome (MS) and recruited for an intervention trial. Of 23,296 participants screened, 22,507 (53% Female) were eligible [8,497 aged 10–14 yrs, 4,763 aged 15–19 yrs and 9,247 aged 20–40 yrs]. 51% had none of the 4 risk-factors, 26% 1 risk-factor and 23% (5,163) ≥2 risk-factors of whom 4,532 were assessed for MS. Raised BMI was noted in 19.7% aged 10–14 yrs, 15.3% between 15–19 yrs, and between 20–40 yrs, 27.4% of males vs. 21.8% of females p<0.001. Prevalence of raised WC was greater in females for each age group: 42.7% vs. 32.1%; 28.1% vs. 16.1%; 34.5% vs. 25.7% (p<0.05 for all) as was physical inactivity: 39.9% vs. 14.5%; 51.7% vs. 20.0%; 62.7% vs. 41.3% which rose in both sexes with age (p<0.05 for all). FH of T2DM was present in 26.2%. In 4532 (50%<16 yrs) with ≥2 risk-factors, impaired fasting glycaemia/impaired glucose tolerance (pre-diabetes) prevalence was 16%. MS was more prevalent in males [10–16 yrs (13.0% vs. 8.8%), 16–40 yrs (29.5% vs. 20.0%) p<0.001 for both].Conclusions/SignificanceThere is a high prevalence of modifiable cardio-metabolic risk-factors in young urban Sri-Lankans with significant gender differences. A primary prevention intervention trial is ongoing in this cohort. Clinical Trial Registration Number SLCTR/2008/World Health Organization (WHO) international clinical trial registry platform.

Prevalence of Glucose Intolerance Among Children and Adolescents in Urban South India (ORANGE-2)

“…35 Many reports have shown clustering of cardiometabolic risk factors in adolescence and HOMA-IR and waist circumference were important contributors to these cardiometabolic abnormalities within these clusters. 30,[36][37][38] Vikram et al 39 studied correlates of T2DM in the young in North India and concluded that early identification through simple anthropometric parameters such as waist circumference may be useful for planning primary prevention in this population.…”

Primary prevention of Type 2 diabetes in South Asians — challenges and the way forward

“…National diabetes programmes have been initiated in Bangladesh [38], India [39], Pakistan (40) and Sri Lanka [41]. Nepal is developing strategies to implement similar national programmes [42].…”

“…The National Diabetes Centre of Sri Lanka, with the collaboration of the scientists at King’s College, London, UK, has reported a high prevalence of risk factors for Type 2 diabetes in youth and adults aged 10–40 years [41]. The study is part of a research programme aimed at creation of awareness and developing methods to prevent diabetes in young Sri Lankans.…”

Metabolic syndrome and insulin resistance in an urban and rural adult population in Sri Lanka

“…Prevalence of metabolic syndrome has been reported to be between 12.8% to 41.1% in different parts of the world (10,11). Studies in Sri Lanka showed that the prevalence of metabolic syndrome was between 27.1% to 29.5% (12,13). Many factors including: female gender, increasing age, urban living, higher socio-economic status and physical inactivity were reported as important associated factors (12).…”