Lipid Profiles, Glycated Hemoglobin, and Diabetes in People Living at High Altitude in Nepal

Aryal, Nirmal; Weatherall, Mark; Bhatta, Yadav Kumar Deo; Mann, Stewart

doi:10.3390/ijerph14091041

Cited by 12 publications

(18 citation statements)

References 27 publications

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“…This is one of few studies, which explores the association of routine lipid parameters with T2DM and prediabetes in Bangladesh. Low HDL-C and high Tg dyslipidemia are more prevalent in our population than in the other South Asian populations [ 8 , 54 ] and have shown stronger association with T2DM and prediabetes. In clinical practice in Bangladesh, T-Chol, Tg, HDL-C, and LDL-C are the parameters available for monitoring lipid abnormalities.…”

Section: Discussionmentioning

confidence: 83%

Serum Lipid Profile and Its Association with Diabetes and Prediabetes in a Rural Bangladeshi Population

Bhowmik

Siddiquee²,

Mujumder³

et al. 2018

IJERPH

123

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Dyslipidemia is commonly associated with diabetes (T2DM). This has been demonstrated for the Caucasian population, but few data are available for Asian Indians. The paper aims to investigate serum lipids (separately or in combination) and their association with glucose intolerance status (T2DM and prediabetes) in a rural Bangladeshi population. A sample of 2293 adults (≥20 years) were included in a community based cross-sectional survey in 2009. Anthropometric measures, blood pressure, blood glucose (fasting and 2-h oral glucose tolerance test) and fasting serum lipids (total cholesterol, T-Chol; triglycerides, Tg; low density lipoprotein cholesterol, LDL-C and high density lipoprotein cholesterol, HDL-C) were registered. Analysis of covariance (ANCOVA) and regression analysis were performed. High Tg levels were seen in 26% to 64% of the participants, depending on glucose tolerance status. Low HDL-C levels were seen in all groups (>90%). Significant linear trends were observed for high T-Chol, high Tg and low HDL-C with increasing glucose intolerance (p for trend <0.001). T2DM was significantly associated with high T-Chol (Odds ratio (OR): 2.43, p < 0.001), high Tg (OR: 3.91, p < 0.001) and low HDL-C (OR: 2.17, p = 0.044). Prediabetes showed a significant association with high Tg (OR: 1.96, p < 0.001) and low HDL-C (OR: 2.93, p = 0.011). Participants with combined high Tg and low HDL-C levels had a 12.75-fold higher OR for T2DM and 4.89 OR for prediabetes. In Asian Indian populations an assessment of serum lipids is warranted not only for T2DM patients, but also for those with prediabetes.

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Section: Discussionmentioning

confidence: 83%

Serum Lipid Profile and Its Association with Diabetes and Prediabetes in a Rural Bangladeshi Population

Bhowmik

Siddiquee²,

Mujumder³

et al. 2018

IJERPH

123

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“…Our study showed the prevalence of overweight and obese participants to be 29.3% (95% CI = 23.0–36.4%). A study conducted at other villages in Mustang district, Nepal, reported the prevalence of overweight and obese population at the rural setting to be 26.7% whereas at the urban settings to be 47.7% and 56.6% respectively [ 27 ]. A possible reason behind these differences may be associated with economic status.…”

Section: Discussionmentioning

confidence: 99%

“…Our result is similar as in other findings examining the prevalence of IHG in different villages that have the same ethnic background as in our study. For instance, research at other villages in Mustang district has observed the prevalence of IHG ranging from 22.1–39.3% [ 27 ]. In addition, examining of the prevalence of IHG at the same altitude in China and India ranged from 22.3–41.6% [ 29 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

Current health status and its risk factors of the Tsarang villagers living at high altitude in the Mustang district of Nepal

Koirala

Nakano

Arima

et al. 2018

J Physiol Anthropol

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BackgroundEpidemiology of noncommunicable diseases (NCDs) such as obesity and diabetes mellitus (DM) are influenced by multiple hosts and environmental factors. This study aims to investigate the prevalence of NCDs and determine their risk factors among the adults residing in an isolated village situated at a rural highland of Nepal.MethodsA cross-sectional survey was conducted in a village located at 3570 m. Each 188 randomly selected participants of age ≥ 18 years old answered a questionnaire and took a full physical exam that included biomedical measurements of glycosylated hemoglobin (HbA1c).ResultsThe prevalence of intermediate hyperglycemia and DM was 31.6% and 4.6% respectively, and the prevalence of hypoxemia (SpO2 < 90%) was 27.1%. A multiple logistic regression analysis for factors for the prevalence of glucose intolerance (HbA1c ≥ 6%) revealed older age (odds ratio [OR] 1.11, 95% confidence interval [CI] 1.06–1.16, for every 1 year increase) and SpO2 (OR for hypoxemia 3.58, 95% CI 1.20–10.68, vs SpO2 ≥ 90%).ConclusionsTibetan highlanders in the remote mountainous Mustang valley of Nepal have high prevalence of impaired glucose metabolism which could be related to hypoxemia imposed by the hypoxic conditions of high altitude living.

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“…12 The result of our study is nearly comparable to the results of the study done in similar geographical region of Nepal by Aryal et al where Overall, 6.9% of participants residing in high altitude had diabetes or were on hypoglycaemic treatment. 3 Another study done by Woolcott et al in United States also revealed that diabetes was substantially less prevalent in high-altitude counties compared to low altitude counties (6.4% [5.4-7.3] and 9.1% [7.8-10.5]). 10 The study revealed male population had higher prevalence of diabetes mellitus in comparison with the female group ), P=0.003).…”

Section: Discussionmentioning

confidence: 95%

“…Hypoxia results in a preference for glucose utilization and decreases uptake of free fatty acids because of oxygen-deficient adaptation. 3 Also, the inhibition of gluconeogenesis in hepatocytes in intermittent hypoxia leading to smaller hepatic glucose output can be an important factor for decreased blood glucose profile in inhabitants of high altitude of Nepal. 4 Moreover, it can also be correlated with the reduced basal insulin level, 4 increased physical activity and dietary pattern in natives residing in mountains of Nepal.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and determinants of diabetes mellitus in high altitude: A cross sectional study in mountainous region of Nepal

et al. 2020

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Background: There had been many studies depicting variations in the prevalence of diabetes mellitus in Nepal ranging from 1.4% to 19%. However, the pooled prevalence was found to be 8.4%. There are only few studies done till date in our part of the world to study the actual prevalence and determinants of Type 2 Diabetes Mellitus ( DM-2) in people residing in mountains. Aims and Objectives: This study was conducted with to estimate the prevalence and determinants of diabetes mellitus among the high-altitude populationin Jomsom district of Nepal. Materials and Methods: A cross sectional study was carried out in Jomsom district of Nepal, at an altitude of 2743 meters on 4th and 5thof June, 2017 . A detailed history from the participants of their past medical illness including diabetes mellitus and hypertension was taken. In addition, blood sugar level, blood pressure, anthropometric variables like weight, height, BMI, Waist, Hip, Waist/hip ratio were documented after the verbal consent of the participants. Results: A total of 617 local residents of Jomsom were enrolled in the study. The mean age of study population was 44.4±17. 6 years with female to male ratio being 1.15:1 (53.5% vs 46.5% male). The prevalence of diabetes mellitus was found to be 5.2%, which was significantly lower than the overall prevalence of diabetes in the Nepalese population which is 8.4%. Male population was found to have higher prevalence of diabetesin our study. Higher BMI and waist/hip ratio were also associated with increased incidence of diabetes mellitus. This study revealed that compared with individuals with a normal BMI, individuals who were overweight or obese were more likely to be diagnosed with DM-2 (OR [95%CI]: ranging from 4.33 [0.96–19.46] for overweight adults to 7.76 [1.76–34.13] for adults in Obesity. Conclusion: The overall prevalence of diabetes mellitus is lower among the individuals residing in higher altitude compared to the general population although the other determinants are comparable.

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Lipid Profiles, Glycated Hemoglobin, and Diabetes in People Living at High Altitude in Nepal

Cited by 12 publications

References 27 publications

Serum Lipid Profile and Its Association with Diabetes and Prediabetes in a Rural Bangladeshi Population

Serum Lipid Profile and Its Association with Diabetes and Prediabetes in a Rural Bangladeshi Population

Current health status and its risk factors of the Tsarang villagers living at high altitude in the Mustang district of Nepal

Prevalence and determinants of diabetes mellitus in high altitude: A cross sectional study in mountainous region of Nepal

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