title: Is vulnerability to cardiometabolic disease in Indians mediated by abdominal adiposity or higher body adiposity.
abstract: BACKGROUND
  Indians may be particularly vulnerable to cardiometabolic disease, potentially due to higher body fat for a given BMI, or a tendency towards depositing abdominal adiposity. The aim of the study is to assess whether different measures of the distribution of adiposity (abdominal versus whole body) or amount of adiposity (DXA versus traditional anthropometric) are better at predicting prevalent cardiometabolic risk markers in an Indian population.
  
  
  METHODS
  Participants were recruited from the Indian Migration Study (IMS) and the Andhra Pradesh Children and Parent Study (APCAPS). Participants attended a clinic in Hyderabad, India, January 2009-December 2010. Adiposity was measured by conventional anthropometry (including weight, height, waist) and DXA scanning (whole body and abdominal). Blood samples were taken and assessed for fasting plasma glucose, insulin, cholesterol, and triglycerides and blood pressure was measured. Lifestyle data were collected by questionnaire.
  
  
  RESULTS
  We invited 4 617 participants to the clinic (1 995 IMS; 2 622 APCAPS) and examined 918 from IMS (46%) and 1 451 from APCAPS (55%). There were strong and consistent relationships between adiposity and cardiometabolic risk factors. Cardiometabolic risk factors did not appear to be more strongly associated with DXA measures as opposed to BMI, or skinfold measures of body fat. There was some evidence that WHR was more closely related to diabetes than total body adiposity, but this was not apparent for the other measures of abdominal adiposity (DXA measures, waist circumference) or other cardiometablic risk factors.
  
  
  CONCLUSIONS
  No strong evidence supports that DXA measures or abdominal measures of adiposity are better at predicting the prevalence of cardiometabolic risk factors in comparison to BMI.
authors.affiliation: Clinical Research Department, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK. Hannah.kuper@lshtm.ac.uk.
authors.forename: Hannah
authors.initials: H
authors.lastname: Kuper
authors.forename: Amy
authors.initials: A
authors.lastname: Taylor
authors.forename: Kankipati Vijay Radha
authors.initials: KV
authors.lastname: Krishna
authors.forename: Yoav
authors.initials: Y
authors.lastname: Ben-Shlomo
authors.forename: Ruby
authors.initials: R
authors.lastname: Gupta
authors.forename: Bharati
authors.initials: B
authors.lastname: Kulkarni
authors.forename: Dorairaj
authors.initials: D
authors.lastname: Prabhakaran
authors.forename: George
authors.initials: G
authors.lastname: Davey Smith
authors.forename: Jonathan
authors.initials: J
authors.lastname: Wells
authors.forename: Shah
authors.initials: S
authors.lastname: Ebrahim
authors.forename: Sanjay
authors.initials: S
authors.lastname: Kinra
mesh_terms: D015502:Absorptiometry, Photon; D050154:Adiposity; D000886:Anthropometry; D001786:Blood Glucose / Q000032:analysis; D001827:Body Height; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D002669:Child Welfare / Q000706:statistics & numerical data*; D015897:Comorbidity; D005260:Female; D006801:Humans; D007194:India; D050152:Intra-Abdominal Fat / Q000503:physiopathology*; D008297:Male; D056128:Obesity, Abdominal / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference
chemical_list: D001786:Blood Glucose; D014280:Triglycerides