title: Socio-economic patterning of cardiometabolic risk factors in rural and peri-urban India: Andhra Pradesh children and parents study (APCAPS).
abstract: OBJECTIVE
  To assess the prevalence of cardiometabolic risk factors by socio-economic position (SEP) in rural and peri-urban Indian population.
  
  
  METHODS
  Cross-sectional survey of 3,948 adults (1,154 households) from Telangana (2010-2012) was conducted to collect questionnaire-based data, physical measurements and fasting blood samples. We compared the prevalence of risk factors and their clustering by SEP adjusting for age using the Mantel Hansel test.
  
  
  RESULTS
  Men and women with no education had higher prevalence of increased waist circumference (men: 8 vs. 6.4 %,P< 0.001; women: 20.9 vs. 12.0 %,P= 0.01), waist-hip ratio (men: 46.5 vs. 25.8 %,P= 0.003; women: 58.8 vs. 29.2 %,P= 0.04) and regular alcohol intake (61.7 vs. 32.5 %,P< 0.001; women: 25.7 vs. 3.8 %,P< 0.001) than educated participants. Unskilled participants had higher prevalence of regular alcohol intake (men: 57.7 vs. 38.7 %,P= 0.001; women: 28.3 vs. 7.3 %,P< 0.001). In contrast, participants with a higher standard of living index had higher prevalence of diabetes (top third vs. bottom third: men 5.2 vs. 3.5 %,P= 0.004; women 5.5 vs. 2.4 %,P= 0.003), hyperinsulinemia (men 29.5 vs. 16.3 %,P= 0.002; women 31.1 vs. 14.3 %,P< 0.001), obesity (men 23.3 vs. 10.6 %,P< 0.001; women 25.9 vs. 12.8 %,P< 0.001), and raised LDL (men 16.8 vs. 11.4 %,P= 0.001; women 21.3 vs. 14.0 %,P< 0.001).
  
  
  CONCLUSIONS
  Cardiometabolic risk factors are common in rural India but do not show a consistent association with SEP except for higher prevalence of smoking and regular alcohol intake in lower SEP group. Strategies to address the growing burden of cardiometabolic diseases in urbanizing rural India should be assessed for their potential impact on social inequalities in health.
authors.affiliation: Department of Anthropology, University of Delhi, New Delhi, 110007 India.
authors.forename: Vipin
authors.initials: V
authors.lastname: Gupta
authors.affiliation: Faculty of Medicine, School of Public Health, Imperial College London, London, UK ; Public Health Foundation of India, Delhi NCR, India.
authors.forename: Christopher
authors.initials: C
authors.lastname: Millett
authors.affiliation: Public Health Foundation of India, Delhi NCR, India.
authors.forename: Gagandeep Kaur
authors.initials: GK
authors.lastname: Walia
authors.affiliation: Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Kinra
authors.affiliation: Public Health Foundation of India, Delhi NCR, India.
authors.forename: Aastha
authors.initials: A
authors.lastname: Aggarwal
authors.affiliation: Public Health Foundation of India, Delhi NCR, India.
authors.forename: Poornima
authors.initials: P
authors.lastname: Prabhakaran
authors.affiliation: Public Health Foundation of India, Delhi NCR, India.
authors.forename: Santhi
authors.initials: S
authors.lastname: Bhogadi
authors.affiliation: Public Health Foundation of India, Delhi NCR, India.
authors.forename: Aniket
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Public Health Foundation of India, Delhi NCR, India.
authors.forename: Ruby
authors.initials: R
authors.lastname: Gupta
authors.affiliation: Public Health Foundation of India, Delhi NCR, India ; Centre for Chronic Disease Control, New Delhi, India.
authors.forename: D
authors.initials: D
authors.lastname: Prabhakaran
authors.affiliation: Public Health Foundation of India, Delhi NCR, India.
authors.forename: K Srinath
authors.initials: KS
authors.lastname: Reddy
authors.affiliation: MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.
authors.forename: George Davey
authors.initials: GD
authors.lastname: Smith
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Yoav
authors.initials: Y
authors.lastname: Ben-Shlomo
authors.affiliation: Indian Council for Medical Research, National Institute of Nutrition, Hyderabad, India.
authors.forename: K V Radha
authors.initials: KV
authors.lastname: Krishna
authors.affiliation: Public Health Foundation of India, Delhi NCR, India ; Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: Shah
authors.initials: S
authors.lastname: Ebrahim
keywords: Cardiovascular; Metabolic disease; Risk factors; Socioeconomic position; Status