The co-occurrence of anemia and cardiometabolic disease risk demonstrates sex-specific sociodemographic patterning in an urbanizing rural region of southern India.
OBJECTIVE
To determine the extent and sociodemographic determinants of anemia, overweight, metabolic syndrome (MetS) and the co-occurrence of anemia with cardiometabolic disease risk factors among a cohort of Indian adults.


METHODS
Cross-sectional survey of adult men (n=3322) and nonpregnant women (n=2895) aged 18 years and older from the third wave of the Andhra Pradesh Children and Parents Study that assessed anemia, overweight based on body mass index, and prevalence of MetS based on abdominal obesity, hypertension and blood lipid and fasting glucose measures. We examined associations of education, wealth and urbanicity with these outcomes and their co-occurrence.


RESULTS
The prevalence of anemia and overweight was 40% and 29% among women, respectively, and 10% and 25% among men (P<0.001), respectively, whereas the prevalence of MetS was the same across sexes (15%; P=0.55). The prevalence of concurrent anemia and overweight (9%), and anemia and MetS (4.5%) was highest among women. Household wealth was positively associated with overweight and MetS across sexes (P<0.05). Independent of household wealth, higher education was positively correlated with MetS among men (odds ratio (95% confidence interval): MetS: 1.4 (0.99, 2.0)) and negatively correlated with MetS among women (MetS: 0.54 (0.29, 0.99)). Similar sex-specific associations were observed for the co-occurrence of anemia with overweight and MetS.


CONCLUSIONS
Women in this region of India may be particularly vulnerable to co-occurring anemia and cardiometabolic risk, and associated adverse health outcomes as the nutrition transition advances in India.
Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
A D
AD
Jones
Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
A K M
AK
Hayter
Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
C P
CP
Baker
Public Health Foundation of India, New Delhi, India.
P
P
Prabhakaran
Department of Anthropology, University of Delhi, New Delhi, India.
V
V
Gupta
National Institute of Nutrition, Indian Council for Medical Research, Hyderabad, India.
B
http://orcid.org/0000-0003-0636-318X
B
Kulkarni
MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.
G D
GD
Smith
School of Social and Community Medicine, University of Bristol, Bristol, UK.
Y
Y
Ben-Shlomo
National Institute of Nutrition, Indian Council for Medical Research, Hyderabad, India.
K V R
KV
Krishna
National Institute of Nutrition, Indian Council for Medical Research, Hyderabad, India.
P U
PU
Kumar
Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
S
S
Kinra
D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000453:epidemiology*; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000453:epidemiology*; D007194:India / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology*; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000097:blood / Q000453:epidemiology*; D050177:Overweight / Q000097:blood / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population; D012959:Socioeconomic Factors; D014507:Urbanization; D055815:Young Adult