Kuntal Bhadra

Impact of body mass index on thyroid functions in Indian children

There is controversy about the relation of thyroid functions and body mass index. The present study was aimed to assess the relationship between thyroid function and body mass index in Indian school children.

Percentage body fat in apparently healthy school children from northern India

ContextIncreased prevalence of obesity in childhood and adolescence, defined by the use of body mass index (BMI), has drawn attention towards direct measurement of body fatObjectiveTo develop age-and sex-specific reference distribution of body fat in apparently healthy North-Indian children in the age group of 7–17 years and to assess agreement between obesity (defined by BMI) and excess body fatDesignStudy subjects for this cross sectional study included1640 apparently healthy school children (825 boys; 815 girls) aged 7–17 years. Total body fat was measured by dual energy X-rays absorptiometry (DXA). The excess body fat by DXA was defined by two methods, prevalence matching and with the use of 85th and 95th centile cutoffs.ResultsThe mean ± SD, 3rd, 10th, 25th, 50th, 75th, 90th and 97th centile values of percentage body fat (PBF) are presented. PBF was highly correlated with BMI in both boys and girls (all boys: r=0.76, P<0.0001; all girls r=0.81, P<0.0001). There was no significant difference noted in PBF between boys and girls at the age of 7–8 years. From 9 years onwards, girls had significantly higher PBF than boys. Moderate degree of agreement was observed between BMI and PBF by DXA by both methods.ConclusionsSmoothened reference distribution of PBF for North-Indian children and adolescents in Delhi are provided. Indian children accumulate more body fat during peri-pubertal years in comparison with US children.

Dyslipidemia in subclinical hypothyroidism in an Indian population.

OBJECTIVES In view of inconsistent reports on the prevalence of dyslipidemia in subclinical hypothyroidism (SCH), we studied lipid abnormalities in Indian subjects with SCH. DESIGN AND METHODS A cross sectional study of 5343 subjects divided in two groups, Group-1 (age≤18 years) and Group-2 (age>18 years) was undertaken. They were further subdivided on the basis of their thyroid functional status: Normal (Control); SCH with TSH≤10.0mIU/L (SCH-1); and SCH with TSH>10mIU/L (SCH-2). RESULTS Prevalence of SCH was 14.7%. The only lipid abnormality in children and adolescents was low HDL in subjects with TSH>10mIU/L compared with controls. Serum total cholesterol (TC), and LDL cholesterol (LDL) were significantly higher in adults with TSH>10mIU/L compared to controls. There were no significant changes in lipid parameters in subjects with SCH having TSH≤10.0mIU/L, compared to controls. Serum TSH was positively and FT3 and FT4 were negatively correlated with TC and LDL. CONCLUSIONS Atherogenic lipid abnormalities were observed in adult subjects with SCH-2 (TSH>10.0mIU/L), and not in subjects with SCH-1 who had TSH≤10.0mIU/L in Indian population.

Peak bone mineral density of physically active healthy Indian men with adequate nutrition and no known current constraints to bone mineralization

We undertook this study to characterize peak bone density and evaluate its determinants in a healthy cohort of young adult male paramilitary personnel. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry in 473 healthy men aged 21-40 yr. The effect of anthropometry and biochemical parameters on BMD was determined. Mean BMD values of L1-L4, forearm, total hip, and femoral neck were 1.170+/-0.137, 0.755+/-0.089, 1.129+/-0.130, and 1.115+/-0.133 g/cm(2), respectively. BMD values for 31- to 40-yr age group were lower than those of 20- to 30-yr age group except for forearm, which was higher in the former. Significant positive correlation was observed between height, weight, and body mass index with BMD. On multivariate regression analysis, weight was the most consistent contributor to variance in the BMD. Compared with age-matched US males, BMD of total hip and femoral neck were higher for Indian paramilitary personnel by 3.58% and 4.2%, whereas lumbar spine BMD was lower by 4.1%. In conclusion, peak BMD in healthy Indian males was achieved by 30 yr of age at lumbar spine and hip, with weight being the most consistent contributor to variance in BMD. Peak BMD in this population was comparable to that reported in white US males.

Relationship of Body Fat and Its Distribution With Bone Mineral Density in Indian Population

Obesity has been associated with increased bone mineral density (BMD). There is evidence of differential effect of regional fat on BMD. Hence, we undertook this study to evaluate the correlation between total body fat and its distribution with BMD in nonobese (mean body mass index: 25.0 ± 4.7 kg/m²) Indian adult volunteers. A total of 2347 participants (men: 39.4% and women: 60.6%) included in this cross-sectional study were divided according to sex and age. Fasting blood samples were drawn for biochemical parameters. Percent total body, truncal, and leg fat and BMD at lumbar spine, femur, and forearm were measured by dual-energy X-ray absorptiometry. The BMD at all sites (radius, femur, and spine) increased from lowest to highest quartiles of percent body fat. Percent truncal fat was positively correlated with BMD at all sites in both sexes, except for femoral neck in men, where it had negative correlation. Percent leg fat was positively related with BMD at all sites in premenopausal women, and spine and radius BMD in postmenopausal women. However, in men, it had negative correlation with femoral neck BMD. On multiple regression analysis, regional fat had positive association with BMD at all sites after adjusting for age, sex, lean mass index, 25-hydroxyvitamin D, and intact parathyroid hormone levels. Leg-to-total body fat ratio was negatively associated with BMD at all sites in men and pre- and postmenopausal women. Percent total body and regional fat have positive association with BMD at all sites in men and women.

Reference intervals of serum calcium, ionized calcium, phosphate and alkaline phosphatase in healthy Indian school children and adolescents.

OBJECTIVE To develop age- and sex-specific reference interval of serum total calcium, ionized calcium, inorganic phosphates and alkaline phosphatase in healthy Indian children in the age group of 6-17 years. DESIGN AND METHOD Subjects for this study were selected from the schools of Delhi. The final analysis included 3,327 children in the age group of 6-17 years (1707 boys; 1620 girls). RESULTS The mean, standard deviation, 5th, 25th, 50th, 75th, 90th, 95th and 97th centile values of biochemical parameters for boys and girls are presented. All these parameters were significantly higher in boys than girls except serum ionized calcium. Serum total calcium (r -0.1362, p<0.001), serum inorganic phosphate (r -0.45, p<0.001) and serum alkaline phosphatase (r -0.5587, p<0.001) have shown inverse relationship with age. CONCLUSIONS Reference interval of selected biochemical parameters for healthy Asian-Indian children in the age group of 6-17 years is presented.

The evolution of thyroid function with puberty

Objective  This study was planned to describe thyroid functional status in different stages of puberty.

Relationship of lipid parameters with bone mineral density in Indian population

Introduction: Cardiovascular disease and osteoporosis share common risk factors including dyslipidemia. There are conflicting reports of differential relation of various lipid parameters on bone mineral density (BMD). Hence, we studied the correlation between lipid parameters and BMD in healthy adult. Materials and Methods: A total of 2347 participants (male 39.4%; female 60.6%) included in this cross-sectional study were divided according to sex and age. Fasting blood samples were drawn for biochemical parameters. BMD at lumbar spine, femur, and forearm were measured by dual energy X-ray absorptiometry (DXA). Results: In males, BMD at femur and lumbar spine decreased significantly with increasing quartiles of total cholesterol (TC) (P < 0.0001, and 0.004) and low-density lipoprotein cholesterol (LDL-c) (P = 0.001, and 0.01). In premenopausal women, BMD at femoral neck (P = 0.001) and lumbar spine (P = 0.029) showed declining trend with LDL-c (P = 0.007). In postmenopausal women, only BMD at total femur decreased significantly with TC (P = 0.024) and LDL-c (P = 0.036). All above findings were confirmed in correlation studies. In multiple regression analysis after adjusting for age, body mass index, ionized calcium, alkaline phosphatase, 25 hydroxy vitamin D, and parathyroid hormone levels correlation of BMD with TC and LDL-c persisted. TC, LDL-c was higher in subjects with low bone density compared those with normal bone density in both sexes. Conclusions: TC and LDL-c had weak but significant negative correlation with BMD at femur and lumbar spine.

Reference intervals of serum lipid profile in healthy Indian school children and adolescents

OBJECTIVE To develop age and sex specific reference intervals of serum lipid parameters in healthy Indian children in the age group of 6-17 years. PARTICIPANTS Study subjects were selected from the schools of Delhi. Children with BMI either in overweight or obese category were excluded to generate reference intervals. The final analysis included 3076 children with BMI in normal range for age. RESULTS The mean±SD, 3rd, 10th, 25th, 50th, 75th, 90th and 97th centile values of lipid parameters are presented. All these parameters were significantly higher in girls than in boys. About 89.2% subjects had total cholesterol in acceptable range while 9.1% had borderline elevated and 1.5% had elevated TC. Optimal serum triglyceride levels were seen in 45.1% subjects while optimal levels of HDL cholesterol were seen in 0.3% subjects only. CONCLUSIONS Reference intervals of serum lipid parameters for healthy Indian children (6-17 years) are presented.

Normative Data of Body Fat Mass and Its Distribution as Assessed by DXA in Indian Adult Population

Dual-energy X-ray absorptiometry (DXA) assessment of body fat mass is precise and highly correlated with under water weighing. In view of ethnic differences, we undertook this study to prepare normative data for body fat mass in apparently healthy adult Indians and correlate it with body mass index (BMI). This cross-sectional population-based study included 2347 subjects (male: 924; female: 1423) aged >20 yr who participated in a general health examination. They were evaluated for anthropometry and body fat mass by DXA. All subjects were categorized as overweight and obese based on standard BMI criteria. Mean age and BMI were 49.1 ± 18.2yr and 25.0 ± 4.7kg/m(2), respectively. Mean percent total and regional fat (trunk, arm, and leg) reached maximum in the age group of 30-40yr in males and 50-60yr in females. Females had significantly higher total and regional fat mass compared with males. Fat mass was positively correlated with age (r = 0.224; p < 0.00001) and BMI (r = 0.668; p < 0.00001). Prevalence of overweight and obesity was seen in 2119 (46.1%) and 536 (13.8%), respectively, according to World Health Organization definition and 64.0% and 31.1%, respectively, as per Indian guidelines. Percent total body fat mass (PTBFM) of 25% in males and 30% in females corresponds to BMI of 22.0kg/m(2) with sensitivity of >80% and specificity of >70% in receiver operating characteristic curve analysis. Body fat mass in Indians is higher than that in Western populations for a given age and BMI. PTBFM of 25% in males and 30% in females corresponds to BMI of 22kg/m(2) in Indians.