Browsing by Author "St. John's National Academy Of Health Sciences India"

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    Adiposity in women and children from transition countries predicts decreased iron absorption, iron deficiency and a reduced response to iron fortification
    (2008-07-01) M. B. Zimmermann; C. Zeder; S. Muthayya; P. Winichagoon; N. Chaouki; I. Aeberli; R. F. Hurrell; ETH Zurich; Wageningen University and Research Centre; St. John's National Academy Of Health Sciences India; Mahidol University; Ministry of Health, Morocco
    Background: Overweight is increasing in transition countries, while iron deficiency remains common. In industrialized countries, greater adiposity increases risk of iron deficiency. Higher hepcidin levels in obesity may reduce dietary iron absorption. Therefore, we investigated the association between body mass index (BMI) and iron absorption, iron status and the response to iron fortification in populations from three transition countries (Thailand, Morocco and India). Methods: In Thai women (n=92), we examined the relationship between BMI and iron absorption from a reference meal containing ∼4 mg of isotopically labeled fortification iron. We analyzed data from baseline (n=1688) and intervention (n=727) studies in children in Morocco and India to look for associations between BMI Z-scores and baseline hemoglobin, serum ferritin and transferrin receptor, whole blood zinc protoporphyrin and body iron stores, and changes in these measures after provision of iron. Results: In the Thai women, 20% were iron deficient and 22% were overweight. Independent of iron status, a higher BMI Z-score was associated with decreased iron absorption (P=0.030). In the Indian and Moroccan children, 42% were iron deficient and 6.3% were overweight. A higher BMI Z-score predicted poorer iron status at baseline (P<0.001) and less improvement in iron status during the interventions (P<0.001). Conclusions: Adiposity in young women predicts lower iron absorption, and pediatric adiposity predicts iron deficiency and a reduced response to iron fortification. These data suggest the current surge in overweight in transition countries may impair efforts to control iron deficiency in these target groups. Interactions of the 'double burden' of malnutrition during the nutrition transition may have adverse consequences. © 2008 Macmillan Publishers Limited All rights reserved.
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    Dried blood spot thyroglobulin as a biomarker of iodine status in pregnant women
    (2017-01-01) Sara Stinca; Maria Andersson; Sandra Weibel; Isabelle Herter-Aeberli; Ralph Fingerhut; Sueppong Gowachirapant; Sonja Y. Hess; Nidhi Jaiswal; Tomislav Jukić; Zvonko Kusic; Ngoako Solomon Mabapa; Ashwini Kumar Nepal; Teofilo O.L. San Luis; Jia Qing Zhen; Michael Bruce Zimmermann; ETH Zurich; Kinderspital Zürich; Mahidol University; University of California, Davis; St. John's National Academy Of Health Sciences India; University of Zagreb School of Medicine; University of Venda for Science and Technology; B P Koirala Institute of Health Sciences; Iodine Global Network (IGN); Shanxi Institute for Endemic Disease Prevention and Treatment
    © 2017 by the Endocrine Society. Context: Thyroglobulin (Tg) could be a sensitive biomarker of iodine nutrition in pregnant women (PW). A dried blood spot (DBS) assay would simplify collection and transport in field studies. Objectives: Our aims were to (1) establish and test a reference range for DBS-Tg in PW; (2) determine whether co-measurement of Tg antibodies (Abs) is necessary to define population iodine status. Design, Setting, and Participants: Standardized cross-sectional studies of 3870 PW from 11 countries. For the DBS-Tg reference range, we included TgAb-negative PW (n = 599) from 3 countries with sufficient iodine intake. Main Outcome Measures: We measured the urinary iodine concentration and DBS thyroidstimulating hormone, total thyroxin, Tg, and TgAb. Results: In the reference population, the median DBS-Tg was 9.2 μg/L (95% confidence interval, 8.7 to 9.8 mg/L) and was not significantly different among trimesters. The reference range was 0.3 to 43.5 mg/L. Over a range of iodine intake, the Tg concentrations were U-shaped. Within countries, the median DBS-Tg and the presence of elevated DBS-Tg did not differ significantly between all PW and PW who were TgAb-negative. Conclusions: A median DBS-Tg of ∼10 mg/L with ,3% of values ≥44 μg/L indicated population iodine sufficiency. Concurrent measurement of TgAb did not appear necessary to assess the population iodine status.
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    Variations in knowledge, awareness and treatment of hypertension and stroke risk by country income level
    (2021-02-01) Martin O'Donnell; Graeme J. Hankey; Sumathy Rangarajan; Siu Lim Chin; Purnima Rao-Melacini; John Ferguson; Denis Xavier; Liu Lisheng; Hongye Zhang; Prem Pais; Patricio Lopez-Jaramillo; Albertino Damasceno; Peter Langhorne; Annika Rosengren; Antonio L. Dans; Ahmed Elsayed; Alvaro Avezum; Charles Mondo; Andrew Smyth; Conor Judge; Hans Christoph Diener; Danuta Ryglewicz; Anna Czlonkowska; Nana Pogosova; Christian Weimar; Romana Iqbal; Rafael Diaz; Khalid Yusoff; Afzalhussein Yusufali; Aytekin Oguz; Xingyu Wang; Ernesto Penaherrera; Fernando Lanas; Okechukwu Samuel Ogah; Adensola Ogunniyi; Helle K. Iversen; German Malaga; Zvonko Rumboldt; Shahram Oveisgharan; Fawaz Alhussain; Magazi Daliwonga; Yongchai Nilanont; Salim Yusuf; Siriraj Hospital; Dubai Health Authority; Universidad de Santander; Istanbul Medeniyet University; Estudios Clínicos Latinoamérica, Argentina; Military Institute of Aviation Medicine; Alzaiem Alazhari University; Universidade Eduardo Mondlane; Hospital Luis Vernaza; University of the Philippines College of Medicine; Universidad Peruana Cayetano Heredia; National Medical Research Center of Cardiology, Moscow; The Aga Khan University; The University of Western Australia; Sahlgrenska Universitetssjukhuset; Københavns Universitet; St. John's National Academy Of Health Sciences India; Hospital Alemao Oswaldo Cruz; Rush University Medical Center; University College Hospital, Ibadan; University of Limpopo; Universität Duisburg-Essen; King Saud University; Universidad de la Frontera; NUI Galway; Hamilton Health Sciences; Universitätsklinikum Essen; Sveučilište u Splitu; University of Ibadan; Universiti Teknologi MARA; University of Glasgow; St John's Research Insitiute; Kiruddu National Referral Hospital; National Center for Cardiovascular Diseases; BDH Clinic Elzach; Beijing Hypertension League Institute
    Objective Hypertension is the most important modifiable risk factor for stroke globally. We hypothesised that country-income level variations in knowledge, detection and treatment of hypertension may contribute to variations in the association of blood pressure with stroke. Methods We undertook a standardised case-control study in 32 countries (INTERSTROKE). Cases were patients with acute first stroke (n=13 462) who were matched by age, sex and site to controls (n=13 483). We evaluated the associations of knowledge, awareness and treatment of hypertension with risk of stroke and its subtypes and whether this varied by gross national income (GNI) of country. We estimated OR and population attributable risk (PAR) associated with treated and untreated hypertension. Results Hypertension was associated with a graded increase in OR by reducing GNI, ranging from OR 1.92 (99% CI 1.48 to 2.49) to OR 3.27 (2.72 to 3.93) for highest to lowest country-level GNI (p-heterogeneity<0.0001). Untreated hypertension was associated with a higher OR for stroke (OR 5.25; 4.53 to 6.10) than treated hypertension (OR 2.60; 2.32 to 2.91) and younger age of first stroke (61.4 vs 65.4 years; p<0.01). Untreated hypertension was associated with a greater risk of intracerebral haemorrhage (OR 6.95; 5.61 to 8.60) than ischaemic stroke (OR 4.76; 3.99 to 5.68). The PAR associated with untreated hypertension was higher in lower-income regions, PAR 36.3%, 26.3%, 19.8% to 10.4% by increasing GNI of countries. Lifetime non-measurement of blood pressure was associated with stroke (OR 1.80; 1.32 to 2.46). Conclusions Deficits in knowledge, detection and treatment of hypertension contribute to higher risk of stroke, younger age of onset and larger proportion of intracerebral haemorrhage in lower-income countries.