Significant lipid, adiposity and metabolic abnormalities amongst 4535 Indians from a developing region of rural Andhra Pradesh

Background and objectiveBoth migrant and local urban populations of Asian Indians have high rates of cardiovascular disease. Metabolic risk factors appear key to this phenomenon but data from rural India are few. We sought to determine the prevalence and distribution of lipids, obesity and metabolic syndrome in a rural region of Andhra Pradesh.MethodsSampling was done in 20 villages representative of the project area with an age- and sex-stratified group of 4535 adults ≥30 years selected at random from a local census list. The sample represented 13% of all adults ≥30 years in the 20 villages with a response rate of 81%. All participants had interviewer administered questionnaire, physical examination and fasting finger-prick glucose. Every fourth individual had venous blood testing for lipid profile (n = 1085). Analysis was done using weighting to obtain estimates of risk factor levels for the adult population in the 20 villages. In addition to standard WHO and 2005 NCEP-ATPIII classifications, exploratory ‘Asian’ definitions were used for overweight and abdominal obesity.ResultsThe population mean levels of total, LDL, HDL-cholesterol and triglycerides were 4.5 (4.4–4.6) mmol/L, 2.8 (2.7–2.9) mmol/L, 1.1 (1.06–1.13) mmol/L, 1.5 (1.4–1.6) mmol/L for men; and 4.8 (4.7–4.9) mmol/L, 3.0 (3.0–3.1) mmol/L, 1.2 (1.16–1.22) mmol/L, 1.3 (1.2–1.4) mmol/L for women. 18.4% of men and 26.3% of women were overweight rising to 32.4% of men and 41.4% of women if ‘Asian’ definitions were used. Criteria for NCEP-ATPIII metabolic syndrome were met by 26.9% of men and 18.4% of women with figures of 32.5% and 23.9%, respectively, if ‘Asian’ waist cut-offs were substituted.ConclusionsDyslipidaemia, adiposity and metabolic syndrome were common in this rural Indian population and prevalence was much greater if proposed Asian definitions for adiposity were used. Metabolic risk factors likely play a major role in cardiovascular disease in this region.