A global epidemiological transition in the prevalence of noncommunicable diseases is taking place due to the emergence of behavioral and metabolic risk factors. A renewed interest in the role of serum uric acid as a risk factor has been generated and a crossover from rheumatology to composite of cardiovascular disorders is taking place. Hyperuricemia (HU) is defined as serum urate level > 6.8 mg/dl that is, the limit of urate solubility at physiological temperature and pH. The prevalence of HU and its complications have increased globally in the past decades. It is an indicator of a widespread transition in lifestyle. The positive association between serum uric acid and hypertension, coronary artery disease, stroke, heart failure, renal failure, and preeclampsia has been recognized. Evidence suggests that elevated serum uric acid is strongly associated with and predictive of insulin resistance and metabolic syndrome. The role of HU in the pathogenesis of cardiovascular and renal diseases involves effects on the endothelial function, oxidative metabolism, and platelet aggregation. Among the constellation of established atherosclerotic cardiovascular risk factors HU has an additive or synergistic impact on the outcomes. As an independent risk factor for cardiovascular and related diseases, the role of HU has been extensively debated for many years. Besides being a biomarker and risk factor, HU is also emerging a target for the prevention of atherosclerotic cardiovascular diseases. In most of the patients, with asymptomatic HU, treatment is not advocated to reduce cardiovascular risk. Currently, no guidelines and recommendations have been updated in the pharmacological management of asymptomatic HU. It will be particularly important to design large, long-term studies that would determine the effects of urate-lowering therapy on cardiovascular disease.

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Background: Diabetes mellitus is a major chronic health problem globally, so the patterns of drug utilization study of oral anti-hyperglycemic drugs are of chief concern to promote rational drug use in diabetics and make available the valuable information for the healthcare providers. Objective: This study was performed to determine the drug utilization pattern of oral anti-hyperglycemic drugs in Type-2 diabetes mellitus (T2DM) patients in a tertiary care teaching hospital in Eastern India. Materials and Methods: A prospective, observational, and noncomparative study was carried for 12 weeks in T2DM patients on oral anti-hyperglycemic drugs for at least 1 week. Results: Total 230 patients were enrolled with mean age of 54.66 ± 13.24 years and duration of diabetes was 8.71 ± 7.78 years. Among these, 78 (33.91%) were in the age group 51–60 years, 132 (57.39%) had a diabetic history of <10 years, and 168 (73.04%) had associated hypertension. Mean number of drugs prescribed were 7.01 ± 2.73. Total numbers of patients receiving more than five drugs were 162 (70.43%). The biguanide (85.21%) was the most commonly prescribed oral anti-hyperglycemic drugs followed by sulfonylureas (58.26%). The 97 (75.78%) female patients were shown good compliance as compared with 72 (70.58%) males. Conclusion: Metformin (Biguanide) was the most commonly prescribed oral anti-hyperglycemic drugs for Type-2 diabetes. This study indicates the clinical monitoring of the patient's compliance to the prescribed drug for achieving good glycemic control is also recommended, along with other comprehensive management such as life style changes, dietary modification, treatment of complications, and co-morbidities related to diabetes.

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Background: Copeptin, a neurohormone, has been identified lately as a biomarker for prediction of metabolic syndrome in recent few years. In this pilot study, we evaluated levels of Copeptin in patients of Type 2 Diabetes mellitus (n=41). Materials and methods: The study was carried out on Type 2 Diabetes mellitus patients (n=41) of either sex. The copeptin levels were estimated using Human C- Reactive protein ELISA Kit, For serum, plasma, cell culture supernatants and urine (Sigma Aldrich Co, LLC)Human Copeptin ELISA Kit (Mybiosource, Antibody. Protein. ELISA Kit). Results: We found that the levels of Copeptin ranged from 0.488 to 9.36 (median 1.18; mean 1.82) pmol/l in our cohort. There was no significant difference observed between Copeptin levels of patients with normal Body Mass Index (BMI) and those with higher than normal BMI. Conclusion: The present study reports for first time the values of Copeptin in Indian patients. However, there is need to estimate the levels in larger sample size to establish its utility and importance in Indian patients with metabolic syndrome.

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Aim: The aim of this study was to find out the prevalence of obesity and overweight in the children and adolescents and association of different factors such as dietary intake, physical activity, duration of sleep, and socioeconomic status with obesity. Methods: Study Design - It was a cross-sectional randomized epidemiological study among school children and adolescent in urban and rural areas of the Union Territory of Dadra Nagar and Haveli (U.T. of D.N.H), India in the year 2013–2014. Informed consent: The consent was taken from the Education Department of U.T. of D.N.H and the Head of the Institute before their inclusion in the study. Participants: Consenting male and female children and adolescents were included in the study. Questionnaire: Five-minute long interviews were conducted with each student involved in the study. A pilot questionnaire was developed and it was divided in demographic information, anthropometry information, physical activity, dietary intake, and socioeconomic status. Results: In this study, the prevalence of obesity and overweight was found to between 3.82% and 7.14%, respectively. The combined prevalence of overweight and obese children was slightly high in the age-group of adolescents (11.56%) as compared to children (10.66%). According to waist circumference (WC) analysis, 5.99% of male and 11.3% of female subjects are abdominally obese. Conclusion: The prevalence of childhood obesity in U.T. of D.N.H. is not very high as compared to other reports from different regions of the country, but the prevalence of underweight is high in U.T. of D.N.H. children and adolescents. The low degrees of physical activity and higher sedentary activity, consuming high-calorie food, less sleep duration, higher socioeconomic status are associated with a higher prevalence of overweight and obesity.

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Background: Altered body fat and muscle mass are features of type 2 diabetes. Qualitative analysis for the same including total body fat (TBF), visceral fat (VF), and subcutaneous fat (SF) can be done by bioelectrical impedance analysis (BIA). Aim: We correlated BIA derived body fat parameters with age, sex and, each other in type 2 diabetics and matched nondiabetics. Materials and Methods: We recruited 78 under treatment sedentary type 2 diabetics of either sex with known glycemic and lipidemic control and an equal number of age-sex matched controls. Parameters of body composition were derived in both groups by Omron KaradaScan (Model HBF -510, China), using the principle of tetra poplar BIA which were correlated for statistical significance. Result: We found a positive correlation of age with body composition parameters in male nondiabetics and female diabetics and vice versa. Body mass index, VF, SF, and TBF correlated positively with each other in all groups. Skeletal muscle mass correlated negatively with all body fat parameters more so in diabetics, with female disadvantage. Conclusion: In sedentary diabetics or matched nondiabetics, altered body composition varies by age and gender, with most body fat parameters correlating positively with each other. BIA can be used after setting age-sex specific norms as a cost-effective tool and further work is suggested.

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Introduction: The variables such as body mass index (BMI), percentage of body fat (PBF), and waist to hip ratio (WHR) are widely used for the evaluation of overweight and obesity. The aim of this study is to investigate the gender specificity for detecting the degree of obesity using BMI, PBF, and WHR as variables. Materials and Methods: The data on the obesity variables were analyzed in 3224 samples (male - 2091, female - 1133). The data were collected retrospectively from "fab fitness" to "muscle and mind" gymnasiums in Mumbai. The mean age of the subjects was 28.82 years for males and 31.13 years for females. The WHR, BMI, and PBF were recorded using bioelectrical impedance analysis (BIA) in body 230 machine. Results: There was a significant correlation in females between BMI and WHR (r² = 0.809), BMI and PBF (r² = 0.78), but no correlation was found between PBF and WHR (r² = 0.65). However, in the male population, WHR and PBF were found to be correlated (r² = 0.762), but no correlation was found between BMI and WHR (r² = 0.69) and BMI and PBF (r² = 0.51). Conclusion: In females, WHR, BMI, and PBF were correlated. However, in males, WHR and PBF were important in the evaluation of obesity. Hence, it is concluded that evaluation of obesity appears to be gender specific, and therefore obesity measurement should be done with the proper selection of variables and procedures.

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Mauriac syndrome (MS) is an uncommon complication of uncontrolled type 1 diabetes mellitus. The syndrome comprises of the following features: Growth retardation, cushingoid facies, hepatomegaly, osteopenia, sarcopenia of proximal large muscles, periodontitis, and delayed puberty. Sometimes, there is evidence of retinopathy and nephropathy too. We report here a case of diabetic retinopathy in an adolescent with a clinical feature of a rare entity, MS.

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Background: Psoriasis has been considered of late as a dermatological disorder with systemic inflammation that could contribute to various systemic effects like atherogenic dyslipidemia. Materials and Methods: Eighty patients with psoriasis and 80 age and sex matched controls were included in the study for their serum lipid profiles. The lipid values were compared with special emphasis on the duration and severity of the disease. Results: Serum triglycerides were found to be significantly higher in the psoriasis group than in the control group (P ≤ 0.05). No significant difference was found between serum total cholesterol, low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C) levels in the two groups. However, Low HDL-C levels were found in patients with disease of more than 2 years (P ≤ 0.05) and elevated total cholesterol (P < 0.05), LDL-C (P < 0.05) was found in severe psoriasis (Psoriasis Area and Severity Index >12). Conclusion: Atherogenic dyslipidemia is observed in psoriasis, but the degree of change may vary based on the duration and severity of psoriasis. More studies with a higher sample size are required to obtain longitudinal data for conclusive evidence about the systemic effects on lipid profiles in psoriasis.

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Introduction: Global epidemic of type 2 diabetes mellitus and metabolic syndrome (MS) has precipitated a growing interest in the structural-functional changes in blood vessels of children and young adolescents. Subjects and Methods: The study was carried out in 45 children with MS, a comparative group of 25 with only primary obesity and 20 without obesity. The lipid levels were estimated along with a test for insulin resistance by standard methods. The daily monitoring of blood pressure (BP), electrocardiogram, and status of the vascular wall were assessed with automated instrumentation. The pulse rate velocity in aorta, BP, arterial rigidity index and other indices were correlated in all the three groups. Results: In children with MS, there was the demonstrable rigidity of vascular wall; it was 3.5 times more than in children with primary obesity. There was a high correlation of arterial hypertension with body mass index and other features of MS. Conclusion: The data suggests there is a need to conduct long-term interventional studies to intervene reversal of vascular changes.

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