The Indian Journal of Nutrition and Dietetics

Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Association Between Glycemic Indices, hs-CRP and Anthropometrical Parameters of Patients With Type 2 Diabetes Mellitus


Affiliations
1 College of Home Science, Nirmala Niketan, University of Mumbai, Mumbai, India
2 Asian Heart Institute and Sir H N R F Hospital, Mumbai, India
     

   Subscribe/Renew Journal


Risk of obesity, inflammatory conditions and poor glycemic control have been reported to be lower among vegetarian T2DM patients due to their lower intake of fat, high intake of dietary fiber and micronutrients. However, several factors influence dietary practices and thereby glycemic control among patients which demands in depth observation. A cross-sectional observational study to examine the association between body composition, glycemic control and hs-CRP of Type 2 Diabetes Mellitus (T2DM) patients was conducted on 160 uncontrolled T2DM patients including 81 (50.6%) vegetarians and 79 (49.4%) non-vegetarians with mean age of 49.8±7.2 years. They were assessed for body composition using anthropometry. Biochemical parameters [(Fasting Blood Sugar (FBS), Post Prandial Blood Sugar (PPBS), Glycosylated Hemoglobin (HbA1c) and high sensitive C Reactive Protein (hs-CRP)] were obtained from their case files. Data were analysed using SPSS software for Windows (Version 16.0, 2007, SPSS Inc, Chicago IL). Anthropometric indices (weight, BMI, WC, hip circumference, WHR, BMR, visceral fat) and hs-CRP levels were significantly higher in vegetarians than non-vegetarians (p<0.05). However, there was no significant difference in FBS, PPBS and HbA1C between the two groups (p>0.05). Vegetarian participants had higher hs-CRP (≥3.0 mg/dl) and poor glycemic control. A positive correlation of anthropometry indices with hs-CRP was also observed among the participants (p<0.05). Dietary practices of vegetarians might vary across the populations and communities and hence there is a strong need to strictly consider these differences in the development of dietary strategies for T2DM.

Keywords

Type 2 Diabetes Mellitus, Anthropometry, Glycemic Marker, Hs-cRP, Vegetarian, Non Vegetarian.
User
Notifications

  • Tuang, T., Asimi, S., Lou, D. and Li, D. Plasma phospholipid polyunsaturated fatty acids and homocysteine in Chinese type 2 diabetes patients. Asia Pac. J. Clin. Nutr., 2012, 21, 3, 394-399.

  • Udupa, A., Nahar, P., Shah, S., Kshirsagar, M. and Ghongane, B. A comparative study of effects of omega-3 fatty acids, alpha lipoic acid and vitamin E in type 2 diabetes mellitus. Ann. Med.Health. Sci. Res., 2013, 3, 3, 442–446. http://doi.org/10.4103/2141-9248.117954

  • Rudkowska, I. Fish oils for cardiovascular disease: Impact on diabetes. Maturitas, 2010, 67, 1, 25-8.

  • Barre, D.E., Mizier-Barre, K.A., Griscti, O. and Hafez, K. High dose flaxseed oil supplementation may affect fasting blood serum glucose management in human type 2 diabetics. J. Oleo. Sci., 2008, 57, 5, 269-273.

  • Malekshahi, A., Saedisomeolia, A., Djalali, M., Djazayery, A., Pooya, S. and Sojoudi, F. Efficacy of omega-3 fatty acid supplementation on serum levels of tumour necrosis factor-alpha, C-reactive protein and interleukin-2 in type 2 diabetes mellitus patients. Singapore. Med. J., 2012, 53, (9), 615-619.

  • Li, D.J. Chemistry behind vegetarians. Agri. Fd. Chem., 2011, 59, 3, 777-784.

  • Rizzo, N.S., Jaceldo-Siegl, K., Sabate, J. and Fraser, G.E. Nutrient profiles of vegetarian and non vegetarian dietary patterns. J.Acad. Nutr.Dietet., 2013, 113, 12, 1610–1619. http://doi.org/10.1016/j.jand.2013.06.349.

  • Lele, R.D. Ancient Indian insights and modern discoveries in nutrition, exercise and weight control. J. A. PI., 2012. 60.

  • WHO Expert Consultation Committee. Appropriate body mass index for Asian populations and its Implications for policy and intervention strategies. Lancet, 2004, 363, 157-163.

  • Craig, W.J. Nutrition concerns and health effects of vegetarian diets. Nutr.Clin. Pract., 2010, 6, 613-620.

  • Bairy, S., Kumar, A.M.V., Raju, M., Achanta, S., Naik, B., Tripathy, J.P. and Zachariah, R. Is adjunctive naturopathy associated with improved glycaemic control and a reduction in need for medications among type 2 Diabetes patients? A prospective cohort study from India. BMC.Comple.Alter. Med., 2016.16, 290. http://doi.org/10.1186/s12906-016-1264-0

  • Agrawal, S., Millett, C.J., Dhillon, P.K., Subramanian, S. and Ebrahim, S. Type of vegetarian diet, obesity and diabetes in adult Indian population. Nutr. J., 2014, 13, 89. http://doi.org/10.1186/1475-2891-13-89

  • Shridhar, K., Dhillon, P.K., Bowen, L., Kinra, S., Bharathi, A.V. and Prabhakaran, D. The association between a vegetarian diet and cardiovascular disease (CVD) risk factors in India: The Indian migration study. PLoS ONE, 2014, 9, 10. http://doi.org/10.1371/journal.pone.0110586

  • Fallucca, F., Fontana, L., Fallucca, S. and Pianesi, M. Gut microbiota and Ma-Pi 2 macrobiotic diet in the treatment of type 2 diabetes. W.J. Diab., 2015, 6, 3, 403-411.

  • Lee, Y.M., Kim, S.A., Lee, I.K., Kim, J.G., Park, K.G., Jeong, J.Y. and Lee, D.H. Effect of a brown rice based vegan diet and conventional diabetic diet on glycemic control of patients with type 2 diabetes: A 12-week randomized clinical trial. PLoS ONE, 2016, 11, 6. http://doi.org/10.1371/journal.pone.0155918.

  • Elorinne, A.L., Alfthan, G., Erlund, I., Kivimaki, H., Paju, A., Salminen, I. and Laakso, J. Food and nutrient intake and nutritional status of Finnish vegans and non-vegetarians. PLoS ONE, 2016, 11, 2. http://doi.org. /10.1371. /journal.pone.0148235.

  • Ellsworth, D.L., Costantino, N.S., Blackburn, H.L., Engler, R.J.M., Kashani, M. and Vernalis, M.N. Lifestyle modification interventions differing in intensity and dietary stringency improve insulin resistance through changes in lipoprotein profiles. Obesity Sci. Pract., 2016, 2, 3, 282–292. http://doi.org/10.1002/osp4.54.

  • McDougall, J., Thomas, L.E., McDougall, C., Moloney, G., Saul, B., Finnell, J.S. and Petersen, K.M. Effects of 7 days on an ad libitum low-fat vegan diet, the McDougall program cohort. Nutr. J., 2014, 13, 99. http://doi.org/10.1186/1475-2891-13-99

  • Azizi-Soleiman, F., Jazayeri, S., Eghtesadi, S., Rajab, A., Heidari, I., Vafa, M.R. and Gohari, M.R. Effects of pure eicosapentaenoic and docosahexaenoic acids on oxidative stress, inflammation and body fat mass in patients with type 2 diabetes. Int. J.P. Med., 2013, 4 (8), 922-928.

  • Lee, T.C., Ivester, P., Hester, A.G., Sergeant, S., Case, L.D., Morgan, T. and Chilton, F.H. The impact of polyunsaturated fatty acid-based dietary supplements on disease biomarkers in a metabolic syndrome/diabetes population. Lip. Health Dis., 2014, 13, 196. http://doi.org/10.1186/1476-511X-13-196.

  • Labonté, M.E., Couture, P., Tremblay, A.J., Hogue, J.C., Lemelin, V. and Lamarche, B.

  • Eicosapentaenoic and docosahexaenoic acid supplementation and inflammatory gene expression in the duodenum of obese patients with type 2 diabetes. Nutr. J., 2013. 12, 98. http://doi.org/10.1186/1475-2891-12-98.

  • Smaoui, M., Koubaa, N., Hammami, S., Abid, N., Feki, M., Chaaba. R., Attia, N., Abid, M. and Hammami, M. Association between dietary fat and antioxidant status of tunisian type 2 diabetic patients. Prostaglandins Leukot Essential Fatty Acids , 2006, 74 (5), 323-329.

  • Lee, Y.J., Wang, M.Y., Lin, M.C. and Lin, P.T. Associations between vitamin B12 status and oxidative stress and inflammation in diabetic vegetarians and omnivores. Nutrients, 2016, 8(3), 118. http://doi.org/10.3390/nu8030118

  • Chen, C.W., Lin, C.T., Lin, Y.L., Lin, T.K. and Lin, C.L. Taiwanese female vegetarians have lower lipoprotein-associated phospholipase A2 compared with omnivores. Yonsei. Med. J., 2011, 52 (1), 13–19. http://doi.org/10.3349/ymj.2011.52.1.13.

  • Kalupahana, N.S., Claycombe, K.J. and Moustaid Moussa, N. Fatty acids alleviate adipose tissue inûammation and insulin resistance, mechanistic insight. Adv. Nutr., 2014, 2, 304-316.

  • Premanath, M., Basavanagowdappa, H., Mahesh, M. and Suresh, M. Correlation of abdominal adiposity with components of metabolic syndrome, anthropometric parameters and Insulin resistance, in obese and non obese, diabetics and non diabetics: A cross sectional observational study. J.Endcrinol.Metab., 2014, 18 (5), 676-682.http://doi.org/10.4103/2230-8210.139231

  • Jain, S., Mahadevaiah, M. and Shivanagappa, M.A. Comparative study of epicardial fat thickness and its association with abdominal visceral fat thickness in obese and non obese type 2 diabetes subjects. J. Cardio. Echograph., 2015, 25 (4), 103-107. http://doi.org/10.4103/2211-4122.172487

  • Meshram, A., Agrawal, U., Dhok, A., Adole, P., Meshram, K. and Khare, K. HbA1c, hs-CRP and anthropometric parameters evaluation in the patients of diabetes mellitus of central rural India. Int. J. Med. Sci. Pub. Health., 2013, 2(2), 293-296.

  • Rai, R., Dahiy1, J., Chugh, P., Sharma, R. and Chopra, C. A study on correlation of anthropometric measures and HbA1c. Int. J. Pharm. Med. Res., 2017, 5(2), 445-447.


Abstract Views: 345

PDF Views: 1




  • Association Between Glycemic Indices, hs-CRP and Anthropometrical Parameters of Patients With Type 2 Diabetes Mellitus

Abstract Views: 345  |  PDF Views: 1

Authors

Hetal N. Parekh
College of Home Science, Nirmala Niketan, University of Mumbai, Mumbai, India
Subhadra Mandalika
College of Home Science, Nirmala Niketan, University of Mumbai, Mumbai, India
Suresh Mehtalia
Asian Heart Institute and Sir H N R F Hospital, Mumbai, India

Abstract


Risk of obesity, inflammatory conditions and poor glycemic control have been reported to be lower among vegetarian T2DM patients due to their lower intake of fat, high intake of dietary fiber and micronutrients. However, several factors influence dietary practices and thereby glycemic control among patients which demands in depth observation. A cross-sectional observational study to examine the association between body composition, glycemic control and hs-CRP of Type 2 Diabetes Mellitus (T2DM) patients was conducted on 160 uncontrolled T2DM patients including 81 (50.6%) vegetarians and 79 (49.4%) non-vegetarians with mean age of 49.8±7.2 years. They were assessed for body composition using anthropometry. Biochemical parameters [(Fasting Blood Sugar (FBS), Post Prandial Blood Sugar (PPBS), Glycosylated Hemoglobin (HbA1c) and high sensitive C Reactive Protein (hs-CRP)] were obtained from their case files. Data were analysed using SPSS software for Windows (Version 16.0, 2007, SPSS Inc, Chicago IL). Anthropometric indices (weight, BMI, WC, hip circumference, WHR, BMR, visceral fat) and hs-CRP levels were significantly higher in vegetarians than non-vegetarians (p<0.05). However, there was no significant difference in FBS, PPBS and HbA1C between the two groups (p>0.05). Vegetarian participants had higher hs-CRP (≥3.0 mg/dl) and poor glycemic control. A positive correlation of anthropometry indices with hs-CRP was also observed among the participants (p<0.05). Dietary practices of vegetarians might vary across the populations and communities and hence there is a strong need to strictly consider these differences in the development of dietary strategies for T2DM.

Keywords


Type 2 Diabetes Mellitus, Anthropometry, Glycemic Marker, Hs-cRP, Vegetarian, Non Vegetarian.

References