Even as the Indian Council of Medical Research is getting set to launch a country-wide study to arrive at Indian diagnostic reference values, here are the results of a study involving over 8,000 participants that underline the urgency of such a task.
The results of the first phase of Sri Ramachandra University's PURSE-HIS project, conducted between April 2008 and June 2011, clearly demonstrates the fact that a different set of reference or ‘normal' values will have to be narrowed down for the Indian ethnic group.
There is undoubtedly a need for a different set of reference values for the Indian population, S. Thanikachalam, who led the project at SRU, said. “For instance, one-third of the population has conditions conducive to the development of a vascular illness – stroke, heart attack, peripheral vascular disease, among others.”
In fact, the study showed that the normal reference value for vascular aging among Indians was much higher than in the Caucasian population. Carmel Mary McEniery, senior researcher, University of Cambridge, said the aging was advanced by at least 10 years, in comparison with the Caucasian population.
Thereby, the vascular age of a 30-year-old in India would be comparable only to that of a 40-year-old in, say, the United Kingdom.
Prof. McEniery and John Ronald Cockroft of Cardiff University, who were in Chennai to explore the possibilities of further collaboration on the study, were treated to a full-fledged presentation on the results.
S. Ramaswamy, director, Vasomeditech, who was also involved in the study, explains that this increases the risk of a vascular incident, and that too at a much earlier age than other ethnic groups. Vascular thickness ignites stiffness of the blood vessels, leading to atherosclerosis, Dr. Thanikachalam added.
About 20 per cent of the urban study participants were diabetic, which made them four times prone to complications such as retinopathy, early heart attack, and limb amputation. The study also showed that the incidence in semi-urban areas, and rural areas was steadily increasing.
In fact, it was disturbing to find that the rural (12.02 per cent) and semi-urban (9.6 per cent) populations had a higher Impaired Fasting Glucose (pre-diabetic condition) than the urban group, Dr. Thanikachalam said. The Impaired Glucose Tolerance levels were also similarly high for suburban and rural populations, indicative of a large group of people who were likely to develop diabetes. “We are exploring the possibilities of a collaboration to look at prevention too,” Dr. Thanikachalam said.
Similarly, warning bells have been sounded for rising pre-hypertension levels as well (readings between 130/85 mmHg and 140/90 mmHg). “India has to focus on pre-diabetes and pre-hypertension. Homocysteine levels, indicative of folic acid deficiency, were also abnormal, and this induces vasculitis. With all these factors, coupled with high oxidative stress, which we have found, the indications are that disease is just round the corner,” Dr. Thanikachalam said.
Siddha drugs
A small number who were part of this study, 73, were treated for their diabetes with Siddha drugs, for six months, and it was found that the drugs were efficacious and safe.
However, the Committee had suggested certain changes in dosage, and formulation of capsule be incorporated into a larger study.
The second phase of the study is likely to probe the genetic angle of diabetes and vascular ageing, Dr. Thanikachalam said. The project, which studied participants from Chennai, Tiruvallur and Kancheepuram, is being funded by the technology development transfer wing of the Department of Science and Technology. The study results were sent to Tufts University for re-validation, he added.
