Screening of cardiovascular risk assessment accuracy of anthropometric indices in Indian children and adolescents.

Background: Body mass index (BMI) is the most popular anthropometric marker to define obesity and cardiometabolic risk. BMI is limited in its ability to discriminate central adiposity and other indices such as waist circumference (WC), and waist to height ratio (WHtR) could be a better choice. In this study, we aimed to evaluate the relative accuracy of these indices for the prediction of hypertension in Indian children and young adults. Methods: Anthropometric indices and blood pressure measurements were obtained in 2609 adolescent children and young adults (10-20 years) across a national residential school system. Z-scores were calculated for anthropometric parameters using the Box-Cox-Cole-Green method and World Health Organization (WHO) growth charts. Hypertension was defined using the sex, age and height specific cutoffs for systolic blood pressure. Receiver operator curve (ROC) analysis was performed to examine the predictive ability.  Results: Girls had higher BMI for age in our dataset (p < 0.001), along with higher odds for stunting (95% CI: 1.21 - 1.88) as well as central obesity (95% CI: 2.44 - 3.99). Hypertension was seen in 10.6% of the subjects, with higher age, and higher BMI or WHtR as the predictors. Prehypertension was higher in males (p <0.001). WHtR had acceptable but modest discrimination ability for hypertension (AUC > 0.6) in boys (AUC=0.62) and girls (AUC=0.66). Performance of BMI was better in boys (AUC = 0.67) but poor in girls (AUC = 0.55) Conclusion: WHtR was a better predictor of hypertension in Indian adolescent girls and could be used as an augmented parameter to BMI for a better assessment of cardiovascular risk.

Feasibility of an Orthogonal Redundant Sensor incorporating Optical plus Redundant Electrochemical Glucose Sensing.

BACKGROUND: Orthogonal redundancy for glucose sensing (multiple sensing elements utilizing distinct methodologies) may enhance performance compared to nonredundant sensors, and to sensors with multiple elements utilizing the same technology (simple redundancy). We compared the performance of a prototype orthogonal redundant sensor (ORS) combining optical fluorescence and redundant electrochemical sensing via a single insertion platform to an electrochemical simple redundant sensor (SRS). METHODS: Twenty-one adults with type 1 diabetes wore an ORS and an SRS concurrently for 7 days. Following sensor insertion, and on Day 4 with a standardized meal, frequent venous samples were collected for reference glucose measurement (laboratory [YSI] and meter) over 3 and 4 hours, respectively. Between study visits reference capillary blood glucose testing was undertaken. Sensor data were processed prospectively. RESULTS: ORS mean absolute relative difference (MARD) was (mean ± SD) 10.5 ± 13.2% versus SRS 11.0 ± 10.4% (P = .34). ORS values in Clarke error grid zones A and A+B were 88.1% and 97.6%, respectively, versus SRS 86.4% and 97.8%, respectively (P = .23 and P = .84). ORS Day 1 MARD (10.7 ± 10.7%) was superior to SRS (16.5 ± 13.4%; P < .0001), and comparable to ORS MARD for the week. ORS sensor survival (time-averaged mean) was 92.1% versus SRS 74.4% (P = .10). ORS display time (96.0 ± 5.8%) was equivalent to SRS (95.6 ± 8.9%; P = .87). CONCLUSIONS: Combining simple and orthogonal sensor redundancy via a single insertion is feasible, with accuracy comparing favorably to current generation nonredundant sensors. Addition of an optical component potentially improves sensor reliability compared to electrochemical sensing alone. Further improvement in optical sensing performance is required prior to clinical application.

Receptor-ligand-based specific cell adhesion on solid surfaces: hippocampal neuronal cells on bilinker functionalized glass.

Cell adhesion through binding between specific cell membrane receptors and corresponding cell-adhesion-molecule (CAM)-coated solid surfaces is examined. The morphology of surfaces at various modification steps leading to functionalization with cell-binding CAMs is characterized. In one week neuron cultures, enhanced growth on surfaces modified with neuron-binding versus astrocyte-binding CAMs is observed. However, nonspecific adhesion on a poly-D-lysine-coated positive control surface is found to be even higher. Potential reasons and further studies needed are discussed.