Physical inactivity, and its association with hypertension among employees in the district of Colombo.

BACKGROUND: Physical inactivity is a leading cause of morbidity and mortality and is a major public health problem. Insufficient activity is responsible for a large proportion of non-communicable diseases such as hypertension. OBJECTIVES: The purpose of this study was to assess socioeconomic variations in physical activity and to measure the association between physical inactivity and hypertension among government officials in Sri Lanka. METHODS: A cross-sectional study was carried out among 275 senior-officers(SOs) and 760 managerial-assistants(MAs) aged 30-60 years and attached to Public Administration institutions in Colombo District in Sri Lanka. Physical-activity(PA) was gathered using the International Physical Activity Questionnaire(IPAQ) adopted and validated to the Sri Lankan context. Blood pressure(measured and classified using JNC-7 guidelines) and anthropometric indices were recorded. Energy utilization of all vigorous and moderated PA and walking was expressed as metabolic-equivalent-of-task(MET) min per week. A total-MET-score was calculated and categorized based on IPAQ guidelines. RESULTS: Socioeconomic variations in PA levels were observed as 58.1%(n = 158) SOs and 30.6%(n = 226) MAs were involved in inadequate PA. Among the SOs diagnosed with hypertension, more half(59.1%; n = 52) were physically inactive, while among MAs, 65.9%(n = 143) with hypertension were physically inactive. After adjusting for potential confounding factors being physically inactive was associated with a higher risk of hypertension among SOs[OR 2.08 [95% CI 1.07, 4.6] and MAs[OR 2.8 [95% CI 1.8, 4.6]. The main modality of commuting to work for SOs(59%) was private transport, and MAs(64%) public transport Commuting distance was positively correlated(p < 0.05) with total transport MET among SOs and MAs. After adjusting for confounders, commuting distance of > 20 km was found to lower the odds of hypertension among SOs and MAs(OR = 0.713; 95% CI 0.4 to1.3; and OR = 0.63; 95% CI 0.46 to 0.87). CONCLUSION: Despite the current knowledge that being physically active promotes health, the practice was different. Physical inactivity was associated with hypertension and prevalent among both SOs and MAs. Higher commuting distance is positively correlated with total transport MET and associated with lower odds of hypertension among SOs and MAs. Longitudinal studies are required to provide a causative association between physical inactivity and hypertension among these employees.

Health-related quality of life and psychological distress in polycystic ovary syndrome: a hidden facet in South Asian women.

OBJECTIVE: polycystic ovary syndrome (PCOS) is associated with symptoms that affect psychological wellbeing and health-related quality of life (HRQoL). We wished to assess psychological distress and HRQoL among Sri Lankan women with PCOS. DESIGN: case-control study. SETTING: Gampaha District, Sri Lanka. POPULATION: a total of 146 newly diagnosed women with PCOS, according to the Rotterdam criteria, and 170 age-matched controls recruited from community screening of 3030 eligible women between 15 and 39 years of age. METHODS: World Health Organization Quality of Life questionnaire (WHOQOL-BREF), validated for Sri Lankans with PCOS and a 30-item General Health Questionnaire (GHQ30) were used to assess HRQoL and psychological distress, respectively. MAIN OUTCOME MEASURES: assessment of psychological distress, HRQoL and their correlates. RESULTS: the mean GHQ score was significantly higher (P < 0.001) among women with PCOS (5.25 ± 6.25 SD) than among controls (1.58 ± 1.46 SD), indicating greater psychological distress. Hirsutism in PCOS (defined as a Ferriman-Gallwey, FG, score ≥ 8) was significantly associated with psychological distress (P = 0.002). Multivariate analysis revealed the FG score as a significant predictor of psychological distress (P < 0.05). Mean scores for the physical, psychological and social relationships domains of the WHOQOL-BREF were significantly lower (P = 0.01) in women with PCOS than in controls, indicating poorer HRQoL. No significant predictors of HRQoL emerged from the multivariate analysis. Women with PCOS did not perceive excess body weight as a factor affecting their psychological wellbeing and HRQoL. CONCLUSIONS: PCOS occurring in South Asians adversely affects their psychological wellbeing and HRQoL. Their psychological distress is related to hirsutism rather than to obesity, which affects white Europeans with PCOS.

A simple screening approach for assessing community prevalence and phenotype of polycystic ovary syndrome in a semi-urban population in Sri Lanka.

In most of South Asia, prevalences and phenotypes of polycystic ovary syndrome (PCOS) among women in the community are unknown. The authors aimed to estimate prevalence and phenotype in a community setting in Sri Lanka and to test a valid, feasible screening approach to early diagnosis. A community-based, cross-sectional study was carried out in 2005-2006. A random sample of 3,030 women aged 15-39 years was selected by cluster sampling proportionate to population size. An interviewer-administered questionnaire was utilized to screen for "probable cases" of PCOS based on menstrual history and clinical manifestations of hyperandrogenism. Selected "probable cases" underwent clinical, biochemical, and ovarian ultrasound assessment. The response rate was 96.2% (n = 2,915). A total of 220 (7.5%) "probable cases" were identified: 209 women with oligo/amenorrhea (95%) and 11 women with hirsutism (5%). Further evaluation of the 220 probable cases confirmed 164 newly diagnosed cases of PCOS based on the 2003 Rotterdam diagnostic criteria. With 19 previously diagnosed cases already present, total prevalence was 6.3% (95% confidence interval: 5.9, 6.8). Of the women with "oligo/amenorrhea and/or hirsutism," 91.1% were confirmed to have PCOS; 99.4% of women with "regular cycles in the absence of clinical hyperandrogenism" were confirmed as normal. The most common phenotypes of PCOS were oligo/amenorrhea and polycystic ovaries (91.4%) and oligo/amenorrhea and hirsutism (48.3%).