Browsing by Author "Chackrewarthy, S."

Now showing 1 - 20 of 31

Association between serum homocysteine and markers of insulin resistance
(Sri Lanka Medical Association, 2010) Chackrewarthy, S.; Wijayasinghe, Y.S.; Gunasekara, D.; Wickremasinghe, A.R.; Kato, N.
OBJECTIVE: To investigate the association between serum homocysteine and markers of insulin resistance in a Sri Lankan population. Similar studies conducted in other ethnic groups have shown conflicting results. METHODS: 177 apparently healthy volunteers (91 men and 86 women) aged 35-65 years were randomly selected from residents in the Ragama MOH area. Anthropometric indices and blood pressure were measured and information on diet, lifestyle factors and medical history were recorded. Fasting plasma glucose and serum levels of homocysteine, insulin, creatinine, folate and lipid profiles were determined using standard protocols. RESULTS: Mean fasting serum homocysteine levels were higher in males compared to females (14.67 (imol/1 ± 6.02 Vs.10.16 u.mol/1 ± 4.28, p
Cardiovascular risk in a Sri Lankan community
(Sri Lanka Medical Association, 2008) Ranawaka, U.K.; Wijekoon, C.N.; Pathmeswaran, A.; de Silva, L.D.R.; Gunasekara, D.; Chackrewarthy, S.; Mizoue, T.; Kato, N.
OBJECTIVE: Identifying the cardiovascular disease (CVD) [coronary heart disease (CHD) and stroke] risk in a community is important in planning preventive strategies, but such data are lacking from Sri Lanka. We sought to describe the CVD and CHD risk in a Sri Lankan community. DESIGN, SETTING AND METHODS: A community survey was conducted in the Ragama Medical Officer of Health area (Ragama Health Study) involving individuals aged 35-65 years, selected by stratified random sampling. Their 10-year CVD and CHD risks were estimated using three widely used risk stratification ALGORITHMS: Framingham score, NCEP-ATP III (National Cholesterol Education Program – Adult Treatment Panel III), and Systematic Coronary Risk Evaluation (SCORE). Results: In the study population (n=2985), 54.5% were females, and the mean age [SD] was 52.4 [7.8] years. According to the Framingham (CHD risk), NCEP-ATP III (CHD risk) and SCORE (total CVD mortality risk) criteria, 11.5%, 37.2% and 9.7% respectively were classified as 'moderate or high risk'. Risks were not significantly different between sexes, except with NCEP-ATP III criteria (M- 54.1%, F- 21%, p55y- 38%, p55y- 64.7%, p<0.001; SCORE: <55y- 9.0%, >55y- 14.6%, P
Cardiovascular risk profile of the estate population of Sri Lanka
(Sri Lanka Medical Association, 2010) Pinidiyapathirage, M.J.; Chackrewarthy, S.; Perera, P.S.; Wijayasinghe, Y.S.; Williams, S.; Williams, S.S.; Kato, N.; Wickremasinghe, A.R.
OBJECTIVES: To estimate the prevalence of biochemical and anthropometric risk markers of cardiovascular diseases in the estate population of Sri Lanka. METHODS: Using a cross sectional design, consenting adults aged 35-64 years resident in 3 selected estates in the Nuwara-Eliya District were recruited with the support of estate medical assistants and welfare officers. AH participants were subjected to an interview, blood pressure and anthropometric measurements and collection of fasting blood samples. RESULTS: Of the 401 participants recruited, 53% were females and 99% were cither Indian or Sri Lankan Tamils. The mean age of the participants was 50.3 years (SD 8.5). 47 (12%) participants had a BMI >25, 8 (2%) a BMI >30. 29 males (15%) and 29 females (14%) had a waist circumference [WC] >90cm and >80 cm, respectively. 151 (38%) participants had systolic blood pressure (SBP) > 140mmHg , 127 (32%) had diastolic blood pressure (DBF) > 90mmHg and 170 (42%) had either SBF > 140 or DBF > 90. 41(10%) participants had fasting blood glucose (FBG) >126mg/dL. In 197 (49%) participants, some form of dyslipidaemia was present. Males had a significantly higher mean BMI, FBG and triglyceride (TG) level and a significantly lower high density lipoprotein (HDL) level as compared to females. CONCLUSIONS: Obesity, as defined by BMI or WC, was low in this population as compared to other reported studies from different population groups in the country. But prevalence of hypertension and dyslipidaemia (especially high TG and low HDL levels in males) was high.
Chemical modifications monitored by electrospray mass-spectrometry: A rapid and simple method for identifying and studying functional residues in protiens and enzymes
(Munksgaard, 1998) Krell, T.; Chackrewarthy, S.; Pitt, A.R.; Elwell, A.; Coggins, J.R.
A simple method to identify functional amino acids in enzymes is described. This method is based on the mass spectrometric detection of molecular weight changes as the consequence of chemical modification of enzymes with group-specific reagents. Here we report the use of phenylglyoxal, trinitrobenzene sulfonic acid, tetranitromethane and diethylpyrocarbonate to identify functional amino acid residues. Precise information is obtained about the stoichiometry of reaction, and a relationship between the loss of enzyme activity and the amount of chemical modification is easily established. Modification sites are located by proteolytic digestion of the modified enzyme, followed by peptide mapping based on high-pressure liquid chromatography using an electrospray mass spectrometer as an on-line detector. In comparison with more conventional methods, protein modification is monitored directly without the need to use radioactively or spectrally labelled reagents. The methodology is limited only by the stability of the chemically modified species produced. The method has been used to characterise the active sites of several shikimate pathway enzymes, and the results obtained have been confirmed by site-directed mutagenesis and X-ray crystallography.
Common variants at the GCK, GCKR, G6PC2-ABCB11 andMTNR1B loci are associated with fasting glucose in two Asian populations
(Springer-Verlag, 2010) Takeuchi, F.; Katsuya, T.; Chackrewarthy, S.; Yamamoto, K.; Fujioka, A.; Serizawa, M.; Fujisawa, T.; Nakashima, E.; Ohnaka, K.; Ikegami, H.; Sugiyama, T.; Nabika, T.; Kasturiratne, A.; Yamaguchi, S.; Kono, S.; Takayanagi, R.; Yamori, Y.; Kobayashi, S.; Ogihara, T.; de Silva, A.; Wickremasinghe, R.; Kato, N.
A Comparison between revised NCEP ATP III and IDF definitions in diagnosing metabolic syndrome in an urban Sri Lankan population: the Ragama Health Study
(Hindawi Publishing Corporation, 2013) Chackrewarthy, S.; Gunasekara, D.; Pathmeswaran, A.; Wijekoon, C.N.; Ranawaka, U.K.; Kato, N.; Takeuchi, F.; Wickremasinghe, A.R.
Background. The prevalence of metabolic syndrome (MetS) within individual cohorts varies with the definition used. The aim of this study was to compare the prevalence of MetS between IDF and revised NCEP ATP III criteria in an urban Sri Lankan population and to investigate the characteristics of discrepant cases. Methods. 2985 individuals, aged 35-65 years, were recruited to the study. Anthropometric and blood pressure measurements and laboratory investigations were carried out following standard protocols. Results. Age and sex-adjusted prevalences of MetS were 46.1% and 38.9% by revised NCEP and IDF definitions, respectively. IDF criteria failed to identify 21% of men and 7% of women identified by the revised NCEP criteria. The discrepant group had more adverse metabolic profiles despite having a lower waist circumference than those diagnosed by both criteria. Conclusion. MetS is common in this urban Sri Lankan cohort regardless of the definition used. The revised NCEP definition was more appropriate in identifying the metabolically abnormal but nonobese individuals, especially among the males predisposed to type 2 diabetes or cardiovascular disease. Further research is needed to determine the suitability of the currently accepted Asian-specific cut-offs for waist circumference in Sri Lankan adults. Copyright © 2013 S. Chackrewarthy et al
Correlates of serum homocysteine in a Sri Lankan population
(American Association For Clinical Chemistry, 2010) Chackrewarthy, S.; Wijayasinghe, Y.S.; Gunasekera, D.; Wickremasinghe, R.; Kato, N.
Correlates of total serum homocysteine concentration in a Sri Lankan population BACKGROUND: Hyperhomocysteinemia, a possible risk factor for vascular disease occurs at a higher prevalence in South Asian countries. Serum homocysteine concentrations are influenced by genetic, nutritional and lifestyle factors. Correlates of total serum homocysteine concentration (tHcy) are not well characterized in the Sri Lankan population. Such information is important in developing therapeutic and preventative strategies. OBJECTIVE: To investigate the factors potentially associated with fasting levels of serum tHcy in a Sri Lankan population. METHODS: In a cross sectional study, 177 apparently healthy volunteers (91 men and 86 women) aged 38-65 years were selected from residents in an urban health administrative area. Individuals with a history of chronic disease and with any pharmacological treatment were excluded from the study. Information on diet, lifestyle factors and medical history were recorded. Anthropometric indices and blood pressure were measured according standard protocols. Fasting serum levels of tHcy, insulin, creatinine, folate and lipids were estimated using standard protocols. RESULTS: Fasting serum tHcy levels were higher in males than in females (geometric mean +/- SD, 13.75 mumol/l +/- 1.41 Vs. 9.58 mumol/l +/- 1.43, p<0.001) and were positively associated with age (r=0.204, p< 0.01) in both sexes. 32.3% of males and 10.3% of females had mild hyperhomocysteinemia (tHcy>15mumol/l). tHcy levels were significantly higher in smokers than in non-smokers (geometric mean +/- SD, 14.58 mumol/l +/- 1.44 Vs.12.71 mumol/l +/- 1.37, p<0.05) and in alcohol consumers than in non-consumers (geometric mean +/- SD, 14.53 mumol/l +/- 1.43 Vs.12.14 mumol/l +/- 1.32, p< 0.02). In males, tHcy levels were negatively related to serum insulin (r= -0.397, p<0.001) and BMI (r= -0.244, p <0.02) and positively related to serum creatinine (r=0.235, p<0.02). In females, there was a positive relationship between tHcy and systolic blood pressure (r= 0.239, p<0.02) but there was no significant correlation with serum insulin. In both sexes, serum tHcy levels strongly correlated with serum folate (r= -0.412, p<0.001). There were no significant associations between tHcy and serum lipids. Stepwise regression analysis confirmed the associations between tHcy and folate (p<0.001 in both sexes), insulin (p=0.026 in males) and creatinine (p=0.036 in males). CONCLUSION: Low intake of folate, alcohol consumption and smoking were associated with increased tHcy concentrations. Serum insulin and creatinine were independent correlates of tHcy in males, but not in females. Difference in tHcy levels between sexes may partly be attributed to differences in lean muscle mass and to a metabolic link between creatinine synthesis and homocysteine production. Insulin may regulate serum tHcy concentrations by homocysteine remethylation or by increasing homocysteine clearance.
Crystallization and preliminary x-ray analysis of shikimate dehydrogenase from Escherichia coli
(Wiley-Blackwell, 2000) Maclean, J.; Campbell, S.J.; Pollock, K.; Chackrewarthy, S.; Coggins, J.R.; Lapthorn, A.J.
Abstract
The Effect of Cassia auriculata and Cardiospermum halicacabum teas on the steady state blood level and toxicity of carbamazepine
(Elsevier, 2004) Thabrew, M.I.; Munasinghe, C.; Chackrewarthy, S.; Senarath, S.
A study was conducted using male Wistar rats as the experimental model, to compare the effects of concurrent administration of herbal tea prepared from dried flowers of Cassia auriculata or aerial parts of Cardiospermum halicacabum and carbamazepine, on (a). steady state serum levels of the prescription drug, and (b). changes in toxicity (as assessed by changes in general behaviour, haematological parameters, and liver and kidney function) that may occur due to drug interaction. Results demonstrate that in rats receiving the Cassia auriculata tea and carbamazepine, the blood levels of the prescription drug were significantly enhanced by 47.1% (P<0.04), when compared with the levels in animals receiving only carbamazepine for the same time period, with no apparent changes in toxicity. In animals receiving the Cardiospermum halicacabum tea, there were no significant changes in the blood levels of carbamazepine or drug-related toxicity. Cassia auriculata tea has therefore the potential to influence the bioavailability of carbamazepine, and hence its therapeutic actions. Concurrent ingestion of carbamazepine with herbal teas containing Cassia auriculata is therefore best avoided by patients under treatment for epilepsy.
Effects of white coconut oil, virgin coconut oil and grated coconut on blood glucose and serum lipids in Wistar rats
(Sri Lanka Medical Association, 2015) Samaranayake, H.A.E.; Chackrewarthy, S.; Karunakaran, R.; Wickremasinghe, A.R.
INTRODUCTION AND OBJECTIVES: This study investigated the effects of white coconut oil (WCO), virgin coconut oil (VCO) and grated coconut on blood glucose and serum lipids in Wistar rats. METHOD: Four groups of male Wistar rats (1-4) were maintained on four isocaloric test diets, containing WCO, VCO, WCO + grated coconut (1:1 ratio) and VCO + grated coconut (1:1 ratio) respectively. After 36 weeks of feeding blood glucose and serum lipids were assayed. Results were analysed using SPSS version 16.0. RESULTS: Compared with the baseline levels, mean blood glucose levels decreased in all four groups; -13.87, -7.22, -41.88, and -41.85 mg/dt respectively. Rats fed with mixtures of oil and grated coconut (groups 3 and 4) showed a significantly higher decrease in blood sugar (p<0.05) compared with diets containing oil only (groups 1 and 2). No significant differences (p>0.05) in blood sugar levels were observed between groups fed with diets containing oil only or between groups fed with diets containing mixtures of oii+ grated coconut. Compared with baseline levels, mean differences in serum total cholesterol (TC) were 9.05, -8.08, 6.11,1.65 mg/dl, triglycerides -31.1, -20.75, -30.5, -49.8 mg/d! and high density lipoproteins (HDL) -1.47, 8.32, 0.816, -10.82 mg/dl in groups 1-4 respectively. Although statistically not significant, lower TC and higher HDL levels were observed in rats fed with VCO containing diet. CONCLUSION: Inclusion of grated coconut in the diet results in significant hypoglyceamic action. Although statistically not significant VCO may have beneficial effects on serum lipids which warrants further investigation.
Erythrocyte antioxidant enzymes in patients with cataract
(Institute for Clinical Science., 2006) Chandrasena, L.G.; Chackrewarthy, S.; Perera, P.T.; de Silva, D.
The pathogenesis of cataract has been found to be influenced by a number of factors including oxidative stress. Catalase, glutathione peroxidase (GPX), and superoxide dismutase (SOD) are some of the antioxidant enzymes that protect the body from oxidative damage. The present study investigates the activities of erythrocyte catalase, GPX, and SOD with respect to senile cataract (non-diabetic cataract) and osmotic cataract (diabetic cataract) in a Sri Lankan population. One hundred and two non-diabetic subjects (50 with cataract and 52 non-cataract) and 106 diabetic subjects (56 with cataract and 50 non-cataract) were recruited into the study. Erythrocyte catalase, GPX, and SOD activities were assayed and the data were analysed by t-test (p <0.05 for significance). In the non-diabetic group, significantly low levels of catalase, GPX, and SOD activities were associated with cataract when compared with non-cataract. No significant changes in catalase, GPX, and SOD activities were observed in the diabetic group between cataract and non-cataract. Senile cataract (non-diabetic cataract) was associated with significantly low levels of erythrocyte catalase, GPX, and SOD when compared with osmotic cataract (diabetic cataract). Positive correlations were observed between catalase and SOD (r = 0.75), catalase and GPX (r = 0.63), and SOD and GPX (r = 0.59) in subjects with senile cataracts. Our results indicate that erythrocyte antioxidant enzyme levels are decreased in senile cataract as opposed to osmotic cataract. Assays of these erythrocyte enzyme activities could provide a marker to identify individuals predisposed to senile cataract.
Evaluation of the hypoglycemic and hypolipidemic effects of an ethylacetate fraction of Artocarpus heterophyllus (jak) leaves in streptozotocin-induced diabetic rats
(Medknow Publications, 2010) Chackrewarthy, S.; Thabrew, M.I.; Weerasuriya, M.K.; Jayasekera, S.
Aqueous extracts of mature leaves of Artocarpus heterophyllus (jak) are used by traditional medical practitioners in Sri Lanka and India for the treatment of diabetes. This study was conducted to investigate the hypoglycemic and hypolipidemic effects of an ethylacetate (EA) fraction of the mature leaves of A. heterophyllus in a streptozotocin (STZ) induced diabetic rat model. In normoglycemic rats, administration of a single dose (20 mg/kg) of the EA fraction resulted in a significant (P < 0.05) reduction in the fasting blood glucose concentration and a significant improvement in glucose tolerance (P < 0.05), compared to the controls. In STZ-induced diabetic rats, chronic administration of the EA fraction of A. heterophyllus leaves daily for 5 weeks resulted in a significant lowering of serum glucose, cholesterol and triglyceride (TG) levels. Compared to control diabetic rats, the extract-treated rats had 39% less serum glucose, 23% lower serum total cholesterol and 40% lower serum TG levels and 11% higher body weight at the end of the fifth week. The percentage reductions in the serum parameters mediated by the test fraction were comparable with those produced by glibenclamide (0.6 mg/kg), the reference drug used in this study. It can be concluded that the EA fraction of A. heterophyllus leaves contains one or more hypoglycemic and hypolipidemic principles which have the potential to be developed further for the treatment of diabetes specifically associated with a hyperlipidemic state
Glucose tolerance
(Intech, 2012) Chackrewarthy, S.
The progression from normal glucose tolerance (NGT) to type 2 diabetes involves intermediate stages of impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), also known as prediabetes. The pathophysiology underlying the development of these glucose metabolic alterations is multifactorial, leading to an alteration in the balance between insulin sensitivity and insulin secretion. Our knowledge of the molecular basis of the signaling pathways mediating the various physiologic effects of insulin is steadily advancing. New substrates and signaling molecules have been identified and potential mechanisms involved in the pathophysiology of type 2 diabetes have been revealed. This book summarises the current state of knowledge on the pathophysiology underlying the progression from normal glucose tolerance to type 2 diabetes and therapeutic advances in the improvement of glycaemic control in prediabetic and diabetic states.
Hypoglycaemic and Hypolipidaemic effect of an ethylacetate fraction of Artocarpus heterophyllus (jak) leaves in streptozotocin induced diabetic rats
(Sri Lanka Association for the Advancement of Science, 2009) Chackrewarthy, S.; Jayasekera, S.; Thabrew, M.I.; Weerasooriya, M.K.B.
Previous investigations have shown that aqueous extracts of Artocarpus heterophyllus (jak) leaves (family Moraceae) can exert significant hypoglycaemic activity, and improve the glucose tolerance of healthy rats and humans, and newly diagnosed maturity onset diabetic patients. A preliminary study carried out by the authors with fractions separated from A. heterophyllus leaves showed that the ethylacetate fraction exerts the greatest hypoglycaemic activity in rats. The objective of the present study was to determine the effects of prolonged administration of ethylacetate fraction of A. heterophyllus leaves on serum glucose and lipid levels in streptozotocin induced diabetic rats since no reports are available on the effects of A. heterophyllus leaves on hyperlipidaemia associated with diabetes despite its clinical significance. Oral administration of the ethylacetate fraction (20 mg kg -1 bw) of A. heterophyllus leaves daily for five weeks significantly lowered serum glucose, cholesterol and triglyceride levels in streptozotocin induced diabetic rats. Compared to the control diabetic rats, the extract treated rats had 39% less serum glucose, 23% lower serum total cholesterol and 40% lower serum triglyceride levels and 11% higher body weight at the end of the fifth week. The percentage reductions in the serum parameters mediated by the test fraction were comparable with those produced by glibenclamide (57%, 32% and 42% reductions in serum glucose, cholesterol and triglycerides, respectively). The stimulation of insulin release by active principles in the ethylacetate fraction may be one of the mechanisms by which this fraction mediates its hypoglycaemic effect. It may be concluded that the ethylacetate fraction of A. heterophyllus leaves contain one or more hypoglycaemic and hypolipidaemic principles which have the potential to be developed further for the treatment of diabetes specifically associated with a hyperlipidaemic state.
Hypoglycaemic and hypolipidaemic effects of an ethylacetate fraction of Artocarpus heterophyllus leaves
(Intech, 2012) Chackrewarthy, S.; Thabrew, M.I.
Metabolic syndrome in the Ragama Health Study: definitions and controversies
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Chackrewarthy, S.
Although there is agreement that the Metabolic Syndrome (MetS) is a major public health challenge worldwide and consistent evidence stresses the need for intervention, the definition of the syndrome remains a matter of debate. Currently, several different definitions of MetS exist which share several features but also include important differences and limitations. Prevalence of MetS in the RHS was estimated using the two most widely used definitions of MetS: International Diabetes Federation (IDF) and revised National Cholesterol Education Program Adult Treatment Panel III (revised NCEP ATP III). Age and sex-adjusted prevalences of MetS in the RHS were 46.1% and 38.9% by revised NCEP and IDF definitions, respectively. IDF criteria failed to identify 21% of men and 7% of women identified by the revised NCEP criteria. The discrepant group had more adverse metabolic profiles despite having a lower waist circumference than those diagnosed by both criteria. This discrepancy was mainly caused by waist circumference criterion which is a prerequisite for the diagnosis of MetS based on IDF definition. In contrast, the revised NCEP definition considers abdominal obesity as one of the equally weighted criteria. The discrepant group in our study included a metabolically obese, normal weight (MONW) group of individuals who are predisposed to diabetes and CVD like people with overt obesity. MONW individuals are common in the general population and they probably represent one end of the spectrum with MetS. The study highlights the need for a unified definition of MetS which would identify individuals with an increased risk of diabetes and CVD.
Micronutrient status and its relationship with nutritional status in preschool children in urban Sri Lanka
(HEC Press, Australia, 2015) Marasinghe, E.; Chackrewarthy, S.; Abeysena, C.; Rajindrajith, S.
OBJECTIVE: To assess the micronutrient status and its relationship with nutritional status in preschool children. METHODS: In a cross sectional study, anthropometric data and fasting blood samples were obtained from 340 children attending preschool in urban Sri Lanka. Serum concentrations of vitamin D, parathyroid hormone, vitamin A, zinc and haemoglobin were measured. Z-scores of anthropometric indices of height-for-age, weight-for-age and weight-for-height were computed to evaluate the nutritional status. RESULTS: Prevalence of stunting, underweight, wasting and anaemia among children were 7.1%, 16.9%, 21.2% and 7.4%, respectively. Deficiencies of zinc and vitamin A occurred among 67% and 38% of children, respectively. Vitamin D deficiency (<10 ng/mL) and insufficiency (10-20 ng/mL) occurred in 5.0% and 29.1% of children, respectively, and12% had parathyroid hormone levels indicative of hypocalcaemia. Nutritional status was significantly correlated (p<0.05) with vitamin D status [height-for-age (r=0.10), weight-for-age (r=-0.18), weight-for-height (r=-0.12)], and with haemoglobin status [weight-for-age (r=0.11)]. Zinc and vitamin A levels were lower in severe stunting compared with normal height (p<0.05). Significant correlations (p<0.05) were observed between vitamin D and parathyroid hormone (r=-0.12) and between haemoglobin and vitamin A (r=0.01), zinc (r=0.02) and vitamin D (r=0.02) levels. CONCLUSIONS: In the surveyed population, zinc deficiency was high and to a lesser degree vitamin A deficiency and vitamin D insufficiency prevailed. The nutritional status of the children was related to vitamin D status and with haemoglobin status. Zinc and vitamin A levels were low in children with severe stunting. Vitamins A, D and zinc levels were associated with haemoglobin status.
Multiple choice questions for self-assesment in Biochemistry with explanatory answers
(Author Publication, 2015) Chackrewarthy, S.
Patterns and predictors of mortality in a semi-urban population-based cohort in Sri Lanka: findings from the Ragama Health Study
(BMJ Publishing Group Ltd, 2020) Kasturiratne, A.; Ediriweera, D.S.; de Silva, S.T.; Niriella, M.A.; Thulani, U.B.; Pathmeswaran, A.; Dassanayake, A.S.; de Silva, A.P.; Chackrewarthy, S.; Ranawaka, U.; Kato, N.; Wickremasinghe, A.R.; de Silva, H.J.
OBJECTIVE: To describe patterns and predictors of mortality in a semi-urban population in Sri Lanka. DESIGN: A prospective population-based cohort study. Setting: Ragama Medical Officer of Health area in the Gampaha district, Sri Lanka. PARTICIPANTS: Adults between 35 and 64 years of age were recruited using an age stratified random sampling technique in 2007. MEASURES: At baseline, we recorded socio-demographic, lifestyle, anthropometric, biochemical and clinical data of the participants. Over 10 years, we obtained the cause and date of death from the death registration documents of deceased participants. We determined the survival probability of the cohort over 10 years and estimated Hazard ratios (HRs) for all-cause mortality (ACM), cardiovascular mortality (CVM) and cancer-related mortality (CRM) using Cox's proportional hazards model. We also estimated the survival probabilities for men and women in each 10-year age group and standardised mortality ratio relative to the source population. RESULTS: There were 169 deaths over 10 years with standardised mortality rates of 5.3 and 2.4 per 1000 years of follow-up for men and women, respectively. Independent predictors of: ACM were older age, lower income, smoking and diabetes mellitus while gender, education, occupation, harmful alcohol use, waist circumference and hypertension were not; CVM were older age, lower income, smoking, diabetes and hypertension while gender and harmful alcohol use were not; CRM was older age while gender, smoking and diabetes were not. Those engaged in clerical and technical occupations or unemployed had a lower risk of CRM as compared with those engaged in elementary occupations. CONCLUSIONS: Older age, lower income, smoking, diabetes and hypertension strongly predict mortality in this cohort. Addressing the identified modifiable predictors through behavioural modification will improve longevity in similar populations. Keywords: coronary heart disease; epidemiology; public health.
Physical activity tracking among Sri Lankan adults: findings from a 7-year follow-up of the Ragama Health Study
(SAGE Publications, 2021) Pinidiyapathirage, J.; Kasturiratne, A.; Bennie, J.A.; Pathmeswaran, A.; Biddle, S.J.H.; de Silva, H.J.; Chackrewarthy, S.; Dassanayake, A.S.; Ranawaka, U.; Kato, N.; Wickremasinghe, A.R.
ABSTRACT: Limited data are available on physical activity tracking among adults in low- and middle-income countries. Using a longitudinal design, we assessed trends and correlates of physical activity among Sri Lankan adults. Individuals selected through age-stratified random sampling, were screened initially in 2007 (n = 2986) and reevaluated in 2014 (n = 2148). On both occasions, structured interviews and clinical measurements were completed. Approximately 40% of the participants engaged in recommended levels of physical activity both at baseline and follow-up. One-fifth reported increased physical activity at follow-up, a similar proportion reported being persistently inactive or a reduction in physical activity. In the adjusted analysis, being persistently active was associated with male sex, a lower educational level and income, being free of any chronic disease conditions, better self-rated health, and sitting time <8 hours. Our findings support public health interventions to help maintain recommended physical activity levels over time, particularly for subgroups at high-risk of physical inactivity. KEYWORDS: Sri Lanka; lower middle-income countries; non-communicable diseases; physical activity; population studies.