Article in PDF
How to Cite
Citation Manager
Readers' Comments (0)
Audio Visual Article Statistics
Link
to PUBMED
Print this Article
Send to a Friend
Advertisers
Access Statistics Resources
Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."
Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011
Dr. Shankar P.R.
"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."
Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011 Anuradha
Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.
Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020
Original article / research
Full Version
Correlation of Sagittal Abdominal Diameter and Other Anthropometric Parameters with Serum Leptin Levels in Young Adults- A Cross-sectional Study
Correspondence Address :
Mayank Agarwal,
Assistant Professor, Department of Physiology, All India Institute of Medical Sciences, Raebareli, Uttar Pradesh, India.
E-mail: mayankphysiology@gmail.com
Introduction: Leptin is secreted in concentrations proportional to body fat mass. The anthropometric parameter among Sagittal Abdominal Diameter (SAD), Body Mass Index (BMI), Hip Circumference (HC), Waist Circumference (WC), Waist-Hip Ratio (WHR), and Waist-Height Ratio (WHtR) that correlates maximally with serum leptin levels could be used preferably to assess adiposity.
Aim: The present study aims to correlate serum leptin levels with SAD, BMI, HC, WC, WHR and WHtR in young and healthy North Indian adults.
Materials and Methods: The present cross-sectional study was conducted jointly in the Department of Physiology and Biochemistry at the King George’s Medical University, Lucknow, Uttar Pradesh, India from September 2015 to August 2016 and it included apparently healthy individuals, aged 18-25 years, native to North India, after obtaining an informed consent. A convenient sample size of 100 was taken. One investigator took all anthropometric measurements. (SAD, BMI, HC, WC, WHR and WHtR) RayBio human leptin ELISA kit was used for the estimation of leptin level. For statistical analysis, Pearson’s correlation coefficient was used. P<0.05 was considered significant.
Results: The study involved 55 males and 45 females aged 21.4±1.5 years with BMI 22.7±2.7 kg/m2, HC 91.5±6.9 cm, WC 81.9±7.9 cm, WHR 0.9±0.1, WHtR 0.50±0.04, SAD 20.8±3.1 cm and serum leptin level 389.6±102.7 pg. Serum leptin level correlated significantly with HC (r=0.23, p=0.02), WC (r=0.29, p=0.003), WHtR (r=0.36, p<0.001), and SAD (r=0.56, p<0.001). A non significant correlation was obtained with BMI (r=0.15, p=0.12) and WHR (r=0.11, p=0.26).
Conclusion: The SAD is a better predictor of body fat and cardiometabolic health than other anthropometric parameters in the present study, as it correlated most strongly with serum leptin levels.
Adiposity, Body mass index, Waist circumference, Waist-hip ratio, Waist-height ratio
The visceral fat accumulation leads to the activation of various inflammatory pathways causing the development of cardiovascular and metabolic disorders (1). Accurate quantification of adipose tissues requires imaging techniques such as Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) (2). However, these imaging techniques are expensive and not readily available, thus impractical for primary healthcare setup.
Traditionally, primary care physicians use BMI or Quetelet index to assess adiposity (3). However, it has been established that the Asian populations develop cardiometabolic complications at a lower BMI than western populations due to the difference in body fat distribution (4). Hence, BMI is not an accurate indicator of body fat percentage, and therefore other clinical anthropometric measurements, such as WC, WHR, and WHtR, came into existence (5),(6). Nevertheless, another anthropometric marker of metabolic syndrome and visceral obesity is the SAD (7),(8). SAD is a measure of the anteroposterior diameter of the abdomen in a supine position that can be measured using a sliding beam abdominal calliper. Previous studies involving populations of different ethnicity, age and BMI have identified SAD as a better predictor of cardiovascular and metabolic health (9),(10),(11). Leptin is a vital adipokine that plays a crucial role in the metabolic homeostasis of the body. Leptin causes satiety, i.e., lowers food intake, increases energy expenditure, and maintains average body weight (12). Leptin is not only an established biomarker of body fat mass in the general population, but also high leptin level is associated with poor cardiometabolic health (13),(14).
Few previous studies have correlated serum leptin levels with different anthropometric measurements (15),(16),(17). The anthropometric parameter that maximally correlates with serum leptin levels could be used preferably to assess adiposity and cardiometabolic health. Therefore, the present study aimed to correlate serum leptin levels with SAD, BMI, HC, WC, WHR and WHtR in young and healthy North Indian adults.
The null hypothesis assumed no correlation exists between serum leptin level and SAD. In contrast, the alternate hypothesis stated that the serum leptin level increases with an increase in SAD.
The present cross-sectional study was conducted jointly in the Department of Physiology and Biochemistry at the King George’s Medical University (KGMU), Lucknow, Uttar Pradesh, India. Institutional ethical clearance (64 ECM II-B/P3) was obtained to conduct the study from September 2015 to August 2016. A structured general and systemic examination was conducted to know the health status of the subjects.
Inclusion criteria: Apparently healthy individuals, aged 18-25 years, native to North India, were recruited for the study irrespective of gender after obtaining informed written consent.
Exclusion criteria: Subjects in which any abnormality was detected during the examination; positive history of substance abuse; history of drug use that interferes with glucose metabolism; family history positive for metabolic diseases, cardiovascular diseases, autoimmune diseases, psychosomatic disorders, or neurological disorders were excluded from the study.
Sample size calculation: A convenient sample size of 100 was taken for the study. G*power v3.1.9.7 determined that at a permissible 5% alpha error, 80% power of the study, and sample size of 100, a correlation coefficient (r) of more than 0.246 in a one-tailed bivariate normal model correlation test would prove the alternate hypothesis (18).
Study Procedure
One investigator took all anthropometric measurements. First, weight was measured using a locally available electronic weighing scale (Omron HBF 212) to the nearest 0.1 kg. For weight measurement, the subject wore light clothing and no shoes, and their feet were placed in the centre of the scale. Next, height was measured to the nearest 0.1 cm when the participant stood barefoot on the platform of a locally available rigid stadiometer (model SECA 213). While measuring the participant’s height-shoulder blades, buttocks, and heels touched the back of the stadiometer, legs were straight, knees and heels were together, toes pointed outwards at approximately 60º angle, the head was in the Frankfort plane, arms were hanging at the sides with palms supine, breath was held in deep inhalation to straighten the spine, and hair was compressed to the crown of the head by the horizontal bar of the stadiometer. Finally, BMI was calculated by Quetelet’s index, i.e., weight (in kilograms) divided by the square of height (in metres) (3).
WC was measured to the nearest 0.1 cm with a flexible and inelastic measuring tape when the participant stood in an end-expiration state with both feet together and arms placed on the contralateral shoulders. The measuring tape was snugly wrapped horizontally around the lateral aspect of each ilium at the mid-axillary line while taking the precaution of not compressing the underlying tissues. HC was measured at the widest part of the hip when the subject stood in a posture similar to the WC measurement. WHR was calculated by dividing WC by HC. WHtR was calculated by dividing WC by height. The SAD was recorded in the supine position with knees bent at approximately 90° angle, feet resting flat on the table, and arms crossed over the chest. The measuring tape was snugly wrapped horizontally around the uppermost lateral aspect of each ilium at the mid-axillary line. A horizontal line is drawn from the umbilicus to the lateral side with a cosmetic pencil on the border of the measuring tape towards the participant’s head end. A locally available sliding beam abdominal calliper’s lower arm was inserted beneath the back of the participant such that the calliper’s arm remained in touch with the subject’s back. The shaft of the calliper was adjusted in a vertical position. The participant was instructed to hold their breath in an end-expiratory position. The calliper’s upper arm was slid over the line drawn previously, taking care not to compress the abdomen. The average of two measurements was taken as the final (19).
For serum leptin level estimation, a trained phlebotomist drew 5 mL of blood after overnight fasting in a vacutainer tube from the superficial vein of the arm of participants under all aseptic conditions. The vacutainer tube containing the blood sample was left undisturbed at room temperature for an hour; after that, the serum was separated from the plasma by centrifugation at 3000 Revolutions Per Minute (RPM). The serum was stored in cryovials at -80° celsius. RayBio human leptin Enzyme-Linked Immunosorbent Assay (ELISA) kit was used to determine the concentration of leptin in serum. Serum leptin levels vary with the fat content of the body and there is a paucity of data regarding normal serum leptin levels in healthy Indian adults. However, data from the Chinese population indicates that serum leptin levels of 0.33-19.85 ng/mL for males and 3.60-54.86 ng/mL for females should be considered normal and this was considered as a reference here in this study as corresponding data from Indian population is not well documented (20).
Statistical Analysis
International Business Machines (IBM) Statistical Package for Social Sciences (SPSS) Statistics for windows version 25.0 10was used to conduct the statistical analysis after entering the initial data in Microsoft excel 2019 software. Data are presented as mean±standard deviation and rounded off to either one or two decimal places. Pearson’s correlation coefficient was used to correlate serum leptin with HC, WC, WHR, WHtR, BMI, and SAD. The confidence interval was 95%. p<0.05 was considered significant.
(Table/Fig 1) shows the characteristics of the participants, anthropometric measurements, and serum leptin level.
(Table/Fig 2) shows a positive, strong, statistically significant correlation between serum leptin level and SAD. Hence, the alternate hypothesis was proved. HC, WC, and WtHR were also positively and significantly correlated with leptin levels. Serum leptin does not show a significant correlation with BMI and WHR.
(Table/Fig 3) shows that BMI and SAD were significantly (p<0.001) associated with serum leptin levels in the multivariate linear regression analysis among the males, i.e., if the BMI and SAD will increase, the serum leptin level will also increase in males. However, only SAD was positively and significantly (p<0.001) associated with the level of serum leptin among females.
Leptin, a polypeptide hormone, is secreted from the adipose tissue that has complex and multidirectional actions in the metabolic homeostasis of the body. Leptin is secreted in concentrations proportional to body fat mass, and its increased level is associated with metabolic syndrome and cardiovascular diseases (21). Previous studies have also indicated that SAD is a better indicator of cardiometabolic health than the widely used BMI for assessing adiposity (9),(10),(11),(22).
The present cross-sectional study involved 100 young and healthy North Indian males and females. Serum leptin levels were correlated with various anthropometric measurements. The study’s main finding was that SAD shows a strong and statistically significant correlation with serum leptin levels in both males and females. The result of the present study is similar to the previous study done by Yadav A et al., which reported a significant and positive correlation of HC and WC with serum leptin levels. Also, similar to the present study results, WHR showed no significant correlation with serum leptin levels in the North Indian healthy adult age group subjects that included both males and females. However, Yadav A et al., reported a positive and significant correlation between BMI and serum leptin level, while in the present study non significant correlation was established (23). Similar results were reported by Ayina CN et al., in the sub-Saharan African population (24). In addition, Ugrinska A et al., reported a significant and positive correlation of serum leptin levels with WC, HC, and BMI in 50 obese women (25).
Agbogu-Ike OU et al., reported that leptin level significantly correlates with BMI in males, but a non significant correlation was obtained for non diabetic Nigerian African females (26). Ste? pien´ M et al., reported a non significant correlation of BMI with serum leptin in elderly, obese, non diabetic, and hypertensive patients (27). Abd Elhafeez MA et al., reported a negative and non significant correlation of BMI with serum leptin levels in multiple sclerosis patients (28). Recently, Abdalla MMI, Soon SC reported a lack of association between serum leptin levels and BMI in normal and obese males (15). A considerable variation in the correlation of BMI with serum leptin levels has been reported in previous studies. The reason for this variation could be different population characteristics. In the present study, SAD correlated more strongly with serum leptin levels than WC, HC, and WHtR, while a non significant correlation was obtained for BMI and WHR. Thus, it can be said that SAD is a better predictor of cardiometabolic health than other anthropometric parameters involved in the present study. Contrary to the present study results, Al-Attas OS et al., reported that BMI correlates more strongly with leptin levels than SAD. Al-Attas OS et al., concluded that BMI is a better predictor of cardiometabolic risk factors than SAD (8). SAD could be the best non invasive surrogate marker for raised serum leptin levels that can be easily measured at a primary care setup without any cost to alert patients of future risk of metabolic syndrome.
Limitation(s)
The present study had a few limitations, including the involvement of only young and healthy individuals; hence, the results might not apply to the general population. A large and diverse population is required to firmly establish the correlation between serum leptin levels and anthropometric measurements.
The study concluded that serum leptin levels in young Indian adults significantly and positively correlated with WHtR, WC, and SAD. In addition, SAD showed the strongest correlation with serum leptin levels. Therefore, primary care physicians should consider including SAD in routine examinations to delineate the patients with a high risk of developing cardiometabolic disorders.
Authors appreciate the enthusiastic participation of the subject involved in the study.
DOI: 10.7860/JCDR/2023/60873.17717
Date of Submission: Oct 19, 2022
Date of Peer Review: Dec 21, 2022
Date of Acceptance: Jan 21, 2023
Date of Publishing: Apr 01, 2023
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Nov 02, 2022
• Manual Googling: Dec 29, 2022
• iThenticate Software: Jan 16, 2023 (13%)
ETYMOLOGY: Author Origin
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
- Index Copernicus ICV 2017: 134.54
- Academic Search Complete Database
- Directory of Open Access Journals (DOAJ)
- Embase
- EBSCOhost
- Google Scholar
- HINARI Access to Research in Health Programme
- Indian Science Abstracts (ISA)
- Journal seek Database
- Popline (reproductive health literature)
- www.omnimedicalsearch.com