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Articles by S. Hashmi
Total Records ( 2 ) for S. Hashmi
  S. D. Rees , M. Islam , M. Z. I. Hydrie , B. Chaudhary , S. Bellary , S. Hashmi , J. P. O`Hare , S. Kumar , D. K. Sanghera , N. Chaturvedi , A. H. Barnett , A. S. Shera , M. N. Weedon , A. Basit , T. M. Frayling , M. A. Kelly and T. H. Jafar
  Aims  A common variant, rs9939609, in the FTO (fat mass and obesity) gene is associated with adiposity in Europeans, explaining its relationship with diabetes. However, data are inconsistent in South Asians. Our aim was to investigate the association of the FTO rs9939609 variant with obesity, obesity-related traits and Type 2 diabetes in South Asian individuals, and to use meta-analyses to attempt to clarify to what extent BMI influences the association of FTO variants with diabetes in South Asians.

Methods  We analysed rs9939609 in two studies of Pakistani individuals: 1666 adults aged ≥ 40 years from the Karachi population-based Control of Blood Pressure and Risk Attenuation (COBRA) study and 2745 individuals of Punjabi ancestry who were part of a Type 2 diabetes case-control study (UK Asian Diabetes Study/Diabetes Genetics in Pakistan; UKADS/DGP). The main outcomes were BMI, waist circumference and diabetes. Regression analyses were performed to determine associations between FTO alleles and outcomes. Summary estimates were combined in a meta-analysis of 8091 South Asian individuals (3919 patients with Type 2 diabetes and 4172 control subjects), including those from two previous studies.

Results  In the 4411 Pakistani individuals from this study, the age-, sex- and diabetes-adjusted association of FTO variant rs9939609 with BMI was 0.45 (95% CI 0.24-0.67) kg/m2 per A-allele (= 3.0 x 10−5) and with waist circumference was 0.88 (95% CI 0.36-1.41) cm per A-allele (= 0.001). The A-allele (30% frequency) was also significantly associated with Type 2 diabetes [per A-allele odds ratio (95% CI) 1.18 (1.07-1.30); = 0.0009]. A meta-analysis of four South Asian studies with 8091 subjects showed that the FTO A-allele predisposes to Type 2 diabetes [1.22 (95% CI 1.14-1.31); = 1.07 x 10-8] even after adjusting for BMI [1.18 (95% CI 1.10-1.27); = 1.02 x 10-5] or waist circumference [1.18 (95% CI 1.10-1.27); = 3.97 x 10−5].

Conclusions  The strong association between FTO genotype and BMI and waist circumference in South Asians is similar to that observed in Europeans. In contrast, the strong association of FTO genotype with diabetes is only partly accounted for by BMI.

  T. H Jafar , Z Qadri and S. Hashmi

Background. Microalbuminuria (MA) is a known predictor of cardiovascular disease (CVD) in European origin populations, but such data are lacking in native Indo-Asian populations, where CVD risks are high. Major electrocardiographic (ECG) changes are predictive of cardiovascular mortality. We determined the association of MA with major ECG changes in the general population of Pakistan.

Methods. A total of 3143 subjects aged ≥40 years from 12 randomly selected communities in Karachi participated. MA was defined as the urine albumin to creatinine (ACR) ratio of < 300 mg/g creatinine and ≥17 mg/g in men and ≥25 mg/g in women from a single-spot morning urine sample. Major changes on ECG were coded in duplicate using Minnesota classification.

Results. The mean age of subjects was 51.5 (10.7) years. The median (25–75 percentile) ACR was 4.2 (2.9–7.9) mg/g in men and 6.0 (3.9–10.8) mg/g in women (P < 0.001). The overall prevalence (95% CI) of MA was 12.3% (11.1–13.5%), and 20.3% in those with major ECG changes. In a multivariable model, major ECG changes (OR, 95% CI) (1.50, 1.10–2.00), diabetes (3.57, 2.93–4.35), hypertension (2.30, 1.85–2.86), female sex (0.61, 0.53–0.69), age (1.09, 1.05–1.13, for each 5-year increase) and eGFR (0.80, 0.78–0.81, for each 10 mg/g increase) were independently associated with MA.

The presence of MA increased the prevalence of major ECG changes from 21 to 31% in those with hypertension (44.9%), 15 to 28% among those with diabetes (21.4%), 14 to 26% among those with overweight or obesity (68.4%) and 14 to 26% among current users of tobacco (38.7%) (P < 0.001) each.

Conclusions. The strong association between MA and major ECG changes underscores the importance of screening Indo-Asian subjects for MA for unmasking underlying CVD, especially those with hypertension, diabetes, obesity, and tobacco users.

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