Browsing by Author "Wijeyaratne, C.N."

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Creating a pro-active health care system to combat chronic diseases in Sri Lanka: the central role of preventive medicine and healthy lifestyle behaviors
(Taylor and Francis Group, 2016) Sagner, M.; Arena, R.; McNeil, A.; Brahmam, G.N.; Hills, A.P.; de Silva, H.J.; Karunapema, R.P.; Wijeyaratne, C.N.; Arambepola, C.; Puska, P.
INTRODUCTION: The current burden and future escalating threat of chronic diseases, constitutes the major global public health challenge. In SriLanka, cardiovascular diseases account for the majority of annual deaths. Data from Sri Lanka also indicate a high incidence and prevalence of pre-diabetes and diabetes; 1 in 5 adults have elevated blood sugar in Sri Lanka. It is well established that chronic diseases share four primary behavioral risk factors: 1) tobacco use; 2) unhealthy diet; 3) physical inactivity; and 4) harmful use of alcohol. AREAS COVERED: Evidence has convincingly shown that replacing these behavioral risk factors with the converse, healthy lifestylecharacteristics, decrease the risk of poor outcomes associated with chronic disease by 60 to 80%. In essence, prevention or reversal of these behavioral risk factors with effective healthy lifestyle programing and interventions is the solution to the current chronic disease crisis. Expert Commentary: Healthy lifestyle is medicine with global applicability, including Sri Lanka and the rest of the South Asia region. This policy statement will discuss the chronic disease crisis in Sri Lanka, its current policies and action implemented to promote healthy lifestyles, and further recommendations on preventive medicine and healthy lifestyle initiatives that are needed to move forward.
Iodine prophylaxis, goitre and thyroid autoimmunity in Sri Lanka
(Sri Lanka Medical Association, 2005) Wijeyaratne, C.N.; Jayasinghe, A.; de Silva, D.G.H.; Parkes, A.B.; Lazarus, J.H.; Premawardena, L.D.K.E.
No Abstract Available
Polycystic ovary syndrome, androgen excess, and the risk of nonalcoholic fatty liver disease in women: A longitudinal study based on a United Kingdom primary care database
(Public Library of Science, 2018) Kumarendran, B.; O'Reilly, M.W.; Manolopoulos, K.N.; Toulis, K.A.; Gokhale, K.M.; Sitch, A.J.; Wijeyaratne, C.N.; Coomarasamy, A.; Arlt, W.; Nirantharakumar, K.
BACKGROUND: Androgen excess is a defining feature of polycystic ovary syndrome (PCOS), which affects 10% of women and represents a lifelong metabolic disorder, with increased risk of type 2 diabetes, hypertension, and cardiovascular events. Previous studies have suggested an increased risk of nonalcoholic fatty liver disease (NAFLD) in individuals with PCOS and implicated androgen excess as a potential driver. METHODS AND FINDINGS: We carried out a retrospective longitudinal cohort study utilizing a large primary care database in the United Kingdom, evaluating NAFLD rates in 63,120 women with PCOS and 121,064 age-, body mass index (BMI)-, and location-matched control women registered from January 2000 to May 2016. In 2 independent cohorts, we also determined the rate of NAFLD in women with a measurement of serum testosterone (n = 71,061) and sex hormone-binding globulin (SHBG; n = 49,625). We used multivariate Cox models to estimate the hazard ratio (HR) for NAFLD and found that women with PCOS had an increased rate of NAFLD (HR = 2.23, 95% CI 1.86-2.66, p < 0.001), also after adjusting for BMI or dysglycemia. Serum testosterone >3.0 nmol/L was associated with an increase in NAFLD (HR = 2.30, 95% CI 1.16-4.53, p = 0.017 for 3-3.49 nmol/L and HR = 2.40, 95% CI 1.24-4.66, p = 0.009 for >3.5 nmol/L). Mirroring this finding, SHBG <30 nmol/L was associated with increased NAFLD hazard (HR = 4.75, 95% CI 2.44-9.25, p < 0.001 for 20-29.99 nmol/L and HR = 4.98, 95% CI 2.45-10.11, p < 0.001 for <20 nmol/L). Limitations of this study include its retrospective nature, absence of detailed information on criteria used to diagnosis PCOS and NAFLD, and absence of data on laboratory assays used to measure serum androgens. CONCLUSIONS: We found that women with PCOS have an increased rate of NAFLD. In addition to increased BMI and dysglycemia, androgen excess contributes to the development of NAFLD in women with PCOS. In women with PCOS-related androgen excess, systematic NAFLD screening should be considered.
Sequential studies on thyroid antibodies during pregnancy
(Mary Ann Liebert Publishers, 2005) Smyth, P.P.; Wijeyaratne, C.N.; Kaluarachi, W.N.; Smith, D.F.; Premawardena, L.D.K.E.; Parkes, A.B.; Jayasinghe, A.; de Silva, D.G.H.; Lazarus, J.H.
Thyroid antibodies were measured sequentially in 25 pregnant women from a Sri Lankan population. A high prevalence of antithyroidantibodies, particularly antithyroglobulin antibodies (TgAb) had previously been demonstrated in female schoolchildren drawn from this population. In the present study TgAb were detected in 36.8% of nonpregnant controls while thyroid peroxidase antibody (TPOAb) positivity was present in 26.3%. The prevalence of both antibodies in the pregnancy study group showed a progressive decline compared to nonpregnant controls throughout gestation becoming undetectable in the third trimester. The results are consistent with an immunosuppressive effect of pregnancy in a population in whom high thyroid autoantibody titers may have resulted from a recent salt iodization program.
Social determinants of obesity in Kalutara District
(Sri Lanka Medical Association, 2014) de Silva, A.P.; de Silva, S.H.P.; Liyanage, I.K.; Rajapakse, L.C.; Jayasinghe, K.S.A.; Kotulanda, P.; Wijeyaratne, C.N.; Wijeratne, S.; Haniffa, R.
INTRODUCTION AND OBJECTIVES: To describe social, cultural and economic determinants of obesity in a representative population in Kalutara METHODS: A cross sectional survey carried out among adults of 35 to 64 years. Applying a stratified random duster sampling method from urban, rural and plantation sectors, 1300 participants were selected. Data gathered using an interviewer administered questionnaire. The body mass index of 23.01 kg/m2-27.50kg/ m2 was considered as overweight and >27.51kg/m2 as obese. Waist circumference (WC) of >90cm and >80cm was regarded as high for men and women respectively. Significance of prevalence of diseases and risk factors across different socio-economic strata were determined by chi square test for trend. RESULTS: Of 1234 adults who were screened age and sex adjusted prevalence of overweight, obesity and abdominal obesity (high WC) were 33.2%, 14.3% and 33.6% respectively. The Muslim population had the highest prevalence of all three categories. Sector, education, income, social status quintiles and area level deprivation categories show-an inverse gradient in obesity categories, mean BM! and mean WC. The differences observed for mean BM! and mean WC between the lowest and .highest groups in these socioeconomic factors were significant. CONCLUSION: There is an inverse gradient of overweight, obese and centrally obese with higher prevalence observed in the more affluent, educated, urban and high income segments of society. In Sri Lanka those in the higher socio economic categories are still at a higher risk of being overweight, obese and having abdominal obesity.