Sheila Bhave’s research while affiliated with KEM Hospital Research Centre and other places

What is this page?


This page lists works of an author who doesn't have a ResearchGate profile or hasn't added the works to their profile yet. It is automatically generated from public (personal) data to further our legitimate goal of comprehensive and accurate scientific recordkeeping. If you are this author and want this page removed, please let us know.

Publications (76)


Proceedings of hepatitis A expert opinion board meet 2024: a stepwise approach. SOL, scientific opinion leaders; KOL, key opinion leaders.
Expert consensus and recommendations on the live attenuated hepatitis A vaccine and immunization practices in India
  • Article
  • Full-text available

January 2025

·

14 Reads

Nitin Shah

·

·

Sheila Bhave

·

[...]

·

Monjori Mitra

While Hepatitis A Virus (HAV) vaccination in global immunization programs has shown a virtual elimination of the disease within few years of the vaccination program, changing epidemiological landscape in India underscores the need for evidence-based, updated guidance on immunization practices. In May 2024, a panel of 15 distinguished opinion leaders and an organizing committee convened for an intensive, face-to-face advisory board meeting on high burden of HAV infection among adults, increased mortality rate in adolescents, symptomatic presentation in children, and evolving landscape globally and within India. Extensive comparable deliberations on long-term follow-up data from India and data from country of origin advocated immunogenicity, tolerability, and long-term protective effects of single-dose live attenuated HAV vaccine in children. Finally, a consensus was achieved on recognition of increased global attention toward HAV prevention through vaccination coverage. The need for a single dose of live attenuated HAV vaccine was an important outcome of this meeting.

Download

Figure 2-Life course evolution of glucose-insulin metabolism in participants of PMNS (NGT vs. glucose intolerant [GI]). The figure shows the life course evolution of parameters of glucose and insulin metabolism in NGT (dotted line) and GI (solid line) participants. The top panel shows fasting plasma glucose (mmol/L) and fasting plasma insulin (pmol/L). The bottom panel shows HOMA indices (A-C) and dynamic indices (D-F). Significant differences between the two groups (P < 0.05) are indicated by an asterisk. IGI, insulinogenic index.
Poor In Utero Growth, and Reduced β-Cell Compensation and High Fasting Glucose From Childhood, Are Harbingers of Glucose Intolerance in Young Indians

October 2021

·

99 Reads

·

15 Citations

Diabetes Care

Objective: India is a double world capital of early-life undernutrition and type 2 diabetes. We aimed to characterize life course growth and metabolic trajectories in those developing glucose intolerance as young adults in the Pune Maternal Nutrition Study (PMNS). Research design and methods: PMNS is a community-based intergenerational birth cohort established in 1993, with serial information on parents and children through pregnancy, childhood, and adolescence. We compared normal glucose-tolerant and glucose-intolerant participants for serial growth, estimates of insulin sensitivity and secretion (HOMA and dynamic indices), and β-cell compensation accounting for prevailing insulin sensitivity. Results: At 18 years (N = 619), 37% of men and 20% of women were glucose intolerant (prediabetes n = 184; diabetes n = 1) despite 48% being underweight (BMI <18.5 kg/m2). Glucose-intolerant participants had higher fasting glucose from childhood. Mothers of glucose-intolerant participants had higher glycemia in pregnancy. Glucose-intolerant participants were shorter at birth. Insulin sensitivity decreased with age in all participants, and those with glucose intolerance had consistently lower compensatory insulin secretion from childhood. Participants in the highest quintile of fasting glucose at 6 and 12 years had 2.5- and 4.0-fold higher risks, respectively, of 18-year glucose intolerance; this finding was replicated in two other cohorts. Conclusion: Inadequate compensatory insulin secretory response to decreasing insulin sensitivity in early life is the major pathophysiology underlying glucose intolerance in thin rural Indians. Smaller birth size, maternal pregnancy hyperglycemia, and higher glycemia from childhood herald future glucose intolerance, mandating a strategy for diabetes prevention from early life, preferably intergenerationally.


Long term Immunogenicity of Single Dose of Live Attenuated Hepatitis A Vaccine in Indian Children — Results of 15-Year Follow-up

February 2021

·

31 Reads

·

5 Citations

Indian Pediatrics

Objectives: To measure anti-HAV antibodies 15 years after a single dose of live attenuated hepatitis A vaccine in Indian children. Methods: Of the 143 children vaccinated in 2004, 109 were evaluated in 2019, clinically and for anti- HAV antibodies. These children have been assessed clinically every year, and for anti-HAV antibodies in 2004, 2007, 2010 and 2014. Result: Of the 109 children who came for the present assessment, 11 had received additional doses of hepatitis A vaccine in 2004/2007 because of low anti-HAV titre (<20 mIU/mL). In the remaining 98 children, 94 (96%) had seroprotective levels with a geometric mean titre of 79.6 mIU/mL. Seroprotection rate in all 109 children was 86.2%. Conclusion: Single dose of live attenuated hepatitis A vaccine in Indian children demonstrated robust immunogenicity at 15 years post vaccination.


Poor in-utero growth, reduced beta cell secretion and high plasma glucose in childhood are harbingers of glucose intolerance in young Indians

November 2020

·

22 Reads

·

1 Citation

Background India is the world’s paradoxical double capital for early life undernutrition and type 2 diabetes. The Pune Maternal Nutrition Study (PMNS) birth cohort offered a unique opportunity to investigate childhood growth and glucose-insulin metabolism as precursors to glucose intolerance in young adulthood. Methods PMNS is a community-based pre-conceptional birth cohort established in 1993, with serial information on parents, and on their children through pregnancy, childhood and adolescence. We compared the children’s growth and glucose-insulin indices between those who were and were not glucose intolerant at age 18 years (ADA criteria). We developed a prediction model for 18-year glucose intolerance and replicated it in two other cohorts (Extended PMNS and Pune Children’s Study). Findings At age 18 years (N=619) 37% men and 20% women were glucose intolerant even though 48% were underweight (BMI<18.5 kg/m ² ). Glucose intolerant participants were shorter at birth, and had lower insulin secretion (both sexes) and insulin insensitivity (men) in childhood than those with normal glucose tolerance. Fasting plasma glucose (FPG) concentrations at 6- and 12-years of age strongly predicted glucose intolerance at 18 years. The risk was 2.5 times higher in the highest compared to the lowest quintile at 6 years, and 4.5 times at 12 years. Comparable findings were seen in the other cohorts. Mothers of glucose intolerant participants had higher glycemia in pregnancy. Interpretation Glucose intolerance in young rural Indians can be traced to linear growth faltering in-utero , reduced beta-cell secretion and higher glycemia since childhood. Our findings mandate a strategy for diabetes prevention starting much earlier than the current practice.


Relationship of height and components of height to body composition
Relationship of components of height to cardiovascular disease risk factors
Do components of adult height predict body composition and cardiometabolic risk in a young adult South Asian Indian population? Findings from a hospital-based cohort study in Pune, India: The PUNE Children's Study

August 2020

·

51 Reads

·

4 Citations

BMJ Open

Objectives: we investigated whether the relationship between components of height and CVD risk may be explained by body composition. We also examined relationships between parental heights and offspring CVD risk. Design: a cohort study using cross-sectional data. Setting: a secondary care hospital setting in Pune, India Participants: we studied 357 young adults and their parents in the Pune Children’s Study. Primary and secondary outcomes: We measured weight, total height, leg length, sitting height, plasma glucose, insulin and lipids, and blood pressure. Total and regional lean and fat mass were measured by dual x-ray absorptiometry. Results: leg length was inversely, and sitting height directly related to BMI. Total height and leg length were directly related to lean mass while sitting height was directly related to both lean and fat mass. Leg length was inversely related to systolic blood pressure and 120-minute glucose, independent of lean and fat mass. Sitting height was directly related to systolic blood pressure and triglycerides; these relationships were attenuated on adjustment for lean and fat mass. When examined simultaneously, greater leg length was protective and greater sitting height was associated with a more detrimental CVD risk profile. Conclusions: shorter adult leg length and greater sitting height are associated with a more adverse CVD risk factor profile. The mechanisms need further study but our findings suggest a role for lean and fat mass. <br/


Birth weight, childhood and adolescent growth and diabetes risk factors in 21-year old Asian Indians: The Pune Children’s Study

August 2020

·

42 Reads

·

10 Citations

Journal of Developmental Origins of Health and Disease

Our objective was to investigate associations of body size (birth weight and body mass index (BMI)) and growth in height, body fat (adiposity) and lean mass during childhood and adolescence, with risk markers for diabetes in young South Asian adults. We studied 357 men and women aged 21 years from the Pune Children’s Study birth cohort. Exposures were 1) birth weight, 21-year BMI, both of these mutually adjusted, and their interaction, and 2) uncorrelated conditional measures of growth in height and proxies for gain in adiposity and lean mass from birth to 8 years (childhood) and 8 to 21 years (adolescence) constructed from birth weight, and weight, height, and skinfolds at 8 and 21 years. Outcomes were plasma glucose and insulin concentrations during an oral glucose tolerance test and derived indices of insulin resistance and secretion. Higher 21-year BMI was associated with higher glucose and insulin concentrations and insulin resistance, and lower disposition index. After adjusting for 21-year BMI, higher birth weight was associated with lower 120-min glucose and insulin resistance, and higher disposition index. In the growth analysis, greater adiposity gain during childhood and adolescence was associated with higher glucose, insulin and insulin resistance, and lower disposition index, with stronger effects from adolescent gain. Greater childhood lean gain and adolescent height gain were associated with lower 120-min glucose and insulin. Consistent with other studies, lower birth weight and higher childhood weight gain increases diabetes risk. Disaggregation of weight gain showed that greater child/adolescent adiposity gain and lower lean and height gain may increase risk.



Figure 1. Participant flow in the study
Baseline characteristics of the Pune (intervention) group and Nasik (control) group at the start of the trial in 2006
Characteristics of the Pune (intervention) group in the 8 th or 9 th standard in 2011 with the Pune (control) group in the 8 th or 9 th standard in 2006
Effectiveness of a 5-year school-based intervention programme to reduce adiposity and improve fitness and lifestyle in Indian children; the SYM-KEM study

September 2015

·

446 Reads

·

42 Citations

Archives of Disease in Childhood

Design Non-randomised non-blinded school-based intervention study. Setting Two schools in the cities of Pune and Nasik, India. Participants The intervention group comprised children attending a Pune school from 7–10 years until 12–15 years of age. Two control groups comprised children of the same age attending a similar school in Nasik, and children in the Pune intervention school but aged 12–15 years at the start of the study. Intervention A 5-year multi-intervention programme, covering three domains: physical activity, diet and general health, and including increased extracurricular and intracurricular physical activity sessions; daily yoga-based breathing exercises; making physical activity a ‘scoring’ subject; nutrition education; healthier school meals; removal of fast-food hawkers from the school environs; and health and nutrition education for teachers, pupils and families. Main outcome measures Body mass index (BMI), waist circumference, physical fitness according to simple tests of strength, flexibility and endurance; diet; and lifestyle indicators (time watching TV, studying and actively playing). Results After 5 years the intervention children were fitter than controls in running, long jump, sit-up and push-up tests (p<0.05 for all). They reported spending less time sedentary (watching TV and studying), more time actively playing and eating fruit more often (p<0.05). The intervention did not reduce BMI or the prevalence of overweight/obesity, but waist circumference was lower than in the Pune controls (p=0.004). Conclusions It was possible to achieve multiple health-promoting changes in an academically competitive Indian school. These changes resulted in improved physical fitness, but had no impact on the children's BMI or on the prevalence of overweight/obesity.


Figure 1 of 1
Long-term Immunogenicity of Single Dose of Live Attenuated Hepatitis A Vaccine in Indian Children

September 2015

·

232 Reads

·

12 Citations

Indian Pediatrics

Objectives: To assess immunogenicity of a single dose of live attenuated hepatitis A vaccine in Indian children, ten years after immunization. Methods: Of 143 children vaccinated in 2004, 121 children were evaluated in 2014, clinically and for anti-HAV antibodies. Results: 13 children were early vaccine failures who received two doses of HAV vaccine subsequently. 106 (98%) of 108 remaining children had seroprotective levels with a geometric mean titer of 100.5 mIU/mL. On analysis of all 121 children, the immunogenicity was 87.6%. Conclusion: Single dose of live attenuated hepatitis A vaccine provides long-term immunity in Indian children.


Table 1 Characteristics of the participants at 8 and 21 years of age 
Table 2 Associations of 8 year and 21 year glucose and insulin variables 
Table 4 RR, sensitivity, specificity, predictive values and ROC AUC of being in the upper quartile of CVD risk factors at 21 years if in the upper quartile of HOMA-IR at 8 years 
Higher glucose, insulin and insulin resistance (HOMA-IR) in childhood predict adverse cardiovascular risk in early adulthood: the Pune Children’s Study

May 2015

·

172 Reads

·

57 Citations

Diabetologia

The Pune Children's Study aimed to test whether glucose and insulin measurements in childhood predict cardiovascular risk factors in young adulthood. We followed up 357 participants (75% follow-up) at 21 years of age who had undergone detailed measurements at 8 years of age (glucose, insulin, HOMA-IR and other indices). Oral glucose tolerance, anthropometry, plasma lipids, BP, carotid intima-media thickness (IMT) and arterial pulse wave velocity (PWV) were measured at 21 years. Higher fasting glucose, insulin and HOMA-IR at 8 years predicted higher glucose, insulin, HOMA-IR, BP, lipids and IMT at 21 years. A 1 SD change in 8 year variables was associated with a 0.10-0.27 SD change at 21 years independently of obesity/adiposity at 8 years of age. A greater rise in glucose-insulin variables between 8 and 21 years was associated with higher cardiovascular risk factors, including PWV. Participants whose HOMA-IR measurement remained in the highest quartile (n = 31) had a more adverse cardiovascular risk profile compared with those whose HOMA-IR measurement remained in the lowest quartile (n = 28). Prepubertal glucose-insulin metabolism is associated with adult cardiovascular risk and markers of atherosclerosis. Our results support interventions to improve glucose-insulin metabolism in childhood to reduce cardiovascular risk in later life.


Citations (57)


... Those with prediabetes and healthy controls were invited from relatives or friends accompanying patients, as well as from within the Pune Maternal Nutrition Study (PMNS) longitudinal cohort. [13] Independent recruitments were performed for inter-rater reliability and sensitivity-to change studies, and these are described under those headings (reliability cohort and responsiveness cohort, respectively). ...

Reference:

Prospective validation of mean metacarpophalangeal joint extension as a measure of flexor compartment fibrotic inflammation in diabetes-related hand manifestations
Poor In Utero Growth, and Reduced β-Cell Compensation and High Fasting Glucose From Childhood, Are Harbingers of Glucose Intolerance in Young Indians

Diabetes Care

... Like inactivated vaccines, live attenuated hepatitis-A vaccines also offer a long duration of protection. After a single dose of H2 strain-based live attenuated vaccine in an endemic region, at least 15-17 years of protection has been demonstrated along with the persistence of immune memory [18][19][20]. ...

Long term Immunogenicity of Single Dose of Live Attenuated Hepatitis A Vaccine in Indian Children — Results of 15-Year Follow-up
  • Citing Article
  • February 2021

Indian Pediatrics

... [12] At 18 years of age, 18% of women in the rural Pune Maternal Nutrition Study were pre-diabetic based on ADA 2014 criteria. [13] These women had higher glucose and lower disposition index from childhood and early adolescence (6, 12 years of age) [18] Similarly, diabetes at 40 years of age was predicted by higher childhood glucose in the cohorts in the i3C study. [19] A retrospective search of records of women diagnosed with 'GDM' in the Kaiser Permanente clinic showed higher glucose and lipid abnormalities years before pregnancy. ...

Poor in-utero growth, reduced beta cell secretion and high plasma glucose in childhood are harbingers of glucose intolerance in young Indians
  • Citing Preprint
  • November 2020

... Although leg length-adult health associations have been similarly documented in differentially affluent populations [48], there has been some inconsistency across Figure 3. Schematic diagram of how tibia/leg length, organs and other variables might interact to influence metabolic and reproductive health and fitness for mothers and their offspring. Some of the associations shown may demonstrate greater plasticity, while others may demonstrate a stronger genetic component countries [49] and additional work is needed to understand global variation in the manifestation of these associations and their potential causes. Finally, our data do not allow us to disentangle the degree to which observed associations are influenced by plasticity, genetics, epigenetics, other factors or a combination of factors, and this is clearly a critical question for further research. ...

Do components of adult height predict body composition and cardiometabolic risk in a young adult South Asian Indian population? Findings from a hospital-based cohort study in Pune, India: The PUNE Children's Study

BMJ Open

... However, only few studies have been conducted regarding the relation between obesity and overweight and their factors in adolescents and their HL level [14,22,23]. To our knowledge, there is no research regarding the association between adolescents' HL and device-measured body composition variables which are considered to be more valid indicators of adiposity in adolescents than BMI [24][25][26][27][28]. While BMI is commonly used as a measure of body fatness, to evaluate underweight, overweight and obesity [29], it has serious limitations for characterization of adiposity, particularly in school-aged children [30,31] where children with the same BMI may have very different fat and fatfree mass distribution [32]. ...

Birth weight, childhood and adolescent growth and diabetes risk factors in 21-year old Asian Indians: The Pune Children’s Study
  • Citing Article
  • August 2020

Journal of Developmental Origins of Health and Disease

... Hunziker [2] reported that in metal tanks, the surface of metal ions such as copper and iron may breakdown the unsaturated lipids into oxidation products during storage or transportation of milk resulting in undesirable flavors. Research by Rice [3] and Tanner [4] showed that copper contamination, resulting from contact of the milk with copper in vacuum pans or bottle caps, may cause tallowness in sweetened condensed milk. Off flavors in stored butters, identified as tallowy, oily, and fishy flavors, are considered to be caused by oxidation [5] [6]. ...

Early introduction of copper contaminated feeds as a possible cause of ICC
  • Citing Article
  • January 1983

The Lancet

... Since the demonstration of an association between birth size and risk of type 2 diabetes and cardiovascular disease (CVD) by Hales et al [1], a number of birth cohorts have been established to document the life course evolution of chronic non-communicable diseases2345. Some of these cohorts showed an inverse association between birthweight and childhood risk factors for type 2 diabetes and CVD [6, 7]. Few of these prospective birth cohorts have reported follow-ups extending into adult life. ...

Leptin and insulin resistance syndrome (IRS) in 8 year old Indian children
  • Citing Conference Paper
  • June 2003

Pediatric Research

... The use of egg protein is more convenient, in terms of both availability and cost, compared with chicken meat or fish in Bangladesh where food preservation by refrigeration is unavailable to the majority of the population. The use of mung beans (Phaseolus aureus) or lentils (Lens esculenta) as protein sources in diets of patients with persistent diarrhoea in India has been reported (Bhave et al. 1983), but its cost is high in Bangladesh and its success was unremarkable in our younger group of patients. A recent report has suggested that patients with persistent diarrhoea associated with mucosal injury have significantly better repair with Zn supplementation (S. ...

Protracted diarrhea and its management
  • Citing Article
  • January 1983

... Wiele obserwacji wskazuje, iż pacjenci z niedoborami odporności znajdują się w grupie ryzyka rozwoju schorzeń o podłożu autoimmunizacyjnym. Dotyczy to zwłaszcza pacjentów z CVID oraz niedoborem IgG i IgA [4,55,57,69,79,88,98]. Istnieje wiele koncepcji próbujących tłumaczyć to zjawisko. ...

ALTERED PATTERNS OF SECRETION OF MONOMERIC IgA AND IgA SUBCLASS 1 BY INTESTINAL MONONUCLEAR CELLS IN INFLAMMATORY BOWEL DISEASE
  • Citing Article
  • January 1987

Journal of Pediatric Gastroenterology and Nutrition

... Further, providing a booklet with recipes containing a variety of healthy breakfast foods has been shown to be effective [9,16,18]. These findings match those observed in earlier studies [21,22]. ...

Effectiveness of a 5-year school-based intervention programme to reduce adiposity and improve fitness and lifestyle in Indian children; the SYM-KEM study

Archives of Disease in Childhood