{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T13:55:13Z","timestamp":1793886913249,"version":"4.8.0"},"reference-count":78,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2020,11,19]],"date-time":"2020-11-19T00:00:00Z","timestamp":1605744000000},"content-version":"unspecified","delay-in-days":18,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Bloomsbury Colleges PhD Studentship","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["083707"],"award-info":[{"award-number":["083707"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To explore associations of night-time light intensity (NTLI), a novel proxy for continuous urbanisation levels, with mean systolic blood pressure (SBP), body mass index (BMI), fasting serum low-density lipoprotein (LDL) and fasting plasma glucose (FPG), among adults in early-stage urbanisation in Telangana, South India.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cross-sectional analysis of the third wave of the Andhra Pradesh Children and Parents Study cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>28 villages representing a continuum of urbanisation levels, ranging from rural settlement to medium-sized town in Telangana, South India.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Data were available from 6944 participants, 6236 of whom were eligible after excluding pregnant women, participants younger than 18 years of age and participants missing data for age. Participants were excluded if they did not provide fasting blood samples, had implausible or missing outcome values, were medicated for hypertension or diabetes or had triglyceride levels invalidating derived LDL. The analysis included 5924 participants for BMI, 5752 participants for SBP, 5287 participants for LDL and 5328 participants for FPG.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Increasing NTLI was positively associated with mean BMI, SBP and LDL but not FPG. Adjusted mean differences across the range of village-level NTLI were 1.0\u2009kg\/m<jats:sup>2<\/jats:sup> (95%\u2009CI 0.01 to 1.9) for BMI; 4.2\u2009mm Hg (95%\u2009CI 1.0 to 7.4) for SBP; 0.3\u2009mmol\/L (95%\u2009CI \u22120.01 to 0.7) for LDL; and \u22120.01\u2009mmol\/L (95%\u2009CI \u22120.4 to 0.4) for FPG. Associations of NTLI with BMI and SBP were stronger in older age groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The association of NTLI with cardiovascular disease (CVD) risk factors identify NTLI as a potentially important tool for exploring urbanisation-related health. Consistent associations of moderate increases in urbanisation levels with important CVD risk factors warrant prevention strategies to curb expected large public health impacts from continued and rapid urbanisation in India.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2019-036213","type":"journal-article","created":{"date-parts":[[2020,11,20]],"date-time":"2020-11-20T08:10:49Z","timestamp":1605859849000},"page":"e036213","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":37,"title":["Is night-time light intensity associated with cardiovascular disease risk factors among adults in early-stage urbanisation in South India? A cross-sectional study of the Andhra Pradesh Children and Parents Study"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1517-6159","authenticated-orcid":false,"given":"Tina Bonde","family":"Sorensen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Gregson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhavani","family":"Shankar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan D","family":"Dangour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay","family":"Kinra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,11,19]]},"reference":[{"key":"2020112000100614000_10.11.e036213.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32804-0"},{"key":"2020112000100614000_10.11.e036213.2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.008729"},{"key":"2020112000100614000_10.11.e036213.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61188-9"},{"key":"2020112000100614000_10.11.e036213.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1311890"},{"key":"2020112000100614000_10.11.e036213.5","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2007.132951"},{"key":"2020112000100614000_10.11.e036213.6","first-page":"217","article-title":"Premature coronary artery disease in Indians and its associated risk factors","volume":"1","author":"Sharma","year":"2005","journal-title":"Vasc Health Risk Manag"},{"key":"2020112000100614000_10.11.e036213.7","first-page":"8","article-title":"Premature coronary heart disease risk factors & reducing the CHD burden in India","volume":"134","author":"Prabhakaran","year":"2011","journal-title":"Indian J Med Res"},{"key":"2020112000100614000_10.11.e036213.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ehb.2013.11.003"},{"key":"2020112000100614000_10.11.e036213.9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1753-4887.2011.00456.x"},{"key":"2020112000100614000_10.11.e036213.10","doi-asserted-by":"publisher","DOI":"10.1007\/s11524-008-9325-4"},{"key":"2020112000100614000_10.11.e036213.11","doi-asserted-by":"publisher","DOI":"10.1093\/jurban\/79.suppl_1.S1"},{"key":"2020112000100614000_10.11.e036213.12","doi-asserted-by":"publisher","DOI":"10.1078\/1438-4639-00223"},{"key":"2020112000100614000_10.11.e036213.13","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwr053"},{"key":"2020112000100614000_10.11.e036213.14","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0014822"},{"key":"2020112000100614000_10.11.e036213.15","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.09.065847"},{"key":"2020112000100614000_10.11.e036213.16","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1093\/ajcn\/84.3.633","article-title":"Patterns, distribution, and determinants of under- and overnutrition: a population-based study of women in India","volume":"84","author":"Subramanian","year":"2006","journal-title":"Am J Clin Nutr"},{"key":"2020112000100614000_10.11.e036213.17","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyh044"},{"key":"2020112000100614000_10.11.e036213.18","doi-asserted-by":"publisher","DOI":"10.1007\/s11524-011-9586-1"},{"key":"2020112000100614000_10.11.e036213.19","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/31.1.218"},{"key":"2020112000100614000_10.11.e036213.20","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.300.6730.967"},{"key":"2020112000100614000_10.11.e036213.21","doi-asserted-by":"publisher","DOI":"10.1186\/1478-7954-4-5"},{"key":"2020112000100614000_10.11.e036213.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2006.11.019"},{"key":"2020112000100614000_10.11.e036213.23","unstructured":"WHO . Knowledge network on urban settings, our cities, our health, our future. Kobe City, Japan: World Health Organization, 2008."},{"key":"2020112000100614000_10.11.e036213.24","doi-asserted-by":"crossref","first-page":"3207","DOI":"10.3390\/s140203207","article-title":"Mapping and evaluating the urbanization process in northeast China using DMSP\/OLS nighttime light data","volume":"14","author":"Yi","year":"2014","journal-title":"Sensors"},{"key":"2020112000100614000_10.11.e036213.25","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.rse.2012.04.018","article-title":"Quantitative estimation of urbanization dynamics using time series of DMSP\/OLS nighttime light data: A comparative case study from China\u2019s cities","volume":"124","author":"Ma","year":"2012","journal-title":"Remote Sens Environ"},{"key":"2020112000100614000_10.11.e036213.26","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/S0034-4257(97)00046-1","article-title":"A technique for using composite DMSP\/OLS \u201cCity Lights\u201d satellite data to map urban area","volume":"61","author":"L.Imhoff","year":"1997","journal-title":"Remote Sens Environ"},{"key":"2020112000100614000_10.11.e036213.27","doi-asserted-by":"crossref","first-page":"2320","DOI":"10.1016\/j.rse.2011.04.032","article-title":"Mapping urbanization dynamics at regional and global scales using multi-temporal DMSP\/OLS nighttime light data","volume":"115","author":"Zhang","year":"2011","journal-title":"Remote Sens Environ"},{"key":"2020112000100614000_10.11.e036213.28","doi-asserted-by":"crossref","unstructured":"Zhang Q , Pandey B , Seto KC . A robust method to generate a consistent time series from DMSP\/OLS nighttime light data. IEEE Transactions on geoscience and remote sensisng, 2016.","DOI":"10.1109\/TGRS.2016.2572724"},{"key":"2020112000100614000_10.11.e036213.29","unstructured":"Andhra Pradesh Children and Parents Study (APCAPS) . Andhra Pradesh children and parents study: London school of hygiene and tropical medicine, 2018. Available: http:\/\/apcaps.lshtm.ac.uk\/ [Accessed 12 Jul 2018]."},{"key":"2020112000100614000_10.11.e036213.30","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyt128"},{"key":"2020112000100614000_10.11.e036213.31","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.a605"},{"key":"2020112000100614000_10.11.e036213.32","doi-asserted-by":"crossref","unstructured":"National Cholesterol Education Program, National Heart L, and Blood Institute, National Institutes of Health . Third report of the National cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). NIH Publication 2002.","DOI":"10.1001\/jama.285.19.2486"},{"key":"2020112000100614000_10.11.e036213.33","unstructured":"National Oceanic and Atmospheric Administration National Centers for Environmental Information . Earth observation group (EOG). defense Meteorological satellite program (DMSP) data Archive, research, and products: National oceanic and atmospheric administration. Available: https:\/\/www.ngdc.noaa.gov\/eog\/dmsp\/dmsp.html [Accessed 13 Jul 2020]."},{"key":"2020112000100614000_10.11.e036213.34","unstructured":"Google Earth Engine . Earth engine data catalog. DMSP OLS: nighttime lights time series version 4, defense Meteorological program operational Linescan system Na. Available: https:\/\/developers.google.com\/earth-engine\/datasets\/catalog\/NOAA_DMSP-OLS_NIGHTTIME_LIGHTS [Accessed 22 Oct 2019]."},{"key":"2020112000100614000_10.11.e036213.35","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/S0924-2716(01)00040-5","article-title":"Night-time lights of the world: 1994\u20131995","volume":"56","author":"Elvidge","year":"2001","journal-title":"ISPRS J Photogram Remote Sens"},{"key":"2020112000100614000_10.11.e036213.36","unstructured":"Organisation for Economic Co-operation and Development . Glossary of statistical terms: urbanization, 2003. Available: https:\/\/stats.oecd.org\/glossary\/detail.asp?ID=2819"},{"key":"2020112000100614000_10.11.e036213.37","unstructured":"United Nations DoEaSA, Population Division . World urbanization prospects: the 2018 revision, methodology. New York: United Nation, 2018."},{"key":"2020112000100614000_10.11.e036213.38","unstructured":"International Organization for Migration un Migration . World migration report 2020. Geneva, 2019."},{"key":"2020112000100614000_10.11.e036213.39","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31679-8"},{"key":"2020112000100614000_10.11.e036213.40","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/18.6.499"},{"key":"2020112000100614000_10.11.e036213.41","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1016\/j.puhe.2014.06.005","article-title":"Socio-economic position and cardiovascular risk in rural Indian adolescents: evidence from the Andhra Pradesh children and parents study (APCAPS)","volume":"128","author":"Kinra","year":"2014","journal-title":"Public Health"},{"key":"2020112000100614000_10.11.e036213.42","doi-asserted-by":"publisher","DOI":"10.1093\/restud\/rdt044"},{"key":"2020112000100614000_10.11.e036213.43","unstructured":"Tacoli C . Urbanization and emerging population issues working paper 7. urbanization, gender and urban poverty: paid work and unpaid carework in the city: United nations population fund, International Institute for environment and development. 48, 2012."},{"key":"2020112000100614000_10.11.e036213.44","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1007\/s13679-016-0187-x","article-title":"Obesity among young adults in developing countries: a systematic overview","volume":"5","author":"Poobalan","year":"2016","journal-title":"Curr Obes Rep"},{"key":"2020112000100614000_10.11.e036213.45","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000268"},{"key":"2020112000100614000_10.11.e036213.46","doi-asserted-by":"crossref","first-page":"301","DOI":"10.3109\/07420528.2016.1143480","article-title":"Outdoor artificial light at night, obesity, and sleep health: cross-sectional analysis in the KoGES study","volume":"33","author":"Koo","year":"2016","journal-title":"Chronobiol Int"},{"key":"2020112000100614000_10.11.e036213.47","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1038\/ijo.2015.255","article-title":"Does artificial light-at-night exposure contribute to the worldwide obesity pandemic?","volume":"40","author":"Rybnikova","year":"2016","journal-title":"Int J Obes"},{"key":"2020112000100614000_10.11.e036213.48","doi-asserted-by":"crossref","DOI":"10.1289\/EHP541","article-title":"Associations between Greenness, Impervious surface area, and nighttime lights on biomarkers of vascular aging in Chennai, India","volume":"125","author":"Lane","year":"2017","journal-title":"Environ Health Perspect"},{"key":"2020112000100614000_10.11.e036213.49","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-012-2697-8"},{"key":"2020112000100614000_10.11.e036213.50","doi-asserted-by":"publisher","DOI":"10.2337\/dc07-1207"},{"key":"2020112000100614000_10.11.e036213.51","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a009018"},{"key":"2020112000100614000_10.11.e036213.52","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1093\/ajcn\/81.3.714","article-title":"Overweight exceeds underweight among women in most developing countries","volume":"81","author":"Mendez","year":"2005","journal-title":"Am J Clin Nutr"},{"key":"2020112000100614000_10.11.e036213.53","doi-asserted-by":"publisher","DOI":"10.1080\/07420520802694020"},{"key":"2020112000100614000_10.11.e036213.54","doi-asserted-by":"crossref","first-page":"1294","DOI":"10.3109\/07420528.2015.1073158","article-title":"Effects of artificial light at night on human health: a literature review of observational and experimental studies applied to exposure assessment","volume":"32","author":"Cho","year":"2015","journal-title":"Chronobiol Int"},{"key":"2020112000100614000_10.11.e036213.55","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1080\/19338244.2016.1169980","article-title":"Is prostate cancer incidence worldwide linked to artificial light at night exposures? review of earlier findings and analysis of current trends","volume":"72","author":"Rybnikova","year":"2017","journal-title":"Arch Environ Occup Health"},{"key":"2020112000100614000_10.11.e036213.56","doi-asserted-by":"publisher","DOI":"10.1080\/07420520801921572"},{"key":"2020112000100614000_10.11.e036213.57","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0000000000000137"},{"key":"2020112000100614000_10.11.e036213.58","doi-asserted-by":"crossref","DOI":"10.1289\/EHP935","article-title":"Outdoor light at night and breast cancer incidence in the nurses' health study II","volume":"125","author":"James","year":"2017","journal-title":"Environ Health Perspect"},{"key":"2020112000100614000_10.11.e036213.59","doi-asserted-by":"publisher","DOI":"10.1007\/s10552-010-9624-4"},{"key":"2020112000100614000_10.11.e036213.60","doi-asserted-by":"publisher","DOI":"10.1186\/1476-072X-12-23"},{"key":"2020112000100614000_10.11.e036213.61","doi-asserted-by":"crossref","first-page":"757","DOI":"10.3109\/07420528.2015.1043369","article-title":"Artificial light at night (alan) and breast cancer incidence worldwide: a revisit of earlier findings with analysis of current trends","volume":"32","author":"Rybnikova","year":"2015","journal-title":"Chronobiol Int"},{"key":"2020112000100614000_10.11.e036213.62","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.lfs.2017.02.008","article-title":"Association between light at night, melatonin secretion, sleep deprivation, and the internal clock: health impacts and mechanisms of circadian disruption","volume":"173","author":"Touitou","year":"2017","journal-title":"Life Sci"},{"key":"2020112000100614000_10.11.e036213.63","doi-asserted-by":"crossref","unstructured":"Government of India . Census of India 2001. data highlights. migration tables (D1, D1 (appendix), D2 and D3 tables, 2001.","DOI":"10.1016\/S1520-765X(01)90111-7"},{"key":"2020112000100614000_10.11.e036213.64","unstructured":"Tacoli C . Urbainzation, gender and poverty. New York, NY: United Nations Population Fund, International Institute for Environment and Development, 2012."},{"key":"2020112000100614000_10.11.e036213.65","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2013.06.030"},{"key":"2020112000100614000_10.11.e036213.66","doi-asserted-by":"publisher","DOI":"10.1079\/PHN2001291"},{"key":"2020112000100614000_10.11.e036213.67","doi-asserted-by":"crossref","DOI":"10.1186\/1476-072X-12-39","article-title":"A cross-sectional analysis of light at night, neighborhood sociodemographics and urinary 6-sulfatoxymelatonin concentrations: implications for the conduct of health studies","volume":"12","author":"Hurley","year":"2013","journal-title":"Int J Health Geogr"},{"key":"2020112000100614000_10.11.e036213.68","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwu117"},{"key":"2020112000100614000_10.11.e036213.69","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwu119"},{"key":"2020112000100614000_10.11.e036213.70","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyp178"},{"key":"2020112000100614000_10.11.e036213.71","doi-asserted-by":"crossref","first-page":"779","DOI":"10.3109\/07420528.2014.900501","article-title":"Association between light exposure at night and nighttime blood pressure in the elderly independent of nocturnal urinary melatonin excretion","volume":"31","author":"Obayashi","year":"2014","journal-title":"Chronobiol Int"},{"key":"2020112000100614000_10.11.e036213.72","doi-asserted-by":"crossref","first-page":"461","DOI":"10.3109\/07420528.2013.840647","article-title":"Effect of exposure to evening light on sleep initiation in the elderly: a longitudinal analysis for repeated measurements in home settings","volume":"31","author":"Obayashi","year":"2014","journal-title":"Chronobiol Int"},{"key":"2020112000100614000_10.11.e036213.73","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k3794"},{"key":"2020112000100614000_10.11.e036213.74","unstructured":"WHO . Urbanization and health, 2019. Available: https:\/\/www.who.int\/bulletin\/volumes\/88\/4\/10-010410\/en\/ [Accessed 16 Jul 2019]."},{"key":"2020112000100614000_10.11.e036213.75","doi-asserted-by":"crossref","unstructured":"Vlahov D , Freudenberg N , Proietti F , et al . A conceptual framework for organizing determinants of urban health. thematic paper 1 for knowledge network on urban settings who centre for health development, 2008.","DOI":"10.1007\/s11524-007-9169-3"},{"key":"2020112000100614000_10.11.e036213.76","doi-asserted-by":"publisher","DOI":"10.1098\/rstb.2010.0136"},{"key":"2020112000100614000_10.11.e036213.77","unstructured":"Estache A , Garsous G . The scope for an impact of infrastructure investments on jobs in developing countries international finance Corporation, 2012."},{"key":"2020112000100614000_10.11.e036213.78","doi-asserted-by":"crossref","first-page":"7","DOI":"10.12927\/whp.2014.23722","article-title":"Urbanization and health in developing countries: a systematic review","volume":"15","author":"Eckert","year":"2014","journal-title":"World Health Popul"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2019-036213","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,20]],"date-time":"2020-11-20T08:12:23Z","timestamp":1605859943000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2019-036213"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11]]},"references-count":78,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2020,11,19]]},"published-print":{"date-parts":[[2020,11]]}},"alternative-id":["10.1136\/bmjopen-2019-036213"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2019-036213","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11]]}}}