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Chen X, Yang W. Epidemic trend of diabetes in China: For the Xiaoren Pan Distinguished Research Award in AASD. J Diabetes Investig 2014; 5:478-81. [PMID: 25411612 PMCID: PMC4188102 DOI: 10.1111/jdi.12254] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 05/23/2014] [Accepted: 05/26/2014] [Indexed: 01/03/2023] Open
Abstract
Epidemiology is now well recognized as the foundation of public health. The Da Qing study in 1986 was the first milestone study to show that lifestyle intervention can prevent or delay the onset of diabetes. The lead investigator of that study, Professor Xiaoren Pan, is regarded as the forerunner epidemiologist for diabetes in China and even in Asia. In 2006, study participants were followed up to assess the long‐term effects of the interventions after 20 years. As compared with the control group, those in the combined lifestyle intervention group had a 51% lower incidence of diabetes during the active intervention period and a 43% lower incidence over the 20‐year period, adjusted by age. Recently, the National Diabetes Prevalence Survey in China was carried out from 2007 to 2008. The data from that study showed that the prevalence of diabetes in Chinese adults was 9.7%, and the increased rate of diabetes prevalence in China exceeded the International Diabetes Federation estimation. Very recently, we have reported that acarbose is a viable choice for initial therapy in Chinese patients newly diagnosed with type 2 diabetes who have a lower body mass index and exaggerated postprandial glucose excursion compared with Caucasian patients. We are expecting more contributions from epidemiology to the study of diabetes.
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Affiliation(s)
- Xiaoping Chen
- Department of Endocrinology China-Japan Friendship Hospital Beijing China
| | - Wenying Yang
- Department of Endocrinology China-Japan Friendship Hospital Beijing China
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552
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553
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Seino Y, Sasaki T, Fukatsu A, Ubukata M, Sakai S, Samukawa Y. Dose-finding study of luseogliflozin in Japanese patients with type 2 diabetes mellitus: a 12-week, randomized, double-blind, placebo-controlled, phase II study. Curr Med Res Opin 2014; 30:1231-44. [PMID: 24673496 DOI: 10.1185/03007995.2014.909390] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Luseogliflozin is a selective sodium glucose cotransporter 2 inhibitor under development for the treatment of type 2 diabetes mellitus (T2DM). This phase II study was conducted to confirm the efficacy and safety of luseogliflozin monotherapy at doses of up to 10 mg in Japanese patients with T2DM. PATIENTS AND METHODS Patients with hemoglobin A1c (HbA1c) of 6.9-10.5% on diet therapy were randomized in a double-blind manner to treatment with 1, 2.5, 5, or 10 mg luseogliflozin or placebo for 12 weeks (n = 56, 56, 54, 58, and 58, respectively). TRIAL REGISTRATION Japan Pharmaceutical Information Center (identifier: Japic CTI-101191). MAIN OUTCOME MEASURES The primary endpoint was the change in HbA1c from baseline to the end of treatment. Other endpoints included fasting plasma glucose (FPG), postprandial plasma glucose (PPG) and body weight. Adverse events were recorded throughout the study. RESULTS HbA1c decreased significantly at the end of treatment in the 1, 2.5, 5, and 10 mg luseogliflozin groups compared with placebo (-0.29, -0.39, -0.46, and -0.43%, respectively, versus +0.22%; all P < 0.001), as did FPG and PPG (all P < 0.001). Body weight also decreased significantly in all luseogliflozin groups compared with placebo (all P < 0.001). The incidence rates of adverse events (40.0-50.0%) were not significantly different among the five groups. The overall incidence of hypoglycemia was low. Limitations of this study include the short study duration and the relatively small sample size. CONCLUSIONS In Japanese patients with T2DM, luseogliflozin was well tolerated, improved glycemic control, and reduced body weight over 12 weeks of treatment at all tested doses. Doses of ≥2.5 mg achieved similar improvements in glycemic control.
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554
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Yermachenko A, Dvornyk V. Nongenetic determinants of age at menarche: a systematic review. BIOMED RESEARCH INTERNATIONAL 2014; 2014:371583. [PMID: 25050345 PMCID: PMC4094877 DOI: 10.1155/2014/371583] [Citation(s) in RCA: 113] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 05/12/2014] [Accepted: 06/06/2014] [Indexed: 02/04/2023]
Abstract
BACKGROUND The acceleration of pubertal development is an important medical and social problem, as it may result in increased morbidity and mortality in later life. This systematic review summarizes relevant data about nongenetic factors, which contribute to age at menarche (AAM), and suggests those which may be the most important. METHODS The available literature from 1980 till July 2013 was searched using PubMed and Google Scholar databases. Finally, 154 papers were selected for the analysis. RESULTS Environmental factors, which may affect AAM, vary in populations of different ethnicity. The prenatal, infancy, and early childhood periods are the most susceptible to these factors. Body weight, high animal protein intake, family stressors (e.g., single parenting), and physical activity seem to influence AAM in most populations. CONCLUSIONS The data about influence of nongenetic factors on AAM are still inconsistent. The factors affecting prenatal and early childhood growth seem to have a larger effect on further sexual maturation. Further studies are needed in order to validate the association between other environmental determinants and AAM in different ethnical groups.
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Affiliation(s)
- Anna Yermachenko
- School of Biological Sciences, The University of Hong Kong, Pokfulam Road, Pokfulam, Hong Kong
| | - Volodymyr Dvornyk
- School of Biological Sciences, The University of Hong Kong, Pokfulam Road, Pokfulam, Hong Kong
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555
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Kuwahara K, Uehara A, Kurotani K, Pham NM, Nanri A, Yamamoto M, Mizoue T. Association of cardiorespiratory fitness and overweight with risk of type 2 diabetes in Japanese men. PLoS One 2014; 9:e98508. [PMID: 24896640 PMCID: PMC4045757 DOI: 10.1371/journal.pone.0098508] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 05/02/2014] [Indexed: 11/19/2022] Open
Abstract
Objective Existing evidence is limited on what extent fitness can counterbalance type 2 diabetes mellitus (T2DM) risk associated with obesity. We investigated the joint association of weight status and estimated VO2max, a marker of fitness, with the risk of developing T2DM among Japanese men using haemoglobin A1c and fasting glucose criterion. Methods The present study included 3,523 male employees aged 18–61 years without diabetes who provided health check-up and fitness data in Japan in 2003–2005. We calculated hazard ratios and 95% confidence intervals for incident diabetes using the Cox regression model. Results During a mean follow-up of 6.0 years, 199 men developed diabetes. Multivariable-adjusted hazard ratios (95% confidence interval) of diabetes were 1.00 (reference), 1.44 (1.01–2.07), and 1.48 (1.03–2.13) for the highest through the lowest tertile of fitness (P for trend = 0.04). Additional adjustment for body mass index largely attenuated the association of fitness with diabetes. Joint analysis showed that adjusted hazard ratios of diabetes were 1.00, 1.32, 2.94, and 1.83 in normal weight high-fit men, normal weight low-fit men, overweight high-fit men, and overweight low-fit men, respectively. Conclusion The results suggest that weight control is more important than fitness in prevention of type 2 diabetes in Japanese men.
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Affiliation(s)
- Keisuke Kuwahara
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
- * E-mail:
| | | | - Kayo Kurotani
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Ngoc Minh Pham
- Department of Epidemiology, Faculty of Public Health, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen Province, Vietnam
| | - Akiko Nanri
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | | | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
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556
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Shih M, Du Y, Lightstone AS, Simon PA, Wang MC. Stemming the tide: rising diabetes prevalence and ethnic subgroup variation among Asians in Los Angeles County. Prev Med 2014; 63:90-5. [PMID: 24657547 DOI: 10.1016/j.ypmed.2014.03.016] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2013] [Revised: 01/22/2014] [Accepted: 03/12/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The primary objective of this analysis was to examine the burden of diabetes among Asians and Asian subgroups in Los Angeles County, which has the largest county population of Asians in the U.S. METHOD Data were analyzed from 6cycles of the Los Angeles County Health Survey, 1997-2011 (n=47,282). Asian adults (n=4672) were categorized into the following ethnic subgroups: Chinese, Filipino, Korean, Japanese, Vietnamese, South Asian, and Other Asian. Descriptive and multivariable logistic regression analyses were conducted to examine trends in prevalence, prevalence among Asian subgroups, and factors associated with diabetes. RESULTS In 2005, we observed a rapid increase in diabetes prevalence among Asians compared to whites despite consistently lower BMI relative to other racial/ethnic groups. Diabetes prevalence was significantly higher among Filipinos and South Asians (>10%) compared to East Asians and Vietnamese (<7%). After adjusting for all covariates, Asians who were older, non-drinkers, insured, and overweight or obese were found to have increased odds of diabetes. CONCLUSION Diabetes prevalence is increasing more rapidly among Asians compared to whites despite overall lower BMI. The significant heterogeneity among Asian subgroups highlights the need for disaggregated data and additional research to develop culturally appropriate interventions for diabetes prevention and control.
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Affiliation(s)
- Margaret Shih
- Office of Health Assessment and Epidemiology, Los Angeles County Department of Public Health, 313 N. Figueroa St., Rm 127, Los Angeles, CA 90012, USA.
| | - Yajun Du
- Office of Health Assessment and Epidemiology, Los Angeles County Department of Public Health, 313 N. Figueroa St., Rm 127, Los Angeles, CA 90012, USA.
| | - Amy S Lightstone
- Office of Health Assessment and Epidemiology, Los Angeles County Department of Public Health, 313 N. Figueroa St., Rm 127, Los Angeles, CA 90012, USA.
| | - Paul A Simon
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, 3530 Wilshire Blvd., 8th Floor, Los Angeles, CA 90010, USA; UCLA Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA 90095, USA.
| | - May C Wang
- UCLA Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA 90095, USA.
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557
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Tanisawa K, Ito T, Sun X, Ise R, Oshima S, Cao ZB, Sakamoto S, Tanaka M, Higuchi M. High cardiorespiratory fitness can reduce glycated hemoglobin levels regardless of polygenic risk for Type 2 diabetes mellitus in nondiabetic Japanese men. Physiol Genomics 2014; 46:497-504. [PMID: 24824210 DOI: 10.1152/physiolgenomics.00027.2014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
High cardiorespiratory fitness (CRF) is associated with a reduced risk of Type 2 diabetes mellitus (T2DM) and improved β-cell function; genetic factors also determine these risks. This cross-sectional study investigated whether CRF modifies the association of polygenic risk of T2DM with glucose metabolism in nondiabetic Japanese men. Fasting plasma glucose, insulin, and glycated hemoglobin (HbA1c) levels were measured in 174 Japanese men (age: 20-79 yr). β-Cell function and insulin resistance were evaluated by calculating HOMA-β and HOMA-IR, respectively. CRF was assessed by measuring maximal oxygen uptake (V̇o2max). Subjects were divided into the low and high CRF groups within each age group according to the median V̇o2max. Eleven single nucleotide polymorphisms (SNPs) associated with T2DM were analyzed and used to calculate genetic risk score (GRS); subjects were divided into the low, middle, and high GRS groups. The high GRS group had higher HbA1c levels than the low GRS group in both the low and high CRF groups (P < 0.05). Furthermore, the individuals with a high GRS had a lower HOMA-β than those with a low GRS regardless of CRF (P < 0.05). In multiple linear regression analysis, although GRS was a significant predictor of HbA1c (β = 0.153, P = 0.025), V̇o2max was also associated with HbA1c (β = -0.240, P = 0.041) independent of GRS. These results suggest that CRF is associated with HbA1c levels independent of GRS derived from T2DM-related SNPs; however, it does not modify the association of GRS with increased HbA1c or impaired β-cell function.
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Affiliation(s)
- Kumpei Tanisawa
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan; Department of Genomics for Longevity and Health, Tokyo Metropolitan Institute of Gerontology, Itabashi, Tokyo, Japan
| | - Tomoko Ito
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
| | - Xiaomin Sun
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
| | - Ryuken Ise
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
| | - Satomi Oshima
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan; and
| | - Zhen-Bo Cao
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan; and
| | - Shizuo Sakamoto
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan; and Institute of Advanced Active Aging Research, Waseda University, Tokorozawa, Saitama, Japan
| | - Masashi Tanaka
- Department of Genomics for Longevity and Health, Tokyo Metropolitan Institute of Gerontology, Itabashi, Tokyo, Japan
| | - Mitsuru Higuchi
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan; and Institute of Advanced Active Aging Research, Waseda University, Tokorozawa, Saitama, Japan
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558
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Age-related macular degeneration: prevalence and risk factors from Korean National Health and Nutrition Examination Survey, 2008 through 2011. Ophthalmology 2014; 121:1756-65. [PMID: 24813632 DOI: 10.1016/j.ophtha.2014.03.022] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Revised: 03/08/2014] [Accepted: 03/17/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To investigate the prevalence and risk factors of age-related macular degeneration (AMD) in the Korean population. DESIGN A cross-sectional study using a complex, stratified, multistage, probability-cluster survey, which can produce nationally representative estimates. PARTICIPANTS Using the database of Korean National Health and Nutrition Examination Survey from 2008 through 2011, 14 352 participants 40 years of age or older with gradable fundus photographs were included. METHODS Age-related macular degeneration was determined by fundus photograph. Prevalences of AMDs were estimated. Risk factor analyses were conducted using logistic regression analyses (LRAs). MAIN OUTCOME MEASURES Prevalence and risk factors of AMD. RESULTS The prevalence of AMD was 6.62% (95% confidence interval [CI], 6.15%-7.09%) in the Korean population: 6.02% (95% CI, 5.56%-6.48%) were early AMD and 0.60% (95% CI, 0.45%-0.75%) were late AMD. The prevalence of early AMD in women (6.73%; 95% CI, 6.11%-7.35%) was higher than that in men (5.25%; 95% CI, 4.61%-5.89%; P<0.001), and the prevalence of late AMD in women (0.37%; 95% CI, 0.22%-0.52%) was lower than that in men (0.85%; 95% CI, 0.59%-1.12%; P<0.001). However, in multiple LRAs both early and late AMD had no association with gender, house income, residence, sun exposure, or systemic comorbidities, including hypertension, diabetes mellitus, and cardiovascular diseases. Early AMD had positive associations with older age groups (P<0.001), lower education (P = 0.027), occupation (P<0.001), anemia (P = 0.027), hepatitis B surface antigen carrier status (P<0.001), not being overweight (body mass index [BMI], P = 0.032; waist circumference, P = 0.041, in separate analyses), and higher serum high-density lipoprotein (HDL) level (P = 0.046), but not with smoking status. Late AMD had positive associations with age groups (P<0.001), current smokers (P = 0.022), and lower BMI (P = 0.037). CONCLUSIONS The results suggest that there are 1.21 million individuals with early AMD and 121 000 individuals with late AMD in Korea. Nonoverweight status and higher HDL levels, generally assumed as positive health indicators, as well as anemia and hepatitis B infection had harmful associations with AMD in our study, implying a possible different pathophysiologic process of AMD in Asians compared with that of white persons.
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559
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Abstract
The prevalence of diabetes mellitus will likely increase globally from 371 million individuals in 2013 to 552 million individuals in 2030. This epidemic is mainly attributable to type 2 diabetes mellitus (T2DM), which represents about 90-95% of all cases. Cardiovascular disease is the leading cause of mortality among individuals with diabetes mellitus, and >50% of patients will die from a cardiovascular event-especially coronary artery disease, but also stroke and peripheral vascular disease. Classic risk factors such as elevated levels of LDL cholesterol and blood pressure, as well as smoking, are risk factors for adverse cardiovascular events in patients with type 1 diabetes mellitus (T1DM) and T2DM to a similar degree as they are in healthy individuals. Patients with T1DM develop insulin resistance in the months after diabetes mellitus diagnosis, and patients with T2DM typically develop insulin resistance before hyperglycaemia occurs. Insulin resistance and hyperglycaemia, in turn, further increase the risk of adverse cardiovascular events. This Review discusses the mechanisms by which T1DM and T2DM can lead to cardiovascular disease and how these relate to the risk factors for coronary artery disease.
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Affiliation(s)
- Markku Laakso
- Institute of Clinical Science, Internal Medicine, University of Eastern Finland and Kuopio University Hospital, Yliopistonranta 1E, 70210 Kuopio, Finland
| | - Johanna Kuusisto
- Institute of Clinical Science, Internal Medicine, University of Eastern Finland and Kuopio University Hospital, Yliopistonranta 1E, 70210 Kuopio, Finland
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560
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The prevalences of impaired fasting glucose and diabetes mellitus in working age men of North China: Anshan Worker Health Survey. Sci Rep 2014; 4:4835. [PMID: 24824525 PMCID: PMC4003584 DOI: 10.1038/srep04835] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 03/21/2014] [Indexed: 01/19/2023] Open
Abstract
To investigate the prevalence of impaired fasting glucose (IFG) and total diabetes mellitus (DM) including known diabetes and newly diagnosed diabetes in working age men of North China. A cross-section study was conducted at health medical center of Ansteel Group Hospital in Anshan city of China. 37,345 males between 20–60 years of age were recruited in this study. Age-standardized prevalence of IFG and total DM in these working age men were 25.3% and 8.4%, respectively. The prevalence of IFG and total DM increased, as the age progressed. After multinomial logit analysis, age, systolic blood pressure, drinking, smoking, overweight and obesity, total cholesterol, triglycerides, serum creatinine and blood urea nitrogen were independent risk factors for both IFG and DM. The prevalence rate of IFG in Anshan male workers was higher compared with mainland China overall. Diabetes-related education and popularization of DM prevention programs should be actively carried out with age increasing.
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561
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Genome-Wide Association Studies of Genetic Impact on Cardiovascular and Metabolic Diseases in Asians: Opportunity for Discovery. CURRENT CARDIOVASCULAR RISK REPORTS 2014. [DOI: 10.1007/s12170-014-0380-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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562
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Tutino GE, Tam WH, Yang X, Chan JCN, Lao TTH, Ma RCW. Diabetes and pregnancy: perspectives from Asia. Diabet Med 2014; 31:302-18. [PMID: 24417604 DOI: 10.1111/dme.12396] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 12/08/2013] [Accepted: 12/10/2013] [Indexed: 12/25/2022]
Abstract
There has been a marked increase in the prevalence of diabetes in Asia over recent years. Diabetes complicating pregnancy, in particular gestational diabetes, has also increased markedly in the region. Multi-ethnic studies have highlighted the increased risk of gestational diabetes mellitus among the different Asian populations. Prevalence of gestational diabetes in Asian countries varies substantially according to the screening strategy and diagnostic criteria applied, and ranges from 1% to 20%, with evidence of an increasing trend over recent years. The International Association for Diabetes in Pregnancy Study group criteria have been adopted by some Asian countries, although they present significant challenges in implementation, especially in low-resource settings. Studies on offspring of mothers with gestational diabetes have reported adverse cardiometabolic profiles and increased risk of diabetes and obesity. Gestational diabetes is likely to be a significant factor contributing to the epidemic of diabetes and other non-communicable diseases in the Asian region. In recognition of this, several large-scale prevention and intervention programmes are currently being implemented in different Asian countries in order to improve glucose control during pregnancy, as well as overall maternal health. Lessons emerging from gestational diabetes studies in Asia may help inform and provide insights on the overall burden and treatment strategies to target gestational diabetes, with the ultimate aim to reduce its adverse short- and long-term consequences.
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Affiliation(s)
- G E Tutino
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Tianjin, China
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563
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Abstract
As the link between heart failure (HF) and diabetes mellitus (DM) becomes unignorable, so the need is further increasing for pathological comprehension: What is "diabetic cardiomyopathy (DMC)?" In response to current concern, the most updated guidelines stated by the ACCF/AHA and by the ESC/EASD take one step further, including the definition of DMC, although it is a matter yet to be completed. For more than 40 years, coronary artery disease and hypertension have been considered as the main causes of diabetes-related cardiac dysfunction. HF was originally considered as a result of reduced left ventricular ejection fraction (HF-REF); however, it has been recognized that HF symptoms are often observed in patients with preserved EF (HF-PEF). DMC includes HF with both reduced and preserved entities independent of coronary stenosis and hypertension. Cardiologists are thus facing a sort of chaos without clear guidelines for the "deadly intersection" of DM and HF. Today, the increasing interest and concern have caused DMC to be revisited and the first step in controlling the chaos around DMC is to organize and analyze all of the available evidence from preclinical and clinical studies. This review aims to illustrate the current concepts of DMC by shedding light on the new molecular mechanisms. (Circ J 2014; 78: 576-583).
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Affiliation(s)
- Yasuko K Bando
- Department of Cardiology, Nagoya University Graduate School of Medicine
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564
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Abstract
According to the recent estimates by the International Diabetes Federation (IDF), South East-Asia (SEA) Region consisting of India, Sri Lanka, Bangladesh, Bhutan, Mauritius and Maldives, is home to more than 72 million adults with diabetes in 2013 and is expected to exceed 123 million in 2035. Nearly 95% of people with diabetes have type 2 diabetes (T2DM). Although type 1 diabetes (T1DM) is relatively rare in these countries, its prevalence is also rising. Furthermore, a large number (24.3 million) of people also have impaired glucose tolerance (IGT). Several characteristic differences are seen in the clinical and immunological presentation of these people when compared with their European counterparts. A sharp increase in the prevalence of T2DM has been observed in the SEA Region, both in urban and rural areas, which is mostly associated with the lifestyle transitions towards urbanisation and industrialisation. Evidence suggests that a large portion of T2DM may be preventable by lifestyle modification. However, morbidity and early mortality occur as a result of inadequate healthcare facilities for early detection and initiation of therapy, as well as suboptimal management of diabetes and associated morbidities. This is largely preventable by primary prevention of diabetes and enhancing awareness about the disease among the public and the healthcare providers. There is an urgent need for concerted efforts by government and non-governmental sectors to implement national programmes aimed at prevention, management and surveillance of the disease.
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Affiliation(s)
- Ambady Ramachandran
- India Diabetes Research Foundation & Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India.
| | - Chamukuttan Snehalatha
- India Diabetes Research Foundation & Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India
| | - Ronald Ching Wan Ma
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, SAR, China
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565
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Abstract
In the 2013 issue of the International Diabetes Federation (IDF) Diabetes Atlas, the prevalence of diabetes in the Western Pacific (WP) Region was reported to be 8.6% in 2013, or 138 million adults, and estimated to rise to 11.1%, or 201 million adults, in 2035. The prevalence estimates of impaired glucose tolerance in 2013 and 2035 were 6.8% and 9.0%, respectively. Over 50% of people with diabetes were undiagnosed. In 2013, 187 million deaths were attributable to diabetes, 44% of which occurred in the under the age of 60. The WP Region is home to one quarter of the world's population, and includes China with the largest number of people with diabetes as well as Pacific Islands countries with the highest prevalence rates. There is a rapid increase in diabetes prevalence in the young-to-middle aged adults, possibly driven by high rates of childhood obesity and gestational diabetes as well as rapid demographic and sociocultural transitions. Differences in genetics, ethnicity, cultures and socioeconomic development have led to complex host-environment-lifestyle interactions with marked disease heterogeneity, further influenced by access to care and treatment. Despite these challenges, the WP Region has provided notable examples to prevent and control diabetes.
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Affiliation(s)
- Juliana C N Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China.
| | - Nam H Cho
- Department of Preventive Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Naoko Tajima
- Jikei University School of Medicine, Tokyo, Japan
| | - Jonathan Shaw
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
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566
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Shaharir SS, Ghafor AHA, Said MSM, Kong NCT. A descriptive study of the factors associated with damage in Malaysian patients with lupus nephritis. Lupus 2014; 23:436-42. [DOI: 10.1177/0961203313518624] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction Renal involvement is the most common serious complication in patients with systemic lupus erythematosus (SLE). Objective The objective of this article is to investigate and determine the associated factors of disease damage among lupus nephritis (LN) patients. Methods Medical records of LN patients who attended regular follow-up for at least one year in the Nephrology/SLE Clinic, Universiti Kebangsaan Malaysia Medical Centre (UKMMC), were reviewed. Their Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index scores were noted. Univariate analysis and multivariable regression analysis were performed to determine the independent factors of disease damage in LN. Results A total of 150 patients were included and their follow-up duration ranged from one to 20 years. Sixty (40%) LN patients had disease damage (SDI ≥1). In the univariate analysis, it was associated with age, longer disease duration, antiphospholipid syndrome (APS), higher maximum daily oral prednisolone dose (mg/day), lower mean C3 and C4, higher chronicity index and global sclerosis on renal biopsies ( p < 0.05). Patients who received early (≤3 months after the SLE diagnosis) hydroxychloroquine (HCQ), optimum HCQ dose at 6.5 mg/kg/day and achieved early complete remission (CR) were less likely to have disease damage ( p < 0.05). After adjustment for age, gender, disease duration and severity, multivariable regression analysis revealed that a higher maximum daily dose of oral prednisolone was independently associated with disease damage while early HCQ and CR were associated with lower disease damage. Conclusion Higher maximum daily prednisolone dose predicted disease damage whereas treatment with early HCQ and early CR had a protective role against disease damage.
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Affiliation(s)
- SS Shaharir
- Department of Internal Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - AH Abdul Ghafor
- Department of Internal Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - MS Mohamed Said
- Department of Internal Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - NCT Kong
- Department of Internal Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
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567
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Ghassibe-Sabbagh M, Deeb M, Salloum AK, Mouzaya F, Haber M, Al-Sarraj Y, Chami Y, Akle Y, Hirbli K, Nemr R, Ahdab R, Platt DE, Abchee AB, El-Shanti H, Zalloua PA. Multivariate epidemiologic analysis of type 2 diabetes mellitus risks in the Lebanese population. Diabetol Metab Syndr 2014; 6:89. [PMID: 25191526 PMCID: PMC4153892 DOI: 10.1186/1758-5996-6-89] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 08/08/2014] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The burden of diabetes in Lebanon requires well-targeted interventions for screening type 2 diabetes mellitus (T2DM) and prediabetes and prevention of risk factors. Newly recruited 998 Lebanese individuals, in addition to 7,292 already available, were studied to investigate the prevalence of diabetes, prediabetes and their associated risk factors. METHODS Participants had fasting blood sugar and glycohemoglobin tests in addition to a lipid profile. Clinical and demographic information were obtained from a detailed questionnaire. The relationship between T2DM, its risk factors, and its complications were tested. Comparisons of these risk factors among diabetics, healthy, and coronary artery disease (CAD) patients were performed. RESULTS The prevalence of T2DM significantly increased with increasing BMI (p < 0.0001). Exercise activity level negatively correlated with the disease (p = 0.002), whereas the prevalence of T2DM (p < 0.0001) and CAD family history (p = 0.006) positively correlated with the affection status. The mean levels of triglycerides and LDL-C were significantly higher in diabetics (1.87; 1.35) compared to individuals with prediabetes (1.63; 1.26) and unaffected controls (1.49; 1.19). People with T2DM showed a significant decrease in HDL-C levels. A strong correlation of overall hyperlipidemia with the diabetes affection status was shown (p < 0.0001). Other comorbid factors such as hypertension (p < 0.0001) and self-reported obesity (p < 0.0001) were highly associated with T2DM and prediabetes. Reproductive health of women showed a strong correlation between giving birth to a baby with a high weight and the occurrence of T2DM and prediabetes later in life (p < 0.0001). Retinopathy and peripheral neuropathy were significantly correlated with diabetes and prediabetes (p < 0.0001). CONCLUSIONS The present study shows an alarming prevalence of diabetes and prediabetes in the studied subgroups representative of the Lebanese population.
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Affiliation(s)
| | - Mary Deeb
- />School of Medicine, Lebanese American University, Beirut, 1102 2801 Lebanon
| | - Angelique K Salloum
- />School of Medicine, Lebanese American University, Beirut, 1102 2801 Lebanon
| | - Francis Mouzaya
- />School of Medicine, Lebanese American University, Beirut, 1102 2801 Lebanon
| | - Marc Haber
- />School of Medicine, Lebanese American University, Beirut, 1102 2801 Lebanon
| | | | - Youssef Chami
- />School of Medicine, Lebanese American University, Beirut, 1102 2801 Lebanon
| | - Yasmine Akle
- />Centre Hospitalier du Nord-CHN, Zgharta, Lebanon
| | - Kamal Hirbli
- />School of Medicine, Lebanese American University, Beirut, 1102 2801 Lebanon
| | - Rita Nemr
- />School of Medicine, Lebanese American University, Beirut, 1102 2801 Lebanon
| | - Rechdi Ahdab
- />School of Medicine, Lebanese American University, Beirut, 1102 2801 Lebanon
| | - Daniel E Platt
- />Bioinformatics and Pattern Discovery, IBM T. J. Watson Research Centre, Yorktown Hgts, NY 10598 USA
| | - Antoine B Abchee
- />Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | | | - Pierre A Zalloua
- />School of Medicine, Lebanese American University, Beirut, 1102 2801 Lebanon
- />Harvard School of Public Health, Boston, MA 02215 USA
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568
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Affiliation(s)
- Ronald C W Ma
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong Special Administrative Region, China; The Li Ka Shing Institute of Health Sciences, Hong Kong Special Administrative Region, China; Hong Kong Institute of Diabetes and Obesity, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
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569
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Kim YJ, Lim MN, Lee DS. Trend Analysis in the Prevalence of Type 2 Diabetes According to Risk Factors among Korean Adults: Based on the 2001~2009 Korean National Health and Nutrition Examination Survey Data. J Korean Acad Nurs 2014; 44:743-50. [DOI: 10.4040/jkan.2014.44.6.743] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Young-Ju Kim
- Department of Statistics, Kangwon National University, Chuncheon, Korea
| | - Myoung-Nam Lim
- Regional Center for Respiratory Disease, Kangwon National University Hospital, Chuncheon, Korea
| | - Dong-Suk Lee
- Department of Nursing, Kangwon National University, Chuncheon, Korea
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570
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Plasma miR-126 is a potential biomarker for early prediction of type 2 diabetes mellitus in susceptible individuals. BIOMED RESEARCH INTERNATIONAL 2013; 2013:761617. [PMID: 24455723 PMCID: PMC3886569 DOI: 10.1155/2013/761617] [Citation(s) in RCA: 94] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Accepted: 12/14/2013] [Indexed: 12/12/2022]
Abstract
Type 2 diabetes mellitus (T2DM) is a major public health problem in China. Diagnostic markers are urgently needed to identify individuals at risk of developing T2DM and encourage them to adapt to a healthier life style. Circulating miRNAs present important sources of noninvasive biomarkers of various diseases. Recently, a novel plasma microRNA signature was identified in T2DM. Here, we evaluated the T2DM-related miRNA signature in plasma of three study groups: normal (fasting glucose (FG), 4.8–5.2 mmol/L), T2DM-susceptible (FG, 6.1–6.9 mmol/L), and T2DM individuals (FG, ≥7.0 mmol/L) and tested the feasibility of using circulating miRNAs to identify individuals at risk of developing T2DM. Among the 5 miRNAs included in the signature, miR-29b and miR-28-3p are not detectable. miR-15a and miR-223 have comparable expression levels among three groups. Notably, miR-126 is the only miRNA that showed significantly reduced expression in susceptible individuals and T2DM patients compared to normal individuals, suggesting that miR-126 in circulation may serve as a potential biomarker for early identification of susceptible individuals to T2DM.
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571
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Ho CCK, Tan HM. Men's health issues in Asia. Aging Male 2013; 16:81-4. [PMID: 23822757 DOI: 10.3109/13685538.2013.809414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Men's health has gained prominence over the past few years but it is still not on par with the attention or funding that women and child health is getting. In Asia, this issue is even more conspicuous. With westernization of lifestyle, Asian men's problems emulate their Western counterparts but there are certain issues unique to Asian men due to cultural differences. This review will discuss the health issues affecting Asian men and suggest measures that can be taken to overcome them.
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Affiliation(s)
- Christopher C K Ho
- Department of Surgery, Universiti Kebangsaan Malaysia Medical Centre, Bandar Tun Razak, Cheras, Kuala Lumpur, Malaysia.
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572
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