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Fu Y, Wang LL, Yi D, Jin L, Liu J, Zhang Y, Ren A. Association between maternal single nucleotide polymorphisms in genes regulating glucose metabolism and risk for neural tube defects in offspring. ACTA ACUST UNITED AC 2014; 103:471-8. [PMID: 25369983 DOI: 10.1002/bdra.23332] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Maternal pregestational hyperglycemia, diabetes, and obesity are well-established risk factors for neural tube defects (NTDs). As a common underlying mechanism, the imbalance of glucose homeostasis is directly related to the development of NTDs. Polymorphisms in genes regulating glucose metabolism in women may impact their chance of having an NTD-affected pregnancy. METHODS We conducted a two-stage case-control study to investigate the association between maternal genetic variants in genes regulating glucose metabolism and risk for NTDs. The cases were 547 women who gave birth to a child with an NTD (anencephaly, spina bifida, or encephalocele); the controls were 543 women who gave birth to a full-term healthy infant. In the first stage, 12 single nucleotide polymorphisms were genotyped in 160 cases and 162 controls. In the second stage, five single nucleotide polymorphisms found in the first stage and potentially associated with NTD risk were genotyped for validation, in an additional 387 cases and 381 controls. RESULTS Combined analysis of data from the two stages showed an association between maternal AA genotype of GCKR rs780094 and increased risk for total NTDs [odds ratio, 1.73; 95% confidence interval, 1.16-2.59) and spina bifida subtype [odds ratio, 1.83; 95% confidence interval, 1.16-2.88). No association was found between the other four single nucleotide polymorphisms (LEPR rs1137100, HK1 rs748235, HHEX rs5015480, KCNQ1 rs2237892) and NTD risk. CONCLUSION The AA genotype in maternal GCKR rs780094 is associated with an increased risk for NTDs and spina bifida in the Chinese population.
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Affiliation(s)
- Yunting Fu
- Institute of Reproductive and Child Health / Ministry of Health Key Laboratory of Reproductive Health, School of Public Health, Peking University, Beijing, China
| | - Lin-lin Wang
- Institute of Reproductive and Child Health / Ministry of Health Key Laboratory of Reproductive Health, School of Public Health, Peking University, Beijing, China
| | - Deqing Yi
- Institute of Reproductive and Child Health / Ministry of Health Key Laboratory of Reproductive Health, School of Public Health, Peking University, Beijing, China
| | - Lei Jin
- Institute of Reproductive and Child Health / Ministry of Health Key Laboratory of Reproductive Health, School of Public Health, Peking University, Beijing, China
| | - Jufen Liu
- Institute of Reproductive and Child Health / Ministry of Health Key Laboratory of Reproductive Health, School of Public Health, Peking University, Beijing, China
| | - Yali Zhang
- Institute of Reproductive and Child Health / Ministry of Health Key Laboratory of Reproductive Health, School of Public Health, Peking University, Beijing, China
| | - Aiguo Ren
- Institute of Reproductive and Child Health / Ministry of Health Key Laboratory of Reproductive Health, School of Public Health, Peking University, Beijing, China
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He W, Li Y, Zhang R, Wu Z, Yin L. Gastro-floating bilayer tablets for the sustained release of metformin and immediate release of pioglitazone: preparation and in vitro/in vivo evaluation. Int J Pharm 2014; 476:223-31. [PMID: 25283698 DOI: 10.1016/j.ijpharm.2014.09.056] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 09/17/2014] [Accepted: 09/29/2014] [Indexed: 11/15/2022]
Abstract
Owing to the complementary mechanisms of action of metformin hydrochloride (MH) and pioglitazone hydrochloride (PG), combination therapy for type 2 diabetes mellitus using the two drugs is highly desired; on the other hand, MH is not well absorbed in lower gastrointestinal tract and has a short half-life, therefore compromising the therapeutic effects. Herein, the present study was to develop gastro-floating bilayer matrix tablets in which the two drugs were incorporated into two separate layers, aiming at sustaining MH release with enhanced absorption and achieving immediate release of PG. The tablets of the optimized formulation floated on the test medium for more than 24 h with 5 min of floating lag time, and sustained MH release for 12 h via a diffusion-dependent manner; and complete release of PG within 5 min were achieved. Moreover, a steady plasma concentration of MH with a 1.5-fold increase in bioavailability, decreased C(max) and reduced T(max) was obtained, and the in vivo behavior of PG was similar to the marked product. Summarily, sustained MH release with improved absorption and immediate release of PG were obtained simultaneously using the gastro-floating bilayer tablet, allowing strengthened combination therapy for diabetes mellitus.
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Affiliation(s)
- Wei He
- State Key Laboratory of Natural Medicines, School of Pharmacy, China Pharmaceutical University, Nanjing 210009, PR China
| | - Yongji Li
- State Key Laboratory of Natural Medicines, School of Pharmacy, China Pharmaceutical University, Nanjing 210009, PR China
| | - Rao Zhang
- State Key Laboratory of Natural Medicines, School of Pharmacy, China Pharmaceutical University, Nanjing 210009, PR China
| | - Zhannan Wu
- State Key Laboratory of Natural Medicines, School of Pharmacy, China Pharmaceutical University, Nanjing 210009, PR China
| | - Lifang Yin
- State Key Laboratory of Natural Medicines, School of Pharmacy, China Pharmaceutical University, Nanjing 210009, PR China.
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Jiao FF, Lam CLK, Fung C, McGhee SM. Comparison of four cardiovascular risk prediction functions among Chinese patients with diabetes mellitus in the primary care setting. J Diabetes Investig 2014; 5:606-14. [PMID: 25411630 PMCID: PMC4188120 DOI: 10.1111/jdi.12188] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 11/01/2013] [Accepted: 11/10/2013] [Indexed: 11/26/2022] Open
Abstract
AIMS/INTRODUCTION To assess the feasibility, convergent validity and sensitivity of four cardiovascular risk prediction functions in Chinese diabetic patients in the primary care setting. MATERIALS AND METHODS A cross-sectional study of 1,140 diabetic patients was carried out to compare four cardiovascular risk functions, which were respectively developed from the Framingham heart study, the USA-People's Republic of China Collaborative Study of Cardiovascular and Cardiopulmonary Epidemiology cohort (PRC), the United Kingdom Prospective Diabetes Study (UKPDS) and the Joint Asia Diabetes Evaluation program (JADE). Feasibility was assessed by the percentage of patients with complete data for risk prediction. Convergent validity was measured by Spearman's rank correlation, paired Wilcoxon signed-rank sum test and Bland-Altman plots. Effect size differences between clinical risk groups were used to assess the sensitivity. RESULTS Risk prediction was feasible by the Framingham, UKPDS and PRC risk functions in more than 98% patients, whereas just 74% of patients had complete data for the JADE function. The annual total coronary heart disease (CHD) risk predicted by the JADE and the UKPDS functions showed excellent agreement with no significant difference, and a correlation of 0.8048. The Framingham and the PRC functions predicted significantly lower CHD risk than those by the UKPDS and the JADE functions. The UKPDS and the Framingham functions were more sensitive in differentiating clinical risk groups. CONCLUSIONS The UKPDS risk engine showed good feasibility, convergent validity and sensitivity in predicting CHD risk in Chinese diabetic patients. The JADE function showed excellent agreement with the UKPDS risk engine, but it was less feasible in the primary care setting.
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Affiliation(s)
- Fang Fang Jiao
- Department of Family Medicine and Primary CareLi Ka Shing Faculty of MedicineThe University of Hong KongPokfulamHong Kong
| | - Cindy Lo Kuen Lam
- Department of Family Medicine and Primary CareLi Ka Shing Faculty of MedicineThe University of Hong KongPokfulamHong Kong
| | - Colman Fung
- Department of Family Medicine and Primary CareLi Ka Shing Faculty of MedicineThe University of Hong KongPokfulamHong Kong
| | - Sarah Morag McGhee
- School of Public HealthLi Ka Shing Faculty of MedicineThe University of Hong KongPokfulamHong Kong
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Wang C, Zhang Y, Zhang L, Hou X, Lu H, Shen Y, Chen R, Fang P, Yu H, Li M, Zhang F, Chen H, Yu H, Zhou J, Liu F, Bao Y, Jia W. Prevalence of type 2 diabetes among high-risk adults in Shanghai from 2002 to 2012. PLoS One 2014; 9:e102926. [PMID: 25047241 PMCID: PMC4105568 DOI: 10.1371/journal.pone.0102926] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 06/23/2014] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE The objective of this study was to evaluate the trend and prevalence of prediabetes and diabetes among high-risk adults in Shanghai from 2002 to 2012. METHODS From 2002 to 2012, 10043 subjects with known risk factors for diabetes participated in the diabetes-screening project at the Shanghai Sixth People's Hospital of Shanghai Jiao Tong University. All participants were asked to complete a nurse-administered standard questionnaire concerning age, sex, smoking status, and personal and family histories of diabetes, cardiovascular disease, stroke, hypertension and other diseases. The participants' body mass index scores, blood pressures and blood glucose levels at 0, 30, 60, 120 and 180 min were measured in response to a 75 g oral glucose tolerance test. RESULTS The overall prevalence of diabetes increased from 27.93% to 34.78% between 2002 and 2012 in high-risk subjects. The study also showed that the prevalence increased much faster in male compared to female subjects. Specifically, an increased rate was seen in middle-aged men, with no change observed in middle-aged females over the eleven-year period. CONCLUSION This study showed that sex, age, parental diabetic history, and being overweight were associated with an increased risk for diabetes in high-risk people. Therefore, as prediabetes and diabetes are highly prevalent in people with multiple diabetes risk factors in Shanghai, screening programs targeting these individuals may be beneficial.
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Affiliation(s)
- Congrong Wang
- Department of Endocrinology and Metabolism, The Metabolic Diseases Biobank, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Diabetes, Shanghai Key Laboratory of Diabetes, Shanghai, China
| | - Yinan Zhang
- Center for Translational Medicine, Shanghai Key Laboratory of Diabetes, Department of Endocrinology and Metabolism, The Metabolic Diseases Biobank, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Lei Zhang
- Department of Endocrinology and Metabolism, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes, Shanghai, China
| | - Xuhong Hou
- Department of Endocrinology and Metabolism, The Metabolic Diseases Biobank, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Diabetes, Shanghai Key Laboratory of Diabetes, Shanghai, China
| | - Huijuan Lu
- Department of Endocrinology and Metabolism, The Metabolic Diseases Biobank, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Diabetes, Shanghai Key Laboratory of Diabetes, Shanghai, China
| | - Yixie Shen
- Department of Endocrinology and Metabolism, The Metabolic Diseases Biobank, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Diabetes, Shanghai Key Laboratory of Diabetes, Shanghai, China
| | - Ruihua Chen
- Department of Endocrinology and Metabolism, The Metabolic Diseases Biobank, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Diabetes, Shanghai Key Laboratory of Diabetes, Shanghai, China
| | - Pingyan Fang
- Department of Endocrinology and Metabolism, The Metabolic Diseases Biobank, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Diabetes, Shanghai Key Laboratory of Diabetes, Shanghai, China
| | - Hong Yu
- Department of Endocrinology and Metabolism, The Metabolic Diseases Biobank, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Diabetes, Shanghai Key Laboratory of Diabetes, Shanghai, China
| | - Ming Li
- Department of Endocrinology and Metabolism, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes, Shanghai, China
| | - Feng Zhang
- Department of Endocrinology and Metabolism, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes, Shanghai, China
| | - Haibing Chen
- Department of Endocrinology and Metabolism, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes, Shanghai, China
| | - Haoyong Yu
- Department of Endocrinology and Metabolism, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes, Shanghai, China
| | - Jian Zhou
- Department of Endocrinology and Metabolism, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes, Shanghai, China
| | - Fang Liu
- Department of Endocrinology and Metabolism, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes, Shanghai, China
| | - Yuqian Bao
- Department of Endocrinology and Metabolism, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes, Shanghai, China
| | - Weiping Jia
- Department of Endocrinology and Metabolism, The Metabolic Diseases Biobank, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Diabetes, Shanghai Key Laboratory of Diabetes, Shanghai, China
- * E-mail:
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Shen C, Schooling CM, Chan WM, Lee SY, Leung GM, Lam TH. Self-reported diabetes and mortality in a prospective Chinese elderly cohort study in Hong Kong. Prev Med 2014; 64:20-6. [PMID: 24704132 DOI: 10.1016/j.ypmed.2014.03.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 03/23/2014] [Accepted: 03/24/2014] [Indexed: 01/19/2023]
Abstract
OBJECTIVE In Western countries, diabetes mellitus is positively associated with death from all- and specific-causes including cancer, cardiovascular and respiratory diseases. In a Chinese setting with a different disease pattern: high diabetes rates in a relatively non-obese population with low ischemic heart disease (IHD) rates where diabetes is positively associated with IHD, we examined the association of self-reported diabetes with death among older people. METHODS Multivariable Cox regression analysis was used in a population-based prospective cohort of 66,820 Chinese (65+ years) enrolled from July 1998 to December 2001 at Elderly Health Centers of the Hong Kong Government Department of Health, followed until May 31, 2012. RESULTS During 10.9 years of follow-up, 19,845 deaths occurred. Self-reported diabetes was associated with death from all-causes (hazard ratio (HR)=1.56, 95% confidence interval (CI) 1.51, 1.62), cardiovascular disease (HR=1.84, 95% CI 1.72, 1.96), cancer (HR=1.11, 95% CI 1.03 to 1.20), liver cancer (HR=1.38, 95% CI 1.13 to 1.69) and stomach cancer (HR=1.38, 95% CI 1.03 to 1.85), adjusted for age, sex, socio-economic position, alcohol use, smoking, exercise and body mass index. CONCLUSION Such a pattern of associations suggests that further investigation into the drivers of diabetes is required in this and similar populations.
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Affiliation(s)
- Chen Shen
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - C Mary Schooling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; City University of New York , School of Public Health and Hunter College, NY, USA.
| | - Wai Man Chan
- Department of Health, Government of Hong Kong SAR, Hong Kong, China
| | - Siu Yin Lee
- Department of Health, Government of Hong Kong SAR, Hong Kong, China
| | - Gabriel M Leung
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Tai Hing Lam
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
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Huang M, Zhao R, Li S, Jiang X. Self-management behavior in patients with type 2 diabetes: a cross-sectional survey in western urban China. PLoS One 2014; 9:e95138. [PMID: 24743326 PMCID: PMC3990599 DOI: 10.1371/journal.pone.0095138] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 03/24/2014] [Indexed: 02/05/2023] Open
Abstract
Purpose To investigate the current status of diabetic self-management behavior and the factors influencing this behavior in Chengdu, a typical city in western China. Methods We performed stratified sampling in 6 urban districts of Chengdu. We used questionnaires concerning self-management knowledge, self-management beliefs, self-management efficacy, social support, and self-management behavior to investigate patients with T2DM from August to November 2011. All of the data were analyzed using the SPSS 17.0 statistical package. Results We enrolled a total of 364 patients in the present study. The median score of self-management behavior was 111.00, the interquartile range was 100.00–119.00, and the index score was 77.77. Self-management was described as “good” in 46%, “fair” in 45%, and “poor” in 6% of patients. A multiple-factor analysis identified age (OR, 0.43; 95% CI, 0.20–0.91; P = 0.026), education in “foot care” (OR, 0.42; 95% CI, 0.18–0.99; P = 0.048), self-management knowledge (OR, 0.86; 95% CI, 0.80–0.92; P<0.001), self-management belief (OR, 0.92; 95% CI, 0.87–0.97; P = 0.002), self-efficacy (OR, 0.93; 95% CI, 0.90–0.96; P<0.001), and social support (OR, 0.62; 95% CI, 0.41–0.94; P = 0.023) as positive factors. Negative factors included diabetes duration (5–9 years: OR, 14.82; 95% CI, 1.64–133.73; P = 0.016; and ≥10 years: OR, 10.28; 95% CI, 1.06–99.79; P = 0.045) and hospitalization experience (OR, 2.96; 95% CI, 1.64–5.36; P<0.001). Conclusion We observed good self-management behavior in patients with T2DM in Chengdu. When self-management education is provided, age, education, knowledge, belief, self-efficacy, and social support should be considered to offer more appropriate intervention and to improve patients' behavior.
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Affiliation(s)
- Mingjun Huang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Rui Zhao
- Nursing Faculty of West China, Sichuan University, Chengdu, Sichuan China
| | - Sheyu Li
- Endocrinology Department, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiaolian Jiang
- Nursing Department, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- * E-mail:
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Tam CHT, Wang Y, Luan J, Lee HM, Luk AOY, Tutino GE, Tong PCY, Kong APS, So WY, Chan JCN, Ma RCW. Maternal history of diabetes is associated with increased cardiometabolic risk in Chinese. Nutr Diabetes 2014; 4:e112. [PMID: 24614663 PMCID: PMC3974036 DOI: 10.1038/nutd.2014.9] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 02/05/2014] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE Positive family history is associated with increased type 2 diabetes (T2D) risk, and reflects both genetic and environmental risks. Several studies have suggested an excess maternal transmission of T2D, although the underlying mechanism is unknown. We aimed to examine the association between maternal diabetes and cardiometabolic risk in the offspring. METHODS Parental history of diabetes and clinical data including anthropometric traits, fasting plasma glucose and insulin (FPG, FPI), blood pressure and lipid profile were collected from 2581 unrelated Chinese offspring (2026 adolescents from a population-based school survey and 555 adults from a community-based health screening programme). A subset of subjects (n=834) underwent oral glucose tolerance test to measure the glucose and insulin concentrations at 0, 15, 30, 60 and 120 min for evaluation of the areas under the curve (AUC) of glucose and insulin at 0-120 min, homoeostasis model assessment of insulin resistance (HOMA-IR) and bell-cell function, insulinogenic index, insulin sensitivity index (ISI) and oral disposition index (DI). RESULTS A positive parental history of diabetes was associated with increased risk of obesity (odd ratios (OR) (95% confidence interval (CI))=1.48 (1.10-2.00)), central obesity (OR (95% CI)=1.67 (1.21-2.32)), higher FPI, HOMA-IR, 2-h insulin, AUC of glucose at 0-120 min, triglycerides, reduced ISI and DI. Compared with individuals without parental diabetes, offspring with diabetic mother had significantly increased risk of obesity (OR (95% CI)=1.59 (1.07-2.35)), central obesity (OR (95% CI)=1.88 (1.23-2.88)), higher glucose levels and BP, were more insulin resistant but also had impaired first-phase insulin response and worse lipid profile. However, paternal history of diabetes had no effect on any of the studied traits, except higher body mass index, waist circumference in females and FPG. CONCLUSIONS Our findings suggested that maternal history of diabetes conferred increased risk of cardiometabolic abnormalities, and was associated with both insulin resistance and impaired first-phase insulin secretion. Further investigation into the mechanism of transgenerational diabetes is warranted.
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Affiliation(s)
- C H T Tam
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
| | - Y Wang
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
| | - J Luan
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
| | - H M Lee
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
| | - A O Y Luk
- 1] Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong [2] CUHK-PWH IDF Centre of Education, Hong Kong
| | - G E Tutino
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
| | - P C Y Tong
- 1] Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong [2] CUHK-PWH IDF Centre of Education, Hong Kong [3] Hong Kong Institute of Diabetes and Obesity, Chinese University of Hong Kong, Hong Kong
| | - A P S Kong
- 1] Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong [2] CUHK-PWH IDF Centre of Education, Hong Kong [3] Hong Kong Institute of Diabetes and Obesity, Chinese University of Hong Kong, Hong Kong [4] Li Ka Shing Institute of Health Sciences, Chinese University of Hong Kong, Hong Kong
| | - W Y So
- 1] Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong [2] CUHK-PWH IDF Centre of Education, Hong Kong [3] Hong Kong Institute of Diabetes and Obesity, Chinese University of Hong Kong, Hong Kong
| | - J C N Chan
- 1] Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong [2] CUHK-PWH IDF Centre of Education, Hong Kong [3] Hong Kong Institute of Diabetes and Obesity, Chinese University of Hong Kong, Hong Kong [4] Li Ka Shing Institute of Health Sciences, Chinese University of Hong Kong, Hong Kong
| | - R C W Ma
- 1] Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong [2] CUHK-PWH IDF Centre of Education, Hong Kong [3] Hong Kong Institute of Diabetes and Obesity, Chinese University of Hong Kong, Hong Kong [4] Li Ka Shing Institute of Health Sciences, Chinese University of Hong Kong, Hong Kong
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Wang X, Chen L, Liu W, Su B, Zhang Y. Early detection of atrophy of foot muscles in Chinese patients of type 2 diabetes mellitus by high-frequency ultrasonography. J Diabetes Res 2014; 2014:927069. [PMID: 25165725 PMCID: PMC4140103 DOI: 10.1155/2014/927069] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Accepted: 07/08/2014] [Indexed: 01/24/2023] Open
Abstract
The aim of this study was to evaluate the diagnostic value of high-frequency ultrasonography in detecting atrophy of foot muscles in Chinese patients of type 2 diabetes mellitus (T2DM). Chinese patients of T2DM with (n = 56) or without (n = 50) diabetic peripheral neuropathy (DPN) and the control subjects (n = 50) were enrolled. The nondominant foot of all subjects was examined with high-frequency ultrasonography. The transverse diameter, thickness, and cross-sectional area of the extensor digitorum brevis muscle (EDB) and the thickness of the muscles of the first interstitium (MILs) were measured. The results showed that the ultrasonographic transverse diameter, thickness, and cross-sectional area of EDB and the thickness of MILs in patients of T2DM with DPN were significantly smaller than those in patients of T2DM without DPN (all P < 0.01) and those in the control subjects (all P < 0.01). The transverse diameter and cross-sectional area of the EDB and thickness of MILs in patients of T2DM without DPN were significantly smaller than those of the control subjects (all P < 0.01). In conclusion, the atrophy of foot muscle in Chinese T2DM patients can be detected by high-frequency ultrasonography. Notably, ultrasonography may detect early atrophy of foot muscles in patients without DPN.
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Affiliation(s)
- Xiaohui Wang
- Department of Ultrasound, Huiqiao VIP and International Medical Centre, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Liang Chen
- Department of Neurobiology, School of Basic Medical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Weiwei Liu
- Library of Dalian Medical University, Dalian 116044, China
| | - Benli Su
- Department of Endocrinology, Second Affiliated Hospital of Dalian Medical University, Dalian 116023, China
| | - Yuhong Zhang
- Department of Diagnostic Ultrasound, Second Affiliated Hospital of Dalian Medical University, 467 Zhongshan Road, Dalian 116023, China
- *Yuhong Zhang:
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Jiaotai Pill enhances insulin signaling through phosphatidylinositol 3-kinase pathway in skeletal muscle of diabetic rats. Chin J Integr Med 2013; 19:668-74. [PMID: 23975131 DOI: 10.1007/s11655-013-1560-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2011] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To investigate the effect of Jiaotai Pill (, JTP) at different constitutional proportions on insulin signaling through phosphatidylinositol 3-kinase (PI3K) pathway in the skeletal muscle of diabetic rats. METHODS The rat model of type 2 diabetes mellitus (T2DM) was established by intravenous injection of a small dose of streptozotoein plus high fat diet feeding. JTP at the same dosage of cinnamon and the increasing dosage of Coptis chinensis was administered to diabetic rats for nine weeks respectively. Plasma glucose and insulin levels were assayed. The expressions of proteins were determined by Western blot method. RESULTS All the three formulations of JTP decreased plasma glucose and fasting insulin levels as well as increased the protein expressions of insulin receptor β (InsRβ) subunit, insulin receptor substrate-1 (IRS-1), PI3K p85 subunit and glucose transporter 4 (GLUT4) in skeletal muscle. Meanwhile, JTP increased the tyrosine phosphorylation of InsRβ subunit and IRS-1, and reduced the serine phosphorylation of IRS-1 in skeletal muscle. Interestingly, the effect of JTP on improving insulin sensitivity was not dose-dependent. In contrast, JTP containing the least amount of Coptis chinensis exhibited the best effect. CONCLUSION JTP at different constitutional proportions attenuates the development of diabetes in a rat model of T2DM. The mechanism might be associated with enhancing insulin signaling through PI3K pathway in the skeletal muscle.
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Liu X, Li C, Gong H, Cui Z, Fan L, Yu W, Zhang C, Ma J. An economic evaluation for prevention of diabetes mellitus in a developing country: a modelling study. BMC Public Health 2013; 13:729. [PMID: 23919839 PMCID: PMC3751006 DOI: 10.1186/1471-2458-13-729] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Accepted: 07/29/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The serious consequences of diabetes mellitus, and the subsequent economic burden, call for urgent preventative action in developing countries. This study explores the clinical and economic outcomes of strategies that could potentially prevent diabetes based on Chinese circumstances. It aims to provide indicators for the long-term allocation of healthcare resources for authorities in developing countries. METHODS A representative sample of Chinese adults was used to create a simulated population of 20,000 people aged 25 years and above. The hybrid decision tree Markov model was developed to compare the long-term clinical and economic outcomes of four simulated diabetes prevention strategies with a control group, where no prevention applied. These preventive strategies were the following: (i) one-off screening for undiagnosed diabetes and impaired glucose tolerance (IGT), with lifestyle interventions on diet, (ii) on exercise, (iii) on diet combined exercise (duo-intervention) respectively in those with IGT, and (iv) one-off screening alone. Independent age-specific models were simulated based on diverse incidences of diabetes, mortalities and health utilities. The reported outcomes were the following: the remaining survival years, the quality-adjusted life years (QALYs) per diabetes or IGT subjects, societal costs per simulated subject and the comparisons between preventions and control over 40 years. Sensitivity analyses were performed based on variations of all assumptions, in addition to the performance and the compliance of screening. RESULTS Compared with the control group, all simulated screening programmes prolonged life expectancy at the initiation ages of 25 and 40 years, postponed the onset of diabetes and increased QALYs at every initiation age. Along with an assumption of six years intervention, prevention programmes were associated with cost-saving compared with the control group, especially in the population aged 25 years. The savings were at least US$2017 per subject, but no statistically significant difference was observed among the intervention strategies within each age groups. The cost savings were reduced when screening was affected by poor performance and noncompliance. CONCLUSIONS Developing countries have few effective strategies to manage the prevention of diabetes. One-off screening for undiagnosed diabetes and IGT, with appropriate lifestyle interventions for those with IGT are cost saving in China, especially in young adults.
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Affiliation(s)
- Xiaoqian Liu
- Department of Health Statistics, College of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin 300070, P.R. China
| | - Changping Li
- Department of Health Statistics, College of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin 300070, P.R. China
| | - Hui Gong
- Department of Health Statistics, College of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin 300070, P.R. China
| | - Zhuang Cui
- Department of Health Statistics, College of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin 300070, P.R. China
| | - Linlin Fan
- Department of Health Statistics, College of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin 300070, P.R. China
| | - Wenhua Yu
- Department of Health Statistics, College of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin 300070, P.R. China
| | - Cui Zhang
- Institute of New Catalytic Materials Science, College of Chemistry, Nankai University, Tianjin 300071, P.R. China
| | - Jun Ma
- Department of Health Statistics, College of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin 300070, P.R. China
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Xuan J, Lin Y, Huang J, Yuan F, Li X, Lu Y, Zhang H, Liu J, Sun Z, Zou H, Chen Y, Gao J, Zhong Y. Exenatide-loaded PLGA microspheres with improved glycemic control: in vitro bioactivity and in vivo pharmacokinetic profiles after subcutaneous administration to SD rats. Peptides 2013; 46:172-9. [PMID: 23770254 DOI: 10.1016/j.peptides.2013.06.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Revised: 06/05/2013] [Accepted: 06/05/2013] [Indexed: 10/26/2022]
Abstract
A subcutaneous exenatide delivery system was developed and characterized in vitro and in vivo. The results clearly showed that the exenatide loaded PLGA microspheres prepared by using a non-aqueous processing medium had low burst release and high drug encapsulation efficiency. Exenatide loaded in the microspheres preserved its bioactivity. The pharmacokinetics parameters were determined after subcutaneous administration of microspheres to SD rats. The plasma concentration of the single dose of the sustained-release microspheres attained C(max) of 108.19±14.92 ng/ml at t(max) of 1.33±0.58 h and the t(½) was 120.65±44.18 h. There was a linear correlation between the in vitro and in vivo release behavior (R²=0.888). Exenatide loaded microspheres may prove to have great potential for clinical use.
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Affiliation(s)
- Jiming Xuan
- Department of Pharmaceutical Science, the Second Military Medical University School of Pharmacy, Shanghai 200433, PR China
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Prescription pattern of chinese herbal products for diabetes mellitus in taiwan: a population-based study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:201329. [PMID: 23843864 PMCID: PMC3703417 DOI: 10.1155/2013/201329] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2012] [Revised: 04/02/2013] [Accepted: 04/17/2013] [Indexed: 11/23/2022]
Abstract
Background. Traditional Chinese medicine (TCM), when given as a therapy for symptom relief, has gained widespread popularity among diabetic patients. The aim of this study is to analyze the utilization of TCM among type 2 diabetic patients in Taiwan. Methods. The use of TCM for type 2 diabetic patients were evaluated using a randomly sampled cohort of 1,000,000 beneficiaries recruited from the National Health Insurance Research Database. Results. Overall, 77.9% (n = 31,289) of type 2 diabetic patients utilized TCM and 13.9% (n = 4,351) of them used TCM for the treatment of type 2 diabetes. Among the top ten most frequently prescribed herbal formulae, four remedies, Zhi-Bo-Di-Huang-Wan, Qi-Ju-Di-Huang-Wan, Ji-Sheng-Shen-Qi-Wan and Ba-Wei-Di-Huang-Wan are derivative formulae of Liu-Wei-Di-Huang-Wan. In other words, Liu-Wei-Di-Huang-Wan and its derivatives were found to be the most common herbal formulae prescribed by TCM doctors for the treatment of diabetes in Taiwan. Conclusion. Although some evidence does support the use TCM to treat diabetes, the results from the current study may have been confounded by placebo effect, which emphasize the need for well conducted, double-blind, randomized, placebo-controlled studies in order to further evaluate the efficacy of Liu-Wei-Di-Huang-Wan on patients with type 2 diabetes.
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Lin CC, Li CI, Hsiao CY, Liu CS, Yang SY, Lee CC, Li TC. Time trend analysis of the prevalence and incidence of diagnosed type 2 diabetes among adults in Taiwan from 2000 to 2007: a population-based study. BMC Public Health 2013; 13:318. [PMID: 23570503 PMCID: PMC3626657 DOI: 10.1186/1471-2458-13-318] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Accepted: 04/02/2013] [Indexed: 12/18/2022] Open
Abstract
Background The prevalence of type 2 diabetes has rapidly increased in the Taiwanese population with the increasing prevalence of a sedentary lifestyle and high-calorie dietary intake. This study aims to determine the annual trends of the prevalence and incidence of diagnosed type 2 diabetes among adults in Taiwan from 2000 to 2007. Methods A population-based study of all residents aged 20 years and over (12,191,076 in 2000 and 18,772,180 in 2007) enrolled in the National Health Insurance (NHI) program, the database of which was used to identify patients diagnosed with type 2 diabetes. The annual prevalence and incidence of diagnosed type 2 diabetes were estimated using the International Classification of Diseases, 9th Revision, Clinical Modification diagnostic codes based on age, gender, insurance premium, and urbanization degree. Logistic regression was used to estimate the odds ratios (OR) of risk factors, as well as to examine the trend in the annual prevalence or incidence of diagnosed type 2 diabetes from 2000 to 2007. Results The crude annual prevalence of diagnosed type 2 diabetes increased significantly from 5.79% in 2000 to 8.30% in 2007. The increase was highest in 2007, among men, individuals aged ≥ 80 years, and individuals residing in aging society areas [OR (95% CI): 1.416 (1.412–1.420), 1.033 (1.032–1.034), 31.810 (31.690–31.931), and 1.090 (1.085–1.094), respectively]. The crude incidence fluctuated throughout the study period, ranging from 7.72 per 1,000 in 2006 to 8.98 per 1,000 in 2000. The decrease was highest in 2006, among individuals with an insurance premium ≥ median value [0.933 (0.925–0.942) and 0.810 (0.805–0.815), respectively]. The greatest increase was among men, individuals aged 60 to 79 years, and individuals residing in aging society areas [1.150 (1.145–1.155), 15.452 (15.329–15.576), and 1.127 (1.113–1.142), respectively]. Conclusion This study demonstrated the substantial increase in annual prevalence of diagnosed type 2 diabetes among adults in Taiwan from 2000 to 2007. The incidence fluctuated between 2000 and 2007.
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Affiliation(s)
- Cheng-Chieh Lin
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
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Ma RCW, Chan JCN. Type 2 diabetes in East Asians: similarities and differences with populations in Europe and the United States. Ann N Y Acad Sci 2013; 1281:64-91. [PMID: 23551121 PMCID: PMC3708105 DOI: 10.1111/nyas.12098] [Citation(s) in RCA: 573] [Impact Index Per Article: 52.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
There is an epidemic of diabetes in Asia. Type 2 diabetes develops in East Asian patients at a lower mean body mass index (BMI) compared with those of European descent. At any given BMI, East Asians have a greater amount of body fat and a tendency to visceral adiposity. In Asian patients, diabetes develops at a younger age and is characterized by early β cell dysfunction in the setting of insulin resistance, with many requiring early insulin treatment. The increasing proportion of young-onset and childhood type 2 diabetes is posing a particular threat, with these patients being at increased risk of developing diabetic complications. East Asian patients with type 2 diabetes have a higher risk of developing renal complications than Europeans and, with regard to cardiovascular complications, a predisposition for developing strokes. In addition to cardiovascular-renal disease, cancer is emerging as the other main cause of mortality. While more research is needed to explain these interethnic differences, urgent and concerted actions are needed to raise awareness, facilitate early diagnosis, and encourage preventive strategies to combat these growing disease burdens.
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Affiliation(s)
- Ronald C W Ma
- Department of Medicine and Therapeutics, Hong Kong Institute of Diabetes and Obesity, and Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, The Prince of Wales Hospital, Hong Kong, China.
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Hu P, Yin Q, Deckert F, Jiang J, Liu D, Kjems L, Dole WP, He YL. Pharmacokinetics and Pharmacodynamics of Vildagliptin in Healthy Chinese Volunteers. J Clin Pharmacol 2013; 49:39-49. [DOI: 10.1177/0091270008325152] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Zhao X, Zhao W, Zhang H, Li J, Shu Y, Li S, Cai L, Zhou J, Li Y, Hu R. Fasting capillary blood glucose: an appropriate measurement in screening for diabetes and pre-diabetes in low-resource rural settings. J Endocrinol Invest 2013; 36:33-7. [PMID: 22453076 DOI: 10.3275/8304] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate the efficiency of fasting capillary blood glucose (FCG) measurement as compared with fasting venous plasma glucose (FPG) measurement in screening diabetes and pre-diabetes in low-resource rural settings. SUBJECTS AND METHODS In 2010, 993 participants were randomly selected from 9 villages in Yunnan province using cluster sampling method. Samples for FCG and FPG test were obtained after demographics and physical examination. The oral glucose tolerance test was performed in parallel as gold standard for diagnosis. Diagnostic capacities of the FCG measurement in predicting undiagnosed diabetes and pre-diabetes were assessed. The performance of FCG and FPG tests was compared. RESULTS Fifty-seven individuals with undiagnosed diabetes and 145 subjects with pre-diabetes were detected. The concordance between FCG and FPG levels was high (r = 0.75, p < 0.001). The area under the curve (AUC) for FCG test in predicting diabetes was 0.88 [95% confidence interval (CI) 0.82-0.93] with the optimal cutoff value of 5.65 mmol/l, sensitivity of 84.2%, and specificity of 79.3%. The corresponding values in FPG tests were 0.92 (95% CI 0.88-0.97) (AUC), 6.51 mmol/l (optimal cutoff point), 82.5% (sensitivity) and 98.3% (specificity), respectively. No significant difference was found in the AUC for the two screening strategies. CONCLUSION FCG measurement is considered to be a convenient, practicable screening method in low-resource rural communities with acceptable test properties.
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Affiliation(s)
- X Zhao
- Department of Endocrinology and Metabolism, HuaShan Hospital, No.12, Wulumuqi Middle Road, Shanghai 200040, China
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CC Chow F, Chan S, Hwu C, Suwanwalaikorn S, Wu AYT, Gan SY, Zacarias MB. Challenges in achieving optimal glycemic control in type 2 diabetes patients with declining renal function: The Southeast Asia perspective. J Diabetes Investig 2012; 3:481-9. [PMID: 24843611 PMCID: PMC4015425 DOI: 10.1111/jdi.12006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Revised: 08/02/2012] [Accepted: 08/12/2012] [Indexed: 01/13/2023] Open
Abstract
It is well recognised that Asia is at the epicenter of the global type 2 diabetes epidemic. Driven by socioeconomic changes involving industrialization, urbanization and adoption of Western lifestyles, the unprecedented increases in the prevalence of diabetes are particularly evident in Southeast Asia. The impact of diabetes is immense, and despite evidence of the benefit of optimal glucose control in reducing the risk of disease progression and development of macrovascular and microvascular complications, many individuals in this region remain poorly controlled. Chronic kidney disease (CKD) is an increasingly common diabetes-associated complication in Asian patients. Furthermore, Southeast Asia has one of the highest rates of end-stage renal disease (ESRD) in the world. Consequently, CKD in diabetes is associated with considerable morbidity and cardiovascular-related mortality, highlighting the need to screen and assess patients early in the course of the disease. The management of type 2 diabetes patients with declining renal function represents a significant challenge. Many of the older antidiabetic agents, such as metformin and sulfonylureas, are limited in their utility in CKD as a result of contraindications or hypoglycemic episodes. In contrast, dipeptidyl-peptidase IV inhibitors have provided a welcome addition to the therapeutic armamentarium for achieving glycemic control in these special populations. With comparable efficacy to and more favorable pharmacokinetic and side-effect profiles than traditional therapies, agents in this drug class, such as linagliptin, offer a more tailored approach to disease control in type 2 diabetes patients with declining renal function.
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Affiliation(s)
- Francis CC Chow
- Department of Medicine and TherapeuticsThe Chinese University of Hong KongHong KongSAR
| | - Siew‐Pheng Chan
- Department of MedicineUniversity of Malaya Medical CentreKuala LumpurMalaysia
| | - Chii‐Min Hwu
- Section of Endocrinology and MetabolismDepartment of MedicineTaipei Veterans General HospitalTaipeiTaiwan, PRC
| | - Sompongse Suwanwalaikorn
- Division of Endocrinology and MetabolismDepartment of MedicineChulalongkorn UniversityBangkokThailand
| | | | - Susan Yu Gan
- Department of MedicineMetropolitan Medical Center, Quezon City
| | - Manuel B Zacarias
- Section of CardiologyDepartment of MedicineFaculty of Medicine and SurgeryUniversity of Santo TomasManilaPhilippines
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Li H, Oldenburg B, Chamberlain C, O'Neil A, Xue B, Jolley D, Hall R, Dong Z, Guo Y. Diabetes prevalence and determinants in adults in China mainland from 2000 to 2010: a systematic review. Diabetes Res Clin Pract 2012; 98:226-35. [PMID: 22658670 DOI: 10.1016/j.diabres.2012.05.010] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Accepted: 05/08/2012] [Indexed: 11/26/2022]
Abstract
AIMS To systematically review trends in diabetes mellitus (DM) prevalence in adults in China over the last 10 years and to identify the determinants of these trends. METHODS A systematic search was conducted for studies published between 2000 and 2010. Studies reporting DM prevalence were included if they met the pre-determined criteria. The prevalence estimates and reported determinants of these studies were compared. RESULTS Twenty-five manuscripts, reporting on 22 studies, were selected for inclusion in the review. There has been an increase in DM prevalence from 2.6% to 9.7% in China over the past decade. DM prevalence is strongly associated with age and is higher in urban residents compared with rural populations. Some studies found a difference in DM prevalence between males and females, but this finding was not consistent. Other commonly reported associations with DM included family history, obesity and hypertension. CONCLUSION Over the period of 2000-2010, we identify a significant increase in DM prevalence at the national level. It is important for all levels of government to develop more effective strategies to prevent and manage this rising diabetes epidemic. There is also an important need for more large-scale studies of diabetes in the western and central regions of China.
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Affiliation(s)
- Hang Li
- Department of Epidemiology and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3004, Australia.
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Lower intake of magnesium and dietary fiber increases the incidence of type 2 diabetes in Taiwanese. J Formos Med Assoc 2012; 111:651-9. [PMID: 23217601 DOI: 10.1016/j.jfma.2012.07.038] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Revised: 07/26/2012] [Accepted: 07/30/2012] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND/PURPOSE Several studies have indicated an inverse association between the incidence of diabetes mellitus and magnesium and dietary fiber intake. Few studies have examined both of these associations together, not to mention in Asian populations with prospective study design. We therefore aimed to study how dietary magnesium and fiber intake levels affect diabetes incidence separately or in combination, in a prospective study in Taiwan. METHODS The study subjects were recruited for a longitudinal study, CardioVascular Disease risk FACtor Two-township Study cycle 2 from November 1990. Data from complete baseline information on dietary and biochemical profile and at least one additional follow-up visit were gathered on a total of 1604 healthy subjects aged 30 years and over. Cox proportional hazard model was used to study the association between diabetes incidence and dietary magnesium and fiber intake level estimated from a food frequency questionnaire. RESULTS A total of 141 diabetes mellitus events were identified and confirmed during the 4.6 years of follow-up (7365.1 person-years). A significantly higher diabetes risk was observed for people in the lowest quintile of total dietary fiber intake (hazard ratio = 2.04; 95% CI = 1.17-3.53) and magnesium intake (hazard ratio = 2.61; 95% CI = 1.42-4.79) compared with the highest quintile after adjusting for traditional cardiovascular disease risk factors. Similar inverse associations for total dietary fiber were also shown for vegetable fiber and fruit fiber. CONCLUSION Lower magnesium, lower total dietary fiber intake, or lower intake of both was associated with higher risk of diabetes in the Taiwanese population. Clinical trials are required to confirm the protective effects of the adequate intake of fiber, magnesium, and/or their combination.
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Lin CC, Chen CC, Kung PT, Li CI, Yang SY, Liu CS, Lin WY, Lee CC, Li TC, Kardia SLR. Joint relationship between renal function and proteinuria on mortality of patients with type 2 diabetes: the Taichung Diabetes Study. Cardiovasc Diabetol 2012; 11:131. [PMID: 23083001 PMCID: PMC3515506 DOI: 10.1186/1475-2840-11-131] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Accepted: 10/18/2012] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Estimated glomerular filtration rate (eGFR) is a powerful predictor of mortality in diabetic patients with limited proteinuria data. In this study, we tested whether concomitant proteinuria increases the risk of mortality among patients with type 2 diabetes. METHODS Participants included 6523 patients > 30 years with type 2 diabetes who were enrolled in a management program of a medical center before 2007. Renal function was assessed by eGFR according to the Modification of Diet in Renal Disease Study equation for Chinese. Proteinuria was assessed by urine dipstick. RESULTS A total of 573 patients (8.8%) died over a median follow-up time of 4.91 years (ranging from 0.01 year to 6.42 years). The adjusted expanded cardiovascular disease (CVD)-related mortality rates among patients with proteinuria were more than three folds higher for those with an eGFR of 60 mL/min/1.73 m2 or less compared with those with an eGFR of 90 mL/min/1.73 m2 or greater [hazard ratio, HR, 3.15 (95% confidence interval, CI, 2.0-5.1)]. The magnitude of adjusted HR was smaller in patients without proteinuria [1.98 (95% CI, 1.1-3.7)]. An eGFR of 60 mL/min/1.73 m2 to 89 mL/min/1.73 m2 significantly affected all-cause mortality and mortality from expanded CVD-related causes only in patients with proteinuria. Similarly, proteinuria affected all outcomes only in patients with an eGFR of <60 mL/min/1.73 m2. CONCLUSION The risks of all-cause mortality, as well as expanded and non-expanded mortality from CVD-related causes associated with proteinuria or an eGFR of 90 mL/min/1.73 m2 or greater are independently increased. Therefore, the use of proteinuria measurements with eGFR increases the precision of risk stratification for mortality.
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Affiliation(s)
- Cheng-Chieh Lin
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
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Abstract
AIM This paper is a report of concept analysis of self-efficacy in elderly with diabetes in China. METHODS Literature was systematically retrieved from 2000 to 2011 using five databases: Cumulative Index to Nursing and Allied Health Literature, MEDLINE, OVID, PsycInfo, and Web of Science. The key words used in the search were self-efficacy, diabetes, type 2, aged, self-care, and China. The electronic search was supplemented by a manual search of current issues of periodicals and follow-up of other cited materials, where appropriate. A total of 45 articles were retrieved. After a careful review of the 45 articles most relevant to the topic, 31 articles remained. They were used to complete a concept analysis using Walker and Avant's technique. RESULTS Four defining attributes of self-efficacy were identified: (a) cognitive recognition of requisite specific techniques and skills required to undertake diabetes self-management, (b) perceived expectations of the outcomes of self-management, (c) confidence in the capability to perform self-management, and (d) sustained efforts in self-management of diabetes. CONCLUSIONS Self-efficacy has been an important determinant in self-management among elderly with diabetes. The application of self-efficacy should be incorporated into decision-making and problem-solving procedures when caring for older adults with diabetes.
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Affiliation(s)
- Tingting Liu
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA 30322, USA.
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Wang CY, Lin CL, Huang TS, Chien MN, Hsieh SH, Huang YY, Shih KC, Tu ST, Chang CT, Chien-Ning H, Chou CW, Wu TJ, Liu RT, Lam HC, Kwok CF, Fu CC, Sheu WHH. Inertia on hypoglycemia: highlight from a Taiwan subgroup analysis of Real-Life Effectiveness and Care Patterns of Diabetes Management (RECAP-DM) study. Diabetes Res Clin Pract 2012; 98:61-7. [PMID: 22704126 DOI: 10.1016/j.diabres.2012.05.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2012] [Revised: 05/13/2012] [Accepted: 05/15/2012] [Indexed: 12/31/2022]
Abstract
Type 2 diabetes mellitus is a global health issue. Patients with poor glycemic control often suffer from cardiovascular, cerebrovascular, neuropathic, and nephropathic complications as well as other chronic conditions. Therapeutic guidelines recommend that diabetic patients should maintain their HbA(1c) level below a certain target in order to minimize the risk of developing complications. However, hypoglycemia is recognized as a major impediment to the adequate control of type 2 diabetes. Hypoglycemia can manifest symptoms of varying degrees of severity. Moreover, an association between hypoglycemia and cardiovascular morbidity and mortality has been reported. Here, we present a post hoc Taiwan subgroup analysis of these data collected in the RECAP-DM study to indicate probably more emphasis and concern on hypoglycemia in type 2 diabetic patients in Taiwan. In this analysis, we found no significant difference was observed in treatment-related satisfaction between Taiwanese patients with or without hypoglycemia. Another finding of our study further shows that varying order of hypoglycemic symptoms or severity has no effect on patients' assessment of health-related quality of life scores. We need to pay more attention to this issue because of its enduring impact on compliance and concerns about hypoglycemia in type 2 diabetic patients. Nevertheless, socio-demographic characteristics are also important factors influencing glycemic control and patients' health-related quality of life. Future interventions and therapeutic algorithms should emphasize the probable patients' unawareness or neglect on hypoglycemia in diabetic patients.
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Affiliation(s)
- Chih-Yuan Wang
- Department of Internal Medicine, Far-Eastern Memorial Hospital and National Taiwan University Hospital, Taipei, Taiwan.
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Tam WH, Ma RCW, Yang X, Ko GTC, Lao TTH, Sahota DS, Chan MHM, Lam CWK, Cockram CS, Chan JCN. Prediction of women's long-term cardiometabolic risks using glycemic indices during pregnancy. J Obstet Gynaecol Res 2012; 39:484-91. [DOI: 10.1111/j.1447-0756.2012.01976.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kasama K, Mui W, Lee WJ, Lakdawala M, Naitoh T, Seki Y, Sasaki A, Wakabayashi G, Sasaki I, Kawamura I, Kow L, Frydenberg H, Chen A, Narwaria M, Chowbey P. IFSO-APC consensus statements 2011. Obes Surg 2012; 22:677-84. [PMID: 22367008 DOI: 10.1007/s11695-012-0610-7] [Citation(s) in RCA: 123] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Associations of BMI with body composition and health outcomes may differ between Asian and European populations. Asian populations have also been shown to have an elevated risk of type 2 diabetes, hypertension, and hyperlipidemia at a relatively low level of BMI. New surgical indication for Asian patients should be discussed by the expert of this field. Forty-four bariatric experts in Asia-Pacific and other regions were chosen to have a voting privilege for IFSO-APC Consensus at the 2nd IFSO-APC Congress. A computerized audience-response voting system was used to analyze the agreement with the sentence of the consensus. Of all delegates, 95% agreed with the necessity of the establishment of IFSO-APC consensus statements, and 98% agreed with the necessity of a new indication for Asian patients. IFSO-APC Consensus statements 2011. Bariatric surgery should be considered for the treatment of obesity for acceptable Asian candidates with BMI ≥ 35 with or without co-morbidities. Bariatric/GI metabolic surgery should be considered for the treatment of T2DM or metabolic syndrome for patients who are inadequately controlled by lifestyle alternations and medical treatment for acceptable Asian candidates with BMI ≥ 30. The surgical approach may be considered as a non-primary alternative to treat inadequately controlled T2DM, or metabolic syndrome, for suitable Asian candidates with BMI ≥ 27.5. Other eight sentences are agreed with by majority of the voting delegates to form IFSO-APC consensus statements. This will help to make safe and wholesome the progress of bariatric and metabolic surgery in Asia.
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Affiliation(s)
- Kazunori Kasama
- Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan.
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Okamoto K, Iwasaki N, Doi K, Noiri E, Iwamoto Y, Uchigata Y, Fujita T, Tokunaga K. Inhibition of glucose-stimulated insulin secretion by KCNJ15, a newly identified susceptibility gene for type 2 diabetes. Diabetes 2012; 61:1734-41. [PMID: 22566534 PMCID: PMC3379671 DOI: 10.2337/db11-1201] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Potassium inwardly rectifying channel, subfamily J, member 15 (KCNJ15) is a type 2 diabetes-associated risk gene, and Kcnj15 overexpression suppresses insulin secretion in rat insulinoma (INS1) cells. The aim of the current study was to characterize the role of Kcnj15 by knockdown of this gene in vitro and in vivo. Human islet cells were used to determine the expression of KCNJ15. Expression of KCNJ15 mRNA in islets was higher in subjects with type 2 diabetes. In INS1 cells, Kcnj15 expression was induced by high glucose-containing medium. Regulation of Kcnj15 by glucose and its effect on insulin secretion were analyzed in INS1 cells and in normal mice and diabetic mice by the inactivation of Kcnj15 using small interfering RNA. Knockdown of Kcnj15 increased the insulin secretion in vitro and in vivo. KCNJ15 and Ca(2+)-sensing receptor (CsR) interact in the kidney. Binding of Kcnj15 with CsR was also detected in INS1 cells. In conclusion, downregulation of Kcnj15 leads to increased insulin secretion in vitro and in vivo. The mechanism to regulate insulin secretion involves KCNJ15 and CsR.
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Affiliation(s)
- Koji Okamoto
- Department of Human Genetics, Graduate School of Tokyo University, Tokyo, Japan
- Department of Nephrology and Endocrinology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Naoko Iwasaki
- Diabetes Center, Tokyo Women’s Medical University, Tokyo, Japan
- Institute of Integrated Medical Science, Tokyo Women’s Medical University, Tokyo, Japan
- Institute of Medical Genetics, Tokyo Women’s Medical University, Tokyo, Japan
- Corresponding authors: Katsushi Tokunaga, , and Naoko Iwasaki,
| | - Kent Doi
- Department of Nephrology and Endocrinology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Eisei Noiri
- Department of Nephrology and Endocrinology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | | | - Yasuko Uchigata
- Diabetes Center, Tokyo Women’s Medical University, Tokyo, Japan
| | - Toshiro Fujita
- Department of Nephrology and Endocrinology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Katsushi Tokunaga
- Department of Human Genetics, Graduate School of Tokyo University, Tokyo, Japan
- Corresponding authors: Katsushi Tokunaga, , and Naoko Iwasaki,
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76
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Wang X, Li H, Fan Z, Liu Y. Effect of zinc supplementation on type 2 diabetes parameters and liver metallothionein expressions in Wistar rats. J Physiol Biochem 2012; 68:563-72. [PMID: 22585619 DOI: 10.1007/s13105-012-0174-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Accepted: 04/19/2012] [Indexed: 01/24/2023]
Abstract
Zinc is a trace metal and acts as an active component of various enzymes. Zinc deficiency has been suggested to be associated with the development of diabetes. The present study investigated the role of zinc supplementation on prevention of diabetic conditions. A double-disease model mimicking hyperlipidemia and type 2 diabetes was created by applying high-fat diet and streptozotocin (STZ) to Wistar rats. We demonstrated that zinc supplementation improved symptoms of diabetes such as polydipsia and increased serum level of high-density lipoprotein cholesterol, indicating that zinc supplementation has a potential beneficial effect on diabetic conditions. The level of maldondialdehyde (MDA), an oxidative stress marker, was reduced in liver by zinc supplementation in high fat-fed rats with or without STZ injection. Meanwhile, we observed an increase in the expression of metallothioneins (MTs) in liver of rats treated with zinc. This suggests that the induction of MTs in liver, which has been shown to be important in scavenging free radicals, could be one of the underlying mechanisms of zinc supplementation on reducing MDA levels in liver. Finally, we found that zinc levels in liver were increased while there was no change in serum zinc levels, indicating that local zinc level might be a critical factor for the induction of MTs. Also, the level of MTs could potentially be an index of zinc bioavailability. Taken together, these results suggest that both zinc and MT could play an important role in balancing nutrition and metabolism to prevent diabetic development.
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Affiliation(s)
- Xue Wang
- School of Republic Health, Jilin University, Changchun, People's Republic of China, 130021.
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77
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The rising tide of diabetes mellitus in a Chinese population: a population-based household survey on 121,895 persons. Int J Public Health 2012; 58:269-76. [DOI: 10.1007/s00038-012-0364-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2011] [Revised: 04/14/2012] [Accepted: 04/16/2012] [Indexed: 10/28/2022] Open
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Sivaprasad S, Gupta B, Crosby-Nwaobi R, Evans J. Prevalence of diabetic retinopathy in various ethnic groups: a worldwide perspective. Surv Ophthalmol 2012; 57:347-70. [PMID: 22542913 DOI: 10.1016/j.survophthal.2012.01.004] [Citation(s) in RCA: 225] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2011] [Revised: 01/17/2012] [Accepted: 01/18/2012] [Indexed: 01/10/2023]
Abstract
The alarming rise in diabetes prevalence is a global public health and economic problem. Diabetic retinopathy is the most common complication of diabetes and the leading cause of blindness among working-age populations in the Western world. Screening and prompt treatment of diabetic retinopathy are not top priorities in many regions of the world, because the impacts of other causes of preventable blindness remain an issue. Ethnicity is a complex, independent risk factor for diabetic retinopathy. Observations from white populations cannot be extrapolated fully to other ethnic groups. The prevalence of diabetic retinopathy, sight-threatening diabetic retinopathy, and clinically significant macular edema are higher in people of South Asian, African, Latin American, and indigenous tribal descent compared to the white population. Although all ethnic groups are susceptible to the established risk factors of diabetic retinopathy-such as length of exposure and severity of hyperglycemia, hypertension, and hyperlipidemia-ethnic-specific risk factors also may influence these rates. Such risk factors may include differential susceptibility to conventional risk factors, insulin resistance, differences in anthropometric measurements, truncal obesity, urbanization, variations in access to healthcare systems, genetic susceptibility, and epigenetics. The rates of nonproliferative diabetic retinopathy appear to be declining in the United States, supporting the observation that better medical management of diabetes and prompt treatment of sight-threatening diabetic retinopathy substantially improve the long-term diabetic retinopathy incidence; studies from other parts of the world are limited and do not mirror this finding, however. We examine the ethnicity and region-based prevalence of diabetic retinopathy around the world and highlight the need to reinforce ethnicity-based screening and treatment thresholds in diabetic retinopathy.
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Affiliation(s)
- Sobha Sivaprasad
- King's College Hospital NHS Foundation Trust, Denmark Hill, London, UK.
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79
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Yang YN, Xie X, Ma YT, Li XM, Fu ZY, Ma X, Huang D, Chen BD, Liu F, Huang Y, Liu C, Zheng YY, Baituola G, YU ZX, Chen Y. Type 2 diabetes in Xinjiang Uygur autonomous region, China. PLoS One 2012; 7:e35270. [PMID: 22506076 PMCID: PMC3323648 DOI: 10.1371/journal.pone.0035270] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2011] [Accepted: 03/13/2012] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The aim of this study was to estimate the prevalence and distribution of type 2 diabetes and to determine the status of type 2 diabetes awareness, treatment, and control in Xinjiang, China. Our data came from the Cardiovascular Risk Survey (CRS) study designed to investigate the prevalence and risk factors for cardiovascular diseases in Xinjiang from October 2007 to March 2010. A total of 14 122 persons (5583 Hans, 4620 Uygurs, and 3919 Kazaks) completed the survey and examination. Diabetes was defined by the American Diabetes Association 2009 criteria. METHODOLOGY/PRINCIPAL FINDINGS Overall, 9.26% of the Han, 6.23% of the Uygur, and 3.65% of the Kazak adults aged ≥35 years had diabetes. Among diabetes patients, only 53.0% were aware of their blood glucose level, 26.7% were taking hypoglycemic agents, and 10.4% achieved blood glucose control in Han, 35.8% were aware of their blood glucose level, 7.3% were taking hypoglycemic agents, and 3.13% achieved blood glucose control in Uygur, and 23.8% were aware of their blood glucose level, 6.3% were taking hypoglycemic agents, and 1.4% achieved blood glucose control in Kazak, respectively. CONCLUSIONS/SIGNIFICANCE Our results indicate that diabetes is highly prevalent in Xinjiang. The percentages of those with diabetes who are aware, treated, and controlled are unacceptably low. These results underscore the urgent need to develop national strategies to improve prevention, detection, and treatment of diabetes in Xinjiang, the west China.
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Affiliation(s)
- Yi-Ning Yang
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, People’s Republic, China
| | - Xiang Xie
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, People’s Republic, China
| | - Yi-Tong Ma
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, People’s Republic, China
| | - Xiao-Mei Li
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, People’s Republic, China
| | - Zhen-Yan Fu
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, People’s Republic, China
| | - Xiang Ma
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, People’s Republic, China
| | - Ding Huang
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, People’s Republic, China
| | - Bang-Dang Chen
- Xinjiang Key Laboratory of Cardiovascular Disease Research, Urumqi, People’s Republic China
| | - Fen Liu
- Xinjiang Key Laboratory of Cardiovascular Disease Research, Urumqi, People’s Republic China
| | - Ying Huang
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, People’s Republic, China
| | - Cheng Liu
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, People’s Republic, China
| | - Ying-Ying Zheng
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, People’s Republic, China
| | - Gulinaer Baituola
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, People’s Republic, China
| | - Zi-Xiang YU
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, People’s Republic, China
| | - You Chen
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, People’s Republic, China
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Zhang M, Zeng L, Wang YJ, An ZM, Ying BW. Associations of Fibroblast Growth Factor 21 Gene 3′ Untranslated Region Single-Nucleotide Polymorphisms with Metabolic Syndrome, Obesity, and Diabetes in a Han Chinese Population. DNA Cell Biol 2012; 31:547-52. [PMID: 21988350 DOI: 10.1089/dna.2011.1302] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Mei Zhang
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Li Zeng
- Department of Physical Examination Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - You-Juan Wang
- Department of Physical Examination Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhen-Mei An
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bin-Wu Ying
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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82
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Mu YM, Misra A, Adam JMF, Chan SP, Chow FCC, Cunanan EC, Deerochanawong C, Jang HC, Khue NT, Sheu WHH, Tan KEK. Managing diabetes in Asia: overcoming obstacles and the role of DPP-IV inhibitors. Diabetes Res Clin Pract 2012; 95:179-88. [PMID: 22019271 DOI: 10.1016/j.diabres.2011.09.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2011] [Revised: 09/13/2011] [Accepted: 09/20/2011] [Indexed: 10/16/2022]
Abstract
Asia bears the world's greatest burden of type 2 diabetes (T2DM) and prevalence is increasing rapidly. Compared to other races, Asians develop T2DM younger, at a lower degree of obesity, suffer longer from its complications and die earlier. Curbing this epidemic requires an integrated, risk-based, and multidisciplinary approach. Inadequately managed T2DM has macrovascular and microvascular sequelae, Asians with T2DM being particularly susceptible to diabetic nephropathy. Earlier and more intensive monitoring and management of risk factors are required, especially for patients with, or at risk of, renal impairment. Particular challenges of T2DM management in Asia include: lack of access to specialist healthcare, insufficient clinical evaluation and delayed diagnosis. As in Caucasians, conventional treatment modalities are limited by deteriorating glycaemic control with disease progression and there is an unmet need for efficacious, safe, cost-effective and convenient pharmacotherapies for treating different stages of T2DM and preventing its complications, particularly in high-risk patients. There is a trend towards increasing use of DPP-IV inhibitors, which are no less efficacious and safe in Asians than Caucasians and may have some advantages over existing oral antidiabetic agents, particularly for certain high-risk groups. Such agents may play a significant future role in the management of T2DM.
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Affiliation(s)
- Yi-Ming Mu
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, China.
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83
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Chan JCN, Chan SP, Deerochanawong C, Go RT, Lee KO, Ma RCW, Pan CY, Sheu WHH, Barter P. Diabetic dyslipidaemia in Asian populations in the Western Pacific Region: what we know and don't know. Diabetes Res Clin Pract 2011; 94:1-13. [PMID: 21742396 DOI: 10.1016/j.diabres.2011.05.034] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Revised: 05/10/2011] [Accepted: 05/31/2011] [Indexed: 11/28/2022]
Abstract
Approximately 77 million persons with diabetes reside in the Western Pacific Region. This number is estimated to rise to 113 million in 2030 with increasing burden of cardio-renal disease, affecting an increasingly young population. Randomized clinical trials have confirmed the benefits of using statins to reduce low-density lipoprotein cholesterol in preventing cardiovascular disease (CVD) in Caucasians, although similar data are lacking in Asia. Experts from the Western Pacific Region met and reviewed evidence regarding risk association of diabetic dyslipidaemia with cardio-renal disease, effects of lipid lowering, recommended guidelines and clinical practices in Asian populations. There is strong evidence supporting the role of diabetic dyslipidaemia in cardio-renal disease and the benefits of lipid lowering in these populations. The high rate of diabetic kidney disease, its close links with CVD, and the benefits of lipid lowering on renal function are particularly relevant to this population. While most national guidelines use criteria similar to the West in management of diabetic dyslipidaemia, there are consistently low rates of use of lipid-lowering drugs and attaining treatment goals in the region. The group recommends conducting randomized studies, strengthening of the health care system to promote early detection, and intervention of diabetic dyslipidaemia to prevent end organ damage.
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Affiliation(s)
- Juliana C N Chan
- Hong Kong Institute of Diabetes and Obesity and Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong Special Administrative Region.
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84
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Wu H, Yu Z, Qi Q, Li H, Sun Q, Lin X. Joint analysis of multiple biomarkers for identifying type 2 diabetes in middle-aged and older Chinese: a cross-sectional study. BMJ Open 2011; 1:e000191. [PMID: 22021786 PMCID: PMC3191581 DOI: 10.1136/bmjopen-2011-000191] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE Identifying individuals with high risk of type 2 diabetes is important. To evaluate discriminatory ability of multiple biomarkers for type 2 diabetes in a Chinese population. METHODS Plasma adiponectin, plasminogen activator inhibitor-1, retinol-binding protein 4, resistin, C-reactive protein, interleukin 6 (IL-6), tumour necrosis factor α receptor 2 and ferritin were measured in a population-based sample of 3189 Chinese (1419 men and 1770 women) aged 50-70 years. A weighted biomarkers risk score (BRS) was developed based on the strength of associations of these biomarkers with type 2 diabetes. The discriminatory ability was tested by the area under receiver operating characteristics curve (AUC). RESULTS Adiponectin, plasminogen activator inhibitor-1, IL-6 and ferritin were independently associated with the prevalence of type 2 diabetes, and they were used to calculate the biomarkers risk score (BRS). After adjustment for the confounding factors, the ORs for type 2 diabetes and impaired fasting glucose with each point increment of BRS were 1.28 (95% CI 1.22 to 1.34) and 1.16 (1.12 to 1.20), respectively. Compared with those in the lowest quintile of the BRS, the participants in the highest quintile have an OR (95% CI) of 6.67 (4.21 to 10.55) for type 2 diabetes. The area under the curve for the BRS and conventional risk factors alone was 0.73 and 0.76, respectively, and substantially increased to 0.81 after combining both BRS and conventional risk factors (p<0.001). CONCLUSIONS These data suggest that combining multiple biomarkers and conventional risk factors might substantially enhance the ability to identify individuals with type 2 diabetes. More prospective data are warranted to confirm this observation.
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Affiliation(s)
- Hongyu Wu
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences and Graduate School of the Chinese Academy of Sciences, Shanghai, China
| | - Zhijie Yu
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences and Graduate School of the Chinese Academy of Sciences, Shanghai, China
| | - Qibin Qi
- Department of Nutrtion, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Huaixing Li
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences and Graduate School of the Chinese Academy of Sciences, Shanghai, China
| | - Qi Sun
- Department of Medicine, Channing Laboratory, Boston, Massachusetts, USA
| | - Xu Lin
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences and Graduate School of the Chinese Academy of Sciences, Shanghai, China
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85
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Taiyeb-Ali TB, Raman RPC, Vaithilingam RD. Relationship between periodontal disease and diabetes mellitus: an Asian perspective. Periodontol 2000 2011; 56:258-68. [DOI: 10.1111/j.1600-0757.2010.00370.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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86
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Lam CS, Benzie IF, Choi SW, Chan LY, Yeung VT, Woo GC. Relationships among Diabetic Retinopathy, Antioxidants, and Glycemic Control. Optom Vis Sci 2011; 88:251-6. [DOI: 10.1097/opx.0b013e318208494a] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Narayan KV, Chan J, Mohan V. Early identification of type 2 diabetes: policy should be aligned with health systems strengthening. Diabetes Care 2011; 34:244-6. [PMID: 21193623 PMCID: PMC3005469 DOI: 10.2337/dc10-1952] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- K.M. Venkat Narayan
- Rollins School of Public Health and School of Medicine, Emory University, Atlanta, Georgia
| | - Juliana Chan
- Department of Medicine and Therapeutics, Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, The Prince of Wales Hospital, Hong Kong, China
| | - Viswanathan Mohan
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialties Centre, Chennai, India
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88
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Zhang L, Zhang WH, Zhang L, Wang PY. Prevalence of overweight/obesity and its associations with hypertension, diabetes, dyslipidemia, and metabolic syndrome: a survey in the suburban area of Beijing, 2007. Obes Facts 2011; 4:284-9. [PMID: 21921651 PMCID: PMC6444797 DOI: 10.1159/000331014] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE This study aims to estimate the up-to-date prevalence of overweight/obesity in the suburban area of Beijing, China, and its associations with hypertension, diabetes, dyslipidemia, and metabolic syndrome (MetS). METHODS A cross-sectional survey in 19,003 suburban adults was carried out in Beijing, 2007. Overweight and obesity class 1, 2, and 3 were defined as a body mass index (BMI) of 25.0-29.9, 30.0-34.9, 35.0-39.9, and ≥ 40 kg/m(2), respectively. RESULTS The age-standardized prevalence of overweight/obesity was 31.9% in the study. With increasing BMI, the prevalence of hypertension, diabetes, dyslipidemia, and MetS also increased. With normal body weight as reference, the adjusted odds ratio (95% confidence interval) of hypertension for overweight and obesity class 1-3 was 2.5 (2.2-2.7), 3.1 (2.8-3.4), 3.6 (3.1-4.3), and 4.5 (4.0-5.2), respectively. The same trend was observed for diabetes and MetS. For dyslipidemia, however, participants with obesity class 2 had the highest odds ratio. CONCLUSION The prevalence of hypertension, diabetes, dyslipidemia, and MetS increases with increasing BMI. Overweight/obesity is an important risk factor for these diseases. To reduce the social burden of these obesity-related diseases, effective strategies for the prevention of overweight/obesity should be implemented.
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Affiliation(s)
- Lei Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Epidemiology, Peking University Cancer Hospital & Institute, Beijing
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Wei-Hong Zhang
- Department of Basic Medicine, Nursing College, Zhengzhou University, Zhengzhou
| | - Lian Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Epidemiology, Peking University Cancer Hospital & Institute, Beijing
| | - Pei-Yu Wang
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
- * Department of Social Medicine and Health Education, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, 100191Beijing, China, Tel./Fax +86 10 8280 2502,
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Lee JSW, Auyeung TW, Leung J, Kwok T, Leung PC, Woo J. The effect of diabetes mellitus on age-associated lean mass loss in 3153 older adults. Diabet Med 2010; 27:1366-71. [PMID: 21059088 PMCID: PMC3059762 DOI: 10.1111/j.1464-5491.2010.03118.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
AIMS Diabetes mellitus may be associated with excessive lean mass loss. Other diabetes-related conditions may also play a role. We assessed body composition changes associated with diabetes in older adults with adjustment for diabetes-related co-morbidities. METHODS Three thousand, one hundred and fifty-three community-living adults aged ≥ 65 years were examined for lifestyle factors, diabetes-related medical conditions and body composition by dual energy X-ray absorptiometry at baseline and 4 years later. Body composition changes were compared between participants with diabetes and those without diabetes. Multivariate linear regression was used to examine the relationship between appendicular lean mass loss and confounders. RESULTS Appendicular lean mass loss in men with diabetes was two times that of men without diabetes (-1.5% in 'no diabetes' vs. -3.0% in 'diabetes') and in women with diabetes was 1.8 times that of those without diabetes (-1.9% in 'no diabetes' vs. -3.4% in 'diabetes') over 4 years. Men with diabetes also had higher total body mass loss and higher total body fat loss than men without diabetes. Women with diabetes had higher total body mass loss but total body fat loss was similar. After adjusting for age, body mass index, diabetes-related conditions, lifestyle factors and total body mass loss, diabetes remained an independent predictor of appendicular lean mass loss in both men and women. CONCLUSION Diabetes was associated with higher body mass loss and higher appendicular lean mass loss in older adults. In men, diabetes was also associated with total body fat loss.
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Affiliation(s)
- J S W Lee
- Division of Geriatrics, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
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90
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Li Z, Liu J, Ye R, Zhang L, Pei L, Zheng X, Ren A. Maternal prepregnancy body mass index and risk of neural tube defects: A population-based case-control study in Shanxi province, China. ACTA ACUST UNITED AC 2010; 88:570-4. [PMID: 20641099 DOI: 10.1002/bdra.20678] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Many studies from the Western world have indicated that maternal obesity is associated with an increased risk of neural tube defects (NTDs). However, few reports have been available on this association from Asian populations. Our aim was to examine the relationship between maternal prepregnancy body mass index (BMI) and the risk of NTDs in a population of northern China. METHODS Data were derived from an ongoing population-based case-control study of birth defects in Shanxi province, China. Subjects were 511 NTD cases and 687 controls selected from the same population between January 2003 and June 2007. BMI was based on maternal height and prepregnancy weight as reported within 1 week of delivery. RESULTS We found no significantly increased risk of NTDs for obese women (adjusted odds ratio [OR], 0.65; 95% confidence interval [CI], 0.29-1.49) or for underweight women (adjusted OR, 1.00; 95% CI, 0.62-1.62) relative to normal-weight women. We found a significantly reduced risk of overall NTDs (adjusted OR, 0.56; 95% CI, 0.41-0.76) and anencephaly (adjusted OR, 0.40; 95% CI, 0.26-0.62) for overweight women compared to normal-weight women. CONCLUSIONS Our results do not support the association between maternal prepregnancy obesity and increased risk of overall NTDs or of any subtype of NTDs in the Chinese population.
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Affiliation(s)
- Zhiwen Li
- Institute of Reproductive and Child Health, Peking University Health Science Center, Beijing, China
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Chen YM, Hu FR, Huang JY, Shen EP, Tsai TY, Chen WL. The effect of topical autologous serum on graft re-epithelialization after penetrating keratoplasty. Am J Ophthalmol 2010; 150:352-359.e2. [PMID: 20579630 DOI: 10.1016/j.ajo.2010.03.024] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2009] [Revised: 03/23/2010] [Accepted: 03/24/2010] [Indexed: 10/19/2022]
Abstract
PURPOSE To analyze factors influencing corneal graft re-epithelialization after penetrating keratoplasty (PK) and evaluate the effect of topical autologous serum in promoting graft re-epithelialization. DESIGN Prospective interventional study. METHODS We analyzed 165 eyes of 165 patients who underwent PK between January 1, 2005 and December 31, 2007. Patients were divided into 2 groups according to routine use or non-use of postoperative 20% topical autologous serum. Postoperative slit-lamp examination after fluorescein staining was performed, and graft re-epithelialization time was recorded. Recipient/donor characteristics, surgical variables, and topical use of autologous serum were analyzed for their effects on post-PK graft re-epithelialization. Statistical analysis was performed by univariate and multivariate regression analysis using the ordinal logistic fit model to assess the potential risk factors influencing graft re-epithelialization after PK. RESULTS In univariate analysis, diabetes mellitus (DM), longer death-to-storage time and death-to-surgery time of the donor, and larger recipient size significantly delayed graft re-epithelialization (P < .05). Use of autologous serum significantly expedited graft re-epithelialization (P = .004). In multiple regression analysis, only DM in the recipient (odds ratio [OR] = 5.10, P < .001), postoperative use of autologous serum (OR = 0.54, P = .046), and larger graft size (OR = 4.44, P < .001) influenced graft re-epithelialization. The beneficial and healing effect of autologous serum is particularly significant in diabetic recipients and larger grafts. CONCLUSIONS Several factors may influence graft re-epithelialization after PK. Graft re-epithelialization time was longer in diabetic recipients and larger grafts. Use of autologous serum may be a beneficial strategy in these patients with potentially delayed epithelial healing.
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92
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Pan C, Shang S, Kirch W, Thoenes M. Burden of diabetes in the adult Chinese population: A systematic literature review and future projections. Int J Gen Med 2010; 3:173-9. [PMID: 20689690 PMCID: PMC2915528 DOI: 10.2147/ijgm.s6343] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2010] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The diabetes epidemic in China imposes an increasing burden on the health care system and the economy. We derived prospective diabetes prevalence rates in China until 2016 from a systematic review of the published literature in the period 1987-2007. The results could help to guide resources of the Chinese health care system in order to address the diabetes epidemic. METHODS We selected articles published in the English/Chinese languages from MEDLINE and the China Wanfang Digital Database using the keywords "China", "diabetes mellitus", "prevalence", and "epidemiology" in order to estimate the current diabetes prevalence in China. For projecting future prevalence rates, we considered the population growth, and assumed that China's diabetes prevalence in first tier cities in 2016 would equal Hong Kong's diabetes prevalence in 2007. RESULTS The number of Chinese adults with diabetes is projected to rise from 53.1 million in 2009 to 76.1 million in 2016. The estimated diabetes prevalence rate in China in 2009 was 3.9% (urban 5.2%, rural 2.9%) and is projected to increase to 5.4% (urban 6.9%, rural 3.8%) in 2016, corresponding to an annual consolidated aggregate growth rate of 4.6%. CONCLUSION We estimate a considerably higher diabetes prevalence in the adult Chinese population than that reported in previous studies. The diabetes prevalence will continue to rise in the future, which points to the importance of increasing awareness and better diagnosis of diabetes in China.
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Affiliation(s)
- Changyu Pan
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, China
| | - Shuhua Shang
- Medical Department, Sanofi-aventis China, Shanghai, China
| | - Wilhelm Kirch
- Institute for Clinical Pharmacology, Technical University Dresden, Dresden, Germany
| | - Martin Thoenes
- Medical Department, Sanofi-aventis China, Shanghai, China
- Institute for Clinical Pharmacology, Technical University Dresden, Dresden, Germany
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93
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Chang CH, Shau WY, Jiang YD, Li HY, Chang TJ, Sheu WHH, Kwok CF, Ho LT, Chuang LM. Type 2 diabetes prevalence and incidence among adults in Taiwan during 1999-2004: a national health insurance data set study. Diabet Med 2010; 27:636-43. [PMID: 20546280 DOI: 10.1111/j.1464-5491.2010.03007.x] [Citation(s) in RCA: 117] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AIM To evaluate annual prevalence and incidence of Type 2 diabetes and to examine possible trends among adults in Taiwan. METHODS A retrospective nationwide longitudinal study using the Taiwan National Health Insurance Research Database collected during 1999-2004. Adult patients aged > or = 20 years old with prevalent and incident Type 2 diabetes were identified using ICD-9-CM diagnostic codes. Age-specific and age-direct-standardized annual incidence and prevalence were calculated to describe their trends in different gender and age group and compared using Poisson regression. RESULTS During the study years, the age-standardized prevalence of Type 2 diabetes increased from 4.7 to 6.5% for men and from 5.3 to 6.6% for women. The increasing trends in prevalence were significant and higher among people aged < 40 and > or = 80 years. The age-standardized incidence rates of Type 2 diabetes per 1000 person-years were approximately 7.6 and remain stable for men, but decreasing from 7.7 to 6.9 for women. However, the incidence increased significantly in younger adults aged < 40 years whose relative incidence (RI with 95% confidence interval) was 1.31 (1.20-1.42) for men and 1.04 (1.01-1.08) for women. The incidence trends for people aged > or = 40 years were decreased for men and women. The differences in incidence trends between age groups and between genders were all statistically significant (all P < 0.001). CONCLUSIONS This study demonstrated a substantial increasing trend in Type 2 diabetes prevalence during 1999-2004 among adults in Taiwan. Despite the incidence decreased in older people, young men aged 20-40 years were most susceptible to higher incidence of Type 2 diabetes.
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Affiliation(s)
- C H Chang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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94
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Hu J, Gruber KJ, Hsueh KH. Psychometric properties of the Chinese version of the SF-36 in older adults with diabetes in Beijing, China. Diabetes Res Clin Pract 2010; 88:273-81. [PMID: 20392508 DOI: 10.1016/j.diabres.2010.03.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2009] [Revised: 12/22/2009] [Accepted: 03/08/2010] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study investigated the psychometric properties of the 36-item Short-Form Health Survey (SF-36) (China version) in older Chinese with diabetes living in Beijing, China. METHODS The SF-36 was administered to community-based sample of 182 older adults with diabetes living in Beijing. Data collection was conducted in face-to-face interviews. Reliability and validity were assessed using internal consistency, convergent and discriminant analyses. Exploratory principal components analyses (PCA) were conducted to compare the sample's response patterns with the hypothesized scale constructs. RESULTS Item level validation of the scale supported the assumptions of the hypothesized structure. Internal consistency reliability (Cronbach's alpha >.70) of the subscales were acceptable except for the General Health subscale (.67). PCA confirmed general support of the two hypothesized dimensional factors and eight concepts (factors). The physical component summary (PCS) and the mental component summary (MCS) explained 62.26% of the variance and the eight factors components explained 67.39% of the variance. Known-group comparisons of scale scores indicated significantly higher levels of functionality for respondents with no blood pressure, heart, or depressive symptomatology problems. CONCLUSIONS The Chinese version of the SF-36 showed good reliability and validity and was culturally equivalent. The scale is appropriate for use with older Chinese adults with diabetes.
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Affiliation(s)
- Jie Hu
- The University of North Carolina at Greensboro, School of Nursing, P.O. Box 26170 Greensboro, NC 27402-6170, USA.
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95
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Use of eye care services among diabetic patients in urban and rural China. Ophthalmology 2010; 117:1755-62. [PMID: 20471689 DOI: 10.1016/j.ophtha.2010.01.019] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2009] [Revised: 01/07/2010] [Accepted: 01/07/2010] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To assess the use of eye care and its predictors among diabetic patients in China. DESIGN Cross-sectional, clinic-based study. PARTICIPANTS Diabetic patients 18 years of age or older were recruited consecutively from an urban tertiary and community hospitals and from a rural clinic in Guangdong, China. METHODS Information obtained by questionnaire and chart review included: demographic and socioeconomic status, knowledge about diabetic retinopathy (DR), and ocular and medical history. MAIN OUTCOME MEASURES Self-reported or chart history of an eye examination ever or within the preceding 12 months. RESULTS The participation rate among 889 eligible subjects was 92.7%. Among 824 participants (mean age, 62.6+/-12.9 years; 58.8% female), 550 (66.7%) had not been examined in the last year as recommended by the American Academy of Ophthalmology, and 356 (43.2%) had never been examined. For the rural hospital, these figures were 81.1% and 68.7%, respectively. In regression analyses, factors associated with having an eye examination in the last year were: attendance at urban hospitals (odds ratio [OR], 3.46 [P<0.001] and 1.76 [P = 0.021] for the tertiary and community hospitals, respectively, compared with the rural clinic), higher DR knowledge score (OR, 1.24; P = 0.001), greater concern about vision loss (OR, 1.22; P = 0.007), and recommendation of regular eye examinations by the provider (OR, 2.36; P = 0.011). Predictors of ever having an eye examination were similar. Monthly income and health insurance status were not predictive of being examined. CONCLUSIONS These results suggest that the low proportion of diabetic receiving recommended annual eye examinations in China may be improved through patient and physician education.
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96
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Overt diabetes mellitus adversely affects surgical outcomes of noncardiovascular patients. Surgery 2010; 147:670-5. [DOI: 10.1016/j.surg.2009.10.070] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2009] [Accepted: 10/27/2009] [Indexed: 11/22/2022]
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97
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Hu J, Wallace DC, Jones E, Liu H. Cardiometabolic health of Chinese older adults with diabetes living in Beijing, China. Public Health Nurs 2010; 26:500-11. [PMID: 19903270 DOI: 10.1111/j.1525-1446.2009.00810.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Using the PRECEDE-PROCEED model, this study examined the presence of metabolic syndrome and modifiable cardiovascular disease (CVD) risk factors associated with metabolic syndrome among Chinese adults with diabetes living in Beijing, China. DESIGN AND SAMPLE The cross-sectional study collected data through face-to-face interviews. The study included 73 Chinese older adults with diabetes. Their mean age was 68 years (+ or - 7.66), with a range from 52 to 90 years. MEASUREMENTS Data were collected on demographic characteristics, blood pressure (BP), body mass index (BMI), waist circumference, lipid profile and fasting glucose, physical activity, diet, and health status. RESULTS The great majority (85%) had metabolic syndrome; 65% had hypertension; 52% had high levels of low-density lipoproteins, and 80.6% had a high level of fasting glucose. Half of the participants (51.4%) were overweight, 16.7% were obese, and 86.3% had central obesity. Age, gender, BMI, income, insurance, smoking history, physical activity, and diet explained 23% of the variance in the metabolic syndrome component, systolic blood pressure. CONCLUSIONS The association of predisposing and enabling factors and health behavior with the metabolic syndrome needs to be further explored. Persons with diabetes should have regular health screenings to check for blood pressure, BMI, cholesterol, glucose, and triglycerides in order to decrease the risks associated with metabolic syndrome and CVD.
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Affiliation(s)
- Jie Hu
- The University of North Carolina at Greensboro, School of Nursing, PO Box 26170, Greensboro, NC 27402-6170,USA.
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98
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Okamoto K, Iwasaki N, Nishimura C, Doi K, Noiri E, Nakamura S, Takizawa M, Ogata M, Fujimaki R, Grarup N, Pisinger C, Borch-Johnsen K, Lauritzen T, Sandbaek A, Hansen T, Yasuda K, Osawa H, Nanjo K, Kadowaki T, Kasuga M, Pedersen O, Fujita T, Kamatani N, Iwamoto Y, Tokunaga K. Identification of KCNJ15 as a susceptibility gene in Asian patients with type 2 diabetes mellitus. Am J Hum Genet 2010; 86:54-64. [PMID: 20085713 PMCID: PMC2801752 DOI: 10.1016/j.ajhg.2009.12.009] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2009] [Revised: 11/07/2009] [Accepted: 12/04/2009] [Indexed: 11/29/2022] Open
Abstract
Recent advances in genome research have enabled the identification of new genomic variations that are associated with type 2 diabetes mellitus (T2DM). Via fine mapping of SNPs in a candidate region of chromosome 21q, the current study identifies potassium inwardly-rectifying channel, subfamily J, member 15 (KCNJ15) as a new T2DM susceptibility gene. KCNJ15 is expressed in the beta cell of the pancreas, and a synonymous SNP, rs3746876, in exon 4 (C566T) of this gene, with T allele frequency among control subjects of 3.1%, showed a significant association with T2DM affecting lean individuals in three independent Japanese sample sets (p = 2.5 x 10(-7), odds ratio [OR] = 2.54, 95% confidence interval [CI] = 1.76-3.67) and with unstratified T2DM (p = 6.7 x 10(-6), OR = 1.76, 95% CI = 1.37-2.25). The diabetes risk allele frequency was, however, very low among Europeans in whom no association between this variant and T2DM could be shown. Functional analysis in human embryonic kidney 293 cells demonstrated that the risk allele of the synonymous SNP in exon 4 increased KCNJ15 expression via increased mRNA stability, which resulted in the higher expression of protein as compared to that of the nonrisk allele. We also showed that KCNJ15 is expressed in human pancreatic beta cells. In conclusion, we demonstrated a significant association between a synonymous variant in KCNJ15 and T2DM in lean Japanese patients with T2DM, suggesting that KCNJ15 is a previously unreported susceptibility gene for T2DM among Asians.
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Affiliation(s)
- Koji Okamoto
- Department of Human Genetics, Graduate School of Tokyo University, Tokyo 113-0033, Japan
- Department of Nephrology and Endocrinology, Graduate School of Medicine, University of Tokyo, Tokyo 113-0033, Japan
| | - Naoko Iwasaki
- Diabetes Center, Tokyo Women's Medical University, Tokyo 162-8666, Japan
- Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo 162-8666, Japan
- Institute of Medical Genetics, Tokyo Women's Medical University, Tokyo 162-8666, Japan
| | - Chisa Nishimura
- Department of Human Genetics, Graduate School of Tokyo University, Tokyo 113-0033, Japan
| | - Kent Doi
- Department of Human Genetics, Graduate School of Tokyo University, Tokyo 113-0033, Japan
- Department of Nephrology and Endocrinology, Graduate School of Medicine, University of Tokyo, Tokyo 113-0033, Japan
| | - Eisei Noiri
- Department of Nephrology and Endocrinology, Graduate School of Medicine, University of Tokyo, Tokyo 113-0033, Japan
| | - Shinko Nakamura
- Diabetes Center, Tokyo Women's Medical University, Tokyo 162-8666, Japan
| | - Miho Takizawa
- Diabetes Center, Tokyo Women's Medical University, Tokyo 162-8666, Japan
| | - Makiko Ogata
- Diabetes Center, Tokyo Women's Medical University, Tokyo 162-8666, Japan
| | - Risa Fujimaki
- Diabetes Center, Tokyo Women's Medical University, Tokyo 162-8666, Japan
| | - Niels Grarup
- Hagedorn Research Institute, 2820 Gentofte, Copenhagen, Denmark
| | - Charlotta Pisinger
- Research Centre for Prevention and Health, Glostrup University Hospital, 2600 Glostrup, Denmark
| | - Knut Borch-Johnsen
- Steno Diabetes Center, 2820 Gentofte, Copenhagen, Denmark
- Faculty of Health Sciences, University of Aarhus, 8000 Aarhus, Denmark
| | - Torsten Lauritzen
- Department of General Practice, University of Aarhus, 8000 Aarhus, Denmark
| | - Annelli Sandbaek
- Department of General Practice, University of Aarhus, 8000 Aarhus, Denmark
| | - Torben Hansen
- Hagedorn Research Institute, 2820 Gentofte, Copenhagen, Denmark
- Faculty of Health Sciences, University of Southern Denmark, 5230 Odense, Denmark
| | - Kazuki Yasuda
- Department of Metabolic Disorder, Research Institute, International Medical Center of Japan, Tokyo 162-8655, Japan
| | - Haruhiko Osawa
- Department of Molecular and Genetic Medicine, Ehime University Graduate School of Medicine, Ehime 790-8577, Japan
| | - Kishio Nanjo
- First Department of Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Takashi Kadowaki
- Department of Metabolic Diseases, Graduate School of Medicine, University of Tokyo, Tokyo 113-0033, Japan
| | - Masato Kasuga
- Division of Diabetes, Metabolism, and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Oluf Pedersen
- Hagedorn Research Institute, 2820 Gentofte, Copenhagen, Denmark
- Faculty of Health Sciences, University of Aarhus, 8000 Aarhus, Denmark
- Institute of Biomedical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Toshiro Fujita
- Department of Nephrology and Endocrinology, Graduate School of Medicine, University of Tokyo, Tokyo 113-0033, Japan
| | - Naoyuki Kamatani
- Institute of Rheumatology, Tokyo Women's Medical University, Tokyo 162-8666, Japan
| | - Yasuhiko Iwamoto
- Diabetes Center, Tokyo Women's Medical University, Tokyo 162-8666, Japan
| | - Katsushi Tokunaga
- Department of Human Genetics, Graduate School of Tokyo University, Tokyo 113-0033, Japan
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Peng LN, Lin MH, Lai HY, Hwang SJ, Chen LK, Chiou ST. Risk factors of new onset diabetes mellitus among elderly Chinese in rural Taiwan. Age Ageing 2010; 39:125-8. [PMID: 19897541 DOI: 10.1093/ageing/afp193] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Li-Ning Peng
- Department of Family Medicine, Taipei Veterans General Hospital, Taiwan
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100
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Wang H, Qiu Q, Tan LL, Liu T, Deng XQ, Chen YM, Chen W, Yu XQ, Hu BJ, Chen WQ. Prevalence and determinants of diabetes and impaired fasting glucose among urban community-dwelling adults in Guangzhou, China. DIABETES & METABOLISM 2009; 35:378-84. [DOI: 10.1016/j.diabet.2009.03.006] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2008] [Revised: 03/03/2009] [Accepted: 03/09/2009] [Indexed: 01/15/2023]
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