51
|
Bae J, Kim SH, Won YJ, Kim YM. Age- and Sex-Specific Differences in Distribution of Cardiometabolic Diseases and Associations of Hand-Grip Strength Indices with Type 2 Diabetes in Korean Adults. Metab Syndr Relat Disord 2022; 20:199-209. [PMID: 35020479 DOI: 10.1089/met.2021.0105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background: To evaluate age- and sex-specific differences in the distribution of cardiometabolic diseases and associations of hand-grip strength (HGS) indices with type 2 diabetes (T2D). Methods: This cross-sectional observational study enrolled participants from the Korea National Health and Nutrition Examination Survey (n = 16,126, age ≥19 years). Information on cardiometabolic diseases was obtained through surveys or proper criteria applied for undiagnosed participants. Absolute and body size-adjusted HGS indices were evaluated. Clinical manifestations were compared, and associations of HGS indices with T2D were estimated by using odd ratio (OR). Results: Prevalence of T2D in all, younger, and older groups were 13.1%, 4.2%, and 21.4%, respectively. Proportions of cardiometabolic diseases were all higher in those with than without T2D in sex-stratified age groups, whereas obesity (OB) and nonalcoholic fatty liver disease (NAFLD) were higher in younger T2D, and hypertension (HTN) was higher in older T2D in both sexes. Adjusted HGS significantly correlated with cardiometabolic parameters, and thus, high ORs for T2D in low tertiles of adjusted HGS were shown in all groups, whereas high ORs for T2D in low tertiles of absolute HGS were observed only in older men. Conclusions: Among highly prevalent cardiometabolic diseases associated with T2D, OB and NAFLD were more prevalent in younger T2D, but HTN was more prevalent in older T2D in both sexes. Low adjusted HGS was associated with higher T2D risk in all groups, whereas low absolute HGS was associated with higher T2D risk in older men. Thus, adjusted HGS might be useful in screening especially younger or obese T2D.
Collapse
Affiliation(s)
- Jaehyun Bae
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, Korea
| | - Se Hwa Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, Korea
| | - Young Jun Won
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, Korea
| | - Yoo Mee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, Korea
| |
Collapse
|
52
|
Hao Z, Huang X, Liu X, He F, Shao H. Association Analysis Between Different Diabetic Family History and Gender with Diagnosed Age of Type 2 Diabetes Mellitus: A Cross-Sectional Study in Tianjin, China. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2022; 59:469580221086364. [PMID: 35348394 PMCID: PMC8969500 DOI: 10.1177/00469580221086364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Type 2 diabetes mellitus (T2DM) was previously considered a common disease in middle-aged and older people, but the age of diagnosis of T2DM is advancing every year, and the trend toward a younger age is obvious. Early-onset T2DM is a clinical syndrome caused by genetic and environmental factors. This study aimed to investigate the association between diabetic family history and gender with the diagnosed age of T2DM. Methods The newly diagnosed T2DM patients admitted to the diabetes identification center of Tianjin 4th Central Hospital (TJ4thch) from October 2017 to June 2020 were registered. According to whether the diagnosis age is over 40 years old, patients were divided into 2 groups (early-onset T2DM group and late-onset T2DM group). In the study, the T2DM family history was divided into 5 types: (a) Father T2DM: father with T2DM, but not the mother; (b) Mother T2DM: mother with T2DM, but not the father; (c) Both parents with T2DM; (d) Another relative(s) (other than the parents) with a history of T2DM; and (e) Without a family history of T2DM. The diagnosed age with different genders and diabetic family history was compared. Multivariate logistic regression analysis was used to investigate the association factors of early-onset T2DM. Results A total of 3725 patients completed the survey. There were 589 patients (15.8%) with early-onset T2DM, and 2469 patients (66.3%) had a diabetic family history. The T2DM-diagnosed age in males was lower than in females (51.7 ± 11.2 vs 54.0 ± 10.2, P = .000). The result was also reflected in the different T2DM family histories (with Both parents T2DM, 46.7 ± 11.1 vs 48.5 ± 10.3, P = .271; with Father T2DM, 46.8 ± 10.8 vs 49.8 ± 11.3, P = .005; with Mother T2DM, 50.4 ± 10.6 vs 52.3 ± 10.2, P = .019; with Other T2DM family history, 54.0 ± 10.8 vs 55.7 ± 9.5, P = .008; with no T2DM family history, 53.0 ± 11.0 vs 55.9 ± 9.3, P = .000). The order of the T2DM-diagnosed age in the different groups was Both parents T2DM (47.5 ± 11.0) and Father T2DM (47.9 ± 11.1) family history < that with Mother T2DM family history (51.1 ± 10.5) < that with Other T2DM family history (54.7 ± 10.3) and no T2DM family history (54.1 ± 10.5). Logistic regression analysis indicated that gender (OR, 1.733; P = .000), Father T2DM history (OR, 2.738; P = .000), Mother T2DM history (OR, 1.536; P = .001), Both parents T2DM (OR, 2.866; P = .000) and body mass index (OR, 1.108, P = .000) were correlated with early-onset T2DM. Conclusion Patients with early-onset T2DM tend to have a more obvious T2DM family history in China. This survey shows that when a parent has a T2DM family history, especially the father with T2DM, male patients are diagnosed with T2DM earlier. We need more intensive screening for diabetes in children with a family history of diabetes, especially in male children.
Collapse
Affiliation(s)
- Zhaohu Hao
- Department of Metabolic Disease Management Center, Tianjin 4th Central Hospital, The 4th Central Hospital Affiliated to Nankai University, 159424The 4th Center Clinical College of Tianjin Medical University, Tianjin, China
| | - Xiao Huang
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Xiaohui Liu
- Department of Endocrinology, 159423Tianjin Fourth Central Hospital, Tianjin, China
| | - Feng He
- Department of Cardiology, 159423Tianjin Fourth Central Hospital, Tianjin, China
| | - Hailin Shao
- Department of Metabolic Disease Management Center, Tianjin 4th Central Hospital, The 4th Central Hospital Affiliated to Nankai University, 159424The 4th Center Clinical College of Tianjin Medical University, Tianjin, China
| |
Collapse
|
53
|
Titmuss A, Davis EA, O'Donnell V, Wenitong M, Maple-Brown LJ, Haynes A. Youth-onset type 2 diabetes among First Nations young people in northern Australia: a retrospective, cross-sectional study. Lancet Diabetes Endocrinol 2022; 10:11-13. [PMID: 34756177 DOI: 10.1016/s2213-8587(21)00286-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 10/11/2021] [Accepted: 10/11/2021] [Indexed: 01/03/2023]
Affiliation(s)
- Angela Titmuss
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT 0811, Australia; Department of Paediatrics, Division of Women, Children and Youth, Darwin, NT, Australia; Royal Darwin Hospital, Darwin, NT, Australia.
| | - Elizabeth A Davis
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Vicki O'Donnell
- Kimberley Aboriginal Medical Services, Broome, WA, Australia
| | - Mark Wenitong
- Apunipima Cape York Health Council, Cairns, QLD, Australia
| | - Louise J Maple-Brown
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT 0811, Australia; Endocrinology Department, Division of Medicine, Darwin, NT, Australia.
| | - Aveni Haynes
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | | |
Collapse
|
54
|
Fetal abdominal overgrowth is already present at 20-24 gestational weeks prior to diagnosis of gestational diabetes mellitus. Sci Rep 2021; 11:23821. [PMID: 34893662 PMCID: PMC8664824 DOI: 10.1038/s41598-021-03145-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 11/26/2021] [Indexed: 12/17/2022] Open
Abstract
Fetal abdominal obesity (FAO) was detected at the time of gestational diabetes mellitus (GDM) diagnosis at 24–28 gestational weeks (GW) in older (≥ 35 years) and/or obese (≥ body mass index 25 kg/m2) women and persisted until delivery. We investigated whether FAO is already present at 20–24 GW. Medical records of 7820 singleton pregnancy including 384 GDM were reviewed. Fetal abdominal overgrowth was assessed by the fetal abdominal overgrowth ratios (FAORs) of the ultrasonographically estimated gestational age (GA) of abdominal circumference per actual GA by the last menstruation period, biparietal diameter or femur length, respectively. FAO was defined as FAOR ≥ 90th percentile. FAORs measured at 20–24 GW in older and/or obese but not in young and non-obese GDM subjects were significantly higher than those in NGT subjects. Relative to NGT subjects without FAO at 20–24 GW, odds ratios for exhibiting FAO at GDM diagnosis and large for gestational age in GDM with FAO at 20–24 GW were 10.15 and 5.57, and their primary cesarean delivery rate was significantly higher than those in GDM without FAO (44% vs. 29%). Earlier diagnosis and active interventions of GDM well before 20–24 GW might be necessary to prevent FAO in the older and/or obese women.
Collapse
|
55
|
Wijayaratna S, Lee A, Park HY, Jo E, Wu F, Bagg W, Cundy T. Socioeconomic status and risk factors for complications in young people with type 1 or type 2 diabetes: a cross-sectional study. BMJ Open Diabetes Res Care 2021; 9:9/2/e002485. [PMID: 34969690 PMCID: PMC8719138 DOI: 10.1136/bmjdrc-2021-002485] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 11/26/2021] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Young people with type 2 diabetes (T2D) develop complications earlier than those with type 1 diabetes (T1D) of comparable duration, but it is unclear why. This apparent difference in phenotype could relate to relative inequality. RESEARCH DESIGN AND METHODS Cross-sectional study of young people referred to secondary diabetes services in Auckland, Aotearoa-New Zealand (NZ): 731 with T1D and 1350 with T2D currently aged <40 years, and diagnosed between 15 and 30 years. Outcome measures were risk factors for complications (glycemic control, urine albumin/creatinine ratio (ACR), cardiovascular disease (CVD) risk) in relation to a validated national index of deprivation (New Zealand Deprivation Index (NZDep)). RESULTS Young people with T2D were an average 3 years older than those with T1D but had a similar duration of diabetes. 71% of those with T2D were of Māori or Pasifika descent, compared with 24% with T1D (p<0.001). T1D cases were distributed evenly across NZDep categories. 78% of T2D cases were living in the lowest four NZDep categories (p<0.001). In both diabetes types, body mass index (BMI) increased progressively across the NZDep spectrum (p<0.002), as did mean glycated hemoglobin (HbA1c) (p<0.001), the prevalence of macroalbuminuria (p≤0.01), and CVD risk (p<0.001). Adjusting for BMI, diabetes type, and duration and age, multiple logistic regression revealed deprivation was the strongest risk factor for poorly controlled diabetes (defined as HbA1c >64 mmol/mol, >8%); OR 1.17, 95% CI 1.13 to 1.22, p<0.0001. Ordinal logistic regression showed each decile increase in NZDep increased the odds of a higher ACR by 11% (OR 1.11, 95% CI 1.06 to 1.16, p<0.001) following adjustment for BMI, blood pressure, diabetes type and duration, HbA1c, and smoking status. Multiple linear regression indicated a 4% increase in CVD risk for every decile increase in NZDep, regardless of diabetes type. CONCLUSIONS The apparent more aggressive phenotype of young-onset T2D is at least in part explicable by relative deprivation.
Collapse
Affiliation(s)
- Sasini Wijayaratna
- Auckland Diabetes Centre, Auckland District Health Board, Auckland, Aotearoa-New Zealand
- Department of Medicine, The University of Auckland Faculty of Medical and Health Sciences, Auckland, Aotearoa-New Zealand
| | - Arier Lee
- Department of Population Health, The University of Auckland Faculty of Medical and Health Sciences, Auckland, Aotearoa-New Zealand
| | - Hyun Young Park
- Department of Medicine, The University of Auckland Faculty of Medical and Health Sciences, Auckland, Aotearoa-New Zealand
| | - Emmanuel Jo
- Department of Medicine, The University of Auckland Faculty of Medical and Health Sciences, Auckland, Aotearoa-New Zealand
- Health Workforce Directorate, New Zealand Ministry of Health, Wellington, Aotearoa-New Zealand
| | - Fiona Wu
- Auckland Diabetes Centre, Auckland District Health Board, Auckland, Aotearoa-New Zealand
| | - Warwick Bagg
- Auckland Diabetes Centre, Auckland District Health Board, Auckland, Aotearoa-New Zealand
- Department of Medicine, The University of Auckland Faculty of Medical and Health Sciences, Auckland, Aotearoa-New Zealand
| | - Tim Cundy
- Auckland Diabetes Centre, Auckland District Health Board, Auckland, Aotearoa-New Zealand
- Department of Medicine, The University of Auckland Faculty of Medical and Health Sciences, Auckland, Aotearoa-New Zealand
| |
Collapse
|
56
|
Wang S, Li W, Qiao Y, Wang S, Zhang T, Liu E, Pan L, Leng J. Abnormal glucose in pre-school children and the association with obesity/physical activity: A large population-based study. Diabetes Metab Res Rev 2021; 37:e3442. [PMID: 33496037 DOI: 10.1002/dmrr.3442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 09/07/2020] [Accepted: 11/13/2020] [Indexed: 11/05/2022]
Abstract
AIM The rise of diabetes mellitus (DM) and impaired fasting glucose (IFG) in children has become a worldwide challenge, but population-based survey targeted on pre-school children is lacking. The aim of the study was to determine the prevalence of DM and IFG in pre-school children and their association with obesity and susceptible behaviours. METHODS A population-based survey was conducted and 21,571 Chinese children aged 5-6 years were recruited from 66 kindergartens in Tianjin, China during the year of 2016-2018. Fasting glucose was measured for all participants. Children with fasting glucose over 7.0 mmol/L was defined as DM, and 5.6-6.9 mmol/L was defined as IFG. RESULTS The prevalence of DM and IFG in the current study among Chinese children aged 5-6 years old was 0.05% and 1.18%, respectively, with significant gender and regional disparities (p < 0.001). The risk of abnormal fasting glucose increased with obesity (OR 1.44, 95% CI 1.00-2.06, p < 0.05), especially with moderate/severe obesity (OR 1.84, 95% CI 1.10-3.10, p < 0.05). Further analyses found that as compared to children who had at least 2 h/day physical activity, physical activity <1 h/day increased the risk of abnormal fasting glucose independently of BMI z-score (OR 1.79, 95% CI 1.10-2.91, p < 0.05). CONCLUSIONS The study was the first population-based large-scale survey of DM and IFG which targeted on pre-school children, and demonstrated that moderate/severe obesity and inadequate physical activity raised the risk of DM and IFG early from pre-school. The findings highlighted the necessity of early detection for abnormal glucose and control of obesity and susceptible behaviours.
Collapse
Affiliation(s)
- Shuo Wang
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Weiqin Li
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Yijuan Qiao
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Shuting Wang
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Tao Zhang
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Enqing Liu
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Lei Pan
- Tianjin Women's and Children's Health Center, Tianjin, China
| | | |
Collapse
|
57
|
Gabbs MH, Dart AB, Woo MR, Pinto T, Wicklow BA. Poor sleep, increased stress, and metabolic co-morbidity in adolescents and youth with type 2 diabetes. Can J Diabetes 2021; 46:142-149. [DOI: 10.1016/j.jcjd.2021.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 04/15/2021] [Accepted: 07/29/2021] [Indexed: 10/20/2022]
|
58
|
Gonzalez DO, Michalsky MP. Update on pediatric metabolic and bariatric surgery. Pediatr Obes 2021; 16:e12794. [PMID: 34041862 DOI: 10.1111/ijpo.12794] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 03/13/2021] [Indexed: 11/28/2022]
Abstract
The prevalence of childhood obesity has risen sharply over the last several decades and poses a significant threat to the health and well-being of today's youth. Childhood-onset obesity is associated with a number of cardiometabolic consequences, which contribute to diminished quality of life. Metabolic and bariatric surgery offers a powerful treatment paradigm with positive long-term health effects. A growing body of literature supports the notion that earlier intervention in younger patients results in long-term health benefits. The development of a multidisciplinary care model and best practice guidelines are central to providing optimal care for this vulnerable patient population. Although the outcomes of metabolic and bariatric surgery in pediatric patients are reassuring and support the ongoing utilization of this important treatment paradigm, a number of significant challenges remain regarding access to care. As the literature continues to support earlier intervention for youth with severe obesity, future efforts should address these challenges to ensure that eligible patients are referred in timely fashion.
Collapse
Affiliation(s)
- Dani O Gonzalez
- Department of Pediatric Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Marc P Michalsky
- Department of Pediatric Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio, USA
| |
Collapse
|
59
|
Kim JH, Lim JS. Trends of Diabetes and Prediabetes Prevalence among Korean Adolescents From 2007 to 2018. J Korean Med Sci 2021; 36:e112. [PMID: 33942577 PMCID: PMC8093603 DOI: 10.3346/jkms.2021.36.e112] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 03/15/2021] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND To provide updated prevalence data and to estimate changes in the prevalence of diabetes among Korean adolescents by sex and age between 2007 and 2018. METHODS We used the data of children and adolescents (8,718 subjects aged 10 to 18 years) from the Korea National Health and Nutrition Examination Survey IV-VII (KNHANES 2007-2018). The recent prevalence of diabetes and pre-diabetes was estimated by using the latest KNHANES VII. The linear trends were estimated by comparing 3-year KNHANES cycles according to sex and by using logistic regression. RESULTS The prevalence of diabetes and pre-diabetes was 0.298% (95% confidence interval [CI], 0.289-0.308) and 7.914% (95% CI, 0.43-0.49). The prevalence of diabetes significantly increased from 0.189 to 0.430 during KNHANE IV and VII. A positive linear trend is significant for diabetes (P trends = 0.006) in only male subjects. The prevalence of pre-diabetes significantly increased from 5.86 to 12.08 in both sexes. During KNHANES IV and VII, the prevalence of obesity increased significantly. CONCLUSION Between 2007 and 2018, the prevalence of diabetes among Korean adolescents increased. Further studies are required to determine the causes of these increases.
Collapse
Affiliation(s)
- Ji Hyun Kim
- Department of Pediatrics, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Jung Sub Lim
- Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea.
| |
Collapse
|
60
|
Cardiovascular Comorbidity Associated With Albuminuria in Youth-Onset Type 2 Diabetes: Analyses From the iCARE Study. Can J Diabetes 2021; 45:458-465. [PMID: 34045147 DOI: 10.1016/j.jcjd.2021.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 03/11/2021] [Accepted: 04/04/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Little is known about the relationship between albuminuria in youth with type 2 diabetes (T2D) and cardiovascular risk. We aimed to determine whether youth with T2D and albuminuria have evidence of increased cardiovascular risk and/or early cardiovascular dysfunction compared with youth with T2D without albuminuria. METHODS Youth with T2D were stratified by albuminuria status. Cardiovascular risk factors, including body mass index (BMI), 24-hour blood pressure, lipid profile, smoking and smoking exposure, habitual physical activity and screen time, were compared between groups. Left ventricular structure and function and carotid intima-media thickness (cIMT) were evaluated in participants who underwent cardiac imaging. RESULTS Two hundred sixty-five youth participated, 83 (31.3%) of whom had albuminuria. Ethnicity, sex, BMI z score, age at diagnosis, duration of diabetes and hepatocyte nuclear factor-1alpha status did not differ between youth stratified by albuminuria. Smoking, exposure to second-hand smoke and low physical activity levels did not differ between groups. Youth with albuminuria were more likely to have hypertension, dyslipidemia and poor glycemic control. Left ventricular structure and carotid cIMT did not differ between groups, but youth with albuminuria had evidence of early left ventricular diastolic dysfunction. CONCLUSIONS We found evidence of increased cardiovascular disease risk factors and left ventricular diastolic dysfunction in youth with T2D and albuminuria compared with those without albuminuria, despite a relatively short duration of disease. Thus, albuminuria may serve as a marker of early cardiovascular disease risk in youth with T2D.
Collapse
|
61
|
Archibald MM, Dart A, Wicklow B, Pundyk KJ, Marks SD, Sellers EAC. Youth perceptions and experiences of type 2 diabetes: Protocol for a collaborative knowledge translation approach and qualitative study. J Adv Nurs 2021; 77:3218-3225. [PMID: 33855741 DOI: 10.1111/jan.14845] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/09/2021] [Accepted: 03/15/2021] [Indexed: 12/28/2022]
Abstract
AIMS The aim of this study is to generate an in-depth understanding of youth perceptions and experiences of living with type 2 diabetes to inform knowledge translation, research and intervention development. DESIGN Interpretive descriptive qualitative study. METHODS Twenty to 25 youth aged 10-18 years with a diagnosis of type 2 diabetes will be purposively recruited through the Diabetes Education Resource for Children and Adolescents in Winnipeg, Manitoba, and through the Improving Renal Complications in Adolescents With Type 2 Diabetes Through the REsearch [iCARE] cohort. Socio-demographic information will be collected. Semi-structured interviews will occur iteratively with inductive thematic analysis. Data will be professionally transcribed and managed using NVivo 1.0 software. The University Ethics Committee approved this study (May 2020). DISCUSSION There is a critical gap in understanding youth experiences of type 2 diabetes. Research involving youth with type 2 diabetes is predominantly quantitative in nature, largely reflecting risk factors, underlying mechanisms and treatment outcomes associated with diabetes management. In-depth qualitative research on youth experiences can help identify youth priorities, provide insight into critical misalignments between stakeholder perspectives, and drive forward a more consolidated youth-centred research agenda. IMPACT Understanding and applying knowledge of youth experiences is critical as the prevalence of, and challenges associated with, youth onset type 2 diabetes continues to increase worldwide. This research will generate a robust interpretive description of youth lived experiences and perceptions of type 2 diabetes where such research is lacking, to inform basic and applied research within an interdisciplinary investigative and clinical research team with relevance to other jurisdictions. In response to calls for youth-oriented research in type 2 diabetes, this work will catalyse collaborative knowledge translation using creative and youth-directed initiatives.
Collapse
Affiliation(s)
- Mandy M Archibald
- Children's Hospital Research Institute of Manitoba, Winnipeg, Canada.,Helen Glass Centre for Nursing, University of Manitoba, Winnipeg, Canada
| | - Allison Dart
- Children's Hospital Research Institute of Manitoba, Winnipeg, Canada.,Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada
| | - Brandy Wicklow
- Children's Hospital Research Institute of Manitoba, Winnipeg, Canada.,Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada
| | - Katherine J Pundyk
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada
| | - Seth D Marks
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada
| | - Elizabeth A C Sellers
- Children's Hospital Research Institute of Manitoba, Winnipeg, Canada.,Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada
| |
Collapse
|
62
|
Abstract
Childhood obesity can lead to comorbidities that cause significant decrease in health-related quality of life and early mortality. Recognition of obesity as a disease of polygenic etiology can help deter implicit bias. Current guidelines for treating severe obesity in children recommend referral to a multidisciplinary treatment center that offers metabolic and bariatric surgery at any age when a child develops a body mass index that is greater than 120% of the 95th percentile. Obesity medications and lifestyle counseling about diet and exercise are not adequate treatment for severe childhood obesity. Early referral can significantly improve quality and quantity of life.
Collapse
Affiliation(s)
- Adi Steinhart
- Department of Pediatrics, Stanford University School of Medicine, 1017 Paradise Way, Palo Alto, CA 94306, USA
| | - Deborah Tsao
- Stanford University School of Medicine, 227 Ayrshire Farm Ln (Apt 203), Stanford, CA 94305, USA
| | - Janey S A Pratt
- Division of Pediatric Surgery, Stanford University School of Medicine, Lucille Packard Children's Hospital, M166 Alway Building, 300 Pasteur Drive, Stanford, CA 94305, USA.
| |
Collapse
|
63
|
Haynes A, Curran JA, Davis EA. Two decades of increasing incidence of childhood-onset type 2 diabetes in Western Australia (2000-2019). Med J Aust 2021; 214:285-285.e1. [PMID: 33641191 DOI: 10.5694/mja2.50970] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/12/2020] [Accepted: 10/19/2020] [Indexed: 11/17/2022]
Affiliation(s)
- Aveni Haynes
- Children's Diabetes Centre, Telethon Kids Institute, University of Western Australia, Perth, WA
| | | | - Elizabeth A Davis
- Children's Diabetes Centre, Telethon Kids Institute, University of Western Australia, Perth, WA.,Perth Children's Hospital, Perth, WA
| |
Collapse
|
64
|
Hu C, Lin L, Zhu Y, Zhang Y, Wang S, Zhang J, Qi H, Li M, Zhu Y, Huo Y, Wan Q, Qin Y, Hu R, Shi L, Su Q, Yu X, Yan L, Qin G, Tang X, Chen G, Xu M, Xu Y, Wang T, Zhao Z, Gao Z, Wang G, Shen F, Luo Z, Chen L, Li Q, Ye Z, Zhang Y, Liu C, Wang Y, Yang T, Deng H, Chen L, Zeng T, Li D, Zhao J, Mu Y, Bi Y, Wang W, Ning G, Wu S, Chen Y, Lu J. Association Between Age at Diagnosis of Type 2 Diabetes and Cardiovascular Diseases: A Nationwide, Population-Based, Cohort Study. Front Endocrinol (Lausanne) 2021; 12:717069. [PMID: 34671316 PMCID: PMC8522833 DOI: 10.3389/fendo.2021.717069] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 09/02/2021] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES Nationwide studies focusing on the impact of early-onset type 2 diabetes and obesity on the development of cardiovascular diseases (CVD) are limited in China. We aimed to investigate the association between age at diagnosis of type 2 diabetes and the risk of CVD, and to further examine the modifying effect of obesity on this association among Chinese adults. METHODS This study included 23,961 participants with previously diagnosed diabetes from a large nationwide population-based cohort study across mainland China. With an interviewer-assisted questionnaire, we collected detailed information on CVDs. Logistic regression analysis was used to evaluate the risk of CVDs associated with age at diagnosis of diabetes. RESULTS Compared with patients with late-onset diabetes (≥60 years), those with earlier-onset diabetes had increased risks for CVD, with adjusted ORs (95% CIs) of 1.72 (1.36-2.17), 1.52 (1.31-1.75) and 1.33 (1.19-1.48) for patients diagnosed aged <40, 40-49 and 50-59 years, respectively. Each 5-year earlier age at diagnosis of type 2 diabetes was significantly associated with 14% increased risk of CVD (OR, 1.14; 95%CI, 1.11-1.18). This association was more prominent for patients with obesity than those with normal body mass index (BMI). Significant interaction was detected between age at diagnosis and BMI categories on CVD risk (P for interaction=0.0457). CONCLUSION Early-onset type 2 diabetes was significantly associated with higher risk of CVD, and this association was more prominent among patients with obesity.
Collapse
Affiliation(s)
- Chunyan Hu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lin Lin
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yujing Zhu
- Department of Endocrinology, Karamay Municipal People’s Hospita , Xinjiang, China
| | - Yi Zhang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuangyuan Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jie Zhang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hongyan Qi
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mian Li
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuanyue Zhu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanan Huo
- Jiangxi Provincial People’s Hospital, Affiliated to Nanchang University, Nanchang, Xinjiang, China
| | - Qin Wan
- Department of Endocrinology, The Affiliated Hospital of Luzhou Medical College, Luzhou, China
| | - Yingfen Qin
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Ruying Hu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Lixin Shi
- Department of Endocrinology, Affiliated Hospital of Guiyang Medical University, Guiyang, China
| | - Qing Su
- Xinhua Hospital, Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xuefeng Yu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li Yan
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Guijun Qin
- Department of Endocrinology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xulei Tang
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, China
| | - Gang Chen
- Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China
| | - Min Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tiange Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhiyun Zhao
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhengnan Gao
- Dalian Municipal Central Hospital, Affiliated of Dalian Medical University, Dalian, China
| | - Guixia Wang
- Department of Endocrinology, The First Hospital of Jilin University, Changchun, China
| | - Feixia Shen
- Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Zuojie Luo
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Li Chen
- Qilu Hospital of Shandong University, Jinan, China
| | - Qiang Li
- Department of Endocrinology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Zhen Ye
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Yinfei Zhang
- Department of Endocrinology, Central Hospital of Shanghai Jiading District, Shanghai, China
| | - Chao Liu
- Department of Endocrinology, Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China
| | - Youmin Wang
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Tao Yang
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Huacong Deng
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lulu Chen
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tianshu Zeng
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Donghui Li
- Department of Gastrointestinal Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Jiajun Zhao
- Shandong Provincial Hospital, Affiliated to Shandong University, Jinan, China
| | - Yiming Mu
- Department of Endocrinology, Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Yufang Bi
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiqing Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guang Ning
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shengli Wu
- Department of Endocrinology, Karamay Municipal People’s Hospita , Xinjiang, China
- *Correspondence: Jieli Lu, ; Yuhong Chen, ; Shengli Wu,
| | - Yuhong Chen
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Jieli Lu, ; Yuhong Chen, ; Shengli Wu,
| | - Jieli Lu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Jieli Lu, ; Yuhong Chen, ; Shengli Wu,
| |
Collapse
|
65
|
Liu B, Li Y, Guo J, Fan Y, Li L, Li P. Body Mass Index and Its Change from Adolescence to Adulthood Are Closely Related to the Risk of Adult Metabolic Syndrome in China. Int J Endocrinol 2021; 2021:8888862. [PMID: 33679975 PMCID: PMC7906799 DOI: 10.1155/2021/8888862] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 01/31/2021] [Accepted: 02/08/2021] [Indexed: 12/05/2022] Open
Abstract
AIMS To investigate the influence of body mass index (BMI) and its change from adolescence to adulthood (ΔBMI) on the risk of metabolic syndrome (MetS) in early adulthood. METHODS We selected 931 students from 12 to 16 years of age in Liaoyang City, China. Ninety-three participants from 18 to 22 years of age with complete baseline data were available for follow-up after 5 years. Statistical analysis determined the relationship of MetS at follow-up with baseline BMI (BMIb), ΔBMI, and follow-up BMI (BMIf). RESULTS ΔBMI was positively correlated with the change of waist circumference (ΔWC), systolic blood pressure (ΔSBP), triglycerides (ΔTG), uric acid, and glycosylated hemoglobin (ΔHbA1c) in follow-up (p < 0.05). For every 1 kg/m2 increase in BMIb, ΔBMI, and BMIf, the risk of MetS at follow-up increased 1.201-fold, 1.406-fold, and 1.579-fold, respectively. Both BMIb and ΔBMI were predictive of MetS at follow-up, with prediction thresholds of 23.47 kg/m2 and 1.95 kg/m2. The participants were divided by the predicted BMIb and ΔBMI threshold values into four study groups. Interestingly, the group with lower BMI but a higher increase in BMI presented the same metabolic derangements and Mets% of the group with higher BMI but lower Δ BMI. CONCLUSION Both BMI of adolescence and ΔBMI were predictive of MetS and cardiovascular risk factors in adulthood. Control of both variables in adolescents would be more effective in decreasing the risk of MetS in young adults than control of BMI alone.
Collapse
Affiliation(s)
- Bingyang Liu
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang 110022, China
| | - Yue Li
- Department of Endocrinology, Tianjin Third Central Hospital, Tianjin, China
| | - Jiamei Guo
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang 110022, China
| | - Yuting Fan
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang 110022, China
| | - Ling Li
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang 110022, China
| | - Ping Li
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang 110022, China
| |
Collapse
|
66
|
Gow ML, Pham-Short A, Jebeile H, Varley BJ, Craig ME. Current Perspectives on the Role of Very-Low-Energy Diets in the Treatment of Obesity and Type 2 Diabetes in Youth. Diabetes Metab Syndr Obes 2021; 14:215-225. [PMID: 33500642 PMCID: PMC7822089 DOI: 10.2147/dmso.s238419] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 01/06/2021] [Indexed: 12/21/2022] Open
Abstract
In both developed and developing countries, pediatric obesity and type 2 diabetes are an increasing public health concern: globally 5.6% of girls and 7.8% of boys aged ≥5 years have obesity. The incidence of type 2 diabetes has increased in youth in recent decades and disproportionately affects those from ethnic/racial minority groups and disadvantaged backgrounds. For the treatment of both conditions, conventional lifestyle intervention is frequently ineffective, access to bariatric surgery is very limited and many young people are unsuitable or unwilling to undergo surgery. A very-low-energy diet (VLED) provides a viable alternative and may be effective for weight reduction and improved glycemic control in youth, based on one systematic review. In particular, in the treatment of type 2 diabetes, a chart review and a pilot study both demonstrated that a VLED can reduce the requirement for medications, including insulin, and lead to the remission of diabetes. However, long-term follow-up and safety data remain limited and therefore a VLED is inconsistently recommended by clinical practice guidelines for the treatment of pediatric obesity and type 2 diabetes. In clinical practice, VLED use in children and adolescents is uniquely challenging due to intolerance of expected side effects, difficulty adhering to the highly restrictive diet and difficulty with behaviour change within the current social context and environment. Ultimately, more research, including larger, longer-term trials with comprehensive safety monitoring are required to strengthen the evidence base. This would inform clinical practice guidelines, which may facilitate more widespread utilization of VLED programs in the management of obesity and type 2 diabetes in youth.
Collapse
Affiliation(s)
- Megan L Gow
- The University of Sydney Children’s Hospital Westmead Clinical School, Sydney, NSW, Australia
- Correspondence: Megan L Gow The University of Sydney Children’s Hospital Westmead Clinical School, Sydney, NSW, AustraliaTel +61 2 9845 0000Fax +61 2 9845 3170 Email
| | - Anna Pham-Short
- Institute of Endocrinology and Diabetes, The Children’s Hospital at Westmead, Sydney, NSW, Australia
| | - Hiba Jebeile
- The University of Sydney Children’s Hospital Westmead Clinical School, Sydney, NSW, Australia
| | - Benjamin J Varley
- The University of Sydney Children’s Hospital Westmead Clinical School, Sydney, NSW, Australia
| | - Maria E Craig
- School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW, Australia
| |
Collapse
|
67
|
Standl E, Khunti K, Hansen TB, Schnell O. The global epidemics of diabetes in the 21st century: Current situation and perspectives. Eur J Prev Cardiol 2020; 26:7-14. [PMID: 31766915 DOI: 10.1177/2047487319881021] [Citation(s) in RCA: 173] [Impact Index Per Article: 43.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Diabetes is on the rise worldwide, with a global prevalence in adults in 2017 being 8.8% of the world population, with the anticipation of a further increase to 9.9% by 2045. In total numbers, this reflects a population of 424.9 million people with diabetes worldwide in 2017, with an estimate of a 48% increase to 628.6 million people by 2045. Depending on age, global diabetes prevalence is about 5%, 10%, 15% and close to 20%, respectively, for the age groups 35-39, 45-49, 55-59 and 65-69 years. On a global scale, diabetes hits particularly 'middle aged' people between 40 and 59 years, which causes serious economic and social implications. Furthermore, diabetes affects especially low and middle income countries, as 77% of all people with diabetes worldwide live in those countries. In addition to overt diabetes, an estimated 352.1 million people worldwide are at risk of diabetes, i.e. have defined pre-diabetes, a figure which is anticipated to rise to 531.6 million by 2045. Some 70-75% of all patients with established coronary artery disease, e.g. with acute myocardial infarction, show concomitant diabetes or abnormal glucose regulation, i.e. close to 50% have overt diabetes, with as many as 20% of those being undiagnosed and another 25% having pre-diabetes.
Collapse
Affiliation(s)
- Eberhard Standl
- Forschergruppe Diabetes eV at Munich Helmholtz Centre, Germany
| | | | | | - Oliver Schnell
- Forschergruppe Diabetes eV at Munich Helmholtz Centre, Germany
| |
Collapse
|
68
|
Manifold A, Atkinson D, Marley JV, Scott L, Cleland G, Edgill P, Singleton S. Complex diabetes screening guidelines for high-risk adolescent Aboriginal Australians: a barrier to implementation in primary health care. Aust J Prim Health 2020; 25:501-508. [PMID: 31634436 DOI: 10.1071/py19030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 09/16/2019] [Indexed: 11/23/2022]
Abstract
The aim of this study is to ascertain whether a simplified screening algorithm incorporating glycated haemoglobin (HbA1c) tests increases type 2 diabetes (T2D) screening in 10- to 14-year-old Aboriginal Australians presenting to primary healthcare (PHC) services. The study involved a 6-month pilot of a locally developed evidence-based screening algorithm in a remote Western Australian Kimberley town. A retrospective audit of electronic health records for the pilot period (27 June-26 December 2016) and a 6-month period before the screening algorithm was introduced (1 October 2015-31 March 2016) was conducted. Interviews were held with 30 PHC staff at participating PHC services, an Aboriginal Community Controlled Health Service (ACCHS) and a hospital-based general practice service. During the pilot, significantly more patients received an initial T2D screening test at the ACCHS (28/130 (22%) v. 50/139 (36%), P = 0.011), but there was no change at the hospital (0.02% v. 0.02%, P = 0.615). Staff feedback suggested measures to improve screening; these include simple guidelines, targeted screening, patient and staff education, point-of-care HbA1c tests and a whole-of-clinic approach to implementation. Implementing a screening algorithm for young-onset diabetes in Aboriginal Australians is challenging, but practical measures can be taken to improve screening.
Collapse
Affiliation(s)
- Andreana Manifold
- The Rural Clinical School of Western Australia, The University of Western Australia, PO Box 1377, Broome, WA 6725, Australia; and Corresponding author.
| | - David Atkinson
- The Rural Clinical School of Western Australia, The University of Western Australia, PO Box 1377, Broome, WA 6725, Australia
| | - Julia V Marley
- The Rural Clinical School of Western Australia, The University of Western Australia, PO Box 1377, Broome, WA 6725, Australia; and Kimberley Aboriginal Medical Services Ltd, PO Box 1377, Broome, WA 6725, Australia
| | - Lydia Scott
- Western Australia Country Health Service Kimberley, PO Box 62, Broome, WA 6725, Australia
| | - Gavin Cleland
- Western Australia Country Health Service Kimberley, PO Box 62, Broome, WA 6725, Australia
| | - Paula Edgill
- Derbarl Yerrigan Health Service, 156-172 Wittenoom Street, East Perth, WA 6004, Australia; and Centre for Aboriginal Medical and Dental Health, The University of Western Australia (M303), 35 Stirling Highway, Perth, WA 6009, Australia
| | - Sally Singleton
- The Rural Clinical School of Western Australia, The University of Western Australia, PO Box 1377, Broome, WA 6725, Australia
| |
Collapse
|
69
|
Abstract
PURPOSE OF REVIEW The current review summarizes extant knowledge regarding the prevalence of depression in youth-onset type 2 diabetes (T2D) and how depression might impact glycemic control through stress-related behavioral and physiological mechanisms. The current review also discusses depression intervention studies in adult-onset T2D, as there are no such studies in youth-onset T2D, and provides recommendations for clinical research. RECENT FINDINGS The prevalence of elevated depression symptoms in youth-onset T2D is approximately 20%. Some studies suggest depression may negatively impact glycemic control through inadequate medication adherence and disordered eating, but there is a dearth of studies investigating associations with depression and physical activity/sedentary time, sleep, and stress-related physiological mechanisms. In adult-onset T2D, evidence-based behavioral interventions tailored to address diabetes-related issues have shown positive effects for depression and glycemic control. Future research is needed to characterize the epidemiology of depression in youth-onset T2D and test interventions to improve depression, glycemic control, and health outcomes in this specific pediatric population.
Collapse
Affiliation(s)
- Lauren D Gulley
- Department of Human Development and Family Studies, College of Health and Human Sciences, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523, USA.
- Section of Endocrinology, Department of Pediatrics, University of Colorado School of Medicine/Anschutz Medical Campus and Children's Hospital Colorado, 13123 E 16th Avenue, B265, Aurora, CO, 80045, USA.
| | - Lauren B Shomaker
- Department of Human Development and Family Studies, College of Health and Human Sciences, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523, USA
- Section of Endocrinology, Department of Pediatrics, University of Colorado School of Medicine/Anschutz Medical Campus and Children's Hospital Colorado, 13123 E 16th Avenue, B265, Aurora, CO, 80045, USA
- Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, CO, USA
| |
Collapse
|
70
|
Zhou T, Huang WK, Xu QY, Zhou X, Shao LQ, Song B. Nec-1 attenuates inflammation and cytotoxicity induced by high glucose on THP-1 derived macrophages through RIP1. Arch Oral Biol 2020; 118:104858. [PMID: 32805637 DOI: 10.1016/j.archoralbio.2020.104858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 07/20/2020] [Accepted: 07/24/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVES This research aimed to study whether necrostain-1 (Nec-1) could alleviate inflammatory injury induced by high glucose upon THP-1 derived macrophages through RIP1. DESIGN Firstly, THP-1 derived macrophages were incubated with 5.5 mM glucose (normal glucose, NG), 25 mM glucose (high glucose, HG), and mannitol as the high osmotic pressure group (5.5 mM glucose+19.5 mM mannitol) for 24, 48, and 72 h respectively. TNF-α, IL-1β, IL-6, and IL-8 levels were measured by ELISA. Secondly, macrophages were exposed to NG, HG, or HG plus 5 μM necrostatin-1 (Nec-1) for 72 h. mRNA expression of inflammatory cytokine was measured by RT-PCR, and protein levels of inflammatory cytokines and LDH leakage were determined by ELISA. RIP1 expression was determined by RT-PCR and WB. Thirdly, macrophages were transfected with si-RIP1 or negative control (si-NC). Wild type and RIP1-silenced macrophages were incubated with NG or HG, and TNF-α, IL-1β, IL-6, IL-8, and LDH levels were measured again by ELISA. RESULTS 1) TNF-α, IL-1β, IL-6, and IL-8 levels were elevated in the HG group, as compared with that the NG group. Inflammation remained unchanged in the mannitol group. 2) Inflammatory response and LDH levels in the HG plus Nec-1 group were remarkably lower than in the HG group. 3) Inflammatory injury in the si-NC group was more severe than in the si-RIP1 group. CONCLUSIONS Current results indicated that Nec-1 could alleviate HG-caused inflammatory injury on THP-1 derived macrophages by regulating RIP1. These findings could help cast light on the relationships between diabetes and periodontitis.
Collapse
Affiliation(s)
- Ting Zhou
- Guizhou Provincial People's Hospital, Guiyang 550002, China.
| | - Wei-Kun Huang
- Guizhou Provincial People's Hospital, Guiyang 550002, China.
| | - Qiu-Yan Xu
- Guizhou Provincial People's Hospital, Guiyang 550002, China.
| | - Xue Zhou
- Guizhou Provincial People's Hospital, Guiyang 550002, China.
| | - Long-Quan Shao
- Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
| | - Bin Song
- Guizhou Provincial People's Hospital, Guiyang 550002, China.
| |
Collapse
|
71
|
Lan D, Jiang HY, Su X, Zhao Y, Du S, Li Y, Bi R, Zhang DF, Yang Q. Transcriptome-wide Association Study Identifies Genetically Dysregulated Genes in Diabetic Neuropathy. Comb Chem High Throughput Screen 2020; 24:319-325. [PMID: 32772906 DOI: 10.2174/1386207323666200808173745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 06/03/2020] [Accepted: 07/14/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Complications are the main cause of the disease burden of diabetes. Genes determining the development and progression of diabetic complications remain to be identified. Diabetic neuropathy is the most common and debilitating complication and mainly affects the nerves of legs and feet. In this study, we attempted to identify diabetic neuropathy-specific genes from reliable large-scale genome-wide association studies (GWASs) for diabetes perse. METHODS Taking advantage of publicly available data, we initially converted the GWAS signals to transcriptomic profiles in the tibial nerve using the functional summary-based imputation (FUSION) algorithm. The FUSION-derived genes were then checked to determine whether they were differentially expressed in the sciatic nerve of mouse models of diabetic neuropathy. The dysregulated genes identified in the sciatic nerve were explored in the blood of patients with diabetes. RESULTS We found that eleven out of 452 FUSION-derived genes were regulated by diabetes GWAS loci and were altered in the sciatic nerve of mouse models with early-stage neuropathy. Among the eleven genes, significant (P-value<0.05) expression alterations of HSD17B4, DHX32, MERTK, and SFXN4 could be detected in the blood of human patients. CONCLUSIONS Our analyses identified genes with an effect in the sciatic nerve and provided the possibility of noninvasive early detection of diabetic neuropathy.
Collapse
Affiliation(s)
- Danfeng Lan
- Department of Geriatrics, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Hong-Yan Jiang
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xiaoyang Su
- Department of Geriatrics, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yan Zhao
- Department of Geriatrics, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Sicheng Du
- Department of Geriatrics, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Ying Li
- Department of Geriatrics, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Rui Bi
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming650223, China
| | - Deng-Feng Zhang
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming650223, China
| | - Qiuping Yang
- Department of Geriatrics, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| |
Collapse
|
72
|
Abstract
PURPOSE OF REVIEW The prevalence of pediatric obesity and its associated complications is increasing around the world. Treatment of obesity is challenging and metabolic and bariatric surgery (MBS) is currently the most effective treatment for this condition. At this time, vertical sleeve gastrectomy (VSG) is the most commonly performed bariatric procedure in adolescents. However, knowledge regarding the efficacy, safety, and durability of VSG in adolescents is still evolving. This review summarizes the most recent updates in the field of MBS particularly VSG in adolescents. RECENT FINDINGS MBS is recommended to treat moderate to severe obesity, especially when complicated by comorbidities. The use of VSG for weight loss is increasing among adolescents and produces similar weight loss at five years in both adolescents and adults. The physiologic mechanisms causing weight loss after VSG are multifactorial and still being investigated. The complication rate after VSG ranges between 0 and 17.5%. SUMMARY VSG appears to be a well-tolerated and effective procedure in adolescents. However, it continues to be underutilized despite the increasing prevalence of moderate to severe obesity in adolescents. It is thus important to educate providers regarding its benefits and safety profile.
Collapse
Affiliation(s)
- Vibha Singhal
- Pediatric Endocrinology, Massachusetts General Hospital for Children
- Neuroendocrine Unit, Massachusetts General Hospital
- MGH Weight Center
| | | | - Madhusmita Misra
- Pediatric Endocrinology, Massachusetts General Hospital for Children
- Neuroendocrine Unit, Massachusetts General Hospital
| |
Collapse
|
73
|
Vidmar AP, Goran MI, Naguib M, Fink C, Wee CP, Hegedus E, Lopez K, Gonzalez J, Raymond JK. Time limited eating in adolescents with obesity (time LEAd): Study protocol. Contemp Clin Trials 2020; 95:106082. [PMID: 32682994 DOI: 10.1016/j.cct.2020.106082] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/22/2020] [Accepted: 07/06/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Time limited eating (TLE) has been shown to be effective for weight loss and improvement of glycemic control in adults with obesity and type 2 diabetes (T2D), but has not been well studied in adolescents. TLE may be a more feasible, flexible and effective dietary intervention for adolescents because it removes the need for intensive counting of calories or macronutrients, and emphasizes eating during a specified time period. OBJECTIVES The aim of this study is to assess the feasibility of a TLE approach in adolescents with obesity using a continuous glucose monitor (CGM) to promote adherence to the intervention. METHODS We propose a prospective, randomized controlled trial, in 60 adolescents (ages 14-18) with obesity (BMI% ≥ 95th percentile). Youth will be randomized to one of three treatment groups for a 12-week intervention: Group 1) Low sugar and carbohydrate education (LSC, 5% of total daily calories from sugar (<35 g)/day; <90 g carbohydrate (CHO)/day) + blinded CGM (used to monitor adherence and glycemic outcomes without real time feedback), Group 2) LSC + TLE (16-h fast/8-h feed for 5 days per week) + blinded CGM, and Group 3) LSC + TLE+ real time feedback via CGM (to evaluate effect of providing CGM data on intervention efficacy). Outcomes will include change in total body fat (TBF) percentage measured on DEXA scan, BMI status and fasting blood glucose at 12 weeks compared to baseline. CONCLUSIONS TLE is a potentially powerful lifestyle intervention that could be readily integrated into pediatric weight management programs to optimize their impact and accelerate healthy changes. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03954223.
Collapse
Affiliation(s)
- Alaina P Vidmar
- Diabetes & Obesity Program, Center for Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Children's Hospital Los Angeles and Keck School of Medicine of USC, Los Angeles, CA, United States of America.
| | - Michael I Goran
- Diabetes & Obesity Program, Center for Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Children's Hospital Los Angeles and Keck School of Medicine of USC, Los Angeles, CA, United States of America
| | - Monica Naguib
- Diabetes & Obesity Program, Center for Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Children's Hospital Los Angeles and Keck School of Medicine of USC, Los Angeles, CA, United States of America
| | - Cassandra Fink
- Diabetes & Obesity Program, Center for Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Children's Hospital Los Angeles and Keck School of Medicine of USC, Los Angeles, CA, United States of America
| | - Choo Phei Wee
- CTSI Biostatics Core, Saban Research Institute, Los Angeles, CA, United States of America
| | - Elizabeth Hegedus
- Diabetes & Obesity Program, Center for Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Children's Hospital Los Angeles and Keck School of Medicine of USC, Los Angeles, CA, United States of America
| | - Kelleen Lopez
- Diabetes & Obesity Program, Center for Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Children's Hospital Los Angeles and Keck School of Medicine of USC, Los Angeles, CA, United States of America
| | - Janelle Gonzalez
- Diabetes & Obesity Program, Center for Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Children's Hospital Los Angeles and Keck School of Medicine of USC, Los Angeles, CA, United States of America
| | - Jennifer K Raymond
- Diabetes & Obesity Program, Center for Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Children's Hospital Los Angeles and Keck School of Medicine of USC, Los Angeles, CA, United States of America
| |
Collapse
|
74
|
Srugo SA, Morrison HI, Villeneuve PJ, de Groh M, Jiang Y. Assessing Dysglycemia Risk Among Younger Adults: A Validation of the Canadian Diabetes Risk Questionnaire. Can J Diabetes 2020; 44:379-386.e3. [DOI: 10.1016/j.jcjd.2019.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 11/19/2019] [Accepted: 11/25/2019] [Indexed: 12/23/2022]
|
75
|
Ibanez-Bruron MC, Solebo AL, Cumberland P, Rahi JS. Epidemiology of visual impairment, sight-threatening or treatment-requiring diabetic eye disease in children and young people in the UK: findings from DECS. Br J Ophthalmol 2020; 105:729-734. [PMID: 32536608 DOI: 10.1136/bjophthalmol-2020-315886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 04/08/2020] [Accepted: 05/26/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND We investigated the incidence and causes of sight-threatening diabetes-related eye disease in children living with diabetes in the UK, to inform the national eye screening programme and enable monitoring of trends. METHODS We undertook a prospective active national surveillance via the British Ophthalmic Surveillance Unit. Eligible cases were children aged 18 years or younger, with type 1 or 2 diabetes, newly diagnosed between January 2015 and February 2017 with sight-threatening diabetic eye disease. RESULTS Eight children were reported. The annual incidence of all sight-threatening diabetes-related eye disease requiring referral to an ophthalmologist among children living with diabetes (n=8) in the UK was 1.21 per 10 000 person-years (95% CI 0.52 to 2.39) and was largely attributable to cataract (n=5) 0.76 per 10 000 person-years (95% CI 0.25 to 1.77). The incidence of sight-threatening diabetic retinopathy (n=3) among those eligible for screening (12 to 18 year-olds living with diabetes) was 1.18 per 10 000 person-years (95% CI 0.24 to 3.46). No subjects eligible for certification as visually impaired or blind were reported. CONCLUSIONS Secondary prevention of visual disability due to retinopathy is currently the sole purpose of national eye screening programmes globally. However, the rarity of treatment-requiring retinopathy in children/young people living with diabetes, alongside growing concerns about suboptimal screening uptake, merit new consideration of the utility of screening for primary prevention of diabetes-related morbidity by using the screening event and findings as a catalyst for better diabetes self-management.
Collapse
Affiliation(s)
- Maria Carolina Ibanez-Bruron
- Great Ormond Street Institute of Child Health, University College London, London, UK.,Departamento de Oftalmologia, Pontificia Universidad Católica de Chile, Santiago, Chile.,Ulverscroft Vision Research Group, London, UK
| | - Ameenat Lola Solebo
- Great Ormond Street Institute of Child Health, University College London, London, UK.,Ulverscroft Vision Research Group, London, UK.,Moorfields NIHR Biomedical Research Centre, London, UK.,Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.,Institute of Ophthalmology, University College London, London, UK
| | - Phillippa Cumberland
- Great Ormond Street Institute of Child Health, University College London, London, UK.,Ulverscroft Vision Research Group, London, UK
| | - Jugnoo S Rahi
- Great Ormond Street Institute of Child Health, University College London, London, UK .,Ulverscroft Vision Research Group, London, UK.,Moorfields NIHR Biomedical Research Centre, London, UK.,Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.,Institute of Ophthalmology, University College London, London, UK
| |
Collapse
|
76
|
Magliano DJ, Sacre JW, Harding JL, Gregg EW, Zimmet PZ, Shaw JE. Young-onset type 2 diabetes mellitus - implications for morbidity and mortality. Nat Rev Endocrinol 2020; 16:321-331. [PMID: 32203408 DOI: 10.1038/s41574-020-0334-z] [Citation(s) in RCA: 231] [Impact Index Per Article: 57.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/13/2020] [Indexed: 12/20/2022]
Abstract
Accumulating data suggest that type 2 diabetes mellitus (T2DM) in younger people (aged <40 years), referred to as young-onset T2DM, has a more rapid deterioration of β-cell function than is seen in later-onset T2DM. Furthermore, individuals with young-onset T2DM seem to have a higher risk of complications than those with type 1 diabetes mellitus. As the number of younger adults with T2DM increases, young-onset T2DM is predicted to become a more frequent feature of the broader diabetes mellitus population in both developing and developed nations, particularly in certain ethnicities. However, the magnitude of excess risk of premature death and incident complications remains incompletely understood; likewise, the potential reasons for this excess risk are unclear. Here, we review the evidence pertaining to young-onset T2DM and its current and future burden of disease in terms of incidence and prevalence in both developed and developing nations. In addition, we highlight the associations of young-onset T2DM with premature mortality and morbidity.
Collapse
Affiliation(s)
- Dianna J Magliano
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.
- Monash University, School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia.
| | - Julian W Sacre
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Jessica L Harding
- Division of Diabetes Translation, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Edward W Gregg
- Faculty of Medicine, School of Public Health, Imperial College, London, UK
| | - Paul Z Zimmet
- Monash University, Department of Diabetes, Melbourne, Victoria, Australia
| | - Jonathan E Shaw
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Monash University, School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
| |
Collapse
|
77
|
Pinchevsky Y, Butkow N, Raal FJ, Chirwa T, Rothberg A. Demographic and Clinical Factors Associated with Development of Type 2 Diabetes: A Review of the Literature. Int J Gen Med 2020; 13:121-129. [PMID: 32280262 PMCID: PMC7127847 DOI: 10.2147/ijgm.s226010] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 01/17/2020] [Indexed: 12/11/2022] Open
Abstract
Diabetes mellitus is a complex and chronic condition that requires lifelong management and interaction with a healthcare system. Failure to control risk factors through preventive care may lead to a host of diabetes-related complications. Underperforming healthcare systems and poor awareness among the general population/healthcare professionals has been suggested as reasons why so many patients remain undiagnosed. Due to the asymptomatic nature of early and even intermediate diabetes mellitus, several years may pass without any diagnosis before complications begin to manifest. Other factors include age, gender, ethnicity, education, marital and unemployment status which may also increase the risk of developing morbidity and mortality associated with diabetes mellitus. This review summarizes the current demographic risk factors and clinical characteristics associated with diabetes mellitus. A literature search was conducted using PubMed, MEDLINE, and Sabinet by using the following search terms: diabetes mellitus, risk factors, characteristics and complications.
Collapse
Affiliation(s)
- Yacob Pinchevsky
- Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Neil Butkow
- Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Frederick J Raal
- Carbohydrate and Lipid Metabolism Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Tobias Chirwa
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Alan Rothberg
- School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
78
|
Evangelista MDSN, Maia R, Toledo JP, Abreu RGD, Barreira D. Tuberculosis associated with diabetes mellitus by age group in Brazil: a retrospective cohort study, 2007–2014. Braz J Infect Dis 2020; 24:130-136. [PMID: 32298639 PMCID: PMC9392016 DOI: 10.1016/j.bjid.2020.03.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 03/23/2020] [Accepted: 03/28/2020] [Indexed: 11/26/2022] Open
Abstract
Diabetes mellitus (DM) has important implications for tuberculosis (TB), as it increases the risk for disease activation and is associated with unfavorable TB treatment outcomes. This study analyzed the association between TB and DM (TBDM) in Brazil from 2007 to 2014. This was a retrospective cohort study carried out in 709,429 new cases of TB reported to the national disease notification system of the Brazilian Ministry of Health. Sociodemographic and clinical data, test results, and treatment outcomes were analyzed. TBDM was found in 6.0% of TB cases, mostly in men aged 18-59 years. The lethality rate was 5.1% higher in all age groups with diabetes, except in those older than 60 years of age. The frequency of multi-drug-resistant tuberculosis (MDR-TB) in patients with DM was higher in those without DM, with a 1.6- to 3.8-fold increase in the odds of MDR-TB. The elderly showed an increase in the prevalence of TBDM from 14.3% to 18.2%. Women were more likely to have DM, and elderly women had 41.0% greater chance of having DM. Relapse was significant among patients younger than 17 years of age. TBDM was high in Brazil, affected all age groups, and was associated with unfavorable TB treatment outcomes. We emphasize the need for strategies for the clinical management of diabetic tuberculosis patients in Brazil aiming at minimizing relapses, deaths, and MDR-TB.
Collapse
|
79
|
Han X, Meng L, Li Y, Li A, Turyk ME, Yang R, Wang P, Xiao K, Zhao J, Zhang J, Zhang Q, Jiang G. Associations between the exposure to persistent organic pollutants and type 2 diabetes in East China: A case-control study. CHEMOSPHERE 2020; 241:125030. [PMID: 31606000 DOI: 10.1016/j.chemosphere.2019.125030] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 09/30/2019] [Accepted: 09/30/2019] [Indexed: 06/10/2023]
Abstract
Persistent organic pollutants (POPs) have been associated with a high risk of type 2 diabetes in different regions, although few studies from China have been published. We aimed to investigate the associations between POP exposure and type 2 diabetes in Chinese population. A total of 158 participants diagnosed with type 2 diabetes and 158 participants without the disorder from Shandong Province were enrolled in this case-control study during 2016-2017. Nine polychlorinated biphenyl congeners (PCBs) and 2 polybrominated diphenyl ethers with detectable levels in ≥75% of the participants were selected for data analysis. The results showed that POP exposure was significantly and positively associated with the risk of diabetes after adjusting for age, sex, BMI, triglycerides and total cholesterol. However, we did not observe an obvious modified effect of adiposity on the associations between POP exposure and diabetes in the present study, as strong associations between POPs and diabetes were observed in both the higher-BMI (BMI≥25 kg/m2) and the lower-BMI (BMI<25 kg/m2) groups. POPs showed stronger associations with diabetes in males than in females. The odds ratio (OR) for the highest quartile of ∑POPs was 6.97 for males, nearly two times higher than that for females (OR = 3.58). All these findings suggest that POP exposure may impact the risk of diabetes in Chinese population.
Collapse
Affiliation(s)
- Xu Han
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China; University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Lingling Meng
- Shandong Provincial Qianfoshan Hospital, The First Hospital Affiliated with Shandong First Medical University, Jinan, 250014, China
| | - Yingming Li
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China.
| | - An Li
- School of Public Health, University of Illinois at Chicago, Chicago, IL, 60612, USA
| | - Mary E Turyk
- School of Public Health, University of Illinois at Chicago, Chicago, IL, 60612, USA
| | - Ruiqiang Yang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China
| | - Pu Wang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China
| | - Ke Xiao
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China
| | - Junpeng Zhao
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China; University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Jianqing Zhang
- POPs Lab, Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, 518055, China
| | - Qinghua Zhang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China; University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Guibin Jiang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China; University of Chinese Academy of Sciences, Beijing, 100049, China
| |
Collapse
|
80
|
Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Chang AR, Cheng S, Delling FN, Djousse L, Elkind MSV, Ferguson JF, Fornage M, Khan SS, Kissela BM, Knutson KL, Kwan TW, Lackland DT, Lewis TT, Lichtman JH, Longenecker CT, Loop MS, Lutsey PL, Martin SS, Matsushita K, Moran AE, Mussolino ME, Perak AM, Rosamond WD, Roth GA, Sampson UKA, Satou GM, Schroeder EB, Shah SH, Shay CM, Spartano NL, Stokes A, Tirschwell DL, VanWagner LB, Tsao CW. Heart Disease and Stroke Statistics-2020 Update: A Report From the American Heart Association. Circulation 2020; 141:e139-e596. [PMID: 31992061 DOI: 10.1161/cir.0000000000000757] [Citation(s) in RCA: 4958] [Impact Index Per Article: 1239.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports on the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2020 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population, metrics to assess and monitor healthy diets, an enhanced focus on social determinants of health, a focus on the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors, implementation strategies, and implications of the American Heart Association's 2020 Impact Goals. RESULTS Each of the 26 chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policy makers, media professionals, clinicians, healthcare administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
Collapse
|
81
|
Shulman R, Slater M, Khan S, Jones C, Walker JD, Jacklin K, Green ME, Frymire E, Shah BR. Prevalence, incidence and outcomes of diabetes in Ontario First Nations children: a longitudinal population-based cohort study. CMAJ Open 2020; 8:E48-E55. [PMID: 31992559 PMCID: PMC6996034 DOI: 10.9778/cmajo.20190226] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND First Nations people are known to have a higher risk of childhood-onset type 2 diabetes, yet population-level data about diabetes in First Nations children are unavailable. In a partnership between Chiefs of Ontario and academic researchers, we describe the epidemiologic features and outcomes of diabetes in First Nations children in Ontario. METHODS We created annual cohorts from 1995/96 to 2014/15 using data from the Registered Persons Database linked with the federal Indian Register. We used the Ontario Diabetes Database to identify children with all types of diabetes and calculated the prevalence and incidence for First Nations children and other children in Ontario. We describe glycemic control in First Nations children and other children in 2014. RESULTS In 2014/15, there were 254 First Nations children and 10 144 other children with diagnosed diabetes in Ontario. From 1995/96 to 2014/15, the prevalence increased from 0.17 to 0.57 per 100 children, and the annual incidence increased from 37 to 94 per 100 000 per year among First Nations children. In 2014/15, the prevalence of diabetes was 0.62/100 among First Nations girls and 0.36/100 among other girls. The mean glycosylated hemoglobin level among First Nations children was 9.1% (standard deviation 2.7%) and for other children, 8.5% (standard deviation 2.1%). INTERPRETATION First Nations children have substantially higher rates of diabetes than non-Aboriginal children in Ontario; this is likely driven by an increased incidence of type 2 diabetes and increased risk for diabetes among First Nations girls. There is an urgent need for strategies to address modifiable factors associated with the risk of diabetes, improve access to culturally sensitive diabetes care and improve outcomes for First Nations children.
Collapse
Affiliation(s)
- Rayzel Shulman
- The Hospital for Sick Children (Shulman); ICES (Shulman, Slater, Khan, Walker, Green, Frymire, Shah); Departments of Pediatrics (Shulman, Green) and Medicine (Shah), University of Toronto, Toronto, Ont.; Department of Family Medicine (Slater), Queen's University, Kingston, Ont.; Chiefs of Ontario (Jones), Toronto, Ont.; School of Rural and Northern Health (Walker), Laurentian University, Sudbury, Ont.; Memory Keepers Medical Discover Team (Jacklin), Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, Minn.; Health Services and Policy Research Institute (Khan, Green, Frymire), Queen's University, Kingston, Ont.; Division of Endocrinology (Shah), Sunnybrook Health Sciences Centre, Toronto, Ont.
| | - Morgan Slater
- The Hospital for Sick Children (Shulman); ICES (Shulman, Slater, Khan, Walker, Green, Frymire, Shah); Departments of Pediatrics (Shulman, Green) and Medicine (Shah), University of Toronto, Toronto, Ont.; Department of Family Medicine (Slater), Queen's University, Kingston, Ont.; Chiefs of Ontario (Jones), Toronto, Ont.; School of Rural and Northern Health (Walker), Laurentian University, Sudbury, Ont.; Memory Keepers Medical Discover Team (Jacklin), Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, Minn.; Health Services and Policy Research Institute (Khan, Green, Frymire), Queen's University, Kingston, Ont.; Division of Endocrinology (Shah), Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Shahriar Khan
- The Hospital for Sick Children (Shulman); ICES (Shulman, Slater, Khan, Walker, Green, Frymire, Shah); Departments of Pediatrics (Shulman, Green) and Medicine (Shah), University of Toronto, Toronto, Ont.; Department of Family Medicine (Slater), Queen's University, Kingston, Ont.; Chiefs of Ontario (Jones), Toronto, Ont.; School of Rural and Northern Health (Walker), Laurentian University, Sudbury, Ont.; Memory Keepers Medical Discover Team (Jacklin), Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, Minn.; Health Services and Policy Research Institute (Khan, Green, Frymire), Queen's University, Kingston, Ont.; Division of Endocrinology (Shah), Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Carmen Jones
- The Hospital for Sick Children (Shulman); ICES (Shulman, Slater, Khan, Walker, Green, Frymire, Shah); Departments of Pediatrics (Shulman, Green) and Medicine (Shah), University of Toronto, Toronto, Ont.; Department of Family Medicine (Slater), Queen's University, Kingston, Ont.; Chiefs of Ontario (Jones), Toronto, Ont.; School of Rural and Northern Health (Walker), Laurentian University, Sudbury, Ont.; Memory Keepers Medical Discover Team (Jacklin), Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, Minn.; Health Services and Policy Research Institute (Khan, Green, Frymire), Queen's University, Kingston, Ont.; Division of Endocrinology (Shah), Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Jennifer D Walker
- The Hospital for Sick Children (Shulman); ICES (Shulman, Slater, Khan, Walker, Green, Frymire, Shah); Departments of Pediatrics (Shulman, Green) and Medicine (Shah), University of Toronto, Toronto, Ont.; Department of Family Medicine (Slater), Queen's University, Kingston, Ont.; Chiefs of Ontario (Jones), Toronto, Ont.; School of Rural and Northern Health (Walker), Laurentian University, Sudbury, Ont.; Memory Keepers Medical Discover Team (Jacklin), Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, Minn.; Health Services and Policy Research Institute (Khan, Green, Frymire), Queen's University, Kingston, Ont.; Division of Endocrinology (Shah), Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Kristen Jacklin
- The Hospital for Sick Children (Shulman); ICES (Shulman, Slater, Khan, Walker, Green, Frymire, Shah); Departments of Pediatrics (Shulman, Green) and Medicine (Shah), University of Toronto, Toronto, Ont.; Department of Family Medicine (Slater), Queen's University, Kingston, Ont.; Chiefs of Ontario (Jones), Toronto, Ont.; School of Rural and Northern Health (Walker), Laurentian University, Sudbury, Ont.; Memory Keepers Medical Discover Team (Jacklin), Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, Minn.; Health Services and Policy Research Institute (Khan, Green, Frymire), Queen's University, Kingston, Ont.; Division of Endocrinology (Shah), Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Michael E Green
- The Hospital for Sick Children (Shulman); ICES (Shulman, Slater, Khan, Walker, Green, Frymire, Shah); Departments of Pediatrics (Shulman, Green) and Medicine (Shah), University of Toronto, Toronto, Ont.; Department of Family Medicine (Slater), Queen's University, Kingston, Ont.; Chiefs of Ontario (Jones), Toronto, Ont.; School of Rural and Northern Health (Walker), Laurentian University, Sudbury, Ont.; Memory Keepers Medical Discover Team (Jacklin), Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, Minn.; Health Services and Policy Research Institute (Khan, Green, Frymire), Queen's University, Kingston, Ont.; Division of Endocrinology (Shah), Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Eliot Frymire
- The Hospital for Sick Children (Shulman); ICES (Shulman, Slater, Khan, Walker, Green, Frymire, Shah); Departments of Pediatrics (Shulman, Green) and Medicine (Shah), University of Toronto, Toronto, Ont.; Department of Family Medicine (Slater), Queen's University, Kingston, Ont.; Chiefs of Ontario (Jones), Toronto, Ont.; School of Rural and Northern Health (Walker), Laurentian University, Sudbury, Ont.; Memory Keepers Medical Discover Team (Jacklin), Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, Minn.; Health Services and Policy Research Institute (Khan, Green, Frymire), Queen's University, Kingston, Ont.; Division of Endocrinology (Shah), Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Baiju R Shah
- The Hospital for Sick Children (Shulman); ICES (Shulman, Slater, Khan, Walker, Green, Frymire, Shah); Departments of Pediatrics (Shulman, Green) and Medicine (Shah), University of Toronto, Toronto, Ont.; Department of Family Medicine (Slater), Queen's University, Kingston, Ont.; Chiefs of Ontario (Jones), Toronto, Ont.; School of Rural and Northern Health (Walker), Laurentian University, Sudbury, Ont.; Memory Keepers Medical Discover Team (Jacklin), Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, Minn.; Health Services and Policy Research Institute (Khan, Green, Frymire), Queen's University, Kingston, Ont.; Division of Endocrinology (Shah), Sunnybrook Health Sciences Centre, Toronto, Ont
| |
Collapse
|
82
|
Liu Y, Lou X. Type 2 diabetes mellitus-related environmental factors and the gut microbiota: emerging evidence and challenges. Clinics (Sao Paulo) 2020; 75:e1277. [PMID: 31939557 PMCID: PMC6945290 DOI: 10.6061/clinics/2020/e1277] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 10/04/2019] [Indexed: 01/15/2023] Open
Abstract
The gut microbiota is a group of over 38 trillion bacterial cells in the human microbiota that plays an important role in the regulation of human metabolism through its symbiotic relationship with the host. Changes in the gut microbial ecosystem are associated with increased susceptibility to metabolic disease in humans. However, the composition of the gut microbiota in those with type 2 diabetes mellitus and in the pathogenesis of metabolic diseases is not well understood. This article reviews the relationship between environmental factors and the gut microbiota in individuals with type 2 diabetes mellitus. Finally, we discuss the goal of treating type 2 diabetes mellitus by modifying the gut microbiota and the challenges that remain in this area.
Collapse
Affiliation(s)
- Yanfen Liu
- Jinhua Municipal Central Hospital, Department of Endocrinology Jinhua, 321000, China
| | - Xueyong Lou
- Jinhua Municipal Central Hospital, Department of Endocrinology Jinhua, 321000, China
- *Corresponding author. E-mail:
| |
Collapse
|
83
|
Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Chang AR, Cheng S, Das SR, Delling FN, Djousse L, Elkind MSV, Ferguson JF, Fornage M, Jordan LC, Khan SS, Kissela BM, Knutson KL, Kwan TW, Lackland DT, Lewis TT, Lichtman JH, Longenecker CT, Loop MS, Lutsey PL, Martin SS, Matsushita K, Moran AE, Mussolino ME, O'Flaherty M, Pandey A, Perak AM, Rosamond WD, Roth GA, Sampson UKA, Satou GM, Schroeder EB, Shah SH, Spartano NL, Stokes A, Tirschwell DL, Tsao CW, Turakhia MP, VanWagner LB, Wilkins JT, Wong SS, Virani SS. Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association. Circulation 2019; 139:e56-e528. [PMID: 30700139 DOI: 10.1161/cir.0000000000000659] [Citation(s) in RCA: 5428] [Impact Index Per Article: 1085.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
|
84
|
Eidkhani V, Parizadeh D, Hasheminia M, Azizi F, Hadaegh F. Impaired fasting glucose prevalence surge among Iranian adolescents in a decade: The Tehran Lipid and Glucose Study. Pediatr Diabetes 2019; 20:1064-1071. [PMID: 31478584 DOI: 10.1111/pedi.12916] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 08/14/2019] [Accepted: 08/18/2019] [Indexed: 12/30/2022] Open
Abstract
PURPOSE Impaired fasting glucose (IFG) is associated with incident diabetes, cardiovascular risk, and markers of atherosclerosis in early adulthood. We aimed to explore the 10-year change in IFG prevalence among adolescent participants of the Tehran Lipid and Glucose Study, a population-based study from Iran. METHODS For our study, we used data on fasting plasma glucose (FPG), anthropometric, and demographic information of 11 to 19-year-old adolescents in study periods I (1999-2005; 1415 boys, 1583 girls) and II (2011-2014; 477 boys, 469 girls). Sex-adjusted and sex-stratified multivariable logistic regression models were used to assess the relationship of the study period (reference: study period I) with IFG. RESULTS The prevalence of IFG, general obesity, and central obesity increased from 7%, 13.3%, and 18.8% in study period I to 16.6%, 24%, and 37.4% in study period II; while a favorable trend was seen for blood pressure, triglycerides, and high-density lipoprotein cholesterol. In the fully adjusted model, being older (age group 15-19 vs 11-14 years) and female sex were associated with lower risk. Being overweight and obese increased the risk by risk ratios (confidence interval) of 1.57 (1.17-2.11) and 1.63 (1.15-2.30), respectively. Central adiposity did not remain as an independent risk factor. Nevertheless, study period persisted as a significant factor despite all adjustments [2.20 (1.81-2.68)]. Results in the sex-stratified models were generally the same. CONCLUSION Our results demonstrated that the over 2-fold rise in IFG prevalence among adolescents was not solely dependent on general and central obesity.
Collapse
Affiliation(s)
- Vahid Eidkhani
- Students Research Committee, Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Donna Parizadeh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mitra Hasheminia
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
85
|
Lascar N, Altaf QA, Raymond NT, E P Brown J, Pattison H, Barnett A, Bailey CJ, Bellary S. Phenotypic characteristics and risk factors in a multi-ethnic cohort of young adults with type 2 diabetes. Curr Med Res Opin 2019; 35:1893-1900. [PMID: 31251092 DOI: 10.1080/03007995.2019.1638239] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background: Early onset of type 2 diabetes (T2DM) is associated with prolonged exposure to hyperglycaemia and increased propensity to chronic complications. The aim of this study was to characterize and compare the phenotypic characteristics and risk factors in a multi-ethnic cohort of young adults with type 2 diabetes (T2DMY). Methods: One hundred young adults (White European [WE], South Asian [SA] and African-Caribbean [AC]) diagnosed with T2DM before the age of 40 years were recruited. Demographics, family history, diabetes related complications, co-morbidities, anthropometry (body mass index [BMI], body composition), physical activity and biochemistry (HbA1c, lipid profile, liver and renal function) and autoantibodies (anti GAD, anti islet cell) were collected for all participants. Data were analysed for the most represented ethnic groups: (WE, N = 36 and SA, N = 53) using SPSS version 23. Results: Mean (± standard deviation) age at diagnosis was 32.5 ± 5.5 years and mean diabetes duration was 7.7 ± 3.8 years. Overweight/obesity was present in 95% of participants, history of maternal diabetes in 68%, deprivation 75%, low physical activity 40%, polycystic ovarian disease 29% (in females), acanthosis nigricans 12% and non-alcoholic fatty liver 11%. There was considerable clustering of risk factors within the cohort with over 75% of all subjects having three or more of the above risk factors and 52% required insulin within 3 years of diagnosis. Two-thirds of the patients had evidence of at least one diabetes related microvascular complication. Conclusion: T2DMY is characterized by a high burden of commonly associated risk factors for both the disease and its long-term complications.
Collapse
Affiliation(s)
- Nadia Lascar
- School of Life and Health Sciences, Aston University , Birmingham , UK
| | | | - Neil T Raymond
- School of Life and Health Sciences, Aston University , Birmingham , UK
| | - James E P Brown
- School of Life and Health Sciences, Aston University , Birmingham , UK
| | - Helen Pattison
- School of Life and Health Sciences, Aston University , Birmingham , UK
| | | | - Clifford J Bailey
- School of Life and Health Sciences, Aston University , Birmingham , UK
| | - Srikanth Bellary
- School of Life and Health Sciences, Aston University , Birmingham , UK
- Diabetes, University Hospitals Birmingham , Birmingham , UK
| |
Collapse
|
86
|
Diabetes Mellitus in Children with Acute Recurrent and Chronic Pancreatitis: Data From the INternational Study Group of Pediatric Pancreatitis: In Search for a CuRE Cohort. J Pediatr Gastroenterol Nutr 2019; 69:599-606. [PMID: 31651815 PMCID: PMC6834233 DOI: 10.1097/mpg.0000000000002482] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Adults with chronic pancreatitis (CP) have a high risk for developing pancreatogenic diabetes mellitus (DM), but little is known regarding potential risk factors for DM in children with acute recurrent pancreatitis (ARP) or CP. We compared demographic and clinical features of children with ARP or CP, with and without DM, in the INternational Study Group of Pediatric Pancreatitis: In Search for a CuRE (INSPPIRE) registry. METHODS We reviewed the INSPPIRE database for the presence or absence of physician-diagnosed DM in 397 children, excluding those with total pancreatectomy with islet autotransplantation, enrolled from August 2012 to August 2017. Patient demographics, BMI percentile, age at disease onset, disease risk factors, disease burden, and treatments were compared between children with DM (n = 24) and without DM (n = 373). RESULTS Twenty-four children (6% of the cohort) had a diagnosis of DM. Five of 13 tested were positive for beta cell autoantibodies. The DM group was 4.2 years [95% confidence interval (CI) 3-5.4] older at first episode of acute pancreatitis, and tended to more often have hypertriglyceridemia [odds ratio (OR) 5.21 (1.33-17.05)], coexisting autoimmune disease [OR 3.94 (0.88-13.65)] or pancreatic atrophy [OR 3.64 (1.13, 11.59)]. CONCLUSION Pancreatic atrophy may be more common among children with DM, suggesting more advanced exocrine disease. However, data in this exploratory cohort also suggest increased autoimmunity and hypertriglyceridemia in children with DM, suggesting that risk factors for type 1 and type 2 DM, respectively may play a role in mediating DM development in children with pancreatitis.
Collapse
|
87
|
Powell J, Isom S, Divers J, Bellatorre A, Johnson M, Smiley J, Begay Q, Benally C, Hu D, Saydah S, Pettitt DJ, Pihoker C, Dabelea D. Increasing burden of type 2 diabetes in Navajo youth: The SEARCH for diabetes in youth study. Pediatr Diabetes 2019; 20:815-820. [PMID: 31260152 PMCID: PMC6786918 DOI: 10.1111/pedi.12885] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 05/16/2019] [Accepted: 06/18/2019] [Indexed: 11/28/2022] Open
Abstract
AIM SEARCH has recently reported that both prevalence and incidence of youth onset type 2 diabetes (YT2D) increased among most US race/ethnic groups in the early 2000s. This study reports on the incidence (2002-2013) and prevalence (2001, 2009) of YT2D in the Navajo Nation among youth age < 20 years from 2001 to 2013. METHODS SEARCH sought to identify prevalent YT2D cases in 2001 (N = 75) and 2009 (N = 70) and all incident YT2D cases in three periods: 2002 to 2005 (N = 53), 2006 to 2009 (N = 68), and 2010 2013 (N = 90) in Navajo Nation. Denominators were based on the active Indian Health Service user population for eligible health care facilities. Prevalence (per 100 000) and period-specific incidence rates (per 100 000 person-years) were computed for youth aged 10 to 19 years. Changes in prevalence were tested with a two-sided skew-corrected inverted score test, while changes in incidence were tested with Poisson regression. RESULTS YT2D prevalence was high but stable in 2001 and 2009, overall [146.6 (116.8, 184.0) vs 141.5 (112.0, 178.8), P = .65) and in all subgroups. In contrast, incidence rates increased particularly between the second and third periods overall and in most subgroups by age and by sex. CONCLUSIONS These data confirm the high burden of YT2D among Navajo youth and suggest an increasing risk in more recent years. However, recent improvements in obesity reduction in this population demonstrate optimism for potential reductions in YT2D in Navajo Nation.
Collapse
Affiliation(s)
- Jeffrey Powell
- Community Health Division, Shiprock Service Unit, Navajo Area Indian Health Service, Shiprock NM
| | - Scott Isom
- Department of Biostatistics, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - Jasmin Divers
- Department of Biostatistics, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - Anna Bellatorre
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Aurora, CO
| | - Melissa Johnson
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Aurora, CO
| | - Janelia Smiley
- Community Health Division, Shiprock Service Unit, Navajo Area Indian Health Service, Shiprock NM
| | - Quanna Begay
- Community Health Division, Shiprock Service Unit, Navajo Area Indian Health Service, Shiprock NM
| | - Christine Benally
- Community Health Division, Shiprock Service Unit, Navajo Area Indian Health Service, Shiprock NM
| | - Diana Hu
- Pediatrics Department, Tuba City Regional Health Care Center, Tuba City, AZ
| | - Sharon Saydah
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA
| | | | | | - Dana Dabelea
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Aurora, CO
| | | |
Collapse
|
88
|
Khanolkar AR, Amin R, Taylor-Robinson D, Viner RM, Warner J, Stephenson T. Inequalities in glycemic control in childhood onset type 2 diabetes in England and Wales-A national population-based longitudinal study. Pediatr Diabetes 2019; 20:821-831. [PMID: 31329349 DOI: 10.1111/pedi.12897] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 04/10/2019] [Accepted: 06/26/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Not much is known about glycaemic-control trajectories in childhood-onset type 2 diabetes (T2D). We investigated characteristics of children and young people (CYP) with T2D and inequalities in glycemic control. METHODS We studied 747 CYP with T2D, <19 years of age in 2009-2016 (from the total population-based National Pediatric Diabetes Audit [>95% diabetes cases in England/Wales]). Linear mixed-effects modeling was used to assess socioeconomic and ethnic differences in longitudinal glycated hemoglobin (HbA1c ) trajectories during 4 years post-diagnosis (3326 HbA1c data points, mean 4.5 data points/subject). Self-identified ethnicity was grouped into six categories. Index of Multiple Deprivation (a small geographical area-level deprivation measure) was grouped into SES quintiles for analysis. RESULTS Fifty-eight percent were non-White, 66% were female, and 41% were in the most disadvantaged SES quintile. Mean age and HbA1c at diagnosis were 13.4 years and 68 mmol/mol, respectively. Following an initial decrease between diagnosis and end of year 1 (-15.2 mmol/mol 95%CI, -19.2, -11.2), HbA1c trajectories increased between years 1 and 3 (10 mmol/mol, 7.6, 12.4), followed by slight gradual decrease subsequently (-1.6 mmol/mol, -2, -1.1). Compared to White CYP, Pakistani children had higher HbA1c at diagnosis (13.2 mmol/mol, 5.6-20.9). During follow-up, mixed-ethnicity and Pakistani CYP had poorer glycemic control. Compared to children in the most disadvantaged quintile, those in the most advantaged had lower HbA1c at diagnosis (-6.3 mmol, -12.6, -0.1). Differences by SES remained during follow-up. Mutual adjustment for SES and ethnicity did not substantially alter the above estimates. CONCLUSIONS About two-thirds of children with childhood-onset T2D were non-White, female adolescents, just under half of whom live in the most disadvantaged areas of England and Wales. Additionally, there are substantial socioeconomic and ethnic inequalities in diabetes control.
Collapse
Affiliation(s)
- Amal R Khanolkar
- GOS Institute of Child Health, University College London (UCL), London, UK.,Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Rakesh Amin
- GOS Institute of Child Health, University College London (UCL), London, UK
| | | | - Russell M Viner
- GOS Institute of Child Health, University College London (UCL), London, UK
| | - Justin Warner
- Department of Paediatrics, Noah's Ark Children's Hospital for Wales, Cardiff, UK
| | - Terence Stephenson
- GOS Institute of Child Health, University College London (UCL), London, UK
| |
Collapse
|
89
|
Telo GH, Cureau FV, Szklo M, Bloch KV, Schaan BD. Prevalence of type 2 diabetes among adolescents in Brazil: Findings from Study of Cardiovascular Risk in Adolescents (ERICA). Pediatr Diabetes 2019; 20:389-396. [PMID: 30737879 DOI: 10.1111/pedi.12828] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 12/13/2018] [Accepted: 02/04/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) in adolescents represents a clinical challenge related to lifestyle and obesity; however, only a few data are available in developing countries. Therefore, our aim was to investigate the prevalence of T2DM and prediabetes among Brazilian adolescents, as well as to describe the cardio-metabolic profile according to the diagnosis. METHODS This is a cross-sectional school-based multicenter study including youth aged 12 to 17 years from cities with more than 100 000 inhabitants in Brazil (n = 37 854 students). Fasting glucose, hemoglobin A1c (HbA1c) and other cardio-metabolic risk factors were measured. Prediabetes was defined by glucose levels 100 to 125 mg/dL or HbA1c 5.7% to 6.4%. T2DM was defined by self-report, glucose ≥126 mg/dL or HbA1c ≥ 6.5%. Multinomial logistic regression was used to estimate the odds ratio (OR) of prediabetes or T2DM according to covariates. RESULTS Prevalences of prediabetes and T2DM were 22.0% (95% confidence interval [CI] 20.6%-23.4%) and 3.3% (95% CI 2.9%-3.7%), respectively. This estimates represented 213 830 adolescents living with T2DM and 1.46 million adolescents with prediabetes in Brazil. Prevalences of cardio-metabolic risk factors were higher in adolescents with prediabetes and T2DM. In the multinomial logistic model, obesity (OR 1.59, 95% CI 1.20-2.11), high waist circumference (OR 1.51, 95% CI 1.13-2.01), and skipping breakfast (OR 1.48, 95% CI 1.21-1.81) were associated with an increased OR for T2DM, while studying at rural area (OR 0.56, 95% CI 0.41-0.78) was associated with a decreased OR for T2DM. CONCLUSIONS The prevalence of T2DM and prediabetes was high among Brazilian adolescents, which highlights that this disease became a public health challenge not only among adults in Brazil.
Collapse
Affiliation(s)
- Gabriela H Telo
- Postraduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Felipe V Cureau
- Postraduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,National Institute of Science and Technology for Health Technology Assessment, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Moyses Szklo
- Department of Epidemiology, Johns Hopkins and Bloomberg School of Public Health, Baltimore, Maryland.,Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Katia V Bloch
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Beatriz D Schaan
- Postraduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| |
Collapse
|
90
|
Hernández-Montoya D, Soriano-Flores A, Castro-Santana A, Benjet C, Bernal-Pérez P, Llanes-Díaz N. A life-course approach to early-onset of diabetes mellitus: Probable contribution of collective violence in Mexico. ADVANCES IN LIFE COURSE RESEARCH 2019; 40:30-42. [PMID: 36694412 DOI: 10.1016/j.alcr.2019.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 01/17/2019] [Accepted: 03/13/2019] [Indexed: 06/17/2023]
Abstract
Type 2 diabetes mellitus (T2DM) is a growing health problem among the pediatric population in the world, and particularly in Mexico. Official data in Mexico reported that during the period from 2003 to 2013 there was an increase in the cumulative incidence among older adolescents between 2010 and 2012, which decreased to the usual measures in 2013. All these variations occurred in a period in which collective violence permeated all levels of Mexican society. It can be argued that there might be a relationship between the two phenomena. This is an ecologic analytical study of trends over time comprising older adolescents (15-19 year olds). T2DM cumulative incidence and mortality rates attributable to violent death (VD) were standardized by direct method according to the World Health Organization. Data were sourced from nationwide official reports. Time series analysis was performed with ARIMA models and significant predictors. The disease ecology analysis was done using cluster analysis. Using significant predictors with ARIMA models, we found that the male VD mortality rates series could forecast 63.1% of the temporal variability of the cumulative incidence of T2DM series. Geographically, states with higher rates of violence also showed a higher incidence of T2DM. These data suggest that collective violence may make some contribution to the early onset of T2DM among adolescents, particularly in those regions most affected by violence. These findings can be conducive to opening new lines of research to explore the relationship between variables at the individual level and the clinical implications.
Collapse
Affiliation(s)
- Dewi Hernández-Montoya
- Instituto Nacional de Pediatría, Insurgentes Sur 3700C, Insurgentes Cuicuilco, Coyoacán, Ciudad de México C.P. 04530, Mexico.
| | - Antonio Soriano-Flores
- Universidad Nacional Autónoma de México, Circuito Exterior s/n, Cd. Universitaria, Coyoacán, Ciudad de México C.P. 04510, Mexico.
| | - Anaclara Castro-Santana
- Universidad Nacional Autónoma de México, Circuito Exterior s/n, Cd. Universitaria, Coyoacán, Ciudad de México C.P. 04510, Mexico.
| | - Corina Benjet
- Instituto Nacional de Psiquiatría, Calzada México-Xochimilco 101 Col. San Lorenzo Huipulco, Tlalpán, Ciudad de México C.P. 14370, Mexico
| | - Pilar Bernal-Pérez
- Instituto Nacional de Pediatría, Insurgentes Sur 3700C, Insurgentes Cuicuilco, Coyoacán, Ciudad de México C.P. 04530, Mexico.
| | - Nathaly Llanes-Díaz
- Consejo Nacional de Ciencia y Tecnología - Instituto Nacional de Pediatría, Insurgentes Sur 3700C, Insurgentes Cuicuilco, Coyoacán, Ciudad de México C.P. 04530, Mexico.
| |
Collapse
|
91
|
Mumphrey MB, Hao Z, Leigh Townsend R, Qualls-Creekmore E, Yu S, Lutz TA, Münzberg H, Morrison CD, Berthoud HR. Gastric bypass surgery in lean adolescent mice prevents diet-induced obesity later in life. Sci Rep 2019; 9:7881. [PMID: 31133715 PMCID: PMC6536499 DOI: 10.1038/s41598-019-44344-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 05/15/2019] [Indexed: 01/09/2023] Open
Abstract
Gastric bypass surgery is the most effective treatment and is often the only option for subjects with severe obesity. However, investigation of critical molecular mechanisms involved has been hindered by confounding of specific effects of surgery and side effects associated with acute surgical trauma. Here, we dissociate the two components by carrying out surgery in the lean state and testing its effectiveness to prevent diet-induced obesity later in life. Body weight and composition of female mice with RYGB performed at 6 weeks of age were not significantly different from sham-operated and age-matched non-surgical mice at the time of high-fat diet exposure 12 weeks after surgery. These female mice were completely protected from high-fat diet-induced obesity and accompanying metabolic impairments for up to 50 weeks. Similar effects were seen in male mice subjected to RYGB at 5-6 weeks, although growth was slightly inhibited and protection from diet-induced obesity was less complete. The findings confirm that RYGB does not indiscriminately lower body weight but specifically prevents excessive diet-induced obesity and ensuing metabolic impairments. This prevention of obesity model should be crucial for identifying the molecular mechanisms underlying gastric bypass surgery.
Collapse
Affiliation(s)
- Michael B Mumphrey
- Neurobiology of Nutrition & Metabolism Department, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Zheng Hao
- Neurobiology of Nutrition & Metabolism Department, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - R Leigh Townsend
- Neurobiology of Nutrition & Metabolism Department, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Emily Qualls-Creekmore
- Neurobiology of Nutrition & Metabolism Department, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Sangho Yu
- Neurobiology of Nutrition & Metabolism Department, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Thomas A Lutz
- Institute of Veterinary Physiology, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland
| | - Heike Münzberg
- Neurobiology of Nutrition & Metabolism Department, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Christopher D Morrison
- Neurobiology of Nutrition & Metabolism Department, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Hans-Rudolf Berthoud
- Neurobiology of Nutrition & Metabolism Department, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA.
| |
Collapse
|
92
|
Xu Z, Tong S, Cheng J, Crooks JL, Xiang H, Li X, Huang C, Hu W. Heatwaves and diabetes in Brisbane, Australia: a population-based retrospective cohort study. Int J Epidemiol 2019; 48:1091-1100. [DOI: 10.1093/ije/dyz048] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2019] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Available data on the effects of heatwaves on hospitalizations for diabetes and the post-discharge status of diabetics are scarce. This study aimed to assess the effects of heatwaves on hospitalizations and post-discharge deaths for diabetes, and to identify the individual- and community-level characteristics [i.e. age, gender, Socio-economic Indexes for Areas (SEIFA), and normalized difference vegetation index (NDVI)] that modified heatwave effects.
Methods
Health data were extracted from a cohort study which included patients in Brisbane, Australia, who were hospitalized due to diabetes from 1st January 2005 to 31st December 2013, and died within 2 months after they were discharged. Data on community-level modifiers, including SEIFA and NDVI (i.e. urban vegetation), were obtained from Australian Bureau of Statistics and Australian Bureau of Meteorology, respectively. Case-crossover design was used to quantify the effects of heatwaves on hospitalizations and post-discharge deaths due to diabetes. Four heatwave definitions incorporating both intensity (i.e. 90th, 95th, 97th and 99th percentiles of mean temperature distribution) and duration (2 days), as well as excess heat factor (EHF), were used. A case-only design was adopted to identify the modifiers of heatwave effects.
Results
There were 10 542 hospitalizations for diabetes, and 513 patients died due to diabetes within 2 months after discharge. During low-intensity heatwave days (i.e. 90th percentile & 2 days), we did not observe a significant increase in hospitalizations for diabetes [9% at lag 0; 95% confidence interval (CI): –3%, 23%; P = 0.146], but we observed a significant increase in post-discharge deaths (46% at lag 2; 95% CI: 3%, 107%; P = 0.036). During middle-intensity heatwave days (i.e. 95th percentile & 2 days), hospitalizations for diabetes increased by 19% at lag 0 (95% CI: 2%, 39%; P = 0.026), and post-discharge deaths increased by 64% at lag 0 (95% CI: 6%, 154%; P = 0.027). During high-intensity heatwave days (i.e. 97th percentile & 2 days), hospitalizations for diabetes increased by 37% at lag 1 (95% CI: 11%, 69%; P = 0.004) and post-discharge deaths increased by 137% at lag 1 (95% CI: 39%, 303%; P = 0.002). When heatwave intensity increased to 99th percentile, we did not observe a significant increase in hospitalizations (–1% at lag 0; 95% CI: –38%, 59%; P = 0.870) or post-discharge deaths (79% at lag 0; 95% CI: –39%, 431%; P = 0.301). When we used EHF to define heatwaves, we observed significant increases of hospitalizations (7%; 95% CI: 1%, 15%; P = 0.039) and post-discharge deaths (68%, 95% CI: 10%, 158%; P = 0.017) during heatwave days, compared with non-heatwave days. Children and male diabetics were particularly vulnerable to heatwave effects, but we did not find any significant modification effect of SEIFA or NDVI on the associations of heatwaves with hospitalizations and post-discharge deaths due to diabetes.
Conclusion
Heatwaves may lead to hospitalizations of diabetics and their premature deaths. Heat-related diabetes burden in children may increase as climate warms and with increasing obesity rates in adolescents.
Collapse
Affiliation(s)
- Zhiwei Xu
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Shilu Tong
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Centre, Shanghai Jiao-Tong University, Shanghai, China
- School of Public Health, Institute of Environment and Human Health, Anhui Medical University, Hefei, China
| | - Jian Cheng
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - James Lewis Crooks
- National Jewish Health, Colorado, Denver, USA
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA
| | - Hao Xiang
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, China
| | - Xiangyu Li
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, China
| | - Cunrui Huang
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Wenbiao Hu
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| |
Collapse
|
93
|
Xie S, Jiang R, Xu W, Chen Y, Tang L, Li L, Li P. The relationship between serum-free insulin- like growth factor-1 and metabolic syndrome in school adolescents of northeast China. Diabetes Metab Syndr Obes 2019; 12:305-313. [PMID: 30881074 PMCID: PMC6408198 DOI: 10.2147/dmso.s195625] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Free insulin-like growth factor-1 (IGF-1) ratio (the ratio of IGF-1/insulin-like growth factor binding protein-3 [IGFBP-3]) was shown to be negatively correlated with metabolic syndrome (MetS) in adults, but it was unknown in Chinese adolescents. PATIENTS AND METHODS The cross-sectional study enrolled 701 healthy school students (aged 12-16 years, 46.1% females) and 93 of them (18-22 years old, 46.2% females) were followed after 5 years. RESULTS In the cross-sectional study, the IGF-1/IGFBP-3 ratios were found correlated with low-density lipoprotein cholesterol (LDL-C; r= -0.071, P<0.05) and diastolic blood pressure (r= -0.077, P=0.034). A lower IGF-1/IGFBP-3 ratio was an independent risk factor for MetS (OR =2.348, 95% CI: 1.040-5.303), hypertension (OR=1.729, 95% CI: 1.040-5.303), and increased LDL-C (OR=1.841, 95% CI: 1.230-2.755). In the follow-up study, all the participants were >18 years old. We found a lower baseline ratio of IGF-1/IGFBP-3 in adolescence was an independent risk factor for MetS in adulthood (OR=10.724, 95% CI: 1.032-11.403) and also indicated a higher body mass index (β=-1.361, 95% CI: -2.513 to -0.208) after 5 years. CONCLUSION The lower IGF-1/IGFBP-3 ratio was an independent risk factor for MetS, hypertension, and high LDL-C in adolescents of northeast China and was also a predictive marker for MetS and increased body mass index in the adulthood.
Collapse
Affiliation(s)
- Shuang Xie
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, P.R. China,
- Department of General Medicine (VIP ward), Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, Liaoning Province, P.R. China
| | - Ranhua Jiang
- Department of Endocrinology, Liaoyang Diabetes Hospital, Liaoyang, Liaoning Province, P.R. China
| | - Wanfeng Xu
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, P.R. China,
| | - Yu Chen
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, P.R. China,
| | - Lei Tang
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, P.R. China,
| | - Ling Li
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, P.R. China,
| | - Ping Li
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, P.R. China,
| |
Collapse
|
94
|
Scholtens DM, Kuang A, Lowe LP, Hamilton J, Lawrence JM, Lebenthal Y, Brickman WJ, Clayton P, Ma RC, McCance D, Tam WH, Catalano PM, Linder B, Dyer AR, Lowe WL, Metzger BE. Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study (HAPO FUS): Maternal Glycemia and Childhood Glucose Metabolism. Diabetes Care 2019; 42:381-392. [PMID: 30617141 PMCID: PMC6385697 DOI: 10.2337/dc18-2021] [Citation(s) in RCA: 157] [Impact Index Per Article: 31.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 11/29/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This study examined associations of maternal glycemia during pregnancy with childhood glucose outcomes in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) cohort. RESEARCH DESIGN AND METHODS HAPO was an observational international investigation that established associations of maternal glucose with adverse perinatal outcomes. The HAPO Follow-up Study included 4,832 children ages 10-14 years whose mothers had a 75-g oral glucose tolerance test (OGTT) at ∼28 weeks of gestation. Of these, 4,160 children were evaluated for glucose outcomes. Primary outcomes were child impaired glucose tolerance (IGT) and impaired fasting glucose (IFG). Additional outcomes were glucose-related measures using plasma glucose (PG), A1C, and C-peptide from the child OGTT. RESULTS Maternal fasting plasma glucose (FPG) was positively associated with child FPG and A1C; maternal 1-h and 2-h PG were positively associated with child fasting, 30 min, 1-h, and 2-h PG, and A1C. Maternal FPG, 1-h, and 2-h PG were inversely associated with insulin sensitivity, whereas 1-h and 2-h PG were inversely associated with disposition index. Maternal FPG, but not 1-h or 2-h PG, was associated with child IFG, and maternal 1-h and 2-h PG, but not FPG, were associated with child IGT. All associations were independent of maternal and child BMI. Across increasing categories of maternal glucose, frequencies of child IFG and IGT, and timed PG measures and A1C were higher, whereas insulin sensitivity and disposition index decreased. CONCLUSIONS Across the maternal glucose spectrum, exposure to higher levels in utero is significantly associated with childhood glucose and insulin resistance independent of maternal and childhood BMI and family history of diabetes.
Collapse
|
95
|
Lowe WL, Scholtens DM, Kuang A, Linder B, Lawrence JM, Lebenthal Y, McCance D, Hamilton J, Nodzenski M, Talbot O, Brickman WJ, Clayton P, Ma RC, Tam WH, Dyer AR, Catalano PM, Lowe LP, Metzger BE. Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study (HAPO FUS): Maternal Gestational Diabetes Mellitus and Childhood Glucose Metabolism. Diabetes Care 2019; 42:372-380. [PMID: 30655380 PMCID: PMC6385693 DOI: 10.2337/dc18-1646] [Citation(s) in RCA: 287] [Impact Index Per Article: 57.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 10/15/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Whether hyperglycemia in utero less than overt diabetes is associated with altered childhood glucose metabolism is unknown. We examined associations of gestational diabetes mellitus (GDM) not confounded by treatment with childhood glycemia in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) cohort. RESEARCH DESIGN AND METHODS HAPO Follow-up Study (FUS) included 4,160 children ages 10-14 years who completed all or part of an oral glucose tolerance test (OGTT) and whose mothers had a 75-g OGTT at ∼28 weeks of gestation with blinded glucose values. The primary predictor was GDM by World Health Organization criteria. Child outcomes were impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and type 2 diabetes. Additional measures included insulin sensitivity and secretion and oral disposition index. RESULTS For mothers with GDM, 10.6% of children had IGT compared with 5.0% of children of mothers without GDM; IFG frequencies were 9.2% and 7.4%, respectively. Type 2 diabetes cases were too few for analysis. Odds ratios (95% CI) adjusted for family history of diabetes, maternal BMI, and child BMI z score were 1.09 (0.78-1.52) for IFG and 1.96 (1.41-2.73) for IGT. GDM was positively associated with child's 30-min, 1-h, and 2-h but not fasting glucose and inversely associated with insulin sensitivity and oral disposition index (adjusted mean difference -76.3 [95% CI -130.3 to -22.4] and -0.12 [-0.17 to -0.064]), respectively, but not insulinogenic index. CONCLUSIONS Offspring exposed to untreated GDM in utero are insulin resistant with limited β-cell compensation compared with offspring of mothers without GDM. GDM is significantly and independently associated with childhood IGT.
Collapse
|
96
|
Liu W, Liu J, Huang Z, Cui Z, Li L, Liu W, Qi Z. Possible role of GLP-1 in antidepressant effects of metformin and exercise in CUMS mice. J Affect Disord 2019; 246:486-497. [PMID: 30599373 DOI: 10.1016/j.jad.2018.12.112] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 12/18/2018] [Accepted: 12/24/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Both depression itself and antidepressant medication have been reported to be significantly related to the risk of type 2 diabetes mellitus (T2DM). Glucagon-like peptide-1 (GLP-1), a treatment target for T2DM, has a neuroprotective effect. As an enhancer and sensitiser of GLP-1, metformin has been reported to be safe for the neurodevelopment. The present study aimed to determine whether and how GLP-1 mediates antidepressant effects of metformin and exercise in mice. METHODS Male C57BL/6 mice were exposed to chronic unpredictable mild stress (CUMS) for 8 weeks. From the 4th week, CUMS mice were subjected to oral metformin treatment and/or treadmill running. A videocomputerized tracking system was used to record behaviors of mice for a 5-min session. ELISA, western blotting and immunohistochemistry were used to examine serum protein concentrations, protein levels in whole hippocampus, protein distribution and expression in dorsal and ventral hippocampus, respectively. RESULTS Our results supported the validity of metformin as a useful antidepressant; moreover, treadmill running favored metformin effects on exploratory behaviors and serum corticosterone levels. CUMS reduced GLP-1 protein levels and phosphorylation levels of extracellular signal-regulated kinase 1/2 (ERK1/2), but increased protein levels of B-cell lymphoma 2-associated X-protein (BAX) in mice hippocampus. All these changes were restored by both single and combined treatment with metformin and exercise. LIMITATIONS We did not establish a causal relationship between GLP-1 expression and related signaling, using GLP-1 agonist and antagonist or knockout techniques. CONCLUSIONS Our findings have demonstrated that protein levels of pERK and BAX may be relevant to the role of GLP-1 in antidepressant effects of metformin and exercise, which may provide a novel topic for future clinical research.
Collapse
Affiliation(s)
- Weina Liu
- Key Laboratory of Adolescent Health Assessment and Exercise Intervention of Ministry of Education, East China Normal University, Shanghai 200241, China; School of Physical Education & Health Care, East China Normal University, Shanghai 200241, China.
| | - Jiatong Liu
- Key Laboratory of Adolescent Health Assessment and Exercise Intervention of Ministry of Education, East China Normal University, Shanghai 200241, China; School of Physical Education & Health Care, East China Normal University, Shanghai 200241, China
| | - Zhuochun Huang
- Key Laboratory of Adolescent Health Assessment and Exercise Intervention of Ministry of Education, East China Normal University, Shanghai 200241, China; School of Physical Education & Health Care, East China Normal University, Shanghai 200241, China
| | - Zhiming Cui
- Key Laboratory of Adolescent Health Assessment and Exercise Intervention of Ministry of Education, East China Normal University, Shanghai 200241, China; School of Physical Education & Health Care, East China Normal University, Shanghai 200241, China
| | - Lingxia Li
- Key Laboratory of Adolescent Health Assessment and Exercise Intervention of Ministry of Education, East China Normal University, Shanghai 200241, China; School of Physical Education & Health Care, East China Normal University, Shanghai 200241, China
| | - Wenbin Liu
- Key Laboratory of Adolescent Health Assessment and Exercise Intervention of Ministry of Education, East China Normal University, Shanghai 200241, China; School of Physical Education & Health Care, East China Normal University, Shanghai 200241, China
| | - Zhengtang Qi
- Key Laboratory of Adolescent Health Assessment and Exercise Intervention of Ministry of Education, East China Normal University, Shanghai 200241, China; School of Physical Education & Health Care, East China Normal University, Shanghai 200241, China.
| |
Collapse
|
97
|
Lim RR, Grant DG, Olver TD, Padilla J, Czajkowski AM, Schnurbusch TR, Mohan RR, Hainsworth DP, Walters EM, Chaurasia SS. Young Ossabaw Pigs Fed a Western Diet Exhibit Early Signs of Diabetic Retinopathy. Invest Ophthalmol Vis Sci 2019; 59:2325-2338. [PMID: 29847637 PMCID: PMC5937800 DOI: 10.1167/iovs.17-23616] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Purpose Recent clinical data suggest an increasing prevalence of obesity and type 2 diabetes in adolescents, placing them at high risk of developing diabetic retinopathy during adult working years. The present study was designed to characterize the early retinal and microvascular alterations in young Ossabaw pigs fed a Western diet, described as a model of metabolic syndrome genetically predisposed to type 2 diabetes. Methods Four-month-old Ossabaw miniature pigs were divided into two groups, lean and diet-induced obesity. Obese pigs were fed a Western diet with high-fat/high-fructose corn syrup/high-choleric content for 10 weeks. Blood and retina were collected for biochemical profiling, trypsin digest, flatmounts, Fluoro-Jade C staining, electron microscopy, quantitative PCR, immunohistochemistry, and Western blots. Results Young Ossabaw pigs had elevated fasting blood glucose after feeding on a Western diet for 10 weeks. Their retina showed disrupted cellular architecture across neural layers, with numerous large vacuoles seen in cell bodies of the inner nuclear layer. Microvessels in the obese animals exhibited thickened basement membrane, along with pericyte ghosts and acellular capillaries. The pericyte to endothelial ratio decreased significantly. Retina flatmounts from obese pigs displayed reduced capillary density, numerous terminal capillary loops, and string vessels, which stained collagen IV but not isolectin IB4. Quantitative PCR and Western blots showed significantly high levels of basement membrane proteins collagen IV and fibronectin in obese pigs. Conclusions This is the first study to describe the ultrastructural neuronal and vascular changes in the retina of young Ossabaw pigs fed a Western diet, simulating early signs of diabetic retinopathy pathogenesis.
Collapse
Affiliation(s)
- Rayne R Lim
- Ocular Immunology and Angiogenesis Lab, Department of Veterinary Medicine & Surgery, University of Missouri, Columbia, Missouri, United States.,Department of Biomedical Sciences, University of Missouri, Columbia, Missouri, United States.,Harry S. Truman Memorial Veteran Hospital, Columbia, Missouri, United States
| | - DeAna G Grant
- Electron Microscopy Core, University of Missouri, Columbia, Missouri, United States
| | - T Dylan Olver
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri, United States
| | - Jaume Padilla
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri, United States.,Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri, United States.,Child Health, University of Missouri, Columbia, Missouri, United States
| | - Alana M Czajkowski
- National Swine Resource and Research Center, University of Missouri, Columbia, Missouri, United States
| | - Teagan R Schnurbusch
- National Swine Resource and Research Center, University of Missouri, Columbia, Missouri, United States
| | - Rajiv R Mohan
- Ocular Immunology and Angiogenesis Lab, Department of Veterinary Medicine & Surgery, University of Missouri, Columbia, Missouri, United States.,Department of Biomedical Sciences, University of Missouri, Columbia, Missouri, United States.,Harry S. Truman Memorial Veteran Hospital, Columbia, Missouri, United States.,Mason Eye Institute, University of Missouri, Columbia, Missouri, United States
| | - Dean P Hainsworth
- Mason Eye Institute, University of Missouri, Columbia, Missouri, United States
| | - Eric M Walters
- National Swine Resource and Research Center, University of Missouri, Columbia, Missouri, United States
| | - Shyam S Chaurasia
- Ocular Immunology and Angiogenesis Lab, Department of Veterinary Medicine & Surgery, University of Missouri, Columbia, Missouri, United States.,Department of Biomedical Sciences, University of Missouri, Columbia, Missouri, United States.,Harry S. Truman Memorial Veteran Hospital, Columbia, Missouri, United States
| |
Collapse
|
98
|
Choi YS, Klaric JS, Beltran TH. Prediction of Insulin Resistance with Anthropometric and Clinical Laboratory Measures in Nondiabetic Teenagers. Metab Syndr Relat Disord 2019; 17:37-45. [DOI: 10.1089/met.2018.0072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Young Sammy Choi
- Department of Medicine, Womack Army Medical Center, Fort Bragg, North Carolina
- Department of Pediatrics, Womack Army Medical Center, Fort Bragg, North Carolina
- Department of Research, Womack Army Medical Center, Fort Bragg, North Carolina
| | - John S. Klaric
- Department of Research, Womack Army Medical Center, Fort Bragg, North Carolina
| | - Thomas H. Beltran
- Department of Research, Womack Army Medical Center, Fort Bragg, North Carolina
| |
Collapse
|
99
|
Titmuss A, Davis EA, Brown A, Maple‐Brown LJ. Emerging diabetes and metabolic conditions among Aboriginal and Torres Strait Islander young people. Med J Aust 2019; 210:111-113.e1. [DOI: 10.5694/mja2.13002] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Angela Titmuss
- Royal Darwin Hospital Darwin NT
- Menzies School of Health Research Darwin NT
| | | | - Alex Brown
- Aboriginal Health Research AccordSouth Australian Health and Medical Research Institute Adelaide SA
- University of South Australia Adelaide SA
| | | |
Collapse
|
100
|
Lin S, Tang L, Jiang R, Chen Y, Yang S, Li L, Li P. The Relationship Between Aspartate Aminotransferase To Alanine Aminotransferase Ratio And Metabolic Syndrome In Adolescents In Northeast China. Diabetes Metab Syndr Obes 2019; 12:2387-2394. [PMID: 31819564 PMCID: PMC6873971 DOI: 10.2147/dmso.s217127] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 09/26/2019] [Indexed: 11/23/2022] Open
Abstract
AIM To investigate the relationship of the aspartate aminotransferase to alanine aminotransferase ratio (AST/ALT) and metabolic syndrome (MetS) in adolescents in northeast China. METHODS A stratified cluster random sample of 935 students 11-16 years of age in a city in the northeast of China were enrolled in 2010-2011. Participants were given a physical examination and a laboratory evaluation, and 93 participants were followed-up after 5 years. RESULTS AST/ALT was negatively correlated with waist circumference (WC), waist-to-hip ratio, body mass index (BMI), diastolic blood pressure, triglycerides, low-density lipoprotein, uric acid, fasting insulin, and insulin resistance. It was positively correlated with high-density lipoprotein. Multivariate logistic regression showed that the risk of MetS was 6.02 times greater in adolescents with the lowest, compared with the highest, AST/ALT. Central obesity was the MetS component most closely associated with low AST/ALT [odds ratio (OR) =5.13, 95% CI: 2.83, 9.28]. Five years later, baseline AST/ALT was negatively correlated with WC (r=-0.21, P=0.046), BMI (r=-0.29, P=0.005) and fasting plasma glucose (r=-0.25, P=0.017). CONCLUSION In adolescents, AST/ALT was significantly associated with MetS and its components and predicted overweight/obesity in adulthood.
Collapse
Affiliation(s)
- Shuang Lin
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
- Department of Cardiology, Zhongyi Northeast International Hospital, Shenyang, Liaoning Province, People’s Republic of China
| | - Lei Tang
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Ranhua Jiang
- Department of Endocrinology, Liaoyang Diabetes Hospital, Liaoyang, Liaoning Province, People’s Republic of China
| | - Yu Chen
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Sheng Yang
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Ling Li
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
- Ling Li Department of Endocrinology, Shengjing Hospital of China Medical University, No.36, Sanhao Street, Heping District, Shenyang110004, Liaoning Province, People’s Republic of ChinaTel +86 18940251181Fax +86 02425944460 Email
| | - Ping Li
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
- Correspondence: Ping Li Department of Endocrinology, Shengjing Hospital of China Medical University, No.39, Huaxiang Road, Tiexi District, Shenyang110022, Liaoning Province, People’s Republic of ChinaTel +86 18940255673 Email
| |
Collapse
|