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Reidpath DD, Soyiri I, Jahan NK, Mohan D, Ahmad B, Ahmad MP, Kassim ZB, Allotey P. Poor glycaemic control and its metabolic and demographic risk factors in a Malaysian community-based study. Int J Public Health 2018; 63:193-202. [PMID: 29372287 DOI: 10.1007/s00038-017-1072-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 11/03/2017] [Accepted: 11/07/2017] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES The lack of population-based evidence on the risk factors for poor glycaemic control in diabetics, particularly in resource-poor settings, is a challenge for the prevention of long-term complications. This study aimed to identify the metabolic and demographic risk factors for poor glycaemic control among diabetics in a rural community in Malaysia. METHODS A total of 1844 (780 males and 1064 females) known diabetics aged ≥ 35 years were identified from the South East Asia Community Observatory (SEACO) health and demographic surveillance site database. RESULTS 41.3% of the sample had poor glycaemic control. Poor glycaemic control was associated with age and ethnicity, with older participants (65+) better controlled than younger adults (45-54), and Malaysian Indians most poorly controlled, followed by Malay and then Chinese participants. Metabolic risk factors were also highly associated with poor glycaemic control. CONCLUSIONS There is a critical need for evidence for a better understanding of the mechanisms of the associations between risk factors and glycaemic control.
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Affiliation(s)
- Daniel D Reidpath
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia.,College of Medicine and Veterinary Medicine, The University Edinburgh, Edinburgh, Scotland, UK.,South East Asia Community Observatory (SEACO), Monash University Malaysia, Bandar Sunway, Malaysia
| | - Ireneous Soyiri
- College of Medicine and Veterinary Medicine, The University Edinburgh, Edinburgh, Scotland, UK
| | - Nowrozy K Jahan
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia.,South East Asia Community Observatory (SEACO), Monash University Malaysia, Bandar Sunway, Malaysia
| | - Devi Mohan
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Badariah Ahmad
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Mohtar Pungut Ahmad
- Hospital Segamat, Ministry of Health Malaysia, KM 6 Jalan Genuang, 85000, Segamat, Johor Darul Takzim, Malaysia
| | - Zaid Bin Kassim
- Segamat District Public Health Office, Ministry of Health Malaysia, Peti Surat 102, Jalan Gudang Ubat, Kampung Gubah, 85000, Segamat, Johor Darul Takzim, Malaysia
| | - Pascale Allotey
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia. .,South East Asia Community Observatory (SEACO), Monash University Malaysia, Bandar Sunway, Malaysia. .,United Nations University, International Institute for Global Health (UNU-IIGH), UNU-IIGH Building, 56000, Bandar Tun Razak, Federal Territory of Kuala Lumpur, Malaysia.
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Fermin CR, Lee AM, Filipp SL, Gurka MJ, DeBoer MD. Serum Alanine Aminotransferase Trends and Their Relationship with Obesity and Metabolic Syndrome in United States Adolescents, 1999-2014. Metab Syndr Relat Disord 2017; 15:276-282. [PMID: 28520503 PMCID: PMC5564053 DOI: 10.1089/met.2017.0023] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Nonalcoholic fatty liver disease (NAFLD), characterized by hepatocyte dysfunction, fat accumulation, and fibrosis, is the most common cause of chronic liver disease in children. Elevated levels of serum alanine aminotransferase (ALT) are used clinically to identify potential liver dysfunction. Our goal was to assess for changes in the national prevalence of elevated ALT over time and potential relationship to trends in the metabolic syndrome (MetS) severity and elevated body mass index (BMI). MATERIALS AND METHODS We studied 5411 non-Hispanic white, non-Hispanic black, and Hispanic adolescents aged 12-19 with complete MetS Z-score and ALT data from the National Health and Nutrition Examination Survey 1999-2014. Elevated ALT levels were defined by two different cutoffs: one for both sexes (30 U/L) and another that was sex specific (22 U/L girls; 25 U/L boys). MetS severity was assessed using a sex- and race-/ethnicity-specific MetS Z-score. RESULTS We did not find a statistically significant linear increase in either mean ALT or the prevalence of elevated ALT differed over time. As expected, ALT levels were significantly correlated with BMI Z-score and MetS Z-score (P < 0.0001). Over time, BMI Z-scores increased and MetS severity Z-score decreased. CONCLUSION Prevalence of elevated ALT did not exhibit a linear change between 1999 and 2014 in U.S. adolescents, potentially due to divergent trends regarding BMI and MetS severity. Continued vigilance in monitoring BMI and ALT levels is advised for the U.S. adolescent population. MetS Z-score could act as an additional tool to monitor risk of elevated ALT and subsequent development of NAFLD.
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Affiliation(s)
- Cyrelle R. Fermin
- Department of Pediatrics, University of Virginia, Charlottesville, Virginia
| | - Arthur M. Lee
- Department of Pediatrics, University of Virginia, Charlottesville, Virginia
| | - Stephanie L. Filipp
- Department of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, Florida
| | - Matthew J. Gurka
- Department of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, Florida
| | - Mark D. DeBoer
- Department of Pediatrics, University of Virginia, Charlottesville, Virginia
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Vahit D, Akboga MK, Samet Y, Hüseyin E. Assessment of monocyte to high density lipoprotein cholesterol ratio and lymphocyte-to-monocyte ratio in patients with metabolic syndrome. Biomark Med 2017; 11:535-540. [PMID: 28685581 DOI: 10.2217/bmm-2016-0380] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
AIM We aimed to investigate the relationships between metabolic syndrome (MS) and monocyte to high density lipoprotein cholesterol ratio (MHR) and lymphocyte-to-monocyte ratio (LMR). METHODS 762 patients (n = 371 MS present and n = 391 MS absent) were enrolled. RESULTS MHR was significantly higher [13.9 (10.5-18.1) vs 11.1 (8.0-14.8); p < 0.001], whereas LMR was significantly lower [4.5 (3.6-5.7) vs 3.6 (2.9-4.8); p < 0.001] in patients with MS. LMR [OR: 0.796 (95% CI): 0.711-0.892); p < 0.001], MHR [OR: 1.052 (95% CI: 1.018-1.088); p = 0.003] and C-reactive protein [OR: 1.048 (95% CI: 1.032-1.065); p < 0.001] remained as independent variables for the presence of MS. CONCLUSION The present study shows that both LMR and MHR may be novel and useful indicators of MS.
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Affiliation(s)
- Demir Vahit
- Cardiology Department, Bozok University Hospital, 66200, Yozgat, Turkey
| | - Mehmet Kadri Akboga
- Cardiology Clinic, Turkey Yuksek Ihtisas Education & Research Hospital, 06100, Sihhiye, Ankara, Turkey
| | - Yilmaz Samet
- Cardiology clinic, Pamukkale University Hospital, 20070, Denizli, Turkey
| | - Ede Hüseyin
- Cardiology Department, Bozok University Hospital, 66200, Yozgat, Turkey
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Musani SK, Martin LJ, Woo JG, Olivier M, Gurka MJ, DeBoer MD. Heritability of the Severity of the Metabolic Syndrome in Whites and Blacks in 3 Large Cohorts. CIRCULATION. CARDIOVASCULAR GENETICS 2017; 10:e001621. [PMID: 28408709 PMCID: PMC5481724 DOI: 10.1161/circgenetics.116.001621] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 03/06/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND Although dichotomous criteria for the metabolic syndrome (MetS) appear heritable, it is not known whether MetS severity as assessed by a continuous MetS score is heritable and whether this varies by race. METHODS AND RESULTS We used SOLAR (Sequential Oligogenic Linkage Analysis Routines) to evaluate heritability of Adult Treatment Panel-III MetS and a sex- and race-specific MetS severity Z score among 3 large familial cohorts: the JHS (Jackson Heart Study, 1404 black participants), TOPS (Take Off Pounds Sensibly, 1947 white participants), and PLRS (Princeton Lipid Research Study, 229 black and 527 white participants). Heritability estimates were larger for Adult Treatment Panel-III MetS among black compared with white cohort members (JHS 0.48; 95% confidence interval [CI], 0.28-0.68 and PLRS blacks 0.93 [95% CI, 0.73-1.13] versus TOPS 0.21 [95% CI, -0.18 to 0.60] and PLRS whites 0.27 [95% CI, -0.04 to 0.58]). The difference by race narrowed when assessing heritability of the MetS severity score (JHS 0.52 [95% CI, 0.38, 0.66] and PLRS blacks 0.64 [95% CI, 0.13-1.15] versus TOPS 0.23 [95% CI, 0.15-0.31] and PLRS whites 0.60 [95% CI, 0.33-0.87]). There was a high degree of genetic and phenotypic correlation between MetS severity and the individual components of MetS among all groups, although the genetic correlations failed to reach statistical significance among PLRS blacks. Meta-analyses revealed a combined heritability estimate for Adult Treatment Panel-III MetS of 0.24 (95% CI, 0.11-0.36) and for the MetS severity score of 0.50 (95% CI, -0.05 to 0.99). CONCLUSIONS MetS severity seems highly heritable among whites and blacks. This continuous MetS severity Z score may provide a more useful means of characterizing phenotypic MetS in genetic studies by minimizing racial differences.
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Affiliation(s)
- Solomon K Musani
- From the Jackson Heart Study, University of Mississippi Medical Center, Jackson (S.K.M.); Division of Human Genetics (L.J.M.) and Division of Epidemiology & Biostatistics (J.G.W.), Cincinnati Children's Hospital Medical Center, OH; Department of Pediatrics, University of Cincinnati, OH (L.J.M., J.G.W.); Texas Biomedical Research Institute, San Antonio (M.O.); Department of Health Outcomes & Policy, University of Florida, Gainesville (M.J.G.); and Department of Pediatrics, University of Virginia, Charlottesville (M.D.D.)
| | - Lisa J Martin
- From the Jackson Heart Study, University of Mississippi Medical Center, Jackson (S.K.M.); Division of Human Genetics (L.J.M.) and Division of Epidemiology & Biostatistics (J.G.W.), Cincinnati Children's Hospital Medical Center, OH; Department of Pediatrics, University of Cincinnati, OH (L.J.M., J.G.W.); Texas Biomedical Research Institute, San Antonio (M.O.); Department of Health Outcomes & Policy, University of Florida, Gainesville (M.J.G.); and Department of Pediatrics, University of Virginia, Charlottesville (M.D.D.)
| | - Jessica G Woo
- From the Jackson Heart Study, University of Mississippi Medical Center, Jackson (S.K.M.); Division of Human Genetics (L.J.M.) and Division of Epidemiology & Biostatistics (J.G.W.), Cincinnati Children's Hospital Medical Center, OH; Department of Pediatrics, University of Cincinnati, OH (L.J.M., J.G.W.); Texas Biomedical Research Institute, San Antonio (M.O.); Department of Health Outcomes & Policy, University of Florida, Gainesville (M.J.G.); and Department of Pediatrics, University of Virginia, Charlottesville (M.D.D.)
| | - Michael Olivier
- From the Jackson Heart Study, University of Mississippi Medical Center, Jackson (S.K.M.); Division of Human Genetics (L.J.M.) and Division of Epidemiology & Biostatistics (J.G.W.), Cincinnati Children's Hospital Medical Center, OH; Department of Pediatrics, University of Cincinnati, OH (L.J.M., J.G.W.); Texas Biomedical Research Institute, San Antonio (M.O.); Department of Health Outcomes & Policy, University of Florida, Gainesville (M.J.G.); and Department of Pediatrics, University of Virginia, Charlottesville (M.D.D.)
| | - Matthew J Gurka
- From the Jackson Heart Study, University of Mississippi Medical Center, Jackson (S.K.M.); Division of Human Genetics (L.J.M.) and Division of Epidemiology & Biostatistics (J.G.W.), Cincinnati Children's Hospital Medical Center, OH; Department of Pediatrics, University of Cincinnati, OH (L.J.M., J.G.W.); Texas Biomedical Research Institute, San Antonio (M.O.); Department of Health Outcomes & Policy, University of Florida, Gainesville (M.J.G.); and Department of Pediatrics, University of Virginia, Charlottesville (M.D.D.)
| | - Mark D DeBoer
- From the Jackson Heart Study, University of Mississippi Medical Center, Jackson (S.K.M.); Division of Human Genetics (L.J.M.) and Division of Epidemiology & Biostatistics (J.G.W.), Cincinnati Children's Hospital Medical Center, OH; Department of Pediatrics, University of Cincinnati, OH (L.J.M., J.G.W.); Texas Biomedical Research Institute, San Antonio (M.O.); Department of Health Outcomes & Policy, University of Florida, Gainesville (M.J.G.); and Department of Pediatrics, University of Virginia, Charlottesville (M.D.D.).
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