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Phuc TT, Duc TQ, Quynh Chi VT, Quang PN. The prevalence of excess weight among Vietnamese adults: A pooled analysis of 58 studies with more 430 thousand participants over the last three decades. Nutr Health 2023; 29:443-452. [PMID: 36285514 DOI: 10.1177/02601060221129440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Chronic noncommunicable diseases (NCDs) associated with excess weight as a significant risk factor, but few studies have been sufficient enough to examine the magnitude of excess weight of Vietnamese adults. This review aimed to provide a generalized estimate of the prevalence of excess weight among Vietnamese adults. METHODS PubMed, Scopus and national database were used to identify articles published up to May 2022. The Newcastle-Ottawa Quality Assessment Scale was used to rate the study quality. The data was analyzed using RStudio software, and the combined effects were estimated using random-effects meta-analysis. The Cochran's Q-test and the I2 test were employed to examine heterogeneity, and subgroups were conducted. Egger's test and visual inspection of the symmetry in funnel plots were used to determine publication bias. RESULTS 58 studies with 432,585 participants from 1998 to 2020 were suitable for inclusion in the final model after meeting the prerequisites. Over the last three decades, the combined pooled prevalence of excess weight among adults in Vietnam was 20.3% (95% CI: 15.2-26.6). Notably, this proportion has a tendency to go up between 1998 and 2020. Moreover, rates of excess weight were found to be substantially higher in non-national studies (23.1%, 17.3-30.1) compared to national studies (8.4%, 3.6-18.3) and significantly higher when Asian and Pacific cut-offs (27.6%, 20.0-36.7) were used rather than WHO classification (11.2%, 6.7-18.0). CONCLUSION The findings suggest healthcare professionals and policymakers should focus more on designing and implementing preventive initiatives to lower the rising prevalence of excess weight adults in Vietnam.
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Affiliation(s)
- Tran Thai Phuc
- Department of Nursing, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam
| | | | | | - Phan Ngoc Quang
- The Center Service For Technology Science Of Medi-Phar, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam
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Social Determinants of Health, Cardiovascular Risk Factors, and Atherosclerotic Cardiovascular Disease in Individuals of Vietnamese Origin. Am J Cardiol 2023; 189:11-21. [PMID: 36481374 DOI: 10.1016/j.amjcard.2022.11.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 11/01/2022] [Accepted: 11/12/2022] [Indexed: 12/12/2022]
Abstract
In 2022, the Vietnamese population in the United States (US) comprises 2.2 million individuals, and Vietnam ranks as the sixth most frequent country of origin among immigrants in the US. The American Heart Association and the National Institutes of Health have called for research to define the burden of cardiovascular risk factors, cardiovascular disease, and their determinants across Asian American subgroups, including Vietnamese Americans. Despite these calls, Vietnamese Americans remain remarkably overlooked in cardiovascular research in the US. Studies in Vietnam, small cross-sectional surveys in the US, and research using US mortality data point to a high prevalence of hypertension and tobacco use among men and a high incidence of gestational diabetes among women. Moreover, Vietnamese Americans have one of the highest rates of cerebrovascular mortality in the country. Adverse social determinants of health-including frequent language barriers, limited health literacy, and low average income-have been suggested as important factors that contribute to cardiovascular risk in this group. In this narrative review, we summarize the existing knowledge in this space, highlight the distinct characteristics of cardiac risk in both Vietnamese and Vietnamese American individuals, discuss upstream determinants, and identify key knowledge gaps. We then outline several proposed interventions and emphasize the need for further studies in this underrepresented population. Our aim is to increase awareness of the significant burden of risk factors and cardiovascular disease shouldered by this large-but thus far overlooked-population in the US, boost research in this space, and help inform tailored, effective preventive interventions.
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Biswas T, Tran N, Thi My Hanh H, Van Hien P, Thi Thu Cuc N, Hong Van P, Anh Tuan K, Thi Mai Oanh T, Mamun A. Type 2 diabetes and hypertension in Vietnam: a systematic review and meta-analysis of studies between 2000 and 2020. BMJ Open 2022; 12:e052725. [PMID: 35940839 PMCID: PMC9364409 DOI: 10.1136/bmjopen-2021-052725] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The objective of this study was to determine the level of type 2 diabetes (T2DM) and hypertension (HTN) in Vietnam and to assess the trend and recommend the future direction of prevention research efforts. DESIGN We searched scientific literature, databases including PubMed, EMBASE, CINHAL and Google Scholar; grey literature and reference lists for primary research published, nation database websites between 1 January 2000 and 30 September 2020. We adapted the modified Newcastle Ottawa Scale for assessing the quality of the study, as recommended by the Cochrane Collaboration. RESULTS In total, 83 studies met our inclusion criteria, representing data of approximately 239 034 population of more than 15 years of age in Vietnam. The findings show that prevalence rates varied widely across studies, from 1.0% to 29.0% for T2DM and 2.0% to 47.0% for HTN. For the total study period, pooled prevalence of T2DM and HTN in Vietnam for all studies was 6.0% (95% CI: 4.0% to 7.0%) and 25% (95% CI: 19% to 31%), respectively. Prevalence rate of both T2DM and HTN was higher among the male population compared with female counterpart. CONCLUSION There is evidence of a rising trend of HTN and T2DM prevalence in Vietnam. Future research should focus on the major drivers, incidence and prognosis of T2DM and HTN. Policy approaches should base upon the trends of T2DM and HTN in Vietnam over the last 20 years and pay more attention on the effective interventions to combat T2DM and HTN. In our study, we included both English and Vietnamese language articles and seems that majority of the articles came from Vietnamese language. PROSPERO REGISTRATION NUMBER CRD42020182959.
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Affiliation(s)
- Tuhin Biswas
- Institute for Social Science Research, The University of Queensland, Brisbane, Queensland, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Queensland, Australia
| | - Nam Tran
- Institute for Social Science Research, The University of Queensland, Brisbane, Queensland, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Queensland, Australia
| | - Hoang Thi My Hanh
- Department of Social Medicine and Population, Health Strategy and Policy Institute, Vietnam Ministry of Health, Hanoi, Vietnam
| | | | - Nguyen Thi Thu Cuc
- Department of Scientific Management, Training, and International Collaboration, Health Strategy and Policy Institute, Vietnam Ministry of Health, Hanoi, Vietnam
| | - Phan Hong Van
- Department of Scientific Management, Training, and International Collaboration, Health Strategy and Policy Institute, Vietnam Ministry of Health, Hanoi, Vietnam
| | - Khuong Anh Tuan
- Health Strategy and Policy Institute, Vietnam Ministry of Health, Hanoi, Vietnam
| | - Tran Thi Mai Oanh
- Health Strategy and Policy Institute, Vietnam Ministry of Health, Hanoi, Vietnam
| | - Abdullah Mamun
- Institute for Social Science Research, The University of Queensland, Brisbane, Queensland, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Queensland, Australia
- UQ Poche Centre for Indigenous Health, The University of Queensland, Brisbane, QLD, Australia
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Tran Quang B, Pham Tran P, Nguyen Thanh C, Bui Thi N, Do Dinh T, Tran Quang T, Duong Tuan L, Bui Thi Thuy N, Nguyen Anh N. High incidence of type 2 diabetes in a population with normal range body mass index and individual prediction nomogram in Vietnam. Diabet Med 2022; 39:e14680. [PMID: 34449919 DOI: 10.1111/dme.14680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 08/11/2021] [Accepted: 08/25/2021] [Indexed: 11/28/2022]
Abstract
AIMS The study aimed at determining 5-year incidence and prediction nomogram for new-onset type 2 diabetes (T2D) in a middle-aged population in Vietnam. METHODS A population-based prospective study was designed to collect socio-economic, anthropometric, lifestyle and clinical data. Five-year T2D incidence was estimated and adjusted for age and sex. Hazard ratio (HR) for T2D was investigated using discrete-time proportional hazards model. T2D prediction model entering the most significant risk factors was developed using the multivariable logistic-regression algorithm. The corresponding prediction nomogram was constructed and checked for discrimination, calibration and clinical usefulness. RESULTS The age- and sex-adjusted incidence was 21.0 cases (95% CI: 12.2-40.0) per 1000 person-years in people with mean BMI of 22.2 (95% CI: 21.9-22.7 kg/m2 ). The HRs (95% CI) for T2D were 1.14 (1.05-1.23) per 10 mmHg systolic blood pressure, 1.05 (1.03-1.08) per 1 cm waist circumference, 1.40 (1.13-1.73) per 1 mmol/L fasting blood glucose, 1.77 (1.15-2.71) per sleeping time (<6 h/day vs 6-7 h/day) and 2.12 (1.25-3.61) per residence (urban vs rural). The prediction nomogram for new-onset T2D had a good discrimination (area under curve: 0.711, 95% CI: 0.666-0.755) and fit calibration (mean absolute error: 0.009). For the predicted probability thresholds between 0.03 and 0.36, the nomogram showed a positive net benefit, without increasing the number of false positives. CONCLUSION This study highlighted an alarmingly high incidence of T2D in a middle-aged population with a normal range BMI in Vietnam. The individual prediction nomogram with decision curve analysis for new-onset T2D would be valuable for early detection, intervention and treatment of the condition.
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Affiliation(s)
- Binh Tran Quang
- National Institute of Nutrition, Hanoi, Vietnam
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
- Dinh Tien Hoang Institute of Medicine, Hanoi, Vietnam
| | | | | | | | - Tung Do Dinh
- National Institute of Diabetes and Metabolic Disorders, Hanoi, Vietnam
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Quang Binh T, Tran Phuong P, Thanh Chung N, Thi Nhung B, Dinh Tung D, Tuan Linh D, Ngoc Luong T, Danh Tuyen L. A simple nomogram for identifying individuals at high risk of undiagnosed diabetes in rural population. Diabetes Res Clin Pract 2021; 180:109061. [PMID: 34597731 DOI: 10.1016/j.diabres.2021.109061] [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: 05/18/2020] [Revised: 08/21/2021] [Accepted: 09/14/2021] [Indexed: 11/19/2022]
Abstract
AIMS To sought for an easily applicable nomogram for detecting individuals at high risk of undiagnosed type 2 diabetes. METHODS The development cohort included 2542 participants recruited randomly from a rural population in 2011.The glycemic status of subjects was determined using the fasting plasma glucose test and the oral glucose tolerance test. The Bayesian Model Average approach was used to search for a parsimonious model with minimum number of predictor and maximum discriminatory power. The corresponding prediction nomograms were constructed and checked for discrimination, calibration, clinical usefulness, and generalizability in nationwide population in 2012. RESULTS The non-lab nomogram including waist circumference and systolic blood pressure was the most parsimonious with the area under receiver operating characteristic curve (AUC) of 0.71 (95 %CI = 0.64-0.76). Adding low-density lipoprotein cholesterol in the non-lab nomogram generated the lab-based nomogram with significantly improved AUC of 0.83 (0.78-0.87, P < 0.001). The nomograms had a positive net benefit at threshold probability between 0.01 and 0.15. Applying the non-lab nomogram to the national population yielded the AUC of 0.66 (0.63-0.70) and 0.68 (0.65-0.71) in the cohorts aged 40-64 and 30-69 years, respectively. CONCLUSIONS The novel nomograms could help promote the early detection of undiagnosed diabetes in rural Vietnamese population.
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Affiliation(s)
- Tran Quang Binh
- National Institute of Nutrition, 48B Tang Bat Ho Street, Hanoi, Vietnam; Dinh Tien Hoang Institute of Medicine, 20 Cat Linh, Dong Da, Hanoi, Vietnam.
| | - Pham Tran Phuong
- National Institute of Nutrition, 48B Tang Bat Ho Street, Hanoi, Vietnam
| | - Nguyen Thanh Chung
- National Institute of Hygiene and Epidemiology, 1 Yersin, Hanoi, Vietnam
| | - Bui Thi Nhung
- National Institute of Nutrition, 48B Tang Bat Ho Street, Hanoi, Vietnam
| | - Do Dinh Tung
- National Institute of Diabetes and Metabolic Disorders, 1 Ton That Tung, Hanoi, Vietnam
| | - Duong Tuan Linh
- National Institute of Nutrition, 48B Tang Bat Ho Street, Hanoi, Vietnam
| | - Tran Ngoc Luong
- National Hospital of Endocrinology, 80, Alley 82, Yen Lang Street, Dong Da District, Hanoi, Vietnam
| | - Le Danh Tuyen
- National Institute of Nutrition, 48B Tang Bat Ho Street, Hanoi, Vietnam
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Causal associations of waist circumference and waist-to-hip ratio with type II diabetes mellitus: new evidence from Mendelian randomization. Mol Genet Genomics 2021; 296:605-613. [PMID: 33629185 DOI: 10.1007/s00438-020-01752-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 12/13/2020] [Indexed: 10/22/2022]
Abstract
Type II diabetes mellitus (T2DM) is a metabolic disease with high incidence, which has seriously affected human life and health. The associations among waist circumference (WC), waist-to-hip ratio (WHR), and T2DM were discovered in observational studies. However, the causality of these associations still remains unknown. The present study aims to apply two-sample Mendelian randomization (TSMR) using genetic variants as instrumental variables (IVs) to evaluate the causality among WC, WHR, and T2DM. The participants were from three independent studies in genome-wide association studies (GWAS) datasets, which included 127,997 Europeans for WC, 73,137 Europeans for WHR and 659,316 Europeans for T2DM. Furthermore, 16 were associated WC SNPs and eight were associated WHR SNPs as instrument variables were selected for TSMR using P < 5 × 10-8 standard. The pooled odd ratios (ORs) for the assessment of higher WC and WHR on the risk of T2DM for these SNPs were calculated using inverse variance weighted (IVW) method, and validated through extensively complementary analyses. The OR for T2DM per SD (cm) higher WC was 2.623 (95% CI 2.286-3.010, P = 5.000E-43), and the OR for T2DM per SD (cm) higher WHR was 1.751 (95% CI 1.122-2.733, P = 0.014). Consistent results for other methods were obtained. Furthermore, the range of OR fluctuation between WC and T2DM was from 2.623 to 2.986, while that between WHR and T2DM was from 0.990 to 2.931. Overall, these present results provide genetic support that suggests that the use of TSMR, and higher WC and WHR increased the T2DM risk among the European population.
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Khader Y, Batieha A, Jaddou H, El-Khateeb M, Ajlouni K. The performance of anthropometric measures to predict diabetes mellitus and hypertension among adults in Jordan. BMC Public Health 2019; 19:1416. [PMID: 31664979 PMCID: PMC6820979 DOI: 10.1186/s12889-019-7801-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 10/17/2019] [Indexed: 01/22/2023] Open
Abstract
Objectives This study aimed to evaluate and compare the abilities of waist circumference (WC), body mass index (BMI), hip circumference (HC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) to predict recently and previously diagnosed diabetes and hypertension and assess their appropriate cut-off values among Jordanian adults. Methods Data from the 2017 cardiovascular risk factors survey were analyzed to achieve the study objective. The survey collected extensive data from a national population-based sample of Jordanian residents. A structured questionnaire was used to collect sociodemographic variables and clinical data. Blood samples were taken for biochemical measurements. Anthropometric characteristics were measured by the same team of trained field researchers. Results This study included a total of 1193 men and 2863 women. Their age ranged from 18 to 90 year with a mean (SD) of 43.8 (14.2) year. WHtR performed better than other anthropometric measures and had a good ability (AUC > 0.80) among women and fair ability among men to predict newly diagnosed diabetes and previously diagnosed diabetes and hypertension. The appropriate cut-off points for anthropometric measures among women were 92 cm form WC, 104 cm for HC, 30 Kg/m2 for BMI, 0.85 for WHR, and 0.60 for WHtR. For men, the appropriate cut-off points were 100 cm for WC, 104 cm for HC, 27 Kg/m2 for BMI, 0.93 for WHR, and 0.57 for WHtR. Conclusion WHtR performed better than other anthropometric measures in predicting diabetes and hypertension among adult population in Jordan. We recommend WHtR as a measure of choice with a cut-off value of 0.6 for women and 0.57 for men to predict diabetes and hypertension among Jordanians.
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Affiliation(s)
- Yousef Khader
- Department of Public Health, Jordan University of Science and Technology, P.O.Box 3030, Irbid, 22110, Jordan.
| | - Anwar Batieha
- Department of Public Health, Jordan University of Science and Technology, P.O.Box 3030, Irbid, 22110, Jordan
| | - Hashem Jaddou
- Department of Public Health, Jordan University of Science and Technology, P.O.Box 3030, Irbid, 22110, Jordan
| | - Mohammed El-Khateeb
- The National Center for Diabetes, Endocrinology and Genetics, The Jordan University, Amman, Jordan
| | - Kamel Ajlouni
- The National Center for Diabetes, Endocrinology and Genetics, The Jordan University, Amman, Jordan
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Meiqari L, Essink D, Wright P, Scheele F. Prevalence of Hypertension in Vietnam: A Systematic Review and Meta-Analysis. Asia Pac J Public Health 2019; 31:101-112. [PMID: 30678477 PMCID: PMC6463272 DOI: 10.1177/1010539518824810] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Studies on the prevalence of hypertension in Vietnam have reported various estimates. There is no up-to-date assessment of the evidence on the magnitude of hypertension in Vietnam. Search engines for scientific and gray literature were used to identify relevant records for eligibility screening and quality assessment. Data from selected articles were extracted using standardized spreadsheets. Statistical analysis included estimating pooled prevalence and odds ratio, heterogeneity evaluation, meta-regression, and subgroup analysis, in addition to sensitivity analysis and publication bias evaluation. The pooled prevalence of measured hypertension in Vietnam was 21.1% (95% confidence interval = 18.5-23.7) based on 10 studies, and 18.4% (95% confidence interval = 15.2-21.8) based on 3 national surveys. Lower pooled prevalence was estimated for hypertension awareness (9.3%) and hypertension treatment (4.7%). The pooled prevalence of measured hypertension is significantly higher among men. The pooled prevalence of measured hypertension and hypertension awareness and treatment were significantly lower in rural settings. There is a need to strengthen efforts for primary and secondary prevention and disease management to reduce morbidity and mortality, especially in rural residence settings.
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Affiliation(s)
- Lana Meiqari
- Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Institute of Tropical Medicine, Antwerp, Belgium
| | - Dirk Essink
- Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Pamela Wright
- Guelph International Health Consulting, Amsterdam, Netherlands
| | - Fedde Scheele
- Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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Bernabe-Ortiz A, Perel P, Miranda JJ, Smeeth L. Diagnostic accuracy of the Finnish Diabetes Risk Score (FINDRISC) for undiagnosed T2DM in Peruvian population. Prim Care Diabetes 2018; 12:517-525. [PMID: 30131300 PMCID: PMC6249987 DOI: 10.1016/j.pcd.2018.07.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 07/23/2018] [Accepted: 07/29/2018] [Indexed: 12/18/2022]
Abstract
AIMS To assess the diagnostic accuracy of the Finnish Diabetes Risk Score (FINDRISC) for undiagnosed T2DM and to compare its performance with the Latin-American FINDRISC (LA-FINDRISC) and the Peruvian Risk Score. MATERIALS AND METHODS A population-based study was conducted. T2DM and undiagnosed T2DM were defined using oral glucose tolerance test (OGTT). Risk scores assessed were FINDRISC, LA-FINDRISC and Peruvian Risk Score. Diagnostic accuracy of risk scores was estimated using the c-statistic and the area under the ROC curve (aROC). A simplified version of FINDRISC was also derived. RESULTS Data from 1609 individuals, mean age 48.2 (SD: 10.6), 810 (50.3%) women, were collected. A total of 176 (11.0%; 95%CI: 9.4%-12.5%) were classified as having T2DM, and 71 (4.7%; 95%CI: 3.7%-5.8%) were classified as having undiagnosed T2DM. Diagnostic accuracy of the FINDRISC (aROC=0.69), LA-FINDRISC (aROC=0.68), and Peruvian Risk Score (aROC=0.64) was similar (p=0.15). The simplified FINDRISC, with 4 variables, had a slightly better performance (aROC=0.71) than the other scores. CONCLUSION The performance of FINDRISC, LA-FINDRISC and Peruvian Risk Score for undiagnosed T2DM was similar. A simplified FINDRISC can perform as well or better for undiagnosed T2DM. The FINDRISC may be useful to detect cases of undiagnosed T2DM in resource-constrained settings.
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Affiliation(s)
- Antonio Bernabe-Ortiz
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima 18, Peru; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK.
| | - Pablo Perel
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK.
| | - Juan Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima 18, Peru; Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima 31, Peru.
| | - Liam Smeeth
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK.
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Li W, Xie B, Qiu S, Huang X, Chen J, Wang X, Li H, Chen Q, Wang Q, Tu P, Zhang L, Yan S, Li K, Maimaitiming J, Nian X, Liang M, Wen Y, Liu J, Wang M, Zhang Y, Ma L, Wu H, Wang X, Wang X, Liu J, Cai M, Wang Z, Guo L, Chen F, Wang B, Monica S, Carlsson PO, Sun Z. Non-lab and semi-lab algorithms for screening undiagnosed diabetes: A cross-sectional study. EBioMedicine 2018; 35:307-316. [PMID: 30115607 PMCID: PMC6154869 DOI: 10.1016/j.ebiom.2018.08.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 08/06/2018] [Accepted: 08/06/2018] [Indexed: 12/29/2022] Open
Abstract
Background The terrifying undiagnosed rate and high prevalence of diabetes have become a public emergency. A high efficiency and cost-effective early recognition method is urgently needed. We aimed to generate innovative, user-friendly nomograms that can be applied for diabetes screening in different ethnic groups in China using the non-lab or noninvasive semi-lab data. Methods This multicenter, multi-ethnic, population-based, cross-sectional study was conducted in eight sites in China by enrolling subjects aged 20–70. Sociodemographic and anthropometric characteristics were collected. Blood and urine samples were obtained 2 h following a standard 75 g glucose solution. In the final analysis, 10,794 participants were included and randomized into model development (n = 8096) and model validation (n = 2698) group with a ratio of 3:1. Nomograms were developed by the stepwise binary logistic regression. The nomograms were validated internally by a bootstrap sampling method in the model development set and externally in the model validation set. The area under the receiver operating characteristic curve (AUC) was used to assess the screening performance of the nomograms. Decision curve analysis was applied to calculate the net benefit of the screening model. Results The overall prevalence of undiagnosed diabetes was 9.8% (1059/10794) according to ADA criteria. The non-lab model revealed that gender, age, body mass index, waist circumference, hypertension, ethnicities, vegetable daily consumption and family history of diabetes were independent risk factors for diabetes. By adding 2 h post meal glycosuria qualitative to the non-lab model, the semi-lab model showed an improved Akaike information criterion (AIC: 4506 to 3580). The AUC of the semi-lab model was statistically larger than the non-lab model (0.868 vs 0.763, P < 0.001). The optimal cutoff probability in semi-lab and non-lab nomograms were 0.088 and 0.098, respectively. The sensitivity and specificity were 76.3% and 81.6%, respectively in semi-lab nomogram, and 72.1% and 67.3% in non-lab nomogram at the optimal cut off point. The decision curve analysis also revealed a bigger decrease of avoidable OGTT test (52 per 100 subjects) in the semi-lab model compared to the non-lab model (36 per 100 subjects) and the existed New Chinese Diabetes Risk Score (NCDRS, 35 per 100 subjects). Conclusion The non-lab and semi-lab nomograms appear to be reliable tools for diabetes screening, especially in developing countries. However, the semi-lab model outperformed the non-lab model and NCDRS prediction systems and might be worth being adopted as decision support in diabetes screening in China.
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Affiliation(s)
- Wei Li
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast Uiversity, Nanjing, China
| | - Bo Xie
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast Uiversity, Nanjing, China
| | - Shanhu Qiu
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast Uiversity, Nanjing, China
| | - Xin Huang
- School of Public Health, Southeast University, Nanjing, China
| | - Juan Chen
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast Uiversity, Nanjing, China
| | - Xinling Wang
- Department of Endocrinology, People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi, China
| | - Hong Li
- Department of Endocrinology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Qingyun Chen
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Qing Wang
- Department of Endocrinology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Ping Tu
- Department of Endocrinology, The Third Hospital of Nanchang, Nanchang, China
| | - Lihui Zhang
- Department of Endocrinology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Sunjie Yan
- Department of Endocrinology, The First Affiliated Hospital of Fujian Medical University, Diabetes Research Institute of Fujian Province, Fuzhou, China
| | - Kaili Li
- Department of Endocrinology, Xinjiang Uygur Autonomous Region Hospital of traditional Chinese Medicine, Urumqi, China
| | - Jimilanmu Maimaitiming
- Department of Endocrinology, People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi, China
| | - Xin Nian
- Department of Endocrinology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Min Liang
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yan Wen
- Department of Endocrinology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Jiang Liu
- Department of Endocrinology, The Third Hospital of Nanchang, Nanchang, China
| | - Mian Wang
- Department of Endocrinology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yongze Zhang
- Department of Endocrinology, The First Affiliated Hospital of Fujian Medical University, Diabetes Research Institute of Fujian Province, Fuzhou, China
| | - Li Ma
- Department of Endocrinology, Xinjiang Uygur Autonomous Region Hospital of traditional Chinese Medicine, Urumqi, China
| | - Hang Wu
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast Uiversity, Nanjing, China
| | - Xuyi Wang
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast Uiversity, Nanjing, China
| | - Xiaohang Wang
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast Uiversity, Nanjing, China
| | - Jingbao Liu
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast Uiversity, Nanjing, China
| | - Min Cai
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast Uiversity, Nanjing, China
| | - Zhiyao Wang
- Suzhou MetroHealth Medical Technology, Co., LTD, Suzhou, China
| | - Lin Guo
- Suzhou MetroHealth Medical Technology, Co., LTD, Suzhou, China
| | - Fangqun Chen
- Suzhou MetroHealth Medical Technology, Co., LTD, Suzhou, China
| | - Bei Wang
- School of Public Health, Southeast University, Nanjing, China
| | - Sandberg Monica
- Department of Medical Cell Biology, Uppsala University, SE-75123 Uppsala, Sweden
| | - Per-Ola Carlsson
- Department of Medical Cell Biology, Uppsala University, SE-75123 Uppsala, Sweden.
| | - Zilin Sun
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast Uiversity, Nanjing, China.
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12
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Abstract
BACKGROUND The prevalence for diabetes, prediabetes, and gestational diabetes in Vietnam are low relative to other parts of the world, but they are increasing at alarming rates. These changes have occurred in the setting of economic and cultural transitions. OBJECTIVES The aim of this study was to provide relevant information depicting the diabetes burden in Vietnam. METHODS Literature was reviewed using PubMed and local Vietnamese sources, including papers published in the Vietnamese language. FINDINGS In 2012, the prevalence of diabetes was 5.4% and prediabetes 13.7%. In 2005, the prevalence of obesity was 1.7%. There is a dual burden of over- and undernutrition observed in Vietnam. Diabetes is associated with an increased waist-to-hip ratio despite normal body mass index. Nutritional transitions occurred with increased protein, fat, and fast foods, and with decreased fresh fruits and vegetables. Tobacco use is very high in Vietnam with 66% of adult men currently smoking. Challenges include endocrinology training, health care coverage, patient education, and lack of coordination among government and specialist agencies. CONCLUSION Diabetes is a growing problem in Vietnam and is associated with obesity, changes in dietary patterns, and other cultural transitions. More research is needed to better understand this health care problem and to devise targeted interventions.
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Affiliation(s)
- Nguyen Thy Khue
- HCMC University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.
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13
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Nguyen HTT, Moir MP, Nguyen TX, Vu AP, Luong LH, Nguyen TN, Nguyen LH, Tran BX, Tran TT, Latkin CA, Zhang MW, Ho RC, Vu HTT. Health-related quality of life in elderly diabetic outpatients in Vietnam. Patient Prefer Adherence 2018; 12:1347-1354. [PMID: 30100711 PMCID: PMC6067618 DOI: 10.2147/ppa.s162892] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Health-related quality of life (HRQoL) is an important indicator for designing care and treatment services for patients with diabetes. This is especially true given its rapid increase among the elderly population in Vietnam. HRQoL data in elderly diabetic Vietnamese are currently limited. This study aimed to 1) measure the HRQoL of elderly patients with type 2 diabetes (T2DM) in Vietnam and 2) identify related factors and their relationship with HRQoL. PATIENTS AND METHODS A cross-sectional study was conducted. We recruited 171 patients aged ≥60 years with T2DM at the Outpatient Department, National Geriatric Hospital from June to November 2015. Patients were asked to evaluate their health status using the EuroQol Five Dimensions Three Levels (EQ-5D-3L) and the Visual Analog Scale (VAS). Sociodemographic, diabetic treatment, and management characteristics were collected. Multivariate Tobit regression was used to determine which factors were associated with HRQoL, and the strength of this relationship. RESULTS Patients reported some problems in all areas of the EQ-5D: pain/discomfort (50.9%), mobility (33.3%), anxiety/depression (24.0%), usual activities (21.1%), and self-care (10.5%). The mean EQ-5D index score was 0.80 (SD=0.20), and the mean EQ-VAS was 57.5 (SD=14.4). Patients who were male, lived in an urban area, could afford treatment, were taking fewer medications, and monitored blood pressure often (1-4 times a week) had a higher EQ-5D index when compared to other groups. Meanwhile, a longer duration of diabetes and older age were negatively associated with the EQ-5D index. Patients with any comorbidity had lower VAS scores than their counterparts. CONCLUSION The presence of diabetes and comorbidity were responsible for a significant decrease in HRQoL. Screening and identifying health problems, providing prompt treatment, and facilitating self-management among patients have the potential to increase diabetic patients' HRQoL.
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Affiliation(s)
- Huong Thi Thu Nguyen
- Department of Gerontology, Hanoi Medical University, Hanoi, Vietnam,
- National Geriatric Hospital, Hanoi, Vietnam,
| | - Mackenzie Pi Moir
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Thanh Xuan Nguyen
- National Geriatric Hospital, Hanoi, Vietnam,
- Dinh Tien Hoang Institute of Medicine, Hanoi, Vietnam
| | | | - Long Hoang Luong
- National Geriatric Hospital, Hanoi, Vietnam,
- Dinh Tien Hoang Institute of Medicine, Hanoi, Vietnam
| | - Tam Ngoc Nguyen
- Department of Gerontology, Hanoi Medical University, Hanoi, Vietnam,
- National Geriatric Hospital, Hanoi, Vietnam,
| | - Long Hoang Nguyen
- School of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Tung Thanh Tran
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
| | - Carl A Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Melvyn Wb Zhang
- Biomedical Global Institute of Healthcare Research & Technology (BIGHEART), National University of Singapore, Singapore
| | - Roger Cm Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Huyen Thanh Thi Vu
- Department of Gerontology, Hanoi Medical University, Hanoi, Vietnam,
- National Geriatric Hospital, Hanoi, Vietnam,
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14
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Vu HTT, Nguyen TX, Nguyen HTT, Le TA, Nguyen TN, Nguyen AT, Nguyen TTH, Nguyen HL, Nguyen CT, Tran BX, Latkin CA, Pham T, Zhang MW, Ho RC. Depressive symptoms among elderly diabetic patients in Vietnam. Diabetes Metab Syndr Obes 2018; 11:659-665. [PMID: 30425543 PMCID: PMC6204855 DOI: 10.2147/dmso.s179071] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND AND AIMS Depression and diabetes are becoming increasingly prevalent within the Vietnamese elderly population. However, the linkage between these health conditions in the Vietnamese elderly has not yet been fully investigated. This study aimed to assess the level of depressive symptoms and associated factors among elderly diabetic patients. METHODS A cross-sectional study was conducted at National Geriatric Hospital in the elder patients aged ≥60 years with type 2 diabetes mellitus (T2DM). Depressive symptoms were assessed using the Geriatric Depression Scale, with three categories: normal (0-4 points), mild (5-9 points), and moderate/severe depressive symptoms (≥10 points). We obtained information on the patient's sociodemographic, medical history, glycemic control (fasting plasma glucose and HbA1c), daily activities (activities of daily living [ADLs] and instruments activities of daily living [IADLs] scale), and fall risks (Time Up and Go test). Logistic regression was used to analyze the factors associated with the presence of depressive symptoms. RESULTS Among 412 patients, 236 (57.3%) had HbA1c level at 7.0% or higher. There were 327 (79.4%) patients having depressive symptoms. The level of HbA1c was significantly different between the depressive symptom group and the non-depressive symptom group (7.74% and 6.61%, P<0.05). The increased likelihood of having depressive symptoms was associated with having risk of falls (OR: 5.50; 95% CI: 1.88-16.11), suffering from 5-10 years of diabetes (OR: 2.74, 95% CI: 1.28-5.85), uncontrolled fasting plasma glucose (OR: 4.06, 95% CI: 1.81-9.12), and an impairment of IADLs (OR: 5.74, 95% CI: 2.24-14.7). CONCLUSION This study highlights a high prevalence of depressive symptoms among elderly T2DM patients in Vietnam, suggesting an urgent need for screening depressive symptoms and providing mental health care services to this population promptly, particularly to those suffering from diabetes for a long period of time or co-functional impairments.
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Affiliation(s)
- Huyen Thi Thanh Vu
- Department of Gerontology, Hanoi Medical University, Hanoi, Vietnam,
- National Geriatric Hospital, Hanoi, Vietnam,
| | - Thanh Xuan Nguyen
- National Geriatric Hospital, Hanoi, Vietnam,
- Dinh Tien Hoang Institute of Medicine, Hanoi, Vietnam
| | - Huong Thi Thu Nguyen
- Department of Gerontology, Hanoi Medical University, Hanoi, Vietnam,
- National Geriatric Hospital, Hanoi, Vietnam,
| | - Tu Anh Le
- Department of Endocrinology, Nghe An Endocrinology Hospital, Nghe An, Vietnam
| | - Tam Ngoc Nguyen
- Department of Gerontology, Hanoi Medical University, Hanoi, Vietnam,
- National Geriatric Hospital, Hanoi, Vietnam,
| | | | - Thu Thi Hoai Nguyen
- Department of Gerontology, Hanoi Medical University, Hanoi, Vietnam,
- National Geriatric Hospital, Hanoi, Vietnam,
| | - Hoang Long Nguyen
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
| | - Bach Xuan Tran
- Department of Health Economics, Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Carl A Latkin
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Thang Pham
- National Geriatric Hospital, Hanoi, Vietnam,
| | - Melvyn Wb Zhang
- Biomedical Global Institute of Healthcare Research & Technology (BIGHEART), National University of Singapore, Singapore
| | - Roger Cm Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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15
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Ho-Pham LT, Nguyen UDT, Tran TX, Nguyen TV. Discordance in the diagnosis of diabetes: Comparison between HbA1c and fasting plasma glucose. PLoS One 2017; 12:e0182192. [PMID: 28817663 PMCID: PMC5560685 DOI: 10.1371/journal.pone.0182192] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Accepted: 07/13/2017] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE HbA1c has been introduced as a complementary diagnostic test for diabetes, but its impact on disease prevalence is unknown. This study evaluated the concordance between HbA1c and fasting plasma glucose (FPG) in the diagnosis of diabetes in the general population. MATERIALS AND METHODS The study was designed as a population based investigation, with participants being sampled from the Ho Chi Minh City, Vietnam. Blood samples were collected after overnight fasting and analyzed within 4 hours after collection. HbA1c was measured with high pressure liquid chromatography (Arkray Adams, Japan). FPG was measured by the hexokinase method (Advia Autoanalyzer; Bayer Diagnostics, Germany). Diabetes was defined as HbA1c ≥ 6.5% or FPG ≥ 7.0 mmol/L. Prediabetes was classified as HbA1c between 5.7% and 6.4%. RESULTS The study included 3523 individuals (2356 women) aged 30 years and above. Based on the HbA1c test, the prevalence of diabetes and prediabetes was 9.7% (95%CI, 8.7-10.7%; n = 342) and 34.6% (33.0-36.2; n = 1219), respectively. Based on the FPG test, the prevalence of diabetes and prediabetes was 6.3% (95%CI, 5.5-7.2%; n = 223) and 12.1% (11.1-13.2; n = 427). Among the 427 individuals identified by FPG as "pre-diabetes", 28.6% were classified as diabetes by HbA1c test. The weighted kappa statistic of concordance between HbA1c and FPG was 0.55, with most of the discordance being in the prediabetes group. CONCLUSION These data indicate that there is a significant discordance in the diagnosis of diabetes between FPG and HbA1c measurements, and the discordance could have significant impact on clinical practice. FPG appears to underestimate the burden of undiagnosed diabetes.
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Affiliation(s)
- Lan T. Ho-Pham
- Bone and Muscle Research Group & Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Vietnam
| | - Uyen D. T. Nguyen
- Department of Internal Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Truong X. Tran
- Department of Internal Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Tuan V. Nguyen
- Bone and Muscle Research Group & Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Vietnam
- Garvan Institute of Medical Research, Sydney, Australia
- School of Public Health and Community Medicine, UNSW Australia, Sydney, Australia
- University of Technology Sydney (UTS), Sydney, New South Wales, Australia
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16
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Miyakawa M, Shimizu T, Van Dat N, Thanh P, Thuy PTP, Anh NTH, Chau NH, Matsushita Y, Kajio H, Mai VQ, Hachiya M. Prevalence, perception and factors associated with diabetes mellitus among the adult population in central Vietnam: a population-based, cross-sectional seroepidemiological survey. BMC Public Health 2017; 17:298. [PMID: 28381223 PMCID: PMC5382364 DOI: 10.1186/s12889-017-4208-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 03/30/2017] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Diabetes Mellitus (DM) has rapidly become a major public health concern in Vietnam. Although the prevalence of DM has been studied in northern and southern Vietnam, little data are available for the central region. Therefore, the aims of this survey were to estimate the prevalence of DM and to identify the perception of and factors associated with DM among the adult population in central Vietnam. METHODS We conducted a cross-sectional, population-based survey in Khánh Hòa Province, Vietnam in December 2014 using three-stage cluster sampling and probability proportional to size sampling in line with the World Health Organization STEPwise approach. Four hundred and eighty residents aged 20-70 years were selected from 30 villages in 10 wards/communes. After obtaining informed consent, all residents participated in interviews regarding lifestyle, medical history, and perception of DM and underwent physical measurements and blood examination for fasting blood glucose and glycated hemoglobin. Factors associated with DM were analyzed using a logistic regression model. RESULTS A total of 376 residents were enrolled (response rate: 78.3%; females: 59%; rural residents: 61%). Among the participants, 14.3% and 18.9% of males and females, respectively, were classified as overweight/obese according to body mass index (BMI), 37.7% and 22.1%, respectively, had hypertension, and 36.4% and 11.7% had metabolic syndrome. The prevalence of DM in the entire population was 7.2% (27/376; 95% confidence interval [CI]: 4.6-9.8). Participants aged 60-70 years were more likely to have DM than those aged 30-39 years (adjusted odds ratio [aOR]: 8.7; 95%CI: 1.4-56.0), and participants classified as obese were more likely to have DM than those with normal or low BMI (aOR: 10.2; 95%CI: 2.2-50.2). Furthermore, more than two-thirds (254/376, 67.6%) of the participants either did not understand or had never heard of DM, and less than half of the DM cases (12/27, 44%) were aware of their history of DM. CONCLUSIONS The results of this study suggested that the prevalence of DM among the adult population in central Vietnam was slightly higher than that in other areas. Additional research is needed to further explore perceptions of and practices regarding DM.
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Affiliation(s)
- Masami Miyakawa
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1, Toyama Shinjuku-ku, Tokyo, Japan
| | - Takayuki Shimizu
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1, Toyama Shinjuku-ku, Tokyo, Japan
| | - Nguyen Van Dat
- Pasteur Institute Nha Trang, 8-10 Pasteur, Xuong Huan, tp, Nha Trang, Khánh Hòam Vietnam
| | - Phung Thanh
- Pasteur Institute Nha Trang, 8-10 Pasteur, Xuong Huan, tp, Nha Trang, Khánh Hòam Vietnam
| | - Pham Thi Phuong Thuy
- Pasteur Institute Nha Trang, 8-10 Pasteur, Xuong Huan, tp, Nha Trang, Khánh Hòam Vietnam
| | - Nguyen Thi Hoang Anh
- Endocrinology Center, Khánh Hòa Provincial Public Health Service, 3A Han Thuyen Street, Nha Trang City, Khánh Hòa Province Vietnam
| | - Nguyen Huu Chau
- Endocrinology Center, Khánh Hòa Provincial Public Health Service, 3A Han Thuyen Street, Nha Trang City, Khánh Hòa Province Vietnam
| | - Yumi Matsushita
- Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1, Toyama Shinjuku-ku, Tokyo, Japan
| | - Hiroshi Kajio
- Department of Diabetes, Endocrinology and Metabolism, Center Hospital, National Center for Global Health and Medicine, 1-21-1, Toyama Shinjuku-ku, Tokyo, Japan
| | - Vien Quang Mai
- Pasteur Institute Nha Trang, 8-10 Pasteur, Xuong Huan, tp, Nha Trang, Khánh Hòam Vietnam
| | - Masahiko Hachiya
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1, Toyama Shinjuku-ku, Tokyo, Japan
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17
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Prediction of cold and heat patterns using anthropometric measures based on machine learning. Chin J Integr Med 2016; 24:16-23. [PMID: 28035540 DOI: 10.1007/s11655-016-2641-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To examine the association of body shape with cold and heat patterns, to determine which anthropometric measure is the best indicator for discriminating between the two patterns, and to investigate whether using a combination of measures can improve the predictive power to diagnose these patterns. METHODS Based on a total of 4,859 subjects (3,000 women and 1,859 men), statistical analyses using binary logistic regression were performed to assess the significance of the difference and the predictive power of each anthropometric measure, and binary logistic regression and Naive Bayes with the variable selection technique were used to assess the improvement in the predictive power of the patterns using the combined measures. RESULTS In women, the strongest indicators for determining the cold and heat patterns among anthropometric measures were body mass index (BMI) and rib circumference; in men, the best indicator was BMI. In experiments using a combination of measures, the values of the area under the receiver operating characteristic curve in women were 0.776 by Naive Bayes and 0.772 by logistic regression, and the values in men were 0.788 by Naive Bayes and 0.779 by logistic regression. CONCLUSIONS Individuals with a higher BMI have a tendency toward a heat pattern in both women and men. The use of a combination of anthropometric measures can slightly improve the diagnostic accuracy. Our findings can provide fundamental information for the diagnosis of cold and heat patterns based on body shape for personalized medicine.
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Ho-Pham LT, Do TT, Campbell LV, Nguyen TV. HbA1c-Based Classification Reveals Epidemic of Diabetes and Prediabetes in Vietnam. Diabetes Care 2016; 39:e93-4. [PMID: 27222509 DOI: 10.2337/dc16-0654] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 04/02/2016] [Indexed: 02/03/2023]
Affiliation(s)
- Lan T Ho-Pham
- Bone and Muscle Research Group, Ton Duc Thang University, Ho Chi Minh City, Vietnam Department of Rheumatology, People's Hospital 115, Ho Chi Minh City, Vietnam
| | - Thanh T Do
- Bone and Muscle Research Group, Ton Duc Thang University, Ho Chi Minh City, Vietnam
| | - Lesley V Campbell
- Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Tuan V Nguyen
- Bone and Muscle Research Group, Ton Duc Thang University, Ho Chi Minh City, Vietnam Garvan Institute of Medical Research, Sydney, New South Wales, Australia School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia University of Technology Sydney, Sydney, New South Wales, Australia
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Pham NM, Eggleston K. Prevalence and determinants of diabetes and prediabetes among Vietnamese adults. Diabetes Res Clin Pract 2016; 113:116-24. [PMID: 26795973 DOI: 10.1016/j.diabres.2015.12.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Revised: 10/26/2015] [Accepted: 12/27/2015] [Indexed: 12/15/2022]
Abstract
AIMS We estimated the prevalence of diabetes and prediabetes among Vietnamese adults, and quantitatively evaluated association with known risk factors. METHODS Subjects were 5602 men and 10,680 women in North Vietnam aged 30-69 years participating in community diabetes screening programs during 2011-2013. We calculated standardized prevalence rates and demographic projections for 2035, and used multinomial regression analysis to examine the associations of multiple risk factors with diabetes and prediabetes. RESULTS The age-, sex- and area of residence-standardized prevalence of diabetes was 6.0% and of prediabetes was 13.5%, with higher prevalence among men than women. Population aging is projected to raise the prevalence of diabetes to 7.0% and of prediabetes to 15.7% by 2035. Older age, obesity, large waist-to-hip ratio and hypertension were each associated with higher prevalence of diabetes, whereas the opposite direction of association was observed for underweight and minority ethnicity. In addition, diabetes was positively associated with family history of diabetes in women, but inversely related to physically heavy work among men. CONCLUSIONS One in 17 and one in 7 adults had diabetes and prediabetes, respectively, in Vietnam. Urbanization, population aging, increased adiposity, hypertension and sedentary work are associated with the increasing prevalence of diabetes.
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Affiliation(s)
- Ngoc Minh Pham
- Walter H. Shorenstein Asia-Pacific Research Center, Stanford University, USA; Faculty of Public Health, Thai Nguyen University of Medicine and Pharmacy, Viet Nam.
| | - Karen Eggleston
- Walter H. Shorenstein Asia-Pacific Research Center, Stanford University, USA
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Bernabe-Ortiz A, Smeeth L, Gilman RH, Sanchez-Abanto JR, Checkley W, Miranda JJ, Study Group CRONICASC. Development and Validation of a Simple Risk Score for Undiagnosed Type 2 Diabetes in a Resource-Constrained Setting. J Diabetes Res 2016; 2016:8790235. [PMID: 27689096 PMCID: PMC5027039 DOI: 10.1155/2016/8790235] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 07/27/2016] [Indexed: 01/14/2023] Open
Abstract
Objective. To develop and validate a risk score for detecting cases of undiagnosed diabetes in a resource-constrained country. Methods. Two population-based studies in Peruvian population aged ≥35 years were used in the analysis: the ENINBSC survey (n = 2,472) and the CRONICAS Cohort Study (n = 2,945). Fasting plasma glucose ≥7.0 mmol/L was used to diagnose diabetes in both studies. Coefficients for risk score were derived from the ENINBSC data and then the performance was validated using both baseline and follow-up data of the CRONICAS Cohort Study. Results. The prevalence of undiagnosed diabetes was 2.0% in the ENINBSC survey and 2.9% in the CRONICAS Cohort Study. Predictors of undiagnosed diabetes were age, diabetes in first-degree relatives, and waist circumference. Score values ranged from 0 to 4, with an optimal cutoff ≥2 and had a moderate performance when applied in the CRONICAS baseline data (AUC = 0.68; 95% CI: 0.62-0.73; sensitivity 70%; specificity 59%). When predicting incident cases, the AUC was 0.66 (95% CI: 0.61-0.71), with a sensitivity of 69% and specificity of 59%. Conclusions. A simple nonblood based risk score based on age, diabetes in first-degree relatives, and waist circumference can be used as a simple screening tool for undiagnosed and incident cases of diabetes in Peru.
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Affiliation(s)
- Antonio Bernabe-Ortiz
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
- *Antonio Bernabe-Ortiz:
| | - Liam Smeeth
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Robert H. Gilman
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Área de Investigación y Desarrollo, Asociación Benéfica PRISMA, Lima, Peru
| | | | - William Checkley
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - J. Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
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Nguyen CT, Pham NM, Lee AH, Binns CW. Prevalence of and Risk Factors for Type 2 Diabetes Mellitus in Vietnam: A Systematic Review. Asia Pac J Public Health 2015; 27:588-600. [PMID: 26187848 DOI: 10.1177/1010539515595860] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
This systematic review examined trends in the prevalence of type 2 diabetes mellitus (T2DM) and identified its risk factors among adults in Vietnam. PubMed, Web of Science, Wiley Online Library, and Scopus databases were searched to identify relevant literature. The search yielded 10 studies, including 2 national surveys and 8 regional investigations. National prevalence estimates of T2DM were 2.7% in 2002 and 5.4% in 2012. The estimates for the northern region were 1.4% in 1994 and 3.7% in 2012 and those for the southern region were 3.8% in 2004, 7.0% in 2008, and 12.4% in 2010. The major determinants of T2DM included older age, urban residence, high levels of body and abdominal fat, physical inactivity, sedentary lifestyle, genetic factors, and hypertension. The prevalence rate by gender was variable in both national and regional studies. There was insufficient information available on some potentially important risk factors such as smoking, dietary intake, income, and educational level. Our review signifies a rapidly growing prevalence of T2DM in Vietnam and suggests that extra effort is required to prevent and control this disease.
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Affiliation(s)
- Chung T Nguyen
- Curtin University, Perth, WA, Australia National Institute of Hygiene and Epidemiology, Vietnam
| | - Ngoc Minh Pham
- Stanford University, Stanford, CA, USA Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
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Masconi KL, Matsha TE, Echouffo-Tcheugui JB, Erasmus RT, Kengne AP. Reporting and handling of missing data in predictive research for prevalent undiagnosed type 2 diabetes mellitus: a systematic review. EPMA J 2015; 6:7. [PMID: 25829972 PMCID: PMC4380106 DOI: 10.1186/s13167-015-0028-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 02/07/2015] [Indexed: 01/10/2023]
Abstract
Missing values are common in health research and omitting participants with missing data often leads to loss of statistical power, biased estimates and, consequently, inaccurate inferences. We critically reviewed the challenges posed by missing data in medical research and approaches to address them. To achieve this more efficiently, these issues were analyzed and illustrated through a systematic review on the reporting of missing data and imputation methods (prediction of missing values through relationships within and between variables) undertaken in risk prediction studies of undiagnosed diabetes. Prevalent diabetes risk models were selected based on a recent comprehensive systematic review, supplemented by an updated search of English-language studies published between 1997 and 2014. Reporting of missing data has been limited in studies of prevalent diabetes prediction. Of the 48 articles identified, 62.5% (n = 30) did not report any information on missing data or handling techniques. In 21 (43.8%) studies, researchers opted out of imputation, completing case-wise deletion of participants missing any predictor values. Although imputation methods are encouraged to handle missing data and ensure the accuracy of inferences, this has seldom been the case in studies of diabetes risk prediction. Hence, we elaborated on the various types and patterns of missing data, the limitations of case-wise deletion and state-of the-art methods of imputations and their challenges. This review highlights the inexperience or disregard of investigators of the effect of missing data in risk prediction research. Formal guidelines may enhance the reporting and appropriate handling of missing data in scientific journals.
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Affiliation(s)
- Katya L Masconi
- Division of Chemical Pathology, Faculty of Health Sciences, National Health Laboratory Service (NHLS) and University of Stellenbosch, Cape Town, South Africa ; Non-Communicable Diseases Research Unit, South African Medical Research Council, PO Box 19070, , Tygerberg, 7505 Cape Town, South Africa
| | - Tandi E Matsha
- Department of Biomedical Technology, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Cape Town, South Africa
| | - Justin B Echouffo-Tcheugui
- Hubert Department of Public Health, Rollins School of Public Health, Emory University, Atlanta, GA USA ; Department of Medicine, MedStar Health System, Baltimore, MD USA
| | - Rajiv T Erasmus
- Division of Chemical Pathology, Faculty of Health Sciences, National Health Laboratory Service (NHLS) and University of Stellenbosch, Cape Town, South Africa
| | - Andre P Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, PO Box 19070, , Tygerberg, 7505 Cape Town, South Africa ; Department of Medicine, University of Cape Town, Cape Town, South Africa
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Prevalence and risk factors of type 2 diabetes in older Vietnam-born Australians. J Community Health 2014; 39:99-107. [PMID: 23913107 DOI: 10.1007/s10900-013-9745-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Vietnamese immigrants in Australia represent the second largest Vietnamese community in developed countries, following the United States. However, limited information is available about prevalence of type 2 diabetes (T2D) and the relative roles of socio-demographic characteristics, lifestyle factors, and Vietnamese ethnicity per se in this population. This study investigated the prevalence of T2D and its risk factors in older Vietnam-born Australians, in comparison to native-born Australians. The study used baseline questionnaire data from 787 Vietnam- and 196,866 Australia-born individuals (≥45 years), who participated in the 45 and Up Study, which is Australia's largest population-based cohort study. Country of birth specific prevalence of T2D and its risk factors were age-standardised to the 2006 Australian population (≥45 years). Multivariable logistic regression models were built for each group to assess the relationship between T2D and socio-demographic characteristics, family history of diabetes, lifestyle factors and health status. Compared to Australia-born counterparts, Vietnam-born individuals had significantly (p < 0.001) higher age-standardised prevalence of T2D (14.7 vs 7.4 %) and significantly (p < 0.001) lower levels of vegetable consumption (≥5 serves/day, 19.4 vs 33.5 %), physical activity (≥5 sessions/week, 68.7 vs 78.5 %) and overweight and obesity (body mass index ≥25 kg/m(2), 21.5 vs 62.7 %). The increased risk of T2D associated with a family history of diabetes for Vietnam-born people [adjusted odds ratio (OR) 7.14, 95 % CI 4.15-12.28] was almost double that for Australia-born people (OR 3.77, 95 % CI 3.63-3.90). The patterns of association between T2D and other factors were similar between the two groups. The findings suggest a genetic predisposition to T2D in people of Vietnamese ethnicity. Reducing lifestyle risk factors for diabetes and better management of diabetes are priorities for Vietnam-born populations.
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Lee BJ, Ku B, Nam J, Pham DD, Kim JY. Prediction of fasting plasma glucose status using anthropometric measures for diagnosing type 2 diabetes. IEEE J Biomed Health Inform 2014; 18:555-61. [PMID: 24608055 DOI: 10.1109/jbhi.2013.2264509] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
It is well known that body fat distribution and obesity are important risk factors for type 2 diabetes. Prediction of type 2 diabetes using a combination of anthropometric measures remains a controversial issue. This study aims to predict the fasting plasma glucose (FPG) status that is used in the diagnosis of type 2 diabetes by a combination of various measures among Korean adults. A total of 4870 subjects (2955 females and 1915 males) participated in this study. Based on 37 anthropometric measures, we compared predictions of FPG status using individual versus combined measures using two machine-learning algorithms. The values of the area under the receiver operating characteristic curve in the predictions by logistic regression and naive Bayes classifier based on the combination of measures were 0.741 and 0.739 in females, respectively, and were 0.687 and 0.686 in males, respectively. Our results indicate that prediction of FPG status using a combination of anthropometric measures was superior to individual measures alone in both females and males. We show that using balanced data of normal and high FPG groups can improve the prediction and reduce the intrinsic bias of the model toward the majority class.
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Zhou X, Qiao Q, Ji L, Ning F, Yang W, Weng J, Shan Z, Tian H, Ji Q, Lin L, Li Q, Xiao J, Gao W, Pang Z, Sun J. Nonlaboratory-based risk assessment algorithm for undiagnosed type 2 diabetes developed on a nation-wide diabetes survey. Diabetes Care 2013; 36:3944-52. [PMID: 24144651 PMCID: PMC3836161 DOI: 10.2337/dc13-0593] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To develop a New Chinese Diabetes Risk Score for screening undiagnosed type 2 diabetes in China. RESEARCH DESIGN AND METHODS Data from the China National Diabetes and Metabolic Disorders Study conducted from June 2007 to May 2008 comprising 16,525 men and 25,284 women aged 20-74 years were analyzed. Undiagnosed type 2 diabetes was detected based on fasting plasma glucose ≥7.0 mmol/L or 2-h plasma glucose ≥11.1 mmol/L in people without a prior history of diabetes. β-Coefficients derived from a multiple logistic regression model predicting the presence of undiagnosed type 2 diabetes were used to calculate the New Chinese Diabetes Risk Score. The performance of the New Chinese Diabetes Risk Score was externally validated in two studies in Qingdao: one is prospective with follow-up from 2006 to 2009 (validation 1) and another cross-sectional conducted in 2009 (validation 2). RESULTS The New Chinese Diabetes Risk Score includes age, sex, waist circumference, BMI, systolic blood pressure, and family history of diabetes. The score ranges from 0 to 51. The area under the receiver operating curve of the score for undiagnosed type 2 diabetes was 0.748 (0.739-0.756) in the exploratory population, 0.725 (0.683-0.767) in validation 1, and 0.702 (0.680-0.724) in validation 2. At the optimal cutoff value of 25, the sensitivity and specificity of the score for predicting undiagnosed type 2 diabetes were 92.3 and 35.5%, respectively, in validation 1 and 86.8 and 38.8% in validation 2. CONCLUSIONS The New Chinese Diabetes Risk Score based on nonlaboratory data appears to be a reliable screening tool to detect undiagnosed type 2 diabetes in Chinese population.
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Carolan-Olah MC, Cassar A, Quiazon R, Lynch S. Diabetes care and service access among elderly Vietnamese with type 2 diabetes. BMC Health Serv Res 2013; 13:447. [PMID: 24168109 PMCID: PMC4231357 DOI: 10.1186/1472-6963-13-447] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Accepted: 10/22/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Vietnamese patients are disproportionately represented in type 2 diabetes mellitus statistics and also incur high rates of diabetes complications. This situation is compounded by limited access to health care. The aim of this project was to gain a deeper understanding of the difficulties Vietnamese patients experience when accessing services and managing their type 2 diabetes mellitus, and to identify factors that are important in promoting health service use. METHODS Three focus groups with 15 Vietnamese participants with type 2 diabetes mellitus, 60 to >70 years of age, were conducted in Vietnamese. Open-ended questions were used and focussed on experiences of living with diabetes and access to healthcare services in the Inner Northwest Melbourne region. Audio recordings were transcribed and then translated into English. Data were analysed using a thematic analysis framework. RESULTS Findings indicate four main themes, which together provide some insight into the experiences of living with diabetes and accessing ongoing care and support, for elderly Vietnamese with type 2 diabetes. Themes included: (1) the value of being healthy; (2) controlling diabetes; (3) staying healthy; and (4) improving services and information access. CONCLUSIONS Participants in this study were encouraged to adhere to diabetes self-management principles, based largely on a fear of medical complications. Important aspects of healthcare access were identified as; being treated with respect, having their questions answered and having access to interpreters and information in Vietnamese. Attention to these details is likely to lead to improved access to healthcare services and ultimately to improve glycemic control and overall health status for this community.
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Affiliation(s)
- Mary C Carolan-Olah
- College of Health and Biomedicine, Victoria University, McKechnie Street, St Albans, Victoria, Australia.
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Hoy D, Rao C, Nhung NTT, Marks G, Hoa NP. Risk factors for chronic disease in Viet Nam: a review of the literature. Prev Chronic Dis 2013; 10:120067. [PMID: 23306076 PMCID: PMC3545704 DOI: 10.5888/pcd10.120067] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Chronic diseases account for most of the disease burden in low- and middle-income countries, particularly those in Asia. We reviewed literature on chronic disease risk factors in Viet Nam to identify patterns and data gaps. METHODS All population-based studies published from 2000 to 2012 that reported chronic disease risk factors were considered. We used standard chronic disease terminology to search PubMed and assessed titles, abstracts, and articles for eligibility for inclusion. We summarized relevant study information in tables listing available studies, risk factors measured, and the prevalence of these risk factors. RESULTS We identified 23 studies conducted before 2010. The most common age range studied was 25 to 64 years. Sample sizes varied, and sample frames were national in 5 studies. A combination of behavioral, physical, and biological risk factors was studied. Being overweight or obese was the most common risk factor studied (n = 14), followed by high blood pressure (n = 11) and tobacco use (n = 10). Tobacco and alcohol use were high among men, and tobacco use may be increasing among Vietnamese women. High blood pressure is common; however, people's knowledge that they have high blood pressure may be low. A high proportion of diets do not meet international criteria for fruit and vegetable consumption. Prevalence of overweight and obesity is increasing. None of the studies evaluated measured dietary patterns or total caloric intake, and only 1 study measured dietary salt intake. CONCLUSION Risk factors for chronic diseases are common in Viet Nam; however, more recent and context-specific information is required for planning and monitoring interventions to reduce risk factors and chronic disease in this country.
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Affiliation(s)
- Damian Hoy
- School of Population Health, University of Queensland, Herston Rd, Herston, QLD, 4006, Australia.
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Binh TQ, Phuong PT, Nhung BT, Thoang DD, Lien HT, Thanh DV. Association of the common FTO-rs9939609 polymorphism with type 2 diabetes, independent of obesity-related traits in a Vietnamese population. Gene 2012; 513:31-5. [PMID: 23142383 DOI: 10.1016/j.gene.2012.10.082] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Revised: 10/09/2012] [Accepted: 10/29/2012] [Indexed: 12/31/2022]
Abstract
Type 2 diabetes (T2D) is a complex disorder resulting from both genetic and environmental factors in its pathogenesis. A case-control study was designed with subjects recruited from a general population to investigate whether the association between T2D and the common T>A polymorphism (rs9939609) in fat mass and obesity associated (FTO) gene is mediated by obesity-related measurements, considering the contribution of socio-economic status and lifestyle factors. The significant association between the FTO rs9939609 polymorphism and T2D was first observed in the model unadjusted (OR per A allele=1.61, 95% CI=1.06-2.44, P=0.024). It remained consistently replicated in the final model after adjustments for sex, age, systolic blood pressure, socio-economic status, lifestyle factors, and obesity-related measurements (body mass index, waist-hip ratio, body fat percentage, and body adiposity index), showing an increased T2D risk with an additive effect of the alleles (ORs per A allele=1.80-1.92, 95% CI=1.09-3.19, P<0.05). The FTO-rs9939609 polymorphism, systolic blood pressure, and waist-hip ratio were the most significant independent predictors for T2D, in which the power of the adjusted prediction model was 0.769. In conclusion, the study suggested that the FTO-rs9939609 polymorphism was significantly associated with the increased risk of T2D, independent of obesity-related measurements in a Vietnamese population.
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Affiliation(s)
- Tran Quang Binh
- National Institute of Hygiene and Epidemiology, 1 Yersin, Hanoi 112800, Vietnam.
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Quang Binh T, Tran Phuong P, Thi Nhung B, Dinh Thoang D, Van Thang P, Khanh Long T, Van Thanh D. Prevalence and correlates of hyperglycemia in a rural population, Vietnam: implications from a cross-sectional study. BMC Public Health 2012; 12:939. [PMID: 23114020 PMCID: PMC3548760 DOI: 10.1186/1471-2458-12-939] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Accepted: 10/29/2012] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND Despite the increasing prevalence of type 2 diabetes in urban areas, relatively little has been known about its actual prevalence and its associations in rural areas, Vietnam. The purpose of this study was to evaluate the prevalence of impaired fasting glucose (IFG), impaired glucose tolerance (IGT), diabetes and their risk factors in a rural province, Vietnam. METHODS A cross-sectional study with a representative sample was designed to estimate the hyperglycemia prevalence, using 75-g oral glucose tolerance test. Potential risk factors for hyperglycemia were analyzed using multinomial logistic regression, taken into account influences of socio-economic status, anthropometric measures, and lifestyle-related factors. RESULTS The age and sex-adjusted prevalence rates (95% CI) of isolated IFG, isolated IGT, combined IFG-IGT, and diabetes were 8.7 (7.0-10.5), 4.3 (3.2-5.4), 1.6 (0.9-2.3), and 3.7% (2.7-4.7%), respectively. There were still 73% of diabetic subjects without knowing the condition. Blood pressure, family history of diabetes, obesity-related measures (waist circumference, waist-hip ratio, body fat percentage, and abdominal obesity) were the independent risk factors for hyperglycemia (IFG, IGT, and diabetes). CONCLUSIONS The prevalence of hyperglycemia in rural areas has not been as sharply increased as that reported in urban cities, Vietnam. Blood pressure and obesity-related measures were the most significant predictors for hyperglycemia level and they can be taken into account in building prognosis models to early detection of diabetes in rural Vietnamese populations.
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Affiliation(s)
- Tran Quang Binh
- Department of Immunology and Molecular Biology, National Institute of Hygiene and Epidemiology, 1 Yersin, Hanoi, Vietnam
| | - Pham Tran Phuong
- Department of Immunology and Molecular Biology, National Institute of Hygiene and Epidemiology, 1 Yersin, Hanoi, Vietnam
| | - Bui Thi Nhung
- National Institute of Nutrition, 48B Tang Bat Ho Street, Hanoi, Vietnam
| | - Dang Dinh Thoang
- Ha Nam Center for Preventive Medicine, Truong Chinh Street, Phu Ly City, Vietnam
| | - Pham Van Thang
- Ha Nam Center for Preventive Medicine, Truong Chinh Street, Phu Ly City, Vietnam
| | - Tran Khanh Long
- Hanoi School of Public Health, 138 Giang Vo Street, Hanoi, Vietnam
| | - Duong Van Thanh
- Department of Immunology and Molecular Biology, National Institute of Hygiene and Epidemiology, 1 Yersin, Hanoi, Vietnam
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King GL, McNeely MJ, Thorpe LE, Mau MLM, Ko J, Liu LL, Sun A, Hsu WC, Chow EA. Understanding and addressing unique needs of diabetes in Asian Americans, native Hawaiians, and Pacific Islanders. Diabetes Care 2012; 35:1181-8. [PMID: 22517939 PMCID: PMC3329823 DOI: 10.2337/dc12-0210] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- George L King
- Asian American Diabetes Initiative, Joslin Diabetes Center, Harvard Medical School, Boston,Massachusetts, USA.
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Consequences of gestational diabetes in an urban hospital in Viet Nam: a prospective cohort study. PLoS Med 2012; 9:e1001272. [PMID: 22911157 PMCID: PMC3404117 DOI: 10.1371/journal.pmed.1001272] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Accepted: 06/12/2012] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is increasing and is a risk for type 2 diabetes. Evidence supporting screening comes mostly from high-income countries. We aimed to determine prevalence and outcomes in urban Viet Nam. We compared the proposed International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criterion, requiring one positive value on the 75-g glucose tolerance test, to the 2010 American Diabetes Association (ADA) criterion, requiring two positive values. METHODS AND FINDINGS We conducted a prospective cohort study in Ho Chi Minh City, Viet Nam. Study participants were 2,772 women undergoing routine prenatal care who underwent a 75-g glucose tolerance test and interview around 28 (range 24-32) wk. GDM diagnosed by the ADA criterion was treated by local protocol. Women with GDM by the IADPSG criterion but not the ADA criterion were termed "borderline" and received standard care. 2,702 women (97.5% of cohort) were followed until discharge after delivery. GDM was diagnosed in 164 participants (6.1%) by the ADA criterion, 550 (20.3%) by the IADPSG criterion. Mean body mass index was 20.45 kg/m(2) in women with out GDM, 21.10 in women with borderline GDM, and 21.81 in women with GDM, p<0.001. Women with GDM and borderline GDM were more likely to deliver preterm, with adjusted odds ratios (aORs) of 1.49 (95% CI 1.16-1.91) and 1.52 (1.03-2.24), respectively. They were more likely to have clinical neonatal hypoglycaemia, aORs of 4.94 (3.41-7.14) and 3.34 (1.41-7.89), respectively. For large for gestational age, the aORs were 1.16 (0.93-1.45) and 1.31 (0.96-1.79), respectively. There was no significant difference in large for gestational age, death, severe birth trauma, or maternal morbidity between the groups. Women with GDM underwent more labour inductions, aOR 1.51 (1.08-2.11). CONCLUSIONS Choice of criterion greatly affects GDM prevalence in Viet Nam. Women with GDM by the IADPSG criterion were at risk of preterm delivery and neonatal hypoglycaemia, although this criterion resulted in 20% of pregnant women being positive for GDM. The ability to cope with such a large number of cases and prevent associated adverse outcomes needs to be demonstrated before recommending widespread screening. Please see later in the article for the Editors' Summary.
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Pongchaiyakul C, Kotruchin P, Wanothayaroj E, Nguyen TV. An innovative prognostic model for predicting diabetes risk in the Thai population. Diabetes Res Clin Pract 2011; 94:193-8. [PMID: 21835485 DOI: 10.1016/j.diabres.2011.07.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2010] [Revised: 07/08/2011] [Accepted: 07/14/2011] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To estimate the prevalence and type 2 diabetes, and to develop a prognostic model for identifying individuals at high risk of undiagnosed type 2 diabetes. RESEARCH DESIGN AND METHODS The study was designed as a cross-sectional investigation with 4314 participants of Thai background, aged between 15 and 85 years (mean age: 48). Fasting plasma glucose was initially measured, and repeated if the first measurement was more than 126 mg/dl. Type 2 diabetes was diagnosed using the World Health Organization's criteria. Logistic regression model was used to develop prognostic models for men and women separately. The prognostic performance of the model was assessed by the area under the receiver operating characteristic curve (AUC) and a nomogram was constructed from the logistic regression model. RESULTS The overall prevalence of type 2 diabetes was 7.4% (n = 125/1693) in men and 3.4% (n = 98/2621) in women. In either gender, the prevalence increased with age and body mass index (BMI). Gender, age, BMI and systolic blood pressure (SBP) were independently associated with type 2 diabetes risk. Based on the estimated parameters of model, a nomogram was constructed for predicting diabetes separated by gender. The AUC for the model with 3 factors was 0.75. CONCLUSIONS These data suggest that the combination of age, BMI and systolic blood pressure could help identify Thai individuals at high risk of undiagnosed diabetes.
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Affiliation(s)
- Chatlert Pongchaiyakul
- Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
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