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Li H, Song Y, Wang Y, Feng X, Li C, Peng J, Yu H. Impact of the COVID-19 pandemic lockdown on Body Mass Index: a three-year follow up study in 6,156 Chinese college students. Front Endocrinol (Lausanne) 2024; 15:1387151. [PMID: 38966211 PMCID: PMC11222588 DOI: 10.3389/fendo.2024.1387151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 06/04/2024] [Indexed: 07/06/2024] Open
Abstract
Background The novel coronavirus disease 2019 as the most pervasive and consequential pandemic in recent years, has exerted significant impacts on human health, including aspects related to body weight. Objectives: This study aims to assess the influence of the lockdown measures implemented during the COVID-19 pandemic on Chinese college students' Body Mass Index (BMI) through a three-year cohort study. Methods We recruited 6156 college students (n = 4,248, 69% male, and n = 1,908, 31% female, with an average age of 18.68 ± 0.86 yr.) from a University in China to participate in this three-year cohort study. All of the subjects took the same physical fitness tests from 2019 to 2021 (pre-lockdown, during lockdown and post-lockdown). Participants' height and weight data were objectively measured by Tongfang Health Fitness Testing Products 5000 series. A paired t-test was performed in the analysis. Results During the lockdown, there is 4.2% increase of BMI among the college student (p<0.001). Moreover, males had a greater overall mean BMI rate increase of 4.74% (p<0.001) than females (2.86%, p<0.001). After the lockdown, there is 0.94% increase of BMI among the college student (p<0.001). However, females had a greater overall mean BMI rate increase of 1.49% (p<0.001) than males (0.72%, p<0.001). During this period, the obese and overweight group's growth rate from 2019 to 2020 was smaller than the normal and underweight group, which were 2.94% (p<0.001), 3.90% (p<0.001), 4.44% (p<0.001) and 5.25% (p<0.001), respectively. Conclusion BMI increased both during and post-lockdown periods among Chinese college students. However, during the lockdown, participants with higher BMI groups appeared to have a diminished BMI growth rate compared to those with lower BMI. After the lockdown, participants with higher BMI levels appeared to have an augmented BMI growth rate. Public policy action is needed to increase the level of physical activity of Chinese college students and take action to improve students' physical fitness performance after the lockdown.
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Affiliation(s)
- Haoxuan Li
- Department of Physical Education, Tsinghua University, Beijing, China
| | - Yiling Song
- Department of Physical Education, Tsinghua University, Beijing, China
| | - Yangyang Wang
- Department of Physical Education, Tsinghua University, Beijing, China
| | - Xiaolu Feng
- Department of Sports Science, College of Education, Zhejiang University, Hangzhou, China
| | - Chengwei Li
- Department of Physical Education, Tsinghua University, Beijing, China
| | - Jianmin Peng
- Department of Physical Education, Tsinghua University, Beijing, China
| | - Hongjun Yu
- Department of Physical Education, Tsinghua University, Beijing, China
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Mehraeen E, Abbaspour F, Banach M, SeyedAlinaghi S, Zarebidoki A, Tamehri Zadeh SS. The prognostic significance of insulin resistance in COVID-19: a review. J Diabetes Metab Disord 2024; 23:305-322. [PMID: 38932824 PMCID: PMC11196450 DOI: 10.1007/s40200-024-01385-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 12/31/2023] [Indexed: 06/28/2024]
Abstract
Objectives Emerging publications indicate that diabetes predisposes patients with COVID-19 to more severe complications, which is partly attributed to inflammatory condition. In the current review, we reviewed recent published literature to provide evidence on the role of insulin resistance (IR) in diabetes, the association between diabetes and COVID-19 severity and mortality, the impact of COVID-19 infection on incident new-onset diabetes, mechanisms responsible for IR in COVID-19 patients, and the predictive value of different surrogates of IR in COVID-19. Method The literature search performs to find out studies that have assessed the association between IR surrogates and morbidity and mortality in patients with COVID-19. Results We showed that there is a bulk of evidence in support of the fact that diabetes is a potent risk factor for enhanced morbidity and mortality in COVID-19 patients. COVID-19 patients with diabetes are more prone to remarkable dysglycemia compared to those without diabetes, which is associated with an unfavourable prognosis. Furthermore, SARS-COV2 can make patients predispose to IR and diabetes via activating ISR, affecting RAAS signaling pathway, provoking inflammation, and changing the expression of PPARɣ and SREBP-1. Additionally, higher IR is associated with increased morbidity and mortality in COVID-19 patients and different surrogates of IR can be utilized as a prognostic biomarker for COVID-19 patients. Conclusion Different surrogates of IR can be utilized as predictors of COVID-19 complications and death.
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Affiliation(s)
- Esmaeil Mehraeen
- Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran
| | - Faeze Abbaspour
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Maciej Banach
- Department of Preventive Cardiology and Lipidology, Medical University of Lodz (MUL), 93338 Lodz, Poland
| | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Ameneh Zarebidoki
- School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seyed Saeed Tamehri Zadeh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24, Parvaneh Street, Velenjak, P.O. Box 19395-4763, Tehran, Iran
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Conte C, Cipponeri E, Roden M. Diabetes Mellitus, Energy Metabolism, and COVID-19. Endocr Rev 2024; 45:281-308. [PMID: 37934800 PMCID: PMC10911957 DOI: 10.1210/endrev/bnad032] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 08/30/2023] [Accepted: 11/01/2023] [Indexed: 11/09/2023]
Abstract
Obesity, diabetes mellitus (mostly type 2), and COVID-19 show mutual interactions because they are not only risk factors for both acute and chronic COVID-19 manifestations, but also because COVID-19 alters energy metabolism. Such metabolic alterations can lead to dysglycemia and long-lasting effects. Thus, the COVID-19 pandemic has the potential for a further rise of the diabetes pandemic. This review outlines how preexisting metabolic alterations spanning from excess visceral adipose tissue to hyperglycemia and overt diabetes may exacerbate COVID-19 severity. We also summarize the different effects of SARS-CoV-2 infection on the key organs and tissues orchestrating energy metabolism, including adipose tissue, liver, skeletal muscle, and pancreas. Last, we provide an integrative view of the metabolic derangements that occur during COVID-19. Altogether, this review allows for better understanding of the metabolic derangements occurring when a fire starts from a small flame, and thereby help reducing the impact of the COVID-19 pandemic.
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Affiliation(s)
- Caterina Conte
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome 00166, Italy
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milan 20099, Italy
| | - Elisa Cipponeri
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milan 20099, Italy
| | - Michael Roden
- Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf 40225, Germany
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf 40225, Germany
- German Center for Diabetes Research, Partner Düsseldorf, Neuherberg 85764, Germany
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Gholi Z, Vahdat Shariatpanahi Z, Yadegarynia D, Eini-Zinab H. Associations of body mass index with severe outcomes of COVID-19 among critically ill elderly patients: A prospective study. Front Nutr 2023; 10:993292. [PMID: 36908906 PMCID: PMC9994813 DOI: 10.3389/fnut.2023.993292] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 01/26/2023] [Indexed: 02/24/2023] Open
Abstract
Background and Aim Few studies assessed the associations of overweight and obesity with severe outcomes of coronavirus disease 2019 (COVID-19) among elderly patients. This study was conducted to assess overweight and obesity in relation to risk of mortality, delirium, invasive mechanical ventilation (IMV) requirement during treatment, re-hospitalization, prolonged hospitalization, and ICU admission among elderly patients with COVID-19. Methods This was a single-center prospective study that was done on 310 elderly patients with COVID-19 hospitalized in the intensive care unit (ICU). We collected data on demographic characteristics, laboratory parameters, nutritional status, blood pressure, comorbidities, medications, and types of mechanical ventilation at baseline. Patients were followed up during ICU admission and until 45 days after the first visit, and data on delirium incidence, mortality, need for a form of mechanical ventilation, discharge day from ICU and hospital, and re-hospitalization were recorded for each patient. Results During the follow-up period, we recorded 190 deaths, 217 cases of delirium, and 35 patients who required IMV during treatment. After controlling for potential confounders, a significant association was found between obesity and delirium such that obese patients with COVID-19 had a 62% higher risk of delirium compared with normal-weight patients (HR: 1.62, 95% CI: 1.02-2.57). This association was not observed for overweight. In terms of other outcomes including ICU/45-day mortality, IMV therapy during treatment, re-hospitalization, prolonged hospitalization, and ICU admission, we found no significant association with overweight and obesity either before or after controlling for potential confounders. Conclusion We found that obesity may be a risk factor for delirium among critically ill elderly patients with COVID-19.
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Affiliation(s)
- Zahra Gholi
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Vahdat Shariatpanahi
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Davood Yadegarynia
- Infectious Disease and Tropical Medicine Research Center, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Hassan Eini-Zinab
- Department of Community Nutrition, Faculty of Nutrition and Food Technology, and National Nutrition and Food Technology Research Institute (WHO Collaborating Center), Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Gerganova A, Assyov Y, Kamenov Z. Stress Hyperglycemia, Diabetes Mellitus and COVID-19 Infection: Risk Factors, Clinical Outcomes and Post-Discharge Implications. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2022; 3:826006. [PMID: 36992767 PMCID: PMC10012081 DOI: 10.3389/fcdhc.2022.826006] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 02/07/2022] [Indexed: 01/08/2023]
Abstract
The novel severe acute respiratory distress syndrome-coronavirus 2 (SARS-CoV-2) has caused one of the most substantial pandemics that has affected humanity in the last century. At the time of the preparation of this review, it has caused the death of around 5 million people around the globe. There is ample evidence linking higher mortality risk rates from Coronavirus disease-19 (COVID-19) with male gender, advancing age and comorbidities, such as obesity, arterial hypertension, cardiovascular disease, chronic obstructive pulmonary disease, diabetes mellitus, and cancer. Hyperglycemia has been found to be accompanying COVID-19 not only in individuals with overt diabetes. Many authors claim that blood glucose levels should also be monitored in non-diabetic patients; moreover, it has been confirmed that hyperglycemia worsens the prognosis even without pre-existing diabetes. The pathophysiological mechanisms behind this phenomenon are complex, remain controversial, and are poorly understood. Hyperglycemia in the setting of COVID-19 could be a consequence of deterioration in pre-existing diabetes, new-onset diabetes, stress-induced or iatrogenic due to substantial usage of corticosteroids within the context of a severe COVID-19 infection. It is also plausible that it might be a result of adipose tissue dysfunction and insulin resistance. Last but not least, SARS-CoV-2 is also claimed to trigger sporadically direct β-cell destruction and β-cell autoimmunity. Pending further validations with longitudinal data are needed to legitimize COVID-19 as a potential risk factor for the development of diabetes. Hereby, we present an emphasized critical review of the available clinical data in an attempt to unravel the complex mechanisms behind hyperglycemia in COVID-19 infection. The secondary endpoint was to evaluate the bidirectional relationship between COVID-19 and diabetes mellitus. As the worldwide pandemic is still expanding, demand for answering these questions is arising. It will be of immense help for the management of COVID-19 patients, as well as for the implementation of post-discharge policies for patients with a high risk of developing diabetes.
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Affiliation(s)
- Antonina Gerganova
- Department of Internal Medicine, Medical University - Sofia, Sofia, Bulgaria
- Clinic of Endocrinology, University Hospital Alexandrovska, Sofia, Bulgaria
| | - Yavor Assyov
- Department of Internal Medicine, Medical University - Sofia, Sofia, Bulgaria
- Clinic of Endocrinology, University Hospital Alexandrovska, Sofia, Bulgaria
| | - Zdravko Kamenov
- Department of Internal Medicine, Medical University - Sofia, Sofia, Bulgaria
- Clinic of Endocrinology, University Hospital Alexandrovska, Sofia, Bulgaria
- *Correspondence: Zdravko Kamenov, orcid.org/0000-0002-4829-9449
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Corcillo A, Saqib A, Sithamparanathan N, Khanam A, Williams J, Gulati A, Kariyawasam D, Karalliedde J. Clinical Features and Changes in Insulin Requirements in People with Type 2 Diabetes Requiring Insulin When Hospitalised with SARS-CoV-2 Infection. Int J Endocrinol 2022; 2022:8030765. [PMID: 35256883 PMCID: PMC8898117 DOI: 10.1155/2022/8030765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/11/2022] [Accepted: 02/03/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Uncontrolled hyperglycaemia before and during hospitalisation is a risk factor for adverse outcomes in people with diabetes and SARS-CoV-2 infection. Insulin often at high doses is frequently required to manage hyperglycaemia associated with SARS-CoV-2 infection during hospitalisation. However, there is limited information on the clinical features and sequelae of people with type 2 diabetes (T2DM) not previously on insulin that require insulin as a new treatment when hospitalised with SARS-CoV-2 infection. AIMS To describe the clinical features and insulin treatment sequelae of 113 people with T2DM that required insulin as a new treatment when hospitalised with SARS-CoV-2 infection. METHODS A single-centre study of 113 people with T2DM who were not on insulin before their admission for SARS-CoV-2 infection. The primary aim of our study was to identify clinical and biochemical features that were associated with the need for insulin as a new treatment in people with known T2DM not on insulin treatment at the time of hospitalisation for SARS-CoV-2 infection. We also describe changes in insulin requirements at time of discharge from hospital and 6 weeks later during the first wave of SARS-CoV-2 infection (April-March 2020) in the UK. Clinical, biochemical, and anthropometric data were collected from electronic health records. RESULTS We observed that of 113 people with T2DM, 35% (n = 39) needed insulin as a new treatment during their hospitalisation for SARS-CoV-2 infection. People requiring insulin were younger, had a higher preadmission HbA1c, were more frequently on oral medication for diabetes before the admission, and were more likely to be obese (body mass index ≥30 kg/m2), with p ≤ 0.001 for all. In multivariable logistic regression analyses, we observed that younger age and higher HbA1c before admission were independently associated with needing insulin, with one-year increase in age associated with decreased odds of needing insulin initiation (OR 0.91, 95% CI 0.83-0.99), and increasing preadmission HbA1c by 1 mmol/mol associated with an increased odds of insulin initiation (OR 1.05, 95% CI 1.002-1.11) (p < 0.05 for both). Of the 39 people with T2DM who required insulin as a new treatment, 28% remained on insulin at the time of discharge with their insulin dose falling from 1.26 U/kg within the first 7 days of admission to 0.39 U/kg at discharge. At 6 weeks after discharge, 24% of people remained on insulin. CONCLUSION More than one-third of people with T2DM not previously treated with insulin required new insulin treatment when hospitalised with SARS-CoV-2 infection, and of this group, 24% remained on insulin at 6 weeks after discharge. This study highlights the important variations of insulin requirements in people with T2DM new to insulin and the importance of a dedicated team for patient education and close follow-up.
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Affiliation(s)
- Antonella Corcillo
- School of Cardiovascular Medicine and Sciences, King's College London, 3.11 Franklin-Wilkins Building, Waterloo Campus, Stamford Street, London SE1 9NH, UK
- Guy's and St Thomas NHS Foundation Trust, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK
| | - Aaisha Saqib
- Guy's and St Thomas NHS Foundation Trust, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK
| | | | - Amina Khanam
- Guy's and St Thomas NHS Foundation Trust, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK
| | - Jamal Williams
- Guy's and St Thomas NHS Foundation Trust, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK
| | - Abhiti Gulati
- Guy's and St Thomas NHS Foundation Trust, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK
| | - Dulmini Kariyawasam
- Guy's and St Thomas NHS Foundation Trust, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK
| | - Janaka Karalliedde
- School of Cardiovascular Medicine and Sciences, King's College London, 3.11 Franklin-Wilkins Building, Waterloo Campus, Stamford Street, London SE1 9NH, UK
- Guy's and St Thomas NHS Foundation Trust, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK
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Goyal A, Gupta Y, Kalaivani M, Praveen PA, Ambekar S, Tandon N. SARS-CoV-2 Seroprevalence in Individuals With Type 1 and Type 2 Diabetes Compared With Controls. Endocr Pract 2021; 28:191-198. [PMID: 34920109 PMCID: PMC8669945 DOI: 10.1016/j.eprac.2021.12.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 11/27/2021] [Accepted: 12/09/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Data for the association between diabetes and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) susceptibility are conflicting. We aimed to evaluate this association using an analytical cross-sectional study design. METHODS Study participants were recruited from endocrine clinics of our hospital and belonged to 3 groups: group 1 (type 1 diabetes mellitus [T1DM]), group 2 (type 2 diabetes mellitus [T2DM]), and group 3 (controls). All participants submitted blood samples for SARS-CoV-2 S1/S2 immunoglobulin G antibody test (LIAISON; DiaSorin) and were interviewed for a history of documented infection. RESULTS We evaluated a total of 643 participants (T1DM, 149; T2DM, 160; control, 334; mean age, 37.9 ± 11.5 years). A total of 324 (50.4%) participants were seropositive for SARS-CoV-2. The seropositivity rate was significantly higher in the T1DM (55.7% vs 44.9%, P = .028) and T2DM (56.9% vs 44.9%, P = .013) groups than in the control group. The antibody levels in seropositive participants with T1DM and T2DM were not significantly different from those in seropositive controls. On multivariable analysis, low education status (odds ratio [OR], 1.41 [95% CI, 1.03-1.94]; P = .035), diabetes (OR, 1.68 [95% CI, 1.20-2.34]; P = .002), and overweight/obesity (OR, 1.52 [95% CI, 1.10-2.10]; P = .012) showed a significant association with SARS-CoV-2 seropositivity. The association between diabetes and SARS-CoV-2 seropositivity was found to further increase in participants with coexisting overweight/obesity (adjusted OR, 2.63 [95% CI, 1.54-4.47]; P < .001). CONCLUSION SARS-CoV-2 seropositivity, assessed before the onset of the national vaccination program, was significantly higher in participants with T1DM and T2DM than in controls. The antibody response did not differ between seropositive participants with and without diabetes. These findings point toward an increased SARS-CoV-2 susceptibility for patients with diabetes, in general, without any differential effect of the diabetes type.
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Affiliation(s)
- Alpesh Goyal
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Yashdeep Gupta
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Mani Kalaivani
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Pradeep A Praveen
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Samita Ambekar
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Nikhil Tandon
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India.
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