1
|
Andriankaja OM, Adatorwovor R, Kantarci A, Hasturk H, Shaddox L, Levine MA. Periodontal Disease, Local and Systemic Inflammation in Puerto Ricans with Type 2 Diabetes Mellitus. Biomedicines 2023; 11:2770. [PMID: 37893143 PMCID: PMC10604368 DOI: 10.3390/biomedicines11102770] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/02/2023] [Accepted: 10/05/2023] [Indexed: 10/29/2023] Open
Abstract
Periodontal disease (PD) is prevalent in type 2 diabetic condition (T2DM). OBJECTIVES We assessed the associations between serum or gingival crevicular fluid (GCF) endothelial and inflammatory mediators and chronic PD among T2DM Hispanic adults. METHODS We enrolled 248 Puerto Rican residents with T2DM aged 40-65 years. The exposures included serum inflammatory mediators (IL-1b, IL-6, IL-10, and TNF-α), endothelial adhesion molecules, RANKL levels, and the GCF content of these analytes from a subset of 158 samples. The outcomes included the percent of sites with a probing pocket depth (PPD) ≥ 4 mm and clinical attachment loss ≥ 4 mm. Adjusted logistic regression models were fit to the categorized outcomes. RESULTS Increased serum IL-10 (Adj. OR: 1.10, p = 0.04), sICAM-1 (Adj. OR: 1.01; p = 0.06), and elevated serum IL-1β (Adj. OR: 1.93; p = 0.06) were statistically significant or close to being significantly associated with a percent of sites with PPD ≥ 4 mm. An increase in GCF IL-1α (Adj. OR: 1.16; p < 0.01) and IL-1β (Adj: 2.40; p = 0.02) was associated with periodontal parameters. CONCLUSIONS Our findings suggested that oral and systemic endothelial and inflammatory mediators are associated with periodontal clinical parameters among Hispanic adults with T2DM.
Collapse
Affiliation(s)
- Oelisoa M. Andriankaja
- Center for Oral Health Research (COHR), University of Kentucky College of Dentistry, Lexington, KY 40536, USA;
| | - Reuben Adatorwovor
- College of Public Health, University of Kentucky, Lexington, KY 40536, USA;
| | | | - Hatice Hasturk
- Center for Clinical and Translational Research, The Forsyth Institute, Cambridge, MA 02142, USA;
| | - Luciana Shaddox
- Center for Oral Health Research (COHR), University of Kentucky College of Dentistry, Lexington, KY 40536, USA;
| | - Michael A. Levine
- Center for Bone Health, Division of Endocrinology and Diabetes, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA;
| |
Collapse
|
2
|
Moore JM, Buono M, Kressler J. Type 1 diabetes mellitus diagnosis in young adult preceded by years of elevated postprandial and fasting glucose but normal HbA1c: A clinical example of discordance. Diabetes Metab Syndr 2022; 16:102630. [PMID: 36166853 DOI: 10.1016/j.dsx.2022.102630] [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: 08/08/2022] [Revised: 09/05/2022] [Accepted: 09/15/2022] [Indexed: 11/16/2022]
Abstract
Herein, a case study of an individual with fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), and postprandial blood glucose (PBG) measures from the 3 years preceding their type 1 diabetes mellitus diagnosis is used to highlight discordance among these common diagnostic tests. Data from the patient's own records, participation in clinical research, and healthcare provider were collated. Measures of FBG (90-160 mg/dL) and PBG (195-247 mg/dL) were elevated for 3 years with a normal HbA1c (5.0-5.4%) and without any symptoms. Overt symptoms, including polyuria, polydipsia, and unexplained weight loss, manifested 3 years later prompting the patient to contact their physician. Testing revealed an elevated HbA1c (9.8%) and presence of glutamic acid decarboxylase autoantibodies (GAD) (9 IU/mL). Daily body composition measures and weighed food logs from the 3 months preceding and 4 months after diagnosis illustrate the effects of glucose spilling and inadequate insulin levels. Both FBG and PBG indicated diabetes 3 years prior to HbA1c. While FBG, PBG, and HbA1c are considered equally appropriate for screening and diagnosing diabetes, this case study highlights the need to revisit important distinctions between these tests that explain their frequent discordance.
Collapse
Affiliation(s)
- Jeff M Moore
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, United States; The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, 90502, United States.
| | - Michael Buono
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, United States
| | - Jochen Kressler
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, United States
| |
Collapse
|
3
|
Abstract
OBJECTIVES Fibromyalgia (FM) patients have an increased risk for glucose metabolism disturbances, and impaired glucose tolerance may be associated with symptom severity. Elevated levels of plasma lactate have been detected in FM patients. Both pyruvate and lactate are produced in glucose metabolism and reflect oxidative metabolism. The objective of our study was to analyse disturbances in glucose, pyruvate, or lactate metabolism in FM patients. METHODS We measured plasma levels of glucose, pyruvate, and lactate during an oral glucose tolerance test in 40 non-diabetic, female FM patients and 30 age- and gender-matched healthy controls. RESULTS FM patients showed a higher glycaemic response to the glucose load at 1 hour (F [1,68] = 10.4, P = .006) and 2 hours (F [1,68] = 7.80, P = .02), and higher glucose area under the curve (13.8 [SD 2.92] vs 11.6 [SD 2.31], P < .01), than healthy controls. Group differences were explained by higher body mass index and percentage of smokers among the FM patients. Pyruvate and lactate levels were similar in both groups. DISCUSSION Impaired glucose regulation in FM patients is likely not due to FM itself, but to associated lifestyle factors. Our results highlight the importance of assessing the glucose regulation status and the lifestyle factors affecting glucose regulation in FM patients for prevention or early treatment of diabetes and associated complications. TRIAL REGISTRATION ClinicalTrials.gov (NCT03300635).
Collapse
Affiliation(s)
- Teemu Zetterman
- Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University and Helsinki University Hospital, Uusimaa, Finland
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; City of Vantaa Health Centre, Vantaa, Finland
| | - Ritva Markkula
- Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University and Helsinki University Hospital, Uusimaa, Finland
| | - Eija Kalso
- Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University and Helsinki University Hospital, Uusimaa, Finland
- Sleepwell Research Programme, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| |
Collapse
|
4
|
Lizarzaburu-Robles JC, Torres-Aparcana L, Mansilla R, Valera J, Vargas G, Vento F, Laca J, Cornetero V, Herman WH. A CROSS-SECTIONAL STUDY OF THE ASSOCIATION BETWEEN THE 1-HOUR ORAL GLUCOSE TOLERANCE TEST AND THE METABOLIC SYNDROME IN A HIGH-RISK SAMPLE WITH IMPAIRED FASTING GLUCOSE. Endocr Pract 2020; 26:529-534. [PMID: 31968195 DOI: 10.4158/ep-2019-0387] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Objective: The aim of this study was to evaluate the association between the 1-hour oral glucose tolerance test (OGTT) (≥155 mg/dL) and metabolic syndrome (MS) in a sample with previous impaired fasting glucose (IFG). Methods: Three hundred and twenty four Peruvian subjects with a history of IFG ≥100 mg/dL were selected for a cross-sectional study. They underwent a 75 g OGTT and were assigned to different groups according to the result. We evaluated the association between 1-hour OGTT and MS. Results: The mean age was 56.5 ± 12.6 years and 191 (61.5%) were female. During the OGTT, we found 28 (8.6%) subjects with diabetes, 74 (22.8%) with IGT, and 222 (68.5%) with a normal glucose tolerance test with a 2-hour glucose <140 mg/dL (NGT). In the NGT group, 124 (38.3%) had 1-hour glucose levels <155 mg/dL, while 98 (30.2%) had 1-hour glucose levels ≥155 mg/dL. Evaluating the association between the 1-hour value in the OGTT and MS, we found that subjects with a 1-hour glucose ≥155 mg/dL were more than twice as likely to have MS as those with a 1-hour glucose <155 mg/dL (odds ratio = 2.64, 95% confidence interval: 1.52 to 4.57). In addition, body mass index, fasting glycemia, triglycerides, and waist circumferences were significantly higher in subjects with 1-hour glucose levels ≥155 mg/dL compared to those with 1-hour glucose levels <155 mg/dL (P<.05). Conclusion: Among subjects with IFG, performing an OGTT was helpful to identify subjects with 1-hour glucose levels ≥155 mg/dL and NGT who were significantly more likely to have MS and a worse cardiometabolic risk profile. Abbreviations: AST = aspartate aminotransferase; BMI = body mass index; CI = confidence interval; IFG = impaired fasting glucose; IGT = impaired glucose tolerance; LDL = low-density lipoprotein; MS = metabolic syndrome; NGT = normal glucose tolerance; OGTT = oral glucose tolerance test; OR = odds ratio; T2DM = type 2 diabetes; TG = triglycerides.
Collapse
|
5
|
Muñoz-Torres FJ, Andriankaja OM, Ruiz JI, Joshipura KJ. Longitudinal association between adiposity and inter-arm blood pressure difference. J Clin Hypertens (Greenwich) 2019; 21:1519-1526. [PMID: 31490614 DOI: 10.1111/jch.13678] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 07/18/2019] [Accepted: 07/26/2019] [Indexed: 12/23/2022]
Abstract
This is the first longitudinal study evaluating whether adiposity is associated with inter-arm blood pressure difference. We evaluated 714 overweight/obese individuals aged 40-65 years over a 3-year follow-up. Systolic and diastolic blood pressures were measured in both arms simultaneously using an automated machine. Linear regression assessed the associations of body mass index, fat %, waist, neck, thigh, and arm circumferences (cm), with absolute inter-arm differences in systolic (IAS) and diastolic (IAD) blood pressure (mm Hg). Poisson regression was used for binary outcomes (IAS and IAD ≥ 10 mm Hg). All models were adjusted for age, gender, smoking, physical activity, and HOMA-IR. Adiposity measures were associated with increased IAS and IAD (β range: 0.09-0.20 and 0.09-0.30). Neck circumference showed the strongest association with IAS (β = 0.20, 95% CI: 0.03, 0.37) and IAD (β = 0.30, 95% CI: 0.12, 0.47); arm circumference showed a similar association with IAS, but lower with IAD. Highest quartiles of BMI, thigh, and arm showed significant associations with IAS (IRR: 2.21, 2.46 and 2.70). Highest quartiles of BMI, waist, neck, and arm circumferences were significantly associated with IAD (IRR: 2.38, 2.68, 4.50 and 2.24). If the associations are corroborated in other populations, adiposity may be an important modifiable risk factor for inter-arm blood pressure difference with a large potential public health impact.
Collapse
Affiliation(s)
- Francisco J Muñoz-Torres
- Center for Clinical Research and Health Promotion, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Oelisoa M Andriankaja
- Center for Clinical Research and Health Promotion, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - José I Ruiz
- Center for Clinical Research and Health Promotion, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Kaumudi J Joshipura
- Center for Clinical Research and Health Promotion, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico.,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| |
Collapse
|
6
|
Bergman M, Jagannathan R, Buysschaert M, Pareek M, Olsen MH, Nilsson PM, Medina JL, Roth J, Chetrit A, Groop L, Dankner R. Lessons learned from the 1-hour post-load glucose level during OGTT: Current screening recommendations for dysglycaemia should be revised. Diabetes Metab Res Rev 2018; 34:e2992. [PMID: 29460410 DOI: 10.1002/dmrr.2992] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 01/14/2018] [Accepted: 02/02/2018] [Indexed: 02/06/2023]
Abstract
This perspective covers a novel area of research describing the inadequacies of current approaches for diagnosing dysglycaemia and proposes that the 1-hour post-load glucose level during the 75-g oral glucose tolerance test may serve as a novel biomarker to detect dysglycaemia earlier than currently recommended screening criteria for glucose disorders. Considerable evidence suggests that a 1-hour post-load plasma glucose value ≥155 mg/dl (8.6 mmol/L) may identify individuals with reduced β-cell function prior to progressing to prediabetes and diabetes and is highly predictive of those likely to progress to diabetes more than the HbA1c or 2-hour post-load glucose values. An elevated 1-hour post-load glucose level was a better predictor of type 2 diabetes than isolated 2-hour post-load levels in Indian, Japanese, and Israeli and Nordic populations. Furthermore, epidemiological studies have shown that a 1-hour PG ≥155 mg/dl (8.6 mmol/L) predicted progression to diabetes as well as increased risk for microvascular disease and mortality when the 2-hour level was <140 mg/dl (7.8 mmol/L). The risk of myocardial infarction or fatal ischemic heart disease was also greater among subjects with elevated 1-hour glucose levels as were risks of retinopathy and peripheral vascular complications in a Swedish cohort. The authors believe that the considerable evidence base supports redefining current screening and diagnostic recommendations with the 1-hour post-load level. Measurement of the 1-hour PG level would increase the likelihood of identifying a larger, high-risk group with the additional practical advantage of potentially replacing the conventional 2-hour oral glucose tolerance test making it more acceptable in a clinical setting.
Collapse
Affiliation(s)
- Michael Bergman
- Division of Endocrinology and Metabolism, Department of Medicine and of Population Health, School of Medicine, NYU Langone Diabetes Prevention Program, New York, NY, USA
| | - Ram Jagannathan
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Martin Buysschaert
- Department of Endocrinology and Diabetology, Université Catholique de Louvain, University Clinic Saint-Luc, Brussels, Belgium
| | - Manan Pareek
- Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, University of Southern Denmark, Odense, Denmark
- Cardiology Section, Department of Internal Medicine, Holbaek Hospital, Holbaek, Denmark
| | - Michael H Olsen
- Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, University of Southern Denmark, Odense, Denmark
- Cardiology Section, Department of Internal Medicine, Holbaek Hospital, Holbaek, Denmark
| | - Peter M Nilsson
- Department of Clinical Sciences and Lund University Diabetes Centre, Lund University, Skåne University Hospital, Malmö, Sweden
| | | | - Jesse Roth
- The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Angela Chetrit
- Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel
| | - Leif Groop
- Lund University Diabetes Centre, Lund University, Malmö, Sweden
| | - Rachel Dankner
- The Feinstein Institute for Medical Research, Manhasset, NY, USA
- Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
7
|
Andriankaja OM, Muñoz-Torres FJ, Vivaldi-Oliver J, Leroux BG, Campos M, Joshipura K, Pérez CM. Insulin resistance predicts the risk of gingival/periodontal inflammation. J Periodontol 2018; 89:549-557. [PMID: 29520795 PMCID: PMC5984160 DOI: 10.1002/jper.17-0384] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 10/19/2017] [Accepted: 10/24/2017] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Evaluate whether insulin resistance (IR) predicts the risk of oral inflammation, assessed as the number of sites with bleeding on probing (BOP) and number of teeth with probing pocket depths (PPD) ≥ 4 mm and BOP. METHODS Data on 870 overweight/obese diabetes free adults, aged 40-65 years from the San Juan Overweight Adults Longitudinal Study over a three-year period, was analyzed. Baseline IR, assessed using the Homeostasis Model Assessment of IR (HOMA-IR) index, was divided into tertiles. BOP was assessed at buccal and lingual sites, and PPD at six sites per tooth. Negative binomial regression was used to estimate the risk ratios (RRs) for oral inflammation adjusted for baseline age, gender, smoking status, alcohol intake, education, physical activity, waist circumference, mean plaque index, and baseline number of sites with BOP, or number of teeth with PPD≥4 mm and BOP. The potential impact of tertiles of serum TNF-α and adiponectin on the IR-oral inflammation association was also assessed in a subsample of 597 participants. RESULTS Participants in the highest HOMA-IR tertile at baseline had significantly higher numbers of sites with BOP [RR = 1.19, 95% confidence interval (CI): 1.03-1.36] and number of teeth with PPD ≥ 4 mm and BOP (RR = 1.39, 95% CI: 1.09-1.78) at follow-up, compared with individuals in the lower two HOMA-IR tertiles. Neither TNF-α nor adiponectin confounded the associations. CONCLUSION IR significantly predicts gingival/periodontal inflammation in this population.
Collapse
Affiliation(s)
- Oelisoa M. Andriankaja
- University of Puerto Rico, Medical Sciences Campus, School of Dental Medicine, Center for Clinical Research and Health Promotion, San Juan, Puerto Rico
| | - Francisco J. Muñoz-Torres
- University of Puerto Rico, Medical Sciences Campus, School of Dental Medicine, Center for Clinical Research and Health Promotion, San Juan, Puerto Rico
| | - José Vivaldi-Oliver
- University of Puerto Rico, Medical Sciences Campus, School of Dental Medicine, Center for Clinical Research and Health Promotion, San Juan, Puerto Rico
| | - Brian G. Leroux
- University of Washington, School of Dentistry and School of Public Health, Seattle, Washington
| | - Maribel Campos
- University of Puerto Rico, Medical Sciences Campus, School of Dental Medicine, Center for Clinical Research and Health Promotion, San Juan, Puerto Rico
| | - Kaumudi Joshipura
- University of Puerto Rico, Medical Sciences Campus, School of Dental Medicine, Center for Clinical Research and Health Promotion, San Juan, Puerto Rico
- Harvard School of Public Health, Boston, Massachusetts
| | - Cynthia M. Pérez
- University of Puerto Rico, Medical Sciences Campus, Graduate School of Public Health, San Juan, Puerto Rico
| |
Collapse
|
8
|
Wheeler E, Marenne G, Barroso I. Genetic aetiology of glycaemic traits: approaches and insights. Hum Mol Genet 2017; 26:R172-R184. [PMID: 28977447 PMCID: PMC5886471 DOI: 10.1093/hmg/ddx293] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 07/18/2017] [Accepted: 07/21/2017] [Indexed: 12/17/2022] Open
Abstract
Glycaemic traits such as fasting and post-challenge glucose and insulin measures, as well as glycated haemoglobin (HbA1c), are used to diagnose and monitor diabetes. These traits are risk factors for cardiovascular disease even below the diabetic threshold, and their study can additionally yield insights into the pathophysiology of type 2 diabetes. To date, a diverse set of genetic approaches have led to the discovery of over 97 loci influencing glycaemic traits. In this review, we will focus on recent advances in the genetic aetiology of glycaemic traits, and the resulting biological insights. We will provide a brief overview of results ranging from common, to low- and rare-frequency variant-trait association studies, studies leveraging the diversity across populations, and studies harnessing the power of genetic and genomic approaches to gain insights into the biological underpinnings of these traits.
Collapse
Affiliation(s)
- Eleanor Wheeler
- Department of Human Genetics, Wellcome Trust Sanger Institute, Genome Campus, Hinxton, Cambridge CB10 1SA, UK
| | - Gaëlle Marenne
- Department of Human Genetics, Wellcome Trust Sanger Institute, Genome Campus, Hinxton, Cambridge CB10 1SA, UK
| | - Inês Barroso
- Department of Human Genetics, Wellcome Trust Sanger Institute, Genome Campus, Hinxton, Cambridge CB10 1SA, UK
- Metabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge CB2 0QQ, UK
| |
Collapse
|
9
|
Ehrlich SF, Hedderson MM, Brown SD, Sternfeld B, Chasan-Taber L, Feng J, Adams J, Ching J, Crites Y, Quesenberry CP, Ferrara A. Moderate intensity sports and exercise is associated with glycaemic control in women with gestational diabetes. DIABETES & METABOLISM 2017; 43:416-423. [PMID: 28238600 DOI: 10.1016/j.diabet.2017.01.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Revised: 01/12/2017] [Accepted: 01/17/2017] [Indexed: 12/16/2022]
Abstract
AIM To assess the association of regular, unsupervised sports and exercise during pregnancy, by intensity level, with glycaemic control in women with gestational diabetes (GDM). METHODS Prospective cohort study of 971 women who, shortly after being diagnosed with GDM, completed a Pregnancy Physical Activity Questionnaire assessing moderate and vigorous intensity sports and exercise in the past 3 months. Self-monitored capillary glucose values were obtained for the 6-week period following the questionnaire, with optimal glycaemic control defined≥80% values meeting the targets<5.3mmol/L for fasting and <7.8mmol/L 1-hour after meals. Logistic regression estimated the odds of achieving optimal control; linear regression estimated activity level-specific least square mean glucose, as well as between-level mean glucose differences. RESULTS For volume of moderate intensity sports and exercise ([MET×hours]/week), the highest quartile, compared to the lowest, had significantly increased odds of optimal control (OR=1.82 [95% CI: 1.06-3.14] P=0.03). There were significant trends for decreasing mean 1-hour post breakfast, lunch and dinner glycaemia with increasing quartile of moderate activity (all P<0.05). Any participation in vigorous intensity sports and exercise was associated with decreased mean 1-hour post breakfast and lunch glycaemia (both P<0.05). No associations were observed for fasting. CONCLUSION Higher volumes of moderate intensity sports and exercise, reported shortly after GDM diagnosis, were significantly associated with increased odds of achieving glycaemic control. Clinicians should be aware that unsupervised moderate intensity sports and exercise performed in mid-pregnancy aids in subsequent glycaemic control among women with GDM.
Collapse
Affiliation(s)
- S F Ehrlich
- Division of research, Kaiser Permanente Northern California, Oakland, CA, USA; Department of Public Health, College of Education, Health and Human Sciences, University of Tennessee, Knoxville, TN, USA.
| | - M M Hedderson
- Division of research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - S D Brown
- Division of research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - B Sternfeld
- Division of research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - L Chasan-Taber
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, USA
| | - J Feng
- Division of research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - J Adams
- Division of research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - J Ching
- Division of Perinatology, Department of Obstetrics and Gynecology, Kaiser Permanente Medical Center, Santa Clara, CA, USA
| | - Y Crites
- Division of Perinatology, Department of Obstetrics and Gynecology, Kaiser Permanente Medical Center, Santa Clara, CA, USA
| | - C P Quesenberry
- Division of research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - A Ferrara
- Division of research, Kaiser Permanente Northern California, Oakland, CA, USA
| |
Collapse
|
10
|
Mattei J, Rodríguez-Orengo JF, Tamez M, Corujo F, Claudio A, Villanueva H, Campos H, Willett WC, Tucker KL, Ríos-Bedoya CF. Challenges and opportunities in establishing a collaborative multisite observational study of chronic diseases and lifestyle factors among adults in Puerto Rico. BMC Public Health 2017; 17:136. [PMID: 28143452 PMCID: PMC5282646 DOI: 10.1186/s12889-017-4035-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Accepted: 01/13/2017] [Indexed: 11/10/2022] Open
Abstract
Background Prevalence of chronic diseases and unhealthy lifestyle behaviors among the adult population of Puerto Rico (PR) is high; however, few epidemiological studies have been conducted to address these. We aimed to document the methods and operation of establishing a multisite cross-sectional study of chronic diseases and risk factors in PR, in partnership with academic, community, clinical, and research institutions. Methods The Puerto Rico Assessment of Diet, Lifestyle and Diseases (PRADLAD) documented lifestyle and health characteristics of adults living in PR, with the goal of informing future epidemiological and intervention projects, as well as public health, policy, and clinical efforts to help improve the population’s health. The study was conducted in three primary care clinics in the San Juan, PR metropolitan area. Eligible volunteers were 30–75y, living in PR for at least 10 months of the previous year, and able to answer interviewer-administered questionnaires without assistance. Questions were recorded electronically by trained interviewers, and included socio-demographic characteristics, lifestyle behaviors, self-reported medically-diagnosed diseases, and psychosocial factors. Waist and hip circumferences were measured following standardized protocols. A subset of participants answered a validated food frequency questionnaire, a legumes questionnaire, and had medical record data abstracted. Process and outcome evaluation indicators were assessed. Results The study screened 403 participants in 5 months. Of these, 396 (98%) were eligible and 380 (94%) had reliable and complete information. A subset of 242 participants had valid dietary data, and 236 had medical record data. The mean time to complete an interview was 1.5 h. Participants were generally cooperative and research collaborators were fully engaged. Having multiple sites helped enhance recruitment and sociodemographic representation. Diagnosed conditions were prevalent across sites. Challenges in data monitoring, interviewer training, and scheduling were identified and corrected, and should be addressed in future studies. Conclusions Epidemiological studies in PR can be successfully implemented in partnership with multiple institutions. Effective recruitment and implementation requires concerted planning and continued involvement from partners, frequent quality control, brief interviews, reasonable incentives, and thorough training/re-training of culturally-sensitive interviewers. Further studies are feasible and needed to help address highly prevalent chronic conditions in PR.
Collapse
Affiliation(s)
- Josiemer Mattei
- Department of Nutrition, Harvard TH Chan School of Public Health, 665 Huntington Ave, Bldg 2, Boston, MA, 02115, USA.
| | - José F Rodríguez-Orengo
- Fundación de Investigación de Puerto Rico, San Juan, PR, USA.,Department of Biochemistry, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, PR, USA
| | - Martha Tamez
- Department of Nutrition, Harvard TH Chan School of Public Health, 665 Huntington Ave, Bldg 2, Boston, MA, 02115, USA
| | | | - Aida Claudio
- Fundación de Investigación de Puerto Rico, San Juan, PR, USA
| | | | - Hannia Campos
- Department of Nutrition, Harvard TH Chan School of Public Health, 665 Huntington Ave, Bldg 2, Boston, MA, 02115, USA.,Centro de Investigación e Innovación en Nutrición Translacional y Salud, Universidad Hispanoamericana, San José, Costa Rica
| | - Walter C Willett
- Department of Nutrition, Harvard TH Chan School of Public Health, 665 Huntington Ave, Bldg 2, Boston, MA, 02115, USA.,Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Katherine L Tucker
- Department of Biomedical and Nutritional Sciences, University of Massachusetts, Lowell, MA, USA
| | - Carlos F Ríos-Bedoya
- Fundación de Investigación de Puerto Rico, San Juan, PR, USA.,Hurley Medical Center, Department of Internal Medicine, Flint, MI, USA
| |
Collapse
|
11
|
Pérez CM, Muñoz F, Andriankaja OM, Ritchie CS, Martínez S, Vergara J, Vivaldi J, López L, Campos M, Joshipura KJ. Cross-sectional associations of impaired glucose metabolism measures with bleeding on probing and periodontitis. J Clin Periodontol 2017; 44:142-149. [PMID: 27978601 DOI: 10.1111/jcpe.12662] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2016] [Indexed: 12/17/2022]
Abstract
AIM This study assessed the associations of pre-diabetes and insulin resistance with bleeding on probing (BOP) and periodontitis among adults. MATERIALS AND METHODS We included 1191 Hispanic adults aged 40-65 years, free of diabetes, enrolled in San Juan Overweight Adults Longitudinal Study. Pre-diabetes was defined as impaired fasting glucose (IFG), impaired glucose tolerance (IGT), or impaired glycated haemoglobin. Impaired one-hour plasma glucose (1hPG) was defined as levels >155 mg/dl. Insulin resistance was defined using the study population-specific 75th percentile (HOMA-IR ≥ 3.13). High BOP was defined as percentage of teeth with bleeding ≥30%. Periodontitis was defined according to the CDC/AAP definition. RESULTS After multivariable adjustment for age, gender, education, smoking status, alcohol consumption, physical activity, obesity, HDL-C, and plaque index, pre-diabetes with and without 1hPG, IFG, impaired 1hPG, IGT, and HOMA-IR were significantly associated with high BOP; pre-diabetes, IFG, and impaired 1hPG were significantly associated with severe periodontitis. Most of these associations remained significant when the analyses were restricted to non-smokers. CONCLUSIONS This study suggests associations between pre-diabetes and insulin resistance with BOP and periodontitis. Given the high prevalence of impaired glucose metabolism and periodontitis, the assessment of the temporal sequence of these associations is of utmost importance.
Collapse
Affiliation(s)
- Cynthia M Pérez
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | - Francisco Muñoz
- Center for Clinical Research and Health Promotion, School of Dental Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | - Oelisoa M Andriankaja
- Center for Clinical Research and Health Promotion, School of Dental Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | - Christine S Ritchie
- San Francisco Veterans Affairs Medical Center, Center for Research on Aging at the Jewish Home of San Francisco, San Francisco, CA, USA
| | - Sasha Martínez
- Center for Clinical Research and Health Promotion, School of Dental Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | - José Vergara
- Center for Clinical Research and Health Promotion, School of Dental Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | - José Vivaldi
- School of Dental Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | - Lydia López
- School of Dental Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | - Maribel Campos
- Center for Clinical Research and Health Promotion, School of Dental Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | - Kaumudi J Joshipura
- Center for Clinical Research and Health Promotion, School of Dental Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, MA, USA
| |
Collapse
|
12
|
Bergman M, Chetrit A, Roth J, Dankner R. One-hour post-load plasma glucose level during the OGTT predicts mortality: observations from the Israel Study of Glucose Intolerance, Obesity and Hypertension. Diabet Med 2016; 33:1060-6. [PMID: 26996391 DOI: 10.1111/dme.13116] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/14/2016] [Indexed: 12/28/2022]
Abstract
AIMS The relationship between 1- and 2-h glucose levels following an oral glucose tolerance test (OGTT) and long-term mortality was evaluated. METHODS Over a 33-year period, 2138 individuals were followed for all-cause mortality. Fasting and post-OGTT glucose parameters categorized the cohort according to baseline glycaemic status. Four categories were established according to 1- and 2-h glucose levels (in mmol/l): group A = 1 h ≤ 8.8 and 2 h < 7.8; group B = 1 h > 8.6 and 2 h < 7.8; group C = 1 h ≤ 8.6 and 2 h = 7.8-11.1 (impaired glucose tolerance); group D = 1 h > 8.6 and 2 h = 7.8-11.1 (impaired glucose tolerance). Individuals with diabetes at baseline were excluded from the cohort. RESULTS By August 2013, 51% of the study cohort had died. The worst prognosis occurred in group D (73.8% mortality), followed by groups C (67.5%), B and A (57.9% and 41.6%, respectively). When the 2-h glucose value is 'normal' (< 7.8 mmol/l), the 1-h glucose value > 8.6 mmol/l is an important predictor of mortality (28% increased risk) compared with group A, controlling for sex, age, smoking, BMI, systolic and diastolic blood pressures. A gradual increased hazard for mortality was seen by study group (hazard ratio = 1.28, 1.60 and 1.76, for groups B, C and D, respectively; group A = reference). CONCLUSIONS A 1-h glucose value > 8.6 mmol/l predicts mortality even when the 2-h level is < 7.8 mmol/l. However, when the 2-h level is in the impaired glucose tolerance range, the hazard for mortality rises significantly independent of the 1-h value. Individuals at risk for developing diabetes could be identified earlier using the 1-h threshold value of 8.6 mmol/l, which could avert progression to diabetes and increased mortality..
Collapse
Affiliation(s)
- M Bergman
- NYU Diabetes Prevention Program, NYU School of Medicine, New York, USA
| | - A Chetrit
- Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel
| | - J Roth
- The Feinstein Institute for Medical Research, Manhasset, USA
| | - R Dankner
- Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel
- The Feinstein Institute for Medical Research, Manhasset, USA
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
13
|
Joshipura K, Muñoz-Torres F, Vergara J, Palacios C, Pérez CM. Neck Circumference May Be a Better Alternative to Standard Anthropometric Measures. J Diabetes Res 2016; 2016:6058916. [PMID: 26981543 PMCID: PMC4766356 DOI: 10.1155/2016/6058916] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 01/03/2016] [Accepted: 01/06/2016] [Indexed: 11/18/2022] Open
Abstract
This paper evaluates neck circumference as a metabolic risk marker. Overweight/obese, nondiabetic Hispanics, 40-65 years old, who are free of major cardiovascular diseases, were recruited for the San Juan Overweight Adults Longitudinal Study (SOALS). Baseline exams were completed by 1,206 participants. Partial correlation coefficients (r) and logistic models adjusted for age, gender, smoking status, and physical activity were computed. Neck circumference was significantly correlated with waist circumference (r = 0.64), BMI (r = 0.66), and body fat % (r = 0.45). Neck circumference, highest (compared to lowest) tertile, had higher association with prediabetes: multivariable OR = 2.30 (95% CI: 1.71-3.06) compared to waist circumference OR = 1.97 (95% CI: 1.48-2.66) and other anthropometric measures. Neck circumference showed higher associations with HOMA, low HDL-C, and triglycerides, multivariable OR = 8.42 (95% CI: 5.43-13.06), 2.41 (95% CI: 1.80-3.21), and 1.52 (95% CI: 1.14-2.03), but weaker associations with hs-CRP and hypertension, OR = 3.61 (95% CI: 2.66-4.90) and OR = 2.58 (95% CI: 1.90-3.49), compared to waist circumference. AIC for model fit was generally similar for neck or waist circumference. Neck circumference showed similar or better associations with metabolic factors and is more practicable than waist circumference. Hence, neck circumference may be a better alternative to waist circumference.
Collapse
Affiliation(s)
- Kaumudi Joshipura
- Center for Clinical Research and Health Promotion, University of Puerto Rico, Medical Sciences Campus, San Juan, PR 00936-5067, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- *Kaumudi Joshipura:
| | - Francisco Muñoz-Torres
- Center for Clinical Research and Health Promotion, University of Puerto Rico, Medical Sciences Campus, San Juan, PR 00936-5067, USA
| | - José Vergara
- Center for Clinical Research and Health Promotion, University of Puerto Rico, Medical Sciences Campus, San Juan, PR 00936-5067, USA
- Graduate School of Public Health, University of Puerto Rico, Medical Sciences Campus, San Juan, PR 00936-5067, USA
| | - Cristina Palacios
- Graduate School of Public Health, University of Puerto Rico, Medical Sciences Campus, San Juan, PR 00936-5067, USA
| | - Cynthia M. Pérez
- Graduate School of Public Health, University of Puerto Rico, Medical Sciences Campus, San Juan, PR 00936-5067, USA
| |
Collapse
|
14
|
Andriankaja OM, Jiménez JJ, Muñoz-Torres FJ, Pérez CM, Vergara JL, Joshipura KJ. Lipid-lowering agents use and systemic and oral inflammation in overweight or obese adult Puerto Ricans: the San Juan Overweight Adults Longitudinal Study (SOALS). J Clin Periodontol 2015; 42:1090-6. [PMID: 26407668 DOI: 10.1111/jcpe.12461] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2015] [Indexed: 01/04/2023]
Abstract
UNLABELLED The effects of lipid-lowering agents (LLA) on reducing systemic and oral inflammation have not been evaluated. OBJECTIVE To assess the association of LLA use with high-sensitivity C-reactive protein (hs-CRP) and oral inflammation. DESIGN Cross-sectional analysis using baseline data from 1300 overweight/obese participants aged 40-65 years, recruited for the ongoing San Juan Overweight Adults Longitudinal Study. Serum hs-CRP was measured by ELISA, gingival/periodontal inflammation was evaluated as bleeding upon probing (BOP), and LLA was self-reported. Separate logistic models were performed for systemic and oral inflammation. RESULTS In all, 24% participants reported history of dyslipidaemia, of which, 50.3% self-reported LLA use. Sixty percent of the participants had elevated hs-CRP (>3 mg/dl) and 50% had high BOP (defined as at or above the median: 21%). After adjusting for age, gender, smoking, HDL-C, physical activity, diabetes, blood pressure medications, and percent body fat composition, LLA users had significantly lower odds of elevated hs-CRP compared to LLA non-users (OR = 0.58; 95% CI: 0.39-0.85). After adjusting for age, gender, smoking status, educational level, mean plaque index and percent body fat, LLA users had significantly lower odds of high BOP compared to LLA non-users (OR = 0.62; 95% CI: 0.42-0.91). CONCLUSIONS Lipid-lowering agents may reduce both systemic and oral inflammatory responses.
Collapse
Affiliation(s)
- Oelisoa M Andriankaja
- Center for Clinical Research and Health Promotion, School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - James J Jiménez
- Center for Clinical Research and Health Promotion, School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Francisco J Muñoz-Torres
- Center for Clinical Research and Health Promotion, School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Cynthia M Pérez
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - José L Vergara
- Center for Clinical Research and Health Promotion, School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Kaumudi J Joshipura
- Center for Clinical Research and Health Promotion, School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| |
Collapse
|
15
|
Tokodai K, Amada N, Haga I, Takayama T, Nakamura A. The 5-time point oral glucose tolerance test as a predictor of new-onset diabetes after kidney transplantation. Diabetes Res Clin Pract 2014; 103:298-303. [PMID: 24468096 DOI: 10.1016/j.diabres.2013.12.049] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 07/10/2013] [Accepted: 12/29/2013] [Indexed: 01/14/2023]
Abstract
AIMS To evaluate the predictive power of the 5-time point oral glucose tolerance test (OGTT) for new-onset diabetes after kidney transplantation (NODAT). METHODS We performed a retrospective study of 145 patients without diabetes who received kidney transplantations at our hospital. The 5-time point OGTT was performed before transplantation. The area under a receiver-operating characteristic curve (aROC) was used for evaluating the predictive power of 5-time point OGTT values. RESULTS Seventeen patients developed NODAT within 1 year after transplantation. All postload plasma glucose (PPG) levels were higher in patients who developed NODAT than in those who did not; fasting plasma glucose levels were not different. The aROC for the area under the glucose concentration-time curve was significantly greater than that for fasting plasma glucose. Univariate and multivariate analyses showed that each PPG level was an independent risk factor for NODAT. Furthermore, patients with normal glucose tolerance (NGT) or impaired glucose tolerance (IGT) could be stratified with a 1-h plasma glucose (1h-PG) cut-off point of 8.4 mmol/L. The incidences of NODAT were 23.5%, 16.7%, 9.1%, and 0% for patients with IGT+1h-PG ≥8.4 mmol/L,IGT+1h-PG <8.4 mmol/L, NGT+1h-PG ≥ 8.4 mmol/L, and NGT+1h-PG<8.4 mmol/L, respectively. CONCLUSIONS The area under the glucose concentration-time curve and each PPG concentration during the 5-time point OGTT are strong predictors of NODAT. A 1h-PG cut-off point of 8.4 mmol/L plus NGT/IGT can be used to identify patients at intermediate and high risk of developing NODAT.
Collapse
Affiliation(s)
- Kazuaki Tokodai
- Department of Surgery, Sendai Shakaihoken Hospital, Sendai, Japan 3-16-1 Tsutsumi-machi, Aoba-ku, Sendai, Miyagi, 981-8501, Japan.
| | - Noritoshi Amada
- Department of Surgery, Sendai Shakaihoken Hospital, Sendai, Japan 3-16-1 Tsutsumi-machi, Aoba-ku, Sendai, Miyagi, 981-8501, Japan
| | - Izumi Haga
- Department of Surgery, Sendai Shakaihoken Hospital, Sendai, Japan 3-16-1 Tsutsumi-machi, Aoba-ku, Sendai, Miyagi, 981-8501, Japan
| | - Tetsuro Takayama
- Department of Surgery, Sendai Shakaihoken Hospital, Sendai, Japan 3-16-1 Tsutsumi-machi, Aoba-ku, Sendai, Miyagi, 981-8501, Japan
| | - Atsushi Nakamura
- Department of Surgery, Sendai Shakaihoken Hospital, Sendai, Japan 3-16-1 Tsutsumi-machi, Aoba-ku, Sendai, Miyagi, 981-8501, Japan
| |
Collapse
|
16
|
Andriankaja OM, Joshipura K. Potential association between prediabetic conditions and gingival and/or periodontal inflammation. J Diabetes Investig 2014; 5:108-114. [PMID: 24729853 PMCID: PMC3980950 DOI: 10.1111/jdi.12122] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 06/06/2013] [Accepted: 06/14/2013] [Indexed: 12/31/2022] Open
Abstract
AIMS/INTRODUCTION Prediabetic conditions, which include impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), might be associated with chronic gingival and/or periodontal inflammation. However, the occurrence of this oral inflammation in prediabetic conditions is poorly understood. The present study aimed to assess the association between prediabetes and gingival and/or periodontal inflammation. MATERIALS AND METHODS A total of 94 Puerto Rican men and women aged 40-65 years, who were residents of San Juan, Puerto Rico, and free of diabetes, were included in the study. All participants had at least one tooth site with clinical attachment loss ≥3 mm. Fasting and 2-h plasma glucose were collected. Gingival/periodontal inflammation was assessed by bleeding on gentle probing of the sulcus at six sites per tooth. RESULTS Participants with the percentage of teeth with bleeding on probing (BOP) equal to or greater than the median were compared with those with the percentage of teeth with BOP less than median. Participants with high BOP tended to present higher IFG (odds ratio [OR] 5.5, 95% confidence interval [CI] 1.2-25.3) and/or prediabetic condition (OR 3.6, 95% CI 1.0-13.2) than those with a low percentage of BOP, adjusting for age, sex, smoking, alcohol consumption, waist circumference and number of missing teeth. Using the continuous form of the outcome, the corresponding adjusted least squares means of percentage of BOP were 26.8 (standard error of the mean [SEM] 2.3) and 43.8 (SEM 6.0) in normal and IFG, respectively (P = 0.01), and 27.0 (SEM 2.4) and 39.0 (SEM 5.3) among healthy and prediabetic individuals, respectively (P = 0.05). CONCLUSION IFG and/or prediabetes are strongly associated with BOP, a marker of chronic gingival/periodontal inflammation.
Collapse
Affiliation(s)
- Oelisoa Mireille Andriankaja
- Center for Clinical Research and Health PromotionSchool of Dental MedicineUniversity of Puerto RicoSan JuanPuerto Rico
| | - Kaumudi Joshipura
- Center for Clinical Research and Health PromotionSchool of Dental MedicineUniversity of Puerto RicoSan JuanPuerto Rico
| |
Collapse
|
17
|
Tokodai K, Amada N, Haga I, Nakamura A, Kashiwadate T, Kawagishi N, Ohuchi N. Pretransplant HbA1c Is a Useful Predictor for the Development of New-Onset Diabetes in Renal Transplant Recipients Receiving No or Low-Dose Erythropoietin. Int J Endocrinol 2014; 2014:436725. [PMID: 25386190 PMCID: PMC4216713 DOI: 10.1155/2014/436725] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2014] [Revised: 09/23/2014] [Accepted: 10/01/2014] [Indexed: 12/27/2022] Open
Abstract
Aims. To evaluate the predictive power of pretransplant HbA1c for new-onset diabetes after transplantation (NODAT) in kidney transplant candidates, who had several predispositions for fluctuated HbA1c levels. Methods. We performed a retrospective study of 119 patients without diabetes who received kidney transplantation between March 2000 and January 2012. Univariate and multivariate logistic regression analyses were used to investigate the association of several parameters with NODAT. Predictive discrimination of HbA1c was assessed using a receiver-operating characteristic curve. Results. Seventeen patients (14.3%) developed NODAT within 1 year of transplantation. Univariate logistic regression analysis revealed that recipient age, gender, and HbA1c were predictors of NODAT. In the multivariate analysis, the association between pretransplant HbA1c and NODAT development did not reach statistical significance (P = 0.07). To avoid the strong influence of high-dose erythropoietin on HbA1c levels, we performed subgroup analyses on 85 patients receiving no or low-dose (≤6000 IU/week) erythropoietin. HbA1c was again an independent predictor for NODAT. Receiver-operating characteristic analysis revealed a cut-off value of 5.2% with an optimal sensitivity of 64% and specificity of 78% for predicting NODAT. Conclusions. Our results reveal that the pretransplant HbA1c level is a useful predictor for NODAT in patients receiving no or low-dose erythropoietin.
Collapse
Affiliation(s)
- Kazuaki Tokodai
- Department of Surgery, Sendai Shakaihoken Hospital, Sendai 980-8574, Japan
- Division of Transplantation, Reconstruction and Endoscopic Surgery, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan
- *Kazuaki Tokodai:
| | - Noritoshi Amada
- Department of Surgery, Sendai Shakaihoken Hospital, Sendai 980-8574, Japan
| | - Izumi Haga
- Department of Surgery, Sendai Shakaihoken Hospital, Sendai 980-8574, Japan
| | - Atsushi Nakamura
- Department of Surgery, Sendai Shakaihoken Hospital, Sendai 980-8574, Japan
| | | | - Naoki Kawagishi
- Division of Transplantation, Reconstruction and Endoscopic Surgery, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan
| | - Noriaki Ohuchi
- Division of Transplantation, Reconstruction and Endoscopic Surgery, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan
| |
Collapse
|
18
|
Wu X, Chen H, Wang Y, Li H. The relationship between coronary risk factors and elevated 1-h postload plasma glucose levels in patients with established coronary heart disease. Clin Endocrinol (Oxf) 2013; 78:67-72. [PMID: 22324971 DOI: 10.1111/j.1365-2265.2012.04362.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2011] [Revised: 01/05/2012] [Accepted: 01/24/2012] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Recent studies have shown that an elevated 1-h postload plasma glucose (1hPG) is able to identify subjects with normal glucose tolerance (NGT) at high risk for future type 2 diabetes and atherosclerotic cardiovascular disease. However, clinical studies about the characteristics of coronary heart disease (CHD) patients with elevated 1hPG are lacking. The aim of this study was to analyse the 1hPG level in CHD patients with NGT. METHODS A total of 204 CHD patients with NGT were recruited. Subjects underwent an oral glucose tolerance test, echocardiography and coronary angiography. Demographic data were recorded and blood samples obtained. According to the 1hPG cut-off point of 8.6 mm, patients were divided into two groups: 1hPG ≥ 8.6 mm (n = 65) and 1hPG < 8.6 mm (n = 139). RESULTS Compared with the 1hPG < 8.6 mm group, subjects with 1hPG ≥ 8.6 mm had a worse metabolic profile, exhibiting significantly higher body mass index, systolic blood pressure, triglyceride level and lower HDL-cholesterol level. Plasma high-sensitivity CRP (hsCRP) levels were higher in the 1hPG ≥ 8.6 mm group than in the 1hPG < 8.6 mm group. Coronary angiography revealed that single-vessel changes were more frequent in the 1hPG < 8.6 mm group, but there were no significant differences in the Gensini score. CONCLUSIONS Patients with CHD with 1hPG ≥ 8.6 mm have a worse metabolic profile, higher levels of hsCRP and multi-vessel coronary atherosclerosis. These findings suggest that, in patients with CHD, elevated 1hPG increases coronary risk factors and may be a marker for early-stage glucose intolerance.
Collapse
Affiliation(s)
- Xing Wu
- Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | | | | | | |
Collapse
|
19
|
Palacios C, Gil K, Pérez CM, Joshipura K. Determinants of vitamin D status among overweight and obese Puerto Rican adults. ANNALS OF NUTRITION AND METABOLISM 2012; 60:35-43. [PMID: 22222318 DOI: 10.1159/000335282] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Accepted: 11/19/2011] [Indexed: 01/09/2023]
Abstract
BACKGROUND/AIMS Low vitamin D status is highly prevalent worldwide, and the major determinants are sun exposure and vitamin D intake. We aimed to measure vitamin D status in a sample of overweight/obese adults in Puerto Rico, an area with plenty of sun exposure, and relate it to vitamin D intake, sun exposure and body composition. METHODS Serum 25(OH)D levels (liquid chromatography-tandem mass spectrometry), body weight and fat (bioimpedance), vitamin D intake and sun exposure (questionnaires) were assessed. Analysis included age-adjusted correlations and multivariate regression. RESULTS In 98 subjects (66% females; 40-65 years), median serum 25(OH)D levels were 30.7 ng/ml (25-75th percentile 25.0-37.3); 55% had levels >30 ng/ml, 31% had levels between 20 and 30 ng/ml and 14% had levels <20 ng/ml. Total vitamin D intake was 180 IU/day (45-615), and the sun exposure score was 22 (17-27). After adjusting for gender, 25(OH)D levels were significantly correlated with vitamin D intake (r = 0.24, p = 0.018), the sum of sun exposure and vitamin D intake indices (r = 0.34, p = 0.001) and percent body fat (r = -0.25, p = 0.01). After adjusting for age, gender and percent body fat, the sum of sun exposure and vitamin D intake indices remained statistically associated with 25(OH)D levels (β = 1.5, p < 0.01). CONCLUSIONS In this group of overweight and obese individuals, 25(OH)D was significantly related to vitamin D intake, sun exposure and vitamin D intake indices and percent body fat.
Collapse
Affiliation(s)
- Cristina Palacios
- Nutrition Program, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, PR.
| | | | | | | |
Collapse
|