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Kaombe TM, Banda JC, Hamuza GA, Muula AS. Bivariate logistic regression model diagnostics applied to analysis of outlier cancer patients with comorbid diabetes and hypertension in Malawi. Sci Rep 2023; 13:8340. [PMID: 37221305 DOI: 10.1038/s41598-023-35475-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/18/2023] [Indexed: 05/25/2023] Open
Abstract
The joint occurrence of diabetes and hypertension conditions in a patient is common. The two diseases share a number of risk factors, and are hence usually modelled concurrently using bivariate logistic regression. However, the postestimation assessment for the model, such as analysis of outlier observations, is seldom carried out. In this article, we apply outlier detection methods for multivariate data models to study characteristics of cancer patients with joint outlying diabetes and hypertension outcomes observed from among 398 randomly selected cancer patients at Queen Elizabeth and Kamuzu Central Hospitals in Malawi. We used R software version 4.2.2 to perform the analyses and STATA version 12 for data cleaning. The results showed that one patient was an outlier to the bivariate diabetes and hypertension logit model. The patient had both diabetes and hypertension and was based in rural area of the study population, where it was observed that comorbidity of the two diseases was uncommon. We recommend thorough analysis of outlier patients to comorbid diabetes and hypertension before rolling out interventions for managing the two diseases in cancer patients to avoid misaligned interventions. Future research could perform the applied diagnostic assessments for the bivariate logit model on a wider and larger dataset of the two diseases.
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Affiliation(s)
- Tsirizani M Kaombe
- Department of Mathematical Sciences, School of Natural and Applied Sciences, University of Malawi, Zomba, Malawi.
| | | | | | - Adamson S Muula
- Department of Mathematical Sciences, School of Natural and Applied Sciences, University of Malawi, Zomba, Malawi
- Department of Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi
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2
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Yan L, Pang Y, Wang Z, Luo H, Han Y, Ma S, Li L, Yuan J, Niu Y, Zhang R. Abnormal fasting blood glucose enhances the risk of long-term exposure to air pollution on dyslipidemia: A cross-sectional study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 237:113537. [PMID: 35468441 DOI: 10.1016/j.ecoenv.2022.113537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/16/2022] [Accepted: 04/16/2022] [Indexed: 06/14/2023]
Abstract
Both long-term exposure to air pollution and abnormal fasting blood glucose (FBG) are linked to dyslipidemia prevalence. However, the joint role of air pollution and FBG on dyslipidemia remains unknown clearly. In this study, we aimed to test whether abnormal FBG could enhance the risks of long-term exposure to air pollutants on dyslipidemia in general Chinese adult population. The present study recruited 8917 participants from 4 cities in Hebei province, China. Participants' individual exposure to air pollutants was evaluated by the Empirical Bayesian Kriging statistical model in ArcGIS10.2 geographic information system. Dyslipidemia was defined according to Guidelines for the Prevention and Treatment of Dyslipidemia in Chinese Adults. Subjects were grouped into normal, prediabetes, diabetes according to FBG level. Generalized linear models were applied to analyze the interaction of air pollutants and FBG on dyslipidemia prevalence. The prevalence of dyslipidemia was 43.83% in our investigation. After adjusting all covariates, we found the risk of four air pollutants (PM2.5, PM10, NO2, SO2) on dyslipidemia prevalence was stronger as higher FBG level, and the adjusted odd ratio of interaction (ORinter (95% CI)) between PM2.5, PM10, NO2, SO2 and FBG levels on dyslipidemia was 1.171 (1.162, 1.189), 1.119 (1.111, 1.127), 1.124 (1.115, 1.130), 1.107 (1.098, 1.115), respectively. Stratified analyses indicated the modifying effects of FBG on the association of air pollution with dyslipidemia were stronger among male, less than 65 years old, overweight/obesity (all Pinter<0.1). Our study concluded that high FBG levels strengthened the risk of long-term exposure to air pollution on dyslipidemia, especially more noticeable in male, less than 65 years old, overweight.
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Affiliation(s)
- Lina Yan
- Department of Epidemiology and Health Statistics, School of Public Health, Hebei Medical University, Shijiazhuang 050017, PR China; Hebei Key Laboratory of Environment and Human Health, Shijiazhuang 050017, PR China
| | - Yaxian Pang
- Department of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang 050017, PR China; Hebei Key Laboratory of Environment and Human Health, Shijiazhuang 050017, PR China
| | - Zhikun Wang
- Office of Academic Affairs, The First Affiliated Hospital of Hebei College of Traditional Chinese Medicine, Shijiazhuang 050017, PR China
| | - Haixia Luo
- Department of Cardiology, Shijiazhuang No.1 Hospital, Shijiazhuang 050011, PR China
| | - Yuquan Han
- Emergency Department, People's Hospital of Qingdao West Coast New Area, Shandong 266400, PR China
| | - Shitao Ma
- Department of Hospital Infection Control, The People's Hospital of Luanzhou, Luanzhou 063700, PR China
| | - Lipeng Li
- Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, PR China
| | - Jing Yuan
- Department of Biostatistics,Clinical Development Division of CSPC, Shijiazhuang 050035, PR China
| | - Yujie Niu
- Hebei Key Laboratory of Environment and Human Health, Shijiazhuang 050017, PR China; Department occupational Health and Environmental Health, School of Public Health, Hebei Medical University, Shijiazhuang 050017, PR China.
| | - Rong Zhang
- Department of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang 050017, PR China; Hebei Key Laboratory of Environment and Human Health, Shijiazhuang 050017, PR China.
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3
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Wu Y, Hu H, Cai J, Chen R, Zuo X, Cheng H, Yan D. Association of hypertension and incident diabetes in Chinese adults: a retrospective cohort study using propensity-score matching. BMC Endocr Disord 2021; 21:87. [PMID: 33926442 PMCID: PMC8082672 DOI: 10.1186/s12902-021-00747-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 04/12/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Reliable quantification of the relationship between hypertension and diabetes risk is limited, especially among Chinese people. We aimed to investigate the association between hypertension and the risk of diabetes in a large cohort of the Chinese population. METHODS This was a retrospective propensity score-matched cohort study among 211,809 Chinese adults without diabetes at baseline between 2010 and 2016. The target independent and dependent variable were hypertension at baseline and incident diabetes during follow-up respectively. The propensity score matching using a non-parsimonious multivariable logistic regression was conducted to balance the confounders between 28,711 hypertensive patients and 28,711 non-hypertensive participants. The doubly robust estimation method was used to investigate the association between hypertension and diabetes. RESULTS In the propensity-score matching cohort, diabetes risk increased by 11.0% among hypertensive patients (HR = 1.110, 95% confidence interval (CI): 1.031-1.195, P = 0.00539). And diabetes risk dropped to 8.3% among hypertensive subjects after adjusting for the propensity score (HR = 1.083, 95%CI: 1.006-1.166, P = 0.03367). Compared to non-hypertensive participants with low propensity score, the risk of incident diabetes increased by 2.646 times among hypertensive patients with high propensity score (HR = 3.646, 95%CI: 2.635-5.045, P < 0.0001). CONCLUSION Hypertension was associated with an 11.0% increase in the risk of developing diabetes in Chinese adults. And the figure dropped to 8.3% after adjusting the propensity score. Additionally, compared to non-hypertensive participants with low propensity scores, the risk of incident diabetes increased by 2.646 times among hypertensive patients with high propensity scores.
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Affiliation(s)
- Yang Wu
- Department of Endocrinology, The First Affiliated Hospital of Shenzhen University, No.3002 Sungang Road, Futian District, Shenzhen, 518035, Guangdong Province, China
- Department of Endocrinology, Shenzhen Second People's Hospital, Shenzhen, 518035, Guangdong Province, China
- Shenzhen University Health Science Center, Shenzhen, 518071, Guangdong Province, China
| | - Haofei Hu
- Shenzhen University Health Science Center, Shenzhen, 518071, Guangdong Province, China
- Department of Nephrology, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518035, Guangdong Province, China
- Department of Nephrology, Shenzhen Second People's Hospital, Shenzhen, 518035, Guangdong Province, China
| | - Jinlin Cai
- Department of Endocrinology, The First Affiliated Hospital of Shenzhen University, No.3002 Sungang Road, Futian District, Shenzhen, 518035, Guangdong Province, China
- Department of Endocrinology, Shenzhen Second People's Hospital, Shenzhen, 518035, Guangdong Province, China
- Shantou University Medical College, Shantou, 515000, Guangdong Province, China
| | - Runtian Chen
- Department of Endocrinology, The First Affiliated Hospital of Shenzhen University, No.3002 Sungang Road, Futian District, Shenzhen, 518035, Guangdong Province, China
- Department of Endocrinology, Shenzhen Second People's Hospital, Shenzhen, 518035, Guangdong Province, China
- Shenzhen University Health Science Center, Shenzhen, 518071, Guangdong Province, China
| | - Xin Zuo
- Department of Endocrinology, The Third People's Hospital of Shenzhen, Shenzhen, 518116, Guangdong Province, China
| | - Heng Cheng
- Department of Endocrinology, The Third People's Hospital of Shenzhen, Shenzhen, 518116, Guangdong Province, China
| | - Dewen Yan
- Department of Endocrinology, The First Affiliated Hospital of Shenzhen University, No.3002 Sungang Road, Futian District, Shenzhen, 518035, Guangdong Province, China.
- Department of Endocrinology, Shenzhen Second People's Hospital, Shenzhen, 518035, Guangdong Province, China.
- Shenzhen University Health Science Center, Shenzhen, 518071, Guangdong Province, China.
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Nga TTT, Blizzard CL, Khue LN, Le Van Ngoc T, Bao TQ, Otahal P, Nelson MR, Magnussen CG, Van Tan B, Srikanth V, Thuy AB, Son HT, Hai PN, Mai TH, Callisaya M, Gall S. The Interdependence of Blood Pressure and Glucose in Vietnam. High Blood Press Cardiovasc Prev 2021; 28:141-150. [PMID: 33453048 DOI: 10.1007/s40292-020-00431-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 12/28/2020] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Modelling of associations of systolic blood pressure (BP) and blood glucose (BG) with their explanatory factors in separate regressions treats them as having independent biological mechanisms. This can lead to statistical inferences that are unreliable because the substantial overlap in their etiologic and disease mechanisms is ignored. AIM This study aimed to examine the relationship of systolic blood pressure (BP) and blood glucose (BG) with measures of obesity and central fat distribution and other factors whilst taking account of the inter-dependence between them. METHODS Participants (n = 14706, 53.5 % females) aged 25-64 years were selected by multi-stage stratified cluster sampling from eight provinces each representing one of the eight geographical regions of Vietnam. Measurements were made using the World Health Organization STEPS protocols. RESULTS Structural modelling identified direct effects for BG (men P = 0.000, women P = 0.029), age (men P = 0.000, women P = 0.000) and body mass index (BMI) (men P = 0.000, women P = 0.000) in the estimation of systolic BP, and for systolic BP (men P = 0.036, women P = 0.000) and waist circumference (WC) (men P = 0.032, women P = 0.009) in the estimation of BG. There were indirect effects of age, cholesterol, physical activity and tobacco smoking via their influence on WC and BMI. The errors in estimation of systolic BP and BG were correlated (men P = 0.000, women P = 0.004), the stability indices (men 0.466, women 0.495) showed the non-recursive models were stable, and the proportion of variance explained was mid-range (men 0.553, women 0.579). CONCLUSION This study provided statistical evidence of a feedback loop between systolic BP and BG. BMI and WC were confirmed to be their primary explanatory factors. Saturated fat intake and physical activity were identified as possible targets of intervention for overweight and obesity, and indirectly for reducing systolic BP and BG. Harmful/hazardous alcohol intake was identified as a target of intervention for systolic BP.
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Affiliation(s)
- Tran Thi Thu Nga
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Christopher Leigh Blizzard
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia.
| | - Luong Ngoc Khue
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Hanoi, Vietnam
| | - Truong Le Van Ngoc
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Hanoi, Vietnam
| | - Tran Quoc Bao
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Hanoi, Vietnam
| | - Petr Otahal
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Mark R Nelson
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Costan G Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia.,Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Bui Van Tan
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Velandai Srikanth
- Department of Medicine, Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Au Bich Thuy
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Ha Thai Son
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Hanoi, Vietnam
| | - Phung Ngoc Hai
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Tran Hoang Mai
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Michele Callisaya
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia.,Department of Medicine, Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Seana Gall
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
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Mohan V, Anjana RM, Unnikrishnan R, Venkatesan U, Uma Sankari G, Rahulashankiruthiyayan T, Samhita SK, Subramanian Shanthi Rani C. Incidence of hypertension among Asian Indians: 10 year follow up of the Chennai Urban Rural Epidemiology Study (CURES-153). J Diabetes Complications 2020; 34:107652. [PMID: 32595016 DOI: 10.1016/j.jdiacomp.2020.107652] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/01/2020] [Accepted: 06/06/2020] [Indexed: 10/24/2022]
Abstract
AIMS There are very few studies on incidence of hypertension from developing countries. We report on the incidence of hypertension and its risk factors in Chennai city in southern India. METHODS Participants were 1691 individuals from the Chennai Urban Rural Epidemiology Study (CURES) cohorts who did not have hypertension (normotensive n = 878, prehypertension n = 813) at baseline and who were followed for a median of 9.0 years. During the follow-up, 41 with missing blood pressure values were excluded, leaving 1650 individuals for the present analysis. Incidence rates of hypertension and predictors of progression to prehypertension and/or hypertension were estimated using Cox proportional hazards model. RESULTS During the follow-up period, 426 out of 1650 individuals developed hypertension, giving an overall incidence of hypertension of 28.7(95%CI 26.1-31.5) per 1000 person-years. Individuals with dysglycemia at baseline had higher incident rates of hypertension. Collectively, four modifiable risk factors [pre-hypertension, dysglycemia, central obesity and physical inactivity] accounted for 87.2% of the population attributable risk of incident hypertension. CONCLUSIONS Higher body weight, BMI, age and dysglycemia were associated with an increased risk of incident hypertension. Prehypertension, dysglycemia, central obesity and physical inactivity accounted for 87% of incident hypertension.
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Affiliation(s)
- Viswanathan Mohan
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control & ICMR Center for Advanced Research on Diabetes, Chennai, India.
| | - Ranjit Mohan Anjana
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control & ICMR Center for Advanced Research on Diabetes, Chennai, India
| | - Ranjit Unnikrishnan
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control & ICMR Center for Advanced Research on Diabetes, Chennai, India
| | - Ulagamathesan Venkatesan
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control & ICMR Center for Advanced Research on Diabetes, Chennai, India
| | - Ganesan Uma Sankari
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control & ICMR Center for Advanced Research on Diabetes, Chennai, India
| | - Thangarajan Rahulashankiruthiyayan
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control & ICMR Center for Advanced Research on Diabetes, Chennai, India
| | - Sharat Kumar Samhita
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control & ICMR Center for Advanced Research on Diabetes, Chennai, India
| | - Coimbatore Subramanian Shanthi Rani
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-communicable Diseases Prevention and Control & ICMR Center for Advanced Research on Diabetes, Chennai, India
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6
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Silveira EA, de Souza Rosa LP, de Carvalho Santos ASEA, de Souza Cardoso CK, Noll M. Type 2 Diabetes Mellitus in Class II and III Obesity: Prevalence, Associated Factors, and Correlation between Glycemic Parameters and Body Mass Index. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3930. [PMID: 32498226 PMCID: PMC7312992 DOI: 10.3390/ijerph17113930] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/24/2020] [Accepted: 05/27/2020] [Indexed: 12/20/2022]
Abstract
Despite the worldwide growth of class II and III obesity, the factors associated with type 2 diabetes mellitus (T2DM) in these obese individuals are not widely understood. Moreover, no study has investigated these associations in South America. Our study aimed to investigate the prevalence of T2DM and its associated factors, with an emphasis on biochemical parameters and eating habits, in class II and III obese individuals. We also aimed to analyze the correlation between glycemic parameters and body mass index (BMI). Baseline data from a randomized clinical trial (DieTBra Trial) of 150 class II and III obese individuals (BMI > 35 kg/m2) was used. An accelerometer, Food Frequency Questionnaire, and bioimpedance analysis were used to assess physical activity levels, eating habits, and body composition, respectively. Blood was collected after 12 h of fasting. Hierarchical multivariate Poisson regression was performed, and prevalence ratios (PRs) were calculated. Correlations between glycemic parameters (fasting blood glucose, glycosylated hemoglobin, homeostasis model assessment of insulin resistance (HOMA-IR), and insulin) and BMI were also analyzed. The prevalence of T2DM was 40.0% (95% CI, 32.1-48.3), high fasting blood glucose level was 19.33% (95% CI, 13.3-26.6), and high glycosylated hemoglobin was 32.67% (95% CI, 25.2-40.8). Age ≥ 50 years (PR = 3.17, 95% CI, 1.26-7.98) was significantly associated with T2DM; there was a positive linear trend between age and T2DM (p = 0.011). Multivariate analysis showed an association with educational level (PR = 1.49, 1.07-2.09, p = 0.018), nonconsumption of whole grains daily (PR = 1.67, 1.00-2.80, p = 0.049), and high HOMA-IR (PR = 1.54, 1.08-2.18, p = 0.016). We found a high prevalence of T2DM and no significant correlations between BMI and glycemic parameters.
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Affiliation(s)
- Erika Aparecida Silveira
- Post-Graduate Program in Health Sciences, School of Medicine, Federal University of Goiás, Goiás 74605-050, Brazil; (L.P.d.S.R.); (A.S.e.A.d.C.S.); (C.K.d.S.C.); (M.N.)
| | - Lorena Pereira de Souza Rosa
- Post-Graduate Program in Health Sciences, School of Medicine, Federal University of Goiás, Goiás 74605-050, Brazil; (L.P.d.S.R.); (A.S.e.A.d.C.S.); (C.K.d.S.C.); (M.N.)
- Federal Institute of Goiás, Goiânia Oeste Campus, Goiás 74270-040, Brazil
| | - Annelisa Silva e Alves de Carvalho Santos
- Post-Graduate Program in Health Sciences, School of Medicine, Federal University of Goiás, Goiás 74605-050, Brazil; (L.P.d.S.R.); (A.S.e.A.d.C.S.); (C.K.d.S.C.); (M.N.)
- United College of Campinas, Goiás 74535-040, Brazil
| | - Camila Kellen de Souza Cardoso
- Post-Graduate Program in Health Sciences, School of Medicine, Federal University of Goiás, Goiás 74605-050, Brazil; (L.P.d.S.R.); (A.S.e.A.d.C.S.); (C.K.d.S.C.); (M.N.)
- Nutrition Course, School of Social and Health Sciences, Pontifical Catholic University of Goiás, Goiás 74605-010, Brazil
| | - Matias Noll
- Post-Graduate Program in Health Sciences, School of Medicine, Federal University of Goiás, Goiás 74605-050, Brazil; (L.P.d.S.R.); (A.S.e.A.d.C.S.); (C.K.d.S.C.); (M.N.)
- Instituto Federal Goiano, Ceres Campus, Goiás 76310-000, Brazil
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7
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Seo JH, Kim HJ, Lee JY. Nomogram construction to predict dyslipidemia based on a logistic regression analysis. J Appl Stat 2019; 47:914-926. [DOI: 10.1080/02664763.2019.1660760] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Ju-Hyun Seo
- Department of Statistics, Yeungnam University, Gyeongsan, Korea
| | - Hyun-Ji Kim
- Department of Statistics, Yeungnam University, Gyeongsan, Korea
| | - Jea-Young Lee
- Department of Statistics, Yeungnam University, Gyeongsan, Korea
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8
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Liu J, Dolikun M, Štambuk J, Trbojević-Akmačić I, Zhang J, Zhang J, Wang H, Meng X, Razdorov G, Menon D, Zheng D, Wu L, Wang Y, Song M, Lauc G, Wang W. Glycomics for Type 2 Diabetes Biomarker Discovery: Promise of Immunoglobulin G Subclass-Specific Fragment Crystallizable N-glycosylation in the Uyghur Population. OMICS-A JOURNAL OF INTEGRATIVE BIOLOGY 2019; 23:640-648. [PMID: 31393219 DOI: 10.1089/omi.2019.0052] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Aberrant immunoglobulin G (IgG) N-glycosylation offers new prospects to detect changes in cell metabolism and by extension, for biomarker discovery in type 2 diabetes mellitus (T2DM). However, past studies did not analyze the individual IgG subclasses in relation to T2DM pathophysiology. We report here original findings through a comparison of the IgG subclass-specific fragment crystallizable (Fc) glycan biosignatures in 115 T2DM patients with 122 healthy controls within the Uyghur population in China. IgG Fc glycosylation profiles were analyzed using nano-liquid chromatography-mass spectrometry to exclude changes attributed to fragment antigen binding N-glycosylation. After correction for clinical covariates, 27 directly measured and 4 derived glycan traits of the IgG subclass-specific N-glycopeptides were significantly associated with T2DM. Furthermore, we observed in T2DM a decrease in bisecting N-acetylglucosamine of IgG2 and agalactosylation of IgG4, and an increase in sialylation of IgG4 and digalactosylation of IgG2. Classification model based on IgG subclass-specific N-glycan traits was able to distinguish patients with T2DM from controls with an area under the receiver operating characteristic curve of 0.927 (95% confidence interval 0.894-0.960, p < 0.001). In conclusion, a robust association between the IgG subclass-specific Fc N-glycomes and T2DM was observed in the Uyghur population sample in China, suggesting a potential for the IgG Fc glycosylation as a biomarker candidate for type 2 diabetes. The integration of glycomics with other system science biomarkers might offer further hope for innovation in diagnosis and treatment of T2DM in the future. Finally, it is noteworthy that "Population Glycomics" is an emerging approach to biomarker discovery for common complex diseases.
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Affiliation(s)
- Jiaonan Liu
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Mamatyusupu Dolikun
- College of the Life Sciences and Technology, Xinjiang University, Urumqi, China
| | - Jerko Štambuk
- Genos Glycoscience Research Laboratory, Zagreb, Croatia
| | | | - Jie Zhang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Jinxia Zhang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Hao Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China.,School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Xiaoni Meng
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | | | - Desmond Menon
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Deqiang Zheng
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Lijuan Wu
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Youxin Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China.,School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Manshu Song
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China.,School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Gordan Lauc
- Genos Glycoscience Research Laboratory, Zagreb, Croatia.,Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
| | - Wei Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China.,School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
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9
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Prevalence of dyslipidaemia among adults in Africa: a systematic review and meta-analysis. LANCET GLOBAL HEALTH 2019; 6:e998-e1007. [PMID: 30103999 DOI: 10.1016/s2214-109x(18)30275-4] [Citation(s) in RCA: 93] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 05/18/2018] [Accepted: 05/22/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND The burden of dyslipidaemia in Africa remains inadequately characterised. We aimed to estimate the prevalence of dyslipidaemia in African adults from hospital-based and community-based studies. METHODS In this systematic review and meta-analysis, we searched MEDLINE via PubMed, Embase, African Journals Online, and African Index Medicus for studies published between Jan 1, 1980, and July 31, 2017, without language restriction. We assessed methodological quality of all cross-sectional studies reporting on the prevalence of elevated concentrations of total cholesterol, LDL cholesterol, or triglycerides, or low concentrations of HDL cholesterol in adults residing in African countries. We excluded reports on Africans living outside Africa, studies of individuals selected on the basis of existing dyslipidaemia or those including children and adolescents, and case series with a small sample size. The most frequently used cutoffs in the included studies were chosen for the subgroup analysis. We used random-effect model meta-analysis to derive the pooled prevalence of elevated total cholesterol, low HDL cholesterol, elevated LDL cholesterol, and elevated triglyceride concentrations. This study is registered with PROSPERO, number CRD42014015376. FINDINGS 181 studies (309 207 participants) were included in the meta-analysis. The pooled prevalence of dyslipidaemia in the general population from population-based studies was 23·6% (95% CI 18·4-29·2) for elevated concentrations of total cholesterol with a cutoff of at least 5·2 mmol/L, 41·1% (33·0-49·4) for low concentrations of HDL cholesterol with a cutoff of less than 1·0 mmol/L, 25·7% (16·2-36·6) for elevated concentrations of LDL cholesterol with a cutoff of at least 3·3 mmol/L, and 16·5% (11·8-21·6) for elevated concentrations of triglycerides with a cutoff of at least 1·7 mmol/L. INTERPRETATION The prevalence of dyslipidaemia is high in the general adult population in Africa. Ongoing efforts to reduce cardiovascular diseases in Africa should integrate effective detection and treatment of dyslipidaemia. FUNDING None.
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Başçiftçi F, Avuçlu E. An expert system design to diagnose cancer by using a new method reduced rule base. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2018; 157:113-120. [PMID: 29477419 DOI: 10.1016/j.cmpb.2018.01.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 12/22/2017] [Accepted: 01/19/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND AND OBJECTIVES A Medical Expert System (MES) was developed which uses Reduced Rule Base to diagnose cancer risk according to the symptoms in an individual. A total of 13 symptoms were used. With the new MES, the reduced rules are controlled instead of all possibilities (213= 8192 different possibilities occur). By controlling reduced rules, results are found more quickly. The method of two-level simplification of Boolean functions was used to obtain Reduced Rule Base. Thanks to the developed application with the number of dynamic inputs and outputs on different platforms, anyone can easily test their own cancer easily. METHODS More accurate results were obtained considering all the possibilities related to cancer. Thirteen different risk factors were determined to determine the type of cancer. The truth table produced in our study has 13 inputs and 4 outputs. The Boolean Function Minimization method is used to obtain less situations by simplifying logical functions. Diagnosis of cancer quickly thanks to control of the simplified 4 output functions. RESULTS Diagnosis made with the 4 output values obtained using Reduced Rule Base was found to be quicker than diagnosis made by screening all 213= 8192 possibilities. With the improved MES, more probabilities were added to the process and more accurate diagnostic results were obtained. As a result of the simplification process in breast and renal cancer diagnosis 100% diagnosis speed gain, in cervical cancer and lung cancer diagnosis rate gain of 99% was obtained. CONCLUSIONS With Boolean function minimization, less number of rules is evaluated instead of evaluating a large number of rules. Reducing the number of rules allows the designed system to work more efficiently and to save time, and facilitates to transfer the rules to the designed Expert systems. Interfaces were developed in different software platforms to enable users to test the accuracy of the application. Any one is able to diagnose the cancer itself using determinative risk factors. Thereby likely to beat the cancer with early diagnosis.
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Affiliation(s)
- Fatih Başçiftçi
- Department of Computer Engineering, Technology Faculty, Selçuk University, Selçuklu, Konya 42003, Turkey.
| | - Emre Avuçlu
- Department of Computer Technology and Computer Programming, Aksaray University, Aksaray, Turkey.
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Akter S, Goto A, Mizoue T. Smoking and the risk of type 2 diabetes in Japan: A systematic review and meta-analysis. J Epidemiol 2017; 27:553-561. [PMID: 28716381 PMCID: PMC5623034 DOI: 10.1016/j.je.2016.12.017] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 12/12/2016] [Indexed: 12/20/2022] Open
Abstract
Cigarette smoking is the leading avoidable cause of disease burden. Observational studies have suggested an association between smoking and risk of type 2 diabetes mellitus (T2DM). We conducted a meta-analysis of prospective observational studies to investigate the association of smoking status, smoking intensity, and smoking cessation with the risk of T2DM in Japan, where the prevalence of smoking has been decreasing but remains high. We systematically searched MEDLINE and the Ichushi database to December 2015 and identified 22 eligible articles, representing 343,573 subjects and 16,383 patients with T2DM. We estimated pooled relative risks (RRs) using a random-effects model and conducted subgroup analyses by participant and study characteristics. Compared with nonsmoking, the pooled RR of T2DM was 1.38 (95% confidence interval [CI], 1.28–1.49) for current smoking (19 studies) and 1.19 (95% CI, 1.09–1.31) for former smoking (15 studies). These associations persisted in all subgroup and sensitivity analyses. We found a linear dose-response relationship between cigarette consumption and T2DM risk; the risk of T2DM increased by 16% for each increment of 10 cigarettes smoked per day. The risk of T2DM remained high among those who quit during the preceding 5 years but decreased steadily with increasing duration of cessation, reaching a risk level comparable to that of never smokers after 10 years of smoking cessation. We estimated that 18.8% of T2DM cases in men and 5.4% of T2DM cases in women were attributable to smoking. The present findings suggest that cigarette smoking is associated with an increased risk of T2DM, so tobacco control programs to reduce smoking could have a substantial effect to decrease the burden of T2DM in Japan. This meta-analysis examined smoking and diabetes risk among Japanese. Current and former smokers showed a higher risk of diabetes than non-smokers. Diabetes risk linearly increased with higher consumption of cigarettes. Diabetes risk steadily decreased after smoking cessation.
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Affiliation(s)
- Shamima Akter
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
| | - Atsushi Goto
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
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Krishnadath ISK, Nahar-van Venrooij LM, Jaddoe VWV, Toelsie JR. Ethnic differences in prediabetes and diabetes in the Suriname Health Study. BMJ Open Diabetes Res Care 2016; 4:e000186. [PMID: 27403324 PMCID: PMC4932318 DOI: 10.1136/bmjdrc-2015-000186] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 04/30/2016] [Accepted: 06/03/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Diabetes is increasing worldwide, and information on risk factors to develop targeted interventions is limited. Therefore, we analyzed data of the Suriname Health Study to estimate the prevalence of prediabetes and diabetes. We also explored whether ethnic differences in prediabetes or diabetes risk could be explained by biological, demographic, lifestyle, anthropometric, and metabolic risk factors. METHOD The study was designed according to the WHO Steps guidelines. Fasting blood glucose levels were measured in 3393 respondents, aged 15-65 years, from an Amerindian, Creole, Hindustani, Javanese, Maroon or Mixed ethnic background. Prediabetes was defined by fasting blood glucose levels between 6.1 and 7.0 mmol/L and diabetes by fasting blood glucose levels ≥7.0 mmol/L or 'self-reported diabetes medication use.' For all ethnicities, we analyzed sex, age, marital status, educational level, income status, employment, smoking status, residence, physical activity, body mass index, waist circumference, hypertension, and the levels of triglyceride, total cholesterol, high-density lipoprotein-cholesterol and low-density lipoprotein-cholesterol. RESULTS The prevalence of prediabetes was 7.4%, while that of diabetes was 13 0%. From these diabetes cases, 39.6% were not diagnosed previously. No ethnic differences were observed in the prevalence of prediabetes. For diabetes, Hindustanis (23.3%) had twice the prevalence compared to other ethnic groups (4.7-14.2%). The associations of the risk factors with prediabetes or diabetes varied among the ethnic groups. The differences in the associations of ethnic groups with prediabetes or diabetes were partly explained by these risk factors. CONCLUSIONS The prevalence of diabetes in Suriname is high and most elevated in Hindustanis. The observed variations in risk factors among ethnic groups might explain the ethnic differences between these groups, but follow-up studies are needed to explore this in more depth.
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Affiliation(s)
- Ingrid S K Krishnadath
- Department of Public Health, Faculty of Medical Sciences , Anton de Kom University of Suriname , Paramaribo , Suriname
| | - Lenny M Nahar-van Venrooij
- Department of Public Health, Faculty of Medical Sciences , Anton de Kom University of Suriname , Paramaribo , Suriname
| | - Vincent W V Jaddoe
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Jerry R Toelsie
- Department of Physiology, Faculty of Medical Sciences , Anton de Kom University of Suriname , Paramaribo , Suriname
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Zhiyuan W, Ming Y, Jie J, Yi W, Tiansheng H, Mingfen L, Zhijie H, Zhenzhen G, Pang LMC. Effect of transcutaneous electrical nerve stimulation at acupoints on patients with type 2 diabetes mellitus: a randomized controlled trial. J TRADIT CHIN MED 2015; 35:134-40. [PMID: 25975045 DOI: 10.1016/s0254-6272(15)30020-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To examine whether transcutaneous electric nerve stimulation at acupoints (Acu-TENS) improved the biochemical and physical indices of patients with type 2 diabetes mellitus (T2DM). METHODS Ninety subjects with T2DM were divided randomly into a control group (n = 30), aerobic exercise group (n = 30), or Acu-TENS group (n = 30). In addition to conventional diabetes drug treatment, patients in the Acu-TENS group received acupoint stimulation, the aerobic exercise group engaged in walking exercises, and the control group was given sham electrical stimulation. All groups were treated for 30 min for each session and five times a week for 2 months. The indices of glycosylated hemoglobin, 2 h postprandial glucose, fasting serum insulin, triglyceride, total cholesterol, and body mass index were assessed at pre-treatment, post-treatment, and follow-up, which was 2 months after treatment. RESULTS The indices of the control group were not changed (P > 0.05) at the three time points. At the pre-treatment measurement, there were significant differences (P > 0.05) in indices among the three groups. At post-treatment, each index of the two groups was lower than that of the control group (P < 0.05), and improved in comparison with the pre-treatment measurement (P < 0.05). In follow-up, each index of the aerobic exercise group and Acu-TENS group increased, but was still decreased compared with the pre-treatment value (P < 0.05), excluding body mass index. CONCLUSION Acu-TENS could improve the state of patients with T2DM and be used as a therapy in clinical application.
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Piva SR, Susko AM, Khoja SS, Josbeno DA, Fitzgerald GK, Toledo FGS. Links between osteoarthritis and diabetes: implications for management from a physical activity perspective. Clin Geriatr Med 2015; 31:67-87, viii. [PMID: 25453302 PMCID: PMC4254543 DOI: 10.1016/j.cger.2014.08.019] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Osteoarthritis (OA) and type 2 diabetes mellitus (T2DM) often coexist in older adults. Those with T2DM are more susceptible to developing arthritis, which has been traditionally attributed to common risk factors, namely, age and obesity. Alterations in lipid metabolism and hyperglycemia might directly impact cartilage health and subchondral bone, contributing to the development/progression of OA. Adequate management of older persons with both conditions benefits from a comprehensive understanding of the associated risk factors. We discuss common risk factors and emerging links between OA and T2DM, emphasizing the importance of physical activity and the implications of safe and effective physical activity.
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Affiliation(s)
- Sara R Piva
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Bridgeside Point 1, 100 Technology Drive, Suite 210, Pittsburgh, PA 15219, USA.
| | - Allyn M Susko
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Bridgeside Point 1, 100 Technology Drive, Suite 210, Pittsburgh, PA 15219, USA
| | - Samannaaz S Khoja
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Bridgeside Point 1, 100 Technology Drive, Suite 210, Pittsburgh, PA 15219, USA
| | - Deborah A Josbeno
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Bridgeside Point 1, 100 Technology Drive, Suite 210, Pittsburgh, PA 15219, USA
| | - G Kelley Fitzgerald
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Bridgeside Point 1, 100 Technology Drive, Suite 210, Pittsburgh, PA 15219, USA
| | - Frederico G S Toledo
- Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, 200 Lothrop Street, BST E1140, Pittsburgh, PA 15261, USA
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Appuhamy JADRN, Kebreab E, Simon M, Yada R, Milligan LP, France J. Effects of diet and exercise interventions on diabetes risk factors in adults without diabetes: meta-analyses of controlled trials. Diabetol Metab Syndr 2014; 6:127. [PMID: 25960772 PMCID: PMC4424492 DOI: 10.1186/1758-5996-6-127] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 11/11/2014] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND AND AIMS Fasting insulin (FI), fasting glucose (FG), systolic blood pressure (SBP), high density lipoproteins (HDL), triacylglycerides (TAG), and body mass index (BMI) are well-known risk factors for type 2 diabetes. Reliable estimates of lifestyle intervention effects on these factors allow diabetes risk to be predicted accurately. The present meta-analyses were conducted to quantitatively summarize effects of diet and exercise intervention programs on FI, FG, SBP, HDL, TAG and BMI in adults without diabetes. MATERIALS AND METHODS MEDLINE and EMBASE were searched to find studies involving diet plus exercise interventions. Studies were required to use adults not diagnosed with type 2 diabetes, involve both dietary and exercise counseling, and include changes in diabetes risk factors as outcome measures. Data from 18, 24, 23, 30, 29 and 29 studies were used for the analyses of FI, FG, SBP, HDL, TAG and BMI, respectively. About 60% of the studies included exclusively overweight or obese adults. Mean age and BMI of participants at baseline were 48 years and 30.1 kg/m(2). Heterogeneity of intervention effects was first estimated using random-effect models and explained further with mixed-effects models. RESULTS Adults receiving diet and exercise education for approximately one year experienced significant (P <0.001) reductions in FI (-2.56 ± 0.58 mU/L), FG (-0.18 ± 0.04 mmol/L), SBP (-2.77 ± 0.56 mm Hg), TAG (-0.258 ± 0.037 mmol/L) and BMI (-1.61 ± 0.13 kg/m(2)). These risk factor changes were related to a mean calorie intake reduction of 273 kcal/d, a mean total fat intake reduction of 6.3%, and 40 minutes of moderate intensity aerobic exercise four times a week. Lifestyle intervention did not have an impact on HDL. More than 99% of total variability in the intervention effects was due to heterogeneity. Variability in calorie and fat intake restrictions, exercise type and duration, length of the intervention period, and the presence or absence of glucose, insulin, or lipid abnormalities explained 23-63% of the heterogeneity. CONCLUSIONS Calorie and total fat intake restrictions coupled with moderate intensity aerobic exercises significantly improved diabetes risk factors in healthy normoglycemic adults although normoglycemic adults with glucose, insulin, and lipid abnormalities appear to benefit more.
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Affiliation(s)
- J A D Ranga Niroshan Appuhamy
- />Department of Animal and Poultry Science, Centre for Nutrition Modelling, University of Guelph, Guelph, N1G 2 W1 Ontario Canada
- />Department of Animal Science, University of California, One Shield Avenue, Davis, CA 95616 USA
| | - Ermias Kebreab
- />Department of Animal Science, University of California, One Shield Avenue, Davis, CA 95616 USA
| | - Mitchell Simon
- />Department of Animal Science, University of California, One Shield Avenue, Davis, CA 95616 USA
| | - Rickey Yada
- />Faculty of Land and Food Systems, University of British Columbia, Vancouver, V6T 1Z4 Canada
| | - Larry P Milligan
- />Department of Animal and Poultry Science, Centre for Nutrition Modelling, University of Guelph, Guelph, N1G 2 W1 Ontario Canada
| | - James France
- />Department of Animal and Poultry Science, Centre for Nutrition Modelling, University of Guelph, Guelph, N1G 2 W1 Ontario Canada
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Başçiftçi F, Eldem A. Using reduced rule base with Expert System for the diagnosis of disease in hypertension. Med Biol Eng Comput 2013; 51:1287-93. [DOI: 10.1007/s11517-013-1096-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 06/23/2013] [Indexed: 11/28/2022]
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Goto A, Goto M, Noda M, Tsugane S. Incidence of type 2 diabetes in Japan: a systematic review and meta-analysis. PLoS One 2013; 8:e74699. [PMID: 24040326 PMCID: PMC3765408 DOI: 10.1371/journal.pone.0074699] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Accepted: 08/02/2013] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The definition of incident type 2 diabetes varies across studies; hence, the actual incidence of type 2 diabetes in Japan is unclear. Here, we reviewed the various definitions of incident type 2 diabetes used in previous epidemiologic studies and estimated the diabetes incidence rate in Japan. METHODS We searched for related literature in the MEDLINE, EMBASE, and Ichushi databases through September 2012. Two reviewers selected studies that evaluated incident type 2 diabetes in the Japanese population. RESULTS From 1824 relevant articles, we included 33 studies with 386,803 participants. The follow-up period ranged from 2.3 to 14 years and the studies were initiated between 1980 and 2003. The random-effects model indicated that the pooled incidence rate of diabetes was 8.8 (95% confidence interval, 7.4-10.4) per 1000 person-years. We observed a high degree of heterogeneity in the results (I(2) = 99.2%; p < 0.001), with incidence rates ranging from 2.3 to 52.6 per 1000 person-years. Three studies based their definition of incident type 2 diabetes on self-reports only, 10 on laboratory data only, and 20 on self-reports and laboratory data. Compared with studies defining diabetes using laboratory data (n = 30; pooled incidence rate = 9.6; 95% confidence interval = 8.3-11.1), studies based on self-reports alone tended to show a lower incidence rate (n = 3; pooled incidence rate = 4.0; 95% confidence interval = 3.2-5.0; p for interaction < 0.001). However, stratified analyses could not entirely explain the heterogeneity in the results. CONCLUSIONS Our systematic review and meta-analysis indicated the presence of a high degree of heterogeneity, which suggests that there is a considerable amount of uncertainty regarding the incidence of type 2 diabetes in Japan. They also suggested that laboratory data may be important for the accurate estimation of the incidence of type 2 diabetes.
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Affiliation(s)
- Atsushi Goto
- Department of Diabetes Research, Diabetes Research Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Maki Goto
- Department of Diabetes Research, Diabetes Research Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Mitsuhiko Noda
- Department of Diabetes Research, Diabetes Research Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shoichiro Tsugane
- Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Centre, Tokyo, Japan
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Thawornchaisit P, de Looze F, Reid CM, Seubsman SA, Sleigh AC. Health risk factors and the incidence of hypertension: 4-year prospective findings from a national cohort of 60 569 Thai Open University students. BMJ Open 2013; 3:e002826. [PMID: 23801711 PMCID: PMC3696868 DOI: 10.1136/bmjopen-2013-002826] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 05/31/2013] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE This study evaluates the impact of a number of demographic, biological, behavioural and lifestyle health risk factors on the incidence of hypertension in Thailand over a 4-year period. DESIGN A 4-year prospective study of health risk factors and their effects on the incidence of hypertension in a national Thai Cohort Study from 2005 to 2009. SETTING As Thailand is transitioning from a developing to a middle-income developed country, chronic diseases (particularly cardiovascular disease) have emerged as major health issues. Hypertension is a major risk factor for heart attack and stroke and cross-sectional studies have indicated that the prevalence is increasing. STUDY PARTICIPANTS A total of 57 558 Sukhothai Thammathirat Open University students who participated in both the 2005 and 2009 questionnaire surveys and who were normotensive in 2005 were included in the analysis. MEASURES Adjusted relative risks associating each risk factor and incidence of hypertension by sex, after controlling for confounders such as age, socioeconomic status, body mass index (BMI) and underlying diseases. RESULTS The overall 4-year incidence of hypertension was 3.5%, with the rate in men being remarkably higher than that in women (5.2% vs 2.1%). In both sexes, hypertension was associated with age, higher BMI and comorbidities but not with income and education. In men, hypertension was associated with physical inactivity, smoking, alcohol and fast food intake. In women, hypertension was related to having a partner. CONCLUSIONS In both men and women, hypertension was strongly associated with age, obesity and comorbidities while it had no association with socioeconomic factors. The cohort patterns of socioeconomy and hypertension reflect that the health risk transition in Thais is likely to be at the middle stage. Diet and lifestyle factors associate with incidence of hypertension in Thais and may be amenable targets for hypertension control programmes.
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Affiliation(s)
- Prasutr Thawornchaisit
- Faculty of Health Sciences, School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Ferdinandus de Looze
- Faculty of Health Sciences, School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Christopher M Reid
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Sam-ang Seubsman
- School of Human Ecology, Sukhothai Thammathirat Open University, Nonthaburi, Thailand
- National Centre for Epidemiology and Population Health, ANU College of Medicine, Biology and Environment, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Adrian C Sleigh
- National Centre for Epidemiology and Population Health, ANU College of Medicine, Biology and Environment, The Australian National University, Canberra, Australian Capital Territory, Australia
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Thawornchaisit P, de Looze F, Reid CM, Seubsman SA, Sleigh A. Health-risk factors and the prevalence of hypertension: cross-sectional findings from a national cohort of 87,143 Thai Open University students. Glob J Health Sci 2013; 5:126-41. [PMID: 23777729 PMCID: PMC4776825 DOI: 10.5539/gjhs.v5n4p126] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2013] [Accepted: 03/28/2013] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Thailand is undergoing a health-risk transition which increases chronic diseases, particularly hypertension, as a result of a rapid transition from a developing to a developed country. This study analyzes the effect of health-risk factors such as demography, socioeconomic status (SES) and body mass index (BMI) on the prevalence of hypertension. METHODS This was a cross-sectional analysis using data obtained in 2005 from 87,143 Sukhothai Thammathirat Open University (STOU) students participating in the Thai Cohort Study (mean age 30.5 years, 54.7% female). Adjusted odds ratios of the association between risk factors and hypertension were analysed across two age groups by sex, after controlling for the confounding factors such as SES and BMI. RESULTS The prevalence of hypertension in men was approximately twice as high as that in women (6.9% vs 2.6%). Hypertension was associated with ageing, a lower education attainment, a higher BMI and having underlying diseases in both sexes. In men, hypertension was associated with being single, having a high income, spending more time on screens (TV & PC), cigarette smoking and drinking alcohol. In women, it was directly correlated with instant and roasted or smoked food consumption. CONCLUSIONS Hypertension was highly associated with obesity and having underlying disease. The Thai health-risk transition is in a later stage. Thais should now be educated about the danger of high blood pressure and the protective power of a low fat and low salt diet, and a normal BMI. Cessation of smoking and moderation in alcohol intake should be promoted.
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