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Sadat Rafiei SK, Fateh F, Arab M, Espanlo M, Dahaghin S, Karami Gilavand H, Shahrokhi M, Fallahi MS, Zardast Z, Ansari A, Seifhashemi SA, Kheirandish A, Erabi G, Ahmadi Hajikolaei F, Nakhaee M, Deravi N. Weight Change and the Risk of Micro and Macro Vascular Complications of Diabetes: A Systematic Review. Malays J Med Sci 2024; 31:18-31. [PMID: 38984251 PMCID: PMC11229574 DOI: 10.21315/mjms2024.31.3.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 12/14/2023] [Indexed: 07/11/2024] Open
Abstract
Type 2 diabetes mellitus (T2DM) is a metabolic disease that can be a significant cause of cardiovascular disease (CVD), leading to macrovascular and microvascular diseases. Many researchers around the world have investigated the effects of weight change on micro and macro CVD in patients with T2DM. This study aimed to investigate the effect of weight change (weight gain and loss) on microvascular and macrovascular complications in patients with T2DM. We searched PubMed, Scopus and Google Scholar from the database until January 2023. We screened the title, abstract, and full text of articles, and after quality assessment, we extracted data from interrelated ones into this systematic review. Reviewing the results of 11 cohort studies with 219,839 individuals (T2DM patients) showed that weight loss caused an increase in the mortality rate in diabetic patients, while weight gain after diabetes diagnosis increased the risk of CVD, chronic kidney disease (CKD), microvascular disease, stroke and mortality. It should be noted that severe body weight variability increases the mortality rate and the risk of microvascular disease. Unlike other studies, one study showed that more than 5% weight gain positively affected CVD and coronary heart disease in T2DM patients. Generally, weight change in patients with T2DM is an essential sign of cardiovascular complications. According to our findings, the risk of cardiovascular complications in patients with weight loss is seen to be higher than in patients with weight gain. In regular patients with body mass index (BMI), stable weight in a healthy range is reported to decrease the risk of CVD.
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Affiliation(s)
- Seyyed Kiarash Sadat Rafiei
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fardad Fateh
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahla Arab
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Espanlo
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saba Dahaghin
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Helia Karami Gilavand
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | | | - Zahra Zardast
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arina Ansari
- Student Research Committee, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Seyyed Alireza Seifhashemi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Kheirandish
- Department of Pharmacology, School of Medicine, Iran University of Medical Sciences, Hemmat Highway, Tehran, Iran
| | - Gisou Erabi
- Student Research Committee, Urmia University of Medical Sciences, Urmia, Iran
| | | | - Mahdi Nakhaee
- Department of Laboratory Medicine, Faculty of Paramedical Sciences, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Niloofar Deravi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Jiang G, Wang Y, Wang L, Chen M, Li W. The mediating effect of depression on new-onset stroke in diabetic population: Evidence from the China health and retirement longitudinal study. J Affect Disord 2023; 321:208-216. [PMID: 36349648 DOI: 10.1016/j.jad.2022.10.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 09/13/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Diabetes has a high incidence in China, which may cause stroke and depression. However, the relationship between diabetes and the incidence of new-onset stroke and depression has not been fully studied. METHODS The data from the China Longitudinal Study on Health and Retirement (CHARLS) from 2013 to 2018 were used. A total of 8530 respondents aged ≥45 years old were included in the follow-up study. Logistic regression model, Cox regression, and Mediation analyses were used to explore the association between diabetes, depression, and new-onset stroke. RESULTS The depression score of patients with diabetes history was higher (HR,95%CI = 1.02, 1.01-1.04) and were more likely to experience new-onset stroke events (HR, 95%CI = 1.046, 1.02-1.07). With a history of hypertension (HR,95%CI = 1.747, 1.381-2.208), older (HR,95%CI = 1.033, 1.020-1.046) with high BMI (HR,95%CI = 1.056, 1.027-1.086) have a high risk of new-onset stroke. In the combined subgroup analysis, the incidence of new-onset stroke in the subgroup with diabetes depression was higher than in others. The mediating effect of depression on new-onset stroke events in diabetic patients is more pronounced in the medium to long term (>3 years) after adjusting covariates. LIMITATIONS We defined new-onset stroke by patient self-report, there might be some memory bias. In addition, new-onset stroke was not classified in the CHARLS questionnaire, which would hinder us to evaluate the mediating effect of depression on different types of new-onset stroke. CONCLUSION Our results showed that depression has a partial mediating effect between diabetes and new-onset stroke in the middle-aged and elderly population in China.
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Affiliation(s)
- Gege Jiang
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science &Technology, Wuhan, China
| | - Yaoling Wang
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science &Technology, Wuhan, China
| | - Liping Wang
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science &Technology, Wuhan, China
| | - Minfang Chen
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science &Technology, Wuhan, China
| | - Wei Li
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science &Technology, Wuhan, China.
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Shi Y, Zhou W. Interactive Effects of Dietary Inflammatory Index with BMI for the Risk of Stroke among Adults in the United States: Insight from NHANES 2011-2018. J Nutr Health Aging 2023; 27:277-284. [PMID: 37170435 DOI: 10.1007/s12603-023-1904-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND AND AIM Research on the correlation between Dietary Inflammation Index (DII) and stroke is limited. Patients with high body mass index (BMI), as a high-risk group for stroke, require attention. Therefore, we aimed to examine the interactive effects of dietary inflammation and BMI on the risk of stroke among adults in the United States. METHODS AND RESULTS Overall, 9,384 participants were included in this study. The exposure variable was the DII, which was calculated based on the overall inflammatory effect score, and the outcome was stroke. Overall, there was a positive relationship between DII (as a continuous variable) and stroke. Increased level of DII was significantly associated with increased risk of stroke (odds ratio [OR]: 1.21, 95% CI: 1.06-1.38), which was enhanced by higher BMI (OR: 1.35, 95% CI: 1.15-1.58) with significant additive interactions. There was a significant secondary interaction of copresence of BMI ≥25 kg/m2, systolic blood pressure (SBP) ≥140 mmHg, and high DII for increased stroke, with a further increase in OR to 1.41 (1.19-1.67). CONCLUSIONS This cross-sectional study shows that the relationship between higher DII levels and the significant increase in stroke prevalence was further amplified in patients with SBP ≥140 mmHg and higher BMI.
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Affiliation(s)
- Y Shi
- Wei Zhou, MPH, Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China.No. 1 Minde Road, Nanchang of Jiangxi, 330006, China,
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Zhang Y, Yang S, Chen J, Zhang Z, He P, Zhou C, Liu M, Ye Z, Wu Q, Li H, Zhang Y, Liu C, Qin X. Associations of serum cystatin C and its change with new-onset cardiovascular disease in Chinese general population. Nutr Metab Cardiovasc Dis 2022; 32:1963-1971. [PMID: 35738955 DOI: 10.1016/j.numecd.2022.05.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 03/08/2022] [Accepted: 05/20/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND AIMS The relation of serum cystatin C with new-onset cardiovascular disease (CVD) remains uncertain. We aimed to evaluate the prospective associations of serum cystatin C and its change with new-onset CVD in Chinese general population. METHODS AND RESULTS A total of 7064 participants free of CVD at baseline were enrolled from the China Health and Retirement Longitudinal Study. The change in serum cystatin C was calculated as cystatin C concentration at 2015 wave minus that at baseline (2011 wave). The primary outcome was new-onset CVD, defined as self-reported physician-diagnosed heart disease, stroke, or both during follow-up. The secondary outcomes were new-onset heart disease, and new-onset stroke. During a median follow-up duration of 7.0 years, a total of 1116 (15.8%) subjects developed new-onset CVD. Overall, after the adjustments for eGFR and other important covariates, there was a positive association between serum cystatin C and new-onset CVD (per SD mg/L increment; adjusted HR, 1.13; 95%CI: 1.08,1.18). When cystatin C was assessed as quintiles, the adjusted HRs for participants in the second, third, fourth and fifth quintiles were 1.15 (95%CI: 0.93, 1.41), 1.37 (95%CI: 1.11, 1.68), 1.47 (95%CI: 1.19, 1.81), and 2.03 (95%CI: 1.60, 2.56), respectively, compared with those in quintile 1 (P for trend<0.001). Furthermore, there was a positive association between the increase in cystatin C concentration and the subsequent new-onset CVD (per SD mg/L increment; adjusted HR, 1.14; 95%CI: 1.02,1.27). CONCLUSION Both serum cystatin C and its increase were positively associated with new-onset CVD among Chinese general population.
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Affiliation(s)
- Yanjun Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou 510515, China
| | - Sisi Yang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou 510515, China
| | - Jia Chen
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou 510515, China; Department of Nephrology, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen 518035, China
| | - Zhuxian Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou 510515, China
| | - Panpan He
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou 510515, China
| | - Chun Zhou
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou 510515, China
| | - Mengyi Liu
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou 510515, China
| | - Ziliang Ye
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou 510515, China
| | - Qimeng Wu
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou 510515, China
| | - Huan Li
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou 510515, China
| | - Yuanyuan Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou 510515, China
| | - Chengzhang Liu
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou 510515, China; Institute of Biomedicine, Anhui Medical University, Hefei 230032, China
| | - Xianhui Qin
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou 510515, China.
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Cui C, He C, Sun Q, Xu Z, Li Q, Yue S, Liu J, Wang L, Wang H. Association between visceral adiposity index and incident stroke: Data from the China Health and Retirement Longitudinal Study. Nutr Metab Cardiovasc Dis 2022; 32:1202-1209. [PMID: 35260305 DOI: 10.1016/j.numecd.2022.01.031] [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: 12/04/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND AIMS Visceral adiposity index (VAI), an indicator of visceral fat, is associated with metabolic health and arterial stiffness. However, studies correlating VAI and stroke are limited. This study aimed to explore the association between VAI and incident stroke in the Chinese population. METHODS AND RESULTS We retrospectively analysed the data of 9127 individuals enrolled in the China Health and Retirement Longitudinal Study. The first survey of the study was conducted during 2011-2012 and the individuals were followed up until Survey 4 (2017-2018). Multivariable-adjusted Cox regression models were used to evaluate the association between VAI and stroke. The mean age of the study population was 59.3 ± 9.5 years and 4938 (54.1%) participants were women. During the median follow-up of 5.2 [1.0-7.0] years, 833 (9.1%) participants developed stroke, and the cumulative incidence of stroke increased with increasing quartiles of VAI (8.6%, 8.7%, 9.2%, and 10.0%). Compared to those in the first quartile of VAI, individuals in the fourth quartile had an increased risk of stroke (adjusted hazard ratio, 1.45; 95% CI, 1.15-1.75). The results were stable in several sensitivity analyses. CONCLUSION Our findings suggest a positive association between VAI and incident stroke in the Chinese population.
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Affiliation(s)
- Cancan Cui
- Department of Laboratory Medicine, China-Japan Union Hospital of Jilin University, Jilin University, Jilin, China.
| | - Chengyan He
- Department of Laboratory Medicine, China-Japan Union Hospital of Jilin University, Jilin University, Jilin, China.
| | - Qichao Sun
- Imaging and Nuclear Medicine, China-Japan Union Hospital of Jilin University, Jilin University, Jilin, China.
| | - Zhonghang Xu
- Department of Gastrointestinal Surgery, China-Japan Union Hospital of Jilin University, Jilin University, Jilin, China.
| | - Qianyu Li
- Department of Nephrology, China-Japan Union Hospital of Jilin University, Jilin University, Jilin, China.
| | - Siqi Yue
- Department of Laboratory Medicine, China-Japan Union Hospital of Jilin University, Jilin University, Jilin, China.
| | - Jinhua Liu
- Department of Laboratory Medicine, China-Japan Union Hospital of Jilin University, Jilin University, Jilin, China.
| | - Liqiang Wang
- Endoscopy Center, China-Japan Union Hospital of Jilin University, Jilin University, Jilin, China.
| | - Hai Wang
- Department of Laboratory Medicine, China-Japan Union Hospital of Jilin University, Jilin University, Jilin, China.
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