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Kovács N, Shahin B, Andrade CAS, Mahrouseh N, Varga O. Lifestyle and metabolic risk factors, and diabetes mellitus prevalence in European countries from three waves of the European Health Interview Survey. Sci Rep 2024; 14:11623. [PMID: 38773149 PMCID: PMC11109107 DOI: 10.1038/s41598-024-62122-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 05/14/2024] [Indexed: 05/23/2024] Open
Abstract
Population shift towards healthier lifestyles can help reduce the burden of type 2 diabetes mellitus (DM), therefore understanding and monitoring the lifestyle-related risk factors are crucial for setting up effective preventive strategies and disease management. The present study aimed to explore the changes in prevalence of DM and major risk factors including smoking, physical activity, fruit and vegetable consumption, as well as body mass index (BMI) over three waves of European Health Interview Survey, and to investigate the association between risk factors and presence of DM across 11 European Union member states. Poisson regression models were used to evaluate the association between risk factors and DM, adjusted for demographic and socioeconomic variables. The estimated age-standardized prevalence of DM increased from 7.01% in 2009 to 7.96% in 2019, with substantial increase in subgroups with higher BMI and unhealthy lifestyle including physically inactive people, or current smokers. Obesity and overweight and physical inactivity were significantly associated with DM in all survey waves. Our findings underline that obesity prevention and weight loss promotion along with physical activity promotion are the subject of lifestyle interventions to reduce the burden of DM in EU member states.
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Affiliation(s)
- Nóra Kovács
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Balqees Shahin
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Carlos Alexandre Soares Andrade
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Nour Mahrouseh
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Orsolya Varga
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
- Syreon Research Institute, Budapest, Hungary.
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Luo Y, Liu Z, Luo J, Li R, Wei Z, Yang L, Li J, He L, Su Y, Peng X, Hu X. BMI Trajectories in Late Middle Age, Genetic Risk, and Incident Diabetes in Older Adults: Evidence From a 26-Year Longitudinal Study. Am J Epidemiol 2024; 193:685-694. [PMID: 37016424 DOI: 10.1093/aje/kwad080] [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] [Received: 01/27/2022] [Revised: 11/16/2022] [Accepted: 04/02/2023] [Indexed: 04/06/2023] Open
Abstract
This study investigated the association between body mass index (BMI) trajectories in late middle age and incident diabetes in later years. A total of 11,441 participants aged 50-60 years from the Health and Retirement Study with at least 2 self-reported BMI records were included. Individual BMI trajectories representing average BMI changes per year were generated using multilevel modeling. Adjusted risk ratios (ARRs) and 95% confidence intervals (95% CIs) were calculated. Associations between BMI trajectories and diabetes risk in participants with different genetic risks were estimated for 5,720 participants of European ancestry. BMI trajectories were significantly associated with diabetes risk in older age (slowly increasing vs. stable: ARR = 1.31, 95% CI: 1.12, 1.54; rapidly increasing vs. stable: ARR = 1.5, 95% CI: 1.25, 1.79). This association was strongest for normal-initial-BMI participants (slowly increasing: ARR = 1.34, 95% CI: 0.96, 1.88; rapidly increasing: ARR = 2.06, 95% CI: 1.37, 3.11). Participants with a higher genetic liability to diabetes and a rapidly increasing BMI trajectory had the highest risk for diabetes (ARR = 2.15, 95% CI: 1.67, 2.76). These findings confirmed that BMI is the leading risk factor for diabetes and that although the normal BMI group has the lowest incidence rate for diabetes, people with normal BMI are most sensitive to changes in BMI.
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Kowall B, Girschik C, Stolpe S. Inconsistencies in self-reported diabetes in a large panel study: the Survey of Health, Ageing and Retirement in Europe (SHARE). BMC Med Res Methodol 2024; 24:7. [PMID: 38212700 PMCID: PMC10782784 DOI: 10.1186/s12874-023-02137-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/22/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND The validity of self-reported chronic conditions has been assessed by comparing them with medical records or register data in several studies. However, the reliability of self-reports of chronic diseases has less often been examined. Our aim was to assess the proportion and determinants of inconsistent self-reports of diabetes in a long panel study. METHODS SHARE (Survey of Health, Ageing and Retirement in Europe) includes 140,000 persons aged ≥ 50 years from 28 European countries and Israel. We used data from waves 1 to 7 (except wave 3) collected between 2004 and 2017. Diabetes was assessed by self-report. An inconsistent report for diabetes was defined as reporting the condition in one wave, but denying it in at least one later wave. The analysis data set included 13,179 persons who reported diabetes, and answered the question about diabetes in at least one later wave. Log-binomial regression models were fitted to estimate crude and adjusted relative risks (RR) with 95% confidence intervals (CI) for the associations between various exposure variables and inconsistent report of diabetes. RESULTS The proportion of persons with inconsistent self-reports of diabetes was 33.0% (95% CI: 32.2%-33.8%). Inconsistencies occurred less often in persons taking antidiabetic drugs (RR = 0.53 (0.53-0.56)), persons with BMI ≥ 35 kg/m2 versus BMI < 25 kg/m2 (RR = 0.70, (0.64-0.77)), and poor versus excellent subjective health (RR = 0.87 (0.75-1.01)). Inconsistencies occurred more often in older persons (RR = 1.15 (1.12-1.18) per 10 years increase of age), and persons not reporting their age at diabetes onset (RR = 1.38 (1.31-1.45)). CONCLUSION In SHARE, inconsistent self-report of diabetes is frequent. Consistent reports are more likely for persons whose characteristics make diabetes more salient, like intake of antidiabetic medication, obesity, and poor subjective health. However, lack of attention in answering the questions, and poor wording of the items may also play a role.
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Affiliation(s)
- Bernd Kowall
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany.
| | - Carolin Girschik
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany
| | - Susanne Stolpe
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany
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Sacramento-Pacheco J, Sánchez-Gómez MB, Gómez-Salgado J, Novo-Muñoz MM, Duarte-Clíments G. Prevalence of Cardiovascular Risk Factors in Spain: A Systematic Review. J Clin Med 2023; 12:6944. [PMID: 37959409 PMCID: PMC10650307 DOI: 10.3390/jcm12216944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 10/30/2023] [Accepted: 11/03/2023] [Indexed: 11/15/2023] Open
Abstract
Cardiovascular diseases are the leading cause of death in Spain, according to data from the National Institute of Statistics, with the lack of control of cardiovascular risk factors (CVRF) being the main contributing factor. The CVRFs of greatest clinical interest are high blood pressure (HBP), smoking, diabetes mellitus (DM2), overweight, obesity, hypercholesterolaemia, and sedentary lifestyle. The main objective of this review was to compare the prevalence of the different CVRFs according to population-based studies carried out in Spain. For this, a systematic review based on publications assessing CVRFs in the adult population and estimating their national prevalence was conducted. Pubmed and Dialnet databases were consulted, and the selected articles were analysed using the Critical Appraisal Skills Programme Español (CASPe) tool for cohort studies and the Berra et al. tool for cross-sectional studies. A total of 33 studies were obtained from the autonomous regions of Andalusia, the Canary Islands, Castilla-Leon, Castilla-La Mancha, Catalonia, Extremadura, the Balearic Islands, Madrid, Murcia, and Navarra. In all the population-based studies, there was a greater representation of women in the sample. The most prevalent CVRFs differed across the studies according to the autonomous region targeted, with dyslipidaemia, sedentary lifestyle, high blood pressure, hypercholesterolaemia, overweight, and obesity standing out. Numerous differences exist between the studies included in this review, such as the age range, the CVRFs analysed and their prevalence, and remarkable aspects such as the over-representation of the female sex in all cases. It can be concluded that, based on the presented results, the prevalence of CVRFs in Spain varies according to the autonomous region, the sex of the individual, and the studied age range.
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Affiliation(s)
- Jennifer Sacramento-Pacheco
- Nuestra Señora de Candelaria Nursing University School, University of La Laguna, 38010 San Cristóbal de La Laguna, Spain
- Europa Sur Educational Centre (CESUR Tenerife), 38006 Santa Cruz de Tenerife, Spain
| | - María Begoña Sánchez-Gómez
- Cátedra de Enfermería, Universidad de La Laguna, 38200 San Cristóbal de La Laguna, Spain
- Cieza Este Health Centre, Area IX, Servicio Murciano de Salud, 30530 Murcia, Spain
| | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, 21071 Huelva, Spain
- Safety and Health Postgraduate Program, Universidad Espíritu Santo, Guayaquil 092301, Ecuador
| | - María Mercedes Novo-Muñoz
- Department of Nursing, Faculty of Health Sciences, University of La Laguna, 38200 San Cristóbal de La Laguna, Spain
| | - Gonzalo Duarte-Clíments
- Cátedra de Enfermería, Universidad de La Laguna, 38200 San Cristóbal de La Laguna, Spain
- Case Management, Area IX, Servicio Murciano de Salud, 30530 Murcia, Spain
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Hassen HY, Abrams S, Musinguzi G, Rogers I, Dusabimana A, Mphekgwana PM, Bastiaens H. Disparities in the non-laboratory INTERHEART risk score and its components in selected countries of Europe and sub-Saharan Africa: analysis from the SPICES multi-country project. EUROPEAN HEART JOURNAL OPEN 2023; 3:oead131. [PMID: 38130418 PMCID: PMC10733186 DOI: 10.1093/ehjopen/oead131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/27/2023] [Accepted: 11/13/2023] [Indexed: 12/23/2023]
Abstract
Aims Accurate prediction of a person's risk of cardiovascular disease (CVD) is vital to initiate appropriate intervention. The non-laboratory INTERHEART risk score (NL-IHRS) is among the tools to estimate future risk of CVD. However, measurement disparities of the tool across contexts are not well documented. Thus, we investigated variation in NL-IHRS and components in selected sub-Saharan African and European countries. Methods and results We used data from a multi-country study involving 9309 participants, i.e. 4941 in Europe, 3371 in South Africa, and 997 in Uganda. Disparities in total NL-IHRS score, specific subcomponents, subcategories, and their contribution to the total score were investigated. The variation in the adjusted total and component scores was compared across contexts using analysis of variance. The adjusted mean NL-IHRS was higher in South Africa (10.2) and Europe (10.0) compared to Uganda (8.2), and the difference was statistically significant (P < 0.001). The prevalence and per cent contribution of diabetes mellitus and high blood pressure were lowest in Uganda. Score contribution of non-modifiable factors was lower in Uganda and South Africa, entailing 11.5% and 8.0% of the total score, respectively. Contribution of behavioural factors to the total score was highest in both sub-Saharan African countries. In particular, adjusted scores related to unhealthy dietary patterns were highest in South Africa (3.21) compared to Uganda (1.66) and Europe (1.09). Whereas, contribution of metabolic factors was highest in Europe (30.6%) compared with Uganda (20.8%) and South Africa (22.6%). Conclusion The total risk score, subcomponents, categories, and their contribution to total score greatly vary across contexts, which could be due to disparities in risk burden and/or self-reporting bias in resource-limited settings. Therefore, primary preventive initiatives should identify risk factor burden across contexts and intervention activities need to be customized accordingly. Furthermore, contextualizing the risk assessment tool and evaluating its usefulness in different settings are recommended.
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Affiliation(s)
- Hamid Y Hassen
- Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Doornstraat 331, Wilrijk 2610, Belgium
| | - Steven Abrams
- Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Doornstraat 331, Wilrijk 2610, Belgium
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Data Science Institute, Hasselt University, Diepenbeek 3590, Belgium
| | - Geofrey Musinguzi
- Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Doornstraat 331, Wilrijk 2610, Belgium
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University, Kampala, Uganda
| | - Imogen Rogers
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | - Alfred Dusabimana
- Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Doornstraat 331, Wilrijk 2610, Belgium
| | - Peter M Mphekgwana
- Research Administration and Development, University of Limpopo, Polokwane 0700, South Africa
| | - Hilde Bastiaens
- Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Doornstraat 331, Wilrijk 2610, Belgium
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Pelgrims I, Devleesschauwer B, Vandevijvere S, De Clercq EM, Vansteelandt S, Gorasso V, Van der Heyden J. Using random-forest multiple imputation to address bias of self-reported anthropometric measures, hypertension and hypercholesterolemia in the Belgian health interview survey. BMC Med Res Methodol 2023; 23:69. [PMID: 36966305 PMCID: PMC10040120 DOI: 10.1186/s12874-023-01892-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 03/16/2023] [Indexed: 03/27/2023] Open
Abstract
BACKGROUND In many countries, the prevalence of non-communicable diseases risk factors is commonly assessed through self-reported information from health interview surveys. It has been shown, however, that self-reported instead of objective data lead to an underestimation of the prevalence of obesity, hypertension and hypercholesterolemia. This study aimed to assess the agreement between self-reported and measured height, weight, hypertension and hypercholesterolemia and to identify an adequate approach for valid measurement error correction. METHODS Nine thousand four hundred thirty-nine participants of the 2018 Belgian health interview survey (BHIS) older than 18 years, of which 1184 participated in the 2018 Belgian health examination survey (BELHES), were included in the analysis. Regression calibration was compared with multiple imputation by chained equations based on parametric and non-parametric techniques. RESULTS This study confirmed the underestimation of risk factor prevalence based on self-reported data. With both regression calibration and multiple imputation, adjusted estimation of these variables in the BHIS allowed to generate national prevalence estimates that were closer to their BELHES clinical counterparts. For overweight, obesity and hypertension, all methods provided smaller standard errors than those obtained with clinical data. However, for hypercholesterolemia, for which the regression model's accuracy was poor, multiple imputation was the only approach which provided smaller standard errors than those based on clinical data. CONCLUSIONS The random-forest multiple imputation proves to be the method of choice to correct the bias related to self-reported data in the BHIS. This method is particularly useful to enable improved secondary analysis of self-reported data by using information included in the BELHES. Whenever feasible, combined information from HIS and objective measurements should be used in risk factor monitoring.
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Affiliation(s)
- Ingrid Pelgrims
- Service Risk and Health Impact Assessment, Sciensano, Rue Juliette Wytsman 14, 1050, Brussels, Belgium.
- Applied Mathematics, Computer Science and Statistics, Ghent University, Krijgslaan 281, S9, BE-9000, Ghent, Belgium.
- Department of Epidemiology and Public Health, Sciensano, Rue Juliette Wytsman 14, 1050, Brussels, Belgium.
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Rue Juliette Wytsman 14, 1050, Brussels, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Ghent University, Salisburylaan 133, Hoogbouw, B-9820, Merelbeke, Belgium
| | - Stefanie Vandevijvere
- Department of Epidemiology and Public Health, Sciensano, Rue Juliette Wytsman 14, 1050, Brussels, Belgium
| | - Eva M De Clercq
- Service Risk and Health Impact Assessment, Sciensano, Rue Juliette Wytsman 14, 1050, Brussels, Belgium
| | - Stijn Vansteelandt
- Applied Mathematics, Computer Science and Statistics, Ghent University, Krijgslaan 281, S9, BE-9000, Ghent, Belgium
| | - Vanessa Gorasso
- Department of Epidemiology and Public Health, Sciensano, Rue Juliette Wytsman 14, 1050, Brussels, Belgium
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Johan Van der Heyden
- Department of Epidemiology and Public Health, Sciensano, Rue Juliette Wytsman 14, 1050, Brussels, Belgium
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Llamas-Saez C, Saez-Vaquero T, Jiménez-García R, López-de-Andrés A, Carabantes-Alarcón D, Zamorano-León JJ, Cuadrado-Corrales N, Pérez-Farinos N, Wärnberg J. Cross Sectional and Case-Control Study to Assess Time Trend, Gender Differences and Factors Associated with Physical Activity among Adults with Diabetes: Analysis of the European Health Interview Surveys for Spain (2014 & 2020). J Clin Med 2023; 12:jcm12062443. [PMID: 36983443 PMCID: PMC10057052 DOI: 10.3390/jcm12062443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/16/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
(1) Background: We aim to assess the time trend from 2014 to 2020 in the prevalence of physical activity (PA), identify gender differences and sociodemographic and health-related factors associated with PA among people with diabetes, and compare PA between people with and without diabetes. (2) Methods: We conducted a cross-sectional and a case-control study using as data source the European Health Interview Surveys for Spain (EHISS) conducted in years 2014 and 2020. The presence of diabetes and PA were self-reported. Covariates included socio-demographic characteristics, health-related variables, and lifestyles. To compare people with and without diabetes, we matched individuals by age and sex. (3) Results: The number of participants aged ≥18 years with self-reported diabetes were 1852 and 1889 in the EHISS2014 and EHISS2020, respectively. The proportion of people with diabetes that had a medium or high frequency of PA improved from 48.3% in 2014 to 52.6% in 2020 (p = 0.009), with 68.5% in 2014 and 77.7% in 2020 being engaged in two or more days of PA (p < 0.001). Males with diabetes reported more PA than females with diabetes in both surveys. After matching by age and gender, participants with diabetes showed significantly lower engagement in PA than those without diabetes. Among adults with diabetes, multivariable logistic regression showed confirmation that PA improved significantly from 2014 to 2020 and that male sex, higher educational level, and better self-rated health were variables associated to more PA. However, self-reported comorbidities, smoking, or BMI > 30 were associated to less PA. (4) Conclusions: The time trend of PA among Spanish adults with diabetes is favorable but insufficient. The prevalence of PA in this diabetes population is low and does not reach the levels of the general population. Gender differences were found with significantly more PA among males with diabetes. Our result could help to improve the design and implementation of public health strategies to improve PA among people with diabetes.
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Affiliation(s)
- Carlos Llamas-Saez
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
| | | | - Rodrigo Jiménez-García
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
| | - Ana López-de-Andrés
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
| | - David Carabantes-Alarcón
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
| | - José J Zamorano-León
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
| | - Natividad Cuadrado-Corrales
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
| | - Napoleón Pérez-Farinos
- Epi-PHAAN Research Group, School of Medicine, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), 29071 Málaga, Spain
| | - Julia Wärnberg
- Epi-PHAAN Research Group, School of Health Sciences, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), 29071 Málaga, Spain
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Psychotic-like experiences are associated with physical disorders in general population: A cross-sectional study from the NESARC II. J Psychosom Res 2023; 165:111128. [PMID: 36608509 DOI: 10.1016/j.jpsychores.2022.111128] [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: 09/16/2022] [Revised: 12/04/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Psychotic-like experiences (PLEs) constitute subthreshold symptoms of psychotic disorders, and belong to five distinct dimensions: Positive, Negative, Depressive, Mania and Disorganization. PLEs are associated with various psychiatric disorders. However, few studies examined their association with physical disorders. OBJECTIVE Our aims were (1) to assess the associations between various physical disorders and PLEs in a U.S. representative sample, and (2) to examine these associations according to the five dimensions of PLEs. METHOD We used data from the wave II (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-II), a large national sample representative of the US population (N = 34,653). Participants were assessed with the Alcohol Use Disorder and Associated Disabilities Interview Schedule 4. Twenty-two PLEs were examined. Lifetime prevalence and adjusted Odds-Ratio (aOR) reflecting the association of sixteen physical disorders (including notably metabolic conditions and heart diseases) with PLEs were calculated. RESULTS All studied physical disorders were associated with the presence of PLEs. Particularly the presence of any physical condition, any heart disease and diabetes were more frequent in participants with at least one PLE compared with the group without any PLE (aOR = 1.74, 95% CI = 1.62-1.87, aOR = 1.44, 95% CI = 1.33-1.55 and aOR = 1.38, 95% CI = 1.24-1.54, respectively). Almost all physical disorders were associated with the five dimensions of PLEs. CONCLUSIONS PLEs were associated with a large range of physical disorders, with a gradual dose effect. To assess PLEs in the general population could help with the screening of subjects with physical disorders.
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Jiménez-García R, López-de-Andrés A, de Miguel-Diez J, Zamorano-León JJ, Carabantes-Alarcón D, Noriega C, Cuadrado-Corrales N, Pérez-Farinos N. Time Trends and Sex Differences in the Association between Diabetes and Chronic Neck Pain, Chronic Low Back Pain, and Migraine. Analysis of Population-Based National Surveys in Spain (2014-2020). J Clin Med 2022; 11:jcm11236953. [PMID: 36498528 PMCID: PMC9739053 DOI: 10.3390/jcm11236953] [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: 10/12/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 11/29/2022] Open
Abstract
(1) Background: To assess the time trend in the prevalence of chronic neck pain (CNP), chronic low back pain (CLBP), and migraine or frequent headache (MFH) among people with diabetes in Spain from 2014 to 2020, this study identified sex differences and compared the prevalence of these pain sites between people with diabetes and age−sex-matched non-diabetic subjects. (2) Methods: The study design included a cross-sectional and a case−control study. The data were obtained from the European Health Interview Surveys for Spain conducted in 2014 and 2020. The presence of diabetes, CNP, CLBP, and MFH was self-reported. Study covariates included sociodemographic characteristics, comorbidities, lifestyles, and pain-related variables. (3) Results: Among people with diabetes, the prevalence of CNP, CLBP, and MFH did not improve from 2014 to 2020. Women with diabetes had a significantly higher prevalence of all the pain sites analyzed than men with diabetes. After matching by sex and age, the prevalence of CNP (26.0% vs. 21.1%; p < 0.001), CLBP (31.2% vs. 25.0%; p < 0.001), and MFH (7.7% vs. 6.5%; p = 0.028) was higher for people with diabetes than for those without diabetes. Self-reported mental disease was independently associated with reporting the three pain sites analyzed in people with diabetes. (4) Conclusions: The prevalence of CNP, CLBP, and MFH has remained stable over time. Remarkable sex differences were found, with a higher prevalence among women than men with diabetes. Diabetes was associated with reporting in all the pain sites analyzed. Self-reported mental disease was associated with reporting CNP, CLBP, and MFH.
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Affiliation(s)
- Rodrigo Jiménez-García
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
| | - Ana López-de-Andrés
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
- Correspondence: ; Tel.: +34-913-941-520
| | - Javier de Miguel-Diez
- Respiratory Care Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, 28007 Madrid, Spain
| | - José J. Zamorano-León
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
| | - David Carabantes-Alarcón
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
| | - Concepción Noriega
- Department of Nursery and Physiotherapy, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain
| | - Natividad Cuadrado-Corrales
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
| | - Napoleón Pérez-Farinos
- Public Health and Psychiatry Department, Faculty of Medicine, Universidad de Málaga, 29016 Málaga, Spain
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Almeida VRD, Ostolin TLVDP, Gonze BDB, de Almeida FR, Romiti M, Arantes RL, Dourado VZ. Early flattening of the oxygen pulse during the cardiopulmonary exercise test in asymptomatic adults and its association with cardiovascular risk factors. Int J Cardiol 2022; 367:65-73. [PMID: 35944764 DOI: 10.1016/j.ijcard.2022.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 07/06/2022] [Accepted: 08/04/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Individuals with cardiovascular exercise limitations present oxygen pulse morphology with early flattening (plateau) during the cardiopulmonary exercise test (CPET). Although this oxygen pulse response is well known in cardiac patients, these changes' prevalence and clinical relevance in asymptomatic individuals are not known. We aimed to quantify the proportion of asymptomatic adults with an early flattening of the oxygen pulse and investigate its association with classical cardiovascular risk factors. METHODS We carried out a cross-sectional study with a sample of 824 adults aged between 18 and 80 years. We assessed anthropometry, body composition, and cardiovascular risk. In addition, we obtained cardiorespiratory and metabolic responses during a ramp protocol treadmill CPET. RESULTS The prevalence of early flattening of the oxygen pulse was 36.8%. These participants were predominantly females, older, less educated, with a higher body mass and percentage of fat and a lower percentage of lean body mass. After a multinominal multiple logistic regression analysis, we identified female sex (odds ratio, 5.46: 95% confidence interval, 3.73-7.99), low education (2.24: 1.47-3.42), dyslipidemia (1.67: 1.14-2.45), smoking (1.64: 1.00-2.69), and physical inactivity (1.39: 1.02-1.96) as the leading independent predictors of the early flattening of oxygen pulse. CONCLUSION The early flattening of oxygen pulse is common in asymptomatic adults and is highly determined by modifiable cardiovascular risk factors. These results suggest that identifying the early flattening of oxygen pulse may be helpful in the prevention of cardiovascular diseases.
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Affiliation(s)
- Vitor Rossi de Almeida
- Department of Human Movement Sciences, Federal University of São Paulo (UNIFESP), Santos, São Paulo, Brazil
| | | | - Bárbara de Barros Gonze
- Department of Human Movement Sciences, Federal University of São Paulo (UNIFESP), Santos, São Paulo, Brazil
| | - Flávio Rossi de Almeida
- Department of Human Movement Sciences, Federal University of São Paulo (UNIFESP), Santos, São Paulo, Brazil
| | - Marcello Romiti
- Angiocorpore Institute of Cardiovascular Medicine, Santos, São Paulo, Brazil.
| | | | - Victor Zuniga Dourado
- Department of Human Movement Sciences, Federal University of São Paulo (UNIFESP), Santos, São Paulo, Brazil; Lown Scholars Program-Harvard T.H. Chan School of Public Health, Boston, MA, United States of America.
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11
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Singh SK, Sharma SK, Mohanty SK, Mishra R, Porwal A, Kishan Gulati B. Inconsistency in prevalence of hypertension based on self-reports and use of standard tests: Implications for large scale surveys. SSM Popul Health 2022; 19:101255. [PMID: 36217312 PMCID: PMC9547289 DOI: 10.1016/j.ssmph.2022.101255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 08/30/2022] [Accepted: 10/02/2022] [Indexed: 11/16/2022] Open
Abstract
Objective Biomarkers are increasingly integrated into population-based surveys to provide reliable estimates of the prevalence of specific diseases. The Demographic and Health Surveys have recently incorporated blood pressure measurements; however, little is known about the extent of agreement between measured and reported levels of hypertension in India. The objective of this study was to examine the extent of agreement between self-reported hypertension and the results of standard blood pressure measurements, as well as to explore the risk groups and factors associated with inconsistencies in self-reported and biomedically measured hypertension. Methods Reliability measures such as sensitivity, specificity, and kappa statistics were used to examine inconsistencies in self-reported and biomedically measured hypertension in the National Family Health Survey-4 data. Multilevel logistic models were adopted to analyse the respondent characteristics related to both false-positive and false-negative responses in the survey. Results Compared to biomedically measured hypertension, self-reported hypertension was inconsistent and disproportionate at disaggregated levels in India. While self-reports severely underestimated hypertension among men aged 15-54 years and women aged 35-49 years, it overestimated hypertension among women below the age of 35 years. The inconsistency in self-reported and biomedically examined hypertension had deviations from a sex standpoint. Women aged <35 years reported a false-positive prevalence of hypertension. False-negative responses were elucidated among women aged ≥35 years and men aged 15-54 years. The likelihood of false-positive responses was higher among pregnant and obese respondents, and those who consumed alcohol. Conclusion The significant deviance of self-reporting of hypertension from the prevalence derived based on standard tests further indicates the need for adopting standard tests in all emerging future large-scale surveys. A back-check survey is recommended to understand and differentiate the excessive false-positive reporting of hypertension among women aged 15-35 years.
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Affiliation(s)
- Shri Kant Singh
- Department of Survey Research & Data Analytics, International Institute for Population Sciences, Mumbai, India
| | - Santosh Kumar Sharma
- International Institute for Population Sciences, Mumbai, India,Corresponding author.
| | - Sanjay K. Mohanty
- Department of Population & Development, International Institute for Population Sciences, Mumbai, India
| | | | | | - Bal Kishan Gulati
- National Institute of Medical Statistics, Indian Council of Medical Research, India
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12
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Socioeconomic Inequalities in the Prevalence of Diabetes in Argentina: A Repeated Cross-Sectional Study in Urban Women and Men. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19158888. [PMID: 35897259 PMCID: PMC9331888 DOI: 10.3390/ijerph19158888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/23/2022] [Accepted: 06/28/2022] [Indexed: 02/04/2023]
Abstract
This study measured the socioeconomic inequalities in the prevalence of diabetes between 2005 and 2018 in an urban Argentinian population. Data were obtained from the repeated cross-sectional surveys “National Survey of Risk Factors” (ENFR is its acronym in Spanish). From 2005 to 2018, four rounds of ENFR were administered to men and women over 18 years of age. Concentration curves (CC) and the Erreygers concentration index (ECI) were used to describe the socioeconomic inequalities in diabetes’ prevalence. A decomposition analysis was performed to determine the contribution of each variable to inequality in diabetes’ prevalence. Data from 41,219 (2005), 34,583 (2009), 32,232 (2013), and 29,094 (2018) individuals were analyzed. Women reported a greater prevalence of diabetes compared with men for all the years included. According to the CC and ECI, we found no evidence of inequality in men throughout all study years. For women, throughout all years, the CCs were above the line of equity, and the ECIs during all the years were negative and different from zero (p < 0.01). For women, we found no evidence of a reduction in inequalities between 2005 and 2018 (p = 0.475). The socioeconomic inequality for women was largely driven by public insurance, primary and secondary education, and employment. Diabetes’ prevalence was not associated with socioeconomic status in men, while the prevalence of diabetes in women was more concentrated among poorer women. During the 13 years, there was no evidence of a reduction of inequality in women, noting that interventions must prioritize and should focus on the main contribution of inequalities, such as education and employment.
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13
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Bhatia M, Dixit P, Kumar M, Dwivedi LK. Validity of self-reported hypertension in India: Evidence from nationally representative survey of adult population over 45 years. J Clin Hypertens (Greenwich) 2022; 24:1506-1515. [PMID: 35809220 PMCID: PMC9659862 DOI: 10.1111/jch.14542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 12/03/2022]
Abstract
Self‐reported measures of health, in the context of developed countries, are well‐researched and commonly regarded as reliable predictors of the underlying health of the population. However, the validity of these measures is under‐researched and questionable in the context of low‐ and middle‐income countries. The authors used Longitudinal Ageing Study in India (LASI) survey data from India to compare self‐reported hypertension with biometrically‐measured hypertension. The results are reported in terms of sensitivity, specificity, and kappa as a measure of agreement. Logistic regression was undertaken to examine the characteristics of those who were unaware of their hypertensive status. Our analysis showed a low sensitivity of 56% and a high specificity of 90.5%. Agreement between self‐reported data and biometric measurement of hypertension was observed to be moderate (κ = 0.48). Large variations were observed among states and sub‐groups. The odds of false negative reporting of hypertension were lower in the individuals with higher age, high education, and greater wealth status. The authors conclude that self‐reported hypertension has important limitations and may be a source of systematic bias. It is recommended that planning and policy‐making in India be based more on an objective assessment of hypertension.
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Affiliation(s)
- Mrigesh Bhatia
- Dept. of Health Policy, London School of Economics, London, UK
| | - Priyanka Dixit
- School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai, India
| | - Manish Kumar
- International Institute for Population Sciences, Mumbai, India
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14
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Comparing self-reported and measured hypertension and hypercholesterolaemia at standard and more stringent diagnostic thresholds: the cross-sectional 2010-2015 Busselton Healthy Ageing study. Clin Hypertens 2022; 28:16. [PMID: 35642010 PMCID: PMC9158272 DOI: 10.1186/s40885-022-00199-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 02/07/2022] [Indexed: 11/25/2022] Open
Abstract
Background Population health behaviour and risk factor surveys most often rely on self-report but there is a lack of studies assessing the validity of self-report using Australian data. This study investigates the sensitivity, specificity and agreement of self-reported hypertension and hypercholesterolaemia with objective measures at standard and more stringent diagnostic thresholds; and factors associated with sensitivity and specificity of self-report at different thresholds. Methods This study was a secondary analysis of a representative community-based cross-sectional sample of 5,092 adults, aged 45–69 years, residing in Busselton, Western Australia, surveyed in 2010–2015. Participants completed a self-administered questionnaire. Blood pressure and serum cholesterol levels were measured. Results At currently accepted diagnostic thresholds, sensitivities of self-reported hypertension and hypercholesterolaemia were 58.5% and 39.6%, respectively and specificities were >90% for both. Agreement using Cohen’s kappa coefficient was 0.562 and 0.223, respectively. At two higher diagnostic thresholds, sensitivities of self-reported hypertension and hypercholesterolaemia improved by an absolute 14–23% and 15–25%, respectively and specificities remained >85%. Agreement was substantial for hypertension (kappa = 0.682–0.717) and moderate for hypercholesterolaemia (kappa = 0.458–0.533). Variables that were independently associated with higher sensitivity and lower specificity of self-report were largely consistent across thresholds and included increasing age, body mass index, worse self-rated health, diabetes and family history of hypertension. Conclusions Self-reported hypertension and hypercholesterolaemia often misclassify individuals’ objective status and underestimate objective prevalences, at standard diagnostic thresholds, which has implications for surveillance studies that rely on self-reported data. Self-reports of hypertension, however, may be reasonable indicators of those with blood pressures ≥160/100 mmHg or those taking anti-hypertensive medications. Self-reported hypercholesterolaemia data should be used with caution at all thresholds.
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15
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Nmezi NA, Turkson-Ocran RA, Tucker CM, Commodore-Mensah Y. The Associations between Depression, Acculturation, and Cardiovascular Health among African Immigrants in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6658. [PMID: 35682247 PMCID: PMC9180644 DOI: 10.3390/ijerph19116658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 02/02/2023]
Abstract
Cardiovascular disease (CVD) is the leading cause of death both globally and in the United States (U.S.). Racial health disparities in cardiovascular health (CVH) persist with non-Hispanic Black adults having a higher burden of CVD morbidity and mortality compared to other racial groups. African immigrants represent an increasingly growing sub-population of the overall U.S. non-Hispanic Black adult population, however little is known about how specific psychological and social factors (i.e., depression and acculturation) influence the CVH of U.S. African immigrants. We sought to examine the association between severity of depression symptomology and CVH among African immigrants, and whether acculturation moderated the relationship between severity of depression symptoms and CVH. Study participants were those in the African Immigrant Health Study conducted in the Baltimore-Washington D.C. area. Severity of depression symptoms were assessed using the Patient Health Questionnaire-8 (PHQ-8). CVH was assessed using the American Heart Association Life's Simple 7 metrics and categorized as poor, intermediate, and ideal CVH. Acculturation measured as length of stay and acculturation strategy was examined as a moderator variable. Multivariable logistic regression was used to examine the association between depression and CVH and the moderating effect of acculturation adjusting for known confounders. In total 317 African immigrants participated in the study. The mean (±SD) age of study participants was 46.9 (±11.1) and a majority (60%) identified as female. Overall, 8.8% of study participants endorsed moderate-to-severe symptoms of depression. African immigrants endorsing moderate-to-severe levels of depression were less likely to have ideal CVH compared to those with minimal-to-mild symptoms of depression (Adjusted Odds Ratio [AOR]: 0.42, 95% CI: 0.17-0.99). Acculturation measured either as length of stay or acculturation strategy did not moderate the relationship between depression and CVH among study participants. Study participants exhibited elevated levels of symptoms of depression. Greater severity of depression symptoms was associated with worse CVH. Efforts to treat and prevent CVD among African immigrants should also include a focus on addressing symptoms of depression within this population.
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Affiliation(s)
- Nwakaego A. Nmezi
- Division of Rehabilitation Psychology and Neuropsychology, Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Ruth-Alma Turkson-Ocran
- Section for Research, Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA;
| | - Carolyn M. Tucker
- Department of Psychology, University of Florida, Gainesville, FL 32611, USA;
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16
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Moradpour F, Piri N, Dehghanbanadaki H, Moradi G, Fotouk-Kiai M, Moradi Y. Socio-demographic correlates of diabetes self-reporting validity: a study on the adult Kurdish population. BMC Endocr Disord 2022; 22:139. [PMID: 35619088 PMCID: PMC9134577 DOI: 10.1186/s12902-022-01056-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 05/24/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND In this research, data of the DehPCS study were used to assess the validity of self-reported diabetes based on the reference criteria, including the history of taking oral anti-diabetic drugs, insulin injection, or high fasting blood sugar. METHODS A cross-sectional analytical study was performed on 4400 participants of the DehPCS study, aged 35-70 years. The reference criteria were oral hypoglycemic drug consumption, insulin injection, and/ or fasting blood sugar ≥126 (mg/dl). The self-reporting diabetes was investigated by well-trained interviewers before the diabetes diagnosis based on the reference criteria. The validity of self-reporting diabetes was assessed using sensitivity, specificity, as well as positive and negative predictive values. Socio-demographic correlates of self-reported agreement were examined by multinomial logistic regression. RESULTS Three thousand nine hundred ninety-six people participated in this study, and the participation rate was equal to 90.8%. The diabetes prevalence among the study population was 13.1% based on self-reports and 9.7% based on the reference criteria. Five hundred twenty-three participants reported diabetes, 213 (41.28%) of whom did not have it. We found a good agreement of 92.3% with an acceptable kappa value of 65.1% between self-reporting diabetes and the reference criteria. Diabetes self-reporting also guaranteed sensitivity of 78.5%, specificity of 93.9%, as well as the positive and negative predictive values of 58.7% and of 98.0%, respectively. Being female, the higher economic class, the higher body mass index (BMI), and the positive family history of diabetes increased the chance of false positive. Being male, older ages and the moderate economic class increased the chance of false positive. CONCLUSION Self-reporting diabetes is identified as a relatively valid tool which could fairly determine the diabetes prevalence in epidemiological studies. It should be noted that its validity is influenced by some socio-demographic characteristics.
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Affiliation(s)
- Farhad Moradpour
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Negar Piri
- Health Network of Dehgolan, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Hojat Dehghanbanadaki
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ghobad Moradi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Department of Epidemiology and Biostatistics, Faculty of Medicine, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mahdiyeh Fotouk-Kiai
- Endocrinology & Metabolism, Department of Internal Medicine, School of Medicine, Tohid Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Yousef Moradi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Department of Epidemiology and Biostatistics, Faculty of Medicine, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
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Maeda D, Matsue Y, Kagiyama N, Jujo K, Saito K, Kamiya K, Saito H, Ogasahara Y, Maekawa E, Konishi M, Kitai T, Iwata K, Wada H, Hiki M, Dotare T, Sunayama T, Kasai T, Nagamatsu H, Ozawa T, Izawa K, Yamamoto S, Aizawa N, Yonezawa R, Oka K, Momomura SI, Minamino T. Inaccurate recognition of own comorbidities is associated with poor prognosis in elderly patients with heart failure. ESC Heart Fail 2022; 9:1351-1359. [PMID: 35088546 PMCID: PMC8934983 DOI: 10.1002/ehf2.13824] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 11/30/2021] [Accepted: 01/14/2022] [Indexed: 12/29/2022] Open
Abstract
Aims A patient's understanding of his or her own comorbidities is part of the recommended patient education for those with heart failure. The accuracy of patients' understanding of their comorbidities and its prognostic impact have not been reported. Methods and results Patients hospitalized for heart failure (n = 1234) aged ≥65 years (mean age: 80.1 ± 7.7 years; 531 females) completed a questionnaire regarding their diagnoses of diabetes, malignancy, stroke, hypertension, chronic obstructive pulmonary disease (COPD), and coronary artery disease (CAD). The patients were categorized into three groups based on the number of agreements between self‐reported comorbidities and provider‐reported comorbidities: low (1–2, n = 19); fair (3–4, n = 376); and high (5–6, n = 839) agreement groups. The primary outcome was a composite of all‐cause mortality or heart failure rehospitalization at 1 year. The low agreement group had more comorbidities and a higher prevalence of a history of heart failure. The agreement was good for diabetes (κ = 0.73), moderate for malignancy (κ = 0.56) and stroke (κ = 0.50), and poor‐to‐fair for hypertension (κ = 0.33), COPD (κ = 0.25), and CAD (κ = 0.30). The fair and low agreement groups had poorer outcomes than the good agreement group [fair agreement group: hazard ratio (HR): 1.25; 95% confidence interval (CI): 1.01–1.56; P = 0.041; low agreement group: HR: 2.74: 95% CI: 1.40–5.35; P = 0.003]. Conclusions The ability to recognize their own comorbidities among older patients with heart failure was low. Patients with less accurate recognition of their comorbidities may be at higher risk for a composite of all‐cause mortality or heart failure rehospitalization.
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Affiliation(s)
- Daichi Maeda
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.,Department of Cardiology, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Yuya Matsue
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.,Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Nobuyuki Kagiyama
- Department of Cardiology, The Sakakibara Heart Institute of Okayama, Okayama, Japan.,Department of Digital Health and Telemedicine R&D, Juntendo University, Tokyo, Japan.,Department of Cardiovascular Biology and Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Kentaro Jujo
- Department of Cardiology, Nishiarai Heart Center Hospital, Tokyo, Japan
| | - Kazuya Saito
- Department of Rehabilitation, The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - Kentaro Kamiya
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
| | - Hiroshi Saito
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.,Department of Rehabilitation, Kameda Medical Center, Kamogawa, Japan
| | - Yuki Ogasahara
- Department of Nursing, The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - Emi Maekawa
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Masaaki Konishi
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Takeshi Kitai
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.,Department of Rehabilitation, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Kentaro Iwata
- Department of Rehabilitation, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Hiroshi Wada
- Department of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Masaru Hiki
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Taishi Dotare
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Tsutomu Sunayama
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Takatoshi Kasai
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.,Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hirofumi Nagamatsu
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Tetsuya Ozawa
- Department of Rehabilitation, Odawara Municipal Hospital, Odawara, Japan
| | - Katsuya Izawa
- Department of Rehabilitation, Kasukabe Chuo General Hospital, Kasukabe, Japan
| | - Shuhei Yamamoto
- Department of Rehabilitation, Shinshu University Hospital, Matsumoto, Japan
| | - Naoki Aizawa
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus, Okinawa, Japan
| | - Ryusuke Yonezawa
- Rehabilitation Center, Kitasato University Medical Center, Kitamoto, Japan
| | - Kazuhiro Oka
- Department of Rehabilitation, Saitama Citizens Medical Center, Saitama, Japan
| | | | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.,Japan Agency for Medical Research and Development-Core Research for Evolutionary Medical Science and Technology (AMED-CREST), Japan Agency for Medical Research and Development, Tokyo, Japan
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Mohajer B, Kwee RM, Guermazi A, Berenbaum F, Wan M, Zhen G, Cao X, Haugen IK, Demehri S. Metabolic Syndrome and Osteoarthritis Distribution in the Hand Joints: A Propensity Score Matching Analysis From the Osteoarthritis Initiative. J Rheumatol 2021; 48:1608-1615. [PMID: 34329188 DOI: 10.3899/jrheum.210189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To investigate the metabolic syndrome (MetS) association with radiographic and symptomatic hand osteoarthritis (HOA). METHODS Using 1:2 propensity score matching for relevant confounders, we included 2509 participants (896 MetS positive and 1613 MetS negative) from the Osteoarthritis Initiative dataset. MetS and its components, according to the International Diabetes Federation criteria, were extracted from baseline data, and included hypertension, abdominal obesity, dyslipidemia, and diabetes. We scored distinct hand joints based on the modified Kellgren-Lawrence (mKL) grade of baseline radiographs, with HOA defined as mKL ≥ 2. In the cross-sectional analysis, we investigated the association between MetS and its components with radiographic HOA and the presence of nodal and erosive HOA phenotypes using regression models. In the longitudinal analysis, we performed Cox regression analysis for hand pain incidence in follow-up visits. RESULTS MetS was associated with higher odds of radiographic HOA, including the number of joints with OA (OR 1.32, 95% CI 1.08-1.62), the sum of joints mKLs (OR 2.42, 95% CI 1.24-4.71), mainly in distal interphalangeal joints (DIPs) and proximal interphalangeal joints (PIPs; OR 1.52, 95% CI 1.08-2.14 and OR 1.38, 95% CI 1.09-1.75, respectively), but not metacarpophalangeal (MCP) and first carpometacarpal (CMC1) joints. Hand pain incidence during follow-up was higher with MetS presence (HR 1.25, 95% CI 1.07-1.47). The erosive HOA phenotype and joints' nodal involvement were more frequent with MetS (OR 1.40, 95% CI 1.01-1.97 and OR 1.28, 95% CI 1.02-1.60, respectively). CONCLUSION MetS, a potentially modifiable risk factor, is associated with radiographic DIP and PIP OA and longitudinal hand pain incidence while sparing MCPs and CMC1s. Nodal and erosive HOA phenotypes are associated with MetS, suggestive of possible distinct pathophysiology.
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Affiliation(s)
- Bahram Mohajer
- This research was supported by the National Institutes of Health (NIH) National Institute on Aging under award number P01AG066603. The Osteoarthritis Initiative (OAI), a collaborative project between public and private sectors, includes 5 contracts: N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262. The OAI is conducted by the OAI project investigators and is financially supported by the National Institutes of Health (NIH). Private funding partners are Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer Inc. In preparing this manuscript, publicly available OAI project datasets were used. The results of this work do not necessarily reflect the opinions of the OAI project investigators, the NIH, or the private funding partners. B. Mohajer, MD, MPH, S. Demehri, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; R.M. Kwee, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, and Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard/ Geleen, the Netherlands; A. Guermazi, MD, PhD, Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA; F. Berenbaum, MD, PhD, Department of Rheumatology, Sorbonne Université, INSERM CRSA, AP-HP Hospital Saint Antoine, Paris, France; M. Wan, PhD, G. Zhen, MD, X. Cao, PhD, Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. AG has received funding from MerckSerono, AstraZeneca, Galapagos, Pfizer, Roche, TissueGene ( for consultation), and Boston Imaging Core Lab (as the president and stockholder). SD has received funding from Toshiba Medical Systems ( for consultation) and grants from the GE Radiology Research Academic Fellowship and Carestream Health ( for a clinical trial study). IH has received funding from the Southeastern Norway Health Authority. None of the authors have any conflicting personal or financial relationships that could have influenced the results of this study. The other authors have no competing interests to declare. Address correspondence to Dr. B. Mohajer, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, MD 21287, USA. . Accepted for publication June 2, 2021
| | - Robert M Kwee
- This research was supported by the National Institutes of Health (NIH) National Institute on Aging under award number P01AG066603. The Osteoarthritis Initiative (OAI), a collaborative project between public and private sectors, includes 5 contracts: N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262. The OAI is conducted by the OAI project investigators and is financially supported by the National Institutes of Health (NIH). Private funding partners are Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer Inc. In preparing this manuscript, publicly available OAI project datasets were used. The results of this work do not necessarily reflect the opinions of the OAI project investigators, the NIH, or the private funding partners. B. Mohajer, MD, MPH, S. Demehri, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; R.M. Kwee, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, and Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard/ Geleen, the Netherlands; A. Guermazi, MD, PhD, Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA; F. Berenbaum, MD, PhD, Department of Rheumatology, Sorbonne Université, INSERM CRSA, AP-HP Hospital Saint Antoine, Paris, France; M. Wan, PhD, G. Zhen, MD, X. Cao, PhD, Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. AG has received funding from MerckSerono, AstraZeneca, Galapagos, Pfizer, Roche, TissueGene ( for consultation), and Boston Imaging Core Lab (as the president and stockholder). SD has received funding from Toshiba Medical Systems ( for consultation) and grants from the GE Radiology Research Academic Fellowship and Carestream Health ( for a clinical trial study). IH has received funding from the Southeastern Norway Health Authority. None of the authors have any conflicting personal or financial relationships that could have influenced the results of this study. The other authors have no competing interests to declare. Address correspondence to Dr. B. Mohajer, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, MD 21287, USA. . Accepted for publication June 2, 2021
| | - Ali Guermazi
- This research was supported by the National Institutes of Health (NIH) National Institute on Aging under award number P01AG066603. The Osteoarthritis Initiative (OAI), a collaborative project between public and private sectors, includes 5 contracts: N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262. The OAI is conducted by the OAI project investigators and is financially supported by the National Institutes of Health (NIH). Private funding partners are Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer Inc. In preparing this manuscript, publicly available OAI project datasets were used. The results of this work do not necessarily reflect the opinions of the OAI project investigators, the NIH, or the private funding partners. B. Mohajer, MD, MPH, S. Demehri, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; R.M. Kwee, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, and Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard/ Geleen, the Netherlands; A. Guermazi, MD, PhD, Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA; F. Berenbaum, MD, PhD, Department of Rheumatology, Sorbonne Université, INSERM CRSA, AP-HP Hospital Saint Antoine, Paris, France; M. Wan, PhD, G. Zhen, MD, X. Cao, PhD, Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. AG has received funding from MerckSerono, AstraZeneca, Galapagos, Pfizer, Roche, TissueGene ( for consultation), and Boston Imaging Core Lab (as the president and stockholder). SD has received funding from Toshiba Medical Systems ( for consultation) and grants from the GE Radiology Research Academic Fellowship and Carestream Health ( for a clinical trial study). IH has received funding from the Southeastern Norway Health Authority. None of the authors have any conflicting personal or financial relationships that could have influenced the results of this study. The other authors have no competing interests to declare. Address correspondence to Dr. B. Mohajer, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, MD 21287, USA. . Accepted for publication June 2, 2021
| | - Francis Berenbaum
- This research was supported by the National Institutes of Health (NIH) National Institute on Aging under award number P01AG066603. The Osteoarthritis Initiative (OAI), a collaborative project between public and private sectors, includes 5 contracts: N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262. The OAI is conducted by the OAI project investigators and is financially supported by the National Institutes of Health (NIH). Private funding partners are Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer Inc. In preparing this manuscript, publicly available OAI project datasets were used. The results of this work do not necessarily reflect the opinions of the OAI project investigators, the NIH, or the private funding partners. B. Mohajer, MD, MPH, S. Demehri, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; R.M. Kwee, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, and Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard/ Geleen, the Netherlands; A. Guermazi, MD, PhD, Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA; F. Berenbaum, MD, PhD, Department of Rheumatology, Sorbonne Université, INSERM CRSA, AP-HP Hospital Saint Antoine, Paris, France; M. Wan, PhD, G. Zhen, MD, X. Cao, PhD, Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. AG has received funding from MerckSerono, AstraZeneca, Galapagos, Pfizer, Roche, TissueGene ( for consultation), and Boston Imaging Core Lab (as the president and stockholder). SD has received funding from Toshiba Medical Systems ( for consultation) and grants from the GE Radiology Research Academic Fellowship and Carestream Health ( for a clinical trial study). IH has received funding from the Southeastern Norway Health Authority. None of the authors have any conflicting personal or financial relationships that could have influenced the results of this study. The other authors have no competing interests to declare. Address correspondence to Dr. B. Mohajer, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, MD 21287, USA. . Accepted for publication June 2, 2021
| | - Mei Wan
- This research was supported by the National Institutes of Health (NIH) National Institute on Aging under award number P01AG066603. The Osteoarthritis Initiative (OAI), a collaborative project between public and private sectors, includes 5 contracts: N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262. The OAI is conducted by the OAI project investigators and is financially supported by the National Institutes of Health (NIH). Private funding partners are Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer Inc. In preparing this manuscript, publicly available OAI project datasets were used. The results of this work do not necessarily reflect the opinions of the OAI project investigators, the NIH, or the private funding partners. B. Mohajer, MD, MPH, S. Demehri, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; R.M. Kwee, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, and Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard/ Geleen, the Netherlands; A. Guermazi, MD, PhD, Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA; F. Berenbaum, MD, PhD, Department of Rheumatology, Sorbonne Université, INSERM CRSA, AP-HP Hospital Saint Antoine, Paris, France; M. Wan, PhD, G. Zhen, MD, X. Cao, PhD, Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. AG has received funding from MerckSerono, AstraZeneca, Galapagos, Pfizer, Roche, TissueGene ( for consultation), and Boston Imaging Core Lab (as the president and stockholder). SD has received funding from Toshiba Medical Systems ( for consultation) and grants from the GE Radiology Research Academic Fellowship and Carestream Health ( for a clinical trial study). IH has received funding from the Southeastern Norway Health Authority. None of the authors have any conflicting personal or financial relationships that could have influenced the results of this study. The other authors have no competing interests to declare. Address correspondence to Dr. B. Mohajer, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, MD 21287, USA. . Accepted for publication June 2, 2021
| | - Gehua Zhen
- This research was supported by the National Institutes of Health (NIH) National Institute on Aging under award number P01AG066603. The Osteoarthritis Initiative (OAI), a collaborative project between public and private sectors, includes 5 contracts: N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262. The OAI is conducted by the OAI project investigators and is financially supported by the National Institutes of Health (NIH). Private funding partners are Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer Inc. In preparing this manuscript, publicly available OAI project datasets were used. The results of this work do not necessarily reflect the opinions of the OAI project investigators, the NIH, or the private funding partners. B. Mohajer, MD, MPH, S. Demehri, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; R.M. Kwee, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, and Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard/ Geleen, the Netherlands; A. Guermazi, MD, PhD, Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA; F. Berenbaum, MD, PhD, Department of Rheumatology, Sorbonne Université, INSERM CRSA, AP-HP Hospital Saint Antoine, Paris, France; M. Wan, PhD, G. Zhen, MD, X. Cao, PhD, Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. AG has received funding from MerckSerono, AstraZeneca, Galapagos, Pfizer, Roche, TissueGene ( for consultation), and Boston Imaging Core Lab (as the president and stockholder). SD has received funding from Toshiba Medical Systems ( for consultation) and grants from the GE Radiology Research Academic Fellowship and Carestream Health ( for a clinical trial study). IH has received funding from the Southeastern Norway Health Authority. None of the authors have any conflicting personal or financial relationships that could have influenced the results of this study. The other authors have no competing interests to declare. Address correspondence to Dr. B. Mohajer, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, MD 21287, USA. . Accepted for publication June 2, 2021
| | - Xu Cao
- This research was supported by the National Institutes of Health (NIH) National Institute on Aging under award number P01AG066603. The Osteoarthritis Initiative (OAI), a collaborative project between public and private sectors, includes 5 contracts: N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262. The OAI is conducted by the OAI project investigators and is financially supported by the National Institutes of Health (NIH). Private funding partners are Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer Inc. In preparing this manuscript, publicly available OAI project datasets were used. The results of this work do not necessarily reflect the opinions of the OAI project investigators, the NIH, or the private funding partners. B. Mohajer, MD, MPH, S. Demehri, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; R.M. Kwee, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, and Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard/ Geleen, the Netherlands; A. Guermazi, MD, PhD, Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA; F. Berenbaum, MD, PhD, Department of Rheumatology, Sorbonne Université, INSERM CRSA, AP-HP Hospital Saint Antoine, Paris, France; M. Wan, PhD, G. Zhen, MD, X. Cao, PhD, Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. AG has received funding from MerckSerono, AstraZeneca, Galapagos, Pfizer, Roche, TissueGene ( for consultation), and Boston Imaging Core Lab (as the president and stockholder). SD has received funding from Toshiba Medical Systems ( for consultation) and grants from the GE Radiology Research Academic Fellowship and Carestream Health ( for a clinical trial study). IH has received funding from the Southeastern Norway Health Authority. None of the authors have any conflicting personal or financial relationships that could have influenced the results of this study. The other authors have no competing interests to declare. Address correspondence to Dr. B. Mohajer, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, MD 21287, USA. . Accepted for publication June 2, 2021
| | - Ida K Haugen
- This research was supported by the National Institutes of Health (NIH) National Institute on Aging under award number P01AG066603. The Osteoarthritis Initiative (OAI), a collaborative project between public and private sectors, includes 5 contracts: N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262. The OAI is conducted by the OAI project investigators and is financially supported by the National Institutes of Health (NIH). Private funding partners are Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer Inc. In preparing this manuscript, publicly available OAI project datasets were used. The results of this work do not necessarily reflect the opinions of the OAI project investigators, the NIH, or the private funding partners. B. Mohajer, MD, MPH, S. Demehri, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; R.M. Kwee, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, and Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard/ Geleen, the Netherlands; A. Guermazi, MD, PhD, Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA; F. Berenbaum, MD, PhD, Department of Rheumatology, Sorbonne Université, INSERM CRSA, AP-HP Hospital Saint Antoine, Paris, France; M. Wan, PhD, G. Zhen, MD, X. Cao, PhD, Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. AG has received funding from MerckSerono, AstraZeneca, Galapagos, Pfizer, Roche, TissueGene ( for consultation), and Boston Imaging Core Lab (as the president and stockholder). SD has received funding from Toshiba Medical Systems ( for consultation) and grants from the GE Radiology Research Academic Fellowship and Carestream Health ( for a clinical trial study). IH has received funding from the Southeastern Norway Health Authority. None of the authors have any conflicting personal or financial relationships that could have influenced the results of this study. The other authors have no competing interests to declare. Address correspondence to Dr. B. Mohajer, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, MD 21287, USA. . Accepted for publication June 2, 2021
| | - Shadpour Demehri
- This research was supported by the National Institutes of Health (NIH) National Institute on Aging under award number P01AG066603. The Osteoarthritis Initiative (OAI), a collaborative project between public and private sectors, includes 5 contracts: N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262. The OAI is conducted by the OAI project investigators and is financially supported by the National Institutes of Health (NIH). Private funding partners are Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer Inc. In preparing this manuscript, publicly available OAI project datasets were used. The results of this work do not necessarily reflect the opinions of the OAI project investigators, the NIH, or the private funding partners. B. Mohajer, MD, MPH, S. Demehri, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; R.M. Kwee, MD, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, and Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard/ Geleen, the Netherlands; A. Guermazi, MD, PhD, Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA; F. Berenbaum, MD, PhD, Department of Rheumatology, Sorbonne Université, INSERM CRSA, AP-HP Hospital Saint Antoine, Paris, France; M. Wan, PhD, G. Zhen, MD, X. Cao, PhD, Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. AG has received funding from MerckSerono, AstraZeneca, Galapagos, Pfizer, Roche, TissueGene ( for consultation), and Boston Imaging Core Lab (as the president and stockholder). SD has received funding from Toshiba Medical Systems ( for consultation) and grants from the GE Radiology Research Academic Fellowship and Carestream Health ( for a clinical trial study). IH has received funding from the Southeastern Norway Health Authority. None of the authors have any conflicting personal or financial relationships that could have influenced the results of this study. The other authors have no competing interests to declare. Address correspondence to Dr. B. Mohajer, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, MD 21287, USA. . Accepted for publication June 2, 2021
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Lopez-Herranz M, Jiménez-García R, Ji Z, de Miguel-Diez J, Carabantes-Alarcon D, Maestre-Miquel C, Zamorano-León JJ, López-de-Andrés A. Mental Health among Spanish Adults with Diabetes: Findings from a Population-Based Case-Controlled Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116088. [PMID: 34200056 PMCID: PMC8200218 DOI: 10.3390/ijerph18116088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/24/2021] [Accepted: 06/03/2021] [Indexed: 12/15/2022]
Abstract
Background: The purpose of this study was to assess and compare the prevalence of self-reported mental disorders, psychological distress, and psychotropic drug consumption among people with diabetes mellitus (DM) and matched non-DM controls. Methods: A case–controlled study using data from the Spanish National Health Interview Survey was conducted in 2017. We identified 2116 DM adults (aged ≥35 years). Non-DM controls were matched 1:1 by age, sex, and province of residence. Results: Prevalence of mental disorders (25.0% vs. 19.2%; p < 0.001), psychological distress (29% vs. 19.5%; p < 0.001), and consumption of psychiatric medications (29.7% vs. 23.5%; p < 0.001) among DM cases were higher than those among matched non-DM controls. The DM patient variables associated with experiencing a mental disorder, psychological distress, and consumption of psychiatric medications were: being a woman, worse self-rated health, and a visit to a psychologist within the last year. Older age (≥80 years) was associated with a lower probability of reporting mental disorders and psychological distress among DM cases. Not practicing physical exercise was significantly associated with experiencing psychological distress. Conclusions: Adults with DM included in our investigation have a significantly higher prevalence of mental disorders, psychological distress, and consumption of psychiatric medications than non-DM controls. It is necessary to implement screening strategies and psychological interventions to improve the mental health of DM patients in Spain, focusing especially on women and those aged 35 to 59 years.
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Affiliation(s)
- Marta Lopez-Herranz
- Nursing Department, Faculty of Nursing, Physiotherapy and Podology, Complutense University of Madrid, 28040 Madrid, Spain;
| | - Rodrigo Jiménez-García
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (D.C.-A.); (J.J.Z.-L.); (A.L.-d.-A.)
- Correspondence:
| | - Zichen Ji
- Respiratory Care Department, Health Research Institute of the Hospital General Universitario Gregorio Marañón (IiSGM), Complutense University of Madrid, 28007 Madrid, Spain; (Z.J.); (J.d.M.-D.)
| | - Javier de Miguel-Diez
- Respiratory Care Department, Health Research Institute of the Hospital General Universitario Gregorio Marañón (IiSGM), Complutense University of Madrid, 28007 Madrid, Spain; (Z.J.); (J.d.M.-D.)
| | - David Carabantes-Alarcon
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (D.C.-A.); (J.J.Z.-L.); (A.L.-d.-A.)
| | - Clara Maestre-Miquel
- School of Health Sciences, University of Castilla–La Mancha, 45600 Talavera de la Reina, Spain;
| | - José J. Zamorano-León
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (D.C.-A.); (J.J.Z.-L.); (A.L.-d.-A.)
| | - Ana López-de-Andrés
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (D.C.-A.); (J.J.Z.-L.); (A.L.-d.-A.)
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20
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Hu T, Jacobs DR, Sinaiko AR, Bazzano LA, Burns TL, Daniels SR, Dwyer T, Hutri-Kähönen N, Juonala M, Murdy KA, Prineas RJ, Raitakari OT, Urbina EM, Venn A, Woo JG, Steinberger J. Childhood BMI and Fasting Glucose and Insulin Predict Adult Type 2 Diabetes: The International Childhood Cardiovascular Cohort (i3C) Consortium. Diabetes Care 2020; 43:2821-2829. [PMID: 32873588 PMCID: PMC7576414 DOI: 10.2337/dc20-0822] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 08/07/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To examine childhood BMI, fasting glucose, and insulin in relation to incident adult type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND METHODS We used data from the International Childhood Cardiovascular Cohort (i3C) Consortium. Data included childhood (age 3-19 years) measurements obtained during the 1970s-1990s; a health questionnaire, including self-report of adult T2DM (occurrence age, medication use) obtained at mean age 40 years; and a medical diagnosis registry (Finland). RESULTS The sample included 6,738 participants. Of these, 436 (6.5%) reported onset of T2DM between ages 20 and 59 (mean 40.8) years, and 86% of them reported use of a confirmed antidiabetic medication. BMI and glucose (age and sex standardized) were associated with incident T2DM after adjustment for cohort, country, sex, race, age, and calendar year of measurement. Increasing levels of childhood BMI and glucose were related to an incrementally increased risk of T2DM beginning at age 30 years, beginning at cut points <95th percentile for BMI and <100 mg/dL for glucose. Insulin was positively associated with adult T2DM after adjustment for BMI and glucose and added to T2DM discrimination. CONCLUSIONS Childhood BMI and glucose are predictors of adult T2DM at levels previously considered to be within the normal range. These easy-to-apply measurements are appealing from a clinical perspective. Fasting insulin has the potential to be an additional predictor.
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Affiliation(s)
- Tian Hu
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Alan R Sinaiko
- Department of Pediatrics, University of Minnesota School of Medicine, Minneapolis, MN
| | - Lydia A Bazzano
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - Trudy L Burns
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA
| | - Stephen R Daniels
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO
| | - Terry Dwyer
- Oxford Martin School, Oxford University, Oxford, U.K
| | - Nina Hutri-Kähönen
- Department of Pediatrics, Tampere University Hospital, and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Markus Juonala
- Department of Internal Medicine, University of Turku, Turku, Finland.,Division of Medicine, Turku University Hospital, Turku, Finland.,Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Kari A Murdy
- Department of Pediatrics, University of Minnesota School of Medicine, Minneapolis, MN
| | - Ronald J Prineas
- Division of Public Health Science, Wake Forest University, Winston-Salem, NC
| | - Olli T Raitakari
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Elaine M Urbina
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Jessica G Woo
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH.,Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Julia Steinberger
- Department of Pediatrics, University of Minnesota School of Medicine, Minneapolis, MN
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21
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Is There an Association between Diabetes and Neck and Back Pain? Results of a Case-Control Study. J Clin Med 2020; 9:jcm9092867. [PMID: 32899769 PMCID: PMC7563531 DOI: 10.3390/jcm9092867] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 08/28/2020] [Accepted: 09/03/2020] [Indexed: 01/02/2023] Open
Abstract
We aimed to assess if subjects with diabetes exhibit higher prevalence of chronic back pain than age-sex-province of residence-matched non-diabetic controls. We also aimed to identify predictors for chronic neck pain (CNP) or chronic low back pain (CLBP) among subjects with diabetes. A case control study was conducted using data obtained from the Spanish National Health Survey 2017. Multivariable conditional and unconditional logistic regression models were constructed. A total of 2095 diabetes sufferers and 2095 non-diabetic matched controls were analyzed. The prevalence of CNP and CLBP was 27.3% and 34.8%, respectively, in diabetes sufferers and 22.1% and 29.0% in non-diabetes controls (both, p < 0.001). After multivariable analysis, the ORs showed significantly higher adjusted risk of CNP (OR 1.34; 95% CI 1.19–1.51) and CLBP (OR 1.19, 95% CI 1.09–1.31) in diabetes cases. Diabetes sufferers with CNP or CLBP showed higher use of pain medication and higher prevalence of migraine/frequent headache than controls. Female sex, worse self-rated health and use of pain medication were predictors for CNP and CLBP in subjects with diabetes. CNP and CLBP are significantly more prevalent in diabetes sufferers than in controls. Current results can help to design better preventive and educational strategies for these highly prevalent and burdensome pains among diabetic patients.
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22
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Narang B, Mirpuri S, Kim SY, Jutagir DR, Gany F. Lurking in plain sight: Hypertension awareness and treatment among New York City taxi/for-hire vehicle drivers. J Clin Hypertens (Greenwich) 2020; 22:962-969. [PMID: 32436644 PMCID: PMC8029946 DOI: 10.1111/jch.13869] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 03/13/2020] [Accepted: 03/27/2020] [Indexed: 11/29/2022]
Abstract
Hypertension is a risk factor for cardiovascular disease, which is the leading cause of death in the United States. Taxi and for-hire vehicle (FHV) drivers, a largely male, immigrant and medically underserved population, are at increased risk of cardiovascular disease, in part due to the nature of their work. This study examined demographic and lifestyle predictors of hypertension diagnosis awareness, objectively measured blood pressure (hypertensive-range vs non-hypertensive-range readings), medication use, and hypertension control. A cross-sectional assessment was conducted with 983 male taxi/FHV drivers who attended health fairs in New York City from 2010 to 2017. Twenty-three percent self-reported a hypertension history and 46% had hypertensive-range BP readings. Approximately, half the drivers lacked health insurance (47%) and a usual care source (46%). Thirty percent did not self-report hypertension and had hypertensive-range BP readings. Medication use was reported by 69% of hypertension-aware drivers, and being older and having health care access (insurance, a usual care source, and seeing a doctor in the past year) was significantly associated with medication use. Hypertension-unaware drivers with hypertensive-range BP readings were less likely to have a usual care source. Over 60% of drivers who were hypertension-aware and on medication had hypertensive-range readings. There is a need for community-based and workplace driver and provider interventions to address BP awareness and management and to provide health care navigation for vulnerable populations such as taxi/FHV vehicle drivers.
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Affiliation(s)
- Bharat Narang
- Immigrant Health and Cancer Disparities ServiceDepartment of Psychiatry and Behavioral SciencesMemorial Sloan Kettering Cancer CenterNew YorkNYUSA
| | - Sheena Mirpuri
- Immigrant Health and Cancer Disparities ServiceDepartment of Psychiatry and Behavioral SciencesMemorial Sloan Kettering Cancer CenterNew YorkNYUSA
| | - Soo Young Kim
- Immigrant Health and Cancer Disparities ServiceDepartment of Psychiatry and Behavioral SciencesMemorial Sloan Kettering Cancer CenterNew YorkNYUSA
| | - Devika R. Jutagir
- Immigrant Health and Cancer Disparities ServiceDepartment of Psychiatry and Behavioral SciencesMemorial Sloan Kettering Cancer CenterNew YorkNYUSA
| | - Francesca Gany
- Immigrant Health and Cancer Disparities ServiceDepartment of Psychiatry and Behavioral SciencesMemorial Sloan Kettering Cancer CenterNew YorkNYUSA
- Department of MedicineDepartment of Public HealthWeill Cornell Medical CollegeNew YorkNYUSA
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23
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Davis CMA, Sentell TL, de Souza Barbosa JF, Ylli A, Curcio CL, Pirkle CM. Meeting Physical Activity Guidelines by Walking in Older Adults From Three Middle-Income Countries: A Cross-Sectional Analysis From the International Mobility in Aging Study. J Aging Phys Act 2020; 28:333-342. [PMID: 31715581 DOI: 10.1123/japa.2018-0463] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 08/06/2019] [Accepted: 08/08/2019] [Indexed: 11/18/2022]
Abstract
Physical activity (PA) among older adults is understudied in middle-income countries. The authors examined the associations of factors across levels of the social ecological model (individual, interpersonal, organizational, and community) with older adults meeting guidelines of 150 min of moderate- to vigorous-intensity PA per week through walking in three middle-income countries: Albania (n = 387), Colombia (n = 404), and Brazil (n = 402). Using 2012 International Mobility in Aging Study data, multivariate logistic regression models identified the following significant associations with meeting PA guidelines through walking (a) individual level: depression (odds ratio [OR] = 0.62, 95% confidence interval, CI [0.45, 0.86]), being female (OR = 0.74, 95% CI [0.56, 0.998]), and high relative education (OR = 1.79, 95% CI [1.33, 2.41]) and (b) interpersonal level: high life partner (OR = 1.38, 95% CI [1.04, 1.83]) and friend social ties (OR = 1.39, 95% CI [1.05, 1.83]). While individual and interpersonal variables were associated with meeting PA guidelines, community-level social and environmental variables were not.
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24
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Wan XZ, Ai C, Chen YH, Gao XX, Zhong RT, Liu B, Chen XH, Zhao C. Physicochemical Characterization of a Polysaccharide from Green Microalga Chlorella pyrenoidosa and Its Hypolipidemic Activity via Gut Microbiota Regulation in Rats. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2020; 68:1186-1197. [PMID: 31855431 DOI: 10.1021/acs.jafc.9b06282] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A bioactive polysaccharide from microalga Chlorella pyrenoidosa (CPP) was successively prepared via DEAE-52 and G-100 columns. Nuclear magnetic resonance analysis showed that the main glycosidic bonds were composed of 1,2-linked-α-l-Fucp, 1,4-linked-α-l-Rhap, 1,4-linked-β-l-Araf, 1-linked-α-d-Glcp, 1,3-linked-β-d-GlcpA, 1,4-linked-β-d-Xylp, and 1,3,6-linked-β-d-Manp. Its molecular weight was 5.63 × 106 Da. The hypolipidemic effect and intestinal flora regulation of CPP on diet-induced rats were evaluated through histopathology and biochemistry analyses. CPP could improve plasma and liver lipid metabolism and accelerate the metabolism of the cecal total bile acids and short-chain fatty acids. CPP has also upregulated the adenosine-monophosphate-activated protein kinase α and downregulated the acetyl-CoA carboxylase, sterol regulatory element-binding protein 1c, and β-hydroxy β-methylglutaryl-CoA expressions. Moreover, with the 16S rRNA gene sequencing, it was revealed that the composition of intestinal flora changed drastically after treatment, such as the bloom of Coprococcus_1, Lactobacillus, and Turicibacter, whereas there was a strong reduction of the [Ruminococcus]_gauvreauii_group. The above results illustrated that CPP might be served as an effective ingredient to ameliorate lipid metabolism disorders and intestinal flora in hyperlipidemia rats.
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Affiliation(s)
- Xu-Zhi Wan
- College of Food Science , Fujian Agriculture and Forestry University , Fuzhou , Fujian 350002 , People's Republic of China
| | - Chao Ai
- School of Food Science and Engineering , South China University of Technology , Guangzhou , Guangdong 510641 , People's Republic of China
| | - Yi-Han Chen
- College of Food Science , Fujian Agriculture and Forestry University , Fuzhou , Fujian 350002 , People's Republic of China
| | - Xiao-Xiang Gao
- College of Food Science , Fujian Agriculture and Forestry University , Fuzhou , Fujian 350002 , People's Republic of China
| | - Ru-Ting Zhong
- College of Food Science , Fujian Agriculture and Forestry University , Fuzhou , Fujian 350002 , People's Republic of China
| | - Bin Liu
- College of Food Science , Fujian Agriculture and Forestry University , Fuzhou , Fujian 350002 , People's Republic of China
- Engineering Research Centre of Fujian-Taiwan Special Marine Food Processing and Nutrition , Ministry of Education , Fuzhou , Fujian 350002 , People's Republic of China
| | - Xin-Hua Chen
- Key Laboratory of Marine Biotechnology of Fujian Province, Institute of Oceanology , Fujian Agriculture and Forestry University , Fuzhou , Fujian 350002 , People's Republic of China
| | - Chao Zhao
- College of Food Science , Fujian Agriculture and Forestry University , Fuzhou , Fujian 350002 , People's Republic of China
- Engineering Research Centre of Fujian-Taiwan Special Marine Food Processing and Nutrition , Ministry of Education , Fuzhou , Fujian 350002 , People's Republic of China
- Key Laboratory of Marine Biotechnology of Fujian Province, Institute of Oceanology , Fujian Agriculture and Forestry University , Fuzhou , Fujian 350002 , People's Republic of China
- Institute of Chinese Medical Sciences, State Key Laboratory of Quality Research in Chinese Medicine , University of Macau , Taipa , Macau 999078 , People's Republic of China
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25
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Montero E, La Rosa M, Montanya E, Calle‐Pascual AL, Genco RJ, Sanz M, Herrera D. Validation of self‐reported measures of periodontitis in a Spanish Population. J Periodontal Res 2019; 55:400-409. [DOI: 10.1111/jre.12724] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 10/29/2019] [Accepted: 11/25/2019] [Indexed: 01/21/2023]
Affiliation(s)
- Eduardo Montero
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group University Complutense Madrid Spain
| | - Martina La Rosa
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group University Complutense Madrid Spain
| | - Eduard Montanya
- Bellvitge Hospital‐IDIBELL Barcelona Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM) Barcelona Spain
- Department of Clinical Sciences University of Barcelona Barcelona Spain
| | - Alfonso L. Calle‐Pascual
- Medical School. University Complutense Madrid Spain
- Endocrinology and Nutrition Department Hospital Clínico Universitario San Carlos Madrid Spain
| | | | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group University Complutense Madrid Spain
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group University Complutense Madrid Spain
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26
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Man REK, Gan AHW, Fenwick EK, Gan ATL, Gupta P, Sabanayagam C, Tan N, Wong KH, Wong TY, Cheng CY, Lamoureux EL. Prevalence, determinants and association of unawareness of diabetes, hypertension and hypercholesterolemia with poor disease control in a multi-ethnic Asian population without cardiovascular disease. Popul Health Metr 2019; 17:17. [PMID: 31806040 PMCID: PMC6896313 DOI: 10.1186/s12963-019-0197-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 11/06/2019] [Indexed: 01/08/2023] Open
Abstract
Background To explore the prevalence and determinants of unawareness of diabetes, hypertension and hypercholesterolemia and its association with poor disease control in a multi-ethnic Asian population without cardiovascular disease (CVD). Methods We included 6904 Chinese, Malay and Indian individuals (mean age [SD] 58.2 [10.2] years; 52.6% female) with diabetes, hypertension and/or hypercholesterolemia from the cross-sectional population-based Singapore Epidemiology of Eye Diseases study (2004–2011). Diabetes was defined as random blood glucose ≥ 11.1 mmol/L or HbA1c > 6.5% or self-reported use of diabetes medication; hypertension as systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg or self-reported use of anti-hypertensive treatment; and hypercholesterolemia as total cholesterol ≥ 6.2 mmol/L or self-reported use of lipid-lowering medications. Unawareness was based on participants’ answers to the questions: “Did your medical practitioner ever tell you that you have diabetes/hypertension/high cholesterol?” The determinants of unawareness, and its association with poor disease control, were assessed using multivariable binary logistic regression models adjusted for known potential confounders. Results Of the 2380 (34.5%), 5386 (78.0%) and 3607 (52.2%) with diabetes, hypertension and hypercholesterolemia, respectively, unawareness rates were 30.7%, 43.1% and 40.9%, respectively. Having a higher BMI, particularly if obese, and Malay ethnicity were associated with greater unawareness of diabetes; Malay and Indian ethnicities and current smoking with greater unawareness of hypertension; and education ≤6 years, current smoking, and blue collar jobs or unemployment with greater unawareness of hypercholesterolemia (all P < 0.05). Lack of awareness of each condition was independently associated with poorer disease control in the case of hypertension and hypercholesterolemia, while the converse was true for diabetes (all P < 0.05). Conclusions Unawareness of diabetes, hypertension, or hypercholesterolemia is high in Singapore, with risk factors varying across all three diseases, although Malay ethnicity is a consistent one. Unawareness was also associated with poor management for hypertension and hypercholesterolemia. Public health education and screening programs should target at-risk individuals, especially Malays, to reduce the likelihood of incident CVD.
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Affiliation(s)
- Ryan E K Man
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Rd, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| | - Alvin Hong Wei Gan
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Rd, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore
| | - Eva K Fenwick
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Rd, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| | - Alfred Tau Liang Gan
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Rd, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore
| | - Preeti Gupta
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Rd, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Rd, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| | - Nicholas Tan
- National University of Singapore, Singapore, Singapore
| | - Kah Hie Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Rd, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore.,National University of Singapore, Singapore, Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Rd, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore.,Duke-NUS Medical School, Singapore, Singapore.,Singapore National Eye Centre, Singapore, Singapore.,National University of Singapore, Singapore, Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Rd, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore.,Duke-NUS Medical School, Singapore, Singapore.,Singapore National Eye Centre, Singapore, Singapore.,National University of Singapore, Singapore, Singapore
| | - Ecosse L Lamoureux
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Rd, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore. .,Duke-NUS Medical School, Singapore, Singapore. .,National University of Singapore, Singapore, Singapore.
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27
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Olaya B, Moneta MV, Bobak M, Haro JM, Demakakos P. Cardiovascular risk factors and memory decline in middle-aged and older adults: the English Longitudinal Study of Ageing. BMC Geriatr 2019; 19:337. [PMID: 31791248 PMCID: PMC6889660 DOI: 10.1186/s12877-019-1350-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 11/06/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We investigated the association between trajectories of verbal episodic memory and burden of cardiovascular risk factors in middle-aged and older community-dwellers. METHODS We analysed data from 4372 participants aged 50-64 and 3005 persons aged 65-79 years old from the English Longitudinal Study of Ageing who were repeatedly evaluated every 2 years and had six interviews of a 10-year follow-up. We measured the following baseline risk factors: diabetes, hypertension, smoking, physical inactivity and obesity to derive a cardiovascular risk factor score (CVRFs). Adjusted linear mixed effect regression models were estimated to determine the association between number of CVFRs and six repeated measurements of verbal memory scores, separately for middle-aged and older adults. RESULTS CVRFs was not significantly associated with memory at baseline. CVFRs was significantly associated with memory decline in middle-aged (50-64y), but not in older (65-79y) participants. This association followed a dose-response pattern with increasing number of CVFRs being associated with greater cognitive decline. Comparisons between none versus some CVRFs yielded significant differences (p < 0.05). CONCLUSIONS Our findings confirm that the effect of cumulative CVRFs on subsequent cognitive deterioration is age-dependent. CVRFs are associated with cognitive decline in people aged 50-64 years, but not in those aged ≥65 years. Although modest, the memory decline associated with accumulation of cardiovascular risk factors in midlife may increase the risk of late-life dementia.
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Affiliation(s)
- Beatriz Olaya
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Maria Victoria Moneta
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Spain
| | - Martin Bobak
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Josep Maria Haro
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Panayotes Demakakos
- Department of Epidemiology and Public Health, University College London, London, UK
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28
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Kislaya I, Tolonen H, Rodrigues AP, Barreto M, Gil AP, Gaio V, Namorado S, Santos AJ, Dias CM, Nunes B. Differential self-report error by socioeconomic status in hypertension and hypercholesterolemia: INSEF 2015 study. Eur J Public Health 2019; 29:273-278. [PMID: 30380048 DOI: 10.1093/eurpub/cky228] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND This study aimed to compare self-reported and examination-based prevalence of hypertension and hypercholesterolemia in Portugal in 2015 and to identify factors associated with the measurement error in self-reports. METHODS We used data from the Portuguese National Health Examination Survey (n = 4911), that combines personal interview, blood collection and, physical examination. Sensitivity and specificity of self-reported hypertension and hypercholesterolemia were calculated. Poisson regression was used to estimate prevalence ratios (PRs) of underreport of hypertension and hypercholesterolemia according to sex, age, socioeconomic status (education and income) and general practitioner (GP) consultation in the past year. RESULTS Sensitivity of self-reports was 69.8% for hypertension and 38.2% for hypercholesterolemia. Underreport of hypertension was associated with male gender (PR = 1.54), lack of GP consultation (PR = 1.70) and being 25-44 years old (PR = 2.45) or 45-54 years old (PR = 2.37). Underreport of hypercholesterolemia was associated with lack of GP consultation (PR = 1.15), younger age (PR = 1.83 for 25-44 age group and PR = 1.52 for 45-54 age group), secondary (PR = 1.30) and higher (PR = 1.27) education. CONCLUSION Self-reported data underestimate prevalence of hypertension and hypercholesterolemia. Magnitude of measurement error in self-reports varies by health conditions and population characteristics. Adding objective measurements to self-reported questionnaires improve data accuracy allowing better understanding of socioeconomic inequalities in health.
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Affiliation(s)
- Irina Kislaya
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Lisboa, Portugal.,Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Hanna Tolonen
- Department of Public Health Solutions, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Ana Paula Rodrigues
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Lisboa, Portugal
| | - Marta Barreto
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Lisboa, Portugal.,Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Ana Paula Gil
- Interdisciplinary Centre of Social Sciences (CICS.NOVA) NOVA School of Social Sciences and Humanities, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Vânia Gaio
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Lisboa, Portugal.,Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Sónia Namorado
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Lisboa, Portugal.,Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Ana João Santos
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Lisboa, Portugal
| | - Carlos Matias Dias
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Lisboa, Portugal.,Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Baltazar Nunes
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, IP, Lisboa, Portugal.,Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal
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29
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Höfelmann DA, Gonzalez-Chica DA, Peres KG, Boing AF, Peres MA. Chronic diseases and socioeconomic inequalities in quality of life among Brazilian adults: findings from a population-based study in Southern Brazil. Eur J Public Health 2019; 28:603-610. [PMID: 29294001 DOI: 10.1093/eurpub/ckx224] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background To evaluate the association between sociodemographic conditions and the quality of life (QoL) in adults and investigate whether these inequalities are greater among individuals with long-lasting chronic health conditions. Methods Cross-sectional analysis of the second wave (2012) of the EpiFloripa Study, a population-based cohort of 1720 adults living in Southern Brazil. QoL domains (physical, psychological, social relationships and environmental) were evaluated using the WHOQoL-BREF. Unadjusted and adjusted means of QoL according to socioeconomic and demographic variables were estimated and stratified by the presence of long-lasting chronic conditions (heart disease, stroke, diabetes, hypertension, chronic kidney disease, cirrhosis, tendinitis, arthritis, rheumatism and/or fibromyalgia) were peformed in 2016. Results Among 1222 interviewed adults (56.6% females, mean age 41.7 ± 11.4 years; follow-up rate 71.1%), the prevalence of 1+ long-lasting chronic disease was 37.3% (95%CI: 34.4-40.3). Their effect on the QoL was four times higher on the physical component (-9.6; 95%CI -12.1; -7.1) than on the other domains. Adults aged 40+ years with black skin colour or lower educational level had a lower physical QoL score only when any chronic disease was present. Among those with some chronic illness, the psychological domain was also lower among those aged 40+ years and with a lower family income. No interaction between sociodemographic variables and chronic diseases was observed for the other QoL domains. Conclusions The occurrence of long-lasting chronic diseases is associated with inequalities in QoL (physical and psychological domains), with stronger adverse effects among older adults, blacks and individuals with lower income or educational levels.
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Affiliation(s)
- Doroteia A Höfelmann
- Post-Graduate Program in Public Health, Department of Nutrition, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - David A Gonzalez-Chica
- Discipline of General Practice, Adelaide Medical School, NHMRC Centre of Research Excellence to Reduce Inequality in Heart Disease, The University of Adelaide, Adelaide, SA, Australia
| | - Karen Glazer Peres
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
| | - Antonio Fernando Boing
- Post-Graduate Program in Public Health, Department of Public Health, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Marco Aurelio Peres
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
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30
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Paalanen L, Koponen P, Laatikainen T, Tolonen H. Public health monitoring of hypertension, diabetes and elevated cholesterol: comparison of different data sources. Eur J Public Health 2019; 28:754-765. [PMID: 29462296 DOI: 10.1093/eurpub/cky020] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Three data sources are generally used in monitoring health on the population level. Health interview surveys (HISs) are based on participants' self-report. Health examination surveys (HESs) yield more objective data, and also persons who are unaware of their elevated risks can be detected. Medical records (MRs) and other administrative registers also provide objective data, but their availability, coverage and quality vary between countries. We summarized studies comparing self-reported data with (i) measured data from HESs or (ii) MRs. We aimed to describe differences in feasibility and comparability of different data sources for monitoring (i) elevated blood pressure or hypertension (ii) elevated blood glucose or diabetes and (iii) elevated total cholesterol. Methods We conducted a literature search to identify studies, which validated self-reported measures against objective measures. We found 30 studies published since the year 2000 fulfilling our inclusion criteria (targeted to adults and comparing prevalence among the same persons). Results Hypertension and elevated total cholesterol were prone to be under-estimated in HISs. The under-estimate was more pronounced, when the HIS data were compared with HES data, and lower when compared with MRs. For diabetes, the HISs and the objective methods resulted in fairly similar prevalence rates. Conclusion The three data sources measure different manifestations of the risk factors and cannot be expected to yield similar prevalence rates. Using HIS data only may lead to under-estimation of elevated risk factor levels or disease prevalence. Whenever possible, information from the three data sources should be evaluated and combined.
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Affiliation(s)
- Laura Paalanen
- Department of Public Health Solutions, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Päivikki Koponen
- Department of Public Health Solutions, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Tiina Laatikainen
- Department of Public Health Solutions, National Institute for Health and Welfare (THL), Helsinki, Finland.,Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.,Siun Sote-Joint Municipal Authority for North Karelia Social and Health Services, Joensuu, Finland
| | - Hanna Tolonen
- Department of Public Health Solutions, National Institute for Health and Welfare (THL), Helsinki, Finland
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31
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George C, Ducatman AM, Conway BN. Increased risk of respiratory diseases in adults with Type 1 and Type 2 diabetes. Diabetes Res Clin Pract 2018; 142:46-55. [PMID: 29802957 DOI: 10.1016/j.diabres.2018.05.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 05/09/2018] [Accepted: 05/17/2018] [Indexed: 01/09/2023]
Abstract
AIMS Diabetes is linked with decreases in lung elasticity and in capacity to transfer carbon monoxide. Systemic inflammation, a common concern with diabetes, may contribute to airflow obstruction. We examined the association of self-reported diabetes with self-reported respiratory diseases (RDs) among 53,146 adults from the C8 Health Project. METHODS Participants were categorized into three groups: Type 1 (T1D, n = 781), Type 2 (T2D, n = 4277), or no diabetes (n = 48,088). ORs (95% CIs) for the association of diabetes with four RDs were computed: emphysema, chronic obstructive pulmonary disease (COPD), chronic bronchitis (CB), and asthma. Covariates controlled for were age, sex, estimated glomerular filtration rate, C-reactive protein, smoking history, BMI, and perfluorooctonaoic acid (C8). RESULTS RDs were present in 26%, 21% and 13% of persons with T1D, T2D, and no diabetes, respectively. In multivariable analyses, persons with T1D were 62% more likely to have any RD (OR: 1.62, CI: (1.36-1.93)), while those with T2D were 1.3 times as likely (OR: 1.26, CI: 1.15-1.37)). Compared to those without diabetes, in those with T1D and T2D diabetes respectively, ORs (CIs) for COPD were 1.89 (1.38-2.57), 1.45 (1.23-1.71), asthma: 1.51 (1.21-1.87), 1.38 (1.24-1.53), CB: 1.96 (1.57-2.45), 1.35 (1.20-1.52) and emphysema: 1.25 (0.85-1.82), 1.31 (1.10-1.56). Population attributable risks for any RDs associated with a history of smoking were 19%, 30%, and 26% for those with Type 1, Type 2, and no diabetes respectively. CONCLUSIONS Diabetes, more so in T1D, appears to increase RD risk. Smoking is an important risk factor, but not as informative in Type 1 diabetes.
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Affiliation(s)
- Chelsey George
- Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, United States
| | - Alan M Ducatman
- Department of Occupational and Environmental Health, School of Public Health, West Virginia University, Morgantown, WV, United States
| | - Baqiyyah N Conway
- Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, United States; Department of Epidemiology and Biostatistics, School of Rural and Community Health, University of Texas Health Science Center at Tyler, Tyler, TX, United States.
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Zemedikun DT, Gray LJ, Khunti K, Davies MJ, Dhalwani NN. Patterns of Multimorbidity in Middle-Aged and Older Adults: An Analysis of the UK Biobank Data. Mayo Clin Proc 2018; 93:857-866. [PMID: 29801777 DOI: 10.1016/j.mayocp.2018.02.012] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 02/05/2018] [Accepted: 02/14/2018] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To assess the prevalence, disease clusters, and patterns of multimorbidity using a novel 2-stage approach in middle-aged and older adults from the United Kingdom. PATIENTS AND METHODS Data on 36 chronic conditions from 502,643 participants aged 40 to 69 years with baseline measurements between March 13, 2006, and October 1, 2010, from the UK Biobank were extracted. We combined cluster analysis and association rule mining to assess patterns of multimorbidity overall and by age, sex, and ethnicity. A maximum of 3 clusters and 30 disease patterns were mined. Comparisons were made using lift as the main measure of association. RESULTS Ninety-five thousand seven hundred-ten participants (19%) had 2 or more chronic conditions. The first cluster included only myocardial infarction and angina (lift=13.3), indicating that the likelihood of co-occurrence of these conditions is 13 times higher than in isolation. The second cluster consisted of 26 conditions, including cardiovascular, musculoskeletal, respiratory, and neurodegenerative diseases. The strongest association was found between heart failure and atrial fibrillation (lift=23.6). Diabetes was at the center of this cluster with strong associations with heart failure, chronic kidney disease, liver failure, and stroke (lift>2). The third cluster contained 8 highly prevalent conditions, including cancer, hypertension, asthma, and depression, and the strongest association was observed between anxiety and depression (lift=5.0). CONCLUSION Conditions such as diabetes, hypertension, and asthma are the epicenter of disease clusters for multimorbidity. A more integrative multidisciplinary approach focusing on better management and prevention of these conditions may help prevent other conditions in the clusters.
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Affiliation(s)
- Dawit T Zemedikun
- Health Economics Unit, Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK; Department of Health Sciences, Centre for Medicine, University of Leicester, Leicester, UK
| | - Laura J Gray
- Department of Health Sciences, Centre for Medicine, University of Leicester, Leicester, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - Melanie J Davies
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - Nafeesa N Dhalwani
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK.
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Lopez-de-Andres A, de Miguel-Diez J, Hernandez-Barrera V, Jiménez-Trujillo I, Martinez-Huedo MA, Del Barrio JL, Jimenez-Garcia R. Effect of the economic crisis on the use of health and home care services among elderly Spanish diabetes patients. Diabetes Res Clin Pract 2018; 140:27-35. [PMID: 29601915 DOI: 10.1016/j.diabres.2018.03.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 01/03/2018] [Accepted: 03/20/2018] [Indexed: 11/22/2022]
Abstract
AIMS To describe the utilization of health and home care services among older people (≥65 years) with diabetes during the economic crisis; to identify the factors associated with changes in the utilization of these services; and to study the time trends (2009-2014). METHODS We used the European Health Interview Surveys for Spain (EEHSS) for 2009/10 and 2014. The dependent variables included self-reported hospitalizations; general practitioner (GP) visits; 'other healthcare services' (OHS) used; and home care services (HCS) used. RESULTS We identified 6026 and 6020 diabetic patients (EEHSS2009 and EEHSS2014, respectively). A significant decrease in the number of GP visits (OR 0.94; 95% CI 0.91-0.98) and the use of HCS (OR 0.95; 95% CI 0.91-0.99) was found; however, we found an increase in the use of OHS (OR 1.06; 95% CI 1.02-1.10). Multivariate models showed that factors associated with an increased use included chronic conditions, worse self-rated health, pain and mental disorders. Physical activity was a strong predictor of lower hospitalizations and HCS use. Female gender was associated with significantly lower hospitalizations and a higher use of OHC and HCS. CONCLUSION We found a decrease in the number of GP visits and the use of HCS among elderly diabetic adults; however, we also observed an increase in the use of OHS, which may partly explain this decrease in the figures. Significant differences in the use of health services were found according to gender. The effect of the economic crisis, if any, seems to have had a small magnitude.
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Affiliation(s)
- Ana Lopez-de-Andres
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Comunidad de Madrid, Spain.
| | - Javier de Miguel-Diez
- Pneumology Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Comunidad de Madrid, Spain
| | - Valentin Hernandez-Barrera
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Comunidad de Madrid, Spain
| | - Isabel Jiménez-Trujillo
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Comunidad de Madrid, Spain
| | - Maria-Angeles Martinez-Huedo
- Preventive Medicine and Public Health, Unidad de Docencia, Hospital Universitario La Paz, Madrid, Comunidad de Madrid, Spain
| | - José Luis Del Barrio
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Comunidad de Madrid, Spain
| | - Rodrigo Jimenez-Garcia
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Comunidad de Madrid, Spain
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Gonçalves VSS, Galvão TF, Silva MT, Kuschnir MC, Dutra ES, Carvalho KMB. Accuracy of self-reported hypertension in Brazilian adolescents: Analysis of the Study of Cardiovascular Risk in Adolescents. J Clin Hypertens (Greenwich) 2018; 20:739-747. [PMID: 29462497 PMCID: PMC8031084 DOI: 10.1111/jch.13238] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 12/29/2017] [Accepted: 01/12/2018] [Indexed: 11/28/2022]
Abstract
Given the high prevalence of hypertension in adolescents, it is important to investigate alternatives for estimating the magnitude of the disease. Our objective was to investigate the accuracy of self-reported hypertension. The study assessed participants of the Study of Cardiovascular Risk in Adolescents (ERICA). The following were calculated: sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). The associations between inaccurate self-reporting and socioeconomic factors were investigated. The accuracy of self-reported hypertension had a sensitivity of 7.5% (95% CI, 6.9-8.2), a specificity of 96.6% (95% CI, 96.5-96.7), a PPV of 18.9% (95% CI, 17.4-20.5), and a NPV of 90.8% (95% CI, 90.6-91.0). The prevalence of inaccurate self-reported hypertension was smaller among girls (PR 0.68; 95% CI, 0.55-0.83) and younger boys (PR 0.68; 95% CI, 0.54-0.86) who were attending private schools. The use of self-reported hypertension was not a good strategy for investigating the hypertension in adolescents.
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Ness-Jensen E, Gottlieb-Vedi E, Wahlin K, Lagergren J. All-cause and cancer-specific mortality in GORD in a population-based cohort study (the HUNT study). Gut 2018; 67:209-215. [PMID: 27789657 DOI: 10.1136/gutjnl-2016-312514] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 10/05/2016] [Accepted: 10/09/2016] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Gastro-oesophageal reflux is a public health concern which could have associated oesophageal complications, including adenocarcinoma, and possibly also head-and-neck and lung cancers. The aim of this study was to test the hypothesis that reflux increases all-cause and cancer-specific mortalities in an unselected cohort. DESIGN The Nord-Trøndelag health study (HUNT), a Norwegian population-based cohort study, was used to identify individuals with and without reflux in 1995-1997 and 2006-2008, with follow-up until 2014. All-cause mortality and cancer-specific mortality were assessed from the Norwegian Cause of Death Registry and Cancer Registry. Multivariable Cox regression was used to calculate HRs with 95% CIs for mortality with adjustments for potential confounders. RESULTS We included 4758 participants with severe reflux symptoms and 51 381 participants without reflux symptoms, contributing 60 323 and 747 239 person-years at risk, respectively. Severe reflux was not associated with all-cause mortality, overall cancer-specific mortality or mortality in cancer of the head-and-neck or lung. However, for men with severe reflux a sixfold increase in oesophageal adenocarcinoma-specific mortality was found (HR 6.09, 95% CI 2.33 to 15.93) and the mortality rate was 0.27 per 1000 person-years. For women, the corresponding mortality was not significantly increased (HR 3.68, 95% CI 0.88 to 15.27) and the mortality rate was 0.05 per 1000 person-years. CONCLUSIONS Individuals with severe reflux symptoms do not seem to have increased all-cause mortality or overall cancer-specific mortality. Although the absolute risk is small, individuals with severe reflux symptoms have a clearly increased oesophageal adenocarcinoma-specific mortality.
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Affiliation(s)
- Eivind Ness-Jensen
- Upper Gastrointestinal Surgery, Department of Molecular medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.,HUNT Research Centre, Department of Public Health and General Practice, NTNU, Norwegian University of Science and Technology, Levanger, Norway.,Medical Department, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Eivind Gottlieb-Vedi
- Upper Gastrointestinal Surgery, Department of Molecular medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Karl Wahlin
- Upper Gastrointestinal Surgery, Department of Molecular medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Jesper Lagergren
- Upper Gastrointestinal Surgery, Department of Molecular medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.,Division of Cancer Studies, King's College London, London, UK
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Herath HMM, Weerasinghe NP, Weerarathna TP, Hemantha A, Amarathunga A. Potential use of telephone-based survey for non-communicable disease surveillance in Sri Lanka. BMC Public Health 2017; 17:984. [PMID: 29284464 PMCID: PMC5747075 DOI: 10.1186/s12889-017-4993-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 12/12/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Telephone survey (TS) has been a popular tool for conducting health surveys, particularly in developed countries. However, the feasibility, and reliability of TS are not adequately explored in Sri Lanka. The main aim of this study is to assess the effectiveness of telephone-based survey in estimating the prevalence of common non-communicable diseases (NCDs) in Sri Lanka. METHODS We carried out an observational cross-sectional study using telephone interview method in Galle district, Sri Lanka. The study participants were selected randomly from the residents living in the households with fixed land telephone lines. The prevalence of the main NCDs was estimated using descriptive statistics. RESULTS Overall, 975 telephone numbers belonging to six main areas of Galle district were called, and 48% agreed to participate in the study. Of the non-respondents, 22% actively declined to participate. Data on NCDs were gathered from 1470 individuals. The most common self-reported NCD was hypertension (17.%), followed by diabetes (16.3%) and dyslipidaemia (15.6%). Smoking was exclusively seen in males (7.4%), and regular alcohol use was significantly more common in males (19.2%) than females (0.4%, P < .001). CONCLUSIONS Our study revealed average response rate for telephone based interview in Sri Lankan setting. Overall prevalence of main NCDs in this study showed a comparable prevalence to studies used face to face interview method. This study supports the potential use of telephone-based survey to assess heath related information in Sri Lanka.
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Affiliation(s)
- H M M Herath
- Department of Medicine, Faculty of Medicine, University of Ruhuna, University Unit, Teaching Hospital, Karapitiya, P.O. Box 70, Galle, Sri Lanka.
| | - N P Weerasinghe
- Department of Microbiology, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
| | - T P Weerarathna
- Department of Medicine, Faculty of Medicine, University of Ruhuna, University Unit, Teaching Hospital, Karapitiya, P.O. Box 70, Galle, Sri Lanka
| | - A Hemantha
- Department of Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
| | - A Amarathunga
- Department of Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
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Emotional stability, conscientiousness, and self-reported hypertension in adulthood. PERSONALITY AND INDIVIDUAL DIFFERENCES 2017. [DOI: 10.1016/j.paid.2016.02.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Olaya B, Moneta MV, Caballero FF, Tyrovolas S, Bayes I, Ayuso-Mateos JL, Haro JM. Latent class analysis of multimorbidity patterns and associated outcomes in Spanish older adults: a prospective cohort study. BMC Geriatr 2017; 17:186. [PMID: 28821233 PMCID: PMC5563011 DOI: 10.1186/s12877-017-0586-1] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 08/10/2017] [Indexed: 01/08/2023] Open
Abstract
Background This study sought to identify multimorbidity patterns and determine the association between these latent classes with several outcomes, including health, functioning, disability, quality of life and use of services, at baseline and after 3 years of follow-up. Methods We analyzed data from a representative Spanish cohort of 3541 non-institutionalized people aged 50 years old and over. Measures were taken at baseline and after 3 years of follow-up. Latent Class Analysis (LCA) was conducted using eleven common chronic conditions. Generalized linear models were conducted to determine the adjusted association of multimorbidity latent classes with several outcomes. Results 63.8% of participants were assigned to the “healthy” class, with minimum disease, 30% were classified under the “metabolic/stroke” class and 6% were assigned to the “cardiorespiratory/mental/arthritis” class. Significant cross-sectional associations were found between membership of both multimorbidity classes and poorer memory, quality of life, greater burden and more use of services. After 3 years of follow-up, the “metabolic/stroke” class was a significant predictor of lower levels of verbal fluency while the two multimorbidity classes predicted poor quality of life, problems in independent living, higher risk of hospitalization and greater use of health services. Conclusions Common chronic conditions in older people cluster together in broad categories. These broad clusters are qualitatively distinct and are important predictors of several health and functioning outcomes. Future studies are needed to understand underlying mechanisms and common risk factors for patterns of multimorbidity and to propose more effective treatments. Electronic supplementary material The online version of this article (doi:10.1186/s12877-017-0586-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Beatriz Olaya
- Research, Innovation and Teaching Unit, Institut de Recerca Sant Joan de Déu, Carrer Dr. Antoni Pujadas, 42, Esplugues de Llobregat, 08830, Barcelona, Spain. .,Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain. .,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
| | - Maria Victoria Moneta
- Research, Innovation and Teaching Unit, Institut de Recerca Sant Joan de Déu, Carrer Dr. Antoni Pujadas, 42, Esplugues de Llobregat, 08830, Barcelona, Spain.,Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Francisco Félix Caballero
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.,Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IP), Hospital Universitario de La Princesa, Madrid, Spain
| | - Stefanos Tyrovolas
- Research, Innovation and Teaching Unit, Institut de Recerca Sant Joan de Déu, Carrer Dr. Antoni Pujadas, 42, Esplugues de Llobregat, 08830, Barcelona, Spain.,Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Ivet Bayes
- Research, Innovation and Teaching Unit, Institut de Recerca Sant Joan de Déu, Carrer Dr. Antoni Pujadas, 42, Esplugues de Llobregat, 08830, Barcelona, Spain.,Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - José Luis Ayuso-Mateos
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.,Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IP), Hospital Universitario de La Princesa, Madrid, Spain
| | - Josep Maria Haro
- Research, Innovation and Teaching Unit, Institut de Recerca Sant Joan de Déu, Carrer Dr. Antoni Pujadas, 42, Esplugues de Llobregat, 08830, Barcelona, Spain.,Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
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Dietary polyphenol intake and risk of type 2 diabetes in the Polish arm of the Health, Alcohol and Psychosocial factors in Eastern Europe (HAPIEE) study. Br J Nutr 2017; 118:60-68. [PMID: 28799519 PMCID: PMC5565930 DOI: 10.1017/s0007114517001805] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This study aimed to test the association between dietary content of total and individual
classes of polyphenols and incident cases of type 2 diabetes in Polish adults
participating to the Health, Alcohol and Psychosocial factors In Eastern Europe study. At
baseline, diet by 148-item FFQ and health information were collected from 5806
participants free of diabetes. Self-reported incident type 2 diabetes was ascertained at
2–4-year follow-up visit. OR and 95 % CI of type 2 diabetes comparing the various
categories of polyphenol intake to the lowest one (reference category) and as 1
sd increase modelled as continuous variable were calculated by performing age-,
energy-, and multivariate-adjusted logistic regression models. During the follow-up, 456
incident cases of type 2 diabetes occurred. When comparing extreme quartiles, intake of
total polyphenol was inversely associated with the risk of type 2 diabetes (OR 0·43; 95 %
CI 0·30, 0·61); 1 sd increase was associated with a reduced risk of diabetes (OR
0·68; 95 % CI 0·59, 0·79). Among the main classes of polyphenols, flavonoids, phenolic
acids, and stilbenes were independent contributors to this association. Both subclasses of
phenolic acids were associated with decreased risk of type 2 diabetes, whereas among
subclasses of flavonoids, high intake of flavanols, flavanones, flavones and anthocyanins
was significantly associated with decreased risk of type 2 diabetes. Total dietary
polyphenols and some classes of dietary polyphenols were associated with lower risk of
type 2 diabetes.
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Marushka L, Batal M, David W, Schwartz H, Ing A, Fediuk K, Sharp D, Black A, Tikhonov C, Chan HM. Association between fish consumption, dietary omega-3 fatty acids and persistent organic pollutants intake, and type 2 diabetes in 18 First Nations in Ontario, Canada. ENVIRONMENTAL RESEARCH 2017; 156:725-737. [PMID: 28482294 DOI: 10.1016/j.envres.2017.04.034] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 04/07/2017] [Accepted: 04/08/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND First Nations (FNs) populations in Canada experience a disproportionally higher rate of obesity and type 2 diabetes (T2D) compared to the general population. Recent data suggest that a high consumption of fish may help prevent T2D. On the other hand, fish might also be a potential source of environmental contaminants which could potentially be a risk factor for T2D. OBJECTIVE To investigate the potential associations between self-reported T2D and consumption of locally-harvested fish, dietary long-chain omega-3 fatty acids (n-3FAs) and persistent organic pollutants intake among adult FNs living on reserve in Ontario. DESIGN Data from the First Nations Food Nutrition and Environment Study, which included a cross-sectional study of 1429 Ontario FNs adults living in 18 communities across 4 ecozones in 2012 were analyzed. Social and lifestyle data were collected using household interviews. The consumption of locally-harvested fish was estimated using a traditional food frequency questionnaire along with portion size information obtained from 24hr recalls. Fish samples were analyzed for the presence of contaminants including dichlorodiphenyldichloroethylene (DDE) and polychlorinated biphenyls (PCBs). Dietary intakes of DDE and PCBs were estimated using community-specific levels of DDE/PCBs in fish species. Multiple logistic regression models adjusted for potential covariates including age, gender, body mass index, physical activity, total energy intake, smoking, and education were developed. RESULTS The prevalence of T2D in Ontario FNs was 24.4%. A significant positive association between fish consumption of one portion per week and more and T2D compared to no fish consumption was found (OR=2.5 (95% CI: 1.38-4.58). Dietary DDE and PCBs intake was positively associated with T2D (OR=1.09 (95%CI: 1.05-1.75) for DDE and OR=1.07 (95%CI: 1.004-1.27) for PCBs) per unit increase in DDE/PCBs while n-3-FAs intake, adjusted for DDE/PCBs intake, showed an inverse effect against T2D among older individuals (OR=0.86 (95% CI: 0.46-0.99). CONCLUSION Our results support previous findings that exposure to DDE and PCBs may increase the risk of T2D. Elevated levels of contaminants in fish may counteract with potentially beneficial effects of n-3FAs from fish consumption. However, the overall health benefits of high consumption of fish with a high n-3 FAs content may outweigh the adverse effect of contaminants.
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Affiliation(s)
| | | | | | - Harold Schwartz
- Health Canada, Environmental Public Health Division, First Nations and Inuit Health Branch (FNIHB), Canada
| | - Amy Ing
- Université de Montréal, Canada
| | - Karen Fediuk
- Dietitian and Nutrition Researcher, British Columbia, Canada
| | | | | | - Constantine Tikhonov
- Health Canada, Environmental Public Health Division, First Nations and Inuit Health Branch (FNIHB), Canada
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Wienert J, Kuhlmann T, Fink S, Hambrecht R, Lippke S. Motivational and Volitional Correlates of Physical Activity in Participants Reporting No, Past, and Current Hypertension: Findings from a Cross-Sectional Observation Study. Int J Behav Med 2017; 24:908-914. [DOI: 10.1007/s12529-017-9649-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Keel S, Xie J, Foreman J, van Wijngaarden P, Taylor HR, Dirani M. The Prevalence of Diabetic Retinopathy in Australian Adults with Self-Reported Diabetes: The National Eye Health Survey. Ophthalmology 2017; 124:977-984. [PMID: 28318640 DOI: 10.1016/j.ophtha.2017.02.004] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 02/06/2017] [Accepted: 02/06/2017] [Indexed: 01/06/2023] Open
Abstract
PURPOSE To determine the prevalence of and factors associated with diabetic retinopathy (DR) among non-Indigenous and Indigenous Australian adults with self-reported diabetes. DESIGN Population-based cross-sectional study. PARTICIPANTS Non-Indigenous Australians (50-98 years of age) and Indigenous Australians (40-92 years of age) with known diabetes. METHODS Diabetes was determined based on self-report of previous diagnosis of the disease. Nonmydriatic fundus photographs were obtained of each eye and graded according to the modified Airlie House classification system. MAIN OUTCOME MEASURES Any DR, vision-threatening DR (VTDR), treatment coverage rates (proportion of participants with proliferative DR [PDR], clinically significant macular edema [CSME], or both who had evidence of retinal scatter and focal laser treatment). RESULTS Four hundred thirty-one non-Indigenous Australians (13.9%) and 645 Indigenous Australians (37.1%) self-reported diabetes, of whom 93% (1004/1076) had retinal images that were gradable for DR. The sampling weight-adjusted prevalence of any DR and VTDR among non-Indigenous adults with self-reported diabetes was 28.5% (95% confidence interval [CI], 22.6-35.3) and 4.5% (95% CI, 2.6-7.9), respectively. Among adults 40 years of age and older, the sampling weight-adjusted prevalence of any DR and VTDR was 39.4% (95% CI, 33.1-46.1) and 9.5% (95% CI, 6.8-13.1), respectively. Longer diabetes duration was associated significantly with VTDR in the Indigenous Australian population (odds ratio [OR], 1.08 per 1-year increase; P = 0.005) and non-Indigenous Australian population (OR, 1.05 per 1-year increase; P = 0.03). The treatment coverage of PDR and CSME was 75% (56/75) in Indigenous Australians and 79% (15/19) in non-Indigenous Australians. Diabetic retinopathy was attributed as the main cause of vision loss (<6/12 in the better eye) in 9% and 19% of non-Indigenous and Indigenous Australian adults with known diabetes, respectively. CONCLUSIONS Three quarters of non-Indigenous and Indigenous Australian adults with PDR or CSME have received laser treatment. The prevalence of VTDR in Indigenous and non-Indigenous Australians in the present study was lower than that found in previous population-based reports, nevertheless, approximately 1 in 10 Indigenous adults with known diabetes experience VTDR. This highlights that intensified prevention strategies are required to delay or prevent avoidable vision loss resulting from DR in Indigenous Australian communities.
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Affiliation(s)
- Stuart Keel
- Centre for Eye Research Australia, Royal Victorian Eye & Ear Hospital, Melbourne, Australia.
| | - Jing Xie
- Centre for Eye Research Australia, Royal Victorian Eye & Ear Hospital, Melbourne, Australia
| | - Joshua Foreman
- Centre for Eye Research Australia, Royal Victorian Eye & Ear Hospital, Melbourne, Australia; Department of Ophthalmology, University of Melbourne, Melbourne, Australia
| | - Peter van Wijngaarden
- Centre for Eye Research Australia, Royal Victorian Eye & Ear Hospital, Melbourne, Australia; Department of Ophthalmology, University of Melbourne, Melbourne, Australia
| | - Hugh R Taylor
- Indigenous Eye Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Mohamed Dirani
- Centre for Eye Research Australia, Royal Victorian Eye & Ear Hospital, Melbourne, Australia
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44
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Long J, Cai Q, Steinwandel M, Hargreaves MK, Bordenstein SR, Blot WJ, Zheng W, Shu XO. Association of oral microbiome with type 2 diabetes risk. J Periodontal Res 2017; 52:636-643. [PMID: 28177125 DOI: 10.1111/jre.12432] [Citation(s) in RCA: 117] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND OBJECTIVE The oral microbiome may help to maintain systemic health, including how it affects blood glucose levels; however, direct evidence linking the oral microbiome with diabetes is lacking. MATERIAL AND METHODS We compared the oral microbiome profiles of 98 participants with incident diabetes, 99 obese non-diabetics and 97 normal weight non-diabetics, via deep sequencing of the 16S rRNA gene. RESULTS We found that the phylum Actinobacteria was present significantly less abundant among patients with diabetes than among the controls (p = 3.9 × 10-3 ); the odds ratio (OR) and 95% confidence interval (CI) was 0.27 (0.11-0.66) for those individuals who had relative abundance higher than the median value. Within this phylum, five families and seven genera were observed, and most of them were less abundant among patients with diabetes. Notably, genera Actinomyces and Atopobium were associated with 66% and 72% decreased risk of diabetes with p-values of 8.9 × 10-3 and 7.4 × 10-3 , respectively. Stratified analyses by race showed that most taxa in this phylum were associated with diabetes in both black and white participants. This phylum was also less abundant among non-diabetic obese subjects compared to normal weight individuals, particularly genera Mobiluncus, Corynebacterium and Bifidobacterium, which showed p < 0.05. CONCLUSION Our study revealed that multiple bacteria taxa in the phylum Actinobacteria are associated with the risk of type 2 diabetes. Some are also associated with the prevalence of obesity, suggesting that the oral microbiome may play an important role in diabetes etiology.
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Affiliation(s)
- J Long
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Q Cai
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - M Steinwandel
- International Epidemiology Institute, Rockville, MD, USA
| | - M K Hargreaves
- Department of Internal Medicine, Meharry Medical College, Nashville, TN, USA
| | - S R Bordenstein
- Department of Biological Sciences, Vanderbilt University, Nashville, TN, USA.,Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, TN, USA
| | - W J Blot
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.,International Epidemiology Institute, Rockville, MD, USA
| | - W Zheng
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - X O Shu
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
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45
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Prevalence of Metabolic Syndrome in an Employed Population as Determined by Analysis of Three Data Sources. J Occup Environ Med 2017; 59:161-168. [DOI: 10.1097/jom.0000000000000931] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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46
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Cho HW, Chu C. Evaluation of Self-assessment in Cardiovascular Diseases Among Korean Older Population. Osong Public Health Res Perspect 2016; 7:75-6. [PMID: 27169003 PMCID: PMC4850369 DOI: 10.1016/j.phrp.2016.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Hae-Wol Cho
- Osong Public Health and Research Perspectives, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Chaeshin Chu
- Osong Public Health and Research Perspectives, Korea Centers for Disease Control and Prevention, Cheongju, Korea
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47
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Abstract
Persons of Mexican origin and some other Latino groups in the United States have experienced a survival advantage compared with their non-Latino White counterparts, a pattern known as the Latino, Hispanic, or epidemiological paradox. However, high rates of obesity and diabetes among Latinos relative to Whites and continued increases in the prevalence of these conditions suggest that this advantage may soon disappear. Other phenomena, including high rates of disability in the older Latino population compared with Whites, new evidence of health declines shortly after migration to the United States, increasing environmental stressors for immigrants, and high-risk values of inflammatory markers among Latinos compared with Whites support this prediction. One powerful counterargument, however, is substantially lower smoking-attributable mortality among Latinos. Still, it is questionable as to whether smoking behavior can counteract the many forces at play that may impede Latinos from experiencing future improvements in longevity on a par with Whites.
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Affiliation(s)
- Noreen Goldman
- Office of Population Research, Princeton University, Princeton, NJ, USA
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48
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Krakowiak P, Walker CK, Tancredi DJ, Hertz-Picciotto I. Maternal Recall Versus Medical Records of Metabolic Conditions from the Prenatal Period: A Validation Study. Matern Child Health J 2016; 19:1925-35. [PMID: 25656730 DOI: 10.1007/s10995-015-1723-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
To assess validity of maternally-reported diabetes and hypertensive disorders, and reliability of BMI measurements during periconception and pregnancy compared with medical records when mothers are interviewed 2-5 years after delivery. To investigate whether reporting accuracy differed by child's case status (autism, delays, typical development). Participants were mothers of 2-5 year old children with and without neurodevelopmental disorders from the CHARGE (CHildhood Autism Risks from Genetics and the Environment) Study who had both prenatal/delivery records and telephone interviews. Sensitivity and specificity of self-report in telephone interview was assessed by comparison with medical records; agreement was evaluated by kappa statistics. Deviations in reported BMI were evaluated with Bland-Altman plots and concordance correlation coefficient (CCC). Mothers of children with neurodevelopmental disorders (autism or developmental delay) reported metabolic conditions slightly more accurately than control mothers. For diabetes, sensitivity ranged from 73 to 87% and specificity was ≥98% across groups. For hypertensive disorders, sensitivity ranged from 57 to 77% and specificity from 93 to 98%. Reliability of BMI was high (CCC = 0.930); when grouped into BMI categories, a higher proportion of mothers of delayed children were correctly classified (κ(wt) = 0.93) compared with the autism group and controls (κ(wt) = 0.85 and κ(wt) = 0.84, respectively; P = 0.05). Multiparity was associated with higher discrepancies in BMI and misreporting of hypertensive disorders. For purposes of etiologic studies, self-reported diabetes and hypertensive disorders during periconception and pregnancy show high validity among mothers irrespective of child's case status. Recall of pre-pregnancy BMI is reliable compared with self-reported values in medical records.
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Affiliation(s)
- Paula Krakowiak
- Divisions of Epidemiology and of Environmental and Occupational Health, Department of Public Health Sciences, School of Medicine, University of California, Davis, CA, USA,
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49
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Sheikh MA, Lund E, Braaten T. Test-retest reliability of self-reported diabetes diagnosis in the Norwegian Women and Cancer Study: A population-based longitudinal study (n =33,919). SAGE Open Med 2016; 4:2050312115622857. [PMID: 26835013 PMCID: PMC4724769 DOI: 10.1177/2050312115622857] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 11/17/2015] [Indexed: 12/16/2022] Open
Abstract
Objective: Self-reported information from questionnaires is frequently used in epidemiological studies, but few of these studies provide information on the reproducibility of individual items contained in the questionnaire. We studied the test–retest reliability of self-reported diabetes among 33,919 participants in Norwegian Women and Cancer Study. Methods: The test–retest reliability of self-reported type 1 and type 2 diabetes diagnoses was evaluated between three self-administered questionnaires (completed in 1991, 1998, and 2005 by Norwegian Women and Cancer participants) by kappa agreement. The time interval between the test–retest studies was ~7 and ~14 years. Sensitivity of the kappa agreement for type 1 and type 2 diabetes diagnoses was assessed. Subgroup analysis was performed to assess whether test–retest reliability varies with age, body mass index, physical activity, education, and smoking status. Results: The kappa agreement for both types of self-reported diabetes diagnoses combined was good (⩾0.65) for all three test–retest studies (1991–1998, 1991–2005, and 1998–2005). The kappa agreement for type 1 diabetes was good (⩾0.73) in the 1991–2005 and the 1998–2005 test–retest studies, and very good (0.83) in the 1991–1998 test–retest study. The kappa agreement for type 2 diabetes was moderate (0.57) in the 1991–2005 test–retest study and good (⩾0.66) in the 1991–1998 and 1998–2005 test–retest studies. The overall kappa agreement in the 1991–1998 test–retest study was stronger than in the 1991–2005 test–retest study and the 1998–2005 test–retest study. There was no clear pattern of inconsistency in the kappa agreements within different strata of age, BMI, physical activity, and smoking. The kappa agreement was strongest among the respondents with 17 or more years of education, while generally it was weaker among the least educated group. Conclusion: The test–retest reliability of the diabetes was acceptable and there was no clear pattern of inconsistency in the kappa agreement stratified by age, body mass index, physical activity, and smoking. The study suggests that self-reported diabetes diagnosis from middle-aged women enrolled in the Norwegian Women and Cancer Study is reliable.
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Affiliation(s)
| | - Eiliv Lund
- Department of Community Medicine, University of Tromsø, Tromsø, Norway
| | - Tonje Braaten
- Department of Community Medicine, University of Tromsø, Tromsø, Norway
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50
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Ning M, Zhang Q, Yang M. Comparison of self-reported and biomedical data on hypertension and diabetes: findings from the China Health and Retirement Longitudinal Study (CHARLS). BMJ Open 2016; 6:e009836. [PMID: 26729390 PMCID: PMC4716227 DOI: 10.1136/bmjopen-2015-009836] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES We examined the level of agreement between biomedical and self-reported measurements of hypertension and diabetes in a Chinese national community sample, and explored associations of the agreement and possible contextual effects among provinces and geographic regions in China. DESIGN Secondary analysis of a cohort sample. SETTING AND PARTICIPANTS Community samples were drawn from the national baseline survey of the China Health and Retirement Longitudinal Study (CHARLS, 2011-2012) through multistage probability sampling, which included households with members 45 years of age or above with a total sample size of 17,708 individuals. OUTCOME MEASURES Sensitivity, specificity and κ were used as measurements of agreements or validity; variance of validity measures among provinces and communities was estimated using random-effects models. RESULTS Self-reports for hypertension and diabetes showed high specificity (96.3% and 98.3%, respectively) but low sensitivity (56.3% and 61.5%, respectively). Agreement between self-reported data and biomedical measurements was moderate for both hypertension (κ 0.57) and diabetes (κ 0.65), with respondents who were older, of higher socioeconomic status, better educated and who had hospital admissions in the past 12 months showing stronger agreements than their counterparts. Large and significant variations in the sensitivity among provinces for hypertension, and among communities for both hypertension and diabetes, could neither be attributed to the effects of respondents' characteristics nor to the contextual effects of city-village differences. CONCLUSIONS As a considerable number of people in the overall sample were unaware of their conditions, self-reports will lead to an underestimation of the prevalence of hypertension and diabetes. However, in more developed communities or provinces, self-reported data can be a reliable estimate of the prevalence of the two conditions. Further investigations of contextual effects at provincial and community levels could highlight public health strategies to improve awareness of the two conditions.
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Affiliation(s)
- Meng Ning
- West China School of Public Health, Sichuan University, Chengdu, China
| | - Qiang Zhang
- West China School of Public Health, Sichuan University, Chengdu, China
| | - Min Yang
- West China School of Public Health, Sichuan University, Chengdu, China
- School of Medicine, University of Nottingham, Nottingham, UK
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