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Chang HC, Wu YS, Tzeng WC, Wu HY, Lee PC, Wang WY. Sex differences in risk factors for metabolic syndrome in middle-aged and senior hospital employees: a population-based cohort study. BMC Public Health 2023; 23:587. [PMID: 36991367 PMCID: PMC10053111 DOI: 10.1186/s12889-023-15491-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 03/21/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Several cross-sectional studies have reported risk factors for metabolic syndrome (MetS). However, these studies did not focus on sex differences in middle-aged and senior populations or employ a longitudinal design. These study design differences are important, as there are sex differences in lifestyle habits associated with MetS, and middle-aged and senior individuals have increased MetS susceptibility. Therefore, the purpose of this study was to examine whether sex differences influenced MetS risk over a ten-year follow-up period among middle-aged and senior hospital employees. METHODS This population-based and prospective cohort study enrolled 565 participants who did not have MetS in 2012 for a ten-year repeated-measurement analysis. Data were retrieved from the hospital's Health Management Information System. Analyses included Student's t tests, χ2 tests and Cox regression. P < 0.05 indicated statistical significance. RESULTS Male middle-aged and senior hospital employees had an elevated MetS risk (hazard ratio (HR) = 1.936, p < 0.001). Men with more than four family history risk factors had an increased risk of MetS (HR = 1.969, p = 0.010). Women who worked shift duty (HR = 1.326, p = 0.020), had more than two chronic diseases (HR = 1.513, p = 0.012), had three family history risk factors (HR = 1.623, p = 0.010), or chewed betel nuts (HR = 9.710, p = 0.002) had an increased risk of MetS. CONCLUSIONS The longitudinal design of our study improves the understanding of sex differences in MetS risk factors in middle-aged and senior adults. A significantly elevated risk of MetS over the ten-year follow-up period was associated with male sex, shift work, the number of chronic diseases, the number of family history risk factors, and betel nut chewing. Women who chewed betel nuts had an especially increased risk of MetS. Our study indicates that population-specific studies are important for the identification of subgroups susceptible to MetS and for the implementation of hospital-based strategies.
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Affiliation(s)
- Hsu-Chieh Chang
- Department of Nursing, Tri-Service General Hospital and School of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Yi-Syuan Wu
- Trauma and Critical Care Service, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Chii Tzeng
- School of Nursing, National Defense Medical Center, Taipei, Taiwan
| | - Hao-Yi Wu
- Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan
| | - Pai-Ching Lee
- Department of Nursing, Tri-Service General Hospital and Graduate Institute of Applied Science and Technology, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Wei-Yun Wang
- Department of Nursing, Tri-Service General Hospital Songshan Branch and School of Nursing, National Defense Medical Center, Taipei, Taiwan.
- Department of Nursing, Tri-Service General Hospital Songshan Branch, 4F, No. 131, Jiankang Rd., Songshan District, Taipei, 105309, Taiwan, ROC.
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Wung CH, Lee MY, Wu PY, Huang JC, Chen SC. Obesity-Related Indices Are Associated with Peripheral Artery Occlusive Disease in Patients with Type 2 Diabetes Mellitus. J Pers Med 2021; 11:jpm11060533. [PMID: 34207835 PMCID: PMC8229333 DOI: 10.3390/jpm11060533] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 05/30/2021] [Accepted: 06/08/2021] [Indexed: 12/15/2022] Open
Abstract
Type 2 diabetes mellitus (DM) is an increasing global health issue. Peripheral artery occlusive disease (PAOD) is a common complication of diabetes, and it is a complex and costly disease. The association between type 2 DM and obesity is well known, however, the relationship between obesity and PAOD in patients with type 2 DM has yet to be elucidated. Therefore, the aim of this study was to examine associations between obesity-related indices and PAOD in patients with type 2 DM. A total of 1872 outpatients with type 2 DM were recruited from two hospitals in southern Taiwan. An ankle–brachial index (ABI) < 0.9 in either leg was considered to indicate the presence of PAOD. The following obesity-related indices were investigated: conicity index (CI), waist–hip ratio (WHR), body roundness index (BRI), waist-to-height ratio (WHtR), abdominal volume index, a body shape index (ABSI), visceral adiposity index (VAI), lipid accumulation product (LAP), body adiposity index, body mass index and triglyceride–glucose index. Overall, 4.1% of the enrolled patients had an ABI < 0.9. High values of the following obesity-related indices were significantly associated with a low ABI: WHtR (p = 0.045), VAI (p = 0.003), CI (p = 0.042), BRI (p = 0.021) and ABSI (p = 0.043). Furthermore, WHR (area under the curve (AUC) = 0.661), CI (AUC = 0.660) and LAP (AUC = 0.642) had the best performance (all p < 0.001) to predict PAOD. In conclusion, high WHtR, BRI, CI, VAI and BAI values were associated with a low ABI in the enrolled patients, and WHR, CI and LAP were the most powerful predictors of PAOD.
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Affiliation(s)
- Chih-Hsuan Wung
- Department of General Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan;
| | - Mei-Yueh Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
| | - Pei-Yu Wu
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan
| | - Jiun-Chi Huang
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan
| | - Szu-Chia Chen
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan
- Correspondence: ; Tel.: +886-7-8036783 (ext. 3440); Fax: +886-7-8063346
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Al-Sharafi BA, Qais AA, Salem K, Bashaaib MO. Family History, Consanguinity and Other Risk Factors Affecting the Prevalence of Prediabetes and Undiagnosed Diabetes Mellitus in Overweight and Obese Yemeni Adults. Diabetes Metab Syndr Obes 2021; 14:4853-4863. [PMID: 34984017 PMCID: PMC8709553 DOI: 10.2147/dmso.s344440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 12/10/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Overweight and obese adults are at high risk for developing prediabetes and diabetes. The aim of this study was to measure the prevalence of prediabetes (pre-DM) and diabetes (DM) among Yemeni adults who were overweight or obese and had first-degree relatives with DM, consanguinity and other risk factors. PATIENTS AND METHODS This cross-sectional study included 612 adults, all with a BMI≥25 kg/m2. BMI, blood pressure (BP) and waist circumference (WC) were measured in the clinic. Fasting blood glucose (FBG) was collected for all subjects. The patients either had first-degree relatives with diabetes or not, and the subjects answered a questionnaire regarding the consanguinity of their parents, exercise, khat chewing, smoking, and eating vegetables and fruits daily. RESULTS Of the 612 study participants (32% males and 68% females) aged 20-70 years old, 429 (70.1%) had a family history (FM) of DM ± consanguinity of parents, and 183 (29.9%) had no FM of diabetes. Multivariate analysis showed significant risk in those with class III obesity for pre-DM (AOR 3.10 95% CI 1.56-6.18 p value 0.001) and DM (AOR 3.35 95% CI 1.47-7.65 p value 0.004) and those who had siblings with DM had a risk for pre-DM (AOR 1.72 95% CI 1.09-2.71 p value 0.02) and DM (AOR 2.24 95% CI 1.25-4.0 p value 0.007). Khat chewing increased the risk for pre-DM (AOR 1.61 95% CI 1.04-2.48 p value 0.032) and for DM (AOR 2.09 95% CI 1.14-3.82 p value 0.017). Having consanguineous parents plus siblings with DM were associated with a higher risk of DM (p value 0.031). CONCLUSION There is a high prevalence of pre-DM and undiagnosed DM among overweight and obese Yemeni individuals. Class III obesity, having siblings with DM, chewing khat, and having consanguineous parents plus siblings with DM all increased the risk. This group should be screened at an early age for early detection of pre-DM and DM.
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Affiliation(s)
- Butheinah A Al-Sharafi
- Department of Internal Medicine, School of Medicine and Health Sciences, Sana’a University, Sana’a, Yemen
- Correspondence: Butheinah A Al-Sharafi Email
| | - Ahmed A Qais
- Department of Internal Medicine, School of Medicine and Health Sciences, Sana’a University, Sana’a, Yemen
| | - Khalil Salem
- Department of Internal Medicine, University of Science and Technology Hospital, Sana’a, Yemen
| | - Muneer O Bashaaib
- Department of Internal Medicine, University of Science and Technology Hospital, Sana’a, Yemen
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