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Shahrestanaki E, Mohammadian Khonsari N, Seif E, Baygi F, Ejtahed HS, Sheidaei A, Djalalinia S, Magliano DJ, Qorbani M. The worldwide trend in diabetes awareness, treatment, and control from 1985 to 2022: a systematic review and meta-analysis of 233 population-representative studies. Front Public Health 2024; 12:1305304. [PMID: 38827607 PMCID: PMC11140097 DOI: 10.3389/fpubh.2024.1305304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 03/06/2024] [Indexed: 06/04/2024] Open
Abstract
Background With the rapid increase in the prevalence of DM, studies on the awareness, treatment, and control of this condition are essential. Therefore, this study aimed to review the literature and pool the awareness, treatment, and control of diabetes at the global, regional, and national levels. Methods In this systematic review and meta-analysis, several databases, including MEDLINE/PubMed, Institute of Scientific Information (ISI), Scopus, and Google Scholar, were searched using appropriate keywords up to June 2022. Observational studies investigating the awareness, treatment, and control of glucose levels among diabetic individuals were included. Awareness, treatment, and control were defined as the proportion of participants who were aware of their diabetes condition, treated pharmacologically, and achieved adequate glucose control, respectively. Two investigators independently conducted the study selection, data extraction, and quality assessment. Heterogeneity among studies was calculated using Chi-square, and a random-effect meta-analysis was used to pool the rates. Results A total of 233 studies published between 1985 and 2022 met the inclusion criteria. The included studies had a combined population of 12,537,968. The pooled awareness of DM was 60% (95%CI: 56-63) and ranged from 41% (25-57) in low-income countries to 68% (64-72) in high-income countries, with no significant trend observed over the assessed periods at the global level. The pooled treatment of DM globally was 45% (42-48) and varied from 37% (31-43) in lower-middle-income countries to 53% (47-59) in high-income countries, showing variation over the examined time period. Before 2000, the proportion of adequate DM control was 16% (12-20), which significantly improved and reached 22% (19-25) after 2010. The pooled awareness, treatment, and control of DM were higher in females, high-income countries, and urban areas compared to males, upper and lower-middle-income countries, and rural areas, respectively. The older adults population had higher awareness and treatment rates than the adult population, but their DM control did not differ significantly. Conclusion Despite the high level of awareness and treatment among the diabetic population, treatment success (control) is considerably low, particularly in low-income countries and rural areas. It is crucial to improve awareness, treatment, and control by strengthening the primary care system in all countries.
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Affiliation(s)
- Ehsan Shahrestanaki
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | | | - Ehsan Seif
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Fereshteh Baygi
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Hanieh-Sadat Ejtahed
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Sheidaei
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Djalalinia
- Deputy of Research & Technology, Ministry of Health & Medical Education, Tehran, Iran
| | - Dianna J. Magliano
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Hu TH, Luh DL, Tsao YY, Lin TY, Chang CJ, Su WW, Yang CC, Yang CJ, Chen HP, Liao PY, Su SL, Chen LS, Hsiu-Hsi Chen T, Yeh YP. Using the Diabetes Care System for a County-Wide Hepatitis C Elimination: An Integrated Community-Based Shared Care Model in Taiwan. Am J Gastroenterol 2024; 119:883-892. [PMID: 38084857 PMCID: PMC11062613 DOI: 10.14309/ajg.0000000000002624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/16/2023] [Indexed: 01/30/2024]
Abstract
INTRODUCTION Despite the serious risks of diabetes with hepatitis C virus (HCV) infection, this preventable comorbidity is rarely a priority for HCV elimination. We aim to examine how a shared care model could eliminate HCV in patients with diabetes (PwD) in primary care. METHODS There were 27 community-based Diabetes Health Promotion Institutes in each township/city of Changhua, Taiwan. PwD from these institutes from January 2018 to December 2020 were enrolled. HCV screening and treatment were integrated into diabetes structured care through collaboration between diabetes care and HCV care teams. Outcome measures included HCV care continuum indicators. Township/city variation in HCV infection prevalence and care cascades were also examined. RESULTS Of the 10,684 eligible PwD, 9,984 (93.4%) underwent HCV screening, revealing a 6.18% (n = 617) anti-HCV seroprevalence. Among the 597 eligible seropositive individuals, 507 (84.9%) completed the RNA test, obtaining 71.8% positives. Treatment was initiated by 327 (89.8%) of 364 viremic patients, and 315 (86.5%) completed it, resulting in a final cure rate of 79.4% (n = 289). Overall, with the introduction of antivirals in this cohort, the prevalence of viremic HCV infection dropped from 4.44% to 1.34%, yielding a 69.70% (95% credible interval 63.64%-77.03%) absolute reduction. DISCUSSION Although HCV prevalence varied, the care cascades achieved consistent results across townships/cities. We have further successfully implemented the model in county-wide hospital-based diabetes clinics, eventually treating 89.6% of the total PwD. A collaborative effort between diabetes care and HCV elimination enhanced the testing and treatment in PwD through an innovative shared care model.
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Affiliation(s)
- Tsung-Hui Hu
- Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung City, Taiwan
| | - Dih-Ling Luh
- Department of Public Health, Chung Shan Medical University, Taichung, Taiwan
- Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yo-Yu Tsao
- Changhua Public Health Bureau, Changhua, Taiwan
| | - Ting-Yu Lin
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | | | - Wei-Wen Su
- Changhua Christian Hospital, Changhua, Taiwan
| | - Chih-Chao Yang
- Changhua Hospital, Ministry of Health and Welfare, Changhua, Taiwan
| | - Chang-Jung Yang
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | | | | | - Shih-Li Su
- Changhua Christian Hospital, Changhua, Taiwan
| | - Li-Sheng Chen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Tony Hsiu-Hsi Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yen-Po Yeh
- Changhua Public Health Bureau, Changhua, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
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Yan Y, Wu T, Zhang M, Li C, Liu Q, Li F. Prevalence, awareness and control of type 2 diabetes mellitus and risk factors in Chinese elderly population. BMC Public Health 2022; 22:1382. [PMID: 35854279 PMCID: PMC9295461 DOI: 10.1186/s12889-022-13759-9] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/29/2022] [Indexed: 12/20/2022] Open
Abstract
Background Type 2 diabetes mellitus is an expanding global public health issue, especially in developing countries. This study aimed to investigate the prevalence, awareness and control rate of type 2 diabetes mellitus, and assess its risk factors in elderly Chinese individuals. Methods The health screening data of 376,702 individuals aged ≥ 65 years in Wuhan, China, were collected to analyse the prevalence, awareness, and control rates of diabetes. Indices, including fasting plasma glucose and other biochemical indicators, were measured for all participants using standard methods at the central laboratory. Multilevel logistic regression analysis was performed to assess the key determinants of the prevalence, awareness, and control rates of diabetes. Results The prevalence, awareness, and control rates of diabetes in the Chinese individuals aged ≥ 65 years were 18.80%, 77.14%, and 41.33%, respectively. There were statistically significant differences in the prevalence, awareness, and control rates by gender. Factors associated with diabetes prevalence were age, body mass index (BMI), and central obesity; while those associated with awareness and control were gender, education level, marital status, physical activity, alcohol consumption, BMI, and central obesity. Conclusions Diabetes is an important public health problem in the elderly in China. The awareness and control rates have improved, but overall remained poor. Therefore, effective measures to raise awareness and control the rates of diabetes should be undertaken to circumvent the growing disease burden in elderly Chinese people. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13759-9.
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Affiliation(s)
- Yaqiong Yan
- Wuhan Centers for Disease Control & Prevention, 288# Machang Road, Wuhan, China
| | - Tingting Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, Hubei, China
| | - Miao Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, Hubei, China
| | - Changfeng Li
- Wuhan Centers for Disease Control & Prevention, 288# Machang Road, Wuhan, China
| | - Qing Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, Hubei, China.
| | - Fang Li
- Wuhan Centers for Disease Control & Prevention, 288# Machang Road, Wuhan, China.
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Chien TM, Lu YM, Li CC, Wu WJ, Chang HW, Chou YH. A retrospective study on sex difference in patients with urolithiasis: who is more vulnerable to chronic kidney disease? Biol Sex Differ 2021; 12:40. [PMID: 34099045 PMCID: PMC8185917 DOI: 10.1186/s13293-021-00382-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 05/17/2021] [Indexed: 11/12/2022] Open
Abstract
Background Urolithiasis is considered a vital public health issue with a substantial burden on kidney function. Additionally, only few reports focused on the gender difference in patients with urolithiasis. Therefore, this study aimed to compare the clinical characteristics of sex difference and their potential risk for chronic kidney disease (CKD) in patients with urolithiasis. Methods Patients diagnosed with stone disease from 2013 to 2018 were retrospectively reviewed and divided into two groups by gender. Clinical demographic characteristics, stone location, stone composition, urine chemistries, and renal function were investigated. Univariate and multivariate analyses were used to assess the relationship and potential risk of CKD between sex groups. Results A total of 1802 patients were included: 1312 from men and 490 from women. Female patients had a higher rate of hypertension, diabetes, and dyslipidemia. Male patients predominantly had calcium-containing stones, especially calcium oxalate stone, uric acid stone, and struvite stone. Carbonate apatite stone was more frequently found in women. Complex surgeries such as percutaneous nephrolithotomy (PCNL) and ureteroscopic lithotripsy (URSL) were more frequently performed in women than that in men. Multivariate analysis confirmed that age > 60 years (odds ratios [ORs] = 6.36; 95% confidence interval [CI], 3.8–10.8), female sex (ORs = 5.31; 95% CI 3.3–8.4), uric acid stone (ORs = 3.55; 95% CI 2.0–6.4), hypertension (OR = 7.20; 95% CI 3.8–13.7), and diabetes (OR = 7.06; 95% CI 3.1–16.2) were independent predictors of poor prognoses in CKD. Conclusions The female gender is significantly associated with a higher prevalence of CKD among patients with urolithiasis. Therefore, women with stone disease may need close renal function monitoring during follow-up.
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Affiliation(s)
- Tsu-Ming Chien
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan.,Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, No.100, Tzyou 1st Road, Kaohsiung, 80756, Taiwan.,Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, 80756, Taiwan
| | - Yen-Man Lu
- Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, No.100, Tzyou 1st Road, Kaohsiung, 80756, Taiwan.,Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, 80756, Taiwan.,Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| | - Ching-Chia Li
- Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, No.100, Tzyou 1st Road, Kaohsiung, 80756, Taiwan.,Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, 80756, Taiwan
| | - Wen-Jeng Wu
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan.,Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, No.100, Tzyou 1st Road, Kaohsiung, 80756, Taiwan.,Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, 80756, Taiwan
| | - Hsueh-Wei Chang
- Department of Biomedical Science and Environmental Biology, College of Life Science, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan.,Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung, 807, Taiwan.,Center for Cancer Research, Kaohsiung Medical University, Kaohsiung, 807, Taiwan
| | - Yii-Her Chou
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan. .,Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, No.100, Tzyou 1st Road, Kaohsiung, 80756, Taiwan. .,Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, 80756, Taiwan.
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Cheng HC, Yen AMF, Lee YH. Factors affecting patient safety culture among dental healthcare workers: A nationwide cross-sectional survey. J Dent Sci 2019; 14:263-268. [PMID: 31528254 PMCID: PMC6739285 DOI: 10.1016/j.jds.2018.12.001] [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: 11/03/2018] [Revised: 11/27/2018] [Indexed: 11/26/2022] Open
Abstract
Background/purpose Patient safety is a major healthcare challenge. Due to a lack of safety culture knowledge among dental professionals, our objectives were to measure the level of patient safety culture using the Safety Attitude Questionnaire in Chinese (SAQ-C) and identify factors associated with positive attitudes toward patient safety. Materials and methods A nationwide cross-sectional survey was conducted within dentistry departments of 20 hospitals and in 40 dental clinics, from which were randomly chosen. The survey (SAQ-C) comprised of 32 items and reflects five dimensions of patient safety culture. The second section collects demographic information that supposedly affects attitudes toward patient safety. Logistic regression analyses were used to identify factors that supposedly influenced positive attitudes toward patient safety. Results Mean SAQ-C scores were significantly higher in respondents who were male, older, dentists, supervisors, and working in clinics. Positive attitudes toward patient safety were found in 172 participants (55.7%). Multivariate analyses revealed age and place of work are significantly associated with positive safety attitudes. A limitation of this study is that the association between SAQ-C scores and patient outcomes could not be examined. Conclusion With a lack of research in the dental field, our study provides important information on patient safety attitudes for dental healthcare workers. Results from this study present the current status of patient safety culture and help raise awareness of it. Most notably, the study identified several factors associated with positive attitudes toward patient safety. The information can be used to improve patient safety in the future.
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Affiliation(s)
- Hsin-Chung Cheng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan
| | - Amy Ming-Fang Yen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi-Hsuan Lee
- Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan
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Tsai LT, Lo FE, Yang CC, Lo WM, Keller JJ, Hwang CW, Lin CF, Lyu SY, Morisky DE. Influence of Socioeconomic Factors, Gender and Indigenous Status on Smoking in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E1044. [PMID: 27792157 PMCID: PMC5129254 DOI: 10.3390/ijerph13111044] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 09/25/2016] [Accepted: 10/10/2016] [Indexed: 11/23/2022]
Abstract
The indigenous Austronesian minority of Taiwan is heavily affected by health disparities which may include suffering from a greater burden of the tobacco epidemic. While a lack of representative data has historically precluded an investigation of the differences in smoking between Taiwanese ethnicities, these data have recently become available through an annual population-based telephone survey conducted by the Health Promotion Administration, Ministry of Health and Welfare (previously known as the Bureau of Health Promotion (BHP), Department of Health). We used the BHP monitoring data to observe the prevalence of smoking and environmental tobacco smoke exposure among indigenous and non-indigenous Taiwanese surrounding a tobacco welfare tax increase in 2006, investigate ethnic differences in smoking prevalence and environmental tobacco smoke exposure each year between 2005 and 2008, and perform multiple logistic regression to estimate measures of association between potential risk factors and smoking status. Despite significant ethnic and gender differences in smoking prevalence, smoking status was not found to be significantly associated with ethnicity after controlling for socioeconomic and demographic factors.
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Affiliation(s)
- Liang-Ting Tsai
- Taiwan Marine Education Center, National Taiwan Ocean University, Keelung City 20224, Taiwan.
- Institute of Indigenous Health and Preventive Medicine Research Center, Taipei Medical University, Taipei 11031, Taiwan.
| | - Feng-En Lo
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 40402 Taiwan.
- Department of Leisure and Recreation Management, Asia University, Taichung 41354, Taiwan.
| | - Chih-Chien Yang
- Graduate Institute of Educational Measurement and Statistics, National Taichung University of Education, Taichung 40306, Taiwan.
| | - Wen-Min Lo
- Institute of Indigenous Health and Preventive Medicine Research Center, Taipei Medical University, Taipei 11031, Taiwan.
- Department of Information Management, Tatung University, Taipei 10452, Taiwan.
| | | | - Chiou-Wei Hwang
- School of Public Health, Taipei Medical University, Taipei 11031, Taiwan.
| | - Ching-Feng Lin
- Institute of Indigenous Health and Preventive Medicine Research Center, Taipei Medical University, Taipei 11031, Taiwan.
- School of Public Health, Taipei Medical University, Taipei 11031, Taiwan.
| | - Shu-Yu Lyu
- Department of Leisure Industry and Health Promotion, National Taipei University of Nursing and Health Sciences, Taipei 11219, Taiwan.
| | - Donald E Morisky
- Department of Community Health Sciences, Fielding School of Public Health, University of California at Los Angeles, Los Angeles, CA 90095, USA.
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Kim YD, Jung YH, Saposnik G. Traditional Risk Factors for Stroke in East Asia. J Stroke 2016; 18:273-285. [PMID: 27733028 PMCID: PMC5066436 DOI: 10.5853/jos.2016.00885] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 08/21/2016] [Accepted: 08/23/2016] [Indexed: 01/19/2023] Open
Abstract
Stroke is one of the leading causes of death and morbidity worldwide. The occurrence of stroke is strongly dependent on well-known vascular risk factors. After rapid modernization, urbanization, and mechanization, East Asian countries have experienced growth in their aged populations, as well as changes in lifestyle and diet. This phenomenon has increased the prevalence of vascular risk factors among Asian populations, which are susceptible to developing cardiovascular risk factors. However, differing patterns of stroke risk factor profiles have been noted in East Asian countries over the past decades. Even though the prevalence of vascular risk factors has changed, hypertension is still prevalent and the burden of diabetes and hypercholesterolemia will continue to increase. Asia remains a high tobacco-consuming area. Although indicators of awareness and management of vascular risk factors have increased in many East Asian countries, their rates still remain low. Here we review the burdens of traditional risk factors, such as hypertension, diabetes, hypercholesterolemia, and smoking in East Asia. We will also discuss the different associations between these vascular risk factors and stroke in Asian and non-Asian populations.
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Affiliation(s)
- Young Dae Kim
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Yo Han Jung
- Department of Neurology, Changwon Fatima Hospital, Changwon, Korea
| | - Gustavo Saposnik
- Stroke Outcomes Research Unit, Division of Neurology, University of Toronto, Toronto, Canada
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Abstract
Taiwan's indigenous population exhibits a higher mortality of cardiovascular disease, but current research has not reported any associations among ethnicities on the blood pressure (BP). We randomly selected representative samples in this population-based study. We measured height, weight, hip and waist circumferences, and blood pressure in a screening survey. Systolic BP and diastolic BP were significantly higher in the indigenous population. Among women, prevalence rates of DBP > 90 mmHg among indigenes (32.9 %) were significantly high than those in Han Chinese (17.4 %). Based on multivariate analysis adjusted for covariates, the results showed gender and ethnicity to be significantly correlated with systolic and diastolic BP. Gender was a modifier between ethnicity and BP. Furthermore, we found an additive effect between ethnicity and age on systolic and diastolic BP by gender. Our study showed independent additive effects on systolic BP and diastolic BP between ethnicity and age by gender.
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Variations in aging, gender, menopause, and obesity and their effects on hypertension in taiwan. Int J Hypertens 2014; 2014:515297. [PMID: 25436143 PMCID: PMC4243128 DOI: 10.1155/2014/515297] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 10/11/2014] [Accepted: 10/13/2014] [Indexed: 01/16/2023] Open
Abstract
Aim. We assessed obesity, sex, menopause, and gender differences on hypertension in a Hakka-majority Taiwanese sample. Methods. 9621 subjects aged 20 and over participated in this community-based study. Trained nurses collected blood pressure (BP) measurements and anthropometric indices, including weight, height, hip circumference (HC), waist circumference (WC), body mass index (BMI), waist to height ratio (WHtR), and waist to hip ratio (WHR). Results. Levels of systolic and diastolic BP significantly increased at a dose-dependent relationship based on four anthropometric indices (BMI, WC, WHR, and WHtR); the slopes for SBP and DBP differed. After controlling for other covariates using multivariate logistic regression, we found the adjusted odds ratios (OR) of hypertension to be significantly related to the four anthropometric indices. Notably, the effect of obesity on the ORs for hypertension was considerably higher in premenopausal women, but we found no such phenomenon among men. BMI, WC, WHR, and WHtR had significant linear associations with BP. Conclusion. Obesity indices are significantly correlated with the risk of hypertension across gender and age, with BMI having the highest relative potency. The effect of obesity on the risk of hypertension is especially high in premenopausal women, implying a relationship between hormones and hypertension.
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Contextual factors influencing leisure physical activity of urbanized indigenous adolescents. J Formos Med Assoc 2014; 114:1082-7. [PMID: 24795217 DOI: 10.1016/j.jfma.2014.03.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Revised: 02/26/2014] [Accepted: 03/27/2014] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND/PURPOSE Indigenous populations suffer from disparities in socioeconomic resources and health status. One approach to addressing these disparities is by targeting modifiable risk factors such as leisure physical activity (LPA). This study investigated and compared factors related to LPA among urbanized indigenous and nonindigenous adolescent students. METHODS This cross-sectional survey comprised fifth to ninth grade indigenous and nonindigenous students (n = 733). The nonindigenous students were matched with indigenous students on sex and academic achievement and used as a reference group. Data were collected through telephone interviews using structured questionnaires. Major items included: demographic characteristics; average time spent watching television per bout; participation in LPA; and stress and depression experiences. RESULTS With the exception of the duration of television watching per bout, Chi-square and independent t tests demonstrated that there were no significant differences between indigenous and nonindigenous adolescents in the selected LPA-related factors. Multiple logistic regression analysis including terms investigating interaction between ethnicity and the contextual factors included in this study indicated that the following factors were correlated with LPA participation: age [odds ratio (OR) = 0.82, 95% confidence interval (CI) = 0.71-0.94], male sex (OR = 1.77, 95%CI = 1.19-2.61), total hours spent watching television in the past 2 weeks (OR = 0.79, 95%CI = 0.63-0.99), life satisfaction (OR = 2.25, 95%CI = 1.04-4.90), and exercise enjoyment (OR = 3.40, 95%CI = 1.71-6.74). However, neither indigenous status (OR = 1.03, 95%CI = 0.19-5.79) nor any of the interaction terms reached the significant level. CONCLUSION No significant ethnic differences were found in LPA participation. LPA was significantly correlated with age, male sex, total time spent watching television, life satisfaction, and enjoyment of exercise.
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Lower intake of magnesium and dietary fiber increases the incidence of type 2 diabetes in Taiwanese. J Formos Med Assoc 2012; 111:651-9. [PMID: 23217601 DOI: 10.1016/j.jfma.2012.07.038] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Revised: 07/26/2012] [Accepted: 07/30/2012] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND/PURPOSE Several studies have indicated an inverse association between the incidence of diabetes mellitus and magnesium and dietary fiber intake. Few studies have examined both of these associations together, not to mention in Asian populations with prospective study design. We therefore aimed to study how dietary magnesium and fiber intake levels affect diabetes incidence separately or in combination, in a prospective study in Taiwan. METHODS The study subjects were recruited for a longitudinal study, CardioVascular Disease risk FACtor Two-township Study cycle 2 from November 1990. Data from complete baseline information on dietary and biochemical profile and at least one additional follow-up visit were gathered on a total of 1604 healthy subjects aged 30 years and over. Cox proportional hazard model was used to study the association between diabetes incidence and dietary magnesium and fiber intake level estimated from a food frequency questionnaire. RESULTS A total of 141 diabetes mellitus events were identified and confirmed during the 4.6 years of follow-up (7365.1 person-years). A significantly higher diabetes risk was observed for people in the lowest quintile of total dietary fiber intake (hazard ratio = 2.04; 95% CI = 1.17-3.53) and magnesium intake (hazard ratio = 2.61; 95% CI = 1.42-4.79) compared with the highest quintile after adjusting for traditional cardiovascular disease risk factors. Similar inverse associations for total dietary fiber were also shown for vegetable fiber and fruit fiber. CONCLUSION Lower magnesium, lower total dietary fiber intake, or lower intake of both was associated with higher risk of diabetes in the Taiwanese population. Clinical trials are required to confirm the protective effects of the adequate intake of fiber, magnesium, and/or their combination.
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Lai MS. National health insurance and the way leading to better diabetes care in Taiwan. Is there a role of comprehensive analyses of the claims data? J Formos Med Assoc 2012; 111:587-8. [PMID: 23217593 DOI: 10.1016/j.jfma.2012.08.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Revised: 08/23/2012] [Accepted: 08/26/2012] [Indexed: 10/27/2022] Open
Affiliation(s)
- Mei-Shu Lai
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taiwan.
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Cheng HC, Su CY, Yen AMF, Huang CF. Factors affecting occupational exposure to needlestick and sharps injuries among dentists in Taiwan: a nationwide survey. PLoS One 2012; 7:e34911. [PMID: 22509367 PMCID: PMC3318009 DOI: 10.1371/journal.pone.0034911] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Accepted: 03/10/2012] [Indexed: 01/05/2023] Open
Abstract
Background Although the risks of needlestick and sharps injuries (NSIs) for dentists are well recognized, most papers published only described the frequency of occupational exposure to NSIs. Less has been reported assessing factors contributing to exposure to NSIs. The purpose of this study was to update the epidemiology of NSIs among dentists in Taiwan and identify factors affecting NSIs in order to find preventive strategies. Methodology/Principal Findings A nationwide survey was conducted in dentists at 60 hospitals and 340 clinics in Taiwan. The survey included questions about factors supposedly affecting exposure to NSIs, such as dentist and facility characteristics, knowledge and attitudes about infectious diseases, and practices related to infection control. Univariate and multivariate logistic regression analyses were conducted to determine the association between risk factors and exposure to NSIs. In total, 434 (74.8%) of 580 dentists returned the survey questionnaires, and 100 (23.0%) reported that they had experienced more than one NSI per week. Our data showed that the risk of occupational NSIs is similarly heightened by an older age (odds ratio [OR], 3.18; 95% confidence interval [CI], 1.62–6.25), more years in practice (OR, 2.57; 95% CI, 1.41–4.69), working in clinics (OR, 1.73; 95% CI, 1.08–2.77), exhibiting less compliance with infection-control procedures (OR, 1.82; 95% CI, 1.04–3.18), having insufficient knowledge of blood-borne pathogens (OR, 1.67; 95% CI, 1.04–2.67), and being more worried about being infected by blood-borne pathogens (OR, 1.82; 95% CI, 1.05–3.13). Conclusions/Significance High rates of NSIs and low compliance with infection-control procedures highly contribute to the chance of acquiring a blood-borne pathogen infection and threaten occupational safety. This study reveals the possible affecting factors and helps in designing prevention strategies for occupational exposure to NSIs.
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Affiliation(s)
- Hsin-Chung Cheng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan
- * E-mail:
| | - Chen-Yi Su
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Amy Ming-Fang Yen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chiung-Fang Huang
- Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan
- School of Dental Technology, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
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14
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Li CI, Chien L, Liu CS, Lin WY, Lai MM, Lee CC, Chen FN, Li TC, Lin CC. Prospective validation of American Diabetes Association risk tool for predicting pre-diabetes and diabetes in Taiwan-Taichung community health study. PLoS One 2011; 6:e25906. [PMID: 21998718 PMCID: PMC3187817 DOI: 10.1371/journal.pone.0025906] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2011] [Accepted: 09/13/2011] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND A simple diabetes risk tool that does not require laboratory tests would be beneficial in screening individuals at higher risk. Few studies have evaluated the ability of these tools to identify new cases of pre-diabetes. This study aimed to assess the ability of the American Diabetes Association Risk Tool (ADART) to predict the 3-year incidence of pre-diabetes and diabetes in Taiwanese. METHODS This was a 3-year prospective study of 1021 residents with normoglycemia at baseline, gathered from a random sample of residents aged 40-88 years in a metropolitan city in Taiwan. The areas under the curve (AUCs) of three models were compared: ADART only, ADART plus lifestyle behaviors at baseline, and ADART plus lifestyle behaviors and biomarkers at baseline. The performance of ADART was compared with that of 16 tools that had been reported in the literature. RESULTS The AUCs and their 95% confidence intervals (CIs) were 0.60 (0.54-0.66) for men and 0.72 (0.66-0.77) for women in model 1; 0.62 (0.56-0.68) for men and 0.74 (0.68-0.80) for women in model 2; and 0.64 (0.58-0.71) for men and 0.75 (0.69-0.80) for women in model 3. The AUCs of these three models were all above 0.7 in women, but not in men. No significant difference in either women or men (p = 0.268 and 0.156, respectively) was observed in the AUC of these three models. Compared to 16 tools published in the literature, ADART had the second largest AUC in both men and women. CONCLUSIONS ADART is a good screening tool for predicting the three-year incidence of pre-diabetes and diabetes in females of a Taiwanese population. The performance of ADART in men was similar to the results with other tools published in the literature. Its performance was one of the best among the tools reported in the literature.
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Affiliation(s)
- Chia-Ing Li
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Institute of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Ling Chien
- Graduate Institute of Biostatistics, College of Public Health, China Medical University, Taichung, Taiwan
| | - Chiu-Shong Liu
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Social Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Wen-Yuan Lin
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Family Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Ming-May Lai
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Family Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Cheng-Chun Lee
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan
| | - Fei-Na Chen
- Department of Social Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Tsai-Chung Li
- Graduate Institute of Biostatistics, College of Public Health, China Medical University, Taichung, Taiwan
- Graduate Institute of China Medical Science, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- Biostatistics Center, China Medical University, Taichung, Taiwan
- Institute of Health Care Administration, College of Health Science, Asia University, Taichung, Taiwan
| | - Cheng-Chieh Lin
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Family Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- School and Graduate Institute of Health Care Administration, College of Public Health, China Medical University, Taichung, Taiwan
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15
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Lin WY, Xaiver Pi-Sunyer F, Chen CC, Davidson LE, Liu CS, Li TC, Wu MF, Li CI, Chen W, Lin CC. Coffee consumption is inversely associated with type 2 diabetes in Chinese. Eur J Clin Invest 2011; 41:659-66. [PMID: 21226707 PMCID: PMC3087821 DOI: 10.1111/j.1365-2362.2010.02455.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Coffee consumption has been shown to be inversely associated to type 2 diabetes mellitus (T2DM), but evidence in Chinese populations is limited. We investigated the relationship between coffee consumption and T2DM in a population-based cohort of middle-aged Chinese. MATERIALS AND METHODS We studied 2332 subjects who participated in the Taichung Community Health Study in Taiwan in 2004. The relationships between coffee consumption, T2DM and fasting glucose were assessed. RESULTS The prevalence of T2DM was 14·0% and 10·4% in men and women. After adjustment for age, body mass index, blood pressure, smoking, alcohol drinking, betel nut chewing, physical activity, income, education level, fat%, protein%, carbohydrate% and magnesium, coffee intake was inversely associated with T2DM. Habitual coffee drinkers had 38-46% lower risk of T2DM than nondrinkers. Compared to nondrinkers, the adjusted odds ratios (ORs) for T2DM according to subjects with habitual coffee consumption (<1, 1-6, ≥7 times per week) were 0·77 (0·52-1·13), 0·46 (0·28-0·76) and 0·37 (0·16-0·83), respectively. The decreasing ORs indicate a dose-response effect of coffee consumption on the likelihood of having T2DM (P<0·001). A similar relationship was also evident in newly diagnosed T2DM (P<0·05). The adjusted mean fasting glucose levels gradually decreased as the frequency of coffee consumption increased (P<0·05). CONCLUSIONS Coffee intake is inversely associated with T2DM in Chinese. Coffee may be a protective agent for T2DM in Chinese.
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Affiliation(s)
- Wen-Yuan Lin
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
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16
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Chang HY, Hsu CC, Pan WH, Liu WL, Cheng JYC, Tseng CH, Bai CH, Yeh WT, Hurng BS. Gender differences in trends in diabetes prevalence from 1993 to 2008 in Taiwan. Diabetes Res Clin Pract 2010; 90:358-64. [PMID: 20970872 DOI: 10.1016/j.diabres.2010.09.032] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2010] [Revised: 09/23/2010] [Accepted: 09/27/2010] [Indexed: 11/15/2022]
Abstract
We examined time trends in the prevalence of diabetes using nationally representative samples, with a focus on gender differences. Data were from the Nutrition and Health Survey in Taiwan (NAHSIT), 1993-1996 (n = 2700), and NAHSIT 2004-2008 (n = 2258). Participants aged 19 years or older with adequate fasting glucose data were included. When needed, rates were standardized to the year 2000 WHO 5-year interval population for comparisons. The prevalence increased significantly in men, whose standardized rate increased from 4.6% to 9.3%. In women, the age standardized prevalence decreased slightly from 7.9% to 6.4%. High triglycerides (≥ 150 mg/dL) was associated with diabetes with odds ratios (OR) of 2.14, and 2.69 (all with p<0.05) in the two surveys. High waist circumference (men ≥ 90 cm; women ≥ 80 cm) was also associated with diabetes with ORs of 2.52, and 1.93 (all with p < 0.05). We recommend the development of innovative health promotion programs targeting not only the general population, but also high risk groups such as men, to further reduce diabetes.
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Affiliation(s)
- Hsing-Yi Chang
- Center for Health Policy Research and Development, Institute of Population Health, National Health Research Institutes, Zhunan Town, Maoli County, Taiwan.
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17
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The equality of resource allocation in health care under the National Health Insurance System in Taiwan. Health Policy 2010; 100:203-10. [PMID: 21112116 DOI: 10.1016/j.healthpol.2010.08.003] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2009] [Revised: 07/16/2010] [Accepted: 08/03/2010] [Indexed: 12/18/2022]
Abstract
An ideal resource allocation in health care should ensure most people to access equal health care services while needed. Not only social welfare economists but also health policy makers concern with rational distribution of health care resources. Taiwan implemented a National Health Insurance (NHI) program in 1995, to reduce financial barriers for all residents with a universal health care system. Horizontal equity, an explicit goal of the NHI system, is to guarantee equal opportunity of access to health care. Accordingly, this study, utilizing cross-sectional data, proposes a multi-criteria decision-making approach with grey incidence analysis to measure horizontal equity of health care resource allocation of the NHI in Taiwan. From the findings of this empirical study, most resources are allocated in North Taiwan resulting in geographical disparity due to unbalanced health care resource allocation. And the large-scale hospitals are mostly congregated only at metropolitan regions; therefore, the access to health care services for patients in rural areas is still limited. Finally, the NHI in Taiwan is a single-payer for all hospitals, in which payment for health care suppliers can be adopted as an efficient strategy to induce the disparity of resource allocation and to redistribute national health care resource.
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18
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Wu YJ, Tsai JJ, Huang CW. Nonketotic hyperglycemia-related reflex epileptic seizures induced by Mah-Jong playing. Epilepsy Behav 2010; 19:533-5. [PMID: 20934919 DOI: 10.1016/j.yebeh.2010.09.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2010] [Revised: 08/31/2010] [Accepted: 09/03/2010] [Indexed: 10/19/2022]
Abstract
Seizures related to nonketotic hyperglycemia (NKH) are often encountered in clinical practice. Among such seizures, reflex seizures are rare, and most of them are movement-induced focal seizures. We describe five patients with NKH and reflex seizures induced exclusively by playing Mah-Jong, a traditional and popular game in Chinese society. Four patients had partial seizures and one had a generalized seizure. All the patients manifested NKH on occurrence of the seizure. During Mah-Jong in the presence of NKH, seizures could arise from the frontal and temporal lobes, which are highly activated during the game. Both avoidance of Mah-Jong playing and control of glucose intake help prevent this disorder.
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Affiliation(s)
- Yi-Jen Wu
- Department of Neurology, National Cheng Kung University Hospital, Tainan, Taiwan
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19
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Kao YT, Huang CC, Leu HB, Wu TC, Huang PH, Lin SJ, Chen JW. Ambulatory pulse pressure as a novel predictor for long-term prognosis in essential hypertensive patients. J Hum Hypertens 2010; 25:444-50. [DOI: 10.1038/jhh.2010.80] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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20
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Sabanayagam C, Shankar A, Saw SM, Tai ES, Lim SC, Lee JJM, Wong TY. Prevalence of Diabetes Mellitus, Glycemic Control, and Associated Factors in a Malay Population in Singapore. Asia Pac J Public Health 2009; 21:385-98. [PMID: 19661105 DOI: 10.1177/1010539509343958] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There is substantial heterogeneity regarding diabetes mellitus prevalence and glycemic control in Asian populations. The authors examined a population-based sample of 3000 adults (52% women) of Malay ethnicity (40-80 years) in Singapore. The age-standardized prevalence of diabetes mellitus was 18.4% (95% confidence interval = 17.0% to 19.8%). Being overweight, presence of hypertension, presence of cardiovascular disease, and family history of diabetes were found to be positively associated with diabetes mellitus. Higher education, employment status, and current smoking were found to be inversely associated with diabetes mellitus. Among those treated for diabetes, 29% achieved the optimal glycemic goal (glycosylated hemoglobin <7%). Lower levels of low-density lipoprotein cholesterol, total cholesterol, and systolic and diastolic blood pressure were associated with good glycemic control. Nearly 1 in 5 middle-aged Malay adults living in a developed Asian society had diabetes mellitus and a substantial proportion had suboptimal glycemic control.
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Affiliation(s)
- Charumathi Sabanayagam
- Department of Community, Occupational, and Family Medicine,
Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Anoop Shankar
- Division of Epidemiology, Department of Community Medicine,
West Virginia University School of Medicine, Morgantown, West Virginia
| | - Seang Mei Saw
- Department of Community, Occupational, and Family Medicine,
Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore National Eye Centre and Singapore Eye Research
Institute
| | | | | | - Jeanette Jen-Mai Lee
- Department of Community, Occupational, and Family Medicine,
Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Tien Yin Wong
- Centre for Eye Research Australia, University of Melbourne,
Melbourne, Australia, Singapore National Eye Centre and Singapore Eye Research
Institute
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21
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Chiu HJ, Loh EW, Lan TH, Sou JH, Hsieh HC, Hu TM. Increase of incidence of impaired fasting glucose in young schizophrenia patients. Psychiatry Clin Neurosci 2009; 63:127-8. [PMID: 19154223 DOI: 10.1111/j.1440-1819.2008.01910.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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22
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Tseng CH, Chong CK, Tseng CP, Chan TT. Age-related risk of mortality from bladder cancer in diabetic patients: a 12-year follow-up of a national cohort in Taiwan. Ann Med 2009; 41:371-9. [PMID: 19191082 DOI: 10.1080/07853890902729778] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND To compare bladder cancer mortality between diabetic patients and the general population. MATERIALS AND METHODS Yearly sex-specific mortality rates for age 25-64, 65-74, and > or =75 years in Taiwanese general population for 1995-2006 were calculated; 113,347 diabetic men and 131,573 diabetic women aged > or =25 years recruited in 1995-1998 were followed prospectively. RESULTS In the general population, 4,943 men and 2,291 women died of bladder cancer, and aging was associated with increased risk. Although the trend of crude mortality was increasing in either sex, the trend of age-standardized rates had been steady. The average crude and age-standardized mortality rates were 5.35 and 5.98 (per 100,000 population), respectively, for men; and were 2.63 and 3.02 for women. A total of 224 diabetic men and 126 diabetic women died of bladder cancer with crude mortality of 26.0 and 11.9 per 100,000 person-years, respectively. The relative risk of bladder cancer mortality (95% confidence interval) for diabetic patients was 2.18 (1.75-2.72), 2.50 (2.06-3.04), and 5.95 (4.57-7.74), in men, and 1.34 (0.96-1.89), 2.48 (1.92-3.19), and 7.44 (5.46-10.15), in women, for ages > or =75, 65-74, and 25-64 years, respectively. CONCLUSIONS Diabetic patients had a higher risk of bladder cancer mortality, which is more remarkable in the younger population.
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Affiliation(s)
- Chin-Hsiao Tseng
- Department of Internal Medicine, National Taiwan University College of Medicine, No. 7 Chung-Shan South Road, Taipei, Taiwan.
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23
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Chen X, Wang Y. The epidemic of diabetes and its impact on cardiovascular health in contemporary China. ACTA ACUST UNITED AC 2009. [DOI: 10.1016/j.cvdpc.2008.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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24
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Tsai AC, Lin YR. Sex and ethnic disparities in weight and height among children of transnational couples, aborigines, and Han Chinese in Taiwan. Nutr Res 2008; 28:664-70. [DOI: 10.1016/j.nutres.2008.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2007] [Revised: 06/13/2008] [Accepted: 06/25/2008] [Indexed: 10/21/2022]
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25
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Pan WH, Lee MS, Chuang SY, Lin YC, Fu ML. Obesity pandemic, correlated factors and guidelines to define, screen and manage obesity in Taiwan. Obes Rev 2008; 9 Suppl 1:22-31. [PMID: 18307695 DOI: 10.1111/j.1467-789x.2007.00434.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The prevalence of obesity and associated chronic diseases has increased rapidly in Taiwan. Data from three consecutive Nutrition and Health surveys in Taiwan show that obesity prevalence has tripled for elementary school boys and doubled for girls since 1993-1996. About one-third of boys (15.5% and 14.7% for overweight and obesity, respectively) and one-quarter of girls were either overweight (14.4%) or obese (9.1%) in 2001-2002. For adults, obesity prevalence rates defined by body mass index > or = 27 kg m(-2) increased from 10.5% in men and 13.2% in women in the 1993-1996 survey, to around 17% in 2005. Prevalence of overweight was around 20% in 1993-1996 for both men or women, and increased to 30% in 2005 for men. No change was found in women. The underprivileged regions usually had higher prevalence of obesity and associated diseases. Scientific bases for Taiwan obesity definition are set out together with the screening and management plans. High-calorie intake was associated with obesity in young children (grades 1-2), but not in older children and adults. Physical inactivity and sedentary lifestyle-related variables were associated with obesity in men and older boys. In addition, good dietary quality was associated with a lower risk of obesity independent of energy intake in elderly Taiwanese. More research is needed to find effective determinants and public health measures for obesity, and concerted efforts are required to combat this rising health problem.
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Affiliation(s)
- W-H Pan
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan.
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26
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The ethnicity of Hakka is associated with a higher risk of hypertension than Fukienese in Taiwanese type 2 diabetic patients. J Hum Hypertens 2008; 22:370-2. [PMID: 18288126 DOI: 10.1038/jhh.2008.7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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27
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Liu CC, Wu WJ, Lee YC, Wang CJ, Ke HL, Li WM, Hsiao HL, Yeh HC, Li CC, Chou YH, Huang CH, Huang SP. The prevalence of and risk factors for androgen deficiency in aging Taiwanese men. J Sex Med 2008; 6:936-946. [PMID: 19210712 DOI: 10.1111/j.1743-6109.2008.01171.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Androgen deficiency in aging men has attracted much medical interest. Most studies on androgen deficiency have been conducted in Caucasian populations, and data from other ethnicities are lacking. AIM To evaluate the prevalence of and risk factors for androgen deficiency and symptomatic androgen deficiency in Taiwanese men over 40 years old. METHODS From August 2007 to April 2008, a free health screening was conducted by a medical center in Kaohsiung, Taiwan, and 819 men participated in this health screening. All participants completed a health questionnaire, received a detailed physical examination, and blood samples were drawn between 8:00 and 12:00 am. MAIN OUTCOME MEASURES Serum total testosterone (TT), albumin, and sex hormone-binding globulin levels were measured. The level of free testosterone (FT) was calculated. Clinical symptoms of androgen deficiency were assessed using the Androgen Deficiency in the Aging Male (ADAM) questionnaire. RESULTS Seven hundred thirty-four men who met the inclusion criteria (mean age 57.4 +/- 6.7 years; range: 43-87 years) were included in this study. The prevalence of androgen deficiency was 24.1% based on the criterion of TT level < 300 ng/dL, and 16.6% based on the criterion of both TT < 300 ng/dL and FT < 5 ng/dL. The prevalence of symptomatic androgen deficiency was 12.0%. Both prevalence of androgen deficiency and symptomatic androgen deficiency increased with age. Older age, obesity, and diabetes mellitus were independent risk factors for androgen deficiency and symptomatic androgen deficiency. CONCLUSIONS In a sample of aging Taiwanese men, a substantial proportion had androgen deficiency and symptomatic androgen deficiency, and the prevalence increased with age. Older age, obesity, and diabetes mellitus were independent risk factors for androgen deficiency and symptomatic androgen deficiency. Those potentially modifiable risk factors like obesity and diabetes mellitus should be prevented to maintain normal testosterone levels during aging in men.
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Affiliation(s)
- Chia-Chu Liu
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Wen-Jeng Wu
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan;; Department of Urology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yung-Chin Lee
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan;; Department of Urology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chii-Jye Wang
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan;; Department of Urology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hung-Lung Ke
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan;; Department of Urology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wei-Ming Li
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Hsi-Lin Hsiao
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Hsin-Chih Yeh
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ching-Chia Li
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yii-Her Chou
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan;; Department of Urology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Hsiung Huang
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan;; Department of Urology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shu-Pin Huang
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan;; Department of Urology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;; Department of Urology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan.
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Wang SL, Chang FH, Liou SH, Wang HJ, Li WF, Hsieh DPH. Inorganic arsenic exposure and its relation to metabolic syndrome in an industrial area of Taiwan. ENVIRONMENT INTERNATIONAL 2007; 33:805-11. [PMID: 17481731 DOI: 10.1016/j.envint.2007.03.004] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2006] [Revised: 01/26/2007] [Accepted: 03/16/2007] [Indexed: 05/15/2023]
Abstract
Past arsenic exposure was found associated with increased incidence of type 2 diabetes. However, the mechanisms remain unclear. Metabolic syndrome has been shown as a strong predictor for diabetes occurrence. We aimed at examining the association of inorganic arsenic exposure and the prevalence of metabolic syndrome. The authors recruited 660 age and gender stratified random population of residents in central Taiwan during 2002-2003. They received home interviews and health examinations at local health care units, where blood and hair specimens were collected. Hair arsenic (H-As) concentrations were determined by inductively coupled plasma-mass spectrometry. Metabolic syndrome was defined as the presence of three or more of the following risk factors: elevated levels of blood pressure, plasma glucose, and triglycerides, also the body mass index, and reduced high-density lipoprotein. Prevalence of metabolic syndrome increased from the 2nd tertile (0.034 ug/g) of H-As levels (odds ratio=2.54, 95% confidence interval: 1.20-5.39, p=0.015) after the adjustment for age, gender, occupation and life styles including cigarette smoking. We further found linear relation between H-As concentrations and increased levels of plasma glucose and lipids, and blood pressures. This first report may help identify modifiable factors associated with diabetogenesis and cardiovascular disease progression and thus be worth following for community health.
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Affiliation(s)
- Shu-Li Wang
- Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Taiwan, ROC
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29
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Le C, Chongsuvivatwong V, Geater A. Contextual socioeconomic determinants of cardiovascular risk factors in rural south-west China: a multilevel analysis. BMC Public Health 2007; 7:72. [PMID: 17480237 PMCID: PMC1871581 DOI: 10.1186/1471-2458-7-72] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2006] [Accepted: 05/05/2007] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND We examined independent influences of contextual variables on cardiovascular risk factors in Shilin county, Yunnan province, South-west China. METHODS Three villages were selected from each of the ten townships based on probability proportional to size. In each selected village, 200 individuals aged > or = 45 years were chosen based on simple random sampling method. From 6006 individuals, information on demographic characteristics, smoking and drinking status was obtained by interview. Blood pressure, height, weight, and waist and hip girth were measured. Fasting blood sugar was measured in a 10-percent subsample. Contextual data were from official reports. Multi-level regression modelling with adjustment for individual and contextual variables was used. RESULTS Contextual variables associated with CVD risk factors included: remoteness of village with higher blood pressure and fasting blood sugar, high proportion of Yi minority with drinking, high literacy rate with a lower rate of smoking and a lower mean waist-hip ratio, and high average income with lower systolic blood pressure and body mass index (BMI) but higher FBS. CONCLUSION While contextual SES is associated with a few CVD risk factors, villages with high level of income are worse off in fasting blood sugar. Strategies of economic development should be reviewed to avoid adverse effects on health.
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Affiliation(s)
- Cai Le
- 191 Western Renmin Road, Department of Health Information and Economics, Faculty of Public Health, Kunming Medical College, Kunming 650031, China
| | | | - Alan Geater
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90112, Thailand
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Guh JY, Chen HC, Tsai JF, Chuang LY. Herbal Therapy Is Associated With the Risk of CKD in Adults Not Using Analgesics in Taiwan. Am J Kidney Dis 2007; 49:626-33. [PMID: 17472844 DOI: 10.1053/j.ajkd.2007.02.259] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2006] [Accepted: 02/13/2007] [Indexed: 11/11/2022]
Abstract
BACKGROUND Taiwan has the greatest incidence rate of end-stage renal disease in the world. Several cases of Chinese herb nephropathy were reported in Taiwan. Therefore, we studied the association between herbal therapy and chronic kidney disease (CKD) in Taiwan. STUDY DESIGN Cross-sectional survey. SETTING & PARTICIPANTS 1,740 adults in the Nutrition and Health Survey in Taiwan (1993 to 1996). PREDICTOR Herbal and analgesic therapy. OUTCOMES & MEASUREMENTS CKD after adjustment for potential confounding variables. RESULTS Among medication users, prevalences of herbal therapy and analgesic use were 21.6% and 13.2%, respectively. The prevalence of CKD was 9.9%. Participants with CKD were older and had more analgesic use, diabetes, hypertension, and cardiovascular disease. Analgesic use was associated independently and positively with CKD (odds ratio, 2.2; 95% confidence interval, 1.4 to 3.5; P = 0.003) and CKD stage (odds ratio, 2.3; 95% confidence interval, 1.4 to 3.6; P = 0.003). Conversely, herbal therapy was associated independently and positively with CKD (odds ratio, 1.39; 95% confidence interval, 1.2 to 1.7; P = 0.002) and CKD stage (odds ratio, 1.38; 95% confidence interval, 1.1 to 1.7; P = 0.004) only in participants who did not use analgesics. LIMITATIONS Because this was a cross-sectional study, cause and effect could not be ascertained. CONCLUSIONS Herbal therapy was associated with CKD in adults in Taiwan who did not use analgesics.
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Affiliation(s)
- Jinn-Yuh Guh
- Department of Internal Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Guh JY, Chen HC, Tsai JF, Chuang LY. Betel-quid use is associated with heart disease in women. Am J Clin Nutr 2007; 85:1229-35. [PMID: 17490957 DOI: 10.1093/ajcn/85.5.1229] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Betel quid (Areca catechu) is used by approximately 10% of the world population. Betel-quid use is associated with the metabolic syndrome--a risk factor for heart disease. OBJECTIVE The objective was to test whether betel-quid use is associated with heart disease in adults. DESIGN Nonpregnant adults aged 20-64 y (n=1932, 52% women) from the nationally representative Nutrition and Health Survey in Taiwan (1993-1996) were studied for independent associations between betel-quid use and heart disease after adjustment for lifestyle factors, age, obesity, diabetes mellitus, hypertension, and concentrations of serum total cholesterol and HDL cholesterol. RESULTS The prevalence of betel-quid use was higher in men than in women (31% compared with 2.4%; P<0.001). The prevalence of heart disease was not significantly different between men and women (3.3% compared with 2.3%; P=0.12). The prevalence of betel-quid use decreased, whereas the prevalence of heart disease increased, with age. Betel-quid users were younger, drank more, had a lower dietary fruit intake, had a higher Framingham risk score, and had higher serum triacylglycerol concentrations than did the nonusers. At a mean consumption rate of 10 times/d (the third quartile of betel-quid consumption in betel-quid users), betel-quid use was independently associated with the Framingham risk score in subjects without heart disease only if obesity was not included as an adjustment factor (P=0.007). Moreover, the daily rate of betel-quid use was independently associated with prevalent heart disease; the odds ratio associated with a betel-quid consumption rate of 10 times/d was 1.37 (95% CI: 1.1, 1.6; P=0.003) in women. CONCLUSION Betel-quid use is independently associated with heart disease in women.
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Affiliation(s)
- Jinn-Yuh Guh
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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Wen CP, Cheng TYD, Tsai SP, Hsu HL, Chan HT, Hsu CC. Exploring the relationships between diabetes and smoking: with the development of glucose equivalent concept for diabetes management. Diabetes Res Clin Pract 2006; 73:70-6. [PMID: 16417941 DOI: 10.1016/j.diabres.2005.12.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2005] [Accepted: 12/01/2005] [Indexed: 11/18/2022]
Abstract
The extent of interaction between smoking and diabetes has been under-appreciated. Smokers had more diabetes, and when diabetes patients smoke, the combined mortality effect was greater than either the addition or multiplication of these two medical problems. Patients seen in the office are usually more interested in reducing blood glucose than in quitting smoking, and yet, smoking caused mortality risks, at a magnitude similar to or more than diabetes. The concept of "glucose equivalent of smoking" was developed to direct more attention to smoking in clinical management. Based on the follow-up observations from a large Asian cohort, the risk of an individual who smokes, from all-cause mortality, was found to be equivalent to an elevation of blood glucose by an average of 41mg/dl for the cohort in general and 68mg/dl for the diabetes in particular. By relating the message of smoking hazards in terms of "glucose equivalent", clinicians will be more alerted to counsel and patients will be more likely to quit. Appreciating this concept has a potential to change the paradigm of diabetes management, to bridge the clinical disconnect between the two, and to provide new ammunition for the diabetes epidemic in Taiwan.
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Affiliation(s)
- Chi Pang Wen
- Division of Health Policy Research, National Health Research Institutes, 35 Keyan Road, Zhunan Town, Miaoli County 350, Taiwan, ROC.
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Guh JY, Chuang LY, Chen HC. Betel-quid use is associated with the risk of the metabolic syndrome in adults. Am J Clin Nutr 2006; 83:1313-20. [PMID: 16762942 DOI: 10.1093/ajcn/83.6.1313] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Betel-quid use has been associated with obesity and hyperglycemia in previous studies. OBJECTIVE The aim was to test whether betel-quid use contributes to the metabolic syndrome, as defined by the National Cholesterol Education Program Adult Treatment Panel III. DESIGN Associations between betel-quid use and the metabolic syndrome, obesity, hypertriacylglycerolemia, low HDL cholesterol, hyperglycemia, and high blood pressure after adjustment for sex, age, smoking, alcohol drinking, physical activity, and dietary intakes were studied in nonpregnant adults aged 20-64 y (n = 1986) from the Nutrition and Health Survey in Taiwan (1993-1996). RESULTS The prevalence of the metabolic syndrome was not significantly different between the men and women (10.1% compared with 9.7%), whereas the prevalence of betel-quid use was higher in the men than in the women (31% compared with 2.3%; P < 0.001). The daily rate of betel-quid use was associated with the metabolic syndrome [odds ratio (OR) associated with a betel-quid consumption rate of 10 times/d: 1.31; 95% CI: 1.12, 1.55; P = 0.003], abdominal obesity (OR: 1.42; 95% CI: 1.2, 1.7; P = 0.001), hypertriacylglycerolemia (OR: 1.33; 95% CI: 1.02, 1.73; P = 0.037), and high blood pressure (OR: 1.2; 95% CI: 1.01, 1.4; P = 0.04). However, the daily rate of betel-quid use was not associated with low HDL cholesterol or hyperglycemia. CONCLUSION The daily rate of betel-quid use is independently and positively associated with the metabolic syndrome in adults.
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Affiliation(s)
- Jinn-Yuh Guh
- Department of Internal Medicine, Kaohs iung Medical University, Kaohsiung, Taiwan
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Wen CP, Cheng TYD, Tsai SP, Hsu HL, Wang SL. Increased mortality risks of pre-diabetes (impaired fasting glucose) in Taiwan. Diabetes Care 2005; 28:2756-61. [PMID: 16249552 DOI: 10.2337/diacare.28.11.2756] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The objective of this article was to assess mortality risks at different levels of fasting blood glucose (FBG) in Taiwan, with particular attention to those pre-diabetic subjects with impaired fasting glucose (IFG). RESEARCH DESIGN AND METHODS Governmental employees and schoolteachers were followed up for an average of 11 years. With the use of Cox regression analyses, mortality risks were calculated for 36,386 subjects, aged 40-69. RESULTS FBG > or =110 mg/dl was associated with increased mortality risks for all causes, cardiovascular diseases (CVD), and diabetes. IFG, when defined as 110-125 mg/dl, was associated with a significant increase for CVD and/or diabetes mortality. These mortality risks remained elevated when known CVD risk factors were adjusted for. The IFG group shared risk factor characteristics more with the FBG > or =126 mg/dl group than with the FBG <110 mg/dl group. When IFG was defined as 100-125 mg/dl, the number of subjects quadrupled, but mortality risks diminished substantially because of the inclusion of 100-109 mg/dl group. The lowest FBG group, 50-75 mg/dl, had a significant 2-fold risk from all causes. CONCLUSIONS There was an overall J-shaped relationship between all-cause mortality and FBG. IFG, when defined as 110-125 mg/dl, is an independent risk factor and should be aggressively treated as a disease because its subsequent mortality risks for CVD and diabetes were significantly increased. The newly defined IFG at 100-125 mg/dl did not have the predictive power for later increases in CVD or diabetes mortality.
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Affiliation(s)
- Chi Pang Wen
- Division of Health Policy Research, National Health Research Institutes, Taiwan, ROC.
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Abstract
OBJECTIVE To examine the association of body mass index (BMI), waist-hip ratio (WHR), and waist circumference (WC) with fasting hyperglycemia after adjustment for age, cigarette smoking, and alcohol use. DESIGN A cross-sectional survey was conducted among individuals visiting four health-screening centers across Taiwan. SUBJECTS A total of 61 568 subjects (28 734 men and 32 834 women) between 25 and 64 years of age were included. Fasting hyperglycemia was defined as fasting plasma glucose > or =6.1 mmol/l or current diagnosis and use of insulin or hypoglycemic agent. RESULTS Fasting hyperglycemia was found in 11.0% of men and 8.3% of women. The factors significantly associated with fasting hyperglycemia in men were age, BMI, WHR, and heavy drinking, while for women these factors were age, educational level, BMI, WHR, and heavy smoking. For men, increased risk of fasting hyperglycemia started from age 30 to 34 years, BMI > or =25 kg/m2, and WHR > or =0.82. For women, increased risk of fasting hyperglycemia started from age 35 to 39 years, BMI > or =24 kg/m2, and WHR > or =0.74. WC lost its significance as a predictor of fasting hyperglycemia when WHR included in the model. CONCLUSION This study found that central obesity and general obesity were both independently associated with increased risk of fasting hyperglycemia in Taiwanese. The relationship between fasting hyperglycemia and central fat accumulation (WHR) begins to appear at levels that would not be regarded as representing obesity in Western populations, suggesting the need to redefine cutoffs for central obesity in this population.
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Affiliation(s)
- L-Y Chien
- Institute of Community Health Nursing, National Yang-Ming University, Taipei, Taiwan
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Current literature in diabetes. Diabetes Metab Res Rev 2003; 19:333-40. [PMID: 12879412 DOI: 10.1002/dmrr.349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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