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Sheibani H, Esmaeili H, Tayefi M, Saberi-Karimian M, Darroudi S, Mouhebati M, Azarpazhooh MR, Divbands G, Ferns GA, Safarian M, Ghayour-Mobarhan M. A comparison of body mass index and percent body fat as predictors of cardiovascular risk factors. Diabetes Metab Syndr 2019; 13:570-575. [PMID: 30641768 DOI: 10.1016/j.dsx.2018.11.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 11/02/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Cardiovascular disease (CVD) is an important cause of global mortality and morbidity. Body mass index (BMI) is the measure of adiposity that is used most frequently in CVD risk algorithms. AIMS We aimed to assess the relationship between several CVD risk factors (RFs) and percent body fat (PBF), and to compare the predictive values obtained using PBF for these cardiovascular RFs with the values obtained using BMI. The CVD RFs included, hypertension (HTN), diabetes mellitus (DM) and the presence of dyslipidemia (DLP). METHODS AND MATERIALS The data were derived from the MASHAD study, a cohort study of 9704 volunteers, aged 35-65 years and living in the city of Mashhad. Based on BMI and PBF values, subjects were classified into 4 groups; group 1 (low or normal BMI and PBF, N = 1670), group 2 (low or normal BMI but high PBF, N = 992), group 3 (high BMI and low or normal PBF, N = 837), and group 4 (high BMI and PBF, N = 6245). Chi-square, covariance and logistic regression were used to analyze the data at a significance level of 0.05. RESULTS There was an increasing trend from group 1 to group 4 for the mean values of all CVD RFs and their prevalence. There were significant differences in the frequency of a low HDL-C, this was substantially higher in Group 3 (38.6% in Group 3 versus 12.2% in Group 2); the frequency of a high serum TG (24% in Group 3 versus 9.9% in Group 2) and the frequency of dyslipidemia overall (56.2% in Group 3 and 28.8% in Group 2) (P-value<0.001 for all comparisons). The frequency of hypertension (22.9% in Group 3 versus 16.2% in Group 2) and IFG (8.5% in Group 3 versus 5.0% in Group 2) were also substantially higher in Group 3 compared to Group 2 (P-value<0.001 for both comparisons). All the mean values for the RFs were higher in group 3 from group 2 except HDL-C. When Group 1 was used as a reference and calculated OR of any RF for any group 2-4 rather than group 1, OR for all RF in group 3 was higher from group 2. CONCLUSION The differences in frequency, means and OR of RFs between Groups 2 and 3 showed a differential impact of a high BMI or high PBF. Compared to PBF, BMI may be a better predictor for several RFs for CVD.
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Affiliation(s)
- Hosein Sheibani
- Vice-chancellery of Treatment, Shahroud University of Medical Science, Shahroud, Iran; Imam Hossein Center for Education, Research and Treatment, Shahroud University of Medical Science, Shahroud, Iran
| | - Habibollah Esmaeili
- Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Tayefi
- Clinical Research Unit, Mashhad University of Medical Sciences, Mashhad, Iran; Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Saberi-Karimian
- Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Susan Darroudi
- Student Research Committee, Department of Modern Sciences and Technologies, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Mouhebati
- Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohmoud Reza Azarpazhooh
- Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ghasemali Divbands
- Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex, BN1 9PH, UK
| | - Mohammad Safarian
- Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Majid Ghayour-Mobarhan
- Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Schwandt A, Bergis D, Dapp A, Ebner S, Jehle PM, Köppen S, Risse A, Zimny S, Holl RW. Psoriasis and Diabetes: A Multicenter Study in 222078 Type 2 Diabetes Patients Reveals High Levels of Depression. J Diabetes Res 2015; 2015:792968. [PMID: 26357664 PMCID: PMC4556326 DOI: 10.1155/2015/792968] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 07/01/2015] [Accepted: 07/22/2015] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE This study aimed to investigate the association between psoriasis and disease outcome in type 2 diabetes (T2D). METHODS 222078 T2D patients (≥10 years old) from the prospective, multicenter diabetes patient registry were analyzed. Specific search items were used to identify psoriasis patients. Multiple regression models were fitted and adjusted for demographic confounder. RESULTS 232 T2D patients had comorbid psoriasis. After adjusting psoriasis patients revealed a higher BMI (31.8 [31.0; 32.6] versus 30.6 [30.5; 30.6] kg/m2, p = 0.004) and HbA1c (64.8 [62.1; 67.6] versus 59.0 [58.9; 59.1] mmol/mol, p < 0.0001). Insulin was used more frequently (62.3 [55.7; 68.5] versus 50.9 [50.7; 51.1] %, p = 0.001), only OAD/GLP-1 was similar, and nonpharmacological treatment was less common (13.3 [9.5; 18.3] versus 21.9 [21.7; 22.1] %, p = 0.002). Severe hypoglycemia (0.31 [0.238; 0.399] versus 0.06 [0.057; 0.060] events per patient-year, p < 0.0001), hypertension (86.1 [81.1; 90.0] versus 68.0 [67.8; 68.2] %, p < 0.0001), and thyroid disease (14.0 [10.1; 19.2] versus 4.6 [4.5; 4.7] %, p < 0.0001) were more prevalent. Depression occurred more often (10.5 [7.1; 15.2] versus 2.8 [2.7; 2.8] %, p < 0.0001). CONCLUSIONS Clinical diabetes characteristics in psoriasis T2D patients were clearly worse compared to patients without psoriasis. Comorbid conditions and depression were more prevalent, and more intensive diabetes therapy was required.
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Affiliation(s)
- Anke Schwandt
- Institute of Epidemiology and Medical Biometry, Central Institute for Biomedical Technology, German Center for Diabetes Research (DZD), University of Ulm, Albert-Einstein-Allee 41, 89081 Ulm, Germany
- *Anke Schwandt:
| | - Dominik Bergis
- Division of Endocrinology & Metabolism, Department of Internal Medicine I, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Albrecht Dapp
- Medical Clinic, Health Center Spaichingen, Diabetes Center, Hospital District Tuttlingen, Robert Koch Straße 31, 78549 Spaichingen, Germany
| | - Stefan Ebner
- 2nd Department of Internal Medicine, General Hospital Linz, Krankenhausstraße 9, 4021 Linz, Austria
| | - Peter M. Jehle
- Department of Internal Medicine, Academic Hospital Paul Gerhardt Stift, Martin Luther University of Halle-Wittenberg, Paul-Gerhardt-Straße 42-45, 06886 Lutherstadt Wittenberg, Germany
| | - Stefan Köppen
- 2nd Department of Internal Medicine, Clinical Center HELIOS Hildesheim, Senator-Braun-Allee 33, 31135 Hildesheim, Germany
| | - Alexander Risse
- Department of Diabetes, Clinical Center Dortmund GmbH, Beurhausstraße 40, 44137 Dortmund, Germany
| | - Stefan Zimny
- Department of General Internal Medicine, Endocrinology and Diabetes, HELIOS Clinic Schwerin, Wismarsche Straße 393-397, 19049 Schwerin, Germany
| | - Reinhard W. Holl
- Institute of Epidemiology and Medical Biometry, Central Institute for Biomedical Technology, German Center for Diabetes Research (DZD), University of Ulm, Albert-Einstein-Allee 41, 89081 Ulm, Germany
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Scheuing N, Bartus B, Berger G, Haberland H, Icks A, Knauth B, Nellen-Hellmuth N, Rosenbauer J, Teufel M, Holl RW. Clinical characteristics and outcome of 467 patients with a clinically recognized eating disorder identified among 52,215 patients with type 1 diabetes: a multicenter german/austrian study. Diabetes Care 2014; 37:1581-9. [PMID: 24623022 DOI: 10.2337/dc13-2156] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To compare clinical characteristics and outcome of type 1 diabetes mellitus (T1DM) between patients with and without a clinically recognized eating disorder (ED). RESEARCH DESIGN AND METHODS A total of 52,215 T1DM patients aged 8 to <30 years from the prospective diabetes data acquisition system DPV were analyzed. A total of 467 patients had an additional diagnosis of ED according to DSM-IV criteria (anorexia nervosa [AN], n = 141 [female: 94.3%]; bulimia nervosa [BN], n = 62 [90.3%]; and EDs not otherwise specified, including binge-eating disorder [EDNOS], n = 264 [74.2%]). Groups were compared using multivariable regression. Cox proportional hazard ratios were calculated for the association between ED and retinopathy. RESULTS After adjustment for age, sex, and duration of diabetes, patients with ED revealed higher HbA1c (no ED vs. AN, BN, or EDNOS, respectively: 8.29 ± 0.01% [67.1 ± 0.1 mmol/mol] vs. 8.61 ± 0.15% [70.6 ± 1.6 mmol/mol], 9.11 ± 0.23% [76.1 ± 2.5 mmol/mol], or 9.00 ± 0.11% [74.9 ± 1.2 mmol/mol]) and a higher rate of pathological insulin injection sites (48.4 vs. 64.3, 64.1, or 62.1%). Furthermore, ketoacidosis (5.7 ± 0.1 vs. 12.1 ± 2.1, 18.0 ± 4.1, or 12.9 ± 1.6 events per 100 person-years) and hospitalization (54.9 ± 0.3 vs. 89.3 ± 6.0, 132.0 ± 12.7, or 91.0 ± 4.4 per 100 person-years) were more common, and duration of hospital stay was longer (4.81 ± 0.01 vs. 11.31 ± 0.21, 18.05 ± 0.48, or 8.44 ± 0.13 days per year). All P values were <0.05. Patients with BN and EDNOS had a 2.5-fold (95% CI 1.3-4.8) and a 1.4-fold (0.8-2.3) higher risk for retinopathy, whereas AN patients had no increased risk (0.9 [95% CI 0.4-2.3]). CONCLUSIONS Diabetes health care professionals should be aware of comorbid EDs in pediatric/young-adult T1DM patients. An ED diagnosis is associated with worse metabolic control and higher rates of diabetes complications.
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Affiliation(s)
- Nicole Scheuing
- Institute of Epidemiology and Medical Biometry, Central Institute for Biomedical Technology, University of Ulm, Ulm, Germany
| | - Béla Bartus
- Pediatric Clinic, Olgahospital Stuttgart, Stuttgart, Germany
| | - Gabriele Berger
- Department of Pediatrics and Adolescent Medicine, Medical University Vienna, Vienna, Austria
| | - Holger Haberland
- Hospital for Children and Adolescents, Sana Hospital Berlin Lindenhof, Berlin, Germany
| | - Andrea Icks
- Department of Public Health, Heinrich-Heine University Düsseldorf, Düsseldorf, GermanyInstitute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center at University of Düsseldorf, Düsseldorf, Germany
| | - Burkhild Knauth
- Diabetes Centre, Christian Association of Youth Villages Berchtesgaden Health-Education-Employment, Berchtesgaden, Germany
| | | | - Joachim Rosenbauer
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center at University of Düsseldorf, Düsseldorf, Germany
| | - Martin Teufel
- Department of Internal Medicine, Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Reinhard W Holl
- Institute of Epidemiology and Medical Biometry, Central Institute for Biomedical Technology, University of Ulm, Ulm, Germany
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Impact of the body mass on complications and outcome in multiple trauma patients: what does the weight weigh? Mediators Inflamm 2013; 2013:345702. [PMID: 24023413 PMCID: PMC3760114 DOI: 10.1155/2013/345702] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Revised: 03/24/2013] [Accepted: 05/22/2013] [Indexed: 11/18/2022] Open
Abstract
Obesity is known as an independent risk factor for various morbidities. The influence of an increased body mass index (BMI) on morbidity and mortality in critically injured patients has been investigated with conflicting results. To verify the impact of weight disorders in multiple traumatized patients, 586 patients with an injury severity score >16 points treated at a level I trauma center between 2005 and 2011 were differentiated according to the BMI and analyzed regarding morbidity and outcome. Plasma levels of interleukin- (IL-) 6 and C-reactive protein (CRP) were measured during clinical course to evaluate the inflammatory response to the "double hit" of weight disorders and multiple trauma. In brief, obesity was the highest risk factor for development of a multiple organ dysfunction syndrome (MODS) (OR 4.209, 95%-CI 1.515-11.692) besides injury severity (OR 1.054, 95%-CI 1.020-1.089) and APACHE II score (OR 1.059, 95%-CI 1.001-1.121). In obese patients as compared to those with overweight, normal weight, and underweight, the highest levels of CRP were continuously present while increased systemic IL-6 levels were found until day 4. In conclusion, an altered posttraumatic inflammatory response in obese patients seems to determine the risk for multiple organ failure after severe trauma.
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