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Huang C, Gao Z, Zhang Y, Li G. Longitudinal study on metabolic abnormalities and diabetes risk in normal-weight japanese adults. Front Endocrinol (Lausanne) 2024; 15:1445934. [PMID: 39268236 PMCID: PMC11390506 DOI: 10.3389/fendo.2024.1445934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Accepted: 08/13/2024] [Indexed: 09/15/2024] Open
Abstract
Background Diabetes is a significant global health concern, with a growing prevalence in Japan. Individuals with normal body mass index who are metabolically unhealthy exhibit an elevated risk of diabetes onset. Investigating the relationship between Metabolically Unhealthy Normal-weight (MUNW) status and the risk of diabetes in non-diabetic individual is vital for implementing early preventive strategies. Methods Using data from the NAGALA cohort, This study categorized 8,194 Japanese adults based on the score of metabolic syndrome (MetS) components they possessed. Cox proportional hazards regression models and multivariate logistic regression were used to assess the relationship between MUNW and the risk of developing diabetes, with analyses stratified by age and sex. Results During an average follow-up of 7.19 years, 123 participants (1.5%) were diagnosed with diabetes. Among the participants, 766 (9.35%) were classified as MUNW, and 157 (1.92%) as having MetS. Compared to those with no MetS components, individuals with 1, 2, and ≥3 MetS components had progressively higher adjusted hazard ratios (HRs) for developing diabetes, at 4.56, 8.79, and 25.16, respectively. Further stratified analysis revealed that men aged ≤40 years had the highest risk of developing diabetes. For men, the adjusted HRs for having 1, 2, and ≥3 MetS components were 5.61, 7.80, and 28.59, respectively, and for participants aged ≤40 years, the HRs were 12.31, 25.57, and 129.82, respectively. Conclusion The prevalence of MUNW in non-diabetic individuals in Japan is 9.35%. The score of MetS components was positively correlated with the risk of diabetes. Early intervention and lifestyle modifications are crucial, especially for MUNW individuals and notably young Japanese men aged ≤40 years, for the prevention and management of diabetes.
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Affiliation(s)
- Cheng Huang
- Department of Colorectal Surgery, First People's Hospital of Xiaoshan District, Hangzhou, Zhejiang, China
| | - Zhichao Gao
- Department of Neurosurgery, First People's Hospital of Xiaoshan District, Hangzhou, Zhejiang, China
| | - Yuhang Zhang
- Department of Orthopedics, First People's Hospital of Xiaoshan District, Hangzhou, Zhejiang, China
| | - Guofeng Li
- Department of Colorectal Surgery, First People's Hospital of Xiaoshan District, Hangzhou, Zhejiang, China
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Wei J, Ou Y, Chen J, Yu Z, Wang Z, Wang K, Yang D, Gao Y, Liu Y, Liu J, Zheng X. Mapping global new-onset, worsening, and resolution of diabetes following partial pancreatectomy: a systematic review and meta-analysis. Int J Surg 2024; 110:1770-1780. [PMID: 38126341 PMCID: PMC10942179 DOI: 10.1097/js9.0000000000000998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND AND AIMS Partial pancreatectomy, commonly used for chronic pancreatitis, or pancreatic lesions, has diverse impacts on endocrine and metabolism system. The study aims to determine the global prevalence of new-onset, worsening, and resolution of diabetes following partial pancreatectomy. METHODS The authors searched PubMed, Embase, Web of Science, and Cochrane Library from inception to October, 2023. DerSimonian-Laird random-effects model with Logit transformation was used. Sensitivity analysis, meta-regression, and subgroup analysis were employed to investigate determinants of the prevalence of new-onset diabetes. RESULTS A total of 82 studies involving 13 257 patients were included. The overall prevalence of new-onset diabetes after partial pancreatectomy was 17.1%. Univariate meta-regression indicated that study size was the cause of heterogeneity. Multivariable analysis suggested that income of country or area had the highest predictor importance (49.7%). For subgroup analysis, the prevalence of new-onset diabetes varied from 7.6% (France, 95% CI: 4.3-13.0) to 38.0% (UK, 95% CI: 28.2-48.8, P <0.01) across different countries. Patients with surgical indications for chronic pancreatitis exhibited a higher prevalence (30.7%, 95% CI: 21.8-41.3) than those with pancreatic lesions (16.4%, 95% CI: 14.3-18.7, P <0.01). The type of surgical procedure also influenced the prevalence, with distal pancreatectomy having the highest prevalence (23.7%, 95% CI: 22.2-25.3, P <0.01). Moreover, the prevalence of worsening and resolution of preoperative diabetes was 41.1 and 25.8%, respectively. CONCLUSIONS Postoperative diabetes has a relatively high prevalence in patients undergoing partial pancreatectomy, which calls for attention and dedicated action from primary care physicians, specialists, and health policy makers alike.
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Affiliation(s)
- Junlun Wei
- Department of Endocrinology and Metabolism, Center for Diabetes and Metabolism Research
| | - Yiran Ou
- Department of Endocrinology and Metabolism, Center for Diabetes and Metabolism Research
| | - Jiaoting Chen
- Department of Endocrinology and Metabolism, Center for Diabetes and Metabolism Research
| | - Zhicheng Yu
- Department of Economics, Keio University, Minato city, Tokyo, Japan
| | - Zhenghao Wang
- Department of Endocrinology and Metabolism, Center for Diabetes and Metabolism Research
| | - Ke Wang
- Department of Vascular Surgery, University Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Dujiang Yang
- Department of General Surgery, Division of Pancreatic Surgery, West China Hospital, Sichuan University
| | - Yun Gao
- Department of Endocrinology and Metabolism, Center for Diabetes and Metabolism Research
| | - Yong Liu
- Department of General Surgery, Division of Pancreatic Surgery, West China Hospital, Sichuan University
| | - Jiaye Liu
- Department of Respiratory and Critical Care Medicine, Frontiers Science Center for Disease-Related Molecular Network, Center of Precision Medicine, Precision Medicine Key Laboratory of Sichuan Province
- Laboratory of Thyroid and Parathyroid diseases, Frontiers Science Center for Disease-Related Molecular Network
- Department of General Surgery, Division of Thyroid Surgery, West China Hospital, Sichuan University
| | - Xiaofeng Zheng
- Department of Endocrinology and Metabolism, Center for Diabetes and Metabolism Research
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Gentiluomo M, Dixon-Suen SC, Farinella R, Peduzzi G, Canzian F, Milne RL, Lynch BM, Campa D. Physical Activity, Sedentary Behavior, and Pancreatic Cancer Risk: A Mendelian Randomization Study. J Endocr Soc 2024; 8:bvae017. [PMID: 38425433 PMCID: PMC10904288 DOI: 10.1210/jendso/bvae017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Indexed: 03/02/2024] Open
Abstract
Pancreatic cancer is currently the seventh leading cause of cancer death worldwide. Understanding whether modifiable factors increase or decrease the risk of this disease is central to facilitating primary prevention. Several epidemiological studies have described the benefits of physical activity, and the risks associated with sedentary behavior, in relation to cancer. This study aimed to assess evidence of causal effects of physical activity and sedentary behavior on pancreatic cancer risk. We conducted a two-sample Mendelian randomization study using publicly available data for genetic variants associated with physical activity and sedentary behavior traits and genetic data from the Pancreatic Cancer Cohort Consortium (PanScan), the Pancreatic Cancer Case-Control Consortium (PanC4), and the FinnGen study for a total of 10 018 pancreatic cancer cases and 266 638 controls. We also investigated the role of body mass index (BMI) as a possible mediator between physical activity and sedentary traits and risk of developing pancreatic cancer. We found evidence of a causal association between genetically determined hours spent watching television (hours per day) and increased risk of pancreatic cancer for each hour increment (PanScan-PanC4 odds ratio = 1.52, 95% confidence interval 1.17-1.98, P = .002). Additionally, mediation analysis showed that genetically determined television-watching time was strongly associated with BMI, and the estimated proportion of the effect of television-watching time on pancreatic cancer risk mediated by BMI was 54%. This study reports the first Mendelian randomization-based evidence of a causal association between a measure of sedentary behavior (television-watching time) and risk of pancreatic cancer and that this is strongly mediated by BMI. Summary: Pancreatic cancer is a deadly disease that is predicted to become the second leading cause of cancer-related deaths by 2030. Physical activity and sedentary behaviors have been linked to cancer risk and survival. However, there is limited research on their correlation with pancreatic cancer. To investigate this, we used a Mendelian randomization approach to examine the genetic predisposition to physical activity and sedentariness and their relation to pancreatic cancer risk, while excluding external confounders. Our findings revealed a causal link between the time spent watching television and an increased risk of pancreatic cancer. Additionally, we determined that over half of the effect of watching television on pancreatic risk is mediated by the individual's BMI.
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Affiliation(s)
- Manuel Gentiluomo
- Unit of Genetics, Department of Biology, University of Pisa, Pisa, Italy 56126
| | - Suzanne C Dixon-Suen
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria 3004, Australia
| | - Riccardo Farinella
- Unit of Genetics, Department of Biology, University of Pisa, Pisa, Italy 56126
| | - Giulia Peduzzi
- Unit of Genetics, Department of Biology, University of Pisa, Pisa, Italy 56126
| | - Federico Canzian
- Genomic Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany 69120
| | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria 3004, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria 3010, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia 3168
| | - Brigid M Lynch
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria 3004, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria 3010, Australia
- Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia 3004
| | - Daniele Campa
- Unit of Genetics, Department of Biology, University of Pisa, Pisa, Italy 56126
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Zhang MZ, Shi JX, Li H, Chen R, Zheng MB, Yan LJ, Wu NJ, He QQ. The impact of educational lifestyle intervention on body weight and psychological health among overweight/obese patients with severe mental disorders. J Affect Disord 2023; 343:71-76. [PMID: 37741469 DOI: 10.1016/j.jad.2023.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 08/29/2023] [Accepted: 09/18/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND There was a high prevalence of overweight/obesity among patients with severe mental disorders (SMD). However, studies on the lifestyle-based interventions in patients with SMD are limited. OBJECTIVE To examine the effects of an educational lifestyle intervention on body weight and psychological health among Chinese community-dwelling overweight/obese patients with SMD. METHODS Community-dwelling overweight/obese patients with SMD was recruited from Shenzhen, China in October 2020. They were randomly allocated into intervention group (IG) and control group (CG). Participants in IG received a 12-month educational lifestyle intervention, while the CG was exposed to routine care. A generalized estimating equation model was used to assess the effect of the intervention over time. RESULTS A total of 176 subjects (88 in IG and 88 in CG) aged 42.2 ± 10.9 years were included in this study. After adjusting for potential confounders, body weight (p = 0.001), body mass index (BMI, p = 0.001), and waist circumference (p = 0.027) in IG significantly decreased compared with CG after 12 months. Besides, IG had significantly higher life satisfaction than CG after intervention (p = 0.026), whereas significant reductions in depressive symptoms were observed in IG from 26.1 % at baseline to 13.6 % after the intervention (p = 0.027), and the between-group differences were marginally significant (p = 0.086). CONCLUSION An educational lifestyle intervention can effectively reduce body weight parameters and improve psychological health in overweight/obese patients with SMD.
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Affiliation(s)
- Min-Zhe Zhang
- School of Public Health, Wuhan University, Wuhan, PR China
| | - Jun-Xia Shi
- Center of Prevention and Control of Pingshan, Shenzhen, PR China
| | - Hui Li
- Medical Department, Taixing People's Hospital, Jiangsu, PR China
| | - Rui Chen
- School of Public Health, Wuhan University, Wuhan, PR China
| | - Miao-Bing Zheng
- School of Nutrition and Exercise, Deakin University, Melbourne, Australia
| | - Li-Jing Yan
- Global Health Research Center, Duke Kunshan University, Suzhou, PR China
| | - Neng-Jian Wu
- Center of Prevention and Control of Pingshan, Shenzhen, PR China
| | - Qi-Qiang He
- School of Public Health, Wuhan University, Wuhan, PR China; Hubei Biomass-Resource Chemistry and Environmental Biotechnology Key Laboratory, Wuhan University, Wuhan, PR China.
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Abdulaziz Alrashed F, Ahmad T, Almurdi MM, Alqahtani AS, Alamam DM, Alsubiheen AM. Investigating the relationship between lifestyle factors, family history, and diabetes mellitus in non-diabetic visitors to primary care centers. Saudi J Biol Sci 2023; 30:103777. [PMID: 37663393 PMCID: PMC10472303 DOI: 10.1016/j.sjbs.2023.103777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/31/2023] [Accepted: 08/05/2023] [Indexed: 09/05/2023] Open
Abstract
We investigated the risk levels associated with diabetes mellitus. They were assessed based on whether anyone in their family had a history of diabetes. The data collected are measurements of blood pressure, weight, height, and smoking habits, as well as physical activity and educational status. Based on the American Diabetes Association's (ADA) recommendations, the questionnaire included a diabetes risk assessment. The risk of diabetes was 76.3% among participants with a family history of diabetes. There is a 41.1% chance of diabetes among those participants whose fathers had diabetes, and a 39.3% chance of diabetes among those participants whose mothers had diabetes. Additionally, those participants who have siblings with diabetes were 24% at high risk for developing diabetes. The prevalence of the risk of having a family history of diabetes is higher in the women in the family (RR = 3.12; P = 0.0001) as compared to the men in the family (RR = 1.9; P = 0.0001). Risk of diabetes more in the male (1.13 times higher) in the current study based on the ADA scale. There is evidence that various factors, including lifestyle choices, physical attributes, and family history, influence the risk of developing diabetes in the current study. The results of the current study indicate that there is a strong association between patients with T2D and those who have a family history of diabetes. Considering Saudi Arabia's high diabetes risk, evidence-based lifestyle modifications are needed.
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Affiliation(s)
- Fahad Abdulaziz Alrashed
- Department of Cardiac Sciences, College of Medicine, King Saud University, P.O. Box 7805, Riyadh 11472, Saudi Arabia
| | - Tauseef Ahmad
- Department of Medical Education, College of Medicine, King Saud University, P.O. Box 7805, Riyadh 11472, Saudi Arabia
| | - Muneera M. Almurdi
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia
| | - Abdulfattah S. Alqahtani
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia
| | - Dalyah M. Alamam
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia
| | - Abdulrahman M. Alsubiheen
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia
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Li J, Sun L. The effects of curcumin supplementation on high-sensitivity C-reactive protein, serum adiponectin, and lipid profile in patients with type 2 diabetes: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e31942. [PMID: 36626493 PMCID: PMC9750569 DOI: 10.1097/md.0000000000031942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is an ensemble of metabolic diseases that has reached pandemic dimensions all over the world. There is a lack of evidence on the contribution of curcumin in the treatment of T2DM. We conducted a protocol for systematic review and meta-analysis to evaluate whether curcumin supplementation is effective and safe in T2DM patients. METHODS The systematic review will follow the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols (PRISMA-P). We will obtain studies through PubMed, Cochrane Library, Embase, Web of Science, and Medline databases. In addition, we will also collect 4 databases of China: China National Knowledge Infrastructure, China Biomedical Literature Database, China Science Journal Database, and Wan-fang Database. Eligible study conference abstracts and reference lists of manuscripts will be searched. The data collection and analysis will be conducted independently by 2 reviewers. Meta-analysis will be performed using Review Manager software, version 5.3 (Update Software Ltd, Oxford, Oxon, UK). RESULTS The results of this systematic review and meta-analysis will be published in a peer-reviewed journal. CONCLUSION The findings of this systematic review may encourage supplementation of curcumin and its preparation specifically in T2DM patients. Nevertheless, the application of curcumin supplementation in clinical practice should be taken with individual's contributing factors.
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Affiliation(s)
- Jie Li
- Department of Clinical Laboratory, First People’s Hospital of Tianshui, Gansu, China
| | - Lifang Sun
- Department of Blood Transfusion, First People’s Hospital of Tianshui, Gansu, China
- * Correspondence: Lifang Sun, Department of Blood Transfusion, First People’s Hospital of Tianshui, Gansu, China (e-mail: )
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Kargarfard M, Nobari H, Kamyar K, Zadeh AK, Oliveira R. Effects of 12-week moderate aerobic exercise on ROCK2 activity, hs-CRP and glycemic index in obese patients with impaired glucose tolerance. Physiol Behav 2022; 257:113976. [PMID: 36183850 DOI: 10.1016/j.physbeh.2022.113976] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 08/23/2022] [Accepted: 09/27/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Obesity is a chronic low-grade inflammatory state that is related to prediabetes, increased Rhoassociated kinase 2 (ROCK2) activity and concentration of high-sensitivity C-reactive protein (hs-CRP). Therefore, the study was conducted to investigate the effects of 12-week moderate aerobic exercise on ROCK2 activity, hs-CRP, glycosylated hemoglobin A1C (HbA1c), and glycemic index in obese patients with impaired glucose tolerance. METHODS In a quasi-experimental design with pre and post-test, 42 obese men with prediabetes [mean±SD, age: 44.73 ± 3.30 years, body mass index (BMI): 33.22 ± 2.05 kg/m2, HbA1c: 6.29 % ± 0.75] were allocated into two randomized homogeneous groups: Aerobic training group (AT, n=22) or control group (C, n=20). Exercise group performed a moderate aerobic exercise program three sessions per week, 60 minutes per session for 12 weeks. Body mass, BMI, maximal oxygen consumption (VO2max), serum levels of fasting blood glucose (FBG), insulin, insulin resistance (HOMA-IR), homeostasis model assessment of β-cell function (HOMA-B); HbA1c, hs-CRP, or ROCK2 activity were measured before and after the study period. The data were analyzed using repeated measures ANOVA 2×2 and paired sample t test at a significant level of p < 0.05. RESULTS AT caused a significant reduction in body mass (p≤ 0.001), BMI (p= 0.04), HOMA-B (p=0.003), serum levels of FBG (p= 0.002), HbA1c (p= 0.039), hs-CRP (p≤ 0.0001), and ROCK2 activity (p= 0.001). In contrast, in the same group, a significant increase was observed in VO2max (p= 0.04). CONCLUSION The results of this study showed that moderate aerobic exercise was an effective and safe method to prevent type 2 diabetes and cardiovascular diseases in obese men with prediabetes by improving glucose metabolism, reduction of body mass, ROCK2 activity and serum levels of hs-CRP.
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Affiliation(s)
- Mehdi Kargarfard
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran.
| | - Hadi Nobari
- Department of Exercise Physiology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil 56199-11367, Iran; Department of motor performance, Faculty of Physical Education and Mountain Sports, Transilvania, University of Braşov, 500068 Braşov, Romania; Department of Physiology, School of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain.
| | - Kian Kamyar
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran.
| | - Ali Khosravi Zadeh
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Guilan, Guilan, Iran.
| | - Rafael Oliveira
- Sports Science School of Rio Maior, Polytechnic Institute of Santarém, 2040-413 Rio Maior, Portugal; Research Center in Sport Sciences, Health Sciences and Human Development, 5001-801 Vila Real, Portugal; Life Quality Research Centre, 2040-413 Rio Maior, Portugal.
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Song Y, Chen L, Wang M, He Q, Xue J, Jiang H. The optimal exercise modality and intensity for hemodialysis patients incorporating Bayesian network meta-analysis and systematic review. Front Physiol 2022; 13:945465. [PMID: 36200055 PMCID: PMC9527310 DOI: 10.3389/fphys.2022.945465] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Physical inactivity is highly prevalent in patients with hemodialysis, and a large body of evidence reported the positive effect of different exercise modalities on their health outcomes. However, the effective dosage of exercise for hemodialysis patients still requires verification. Objective: We aimed to determine the most effective exercise intensity and modality for improvements in physical function, blood pressure control, dialysis adequacy, and health-related quality of life for hemodialysis patients. Design: Systematic review with network meta-analysis of randomized trials. Data sources: Five electronic databases (PubMed, EMBASE, Web of Science, Cochrane CENTRAL, and Scopus) were searched for randomized controlled trials. Data extraction and quality appraisal were conducted by two authors independently. Data were analyzed by the R (version.3.6.2) and the Stata (version.15.0). Result: We included 1893 patients involving four exercise modalities and six exercise intensities. Combined training (aerobic exercise plus resistance exercise) has been the top-ranking exercise modality for improving the 6-min walk test (6MWT) (surface under the cumulative ranking curve analysis (SUCRA) score, 90.63), systolic blood pressure control (SUCRA score, 77.35), and diastolic pressure control (SUCRA score, 90.56). Moreover, the top-ranking exercise intensity was moderate–vigorous for 6MWT (SUCRA score, 82.36), systolic blood pressure (SUCRA score, 77.43), and diastolic blood pressure (SUCRA score, 83.75). Regarding dialysis adequacy and health-related quality of life, we found no exercise modality or intensity superior to the placebo. Conclusion: This network meta-analysis indicated that combined training and moderate–vigorous intensity might be the most effective interventions to improve 6MWT and blood pressure control. This finding helps further guide clinical exercise prescriptions for hemodialysis patients. Systematic Review Registration: [https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42021268535].
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Skovbjerg F, Honoré H, Mechlenburg I, Lipperts M, Gade R, Næss-Schmidt ET. Monitoring Physical Behavior in Rehabilitation Using a Machine Learning-Based Algorithm for Thigh-Mounted Accelerometers: Development and Validation Study. JMIR BIOINFORMATICS AND BIOTECHNOLOGY 2022; 3:e38512. [PMID: 38935944 PMCID: PMC11135216 DOI: 10.2196/38512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/24/2022] [Accepted: 07/07/2022] [Indexed: 06/29/2024]
Abstract
BACKGROUND Physical activity is emerging as an outcome measure. Accelerometers have become an important tool in monitoring physical behavior, and newer analytical approaches of recognition methods increase the degree of details. Many studies have achieved high performance in the classification of physical behaviors through the use of multiple wearable sensors; however, multiple wearables can be impractical and lower compliance. OBJECTIVE The aim of this study was to develop and validate an algorithm for classifying several daily physical behaviors using a single thigh-mounted accelerometer and a supervised machine-learning scheme. METHODS We collected training data by adding the behavior classes-running, cycling, stair climbing, wheelchair ambulation, and vehicle driving-to an existing algorithm with the classes of sitting, lying, standing, walking, and transitioning. After combining the training data, we used a random forest learning scheme for model development. We validated the algorithm through a simulated free-living procedure using chest-mounted cameras for establishing the ground truth. Furthermore, we adjusted our algorithm and compared the performance with an existing algorithm based on vector thresholds. RESULTS We developed an algorithm to classify 11 physical behaviors relevant for rehabilitation. In the simulated free-living validation, the performance of the algorithm decreased to 57% as an average for the 11 classes (F-measure). After merging classes into sedentary behavior, standing, walking, running, and cycling, the result revealed high performance in comparison to both the ground truth and the existing algorithm. CONCLUSIONS Using a single thigh-mounted accelerometer, we obtained high classification levels within specific behaviors. The behaviors classified with high levels of performance mostly occur in populations with higher levels of functioning. Further development should aim at describing behaviors within populations with lower levels of functioning.
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Affiliation(s)
- Frederik Skovbjerg
- Research Unit, Hammel Neurorehabilitation Centre & University Research Clinic, Hammel, Denmark
| | - Helene Honoré
- Research Unit, Hammel Neurorehabilitation Centre & University Research Clinic, Hammel, Denmark
| | | | - Matthijs Lipperts
- Department of Medical Information and Communication Technology, St. Anna Hospital, Geldrop, Netherlands
| | - Rikke Gade
- Section of Media Technology, Aalborg University, Aalborg, Denmark
| | - Erhard Trillingsgaard Næss-Schmidt
- Research Unit, Hammel Neurorehabilitation Centre & University Research Clinic, Hammel, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Jahromi R, Zahed K, Sasangohar F, Erraguntla M, Mehta R, Qaraqe K. Hypoglycemia Detection Using Hand Tremors: A Home Study in Patients with Type 1 Diabetes (Preprint). JMIR Diabetes 2022; 8:e40990. [PMID: 37074783 PMCID: PMC10157461 DOI: 10.2196/40990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 01/26/2023] [Accepted: 02/20/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Diabetes affects millions of people worldwide and is steadily increasing. A serious condition associated with diabetes is low glucose levels (hypoglycemia). Monitoring blood glucose is usually performed by invasive methods or intrusive devices, and these devices are currently not available to all patients with diabetes. Hand tremor is a significant symptom of hypoglycemia, as nerves and muscles are powered by blood sugar. However, to our knowledge, no validated tools or algorithms exist to monitor and detect hypoglycemic events via hand tremors. OBJECTIVE In this paper, we propose a noninvasive method to detect hypoglycemic events based on hand tremors using accelerometer data. METHODS We analyzed triaxial accelerometer data from a smart watch recorded from 33 patients with type 1 diabetes for 1 month. Time and frequency domain features were extracted from acceleration signals to explore different machine learning models to classify and differentiate between hypoglycemic and nonhypoglycemic states. RESULTS The mean duration of the hypoglycemic state was 27.31 (SD 5.15) minutes per day for each patient. On average, patients had 1.06 (SD 0.77) hypoglycemic events per day. The ensemble learning model based on random forest, support vector machines, and k-nearest neighbors had the best performance, with a precision of 81.5% and a recall of 78.6%. The results were validated using continuous glucose monitor readings as ground truth. CONCLUSIONS Our results indicate that the proposed approach can be a potential tool to detect hypoglycemia and can serve as a proactive, nonintrusive alert mechanism for hypoglycemic events.
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Affiliation(s)
- Reza Jahromi
- Industrial and Systems Engineering, Texas A&M University, College Station, TX, United States
- Department of Computer Science and Engineering, Texas A&M University, College Station, TX, United States
| | - Karim Zahed
- Industrial and Systems Engineering, Texas A&M University, College Station, TX, United States
| | - Farzan Sasangohar
- Industrial and Systems Engineering, Texas A&M University, College Station, TX, United States
- Center for Critical Care, Houston Methodist Hospital, Houston, TX, United States
| | - Madhav Erraguntla
- Industrial and Systems Engineering, Texas A&M University, College Station, TX, United States
| | - Ranjana Mehta
- Industrial and Systems Engineering, Texas A&M University, College Station, TX, United States
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The 10-week of aerobic-functional training improves fasting blood sugar, insulin resistance, and lipid profile in patients with diabetic peripheral neuropathy: A randomized controlled trial. BIOMEDICAL HUMAN KINETICS 2022. [DOI: 10.2478/bhk-2022-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Study aim: This study aimed to investigate the effect of a 10-week of combined training course on concentrations of blood sugar, Insulin Resistance (HOMA-IR), and lipid profile in patients with diabetic peripheral neuropathy.
Materials and methods: This clinical trial was performed in diabetic neuropathy women and men (30–60 years old). Participants were randomly assigned to two groups: exercise (EG; n = 10) and control (CG; n = 10). The EG performed 10-week programme with one session of aerobic exercises (40% to 70% of HRReserve) and one session of functional exercises (60–90 min/ day) at the same day for four days/week and the CG performed their daily activities. The Blood glucose, IR, and lipid profile were measured initially and after the intervention.
Results: Repeated-measures ANOVA showed significant decrease in fasting blood sugar (p < 0.01) and HOMA-IR (p < 0.01), and greater improvements in TG (p < 0.05) and LDL (p < 0.05) in EG than CG, but. HDL concentration did not show significant changes.
Conclusion: The 10-week of aerobic-functional training improves fasting blood sugar, IR, and lipid profile in patients with diabetic neuropathy.
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12
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Gut Microbiota and Type 2 Diabetes Mellitus: Association, Mechanism, and Translational Applications. Mediators Inflamm 2021; 2021:5110276. [PMID: 34447287 PMCID: PMC8384524 DOI: 10.1155/2021/5110276] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/26/2021] [Indexed: 02/07/2023] Open
Abstract
Gut microbiota has attracted widespread attention due to its crucial role in disease pathophysiology, including type 2 diabetes mellitus (T2DM). Metabolites and bacterial components of gut microbiota affect the initiation and progression of T2DM by regulating inflammation, immunity, and metabolism. Short-chain fatty acids, secondary bile acid, imidazole propionate, branched-chain amino acids, and lipopolysaccharide are the main molecules related to T2DM. Many studies have investigated the role of gut microbiota in T2DM, particularly those butyrate-producing bacteria. Increasing evidence has demonstrated that fecal microbiota transplantation and probiotic capsules are useful strategies in preventing diabetes. In this review, we aim to elucidate the complex association between gut microbiota and T2DM inflammation, metabolism, and immune disorders, the underlying mechanisms, and translational applications of gut microbiota. This review will provide novel insight into developing individualized therapy for T2DM patients based on gut microbiota immunometabolism.
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Janssen JAMJL. Hyperinsulinemia and Its Pivotal Role in Aging, Obesity, Type 2 Diabetes, Cardiovascular Disease and Cancer. Int J Mol Sci 2021; 22:ijms22157797. [PMID: 34360563 PMCID: PMC8345990 DOI: 10.3390/ijms22157797] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/11/2021] [Accepted: 07/13/2021] [Indexed: 01/10/2023] Open
Abstract
For many years, the dogma has been that insulin resistance precedes the development of hyperinsulinemia. However, recent data suggest a reverse order and place hyperinsulinemia mechanistically upstream of insulin resistance. Genetic background, consumption of the “modern” Western diet and over-nutrition may increase insulin secretion, decrease insulin pulses and/or reduce hepatic insulin clearance, thereby causing hyperinsulinemia. Hyperinsulinemia disturbs the balance of the insulin–GH–IGF axis and shifts the insulin : GH ratio towards insulin and away from GH. This insulin–GH shift promotes energy storage and lipid synthesis and hinders lipid breakdown, resulting in obesity due to higher fat accumulation and lower energy expenditure. Hyperinsulinemia is an important etiological factor in the development of metabolic syndrome, type 2 diabetes, cardiovascular disease, cancer and premature mortality. It has been further hypothesized that nutritionally driven insulin exposure controls the rate of mammalian aging. Interventions that normalize/reduce plasma insulin concentrations might play a key role in the prevention and treatment of age-related decline, obesity, type 2 diabetes, cardiovascular disease and cancer. Caloric restriction, increasing hepatic insulin clearance and maximizing insulin sensitivity are at present the three main strategies available for managing hyperinsulinemia. This may slow down age-related physiological decline and prevent age-related diseases. Drugs that reduce insulin (hyper) secretion, normalize pulsatile insulin secretion and/or increase hepatic insulin clearance may also have the potential to prevent or delay the progression of hyperinsulinemia-mediated diseases. Future research should focus on new strategies to minimize hyperinsulinemia at an early stage, aiming at successfully preventing and treating hyperinsulinemia-mediated diseases.
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Affiliation(s)
- Joseph A M J L Janssen
- Department of internal Medicine, Division of Endocrinology, Erasmus Medical Center, 40, 3015 GD Rotterdam, The Netherlands
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Sgrò P, Emerenziani GP, Antinozzi C, Sacchetti M, Di Luigi L. Exercise as a drug for glucose management and prevention in type 2 diabetes mellitus. Curr Opin Pharmacol 2021; 59:95-102. [PMID: 34182427 DOI: 10.1016/j.coph.2021.05.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/19/2021] [Accepted: 05/25/2021] [Indexed: 02/06/2023]
Abstract
Physical inactivity and sedentary behavior are risk factors for type 2 diabetes mellitus (T2DM). Therefore, physical exercise (PE) together with medical treatment might be considered as a key strategy to counteract T2DM. Glycemic control is a central objective in the prevention and management of T2DM, and PE might be able to substantially affect the processes that determine it. Just like a drug, exercise can be dosed based on the characteristics of the individual to increase its benefits and reduce side effects. In this brief review, the mechanisms underlying the effects of PE on glucose metabolism in muscle are illustrated, and the effects of modulation of the parameters characterizing this atypical "drug" on glucose homeostasis are described.
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Affiliation(s)
- Paolo Sgrò
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Gian Pietro Emerenziani
- Department of Experimental and Clinical Medicine, University of Catanzaro "Magna Græcia", Catanzaro, Italy
| | - Cristina Antinozzi
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Massimo Sacchetti
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Luigi Di Luigi
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy.
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15
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Beneficial Effects of Physical Activity in Diabetic Patients. J Funct Morphol Kinesiol 2020; 5:jfmk5030070. [PMID: 33467285 PMCID: PMC7739324 DOI: 10.3390/jfmk5030070] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/30/2020] [Accepted: 09/01/2020] [Indexed: 12/14/2022] Open
Abstract
One of the main goals of diabetic therapy is to achieve the best metabolic control to prevent the development and progression of potential complications. A multidisciplinary approach characterized by the combination of diet, physical activity (PA) and drug therapy with oral and injectable (non-insulin) pharmacological agents, is desirable to optimize metabolic control. The aim of this review is to explain the contribution of PA and its beneficial effects on patients affected by type 1 (T1D) and type 2 diabetes (T2D). We provide an overview of evidence on the effects of PA for the main two types of diabetes mellitus (DM) to identify the right level of PA to be recommended. We discuss the physiological and clinical role of PA in people with DM. It can be concluded that the objective of antidiabetic therapy should be the achievement and optimization of metabolic control through a multidisciplinary approach involving non-pharmacological therapy such as diet and PA, which has a crucial role.
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16
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Wake AD. Antidiabetic Effects of Physical Activity: How It Helps to Control Type 2 Diabetes. Diabetes Metab Syndr Obes 2020; 13:2909-2923. [PMID: 32884317 PMCID: PMC7443456 DOI: 10.2147/dmso.s262289] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 07/01/2020] [Indexed: 12/15/2022] Open
Abstract
Despite the improvements in clinical care of the patients, research updates, and public health interventions, there is still an increase in the prevalence, incidence, and mortality because of diabetes mellitus (DM). DM is a public health problem in both developed and developing countries. It has increased alarmingly, putting this disease in the dimension of an epidemic. Diabetes is associated with several complications which increase the risk of many serious health problems on the other side. Therefore, this review was aimed to discuss the antidiabetic effects of physical activity (PA) on type 2 DM (T2DM) by summarizing the significant studies on this topic. This review found that several studies have recommended the utilization of PA for the effective management of T2DM. PA is a non-pharmacologic therapy which is a significant strategy for the management of T2DM and is an appropriate lifestyle modification approach to be practiced by these patients. The studies showed that PA has antidiabetic effects which are evidenced by its substantial role in improving the blood glucose (BG) levels of the individuals with T2DM where it helps them to control their levels of glucose in the blood. It plays a significant role in glycemic control of this disease by lowering the BG levels through possible mechanisms such as decreasing insulin resistance, increasing production of glucose transporter type 4 (GLUT-4), lowering visceral adipose tissue (VAT), increasing pancreatic β-cell functions, using glucose for energy, and so on. In turn, the controlled glycemia helps to prevent the complications associated with uncontrolled T2DM and this would further improve the overall health of the patients and the burden on the health professionals as well. Finally, this review concludes that PA is the cornerstone in the management of T2DM. It also suggests that more attention is needed to its significance in the prevention, glycemic control, and its role in the management of the morbidity and mortality associated with T2DM. Practical PA recommendations and suggestions for the future direction of research in this area are also provided.
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Affiliation(s)
- Addisu Dabi Wake
- Nursing Department, College of Health Sciences, Arsi University, Assela, Oromia, Ethiopia
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