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Liu J, Shen M, Zhuang G, Zhang L. Investigating the temporal trends of diabetes disease burden in China during 1990-2019 from a global perspective. Front Endocrinol (Lausanne) 2024; 15:1324318. [PMID: 38800477 PMCID: PMC11116686 DOI: 10.3389/fendo.2024.1324318] [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: 10/20/2023] [Accepted: 04/22/2024] [Indexed: 05/29/2024] Open
Abstract
Introduction Diabetes poses a global public health challenge and our understanding of its temporal evolution in China relative to the rest of the world is limited. Our study aims to comprehensively examine the temporal trend of diabetes DALYs in China from a global perspective. Methods We analyzed data on diabetes incidence, prevalence, and mortality for individuals aged ≥20 years in China and globally from the Global Burden of Disease (GBD) 2019 study. We assessed trends in age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) of diabetes in China and globally by estimating annual percentage changes (EAPCs). We employed decomposition analysis to reveal factors driving the trend of diabetes DALYs in China. Results During 1990-2019, the number of diabetes patients increased by 160% from 35.14 million to 91.70 million in China. The ASIR of diabetes increased from 249 per 100,000 to 329 per 100,000 in China, which was lower than the global rate (419 per 100,000 in 2019). The EAPC of diabetes incidence was also lower in China compared to the global rate (1.02% vs. 1.57%). Consistently, the age-standardized prevalence rate of diabetes increased from 4788 per 100,000 to 8170 per 100,000 during 1990-2019 in China, which remained lower than the corresponding global rate (8827 per 100,000 in 2019). Further, the ASMR of diabetes increased from 9 per 100,000 to 15 per 100,000 during 1990-2019 in China, which was lower than the corresponding global rate (30 per 100,000 in 2019). However, EAPC of diabetes mortality in China was much higher than the global level (1.75% vs. 1.07%). Globally, the rising diabetes DALYs was predominantly attributed to population growth (55.2%) and epidemiologic changes (24.6%). In comparison, population growth (48.9%) also played an important role in the increasing diabetes DALYs in China, but aging (43.7%) was second major contributor. Conclusion Our findings show that diabetes DALYs in China followed a global increasing trend during 1990-2019. Notably, aging has a very substantial contribution to the increase in diabetes DALYs in China in addition to population growth. .
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Affiliation(s)
- Jinli Liu
- Department of Endocrinology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi’an, Shaanxi, China
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi’an, China
| | - Mingwang Shen
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Guihua Zhuang
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Lei Zhang
- Department of Endocrinology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi’an, Shaanxi, China
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia
- Central Clinical School, Faculty of Medicine, Monash University, Melbourne, VIC, Australia
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Zhu T, Chen Q, Chen H, You L, Liu D, Zhang X, Li F, Wu H, Tang J, Lin D, Sun K, Yan L, Ren M. Independent and interactive associations of heart rate and obesity with type 2 diabetes mellites: A population-based study. J Diabetes 2024; 16:e13529. [PMID: 38599825 PMCID: PMC11006609 DOI: 10.1111/1753-0407.13529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 12/13/2023] [Accepted: 12/25/2023] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Although obesity and heart rate (HR) were closely related to the prevalence and development of type 2 diabetes mllitus (T2DM), few studies have shown a co-association effect of them on T2DM. We aimed at assessing the interactive effects of HR and obesity with prevalence of T2DM in Chinese population, providing the exact cutpoint of the risk threshold for blood glucose with high HR. MATERIALS AND METHODS In the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal study (REACTION) cohorts (N = 8398), the relationship between HR and T2DM was explored by linear regression, logistic regression, and restricted cubic spline, and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Interaction terms between HR and body mass index (BMI) and HR and waist circumference (WC) were introduced into the logistic regression model. RESULTS In those with HR > 88.0 beats/min, fasting plasma glucose and oral glucose tolerance tests were significantly correlated with HR, and the prevalence of T2DM was highly correlated with HR (all p < .05). There were interactive associations of HR and obesity in patients with T2DM with HR < 74 beats/min. CONCLUSION High HR was in interaction with obesity, associating with prevalence of T2DM. The newly subdivided risk threshold for HR with T2DM might be HR > 88 beats/minute.
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Affiliation(s)
- Tianxin Zhu
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Qingyu Chen
- Health Examination Center, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Hongxing Chen
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Lili You
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Dan Liu
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Xiaoyun Zhang
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Feng Li
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Hongshi Wu
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Juying Tang
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Diaozhu Lin
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Kan Sun
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Li Yan
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Meng Ren
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
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Maskarinec G, Kristal BS, Wilkens LR, Quintal G, Bogumil D, Setiawan VW, Le Marchand L. Risk Factors for Type 2 Diabetes in the Multiethnic Cohort. Can J Diabetes 2023; 47:627-635.e2. [PMID: 37406880 PMCID: PMC10761589 DOI: 10.1016/j.jcjd.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 06/21/2023] [Accepted: 06/23/2023] [Indexed: 07/07/2023]
Abstract
OBJECTIVES In this report, we investigated the association between established risk factors and type 2 diabetes (T2D) across 5 distinct ethnic groups and explored differences according to T2D definition within the Multiethnic Cohort (MEC) Study. METHODS Using the full MEC, with participants in Hawaii and Los Angeles (N=172,230), we applied Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). All participants completed questionnaires asking about demographics, anthropometrics, lifestyle factors, and regular diet. T2D status was determined from self-reported diagnosis/medication and Medicare claims. We assessed the associations between well-established risk factors and T2D in the full cohort, after stratification by ethnic group, according to the T2D definition, and in a biorepository subset. Effect modification by ethnicity was evaluated using Wald's tests. RESULTS Overall, 46,500 (27%) participants had an incident T2D diagnosis after a mean follow-up of 17.1±6.9 years. All predictors were significantly associated with T2D: overweight (HR=1.74), obesity (HR=2.90), red meat intake (HR=1.15), short (HR=1.04) and long (HR=1.08) sleep duration, and smoking (HR=1.26) predicted a significantly higher T2D incidence, whereas coffee (HR=0.90) and alcohol (HR=0.78) consumption, physical activity (HR=0.89), and diet quality (HR=0.96) were associated with lower T2D incidence. The strength of these associations was similar across ethnic groups with noteworthy disparities for overweight/obesity, physical activity, alcohol intake, coffee consumption, and diet quality. CONCLUSIONS These findings confirm the importance of known risk factors for T2D across ethnic groups, but small differences were detected that may contribute to disparate incidence rates in some ethnic groups, especially for obesity and physical activity.
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Affiliation(s)
- Gertraud Maskarinec
- Population Sciences in the Pacific, University of Hawaii Cancer Center, Honolulu, Hawaii, United States.
| | - Bruce S Kristal
- Division of Sleep Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Lynne R Wilkens
- Population Sciences in the Pacific, University of Hawaii Cancer Center, Honolulu, Hawaii, United States
| | - Gino Quintal
- Population Sciences in the Pacific, University of Hawaii Cancer Center, Honolulu, Hawaii, United States
| | - David Bogumil
- Preventive Medicine, University of Southern California, Los Angeles, California, United States
| | - Veronica W Setiawan
- Preventive Medicine, University of Southern California, Los Angeles, California, United States
| | - Loïc Le Marchand
- Population Sciences in the Pacific, University of Hawaii Cancer Center, Honolulu, Hawaii, United States
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Krasivskyi I, Djordjevic I, Ivanov B, Eghbalzadeh K, Großmann C, Reichert S, Radwan M, Sandoval Boburg R, Sabashnikov A, Schlensak C, Wahlers T, Rustenbach CJ. Consequences of Obesity on Short-Term Outcomes in Patients Who Underwent Off-Pump Coronary Artery Bypass Grafting Surgery. J Clin Med 2023; 12:jcm12051929. [PMID: 36902716 PMCID: PMC10003424 DOI: 10.3390/jcm12051929] [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: 02/11/2023] [Revised: 02/22/2023] [Accepted: 02/27/2023] [Indexed: 03/05/2023] Open
Abstract
The correlation between off-pump coronary artery bypass (OPCAB) surgery and obesity-related outcomes is still uncertain. The aim of our study was to analyse the pre-, intra-, and postoperative short-term outcomes between obese and non-obese patients after off-pump bypass surgery. We performed a retrospective analysis from January 2017 until November 2022, including a total of 332 (non-obese (n = 193) and obese (n = 139)) patients who underwent an OPCAB procedure due to coronary artery disease (CAD). The primary outcome was all-cause in-hospital mortality. Our results showed no difference regarding mean age of the study population between both groups. The use of the T-graft technique was significantly higher (p = 0.045) in the non-obese group compared to the obese group. The dialysis rate was significantly lower in non-obese patients (p = 0.019). In contrast, the wound infection rate was significantly higher (p = 0.014) in the non-obese group compared to the obese group. The all-cause in-hospital mortality rate did not differ significantly (p = 0.651) between the two groups. Furthermore, ST-elevation myocardial infarction (STEMI) and reoperation were relevant predictors for in-hospital mortality. Therefore, OPCAB surgery remains a safe procedure even in obese patients.
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Affiliation(s)
- Ihor Krasivskyi
- Department of Cardiothoracic Surgery, University Hospital Cologne, 50937 Cologne, Germany
- Correspondence: ; Tel.: +49-176-353-88-719
| | - Ilija Djordjevic
- Department of Cardiothoracic Surgery, University Hospital Cologne, 50937 Cologne, Germany
| | - Borko Ivanov
- Department of Cardiothoracic Surgery, Helios Hospital Siegburg, 53721 Siegburg, Germany
| | - Kaveh Eghbalzadeh
- Department of Cardiothoracic Surgery, University Hospital Cologne, 50937 Cologne, Germany
| | - Clara Großmann
- Department of Cardiothoracic Surgery, University Hospital Cologne, 50937 Cologne, Germany
| | - Stefan Reichert
- Department of Cardiothoracic Surgery, University Hospital Tuebingen, 72076 Tuebingen, Germany
| | - Medhat Radwan
- Department of Cardiothoracic Surgery, University Hospital Tuebingen, 72076 Tuebingen, Germany
| | - Rodrigo Sandoval Boburg
- Department of Cardiothoracic Surgery, University Hospital Tuebingen, 72076 Tuebingen, Germany
| | - Anton Sabashnikov
- Department of Cardiothoracic Surgery, University Hospital Cologne, 50937 Cologne, Germany
| | - Christian Schlensak
- Department of Cardiothoracic Surgery, University Hospital Tuebingen, 72076 Tuebingen, Germany
| | - Thorsten Wahlers
- Department of Cardiothoracic Surgery, University Hospital Cologne, 50937 Cologne, Germany
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Luo J, Wang T, Yang K, Wang X, Xu R, Gong H, Zhang X, Wang J, Yang R, Gao P, Ma Y, Jiao L. Endovascular therapy versus medical treatment for symptomatic intracranial artery stenosis. Cochrane Database Syst Rev 2023; 2:CD013267. [PMID: 36738471 PMCID: PMC9897029 DOI: 10.1002/14651858.cd013267.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Intracranial artery stenosis (ICAS) is an arterial narrowing in the brain that can cause stroke. Endovascular therapy (ET) and conventional medical treatment (CMT) may prevent recurrent ischaemic stroke caused by ICAS. However, there is no consensus on the best treatment for people with ICAS. OBJECTIVES To evaluate the safety and efficacy of endovascular therapy plus conventional medical treatment compared with conventional medical treatment alone for the management of symptomatic intracranial artery stenosis. SEARCH METHODS We searched the Cochrane Stroke Group Trials Register, CENTRAL, MEDLINE, Embase, four other databases, and three trials registries on 16 August 2022. We contacted study authors and researchers when we required additional information. SELECTION CRITERIA We included randomised controlled trials (RCTs) comparing ET plus CMT with CMT alone for the treatment of symptomatic ICAS. ET modalities included angioplasty alone, balloon-mounted stent, and angioplasty followed by placement of a self-expanding stent. CMT included antiplatelet therapy in addition to control of risk factors such as hypertension, hyperlipidaemia, and diabetes. DATA COLLECTION AND ANALYSIS Two review authors independently screened the records to select eligible RCTs, then extracted data from them. We resolved any disagreements through discussion, reaching consensus decisions among the full team. We assessed risk of bias and applied the GRADE approach to assess the certainty of the evidence. The primary outcome was death by any cause or non-fatal stroke of any type within three months of randomisation. Secondary outcomes included all-cause death or non-fatal stroke of any type occurring more than three months after randomisation, ipsilateral stroke, transient ischaemic attack, ischaemic stroke, haemorrhagic stroke, death, restenosis, dependency, and health-related quality of life. MAIN RESULTS We included four RCTs with 989 participants who had symptomatic ICAS, with an age range of 18 to 85 years. We identified two ongoing RTCs. All trials had high risk of performance bias, as it was impossible to blind participants and personnel to the intervention. Three trials were terminated early. One trial was at high risk of attrition bias because of substantial loss to follow-up after one year and a high proportion of participants transferring from ET to CMT. The certainty of evidence ranged from low to moderate; we downgraded for imprecision. Compared to CMT alone, ET plus CMT probably increases the risk of short-term death or stroke (risk ratio (RR) 2.93, 95% confidence interval (CI) 1.81 to 4.75; 4 RCTs, 989 participants; moderate certainty), short-term ipsilateral stroke (RR 3.26, 95% CI 1.94 to 5.48; 4 RCTs, 989 participants; moderate certainty), short-term ischaemic stroke (RR 2.24, 95% CI 1.30 to 3.87; 4 RCTs, 989 participants; moderate certainty), and long-term death or stroke (RR 1.49, 95% CI 1.12 to 1.99; 4 RCTs, 970 participants; moderate certainty). Compared to CMT alone, ET plus CMT may increase the risk of short-term haemorrhagic stroke (RR 13.49, 95% CI 2.59 to 70.15; 4 RCTs, 989 participants; low certainty), short-term death (RR 5.43, 95% CI 1.21 to 24.40; 4 RCTs, 989 participants; low certainty), and long-term haemorrhagic stroke (RR 7.81, 95% CI 1.43 to 42.59; 3 RCTs, 879 participants; low certainty). It is unclear if ET plus CMT compared with CMT alone has an effect on the risk of short-term transient ischaemic attack (RR 0.79, 95% CI 0.30 to 2.07; 3 RCTs, 344 participants; moderate certainty), long-term transient ischaemic attack (RR 1.05, 95% CI 0.50 to 2.19; 3 RCTs, 335 participants; moderate certainty), long-term ipsilateral stroke (RR 1.78, 95% CI 1.00 to 3.17; 4 RCTs, 970 participants; moderate certainty), long-term ischaemic stroke (RR 1.56, 95% CI 0.77 to 3.16; 4 RCTs, 970 participants; moderate certainty), long-term death (RR 1.61, 95% CI 0.77 to 3.38; 4 RCTs, 951 participants; moderate certainty), and long-term dependency (RR 1.51, 95% CI 0.93 to 2.45; 4 RCTs, 947 participants; moderate certainty). No subgroup analyses significantly modified the effect of ET plus CMT versus CMT alone. The trials included no data on restenosis or health-related quality of life. AUTHORS' CONCLUSIONS This review provides moderate-certainty evidence that ET plus CMT compared with CMT alone increases the risk of short-term stroke and death in people with recent symptomatic severe ICAS. This effect was still apparent at long-term follow-up but appeared to be due to the early risks of ET; therefore, there may be no clear difference between the interventions in terms of their effects on long-term stroke and death. The impact of delayed ET intervention (more than three weeks after a qualifying event) warrants further study.
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Affiliation(s)
- Jichang Luo
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- China International Neuroscience Institute (China-INI), Beijing, China
| | - Tao Wang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- China International Neuroscience Institute (China-INI), Beijing, China
| | - Kun Yang
- Department of Evidence-based Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xue Wang
- Medical Library of Xuanwu Hospital, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Ran Xu
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- China International Neuroscience Institute (China-INI), Beijing, China
| | - Haozhi Gong
- China International Neuroscience Institute (China-INI), Beijing, China
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xiao Zhang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- China International Neuroscience Institute (China-INI), Beijing, China
| | - Jie Wang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- China International Neuroscience Institute (China-INI), Beijing, China
| | - Renjie Yang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- China International Neuroscience Institute (China-INI), Beijing, China
| | - Peng Gao
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- China International Neuroscience Institute (China-INI), Beijing, China
| | - Yan Ma
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- China International Neuroscience Institute (China-INI), Beijing, China
| | - Liqun Jiao
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- China International Neuroscience Institute (China-INI), Beijing, China
- Department of Interventional Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China
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Hu Y, Li J, Yin C, Xu L, Li S, Chen Y, Wang Y, Cheng Z, Bai Y. Mediating effect of metabolic diseases on the relationship between hyperuricemia and coronary heart disease. Nutr Metab Cardiovasc Dis 2023; 33:315-322. [PMID: 36599782 DOI: 10.1016/j.numecd.2022.11.005] [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: 07/05/2022] [Revised: 10/11/2022] [Accepted: 11/02/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND AIMS Studies have shown that elevated serum uric acid (SUA) may increase the risk of coronary heart disease (CHD). However, it is still disputable how mediate effects between metabolic diseases and hyperuricemia affect the incidence of CHD. This study aimed to explore whether metabolic diseases may mediate the connection from hyperuricemia at baseline to the elevated incidence risk of CHD during follow-ups. METHODS AND RESULTS Based on the Jinchang cohort, 48 001 subjects were followed for 9 years between June 2011 and December 2019. Multivariate-adjusted Cox regression models were applied to estimate hazard ratios (HRs) of CHD with 95% confidence intervals (CIs). Significantly increased risks of CHD were observed in hyperuricemia (HR:1.46, 95%CI:1.28, 1.67) when compared with normouricemia population. The mediating effect model further demonstrated that metabolic diseases could mediate the association between hyperuricemia and CHD pathogenesis, partially for the combined metabolic diseases with mediation effects of 45.12%, 25.24% for hypertension, 28.58% for overweight or obese status, 29.05% for hypertriglyceridemia, 6.70% for hypercholesterolemia, 3.52% for low high density lipoprotein cholesterol (HDL-C), and 6.51% for high low density lipoprotein cholesterol (LDL-C), respectively. CONCLUSIONS Hyperuricemia significantly increased the risk of incident CHD, and this association was partly mediated by metabolic diseases.
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Affiliation(s)
- Yujia Hu
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Street, Lanzhou, Gansu 730000, China
| | - Jing Li
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Street, Lanzhou, Gansu 730000, China
| | - Chun Yin
- Workers' Hospital of Jinchuan Group Co., Ltd., Jinchang, Gansu, China
| | - Lulu Xu
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Street, Lanzhou, Gansu 730000, China
| | - Siyu Li
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Street, Lanzhou, Gansu 730000, China
| | - Yarong Chen
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Street, Lanzhou, Gansu 730000, China
| | - Yufeng Wang
- Workers' Hospital of Jinchuan Group Co., Ltd., Jinchang, Gansu, China
| | - Zhiyuan Cheng
- School of Public Health and Emergency Management, Southern University of Science and Technology, 1088 Xueyuan Street, Shenzhen, 518055, China
| | - Yana Bai
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Street, Lanzhou, Gansu 730000, China.
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Ghazi L, Annabathula RV, Bello NA, Zhou L, Stacey RB, Upadhya B. Hypertension Across a Woman's Life Cycle. Curr Hypertens Rep 2022; 24:723-733. [PMID: 36350493 PMCID: PMC9893311 DOI: 10.1007/s11906-022-01230-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2022] [Indexed: 11/11/2022]
Abstract
PURPOSE OF REVIEW We reviewed the effects of hypertension and the means to prevent and treat it across the spectrum of a woman's lifespan and identified gaps in sex-specific mechanisms contributing to hypertension in women that need to be addressed. RECENT FINDINGS Hypertension continues to be an important public health problem for women across all life stages from adolescence through pregnancy, menopause, and older age. There remain racial, ethnic, and socioeconomic differences in hypertension rates not only overall but also between the sexes. Blood pressure cutoffs during pregnancy have not been updated to reflect the 2017 ACC/AHA changes due to a lack of data. Additionally, the mechanisms behind hypertension development in menopause, including sex hormones and genetic factors, are not well understood. In the setting of increasing inactivity and obesity, along with an aging population, hypertension rates are increasing in women. Screening and management of hypertension throughout a women's lifespan are necessary to reduce the burden of cardiovascular disease, and further research to understand sex-specific hypertension mechanisms is needed.
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Affiliation(s)
- Lama Ghazi
- Department of Internal Medicine, Clinical and Translational Research Accelerator, Yale University, New Haven, CT, USA
| | - Rahul V Annabathula
- Section on Cardiovascular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Medical Center Boulevard, NC, 27157-1045, Winston-Salem, USA
| | - Natalie A Bello
- Department of Cardiology, Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA, USA
| | - Li Zhou
- Section on Cardiovascular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Medical Center Boulevard, NC, 27157-1045, Winston-Salem, USA
| | - Richard Brandon Stacey
- Section on Cardiovascular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Medical Center Boulevard, NC, 27157-1045, Winston-Salem, USA
| | - Bharathi Upadhya
- Section on Cardiovascular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Medical Center Boulevard, NC, 27157-1045, Winston-Salem, USA.
- Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
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Hong N, Lin Y, Ye Z, Yang C, Huang Y, Duan Q, Xie S. The relationship between dyslipidemia and inflammation among adults in east coast China: A cross-sectional study. Front Immunol 2022; 13:937201. [PMID: 36032093 PMCID: PMC9403313 DOI: 10.3389/fimmu.2022.937201] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 07/07/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Dyslipidemia is one of the major public health problems in China. It is characterized by multisystem dysregulation and inflammation, and oxidant/antioxidant balance has been suggested as an important factor for its initiation and progression. The objective of this study was to determine the relationship between prevalence of dyslipidemia and measured changes in the levels of proinflammatory cytokines (IL-6, TNF-a, and MCP-1), thiobarbituric acid-reactant substances (TBARS), and serum total antioxidant capacity (TAC) in serum samples. Study design A cross-sectional survey with a purposive sampling of 2,631 enrolled participants (age 18–85 years) was performed using the adult population of long-term residents of the municipality of east coast China in Fujian province between the years 2017 and 2019. Information on general health status, dyslipidemia prevalence, and selected mediators of inflammation was collected through a two-stage probability sampling design according to socioeconomic level, sex, and age. Methods The lipid profile was conducted by measuring the levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG) with an autoanalyzer. Dyslipidemia was defined according to National Cholesterol Education Program Adult Treatment Panel III diagnostic criteria, and patients with it were identified by means of a computerized database. Serum parameters including IL-6/TNF-a/MCP-1, TBARS, and TAC were measured in three consecutive years. Familial history, education level, risk factors, etc. were determined. The association between dyslipidemia and serum parameters was explored using multivariable logistic regression models. Sociodemographic, age, and risk factors were also investigated among all participants. Results The mean prevalence of various dyslipidemia in the population at baseline (2017) was as follows: dyslipidemias, 28.50%; hypercholesterolemia, 26.33%; high LDL-C, 26.10%; low HDL-C, 24.44%; and hypertriglyceridemia, 27.77%. A significant effect of aging was found among all male and female participants. The mean levels of serum Il-6/TNF-a/MCP-1 were significantly higher in all the types of dyslipidemia among male participants. Female participants with all types of dyslipidemia but low HDL-C showed an elevation of IL-6 and MCP-1 levels, and those with dyslipidemias and hypercholesterolemia presented higher levels of TNF-a compared to the normal participants. The oxidative stress marker TBARS increased among all types of dyslipidemia except hypertriglyceridemia. All participants with different types of dyslipidemia had a lower total antioxidant capacity. Correlation analysis showed that cytokines and TBARS were positively associated with age, obesity, and diabetes mellitus, but not sex, sedentary leisure lifestyle, hypertension, and CVD/CHD history. The activity of TAC was negatively associated with the above parameters. Conclusions The correlation between the prevalence of dyslipidemia and the modification of inflammation status was statistically significant. The levels of proinflammatory cytokines, oxidative stress, and antioxidant capacity in serum may reflect the severity of the lipid abnormalities. These promising results further warrant a thorough medical screening in enhanced anti-inflammatory and reduced oxidative stress to better diagnose and comprehensively treat dyslipidemia at an early stage.
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Affiliation(s)
- Najiao Hong
- Department of General Medicine, The First Hospital of Quanzhou affiliated to Fujian Medical University, Quanzhou, China
- *Correspondence: Najiao Hong, ; Sixin Xie,
| | - Yongjun Lin
- Department of General Medicine, The First Hospital of Quanzhou affiliated to Fujian Medical University, Quanzhou, China
| | - Zhirong Ye
- Department of General Medicine, The First Hospital of Quanzhou affiliated to Fujian Medical University, Quanzhou, China
| | - Chunbaixue Yang
- Department of Mathematics, Virginia Tech, Blacksburg, VA, United States
| | - Yulong Huang
- Department of General Medicine, The First Hospital of Quanzhou affiliated to Fujian Medical University, Quanzhou, China
| | - Qi Duan
- Department of General Medicine, The First Hospital of Quanzhou affiliated to Fujian Medical University, Quanzhou, China
| | - Sixin Xie
- Department of General Medicine, The First Hospital of Quanzhou affiliated to Fujian Medical University, Quanzhou, China
- *Correspondence: Najiao Hong, ; Sixin Xie,
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Yue L, Zhang R, Chen S, Duan G. Relationship between Helicobacter pylori and Incident Hypertension as well as Blood Pressure: A Systematic Review and Meta-Analysis. Dig Dis 2022; 41:124-137. [PMID: 35378540 DOI: 10.1159/000524078] [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: 07/03/2021] [Accepted: 03/14/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Helicobacter pylori (H. pylori) may be a risk factor for hypertension, but the reported studies have given conflicting results. This study aimed to explore the association between H. pylori infection and hypertension risk and blood pressure. METHOD PubMed, Embase, Web of Science, CNKI, Weipu, and Wanfang databases were searched for articles published up to June 2, 2021. Dual-selection and data abstraction were conducted. Random-effect models were used to measure pooled estimates. All data were analyzed with Stata 14.0 SE (StataCorp, College Station, TX, USA). RESULTS A total of 55 studies with 198,750 individuals were included in the meta-analysis. Among them, 33 studies reported the relationship between H. pylori infection and the risk of hypertension, and 25 studies reported the association of H. pylori infection with systolic blood pressure (SBP) and diastolic blood pressure (DBP). Three studies reported both of the above. Meta-analysis showed that H. pylori infection increased the risk of hypertension by 32% (odd ratio: 1.32, 95% CI: 1.15-1.52). Compared with non-H. pylori-infection individuals, the subjects with H. pylori infection had elevated levels of SBP (WMD: 1.86, 95% CI: 1.21-2.50) and DBP (WMD: 1.12, 95% CI: 0.81-1.43). CONCLUSION This meta-analysis suggested that H. pylori infection increased the risk of hypertension. This may provide a new strategy for hypertension prevention. However, the association between H. pylori infection and hypertension needs to be confirmed in further prospective cohort studies.
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Affiliation(s)
- Limin Yue
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Rongguang Zhang
- The First Affiliated Hospital and International School of Public Health and One Health, Hainan Medical University, Haikou, China.,Molecular Epidemiology Group, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Shuaiyin Chen
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Guangcai Duan
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, China
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Zheng R, Li M, Xu M, Lu J, Wang T, Dai M, Zhang D, Chen Y, Zhao Z, Wang S, Lin H, Wang W, Bi Y, Xu Y, Ning G. Chinese Adults Are More Susceptible to Effects of Overall Obesity and Fat Distribution on Cardiometabolic Risk Factors. J Clin Endocrinol Metab 2021; 106:e2775-e2788. [PMID: 33570562 DOI: 10.1210/clinem/dgab049] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Indexed: 01/19/2023]
Abstract
CONTEXT The body mass index (BMI) and waist circumference (WC) as diagnostic tools of obesity do not reflect the same level of fat mass and whether obesity leads to various effects on cardiometabolic risk factors among different racial/ethnic population is unknown. OBJECTIVE The study aims to address the multicollinearity between BMI and WC by using the residual model approach and to assess and compare the effects of obesity metrics on cardiometabolic risk factors among different races/ethnicities. DESIGN, SETTING, AND PARTICIPANTS Data from a nationally representative sample of mainland Chinese adults collected in 2010 and data from the National Health and Nutrition Evaluation Survey 2005-2016 were used. By conducting a regression analysis between WC and BMI, the variation of BMI was removed from WC measures and residual of WC was obtained. The associations between obesity metrics and cardiometabolic risk factors were compared among different races/ethnicities by sex. RESULTS The residual WC was significantly associated with all the cardiometabolic risk factors in mainland Chinese, and most of the factors in non-Hispanic white and non-Hispanic black adults, but not in the other races/ethnicities. The standardized regression coefficients of the associations between obesity metrics and cardiometabolic factors showed that the obesity metrics had greater impact on systolic blood pressure, diastolic blood pressure, and triglyceride in Chinese adults than those of other racial/ethnic groups. CONCLUSIONS Chinese adults are more susceptible to the effects of overall obesity and fat distribution on cardiometabolic risk factors than the other racial/ethnic population.
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Affiliation(s)
- Ruizhi Zheng
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Mian Li
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Min Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jieli Lu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Tiange Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Meng Dai
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Di Zhang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yuhong Chen
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhiyun Zhao
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Shuangyuan Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hong Lin
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Weiqing Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yufang Bi
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yu Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Guang Ning
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Wang T, Luo J, Wang X, Yang K, Jadhav V, Gao P, Ma Y, Zhao N, Jiao L. Endovascular therapy versus medical treatment for symptomatic intracranial artery stenosis. Cochrane Database Syst Rev 2020; 8:CD013267. [PMID: 32789891 PMCID: PMC7437396 DOI: 10.1002/14651858.cd013267.pub2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Intracranial atherosclerotic stenosis (ICAS) is an arterial narrowing in the brain that can cause stroke. Endovascular therapy and medical management may be used to prevent recurrent ischaemic stroke caused by ICAS. However, there is no consensus on the best treatment for people with ICAS. OBJECTIVES To compare the safety and efficacy of endovascular therapy (ET) plus conventional medical treatment (CMT) with CMT alone for the management of symptomatic ICAS. SEARCH METHODS We searched the Cochrane Stroke Group Trials Register (30 August 2019), Cochrane Central Register of Controlled Trials (CENTRAL: to 30 August 2019), MEDLINE Ovid (1946 to 30 August 2019), Embase Ovid (1974 to 30 August 2019), Scopus (1960 to 30 August 2019), Science Citation Index Web of Science (1900 to 30 July 2019), Academic Source Complete EBSCO (ASC: 1982 to 30 July 2019), and China Biological Medicine Database (CBM: 1978 to 30 July 2019). We also searched the following trial registers: ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, and Stroke Trials Registry. We also contacted trialists and researchers where additional information was required. SELECTION CRITERIA Randomised controlled trials (RCTs) comparing ET plus CMT with CMT alone for the treatment of symptomatic ICAS. ET modalities included angioplasty alone, balloon-mounted stent, and angioplasty followed by placement of a self-expanding stent. CMT included antiplatelet therapy in addition to control of risk factors such as hypertension, hyperlipidaemia, and diabetes. DATA COLLECTION AND ANALYSIS Two review authors independently screened trials to select potentially eligible RCTs and extracted data. Any disagreements were resolved by discussing and reaching consensus decisions with the full team. We assessed risk of bias and applied the GRADE approach to assess the quality of the evidence. The primary outcome was death of any cause or non-fatal stroke of any type within three months of randomisation. Secondary outcomes included any-cause death or non-fatal stroke of any type more than three months of randomisation, ipsilateral stroke, type of recurrent event, death, restenosis, dependency, and health-related quality of life. MAIN RESULTS We included three RCTs with 632 participants who had symptomatic ICAS with an age range of 18 to 85 years. The included trials had high risks of performance bias and other potential sources of bias due to the impossibility of blinding of the endovascular intervention and early termination of the trials. Moreover, one trial had a high risk of attrition bias because of the high rate of loss of one-year follow-up and the high proportion of participants transferred from endovascular therapy to medical management. The quality of evidence ranged from low to moderate, downgraded for imprecision. Compared to CMT, ET probably results in a higher rate of 30-day death or stroke (risk ratio (RR) 3.07, 95% confidence interval (CI) 1.80 to 5.24; 3 RCTs, 632 participants, moderate-quality evidence), 30-day ipsilateral stroke (RR 3.54, 95% CI 1.98 to 6.33; 3 RCTs, 632 participants, moderate-quality evidence), 30-day ischaemic stroke (RR 2.52, 95% CI 1.37 to 4.62; 3 RCTs, 632 participants, moderate-quality evidence), and 30-day haemorrhagic stroke (RR 15.53, 95% CI 2.10 to 115.16; 3 RCTs, 632 participants, low-quality evidence). ET was also likely associated with a worse outcome in one-year death or stroke (RR 1.69, 95% CI 1.21 to 2.36; 3 RCTs, 632 participants, moderate-quality evidence), one-year ipsilateral stroke (RR 2.28, 95% CI 1.52 to 3.42; 3 RCTs, 632 participants, moderate-quality evidence), one-year ischaemic stroke (RR 2.07, 95% CI 1.37 to 3.13; 3 RCTs, 632 participants, moderate-quality evidence), and one-year haemorrhagic stroke (RR 10.13, 95% CI 1.31 to 78.51; 2 RCTs, 521 participants, low-quality evidence). There were no significant differences between ET and CMT in 30-day transient ischaemic attacks (TIA) (RR 0.52, 95% CI 0.11 to 2.35, P = 0.39; 2 RCTs, 181 participants, moderate-quality evidence), 30-day death (RR 5.53, 95% CI 0.98 to 31.17, P = 0.05; 3 RCTs, 632 participants, low-quality evidence), one-year TIA (RR 0.82, 95% CI 0.32 to 2.12; 2 RCTs, 181 participants, moderate-quality evidence), one-year death (RR 1.20, 95% CI 0.50 to 2.86, P = 0.68; 3 RCTs, 632 participants, moderate-quality evidence), and one-year dependency (RR 1.90, 95% CI 0.91 to 3.97, P = 0.09; 3 RCTs, 613 participants, moderate-quality evidence). No data on restenosis and health-related quality of life for meta-analysis were available from the included trials. Two RCTs are ongoing. AUTHORS' CONCLUSIONS This systematic review provides moderate-quality evidence showing that ET, compared with CMT, in people with recent symptomatic severe intracranial atherosclerotic stenosis probably does not prevent recurrent stroke and appears to carry an increased hazard. The impact of delayed ET intervention (more than three weeks after a qualifying event) is unclear and may warrant further study.
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Affiliation(s)
- Tao Wang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jichang Luo
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xue Wang
- Medical Library of Xuanwu Hospital, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Kun Yang
- Department of Evidence-based Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Vikram Jadhav
- Neurosciences, Essentia Health, St Mary's Medical Center, Duluth, Minnesota, USA
- Neurosciences, Stroke and Cerebrovascular, CentraCare Health System, St Cloud, Minnesota, USA
| | - Peng Gao
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yan Ma
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Na Zhao
- Department of Anesthesiology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Liqun Jiao
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
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Guo B, Shi Z, Zhang W, Zhao H, He K, Hu X, Gan Y, Shi S, Tian Q. Trajectories of body mass index (BMI) and hypertension risk among middle-aged and elderly Chinese people. J Hum Hypertens 2020; 35:537-545. [PMID: 32581292 DOI: 10.1038/s41371-020-0368-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 05/29/2020] [Accepted: 06/09/2020] [Indexed: 11/09/2022]
Abstract
This study aimed to identify heterogeneity in BMI trajectories and evaluate the impact of BMI trajectories on the risk of hypertension in middle-aged and elderly Chinese people. After data screening, 28, 706 residents' e-health records from 2010 to 2018, including basic personal information, lifestyle and health, were finally included in this population-based longitudinal study. By latent class growth modeling, we identified 12 BMI trajectories: "underweight-increase I (A1)" and "underweight-increase II (A2)"; "normal weight-stable (B1)", "normal weight-decrease (B2)", "normal weight-increase I (B3)" and "normal weight-increase II (B4)"; "overweight-stable (C1)", "overweight-decrease (C2)" and "overweight-increase (C3)"; and "obese-stable I (D1)", "obese-decrease (D2)" and "obese-stable II (D3)". By Cox proportional hazards models, we found that the risk of hypertension in the BMI stable group was lower than that in the BMI increasing trajectory group and higher than that in the BMI decreasing group. For the underweight and normal weight groups, the risk of hypertension was related not only to the magnitude of BMI growth, but also to the rate of growth. For overweight and obesity groups, the risk of hypertension was higher in the high-level stable BMI group than in the low-level stable BMI group. Therefore, for underweight and normal weight people, weight growth and growth rate should be controlled; for overweight and obese people, health education or targeted weight loss exercise should be taken to reduce weight as much as possible to prevent hypertension.
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Affiliation(s)
- Bingxin Guo
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Kexue Avenue 100, Zhengzhou, 450001, Henan, China
| | - Zhan Shi
- Department of Pharmacy, People's Hospital of Zhengzhou, Huanghe Road 33, Zhengzhou, 450003, Henan, China
| | - Wenli Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Kexue Avenue 100, Zhengzhou, 450001, Henan, China
| | - Hao Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Kexue Avenue 100, Zhengzhou, 450001, Henan, China
| | - Kun He
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Kexue Avenue 100, Zhengzhou, 450001, Henan, China
| | - Xueqi Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Kexue Avenue 100, Zhengzhou, 450001, Henan, China
| | - Yuan Gan
- Department of Pharmacy, Fuwai Central China Cardiovascular Hospital, Fuwai Avenue 1, Zhengzhou, 450000, Henan, China
| | - Songhe Shi
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Kexue Avenue 100, Zhengzhou, 450001, Henan, China.
| | - Qingfeng Tian
- Department of Social Medicine and Health Management, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, China
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Kalyan M, Dhore P, Purandare V, Deshpande S, Unnikrishnan AG. Obesity and its Link to Undiagnosed Diabetes Mellitus and Hypertension in Rural Parts of Western India. Indian J Endocrinol Metab 2020; 24:155-159. [PMID: 32699782 PMCID: PMC7333747 DOI: 10.4103/ijem.ijem_582_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 12/26/2019] [Accepted: 02/06/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Obesity and overweight are becoming major health concerns worldwide. Hence, we studied the association between overweight and obesity with new-onset diabetes and hypertension in a selected rural population. METHODOLOGY Community health workers made house-to-house visits, inviting adults >20 years of age who were at a higher risk of diabetes, from a predefined rural area of Maharashtra, to visit a mobile diabetes clinic operating in a hub and spoke manner. Sociodemographic data and anthropometric measurements were recorded. BMI and waist circumference was classified according to the WHO recommended cutoffs for Asians. Subjects with capillary blood fasting glucose of ≥126 mg/dL or random glucose of ≥200 mg/dL by glucometer were diagnosed as diabetes and blood pressure of ≥140/90 mmHg by sphygmomanometer were diagnosed as hypertension. Subjects with a known history of diabetes mellitus and hypertension were excluded. RESULTS Out of 29,324 total population, 16.5% of subjects were overweight and 26.4% were obese. Mean ± SD of BMI of the participants was 22.9 ± 4.1 kg/m2 in males and 22.4 ± 4.2 kg/m2 in females. Around 35% of males and 30.5% of females had a high waist circumference of ≥90 cm and ≥80 cm, respectively, 20.5% of subjects had newly diagnosed hypertension, and 11.4% of subjects had newly diagnosed diabetes mellitus. The occurrence of newly diagnosed hypertension and diabetes showed an increasing trend with increasing BMI. CONCLUSION Our community-based screening suggested a high prevalence of overweight and obesity in rural India. There was a high prevalence of newly diagnosed hypertension and diabetes in this population.
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Affiliation(s)
- Meenakshi Kalyan
- Department of Endocrinology and Diabetes, Chellaram Diabetes Institute, Pune, Maharashtra, India
| | - Prasanna Dhore
- Department of Education and outreach, Chellaram Diabetes Institute, Pune, Maharashtra, India
| | - Vedavati Purandare
- Department of Endocrinology and Diabetes, Chellaram Diabetes Institute, Pune, Maharashtra, India
| | - Shailesh Deshpande
- Department of Education and outreach, Chellaram Diabetes Institute, Pune, Maharashtra, India
| | - A. G. Unnikrishnan
- Department of Endocrinology and Diabetes, Chellaram Diabetes Institute, Pune, Maharashtra, India
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Zhu Y, Zheng H, Zou Z, Jing J, Ma Y, Wang H, Luo J, Zhang X, Luo C, Wang H, Zhao H, Pan D, Sangild P, Karmacharya BM, Ma J, Chen Y. Metabolic Syndrome and Related Factors in Chinese Children and Adolescents: Analysis from a Chinese National Study. J Atheroscler Thromb 2019; 27:534-544. [PMID: 31827007 PMCID: PMC7355101 DOI: 10.5551/jat.50591] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Aims: Metabolic syndrome (MetS) has become a worldwide epidemic; however, few studies have described its status in Chinese children. This study aimed to estimate MetS status and its associations with geography, economic development, birth weight, and parental education of Chinese children and adolescents. Methods: Data were derived from 15,045 participants aged 7–18 years across seven Chinese provinces. Physical measurement and blood tests were conducted to assess the five classical MetS components described by the International Diabetes Federation, including abdominal obesity (the essential component), high blood pressure, low high-density cholesterol (HDL-C), high triglyceride, and elevated fasting glucose (FG). Logistic regression was adopted to explore possible associations between MetS and other factors. Results: Overall, MetS prevalence was 2.3%, higher in males (2.8% vs. 1.7% in females), northern regions (3.1%), more developed regions (2.9%), and older participants (aged 16–18 years) (P < 0.05 for all). Among the five MetS components, abdominal obesity and low HDL-C level were most prevalent (21.8% and 14.4%), and 35.9% of the participants had at least one component. In logistic regression, MetS itself did not correlate with birth weight or parental education. High birth weight was positively correlated with abdominal obesity (odds ratio, 1.48) butnegatively associated with elevated FG (odds ratio, 0.49). Concusions: MetS itself was not common in Chinese children and adolescents, whereas its certain components were far more prevalent. Children from North China, more-developed areas, and at an older age were more likely to develop MetS. Strategies designed to prevent pediatric MetS in China should focus on prevalent components as well as its geographic and economic development predilections.
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Affiliation(s)
- Yanna Zhu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University
| | - Hao Zheng
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University
| | - Zhiyong Zou
- Institute of Child and Adolescent Health, School of Public Health, Peking University
| | - Jin Jing
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University
| | - Yinghua Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University
| | - Haijun Wang
- Institute of Child and Adolescent Health, School of Public Health, Peking University
| | - Jiayou Luo
- Department of Maternal and Child Health, School of Public Health, Central South University
| | - Xin Zhang
- School of Public Health, Tianjin Medical University
| | - Chunyan Luo
- Shanghai Municipal Center for Disease Control and Prevention & Shanghai Institute of Preventive Medicine
| | | | | | | | - Per Sangild
- Department of Nutrition and Sport, University of Copenhagen
| | - Biraj M Karmacharya
- Department of Community Medicine, Kathmandu University, Nepal. & Sun Yat-sen Global Health Institute, Sun Yat-sen University
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University
| | - Yajun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University
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15
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Xu C, Zhong J, Zhu H, Hu R, Fang L, Wang M, Zhang J, Guo Y, Bian Z, Chen Z, Li L, Yu M. Independent and interactive associations of heart rate and body mass index or blood pressure with type 2 diabetes mellitus incidence: A prospective cohort study. J Diabetes Investig 2019; 10:1068-1074. [PMID: 30592161 PMCID: PMC6626957 DOI: 10.1111/jdi.12999] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 12/10/2018] [Accepted: 12/26/2018] [Indexed: 02/05/2023] Open
Abstract
AIMS/INTRODUCTION An elevated heart rate has been reported to be associated with an increased incidence of type 2 diabetes mellitus. We investigated whether heart rate independently and interactively with body mass index or blood pressure was associated with the incidence of type 2 diabetes mellitus in a rural Chinese population. MATERIALS AND METHODS We measured the association between heart rate and type 2 diabetes mellitus in the Tongxiang China Kadoorie Biobank prospective cohort study using Cox proportional hazard models. Analyses included 53,817 participants without any history of diabetes, cancer, cardiovascular or rheumatic heart disease at baseline. Incident type 2 diabetes mellitus cases were identified through linkage with established Disease Registries and the China National Health Insurance System. RESULTS After a mean follow-up period of 6.9 years, 1,766 people had developed type 2 diabetes mellitus with an incidence of 4.75 per 1,000 person-years. Multivariable-adjusted hazard ratios and for type 2 diabetes mellitus across increasing quintiles of heart rate were 1.00 (reference), 1.24 (95% confidence interval [CI] 1.05-1.45), 1.21 (95% CI 1.03-1.41), 1.24 (95% CI 1.05-1.47) and 1.49 (95% CI 1.28-1.74), respectively, with a Ptrend <0.001. This relationship was particularly evident among non-overweight/obese participants. A significant interaction between heart rate and body mass index on incident type 2 diabetes mellitus was observed with a P for interaction = 0.005. CONCLUSIONS Elevated heart rate is independently, in interaction with a higher body mass index, associated with a higher incidence of type 2 diabetes mellitus.
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Affiliation(s)
- Chunxiao Xu
- Department of Chronic Non‐Communicable Diseases Control and PreventionZhejiang Provincial Center for Disease Control and PreventionHangzhouChina
| | - Jieming Zhong
- Department of Chronic Non‐Communicable Diseases Control and PreventionZhejiang Provincial Center for Disease Control and PreventionHangzhouChina
| | - Honghong Zhu
- Preventive Medicine InstituteLouisianaMissouriUSA
| | - Ruying Hu
- Department of Chronic Non‐Communicable Diseases Control and PreventionZhejiang Provincial Center for Disease Control and PreventionHangzhouChina
| | - Le Fang
- Department of Chronic Non‐Communicable Diseases Control and PreventionZhejiang Provincial Center for Disease Control and PreventionHangzhouChina
| | - Meng Wang
- Department of Chronic Non‐Communicable Diseases Control and PreventionZhejiang Provincial Center for Disease Control and PreventionHangzhouChina
| | - Jie Zhang
- Department of Chronic Non‐Communicable Diseases Control and PreventionZhejiang Provincial Center for Disease Control and PreventionHangzhouChina
| | - Yu Guo
- Chinese Academy of Medical SciencesBeijingChina
| | - Zheng Bian
- Chinese Academy of Medical SciencesBeijingChina
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU)Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Liming Li
- Chinese Academy of Medical SciencesBeijingChina
- School of Public HealthPeking University Health Sciences CenterBeijingChina
| | - Min Yu
- Department of Chronic Non‐Communicable Diseases Control and PreventionZhejiang Provincial Center for Disease Control and PreventionHangzhouChina
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16
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Tsang ACO, Orru E, Klostranec JM, Yang IH, Lau KK, Tsang FCP, Lui WM, Pereira VM, Krings T. Thrombectomy Outcomes of Intracranial Atherosclerosis-Related Occlusions. Stroke 2019; 50:1460-1466. [DOI: 10.1161/strokeaha.119.024889] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Anderson Chun On Tsang
- Division of Neurosurgery, Department of Surgery (A.C.O.T., F.C.P.T., W.M.L.), The University of Hong Kong
- Division of Neuroradiology, Joint Department of Medical Imaging (A.C.O.T., E.O., J.M.K., I.-H.Y., V.M.P., T.K.), Toronto Western Hospital, University of Toronto, Canada
| | - Emanuele Orru
- Division of Neuroradiology, Joint Department of Medical Imaging (A.C.O.T., E.O., J.M.K., I.-H.Y., V.M.P., T.K.), Toronto Western Hospital, University of Toronto, Canada
| | - Jesse M. Klostranec
- Division of Neuroradiology, Joint Department of Medical Imaging (A.C.O.T., E.O., J.M.K., I.-H.Y., V.M.P., T.K.), Toronto Western Hospital, University of Toronto, Canada
| | - I-Hsiao Yang
- Division of Neuroradiology, Joint Department of Medical Imaging (A.C.O.T., E.O., J.M.K., I.-H.Y., V.M.P., T.K.), Toronto Western Hospital, University of Toronto, Canada
| | - Kui Kai Lau
- Division of Neurology, Department of Medicine (K.K.L.), The University of Hong Kong
| | - Frederick Chun Pong Tsang
- Division of Neurosurgery, Department of Surgery (A.C.O.T., F.C.P.T., W.M.L.), The University of Hong Kong
| | - Wai Man Lui
- Division of Neurosurgery, Department of Surgery (A.C.O.T., F.C.P.T., W.M.L.), The University of Hong Kong
| | - Vitor Mendes Pereira
- Division of Neuroradiology, Joint Department of Medical Imaging (A.C.O.T., E.O., J.M.K., I.-H.Y., V.M.P., T.K.), Toronto Western Hospital, University of Toronto, Canada
- Division of Neurosurgery, Department of Surgery, University Health Network (V.M.P.), Toronto Western Hospital, University of Toronto, Canada
| | - Timo Krings
- Division of Neuroradiology, Joint Department of Medical Imaging (A.C.O.T., E.O., J.M.K., I.-H.Y., V.M.P., T.K.), Toronto Western Hospital, University of Toronto, Canada
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17
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Wang T, Yang K, Wang X, Luo J, Gao P, Ma Y, Jadhav V, Zhao N, Jiao L. Endovascular therapy versus medical treatment for symptomatic intracranial artery stenosis. Hippokratia 2019. [DOI: 10.1002/14651858.cd013267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Tao Wang
- Xuanwu Hospital, Capital Medical University; Department of Neurosurgery; No. 45 Changchun Street Beijing China 100053
| | - Kun Yang
- Xuanwu Hospital, Capital Medical University; Department of Evidence-based Medicine; No. 45 Changchun Street Beijing China 100053
| | - Xue Wang
- Xuanwu Hospital, Capital Medical University; Medical Library of Xuanwu Hospital; No. 45 Changchun Street Beijing China 100053
| | - Jichang Luo
- Xuanwu Hospital, Capital Medical University; Department of Neurosurgery; No. 45 Changchun Street Beijing China 100053
| | - Peng Gao
- Xuanwu Hospital, Capital Medical University; Department of Neurosurgery; No. 45 Changchun Street Beijing China 100053
| | - Yan Ma
- Xuanwu Hospital, Capital Medical University; Department of Neurosurgery; No. 45 Changchun Street Beijing China 100053
| | - Vikram Jadhav
- CentraCare Health System; Neurosciences - Stroke and Cerebrovascular; 1406 Sixth Ave North St Cloud Minnesota USA
| | - Na Zhao
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University; Department of Anesthesiology; Beijing China
| | - Liqun Jiao
- Xuanwu Hospital, Capital Medical University; Department of Neurosurgery; No. 45 Changchun Street Beijing China 100053
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18
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Trudel X, Brisson C, Gilbert-Ouimet M, Duchaine CS, Dalens V, Talbot D, Milot A. Masked hypertension incidence and risk factors in a prospective cohort study. Eur J Prev Cardiol 2018; 26:231-237. [DOI: 10.1177/2047487318802692] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims Masked hypertension may affect up to 30% of the general population and is associated with a high cardiovascular disease risk. No previous study has examined the incidence of masked hypertension and its risk factors. The study aim was to determine the incidence of masked hypertension and to examine its related risk factors. Methods This is a cohort study including 1836 initially normotensive participants followed up on average for 2.9 years. Blood pressure was measured using Spacelabs 90207. Manual blood pressure was defined as the mean of the first three readings taken at rest. Ambulatory blood pressure was defined as the mean of the next readings recorded every 15 minutes during daytime working hours. Masked hypertension incidence at follow-up was defined as manual blood pressure less than 140 and less than 90 mmHg and ambulatory blood pressure at least 135 or at least 85 mmHg. Generalised estimating equations were used. Results The cumulative incidence of masked hypertension was 10.3% and was associated with male gender (relative risk (RR) 1.51, 95% confidence interval (CI) 1.18–1.94), older age (RR40–49 years 1.56, 95% CI 1.16–2.11, RR≥50 years 1.50, 95% CI 1.06–2.10), higher education (RRcollege 1.31, 95% CI 1.03–1.65), body mass index (RR≥27 1.43, 95% CI 1.11–1.85), smoking (RR 1.51, 95% CI 1.09–2.010) and alcohol intake (RR≥6/week 1.65, 95% CI 1.13–2.03). Conclusion The present study is the first to identify risk factors for the incidence of masked hypertension. Current guidelines for hypertension detection recommend ambulatory blood pressure in patients with an elevated blood pressure reading at the clinic. As it is impractical to measure ambulatory blood pressure in all normotensive patients, factors identified in the present study should be considered for the screening of at-risk individuals and for primary prevention of masked hypertension.
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Affiliation(s)
- Xavier Trudel
- Social and Preventive Medicine Department, Laval University, Canada
- Axe santé des populations et pratiques optimales en santé, Laval University, Canada
| | - Chantal Brisson
- Social and Preventive Medicine Department, Laval University, Canada
- Axe santé des populations et pratiques optimales en santé, Laval University, Canada
| | | | - Caroline S Duchaine
- Axe santé des populations et pratiques optimales en santé, Laval University, Canada
| | - Violaine Dalens
- Axe santé des populations et pratiques optimales en santé, Laval University, Canada
| | - Denis Talbot
- Social and Preventive Medicine Department, Laval University, Canada
- Axe santé des populations et pratiques optimales en santé, Laval University, Canada
| | - Alain Milot
- Axe santé des populations et pratiques optimales en santé, Laval University, Canada
- Department of Medicine, Laval University, Canada
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19
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Al Kasab S, Derdeyn CP, Guerrero WR, Limaye K, Shaban A, Adams HP. Intracranial Large and Medium Artery Atherosclerotic Disease and Stroke. J Stroke Cerebrovasc Dis 2018; 27:1723-1732. [DOI: 10.1016/j.jstrokecerebrovasdis.2018.02.050] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 02/09/2018] [Accepted: 02/23/2018] [Indexed: 10/17/2022] Open
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20
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Zhang G, Li C, Zhu N, Chen Y, Yu Q, Liu E, Wang R. Sex differences in the formation of atherosclerosis lesion in apoE-/-mice and the effect of 17β-estrodiol on protein S-nitrosylation. Biomed Pharmacother 2018; 99:1014-1021. [DOI: 10.1016/j.biopha.2018.01.145] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 01/12/2018] [Accepted: 01/28/2018] [Indexed: 01/19/2023] Open
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21
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Jayedi A, Shab-Bidar S. Nonlinear dose–response association between body mass index and risk of all-cause and cardiovascular mortality in patients with hypertension: A meta-analysis. Obes Res Clin Pract 2018; 12:16-28. [DOI: 10.1016/j.orcp.2018.01.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Revised: 12/07/2017] [Accepted: 01/08/2018] [Indexed: 01/15/2023]
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22
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Chen JL, Guedes CM, Cooper BA, Lung AE. Short-Term Efficacy of an Innovative Mobile Phone Technology-Based Intervention for Weight Management for Overweight and Obese Adolescents: Pilot Study. Interact J Med Res 2017; 6:e12. [PMID: 28768612 PMCID: PMC5559653 DOI: 10.2196/ijmr.7860] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 05/26/2017] [Accepted: 06/13/2017] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND In the United States, approximately one-third of adolescents are now overweight or obese, and one in six is obese. This financial cost and the larger nonfinancial costs of obesity make obesity prevention and management for adolescents imperative for the health of the nation. However, primary care visits are typically brief, and primary care providers may lack adequate resources to help overweight or obese adolescents to manage weight issues. To augment the efficacy of primary care visits for adolescent weight management, mobile phone technology can be used as an adjunct treatment that provides additional opportunities for encouraging improvement in lifestyle, attainment, and maintenance of healthy weight. OBJECTIVE The purposes of this study were to (1) measure effects of an innovative mobile phone technology-based intervention for overweight and obese adolescents and to (2) examine the intervention's feasibility for use in primary care clinics. METHODS The mobile phone-based intervention had three components: use of the Fitbit Flex, participation in an online educational program, and receipt of biweekly text messages during the maintenance phase. A randomized controlled study design was utilized. Data regarding anthropometrics (body mass index [BMI] and waist-to-hip ratio), blood pressure, levels of physical and sedentary activity, diet, and self-efficacy regarding physical activity and diet were collected at baseline and at 3 and 6 months after the baseline assessment. RESULTS A total of 40 adolescents participated in the study. At the 6-month follow-up visit, compared to participants in the control group, the mobile phone-based intervention participants had significant improvement in BMI (z=-4.37, P=.001), diastolic blood pressure (z=-3.23, P=.001), physical activity days per week (z=2.58, P=.01), TV and computer time (z=-3.34, P=.001), servings of fruits and vegetables per day (z=2.74, P=.006), servings of soda and sweetened drinks (z=-3.19, P=.001), physical activity self-efficacy (z=2.75, P=.006), and dietary self-efficacy (z=5.05, P=.001). Medium to large effect sizes were found in these outcome variables. CONCLUSIONS The use of mobile technologies may offer a practical, reliable adjunct to weight management for overweight and obese adolescents in busy primary care clinics serving adolescents. TRIAL REGISTRATION Clinicaltrials.gov NCT 01693250; https://clinicaltrials.gov/ct2/show/NCT01693250? term=Adolescent+ obesity+AND+mhealth&rank=5 (Archived by WebCite at ).
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Affiliation(s)
- Jyu-Lin Chen
- School of Nursing, Department of Family Health Care Nursing, University of California San Francico, San Francisco, CA, United States
| | - Claudia M Guedes
- Department of Kinesiology, San Francisco State University, San Francisco, CA, United States
| | - Bruce A Cooper
- School of Nursing, University of California San Francisco, San Francsico, CA, United States
| | - Audrey E Lung
- Department of Pediatrics, North East Medical Services, San Francisco, CA, United States
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23
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Sun A, Cheng J, Bui Q, Liang Y, Ng T, Chen JL. Home-Based and Technology-Centered Childhood Obesity Prevention for Chinese Mothers With Preschool-Aged Children. J Transcult Nurs 2017; 28:616-624. [DOI: 10.1177/1043659617719139] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Angela Sun
- Chinese Community Health Resource Center, San Francisco, CA, USA
| | - Joyce Cheng
- Chinese Community Health Resource Center, San Francisco, CA, USA
| | | | - Yvonne Liang
- Chinese Community Health Resource Center, San Francisco, CA, USA
| | - Terence Ng
- Chinese Community Health Resource Center, San Francisco, CA, USA
| | - Jyu-Lin Chen
- University of California, San Francisco, CA, USA
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24
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Zhang M, Zhao Y, Sun H, Luo X, Wang C, Li L, Zhang L, Wang B, Ren Y, Zhou J, Han C, Zhang H, Yang X, Pang C, Yin L, Feng T, Zhao J, Hu D. Effect of dynamic change in body mass index on the risk of hypertension: Results from the Rural Chinese Cohort Study. Int J Cardiol 2017; 238:117-122. [DOI: 10.1016/j.ijcard.2017.03.025] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 03/03/2017] [Accepted: 03/08/2017] [Indexed: 02/03/2023]
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25
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Melton CD, Luo R, Wong BJ, Spasojevic I, Wagenknecht LE, D'Agostino RB, Il'yasova D. Urinary F 2-isoprostanes and the risk of hypertension. Ann Epidemiol 2017; 27:391-396. [PMID: 28558917 DOI: 10.1016/j.annepidem.2017.05.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 03/21/2017] [Accepted: 05/08/2017] [Indexed: 02/05/2023]
Abstract
PURPOSE There is strong biological plausibility for a causal role of reactive oxygen species in vascular pathology but no direct epidemiological evidence linking elevated reactive oxygen species levels to hypertension development. We examined cross-sectional and prospective associations between oxidative status (urinary F2-isoprostanes) and hypertension in the Insulin Resistance Atherosclerosis Study cohort (n = 831). METHODS The cohort included non-Hispanic white, Hispanic, and non-Hispanic black individuals, with 252 (30%) having prevalent hypertension and 579 participants normotensive at baseline, 122 (21%) of whom developed hypertension during the 5-year follow-up. Four urinary F2-isoprostane isomers were quantified in baseline specimens using LC/MS-MS and were summarized as a composite index. Examined outcomes included hypertension status (yes/no), systolic (SBP) and diastolic blood pressure (DBP), pulse pressure (PP), and mean arterial pressure (MAP). RESULTS Prevalent and incident hypertension were associated with greater age, Black race, impaired glucose tolerance, and greater BMI. F2-IsoP levels were lower among men and among non-Hispanic Blacks, were inversely associated with age, and were directly associated with BMI. No cross-sectional association was found between F2-isoprostanes and hypertension status (OR = 0.93, 0.77-0.12). Among the continuous measures of blood pressure only PP was associated with F2-isoprostanes at baseline (beta-coefficient = 0.99, 0.11-1.86). No prospective association was found between F2-isoprostanes and incident hypertension: OR = 0.98, 0.77-1.25. No prospective associations were found for systolic blood pressure and diastolic blood pressure, and pulse pressure. Mean arterial pressure showed an inverse association (beta-coefficient = -0.16, -0.31 to -0.01). CONCLUSIONS Elevated F2-isoprostane levels do not increase the risk of hypertension.
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Affiliation(s)
| | - Ruiyan Luo
- School of Public Health, Georgia State University, Atlanta
| | - Brett J Wong
- Department of Kinesiology & Health, Georgia State University, Atlanta
| | - Ivan Spasojevic
- Duke Cancer Institute, Duke University Medical Center, Durham, NC
| | - Lynne E Wagenknecht
- Public Health Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC
| | - Ralph B D'Agostino
- Public Health Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC
| | - Dora Il'yasova
- School of Public Health, Georgia State University, Atlanta; Duke Cancer Institute, Duke University Medical Center, Durham, NC.
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26
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Cheung EL, Bell CS, Samuel JP, Poffenbarger T, Redwine KM, Samuels JA. Race and Obesity in Adolescent Hypertension. Pediatrics 2017; 139:peds.2016-1433. [PMID: 28557717 PMCID: PMC5404724 DOI: 10.1542/peds.2016-1433] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/14/2017] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The overall prevalence of essential hypertension in adolescents may be growing. Differences in blood pressure (BP) are well established in adults, but are less clear in adolescents. We hypothesize that the prevalence of hypertension differs by race/ethnicity among adolescents at school-based screenings. METHODS We performed school-based BP screening in over 20 000 adolescents from 2000 to 2015. Race/ethnicity was self-reported. Height and weight were measured to determine BMI, and BP status was confirmed on 3 occasions to diagnose sustained hypertension according to Fourth Working Group Report criteria. RESULTS We successfully screened 21 062 adolescents aged 10 to 19 years (mean, 13.8 years). The final prevalence of sustained hypertension in all subjects was 2.7%. Obesity rates were highest among African American (3.1%) and Hispanic (2.7%) adolescents. The highest rate of hypertension was seen in Hispanic (3.1%), followed by African American (2.7%), white (2.6%), and Asian (1.7%) adolescents (P = .019). However, obese white adolescents had the highest prevalence of sustained hypertension (7.4%) compared with obese African American adolescents (4.5%, P < .001). At lower BMI percentiles (<60th percentile), Hispanic adolescents actually had the lowest predicted prevalence of hypertension among the 4 groups. CONCLUSIONS The prevalence of hypertension varies among different race/ethnicities. Although obesity remains the strongest predictor of early hypertension, the strength of this relationship is intensified in Hispanic and white adolescents, whereas it is lessened in African American adolescents.
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Affiliation(s)
- Eric L. Cheung
- Division of Pediatric Nephrology and Hypertension, Department of Pediatrics, University of Texas McGovern Medical School at Houston, Children’s Memorial Hermann Hospital, Houston, Texas; and
| | - Cynthia S. Bell
- Division of Pediatric Nephrology and Hypertension, Department of Pediatrics, University of Texas McGovern Medical School at Houston, Children’s Memorial Hermann Hospital, Houston, Texas; and
| | - Joyce P. Samuel
- Division of Pediatric Nephrology and Hypertension, Department of Pediatrics, University of Texas McGovern Medical School at Houston, Children’s Memorial Hermann Hospital, Houston, Texas; and
| | - Tim Poffenbarger
- Division of Pediatric Nephrology and Hypertension, Department of Pediatrics, University of Texas McGovern Medical School at Houston, Children’s Memorial Hermann Hospital, Houston, Texas; and
| | - Karen McNiece Redwine
- Division of Pediatric Nephrology and Hypertension, Department of Pediatrics, University of Texas McGovern Medical School at Houston, Children’s Memorial Hermann Hospital, Houston, Texas; and,Division of Children’s Nephrology, St. Luke’s Health System, Boise, Idaho
| | - Joshua A. Samuels
- Division of Pediatric Nephrology and Hypertension, Department of Pediatrics, University of Texas McGovern Medical School at Houston, Children’s Memorial Hermann Hospital, Houston, Texas; and
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Liang J, Le TH, Edwards DRV, Tayo BO, Gaulton KJ, Smith JA, Lu Y, Jensen RA, Chen G, Yanek LR, Schwander K, Tajuddin SM, Sofer T, Kim W, Kayima J, McKenzie CA, Fox E, Nalls MA, Young JH, Sun YV, Lane JM, Cechova S, Zhou J, Tang H, Fornage M, Musani SK, Wang H, Lee J, Adeyemo A, Dreisbach AW, Forrester T, Chu PL, Cappola A, Evans MK, Morrison AC, Martin LW, Wiggins KL, Hui Q, Zhao W, Jackson RD, Ware EB, Faul JD, Reiner AP, Bray M, Denny JC, Mosley TH, Palmas W, Guo X, Papanicolaou GJ, Penman AD, Polak JF, Rice K, Taylor KD, Boerwinkle E, Bottinger EP, Liu K, Risch N, Hunt SC, Kooperberg C, Zonderman AB, Laurie CC, Becker DM, Cai J, Loos RJF, Psaty BM, Weir DR, Kardia SLR, Arnett DK, Won S, Edwards TL, Redline S, Cooper RS, Rao DC, Rotter JI, Rotimi C, Levy D, Chakravarti A, Zhu X, Franceschini N. Single-trait and multi-trait genome-wide association analyses identify novel loci for blood pressure in African-ancestry populations. PLoS Genet 2017; 13:e1006728. [PMID: 28498854 PMCID: PMC5446189 DOI: 10.1371/journal.pgen.1006728] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 05/26/2017] [Accepted: 03/30/2017] [Indexed: 02/07/2023] Open
Abstract
Hypertension is a leading cause of global disease, mortality, and disability. While individuals of African descent suffer a disproportionate burden of hypertension and its complications, they have been underrepresented in genetic studies. To identify novel susceptibility loci for blood pressure and hypertension in people of African ancestry, we performed both single and multiple-trait genome-wide association analyses. We analyzed 21 genome-wide association studies comprised of 31,968 individuals of African ancestry, and validated our results with additional 54,395 individuals from multi-ethnic studies. These analyses identified nine loci with eleven independent variants which reached genome-wide significance (P < 1.25×10-8) for either systolic and diastolic blood pressure, hypertension, or for combined traits. Single-trait analyses identified two loci (TARID/TCF21 and LLPH/TMBIM4) and multiple-trait analyses identified one novel locus (FRMD3) for blood pressure. At these three loci, as well as at GRP20/CDH17, associated variants had alleles common only in African-ancestry populations. Functional annotation showed enrichment for genes expressed in immune and kidney cells, as well as in heart and vascular cells/tissues. Experiments driven by these findings and using angiotensin-II induced hypertension in mice showed altered kidney mRNA expression of six genes, suggesting their potential role in hypertension. Our study provides new evidence for genes related to hypertension susceptibility, and the need to study African-ancestry populations in order to identify biologic factors contributing to hypertension.
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Affiliation(s)
- Jingjing Liang
- Department of Epidemiology & Biostatistics, School of Medicine, Case Western Reserve University, Cleveland, OH, United States of America
| | - Thu H. Le
- Department of Medicine, Division of Nephrology, University of Virginia, Charlottesville, Virginia, United States of America
| | - Digna R. Velez Edwards
- Department of Obstetrics and Gynecology, Institute for Medicine and Public Health, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Bamidele O. Tayo
- Department of Public Health Sciences, Loyola University Chicago Stritch School of Medicine, Maywood, Illinois, United States of America
| | - Kyle J. Gaulton
- Department of Pediatrics, University of California San Diego, La Jolla, California, United States of America
| | - Jennifer A. Smith
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Yingchang Lu
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York, United States of America
- The Genetics of Obesity and Related Metabolic Traits Program, Ichan School of Medicine at Mount Sinai, New York City, New York, United States of America
- Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Richard A. Jensen
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, Washington, United States of America
| | - Guanjie Chen
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Lisa R. Yanek
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Karen Schwander
- Division of Biostatistics, School of Medicine, Washington University in St. Louis, St. Louis, Missouri, United States of America
| | - Salman M. Tajuddin
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, United States of America
| | - Tamar Sofer
- Department of Biostatistics, University of Washington, Seattle, Washington, United States of America
| | - Wonji Kim
- Interdisciplinary Program of Bioinformatics, Seoul National University, Seoul, Republic of Korea
| | - James Kayima
- Division of Adult Cardiology, Uganda Heart Institute, Makerere University College of Health Sciences, Kampala, Uganda
- Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Colin A. McKenzie
- Tropical Metabolism Research Unit, Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - Ervin Fox
- Department of Preventive Medicine, University of Mississippi Medical Center, Jackson, Mississippi, United States of America
| | - Michael A. Nalls
- Data Tecnica International, Glen Echo, MD, United States of America and Laboratory of Neurogenetics, National Institute on Aging, National Institute of Health, Bethesda, Maryland, United States of America
| | - J. Hunter Young
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Yan V. Sun
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Jacqueline M. Lane
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
- Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, United States of America
| | - Sylvia Cechova
- Department of Medicine, Division of Nephrology, University of Virginia, Charlottesville, Virginia, United States of America
| | - Jie Zhou
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Hua Tang
- Department of Genetics, Stanford University School of Medicine, Stanford, California, United States of America
| | - Myriam Fornage
- Institute of Molecular Medicine and Human Genetics Center, University of Texas Health Science Center at Houston, Houston, TX, United States of America
| | - Solomon K. Musani
- Department of Preventive Medicine, University of Mississippi Medical Center, Jackson, Mississippi, United States of America
| | - Heming Wang
- Department of Epidemiology & Biostatistics, School of Medicine, Case Western Reserve University, Cleveland, OH, United States of America
| | - Juyoung Lee
- Division of Structural and Functional Genomics, Center for Genome Science, Korea National Institute of Health, Cheongju, Republic of Korea
| | - Adebowale Adeyemo
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Albert W. Dreisbach
- Department of Preventive Medicine, University of Mississippi Medical Center, Jackson, Mississippi, United States of America
| | - Terrence Forrester
- Tropical Metabolism Research Unit, Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - Pei-Lun Chu
- Department of Internal Medicine, Graduate Institute of Biomedical and Pharmaceutical Science, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Anne Cappola
- Division of Endocrinology, Diabetes, and Metabolism, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, United States of America
| | - Michele K. Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, United States of America
| | - Alanna C. Morrison
- Human Genetics Center, School of Public Health, University of Texas Health Science Center, Houston, Texas, United States of America
| | - Lisa W. Martin
- The George Washington University School of Medicine and Health Sciences, Washington DC. United States of America
| | - Kerri L. Wiggins
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, Washington, United States of America
| | - Qin Hui
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Wei Zhao
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Rebecca D. Jackson
- Department of Internal Medicine, Ohio State University, Columbus, Ohio, United States of America
| | - Erin B. Ware
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America
- Survey Research Center, Institute for Social Research, University of Michigan Ann Arbor, Michigan, United States of America
| | - Jessica D. Faul
- Survey Research Center, Institute for Social Research, University of Michigan Ann Arbor, Michigan, United States of America
| | - Alex P. Reiner
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Michael Bray
- Department of Obstetrics and Gynecology, Institute for Medicine and Public Health, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Joshua C. Denny
- Department of Biomedical Informatics, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Thomas H. Mosley
- Department of Preventive Medicine, University of Mississippi Medical Center, Jackson, Mississippi, United States of America
| | - Walter Palmas
- Department of Medicine, Columbia University, New York City, New York, United States of America
| | - Xiuqing Guo
- Medical Genetics Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America
| | - George J. Papanicolaou
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Alan D. Penman
- Department of Preventive Medicine, University of Mississippi Medical Center, Jackson, Mississippi, United States of America
| | - Joseph F. Polak
- Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts, United States of America
| | - Kenneth Rice
- Department of Biostatistics, University of Washington, Seattle, Washington, United States of America
| | - Ken D. Taylor
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA
| | - Eric Boerwinkle
- Human Genetics Center, School of Public Health, University of Texas Health Science Center, Houston, Texas, United States of America
| | - Erwin P. Bottinger
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York, United States of America
| | - Kiang Liu
- Department of Preventive Medicine, Northwestern University Medical School, Chicago, Illinois, United States of America
| | - Neil Risch
- Institute for Human Genetics, University of California, San Francisco, California, United States of America
| | - Steven C. Hunt
- Cardiovascular Genetics, University of Utah, Salt Lake City, Utah, United States of America
| | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Alan B. Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, United States of America
| | - Cathy C. Laurie
- Department of Biostatistics, University of Washington, Seattle, Washington, United States of America
| | - Diane M. Becker
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Jianwen Cai
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States of America
| | - Ruth J. F. Loos
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York, United States of America
- The Genetics of Obesity and Related Metabolic Traits Program, Ichan School of Medicine at Mount Sinai, New York City, New York, United States of America
- The Mindich Child Health and Development Institute, Ichan School of Medicine at Mount Sinai, New York City, New York, United States of America
| | - Bruce M. Psaty
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, Washington, United States of America
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington, United States of America
| | - David R. Weir
- Survey Research Center, Institute for Social Research, University of Michigan Ann Arbor, Michigan, United States of America
| | - Sharon L. R. Kardia
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Donna K. Arnett
- University of Kentucky, College of Public Health, Lexington, KY
| | - Sungho Won
- Interdisciplinary Program of Bioinformatics, Seoul National University, Seoul, Republic of Korea
- Department of Public Health Science, Seoul National University, Seoul, Republic of Korea
| | - Todd L. Edwards
- Division of Epidemiology, Department of Medicine, Institute of Medicine and Public Health, Vanderbilt Genetics Institute, Vanderbilit University Medical Center, Nashville, Tennessee, United States of America
| | - Susan Redline
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Richard S. Cooper
- Department of Public Health Sciences, Loyola University Chicago Stritch School of Medicine, Maywood, Illinois, United States of America
| | - D. C. Rao
- Division of Biostatistics, School of Medicine, Washington University in St. Louis, St. Louis, Missouri, United States of America
| | - Jerome I. Rotter
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA
| | - Charles Rotimi
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Daniel Levy
- Population Sciences Branch, National Heart, Lung, and Blood Institute of the National Institutes of Health, Bethesda, MD, and the Framingham Heart Study, Framingham, Massachusetts, United States of America
| | - Aravinda Chakravarti
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Xiaofeng Zhu
- Department of Epidemiology & Biostatistics, School of Medicine, Case Western Reserve University, Cleveland, OH, United States of America
| | - Nora Franceschini
- Epidemiology, Gilling School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
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Banerjee C, Chimowitz MI. Stroke Caused by Atherosclerosis of the Major Intracranial Arteries. Circ Res 2017; 120:502-513. [PMID: 28154100 PMCID: PMC5312775 DOI: 10.1161/circresaha.116.308441] [Citation(s) in RCA: 257] [Impact Index Per Article: 36.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 11/16/2016] [Accepted: 11/17/2016] [Indexed: 11/16/2022]
Abstract
Our goal in this review is to discuss the pathophysiology, diagnosis, and treatment of stroke caused by atherosclerosis of the major intracranial arteries. References for the review were identified by searching PubMed for related studies published from 1955 to June 2016 using search terms intracranial stenosis and intracranial atherosclerosis. Reference sections of published randomized clinical trials and previously published reviews were searched for additional references. Intracranial atherosclerotic disease is a highly prevalent cause of stroke that is associated with a high risk of recurrent stroke. It is more prevalent among blacks, Hispanics, and Asians compared with whites. Diabetes mellitus, hypertension, metabolic syndrome, smoking, hyperlipidemia, and a sedentary lifestyle are the major modifiable risk factors associated with intracranial atherosclerotic disease. Randomized clinical trials comparing aggressive management (dual antiplatelet treatment for 90 days followed by aspirin monotherapy and intensive management of vascular risk factors) with intracranial stenting plus aggressive medical management have shown medical management alone to be safer and more effective for preventing stroke. As such, aggressive medical management has become the standard of care for symptomatic patients with intracranial atherosclerotic disease. Nevertheless, there are subgroups of patients who are still at high risk of stroke despite being treated with aggressive medical management. Future research should aim to establish clinical, serological, and imaging biomarkers to identify high-risk patients, and clinical trials evaluating novel therapies should be focused on these patients.
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Affiliation(s)
- Chirantan Banerjee
- From the Department of Neurology, Stroke Division, Medical University of South Carolina, Charleston
| | - Marc I Chimowitz
- From the Department of Neurology, Stroke Division, Medical University of South Carolina, Charleston.
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Papier K, Jordan S, D‘Este C, Bain C, Peungson J, Banwell C, Yiengprugsawan V, Seubsman SA, Sleigh A. Incidence and risk factors for type 2 diabetes mellitus in transitional Thailand: results from the Thai cohort study. BMJ Open 2016; 6:e014102. [PMID: 27974373 PMCID: PMC5168599 DOI: 10.1136/bmjopen-2016-014102] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is increasingly prevalent in countries undergoing rapid development, including Thailand. We assessed T2DM incidence over an 8-year period in a nationwide cohort of Thai adults. METHODS Thai Cohort Study participants were surveyed in 2005, 2009 and 2013. The analysed cohort members were aged (15-88), did not have diabetes in 2005 and were followed up by questionnaire in 2013 (n=39 507). T2DM was ascertained using self-report, which has been validated using physician interviews. We calculated the 8-year cumulative incidence of T2DM. Multivariable logistic regression assessed associations between potential risk factors and T2DM incidence. RESULTS 8-year cumulative incidence of T2DM (2005 to 2013) was 177 per 10 000 (95% CI 164 to 190). Crude and age-standardised cumulative incidences of T2DM by sex were 249 per 10 000 (95% CI 226 to 272) and 222 per 10 000 (95% CI 219 to 225) for men; and 119 per 10 000 (95% CI 105 to 133) and 96 per 10 000 (95% CI 94 to 98) for women, respectively. T2DM increased significantly for both sexes with increasing age and body mass index (BMI) (p trend <0.001 for both). Residence in an urban area as a child associated with T2DM among men and women (OR=1.4, 95% CI 1.1 to 1.7 and OR=1.4, 95% CI 1.01 to 1.79); this was no longer statistically significant after adjusting for BMI. Among men, smoking (OR=1.7, 95% CI 1.3 to 2.2) and alcohol intake (OR=1.8, 95% CI 1.1 to 3.0) were associated with T2DM. CONCLUSIONS This study found that the sociodemographic and lifestyle changes that have accompanied Thailand's economic development are associated with T2DM risk in a large cohort of Thai adults. Our findings highlight the need to address these transitions to prevent a further increase in the national incidence of T2DM, particularly among Thai men.
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Affiliation(s)
- Keren Papier
- National Centre for Epidemiology and Population Health (NCEPH) and Department of Global Health, Research School of Population Health, College of Medicine, Biology and Environment, The Australian National University, Canberra, Australia
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Susan Jordan
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Catherine D‘Este
- National Centre for Epidemiology and Population Health (NCEPH) and Department of Global Health, Research School of Population Health, College of Medicine, Biology and Environment, The Australian National University, Canberra, Australia
| | - Chris Bain
- National Centre for Epidemiology and Population Health (NCEPH) and Department of Global Health, Research School of Population Health, College of Medicine, Biology and Environment, The Australian National University, Canberra, Australia
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Janya Peungson
- Thai Health-Risk Transition Study, School of Human Ecology, Sukhothai Thammathirat Open University, Nonthaburi, Thailand
| | - Cathy Banwell
- National Centre for Epidemiology and Population Health (NCEPH) and Department of Global Health, Research School of Population Health, College of Medicine, Biology and Environment, The Australian National University, Canberra, Australia
| | - Vasoontara Yiengprugsawan
- National Centre for Epidemiology and Population Health (NCEPH) and Department of Global Health, Research School of Population Health, College of Medicine, Biology and Environment, The Australian National University, Canberra, Australia
- Health and Wellbeing and Department of Global Health, Centre for Research on Ageing, Research School of Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Sam-ang Seubsman
- Thai Health-Risk Transition Study, School of Human Ecology, Sukhothai Thammathirat Open University, Nonthaburi, Thailand
| | - Adrian Sleigh
- National Centre for Epidemiology and Population Health (NCEPH) and Department of Global Health, Research School of Population Health, College of Medicine, Biology and Environment, The Australian National University, Canberra, Australia
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Yoon YS, Choi HS, Kim JK, Kim YI, Oh SW. Differences in the associations of anthropometric measures with insulin resistance and type 2 diabetes mellitus between Korean and US populations: Comparisons of representative nationwide sample data. Obes Res Clin Pract 2016; 10:642-651. [PMID: 26750428 DOI: 10.1016/j.orcp.2015.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 10/15/2015] [Accepted: 11/02/2015] [Indexed: 01/16/2023]
Abstract
BACKGROUNDS Variation among ethnic groups in the association between obesity and insulin resistance (IR)/diabetes has been suggested, but studies reported inconsistent results. We evaluated ethnic differences in the association between obesity and insulin resistance (IR)/diabetes. METHODS We conducted a cross-sectional analysis using Korea (n=18,845) and the USA (n=4657) National Health and Nutrition Examination Survey(NHANES) 2007-2010. We performed statistical comparisons of AUC-ROC (area under the curve in a receiver operating characteristic curve) values for body mass index (BMI), waist circumference (WC) and homeostasis model assessment of insulin resistance (HOMA-IR) to predict IR or diabetes among different ethnic groups. RESULTS AUC-ROC values for BMI and WC for predicting IR were highest in Whites (0.8324 and 0.8468) and lowest in Koreans (0.7422 and 0.7367). Whites showed the highest AUC-ROC values for BMI (0.6869) and WC (0.7421) for predicting diabetes, while the AUC-ROC for HOMA-IR was highest in Koreans (0.8861). Linear regression showed significant interactions between ethnicity and the main effects (all P<0.0001). Increases in BMI were associated with a larger increase in HOMA-IR in Whites (β=0.0719) and WC in Hispanics (β=0.0324), while BMI was associated with a larger increase in fasting glucose in Koreans (β=0.8279) and WC in Blacks (β=0.4037). In addition, the slope for fasting glucose with increasing HOMA-IR was steeper in Koreans (β=16.5952, P<0.001) than in other groups. CONCLUSION The ability of BMI and WC to predict IR and diabetes was highest in Whites, while the ability of HOMA-IR to predict diabetes was highest in Koreans.
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Affiliation(s)
- Yeong Sook Yoon
- Department of Family Medicine, Inje University Ilsan Paik Hospital, Goyang-Si, Gyeonggi-Do, South Korea
| | - Han Seok Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang-Si, Gyeonggi-Do, South Korea
| | - Jin Kuk Kim
- Department of Neurosurgery, Seoul Na Eun Hospital, Seoul, South Korea; Department of Family Medicine, Center for Obesity, Metabolism and Nutrition, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang-Si, Gyeonggi-Do, South Korea
| | - Yu Il Kim
- Department of Family Medicine, Center for Obesity, Metabolism and Nutrition, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang-Si, Gyeonggi-Do, South Korea
| | - Sang Woo Oh
- Department of Family Medicine, Center for Obesity, Metabolism and Nutrition, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang-Si, Gyeonggi-Do, South Korea; Channelopathy Research Center, Dongguk University College of Medicine, Goyang-Si, Gyeonggi-Do, South Korea.
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Liang J, Sun Y, Liu X, Zhu Y, Pei Y, Wang Y, Qiu Q, Yang M, Qi L. Genetic predisposition to obesity is associated with insulin secretion in Chinese adults: The Cardiometabolic Risk in Chinese (CRC) study. J Diabetes Complications 2016; 30:1229-33. [PMID: 27324702 DOI: 10.1016/j.jdiacomp.2016.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 05/03/2016] [Accepted: 06/06/2016] [Indexed: 11/28/2022]
Abstract
AIMS The etiological role of obesity in determining diabetes risk among Asians may be different from that among Caucasians. The current study aimed to investigate the association between genetic predisposition to obesity and measures of insulin secretion and resistance in a large Chinese cohort. METHODS Study samples were from a community-based health examination survey in central China. A total of 2058 subjects with available biomarkers levels were included in the present study. A genetic risk score (GRS) of obesity was derived on the basis of thirteen Asian-specific body mass index (BMI)-associated variants. RESULTS High obesity GRS was significantly associated with increased homeostasis model assessment (HOMA)-B score (β=7.309; P=0.001) but not related to measures of insulin resistance. Adjustment for age, sex, BMI, and levels of lipids did not appreciably change the results. In addition, we found significant interactions between the obesity GRS and measures of body fat distribution including waist circumference (WC; P for interaction=0.004) and neck circumference (NC; P for interaction=0.014) on HOMA-B score. CONCLUSIONS Our results suggest that genetic predisposition to obesity may affect beta cell function in Chinese; and body fat distribution may modify the genetic effects.
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Affiliation(s)
- Jun Liang
- Department of Endocrinology of Xuzhou Central Hospital, Xuzhou Institute of Medical Sciences, Xuzhou Institute of Diabetes, Jiangsu 221009, China; Xuzhou Clinical School of Xuzhou Medical College, Xuzhou Central Hospital Affiliated to Nanjing University of Chinese Medicine, Affiliated Hospital of Southeast University, Xuzhou, Jiangsu 221009, China.
| | - Yuting Sun
- Xuzhou Medical College, Jiangsu 221000, China
| | - Xuekui Liu
- Department of Endocrinology of Xuzhou Central Hospital, Xuzhou Institute of Medical Sciences, Xuzhou Institute of Diabetes, Jiangsu 221009, China; Xuzhou Clinical School of Xuzhou Medical College, Xuzhou Central Hospital Affiliated to Nanjing University of Chinese Medicine, Affiliated Hospital of Southeast University, Xuzhou, Jiangsu 221009, China
| | - Yan Zhu
- Xuzhou Medical College, Jiangsu 221000, China
| | - Ying Pei
- School of Medicine, Southeast University, Jiangsu 210009, China
| | - Yu Wang
- Department of Endocrinology of Xuzhou Central Hospital, Xuzhou Institute of Medical Sciences, Xuzhou Institute of Diabetes, Jiangsu 221009, China; Xuzhou Clinical School of Xuzhou Medical College, Xuzhou Central Hospital Affiliated to Nanjing University of Chinese Medicine, Affiliated Hospital of Southeast University, Xuzhou, Jiangsu 221009, China
| | - Qinqin Qiu
- Xuzhou Medical College, Jiangsu 221000, China
| | - Manqing Yang
- Department of Endocrinology of Xuzhou Central Hospital, Xuzhou Institute of Medical Sciences, Xuzhou Institute of Diabetes, Jiangsu 221009, China; Xuzhou Clinical School of Xuzhou Medical College, Xuzhou Central Hospital Affiliated to Nanjing University of Chinese Medicine, Affiliated Hospital of Southeast University, Xuzhou, Jiangsu 221009, China
| | - Lu Qi
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70118, United States; Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, United States.
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Chen JL, Kwan M. Short-Term Efficacy and Correlates of Change in Health Weight Management Program for Chinese American Children. Clin Pediatr (Phila) 2016; 55:463-9. [PMID: 26149851 DOI: 10.1177/0009922815592608] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A pretest and posttest study design was used to test a healthy weight management intervention with overweight and/or obese Chinese American children. Children attended 8-weekly small group sessions while parents attended a single 2-hour parent workshop. Children had their weight, height, blood pressure, waist and hip circumference, and fast lipids data assessed and completed several questions questionnaires regarding food choices, self-efficacy, and knowledge at baseline, 2 months, and 6 months. Parents completed questionnaires regarding demographic, acculturation level and family environment. We found significant reduction of body mass index, waist/hip ratio, systolic blood pressure and improvement of child's eating style, physical activity knowledge, self-efficacy, and children's quality of life at 6-month follow-up. In addition, significant improvement of high-density lipoprotein cholesterol and decrease in triglyceride were found at 6-month follow-up. Improvement of nutrition self-efficacy and decreased stimulus environment were associated with decreased body mass index in overweight and obese Chinese American children.
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Affiliation(s)
- Jyu-Lin Chen
- University of California San Francisco, San Francisco, CA, USA
| | - Monica Kwan
- North East Medical Services, San Francisco, CA, USA
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Overweight, resting heart rate, and prediabetes/diabetes: A population-based prospective cohort study among Inner Mongolians in China. Sci Rep 2016; 6:23939. [PMID: 27029423 PMCID: PMC4814924 DOI: 10.1038/srep23939] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 03/16/2016] [Indexed: 01/14/2023] Open
Abstract
We aimed to investigate the cumulative effect of overweight and resting heart rate on prediabetes/diabetes incidence in an 10-year follow-up study in Inner Mongolians. Among 1729 participants who were free from prediabetes and diabetes at baseline, 503 and 155 subjects developed prediabetes and diabetes, respectively. We categorized the participants into 4 subgroups according to overweight and resting heart rate status. The multivariate-adjusted OR (95% CI) in normal weight with heart rate ≥80 bpm, overweight with heart rate <80 bpm, and overweight with heart rate ≥80 bpm were 1.24 (0.95-1.61), 1.83 (1.29-2.61), 2.20 (1.41-3.45) for prediabetes and 1.52 (0.97-2.40), 3.64 (2.21-6.01), 4.61 (2.47-8.61) for diabetes, respectively, compared with normal weight with heart rate <80 bpm. The area under ROC curve (AUC) for the prediction of diabetes incidence for a model containing overweight and resting heart rate, along with conventional factors (AUC = 0.751), was significantly (P = 0.003) larger than the one containing only conventional factors (AUC = 0.707). Our study indicated that overweight was an independent risk factor of prediabetes and diabetes, and overweight with faster resting heart rate might further increase the risk of prediabetes and diabetes.
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Levay P, Ainsworth N, Kettle R, Morgan A. Identifying evidence for public health guidance: a comparison of citation searching with Web of Science and Google Scholar. Res Synth Methods 2015; 7:34-45. [PMID: 26147600 DOI: 10.1002/jrsm.1158] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 03/31/2015] [Accepted: 05/11/2015] [Indexed: 11/11/2022]
Abstract
AIM To examine how effectively forwards citation searching with Web of Science (WOS) or Google Scholar (GS) identified evidence to support public health guidance published by the National Institute for Health and Care Excellence. METHOD Forwards citation searching was performed using GS on a base set of 46 publications and replicated using WOS. OUTCOMES WOS and GS were compared in terms of recall; precision; number needed to read (NNR); administrative time and costs; and screening time and costs. Outcomes for all publications were compared with those for a subset of highly important publications. RESULTS The searches identified 43 relevant publications. The WOS process had 86.05% recall and 1.58% precision. The GS process had 90.7% recall and 1.62% precision. The NNR to identify one relevant publication was 63.3 with WOS and 61.72 with GS. There were nine highly important publications. WOS had 100% recall, 0.38% precision and NNR of 260.22. GS had 88.89% recall, 0.33% precision and NNR of 300.88. Administering the WOS results took 4 h and cost £88-£136, compared with 75 h and £1650-£2550 with GS. CONCLUSION WOS is recommended over GS, as citation searching was more effective, while the administrative and screening times and costs were lower.
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Affiliation(s)
- Paul Levay
- National Institute for Health and Care Excellence, Guidance Information Services, Manchester, UK
| | - Nicola Ainsworth
- National Institute for Health and Care Excellence, Centre for Public Health, Manchester, UK
| | - Rachel Kettle
- National Institute for Health and Care Excellence, Centre for Public Health, Manchester, UK
| | - Antony Morgan
- National Institute for Health and Care Excellence, Centre for Public Health, Manchester, UK
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Guerrero AD, Ponce NA, Chung PJ. Obesogenic Dietary Practices of Latino and Asian Subgroups of Children in California: An Analysis of the California Health Interview Survey, 2007-2012. Am J Public Health 2015; 105:e105-12. [PMID: 26066936 DOI: 10.2105/ajph.2015.302618] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined obesogenic dietary practices among Latino and Asian subgroups of children living in California. METHODS We analyzed 2007, 2009, and 2011-2012 California Health Interview Survey data to examine the differences in dietary practices among Mexican and non-Mexican Latino children and 7 ethnic subgroups of Asian children. We used multivariable regression to examine the sociodemographic factors associated with specific dietary practices. RESULTS Latino subgroups of children had few differences in obesogenic dietary practices, whereas Asian subgroups of children exhibited significant differences in several obesogenic dietary practices. Korean and Filipino children were more likely than Chinese children to consume fast food and have low vegetable intake. Filipino children, followed by Japanese children, had the most obesogenic dietary practices compared with Chinese children, who along with South Asian children appeared to have the least obesogenic dietary practices. In general, income, education, and acculturation did not explain the dietary differences among Asian groups. CONCLUSIONS Our findings suggest the need to disaggregate dietary profiles of Asian and Latino children and to consider nontraditional sociodemographic factors for messaging and counseling on healthy dietary practices among Asian populations.
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Affiliation(s)
- Alma D Guerrero
- Alma D. Guerrero and Paul J. Chung are with the Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles (UCLA). Alma D. Guerrero is also with the Children's Discovery and Innovation Institute, Mattel Children's Hospital, UCLA. Paul J. Chung is also with the Department of Health Policy and Management, UCLA Fielding School of Public Health. Ninez A. Ponce is with the Center for Health Policy and Management and the Center for Global and Immigrant Health, UCLA Fielding School of Public Health
| | - Ninez A Ponce
- Alma D. Guerrero and Paul J. Chung are with the Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles (UCLA). Alma D. Guerrero is also with the Children's Discovery and Innovation Institute, Mattel Children's Hospital, UCLA. Paul J. Chung is also with the Department of Health Policy and Management, UCLA Fielding School of Public Health. Ninez A. Ponce is with the Center for Health Policy and Management and the Center for Global and Immigrant Health, UCLA Fielding School of Public Health
| | - Paul J Chung
- Alma D. Guerrero and Paul J. Chung are with the Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles (UCLA). Alma D. Guerrero is also with the Children's Discovery and Innovation Institute, Mattel Children's Hospital, UCLA. Paul J. Chung is also with the Department of Health Policy and Management, UCLA Fielding School of Public Health. Ninez A. Ponce is with the Center for Health Policy and Management and the Center for Global and Immigrant Health, UCLA Fielding School of Public Health
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He W, Li Q, Yang M, Jiao J, Ma X, Zhou Y, Song A, Heymsfield SB, Zhang S, Zhu S. Lower BMI cutoffs to define overweight and obesity in China. Obesity (Silver Spring) 2015; 23:684-91. [PMID: 25645003 DOI: 10.1002/oby.20995] [Citation(s) in RCA: 117] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 11/13/2014] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To investigate ethnic difference in the associations of BMI with comorbidity, mortality, and body composition between mainland Chinese and U.S. whites. METHODS Ethnic-comparison study using data from China Health and Nutrition Survey, U.S. National Health and Nutrition Examination Survey, and data from Zhejiang University (China) and Columbia University (U.S.). RESULTS Chinese people experienced greater odds of comorbidities than whites for a given BMI after standardizing for age and sex: 43% for diabetes, 30% for dyslipidemia, 28% for hypertension, 38% for metabolic syndrome, and 48% for hyperuricemia. Comparisons of BMI-mortality associations found that the U-shaped BMI-mortality curve shifted 1-2 kg m(-2) to the left in Chinese compared to whites. Compared to whites at BMIs of 25 and 30 kg m(-2), corresponding cutoffs in Chinese were 22.5 and 25.9 kg m(-2) in men, and 22.8 and 26.6 kg m(-2) in women after both fat and fat distribution were taken into account. CONCLUSIONS Comorbidity, mortality, and body composition data consistently support the use of lower BMI cutoffs in Chinese than those in whites.
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Affiliation(s)
- Wei He
- Obesity and Body Composition Research Center, Chronic Disease Research Institute, Zhejiang University School of Public Health, School of Medicine, Hangzhou, China; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Wang C, Li J, Xue H, Li Y, Huang J, Mai J, Chen J, Cao J, Wu X, Guo D, Yu L, Gu D. Type 2 diabetes mellitus incidence in Chinese: contributions of overweight and obesity. Diabetes Res Clin Pract 2015; 107:424-32. [PMID: 25649908 DOI: 10.1016/j.diabres.2014.09.059] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 06/20/2014] [Accepted: 09/14/2014] [Indexed: 12/21/2022]
Abstract
AIMS To estimate the incidence of Type 2 diabetes mellitus (T2DM) and the number of those with T2DM attributable to overweight and obesity in China. METHODS We conducted a prospective cohort study among 15680 participants (46.4%, men) aged 35-74 years. The mean duration of follow-up was 8.0 years. We examined the relationship between overweight, obesity and risk of T2DM by Cox proportional hazards models. Population attributable risk (PAR) of overweight and obesity was also calculated. Moreover, we estimated the number of T2DM events attributed to overweight and obesity using PAR, incidence of T2DM and the population size of China in 2010. RESULTS During a mean follow-up of 8.0 years, the age-standardized incidence of T2DM was 9.5 per 1000 person-years in men and 9.2 in women. Overweight accounted for 28.3% (95% confidence interval [CI]: 20.1, 36.2) of incident T2DM among men and 31.3% (95% CI: 25.5, 36.9) among women. The corresponding PAR of obesity was 10.1% (95% CI: 6.0, 14.2) among men and 16.8% (95% CI: 12.0, 21.6) among women. Approximately 3.32 million (95% CI: 2.47, 4.24) incident T2DM were attributable to overweight and obesity in Chinese adults who were 35 to 74 years in 2010. CONCLUSION Our results indicate that incident T2DM is mainly attributable to overweight and obesity in China. It is extremely important to advocate healthy lifestyle and prevent excessive weight gain for reducing T2DM burden in China.
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Affiliation(s)
- Chao Wang
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, China; Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianxin Li
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, China; Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Haifeng Xue
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, China; Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Food and Environment, School of Public Health, Qiqihar Medical University, Qiqihar, China
| | - Ying Li
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, China; Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianfeng Huang
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, China; Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jingzhuang Mai
- Guangdong Provincial People's Hospital and Cardiovascular Institute, Guangzhou, China
| | - Jichun Chen
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, China; Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie Cao
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, China; Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xianping Wu
- Sichuan Centre for Disease Control and Prevention, Chengdu, China
| | | | - Ling Yu
- Fujian Provincial People's Hospital, Fuzhou, China
| | - Dongfeng Gu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, China; Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Spaniolas K, Pender J, Cunningham ER, Pories WJ. Bariatric surgery and diabetes. Diabetes Technol Ther 2015; 17 Suppl 1:S76-9. [PMID: 25679433 PMCID: PMC4334459 DOI: 10.1089/dia.2015.1509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Konstantinos Spaniolas
- Department of Surgery, Brody School of Medicine, East Carolina University , Greenville, NC
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Ukawa S, Tamakoshi A, Wakai K, Ando M, Kawamura T. Body Mass Index Is Associated with Hypertension in Japanese Young Elderly Individuals: Findings of the New Integrated Suburban Seniority Investigation. Intern Med 2015; 54:3121-5. [PMID: 26666597 DOI: 10.2169/internalmedicine.54.4702] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the association between BMI at 65 years of age and the development of hypertension during the subsequent five years. METHODS A total of 1,003 participants (65 years of age) who had no history of myocardial infarction and/or hypertension at baseline health check-ups (1996-2005) and participated in a secondary health check-up when the subjects reached 70 years of age were analyzed. RESULTS Using fully adjusted models, men with a BMI of <18.5 [odds ratio (OR), 4.08; 95% confidence interval (CI), 1.32-1.83], BMI of 23.0-24.9 (OR, 2.00; 95% CI, 1.18-3.40) and BMI of ≥25.0 (OR, 1.98; 95% CI, 1.10-3.56) were found to be at higher risk of developing hypertension than did those with a BMI of 18.5-22.9. CONCLUSION Leanness or being overweight/obese at age 65 increases the risk of subsequent hypertension.
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Affiliation(s)
- Shigekazu Ukawa
- Department of Public Health, Hokkaido University Graduate School of Medicine, Japan
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Wang YJ, Tayo BO, Bandyopadhyay A, Wang H, Feng T, Franceschini N, Tang H, Gao J, Sung YJ, Elston RC, Williams SM, Cooper RS, Mu TW, Zhu X. The association of the vanin-1 N131S variant with blood pressure is mediated by endoplasmic reticulum-associated degradation and loss of function. PLoS Genet 2014; 10:e1004641. [PMID: 25233454 PMCID: PMC4169380 DOI: 10.1371/journal.pgen.1004641] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 07/30/2014] [Indexed: 02/07/2023] Open
Abstract
High blood pressure (BP) is the most common cardiovascular risk factor worldwide and a major contributor to heart disease and stroke. We previously discovered a BP-associated missense SNP (single nucleotide polymorphism)–rs2272996–in the gene encoding vanin-1, a glycosylphosphatidylinositol (GPI)-anchored membrane pantetheinase. In the present study, we first replicated the association of rs2272996 and BP traits with a total sample size of nearly 30,000 individuals from the Continental Origins and Genetic Epidemiology Network (COGENT) of African Americans (P = 0.01). This association was further validated using patient plasma samples; we observed that the N131S mutation is associated with significantly lower plasma vanin-1 protein levels. We observed that the N131S vanin-1 is subjected to rapid endoplasmic reticulum-associated degradation (ERAD) as the underlying mechanism for its reduction. Using HEK293 cells stably expressing vanin-1 variants, we showed that N131S vanin-1 was degraded significantly faster than wild type (WT) vanin-1. Consequently, there were only minimal quantities of variant vanin-1 present on the plasma membrane and greatly reduced pantetheinase activity. Application of MG-132, a proteasome inhibitor, resulted in accumulation of ubiquitinated variant protein. A further experiment demonstrated that atenolol and diltiazem, two current drugs for treating hypertension, reduce the vanin-1 protein level. Our study provides strong biological evidence for the association of the identified SNP with BP and suggests that vanin-1 misfolding and degradation are the underlying molecular mechanism. Hypertension (HTN) or high blood pressure (BP) is common worldwide and a major risk factor for cardiovascular disease and all-cause mortality. Identification of genetic variants of consequence for HTN serves as the molecular basis for its treatment. Using admixture mapping analysis of the Family Blood Pressure Program data, we recently identified that the VNN1 gene (encoding the protein vanin-1), in particular SNP rs2272996 (N131S), was associated with BP in both African Americans and Mexican Americans. Vanin-1 was reported to act as an oxidative stress sensor using its pantetheinase enzyme activity. Because a linkage between oxidative stress and HTN has been hypothesized for many years, vanin-1's pantetheinase activity offers a physiologic rationale for BP regulation. Here, we first replicated the association of rs2272996 with BP in the Continental Origins and Genetic Epidemiology Network (COGENT), which included nearly 30,000 African Americans. We further demonstrated that the N131S mutation in vanin-1 leads to its rapid degradation in cells, resulting in loss of function on the plasma membrane. The loss of function of vanin-1 is associated with reduced BP. Therefore, our results indicate that vanin-1 is a new candidate to be manipulated to ameliorate HTN.
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Affiliation(s)
- Ya-Juan Wang
- Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
- Center for Proteomics and Bioinformatics, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
- * E-mail: (YJW); (XZ)
| | - Bamidele O. Tayo
- Department of Public Health Sciences, Loyola University Chicago, Stritch School of Medicine, Maywood, Illinois, United States of America
| | - Anupam Bandyopadhyay
- Department of Chemistry, Boston College, Chestnut Hill, Massachusetts, United States of America
| | - Heming Wang
- Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Tao Feng
- Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Nora Franceschini
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Hua Tang
- Department of Genetics, Stanford University School of Medicine, Stanford, California, United States of America
| | - Jianmin Gao
- Department of Chemistry, Boston College, Chestnut Hill, Massachusetts, United States of America
| | - Yun Ju Sung
- Division of Biostatistics, Washington University School of Medicine, St Louis, Missouri, United States of America
| | | | - Robert C. Elston
- Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Scott M. Williams
- Department of Genetics, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, United States of America
| | - Richard S. Cooper
- Department of Public Health Sciences, Loyola University Chicago, Stritch School of Medicine, Maywood, Illinois, United States of America
| | - Ting-Wei Mu
- Department of Physiology and Biophysics, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Xiaofeng Zhu
- Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
- * E-mail: (YJW); (XZ)
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Nie JX, Ardern CI. Association between obesity and cardiometabolic health risk in Asian-Canadian sub-groups. PLoS One 2014; 9:e107548. [PMID: 25222283 PMCID: PMC4164624 DOI: 10.1371/journal.pone.0107548] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 08/13/2014] [Indexed: 01/26/2023] Open
Abstract
Objectives To quantify and compare the association between the World Health Organizations’ Asian-specific trigger points for public health action [‘increased risk’: body mass index (BMI) ≥23 kg/m2, and; ‘high risk’: BMI ≥27.5 kg/m2] with self-reported cardiovascular-related conditions in Asian-Canadian sub-groups. Methods Six cycles of the Canadian Community Health Survey (2001–2009) were pooled to examine BMI and health in Asian sub-groups (South Asians, Chinese, Filipino, Southeast Asians, Arabs, West Asians, Japanese and Korean; N = 18 794 participants, ages 18–64 y). Multivariable logistic regression, adjusting for demographic, lifestyle characteristics and acculturation measures, was used to estimate the odds of cardiovascular-related health (high blood pressure, heart disease, diabetes, ‘at least one cardiometabolic condition’) outcomes across all eight Asian sub-groups. Results Compared to South Asians (OR = 1.00), Filipinos had higher odds of having ‘at least one cardiometabolic condition’ (OR = 1.29, 95% CI: 1.04–1.62), whereas Chinese (0.63, 0.474–0.9) and Arab-Canadians had lower odds (0.38, 0.28–0.51). In ethnic-specific analyses (with ‘acceptable’ risk weight as the referent), ‘increased’ and ‘high’ risk weight categories were the most highly associated with ‘at least one cardiometabolic condition’ in Chinese (‘increased’: 3.6, 2.34–5.63; ‘high’: 8.9, 3.6–22.01). Compared to normal weight South Asians, being in the ‘high’ risk weight category in all but the Southeast Asian, Arab, and Japanese ethnic groups was associated with approximately 3-times the likelihood of having ‘at least one cardiometabolic condition’. Conclusion Differences in the association between obesity and cardiometabolic health risks were seen among Asian sub-groups in Canada. The use of WHO’s lowered Asian-specific BMI cut-offs identified obesity-related risks in South Asian, Filipino and Chinese sub-groups that would have been masked by traditional BMI categories. These findings have implications for public health messaging, especially for ethnic groups at higher odds of obesity-related health risks.
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Affiliation(s)
- Jason X. Nie
- School of Kinesiology and Health Science, York University, Bethune College, Toronto, Ontario, Canada
| | - Chris I. Ardern
- School of Kinesiology and Health Science, York University, Bethune College, Toronto, Ontario, Canada
- * E-mail:
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Kong X, Zhang X, Zhao Q, He J, Chen L, Zhao Z, Li Q, Ge J, Chen G, Guo X, Lu J, Weng J, Jia W, Ji L, Xiao J, Shan Z, Liu J, Tian H, Ji Q, Zhu D, Zhou Z, Shan G, Yang W. Obesity-related genomic loci are associated with type 2 diabetes in a Han Chinese population. PLoS One 2014; 9:e104486. [PMID: 25093408 PMCID: PMC4122466 DOI: 10.1371/journal.pone.0104486] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 07/09/2014] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND AND AIMS Obesity is a well-known risk factor for type 2 diabetes. Genome-wide association studies have identified a number of genetic loci associated with obesity. The aim of this study is to examine the contribution of obesity-related genomic loci to type 2 diabetes in a Chinese population. METHODS We successfully genotyped 18 obesity-related single nucleotide polymorphisms among 5338 type 2 diabetic patients and 4663 controls. Both individual and joint effects of these single nucleotide polymorphisms on type 2 diabetes and quantitative glycemic traits (assessing β-cell function and insulin resistance) were analyzed using logistic and linear regression models, respectively. RESULTS Two single nucleotide polymorphisms near MC4R and GNPDA2 genes were significantly associated with type 2 diabetes before adjusting for body mass index and waist circumference (OR (95% CI) = 1.14 (1.06, 1.22) for the A allele of rs12970134, P = 4.75×10(-4); OR (95% CI) = 1.10 (1.03, 1.17) for the G allele of rs10938397, P = 4.54×10(-3)). When body mass index and waist circumference were further adjusted, the association of MC4R with type 2 diabetes remained significant (P = 1.81×10(-2)) and that of GNPDA2 was attenuated (P = 1.26×10(-1)), suggesting the effect of the locus including GNPDA2 on type 2 diabetes may be mediated through obesity. Single nucleotide polymorphism rs2260000 within BAT2 was significantly associated with type 2 diabetes after adjusting for body mass index and waist circumference (P = 1.04×10(-2)). In addition, four single nucleotide polymorphisms (near or within SEC16B, BDNF, MAF and PRL genes) showed significant associations with quantitative glycemic traits in controls even after adjusting for body mass index and waist circumference (all P values<0.05). CONCLUSIONS This study indicates that obesity-related genomic loci were associated with type 2 diabetes and glycemic traits in the Han Chinese population.
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Affiliation(s)
- Xiaomu Kong
- Department of Endocrinology, Key Laboratory of Diabetes Prevention and Control of China-Japan Friendship Hospital, Beijing, China
| | - Xuelian Zhang
- Department of Endocrinology, Key Laboratory of Diabetes Prevention and Control of China-Japan Friendship Hospital, Beijing, China
| | - Qi Zhao
- Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America
| | - Jiang He
- Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America
| | - Li Chen
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Zhigang Zhao
- Department of Endocrinology, Henan Province People's Hospital, Zhengzhou, Henan, China
| | - Qiang Li
- Department of Endocrinology, Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Jiapu Ge
- Department of Endocrinology, Xinjiang Uygur Autonomous Region's Hospital, Urmqi, Xinjiang, China
| | - Gang Chen
- Department of Endocrinology, Fujian Provincial Hospital, Fuzhou, Fujian, China
| | - Xiaohui Guo
- Department of Endocrinology, Peking University First Hospital, Beijing, China
| | - Juming Lu
- Department of Endocrinology, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Jianping Weng
- Department of Endocrinology, Sun Yat-sen University Third Hospital, Guangzhou, Guangdong, China
| | - Weiping Jia
- Department of Endocrinology, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Linong Ji
- Department of Endocrinology, Peking University People's Hospital, Beijing, China
| | - Jianzhong Xiao
- Department of Endocrinology, Key Laboratory of Diabetes Prevention and Control of China-Japan Friendship Hospital, Beijing, China
| | - Zhongyan Shan
- Department of Endocrinology, First Affiliated Hospital, Chinese Medical University, Shenyang, Liaoning, China
| | - Jie Liu
- Department of Endocrinology, Shanxi Province People's Hospital, Taiyuan, Shanxi, China
| | - Haoming Tian
- Department of Endocrinology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qiuhe Ji
- Department of Endocrinology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Dalong Zhu
- Department of Endocrinology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Zhiguang Zhou
- Department of Endocrinology, Xiangya Second Hospital, Changsha, Hunan, China
| | - Guangliang Shan
- Department of Epidemiology, Peking Union Medical College, Beijing, China
| | - Wenying Yang
- Department of Endocrinology, Key Laboratory of Diabetes Prevention and Control of China-Japan Friendship Hospital, Beijing, China
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Heianza Y, Kodama S, Arase Y, Hsieh SD, Yoshizawa S, Tsuji H, Saito K, Tanaka S, Hara S, Sone H. Role of Body Mass Index History in Predicting Risk of the Development of Hypertension in Japanese Individuals. Hypertension 2014; 64:247-52. [DOI: 10.1161/hypertensionaha.113.02918] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Yoriko Heianza
- From the Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan (Y.H., S.K., S.Y., K.S., H.S.); Health Management Center, Toranomon Hospital, Tokyo, Japan (Y.H., S.K., Y.A., S.D.H., H.T., K.S., S.H., H.S.); Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan (Y.A., S.D.H., H.T., S.H.); and Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan (S.T.)
| | - Satoru Kodama
- From the Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan (Y.H., S.K., S.Y., K.S., H.S.); Health Management Center, Toranomon Hospital, Tokyo, Japan (Y.H., S.K., Y.A., S.D.H., H.T., K.S., S.H., H.S.); Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan (Y.A., S.D.H., H.T., S.H.); and Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan (S.T.)
| | - Yasuji Arase
- From the Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan (Y.H., S.K., S.Y., K.S., H.S.); Health Management Center, Toranomon Hospital, Tokyo, Japan (Y.H., S.K., Y.A., S.D.H., H.T., K.S., S.H., H.S.); Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan (Y.A., S.D.H., H.T., S.H.); and Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan (S.T.)
| | - Shiun Dong Hsieh
- From the Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan (Y.H., S.K., S.Y., K.S., H.S.); Health Management Center, Toranomon Hospital, Tokyo, Japan (Y.H., S.K., Y.A., S.D.H., H.T., K.S., S.H., H.S.); Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan (Y.A., S.D.H., H.T., S.H.); and Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan (S.T.)
| | - Sakiko Yoshizawa
- From the Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan (Y.H., S.K., S.Y., K.S., H.S.); Health Management Center, Toranomon Hospital, Tokyo, Japan (Y.H., S.K., Y.A., S.D.H., H.T., K.S., S.H., H.S.); Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan (Y.A., S.D.H., H.T., S.H.); and Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan (S.T.)
| | - Hiroshi Tsuji
- From the Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan (Y.H., S.K., S.Y., K.S., H.S.); Health Management Center, Toranomon Hospital, Tokyo, Japan (Y.H., S.K., Y.A., S.D.H., H.T., K.S., S.H., H.S.); Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan (Y.A., S.D.H., H.T., S.H.); and Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan (S.T.)
| | - Kazumi Saito
- From the Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan (Y.H., S.K., S.Y., K.S., H.S.); Health Management Center, Toranomon Hospital, Tokyo, Japan (Y.H., S.K., Y.A., S.D.H., H.T., K.S., S.H., H.S.); Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan (Y.A., S.D.H., H.T., S.H.); and Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan (S.T.)
| | - Shiro Tanaka
- From the Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan (Y.H., S.K., S.Y., K.S., H.S.); Health Management Center, Toranomon Hospital, Tokyo, Japan (Y.H., S.K., Y.A., S.D.H., H.T., K.S., S.H., H.S.); Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan (Y.A., S.D.H., H.T., S.H.); and Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan (S.T.)
| | - Shigeko Hara
- From the Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan (Y.H., S.K., S.Y., K.S., H.S.); Health Management Center, Toranomon Hospital, Tokyo, Japan (Y.H., S.K., Y.A., S.D.H., H.T., K.S., S.H., H.S.); Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan (Y.A., S.D.H., H.T., S.H.); and Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan (S.T.)
| | - Hirohito Sone
- From the Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan (Y.H., S.K., S.Y., K.S., H.S.); Health Management Center, Toranomon Hospital, Tokyo, Japan (Y.H., S.K., Y.A., S.D.H., H.T., K.S., S.H., H.S.); Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan (Y.A., S.D.H., H.T., S.H.); and Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan (S.T.)
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Rubino F. From bariatric to metabolic surgery: definition of a new discipline and implications for clinical practice. Curr Atheroscler Rep 2014; 15:369. [PMID: 24194467 DOI: 10.1007/s11883-013-0369-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Bariatric surgery indicates a variety of gastrointestinal (GI) surgical procedures originally designed to induce weight reduction in morbidly obese patients. Benefits of bariatric surgery, however, extend well beyond weight loss and include dramatic improvement of type 2 diabetes, hypertension, dyslipidemia, and reduction of overall mortality. Furthermore, studies in rodents and humans show that the anti-diabetes effect of certain bariatric procedures results from a variety of neuroendocrine and metabolic mechanisms secondary to changes in GI anatomy. The recognition that benefits and mechanisms of GI operations are not limited to weight reduction provided a rationale for the emergence of metabolic surgery intended as a surgical approach primarily aimed to the treatment of diabetes and metabolic disease. Consistent with the goals of improving glycemic and metabolic control, in contrast to mere weight loss, metabolic surgery implies the development of a new model of care distinct from traditional bariatric surgery. This paper discusses the definition of metabolic surgery and its clinical practice.
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Abstract
OBJECTIVE This study investigated the practical clinical consequences of offering surgery for metabolic disease and diabetes as opposed to weight loss. BACKGROUND The terms "metabolic" and "diabetes surgery" indicate a surgical approach whose primary intent is the control of metabolic alterations/hyperglycemia in contrast to "bariatric surgery," conceived as a mere weight-reduction therapy. METHODS A "metabolic surgery" program distinct from the "bariatric surgery" program was recently established at a tertiary US academic medical center. The 2 programs differ in their stated goals but offer the same procedures and use identical eligibility criteria for patients with morbid obesity. Demographics, clinical characteristics, and 30-day postoperative morbidity and mortality were assessed from a prospective database of 200 consecutive patients who underwent surgery at these units. RESULTS Metabolic surgery patients were older (45.8±13.4 v 41.8±11.7, P<0.05), had a lower body mass index (42.4±7.1 vs 48.6±9.5 kg/m; P<0.01), and a higher prevalence of being of the male sex (42% vs 26%, P<0.05), having diabetes (62% vs 35%; P<0.01), hypertension (68% vs 52%; P<0.05), dyslipidemia (48% vs 31%; P<0.05), and cardiovascular disease (14% vs 5%; P<0.05). Diabetes was more severe among metabolic surgery patients (higher glycated hemoglobin levels; greater percentage of insulin use). There was no mortality, and there were no differences in perioperative complications. CONCLUSIONS Offering surgery to treat metabolic disease or diabetes rather than as a mere weight-reduction therapy changes demographical and clinical characteristics of surgical candidates. This has important and practical ramifications for clinical care and support consideration of metabolic/diabetes surgery as a novel practice distinct from traditional bariatric surgery.
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Abstract
Atherosclerotic disease often involves the intracranial arteries including those encased by cranial bones and dura, and those located in the subarachnoid space. Age, hypertension, and diabetes mellitus are independent risk factors for intracranial atherosclerosis. Intracranial atherosclerosis can result in thromboembolism with or without hypoperfusion leading to transient or permanent cerebral ischaemic events. High rates of recurrent ischaemic stroke and other cardiovascular events mandate early diagnosis and treatment. Present treatment is based on a combination of antiplatelet drugs, optimisation of blood pressure and LDL cholesterol values, and intracranial angioplasty or stent placement, or both, in selected patients.
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Affiliation(s)
- Adnan I Qureshi
- Zeenat Qureshi Stroke Institute and CentraCare Health, St Cloud, MN, USA.
| | - Louis R Caplan
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
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Katz EG, Stevens J, Truesdale KP, Cai J, North KE, Steffen LM. Associations of body mass index with incident hypertension in American white, American black and Chinese Asian adults in early and middle adulthood: the Coronary Artery Risk Development in Young Adults (CARDIA) study, the Atherosclerosis Risk in Communities (ARIC) study and the People's Republic of China (PRC) study. Asia Pac J Clin Nutr 2014; 22:626-34. [PMID: 24231024 DOI: 10.6133/apjcn.2013.22.4.12] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The association of body mass index (BMI) with blood pressure may be stronger in Asian than non-Asian populations, however, longitudinal studies with direct comparisons between ethnicities are lacking. We compared the relationship of BMI with incident hypertension over approximately 9.5 years of follow-up in young (24-39 years) and middle-aged (45-64 years) Chinese Asians (n=5354), American Blacks (n=6076) and American Whites (n=13451). We estimated risk differences using logistic regression models and calculated adjusted incidences and incidence differences. To facilitate comparisons across ethnicities, standardized estimates were calculated using mean covariate values for age, sex, smoking, education and field center, and included the quadratic terms for BMI and age. Weighted least-squares regression models with were constructed to summarize ethnic-specific incidence differences across BMI. Wald statistics and p-values were calculated based on chi-square distributions. The association of BMI with the incidence difference for hypertension was steeper in Chinese (p<0.05) than in American populations during young and middle-adulthood. For example, at a BMI of 25 vs 21 kg/m2 the adjusted incidence differences per 1000 persons (95% CI) in young adults with a BMI of 25 vs those with a BMI of 21 was 83 (36- 130) for Chinese, 50 (26-74) for Blacks and 30 (12-48) for Whites; among middle-aged adults it was 137 (77-198) for Chinese, 49 (9-88) for Blacks and 54 (38-69) for Whites. Whether hypertension carries the same level of risk of stroke or cardiovascular disease across national or ethnic groups remains uncertain.
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Affiliation(s)
- Eva G Katz
- Department of Nutrition, University of North Carolina at Chapel Hill, 135 Dauer Drive, Campus Box 7461, Chapel Hill 27599, U.S.A.
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Shi L, Hu J, Zhu K, Fu Y, Xia R, Hu X. Changes of prevalence of dyslipidemia among adults: a cross-sectional study with a 2-year follow-up in urban southeast China. ACTA ACUST UNITED AC 2014. [DOI: 10.2217/clp.13.82] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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