1
|
Beard J, Katja H, Si Y, Thiyagarajan J, Moreno-Agostino D. Is 70 the new 60? A longitudinal analysis of cohort trends inintrinsic capacity in England and China. RESEARCH SQUARE 2024:rs.3.rs-4271576. [PMID: 38853854 PMCID: PMC11160896 DOI: 10.21203/rs.3.rs-4271576/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
To understand how the health of older adults today compares to that of previous generations, we estimated intrinsic capacity and subdomains of cognitive, locomotor, sensory, psychological and vitality capacities in participants of the English Longitudinal Study on Ageing (ELSA) and the China Health and Retirement Longitudinal Study (CHARLS). We applied multilevel growth curve models to examine change over time and cohort trends. We found that more recent cohorts entered older ages with higher levels of capacity, and their subsequent age-related declines were somewhat compressed compared to earlier cohorts. These improvements in capacity were large, with the greatest gains being in the most recent cohorts. For example, a 68-year-old ELSA participant born in 1950 had higher capacity than a 62-year-old born just 10 years earlier. Trends were similar for men and women, and findings were generally consistent across English and Chinese cohorts.
Collapse
Affiliation(s)
- John Beard
- Columbia University - Mailman School of Public Health
| | | | - Yafei Si
- The University of New South Wales
| | | | | |
Collapse
|
2
|
Shahrestanaki E, Mohammadian Khonsari N, Seif E, Baygi F, Ejtahed HS, Sheidaei A, Djalalinia S, Magliano DJ, Qorbani M. The worldwide trend in diabetes awareness, treatment, and control from 1985 to 2022: a systematic review and meta-analysis of 233 population-representative studies. Front Public Health 2024; 12:1305304. [PMID: 38827607 PMCID: PMC11140097 DOI: 10.3389/fpubh.2024.1305304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 03/06/2024] [Indexed: 06/04/2024] Open
Abstract
Background With the rapid increase in the prevalence of DM, studies on the awareness, treatment, and control of this condition are essential. Therefore, this study aimed to review the literature and pool the awareness, treatment, and control of diabetes at the global, regional, and national levels. Methods In this systematic review and meta-analysis, several databases, including MEDLINE/PubMed, Institute of Scientific Information (ISI), Scopus, and Google Scholar, were searched using appropriate keywords up to June 2022. Observational studies investigating the awareness, treatment, and control of glucose levels among diabetic individuals were included. Awareness, treatment, and control were defined as the proportion of participants who were aware of their diabetes condition, treated pharmacologically, and achieved adequate glucose control, respectively. Two investigators independently conducted the study selection, data extraction, and quality assessment. Heterogeneity among studies was calculated using Chi-square, and a random-effect meta-analysis was used to pool the rates. Results A total of 233 studies published between 1985 and 2022 met the inclusion criteria. The included studies had a combined population of 12,537,968. The pooled awareness of DM was 60% (95%CI: 56-63) and ranged from 41% (25-57) in low-income countries to 68% (64-72) in high-income countries, with no significant trend observed over the assessed periods at the global level. The pooled treatment of DM globally was 45% (42-48) and varied from 37% (31-43) in lower-middle-income countries to 53% (47-59) in high-income countries, showing variation over the examined time period. Before 2000, the proportion of adequate DM control was 16% (12-20), which significantly improved and reached 22% (19-25) after 2010. The pooled awareness, treatment, and control of DM were higher in females, high-income countries, and urban areas compared to males, upper and lower-middle-income countries, and rural areas, respectively. The older adults population had higher awareness and treatment rates than the adult population, but their DM control did not differ significantly. Conclusion Despite the high level of awareness and treatment among the diabetic population, treatment success (control) is considerably low, particularly in low-income countries and rural areas. It is crucial to improve awareness, treatment, and control by strengthening the primary care system in all countries.
Collapse
Affiliation(s)
- Ehsan Shahrestanaki
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | | | - Ehsan Seif
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Fereshteh Baygi
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Hanieh-Sadat Ejtahed
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Sheidaei
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Djalalinia
- Deputy of Research & Technology, Ministry of Health & Medical Education, Tehran, Iran
| | - Dianna J. Magliano
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
3
|
Mötzing M, Blüher M, Grunwald T, Hoffmann R. Immunological Quantitation of the Glycation Site Lysine-414 in Serum Albumin in Human Plasma Samples by Indirect ELISA Using Highly Specific Monoclonal Antibodies. Chembiochem 2024; 25:e202300550. [PMID: 37873910 DOI: 10.1002/cbic.202300550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 10/18/2023] [Accepted: 10/23/2023] [Indexed: 10/25/2023]
Abstract
Diabetes mellitus, a metabolic disorder that is characterized by elevated blood glucose levels, is common throughout the world and its prevalence is steadily increasing. Early diagnosis and treatment are important to prevent acute complications and life-threatening long-term organ damage. Glycation sites in human serum albumin (HSA) are considered to be promising biomarkers of systemic glycemic status. This work aimed to develop a sensitive and clinically applicable ELISA for the quantification of glycation site Lys414 in HSA (HSAK414 ). The monoclonal antibodies (mAbs) were generated by immunizing mice with a glycated peptide. The established indirect ELISA based on mAb 50D8 (IgG1 isotype) yielded a limit of detection of 0.39 nmol/g HSA for HSAK414 with a linear dynamic range from 0.50 to 6.25 nmol/g glycated HSA. The inter- and intra-day assays with coefficients of variation less than 20 % indicated good assay performance and precision. Assay evaluation was based on plasma samples from diabetic and non-diabetic subjects with known HSAK414 glycation levels previously determined by LC-MS. Both data sets correlated very well. In conclusion, the generated mAb 50D8 and the established ELISA could be a valuable tool for the rapid quantitation of glycation site HSAK414 in plasma samples to evaluate its clinical relevance.
Collapse
Affiliation(s)
- Marina Mötzing
- Institute of Bioanalytical Chemistry and, Center for Biotechnology and Biomedicine, University Leipzig, Deutscher Platz 5, 04103, Leipzig, Germany
| | - Matthias Blüher
- Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG), Helmholtz Zentrum München at the University of Leipzig and, University Hospital Leipzig, Philipp-Rosenthal-Straße 27, 04103, Leipzig, Germany
| | - Thomas Grunwald
- Fraunhofer Institute for Cell Therapy and Immunology IZI, Perlickstraße 1, 04103, Leipzig, Germany
| | - Ralf Hoffmann
- Institute of Bioanalytical Chemistry and, Center for Biotechnology and Biomedicine, University Leipzig, Deutscher Platz 5, 04103, Leipzig, Germany
| |
Collapse
|
4
|
Chen S, Zhu Y, Jin S, Zhao D, Guo J, Chen L, Huang Y. Association of glycemic control with hypertension in patients with diabetes: a population-based longitudinal study. BMC Cardiovasc Disord 2023; 23:501. [PMID: 37817110 PMCID: PMC10566157 DOI: 10.1186/s12872-023-03478-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/29/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Diabetes increases the risk of hypertension morbidity, but whether this association is varied with glycemic control remains unknown. We aimed to examine the association of glycemic control with hypertension among individuals with diabetes. METHODS Data was from the China Health and Retirement Longitudinal Study (CHARLS) between 2011 and 2018. Participants were categorized as having adequate glycemic control (HbA1c < 7%) and inadequate glycemic uncontrol (HbA1c ≥ 7%) by combining blood glucose tests and physician's diagnoses in 2011. Incident hypertension was ascertained through self-reported physician diagnoses from 2011 to 2018. Cox proportional hazards regression models were used to examine the effect of glycemic control on hypertension. RESULTS Among 436 participants with diabetes in this study, 102 met the glycemic control standard, and 334 were insufficient glycemic control. During 7 years of follow-up, 141 individuals developed hypertension. Compared with adequate glycemic control, the hazard ratio of inadequate glycemic control on hypertension was 1.54 (95% CI, 1.07-2.21) in the multivariate model. Additionally, the influence of glycemic control on hypertension varied based on educational attainment and the presence of depressive symptoms (P for interaction < 0.05). CONCLUSIONS Insufficient glycemic control was associated with a higher risk of hypertension among individuals with diabetes. Notably, the effect of glycemic control on hypertension was more pronounced among those with lower educational attainment and those exhibiting depressive symptoms. These findings underscore the significance of vigilant glycemic monitoring, educational background considerations, and mental health assessments in managing diabetic individuals.
Collapse
Affiliation(s)
- Shengliang Chen
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74, Zhongshan 2nd Road, Guangzhou, 510030, Guangdong, P. R. China
| | - Yi Zhu
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74, Zhongshan 2nd Road, Guangzhou, 510030, Guangdong, P. R. China
| | - Sihui Jin
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74, Zhongshan 2nd Road, Guangzhou, 510030, Guangdong, P. R. China
| | - Dongbao Zhao
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74, Zhongshan 2nd Road, Guangzhou, 510030, Guangdong, P. R. China
| | - Jianwei Guo
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74, Zhongshan 2nd Road, Guangzhou, 510030, Guangdong, P. R. China
| | - Lijin Chen
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74, Zhongshan 2nd Road, Guangzhou, 510030, Guangdong, P. R. China
| | - Yixiang Huang
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74, Zhongshan 2nd Road, Guangzhou, 510030, Guangdong, P. R. China.
| |
Collapse
|
5
|
Bjarkø VV, Haug EB, Sørgjerd EP, Stene LC, Ruiz PL, Birkeland KI, Berg TJ, Gulseth HL, Iversen MM, Langhammer A, Åsvold BO. Undiagnosed diabetes: Prevalence and cardiovascular risk profile in a population-based study of 52,856 individuals. The HUNT Study, Norway. Diabet Med 2022; 39:e14829. [PMID: 35288977 PMCID: PMC9310609 DOI: 10.1111/dme.14829] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 03/01/2022] [Accepted: 03/11/2022] [Indexed: 12/16/2022]
Abstract
AIMS We investigated the current extent of undiagnosed diabetes and prediabetes and their associated cardiovascular risk profile in a population-based study. METHODS All residents aged ≥20 years in the Nord-Trøndelag region, Norway, were invited to the HUNT4 Survey in 2017-2019, and 54% attended. Diagnosed diabetes was self-reported, and in those reporting no diabetes HbA1c was used to classify undiagnosed diabetes (≥48 mmol/mol [6.5%]) and prediabetes (39-47 mmol/mol [5.7%-6.4%]). We estimated the age- and sex-standardized prevalence of these conditions and their age- and sex-adjusted associations with other cardiovascular risk factors. RESULTS Among 52,856 participants, the prevalence of diabetes was 6.0% (95% CI 5.8, 6.2), of which 11.1% were previously undiagnosed (95% CI 10.1, 12.2). The prevalence of prediabetes was 6.4% (95% CI 6.2, 6.6). Among participants with undiagnosed diabetes, 58% had HbA1c of 48-53 mmol/mol (6.5%-7.0%), and only 14% (i.e., 0.1% of the total study population) had HbA1c >64 mmol/mol (8.0%). Compared with normoglycaemic participants, those with undiagnosed diabetes or prediabetes had higher body mass index, waist circumference, systolic blood pressure, triglycerides and C-reactive protein but lower low-density lipoprotein cholesterol (all p < 0.001). Participants with undiagnosed diabetes had less favourable values for every measured risk factor compared with those with diagnosed diabetes. CONCLUSIONS The low prevalence of undiagnosed diabetes suggests that the current case-finding-based diagnostic practice is well-functioning. Few participants with undiagnosed diabetes had very high HbA1c levels indicating severe hyperglycaemia. Nonetheless, participants with undiagnosed diabetes had a poorer cardiovascular risk profile compared with participants with known or no diabetes.
Collapse
Affiliation(s)
- Vera Vik Bjarkø
- K.G. Jebsen Center for Genetic EpidemiologyDepartment of Public Health and NursingNorwegian University of Science and TechnologyTrondheimNorway
- Clinic of MedicineSt. Olavs HospitalTrondheim University HospitalTrondheimNorway
| | - Eirin B. Haug
- K.G. Jebsen Center for Genetic EpidemiologyDepartment of Public Health and NursingNorwegian University of Science and TechnologyTrondheimNorway
- MRC Integrative Epidemiology UnitDepartment of Population Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
| | - Elin P. Sørgjerd
- Clinic of MedicineSt. Olavs HospitalTrondheim University HospitalTrondheimNorway
- HUNT Research CentreDepartment of Public Health and NursingNorwegian University of Science and TechnologyLevangerNorway
| | - Lars C. Stene
- Department of Chronic DiseasesNorwegian Institute of Public HealthOsloNorway
| | - Paz Lopez‐Doriga Ruiz
- Department of Chronic DiseasesNorwegian Institute of Public HealthOsloNorway
- Department of Endocrinology, Morbid Obesity and Preventive MedicineOslo University HospitalOsloNorway
| | | | | | | | - Marjolein M. Iversen
- Faculty of Health and Social SciencesWestern Norway University of Applied SciencesBergenNorway
| | - Arnulf Langhammer
- HUNT Research CentreDepartment of Public Health and NursingNorwegian University of Science and TechnologyLevangerNorway
- Levanger HospitalNord‐Trøndelag Hospital TrustLevangerNorway
| | - Bjørn Olav Åsvold
- K.G. Jebsen Center for Genetic EpidemiologyDepartment of Public Health and NursingNorwegian University of Science and TechnologyTrondheimNorway
- HUNT Research CentreDepartment of Public Health and NursingNorwegian University of Science and TechnologyLevangerNorway
- Department of EndocrinologyClinic of MedicineSt Olavs HospitalTrondheim University HospitalTrondheimNorway
| |
Collapse
|
6
|
Huang YT, Steptoe A, Wei L, Zaninotto P. Dose-response relationships between polypharmacy and all-cause and cause-specific mortality among older people. J Gerontol A Biol Sci Med Sci 2021; 77:1002-1008. [PMID: 34079992 PMCID: PMC9071388 DOI: 10.1093/gerona/glab155] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Indexed: 12/16/2022] Open
Abstract
Background Although medicines are prescribed based on clinical guidelines and expected to benefit patients, both positive and negative health outcomes have been reported associated with polypharmacy. Mortality is the main outcome, and information on cause-specific mortality is scarce. Hence, we investigated the association between different levels of polypharmacy and all-cause and cause-specific mortality among older adults. Method The English Longitudinal Study of Ageing is a nationally representative study of people aged 50+. From 2012/2013, 6 295 individuals were followed up to April 2018 for all-cause and cause-specific mortality. Polypharmacy was defined as taking 5–9 long-term medications daily and heightened polypharmacy as 10+ medications. Cox proportional hazards regression and competing-risks regression were used to examine associations between polypharmacy and all-cause and cause-specific mortality, respectively. Results Over a 6-year follow-up period, both polypharmacy (19.3%) and heightened polypharmacy (2.4%) were related to all-cause mortality, with hazard ratios of 1.51 (95% CI: 1.05–2.16) and 2.29 (95% CI: 1.40–3.75) respectively, compared with no medications, independently of demographic factors, serious illnesses and long-term conditions, cognitive function, and depression. Polypharmacy and heightened polypharmacy also showed 2.45 (95% CI: 1.13–5.29) and 3.67 (95% CI: 1.43–9.46) times higher risk of cardiovascular disease deaths, respectively. Cancer mortality was only related to heightened polypharmacy. Conclusion Structured medication reviews are currently advised for heightened polypharmacy, but our results suggest that greater attention to polypharmacy in general for older people may reduce adverse effects and improve older adults’ health.
Collapse
Affiliation(s)
- Yun-Ting Huang
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
| | - Li Wei
- School of Pharmacy, University College London, London, UK
| | - Paola Zaninotto
- Department of Epidemiology and Public Health, University College London, London, UK
| |
Collapse
|