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Nga TTT, Blizzard CL, Khue LN, Le Van Ngoc T, Bao TQ, Otahal P, Nelson MR, Magnussen CG, Van Tan B, Srikanth V, Thuy AB, Son HT, Hai PN, Mai TH, Callisaya M, Gall S. The Interdependence of Blood Pressure and Glucose in Vietnam. High Blood Press Cardiovasc Prev 2021; 28:141-150. [PMID: 33453048 DOI: 10.1007/s40292-020-00431-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 12/28/2020] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Modelling of associations of systolic blood pressure (BP) and blood glucose (BG) with their explanatory factors in separate regressions treats them as having independent biological mechanisms. This can lead to statistical inferences that are unreliable because the substantial overlap in their etiologic and disease mechanisms is ignored. AIM This study aimed to examine the relationship of systolic blood pressure (BP) and blood glucose (BG) with measures of obesity and central fat distribution and other factors whilst taking account of the inter-dependence between them. METHODS Participants (n = 14706, 53.5 % females) aged 25-64 years were selected by multi-stage stratified cluster sampling from eight provinces each representing one of the eight geographical regions of Vietnam. Measurements were made using the World Health Organization STEPS protocols. RESULTS Structural modelling identified direct effects for BG (men P = 0.000, women P = 0.029), age (men P = 0.000, women P = 0.000) and body mass index (BMI) (men P = 0.000, women P = 0.000) in the estimation of systolic BP, and for systolic BP (men P = 0.036, women P = 0.000) and waist circumference (WC) (men P = 0.032, women P = 0.009) in the estimation of BG. There were indirect effects of age, cholesterol, physical activity and tobacco smoking via their influence on WC and BMI. The errors in estimation of systolic BP and BG were correlated (men P = 0.000, women P = 0.004), the stability indices (men 0.466, women 0.495) showed the non-recursive models were stable, and the proportion of variance explained was mid-range (men 0.553, women 0.579). CONCLUSION This study provided statistical evidence of a feedback loop between systolic BP and BG. BMI and WC were confirmed to be their primary explanatory factors. Saturated fat intake and physical activity were identified as possible targets of intervention for overweight and obesity, and indirectly for reducing systolic BP and BG. Harmful/hazardous alcohol intake was identified as a target of intervention for systolic BP.
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Affiliation(s)
- Tran Thi Thu Nga
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Christopher Leigh Blizzard
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia.
| | - Luong Ngoc Khue
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Hanoi, Vietnam
| | - Truong Le Van Ngoc
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Hanoi, Vietnam
| | - Tran Quoc Bao
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Hanoi, Vietnam
| | - Petr Otahal
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Mark R Nelson
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Costan G Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia.,Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Bui Van Tan
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Velandai Srikanth
- Department of Medicine, Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Au Bich Thuy
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Ha Thai Son
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Hanoi, Vietnam
| | - Phung Ngoc Hai
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Tran Hoang Mai
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Michele Callisaya
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia.,Department of Medicine, Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Seana Gall
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
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Qin Y, Yan G, Qiao Y, Wang D, Luo E, Hou J, Tang C. Predictive value of random blood glucose versus fasting blood glucose on in-hospital adverse events in patients with ST-segment elevation acute myocardial infarction. BMC Cardiovasc Disord 2020; 20:95. [PMID: 32103724 PMCID: PMC7045631 DOI: 10.1186/s12872-020-01394-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 02/17/2020] [Indexed: 01/08/2023] Open
Abstract
Background We aim to find out the relationship between random blood glucose (RBG), fasting blood glucose (FBG) and in-hospital adverse events in ST-segment elevation acute myocardial infarction (STEMI) patients. We evaluate and compare the predictive value of RBG and FBG on in-hospital adverse events, and give an appropriate cut-off value of RBG and FBG. Method A retrospective study enrolled 958 consecutive AMI patients undergoing emergency coronary angiography at Zhongda Hospital were enrolled from January 1, 2016, to December 31, 2018 was performed. RBG and FBG, baseline data and adverse events were recorded. Major adverse cardiovascular and cerebrovascular events (MACCE) were defined as death, nonfatal recurrent myocardial infarction and stroke. Other adverse events included malignant arrhythmia, cardiac shock and hemorrhage. Patients with RBG > 11.1 mmol/L were divided into elevated RBG group. Patients with FBG > 6.1 mmol/L were divided into elevated FBG group. The incidence of in-hospital adverse events were compared in elevated RBG/FBG group and the control group. ROC curve was used to evaluate the predictive value of RBG and FBG on in-hospital adverse events. Result The incidence of death, hemorrhage, cardiac shock and malignant arrhythmia significantly increases in elevated RBG and FBG group. Binary logistic regression showed that age, hypertension, diabetes, FBG and RBG were independent risk factors for in-hospital adverse events in STEMI patients. The AUC and 95% CI of RBG and FBG in predicting death of AMI patients were 0.789, 0.759~0.816; 0.810, 0.783~0.835, respectively. The cut-off values were 13.82 and 7.35 mmol/L. RBG and FBG also had fine predictive value on cardiac shock and malignant arrhythmia, no statistical difference was found in the predictive value on in-hospital adverse events (P = 0.462, P = 0.570, P = 0.694). Conclusion Incidence of in-hospital adverse events significantly increases in AMI patients combined with elevated RBG or FBG. Both RBG and FBG were independent risk factors for in-hospital adverse events, they had good value on predicting in-hospital adverse events and there was no statistical difference in their predictive value.
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Affiliation(s)
- Yuhan Qin
- Medical school of Southeast University, Nanjing, 210009, People's Republic of China
| | - Gaoliang Yan
- Department of Cardiology, Zhongda Hospital affiliated to Southeast University, Nanjing, 210009, People's Republic of China
| | - Yong Qiao
- Department of Cardiology, Zhongda Hospital affiliated to Southeast University, Nanjing, 210009, People's Republic of China
| | - Dong Wang
- Department of Cardiology, Zhongda Hospital affiliated to Southeast University, Nanjing, 210009, People's Republic of China
| | - Erfei Luo
- Medical school of Southeast University, Nanjing, 210009, People's Republic of China
| | - Jiantong Hou
- Medical school of Southeast University, Nanjing, 210009, People's Republic of China
| | - Chengchun Tang
- Department of Cardiology, Zhongda Hospital affiliated to Southeast University, Nanjing, 210009, People's Republic of China.
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Hu Z, Zhu X, Kaminga AC, Xu H. Associated risk factors and their interactions with type 2 diabetes among the elderly with prediabetes in rural areas of Yiyang City: A nested case-control study. Medicine (Baltimore) 2019; 98:e17736. [PMID: 31689819 PMCID: PMC6946335 DOI: 10.1097/md.0000000000017736] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
To explore associated risk factors and their interactions with type 2 diabetes (T2DM) among the elderly with prediabetes in rural areas in China.A nested case-control study was conducted in a fixed cohort to identify the risk factors for T2DM among the elderly with prediabetes in rural areas of Yiyang City in China. A total of 37 elderly with T2DM were included in the cases group and 111 elderly subjects with prediabetes were matched in the control group. Data related to sociodemographic characteristics, lifestyle behavior, and anthropometric variables were collected by trained staff using standard tools. The risk factors for T2DM were determined using conditional logistic regression analysis, and their additive interactions were also explored.Multivariable conditional logistic regression analysis results showed that overweight/obesity (odds ratio [OR] = 4.80, 95% confidence interval [CI]: 1.20-12.28), family history of diabetes (OR = 3.63, 95% CI: 1.03-12.81), physically inactive (OR = 3.08, 95% CI: 1.14-8.30), high waist-to-hip ratio (WHR) (OR = 3.15, 95% CI: 1.27-7.80), and inadequate diabetes-specific health literacy (DSHL) (OR = 3.92, 95% CI: 1.14-13.48) increased the risk for T2DM. Additive interactions for T2DM were observed between a family history of diabetes and high WHR with a relative excess risk of interaction (RERI) of 10.02 (95% CI: 4.25, 15.78), and between high WHR and overweight or obesity, with an RERI of 3.90 (95% CI: 0.36, 7.44).The independent risk factors for T2DM are overweight or obesity, high WHR, family history of diabetes, physically inactive, and inadequate DSHL. High WHR as a risk factor for T2DM has additive interactions with family history of diabetes and overweight or obesity.
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Affiliation(s)
- Zhao Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Xidi Zhu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Atipatsa Chiwanda Kaminga
- Department of Mathematics and Statistics, Mzuzu University, Mzuzu, Malawi
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Huilan Xu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
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Yan Q, Sun D, Li X, Chen G, Zheng Q, Li L, Gu C, Feng B. Association of blood glucose level and hypertension in Elderly Chinese Subjects: a community based study. BMC Endocr Disord 2016; 16:40. [PMID: 27412111 PMCID: PMC4944450 DOI: 10.1186/s12902-016-0119-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 06/22/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND There is a scarcity of epidemiological researches examining the relationship between blood pressure (BP) and glucose level among older adults. The objective of the current study was to investigate the association of high BP and glucose level in elderly Chinese. METHODS A cross-sectional study of a population of 2092 Chinese individuals aged over 65 years was conducted. Multiple logistic analysis was used to explore the association between hypertension and hyperglycemia. Independent risk factors for systolic and diastolic BP were analyzed using stepwise linear regression. RESULTS Subjects in impaired fasting glucose group (IFG) (n = 144) and diabetes (n = 346), as compared with normal fasting glucose (NFG) (n = 1277), had a significant higher risk for hypertension, with odds ratios (ORs) of 1.81 (95 % CI, 1.39-2.35) (P = 0.000) and 1.40 (95 % CI, 1.09-1.80) (P = 0.009), respectively. Higher fasting plasma glucose (FPG) levels in the normal range were still significantly associated with a higher prevalence of hypertension in both genders, with ORs of 1.24 (95 % CI, 0.85-1.80), R (2) = 0.114, P = 0.023 in men and 1.61 (95 % CI, 1.12-2.30), R (2) = 0.082, P = 0.010 in women, respectively, when compared with lower FPG. Linear regression analysis revealed FPG was an independent factor of systolic and diastolic BP. CONCLUSIONS Our findings suggest that hyperglycemia as well as higher FPG within the normal range is associated with a higher prevalence of hypertension independent of other cardiovascular risk factors in elderly Chinese. Further studies are needed to explore the relationship between hyperglycemia and hypertension in a longitudinal setting.
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Affiliation(s)
- Qun Yan
- />Department of Endocrinology, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120 China
| | - Dongmei Sun
- />Department of Endocrinology, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120 China
- />Puxing Community Health-Care Center, Pudong New District, 250 GuiChang Road, Shanghai, 200136 China
| | - Xu Li
- />Department of Endocrinology, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120 China
| | - Guoliang Chen
- />Puxing Community Health-Care Center, Pudong New District, 250 GuiChang Road, Shanghai, 200136 China
| | - Qinghu Zheng
- />Puxing Community Health-Care Center, Pudong New District, 250 GuiChang Road, Shanghai, 200136 China
| | - Lun Li
- />Puxing Community Health-Care Center, Pudong New District, 250 GuiChang Road, Shanghai, 200136 China
| | - Chenhong Gu
- />Puxing Community Health-Care Center, Pudong New District, 250 GuiChang Road, Shanghai, 200136 China
| | - Bo Feng
- />Department of Endocrinology, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120 China
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Janghorbani M, Amini M. Progression from optimal blood glucose and pre-diabetes to type 2 diabetes in a high risk population with or without hypertension in Isfahan, Iran. Diabetes Res Clin Pract 2015; 108:414-22. [PMID: 25814432 DOI: 10.1016/j.diabres.2015.03.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 09/03/2014] [Accepted: 03/06/2015] [Indexed: 12/25/2022]
Abstract
AIM To estimate the progression rates from normal glucose tolerance (NGT), isolated impaired glucose tolerance (IGT), isolated impaired fasting glucose (IFG) and combined IFG/IGT to type 2 diabetes (T2D) in a high risk population with and without hypertension (HTN) in Isfahan, Iran. METHODS During a mean (SD) follow-up period of 6.8 (1.7) years, 1489 non-diabetic first-degree relatives of patients with T2D with or without HTN were followed for the occurrence of T2D. At baseline and through follow-ups, participants underwent a standard 75g 2-h oral glucose tolerance test. Blood pressure was measured by standardised protocols and HTN was defined according to the criteria of the JNC7. RESULTS The progression rate (95% confidence interval) from NGT, isolated IFG, isolated IGT, and combined IFG/IGT to T2D was 10.0 (4.3, 19.6), 21.7 (9.5, 42.3), 28.2 (12.3, 54.7) and 64.7 (41.0, 96.4) per 1000 person-years in participants with HTN and 3.1 (1.5, 4.7), 16.3 (10.3, 24.2), 25.9 (17.0, 37.7) and 57.9 (46.1, 71.7) per 1000 person-years in participants without HTN based on 10,134 person-years of follow-up. Compared with individuals with NGT and without HTN, individuals with NGT and HTN, isolated IFG, isolated IGT, and combined IFG/IGT with or without HTN at baseline were more likely to progress to T2D. Compared with participants without HTN, individuals with concomitant HTN were not significantly more likely to progress to T2D. CONCLUSIONS Compared with individuals without HTN, the presence of NGT, isolated IFG, isolated IGT, and combined IFG/IGT with concomitant HTN was not associated with higher likelihood of progression to T2D in high-risk individuals in Iran.
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Affiliation(s)
- Mohsen Janghorbani
- Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran; Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Masoud Amini
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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