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Kovács N, Shahin B, Andrade CAS, Mahrouseh N, Varga O. Lifestyle and metabolic risk factors, and diabetes mellitus prevalence in European countries from three waves of the European Health Interview Survey. Sci Rep 2024; 14:11623. [PMID: 38773149 PMCID: PMC11109107 DOI: 10.1038/s41598-024-62122-y] [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: 09/21/2023] [Accepted: 05/14/2024] [Indexed: 05/23/2024] Open
Abstract
Population shift towards healthier lifestyles can help reduce the burden of type 2 diabetes mellitus (DM), therefore understanding and monitoring the lifestyle-related risk factors are crucial for setting up effective preventive strategies and disease management. The present study aimed to explore the changes in prevalence of DM and major risk factors including smoking, physical activity, fruit and vegetable consumption, as well as body mass index (BMI) over three waves of European Health Interview Survey, and to investigate the association between risk factors and presence of DM across 11 European Union member states. Poisson regression models were used to evaluate the association between risk factors and DM, adjusted for demographic and socioeconomic variables. The estimated age-standardized prevalence of DM increased from 7.01% in 2009 to 7.96% in 2019, with substantial increase in subgroups with higher BMI and unhealthy lifestyle including physically inactive people, or current smokers. Obesity and overweight and physical inactivity were significantly associated with DM in all survey waves. Our findings underline that obesity prevention and weight loss promotion along with physical activity promotion are the subject of lifestyle interventions to reduce the burden of DM in EU member states.
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Affiliation(s)
- Nóra Kovács
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Balqees Shahin
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Carlos Alexandre Soares Andrade
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Nour Mahrouseh
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Orsolya Varga
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
- Syreon Research Institute, Budapest, Hungary.
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Kong D, Chen R, Chen Y, Zhao L, Huang R, Luo L, Lai F, Yang Z, Wang S, Zhang J, Chen H, Mai Z, Yu H, Wu K, Ding Y. Bayesian network analysis of factors influencing type 2 diabetes, coronary heart disease, and their comorbidities. BMC Public Health 2024; 24:1267. [PMID: 38720267 PMCID: PMC11080276 DOI: 10.1186/s12889-024-18737-x] [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: 11/07/2023] [Accepted: 04/29/2024] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVE Bayesian network (BN) models were developed to explore the specific relationships between influencing factors and type 2 diabetes mellitus (T2DM), coronary heart disease (CAD), and their comorbidities. The aim was to predict disease occurrence and diagnose etiology using these models, thereby informing the development of effective prevention and control strategies for T2DM, CAD, and their comorbidities. METHOD Employing a case-control design, the study compared individuals with T2DM, CAD, and their comorbidities (case group) with healthy counterparts (control group). Univariate and multivariate Logistic regression analyses were conducted to identify disease-influencing factors. The BN structure was learned using the Tabu search algorithm, with parameter estimation achieved through maximum likelihood estimation. The predictive performance of the BN model was assessed using the confusion matrix, and Netica software was utilized for visual prediction and diagnosis. RESULT The study involved 3,824 participants, including 1,175 controls, 1,163 T2DM cases, 982 CAD cases, and 504 comorbidity cases. The BN model unveiled factors directly and indirectly impacting T2DM, such as age, region, education level, and family history (FH). Variables like exercise, LDL-C, TC, fruit, and sweet food intake exhibited direct effects, while smoking, alcohol consumption, occupation, heart rate, HDL-C, meat, and staple food intake had indirect effects. Similarly, for CAD, factors with direct and indirect effects included age, smoking, SBP, exercise, meat, and fruit intake, while sleeping time and heart rate showed direct effects. Regarding T2DM and CAD comorbidities, age, FBG, SBP, fruit, and sweet intake demonstrated both direct and indirect effects, whereas exercise and HDL-C exhibited direct effects, and region, education level, DBP, and TC showed indirect effects. CONCLUSION The BN model constructed using the Tabu search algorithm showcased robust predictive performance, reliability, and applicability in forecasting disease probabilities for T2DM, CAD, and their comorbidities. These findings offer valuable insights for enhancing prevention and control strategies and exploring the application of BN in predicting and diagnosing chronic diseases.
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Affiliation(s)
- Danli Kong
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, 523808, Guangdong, China
| | - Rong Chen
- Department of Infection Control, Ankang Hospital of Traditional Chinese Medicine, Ankang, 725000, Shaanxi, China
| | - Yongze Chen
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, 523808, Guangdong, China
- Department of Gastroenterology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524002, Guangdong, China
| | - Le Zhao
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, 523808, Guangdong, China
| | - Ruixian Huang
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, 523808, Guangdong, China
| | - Ling Luo
- School of Public Health and Emergency Management, South University of Science and Technology of China, Shenzhen, 518055, Guangdong, China
| | - Fengxia Lai
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, 523808, Guangdong, China
| | - Zihua Yang
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, 523808, Guangdong, China
| | - Shuang Wang
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, 523808, Guangdong, China
| | - Jingjing Zhang
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, 523808, Guangdong, China
| | - Hao Chen
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, 523808, Guangdong, China
| | - Zhenhua Mai
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, 523808, Guangdong, China.
- Department of Critical Care Medicine, Affiliated Hospital of Guangdong Medical University Zhanjiang, Zhanjiang, 524001, China.
| | - Haibing Yu
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, 523808, Guangdong, China.
| | - Keng Wu
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, 523808, Guangdong, China.
- Department of Cardiology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524002, Guangdong, China.
| | - Yuanlin Ding
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, 523808, Guangdong, China.
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Kurniawan F, Sigit FS, Trompet S, Yunir E, Tarigan TJE, Harbuwono DS, Soewondo P, Tahapary DL, de Mutsert R. Lifestyle and clinical risk factors in relation with the prevalence of diabetes in the Indonesian urban and rural populations: The 2018 Indonesian Basic Health Survey. Prev Med Rep 2024; 38:102629. [PMID: 38375173 PMCID: PMC10874845 DOI: 10.1016/j.pmedr.2024.102629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/06/2024] [Accepted: 01/20/2024] [Indexed: 02/21/2024] Open
Abstract
Aims To investigate the differences between Indonesian urban and rural populations in the association of lifestyle and clinical factors with diabetes prevalence. Methods Using database of the 2018 Indonesian Basic Health Survey, which was conducted in April-May 2018, non-pregnant respondents aged ≥15 years old with available blood glucose data (n urban = 17,129, n rural = 16,585) were included in this study. The diagnosis of diabetes was based on the combination of known diabetes, i.e., a previous history of diabetes or use of anti-diabetes medication, and unknown diabetes based on blood glucose criteria. We performed logistic regression analyses separately for the urban and rural populations to examine the association of lifestyle and clinical factors with prevalent diabetes. Results Indonesian urban population was less physically active, had a lower proportion of adequate fruit and vegetable intake, and had higher individuals with obesity than rural population. Although there were no differences in the total prevalence of diabetes between the two populations (10.9 % vs. 11.0 %, for urban and rural, respectively), the prevalence of known diabetes was twice higher in urban than in rural population (3.8 % vs. 1.9 %). Physical activity was associated with lower risk of diabetes, especially in the urban population [prevalence OR (95 %CI): 0.91 (0.85; 0.98) for urban and 0.94 (0.89; 1.00) for rural). Obesity, hypertension, and dyslipidemia were risk factors for prevalent diabetes in both populations. Conclusions Indonesian rural population showed relatively better lifestyle and clinical profiles compared to their urban counterparts. However, no differences were observed between the two populations in the relation between risk factors and diabetes. Special attention needs to be addressed to the high prevalence of undiagnosed and untreated diabetes in Indonesia.
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Affiliation(s)
- Farid Kurniawan
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital/Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
- Metabolic Disorder, Cardiovascular, and Aging Research Cluster, The Indonesian Medical Educational and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Fathimah S. Sigit
- Metabolic Disorder, Cardiovascular, and Aging Research Cluster, The Indonesian Medical Educational and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
- Department of Public Health Nutrition, Faculty of Public Health Universitas Indonesia, Jakarta, Indonesia
| | - Stella Trompet
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Em Yunir
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital/Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
- Metabolic Disorder, Cardiovascular, and Aging Research Cluster, The Indonesian Medical Educational and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Tri Juli E. Tarigan
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital/Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
- Metabolic Disorder, Cardiovascular, and Aging Research Cluster, The Indonesian Medical Educational and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Dante S. Harbuwono
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital/Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
- Metabolic Disorder, Cardiovascular, and Aging Research Cluster, The Indonesian Medical Educational and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Pradana Soewondo
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital/Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
- Metabolic Disorder, Cardiovascular, and Aging Research Cluster, The Indonesian Medical Educational and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Dicky L. Tahapary
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital/Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
- Metabolic Disorder, Cardiovascular, and Aging Research Cluster, The Indonesian Medical Educational and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Renée de Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
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Kyung Y, Park YS, Jin MH, Lee HJ. Variability in the association of smoking status with the prevalence of diabetes mellitus in the Korean population according to different definitions of smoking status: analysis based on the Korea National Health and Nutrition Examination Survey (2014-2020). INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024:1-14. [PMID: 38174714 DOI: 10.1080/09603123.2023.2300036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 12/23/2023] [Indexed: 01/05/2024]
Abstract
We evaluated the association between smoking and diabetes, as well as the effects of gender differences and hidden smoking among females on this association using nationally representative data. Analyzing data from 44,049 individuals aged 19 and older, we utilized multivariable logistic regression to investigate associations, controlling for sociodemographic factors. Subgroup analysis based on smoking status determined factors associated with diabetes. To better our understanding of the smoking-diabetes relationship, we introduced a new variable, survey-cotinine verified smoking status (SCS). This study provides valuable insight by exploring the correlation between smoking and diabetes using different definitions of smoking status. Both male and female smokers showed correlations with diabetes according to cotinine-verified smoking status (OR: 1.22 and 1.48, respectively). According to smoking amount, cotinine-verified heavy smokers correlated with diabetes in males (OR: 1.37), while light smokers exhibited a negative correlation with diabetes in females for both cotinine-verified smoking status (OR: 0.60) and survey-cotinine verified status (OR: 0.58) Smoking was associated with diabetes in the overall population, with gender differences observed. When evaluating this association, we should consider variables of smoking amount, passive and intermittent smoking, and specifically, account for the influence of hidden smoking among females, particularly when utilizing self-reported questionnaires in Korea.
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Affiliation(s)
- Yechan Kyung
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Young Sook Park
- Department of Physical & Rehabilitation Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Mi Hyeon Jin
- Department of Biostatistics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Hae Jeong Lee
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
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Liu C, He L, Li Y, Yang A, Zhang K, Luo B. Diabetes risk among US adults with different socioeconomic status and behavioral lifestyles: evidence from the National Health and Nutrition Examination Survey. Front Public Health 2023; 11:1197947. [PMID: 37674682 PMCID: PMC10477368 DOI: 10.3389/fpubh.2023.1197947] [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: 03/31/2023] [Accepted: 08/09/2023] [Indexed: 09/08/2023] Open
Abstract
Background Diabetes disproportionately affects minorities and those with low socioeconomic status (SES) in the United States, and differences in behavioral lifestyles are largely responsible for the unequal distribution of diabetes among different groups. Methods With data of 9,969 participants collected in the 2007-2008 and 2009-2010 cycles of the US National Health and Nutrition Examination Survey (NHANES), this study examined several mediators and their mediating effects in the connection between SES and the risk of diabetes. The SES is assessed by the income-to-poverty ratio (IPR), education level, and employment status. For the mediation analysis, we used health-related behaviors as mediators (smoking, alcohol use, consumption of green vegetables and fruits, physical activity and sedentary time, health insurance, and healthcare). In this study, the structural equation model was utilized to evaluate the mediating effects of behavioral lifestyle as a mediator in the relationship between SES and diabetes. Results A total of 9,969 participants were included in this study. We found a negative nonlinear association between IPR and diabetes risk (Poverall < 0.001; Pnon-linear = 0.46), which was independent of the majority of known or suspected risk factors and confounding variables (gender, age, race). Participants with lower SES had higher risk of diabetes compared with those with higher SES. In mediating analysis, we found alcohol intake (OR = 0.996), physical activity (OR = 0.993), health insurance (OR = 0.998), and healthcare (OR = 1.002) mediated the IPR-diabetes association. But in the relationship between education status and diabetes, the mediation effect of alcohol intake (OR = 0.995), physical activity (OR = 0.991), and health care (OR = 1.008) were obvious. Likewise, alcohol intake (OR = 0.996), fruit intake (OR = 0.998), and health care (OR = 0.975) were important mediators in the association between employment status and diabetes. Conclusion This study provides critical insights on the link between SES and diabetes. Our results highlight that poor health-related behaviors and limited access to healthcare are important pathways for increased diabetes risk related to those with low SES, particularly among Mexican Americans and males. They should be top priorities for agencies and healthcare providers to develop behavior-related interventions to reduce inequalities in diabetes risk.
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Affiliation(s)
- Ce Liu
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, China
| | - Li He
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, China
| | - Yuanfei Li
- Department of Sociology, University at Albany, State University of New York, Albany, CA, United States
| | - Aimin Yang
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Kai Zhang
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, NY, United States
| | - Bin Luo
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, China
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Boadu WIO, Anto EO, Frimpong J, Ntiful F, Korsah EE, Ansah E, Tamakloe VCKT, Agyapomaa A, Opoku S, Senu E, Nyantakyi M, Etwi‐Mensah A, Acheampong E, Boadu KO, Donkoh ET, Obirikorang C. Prevalence, knowledge, and lifestyle-associated risk factors of dyslipidemia among Ghanaian type-2 diabetes mellitus patients in rural and urban areas: A multicenter cross-sectional study. Health Sci Rep 2023; 6:e1475. [PMID: 37636287 PMCID: PMC10447875 DOI: 10.1002/hsr2.1475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 07/09/2023] [Accepted: 07/23/2023] [Indexed: 08/29/2023] Open
Abstract
Background and Aims Dyslipidemia in diabetes mellitus has been linked to unhealthy lifestyle and bad eating habits. However, this association has not been well studied among rural and urban Ghanaian populations. In this study, we determined the prevalence, knowledge, and lifestyle-associated risk factors of dyslipidemia among Ghanaian type-2 diabetes mellitus (T2DM) patients in rural and urban areas. Methods This comparative multicentre-cross-sectional study recruited 228 T2DM outpatients attending the St. Michael Hospital, Pramso (rural) and Kumasi South Regional Hospital (urban), Ghana for routine check-ups. Self-structured questionnaire was used to collect sociodemographic, knowledge, and lifestyle characteristics. Fasting blood samples were taken to measure lipid profiles. Dyslipidemia was defined per the American Diabetes Association criteria. All p < 0.05 were considered statistically significant. Results The overall prevalence of dyslipidemia was 79/228 (34.7%). Dyslipidemia was more prevalent among urban participants 43 (18.9%) than rural participants 36 (15.8%). Twenty-seven (11.7%) had adequate knowledge about the risk factors, complications, and management of diabetes. Eating supper after 7 p.m. [adjusted odds ratio = 3.77, 95% confidence interval (1.70-8.37), p = 0.001] significantly increased one's risk of having dyslipidemia by 3.8-fold compared to eating supper earlier (before 5 p.m.). Conclusion Dyslipidemia is increasing among T2DM patients in both urban and rural areas and it's independently influenced by eating supper after 7 p.m. Most participants were ignorant of the risk factors, complications, and management of diabetes. Adjusting eating habits and increasing diabetes awareness programs to sensitize the general public can mitigate the increasing prevalence of dyslipidemia in both urban and rural areas.
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Affiliation(s)
- Wina I. O. Boadu
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Enoch O. Anto
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
- School of Medical and Health SciencesEdith Cowan UniversityPerthAustralia
- Centre for Precision Health, ECU Strategic Research CentreEdith Cowan UniversityPerthAustralia
| | - Joseph Frimpong
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Felix Ntiful
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Emmanuel E. Korsah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Ezekiel Ansah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Valentine C. K. T. Tamakloe
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Afia Agyapomaa
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Stephen Opoku
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Ebenezer Senu
- Department of Molecular Medicine, School of Medicine and DentistryKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Michael Nyantakyi
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Albright Etwi‐Mensah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Emmanuel Acheampong
- School of Medical and Health SciencesEdith Cowan UniversityPerthAustralia
- Department of Molecular Medicine, School of Medicine and DentistryKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Kwame O. Boadu
- Department of Obstetrics and Gynaecology, Kumasi South HospitalAtonsu‐AgogoKumasiGhana
| | - Emmanuel Timmy Donkoh
- Department of Medical Laboratory ScienceUniversity of Energy and Natural ResourcesSunyaniGhana
| | - Christian Obirikorang
- Department of Molecular Medicine, School of Medicine and DentistryKwame Nkrumah University of Science and TechnologyKumasiGhana
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Bavuma CM, Niyibizi JB, Bitunguhari L, Musafiri S, McQuillan R, Wild S. Prevalence and characteristics associated with diabetes mellitus and impaired fasting glucose among people aged 15 to 64 years in rural and urban Rwanda: secondary data analysis of World Health Organization surveillance data. Pan Afr Med J 2022; 41:115. [PMID: 35465373 PMCID: PMC8994463 DOI: 10.11604/pamj.2022.41.115.30682] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 01/19/2022] [Indexed: 12/13/2022] Open
Abstract
Introduction diabetes mellitus is an increasing public health burden in developing countries. The magnitude of diabetes association with traditional risk factors for diabetes have been given less attention in rural population. This study aims to determine the prevalence of diabetes and impaired fasting glucose and to assess associated characteristics to hyperglycemia in rural and urban Rwanda. Methods this is a secondary analysis of data from a population-based cross-sectional study of 7240 people describing risk factors for non-communicable diseases using the WHO stepwise methods (STEPS). Relative frequencies of variables of interest were compared in rural and urban residence using Pearson chi-square tests. Diabetes and impaired fasting glucose were combined in a single hyperglycemia variable and odds ratios with 95% confidence intervals were used to explore associations between hyperglycemia, socio-demographic and health factors in urban and rural populations. Results the prevalence in rural and urban areas was 7.5% and 9.7% (p.005) for diabetes and 5.0% and 6.2% for impaired fasting glucose (p.079) respectively. Obesity (AOR 2.57: CI: 0.86-7.9), high total cholesterol (AOR 3.83: CI: 2.03-7.208), hypertension (AOR 1.18: CI: 0.69-2.00), increasing age were associated with hyperglycemia in urban participants but only high total cholesterol and low high density lipoproteins (HDL) cholesterol were risk factors for hyperglycemia in rural participants. Conclusion approximately one in six people in Rwanda have hyperglycemia. The magnitude of the association with traditional risk factors for diabetes differ in rural and urban settings. Different approaches to primary and secondary prevention of diabetes may be needed in rural populations.
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Affiliation(s)
- Charlotte Munganyinka Bavuma
- Kigali University Teaching Hospital, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Jean Berchmans Niyibizi
- Single Project Implementation Unit, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Leopold Bitunguhari
- Kigali University Teaching Hospital, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Sanctus Musafiri
- Kigali University Teaching Hospital, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Ruth McQuillan
- Usher Institute, University of Edinburgh, Scotland, United Kingdom
| | - Sarah Wild
- Usher Institute, University of Edinburgh, Scotland, United Kingdom
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Cranney L, McGill B, Clare PJ, Bauman A. Trends in risk factors and management strategies used by people with type 2 diabetes in New South Wales, Australia. Prev Med 2022; 157:107004. [PMID: 35240142 DOI: 10.1016/j.ypmed.2022.107004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 01/28/2022] [Accepted: 02/23/2022] [Indexed: 11/29/2022]
Abstract
Adopting healthy lifestyle behaviours is an important component of Type 2 diabetes (T2D) self-management, which can lower risks of further health complications. Monitoring lifestyle risk factors including overweight or obesity, healthy diet and physical activity behaviours, alcohol consumption, smoking and psychological distress remain important. This study examined prevalence trends in these factors and adoption of three diabetes lifestyle self-management strategies in adults (aged 40+) with T2D in New South Wales (NSW), Australia. Analyses were conducted on NSW Adult Population Health Survey data, 2004-2019 (n = 142,168), using predicted probabilities from generalised linear models, weighted to population estimates. Throughout the study period overweight or obesity prevalence remained higher amongst those with T2D (83.1% to 81.7%) compared to those without diabetes (61.0 to 61.2%); only 8.9% of those with T2D were trying to lose weight. During the study period, there were declines in the proportions of those with T2D reporting sufficient fruit consumption [63.9% to 50.1%], moderate vegetable consumption (3 serves) [49.0% to 37.7%], and achieving sufficient physical activity [40.0% to 34.0%]. There were also declines in those reporting they manage their diabetes through following a special diet [73.6% to 55.9%] and exercising most days [33.5% to 22.2%]. This study highlights potential gaps in T2D secondary prevention and suggests more targeted diabetes education services are needed to address lifestyle risks. Increased understanding of why fewer people with T2D adopt these lifestyle management strategies is needed to inform policy and practice.
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Affiliation(s)
- Leonie Cranney
- The University of Sydney, Faculty of Medicine and Health, Sydney School of Public Health, Prevention Research Collaboration, Sydney, New South Wales, Australia; The University of Sydney, Charles Perkins Centre, Sydney, New South Wales, Australia.
| | - Bronwyn McGill
- The University of Sydney, Faculty of Medicine and Health, Sydney School of Public Health, Prevention Research Collaboration, Sydney, New South Wales, Australia; The University of Sydney, Charles Perkins Centre, Sydney, New South Wales, Australia
| | - Philip J Clare
- The University of Sydney, Faculty of Medicine and Health, Sydney School of Public Health, Prevention Research Collaboration, Sydney, New South Wales, Australia; The University of Sydney, Charles Perkins Centre, Sydney, New South Wales, Australia; National Drug and Alcohol Research Centre, UNSW, Sydney, New South Wales, Australia
| | - Adrian Bauman
- The University of Sydney, Faculty of Medicine and Health, Sydney School of Public Health, Prevention Research Collaboration, Sydney, New South Wales, Australia; The University of Sydney, Charles Perkins Centre, Sydney, New South Wales, Australia
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Pardhan S, Zheng D, Chen Z, López Sánchez GF. Obesity needs to be addressed to tackle the increased prevalence of diabetes in China - Temporal changes from 2003 to 2009. Prev Med Rep 2021; 24:101625. [PMID: 34987954 PMCID: PMC8693873 DOI: 10.1016/j.pmedr.2021.101625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/10/2021] [Accepted: 10/23/2021] [Indexed: 11/10/2022] Open
Abstract
This study aimed to analyse the temporal change of diabetes and any associated risk and protective factors for diabetes in Chinese adults between Wave 0 (2003) and Wave 1 (2009) of the World Health Organization (WHO) Study on global AGEing and adult health (SAGE). Data from China of the SAGE were analysed. Diabetes (outcome variable) was assessed by the yes/no question: "Have you ever been diagnosed with diabetes (high blood sugar)?". Exposure variables examined in bivariate and multivariate multiple regression included sex, age, marital status, education, smoking, alcohol, fruit and vegetables consumption, physical activity and body mass index (BMI). Significant exposure variables in bivariate analyses were included in multivariate analyses (2003: age and tobacco; 2009: age, BMI, education and alcohol). In Wave 0 (2003), there were 3993 Chinese adults, of which 67 (1.7%) self-reported to have diabetes. In Wave 1 (2009), there were a total of 9524 Chinese adults, of which 770 (8.1%) had diabetes. The overall prevalence of diabetes in Chinese adults increased by 4.76 times between the two timeframes (1.7%, age range 27-84 years, average age 58.51 ± 12.70 years, 59.70% females in 2003 to 8.1%, age range 20-95 years, average age 65.31 ± 10.19 years, 53.64% females in 2009). Multivariate regression retained older age ≥ 60 years (OR 4.34, 95% CI 2.67-7.07) as the main risk factor in 2003 data, while in 2009 the odds ratio for older age ≥ 60 years decreased (OR 2.45, 95% CI 2.06-2.92), but included a significant association of obesity (OR 2.11, 95% CI 1.60-2.78) and excess weight (OR 1.42, 95% CI 1.19-1.69). The significant association with excess weight and obesity associated with the increased prevalence of diabetes in 2009 is a cause of concern and should be addressed by public health strategies in China.
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Affiliation(s)
- Shahina Pardhan
- Vision and Eye Research Institute, School of Medicine, Faculty of Health,
Education, Medicine and Social Care, Anglia Ruskin University, Cambridge CB1
1PT, United Kingdom
| | - Dingchang Zheng
- Faculty of Health and Life Sciences, University of Coventry, Coventry,
United Kingdom
| | - Zhiqing Chen
- Eye Centre, the Second Affiliated Hospital of the School of Medicine,
Zhejiang University, 88 Jiefang Road, Hangzhou, Zhejiang 310009, PR
China
- Key Laboratory of Ophthalmology of Zhejiang Province, 88 Jiefang Road,
Hangzhou, Zhejiang 310009, PR China
| | - Guillermo F. López Sánchez
- Vision and Eye Research Institute, School of Medicine, Faculty of Health,
Education, Medicine and Social Care, Anglia Ruskin University, Cambridge CB1
1PT, United Kingdom
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10
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Guo F, Wang M, Guo X, Pu L, Sun M, Li S, Feng T, Tong L, Zhao S, Gao W, Lin X, Yao Y, Jin L. The association between fatty acid intake and breast cancer based on the NHANES and Mendelian randomization study. Cancer Epidemiol 2021; 73:101966. [PMID: 34146915 DOI: 10.1016/j.canep.2021.101966] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 05/20/2021] [Accepted: 06/07/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Observational studies have examined the association between fatty acid intake and breast cancer (BC), and the association might vary depending on menopausal status, but the results remain controversial. The objective of this study was to investigate the associations between fatty acid intake and BC. METHODS The National Health and Nutrition Examination Survey (NHANES) 1999-2016 was used in the study, and stratified analysis by menopausal status was performed. Logistic regression models were used to evaluate the associations between BC and intake of saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs), and polyunsaturated fatty acids (PUFAs), adjusting for covariates. Three two-sample Mendelian randomization (MR) methods-inverse variance weighted (IVW), weighted median, and Mendelian randomization-Egger (MR-Egger) regression-were applied to further verify the associations between intake of fatty acids and BC. RESULTS Higher intake of MUFAs was associated with lower risk of BC in premenopausal women: ORs (95 %CI): 0.325 (0.110, 0.964). IVW showed that increased intake of MUFAs was associated with a reduced risk of BC: 0.997 (0.995, 1.000), p = 0.024. No associations between BC and SFAs, MUFAs or PUFAs were found in postmenopausal women or in the overall population. CONCLUSIONS Increasing intake of MUFAs might reduce the risk of BC in premenopausal women. The protective effect of MUFAs on BC was also supported by MR study.
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Affiliation(s)
- Feng Guo
- Epidemiology and Biostatistics, School of Public Health, No. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021, China.
| | - Min Wang
- Epidemiology and Biostatistics, School of Public Health, No. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021, China.
| | - Xuecan Guo
- Epidemiology and Biostatistics, School of Public Health, No. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021, China.
| | - Liyuan Pu
- Epidemiology and Biostatistics, School of Public Health, No. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021, China.
| | - Mengzi Sun
- Epidemiology and Biostatistics, School of Public Health, No. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021, China.
| | - Shuo Li
- Epidemiology and Biostatistics, School of Public Health, No. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021, China.
| | - Tianyu Feng
- Epidemiology and Biostatistics, School of Public Health, No. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021, China.
| | - Li Tong
- Epidemiology and Biostatistics, School of Public Health, No. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021, China.
| | - Saisai Zhao
- Epidemiology and Biostatistics, School of Public Health, No. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021, China.
| | - Wenhui Gao
- Epidemiology and Biostatistics, School of Public Health, No. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021, China.
| | - Xinli Lin
- Department of Child and Adolescent Health, School of Public Health, No. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021, China.
| | - Yan Yao
- Epidemiology and Biostatistics, School of Public Health, No. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021, China.
| | - Lina Jin
- Epidemiology and Biostatistics, School of Public Health, No. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021, China.
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11
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Gallardo-Rincón H, Cantoral A, Arrieta A, Espinal C, Magnus MH, Palacios C, Tapia-Conyer R. Review: Type 2 diabetes in Latin America and the Caribbean: Regional and country comparison on prevalence, trends, costs and expanded prevention. Prim Care Diabetes 2021; 15:352-359. [PMID: 33077379 DOI: 10.1016/j.pcd.2020.10.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/30/2020] [Accepted: 10/03/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE To present an overview of type 2 diabetes status in Latin America and the Caribbean region. METHODS The data were collected from the International Diabetes Federation Atlas and other available published sources where we identified the prevalence in Latin America and the Caribbean, the trends by regions, and sex. Also, we summarized the type 2 diabetes direct and indirect costs, and the current preventative programs and policies available for each region. RESULTS Latin America and the Caribbean has one of the fastest-growing prevalence of type 2 diabetes, in particular the Caribbean region. Costs are relatively high in Central American countries and the Caribbean Islands. Currently, type 2 diabetes prevention, diagnosis, and management are insufficient in Latin America and the Caribbean and they do not offer a multidisciplinary integrative approach. CONCLUSION Effective and preventive multidisciplinary policies should be implemented in Latin America and the Caribbean to decrease the high burden of type 2 diabetes.
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Affiliation(s)
| | | | - Alejandro Arrieta
- Robert Stempel College of Public Health and Social Work, Florida International University, United States
| | - Carlos Espinal
- Robert Stempel College of Public Health and Social Work, Florida International University, United States
| | - Marcia H Magnus
- Robert Stempel College of Public Health and Social Work, Florida International University, United States
| | - Cristina Palacios
- Robert Stempel College of Public Health and Social Work, Florida International University, United States
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12
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Alvarez-Alvarez M, de la Vega-Marcos R, Jiménez-Castuera R, Leyton-Román M. Psychometric Properties of the Healthy Lifestyle Questionnaire for Ecuadorian University Students (EVS-EUE). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1087. [PMID: 33530514 PMCID: PMC7908251 DOI: 10.3390/ijerph18031087] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/18/2021] [Accepted: 01/22/2021] [Indexed: 12/24/2022]
Abstract
University students are considered a key population in promoting and establishing healthy lifestyles that will ensure a full life for the next generations. The purpose of this study was to do a cultural and linguistic adaptation of the healthy lifestyle questionnaire for Ecuadorian university students (EVS-EUE). Two thousand, one hundred and eight (2108) students from 17 to 19 years old (27%), 20 to 24 years old (57%), and over 24 years old (16%) participated (M = 21.81 years; SD = 3.04). A confirmatory factor analysis, internal consistency analysis, and concurrent validity were conducted. The results of the EVS-EUE Questionnaire presented adequate values (χ2/d.f = 9.02, Comparative Fit Index (CFI) = 0.96, Incremental Fit Index (IFI) = 0.96, McDonald Fit Index (MFI) = 0.91, Adjusted Goodness of Fit Index (AGFI) = 0.94, Root Mean Square Error of Approximation (RMSEA) = 0.06, Standardized Root Mean Square Residual (SRMR) = 0.03). The internal consistency showed values above 0.70, and analyzed its concurrent validity, reaching adequate values. This study has provided a valid and reliable questionnaire to evaluate healthy lifestyles in the Ecuadorian population.
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Affiliation(s)
- Mario Alvarez-Alvarez
- Research Group in Physical Activity and Sport Sciences, Universidad Politécnica Salesiana, Cuenca 010105, Ecuador;
| | - Ricardo de la Vega-Marcos
- Department of Physical Education, Sport and Human Movement, Autonomous University of Madrid, 28049 Madrid, Spain;
| | - Ruth Jiménez-Castuera
- Didactic and Behavioral Analysis in Sport Research Group, Faculty of Sports Science, University of Extremadura, 10003 Cáceres, Spain;
| | - Marta Leyton-Román
- Sport of Studies Center, Rey Juan Carlos University, 28933 Madrid, Spain
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13
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Consumption of Dairy Products in Relation to Type 2 Diabetes Mellitus in Chinese People: The Henan Rural Cohort Study and an Updated Meta-Analysis. Nutrients 2020; 12:nu12123827. [PMID: 33333780 PMCID: PMC7765212 DOI: 10.3390/nu12123827] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/01/2020] [Accepted: 12/11/2020] [Indexed: 01/15/2023] Open
Abstract
Recent studies on whether dairy consumption is associated with type 2 diabetes mellitus (T2DM) have yielded inconsistent results, so we explored the relationship between dairy consumption and T2DM through a large-sample, cross-sectional study and a meta-analysis. In the meta-analysis, summary relative risks (RRs) of 23 articles were compiled with a random effects model, and a restricted cubic spline regression model was used to explore whether there is a nonlinear relationship between dairy intake and T2DM risk. This cross-sectional study used baseline data from 38,735 participants of the Henan Rural Cohort study and the association between dairy consumption and T2DM was analyzed by a logistic regression model. The meta-analysis revealed a borderline negative significant association between total dairy intake and risk of T2DM, the RR and 95% confidence interval (CI) was 0.94; (0.89, 1.00), and the risk was lowest at 270 g daily dairy intake. In the cross-sectional study, there were 3654 T2DM patients and 68.3 percent of the respondents had no dairy intake. The average intake of dairy in the total population was 12 g per day. Fully adjusted analyses suggested positive associations, with an odds ratio (OR) comparing the highest with the zero intake of 1.34 (95% CI: 1.22, 1.48) for all participants, which was unaffected by sex. Dairy intake in rural areas of Henan province is low, and we found, in the context of overall low dairy intake, that a high intake was positively associated with T2DM, which is inconsistent with the meta-analysis results suggesting that dairy has marginal protective effects against T2DM.
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14
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Fan M, Li Y, Wang C, Mao Z, Zhou W, Zhang L, Yang X, Cui S, Li L. Dietary Protein Consumption and the Risk of Type 2 Diabetes: ADose-Response Meta-Analysis of Prospective Studies. Nutrients 2019; 11:nu11112783. [PMID: 31731672 PMCID: PMC6893550 DOI: 10.3390/nu11112783] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 11/08/2019] [Accepted: 11/12/2019] [Indexed: 12/11/2022] Open
Abstract
The relationship between dietary protein consumption and the risk of type 2 diabetes (T2D) has been inconsistent. The aim of this meta-analysis was to explore the relations between dietary protein consumption and the risk of T2D. We conducted systematic retrieval of prospective studies in PubMed, Embase, and Web of Science. Summary relative risks were compiled with a fixed effects model or a random effects model, and a restricted cubic spline regression model and generalized least squares analysis were used to evaluate the diet–T2D incidence relationship. T2D risk increased with increasing consumption of total protein and animal protein, red meat, processed meat, milk, and eggs, respectively, while plant protein and yogurt had an inverse relationship. A non-linear association with the risk for T2D was found for the consumption of plant protein, processed meat, milk, yogurt, and soy. This meta-analysis suggests that substitution of plant protein and yogurt for animal protein, especially red meat and processed meat, can reduce the risk for T2D.
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Affiliation(s)
- Mengying Fan
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450000, China; (M.F.); (C.W.); (Z.M.); (W.Z.); (L.Z.); (X.Y.); (S.C.)
| | - Yuqian Li
- Department of Clinical Pharmacology, School of Pharmaceutical Science, Zhengzhou University, Zhengzhou 450000, China;
| | - Chongjian Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450000, China; (M.F.); (C.W.); (Z.M.); (W.Z.); (L.Z.); (X.Y.); (S.C.)
| | - Zhenxing Mao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450000, China; (M.F.); (C.W.); (Z.M.); (W.Z.); (L.Z.); (X.Y.); (S.C.)
| | - Wen Zhou
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450000, China; (M.F.); (C.W.); (Z.M.); (W.Z.); (L.Z.); (X.Y.); (S.C.)
| | - Lulu Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450000, China; (M.F.); (C.W.); (Z.M.); (W.Z.); (L.Z.); (X.Y.); (S.C.)
| | - Xiu Yang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450000, China; (M.F.); (C.W.); (Z.M.); (W.Z.); (L.Z.); (X.Y.); (S.C.)
| | - Songyang Cui
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450000, China; (M.F.); (C.W.); (Z.M.); (W.Z.); (L.Z.); (X.Y.); (S.C.)
| | - Linlin Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450000, China; (M.F.); (C.W.); (Z.M.); (W.Z.); (L.Z.); (X.Y.); (S.C.)
- Correspondence: ; Tel.: +86-0371-67781247; Fax: +86-0371-67781868
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15
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Wang S, Chen J, Wang Y, Yang Y, Zhang D, Liu C, Wang K. Cigarette Smoking Is Negatively Associated with the Prevalence of Type 2 Diabetes in Middle-Aged Men with Normal Weight but Positively Associated with Stroke in Men. J Diabetes Res 2019; 2019:1853018. [PMID: 31612146 PMCID: PMC6755302 DOI: 10.1155/2019/1853018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 08/05/2019] [Accepted: 08/23/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The prevalence of diabetes and potentially related complications, including stroke, is rapidly increasing in China. The long-term effects of lifestyle may affect glucose metabolism in the general population. Although some studies have shown an association between smoking and the risk of type 2 diabetes mellitus (T2DM), the relationship remains unclear. Furthermore, the relationship between smoking and stroke in patients with T2DM has not been fully elucidated. OBJECTIVE We investigated the influence of cigarette smoking on T2DM and stroke in China. Detailed questionnaires about smoking status and anthropometric measurement were completed by participants, and oral glucose tolerance testing (OGTT), hemoglobin A1c (HbA1c), homeostasis model assessment of IR (HOMA-IR), and blood lipids were measured. RESULTS In total, 8196 adults aged 40 years or older were included. We found a reduced risk of impaired glucose regulation (IGR) and T2DM in male smokers with normal weight (body mass index (BMI) < 25 kg/m2 or waist circumference (WC) < 90 cm) compared with nonsmokers after adjusting for age, alcohol intake, physical activity, educational level, family history of diabetes, SBP, DBP, TG, TC, HDL-C, and LDL-C. However, no significant association was detected in male current smokers with overweight/obesity or female smokers. In addition, compared with nonsmokers without T2DM, current smokers with T2DM had a significantly higher risk of stroke (odds ratio: 2.64, 95% confidence interval: 1.25-5.57; P = 0.011) after adjusting for confounders. CONCLUSIONS Smoking was negatively associated with T2DM in Chinese men of normal body weight, but no significant association was found for men with overweight/obesity or women. In addition, smoking was positively associated with nonfatal stroke, especially in patients with T2DM. Further prospective studies are needed to examine the association between smoking, diabetes, and stroke in different ethnic groups.
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Affiliation(s)
- Su Wang
- Department of Endocrinology, Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Jie Chen
- Department of Endocrinology, Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yuzhong Wang
- Department of Geriatrics, Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Yu Yang
- Department of Endocrinology, Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Danyu Zhang
- Department of Endocrinology, Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Chao Liu
- Department of Endocrinology, Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Kun Wang
- Department of Endocrinology, Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
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16
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Liu Y, Yu Y, Nickel JC, Iwasaki LR, Duan P, Simmer-Beck M, Brown L. Gender differences in the association of periodontitis and type 2 diabetes. Int Dent J 2018; 68:433-440. [DOI: 10.1111/idj.12399] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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17
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Liu Y, Bie R, Iwasaki LR, Nickel JC. Prevalence differentiations of periodontitis by diabetic status among US adults. J Diabetes 2018; 10:896-898. [PMID: 29761666 DOI: 10.1111/1753-0407.12781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 04/25/2018] [Accepted: 05/11/2018] [Indexed: 12/26/2022] Open
Affiliation(s)
- Ying Liu
- Department of Biostatistics and Epidemiology, East Tennessee State University, Johnson City, Tennessee, USA
| | - Ronghai Bie
- Henan University of Chinese Medicine, Henan, China
| | - Laura R Iwasaki
- School of Dentistry, Department of Orthodontics, Oregon Health and Science University, Portland, Oregon, USA
| | - Jeffrey C Nickel
- School of Dentistry, Department of Orthodontics, Oregon Health and Science University, Portland, Oregon, USA
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18
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Tabung FK, Smith-Warner SA, Chavarro JE, Fung TT, Hu FB, Willett WC, Giovannucci EL. An Empirical Dietary Inflammatory Pattern Score Enhances Prediction of Circulating Inflammatory Biomarkers in Adults. J Nutr 2017; 147:1567-1577. [PMID: 28659407 PMCID: PMC5525108 DOI: 10.3945/jn.117.248377] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 03/27/2017] [Accepted: 06/05/2017] [Indexed: 01/14/2023] Open
Abstract
Background: Two indexes exist to describe dietary inflammatory potential: an empirical dietary inflammatory pattern (EDIP) composed of food groups as reported on a food-frequency questionnaire (FFQ) and a literature-derived dietary inflammatory index (DII) composed mainly of nutrients.Objective: We compared the ability of the 2 indexes to predict concentrations of inflammatory markers and hypothesized that the EDIP would be more predictive because it was derived on the basis of circulating inflammatory markers.Methods: Both EDIP and DII scores were calculated from FFQ data reported by 5826 women in the Nurses' Health Study II and 5227 men in the Health Professionals Follow-Up Study. We used multivariable-adjusted linear regression analyses to calculate relative differences in concentrations of 4 plasma inflammatory markers-C-reactive protein (CRP; milligrams per liter), interleukin 6 (IL-6; picograms per milliliter), tumor necrosis factor α receptor 2 (TNFαR2; picograms per milliliter), and adiponectin (nanograms per milliliter)-in quintiles of the dietary indexes.Results: Spearman correlations between the EDIP and DII scores were modest (r = 0.29 and 0.21 for women and men, respectively; all P < 0.0001). Higher scores on both dietary indexes were associated with higher concentrations of inflammatory markers, although they were associated with lower adiponectin concentrations and there was no association between the DII and adiponectin in men. For example, percentage differences in concentrations of biomarkers in quintile 5 generally were higher (lower for adiponectin) than in quintile 1 (for the EDIP and DII, respectively-women: CRP, +60% and +49%; IL-6, +23% and +21%; TNFαR2, +7% and +4%; adiponectin, -21% and -14%; men: CRP, +38% and +29%; IL-6, +14% and +24%; TNFαR2, +9% and +5%; adiponectin, -16% and -4%.)Conclusion: Despite design differences, the EDIP and DII both assess dietary inflammatory potential in men and women, with the EDIP showing a greater ability to predict concentrations of plasma inflammatory markers.
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Affiliation(s)
- Fred K Tabung
- Departments of Nutrition and .,Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Stephanie A Smith-Warner
- Departments of Nutrition and,Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Jorge E Chavarro
- Departments of Nutrition and,Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA;,Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA;,Department of Medicine, Harvard Medical School, Boston, MA; and
| | - Teresa T Fung
- Departments of Nutrition and,Department of Nutrition, Simmons College, Boston, MA
| | - Frank B Hu
- Departments of Nutrition and,Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA;,Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA;,Department of Medicine, Harvard Medical School, Boston, MA; and
| | - Walter C Willett
- Departments of Nutrition and,Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA;,Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA;,Department of Medicine, Harvard Medical School, Boston, MA; and
| | - Edward L Giovannucci
- Departments of Nutrition and,Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA;,Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA;,Department of Medicine, Harvard Medical School, Boston, MA; and
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19
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Jang HD, Hong JY, Han K, Lee JC, Shin BJ, Choi SW, Suh SW, Yang JH, Park SY, Bang C. Relationship between bone mineral density and alcohol intake: A nationwide health survey analysis of postmenopausal women. PLoS One 2017; 12:e0180132. [PMID: 28662191 PMCID: PMC5491129 DOI: 10.1371/journal.pone.0180132] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 06/10/2017] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES Among a variety of relevant factors of osteoporosis, the association between alcohol intake and postmenopausal women's bone mineral density (BMD) by using data from the Korean National Health and Nutrition Examination Survey was evaluated in this study. MATERIALS AND METHODS Among a total of 31,596 subjects, males, premenopausal women, participants without BMD data were excluded. Finally, a total number of subjects in the study was 3,312. The frequency and amount of alcohol intake were determined by self-reported questionnaires, and BMD was measured by dual-energy x-ray absorptiometry. RESULTS Mean femoral BMD for light drinkers was statistically significantly greater than that for heavy drinkers and non-drinkers. We observed the characteristic trends for BMD by drinking frequency; the mean BMD gradually increased from non-drinkers to the participants who drank 2-3 times per week; these participants exhibited the highest BMD. Participants who drank alcohol greater than 4 times per week showed a lower BMD. In the risk factor analysis, the adjusted odds ratio for osteoporosis (at femoral neck) was 1.68 in non-drinkers and 1.70 in heavy drinkers compared with light drinkers. CONCLUSIONS Light alcohol intake (2-3 times per week and 1-2 or 5-6 glasses per occasion) in South Korean postmenopausal women was related to high femoral BMD. Non-drinkers and heavy drinkers had approximately a 1.7-times greater risk for osteoporosis than light drinkers.
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Affiliation(s)
- Hae-Dong Jang
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital, Seoul, South Korea
| | - Jae-Young Hong
- Department of Orthopedics, Korea University Hospital, Ansan, South Korea
- * E-mail:
| | - Kyungdo Han
- Department of Biostatistics, College of Medicine, Catholic University, Seoul, South Korea
| | - Jae Chul Lee
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital, Seoul, South Korea
| | - Byung-Joon Shin
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital, Seoul, South Korea
| | - Sung-Woo Choi
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital, Seoul, South Korea
| | - Seung-Woo Suh
- Scoliosis Research Institute, Department of Orthopedics, Korea University Medical College, Guro Hospital, Seoul, South Korea
| | - Jae-Hyuk Yang
- Scoliosis Research Institute, Department of Orthopedics, Korea University Medical College, Guro Hospital, Seoul, South Korea
| | - Si-Young Park
- Department of Orthopaedic Surgery, Korea University, College of Medicine, Anam Hospital, Seoul, South Korea
| | - Chungwon Bang
- Department of Orthopaedic Surgery, Cheonan Hospital, Soonchunhyang University, Chungcheongnam-do, South Korea
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