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Driva S, Korkontzelou A, Tonstad S, Tentolouris N, Litsiou E, Vasileiou V, Vassiliou AG, Saltagianni V, Katsaounou P. Metabolic Changes Following Smoking Cessation in Patients with Type 2 Diabetes Mellitus. Biomedicines 2024; 12:1882. [PMID: 39200346 PMCID: PMC11352061 DOI: 10.3390/biomedicines12081882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2024] [Revised: 08/08/2024] [Accepted: 08/14/2024] [Indexed: 09/02/2024] Open
Abstract
BACKGROUND Smoking cessation is crucial for reducing complications of type 2 diabetes mellitus (T2DM), but associated weight gain can worsen glycemic control, discouraging quitting attempts. Varenicline, a partial agonist of α4β2 nicotinic receptors, aids smoking cessation. This study examines the effects of varenicline on body weight and metabolic parameters in patients with T2DM and prediabetes. METHODS Fifty-three patients were enrolled, of which 32 successfully quit smoking after a three-month course of varenicline and were examined after an additional month with no medication. Measurements taken at baseline, 2.5 months, and 4 months included body weight, blood pressure, resting metabolic rate (RMR), glycated hemoglobin (HbA1c), fasting glucose, blood lipids, C-reactive protein (CRP), appetite-related hormones, and physical activity. RESULTS Post-treatment, there were no significant changes in body weight, blood pressure, RMR, or glycemic control. Total (CHOL) and low-density lipoprotein (LDL-C) cholesterol decreased significantly at 4 months of the study (from 168 to 156 mg/dL, p = 0.013, and from 96 to 83 mg/dL, p = 0.013, respectively). Leptin levels increased (from 11 to 13.8 ng/dL, p = 0.004), as did glucagon-like peptide-1 (GLP-1) levels (from 39.6 to 45.8 pM, p = 0.016) at 4 months of follow-up. The percentage of participants who reported moderate-intensity activity increased from 28% to 56%, while those reporting high-intensity activity increased from 19% to 22%, respectively (p = 0.039). CONCLUSIONS Our study showed that smoking cessation with varenicline in smokers with T2DM and prediabetes led to significant improvements in lipid profile, significant increase in plasma leptin and GLP-1 levels, and increased physical activity, without significant weight gain. Thus, smoking cessation without weight gain or deteriorated glycemic control is feasible for these smokers, with added benefits to lipid profiles, GLP-1 regulation, and physical activity.
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Affiliation(s)
- Stamatina Driva
- Smoking Cessation Outpatient Clinic, Respiratory Department, First Intensive Care Unit, Evangelismos General Hospital, 10676 Athens, Greece (E.L.)
- Diabetes Centre, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece
- Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Aliki Korkontzelou
- Smoking Cessation Outpatient Clinic, Respiratory Department, First Intensive Care Unit, Evangelismos General Hospital, 10676 Athens, Greece (E.L.)
- Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Serena Tonstad
- Department of Preventive Cardiology, Oslo University Hospital, 0424 Oslo, Norway
| | - Nikolaos Tentolouris
- Diabetes Centre, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece
| | - Eleni Litsiou
- Smoking Cessation Outpatient Clinic, Respiratory Department, First Intensive Care Unit, Evangelismos General Hospital, 10676 Athens, Greece (E.L.)
| | - Vasiliki Vasileiou
- Endocrinology Department, Diabetes Center, Alexandra Hospital, 11528 Athens, Greece
| | - Alice G. Vassiliou
- Smoking Cessation Outpatient Clinic, Respiratory Department, First Intensive Care Unit, Evangelismos General Hospital, 10676 Athens, Greece (E.L.)
| | - Vassiliki Saltagianni
- Smoking Cessation Outpatient Clinic, Respiratory Department, First Intensive Care Unit, Evangelismos General Hospital, 10676 Athens, Greece (E.L.)
| | - Paraskevi Katsaounou
- Smoking Cessation Outpatient Clinic, Respiratory Department, First Intensive Care Unit, Evangelismos General Hospital, 10676 Athens, Greece (E.L.)
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Sukhram SD, Zarini GG, Shaban LH, Vaccaro JA, Sukhram AR, Huffman FG. Serum cotinine as a predictor of lipid-related indices in Turkish immigrants with type 2 diabetes: A clinic-based cross-sectional study. Front Med (Lausanne) 2023; 10:1011045. [PMID: 36873883 PMCID: PMC9978330 DOI: 10.3389/fmed.2023.1011045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 01/13/2023] [Indexed: 02/18/2023] Open
Abstract
Background Turkish immigrants form the largest ethnic minority group in the Netherlands and show a higher prevalence of (i) cardiovascular disease (CVD), (ii) cigarette smoking, and (iii) type 2 diabetes (T2D) as compared to the native Dutch. This study examines the association of CVD risk factors: serum cotinine, as an indicator of cigarette smoke, and lipid-related indices among first-generation (foreign-born) Turkish immigrants with T2D living in deprived neighbourhoods in the Netherlands. Methods A total of 110 participants, physician-diagnosed with T2D, aged 30 years and older, were recruited by convenience sampling from the Schilderswijk neighbourhood of The Hague in a clinic-based cross-sectional design. Serum cotinine (independent variable) was measured with a solid-phase competitive chemiluminescent immunoassay. Serum lipids/lipoproteins (dependent variables) were determined by enzymatic assays and included: total cholesterol (CHOL), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), and triglycerides (TG). The Castelli Risk Index-I (CRI-I), and Atherogenic Coefficient (AC) were calculated using standardised formulas and assessed as dependent variables in multiple linear regression (MLR) models. Log-transformation of HDL-c, TG, CRI-I, and AC values were performed to account for the extreme right skewness of the data. Statistical analyses included descriptive characteristics and MLR models were adjusted for all major confounders of cotinine and lipids. Results The sample size had a mean age of 52.5 years [standard deviation (SD) = 9.21]. The geometric mean of serum cotinine level was 236.63 ng/mL [confidence interval (CI) = 175.89 ± 318.36]. The MLR models indicated that high serum cotinine levels (≥10 ng/mL) was positively associated with HDL-c (P = 0.04), CRI-I (P = 0.03), and AC (P = 0.03) in the age, gender, WC, diabetes medications, and statins-adjusted models (n = 32). Conclusion This study indicated that lipid ratios of HDL-c, CRI-I and AC are dependent determinants of serum cotinine and higher serum cotinine levels (≥10 ng/mL) are associated with worse HDL-c, CRI-I and AC values in participants with T2D. Clinical comprehension of these biochemical indicators (lipids/lipoproteins) and symptomatic results (CVD risk) in individuals with T2D will aid in the intervention (smoking) approach for this vulnerable cohort (Turkish immigrants). Therapy that is targetted to modify this behavioural risk factor may improve cardiovascular health outcomes and prevent comorbidities in Turkish immigrants with T2D living in deprived neighbourhoods in the Netherlands. In the meantime, this report contributes to a growing body of information and provides essential guidance to researchers and clinicians.
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Affiliation(s)
- Shiryn D Sukhram
- Department of Biology, College of Staten Island, City University of New York, New York City, NY, United States
| | - Gustavo G Zarini
- Clinical & Scientific Research, Oxford Biomedical Technologies, West Palm Beach, FL, United States
| | - Lemia H Shaban
- Department of Food Science and Nutrition, College of Life Sciences, Kuwait City, Kuwait
| | - Joan A Vaccaro
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, United States
| | | | - Fatma G Huffman
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, United States
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Molla GJ, Ismail-Beigi F, Larijani B, Khaloo P, Moosaie F, Alemi H, Mansournia MA, Ghadimi T, Ghaemi F, Nakhjavani M, Esteghamati A. Smoking and Diabetes Control in Adults With Type 1 and Type 2 Diabetes: A Nationwide Study From the 2018 National Program for Prevention and Control of Diabetes of Iran. Can J Diabetes 2020; 44:246-252. [DOI: 10.1016/j.jcjd.2019.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 06/29/2019] [Accepted: 07/08/2019] [Indexed: 02/06/2023]
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The association between periodontitis and dyslipidemia according to smoking and harmful alcohol use in a representative sample of Korean adults. Clin Oral Investig 2019; 24:937-944. [DOI: 10.1007/s00784-019-02989-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 06/27/2019] [Indexed: 01/17/2023]
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Sun C, Sun L, Xi S, Zhang H, Wang H, Feng Y, Deng Y, Wang H, Xiao X, Wang G, Gao Y, Wang G. Mobile Phone-Based Telemedicine Practice in Older Chinese Patients with Type 2 Diabetes Mellitus: Randomized Controlled Trial. JMIR Mhealth Uhealth 2019; 7:e10664. [PMID: 30609983 PMCID: PMC6682265 DOI: 10.2196/10664] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 09/19/2018] [Accepted: 10/07/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Previous studies on telemedicine interventions have shown that older diabetic patients experience difficulty in using computers, which is a barrier to remote communication between medical teams and older diabetic patients. However, older people in China tend to find it easy to use mobile phones and personal messaging apps that have a user-friendly interface. Therefore, we designed a mobile health (mHealth) system for older people with diabetes that is based on mobile phones, has a streamlined operation interface, and incorporates maximum automation. OBJECTIVE The goal of the research was to investigate the use of mobile phone-based telemedicine apps for management of older Chinese patients with type 2 diabetes mellitus (T2DM). Variables of interest included efficacy and safety. METHODS A total of 91 older (aged over 65 years) patients with T2DM who presented to our department were randomly assigned to one of two groups. Patients in the intervention group (n=44) were provided glucometers capable of data transmission and received advice pertaining to medication, diet, and exercise via the mHealth telemedicine system. Patients assigned to the control group (n=47) received routine outpatient care with no additional intervention. Patients in both groups were followed up at regular 3-month intervals. RESULTS After 3 months, patients in the intervention group showed significant (P<.05) improvement in postprandial plasma glucose level. After 6 months, patients in the intervention group exhibited a decreasing trend in postprandial plasma glucose and glycated hemoglobin levels compared with the baseline and those in the control group (P<.05). CONCLUSIONS Mobile phone-based telemedicine apps help improve glycemic control in older Chinese patients with T2DM. TRIAL REGISTRATION China Clinical Trial Registration Center ChiCTR 1800015214; http://www.chictr.org.cn/showprojen.aspx?proj=25949 (Archived by WebCite at http://www.webcitation.org/73wKj1GMq).
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Affiliation(s)
- Chenglin Sun
- Department of Endocrinology, First Hospital of Jilin University, Changchun, China
| | - Lin Sun
- Department of Endocrinology, First Hospital of Jilin University, Changchun, China
| | - Shugang Xi
- Department of Endocrinology, First Hospital of Jilin University, Changchun, China
| | - Hong Zhang
- Department of Endocrinology, First Hospital of Jilin University, Changchun, China
| | - Huan Wang
- Department of Endocrinology, First Hospital of Jilin University, Changchun, China
| | - Yakun Feng
- Health Management Center, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yufeng Deng
- Department of Endocrinology, First Hospital of Jilin University, Changchun, China
| | - Haimin Wang
- Department of Endocrinology, First Hospital of Jilin University, Changchun, China
| | - Xianchao Xiao
- Department of Endocrinology, First Hospital of Jilin University, Changchun, China
| | - Gang Wang
- Department of Endocrinology, First Hospital of Jilin University, Changchun, China
| | - Yuan Gao
- Department of Endocrinology, First Hospital of Jilin University, Changchun, China
| | - Guixia Wang
- Department of Endocrinology, First Hospital of Jilin University, Changchun, China
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Yang J, Ye J, Guo Q, Sun Y, Zheng Y, Zhang Y. The Joint Effects of Smoking and Alcohol Drinking on Lipid-Related Indices among Chinese Males-Comparing Exercise and Non-Exercise Groups. Subst Use Misuse 2018; 53:2431-2438. [PMID: 29889587 DOI: 10.1080/10826084.2018.1482347] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Smoking and drinking are two predisposing factors for dyslipidemia. Exercise has been proposed as a strategy to improve the blood lipids. However, it remains unclear how smoking and drinking jointly affect blood lipids and whether exercise influences their effects. OBJECTIVES To evaluate the effects of smoking and drinking, either alone or in combination, on lipid-related indices in both exercise and non-exercise groups among Chinese men. METHODS This study was conducted in a health examination center between 2015 and 2016. A sample of 6,179 male subjects was divided into exercise and non-exercise groups. Logistic and linear regression analyses were used to calculate the odds ratios for abnormal lipid-related indices and correlation coefficients between smoking/drinking and lipid-related indices. RESULTS In the study population, the percentage of stable smokers and stable drinkers was 46.3% (2,860/6,179) and 77.6% (4,795/6,179), respectively. An increased smoking amount was significantly associated with an elevated triglyceride (TG) level and a decreased high-density lipoprotein cholesterol (HDL-C) level. Heavier smokers had higher odds ratios for high TG and low HDL-C. Heavier drinkers had higher levels of total cholesterol (TC), TG, and HDL-C and higher odds ratios for high TC and high TG but lower odds ratio for low HDL-C. The exercise group had lower TG levels and higher HDL-C levels than did the non-exercise group. CONCLUSIONS Both heavier smoking and heavier drinking were associated with poorer TG levels, and the results suggest that drinking may be helpful for HDL-C. Exercise may relieve the negative effects of smoking and drinking.
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Affiliation(s)
- Jian Yang
- a Research Center for Information Technology of Sports and Health, Institute of Intelligent Machines , Chinese Academy of Sciences , Hefei , Anhui , P. R. China.,b Department of Automation , University of Science and Technology of China , Hefei , Anhui , P. R. China
| | - Jun Ye
- a Research Center for Information Technology of Sports and Health, Institute of Intelligent Machines , Chinese Academy of Sciences , Hefei , Anhui , P. R. China
| | - Qiao Guo
- b Department of Automation , University of Science and Technology of China , Hefei , Anhui , P. R. China
| | - Yining Sun
- a Research Center for Information Technology of Sports and Health, Institute of Intelligent Machines , Chinese Academy of Sciences , Hefei , Anhui , P. R. China
| | - Yansong Zheng
- c Institute of Health Management , PLA General Hospital , Beijing , P. R.China
| | - Yongliang Zhang
- a Research Center for Information Technology of Sports and Health, Institute of Intelligent Machines , Chinese Academy of Sciences , Hefei , Anhui , P. R. China.,d Jiangsu Research Institute of Sports Science , Nanjing , Jiangsu , P. R.China.,e Beijing Sport University , Beijing , P. R.China
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Agongo G, Nonterah EA, Debpuur C, Amenga-Etego L, Ali S, Oduro A, Crowther NJ, Ramsay M. The burden of dyslipidaemia and factors associated with lipid levels among adults in rural northern Ghana: An AWI-Gen sub-study. PLoS One 2018; 13:e0206326. [PMID: 30485283 PMCID: PMC6261546 DOI: 10.1371/journal.pone.0206326] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 10/10/2018] [Indexed: 12/15/2022] Open
Abstract
Dyslipidaemia is a primary risk factor for cardiometabolic disease, causing over 17 million deaths globally in 2015. However, the burden of dyslipidaemia and factors associated with lipid levels remain unknown in many rural African populations. Therefore, this study evaluated the association of socio-demographic, anthropometric and behavioural factors with lipid levels in rural Ghana. The prevalence of hypercholesterolaemia, hypertriglyceridaemia and elevated LDL-C in the total population of 1839 (846 men and 993 women) was 4.02%, 2.12%, and 5.55% respectively and did not differ between genders. The prevalence of low HDL-C levels was 60.30% and differed (p = 0.005) between men (56.86%) and women (63.24%). Subcutaneous abdominal fat was associated with TC (β = 0.067, p = 0.015) and TG (β = 0.137, p<0.001) among women and LDL-C (β = 0.139, p = 0.006) and TC (β = 0.071, p = 0.048) among men. Body mass index was associated with TC (β = 0.010, p = 0.043) among men while waist circumference was associated with LDL-C (β = 0.116, p<0.001) and TG (β = 0.094, p<0.001) among women. Hip circumference was negatively associated (β = -0.053, p = 0.043) while visceral fat was positively associated with TG (β = 0.033, p = 0.022) among women. Socioeconomic status, education, being unmarried and employment were associated with HDL-C (β = 0.081, p = 0.004), LDL-C (β = 0.095, p = 0.004) and TG (β = 0.095, p = 0.001) all among women, and TC (β = 0.070, p = 0.010) among men, respectively. Nankana women had lower TC (β = -0.069, p = 0.001), and men lower TG levels (β = -0.084, p = 0.008) than the other ethnic groups. Tobacco smoking (β = 0.066, p = 0.024) and alcohol intake (β = 0.084, p = 0.001) were associated with HDL-C levels among men and women respectively. Further studies are required to investigate whether high prevalence of low HDL-C levels in this population presents with any adverse cardiovascular disease outcomes. Associations of education, employment and adiposity with lipid levels suggest that future societal advances and increases in the prevalence of obesity may lead to associated adverse health consequences. Monitoring and interventions are required to limit these effects.
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Affiliation(s)
- Godfred Agongo
- Navrongo Health Research Centre, Navrongo, Ghana
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Engelbert Adamwaba Nonterah
- Navrongo Health Research Centre, Navrongo, Ghana
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | | | | | - Stuart Ali
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Nigel J. Crowther
- Department of Chemical Pathology, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | - Michèle Ramsay
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Awadalla H, Almobarak AO, Ahmed MH. Prevalence of smoking in Sudanese individuals with diabetes and associated complications: Population-based study. Diabetes Metab Syndr 2018; 12:749-751. [PMID: 29724570 DOI: 10.1016/j.dsx.2018.04.038] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 04/23/2018] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Smoking cigarettes and diabetes are major public health problems in Sudan. Smoking is associated with insulin resistance and can be associated with type 2 diabetes. The aim of this study was to investigate the prevalence of smoking in individuals with diabetes and associated complications. METHODOLOGY a descriptive analytical cross-sectional study, included 315 of participants with diabetes. The data collection was performed to gather demographic information, prevalence of smoking and presence of complications. In addition to measurement of blood pressure, weight and height measurement for calculation of body mass index and biochemical tests. Statistical association at p.value of 0.05 was measured using T-test for quantitative data and Chi square test for categorical data. RESULTS The overall prevalence of smoking was found to be 33.9%. Smoking was statistically significant associated with being male; increase in age; and being married. HbA1c and triglycerides are significantly associated with smoking (P value = 0.01 and 0.05 respectively); therefore, statistical significance was found with ischemic heart disease(IHD) as well (P value = 0.05). Hypertension, duration of diabetes, low density lipoprotein (LDL), cholesterol and body mass index (BMI) were not statistically significant with smoking. CONCLUSION Almost third of the population with diabetes are smokers (33.9%). Smoking is statistically associated with IHD, high triglyceride and HbA1c. Therefore, smoking cessation schemes should be advocated by health authorities and the public in Sudan.
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Affiliation(s)
- Heitham Awadalla
- Department of community Medicine, Faculty of Medicine, University of Khartoum, Sudan
| | - Ahmed O Almobarak
- Department of Pathology, Faculty of Medicine, University of Medical Sciences and Technology, Khartoum, Sudan
| | - Mohamed H Ahmed
- Department of Medicine and HIV Metabolic Clinic, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, Buckinghamshire, UK.
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Kim YM, Delen D. Critical assessment of health disparities across subpopulation groups through a social determinants of health perspective: The case of type 2 diabetes patients. Inform Health Soc Care 2017; 43:172-185. [PMID: 29035610 DOI: 10.1080/17538157.2017.1364244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Studies on diabetes have shown that population subgroups have varying rates of medical events and related procedures; however, existing studies have investigated either medical events or procedures, and hence, it is unknown whether disparities exist between medical events and procedures. PURPOSE The objective of this study is to investigate how diabetes-related medical events and procedures are different across population subgroups through a social determinants of health (SDH) perspective. METHODS Because the purpose of this manuscript is to explore whether statistically significant health disparities exist across population subgroups regarding diabetes patients' medical events and procedures, group difference test methods were employed. Diabetes patients' data were drawn from the Cerner Health Facts® data warehouse. RESULTS The study revealed systematic disparities across population subgroups regarding medical events and procedures. The most significant disparities were connected with smoking status, alcohol use, type of insurance, age, marital status, and gender. CONCLUSIONS Some population subgroups have higher rates of medical events and yet receive lower rates of treatments, and such disparities are systematic. Socially constructed behaviors and structurally discriminating public policies in part contribute to such systematic health disparities across population subgroups.
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Affiliation(s)
- Yong-Mi Kim
- a School of Library and Information Studies , University of Oklahoma, Schusterman Center , Tulsa , OK , USA
| | - Dursun Delen
- b Center for Health Systems Innovation (CHSI), Spears School of Business , Oklahoma State University , Tulsa , OK , USA
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Kar D, Gillies C, Zaccardi F, Webb D, Seidu S, Tesfaye S, Davies M, Khunti K. Relationship of cardiometabolic parameters in non-smokers, current smokers, and quitters in diabetes: a systematic review and meta-analysis. Cardiovasc Diabetol 2016; 15:158. [PMID: 27881170 PMCID: PMC5121966 DOI: 10.1186/s12933-016-0475-5] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 11/10/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Smoking is associated with increased macrovascular and microvascular complications in people with diabetes. In addition to other concomitant vascular perturbations, it also seems to influence the cardiometabolic parameters, which may partly explain the accelerated rate of vascular complications in smokers with diabetes. While smoking cessation is advocated as a universal component of the management of diabetes, there is some anecdotal evidence that HbA1c could increase following smoking cessation. The aim of this review is to explore the relationship between smoking and its cessation on cardiometabolic parameters in diabetes. METHODS Searches were conducted on Medline, EMBASE and CINAHL up to March 2016. After screening 6866 studies (Additional file 1), 14 observational studies with a total of 98,978 participants' with either type 1 or type 2 diabetes were selected for review. Narrative synthesis and meta-analyses were carried out to explore the relationship between smoking and its cessation. RESULTS Meta-analysis showed that the pooled mean difference of HbA1c between non-smokers and smokers was -0.61% (95% CI -0.88 to -0.33, p < 0.0001). The difference in LDL cholesterol between non-smokers and smokers was -0.11 mmol/l (95% CI -0.21 to -0.01, p = 0.04). The difference in HDL cholesterol between non-smokers and smokers was 0.12 mmol/l (95% CI 0.08-0.15, p < 0.001). However, there was no statistically significant difference in blood pressure between the two groups. The difference in HbA1c between quitters and continued smokers was not statistically significant -0.10% (95% CI -0.42 to 0.21, p = 0.53). However, a narrative synthesis revealed that over a period of 10 years, the HbA1c was comparable between non-smokers and quitters. CONCLUSION Non-smokers have a statistically significant lower HbA1c and more favourable lipid profile compared to smokers. Smoking cessation does not lead to an increase in HbA1c in long-term and may reduce vascular complications in diabetes by its favourable impact on lipid profile.
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Affiliation(s)
- Debasish Kar
- Diabetes Research Centre, University of Leicester, Leicester General Infirmary, Gwendolen Road, Leicester, LE5 4AW, UK. .,Derbyshire Community Health Services NHS Foundation Trust, Castle Street Medical Centre, Castle Street, Bolsover, Chesterfield, Derbyshire, UK.
| | - Clare Gillies
- Diabetes Research Centre, University of Leicester, Leicester General Infirmary, Gwendolen Road, Leicester, LE5 4AW, UK
| | - Francesco Zaccardi
- Diabetes Research Centre, University of Leicester, Leicester General Infirmary, Gwendolen Road, Leicester, LE5 4AW, UK
| | - David Webb
- Diabetes Research Centre, University of Leicester, Leicester General Infirmary, Gwendolen Road, Leicester, LE5 4AW, UK
| | - Samuel Seidu
- Diabetes Research Centre, University of Leicester, Leicester General Infirmary, Gwendolen Road, Leicester, LE5 4AW, UK
| | - Solomon Tesfaye
- Academic Unit of Diabetes and Endocrinology, University of Sheffield, Sheffield, UK
| | - Melanie Davies
- Diabetes Research Centre, University of Leicester, Leicester General Infirmary, Gwendolen Road, Leicester, LE5 4AW, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester General Infirmary, Gwendolen Road, Leicester, LE5 4AW, UK
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Wakabayashi I. Associations of blood lipid-related indices with blood pressure and pulse pressure in middle-aged men. Metab Syndr Relat Disord 2014; 13:22-8. [PMID: 25321638 DOI: 10.1089/met.2014.0093] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Low-density lipoprotein cholesterol to high-density lipoprotein cholesterol (LDL-C/HDL-C) ratio is known as a classical atherogenic index. In addition, triglycerides to HDL-C (TGs/HDL-C) ratio and lipid accumulation product (LAP) have been proposed to be good discriminators for cardiometabolic risk. The aim of this study was to determine which lipid index is most strongly associated with blood pressure and pulse pressure. METHODS The subjects were 36,536 Japanese men aged 35-60 years who were not receiving drug therapy for dyslipidemia. Relationships of each lipid index with blood pressure and pulse pressure were investigated by using linear and logistic regression analyses. RESULTS There were significant positive correlations of systolic and diastolic blood pressure and pulse pressure with the lipid-related indices such as LDL-C/HDL-C ratio, TGs/HDL-C ratio, and LAP. The correlations with LAP were significantly stronger than those with the LDL-C/HDL-C ratio and the TGs/HDL-C ratio. Odds ratios (ORs) for hypertension and high pulse pressure in subjects with versus subjects without high levels of each lipid-related index were significantly higher than the reference level of 1.00. The ORs of subjects with versus subjects without high LAP tended to be higher than the ORs of subjects with versus subjects without high LDL-C/HDL-C ratio or high TGs/HDL-C ratio. In the linear and logistic regression analyses, the associations of the lipid-related indices with pulse pressure were weaker than the corresponding associations with blood pressure. CONCLUSION LAP shows stronger associations with blood pressure and pulse pressure than the other lipid-related indices and is suggested to be better for discriminating the risk of hypertension.
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Affiliation(s)
- Ichiro Wakabayashi
- Department of Environmental and Preventive Medicine, Hyogo College of Medicine , Nishinomiya, Hyogo, Japan
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12
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The metabolic syndrome and related characteristics in major depression: inpatients and outpatients compared: metabolic differences across treatment settings. Gen Hosp Psychiatry 2014; 36:509-15. [PMID: 25001528 DOI: 10.1016/j.genhosppsych.2014.05.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Revised: 05/05/2014] [Accepted: 05/23/2014] [Indexed: 01/19/2023]
Abstract
OBJECTIVE We aimed to systematically compare patients with major depressive disorder from three different treatment settings (a primary care outpatient, a secondary care outpatient and one inpatient sample), with regard to metabolic syndrome (MetSyn) prevalences, individual MetSyn components and related metabolic variables. METHOD The outpatient samples were drawn from the ongoing Netherlands Study of Depression and Anxiety (302 primary care and 445 secondary care outpatients). The inpatient sample (n=80) was recruited from five Dutch mental health hospitals. The assessments of MetSyn and related variables [waist circumference (WC), high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, triglycerides, glucose, systolic and diastolic blood pressure (SBP, DBP), body mass index (BMI), waist-hip ratio (WHR), LDL and total cholesterol (TC)] were compared using analysis of (co)variance and regression analysis, whereas medication analyses examined the extent to which clinical differences (e.g., depression severity or medication use) mediated the observed metabolic differences across setting. RESULTS MetSyn prevalences (26% primary, 24% secondary care and 28% inpatients) did not significantly differ (P=.71). WC, BMI, LDL cholesterol, glucose and DBP were not significantly different across settings. However, WHR, TC and triglyceride levels were higher in inpatients than in both outpatients groups, while HDL cholesterol levels and SBP were lower. There was some mediating role for tricyclic and non-selective serotonin-reuptake inhibitor antidepressant use, but overall, the mediating role of clinical differences was limited. CONCLUSIONS Although overall MetSyn prevalences did not differ, patterns of individual MetSyn-related variables differed more markedly across depressed inpatients and outpatients. Inpatients showed more adverse WHR and serum lipid profiles, while SBP levels were lower.
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