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Mavridis A, Abzhandadze T, Viktorisson A, Sunnerhagen KS. Physical activity modification following a Transient Ischemic Attack in individuals with diabetes. Cardiovasc Diabetol 2024; 23:288. [PMID: 39113088 PMCID: PMC11304772 DOI: 10.1186/s12933-024-02382-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Accepted: 07/30/2024] [Indexed: 08/11/2024] Open
Abstract
BACKGROUND Individuals with diabetes exhibit a higher risk of cardiovascular disease and mortality compared to healthy individuals. Following a transient ischemic attack (TIA) the risk of stroke and death increase further. Physical activity engagement after a TIA is an effective way of secondary prevention. However, there's a lack of research on how individuals with diabetes modify physical activity levels and how these adjustments impact survival post-TIA. This study aimed to determine the extent to which individuals with diabetes alter their physical activity levels following a TIA and to assess the impact of these changes on mortality. METHODS This was a nationwide longitudinal study, employing data from national registers in Sweden spanning from 01/01/2003 to 31/12/2019. Data were collected 2 years retro- and prospectively of TIA occurrence, in individuals with diabetes. Individuals were grouped based on decreasing, remaining, or increasing physical activity levels after the TIA. Cox proportional hazards models were fitted to evaluate the adjusted relationship between change in physical activity and all-cause, cardiovascular, and non-cardiovascular mortality. RESULTS The final study sample consisted of 4.219 individuals (mean age 72.9 years, 59.4% males). Among them, 35.8% decreased, 37.5% kept steady, and 26.8% increased their physical activity after the TIA. A subsequent stroke occurred in 6.7%, 6.4%, and 6.1% of individuals, while death occurred in 6.3%, 7.3%, and 3.7% of individuals, respectively. In adjusted analyses, participants who increased their physical activity had a 45% lower risk for all-cause mortality and a 68% lower risk for cardiovascular mortality, compared to those who decreased their physical activity. CONCLUSIONS Positive change in physical activity following a ΤΙΑ was associated with a reduced risk of mortality. Increased engagement in physical activity should be promoted after TIA, thereby actively supporting individuals with diabetes in achieving improved health outcomes.
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Affiliation(s)
- Anastasios Mavridis
- Institute of Neuroscience and Physiology, Rehabilitation Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Tamar Abzhandadze
- Institute of Neuroscience and Physiology, Rehabilitation Medicine, University of Gothenburg, Gothenburg, Sweden.
- Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden.
- Department of Rehabilitation Medicine, Neurocare, Sahlgrenska University Hospital, Vita stråket 12, fl. 4, 18 Sahlgrenska, 41345 Gothenburg, Gothenburg, Sweden.
| | - Adam Viktorisson
- Institute of Neuroscience and Physiology, Rehabilitation Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Rehabilitation Medicine, Neurocare, Sahlgrenska University Hospital, Vita stråket 12, fl. 4, 18 Sahlgrenska, 41345 Gothenburg, Gothenburg, Sweden
| | - Katharina S Sunnerhagen
- Institute of Neuroscience and Physiology, Rehabilitation Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Rehabilitation Medicine, Neurocare, Sahlgrenska University Hospital, Vita stråket 12, fl. 4, 18 Sahlgrenska, 41345 Gothenburg, Gothenburg, Sweden
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Ahmad A, Lim LL, Morieri ML, Tam CHT, Cheng F, Chikowore T, Dudenhöffer-Pfeifer M, Fitipaldi H, Huang C, Kanbour S, Sarkar S, Koivula RW, Motala AA, Tye SC, Yu G, Zhang Y, Provenzano M, Sherifali D, de Souza RJ, Tobias DK, Gomez MF, Ma RCW, Mathioudakis N. Precision prognostics for cardiovascular disease in Type 2 diabetes: a systematic review and meta-analysis. COMMUNICATIONS MEDICINE 2024; 4:11. [PMID: 38253823 PMCID: PMC10803333 DOI: 10.1038/s43856-023-00429-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 12/14/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Precision medicine has the potential to improve cardiovascular disease (CVD) risk prediction in individuals with Type 2 diabetes (T2D). METHODS We conducted a systematic review and meta-analysis of longitudinal studies to identify potentially novel prognostic factors that may improve CVD risk prediction in T2D. Out of 9380 studies identified, 416 studies met inclusion criteria. Outcomes were reported for 321 biomarker studies, 48 genetic marker studies, and 47 risk score/model studies. RESULTS Out of all evaluated biomarkers, only 13 showed improvement in prediction performance. Results of pooled meta-analyses, non-pooled analyses, and assessments of improvement in prediction performance and risk of bias, yielded the highest predictive utility for N-terminal pro b-type natriuretic peptide (NT-proBNP) (high-evidence), troponin-T (TnT) (moderate-evidence), triglyceride-glucose (TyG) index (moderate-evidence), Genetic Risk Score for Coronary Heart Disease (GRS-CHD) (moderate-evidence); moderate predictive utility for coronary computed tomography angiography (low-evidence), single-photon emission computed tomography (low-evidence), pulse wave velocity (moderate-evidence); and low predictive utility for C-reactive protein (moderate-evidence), coronary artery calcium score (low-evidence), galectin-3 (low-evidence), troponin-I (low-evidence), carotid plaque (low-evidence), and growth differentiation factor-15 (low-evidence). Risk scores showed modest discrimination, with lower performance in populations different from the original development cohort. CONCLUSIONS Despite high interest in this topic, very few studies conducted rigorous analyses to demonstrate incremental predictive utility beyond established CVD risk factors for T2D. The most promising markers identified were NT-proBNP, TnT, TyG and GRS-CHD, with the highest strength of evidence for NT-proBNP. Further research is needed to determine their clinical utility in risk stratification and management of CVD in T2D.
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Affiliation(s)
- Abrar Ahmad
- Department of Clinical Sciences, Lund University Diabetes Centre, Lund University, Malmö, Sweden
| | - Lee-Ling Lim
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
- Asia Diabetes Foundation, Hong Kong SAR, China
| | - Mario Luca Morieri
- Metabolic Disease Unit, University Hospital of Padova, Padova, Italy
- Department of Medicine, University of Padova, Padova, Italy
| | - Claudia Ha-Ting Tam
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
- Laboratory for Molecular Epidemiology in Diabetes, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Feifei Cheng
- Health Management Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China
| | - Tinashe Chikowore
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Hugo Fitipaldi
- Department of Clinical Sciences, Lund University Diabetes Centre, Lund University, Malmö, Sweden
| | - Chuiguo Huang
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
- Laboratory for Molecular Epidemiology in Diabetes, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong SAR, China
| | | | - Sudipa Sarkar
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Robert Wilhelm Koivula
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, United Kingdom
| | - Ayesha A Motala
- Department of Diabetes and Endocrinology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Sok Cin Tye
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, Groningen, the Netherlands
- Sections on Genetics and Epidemiology, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Gechang Yu
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
- Laboratory for Molecular Epidemiology in Diabetes, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yingchai Zhang
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
- Laboratory for Molecular Epidemiology in Diabetes, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Michele Provenzano
- Nephrology, Dialysis and Renal Transplant Unit, IRCCS-Azienda Ospedaliero-Universitaria di Bologna, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Diana Sherifali
- Heather M. Arthur Population Health Research Institute, McMaster University, Ontario, Canada
| | - Russell J de Souza
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Population Health Research Institute, Hamilton Health Sciences Corporation, Hamilton, Ontario, Canada
| | | | - Maria F Gomez
- Department of Clinical Sciences, Lund University Diabetes Centre, Lund University, Malmö, Sweden.
- Faculty of Health, Aarhus University, Aarhus, Denmark.
| | - Ronald C W Ma
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China.
- Laboratory for Molecular Epidemiology in Diabetes, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China.
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Nestoras Mathioudakis
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
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Ahmad A, Lim LL, Morieri ML, Tam CHT, Cheng F, Chikowore T, Dudenhöffer-Pfeifer M, Fitipaldi H, Huang C, Kanbour S, Sarkar S, Koivula RW, Motala AA, Tye SC, Yu G, Zhang Y, Provenzano M, Sherifali D, de Souza R, Tobias DK, Gomez MF, Ma RCW, Mathioudakis NN. Precision Prognostics for Cardiovascular Disease in Type 2 Diabetes: A Systematic Review and Meta-analysis. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.26.23289177. [PMID: 37162891 PMCID: PMC10168509 DOI: 10.1101/2023.04.26.23289177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Background Precision medicine has the potential to improve cardiovascular disease (CVD) risk prediction in individuals with type 2 diabetes (T2D). Methods We conducted a systematic review and meta-analysis of longitudinal studies to identify potentially novel prognostic factors that may improve CVD risk prediction in T2D. Out of 9380 studies identified, 416 studies met inclusion criteria. Outcomes were reported for 321 biomarker studies, 48 genetic marker studies, and 47 risk score/model studies. Results Out of all evaluated biomarkers, only 13 showed improvement in prediction performance. Results of pooled meta-analyses, non-pooled analyses, and assessments of improvement in prediction performance and risk of bias, yielded the highest predictive utility for N-terminal pro b-type natriuretic peptide (NT-proBNP) (high-evidence), troponin-T (TnT) (moderate-evidence), triglyceride-glucose (TyG) index (moderate-evidence), Genetic Risk Score for Coronary Heart Disease (GRS-CHD) (moderate-evidence); moderate predictive utility for coronary computed tomography angiography (low-evidence), single-photon emission computed tomography (low-evidence), pulse wave velocity (moderate-evidence); and low predictive utility for C-reactive protein (moderate-evidence), coronary artery calcium score (low-evidence), galectin-3 (low-evidence), troponin-I (low-evidence), carotid plaque (low-evidence), and growth differentiation factor-15 (low-evidence). Risk scores showed modest discrimination, with lower performance in populations different from the original development cohort. Conclusions Despite high interest in this topic, very few studies conducted rigorous analyses to demonstrate incremental predictive utility beyond established CVD risk factors for T2D. The most promising markers identified were NT-proBNP, TnT, TyG and GRS-CHD, with the highest strength of evidence for NT-proBNP. Further research is needed to determine their clinical utility in risk stratification and management of CVD in T2D.
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A Comparison between Healthy Lifestyle Behaviors and Physical Activity Levels of Elderly İndividuals Residing in the City Center and Rural, and Analyzing Their Relationship with Depression. JOURNAL OF BASIC AND CLINICAL HEALTH SCIENCES 2022. [DOI: 10.30621/jbachs.1092493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
ABSTRACT
Purpose: Our study aimed to determine the differences in the levels of physical activity and healthy lifestyle behaviours in elderly individuals living in urban and rural and to examine their relationship with depression.
Methods: Individuals who are over 65 and residing in the city and rural were included in the study. The Healthy Lifestyle Behaviour’s Scale-II, the Physical Activity Scale for the Elderly, and the Geriatric Depression Scale-15 were used on the participants
Results: Healthy Lifestyle Behaviour’s Scale-II scores was no significant difference between the two groups (p=0.430). Physical Activity Scale for the Elderly score in rural (p= 0.001); Geriatric Depression Scale-15 score was statistically higher in the city (p= 0.01). While the relationship between the Healthy Lifestyle Behaviour’s Scale-II and Geriatric Depression Scale-15 scores was significant in both groups (p= 0.001 and p= 0.03), the relationship between the Elderly Physical Activity Scale-II and Geriatric Depression Scale-15 scores was significant only in the rural (p= 0.001).
Conclusion: The elderly individuals in rural are more physically active than in city, the elderly living in city have higher depression levels. The factors affecting depression in the elderly living in cities need to be examined in detail.
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Rietz M, Lehr A, Mino E, Lang A, Szczerba E, Schiemann T, Herder C, Saatmann N, Geidl W, Barbaresko J, Neuenschwander M, Schlesinger S. Physical Activity and Risk of Major Diabetes-Related Complications in Individuals With Diabetes: A Systematic Review and Meta-Analysis of Observational Studies. Diabetes Care 2022; 45:3101-3111. [PMID: 36455117 PMCID: PMC9862380 DOI: 10.2337/dc22-0886] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 09/19/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND Physical activity is a cornerstone in diabetes management; however, evidence synthesis on the association between physical activity and long-term diabetes-related complications is scarce. PURPOSE To summarize and evaluate findings on physical activity and diabetes-related complications, we conducted a systematic review and meta-analysis. DATA SOURCES We searched PubMed, Web of Science, and the Cochrane Library for articles published up to 6 July 2021. STUDY SELECTION We included prospective studies investigating the association between physical activity and incidence of and mortality from diabetes-related complications, i.e., cardiovascular disease (CVD), coronary heart disease, cerebrovascular events, heart failure, major adverse cardiovascular events, and microvascular complications such as retinopathy and nephropathy, in individuals with diabetes. DATA EXTRACTION Study characteristics and risk ratios with 95% CIs were extracted. Random-effects meta-analyses were performed, and the certainty of evidence and risk of bias were evaluated with use of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) and Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I) tools. DATA SYNTHESIS Overall, 31 studies were included. There was moderate certainty of evidence that high versus low levels of physical activity were inversely associated with CVD incidence, CVD mortality (summary risk ratio 0.84 [95% CI 0.77, 0.92], n = 7, and 0.62 [0.55, 0.69], n = 11), and microvascular complications (0.76 [0.67, 0.86], n = 8). Dose-response meta-analyses showed that physical activity was associated with lower risk of diabetes-related complications even at lower levels. For other outcomes, similar associations were observed but certainty of evidence was low or very low. LIMITATIONS Limitations include residual confounding and misclassification of exposure. CONCLUSIONS Physical activity, even below recommended amounts, was associated with reduced incidence of diabetes-related complications.
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Affiliation(s)
- Marlene Rietz
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Research Unit for Exercise Epidemiology (ExE), Department of Sports Science and Clinical Biomechanics, Syddansk Universitet, Odense, Denmark
| | - Alexander Lehr
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Eriselda Mino
- Department of Sport Science and Sport, Division Exercise and Health, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Alexander Lang
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Edyta Szczerba
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, Düsseldorf, Germany
| | - Tim Schiemann
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Christian Herder
- German Center for Diabetes Research (DZD), Partner Düsseldorf, Düsseldorf, Germany
- Institute of Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Nina Saatmann
- German Center for Diabetes Research (DZD), Partner Düsseldorf, Düsseldorf, Germany
- Institute of Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Wolfgang Geidl
- Department of Sport Science and Sport, Division Exercise and Health, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Janett Barbaresko
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Manuela Neuenschwander
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, Düsseldorf, Germany
| | - Sabrina Schlesinger
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, Düsseldorf, Germany
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Horikawa C, Tsuda K, Oshida Y, Satoh J, Hayashino Y, Tajima N, Nishimura R, Sone H. Dietary intake and physical activity in Japanese patients with type 2 diabetes: the Japan Diabetes Complication and its Prevention prospective study (JDCP study 8). Diabetol Int 2022; 13:344-357. [PMID: 35463859 PMCID: PMC8980175 DOI: 10.1007/s13340-022-00575-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 02/23/2022] [Indexed: 10/18/2022]
Abstract
Medical nutrition therapy and exercise therapy are the cornerstones of treatment for patients with type 2 diabetes; however, there has not been a nationwide study on the actual dietary intake and physical activity status of patients since the 2000s. We aimed to clarify this in Japanese patients with type 2 diabetes using data from the Japan Diabetes Complication and its Prevention prospective (JDCP), a nationwide study launched in 2007. A total of 1992 patients with type 2 diabetes, aged 40-75 years, completed either the Brief-type, self-administered Diet History Questionnaire (1643 patients) or International Physical Activity Questionnaire (1834 patients), and their data were analyzed in this study. Mean daily energy intake for all participants was 1686.8 kcal/day, and the mean proportions of carbohydrate, protein, and fat comprising total energy intake were 60.2, 16.2, and 23.6%, respectively. The patients in this study had similar energy and nutrient intake status to patients in the 1996 Japan Diabetes Complications Study; however, Japanese patients still had higher carbohydrate and lower fat consumption than patients with diabetes in Western countries. The physical activity questionnaire reported that 31.0% of patients did not have exercise habits; this was particularly noticeable in female patients and patients under the age of 65. BMI increased from 22.7 to 24.1 kg/m2 in men and 23.2 to 24.8 kg/m2 in women from 1996 to 2007, respectively. Further research is required to investigate how dietary intake and physical activity associates with the risk of developing complications in type 2 diabetes patients.
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Affiliation(s)
- Chika Horikawa
- grid.471930.80000 0004 4648 6237Department of Health and Nutrition, University of Niigata Prefecture Faculty of Human Life Studies, 471 Ebigase, Higashi-ku, Niigata, 950-8680 Japan
| | - Kinsuke Tsuda
- grid.419931.70000 0001 2292 726XTezukayama Gakuin University Faculty of Human Sciences, 4-2-2, Harumidai, Minami-ku, Sakai-shi, Osaka 590-0013 Japan
| | - Yoshiharu Oshida
- Medical Checkup Center, Minami Seikyo Hospital, 2-204 Minamiohdaka, Midori-ku, Nagoya, 459-8540 Japan
| | - Jo Satoh
- grid.412755.00000 0001 2166 7427Tohoku Medical and Pharmaceutical University, Wakabayashi Hospital, 2-29-1, Yamatomachi, Wakabayashi-ku, Sendai, Miyagi 984-8560 Japan
| | - Yasuaki Hayashino
- grid.416952.d0000 0004 0378 4277Department of Endocrinology, Tenri Hospital, 200 Mishima-cho, Tenri, Nara 632-8552 Japan
| | - Naoko Tajima
- grid.411898.d0000 0001 0661 2073Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105-8461 Japan
| | - Rimei Nishimura
- grid.411898.d0000 0001 0661 2073Division of Diabetes, Department of Internal Medicine, Metabolism and Endocrinology, Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105-8461 Japan
| | - Hirohito Sone
- grid.260975.f0000 0001 0671 5144Department of Hematology, Endocrinology, and Metabolism, Niigata University Faculty of Medicine, 1-757 Asahimachi-dori, Chuoh-ku, Niigata, 951-8510 Japan
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Chen Y, Su J, Qin Y, Luo P, Shen C, Pan E, Lu Y, Miao D, Zhang N, Zhou J, Yu X, Wu M. Fresh fruit consumption, physical activity, and five-year risk of mortality among patients with type 2 diabetes: A prospective follow-up study. Nutr Metab Cardiovasc Dis 2022; 32:878-888. [PMID: 35078677 DOI: 10.1016/j.numecd.2021.10.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 10/19/2021] [Accepted: 10/27/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND AIMS We explored the associations among fruit consumption, physical activity, and their dose-response relationship with all-cause and cardiovascular disease (CVD) mortality in type 2 diabetic patients. METHODS AND RESULTS We prospectively followed 20,340 community-dwelling type 2 diabetic patients aged 21-94 years. Information on diets and physical activity was collected using standardized questionnaires. All-cause and CVD mortality were assessed. Hazard ratios (HRs) for all-cause mortality were estimated with Cox regression models, and HRs for CVD mortality were derived from a competing risk model. Restricted cubic spline regression was used to analyze dose-response relationships. We identified 1362 deaths during 79,844 person-years. Compared to non-consumption, fruit consumption >42.9 g/d was inversely associated with all-cause mortality (HR 0.76; 95% CI 0.64-0.88), CVD mortality (HR 0.69, 0.51-0.94) and stroke mortality (HR 0.57, 0.36-0.89), but not with heart disease mortality (HR 0.93, 0.56-1.52). The HRs comparing the top vs bottom physical activity quartiles were 0.44 (0.37-0.53) for all-cause mortality, 0.46 (0.33-0.64) for CVD mortality, 0.46 (0.29-0.74) for stroke mortality and 0.51 (0.29-0.88) for heart disease mortality. Lower fruit consumption combined with a lower physical activity level was associated with a greater mortality risk. A nonlinear threshold of 80 g fruit/day was identified; all-cause mortality risk was reduced by approximately 24% at this value. A physical activity threshold of eight metabolic equivalents (MET) h/day was also identified, after which the risk of mortality did not decrease. CONCLUSIONS Fruit consumption and physical activity may reduce all-cause, CVD, and stroke mortality in type 2 diabetic patients.
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Affiliation(s)
- Yijia Chen
- Department of Non-communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, 210003, China
| | - Jian Su
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Yu Qin
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Pengfei Luo
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Chong Shen
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Enchun Pan
- Department of Chronic Disease Prevention and Control, Huai'an City Center for Disease Control and Prevention, Huai'an, 223001, China
| | - Yan Lu
- Department of Chronic Disease Prevention and Control, Suzhou City Center for Disease Control and Prevention, Suzhou, 215003, China
| | - Dandan Miao
- Department of Chronic Disease Prevention and Control, Huai'an City Center for Disease Control and Prevention, Huai'an, 223001, China
| | - Ning Zhang
- Changshu County Center for Disease Control and Prevention, Suzhou, 215500, China
| | - Jinyi Zhou
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Xiaojin Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing, 210009, China
| | - Ming Wu
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China.
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Gomes IC, Tavares VDDO, Oliveira Neto L, Agrícola PMD, Jenkins M, Smith L, Oliveira Duarte YAD. Associations between levels of physical activity and mortality in older adults: a prospective cohort study. SPORT SCIENCES FOR HEALTH 2022. [DOI: 10.1007/s11332-021-00891-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Fortes C, Mastroeni S, Tubili C, Gianni S, Pandolfo MM, Fano V. Mediterranean diet, walking outdoors and polypharmacy in older patients with type II diabetes. Eur J Public Health 2021; 31:829-835. [PMID: 34499712 DOI: 10.1093/eurpub/ckab113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Polypharmacy and its adverse health effects is an emerging public health issue, with increasing prevalence among patients with multiple chronic conditions, such as older adults with diabetes. A healthy lifestyle has been shown to improve both diabetes and polypharmacy incidence. We conducted a cross-sectional study to investigate the association of a healthy lifestyle with polypharmacy and comorbidities in older people with diabetes. METHODS All out-patients from January 2013 to June 2015 with type II diabetes aged 65 years or more from a Lazio Region reference centre for diabetes were included in the study. Socio-demographic, clinical and lifestyle data were collected from medical records and through face-to-face standardized questionnaires. The comorbidity-polypharmacy score (CPS) was used to characterize the overall patients' frailty, by assessing concurrently the presence of comorbidities and polypharmacy. The cumulative logit model was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS Adjusted ORs for age, sex, body mass index, physical activity and cognitive status, showed that CPS score was inversely related to weekly consumption of cruciferous vegetables (OR: 0.56, 95% CI: 0.35-0.90; P-trend = 0.015), leafy green vegetables (OR: 0.54, 95% CI: 0.33-0.87; P-trend = 0.013) and daily intake of fruits (OR: 0.63, 95% CI: 0.41-0.97; P-trend = 0.036). Walking outdoors was found inversely related to CPS score (age- and sex-adjusted OR: 0.60, 95% CI: 0.42-0.86). CONCLUSION Our findings suggest that eating some dietary factors present in the Mediterranean diet and walking outdoors regularly is associated with a lower intensity of medicines need to treat comorbidities among older people with diabetes.
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Affiliation(s)
- Cristina Fortes
- Istituto Dermopatico dell'Immacolata, IDI-IRCCS, Rome, Italy
| | | | - Claudio Tubili
- Diabetes Unit, S. Camillo-Forlanini Hospital, Rome, Italy
| | - Simona Gianni
- Diabetes Unit, S. Camillo-Forlanini Hospital, Rome, Italy
| | | | - Valeria Fano
- Local Health Authority Roma 3 (Asl RM3), Rome, Italy
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Epidemiology of Cardiovascular Diseases in the Elderly. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1216:29-38. [DOI: 10.1007/978-3-030-33330-0_4] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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11
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[Effect of lifestyle on aging and geriatric disease]. Nihon Ronen Igakkai Zasshi 2020; 57:361-373. [PMID: 33268620 DOI: 10.3143/geriatrics.57.361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
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12
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Ida S, Kaneko R, Imataka K, Okubo K, Shirakura Y, Azuma K, Hujiwara R, Takahashi H, Murata K. Effects of Flash Glucose Monitoring on Dietary Variety, Physical Activity, and Self-Care Behaviors in Patients with Diabetes. J Diabetes Res 2020; 2020:9463648. [PMID: 32352017 PMCID: PMC7171657 DOI: 10.1155/2020/9463648] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 03/27/2020] [Indexed: 01/02/2023] Open
Abstract
The aim of this study was to evaluate the effects of flash glucose monitoring on dietary variety, physical activity, and self-care behavior in patients with diabetes. This study included outpatients with diabetes using insulin who presented at the Department of Diabetes and Metabolism of the Ise Red Cross Hospital. Before initiating flash glucose monitoring and 12 weeks after its initiation, blood glucose-related parameters were assessed and self-administered questionnaires were completed (Dietary Variety Score (DVS), the International Physical Activity Questionnaire (IPAQ), the Summary of Diabetes Self-Care Activities Measure (SDSCA), and the Diabetes Treatment Satisfaction Questionnaire (DTSQ)) and compared between the two time points. We analyzed 42 patients with type 1 diabetes mellitus and 48 patients with type 2 diabetes mellitus. In patients with type 2 diabetes mellitus, but not type 1 diabetes mellitus, there was an increase in moderate/high category scores for IPAQ (P < 0.001) and for treatment satisfaction reported via DTSQ. Furthermore, in patients with type 2 diabetes mellitus, the glycemic excursion index improved significantly and HbA1c decreased significantly (from 7.7 (1.2) to 7.4 (0.8), P = 0.025). Results showed that standard deviation and mean amplitude of glycemic excursions significantly decreased in patients with type 1 diabetes mellitus (from 71.2 (20.4) to 66.2 (17.5), P = 0.033 and from 124.6 (31.9) to 108.1 (28.4), P < 0.001, respectively). Flash glucose monitoring is a useful tool to improve physical activity in patients with type 2 diabetes.
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Affiliation(s)
- Satoshi Ida
- Department of Diabetes and Metabolism, Ise Red Cross Hospital, Ise-shi, Mie 516-8512, Japan
| | - Ryutaro Kaneko
- Department of Diabetes and Metabolism, Ise Red Cross Hospital, Ise-shi, Mie 516-8512, Japan
| | - Kanako Imataka
- Department of Diabetes and Metabolism, Ise Red Cross Hospital, Ise-shi, Mie 516-8512, Japan
| | - Kaoru Okubo
- Department of Diabetes and Metabolism, Ise Red Cross Hospital, Ise-shi, Mie 516-8512, Japan
| | - Yoshitaka Shirakura
- Department of Diabetes and Metabolism, Ise Red Cross Hospital, Ise-shi, Mie 516-8512, Japan
| | - Kentaro Azuma
- Department of Diabetes and Metabolism, Ise Red Cross Hospital, Ise-shi, Mie 516-8512, Japan
| | - Ryoko Hujiwara
- Department of Diabetes and Metabolism, Ise Red Cross Hospital, Ise-shi, Mie 516-8512, Japan
| | - Hiroka Takahashi
- Department of Diabetes and Metabolism, Ise Red Cross Hospital, Ise-shi, Mie 516-8512, Japan
| | - Kazuya Murata
- Department of Diabetes and Metabolism, Ise Red Cross Hospital, Ise-shi, Mie 516-8512, Japan
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Ceschini F, Figueira Junior A, Andrade ELD, Araújo TL, Rica RL, Miranda MLDJ, Matsudo VKR, Bocalini DS. LEVEL OF KNOWLEDGE OF PHYSICAL EDUCATION PROFESSIONALS ABOUT AEROBIC AND RESISTANCE EXERCISE PRESCRIPTION FOR ELDERLY PEOPLE. REV BRAS MED ESPORTE 2018. [DOI: 10.1590/1517-869220182406188634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Introduction: Regular aerobic and resistance exercises are recommended to improve functional capacity and quality of life in the elderly. Objective: To describe the familiarity of physical education professionals with the recommendation of aerobic and resistance exercise for the elderly, and to identify associated factors. Methods: We assessed 610 physical education professionals working in fitness academies in the city of São Paulo. Familiarity with the recommendation was assessed using a questionnaire constructed for this study. We assessed the criteria that make up the recommendation of aerobic and resistance exercise, following the American College of Sports Medicine guidelines. The data analysis with statistical significance of p <0.05 was carried out using the chi-square test and multiple logistic regression. Results: The level of knowledge of physical education professionals working in fitness centers, considering fulfilment of the criteria that make up the recommendation of aerobic and resistance exercise for the elderly, was limited, attaining only 9.3% and 12.6%, respectively. Age, number of jobs, completion of a graduate program and reading of scientific papers were factors associated with familiarity with the recommendation of resistance exercise. Factors associated with familiarity with aerobic exercise recommendation were: age, number of jobs and reading of scientific papers. Conclusion: The level of familiarity of physical education professionals with the recommendation of aerobic and resistance exercise for older people was low, suggesting the need for better professional training to meet the demand of older people at the fitness centers in the city of Sao Paulo. Level of Evidence I; Type of Study: Therapeutic Study - Investigation of Treatment Results.
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Ethisan P, Somrongthong R, Ahmed J, Kumar R, Chapman RS. Factors Related to Physical Activity Among the Elderly Population in Rural Thailand. J Prim Care Community Health 2016; 8:71-76. [PMID: 27799413 PMCID: PMC5932662 DOI: 10.1177/2150131916675899] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Physical activity in later years of life is not only essential to healthy aging and independent functioning, but it also helps prevent chronic diseases. We aimed this cross-sectional study to assess the prevalence of physical activity and associated factors among rural elderly Thais. We conducted this study on a sample of 300 elderly in 2 rural districts of Phranakornsiayutthaya province in Thailand. The mean age of participants were 67.5±6 years and 42% of them did not perform physical activity. Prevalence of vigorous and moderate intensity physical activity was 43.7% and 48.7%, respectively. About 43.7% elderly used any active transport and spent 2.81 hours on sedentary activities, daily. Females and those with enough income were 3.64 and 0.59 times, respectively, less likely to be physically active ( P < .05). Our study concluded that almost half of the rural Thai elderly were physically inactive. Also male and wealthy elderly were less likely to be engaged in physical activity. We recommend for improved efforts to involve rural Thai elderly in physical activity by offering them opportunities for locally relevant recreational and leisure time physical activities, with special focus on males and higher income elderly.
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Affiliation(s)
- Plernta Ethisan
- 1 Praboromarajchanok Institute, Ministry of Public Health, Bangkok, Thailand
| | | | - Jamil Ahmed
- 3 Arabian Gulf University, Manama, Kingdom of Bahrain
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Farrokhian A, Bahmani F, Taghizadeh M, Mirhashemi SM, Aarabi MH, Raygan F, Aghadavod E, Asemi Z. Selenium Supplementation Affects Insulin Resistance and Serum hs-CRP in Patients with Type 2 Diabetes and Coronary Heart Disease. Horm Metab Res 2016; 48:263-8. [PMID: 26743526 DOI: 10.1055/s-0035-1569276] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
To our knowledge, this study is the first indicating the effects of selenium supplementation on metabolic status of patients with type 2 diabetes mellitus (T2DM) and coronary heart disease (CHD). This study was conducted to evaluate the effects of selenium supplementation on metabolic profiles, biomarkers of inflammation, and oxidative stress of patients with T2DM and CHD. This randomized, double-blind, placebo-controlled trial was performed among 60 patients with T2DM and CHD aged 40-85 years. Participants were randomly divided into 2 groups. Group A received 200 μg selenium supplements (n=30) and group B received placebo per day (n=30) for 8 weeks. Fasting blood samples were taken at the beginning of the study and after 8-week intervention to quantify metabolic profiles. After 8 weeks, compared with the placebo, selenium supplementation resulted in a significant decrease in serum insulin levels (- 2.2±4.6 vs. + 3.6±8.4 μIU/ml, p=0.001), homeostasis model of assessment-insulin resistance (HOMA-IR) (- 0.7±1.3 vs. + 0.9±2.4, p=0.004), homeostatic model assessment-beta cell function (HOMA-B) (- 7.5±17.2 vs. + 15.1±34.5, p=0.002) and a significant increase in quantitative insulin sensitivity check index (QUICKI) (+0.01±0.03 vs. - 0.01±0.03, p=0.02). In addition, patients who received selenium supplements had a significant reduction in serum high-sensitivity C-reactive protein (hs-CRP) (- 1 372.3±2 318.8 vs. - 99.8±1 453.6 ng/ml, p=0.01) and a significant rise in plasma total antioxidant capacity (TAC) concentrations (+ 301.3±400.6 vs. - 127.2±428.0 mmol/l, p<0.001) compared with the placebo. A 200 μg/day selenium supplementation among patients with T2DM and CHD resulted in a significant decrease in insulin, HOMA-IR, HOMA-B, serum hs-CRP, and a significant increase in QUICKI score and TAC concentrations.
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Affiliation(s)
- A Farrokhian
- Department of Cardiology, School of Medicine, Kashan University of Medical Sciences, Kashan, I. R. Iran
| | - F Bahmani
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I. R. Iran
| | - M Taghizadeh
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I. R. Iran
| | - S M Mirhashemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I. R. Iran
| | - M H Aarabi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I. R. Iran
| | - F Raygan
- Department of Cardiology, School of Medicine, Kashan University of Medical Sciences, Kashan, I. R. Iran
| | - E Aghadavod
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I. R. Iran
| | - Z Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I. R. Iran
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Effects of Organized Physical Activity on Selected Health Indices among Women Older than 55 Years. ScientificWorldJournal 2015; 2015:625032. [PMID: 26106642 PMCID: PMC4461793 DOI: 10.1155/2015/625032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Revised: 05/04/2015] [Accepted: 05/07/2015] [Indexed: 11/28/2022] Open
Abstract
The main aim of this study was to determine health benefits among women older than 55 years who participated in organized, group-based physical activity (OPA). Thirty-five women aged 65.0 ± 7.3 years volunteered for this study. The classical and nonclassical cardiovascular (CVD) risk factors were measured before and after a 2-week OPA camp in a remote location and 3 months of OPA. Self-guided physical activity was analyzed 18 months after OPA. Two-week effects included significant decreases in body mass index, waist and hip circumferences, resting systolic and diastolic blood pressure (BP) and resting heart rate, improved exercise capacity (EC), improved low-density lipoprotein and high-density lipoprotein (HDL-C), cholesterol, and other atherogenic lipid indices (ALI), and a reduction in 10-year estimated risk of death from CVD. Three-month effects included a further decrease in systolic BP, improvements in EC and HDL-C, and maintenance of lower levels of ALI, as well as lower CVD risk.
The implementation of the OPA programme had a positive impact on somatic features, exercise capacity, biochemical indices, and risk for death from CVD. The presented programme can be regarded as an effective element of primary prevention of cardiovascular diseases among women older than 55 years.
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Kaizu S, Kishimoto H, Iwase M, Fujii H, Ohkuma T, Ide H, Jodai T, Kikuchi Y, Idewaki Y, Hirakawa Y, Nakamura U, Kitazono T. Impact of leisure-time physical activity on glycemic control and cardiovascular risk factors in Japanese patients with type 2 diabetes mellitus: the Fukuoka Diabetes Registry. PLoS One 2014; 9:e98768. [PMID: 24897110 PMCID: PMC4045868 DOI: 10.1371/journal.pone.0098768] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 05/07/2014] [Indexed: 11/18/2022] Open
Abstract
AIMS/HYPOTHESIS The effects of leisure-time physical activity (LTPA) on glycemia and cardiovascular risk factors are not fully understood in Asian type 2 diabetic patients, who are typically non-obese. We studied associations between LTPA and glycemia and cardiovascular risk factors in Japanese type 2 diabetic patients. METHODS A total of 4,870 Japanese type 2 diabetic patients aged ≥ 20 years were divided into eight groups according to their LTPA. We investigated associations between the amount and intensity levels of physical activity (PA) and glycemic control, insulin sensitivity, cardiovascular risk factors, and low-grade systemic inflammation in a cross-sectional study. RESULTS LTPA was dose-dependently associated with body mass index (BMI), waist circumference, hemoglobin A1c (HbA1c), fasting plasma glucose, homeostasis model assessment of insulin resistance, triglyceride, high density lipoprotein cholesterol, high sensitivity C-reactive protein, and prevalence of metabolic syndrome, but not with blood pressure, low density lipoprotein cholesterol or adiponectin. The amount of PA required to lower HbA1c was greater than that required to improve cardiovascular risk factors. LTPA was inversely associated with HbA1c in non-obese participants but not in obese participants after multivariate adjustments for age, sex, duration of diabetes, current smoking, current drinking, energy intake, cardiovascular diseases, depressive symptoms, and treatment of diabetes. Higher-intensity LTPA, not lower-intensity LTPA was associated with HbA1c after multivariate adjustments with further adjustment including BMI. CONCLUSIONS/INTERPRETATION LTPA was dose-dependently associated with better glycemic control and amelioration of some cardiovascular risk factors in Japanese type 2 diabetic patients. In addition, increased higher-intensity LTPA may be appropriate for glycemic control.
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Affiliation(s)
- Shinako Kaizu
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiro Kishimoto
- Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masanori Iwase
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Diabetes Center, Hakujyuji Hospital, Fukuoka, Japan
- * E-mail:
| | - Hiroki Fujii
- Division of General Internal Medicine, School of Oral Health Science, Kyushu Dental University, Kitakyushu, Japan
| | - Toshiaki Ohkuma
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hitoshi Ide
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tamaki Jodai
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | | | | | - Yoichiro Hirakawa
- Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Udai Nakamura
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Xiang L, Xiang G, Yue L, Zhang J, Zhao L. Circulating irisin levels are positively associated with endothelium-dependent vasodilation in newly diagnosed type 2 diabetic patients without clinical angiopathy. Atherosclerosis 2014; 235:328-33. [PMID: 24911636 DOI: 10.1016/j.atherosclerosis.2014.04.036] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 03/29/2014] [Accepted: 04/29/2014] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Irisin is a newly identified myokine that can promote energy expenditure and alleviate insulin-resistance in animal model. It has been established that insulin resistance is frequently associated with endothelial dysfunction. Therefore, we hypothesize that circulating irisin levels are associated with endothelial dysfunction in type 2 diabetes. METHODS One hundred and eighty eight patients with newly diagnosed type 2 diabetes and 40 healthy subjects were recruited. Serum irisin concentrations were measured by using enzyme-linked immunosorbent assay, and flow-mediated dilation (FMD) was evaluated by using high-resolution ultrasound. RESULTS The mean value of circulating irisin levels in newly diagnosed type 2 diabetes was 13.25 ng/ml, which was significantly lower than that in controls (25.98 ng/ml, p < 0.001). By dividing the distribution of FMD levels into quartiles, serum irisin levels were increased gradually with the increase of FMD levels (p < 0.001). Multivariate stepwise regression analysis demonstrated that serum irisin levels were independently associated with FMD (p = 0.009). By logistic regression analysis the odds ratio for lower FMD levels was reduced by 11.8% per 1 ng/ml increase in serum irisin concentration after adjustment for multivariate metabolic factors [OR (95% CI); 0.882 (0.709-0.969)]. CONCLUSION These results demonstrated that circulating irisin levels were decreased in newly diagnosed Chinese type 2 diabetic patients without clinical angiopathy and positively associated with FMD levels.
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Affiliation(s)
- Lin Xiang
- Graduate School, Southern Medical University, Guangzhou Avenue North 1838, Guangzhou 510515, China; Department of Endocrinology, Wuhan General Hospital of Guangzhou Command, Wuluo Road 627, Wuhan 430070, Hubei Province, China.
| | - Guangda Xiang
- Department of Endocrinology, Wuhan General Hospital of Guangzhou Command, Wuluo Road 627, Wuhan 430070, Hubei Province, China.
| | - Ling Yue
- Department of Endocrinology, Wuhan General Hospital of Guangzhou Command, Wuluo Road 627, Wuhan 430070, Hubei Province, China.
| | - Junxia Zhang
- Department of Endocrinology, Wuhan General Hospital of Guangzhou Command, Wuluo Road 627, Wuhan 430070, Hubei Province, China.
| | - Linshuang Zhao
- Department of Endocrinology, Wuhan General Hospital of Guangzhou Command, Wuluo Road 627, Wuhan 430070, Hubei Province, China.
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Lipscombe C, Smith KJ, Gariépy G, Schmitz N. Gender differences in the relationship between anxiety symptoms and physical inactivity in a community-based sample of adults with type 2 diabetes. Can J Diabetes 2014; 38:444-50. [PMID: 24852706 DOI: 10.1016/j.jcjd.2013.12.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 11/18/2013] [Accepted: 12/06/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To examine the association between physical inactivity and anxiety symptoms in a community-based sample of men and women with type 2 diabetes mellitus. METHODS Eligibility criteria included residents of Quebec, Canada aged between 40 and 75 years, having a diagnosis of type 2 diabetes (≤10 years), being insulin-naive and having participated in a previous telephone-based survey of diabetes treatments. Of the 2028 eligible respondents, 1953 (96.3%) provided information on anxiety symptoms and were included in this analysis. Participants were interviewed and provided information on diabetes-related clinical and sociodemographic factors. RESULTS A total of 27.3% of participants reported being physically inactive. The prevalence of mild to severe anxiety symptoms was 22.9%. Persons with mild anxiety symptoms and moderate to severe anxiety symptoms were 1.4 times and 1.7 times more likely to report being inactive than persons without anxiety symptoms, respectively. Subgroup analyses according to gender revealed that women who had mild anxiety symptoms were 1.5 times more likely to report being inactive compared with women who did not have anxiety symptoms, whereas men who had moderate to severe anxiety symptoms were 2.5 times more likely to be inactive than men who did not have anxiety symptoms. CONCLUSIONS Anxiety symptoms in the mild and moderate to severe range are a relevant clinical comorbidity in persons with type 2 diabetes, and men may represent a particularly vulnerable subgroup. Future research is recommended to further assess the relationship between anxiety symptoms and diabetes-related health behaviours.
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Affiliation(s)
- Carla Lipscombe
- Douglas Mental Health University Institute, Montréal, Quebec, Canada; Department of Epidemiology and Biostatistics, McGill University, Montréal, Québec, Canada
| | - Kimberley J Smith
- Department of Psychiatry, McGill University, Montréal, Quebec, Canada; Douglas Mental Health University Institute, Montréal, Quebec, Canada
| | - Geneviève Gariépy
- Douglas Mental Health University Institute, Montréal, Quebec, Canada; Department of Epidemiology and Biostatistics, McGill University, Montréal, Québec, Canada
| | - Norbert Schmitz
- Department of Psychiatry, McGill University, Montréal, Quebec, Canada; Douglas Mental Health University Institute, Montréal, Quebec, Canada; Department of Epidemiology and Biostatistics, McGill University, Montréal, Québec, Canada; Montréal Diabetes Research Centre, Montréal, Quebec, Canada.
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Abstract
There is evidence from high quality studies to strongly support the positive association between increased levels of physical activity, exercise participation and improved health in older adults. Worldwide, around 3.2 million deaths per year are being attributed to inactivity. In industrialised countries where people are living longer lives, the levels of chronic health conditions are increasing and the levels of physical activity are declining. Key factors in improving health are exercising at a moderate-to-vigorous level for at least 5 days per week and including both aerobic and strengthening exercises. Few older adults achieve the level of physical activity or exercise that accompanies health improvements. A challenge for health professionals is to increase physical activity and exercise participation in older adults. Some success in this has been reported when physicians have given specific, detailed and localised information to their patients, but more high quality research is needed to continue to address this issue of non-participation in physical activity and exercise of a high enough level to ensure health benefits.
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Affiliation(s)
- Denise Taylor
- Faculty of Health & Environmental Sciences, Health & Rehabilitation Research Institute, North Shore Campus, AUT University, , Auckland, New Zealand
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Huang JH, Cheng FC, Tsai LC, Lee NY, Lu YF. Appropriate physical activity and dietary intake achieve optimal metabolic control in older type 2 diabetes patients. J Diabetes Investig 2013; 5:418-27. [PMID: 25411601 PMCID: PMC4210067 DOI: 10.1111/jdi.12164] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 08/29/2013] [Accepted: 09/01/2013] [Indexed: 11/30/2022] Open
Abstract
Aims/Introduction The aim of the present study was to investigate an appropriate level of physical activity and optimal dietary intake in older type 2 diabetes patients. Materials and Methods The cross‐sectional study enrolled 210 older type 2 diabetes patients. Participants were interviewed to obtain information on physical activity, 24‐h dietary recall and typical weekly dietary patterns. Anthropometric measurements, and biochemical analysis of blood and urine were determined. Results Moderate physical activity (either moderate leisure‐time physical activity or moderate physical activity level) and diet with protein intake of ≥0.8 g/kg/day were associated with lower glycated hemoglobin and triglyceride, higher high‐density lipoprotein, lower waist circumference, body mass index and body fat, as well as better serum magnesium and albumin levels in older diabetic patients. In contrast, inadequate protein intake was correlated with higher glycated hemoglobin, triglyceride, body fat percentage, waist circumference and body mass index. In addition, high physical activity with inadequate protein and magnesium intake might exacerbate magnesium deficiency, resulting in poor glycemic control in older diabetic patients. Furthermore, low physical activity and inadequate protein intake were linked with poor glycemic control, and lower high‐density lipoprotein, and higher triglyceride, body fat percentage, waist circumference and body mass index. Conclusions Moderate physical activity and adequate dietary protein intake (≥0.8 g/kg/day) might be the optimal recommendation for better metabolic control in older adults with type 2 diabetes.
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Affiliation(s)
- Jui-Hua Huang
- PhD Program in Nutrition and Food Science and Department of Nutritional Science Fu-Jen Catholic University Hsinchuang New Taipei City Taiwan
| | - Fu-Chou Cheng
- Stem Cell Center Department of Medical Research Taichung Veterans General Hospital Taichung Taiwan
| | - Leih-Ching Tsai
- Division of Endocrine and Metabolism Department of Internal Medicine Erlin-Branch Changhua Christian Hospital Changhua Taiwan
| | - Ning-Yuean Lee
- College of Living Technology Tainan University of Technology Tainan Taiwan
| | - Yi-Fa Lu
- PhD Program in Nutrition and Food Science and Department of Nutritional Science Fu-Jen Catholic University Hsinchuang New Taipei City Taiwan
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Sone H, Akanuma Y, Yamada N. [Cutting-edge of medicine; clinical epidemiology regarding clinical and pathophysiological features of Japanese patients with type 2 diabetes mellitus]. NIHON NAIKA GAKKAI ZASSHI. THE JOURNAL OF THE JAPANESE SOCIETY OF INTERNAL MEDICINE 2013; 102:2714-2722. [PMID: 24400556 DOI: 10.2169/naika.102.2714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Hirohito Sone
- Department of Hematology, Endocrinology and Metabolism, Niigata University Graduate School of Medical and Dental Sciences, Japan
| | - Yasuo Akanuma
- Institute for Adult Disease. Asahi Life Foundation, Japan
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Koivula RW, Tornberg AB, Franks PW. Exercise and diabetes-related cardiovascular disease: systematic review of published evidence from observational studies and clinical trials. Curr Diab Rep 2013; 13:372-80. [PMID: 23494754 DOI: 10.1007/s11892-013-0373-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The cost of treating cardiovascular disease (CVD) and diabetes is enormous and is set to rise in the coming years. Physical inactivity and sedentary behaviors are major risk factors for these diseases and are estimated to account for several million global deaths annually. Lifestyle interventions, particularly those aimed at enhancing physical activity levels, have a substantial favorable impact on diabetes progression in people at high risk of the disease. Although observational studies and small intervention studies suggest that physical activity might also prevent CVD in people with diabetes, this is not supported by the results of larger randomized controlled trials of lifestyle intervention. The purpose of this review is to provide an overview of the published studies focused on the role of physical activity in CVD prevention in persons with diabetes, and to discuss the implications of these studies' findings. Our review identified almost 100 studies published in the past decade relevant to this topic.
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Affiliation(s)
- Robert W Koivula
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University, SE-205 02 Malmö, Sweden
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Sone H, Tanaka S, Tanaka S, Suzuki S, Seino H, Hanyu O, Sato A, Toyonaga T, Okita K, Ishibashi S, Kodama S, Akanuma Y, Yamada N. Leisure-time physical activity is a significant predictor of stroke and total mortality in Japanese patients with type 2 diabetes: analysis from the Japan Diabetes Complications Study (JDCS). Diabetologia 2013; 56:1021-30. [PMID: 23443242 DOI: 10.1007/s00125-012-2810-z] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2012] [Accepted: 11/29/2012] [Indexed: 10/27/2022]
Abstract
AIMS/HYPOTHESIS Our aim was to clarify the association between leisure-time physical activity (LTPA) and cardiovascular events and total mortality in a nationwide cohort of Japanese diabetic patients. METHODS Eligible patients (1,702) with type 2 diabetes (mean age, 58.5 years; 47% women) from 59 institutes were followed for a median of 8.05 years. A comprehensive lifestyle survey including LTPA and occupation was performed using standardised questionnaires. Outcome was occurrence of coronary heart disease (CHD), stroke and total mortality. The adjusted HR and 95% CI were calculated by Cox regression analysis. RESULTS A significant reduction in HR in patients in the top (≥ 15.4 metabolic equivalents [MET] h/week) vs the bottom tertile (≤ 3.7 MET h/week) of LTPA, adjusted by age, sex and diabetes duration, was observed in stroke (HR 0.55, 95% CI 0.32, 0.94) and total mortality (HR 0.49, 95% CI 0.26, 0.91) but not in CHD (HR 0.77, 95% CI 0.48, 1.25). The HR for stroke became borderline significant or nonsignificant after adjustment for lifestyle or clinical variables including diet or serum lipids. The significantly reduced total mortality by LTPA was independent of these variables and seemed not to be, at least mainly, attributed to reduced cardiovascular disease. CONCLUSIONS/INTERPRETATION In Japanese persons with type 2 diabetes, LTPA of 15.4 MET h/week or more was associated with a significantly lower risk of stroke partly through ameliorating combinations of cardiovascular risk factors. It was also associated with significantly reduced total mortality but independently of cardiovascular risk factors or events. These findings, implying differences from Western diabetic populations, should be considered in the clinical management of East Asians with diabetes.
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Affiliation(s)
- H Sone
- Department of Internal Medicine, Niigata University Faculty of Medicine, 1-757 Asahimachi-dori, Chuoh-ku, Niigata 951-8510, Japan.
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Iijima K. [Learn from the importance of physical activity level in the elderly. How should we encourage and keep it?]. Nihon Ronen Igakkai Zasshi 2013; 50:56-59. [PMID: 23925093 DOI: 10.3143/geriatrics.50.56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Araki A. [Risk factors for atherosclerotic disease from the Japanese Elderly Diabetes Intervention Trial (J-EDIT)]. Nihon Ronen Igakkai Zasshi 2013; 50:53-55. [PMID: 23925092 DOI: 10.3143/geriatrics.50.53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Yaegashi Y, Satoh A, Kudoh H, Lee S, Kitamiy C, Butler JP, Sasaki H. Diets of obese and non-obese older subjects. Health (London) 2013. [DOI: 10.4236/health.2013.53048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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