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Liu L, Gracely EJ, Zhao X, Gliebus GP, May NS, Volpe SL, Shi J, DiMaria-Ghalili RA, Eisen HJ. Association of multiple metabolic and cardiovascular markers with the risk of cognitive decline and mortality in adults with Alzheimer's disease and AD-related dementia or cognitive decline: a prospective cohort study. Front Aging Neurosci 2024; 16:1361772. [PMID: 38628973 PMCID: PMC11020085 DOI: 10.3389/fnagi.2024.1361772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 02/26/2024] [Indexed: 04/19/2024] Open
Abstract
Background and objectives There is a scarcity of data stemming from large-scale epidemiological longitudinal studies focusing on potentially preventable and controllable risk factors for Alzheimer's disease (AD) and AD-related dementia (ADRD). This study aimed to examine the effect of multiple metabolic factors and cardiovascular disorders on the risk of cognitive decline and AD/ADRD. Methods We analyzed a cohort of 6,440 participants aged 45-84 years at baseline. Multiple metabolic and cardiovascular disorder factors included the five components of the metabolic syndrome [waist circumference, high blood pressure (HBP), elevated glucose and triglyceride (TG) concentrations, and reduced high-density lipoprotein cholesterol (HDL-C) concentrations], C-reactive protein (CRP), fibrinogen, interleukin-6 (IL-6), factor VIII, D-dimer, and homocysteine concentrations, carotid intimal-medial thickness (CIMT), and urine albumin-to-creatinine ratio (ACR). Cognitive decline was defined using the Cognitive Abilities Screening Instrument (CASI) score, and AD/ADRD cases were classified using clinical diagnoses. Results Over an average follow-up period of 13 years, HBP and elevated glucose, CRP, homocysteine, IL-6, and ACR concentrations were significantly associated with the risk of mortality in the individuals with incident AD/ADRD or cognitive decline. Elevated D-dimer and homocysteine concentrations, as well as elevated ACR were significantly associated with incident AD/ADRD. Elevated homocysteine and ACR were significantly associated with cognitive decline. A dose-response association was observed, indicating that an increased number of exposures to multiple risk factors corresponded to a higher risk of mortality in individuals with cognitive decline or with AD/ADRD. Conclusion Findings from our study reaffirm the significance of preventable and controllable factors, including HBP, hyperglycemia, elevated CRP, D-dimer, and homocysteine concentrations, as well as, ACR, as potential risk factors for cognitive decline and AD/ADRD.
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Affiliation(s)
- Longjian Liu
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
| | - Edward J. Gracely
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
- Department of Family, Community & Preventive Medicine, College of Medicine, Drexel University, Philadelphia, PA, United States
| | - Xiaopeng Zhao
- Department of Mechanical, Aerospace, and Biomedical Engineering, University of Tennessee, Knoxville, Knoxville, TN, United States
| | - Gediminas P. Gliebus
- Department of Neurology, College of Medicine, Drexel University Philadelphia, Philadelphia, PA, United States
| | - Nathalie S. May
- Department of Medicine, College of Medicine, Drexel University, Philadelphia, PA, United States
| | - Stella L. Volpe
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States
| | - Jingyi Shi
- Department of Mathematics and Statistics, Mississippi State University, Starkville, MS, United States
| | - Rose Ann DiMaria-Ghalili
- Doctoral Nursing Department, Nutrition Science Department, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, United States
| | - Howard J. Eisen
- Clinical Research for the Advanced Cardiac and Pulmonary Vascular Disease Program, Thomas Jefferson University Hospital, Philadelphia, PA, United States
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Alqahtani RM, Althagafi SE, Althagafi AA, Alsayyad JM, Saeedi AA, Mishiming OS, Yaghmour KA, Jan MA. Association of ABO Blood Groups and Obesity in Patients With Diabetes Mellitus in King Abdulaziz University Hospital. Cureus 2024; 16:e51569. [PMID: 38313972 PMCID: PMC10835745 DOI: 10.7759/cureus.51569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2024] [Indexed: 02/06/2024] Open
Abstract
BACKGROUND Differences in the blood, resulting from the presence or absence of antigens corresponding to specific blood types, have indirect implications for susceptibility to diseases. The aim of this study was to examine the association between the ABO type and obesity in patients with diabetes mellitus. METHODS This is a cross-sectional observational study that was conducted at King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia. Data were collected using a simple random method through hospital records during the period between August and September 2022. Patients with type 1 diabetes mellitus (T1DM) and T2DM were included in this study. Binary logistic regression analysis was used to identify the association between blood group and obesity. RESULTS A total of 411 patients were involved in this study. More than half of the patients (54.3%; n= 223) are diagnosed with T1DM. O-positive was the most common blood group type among the patients, accounting for 38.6% (n= 161). Only 23.6% (n= 97) of the patients were classified as having normal weight. Around 32.6% (n= 134) of the patients were classified as having the pre-obesity stage. More than one-third of the patients (35.1%; n= 145) were classified as being obese. There was no statistically significant difference between the patients in terms of their blood type group and its association with obesity (p>0.05). CONCLUSION Many diabetics are overweight or obese, according to this study. This shows the importance of weight management for diabetes treatment. Many patients were overweight, emphasizing the importance of obesity prevention and diabetes care. Most patients were O-positive, according to blood type tests. Previous research suggests that blood types may be linked to diabetes. However, this study found no significant relationships. More research is needed to understand the complex link between blood types, weight, and diabetes.
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Affiliation(s)
- Reem Mohammed Alqahtani
- Department of Family Medicine, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, SAU
| | | | | | | | | | | | - Khaled A Yaghmour
- Department of Family Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, SAU
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Oommen AM, Kapoor N, Thomas N, George K. Prevalence and clinical characteristics of individuals with newly detected lean diabetes in Tamil Nadu, South India: a community-based cross-sectional study. Int J Diabetes Dev Ctries 2019. [DOI: 10.1007/s13410-019-00724-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Pizzol D, Veronese N, Quaglio G, Di Gennaro F, Deganello D, Stubbs B, Koyanagi A. The association between diabetes and cataract among 42,469 community-dwelling adults in six low- and middle-income countries. Diabetes Res Clin Pract 2019; 147:102-110. [PMID: 30529577 DOI: 10.1016/j.diabres.2018.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 11/13/2018] [Accepted: 12/03/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND Cataract is a major cause of visual impairment in people with diabetes, yet a paucity of data is available in low- and middle-income countries (LMICs) on this comorbidity. Thus we assessed the association between diabetes and cataract in 6 LMICs. METHODS Cross-sectional, community-based data from the Study on Global Ageing and Adult Health (SAGE) was analyzed (n = 42,469 aged ≥18 years). Five years information on self-reported diagnosis of cataract was collected. Three definitions for cataract were used: (a) Self-reported diagnosis and/or past 12-month symptoms; (b) Solely self-reported diagnosis; and (c) Surgical treatment for cataract in the past five years. Diabetes was based on self-reported diagnosis. Multivariable logistic regression was conducted to assess the associations. RESULTS Overall, the prevalence of diabetes was 3.1% (95%CI = 2.7-3.5%) and that of cataract based on the three different definitions was: (a) 13.3% (95%CI = 12.4-14.3%); (b) 4.4% (95%CI = 3.9-4.8%), (c) 1.7% (95%CI = 1.5-2.0%). After adjustment the association was significantly elevated: (a) OR = 2.10 (95%CI = 1.59-2.76); (b) OR = 2.62 (95%CI = 2.00-3.42); (c) OR = 2.80 (95%CI = 1.78-4.40). These associations were particularly pronounced among those aged <50 years. CONCLUSIONS A strong association between diabetes and cataract was observed in LMICs. Considering the impact on health and quality of life and the limited treatment options especially for cataract it is mandatory to promote the prevention through bi-directional screening and treatment.
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Affiliation(s)
- Damiano Pizzol
- Operational Research Unit, Doctors with Africa, Mozambique.
| | - Nicola Veronese
- National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy; Institute for Clinical Research and Education in Medicine (IREM), Padova, Italy
| | - Gianluca Quaglio
- European Parliamentary Research Services (EPRS), European Parliament, Brussels, Belgium
| | | | - Davide Deganello
- Department of Neurosciences, Ophthalmology Unit, University of Padova, Italy
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, United Kingdom
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
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de Lima Filho BF, da Nóbrega Dias V, Carlos AG, Fontes FP, de Sousa AGP, Gazzola JM. Factors related to depressive symptoms in older adult patients with type 2 Diabetes Mellitus. Exp Gerontol 2018; 117:72-75. [PMID: 30414438 DOI: 10.1016/j.exger.2018.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 10/27/2018] [Accepted: 11/07/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND The association of type 2 Diabetes Mellitus (DM2) with depressive symptoms may affect the quality of life of older adults and increase their risk of morbidity and deterioration in functional activities. This study aimed to investigate the variables related to depressive symptoms in older adult patients with DM2. METHODS This cross-sectional, descriptive, analytical study included 102 older adult patients with DM2, treated in northeastern Brazil. We evaluated demographic, clinical, and functional variables [Timed Up and Go (TUG) test, a scale to assess performance (WHO Disability Assessment Schedule), and psycho-cognitive variables (using the Mini Mental State Examination (MMSE) and Geriatric Depression Scale (GDS)). RESULTS There was a significant correlation between the GDS and body mass index (p = 0.04, ρ = 0.20) and intensity of pain (p = 0.09, ρ = 0.26); and scores on the MMSE (p = 0.01, ρ = -0.25); WHODAS (p < 0.001, ρ = 0.61); TUG test (p = 0.016, ρ = 0.25), and TUG dual task (p = 0.029, ρ = 0.23). CONCLUSION Depressive symptoms in older adult patients with DM2 were associated with being female, being single, being illiterate, having poor overall health, using a walking aid, having higher body mass index, having a greater intensity of dizziness, exhibiting functional impairment, and having gait and cognition deficits.
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Affiliation(s)
| | - Vanessa da Nóbrega Dias
- Federal University of Rio Grande Do Norte, University Hospital Onofre Lopes, Natal/Rn 2016, Brazil
| | - Adriana Guedes Carlos
- Federal University of Rio Grande Do Norte, University Hospital Onofre Lopes, Natal/Rn 2016, Brazil
| | - Fabieli Pereira Fontes
- Federal University of Rio Grande Do Norte, University Hospital Onofre Lopes, Natal/Rn 2016, Brazil.
| | | | - Juliana Maria Gazzola
- Federal University of Rio Grande Do Norte, University Hospital Onofre Lopes, Natal/Rn 2016, Brazil
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Millogo T, Bicaba BW, Soubeiga JK, Dabiré E, Médah I, Kouanda S. Diabetes and abnormal glucose regulation in the adult population of Burkina Faso: prevalence and predictors. BMC Public Health 2018; 18:350. [PMID: 29534705 PMCID: PMC5851249 DOI: 10.1186/s12889-018-5257-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 03/06/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prevalence of diabetes mellitus (DM) is reportedly growing fast in sub-Saharan Africa. There is however a scarcity of epidemiologic data on DM in Burkina Faso. We carried out a secondary analysis of the first survey conducted in Burkina Faso on a nationally representative sample following the World Health Organization (WHO) Stepwise approach to risk factors Surveillance (STEPS) for non-communicable diseases (NCDs) with the aims of identifying the prevalence of NCDs and the prevalence of common risk factors for NCDs. We report here on the prevalence of diabetes and overall abnormal glucose regulation (AGR) and their associated risk factors. METHODS In the primary study 4800 individuals were randomly sampled using a stratified multistage clusters sampling process. We used fasting capillary whole blood glucose level to define three glucose regulation statuses using WHO's cut-off levels: normal, diabetes and overall abnormal glucose regulation (impaired fasting glucose and diabetes). Appropriate statistical techniques for the analysis of survey data were used to identify the factors associated with diabetes and abnormal glucose regulation fitting a logistic regression model. Analyses were carried out using Stata Version 14 software. RESULTS The prevalence of DM and AGR were respectively 5.8% (95% CI: 5-6.7) and 9% (95% CI: 8-10.1). Significant risk factors for DM include age (OR = 1.9; P = 0.009 for the age group of 55-64), obesity (OR: 2.6; P = 0.001), former smoke (OR:2; P = 0.03), second-hand smoke (OR = 1.7; P = 0.006) and total cholesterol level (OR: 2.1; P = 0.024). The same predictors were also found significantly associated with AGR. In addition, having an history family diabetes was protective against AGR (OR = 0.5; P = 0.032). CONCLUSION Diabetes is no longer a rare disease in the adult active population of Burkina Faso. Its burden is significant in both rural and urban areas. Health policies that promote healthy life style are needed to give precedence to the prevention in a context of an under-resourced country.
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Affiliation(s)
- Tieba Millogo
- Institut Africain de Santé publique (IASP), Ouagadougou, 12 BP 199 Burkina Faso
- Institut de recherche en sciences de la santé (IRSS), Ouagadougou 03, 03 BP 7102 Burkina Faso
| | - Brice W. Bicaba
- Institut Africain de Santé publique (IASP), Ouagadougou, 12 BP 199 Burkina Faso
- Ministry of Health, Ouagadougou, Burkina Faso
| | - Joseph Kouesyandé Soubeiga
- Institut Africain de Santé publique (IASP), Ouagadougou, 12 BP 199 Burkina Faso
- Ministry of Health, Ouagadougou, Burkina Faso
| | | | - Isaie Médah
- Ministry of Health, Ouagadougou, Burkina Faso
| | - Séni Kouanda
- Institut Africain de Santé publique (IASP), Ouagadougou, 12 BP 199 Burkina Faso
- Institut de recherche en sciences de la santé (IRSS), Ouagadougou 03, 03 BP 7102 Burkina Faso
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Abstract
Hepatic steatosis is an underlying feature of nonalcoholic fatty liver disease (NAFLD), which is the most common form of liver disease and is present in up to ∼70% of individuals who are overweight. NAFLD is also associated with hypertriglyceridaemia and low levels of HDL, glucose intolerance, insulin resistance and type 2 diabetes mellitus. Hepatic steatosis is a strong predictor of the development of insulin resistance and often precedes the onset of other known mediators of insulin resistance. This sequence of events suggests that hepatic steatosis has a causal role in the development of insulin resistance in other tissues, such as skeletal muscle. Hepatokines are proteins that are secreted by hepatocytes, and many hepatokines have been linked to the induction of metabolic dysfunction, including fetuin A, fetuin B, retinol-binding protein 4 (RBP4) and selenoprotein P. In this Review, we describe the factors that influence the development of hepatic steatosis, provide evidence of strong links between hepatic steatosis and insulin resistance in non-hepatic tissues, and discuss recent advances in our understanding of how steatosis alters hepatokine secretion to influence metabolic phenotypes through inter-organ communication.
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Affiliation(s)
- Ruth C R Meex
- Monash Biomedicine Discovery Institute, Metabolic Disease and Obesity Program and the Department of Physiology, Monash University, Wellington Road, Clayton, Victoria 3800, Australia
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Universiteitssingel 50, 6229 ER Maastricht, The Netherlands
| | - Matthew J Watt
- Monash Biomedicine Discovery Institute, Metabolic Disease and Obesity Program and the Department of Physiology, Monash University, Wellington Road, Clayton, Victoria 3800, Australia
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Cai J, Ma A, Wang Q, Han X, Zhao S, Wang Y, Schouten EG, Kok FJ. Association between body mass index and diabetes mellitus in tuberculosis patients in China: a community based cross-sectional study. BMC Public Health 2017; 17:228. [PMID: 28245792 PMCID: PMC5331649 DOI: 10.1186/s12889-017-4101-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 02/02/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We planned to determine the association of body mass index (BMI) with diabetes mellitus (DM) and impaired fasting glucose (IFG) in Chinese pulmonary tuberculosis (PTB) patients. METHODS 3,505 newly-diagnosed PTB patients registered in PTB clinics in Linyi of China between September 2010 and March 2013 were enrolled. DM and IFG were identified based on fasting plasma glucose levels. ROC analysis was used to predict the ability of screening of BMI for DM and IFG in PTB patients. RESULTS Compared with 18.5-23.9 kg/m2, patients with DM and IFG had significantly increased trends when BMI ≥ 24.0 kg/m2, and aORs were 2.28 (95%CI 1.44-3.60) and 1.30 (95%CI 1.04-1.64), respectively. After adjustment for age, gender, and educational level, there was an increased odd in BMI ≥ 23.41 kg/m2 for IFG, and a decreased odd in BMI < 19.82 kg/m2 for DM (p < 0.05). The cut-offs of BMI for screening IFG and DM in PTB patients were 22.22 kg/m2 (AUC 0.56) and 22.34 kg/m2 (AUC 0.59). CONCLUSIONS In PTB patients, BMI is significantly associated with IFG and DM. However, the predictive power of BMI was not sufficient, so it may only be a limited screening tool for DM and IFG among PTB patients in China.
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Affiliation(s)
- Jing Cai
- The College of Public Health, Qingdao University, 38 Dengzhou Road, Qingdao, Shandong Province, 266021, People's Republic of China
| | - Aiguo Ma
- The College of Public Health, Qingdao University, 38 Dengzhou Road, Qingdao, Shandong Province, 266021, People's Republic of China.
| | - Qiuzhen Wang
- The College of Public Health, Qingdao University, 38 Dengzhou Road, Qingdao, Shandong Province, 266021, People's Republic of China
| | - Xiuxia Han
- The College of Public Health, Qingdao University, 38 Dengzhou Road, Qingdao, Shandong Province, 266021, People's Republic of China
| | | | - Yu Wang
- The Department of Public Health, Lanzhou University, 222 Tianshui South Road, Lanzhou, 730000, China
| | - Evert G Schouten
- Division of Human Nutrition, Wageningen University, Wageningen, 6700, The Netherlands
| | - Frans J Kok
- Division of Human Nutrition, Wageningen University, Wageningen, 6700, The Netherlands
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Liu L, Simon B, Shi J, Mallhi AK, Eisen HJ. Impact of diabetes mellitus on risk of cardiovascular disease and all-cause mortality: Evidence on health outcomes and antidiabetic treatment in United States adults. World J Diabetes 2016; 7:449-461. [PMID: 27795819 PMCID: PMC5065665 DOI: 10.4239/wjd.v7.i18.449] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 06/22/2016] [Accepted: 08/18/2016] [Indexed: 02/05/2023] Open
Abstract
AIM To examine the epidemic of diabetes mellitus (DM) and its impact on mortality from all-cause and cardiovascular disease (CVD), and to test the effect of antidiabetic therapy on the mortality in United States adults.
METHODS The analysis included a randomized population sample of 272149 subjects ages ≥ 18 years who participated in the National Health Interview Surveys (NHIS) in 2000-2009. Chronic conditions (hypertension, DM and CVD) were classified by participants’ self-reports of physician diagnosis. NHIS-Mortality Linked Files, and NHIS-Medical Expenditure Panel Survey Linkage Files on prescribed medicines for patients with DM were used to test the research questions. χ2, Poisson and Cox’s regression models were applied in data analysis.
RESULTS Of all participants, 22305 (8.2%) had DM. The prevalence of DM significantly increased from 2000 to 2009 in all age groups (P < 0.001). Within an average 7.39 (SD = 3) years of follow-up, male DM patients had 1.56 times higher risk of death from all-cause (HR = 1.56, 95%CI: 1.49-1.64), 1.72 times higher from heart disease [1.72 (1.53-1.93)], 1.48 times higher from cerebrovascular disease [1.48 (1.18-1.85)], and 1.67 times higher from CVD [1.67 (1.51-1.86)] than subjects without DM, respectively. Similar results were observed in females. In males, 10% of DM patients did not use any antidiabetic medications, 38.1% used antidiabetic monotherapy, and 51.9% used ≥ 2 antidiabetic medications. These corresponding values were 10.3%, 40.4% and 49.4% in females. A significant protective effect of metformin monotherapy or combination therapy (except for insulin) on all-cause mortality and a protective but non-significant effect on CVD mortality were observed.
CONCLUSION This is the first study using data from multiple linkage files to confirm a significant increased prevalence of DM in the last decade in the United States. Patients with DM have significantly higher risk of death from all-cause and CVD than those without DM. Antidiabetic mediations, specifically for metformin use, show a protective effect against all-cause and CVD mortalities.
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Pizzol D, Di Gennaro F, Chhaganlal KD, Fabrizio C, Monno L, Putoto G, Saracino A. Tuberculosis and diabetes: current state and future perspectives. Trop Med Int Health 2016; 21:694-702. [PMID: 27102229 DOI: 10.1111/tmi.12704] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This review outlines the association between tuberculosis and diabetes, focusing on epidemiology, physiopathology, clinical aspects, diagnosis and treatment, and evaluates future perspectives, with particular attention to developing countries.
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Affiliation(s)
- Damiano Pizzol
- Research Section, Doctors with Africa CUAMM, Beira, Mozambique
| | | | - Kajal D Chhaganlal
- Center for Research in Infectious Diseases, Faculty of Health Sciences, Catholic University of Mozambique, Beira, Mozambique
| | | | - Laura Monno
- Clinic of Infectious Diseases, University of Bari, Bari, Italy
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Mainous AG, Tanner RJ, Anton SD, Jo A. Grip Strength as a Marker of Hypertension and Diabetes in Healthy Weight Adults. Am J Prev Med 2015; 49:850-8. [PMID: 26232901 PMCID: PMC4656117 DOI: 10.1016/j.amepre.2015.05.025] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 04/29/2015] [Accepted: 05/08/2015] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Muscle strength may play a role in cardiometabolic disease. We examined the relationship between hand grip strength and diabetes and hypertension in a sample of healthy weight adults. METHODS In 2015, we analyzed the National Health and Nutrition Examination Survey 2011-2012 for adults aged ≥20 years with healthy BMIs (between 18.5 and <25) and no history of cardiovascular disease (unweighted n=1,467; weighted n=61,587,139). Hand grip strength was assessed with a dynamometer. Diabetes was based on hemoglobin A1c level and reported diabetes diagnosis. Hypertension was based on measured blood pressure and reported hypertension diagnosis. RESULTS Individuals with undiagnosed diabetes compared with individuals without diabetes had lower grip strength (51.9 vs 69.8, p=0.0001), as did individuals with diagnosed diabetes compared with individuals without diabetes (61.7 vs 69.8, p=0.008). Mean grip strength was lower among individuals with undiagnosed hypertension compared with individuals without hypertension (63.5 vs 71.5, p=0.008) as well as among individuals with diagnosed hypertension compared with those without hypertension (60.8 vs 71.5, p<0.0001). In adjusted analyses controlling for age, sex, race, smoking status, and first-degree relative with disease, mean grip strength was lower for undiagnosed diabetes (β=-10.02, p<0.0001) and diagnosed diabetes (β=-8.21, p=0.03) compared with individuals without diabetes. In adjusted analyses, grip strength was lower among individuals with undiagnosed hypertension (β=-6.6, p=0.004) and diagnosed hypertension (β=-4.27, p=0.04) compared with individuals without hypertension. CONCLUSIONS Among healthy weight adults, combined grip strength is lower in individuals with diagnosed and undiagnosed diabetes and hypertension.
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Affiliation(s)
- Arch G Mainous
- Department of Health Services Research, Management, and Policy, University of Florida, Gainesville, Florida; Department of Family and Community Medicine, University of Florida, Gainesville, Florida;.
| | - Rebecca J Tanner
- Department of Health Services Research, Management, and Policy, University of Florida, Gainesville, Florida
| | - Stephen D Anton
- Department of Aging and Geriatric Research, University of Florida, Gainesville, Florida
| | - Ara Jo
- Department of Health Services Research, Management, and Policy, University of Florida, Gainesville, Florida
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Tyrovolas S, Koyanagi A, Garin N, Olaya B, Ayuso-Mateos JL, Miret M, Chatterji S, Tobiasz-Adamczyk B, Koskinen S, Leonardi M, Haro JM. Diabetes mellitus and its association with central obesity and disability among older adults: a global perspective. Exp Gerontol 2015; 64:70-7. [PMID: 25688991 DOI: 10.1016/j.exger.2015.02.010] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 02/11/2015] [Accepted: 02/13/2015] [Indexed: 11/25/2022]
Abstract
The aim of the study was to evaluate the association between various factors and diabetes type II (DM) with a particular emphasis on indicators of central obesity, and to compare the effect of DM on disability among elder populations (≥ 50 years old) in nine countries. Data were available for 52,946 people aged ≥ 18 years who participated in the WHO Study on global AGEing and adult health and the Collaborative Research on Ageing in Europe studies conducted between 2007 and 2012. DM was defined as self-report of physician diagnosis. Height, weight, and waist circumference were measured. Disability status was assessed with the WHODAS II questionnaire. The overall prevalence of DM was 7.9% and ranged from 3.8% (Ghana) to 17.6% (Mexico). A 10 cm increase in waist circumference and waist-to-height ratio of >0.5 were associated with a significant 1.26 (India) to 1.77 (Finland), and 1.68 (China, Spain) to 5.40 (Finland) times higher odds for DM respectively. No significant associations were observed in Mexico and South Africa. DM was associated with significantly higher disability status in all countries except Mexico in the model adjusted for demographics and smoking. The inclusion of chronic conditions associated with diabetes in the model attenuated the coefficients in varying degrees depending on the country. A considerable proportion of the studied older population had DM. Central obesity may be a key factor for the prevention of DM among older populations globally. Prevention of DM especially among the older population globally may contribute to reducing the burden of disability.
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Affiliation(s)
- Stefanos Tyrovolas
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujades, 42, 08830 Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain
| | - Ai Koyanagi
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujades, 42, 08830 Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain
| | - Noe Garin
- Pharmacy Department, Hospital de la Santa Creu i Sant Pau, Institut d'Investigacions Biomèdiques Sant Pau (IIB Sant Pau), Sant Antoni Maria Claret 167, 08025 Barcelona, Spain; Universitat Autònoma de Barcelona, Bellaterra 08193 Cerdanyola del Vallès, Spain
| | - Beatriz Olaya
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujades, 42, 08830 Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain
| | - Jose Luis Ayuso-Mateos
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid, Instituto de Investigación Sanitaria Princesa (IP), Hospital Universitario la Princesa, Madrid, Spain
| | - Marta Miret
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid, Instituto de Investigación Sanitaria Princesa (IP), Hospital Universitario la Princesa, Madrid, Spain
| | - Somnath Chatterji
- Department of Health Statistics and Information Systems, World Health Organization, Geneva, Switzerland
| | - Beata Tobiasz-Adamczyk
- Department of Medical Sociology, Jagiellonian University Medical College, Krakow, Poland
| | - Seppo Koskinen
- National Institute for Health and Welfare, Helsinki, Finland
| | - Matilde Leonardi
- Neurology, Public Health and Disability Unit, Neurological Institute "Carlo Besta" Foundation IRCCS (Istituto di ricovero e cura a carattere scientifico), Milan, Italy
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujades, 42, 08830 Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain.
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13
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Liu L, Núṅez AE, An Y, Liu H, Chen M, Ma J, Chou EY, Chen Z, Eisen HJ. Burden of Cardiovascular Disease among Multi-Racial and Ethnic Populations in the United States: an Update from the National Health Interview Surveys. Front Cardiovasc Med 2014; 1:8. [PMID: 26664859 PMCID: PMC4668845 DOI: 10.3389/fcvm.2014.00008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Accepted: 10/23/2014] [Indexed: 01/05/2023] Open
Abstract
PURPOSE The study aimed to provide new evidence of health disparities in cardiovascular disease (CVD) and diabetes mellitus (DM), and to examine their associations with lifestyle-related risk factors across the U.S. multi-racial and ethnic groups. METHODS The analysis included a randomized population sample of 68,321 subjects aged ≥18 years old who participated in the U.S. 2012 and 2013 National Health Interview Surveys. Hypertension, coronary heart disease (CHD), stroke, and DM were classified according to participants' self-report of physician diagnosis. Assessments of risk factors were measured using standard survey instruments. Associations of risk factors with hypertension, CHD, stroke, and DM were analyzed using univariable and multivariable analysis methods. RESULTS Non-Hispanic (NH)-Blacks had significantly higher odds of hypertension, while Hispanics had significantly lower odds of hypertension, and NH-Asians and Hispanics had significantly lower odds of stroke than NH-Whites (p < 0.001). All minority groups, NH-Blacks, NH-Asians, and Hispanics had significantly higher odds of DM, but they had significantly lower odds of CHD than NH-Whites (p < 0.001). Increased body weight, cigarette smoking, and physical inactivity were significantly associated with increased odds of hypertension, CHD, stroke, and DM (p < 0.001). However, the strengths of associations between lifestyle-related factors and the study outcomes were different across racial and ethnic groups. NH-Asians with BMI ≥30 kg/m(2) had the highest odds ratios (OR, 95% CI) for hypertension (5.37, 4.01-7.18), CHD (2.93, 1.90-4.52), and stroke (2.23, 1.08-4.61), and had the second highest odd ratios for DM (3.78, 2.68-5.35) than NH-Whites, NH-Blacks, and Hispanics. CONCLUSION CVD and DM disproportionately affect the U.S. multi-racial and ethnic population. Although lifestyle-related risk factors are significantly associated with increased odds of CVD and DM, the magnitudes of these associations are different by race and ethnicity.
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Affiliation(s)
- Longjian Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Drexel University , Philadelphia, PA , USA ; Department of Environmental and Occupational Health, School of Public Health, Drexel University , Philadelphia, PA , USA
| | - Ana E Núṅez
- Department of Medicine, Drexel University College of Medicine , Philadelphia, PA , USA
| | - Yuan An
- College of Computing and Informatics, Drexel University , Philadelphia, PA , USA
| | - Hui Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Drexel University , Philadelphia, PA , USA
| | - Ming Chen
- Department of Cardiology, First Affiliated Hospital of Chongqing Medical University , Chongqing , China
| | - Jixiang Ma
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Centers for Disease Control and Prevention , Beijing , China
| | - Edgar Y Chou
- Department of Medicine, Drexel University College of Medicine , Philadelphia, PA , USA
| | - Zhengming Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford , Oxford , UK
| | - Howard J Eisen
- Department of Medicine, Drexel University College of Medicine , Philadelphia, PA , USA
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14
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Odone A, Houben RMGJ, White RG, Lönnroth K. The effect of diabetes and undernutrition trends on reaching 2035 global tuberculosis targets. Lancet Diabetes Endocrinol 2014; 2:754-64. [PMID: 25194888 DOI: 10.1016/s2213-8587(14)70164-0] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
To achieve the post-2015 global tuberculosis target of 90% reduction in tuberculosis incidence by 2035, the present rate of decline must accelerate. Among factors that hinder tuberculosis control, malnutrition and diabetes are key challenges. We review available data to describe the complex relationship between tuberculosis, diabetes, and nutritional status. Additionally, we review past trends, present burden, and available future global projections for diabetes, overweight and obesity, as well as undernutrition and food insecurity. Using a mathematical model, we estimate the potential effect of these factors on tuberculosis burden up to 2035. Great potential exists for reduction of worldwide tuberculosis burden by combination of improved prevention and care of diabetes with reduction of undernutrition. To achieve this combination will require joint efforts and strong cross-programme links, enabling synergistic effects of public health policies that promote good nutrition and optimum clinical care for tuberculosis and diabetes.
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Affiliation(s)
- Anna Odone
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
| | - Rein M G J Houben
- Tuberculosis Modelling Group, Tuberculosis Centre and Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Richard G White
- Tuberculosis Modelling Group, Tuberculosis Centre and Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Knut Lönnroth
- Global Tuberculosis Programme, World Health Organization, Geneva, Switzerland
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15
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Hypertension and Diabetes Prevalence in Older Persons in Jamaica, 2012. W INDIAN MED J 2014; 63:416-23. [PMID: 25781276 DOI: 10.7727/wimj.2014.065] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 03/27/2014] [Indexed: 02/08/2023]
Abstract
The Jamaican population is experiencing both a demographic and epidemiological transition. This 2012 study of 2943 community dwelling persons over sixty years of age sought to determine the prevalence of hypertension and diabetes and how it has increased since the earlier 1989 study. Hypertension was the most prevalent non-communicable disease with 61.4% and had increased from 41.4% since 1989. It increased with age and was more common in females than males. Diabetes, at 26.3%, was the third most prevalent; it had increased by 157.1% since 1989. While the majority of affected persons were on medication, control of both diseases was less than adequate. Obesity was associated with both diseases. The paper discusses the implications for healthcare systems.
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16
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Wang A, Stronks K, Arah OA. Global educational disparities in the associations between body mass index and diabetes mellitus in 49 low-income and middle-income countries. J Epidemiol Community Health 2014; 68:705-11. [PMID: 24683177 DOI: 10.1136/jech-2013-203200] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Despite the well-established link between body mass index (BMI) and diabetes mellitus (DM), it remains unclear whether this association is more pronounced at certain levels of education. This study assessed the modifying effect of educational attainment on the associations between BMI and DM-as well as the joint associations of BMI and education with DM-in low-income countries (LICs) and middle-income countries (MICs). METHODS The authors used cross-sectional data from 160 381 participants among 49 LICs and MICs in the World Health Survey. Overweight and obesity levels were defined using WHO's classification. Educational attainment was classified in four categories: 'no formal education', 'some/completed primary school', 'secondary/high school completed' and 'college and beyond'. We used random-intercept multilevel logistic regressions to investigate the modifying influence of educational attainment on the associations of different BMI levels-as well as their joint associations-with DM. RESULTS We found positive associations between excessive BMI and DM at each education level in both LICs and MICs. We found that the joint associations of BMI and education with DM were larger than the product of their separate single associations among females in LICs. With joint increases in BMI and education, males and females in LICs had similar increased odds of DM, but males had higher such odds than females in MICs. CONCLUSIONS BMI and education are associated with the DM, but the associations seem to differ in complex ways between LICs and MICs and by gender.
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Affiliation(s)
- Aolin Wang
- Department of Epidemiology, The Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, California, USA
| | - Karien Stronks
- Department of Public Health, Academic Medical Center, Amsterdam, The Netherlands
| | - Onyebuchi A Arah
- Department of Epidemiology, The Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, California, USA Department of Public Health, Academic Medical Center, Amsterdam, The Netherlands UCLA Center for Health Policy Research, Los Angeles, California, USA
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17
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Nandi A, Sweet E, Kawachi I, Heymann J, Galea S. Associations between macrolevel economic factors and weight distributions in low- and middle-income countries: a multilevel analysis of 200,000 adults in 40 countries. Am J Public Health 2013; 104:e162-71. [PMID: 24228649 DOI: 10.2105/ajph.2013.301392] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVES We examined associations between macrolevel economic factors hypothesized to drive changes in distributions of weight and body mass index (BMI) in a representative sample of 200,796 men and women from 40 low- and middle-income countries. METHODS We used meta-regressions to describe ecological associations between macrolevel factors and mean BMIs across countries. Multilevel regression was used to assess the relation between macrolevel economic characteristics and individual odds of underweight and overweight relative to normal weight. RESULTS In multilevel analyses adjusting for individual-level characteristics, a 1-standard-deviation increase in trade liberalization was associated with 13% (95% confidence interval [CI] = 0.76, 0.99), 17% (95% CI = 0.71, 0.96), 13% (95% CI = 0.76, 1.00), and 14% (95% CI = 0.75, 0.99) lower odds of underweight relative to normal weight among rural men, rural women, urban men, and urban women, respectively. Economic development was consistently associated with higher odds of overweight relative to normal weight. Among rural men, a 1-standard-deviation increase in foreign direct investment was associated with 17% (95% CI = 1.02, 1.35) higher odds of overweight relative to normal weight. CONCLUSIONS Macrolevel economic factors may be implicated in global shifts in epidemiological patterns of weight.
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Affiliation(s)
- Arijit Nandi
- Arijit Nandi and Jody Heymann are with the Institute for Health and Social Policy and the Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec. Elizabeth Sweet is with the Center on Social Disparities and Health, Institute for Policy Research, Northwestern University, Evanston, IL. Ichiro Kawachi is with the Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA. Sandro Galea is with the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY
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