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Cai Q, Shi S, Shen H, Ye B, Cheng W. Combined general and central obesity indices to predict gestational diabetes. J Matern Fetal Neonatal Med 2023; 36:2183765. [PMID: 36860096 DOI: 10.1080/14767058.2023.2183765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
OBJECTIVE To investigate the relationship between general and central obesity in the first trimester of pregnancy and gestational diabetes and its predicted value. MATERIALS AND METHODS We recruited 813 women who registered at 6-12 weeks of gestation. Anthropometric measurements were done at the first antenatal visit. At 24-28 weeks of pregnancy, gestational diabetes was diagnosed using the 75 g oral glucose tolerance test. Binary logistic regression was used to determine odds ratios and 95% confidence intervals. The receiver-operating characteristic curve was used to evaluate the ability of obesity indices to predict the risk of gestational diabetes. RESULTS Odds ratios (95% confidence intervals) of gestational diabetes across increasing quartiles of waist-to-hip ratio were 1.00, 1.54 (0.65-3.66), 2.63 (1.18-5.85), and 4.96 (2.27-10.85), respectively (p < .001), while those for waist-to-height ratio were 1.00, 1.21 (0.47-3.08), 2.99 (1.26-7.10), and 4.01 (1.57-10.19), respectively (p < .001). Areas under the curve for general and central obesity were similar. However, the area under the curve of body mass index combined with the waist-to-hip ratio was the biggest. CONCLUSION Higher waist-to-hip ratio and waist-to-height ratio in the first trimester of pregnancy are associated with increased risks of gestational diabetes in Chinese women. The combination of body mass index and waist-to-hip ratio in the first trimester of pregnancy is a good predictor for gestational diabetes.
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Affiliation(s)
- Qunying Cai
- Department of Gynecology and Obstetrics, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China
| | - Shu Shi
- Department of Gynecology and Obstetrics, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China
| | - Hong Shen
- Department of Gynecology and Obstetrics, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China
| | - Baoying Ye
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China.,Department of Ultrasound, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Weiwei Cheng
- Department of Gynecology and Obstetrics, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China
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Saberi‐Karimian M, Mansoori A, Bajgiran MM, Hosseini ZS, Kiyoumarsioskouei A, Rad ES, Zo MM, Khorasani NY, Poudineh M, Ghazizadeh S, Ferns G, Esmaily H, Ghayour‐Mobarhan M. Data mining approaches for type 2 diabetes mellitus prediction using anthropometric measurements. J Clin Lab Anal 2022; 37:e24798. [PMID: 36510349 PMCID: PMC9833979 DOI: 10.1002/jcla.24798] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/15/2022] [Accepted: 11/21/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The aim of this study was to evaluate the anthropometric measurements most associated with type 2 diabetes mellitus (T2DM) using machine learning approaches. METHODS A prospective study was designed for a total population of 9354 (43% men and 57% women) aged 35-65. Anthropometric measurements include weight, height, demispan, Hip Circumference (HC), Mid-arm Circumference (MAC), Waist Circumference (WC), Body Roundness Index (BRI), Body Adiposity Index (BAI), A Body Shape Index (ABSI), Body Mass Index (BMI), Waist-to-height Ratio (WHtR), and Waist-to-hip Ratio (WHR) were completed for all participants. The association was assessed using logistic regression (LR) and decision tree (DT) analysis. Receiver operating characteristic (ROC) curve was performed to evaluate the DT's accuracy, sensitivity, and specificity using R software. RESULTS Traditionally, 1461 women and 875 men with T2DM (T2DM group). According to the LR, in males, WC and BIA (p-value < 0.001) and in females, demispan and WC (p-value < 0.001) had the highest correlation with T2DM development risk. The DT indicated that WC has the most crucial effect on T2DM development risk, followed by HC, and BAI. CONCLUSIONS Our results showed that in both men and women, WC was the most important anthropometric factor to predict T2DM.
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Affiliation(s)
- Maryam Saberi‐Karimian
- International UNESCO center for Health Related Basic Sciences and Human NutritionMashhad University of Medical SciencesMashhadIran
| | - Amin Mansoori
- International UNESCO center for Health Related Basic Sciences and Human NutritionMashhad University of Medical SciencesMashhadIran,Department of Biostatistics, School of HealthMashhad University of Medical SciencesMashhadIran
| | - Maryam Mohammadi Bajgiran
- International UNESCO center for Health Related Basic Sciences and Human NutritionMashhad University of Medical SciencesMashhadIran
| | | | | | - Elias Sadooghi Rad
- Student Research Committee, School of MedicineMashhad University of Medical sciencesMashhadIran,Student Research Committee, School of MedicineBirjand University of Medical sciencesBirjandIran
| | - Mostafa Mahmoudi Zo
- Student Research Committee, School of MedicineMashhad University of Medical sciencesMashhadIran
| | - Negar Yeganeh Khorasani
- Student Research Committee, School of MedicineMashhad University of Medical sciencesMashhadIran
| | - Mohadeseh Poudineh
- Student Research Committee, School of MedicineMashhad University of Medical sciencesMashhadIran,School of MedicineZanjan University of Medical SciencesZanjanIran
| | - Sara Ghazizadeh
- Department of Biology, Faculty of SciencesMashhad Branch, Islamic Azad UniversityMashhadIran
| | - Gordon Ferns
- Brighton and Sussex Medical SchoolDivision of Medical EducationBrightonUK
| | - Habibollah Esmaily
- Department of Biostatistics, School of HealthMashhad University of Medical SciencesMashhadIran,Social Determinants of Health Research CenterMashhad University of Medical SciencesMashhadIran
| | - Majid Ghayour‐Mobarhan
- International UNESCO center for Health Related Basic Sciences and Human NutritionMashhad University of Medical SciencesMashhadIran
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Hao J, Yao Q, Lin Y, Sun Y, Zhang B, Hu M, Zhang J, Zhao N, Pei J, Liu Z, Zhu C. Cost-effectiveness of two screening strategies based on Chinese diabetes risk score for pre-diabetes in China. Front Public Health 2022; 10:1018084. [PMID: 36530668 PMCID: PMC9747942 DOI: 10.3389/fpubh.2022.1018084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 11/14/2022] [Indexed: 12/05/2022] Open
Abstract
Objective Studies have shown that screening for pre-diabetes mellitus (pre-DM) is essential to prevent type 2 diabetes mellitus (T2DM). This study evaluates the cost-effectiveness of two screening strategies that apply the Chinese Diabetes Risk Score (CDRS) to screen for pre-DM in China. Methods A Markov microsimulation model was conducted from a social perspective, and the input parameters were obtained from published literature or publicly available data. Two screening strategies for pre-DM based on CDRS were built and compared with the control group to determine the cost-effective strategy. The screening strategy of the control group was screening for pre-DM by fasting plasma glucose (FPG) test in adults undergoing annual health examination and no screening in adults without an annual health examination (status quo). Two screening strategies were strategy 1: screening for pre-DM using CDRS in all adults (including with or without an annual health examination); and strategy 2: supplemental self-screening for pre-DM using CDRS in adults without an annual health examination, based on the status quo. We focus on the cumulative prevalence of T2DM and the incremental cost-effectiveness ratio which signifies the cost per case of T2DM prevented. We also evaluated the cost-effectiveness from the health system perspective. One-way and probabilistic sensitivity analyses were conducted to verify the robustness of the results. Results The costs a case of T2DM prevented for strategy 1 compared with the control group and strategy 2 were $299.67 (95% CI 298.88, 300.46) and $385.89 (95% CI 381.58, 390.20), respectively. In addition, compared with the control group, the cost of strategy 2 to prevent a case of T2DM was $272.23 (95% CI 271.50, 272.96). Conclusions Screening for pre-DM using CDRS in all adults was the most cost-effective health policy. We suggest that medical institutions replace FPG with CDRS for pre-DM screening; at the same time, self-screening for pre-DM using CDRS is widely promoted among adults without an annual health examination. There were still some disputes about how CDRS is included in the health examination projects, so strategy 2 should be considered as an alternative screening strategy. Findings provide a reference for the application of the CDRS in pre-DM screening and contribute to T2DM prevention.
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Affiliation(s)
- Jingjing Hao
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Qiang Yao
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yidie Lin
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yue Sun
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Baiyang Zhang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Meijing Hu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jing Zhang
- Department of Cardiology, Daping Hospital, The Third Military Medical University, Chongqing, China
| | - Ningxuan Zhao
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jiao Pei
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Zhonghua Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China,*Correspondence: Zhonghua Liu
| | - Cairong Zhu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China,Cairong Zhu
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Shu L, Zhao Y, Shen Y, Jia L, Zhang J. Interaction analysis of lipid accumulation product and family history of diabetes on impaired fasting glucose and diabetes risk in population with normotension in Eastern China: a community-based cross-sectional survey. Arch Public Health 2022; 80:217. [PMID: 36183132 PMCID: PMC9526958 DOI: 10.1186/s13690-022-00972-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 09/23/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Lipid accumulation product (LAP) is considered to be a new convenient useful indicator to assess the visceral fat. Therefore, we aimed to evaluate the risk factors of impaired fasting glucose (IFG) and diabetes, and explore the possible interacting influences of LAP with other factors on the risk of IFG and diabetes among Chinese normotension adults. METHODS A multistage stratified cluster sampling method was conducted to select urban residents in Bengbu, China. For each eligible participant, data on questionnaire survey, anthropometric measurements and laboratory tests were obtained. The effects of body mass index (BMI), waist circumference (WC), waist to height ratio (WHtR) and LAP for predicting IFG and diabetes were performed by multiple logistic regressions and receiver operating characteristic (ROC) analyses. The interaction effects were evaluated by relative excess risk of interaction (RERI), attributable proportion due to interaction (AP) and synergy index (SI). RESULTS Six thousand, four hundred sixty-seven normotension subjects (2695 men and 3772 women) were enrolled in our study, the prevalence of IFG and diabetes were 9.37% and 14.33%, respectively. When assessed using ROC curve analysis, LAP exhibited higher diagnostic accuracy for identifying IFG and diabetes than BMI, the area under the AUC curve was 0.650 (95% CI: 0.637 to 0.662). After adjustment for age, sex, educational level and other confounding factors, multivariate logistic regression analyses indicated that subjects with the fourth quartile of LAP were more likely to develop IFG (adjusted OR: 2.735, 95% CI: 1.794-4.170) and diabetes (adjusted OR: 1.815, 95% CI: 1.297-2.541) than those with the first quartile. A significant interaction between LAP and family history of diabetes was observed in participants (RERI = 1.538, 95%CI: 0.167 to 3.612; AP = 0.375, 95%CI: 0.118 to 0.631; SI = 1.980, 95%CI: 1.206 to 3.251). However, a significant interaction between LAP and abdominal obesity was indicated by the value of RERI (1.492, 95%CI: 0.087 to 3.723) and AP (0.413, 95%CI: 0.014 to 0.756), but not the value of SI (1.824, 95%CI: 0.873 to 3.526). CONCLUSION Our results demonstrated that there might be synergistic effect between LAP and family history of diabetes on the risk of IFG and diabetes.
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Affiliation(s)
- Li Shu
- grid.252957.e0000 0001 1484 5512School of Public Health, Bengbu Medical College, Bengbu, Anhui Province China
| | | | - Yanqi Shen
- grid.252957.e0000 0001 1484 5512School of Public Health, Bengbu Medical College, Bengbu, Anhui Province China
| | - Linlin Jia
- grid.252957.e0000 0001 1484 5512School of Public Health, Bengbu Medical College, Bengbu, Anhui Province China
| | - Jiaye Zhang
- grid.252957.e0000 0001 1484 5512School of Public Health, Bengbu Medical College, Bengbu, Anhui Province China
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Chi JH, Lee BJ. Risk factors for hypertension and diabetes comorbidity in a Korean population: A cross-sectional study. PLoS One 2022; 17:e0262757. [PMID: 35045123 PMCID: PMC8769319 DOI: 10.1371/journal.pone.0262757] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 01/04/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Hypertension and diabetes are risk factors for severe cardiovascular disease and are prevalent comorbidities. No studies have examined the associations of various risk factors related to anthropometry, bone mineral density and body composition of specific body regions with hypertension and diabetes comorbidity (HDC). This study explored the association between HDC and various risk factors related to specific body regions. METHOD A total of 7,978 subjects (3,451 men and 4,527 women) aged ≥ 50 years were included in the analysis. A binary logistic regression analysis based on complex sample data analysis was conducted to examine associations between the normal and diabetes groups, between the normal and hypertension groups, and between the normal and HDC groups. RESULTS Among Korean adults aged ≥ 50 years, 11.27% of men and 10.05% of women had both diabetes and hypertension. The HDC prevalence was higher in men than in women. In men, waist-to-height ratio (WHtR, adjusted OR = 1.63 [1.22-2.18], adjusted p<0.001) exhibited a more significant association with HDC than other indices, left leg fat mass (adjusted OR = 0.61 [0.45-0.81], adjusted p = 0.0009) and right leg fat mass (adjusted OR = 0.60 [0.45-0.81], adjusted p = 0.0007) displayed strong negative associations with diabetes, and left leg lean mass (adjusted OR = 0.77 [0.67-0.89], adjusted p = 0.0002) and trunk fat mass (adjusted OR = 1.28 [1.07-1.52], adjusted p = 0.0062) were significantly associated with hypertension. In women, left leg fat mass (adjusted OR = 0.29 [0.22-0.39], adjusted p<0.0001) and right leg fat mass (adjusted OR = 0.32 [0.23-0.45], adjusted p<0.0001) exhibited strong negative associations with HDC, waist circumference (WC) (adjusted OR = 2.15 [1.40-3.30], adjusted p = 0.0005) showed a stronger association with diabetes than did other indices, and WC (adjusted OR = 1.39 [1.11-1.74], adjusted p = 0.0040) and WHtR (adjusted OR = 1.39 [1.09-1.76], adjusted p = 0.0075) were significantly associated with hypertension. DISCUSSION HDC was more strongly associated with fat and lean mass than diabetes and hypertension. The association between HDC and body fat variables was more robust in women than in men.
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Affiliation(s)
- Jeong Hee Chi
- Department of Computer Science and Engineering, Konkuk University, Seoul, Republic of Korea
| | - Bum Ju Lee
- Digital Health Research Division, Korea Institute of Oriental Medicine, Deajeon, Republic of Korea
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Clinical Usefulness of Anthropometric Indices to Predict the Presence of Prediabetes. Data from the ILERVAS Cohort. Nutrients 2021; 13:nu13031002. [PMID: 33808883 PMCID: PMC8003825 DOI: 10.3390/nu13031002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 03/11/2021] [Accepted: 03/16/2021] [Indexed: 12/17/2022] Open
Abstract
Prediabetes is closely related to excess body weight and adipose distribution. For this reason, we aimed to assess and compare the diagnostic usefulness of ten anthropometric adiposity indices to predict prediabetes. Cross-sectional study with 8188 overweight subjects free of type 2 diabetes from the ILERVAS project (NCT03228459). Prediabetes was diagnosed by levels of glycated hemoglobin (HbA1c). Total body adiposity indices [BMI, Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE) and Deurenberg's formula] and abdominal adiposity (waist and neck circumferences, conicity index, waist to height ratio, Bonora's equation, A body shape index, and body roundness index) were calculated. The area under the receiver-operating characteristic (ROC) curve, the best cutoff and the prevalence of prediabetes around this value were calculated for every anthropometric index. All anthropometric indices other than the A body adiposity were higher in men and women with prediabetes compared with controls (p < 0.001 for all). In addition, a slightly positive correlation was found between indices and HbA1c in both sexes (r ≤ 0.182 and p ≤ 0.026 for all). None of the measures achieved acceptable levels of discrimination in ROC analysis (area under the ROC ≤ 0.63 for all). Assessing BMI, the prevalence of prediabetes among men increased from 20.4% to 36.2% around the cutoff of 28.2 kg/m2, with similar data among women (from 29.3 to 44.8% with a cutoff of 28.6 kg/m2). No lonely obesity index appears to be the perfect biomarker to use in clinical practice to detect individuals with prediabetes.
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Alzeidan R, Fayed A, Rabiee F, Hersi A, Elmorshedy H. Diagnostic performance of waist-to-height ratio in identifying cardiovascular risk factors and metabolic syndrome among adult Saudis. A cross-sectional study. Saudi Med J 2021; 41:253-260. [PMID: 32114597 PMCID: PMC7841557 DOI: 10.15537/smj.2020.3.24915] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Objectives: To evaluate the diagnostic performance of waist to height ratio (WHtR) to screen for cardiovascular risk factors (CVRF) and metabolic syndrome (MetS) among Saudis. Methods: Between June 2013 and August 2014, a cross-sectional study of 3,063 adult Saudis of both genders from King Khalid Hospital, Riyadh, Saudi Arabia was conducted. Using the “WHO STEPwise Surveillance-Instrument V2.1”, which uses sequential steps including questionnaires and anthropometric and biochemical measurements of MetS and CVRF. Waist to height ratio validity in defining central obesity, MetS, and CVRF were tested using receiver operating characteristic curve (ROC), sensitivity, specificity, positive and negative predictive values, and accuracy. Using multivariate regression analyses for adjustment of confounders as age and gender were applied to compute adjusted odds ratios (aOR). Results: The diagnostic potential of WHtR was excellent for central obesity (area under the curve [AUC] = 0.98), and MetS (AUCs = 0.86); it was good for CVRF ≥2 (AUCs = 0.79) and was satisfactory for dyslipidemia (AUCs = 0.66). The sensitivities and negative predictive values exceeded 85% for diagnosing central obesity, diabetes, and hypertension. Adjusted odds ratios for age and gender showed that WHtR ≥0.50 significantly increased the risk of diabetes, hypertension, and ≥2 CVRF by almost 4-fold, and increased the risk of dyslipidemia by 2-fold. Conclusion: Waist height ratio showed a good diagnostic performance for CVRF and MetS among Saudis. Furthermore, WHtR ≥0.5 increased the risk of dyslipidemia, diabetes mellitus and hypertension.
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Affiliation(s)
- Rasmieh Alzeidan
- Cardiac Sciences Department, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.
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Tian X, Li Y, Liu J, Lin Q, Yang Q, Tu J, Wang J, Li J, Ning X. Epidemiology of Isolated Impaired Glucose Tolerance Among Adults Aged Above 50 Years in Rural China. Diabetes Metab Syndr Obes 2021; 14:4067-4078. [PMID: 34557009 PMCID: PMC8453426 DOI: 10.2147/dmso.s330470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 09/04/2021] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Isolated impaired glucose tolerance (i-IGT) is a subtype of prediabetes in which an individual demonstrates elevated 2-h post-glucose load glucose levels but normal fasting plasma glucose levels. However, few studies have explored the prevalence and risk factors of i-IGT among adults in rural China. Thus, we aimed to explore the prevalence and risk factors of i-IGT among adults ≥50 years old in a low-income, rural population in China. MATERIALS AND METHODS Individuals aged ≥50 years with normal fasting plasma glucose levels were included in the final analysis. Fasting and 2-h venous blood samples were collected to assess the selected parameter measurements. RESULTS A total of 2175 individuals were included in this study. The i-IGT prevalence was 22.9% and significantly higher among females than among males (P<0.05). Older age [odds ratio (OR), 1.606; 95% confidence interval (CI), 1.101-2.342; P=0.014), hypertension (OR, 1.554; 95% CI, 1.152-2.019; P=0.004), and central obesity (OR, 1.395; 95% CI, 1.099-1.771; P=0.006) were associated with i-IGT. Moreover, white blood cell (OR, 1.089; 95% CI, 1.009-1.175; P=0.029), high-sensitivity C-reactive protein (OR, 1.049; 95% CI, 1.020-1.078; P=0.001), serum uric acid (OR, 1.0003; 95% CI, 1.001-1.004; P=0.001), triglyceride (OR, 1.540; 95% CI, 1.105-2.147; P=0.011), and alanine aminotransferase (OR, 1.012; 95% CI, 1.004-1.021; P=0.004) levels were also linked to i-IGT in the analyzed population. CONCLUSION Health promotion education and a standardized approach to managing body weight, BP, and lipid and uric acid levels would benefit this low-income population in rural China for reducing the risk of cardiovascular disease.
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Affiliation(s)
- Xiaobing Tian
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
| | - Yan Li
- Center of Clinical Epidemiology & Evidence-Based Medicine, The Jizhou People’s Hospital, Tianjin, People’s Republic of China
- Department of Anesthesiology, The Jizhou People’s Hospital, Tianjin, People’s Republic of China
| | - Jie Liu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
- Center of Clinical Epidemiology & Evidence-Based Medicine, The Jizhou People’s Hospital, Tianjin, People’s Republic of China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, People’s Republic of China
- Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, People’s Republic of China
| | - Qiuxing Lin
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
- Center of Clinical Epidemiology & Evidence-Based Medicine, The Jizhou People’s Hospital, Tianjin, People’s Republic of China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, People’s Republic of China
- Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, People’s Republic of China
| | - Qiaoxia Yang
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
| | - Jun Tu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
- Center of Clinical Epidemiology & Evidence-Based Medicine, The Jizhou People’s Hospital, Tianjin, People’s Republic of China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, People’s Republic of China
- Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, People’s Republic of China
| | - Jinghua Wang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
- Center of Clinical Epidemiology & Evidence-Based Medicine, The Jizhou People’s Hospital, Tianjin, People’s Republic of China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, People’s Republic of China
- Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, People’s Republic of China
| | - Jidong Li
- Center of Clinical Epidemiology & Evidence-Based Medicine, The Jizhou People’s Hospital, Tianjin, People’s Republic of China
- Department of Neurosurgery, The Jizhou People’s Hospital, Tianjin, People’s Republic of China
| | - Xianjia Ning
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
- Center of Clinical Epidemiology & Evidence-Based Medicine, The Jizhou People’s Hospital, Tianjin, People’s Republic of China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, People’s Republic of China
- Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, People’s Republic of China
- Correspondence: Xianjia Ning; Jidong Li Email ;
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Fu X, Jia Y, Liu J, Lei Q, Li L, Li N, Hu Y, Wang S, Liu H, Yan S. The Predictive Effect of Health Examination in the Incidence of Diabetes Mellitus in Chinese Adults: A Population-Based Cohort Study. J Diabetes Res 2021; 2021:3552080. [PMID: 34423045 PMCID: PMC8377476 DOI: 10.1155/2021/3552080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/25/2021] [Accepted: 07/29/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The incidence of diabetes mellitus (DM) was increasing in recent years, and it is important to screen those nondiabetic populations through health examination to detect the potential risk factors for DM. We aimed to find the predictive effect of health examination on DM. METHODS We used the public database from Rich Healthcare Group of China to evaluate the potential predictive effect of health examination in the onset of DM. The colinear regression was used for estimating the relationship between the dynamics of the health examination index and the incident year of DM. The time-dependent ROC was used to calculate the best cutoff in predicting DM in the follow-up year. The Kaplan-Meier method and Cox regression were used to evaluate the HR of related health examination. RESULTS A total of 211,833 participant medical records were included in our study, with 4,172 participants diagnosing as DM in the following years (among 2-7 years). All the initial health examination was significantly different in participants' final diagnosing as DM to those without DM. We found a negative correlation between the incidence of years of DM and the average initial FPG (r = -0.1862, P < 0.001). Moreover, the initial FPG had a strong predictive effect in predicting the future incidence of DM (AUC = 0.961), and the cutoff was 5.21 mmol/L. Participants with a higher initial FPG (>5.21 mmol/L) had a 2.73-fold chance to develop as DM in follow-up (95%CI = 2.65-2.81, P < 0.001). CONCLUSION Initial FPG had a good predictive effect for detecting DM. The FPG should be controlled less than 5.21 mmol/L.
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Affiliation(s)
- Xiaomin Fu
- Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China
| | - Yingmin Jia
- Department of Nephrology, Shunyi Hospital, Beijing Traditional Chinese Medicine Hospital, No. 5 Zhanqian East Street, Shunyi District, Beijing 101300, China
| | - Jing Liu
- Clinics of Cadre, Department of Outpatient, The First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China
| | - Qinghua Lei
- Physical Examination Center, Central Hospital of Handan City, No. 59 Congtai North Road, Congtai District, Handan, Hebei Province 056008, China
| | - Lele Li
- Department of Endocrinology, Genetics, Metabolism and Adolescent Medicine, Beijing Children's Hospital, The Capital Medical University, National Center for Children's Health, No. 56 Nan Li Shi Road, West District, Beijing 100045, China
| | - Nan Li
- Department of Endocrinology, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China
| | - Yanyan Hu
- Physical Examination Center, Central Hospital of Handan City, No. 59 Congtai North Road, Congtai District, Handan, Hebei Province 056008, China
| | - Shanshan Wang
- Physical Examination Center, Central Hospital of Handan City, No. 59 Congtai North Road, Congtai District, Handan, Hebei Province 056008, China
| | - Hongzhou Liu
- Department of Endocrinology, First Hospital of Handan City, No. 25 Congtai Road, Congtai District, Handan, Hebei Province 056002, China
| | - Shuangtong Yan
- Department of Endocrinology, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China
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Tian X, Zhang Y, Li H, Li Y, Wang N, Zhang W, Ma B. Palmatine ameliorates high fat diet induced impaired glucose tolerance. Biol Res 2020; 53:39. [PMID: 32928312 PMCID: PMC7491132 DOI: 10.1186/s40659-020-00308-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 09/07/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The impaired glucose tolerance (IGT) is a representative prediabetes characterized by defective glucose homeostasis, and palmatine (PAL) is a natural isoquinoline alkaloid with multiple pharmacological effects. Our study aims to investigate the therapeutic effect of PAL on the impaired glucose tolerance. METHODS Male Sprague-Dawley rats were used to establish an IGT model with high fat diet (HFD). Oral glucose tolerance test (OGTT) and further biochemical analysis were conducted to determine the effect of PAL on glucose intolerance in vivo. Molecular details were clarified in a cellular model of IGT induced by Palmitate (PA) on INS-1 cells. RESULTS Our study demonstrated a relief of IGT with improved insulin resistance in HFD induced rats after PAL treatment. Besides, promoted pancreas islets function was validated with significantly increased β cell mass after the treatment of PAL. We further found out that PAL could alleviate the β cell apoptosis that accounts for β cell mass loss in IGT model. Moreover, MAPK signaling was investigated in vivo and vitro with the discovery that PAL regulated the MAPK signaling by restricting the ERK and JNK cascades. The insulin secretion assay indicated that PAL significantly promoted the defective insulin secretion in PA-induced INS-1 cells via JNK rather than ERK signaling. Furthermore, PAL treatment was determined to significantly suppress β cell apoptosis in PA-induced cells. We thus thought that PAL promoted the PA-induced impaired insulin release by inhibiting the β cell apoptosis and JNK signaling in vitro. CONCLUSION In summary, PAL ameliorates HFD-induced IGT with novel mechanisms.
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Affiliation(s)
- Xusheng Tian
- Teaching and Research Department of Theories of Schools of Traditional Chinese Medicine, School of Basic Medical Sciences, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, 150040, People's Republic of China
| | - Yukun Zhang
- Laboratory of Anatomy, Experimental and Training Center, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, 150040, People's Republic of China
| | - Han Li
- Department of Febrile Disease, School of Basic Medical Sciences, Heilongjiang University of Chinese Medicine, 24 Heping Road, Harbin, Heilongjiang, 150040, People's Republic of China
| | - Yunfeng Li
- Department of Febrile Disease, School of Basic Medical Sciences, Heilongjiang University of Chinese Medicine, 24 Heping Road, Harbin, Heilongjiang, 150040, People's Republic of China
| | - Ning Wang
- Department of Febrile Disease, School of Basic Medical Sciences, Heilongjiang University of Chinese Medicine, 24 Heping Road, Harbin, Heilongjiang, 150040, People's Republic of China
| | - Wei Zhang
- Department of Chinese Medicinal Formulae, School of Basic Medical Sciences, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, 150040, People's Republic of China
| | - Boyan Ma
- Department of Febrile Disease, School of Basic Medical Sciences, Heilongjiang University of Chinese Medicine, 24 Heping Road, Harbin, Heilongjiang, 150040, People's Republic of China.
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Chi JH, Shin MS, Lee BJ. Association of type 2 diabetes with anthropometrics, bone mineral density, and body composition in a large-scale screening study of Korean adults. PLoS One 2019; 14:e0220077. [PMID: 31339947 PMCID: PMC6656355 DOI: 10.1371/journal.pone.0220077] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 07/07/2019] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Type 2 diabetes mellitus (T2DM) is a common, chronic disease that is closely associated with anthropometric indices related to obesity. However, no study published to date has simultaneously examined the associations of T2DM with anthropometrics, bone mineral density (BMD), and body composition variables. The present study aimed to evaluate the associations of T2DM with anthropometrics, BMD and body composition variables and to identify the best indicator of T2DM in Korean adults. METHODS The data used in this study were obtained from the Korea National Health and Nutrition Examination Survey conducted from 2008 to 2011. A total of 7,835 participants aged from 40 to 90 years were included in this study. A binary logistic regression analysis was performed to examine the significance of differences between the groups with and without T2DM, and the areas under the receiver operating characteristic (AUCs) curves were calculated to compare the predictive power of all variables. RESULTS In men, waist-to-height ratio (WHtR) displayed the strongest association with T2DM (adjusted odds ratio (OR) = 1.838 [1.513-2.233], adjusted p<0.001), and waist circumference (WC) and WHtR were the best indicators (WC: AUC = 0.662 [0.639-0.685], WHtR: AUC = 0.680 [0.658-0.703]) of T2DM among all the variables. In women, left leg (LL) and right leg (RL) fat displayed strong negative associations with T2DM (LL fat: adjusted OR = 0.367 [0.321-0.419], adjusted p<0.001, RL fat: adjusted OR = 0.375 [0.329-0.428], adjusted p<0.001), and WC and WHtR were excellent indicators (WC: AUC = 0.730 [0.709-0.750], WHtR: AUC = 0.747 [0.728-0.766]) of T2DM among all the variables. In particular, the WHtR in men and LL and RL fat in women exhibited the strongest associations with T2DM, and the predictive power of the WC and WHtR was stronger than BMD, fat, and muscle mass variables in both men and women. Additionally, the predictive power of the WC and WHtR was stronger in women than in men. DISCUSSION Of the anthropometric indices, BMD, and body fat and muscle variables, the best indicators of T2DM were WC and WHtR in both Korean men and women. The results of the present investigation will provide basic information for clinical studies of patients with T2DM and evidence for the prevention and management of T2DM.
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Affiliation(s)
- Jeong Hee Chi
- Department of Software, Konkuk University, Seoul, Republic of Korea
| | - Moon Sun Shin
- Department of Computer Engineering, Konkuk University, Chungju, Republic of Korea
| | - Bum Ju Lee
- Future Medicine Division, Korea Institute of Oriental Medicine, Deajeon, Republic of Korea
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