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Rivara AC, Russell EM, Carlson JC, Pomer A, Naseri T, Reupena MS, Manna SL, Viali S, Minster RL, Weeks DE, DeLany JP, Kershaw EE, McGarvey ST, Hawley NL. Associations between fasting glucose rate-of-change and the missense variant, rs373863828, in an adult Samoan cohort. PLoS One 2024; 19:e0302643. [PMID: 38829901 PMCID: PMC11146712 DOI: 10.1371/journal.pone.0302643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 04/09/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND The A allele of rs373863828 in CREB3 regulatory factor is associated with high Body Mass Index, but lower odds of type 2 diabetes. These associations have been replicated elsewhere, but to date all studies have been cross-sectional. Our aims were (1) to describe the development of type 2 diabetes and change in fasting glucose between 2010 and 2018 among a longitudinal cohort of adult Samoans without type 2 diabetes or who were not using diabetes medications at baseline, and (2) to examine associations between fasting glucose rate-of-change (mmol/L per year) and the A allele of rs373863828. METHODS We describe and test differences in fasting glucose, the development of type 2 diabetes, body mass index, age, smoking status, physical activity, urbanicity of residence, and household asset scores between 2010 and 2018 among a cohort of n = 401 adult Samoans, selected to have a ~2:2:1 ratio of GG:AG: AA rs373863828 genotypes. Multivariate linear regression was used to test whether fasting glucose rate-of-change was associated with rs373863828 genotype, and other baseline variables. RESULTS By 2018, fasting glucose and BMI significantly increased among all genotype groups, and a substantial portion of the sample developed type 2 diabetes mellitus. The A allele was associated with a lower fasting glucose rate-of-change (β = -0.05 mmol/L/year per allele, p = 0.058 among women; β = -0.004 mmol/L/year per allele, p = 0.863 among men), after accounting for baseline variables. Mean fasting glucose and mean BMI increased over an eight-year period and a substantial number of individuals developed type 2 diabetes by 2018. However, fasting glucose rate-of-change, and type 2 diabetes development was lower among females with AG and AA genotypes. CONCLUSIONS Further research is needed to understand the effect of the A allele on fasting glucose and type 2 diabetes development. Based on our observations that other risk factors increased over time, we advocate for the continued promotion for diabetes prevention and treatment programming, and the reduction of modifiable risk factors, in this setting.
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Affiliation(s)
- Anna C. Rivara
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Emily M. Russell
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Jenna C. Carlson
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States of America
- Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Alysa Pomer
- Center of Surgery and Public Health, Brigham and Women’s Hospital, Boston, MA, United States of America
| | - Take Naseri
- Family Health Clinic, Apia, Samoa
- Naseri & Associates Health Consultancy Firm, Apia, Samoa
| | | | - Samantha L. Manna
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States of America
- Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Satupaitea Viali
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, United States of America
- Oceania University of Medicine, Apia, Samoa
| | - Ryan L. Minster
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Daniel E. Weeks
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States of America
- Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - James P. DeLany
- Advent Health Orlando, Translational Research Institute, Orlando, FL, United States of America
| | - Erin E. Kershaw
- Division of Endocrinology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Stephen T. McGarvey
- Department of Epidemiology, International Health Institute, School of Public Health, Brown University, Providence, RI, United States of America
- Department of Anthropology, Brown University, Providence, RI, United States of America
| | - Nicola L. Hawley
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, United States of America
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Mendez I, Strassle PD, Ponce S, Le R, Stewart AL, Nápoles AM. Age-related differences in the association between financial hardship and weight change during the COVID-19 pandemic. Heliyon 2024; 10:e30917. [PMID: 38779010 PMCID: PMC11108839 DOI: 10.1016/j.heliyon.2024.e30917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 05/06/2024] [Accepted: 05/08/2024] [Indexed: 05/25/2024] Open
Abstract
Objective To examine the association of financial hardship with weight changes in the US during the COVID-19 pandemic. Methods We used data from the COVID-19's Unequal Racial Burden survey, a nationally representative, cross-sectional, online survey of diverse adults living in the US, 12/2020-2/2021. This study included 1000 Asian, Black, Latino (half Spanish-speaking), and White adults and 500 American Indian or Alaska Native, Native Hawaiian or Pacific Islander, and multiracial adults (5500 total). Age-specific (18-39, 40-59, ≥60) associations between financial hardship domains and weight change were estimated using multinomial logistic regression, adjusted for demographic and health characteristics. Results Financial hardship during the COVID-19 pandemic was prevalent across all age groups (18-39: 76.2 %; 40-59: 75.6 %; ≥60: 50.6 %). Among adults aged 18-39 and ≥ 60 years old, food insecurity was significantly associated with weight loss (18-39: aOR = 1.42, 95 % CI = 1.04, 1.95; ≥60: aOR = 3.67, 95 % CI = 1.50, 8.98). Among all age groups, unmet healthcare expenses was also associated with weight loss (18-39: aOR = 1.31, 95 % CI = 1.01, 1.70; 40-59: aOR = 1.49, 95 % CI = 1.06, 2.08; ≥60: aOR = 1.73, 95 % CI = 1.03, 2.91). Among adults aged 18-39 and ≥ 60 years old, lost income was significantly associated with weight gain (18-39: aOR = 1.36, 95 % CI = 1.09-1.69; ≥60: aOR = 1.46, 95 % CI = 1.04, 2.06), and among adults 40-59 years old, experiencing increased debt was significantly associated with weight gain (aOR = 1.50, 95 % CI = 1.13, 1.99). Conclusions For those aged 18-39 and ≥ 60 years old experiencing financial hardship during the COVID-19 pandemic was associated with both weight loss and weight gain. Less correlation was observed among adults aged 40-59.
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Affiliation(s)
- Izabelle Mendez
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institute of Health, Bethesda, MD, USA
- Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Paula D. Strassle
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institute of Health, Bethesda, MD, USA
| | - Stephanie Ponce
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institute of Health, Bethesda, MD, USA
| | - Randy Le
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institute of Health, Bethesda, MD, USA
| | - Anita L. Stewart
- University of California San Francisco, Institute for Health & Aging, Center for Aging in Diverse Communities, USA
| | - Anna M. Nápoles
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institute of Health, Bethesda, MD, USA
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Honfo SH, Senior AM, Legault V, Presse N, Turcot V, Gaudreau P, Simpson SJ, Raubenheimer D, Cohen AA. Evidence for protein leverage on total energy intake, but not body mass index, in a large cohort of older adults. Int J Obes (Lond) 2024; 48:654-661. [PMID: 38145994 DOI: 10.1038/s41366-023-01455-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 12/11/2023] [Accepted: 12/15/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND Protein leverage (PL) is the phenomenon of consuming food until absolute intake of protein approaches a 'target value', such that total energy intake (TEI) varies passively with the ratio of protein: non-protein energy (fat + carbohydrate) in the diet. The PL hypothesis (PLH) suggests that the dilution of protein in energy-dense foods, particularly those rich in carbohydrates and fats, combines with protein leverage to contribute to the global obesity epidemic. Evidence for PL has been reported in younger adults, children and adolescents. This study aimed to test for PL and the protein leverage hypothesis (PLH) in a cohort of older adults. METHODS We conducted a retrospective analysis of dietary intake in a cohort of 1699 community-dwelling older adults aged 67-84 years from the NuAge cohort. We computed TEI and the energy contribution (EC) from each macronutrient. The strength of leverage of macronutrients was assessed through power functions ( TEI = μ * EC L ). Body mass index (BMI) was calculated, and mixture models were fitted to predict TEI and BMI from macronutrients' ECs. RESULTS In this cohort of older adults, 53% of individuals had obesity and 1.5% had severe cases. The mean TEI was 7673 kJ and macronutrients' ECs were 50.4%, 33.2% and 16.4%, respectively for carbohydrates, fat, and protein. There was a strong negative association (L = -0.37; p < 0.001) between the protein EC and TEI. Each percent of energy intake from protein reduced TEI by 77 kJ on average, ceteris paribus. However, BMI was unassociated with TEI in this cohort. CONCLUSIONS Findings indicate clear evidence for PL on TEI, but not on BMI, likely because of aging, body composition, sarcopenia, or protein wasting.
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Affiliation(s)
- Sewanou H Honfo
- PRIMUS Research Group, Department of Family Medicine, Université de Sherbrooke, 3001 12e Ave N, Sherbrooke, QC, J1H 5N4, Canada
| | - Alistair M Senior
- University of Sydney, Charles Perkins Centre, Camperdown, NSW, 2006, Australia
- University of Sydney, School of Life and Environmental Science, Camperdown, NSW, 2006, Australia
- University of Sydney, Sydney Precision Data Science Centre, Camperdown, NSW, 2006, Australia
| | - Véronique Legault
- Research Center on Aging, CIUSSS-de-l'Estrie-CHUS, Sherbrooke, QC, Canada
| | - Nancy Presse
- Research Center on Aging, CIUSSS-de-l'Estrie-CHUS, Sherbrooke, QC, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada
- Department of Community Health Sciences, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Valérie Turcot
- Research Center on Aging, CIUSSS-de-l'Estrie-CHUS, Sherbrooke, QC, Canada
| | - Pierrette Gaudreau
- Department of Medicine, Université de Montréal, Montréal, QC, Canada
- Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Stephen J Simpson
- University of Sydney, Charles Perkins Centre, Camperdown, NSW, 2006, Australia
- University of Sydney, School of Life and Environmental Science, Camperdown, NSW, 2006, Australia
| | - David Raubenheimer
- University of Sydney, Charles Perkins Centre, Camperdown, NSW, 2006, Australia
- University of Sydney, School of Life and Environmental Science, Camperdown, NSW, 2006, Australia
| | - Alan A Cohen
- PRIMUS Research Group, Department of Family Medicine, Université de Sherbrooke, 3001 12e Ave N, Sherbrooke, QC, J1H 5N4, Canada.
- Research Center on Aging, CIUSSS-de-l'Estrie-CHUS, Sherbrooke, QC, Canada.
- Department of Environmental Health Sciences, Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, New York, NY, USA.
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Hara K, Hirase T, Pathadka S, Cai Z, Sato M, Ishida N, Takemura R. Trends of HbA1c and BMI in People with Type 2 Diabetes: A Japanese Claims-Based Study. Diabetes Ther 2024; 15:801-817. [PMID: 38401022 PMCID: PMC10951166 DOI: 10.1007/s13300-024-01543-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 02/01/2024] [Indexed: 02/26/2024] Open
Abstract
INTRODUCTION Obesity prevalence has increased in Japan in recent years. Given the strong association of obesity with poor glycemic control, and increased risk of type 2 diabetes (T2D) with central obesity, this study describes the current trends and relationships between glycated hemoglobin (HbA1c), body mass index (BMI), and waist circumference in the Japanese people with T2D. METHODS This was a retrospective, cross-sectional study of people with T2D who had at least one recorded HbA1c and BMI (or waist circumference) value in the Japan Medical Data Center Claims database. Five annual cohorts of the study population were formed between January 2017 and December 2021. Annual trends of HbA1c across BMI categories (obesity class I [≥ 25 ~ < 30 kg/m2]-IV [≥ 40 kg/m2]) and in people with central obesity (waist circumference: ≥ 85 cm in men; ≥ 90 cm in women) were described by sex and age groups. RESULTS Overall, 106,089 people with T2D (HbA1c and BMI data: 106,079; HbA1c and waist circumference data: 105,424) were included, with the majority of people belonging to obesity class I (range: 39.7-40.6%) and obesity class II (range: 16.2-17.7%) categories across all annual cohorts. People in higher BMI categories had higher mean HbA1c, with > 50% of people with T2D in obesity class I-IV (54.8-56.5%) having HbA1c ≥ 7%. Between 2017 and 2021, BMI and waist circumference increased in the age group 18-44 years. More than 50% of people with T2D and central obesity in both sexes and people of age group 18-44 years across obesity class I-IV or with central obesity had HbA1c ≥ 7%. CONCLUSION More than half of the people with T2D belonging to obesity class I-IV or central obesity had poor glycemic control (HbA1c ≥ 7%), especially in the 18-44 age group. This highlights the need for body weight management for better glycemic control in relatively young Japanese people with T2D and obesity.
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Affiliation(s)
- Kazuo Hara
- Department of Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Tetsuaki Hirase
- Japan Drug Development and Medical Affairs, Eli Lilly Japan K.K., Kobe, Japan
| | - Swathi Pathadka
- Lilly Capability Center India, Eli Lilly Services India Private Limited, Primrose 7B, Embassy Tech Village, Devarabisanahalli, Bengaluru, Karnataka, 560103, India.
| | - Zhihong Cai
- Japan Drug Development and Medical Affairs, Eli Lilly Japan K.K., Kobe, Japan
| | - Manaka Sato
- Japan Drug Development and Medical Affairs, Eli Lilly Japan K.K., Kobe, Japan
| | - Noriyuki Ishida
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | - Ryo Takemura
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
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Ohno R, Kaneko H, Ueno K, Aoki H, Okada A, Kamiya K, Suzuki Y, Matsuoka S, Fujiu K, Takeda N, Jo T, Ako J, Morita H, Node K, Yasunaga H, Komuro I. Association of Body Mass Index and Its Change With Incident Diabetes Mellitus. J Clin Endocrinol Metab 2023; 108:3145-3153. [PMID: 37350488 DOI: 10.1210/clinem/dgad374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 06/01/2023] [Accepted: 06/20/2023] [Indexed: 06/24/2023]
Abstract
CONTEXT There have been insufficient data on the threshold of body mass index (BMI) for developing diabetes mellitus (DM) and the relationship between change in BMI and the subsequent risk of DM. OBJECTIVE We sought to clarify the association of BMI and its change with incident DM. METHODS We conducted a retrospective observational cohort study using the JMDC Claims Database between 2005 and 2021. We included 3 400 303 individuals without a prior history of DM or usage of glucose-lowering medications. The median age was 44 years, and 57.5% were men. We categorized the study participants into 4 groups: underweight (BMI < 18.5 kg/m2), normal weight (BMI 18.5-24.9 kg/m2), overweight (BMI 25.0-29.9 kg/m2), and obese (BMI ≥ 30 kg/m2). According to the change in BMI from the initial health check-up to the health check-up 1 year after that, we divided the study participants into 3 groups: ≤-5.0%, -5.0% to +5.0%, and ≥+5.0%. RESULTS The risk of developing DM increased steeply after BMI exceeded approximately 20 to 21 kg/m2. Compared with participants with stable BMI (-5.0% to +5.0%), the relative risk for DM among those whose BMI had increased by 5.0% or more was 1.33 (95% CI 1.31-1.36). In contrast, the relative risk for DM among those whose BMI decreased by 5.0% or more was 0.82 (95% CI 0.80-0.84). Moreover, people classified as normal weight, overweight, and obese reduced the risk of developing DM when they reduced their BMI, whereas the risk of developing DM for people classified as underweight increased when they reduced their BMI. CONCLUSION Our findings offer novel insights into improving an optimal bodyweight management strategy to prevent the development of DM.
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Affiliation(s)
- Ryusei Ohno
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Hidehiro Kaneko
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
- The Department of Advanced Cardiology, The University of Tokyo, Toyo, Japan
| | - Kensuke Ueno
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan
| | - Hiroyuki Aoki
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Akira Okada
- Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kentaro Kamiya
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan
| | - Yuta Suzuki
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Satoshi Matsuoka
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
- Department of Cardiology, New Tokyo Hospital, Matsudo, Japan
| | - Katsuhito Fujiu
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
- The Department of Advanced Cardiology, The University of Tokyo, Toyo, Japan
| | - Norifumi Takeda
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Taisuke Jo
- The Department of Health Services Research, The University of Tokyo, Tokyo, Japan
| | - Junya Ako
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Hiroyuki Morita
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Hideo Yasunaga
- The Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Issei Komuro
- The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
- International University of Health and Welfare, Tokyo, Japan
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Mittendorfer B, Kayser BD, Yoshino M, Yoshino J, Watrous JD, Jain M, Eagon JC, Patterson BW, Klein S. Heterogeneity in the effect of marked weight loss on metabolic function in women with obesity. JCI Insight 2023; 8:e169541. [PMID: 37159276 PMCID: PMC10371235 DOI: 10.1172/jci.insight.169541] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/03/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUNDThere is considerable heterogeneity in the effect of weight loss on metabolic function in people with obesity.METHODSWe evaluated muscle and liver insulin sensitivity, body composition, and circulating factors associated with insulin action before and after approximately 20% weight loss in women identified as "Responders" (n = 11) or "Non-responders" (n = 11), defined as the top (>75% increase) and bottom (<5% increase) quartiles of the weight loss-induced increase in glucose disposal rate (GDR) during a hyperinsulinemic-euglycemic clamp procedure, among 43 women with obesity (BMI: 44.1 ± 7.9 kg/m2).RESULTSAt baseline, GDR, which provides an index of muscle insulin sensitivity, and the hepatic insulin sensitivity index were more than 50% lower in Responders than Non-responders, but both increased much more after weight loss in Responders than Non-responders, which eliminated the differences between groups. Weight loss also caused greater decreases in intrahepatic triglyceride content and plasma adiponectin and PAI-1 concentrations in Responders than Non-responders and greater insulin-mediated suppression of plasma free fatty acids, branched-chain amino acids, and C3/C5 acylcarnitines in Non-responders than Responders, so that differences between groups at baseline were no longer present after weight loss. The effect of weight loss on total body fat mass, intra-abdominal adipose tissue volume, adipocyte size, and circulating inflammatory markers were not different between groups.CONCLUSIONThe results from our study demonstrate that the heterogeneity in the effects of marked weight loss on muscle and hepatic insulin sensitivity in people with obesity is determined by baseline insulin action, and reaches a ceiling when "normal" insulin action is achieved.TRIAL REGISTRATIONNCT00981500, NCT01299519, NCT02207777.FUNDINGNIH grants P30 DK056341, P30 DK020579, P30 DK052574, UL1 TR002345, and T32 HL13035, the American Diabetes Association (1-18-ICTS-119), the Longer Life Foundation (2019-011), and the Atkins Philanthropic Trust.
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Affiliation(s)
- Bettina Mittendorfer
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Brandon D. Kayser
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri, USA
- Genentech, South San Francisco, California, USA
| | - Mihoko Yoshino
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Jun Yoshino
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri, USA
| | | | - Mohit Jain
- Department of Medicine, UCSD, La Jolla, California, USA
| | - J. Christopher Eagon
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Bruce W. Patterson
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Samuel Klein
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri, USA
- Sansum Diabetes Research Institute, Santa Barbara, California, USA
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Chen S, Liang Y, Ye X, Zhu Z, Dong K, Liu Y, Jiang F, Wei L, Bao Y, Hou X. Effect of changes in anthropometric measurements on the remission and progression of prediabetes: A community-based cohort study. Diabetes Res Clin Pract 2023; 196:110163. [PMID: 36403679 DOI: 10.1016/j.diabres.2022.110163] [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: 03/17/2022] [Revised: 11/06/2022] [Accepted: 11/14/2022] [Indexed: 11/18/2022]
Abstract
AIMS We assessed the impact of changes in body mass index (BMI), body fat percentage (BF%), and waist circumference (WC) on prediabetes among middle-aged and elderly Chinese adults. SUBJECTS, MATERIALS AND METHODS 2.5-year changes in BMI, BF%, and WC were calculated by subtracting baseline levels from follow-up, based on a cohort of 3,632 participants with prediabetes, and outcomes were defined as remission to normal glucose regulation (NGR), persistence in prediabetes, and progression to newly diagnosed diabetes mellitus (NDM). RESULTS Among participants with prediabetes, 16.9% returned to NGR and 24.6% progressed to NDM. Changes in BMI, BF%, but not WC were associated with remission and progression of prediabetes (risk ratio per standard deviation increase of BMI: 0.86 [0.79-0.93] and 1.15 [1.08-1.23]; BF%: 0.91 [0.84-0.98] and 1.11 [1.03-1.19]). Among participants with combined impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), only BF% change was significantly associated with remission of prediabetes. CONCLUSION Short-term management of BMI and BF% should be emphasized to promote the remission and prevent the progression of prediabetes. Moreover, it is of particular clinical importance to monitor BF% among people with combined IFG and IGT.
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Affiliation(s)
- Siyu Chen
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China; Department of Endocrinology and Metabolism, Suzhou Dushu Lake Hospital (Dushu Lake Hospital Affiliated to Soochow University), Suzhou, Jiangsu, China
| | - Yebei Liang
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China; Department of Geriatrics, Fujian Hypertension Research Institute, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Xiaoqi Ye
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Zhijun Zhu
- General Practitioner Teams in Community Health Service Center of Nicheng, Pudong New District, Shanghai, China
| | - Keqing Dong
- General Practitioner Teams in Community Health Service Center of Nicheng, Pudong New District, Shanghai, China
| | - Yuexing Liu
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Fusong Jiang
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Li Wei
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Yuqian Bao
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Xuhong Hou
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China.
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Chen Y, Zhou X, Bullard KM, Zhang P, Imperatore G, Rolka DB. Income-related inequalities in diagnosed diabetes prevalence among US adults, 2001-2018. PLoS One 2023; 18:e0283450. [PMID: 37053158 PMCID: PMC10101461 DOI: 10.1371/journal.pone.0283450] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 03/01/2023] [Indexed: 04/14/2023] Open
Abstract
AIMS The overall prevalence of diabetes has increased over the past two decades in the United States, disproportionately affecting low-income populations. We aimed to examine the trends in income-related inequalities in diabetes prevalence and to identify the contributions of determining factors. METHODS We estimated income-related inequalities in diagnosed diabetes during 2001-2018 among US adults aged 18 years or older using data from the National Health Interview Survey (NHIS). The concentration index was used to measure income-related inequalities in diabetes and was decomposed into contributing factors. We then examined temporal changes in diabetes inequality and contributors to those changes over time. RESULTS Results showed that income-related inequalities in diabetes, unfavorable to low-income groups, persisted throughout the study period. The income-related inequalities in diabetes decreased during 2001-2011 and then increased during 2011-2018. Decomposition analysis revealed that income, obesity, physical activity levels, and race/ethnicity were important contributors to inequalities in diabetes at almost all time points. Moreover, changes regarding age and income were identified as the main factors explaining changes in diabetes inequalities over time. CONCLUSIONS Diabetes was more prevalent in low-income populations. Our study contributes to understanding income-related diabetes inequalities and could help facilitate program development to prevent type 2 diabetes and address modifiable factors to reduce diabetes inequalities.
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Affiliation(s)
- Yu Chen
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Xilin Zhou
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Kai McKeever Bullard
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Ping Zhang
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Giuseppina Imperatore
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Deborah B Rolka
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
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9
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Vincens N, Persson Waye K. Railway noise and diabetes among residents living close to the railways in Västra Götaland, Sweden: Cross-sectional mediation analysis on obesity indicators. ENVIRONMENTAL RESEARCH 2022; 212:113477. [PMID: 35588775 DOI: 10.1016/j.envres.2022.113477] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 05/06/2022] [Accepted: 05/11/2022] [Indexed: 06/15/2023]
Abstract
Railway noise is expected to increase in Europe and Sweden as well, following recommendations for a more sustainable transportation mode. This forecasted increase might lead to higher level of noise exposure, higher population exposure and potentially increased night-time exposure. Evidence supports an effect of transportation noise on several health outcomes, including metabolic conditions such as diabetes. However, few studies were directed to railway noise; present studies on railway noise and diabetes so far show ambiguous results while some studies report an association between railway noise and obesity. The aim of this study is to investigate the relationship between railway noise and diabetes prevalence and to assess whether obesity might be a mediator in this association. The study population (N = 5381) was randomly selected from residents living within 1 km of a trafficked railway in Västra Götaland, Sweden. Survey data was combined with modelled exposures and health register data (ICD10 codes for diabetes). The study uses a cross sectional design, logistic regression analysis and a counterfactual mediation analysis. We found an increase in the prevalence of diabetes associated with the exposure to railway noise: OR = 1.33 per 10 dB increase Lden (95% CI 1.09-1.63) accounting for sociodemographic and lifestyle factors. BMI and waist circumference partially mediate the association between railway noise and diabetes. This is the first study to report an association between railway noise and diabetes in Sweden. BMI and waist circumference seem to be a potential mediators in this association. Still, future studies should further explore the mechanisms from noise to diabetes, considering different pathways in relation to obesity but also exploring other potential mediators.
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Affiliation(s)
- Natalia Vincens
- Sound Environment and Health, Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
| | - Kerstin Persson Waye
- Sound Environment and Health, Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
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10
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Emsley C, Snell G, Paul E, Fuller L, Paraskeva M, Nyulasi I, King S. Can we HALT obesity following lung transplant? A Dietitian- and Physiotherapy-directed pilot intervention. Clin Transplant 2022; 36:e14763. [PMID: 35761751 DOI: 10.1111/ctr.14763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/08/2022] [Accepted: 06/21/2022] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Unintentional weight gain, overweight and obesity following solid organ transplantation (SOT) are well-established and linked to morbidity and mortality risk factors. No interventional studies aimed at prevention have been undertaken among lung transplant (LTx) recipients. The combination of group education and telephone coaching is effective in the general population but is untested among SOT cohorts. METHODS A non-randomised, interventional pilot study was conducted among new LTx recipients. The control group received standard care. In addition to standard care, the intervention involved four group education and four individual, telephone coaching sessions over 12-months. Data collection occurred at 2 weeks, 3- and 12 months post-LTx. Measurements included weight, BMI, fat mass (FM), fat mass index (FMI), fat-free mass (FFM), fat-free mass index (FFMI), waist circumference (WC), visceral adipose tissue (VAT), nutrition knowledge, diet, physical activity, lipid profile, HbA1C , FEV1 , six-minute walk distance and patient satisfaction. RESULTS Fifteen LTx recipients were recruited into each group. One control participant died 120 days post-LTx, unrelated to the study. There were trends towards lower increases in weight (6.7±7.2kg vs 9.8±11.3kg), BMI (9.6% of baseline vs 13%), FM (19.7% vs 40%), FMI, VAT (7.1% vs 30.8%) and WC (5.5% vs 9.5%), and greater increases in FFM and FFMI (all p>0.05), among the intervention group by 12 months. The intervention was well-accepted by participants. CONCLUSION This feasible intervention demonstrated non-significant, but clinically meaningful, favourable weight and body composition trends among LTx recipients over 12 months compared to standard care. Australian New Zealand Clinical Trials Registry (ACTRN12619001606178) This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Christie Emsley
- Nutrition Department, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Greg Snell
- Lung Transplant Service, The Alfred Hospital, Victoria, Australia
| | - Eldho Paul
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Department of Clinical Haematology, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Louise Fuller
- Physiotherapy Department, The Alfred Hospital, Melbourne, Victoria, Australia
| | | | - Ibolya Nyulasi
- Nutrition Department, The Alfred Hospital, Melbourne, Victoria, Australia.,Discipline of Food, Nutrition and Dietetics, LaTrobe University, Bundoora, Victoria, Australia.,Department of Medicine, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Susannah King
- Nutrition Department, The Alfred Hospital, Melbourne, Victoria, Australia.,Discipline of Food, Nutrition and Dietetics, LaTrobe University, Bundoora, Victoria, Australia
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11
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Masri D, Masri-Iraqi H, Nissan J, Nemcovsky C, Gillman L, Naishlos S, Chaushu L. On the Association between Implant-Supported Prosthesis and Glycemic Control (HbA1c Values). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116923. [PMID: 35682506 PMCID: PMC9180096 DOI: 10.3390/ijerph19116923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 06/04/2022] [Accepted: 06/05/2022] [Indexed: 12/10/2022]
Abstract
Background: Dietary habits, food intake and oral health are important factors for general health. The aim of these present study was to assess the association between implant-supported fixed oral rehabilitation and glycemia, by monitoring HbA1c values before and after implant-supported prostheses (ISP) delivery to diabetic individuals. Methods: Retrospective, cohort study based on dental records. All treatments were performed by experienced oral and maxillofacial surgeons and experienced prosthodontists. Inclusion criteria: ISP delivery, diagnosis of diabetes in the medical files, consecutive individuals. Variables included—primary outcome—differences (delta) in HbA1c values prior to implant placement and one year after ISP delivery, early implant failure (EIF). Confounding factors included age, gender, physical status, smoking, implant jaw location, implant length, implant width, total implant count per individual. Results: Statistically significant (p < 0.01) decrease in HbA1c from 7.10 ± 1.09% to 6.66 ± 1.02% following ISP delivery was recorded. The mean HbA1c delta was 0.44 ± 0.73%, where 39.0% of the patients had a significant improvement (delta decrease > 0.5%). Univariate and multivariate model using logistic regression at individual level showed that initial high HbA1c levels was the only factor positively predicting improvement (OR = 1.96, CI [1.22, 3.14], p < 0.01). Univariate model at implant level demonstrated that implants placed in the anterior maxilla also contributed to significant improvement in HbA1c values. Multivariate analysis at implant level was similar to individual level. Number of missing teeth did not affect the results significantly. Conclusion: ISP delivery to partially or completely edentulous diabetic individuals may improve HbA1c balance. The mechanism awaits future elucidation.
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Affiliation(s)
- Daya Masri
- Department of Oral and Maxillofacial Surgery, Rabin Medical Center, Petach-Tikva 4941492, Israel; (D.M.); (L.G.)
| | - Hiba Masri-Iraqi
- Department of Endocrinology, Rabin Medical Center, Petach-Tikva 4941492, Israel;
| | - Joseph Nissan
- Department of Oral-Rehabilitation, Rabin Medical Center, Petach-Tikva 4941492, Israel;
- The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Carlos Nemcovsky
- Department of Periodontology and Oral Implantology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Leon Gillman
- Department of Oral and Maxillofacial Surgery, Rabin Medical Center, Petach-Tikva 4941492, Israel; (D.M.); (L.G.)
| | - Sarit Naishlos
- Department of Pedodontics, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Liat Chaushu
- Department of Periodontology and Oral Implantology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
- Correspondence:
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Farid D, Li P, Da Costa D, Afif W, Szabo J, Dasgupta K, Rahme E. Depression, diabetes and immigration status: a retrospective cohort study using the Canadian Longitudinal Study on Aging. CMAJ Open 2022; 10:E508-E518. [PMID: 35700994 PMCID: PMC9343120 DOI: 10.9778/cmajo.20210019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND A bidirectional association between depression and diabetes exists, but has not been evaluated in the context of immigrant status. Given that social determinants of health differ between immigrants and nonimmigrants, we evaluated the association between diabetes and depression incidence, depression and diabetes incidence, and whether immigrant status modified this association, among immigrants and nonimmigrants in Canada. METHODS We employed a retrospective cohort design using data from the Canadian Longitudinal Study on Aging Comprehensive cohort (baseline [2012-2015] and 3-year follow-up [2015-2018]). We defined participants as having diabetes if they self-reported it or if their glycated hemoglobin A1c level was 7% or more; we defined participants as having depression if their Center for Epidemiological Studies Depression score was 10 or higher or if they were currently undergoing depression treatment. We excluded those with baseline depression (Cohort 1) and baseline diabetes (Cohort 2) to evaluate the associations between diabetes and depression incidence, and between depression and diabetes incidence, respectively. We constructed logistic regression models with interaction by immigrant status. RESULTS Cohort 1 (n = 20 723; mean age 62.7 yr, standard deviation [SD] 10.1 yr; 47.6% female) included 3766 (18.2%) immigrants. Among immigrants, 16.4% had diabetes, compared with 15.6% among nonimmigrants. Diabetes was associated with an increased risk of depression in nonimmigrants (adjusted odds ratio [OR] 1.27, 95% confidence interval [CI] 1.08-1.49), but not in immigrants (adjusted OR 1.12, 95% CI 0.80-1.56). Younger age, female sex, weight change, poor sleep quality and pain increased depression risk. Cohort 2 (n = 22 054; mean age 62.1 yr, SD 10.1 yr; 52.2% female) included 3913 (17.7%) immigrants. Depression was associated with an increased risk of diabetes in both nonimmigrants (adjusted OR 1.39, 95% CI 1.16-1.68) and immigrants (adjusted OR 1.60, 95% CI 1.08-2.37). Younger age, male sex, waist circumference, weight change, hypertension and heart disease increased diabetes risk. INTERPRETATION We found an overall bidirectional association between diabetes and depression that was not significantly modified by immigrant status. Screening for diabetes for people with depression and screening for depression for those with diabetes should be considered.
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Affiliation(s)
- Doaa Farid
- Department of Family Medicine (Farid, Szabo), McGill University; Centre for Outcomes Research and Evaluation (Farid, Li, Da Costa, Dasgupta, Rahme), Research Institute of the McGill University Health Centre; Department of Pediatrics (Li), and Division of Clinical Epidemiology (Da Costa, Rahme), Department of Medicine, McGill University; Division of Gastroenterology (Afif), Department of Medicine, and Chronic Viral Illnesses Service (Szabo), McGill University Health Centre; Division of General Internal Medicine (Dasgupta), Department of Medicine, McGill University, Montréal, Que
| | - Patricia Li
- Department of Family Medicine (Farid, Szabo), McGill University; Centre for Outcomes Research and Evaluation (Farid, Li, Da Costa, Dasgupta, Rahme), Research Institute of the McGill University Health Centre; Department of Pediatrics (Li), and Division of Clinical Epidemiology (Da Costa, Rahme), Department of Medicine, McGill University; Division of Gastroenterology (Afif), Department of Medicine, and Chronic Viral Illnesses Service (Szabo), McGill University Health Centre; Division of General Internal Medicine (Dasgupta), Department of Medicine, McGill University, Montréal, Que
| | - Deborah Da Costa
- Department of Family Medicine (Farid, Szabo), McGill University; Centre for Outcomes Research and Evaluation (Farid, Li, Da Costa, Dasgupta, Rahme), Research Institute of the McGill University Health Centre; Department of Pediatrics (Li), and Division of Clinical Epidemiology (Da Costa, Rahme), Department of Medicine, McGill University; Division of Gastroenterology (Afif), Department of Medicine, and Chronic Viral Illnesses Service (Szabo), McGill University Health Centre; Division of General Internal Medicine (Dasgupta), Department of Medicine, McGill University, Montréal, Que
| | - Waqqas Afif
- Department of Family Medicine (Farid, Szabo), McGill University; Centre for Outcomes Research and Evaluation (Farid, Li, Da Costa, Dasgupta, Rahme), Research Institute of the McGill University Health Centre; Department of Pediatrics (Li), and Division of Clinical Epidemiology (Da Costa, Rahme), Department of Medicine, McGill University; Division of Gastroenterology (Afif), Department of Medicine, and Chronic Viral Illnesses Service (Szabo), McGill University Health Centre; Division of General Internal Medicine (Dasgupta), Department of Medicine, McGill University, Montréal, Que
| | - Jason Szabo
- Department of Family Medicine (Farid, Szabo), McGill University; Centre for Outcomes Research and Evaluation (Farid, Li, Da Costa, Dasgupta, Rahme), Research Institute of the McGill University Health Centre; Department of Pediatrics (Li), and Division of Clinical Epidemiology (Da Costa, Rahme), Department of Medicine, McGill University; Division of Gastroenterology (Afif), Department of Medicine, and Chronic Viral Illnesses Service (Szabo), McGill University Health Centre; Division of General Internal Medicine (Dasgupta), Department of Medicine, McGill University, Montréal, Que
| | - Kaberi Dasgupta
- Department of Family Medicine (Farid, Szabo), McGill University; Centre for Outcomes Research and Evaluation (Farid, Li, Da Costa, Dasgupta, Rahme), Research Institute of the McGill University Health Centre; Department of Pediatrics (Li), and Division of Clinical Epidemiology (Da Costa, Rahme), Department of Medicine, McGill University; Division of Gastroenterology (Afif), Department of Medicine, and Chronic Viral Illnesses Service (Szabo), McGill University Health Centre; Division of General Internal Medicine (Dasgupta), Department of Medicine, McGill University, Montréal, Que
| | - Elham Rahme
- Department of Family Medicine (Farid, Szabo), McGill University; Centre for Outcomes Research and Evaluation (Farid, Li, Da Costa, Dasgupta, Rahme), Research Institute of the McGill University Health Centre; Department of Pediatrics (Li), and Division of Clinical Epidemiology (Da Costa, Rahme), Department of Medicine, McGill University; Division of Gastroenterology (Afif), Department of Medicine, and Chronic Viral Illnesses Service (Szabo), McGill University Health Centre; Division of General Internal Medicine (Dasgupta), Department of Medicine, McGill University, Montréal, Que.
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Asundi A, Olson A, Jiang W, Varshney SP, White LF, Sagar M, Lin NH. Integrase Inhibitor Use Associated with Weight Gain in Women and Incident Diabetes Mellitus. AIDS Res Hum Retroviruses 2022; 38:208-215. [PMID: 34877881 PMCID: PMC8968841 DOI: 10.1089/aid.2021.0091] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Excessive weight gain associated with integrase strand transfer inhibitor (InSTI) antiretrovirals is an emerging issue; however, the metabolic consequences of this effect have not been established. Our objective was to evaluate for InSTI-emergent weight gain and potential associated type 2 diabetes mellitus (T2DM) among a diverse HIV patient cohort. For this retrospective cohort study, we obtained clinical warehouse data for HIV+ patients between fiscal years 2007-17. We compared patients initiated on an InSTI with those started on an alternate regimen. Our primary outcome was percentage weight change from baseline to 24 months postinitiation using the linear mixed-effects model fit by restricted maximum likelihood. Our secondary outcome was incident T2DM as defined by a new prescription for antihyperglycemic medication within 18 months after antiretroviral therapy (ART) start. Diabetes-free survival was estimated using the Kaplan-Meier method, log-rank test, and Cox proportional-hazards model. The cohort included 1,235 individuals initiating ART, 136 (11.0%) with an InSTI. InSTI use in women was significantly associated with greater weight gain compared with non-InSTIs (11.0%, 95% confidence interval, CI: 5.22 to 16.8, p < .01), after adjusting for potential confounding variables. In a univariate analysis, InSTI use was associated with more incident T2DM diagnoses compared with non-InSTI regimens (unadjusted hazard ratio = 3.27, p = .01), although incident T2DM was not associated with weight gain. InSTIs were significantly associated with weight gain among females. We also observed an increased risk of incident diabetes mellitus among both sexes, however, unrelated to weight changes. Further prospective studies will be necessary to confirm this finding and investigate its mechanism.
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Affiliation(s)
- Archana Asundi
- Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
- Section of Infectious Diseases, Boston Medical Center, Boston, Massachusetts, USA
| | - Alex Olson
- Section of Infectious Diseases, Boston Medical Center, Boston, Massachusetts, USA
| | - Wenqing Jiang
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Swati P. Varshney
- Section of Infectious Diseases, Boston Medical Center, Boston, Massachusetts, USA
| | - Laura F. White
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Manish Sagar
- Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
- Section of Infectious Diseases, Boston Medical Center, Boston, Massachusetts, USA
| | - Nina H. Lin
- Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
- Section of Infectious Diseases, Boston Medical Center, Boston, Massachusetts, USA
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14
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Emond B, Rossi C, Côté-Sergent A, Bookhart B, Anderson D, Lefebvre P, Lafeuille MH, Donga P. Body mass index increase and weight gain among people living with HIV-1 initiated on single-tablet darunavir/cobicistat/emtricitabine/tenofovir alafenamide or bictegravir/emtricitabine/tenofovir alafenamide in the United States. Curr Med Res Opin 2022; 38:287-298. [PMID: 34812097 DOI: 10.1080/03007995.2021.2007006] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This study evaluated body mass index (BMI) and weight changes in people living with human immunodeficiency virus (HIV-1; PLWH) initiated on single-tablet darunavir/cobicistat/emtricitabine/tenofovir alafenamide (DRV/c/FTC/TAF) or bictegravir/FTC/TAF (BIC/FTC/TAF). METHODS Electronic medical record (EMR) data for treatment-naïve or virologically suppressed adults with HIV-1 who initiated treatment with DRV/c/FTC/TAF or BIC/FTC/TAF (index date) were obtained from Decision Resources Group's EMRs (17 July 2017-1 March 2020). Inverse probability of treatment weighting was used to account for differences in baseline characteristics between the two cohorts. BMI and weight changes from pre-index to 3, 6, 9 and 12 months following the index date were compared using weighted mean differences (MDs). The time until an increase in BMI or weight ≥5% or ≥10% was compared using weighted hazard ratios (HRs). RESULTS The weighted DRV/c/FTC/TAF and BIC/FTC/TAF cohorts comprised 1116 and 1134 PLWH, respectively (mean age = ∼49 years, females: ∼28%). Larger increases in BMI and weight from pre-index to each post-index time point were observed in PLWH initiating BIC/FTC/TAF vs DRV/c/FTC/TAF (12 months: MD in BMI = 1.23 kg/m2, p < .001; MD in weight = 2.84 kg [6.26 lbs], p = .008). PLWH receiving BIC/FTC/TAF were significantly more likely to experience weight gain ≥5% (HR = 1.76, p = .004) and ≥10% (HR = 2.01, p = .020), and BMI increase ≥5% (HR = 1.77, p = .004) and ≥10% (HR = 1.76, p = .044) than those receiving DRV/c/FTC/TAF. CONCLUSIONS BIC/FTC/TAF was associated with greater BMI and weight increases compared to DRV/c/FTC/TAF. Weight gain and its sequelae may add to the clinical burden of PLWH and should be considered among other factors when selecting antiretroviral single-tablet regimens.
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Affiliation(s)
| | | | | | | | | | | | | | - Prina Donga
- Janssen Scientific Affairs, LLC, Titusville, NJ, USA
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15
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Ruggiero E, Bonaccio M, Costanzo S, Esposito S, Di Castelnuovo A, Carpineta E, Cerletti C, Donati MB, Paolini S, Esposito V, de Gaetano G, Innocenzi G, Iacoviello L. Dietary factors and the risk of lumbar spinal stenosis: A case-control analysis from the PREFACE study. Nutr Metab Cardiovasc Dis 2022; 32:90-97. [PMID: 34802849 DOI: 10.1016/j.numecd.2021.09.019] [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: 05/17/2021] [Revised: 09/10/2021] [Accepted: 09/14/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIMS There is a lack of knowledge on the association of dietary factors and Lumbar Spinal Stenosis (LSS). We evaluated the association of a Mediterranean diet (MD), its major food components and ultra-processed food (UPF) with the risk of LSS. METHODS AND RESULTS Participants were recruited from the Neurosurgery Department of the IRCCS Neuromed, Italy. The study sample consisted of 156 cases of LSS, and 312 controls matched 1:2 for sex, age (±6 months) and physical activity, without a history or clinical evidence of LSS who were identified from the general population. Adherence to MD was assessed by the Mediterranean Diet Score based on 9 food groups. UPF was defined according to NOVA classification and calculated as the ratio (%) of UPF (g/d) on total food consumed (g/d). In multivariable-adjusted analysis, a 2-point increase in the MD score was not associated with LSS risk (OR: 1.02, 95% CI: 0.72-1.46). An increment of 10 g/d of fruits and nuts, cereals or fish led to lower odds of LSS (OR: 0.97, 95% CI: 0.95-0.99; OR: 0.88, 95% CI: 0.82-0.94; OR: 0.87, 95% CI: 0.76-0.99, respectively). Additionally, 1% increment in the consumption of UPF in the diet was independently associated with higher LSS risk (OR: 1.09, 95% CI: 1.04-1.14). CONCLUSION A diet rich in fruits, cereals, fish is associated with lower risk of LSS while a large dietary share of UPF increases the risk of this disease. Further studies with a prospective design and larger sample sizes are warranted.
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Affiliation(s)
- Emilia Ruggiero
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, IS, Italy
| | - Marialaura Bonaccio
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, IS, Italy
| | - Simona Costanzo
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, IS, Italy
| | - Simona Esposito
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, IS, Italy
| | | | | | - Chiara Cerletti
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, IS, Italy
| | | | - Sergio Paolini
- Neurosurgery Department, IRCCS NEUROMED, Pozzilli, IS, Italy
| | | | - Giovanni de Gaetano
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, IS, Italy
| | | | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, IS, Italy; Research Center in Epidemiology and Preventive Medicine (EPIMED), Department of Medicine and Surgery, University of Insubria, Varese, Italy.
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Martin JC, Awoke MA, Misso ML, Moran LJ, Harrison CL. Preventing weight gain in adults: A systematic review and meta-analysis of randomized controlled trials. Obes Rev 2021; 22:e13280. [PMID: 34028958 DOI: 10.1111/obr.13280] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 04/15/2021] [Accepted: 04/15/2021] [Indexed: 12/22/2022]
Abstract
Weight gain prevention is a global public health priority to address escalating adiposity in adults. This review evaluates the efficacy of weight gain prevention trials targeting adults aged 18-50 years and adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. Trials of any duration from inception to May 2020 that evaluated a weight gain prevention intervention (using either prescriptive diet, prescriptive physical activity, prescriptive diet, and/or physical activity or non-prescriptive lifestyle) and included weight or body mass index (weight [kg]/height [m2 ]) were eligible. Twenty-nine trials across 34 publications (participants n = 37,407) were included. Intervention resulted in less weight gain compared with controls (-1.15 kg [95% CI -1.50, -0.80 kg] p < 0.001). Subgroup analysis demonstrated greater effectiveness with prescriptive (-1.60 kg [95% CI -2.00, -1.19] p < 0.001) compared with non-prescriptive (-0.81 kg [95% CI 1.10, -0.53] p < 0.001) intervention types. Interventions had greatest impact in healthy weight (18.5-24.9 kg/m2 ) (-0.82 kg [95% CI -1.5, -0.50] p < 0.001) or overweight (25.0-29.9 kg/m2 ) (-1.48 kg [95% CI -1.85, -1.12] p < 0.001) compared with obese populations (≥30.0 kg/m2 ) (-0.56 kg [95% CI -1.40, 0.27] p = 0.19). These findings demonstrate that lifestyle intervention prevents cumulative weight gain in non-obese adults, with future research required to inform cost-effectiveness and implementation feasibility.
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Affiliation(s)
- Julie C Martin
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Mamaru Ayenew Awoke
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Marie L Misso
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Lisa J Moran
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Cheryce L Harrison
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Marchand NE, Sparks JA, Malspeis S, Yoshida K, Prisco L, Zhang X, Costenbader K, Hu F, Karlson EW, Lu B. Long-term Weight Changes and Risk of Rheumatoid Arthritis Among Women in a Prospective Cohort: A Marginal Structural Model Approach. Rheumatology (Oxford) 2021; 61:1430-1439. [PMID: 34247242 DOI: 10.1093/rheumatology/keab535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 07/02/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To examine the association of long-term weight change with rheumatoid arthritis (RA) risk in a large prospective cohort study. METHODS The Nurses' Health Study (NHS) II started in 1989 (baseline); after exclusions, we studied 108,505 women 25-42 years old without RA. Incident RA was reported by participant and confirmed by medical record review. Body weight was reported biennially through 2015. We investigated two time-varying exposures: weight changes from baseline and from age 18; change was divided into 5 categories. We used a marginal structural model (MSM) approach to account for time-varying weight change and covariates. RESULTS Over 2,583,266 person-years, with a median follow-up time of 25.3 years, 541 women developed RA. Compared to women with stable weight from baseline, weight change was significantly associated with increased RA risk [weight gain 2-<10 kg: RR = 1.98 (95% CI 1.38, 2.85); 10-<20 kg: RR = 3.28 (95% CI 2.20, 4.89); ≥20 kg: RR = 3.81 (95% CI 2.39, 6.07); and weight loss >2 kg: RR = 2.05 (95% CI 1.28, 3.28)]. Weight gain of 10 kg or more from age 18 compared with stable weight was also associated with increased RA risk [10-< 20 kg: RR = 2.12 (95% CI 1.37, 3.27), ≥20 kg: RR = 2.31 (95% CI 1.50, 3.56)]. Consistent findings were observed for seropositive and seronegative RA. CONCLUSION Long-term weight gain was strongly associated with increased RA risk in women, with weight gain of ≥ 20 kg associated with more than a three-fold increased RA risk. Maintenance of healthy weight may be a strategy to prevent or delay RA.
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Affiliation(s)
- Nathalie E Marchand
- Division of Rheumatology, Inflammation, and Immunity, Brigham & Women's Hospital and Harvard Medical School, Boston, MA 02115
| | - Jeffrey A Sparks
- Division of Rheumatology, Inflammation, and Immunity, Brigham & Women's Hospital and Harvard Medical School, Boston, MA 02115
| | - Susan Malspeis
- Division of Rheumatology, Inflammation, and Immunity, Brigham & Women's Hospital and Harvard Medical School, Boston, MA 02115
| | - Kazuki Yoshida
- Division of Rheumatology, Inflammation, and Immunity, Brigham & Women's Hospital and Harvard Medical School, Boston, MA 02115
| | - Lauren Prisco
- Division of Rheumatology, Inflammation, and Immunity, Brigham & Women's Hospital and Harvard Medical School, Boston, MA 02115
| | - Xuehong Zhang
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital, Boston, MA 02115.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115
| | - Karen Costenbader
- Division of Rheumatology, Inflammation, and Immunity, Brigham & Women's Hospital and Harvard Medical School, Boston, MA 02115
| | - Frank Hu
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital, Boston, MA 02115.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115
| | - Elizabeth W Karlson
- Division of Rheumatology, Inflammation, and Immunity, Brigham & Women's Hospital and Harvard Medical School, Boston, MA 02115
| | - Bing Lu
- Division of Rheumatology, Inflammation, and Immunity, Brigham & Women's Hospital and Harvard Medical School, Boston, MA 02115
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Piqueras P, Ballester A, Durá-Gil JV, Martinez-Hervas S, Redón J, Real JT. Anthropometric Indicators as a Tool for Diagnosis of Obesity and Other Health Risk Factors: A Literature Review. Front Psychol 2021; 12:631179. [PMID: 34305707 PMCID: PMC8299753 DOI: 10.3389/fpsyg.2021.631179] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 06/07/2021] [Indexed: 12/18/2022] Open
Abstract
Obesity is characterized by the accumulation of an excessive amount of fat mass (FM) in the adipose tissue, subcutaneous, or inside certain organs. The risk does not lie so much in the amount of fat accumulated as in its distribution. Abdominal obesity (central or visceral) is an important risk factor for cardiovascular diseases, diabetes, and cancer, having an important role in the so-called metabolic syndrome. Therefore, it is necessary to prevent, detect, and appropriately treat obesity. The diagnosis is based on anthropometric indices that have been associated with adiposity and its distribution. Indices themselves, or a combination of some of them, conform to a big picture with different values to establish risk. Anthropometric indices can be used for risk identification, intervention, or impact evaluation on nutritional status or health; therefore, they will be called anthropometric health indicators (AHIs). We have found 17 AHIs that can be obtained or estimated from 3D human shapes, being a noninvasive alternative compared to X-ray-based systems, and more accessible than high-cost equipment. A literature review has been conducted to analyze the following information for each indicator: definition; main calculation or obtaining methods used; health aspects associated with the indicator (among others, obesity, metabolic syndrome, or diabetes); criteria to classify the population by means of percentiles or cutoff points, and based on variables such as sex, age, ethnicity, or geographic area, and limitations.
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Affiliation(s)
- Paola Piqueras
- Instituto de Biomecánica de Valencia, Universitat Politècnica de Valencia, Valencia, Spain
| | - Alfredo Ballester
- Instituto de Biomecánica de Valencia, Universitat Politècnica de Valencia, Valencia, Spain
| | - Juan V. Durá-Gil
- Instituto de Biomecánica de Valencia, Universitat Politècnica de Valencia, Valencia, Spain
| | - Sergio Martinez-Hervas
- Service of Endocrinology and Nutrition, Hospital Clínico Universitario de Valencia, Valencia, Spain
- Institute of Health Research of the Hospital Clinico Universitario de Valencia (INCLIVA), Valencia, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Josep Redón
- Department of Internal Medicine, Hospital Clínico de Valencia, University of Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CB06/03), Instituto de Salud Carlos III, Madrid, Spain
- Cardiovascular and Renal Risk Research Group, Institute of Health Research of the Hospital Clinico Universitario de Valencia (INCLIVA), University of Valencia, Valencia, Spain
| | - José T. Real
- Service of Endocrinology and Nutrition, Hospital Clínico Universitario de Valencia, Valencia, Spain
- Institute of Health Research of the Hospital Clinico Universitario de Valencia (INCLIVA), Valencia, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
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Bailey-Davis L, Wood GC, Cook A, Cunningham K, Jamieson S, Mowery J, Naylor A, Rolston DD, Seiler C, Still CD. Communicating personalized risk of diabetes and offering weight reduction program choice: Recruitment, participation, and outcomes. PATIENT EDUCATION AND COUNSELING 2021; 104:1193-1199. [PMID: 33097360 DOI: 10.1016/j.pec.2020.10.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 10/05/2020] [Accepted: 10/08/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Low patient recruitment into diabetes prevention programs is a challenge. The primary aim of this study was to demonstrate that an increased recruitment rate can be achieved by communicating personalized risk of progression to type 2 diabetes, estimating risk reduction with weight loss, and offering program choice. Secondary aims included program participation rate, weight loss, and short-term decreased diabetes risk. METHODS In this single-arm study, persons with prediabetes from 3 primary care sites received a letter that communicated their personalized risk of progression to diabetes within 3-years, estimated risk reduction with 5, 10, 15 % weight loss, reported in pounds, and offered a choice of 5 free, 6-month, programs. A one-sided test was used to compare the recruitment rate against the maximum expected rate of (10 %). RESULTS Recruitment response rate was 25.3 % (81/328, 95 % CI=[20.0 %, 29.4 %]) which was significantly higher than expected (p < 0.0001). Overall, 65 % of participants completed >75 % of contacts. BMI, HbA1c, and diabetes risk (all p < 0.0001) improved at 6 months; BMI (p < 0.0001) and HbA1c (p < 0.05) improved at 12 months. CONCLUSION Recruitment response rate was better than expected. PRACTICE IMPLICATIONS Communicating personalized risk and reduction estimates with a choice of programs resulted in favorable outcomes, sustained at 1-year.
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Affiliation(s)
- Lisa Bailey-Davis
- Geisinger Obesity Institute, 100 N Academy Ave, MC 26-08, Danville, PA 17822 USA; Department of Population Health Sciences, Geisinger, 100 N Academy Ave, MC 44-00, Danville, PA 17822 USA.
| | - G Craig Wood
- Geisinger Obesity Institute, 100 N Academy Ave, MC 26-08, Danville, PA 17822 USA
| | - Adam Cook
- Geisinger Obesity Institute, 100 N Academy Ave, MC 26-08, Danville, PA 17822 USA
| | - Krystal Cunningham
- Geisinger Obesity Institute, 100 N Academy Ave, MC 26-08, Danville, PA 17822 USA
| | - Scott Jamieson
- Geisinger Obesity Institute, 100 N Academy Ave, MC 26-08, Danville, PA 17822 USA
| | - Jacob Mowery
- Geisinger Obesity Institute, 100 N Academy Ave, MC 26-08, Danville, PA 17822 USA
| | - Allison Naylor
- Geisinger Obesity Institute, 100 N Academy Ave, MC 26-08, Danville, PA 17822 USA
| | - David D Rolston
- Geisinger Obesity Institute, 100 N Academy Ave, MC 26-08, Danville, PA 17822 USA; Department of Internal Medicine, Geisinger, 100 N Academy Ave, MC 14-01, Danville, PA 17822 USA
| | - Christopher Seiler
- Geisinger Obesity Institute, 100 N Academy Ave, MC 26-08, Danville, PA 17822 USA
| | - Christopher D Still
- Geisinger Obesity Institute, 100 N Academy Ave, MC 26-08, Danville, PA 17822 USA
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Di Prospero NA, Yee J, Frustaci ME, Samtani MN, Alba M, Fleck P. Efficacy and safety of glucagon-like peptide-1/glucagon receptor co-agonist JNJ-64565111 in individuals with type 2 diabetes mellitus and obesity: A randomized dose-ranging study. Clin Obes 2021; 11:e12433. [PMID: 33475251 DOI: 10.1111/cob.12433] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/17/2020] [Accepted: 11/29/2020] [Indexed: 12/15/2022]
Abstract
Weight loss has been shown to improve metabolic parameters and cardiovascular risk in people with type 2 diabetes mellitus (T2DM). This phase 2 study evaluated the safety and efficacy of JNJ-64565111, a dual agonist of GLP-1 and glucagon receptors, in individuals with T2DM and class II/III obesity. In this randomized, double-blind study, participants with T2DM (HbA1c 6.5%-9.5%), body mass index of 35 to 50 kg/m2 and stable weight were randomly assigned (1:1:1:1) to placebo or JNJ-64565111 (5.0 mg, 7.4 mg or 10.0 mg). The primary endpoint was percent change from baseline in body weight at week 12. Of 195 dosed participants, 144 (73.8%) completed treatment. At week 12, placebo-subtracted body weight changes were -4.6%, -5.9% and -7.2% with JNJ-64565111 5.0 mg, 7.4 mg and 10.0 mg, respectively. All JNJ-64565111 doses were associated with no change in HbA1c and slight numerical elevation of fasting insulin. Numerical increases in fasting plasma glucose were observed with JNJ-64565111 5.0 mg and 7.4 mg. Incidence of treatment-emergent adverse events, especially nausea and vomiting, was higher with JNJ-64565111 vs placebo. Overall, JNJ-64565111 significantly reduced body weight in a dose-dependent manner vs placebo but was associated with greater incidence of treatment-emergent adverse events, no HbA1c reductions, and increased fasting plasma glucose and fasting insulin.
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Affiliation(s)
| | - Jaqueline Yee
- Janssen Research & Development, LLC, Raritan, New Jersey, USA
| | - Mary E Frustaci
- Janssen Research & Development, LLC, Spring House, Pennsylvania, USA
| | | | - Maria Alba
- Janssen Research & Development, LLC, Raritan, New Jersey, USA
| | - Penny Fleck
- Janssen Research & Development, LLC, Raritan, New Jersey, USA
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21
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Nash SH, Day G, Hiratsuka VY, Beans J, Redwood D, Holck P, Howard BV, Umans J, Koller KR. Ten-year weight gain is not associated with multiple cardiometabolic measures in Alaska EARTH study participants. Nutr Metab Cardiovasc Dis 2021; 31:403-410. [PMID: 33127251 PMCID: PMC7887000 DOI: 10.1016/j.numecd.2020.09.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 09/01/2020] [Accepted: 09/17/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND AIMS Alaska Native (AN) traditional lifestyle may be protective against chronic disease risk. Weight gain in adulthood has been linked to increases in chronic disease risk among other populations; yet, its impact among Alaska Native people has never been evaluated. We aimed to evaluate changes in obesity-related metrics over time, and determine associations of changes with cardiometabolic markers of chronic disease risk among AN people. METHODS AND RESULTS Study participants enrolled in the southcentral Alaska Education and Research Towards Health Study in 2004-2006 were invited to participate in a follow-up study conducted 2015-2017. Of the original 1320 participants, 388 completed follow-up health assessments consisting of multiple health surveys, anthropometric measurements, and cardiometabolic measures including blood sugars, blood lipids, and blood pressure. Differences in measurements between visits were determined and associations of weight change with cardiometabolic measures evaluated. Body mass index increased by 3.7 kg/m2 among men and 4.8 kg/m2 among women. Hip circumference (1.1 cm, p < 0.01) and waist circumference (0.7 cm, p < 0.01) increased among women; only waist circumference increased among men (1.6 cm, p < 0.01). Among men, there were no associations of weight change with cardiometabolic measures. Among women, there was an inverse association between weight gain and high-density lipoprotein cholesterol only (0.17 mg/dL (CI: -3.1, -0.03), p = 0.02). CONCLUSIONS While weight increase over a 10-year period was not associated with substantive changes in cardiometabolic measures among AN men, there was a decrease in high density lipid cholesterol associated with weight gain among AN women.
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Affiliation(s)
- Sarah H Nash
- Alaska Native Epidemiology Center, Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA.
| | - Gretchen Day
- Clinical and Research Services, Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | | | - Julie Beans
- Clinical and Research Services, Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Diana Redwood
- Alaska Native Epidemiology Center, Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Peter Holck
- Clinical and Research Services, Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Barbara V Howard
- Medstar Health Research Institute, Hyattsville, MD, USA; Georgetown/Howard Universities Center for Clinical and Translational Research, Washington, DC, USA
| | - Jason Umans
- Medstar Health Research Institute, Hyattsville, MD, USA; Georgetown/Howard Universities Center for Clinical and Translational Research, Washington, DC, USA
| | - Kathryn R Koller
- Clinical and Research Services, Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
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Genario R, Cipolla-Neto J, Bueno AA, Santos HO. Melatonin supplementation in the management of obesity and obesity-associated disorders: A review of physiological mechanisms and clinical applications. Pharmacol Res 2020; 163:105254. [PMID: 33080320 DOI: 10.1016/j.phrs.2020.105254] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 10/11/2020] [Accepted: 10/11/2020] [Indexed: 02/08/2023]
Abstract
Despite the evolving advances in clinical approaches to obesity and its inherent comorbidities, the therapeutic challenge persists. Among several pharmacological tools already investigated, recent studies suggest that melatonin supplementation could be an efficient therapeutic approach in the context of obesity. In the present review, we have amalgamated the evidence so far available on physiological effects of melatonin supplementation in obesity therapies, addressing its effects upon neuroendocrine systems, cardiometabolic biomarkers and body composition. Most studies herein appraised employed melatonin supplementation at dosages ranging from 1 to 20 mg/day, and most studies followed up participants for periods from 3 weeks to 12 months. Overall, it was observed that melatonin plays an important role in glycaemic homeostasis, in addition to modulation of white adipose tissue activity and lipid metabolism, and mitochondrial activity. Additionally, melatonin increases brown adipose tissue volume and activity, and its antioxidant and anti-inflammatory properties have also been demonstrated. There appears to be a role for melatonin in adiposity reduction; however, several questions remain unanswered, for example melatonin baseline levels in obesity, and whether any seeming hypomelatonaemia or melatonin irresponsiveness could be clarifying factors. Supplementation dosage studies and more thorough clinical trials are needed to ascertain not only the relevance of such findings but also the efficacy of melatonin supplementation.
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Affiliation(s)
- Rafael Genario
- School of Medicine, University of Sao Paulo (USP), São Paulo, Brazil.
| | - José Cipolla-Neto
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo (USP), São Paulo, Brazil
| | - Allain A Bueno
- College of Health, Life and Environmental Sciences, University of Worcester, Worcester, United Kingdom
| | - Heitor O Santos
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil.
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Hepatic FTO is dispensable for the regulation of metabolism but counteracts HCC development in vivo. Mol Metab 2020; 42:101085. [PMID: 32956847 PMCID: PMC7560164 DOI: 10.1016/j.molmet.2020.101085] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 12/21/2022] Open
Abstract
Objective Single-nucleotide polymorphisms in the FTO gene encoding an m6Am and an m6A demethylase are associated with obesity. Moreover, recent studies have linked a dysregulation of m6A modifications and its machinery, including FTO, to the development of several forms of cancers. However, the functional role of hepatic FTO in metabolism and the development and progression of hepatocellular carcinoma (HCC), a proteotypic obesity-associated cancer, remains unclear. Thus, we aimed to reveal the role of hepatic FTO in metabolism and in the initiation and progression of HCC in vivo. Methods We generated mice with hepatic FTO deficiency (FTOL−KO). The effect of hepatic FTO on metabolism was investigated by extensive metabolic phenotyping. To determine the impact of hepatic FTO on HCC development, FTOL−KO and Ctrl mice were subjected to long-term diethylnitrosamine (DEN)-induced HCC-development and the tumor initiation phase was examined via a short-term DEN protocol. Results In long-term DEN experiments, FTOL−KO mice exhibit increased HCC burden compared to Ctrl mice. In the tumor initiation phase, Ctrl mice display a dynamic regulation of FTO upon induction of liver damage, while this response is abrogated in FTO-deficient mice. Proteomic analyses revealed that liver damage-induced increases in FTO expression reduce CUL4A protein abundance. Functionally, simultaneous knockdown of Cul4a reverses the increased hepatocyte proliferation observed upon loss of FTO. Conclusion Collectively, our study demonstrates that hepatic FTO is dispensable for the control of energy homeostasis and glucose metabolism. However, we show a protective function of FTO in liver carcinogenesis and suggest the FTO-dependent dynamic mRNA demethylation of Cul4a in the initiation of HCC development contributes to this effect. Hepatic FTO is dispensable for whole body metabolism. FTO is dynamically regulated upon acute liver damage and controls proliferation. Hepatic FTO function protects against the development of hepatocellular carcinoma (HCC). Cul4a is a downstream target of FTO, and Cul4a knockdown reduces damage-induced proliferation in FTOL−KO livers.
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Ghosal S, Arora B, Dutta K, Ghosh A, Sinha B, Misra A. Increase in the risk of type 2 diabetes during lockdown for the COVID19 pandemic in India: A cohort analysis. Diabetes Metab Syndr 2020; 14:949-952. [PMID: 32604013 PMCID: PMC7303633 DOI: 10.1016/j.dsx.2020.06.020] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 06/10/2020] [Accepted: 06/10/2020] [Indexed: 01/19/2023]
Abstract
UNLABELLED Lockdown due to the Coronavirus disease 2019 (COVID 19) pandemic may cause weight gain and enhance the risk of type 2 diabetes mellitus (T2DM). We aimed to determine this risk in apparently non-diabetic individuals. MATERIAL METHODS Baseline demographic and clinical data from 100 apparently non-diabetic household members (related or unrelated) of patients with type 2 diabetes mellitus were collected until 49 days of lockdown and analyzed using the XL-STAT statistical software. A two-pronged analytical strategy was employed. First, the metabolic risk profile related to age, sex, weight, family history, and exercise pattern was analyzed. This was followed by an assessment of the risk of developing type 2 diabetes using an established risk assessment engine. RESULTS There was a trend towards weight gain seen in 40% of the cohort, with 16% of the population experiencing a 2.1-5 kg weight increment. When all the risk parameters were analyzed together using the ADA risk engine, there was an increase in the ADA diabetes risk score in 7% of the population, with 6.66% in the high-risk group. There was a further increase in weight among 3% of the population who were already obese at baseline. CONCLUSION We show an increased risk of T2MD consequent to weight gain during 49 days of lockdown in India.
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Affiliation(s)
| | - Bhavya Arora
- Fortis CDOC Hospital for Diabetes and Allied Specialties, Chirag Enclave, New Delhi, India
| | - Koel Dutta
- Fortis CDOC Hospital for Diabetes and Allied Specialties, Chirag Enclave, New Delhi, India
| | - Amerta Ghosh
- Fortis CDOC Hospital for Diabetes and Allied Specialties, Chirag Enclave, New Delhi, India
| | | | - Anoop Misra
- Fortis CDOC Hospital for Diabetes and Allied Specialties, Chirag Enclave, New Delhi, India; National Diabetes, Obesity and Cholesterol Foundation, New Delhi, India; Diabetes Foundation (India), New Delhi, India
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Bai L, Kumar S, Verma S, Seshadri S. Bacteriocin PJ4 from probiotic lactobacillus reduced adipokine and inflammasome in high fat diet induced obesity. 3 Biotech 2020; 10:355. [PMID: 32766096 DOI: 10.1007/s13205-020-02317-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 06/23/2020] [Indexed: 12/12/2022] Open
Abstract
One of the characteristic features of obesity is increased body weight and accumulation of adipose tissue. It is associated with low grade inflammation and gut dysbiosis. Probiotics and its products could be an ideal strategy to prevent or treat diabetes. In the present study, animals were induced obesity by providing them with high fat diet. Three purified bacteriocins i.e., DT24, PJ4 and TSU4, previously isolated and purified from various probiotic strains, were given as treatment strategies, following the induction of obesity. Upon the completion of the study, animals were sacrificed and were checked for their tissue expression of inflammatory mediators and adipokines. Serum hormone and cytokines analysis were performed to check their inflammatory state. Treatment with purified bacteriocin DT24 did not show any therapeutic effect in any of the parameter studied. Bacteriocin TSU4 on the other hand showed better reversal compared to DT24. Bacteriocin PJ4 showed the most promising results by reversing all the altered parameters significantly. It significantly reversed all the biochemical, immunological in terms of serum cytokines as well as altered morphological characteristics. PJ4 can be further explored to determine its mode of action. The anti-microbial proteins or to be more specific, bacteriocins, which shows broad spectrum efficacy, could be a better alternative in modulating gut microflora for the treatment of obesity and diabetes characteristics. The efficacy of bacteriocin PJ4 may also be due to the source of the host of Lactobacillus.
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Affiliation(s)
- Lian Bai
- Department of General Medicine, Jinan Central Hospital Affiliated To Shandong University, Jinan, Shandong Province 250013 People's Republic of China
| | - Sunny Kumar
- Institute of Science, Nirma University, Sarkhej Gandhinagar Highway, Ahmedabad, Gujarat India
| | - Shailja Verma
- Institute of Science, Nirma University, Sarkhej Gandhinagar Highway, Ahmedabad, Gujarat India
- National Foods - The Hing Research Center, GIDC-Waghodia, Vadodara, India
| | - Sriram Seshadri
- Institute of Science, Nirma University, Sarkhej Gandhinagar Highway, Ahmedabad, Gujarat India
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Nasab SB, Homaei A, Pletschke BI, Salinas-Salazar C, Castillo-Zacarias C, Parra-Saldívar R. Marine resources effective in controlling and treating diabetes and its associated complications. Process Biochem 2020. [DOI: 10.1016/j.procbio.2020.01.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Sofra X. The Importance of Systemic Balance in Safeguarding Health: A Randomized Double-Blind Clinical Trial on VLDL, Triglycerides, Free T3, Leptin, Ghrelin, Cortisol and Visceral Adipose Tissue. Health (London) 2020. [DOI: 10.4236/health.2020.128078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Pace ND, Siega-Riz AM, Olshan AF, Chescheir NC, Cole SR, Desrosiers TA, Tinker SC, Hoyt AT, Canfield MA, Carmichael SL, Meyer RE. Survival of infants with spina bifida and the role of maternal prepregnancy body mass index. Birth Defects Res 2019; 111:1205-1216. [PMID: 31322328 PMCID: PMC7285624 DOI: 10.1002/bdr2.1552] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 01/08/2019] [Accepted: 06/30/2019] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To investigate first-year survival of infants born with spina bifida, and examine the association of maternal prepregnancy body mass index (BMI) with infant mortality. METHODS This is a retrospective cohort study of 1,533 liveborn infants with nonsyndromic spina bifida with estimated dates of delivery from 1998 to 2011 whose mothers were eligible for the National Birth Defects Prevention Study (NBDPS). NBDPS data were linked to death records to conduct survival analyses. Kaplan-Meier survival functions estimated mortality risk over the first year of life. Cox proportional hazards models estimated hazard ratios (HRs) for maternal prepregnancy BMI categorized as underweight (<18.5), normal (18.5-24.9), overweight (25-29.9), and obese (≥30). RESULTS Infant mortality risk among infants with spina bifida was (4.4% [3.52, 5.60%]). Infants with multiple co-occurring defects, very preterm delivery, multiple gestation, high-level spina bifida lesions, or non-Hispanic Black mothers had an elevated risk of infant mortality. Maternal prepregnancy underweight and obesity were associated with higher infant mortality (15.7% [7.20, 32.30%] and 5.82% [3.60, 9.35%], respectively). Adjusted HR estimates showed underweight and obese mothers had greater hazard of infant mortality compared to normal weight mothers (HR: 4.5 [1.08, 16.72] and 2.6 [1.36, 8.02], respectively). CONCLUSION The overall risk of infant mortality for infants born with spina bifida was lower than most previously reported estimates. Infants born with spina bifida to mothers who were underweight or obese prepregnancy were at higher risk of infant mortality. This study provides additional evidence of the importance of healthy maternal weight prior to pregnancy.
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Affiliation(s)
- Nelson D. Pace
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Anna Maria Siega-Riz
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Andrew F. Olshan
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Nancy C. Chescheir
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Stephen R. Cole
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Tania A. Desrosiers
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Sarah C. Tinker
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Adrienne T. Hoyt
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas
| | - Mark A. Canfield
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas
| | - Suzan L. Carmichael
- Department of Pediatrics, Division of Neonatology and Developmental Medicine, Stanford University School of Medicine, Stanford, California
| | - Robert E. Meyer
- Birth Defects Monitoring Program, North Carolina Department of Health and Human Services, Raleigh, North Carolina
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Muhammad MU, Jiadong R, Muhammad NS, Hussain M, Muhammad I. Principal Component Analysis of Categorized Polytomous Variable-Based Classification of Diabetes and Other Chronic Diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3593. [PMID: 31557898 PMCID: PMC6801713 DOI: 10.3390/ijerph16193593] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 09/17/2019] [Accepted: 09/19/2019] [Indexed: 12/21/2022]
Abstract
A chronic disease diabetes mellitus is assuming pestilence proportion worldwide. Therefore prevalence is important in all aspects. Researchers have introduced various methods, but still, the improvement is a need for classification techniques. This paper considers data mining approach and principal component analysis (PCA) techniques, on a single platform to approaches on the polytomous variable-based classification of diabetes mellitus and some selected chronic diseases. The PCA result shows eigenvalues, and the total variance is explained for the principal components (PCs) solution. Total of twelve attributes was analyzed with the intention to precise the pattern of the correlation with minimum factors as possible. Usually, factors with large eigenvalues retained. The first five components have their eigenvalues large enough to be retained. Their variances are 18.9%, 14.0%, 13.6%, 10.3%, and 8.6%, respectively. That explains ~65.3% of the total variance. We further applied K-means clustering with the aid of the first two PCs. As well, correlation results between diabetes mellitus and selected diseases; it has revealed that diabetes patients are more likely to have kidney and hypertension. Therefore, the study validates the proposed polytomous method for classification techniques. Such a study is important in better assessment on low socio-economic status zone regions around the globe.
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Affiliation(s)
- Musa Uba Muhammad
- Department of Information sciences and Technology, Yanshan University, Qinhuangdao, Hebei 066000, China.
| | - Ren Jiadong
- Department of Information sciences and Technology, Yanshan University, Qinhuangdao, Hebei 066000, China.
| | - Noman Sohail Muhammad
- Department of Information sciences and Technology, Yanshan University, Qinhuangdao, Hebei 066000, China.
| | - Munawar Hussain
- Department of Information sciences and Technology, Yanshan University, Qinhuangdao, Hebei 066000, China.
| | - Irshad Muhammad
- Department of Information sciences and Technology, Yanshan University, Qinhuangdao, Hebei 066000, China.
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Nash MS, Groah SL, Gater DR, Dyson-Hudson TA, Lieberman JA, Myers J, Sabharwal S, Taylor AJ. Identification and Management of Cardiometabolic Risk after Spinal Cord Injury. J Spinal Cord Med 2019; 42:643-677. [PMID: 31180274 PMCID: PMC6758611 DOI: 10.1080/10790268.2018.1511401] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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Režić T, Blaslov K, Kruljac I, Rahelić D, Vrkljan M, Renar IP. The possible synergistic action of sex hormones and glucagon-like peptide-1 (GLP-1) agonists on body mass decline in patients with type 2 diabetes mellitus. Med Hypotheses 2019; 131:109308. [PMID: 31443779 DOI: 10.1016/j.mehy.2019.109308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 07/07/2019] [Accepted: 07/12/2019] [Indexed: 10/26/2022]
Abstract
Adiposity is a chronic disease and one of the major modifiable risk factors for the development of type 2 diabetes mellitus (T2DM). Its prevalence in the world could be considered epidemic with 80% of patients with T2DM being obese. Novel antidiabetic drugs, such as glucagone-like peptide-1 (GLP-1) agonists have demonstrated benefitial effect on weight reduction. Nevertheless, in the last decades the need for new therapeutic strategies in the management of adiposity have emerged. Both adiposity and T2DM have negative effect on hypothalamic-pituitary-gonadal axis. Conversely, it has been known that sex hormone replacement therapy improves metabolic parameters in hypogonadal subjects. Recent research has found potential therapeutic effect of combination therapies with sex hormones and GLP-1 agonists in reducing body weight. Based on the aforementioned, we hypothesize that there is a possible synergistic effect of GLP-1 agonists and sex hormones on body mass reduction in patients with type 2 diabetes. The possible additional effect of sex hormones on weight loss could contribute to more effective treatment of T2DM and its complications.
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Affiliation(s)
- T Režić
- Department of Endocrinology, Diabetes and Clinical Pharmacology, Dubrava University Hospital, Zagreb, Croatia.
| | - K Blaslov
- Department of Endocrinology, Diabetes and Metabolic Diseases ''Mladen Sekso'', University Hospital Centre ''Sestre Milosrdnice'', Zagreb, Croatia; University of Zagreb School of Medicine, Zagreb, Croatia
| | - I Kruljac
- Department of Endocrinology, Diabetes and Metabolic Diseases ''Mladen Sekso'', University Hospital Centre ''Sestre Milosrdnice'', Zagreb, Croatia; University of Zagreb School of Medicine, Zagreb, Croatia
| | - D Rahelić
- University of Zagreb School of Medicine, Zagreb, Croatia; Department of Diabetes and Endocrinology, Vuk Vrhovac University Clinic for Diabetes, Endocrinology and Metabolic Diseases, Merkur University Hospital, Zagreb, Croatia
| | - M Vrkljan
- Department of Endocrinology, Diabetes and Metabolic Diseases ''Mladen Sekso'', University Hospital Centre ''Sestre Milosrdnice'', Zagreb, Croatia; University of Zagreb School of Medicine, Zagreb, Croatia
| | - I P Renar
- University of Zagreb School of Medicine, Zagreb, Croatia
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Saxena A, Stacey N, Puech PDR, Mudara C, Hofman K, Verguet S. The distributional impact of taxing sugar-sweetened beverages: findings from an extended cost-effectiveness analysis in South Africa. BMJ Glob Health 2019; 4:e001317. [PMID: 31543983 PMCID: PMC6730580 DOI: 10.1136/bmjgh-2018-001317] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 05/27/2019] [Accepted: 05/28/2019] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Facing increasing obesity prevalence and obesity-related disease burden, South Africa has devised an obesity prevention strategy that includes a recently implemented tax on the sugar content of sugar-sweetened beverages (SSB). We assess the potential distributional impact (across socioeconomic groups) of this tax on type 2 diabetes mellitus (T2DM) incidence and associated mortality and its financial burden on households. METHODS We conducted an extended cost-effectiveness analysis of the new 10% tax on SSBs in South Africa, and estimated: the averted premature deaths related to T2DM, the financial benefits to households (out-of-pocket (OOP) medical costs and indirect costs due to productivity losses averted), the increased government tax revenues and healthcare savings for the government, all across income quintiles. FINDINGS A 10% SSB tax increase would avert an estimated 8000 T2DM-related premature deaths over 20 years, with most deaths averted among the third and fourth income quintiles. The government would save about South African rand (ZAR) 2 billion (US$140 million) in subsidised healthcare over 20 years; and would raise ZAR6 billion (US$450 million) in tax revenues per annum. The bottom two quintiles would bear the smallest tax burden increase (36% of the additional taxes). The bottom two income quintiles would also have the lowest savings in OOP payments due to significant subsidisation provided by government healthcare. Lastly, an estimated 32 000 T2DM-related cases of catastrophic expenditures and 12 000 cases of poverty would be averted. CONCLUSIONS SSB taxation would have a substantial distributional impact on obesity-related premature deaths, cost savings to the government and the financial outcomes of South Africa's population.
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Affiliation(s)
- Akshar Saxena
- Economics, Nanyang Technological University, Singapore, Singapore
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Nicholas Stacey
- SAMRC/Wits Center for Health Economics and Decision Science - PRICELESS SA School of Public Health Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Paula Del Ray Puech
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Caroline Mudara
- SAMRC/Wits Center for Health Economics and Decision Science - PRICELESS SA School of Public Health Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Karen Hofman
- SAMRC/Wits Center for Health Economics and Decision Science - PRICELESS SA School of Public Health Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Stéphane Verguet
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Tait CA, L'Abbé MR, Smith PM, Watson T, Kornas K, Rosella LC. Adherence to Predefined Dietary Patterns and Risk of Developing Type 2 Diabetes in the Canadian Adult Population. Can J Diabetes 2019; 44:175-183.e2. [PMID: 31420278 DOI: 10.1016/j.jcjd.2019.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 03/25/2019] [Accepted: 06/05/2019] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Diet quality indices are increasingly being used in epidemiologic research. However, no studies have addressed whether adherence to Canadian dietary guidelines is longitudinally associated with decreased risk of type 2 diabetes in a population-based sample. The objective of this study is to examine the association between the Healthy Eating Index (HEI) and incident type 2 diabetes in the Canadian population. METHODS We used data from Ontario respondents to the 2004 Canadian Community Health Survey linked to health administrative data (n=4,755). Adherence to the HEI was analyzed with a 24-hour dietary recall. Type 2 diabetes was ascertained through the Ontario Diabetes Database, and tracked up to 12.1 years from baseline. Cox proportional hazards models were used to estimate type 2 diabetes risk as a function of HEI score. Given obesity's potential role as a mediator, we explored the effects of removing body mass index from the final model. RESULTS High HEI adherence was not associated with a reduction in diabetes risk overall (hazard ratio [HR], 0.97; 95% confidence interval, 0.62 to 1.50), nor in separate strata of men (HR, 0.94) or women (HR, 1.03). Additional adjustment for body mass index attenuated the multivariable adjusted hazard ratios toward the null. CONCLUSIONS This is the first study to prospectively explore the relationship between adherence to the dietary recommendations of the HEI and diabetes risk in a representative, population-based sample. Our analyses challenge previous findings and highlight the utility of linked data to evaluate the role of healthy dietary patterns in relation to population-level morbidity.
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Affiliation(s)
- Christopher A Tait
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada
| | - Mary R L'Abbé
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Peter M Smith
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Institute for Work & Health, Toronto, Ontario, Canada; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Tristan Watson
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada
| | - Kathy Kornas
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Laura C Rosella
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; Public Health Ontario, Toronto, Ontario, Canada.
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Ling J, Cheng P, Ge L, Zhang DH, Shi AC, Tian JH, Chen YJ, Li XX, Zhang JY, Yang KH. The efficacy and safety of dipeptidyl peptidase-4 inhibitors for type 2 diabetes: a Bayesian network meta-analysis of 58 randomized controlled trials. Acta Diabetol 2019; 56:249-272. [PMID: 30242726 DOI: 10.1007/s00592-018-1222-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 08/30/2018] [Indexed: 12/22/2022]
Abstract
AIMS The aim is to evaluate the efficacy and safety of dipeptidyl peptidase-4 inhibitors (DPP4-I: sitagliptin, saxagliptin, linagliptin, vildagliptin and alogliptin) in patients with type 2 diabetes. METHODS We searched the Cochrane Library, PubMed, EMBASE, Chinese Biomedical Database (CBM), China National Knowledge Infrastructure (CNKI), and the Wanfang Database from inception to April, 2018. Randomized controlled trials were included if they compared the different versions of DPP4-I with each other or with placebo in treatment of type 2 diabetes. Bayesian network meta-analysis and pairwise meta-analysis were performed to evaluate the efficacy and safety of the different kinds of DPP4-I and placebo. The data were analyzed using STATA 12.0 and WinBUGS1.4 software. RESULTS We identified 58 eligible studies (with 31356 patients) involving 14 treatment arms. Indirect comparison results showed that except for alogliptin, a decrease was found for all DPP4-I versus the placebo for hemoglobin A1c (HbA1c) with vildagliptin50 twice daily (BID) showing the highest probability. Linagliptin5 once daily (QD) decreased the level of fasting plasma glucose (FPG) the most for all DPP4-I versus the placebo; when comparing them with each other, alogliptin25QD was more effective when compared with sitagliptin100QD and vildaglipti50BID; linagliptin5qd had the highest decrease impact on body mass index (BMI). Except for hypoglycemia and upper respiratory tract infection (URTI), there are no statistical significance on incidence of adverse events and the body weight when DPP4-I are compared with each other or with placebo. CONCLUSION Our network meta-analysis presents the associations of DPP4-I versus placebos on HbA1c, FPG, 2 h postprandial blood glucose (2HPPG), BMI, body weight and adverse events. DPP4-I have a lowering effect on the glycemic level (HbA1c, FPG), especially vildaglipti50BID and linagliptin10QD, respectively. Besides, linagliptin5QD has the greatest probabilities of reducing BMI. In addition, DPP4-I were associated with not increasing the incidence of adverse events. Among them, vildagliptin100QD and sitagliptin100QD have the lowest probability in reducing the incidence of hypoglycemia and URTI, respectively.
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Affiliation(s)
- Juan Ling
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China
- Key Laboratory of Evidence-based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
- Chinese GRADE Center, Lanzhou University, Lanzhou, 730000, China
- WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou, 730000, China
| | - Peng Cheng
- Department of Orthopedics, The Second Hospital of Lanzhou University, Lanzhou, China
| | - Long Ge
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China
- Key Laboratory of Evidence-based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
- Chinese GRADE Center, Lanzhou University, Lanzhou, 730000, China
- WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou, 730000, China
- First Clinical Medical College of Lanzhou University, Lanzhou, 730000, China
| | - Ding-Hua Zhang
- Department of Endocrinology, Gansu Province Hospital of Traditional Chinese Medicine, Lanzhou, China
| | - An-Chen Shi
- Second Clinical Medical College of Lanzhou University, Lanzhou, 730000, China
| | - Jin-Hui Tian
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China
- Key Laboratory of Evidence-based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
- Chinese GRADE Center, Lanzhou University, Lanzhou, 730000, China
- WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou, 730000, China
| | - Ya-Jing Chen
- School of Public Health of Lanzhou University, Lanzhou, 730000, Gansu, China
| | - Xiu-Xia Li
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China
- Key Laboratory of Evidence-based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
- Chinese GRADE Center, Lanzhou University, Lanzhou, 730000, China
- WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou, 730000, China
| | - Jing-Yun Zhang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China
- Key Laboratory of Evidence-based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
- Chinese GRADE Center, Lanzhou University, Lanzhou, 730000, China
- WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou, 730000, China
| | - Ke-Hu Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China.
- Key Laboratory of Evidence-based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China.
- Chinese GRADE Center, Lanzhou University, Lanzhou, 730000, China.
- WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou, 730000, China.
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Arora S, Stouffer GA, Kucharska-Newton AM, Qamar A, Vaduganathan M, Pandey A, Porterfield D, Blankstein R, Rosamond WD, Bhatt DL, Caughey MC. Twenty Year Trends and Sex Differences in Young Adults Hospitalized With Acute Myocardial Infarction. Circulation 2019; 139:1047-1056. [PMID: 30586725 PMCID: PMC6380926 DOI: 10.1161/circulationaha.118.037137] [Citation(s) in RCA: 400] [Impact Index Per Article: 80.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 10/19/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Sex differences are known to exist in the management of older patients presenting with acute myocardial infarction (AMI). Few studies have examined the incidence and risk factors of AMI among young patients, or whether clinical management differs by sex. METHODS The Atherosclerosis Risk in Communities (ARIC) Surveillance study conducts hospital surveillance of AMI in 4 US communities (MD, MN, MS, and NC). AMI was classified by physician review, using a validated algorithm. Medications and procedures were abstracted from the medical record. Our study population was limited to young patients aged 35 to 54 years. RESULTS From 1995 to 2014, 28 732 weighted hospitalizations for AMI were sampled among patients aged 35 to 74 years. Of these, 8737 (30%) were young. The annual incidence of AMI hospitalizations increased for young women but decreased for young men. The overall proportion of AMI admissions attributable to young patients steadily increased, from 27% in 1995 to 1999 to 32% in 2010 to 2014 ( P for trend=0.002), with the largest increase observed in young women. History of hypertension (59% to 73%, P for trend<0.0001) and diabetes mellitus (25% to 35%, P for trend<0.0001) also increased among young AMI patients. Compared to young men, young women presenting with AMI were more often black and had a greater comorbidity burden. In adjusted analyses, young women had a lower probability of receiving lipid-lowering therapies (relative risk [RR]=0.87; 95% confidence interval [CI], 0.80-0.94), nonaspirin antiplatelets (RR=0.83; 95% CI, 0.75-0.91), beta blockers (RR=0.96; 95% CI, 0.91-0.99), coronary angiography (RR=0.93; 95% CI, 0.86-0.99) and coronary revascularization (RR = 0.79; 95% CI, 0.71-0.87). However, 1-year all-cause mortality was comparable for women versus men (HR=1.10; 95% CI, 0.83-1.45). CONCLUSIONS The proportion of AMI hospitalizations attributable to young patients increased from 1995 to 2014 and was especially pronounced among women. History of hypertension and diabetes among young patients admitted with AMI increased over time as well. Compared with young men, young women presenting with AMI had a lower likelihood of receiving guideline-based AMI therapies. A better understanding of factors underlying these changes is needed to improve care of young patients with AMI.
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Affiliation(s)
- Sameer Arora
- Division of Cardiology, University of North Carolina School of Medicine, Chapel Hill (S.A., G.S., M.C.)
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill (S.A., A.KN, W.R.)
- Division of Family Medicine, University of North Carolina School of Medicine, Chapel Hill (S.A.)
| | - George A Stouffer
- Division of Cardiology, University of North Carolina School of Medicine, Chapel Hill (S.A., G.S., M.C.)
| | - Anna M Kucharska-Newton
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill (S.A., A.KN, W.R.)
| | - Arman Qamar
- Brigham and Women's Hospital Heart and Vascular Center and Harvard Medical School, Boston, MA (A.Q., M.V, D.L.B.)
| | - Muthiah Vaduganathan
- Brigham and Women's Hospital Heart and Vascular Center and Harvard Medical School, Boston, MA (A.Q., M.V, D.L.B.)
| | - Ambarish Pandey
- Division of Cardiology, University of Texas Southwestern Medical Center, Dallas (A.P.)
| | - Deborah Porterfield
- Social and Health Organizational Research and Evaluation Program, RTI International, Research Triangle Park, NC (D.P.)
| | - Ron Blankstein
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (R.B.)
| | - Wayne D Rosamond
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill (S.A., A.KN, W.R.)
| | - Deepak L Bhatt
- Brigham and Women's Hospital Heart and Vascular Center and Harvard Medical School, Boston, MA (A.Q., M.V, D.L.B.)
| | - Melissa C Caughey
- Division of Cardiology, University of North Carolina School of Medicine, Chapel Hill (S.A., G.S., M.C.)
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Psychiatric adverse events and effects on mood with prolonged-release naltrexone/bupropion combination therapy: a pooled analysis. Int J Obes (Lond) 2019; 43:2085-2094. [PMID: 30664661 PMCID: PMC7111229 DOI: 10.1038/s41366-018-0302-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 10/25/2018] [Accepted: 11/29/2018] [Indexed: 11/20/2022]
Abstract
Background/objectives Prolonged-release (PR) naltrexone 32 mg/bupropion 360 mg (NB) is approved for chronic weight management as an adjunct to reduced-calorie diet and increased physical activity. Central nervous system-active medications have the potential to affect mood; therefore, post hoc analysis of clinical trial data was conducted to evaluate psychiatric adverse events (PAEs) and effects on mood of NB therapy versus placebo. Subjects/methods Data were pooled from 5 prospective, double-blind, randomized, placebo-controlled clinical trials (duration range, 24–56 weeks) of NB in subjects with overweight or obesity. PAEs were collected via AE preferred terms, organized into major subtopics (e.g., anxiety, depression, sleep disorders), and divided into category terms (e.g., anxiety, potential anxiety symptoms). Additionally, the Inventory of Depressive Symptomatology Self Report (IDS-SR; score range 0–84) and the Columbia Classification Algorithm of Suicide Assessment (C-CASA) evaluated treatment-emergent depressive/anxiety symptoms and suicidal behavior/ideation, respectively. Results Baseline characteristics and comorbidities were comparable for placebo (n = 1515) and NB (n = 2545). Most common PAEs in the NB group (using category grouping; NB vs placebo) were sleep disorders (12.7 vs 7.9%, P < 0.001), anxiety (5.4 vs 3.3%, P = 0.029), and depression (1.8 vs 2.7%, P = 0.014); PAEs were more frequent during dose escalation and generally mild or moderate. Mean (SD) changes in IDS-SR total score from baseline to endpoint were small in both groups: 0.13 (5.83) for NB and −0.45 (5.65) for placebo. Retrospective AE categorization via C-CASA confirmed no completed suicides, suicide attempts, or preparatory acts toward imminent suicidal behavior. Conclusions This large pooled analysis of 5 clinical trials provides additional safety information about the NB PAE profile. Anxiety and sleep disorder-related PAEs were more frequent with NB versus placebo but were mostly mild to moderate and generally occurred early. Depression-related PAEs were less common with NB than placebo, and NB was not associated with suicidal ideation or behavior in this patient population.
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Bowman PRT, Smith GL, Gould GW. Cardiac SNARE Expression in Health and Disease. Front Endocrinol (Lausanne) 2019; 10:881. [PMID: 31920989 PMCID: PMC6930865 DOI: 10.3389/fendo.2019.00881] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 12/03/2019] [Indexed: 12/16/2022] Open
Abstract
SNARE proteins are integral to intracellular vesicular trafficking, which in turn is the process underlying the regulated expression of substrate transporters such as the glucose transporter GLUT4 at the cell surface of insulin target tissues. Impaired insulin stimulated GLUT4 trafficking is associated with reduced cardiac function in many disease states, most notably diabetes. Despite this, our understanding of the expression and regulation of SNARE proteins in cardiac tissue and how these may change in diabetes is limited. Here we characterize the array of SNARE proteins expressed in cardiac tissue, and quantify the levels of expression of VAMP2, SNAP23, and Syntaxin4-key proteins involved in insulin-stimulated GLUT4 translocation. We examined SNARE protein levels in cardiac tissue from two rodent models of insulin resistance, db/db mice and high-fat fed mice, and show alterations in patterns of expression are evident. Such changes may have implications for cardiac function.
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Affiliation(s)
- Peter R. T. Bowman
- Henry Wellcome Laboratory of Cell Biology, College of Medical, Veterinary and Life Sciences, Institute of Molecular Cell and Systems Biology, University of Glasgow, Glasgow, United Kingdom
| | - Godfrey L. Smith
- College of Medical, Veterinary and Life Sciences, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Gwyn W. Gould
- Henry Wellcome Laboratory of Cell Biology, College of Medical, Veterinary and Life Sciences, Institute of Molecular Cell and Systems Biology, University of Glasgow, Glasgow, United Kingdom
- *Correspondence: Gwyn W. Gould
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Bauman V, Ariel-Donges AH, Gordon EL, Daniels MJ, Xu D, Ross KM, Limacher MC, Perri MG. Effect of dose of behavioral weight loss treatment on glycemic control in adults with prediabetes. BMJ Open Diabetes Res Care 2019; 7:e000653. [PMID: 31245006 PMCID: PMC6557466 DOI: 10.1136/bmjdrc-2019-000653] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 04/28/2019] [Accepted: 05/06/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE This study examined the effects of three doses of behavioral weight loss treatment, compared with a nutrition education control group, on changes in glycemic control in individuals with obesity and prediabetes. RESEARCH DESIGN AND METHODS The study included 287 adults (77% female, 81% White; mean (SD) age=54.1 (10.5) years, body mass index=36.3 (3.9) kg/m2, and hemoglobin A1c (HbA1c)=5.9 (0.2%)). Participants were randomized to one of three behavioral treatment doses (high=24 sessions, moderate=16 sessions, or low=8 sessions) or to an education group (control=8 sessions). Changes in HbA1c, fasting glucose, and body weight were assessed from baseline to 6 months. RESULTS Mean (99.2% credible interval (CI)) reductions in HbA1c were 0.11% (0.07% to 0.16%), 0.08% (0.03% to 0.13%), 0.03% (-0.01% to 0.07%), and 0.02% (-0.02% to 0.07%), for the high, moderate, low, and control conditions, respectively. Mean (CI) reductions in fasting blood glucose were 0.26 mmol/L (0.14 to 0.39), 0.09 mmol/L (0 to 0.19), 0.01 mmol/L (-0.07 to 0.09), and 0.04 mmol/L (-0.03 to 0.12) for the high, moderate, low, and control conditions, respectively. The high-dose treatment produced significantly greater reductions in HbA1c and fasting blood glucose than the low-dose and control conditions (posterior probabilities (pp)<0.001); no other significant between-group differences were observed. Mean (CI) reductions in body weight were 10.91 kg (9.30 to 12.64), 10.08 kg (8.38 to 11.72), 6.35 kg (5.19 to 7.69), and 3.82 kg (3.04 to 4.54) for the high, moderate, low, and control conditions, respectively. All between-group differences in 6-month weight change were significant (pps<0.001) except for the high-dose versus moderate-dose comparison. CONCLUSION For adults with obesity and prediabetes a high dose of behavioral treatment involving 24 sessions over 6 months may be needed to optimize improvements in glycemic control. TRIAL REGISTRATION NUMBER NCT00912652.
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Affiliation(s)
- Viviana Bauman
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA
| | - Aviva H Ariel-Donges
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA
| | - Eliza L Gordon
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA
| | - Michael J Daniels
- Department of Statistics, University of Florida, Gainesville, Florida, USA
| | - Dandan Xu
- Department of Statistics and Data Sciences, University of Texas at Austin, Austin, Texas, USA
| | - Kathryn M Ross
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA
| | - Marian C Limacher
- Department of Medicine, University of Florida, Gainesville, Florida, USA
| | - Michael G Perri
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA
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Krishnaswami A, Ashok R, Sidney S, Okimura M, Kramer B, Hogan L, Sorel M, Pruitt S, Smith W. Real-World Effectiveness of a Medically Supervised Weight Management Program in a Large Integrated Health Care Delivery System: Five-Year Outcomes. Perm J 2018; 22:17-082. [PMID: 29401050 DOI: 10.7812/tpp/17-082] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
CONTEXT There are insufficient data on the long-term, nonsurgical, nonpharmacologic treatment of obesity. OBJECTIVE To determine changes in weight over 5 years in participants enrolled between April 1, 2007, and December 31, 2014, in a medically supervised weight management program at Kaiser Permanente Northern California Medical Centers. The program consisted of 3 phases: Complete meal replacement for 16 weeks; transition phase, 17 to 29 weeks; and lifestyle maintenance phase, 30 to 82 weeks. DESIGN Retrospective observational study of 10,693 participants (2777 available for analysis at 5 years); no comparator group. MAIN OUTCOME MEASURES Average change in weight from baseline to follow-up. RESULTS Average age was 51.1 (standard deviation = 12.4) years, and 72.8% were women. Average baseline weight in the entire cohort was 112.9 kg (standard error [SE] = 0.23). Weight (kg) significantly changed over time: 4 months, -17.3 (SE = 0.12); 1 year, -14.2 (SE = 0.12); 2 years, -8.6 (SE = 0.14); 3 years, -6.9 (SE = 0.17); 4 years, -6.5 (SE = 0.16), and 5 years, -6.4 (SE = 0.29); p < 0.0001). In those with 5-year follow-up, weight loss between 5.0 and 9.9% below baseline occurred in 16.3% (SE = 0.004, 95% CI = 15.3% - 17.2%) and weight loss of 10.0% or more of baseline occurred in 35.2% (SE = 0.01, 95% CI = 33.6% - 36.7%). CONCLUSION The average weight change of obese adults who participated in a medically supervised weight management program, with available 5-year data, was a statistically and clinically significant 5.8% weight loss from baseline.
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Affiliation(s)
| | - Rohini Ashok
- Internist and Obesity Specialist at the San Jose Medical Center in CA.
| | - Stephen Sidney
- Associate Director of Clinical Research at the Division of Research in Oakland, CA.
| | - Michael Okimura
- Retired Endocrinologist from the Roseville Medical Center in CA.
| | - Beth Kramer
- Venture Manager at the Permanente Medical Group in Oakland, CA.
| | - Lindsey Hogan
- Venture Manager at the Permanente Medical Group in Oakland, CA.
| | - Michael Sorel
- Project Analyst at the Division of Research in Oakland, CA.
| | - Sheri Pruitt
- Director of Behavior Science Integration at the Roseville Medical Center in CA.
| | - Wayne Smith
- Staff Physician in Physical Medicine and Rehabilitation at the San Jose Medical Center in CA.
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Yarnoff BO, Hoerger TJ, Shrestha SS, Simpson SK, Burrows NR, Anderson AH, Xie D, Chen HY, Pavkov ME. Modeling the impact of obesity on the lifetime risk of chronic kidney disease in the United States using updated estimates of GFR progression from the CRIC study. PLoS One 2018; 13:e0205530. [PMID: 30339684 PMCID: PMC6195263 DOI: 10.1371/journal.pone.0205530] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 09/26/2018] [Indexed: 11/25/2022] Open
Abstract
Rationale & objective As the prevalence of obesity continues to rise in the United States, it is important to understand its impact on the lifetime risk of chronic kidney disease (CKD). Study design The CKD Health Policy Model was used to simulate the lifetime risk of CKD for those with and without obesity at baseline. Model structure was updated for glomerular filtration rate (GFR) decline to incorporate new longitudinal data from the Chronic Renal Insufficiency Cohort (CRIC) study. Setting and population The updated model was populated with a nationally representative cohort from National Health and Nutrition Examination Survey (NHANES). Outcomes Lifetime risk of CKD, highest stage and any stage. Model, perspective, & timeframe Simulation model following up individuals from current age through death or age 90 years. Results Lifetime risk of any CKD stage was 32.5% (95% CI 28.6%–36.3%) for persons with normal weight, 37.6% (95% CI 33.5%–41.7%) for persons who were overweight, and 41.0% (95% CI 36.7%–45.3%) for persons with obesity at baseline. The difference between persons with normal weight and persons with obesity at baseline was statistically significant (p<0.01). Lifetime risk of CKD stages 4 and 5 was higher for persons with obesity at baseline (Stage 4: 2.1%, 95% CI 0.9%–3.3%; stage 5: 0.6%, 95% CI 0.0%–1.1%), but the differences were not statistically significant (stage 4: p = 0.08; stage 5: p = 0.23). Limitations Due to limited data, our simulation model estimates are based on assumptions about the causal pathways from obesity to CKD, diabetes, and hypertension. Conclusions The results of this study indicate that obesity may have a large impact on the lifetime risk of CKD. This is important information for policymakers seeking to set priorities and targets for CKD prevention and treatment.
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Affiliation(s)
- Benjamin O. Yarnoff
- RTI International, Research Triangle Park, North Carolina, United States of America
- * E-mail:
| | - Thomas J. Hoerger
- RTI International, Research Triangle Park, North Carolina, United States of America
| | - Sundar S. Shrestha
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Siobhan K. Simpson
- RTI International, Research Triangle Park, North Carolina, United States of America
| | - Nilka R. Burrows
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | | | - Dawei Xie
- University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Hsiang-Yu Chen
- University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Meda E. Pavkov
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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Wang Y, Chen F, Wang J, Wang T, Zhang J, Han Q, Wu Y, Zhang R, Liu F. The Relationship Between Increased Ratio of Visceral-to-Subcutaneous Fat Area and Renal Outcome in Chinese Adults With Type 2 Diabetes and Diabetic Kidney Disease. Can J Diabetes 2018; 43:415-420. [PMID: 30503868 DOI: 10.1016/j.jcjd.2018.08.199] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 07/09/2018] [Accepted: 08/22/2018] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Abdominal obesity is a risk factor of diabetes and hypertension. The aim of this study was to investigate the association between excessive abdominal fat and renal outcomes in patients with type 2 diabetes and diabetic kidney disease. METHODS Thirty-five patients with type 2 diabetes and diabetic kidney disease who were followed up on for at least 1 year were enrolled. Visceral fat area and subcutaneous fat area were assessed by computed tomography to evaluate the degree of abdominal fat. Patients were divided into 2 groups. Patients in group 1 had a ratio of visceral fat area to subcutaneous fat area (V/S ratio) <0.70 (n=16), and those in group 2 had a V/S ratio ≥0.70 (n=19) according to the second quartile. Renal outcome was defined as end-stage renal disease and initiation of renal replacement therapy. RESULTS At baseline, patients with a high V/S ratio had higher levels of triglycerides (p=0.060) and C-reactive protein (p=0.028), but lower high-density lipoprotein cholesterol levels (p=0.006). Strong correlations between V/S ratio and C-reactive protein (r=0.521, p=0.015) and high-density lipoprotein cholesterol (r=-0.576, p<0.001) were observed. Univariate Cox regression indicated the higher the V/S ratio, the greater the risk for a poor renal outcome (hazard ratio, 3.536; 95% confidence interval, 1.140 to 10.960; p=0.029). However, multivariate Cox analysis demonstrated that a higher V/S ratio was not an independent risk factor for progression to end-stage renal disease (hazard ratio, 2.212; 95% confidence interval, 0.543 to 9.005; p=0.268) when adjustments were made for important clinical variables. CONCLUSION The V/S ratio was positively correlated with C-reactive protein and high-density lipoprotein cholesterol. The higher V/S ratio was associated with a greater risk for progression to end-stage renal disease, although it did not emerge as an independent predictor of diabetic kidney disease progression.
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Affiliation(s)
- Yiting Wang
- Division of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Feng Chen
- Division of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Jiali Wang
- Division of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Tingli Wang
- Division of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Junlin Zhang
- Division of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Qianqian Han
- Division of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Yucheng Wu
- Division of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Rui Zhang
- Division of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Fang Liu
- Division of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China.
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Arner P, Andersson DP, Bäckdahl J, Dahlman I, Rydén M. Weight Gain and Impaired Glucose Metabolism in Women Are Predicted by Inefficient Subcutaneous Fat Cell Lipolysis. Cell Metab 2018; 28:45-54.e3. [PMID: 29861390 DOI: 10.1016/j.cmet.2018.05.004] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 04/13/2018] [Accepted: 05/03/2018] [Indexed: 12/14/2022]
Abstract
Adipocyte mobilization of fatty acids (lipolysis) is instrumental for energy expenditure. Lipolysis displays both spontaneous (basal) and hormone-stimulated activity. It is unknown if lipolysis is important for future body weight gain and associated disturbed glucose metabolism, and this was presently investigated in subcutaneous adipocytes from two female cohorts before and after ≥10-year follow-up. High basal and low stimulated lipolysis at baseline predicted future weight gain (odds ratios ≥4.6) as well as development of insulin resistance and impaired fasting glucose/type 2 diabetes (odds ratios ≥3.2). At baseline, weight gainers displayed lower adipose expression of several established lipolysis-regulating genes. Thus, inefficient lipolysis (high basal/low stimulated) involving altered gene expression is linked to future weight gain and impaired glucose metabolism and may constitute a treatment target. Finally, low stimulated lipolysis could be accurately estimated in vivo by simple clinical/biochemical measures and may be used to identify risk individuals for intensified preventive measures.
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Affiliation(s)
- Peter Arner
- Department of Medicine (H7), Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm 141 86, Sweden.
| | - Daniel P Andersson
- Department of Medicine (H7), Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm 141 86, Sweden
| | - Jesper Bäckdahl
- Department of Medicine (H7), Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm 141 86, Sweden
| | - Ingrid Dahlman
- Department of Medicine (H7), Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm 141 86, Sweden
| | - Mikael Rydén
- Department of Medicine (H7), Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm 141 86, Sweden.
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Kamble PS, Hayden J, Collins J, Harvey RA, Suehs B, Renda A, Hammer M, Huang J, Bouchard J. Association of obesity with healthcare resource utilization and costs in a commercial population. Curr Med Res Opin 2018; 34:1335-1343. [PMID: 29649917 DOI: 10.1080/03007995.2018.1464435] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To examine the association of obesity with healthcare resource utilization (HRU) and costs among commercially insured individuals. METHODS This retrospective observational cohort study used administrative claims from 1 January 2007 to 1 December 2013. The ICD-9-CM status codes (V85 hierarchy) from 2008 to 2012 classified body mass index (BMI) into the World Health Organizations' BMI categories. The date of first observed BMI code was defined as the index date and continuous eligibility for one year pre- and post- index date was ensured. Post-index claims determined individuals' HRU and costs. Sampling weights developed using the entropy balance method and National Health and Nutrition Examination Survey data ensured representation of the US adult commercially insured population. Baseline characteristics were described across BMI classes and associations between BMI categories, and outcomes were examined using multivariable regression. RESULTS The cohort included 9651 individuals with BMI V85 codes. After weighting, the BMI distribution was: normal (31.1%), overweight (33.4%), obese class I (22.0%), obese class II (8.1%) and obese class III (5.4%). Increasing BMI was associated with greater prevalence of cardiometabolic conditions, including hypertension, type 2 diabetes and metabolic syndrome. The use of antihypertensives, antihyperlipidemics, antidiabetics, analgesics and antidepressants rose with increasing BMI. Greater BMI level was associated with increased inpatient, emergency department and outpatient utilization, and higher total healthcare, medical and pharmacy costs. CONCLUSIONS Increasing BMI was associated with higher prevalence of cardiometabolic conditions and higher HRU and costs. There is an urgent need to address the epidemic of obesity and its clinical and economic impacts.
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Affiliation(s)
- Pravin S Kamble
- a Comprehensive Health Insights Inc. , Louisville , KY , USA
| | - Jennifer Hayden
- a Comprehensive Health Insights Inc. , Louisville , KY , USA
| | - Jenna Collins
- a Comprehensive Health Insights Inc. , Louisville , KY , USA
| | | | - Brandon Suehs
- a Comprehensive Health Insights Inc. , Louisville , KY , USA
| | | | - Mette Hammer
- c Novo Nordisk Pharmaceuticals Inc. , Plainsboro , NJ , USA
| | - Joanna Huang
- c Novo Nordisk Pharmaceuticals Inc. , Plainsboro , NJ , USA
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Kim S, Huang E, Park S, Holzapfel W, Lim SD. Physiological Characteristics and Anti-obesity Effect of Lactobacillus plantarum K10. Korean J Food Sci Anim Resour 2018; 38:554-569. [PMID: 30018499 PMCID: PMC6048381 DOI: 10.5851/kosfa.2018.38.3.554] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 05/15/2018] [Accepted: 05/17/2018] [Indexed: 11/25/2022] Open
Abstract
This study aimed to investigate the physiological characteristics and anti-obesity effects of Lactobacillus plantarum K10. The α-amylase inhibitory activity, α-glucosidase inhibitory activity, and lipase inhibitory activity of L. plantarum K10 was 94.66±4.34%, 99.78±0.12%, and 87.40±1.41%, respectively. Moreover, the strain inhibited the adipocyte differentiation of 3T3-L1 cells (32.61±8.32%) at a concentration of 100 µg/mL. In order to determine its potential for use as a probiotic, we investigated the physiological characteristics of L. plantarum K10. L. plantarum K10 was resistant to gentamycin, kanamycin, streptomycin, ampicillin, ciprofloxacin, tetracycline, vancomycin, and chloramphenicol. It also showed higher Leucine arylamidase, Valine arylamidase, and β-galactosidase activities. Moreover, it was comparatively tolerant to bile juice and acid, exhibiting resistance to Escherichia coli, Salmonella Typhimurium, Listeria monocytogenes, and Staphylococcus aureus with rates of 90.71%, 11.86%, 14.19%, and 23.08%, respectively. The strain did not produce biogenic amines and showed higher adhesion to HT-29 cells compared to L. rhamnosus GG. As a result of the animal study, L. plantarum K10 showed significantly lower body weight compared to the high-fat diet group. The administration of L. plantarum K10 resulted in a reduction of subcutaneous fat mass and mesenteric fat mass compared to the high-fat diet (HFD) group. L. plantarum K10 also showed improvement in gut permeability compared to the HFD positive control group. These results demonstrate that L. plantarum K10 has potential as a probiotic with anti-obesity effects.
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Affiliation(s)
- Seulki Kim
- Korea Food Research Institute,
Wanju 55365, Korea
| | - Eunchong Huang
- Advanced Green Energy and Environment, Handong
Global University, Pohang 37673,
Korea
| | - Soyoung Park
- Advanced Green Energy and Environment, Handong
Global University, Pohang 37673,
Korea
| | - Wilhelm Holzapfel
- Advanced Green Energy and Environment, Handong
Global University, Pohang 37673,
Korea
- Holzapfel Effective Microbes,
103 Techno-Business Center, Pohang 37673, Korea
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Lee J, Sa J, Chaput JP, Seo DC, Samuel T. Racial/ethnic differences in body weight perception among U.S. college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2018; 66:429-437. [PMID: 29488857 DOI: 10.1080/07448481.2018.1446437] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To examine racial/ethnic differences in weight perception by sex among U.S. college students. PARTICIPANTS a national sample (N = 70,267) of college students selected from 2- and 4-year postsecondary institutions (N = 62) during the Fall semester from 2011 to 2014. METHODS This is a secondary data analysis using 4 years of American College Health Association-National College Health Assessment IIb data. Sex-stratified multinomial logistic regression was performed to investigate racial/ethnic differences in body weight perception. RESULTS Compared with non-Hispanic whites, non-Hispanic black men and women were more likely to underestimate their body weight (p < .01). Asian men and women were more likely to overestimate their body weight than non-Hispanic whites (p < .001). CONCLUSIONS Weight-related interventions should take into account racial/ethnic differences in body weight perception.
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Affiliation(s)
- Jounghee Lee
- a Department of Nutrition Education , Graduate School of Education, Kyonggi University , Suwon City , Kyonggi Province , South Korea
| | - Jaesin Sa
- b College of Education and Health Sciences, Touro University , Vallejo , California , USA
| | - Jean-Philippe Chaput
- c Department of Pediatrics , Children's Hospital of Eastern Ontario , Ottawa , Ontario , Canada
| | - Dong-Chul Seo
- d Department of Applied Health Science , Indiana University School of Public Health , Bloomington , Indiana , USA
| | - Tonya Samuel
- e College of Nursing and Public Health, Adelphi University , Garden City , New York , USA
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Li YC, Li YZ, Li R, Lan L, Li CL, Huang M, Shi D, Feng RN, Sun CH. Dietary Sulfur-Containing Amino Acids Are Associated with Higher Prevalence of Overweight/Obesity in Northern Chinese Adults, an Internet-Based Cross-Sectional Study. ANNALS OF NUTRITION AND METABOLISM 2018; 73:44-53. [PMID: 29879713 DOI: 10.1159/000490194] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 05/14/2018] [Indexed: 01/19/2023]
Abstract
BACKGROUND/AIMS Elevation of plasma sulfur-containing amino acids (SAAs) is generally associated with higher body mass index (BMI) and unfavorable lipid profiles. It is not known how dietary SAAs relate to these associations in humans. METHODS A convenient tool named internet-based dietary questionnaire for Chinese (IDQC) was used to estimate dietary SAAs intake. A total of 936 participants were randomly recruited and asked to complete the IDQC. Furthermore, 90 subjects were randomly selected to perform a subgroup study. The associations between dietary SAAs and prevalence of obesity, lipid profiles, and status of insulin resistance (IR), inflammation and oxidative stress were assessed. RESULTS Dietary total SAAs and cysteine of overweight/obese participants were significantly higher. Dietary total SAAs and cysteine were positively associated with BMI and waist circumference. Higher dietary total SAAs were associated with higher prevalence of overweight/obesity. Higher dietary total SAAs and cysteine also associated with higher serum triglyceride (total cholesterol), low density lipoprotein, fasting blood glucose, 2 h-postprandial glucose, and homeostasis model assessment of IR. In the subgroup study, positive associations between dietary SAAs and inflammation biomarkers were also observed. CONCLUSIONS Dietary SAAs are associated with higher prevalence of overweight/obesity, unfavorable lipid profiles and status of IR, and inflammation.
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Affiliation(s)
- Yan-Chuan Li
- Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China.,Department of Nutrition and Food Hygiene, School of Public Health, Hainan Medical University, Haikou, China
| | - Yu-Zheng Li
- Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
| | - Rui Li
- Department of Food and School Hygiene, Dalian Center for Disease Control and Prevention, Dalian, China
| | - Li Lan
- Department of Chronic Disease Prevention and Control, Harbin Center for Disease Control and Prevention, Harbin, China
| | - Chun-Long Li
- Department of General Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Min Huang
- Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
| | - Dan Shi
- Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
| | - Ren-Nan Feng
- Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
| | - Chang-Hao Sun
- Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
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Stokes A, Collins JM, Grant BF, Scamuffa RF, Hsiao CW, Johnston SS, Ammann EM, Manson JE, Preston SH. Obesity Progression Between Young Adulthood and Midlife and Incident Diabetes: A Retrospective Cohort Study of U.S. Adults. Diabetes Care 2018; 41:1025-1031. [PMID: 29506982 PMCID: PMC5911788 DOI: 10.2337/dc17-2336] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 02/07/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Understanding how changes in weight over the life course shape risk for diabetes is critical for the prevention of diabetes. Using data from the National Health and Nutrition Examination Survey (NHANES), we investigated the association between self-reported weight change from young adulthood to midlife and incident diabetes. RESEARCH DESIGN AND METHODS We categorized individuals into four weight-change groups: those who remained nonobese (stable nonobese), those who moved from an obese BMI to a nonobese BMI (losing), those who moved from a nonobese BMI to an obese BMI (gaining), and those who remained obese (stable obese). Diabetes status was determined by self-report of a prior diagnosis, and age at diagnosis was used to establish time of diabetes onset. Hazard ratios (HRs) relating weight change to incident diabetes over 10 years of follow-up were calculated using Cox models adjusting for covariates. RESULTS Those who were obese and lost weight exhibited a significantly lower risk (HR 0.33; 95% CI 0.14, 0.76) of diabetes compared with those with stable obesity. We also observed lower risk among those who were stable nonobese (HR 0.22; 95% CI 0.18, 0.28) and those in the gaining category (HR 0.70; 95% CI 0.57, 0.87). Further, there was evidence of an increased incidence of diabetes among obese individuals who lost weight compared with individuals who were stable nonobese; however, weight loss was rare, and the association was not statistically significant. If those who were obese had become nonobese during the 10-year period, we estimate that 9.1% (95% CI 5.3, 12.8) of observed diabetes cases could have been averted, and if the population had maintained a normal BMI during the period, 64.2% (95% CI 59.4, 68.3) of cases could have been averted. CONCLUSIONS The findings from this study underscore the importance of population-level approaches to the prevention and treatment of obesity across the life course of individuals.
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Affiliation(s)
- Andrew Stokes
- Department of Global Health, Boston University School of Public Health, Boston, MA
| | - Jason M Collins
- Department of Global Health, Boston University School of Public Health, Boston, MA
| | | | | | | | | | | | - JoAnn E Manson
- Division of Preventive Medicine, Brigham and Women's Hospital, and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Samuel H Preston
- Department of Sociology and Population Studies Center, University of Pennsylvania, Philadelphia, PA
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Preuss HG, Kaats GR, Mrvichin N, Bagchi D, Swaroop A. Longitudinal Examination of Links Between Risk Factors for the Metabolic Syndrome and Both Age and Fasting Glucose Levels in Nondiabetic Subjects. J Am Coll Nutr 2018. [PMID: 29533157 DOI: 10.1080/07315724.2017.1413962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Previous evaluations in nondiabetic subjects revealed statistically significant correlations between fasting blood glucose (FBG) levels used as an estimate of insulin resistance and many components constituting the metabolic syndrome. Similar significant correlations were not found employing chronological age as the independent variable in the same nondiabetic individuals. OBJECTIVE The major purpose here was to replicate as well as corroborate the previous cross-sectional observations, emphasizing results obtained from data collected longitudinally. METHODS Material was assessed from 99 nondiabetic volunteers who had undergone 2 separate baseline measurements carried out over a minimum of 5 and up to a maximum of 20 years. RESULTS Findings from the starting baseline measurements mimicked many observations perceived in the earlier published cross-sectional material. The following correlations with elements constituting the metabolic syndrome using FBG as an independent variable were once more statistically significantly positive: scale weight, fat mass, circulating levels of triglycerides and high-sensitivity C-reactive protein (hsCRP). High-density lipoprotein (HDL) cholesterol was once again appropriately significant in a negative direction. In contrast, the same correlations were generally nonsignificant when age replaced FBG as the independent variable. Examining the 2 data sets over the 5-20-year intervals, FBG increased statistically significantly over time. However, the average increase clinically was relatively minor: -92.1 mg/dL ± 1.1 (SEM) vs 95.1 mg/dL ± 1.1 (SEM), p < 0.007. When the actual changes (delta) in the dependent parameters were correlated with the individual passages of time (intervals in years), only downward changes in aspartate aminotransferase (AST) levels were statistically significant. Fat-free mass showed a trend downward, whereas fat mass, trunk fat, and triglycerides merely demonstrated trends upward. CONCLUSION Current findings gathered over years are consistent with the original hypothesis that maintaining relatively low, stable circulating glucose levels during aging retards the development and intensity of many common manifestations of the metabolic syndrome.
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Affiliation(s)
- Harry G Preuss
- a Department of Biochemistry , Georgetown University Medical Center , Washington, DC , USA
| | - Gilbert R Kaats
- b Integrative Health Technologies , San Antonio , Texas , USA
| | - Nate Mrvichin
- b Integrative Health Technologies , San Antonio , Texas , USA
| | - Debasis Bagchi
- c Department of Pharmacological and Pharmaceutical Services , University of Houston , Houston , Texas , USA
| | - Anand Swaroop
- d Cepham Research Center , Piscataway , New Jersey , USA
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Fukuda T, Bouchi R, Takeuchi T, Nakano Y, Murakami M, Minami I, Izumiyama H, Hashimoto K, Yoshimoto T, Ogawa Y. Ratio of visceral-to-subcutaneous fat area predicts cardiovascular events in patients with type 2 diabetes. J Diabetes Investig 2018; 9:396-402. [PMID: 28686352 PMCID: PMC5835471 DOI: 10.1111/jdi.12713] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 07/01/2017] [Accepted: 07/03/2017] [Indexed: 11/30/2022] Open
Abstract
AIMS/INTRODUCTION To investigate whether the ratio of visceral fat area (VFA) to subcutaneous fat area (SFA; V/S ratio) could be predictive of cardiovascular disease (CVD) as compared with VFA or SFA in patients with diabetes. MATERIALS AND METHODS A total of 682 patients with type 2 diabetes (mean age 64 ± 13 years; 41% women) were enrolled. VFA (cm2 ) and SFA (cm2 ) were assessed by a dual bioelectrical impedance analyzer. The patients were divided into four groups according to the quartiles of the V/S ratio. The study end-point was the first occurrence or recurrence of CVD. RESULTS Over a median follow up of 2.5 years, 21 patients reached the end-point. The number of patients who reached the end-point was increased along with the increasing of the V/S ratio quartiles. The V/S ratio was significantly associated with incident or recurrent CVD (hazard ratio [HR] 1.82, 95% CI: 1.09-3.04, P = 0.021) after adjusting for estimated glomerular filtration rate (HR 0.98, 95% CI: 0.96-1.00), brain-type natriuretic peptide (HR 1.00, 95% CI: 1.00-1.01), use of antiplatelet agents (HR 4.26, 95% CI: 1.63-11.13), coefficient of variation of R-R intervals (HR 0.85, 95% CI: 0.69-1.10) and glycated hemoglobin (HR 1.37, 95% CI: 1.05-1.79). The addition of the V/S ratio to age, estimated glomerular filtration rate, brain-type natriuretic peptide, antiplatelet agents and glycated hemoglobin significantly improved classification performance for CVD using net reclassification improvement (0.60, 95% CI: 0.21-1.00) and the integrated discrimination improvement (0.02, 95% CI: 0.00-0.05). CONCLUSIONS The V/S ratio measured by dual bioelectrical impedance analyzer is an independent predictor of CVD in patients with type 2 diabetes.
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Affiliation(s)
- Tatsuya Fukuda
- Department of Molecular Endocrinology and MetabolismGraduate School of Medical and Dental SciencesTokyo Medical and Dental UniversityTokyoJapan
| | - Ryotaro Bouchi
- Department of Molecular Endocrinology and MetabolismGraduate School of Medical and Dental SciencesTokyo Medical and Dental UniversityTokyoJapan
| | - Takato Takeuchi
- Department of Molecular Endocrinology and MetabolismGraduate School of Medical and Dental SciencesTokyo Medical and Dental UniversityTokyoJapan
| | - Yujiro Nakano
- Department of Molecular Endocrinology and MetabolismGraduate School of Medical and Dental SciencesTokyo Medical and Dental UniversityTokyoJapan
| | - Masanori Murakami
- Department of Molecular Endocrinology and MetabolismGraduate School of Medical and Dental SciencesTokyo Medical and Dental UniversityTokyoJapan
| | - Isao Minami
- Department of Molecular Endocrinology and MetabolismGraduate School of Medical and Dental SciencesTokyo Medical and Dental UniversityTokyoJapan
| | - Hajime Izumiyama
- Department of Molecular Endocrinology and MetabolismGraduate School of Medical and Dental SciencesTokyo Medical and Dental UniversityTokyoJapan
- Center for Medical Welfare and Liaison ServicesTokyo Medical and Dental UniversityTokyoJapan
| | - Koshi Hashimoto
- Department of Molecular Endocrinology and MetabolismGraduate School of Medical and Dental SciencesTokyo Medical and Dental UniversityTokyoJapan
- Department of Preemptive Medicine and MetabolismGraduate School of Medical and Dental SciencesTokyo Medical and Dental UniversityTokyoJapan
| | - Takanobu Yoshimoto
- Department of Molecular Endocrinology and MetabolismGraduate School of Medical and Dental SciencesTokyo Medical and Dental UniversityTokyoJapan
| | - Yoshihiro Ogawa
- Department of Molecular Endocrinology and MetabolismGraduate School of Medical and Dental SciencesTokyo Medical and Dental UniversityTokyoJapan
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50
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Spencer L, Rollo M, Hauck Y, MacDonald-Wicks L, Wood L, Hutchesson M, Giglia R, Smith R, Collins C. The effect of weight management interventions that include a diet component on weight-related outcomes in pregnant and postpartum women: a systematic review protocol. ACTA ACUST UNITED AC 2018; 13:88-98. [PMID: 26447010 DOI: 10.11124/jbisrir-2015-1812] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
REVIEW QUESTION/OBJECTIVE What are the effects of weight management interventions that include a diet component on weight-related outcomes in pregnant and postpartum women?The primary objective of this systematic review is to evaluate the effectiveness of weight management interventions which include a diet component and are aimed at limiting gestational weight gain and postpartum weight retention in women.The second objective of this systematic review is to investigate included intervention components with respect to effect on weight-related outcomes. This may include, but is not limited to: length of intervention, use of face-to-face counselling, group or individual consultations, use of other interventions components including exercise, use of goals and use of support tools like food diaries, coaching, including email or text message support. BACKGROUND Around half of all women of reproductive age are either overweight or obese, with women aged 25-34 years having a greater risk of substantial weight gain compared with men of all ages. Excessive gestational weight gain (GWG) and postpartum weight retention (PPWR) may play a significant role in long term obesity. Having one child doubles the five- and 10-year obesity incidence for women, with many women who gain excessive weight during pregnancy remaining obese permanently. Excessive GWG and/or PPWR can also significantly contribute to short- and long-term adverse health outcomes for mother, baby and future pregnancies.Maternal obesity increases the risk of pregnancy related complications such as pre-eclampsia, gestational diabetes mellitus, stillbirth and the rate of caesarean section. Childhood obesity is a further long term complication of maternal obesity for offspring, which may persist in to adulthood. Excess GWG is also a risk factor for PPWR both in the short and long-term. Nehring et al. conducted a meta-analysis with over 65,000 women showing that, compared to women who gained weight within recommendations during pregnancy, women with GWG above Institute of Medicine weight gain recommendations, retained an additional 3.1 kg and 4.7kg after three and greater than or equal to 15 years postpartum, respectively. The health risk associated with PPWR is highlighted in a study of 151,025 Swedish women followed between 1992 and 2001.The study identified the risk of adverse pregnancy outcomes for those who gained three or more units of Body Mass Index (kg/m2) between consecutive pregnancies (an average of two years) was much higher compared with women whose BMI changed from -1.0 and 0.9 units. Long-term chronic disease risk may also be affected by PPWR as weight retention at the end of the first year post-partum has been found to be a predictor of maternal overweight 15 years later.With around 14-20% of women retaining 5kg or more 12 months postpartum, the risk of developing conditions like diabetes, metabolic syndrome and cardiovascular disease may be increased. It becomes evident that interventions which aim to support attainment of healthy weight both in the antenatal and postpartum periods are key health priorities for women during this life stage.Lifestyle factors of overweight, having poor diet quality, and not undertaking enough moderate-to-vigorous physical activity are amongst the top five predictors of mortality in women. Additionally it is noted that, for many women, pregnancy and the postpartum period are associated with a reduction in physical activity. It is known that a combination of poor dietary choices, an increase in sedentary time and reduction in physical activity are all contributors to the development of overweight and obesity. With this in mind, current research has focused on lifestyle interventions to limit GWG and PPWR. Thangaratinam et al. reviewed 44 randomized controlled trials (7278 women) where interventions including diet, physical activity or both were evaluated for their influence on maternal weight during pregnancy. Results indicate that all were significantly effective in reducing GWG compared with the control group. More specifically, dietary interventions were the most effective in reducing weight gain, with a mean weight loss of -3.84kg compared with -0.72kg and -1.06kg for physical activity and the mixed (diet plus physical activity) approach, respectively. This finding is supported by Hill and colleagues' recent systematic review of theory based interventions to limit GWG. Included studies in this review reported an underpinning theory base and were classified as adopting a dietary, physical activity or mixed approach. Hill et al. concluded that studies which included a diet intervention were significantly more effective at limiting GWG.In 2011 Tanentsapf et al. reviewed the effect of dietary interventions alone for reducing GWG in normal weight, overweight and obese pregnant women. This review analysed 13 randomized controlled trials and quasi-randomized controlled trials with a dietary intervention to prevent excessive GWG in women. The review concluded that dietary interventions during pregnancy were effective in reducing GWG with an effect of -1.92kg (n=1434) compared with the control group.Tanentsapf et al. identified that trials differed in the conduct of the interventions with various diet and non-diet related components utilised. Dietary approaches were highly variable with some trials focusing only on calorie restriction and others included additional target macronutrient distribution for intake. Some trials further provided feedback based on maternal weight gain guidelines. Interventions also varied in delivery method with a variety of modes used, including face-to-face, individual or group consultations and/or written correspondence. The frequency of communication, despite the type or mix, also changed from trial to trial with additional methods via telephone, posted materials, feedback or food diaries utilised. The inclusion of physical activity in addition to diet intervention was also common. Whilst the recent review by Tanentsapf et al. identified that dietary interventions are effective in reducing GWG, the review did not investigate the impact that different intervention components, delivery methods or dietary counselling approaches had on gestational weight management. It remains unclear as to which intervention components optimize GWG in women.The impact of lifestyle interventions has also been investigated in the postpartum period. The recent systematic review from van der Pligt et al. reported seven of 11 studies reviewed were successful in limiting PPWR. As with studies aimed at limiting GWG, interventions included in van der Pligt et al.'s review differed greatly in their conduct. Six of these seven studies included both dietary and physical activity components for the intervention, with the final successful study including a diet only intervention. Five of the successful studies recruited overweight or obese women only. Intervention time varied considerably in successful studies with some running for as little at ten days, and others up to six months.Bertz et al. demonstrated that their 12-week behavior modification intervention which targeted diet alone or diet and exercise, including two individual sessions with a dietitian and physical therapist, provision of scales for weight self-monitoring and bi-weekly text messages was successful in achieving significant weight loss following the intervention, and sustained at one year. The diet intervention and the diet and exercise intervention yielded significant weight loss compared to the control. Following 12 weeks a reduction of -8.3 +/- 4.2kg for diet intervention and -6.9 +/- 3.0kg for diet and exercise was observed. Additionally after one year, the diet intervention showed -10.2 +/- 5.7kg reduction and -7.3 +/- 6.3kg for the diet and exercise intervention (p<0.001). Colleran et al. also found significant weight change results by implementing a 16-week intervention which consisted of weekly individual sessions with a dietitian regarding calorie restriction, two additional home visits regarding exercise, weekly food diary completion and email support. The intervention group had greater weight loss compared to the control group (-5.8kg +/- 3.5kg vs -1.6kg +/- 5.4kg). It can be seen that various methods have been utilized in investigating the impact of diet and physical activity interventions on PPWR. The review by van der Pligt et al. highlights the impact successful lifestyle interventions can have on postpartum weight change. However, this review did not investigate the different intervention strategies utilized. It remains unclear as to the optimal setting, delivery method, diet strategy, contact frequency or intervention length to limit PPWR.Previous systematic reviews for both GWG and PPWR have focused on the effectiveness of lifestyle interventions as a whole for weight management in pregnant and postpartum women. And despite Tanentsapf et al.'s focus on dietary interventions for GWG, much is still unknown about the effectiveness of differing diet interventions over the antenatal and postpartum period. Specifically, the impact of differing diet intervention strategies on maternal weight gain is not known. Firstly, this systematic review will focus on whether weight management interventions which include a dietary component are effective in pregnant and postpartum women. In addition to this, this review will investigate the different intervention strategies utilized and their effectiveness in maternal weight management. A search of systematic review protocol databases has shown that there is no current review underway for this topic.
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Affiliation(s)
- Lisa Spencer
- 1 School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre in Physical Activity and Nutrition. The University of Newcastle, New South Wales2 School of Nursing and Midwifery, Curtin University and King Edward Memorial Hospital, Perth, Western Australia3 School of Biomedical Science and Pharmacy, Faculty of Health, University of Newcastle, New South Wales4 School of Public Health, Western Australian Centre for Health Promotion Research, Curtin University, Perth, Western Australia5 School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, New South Wales.6 The Western Australian Group for Evidence Informed Healthcare Practice: an Affiliate centre of The Joanna Briggs Institute7 University of Newcastle Evidence Based Health Care Group: a JBI Evidence Synthesis Group
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