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Al Sifri S, Aldahash R, de Luis Roman DA, Amin A, Camprubi-Robles M, Kerr KW, Juusti-Hawkes A, Beresniak A. Optimizing Diabetes Management Using a Low-Calorie Diet in Saudi Arabia: A Cost-Benefit Analysis. Diabetes Ther 2024; 15:155-164. [PMID: 37889472 PMCID: PMC10786763 DOI: 10.1007/s13300-023-01495-1] [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: 08/04/2023] [Accepted: 10/11/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Low-calorie diets, high in protein and low in carbohydrates, are commonly recommended for patients with pre-diabetes and type 2 diabetes. The objective of this study was to carry out a cost-benefit analysis (CBA) of a low-calorie versus a standard diet from the perspective of the Saudi Arabian health system. METHODS The CBA compares costs and benefits of the two diet strategies over a 1-year time horizon. Costs included diet and diabetes treatment-related resources while benefits were measured in terms of the costs of diabetes complications avoided. Data on costs and benefits were collected from published literature and subject matter experts. Incremental costs were estimated as the cost difference between low-calorie and standard diet. Incremental benefits were estimated as cost difference from medical complications when following a low-calorie or standard diet. The incremental absolute cost-benefit ratio was calculated to show the difference between the costs and benefits of the low-calorie diet. Incremental relative cost-benefit ratio was calculated to show the cost per dollar of benefit obtained. Monte Carlo simulation modeled variability in outcomes due to variation in costs and uncertainty of diabetes complications. RESULTS The 1 year cost of standard diet was US$2515 ± 156 compared to US$2469 ± 107 per patient for a low-calorie diet. Incremental benefit is estimated at US$21,438 ± 7367 per patient. The estimated incremental absolute cost-benefit ratio was US$ - 21,360 establishing that benefits are greater than costs, while the estimated incremental relative cost-benefit ratio is 0.0037, establishing that benefits are 270 times greater than costs. CONCLUSION The low-calorie diet was the dominant strategy compared to the standard diet in modeled scenarios. These findings highlight the importance of a low-calorie diet as part of diabetes management programs for outpatients with type 2 diabetes.
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Affiliation(s)
- Saud Al Sifri
- Department of Endocrinology and Diabetes, Alhada Armed Forces Hospital, Taif, Saudi Arabia
| | - Raed Aldahash
- Department of Medicine, Ministry of National Guard-Heath Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud Bin Abdulaziz for Health Science, Riyadh, Saudi Arabia
| | - Daniel-Antonio de Luis Roman
- Servicio Endocrinología y Nutrición Hospital Clínico Universitario Valladolid, Valladolid, Spain
- Centro de Investigación de Endocrinologia y Nutrición. Facultad de Medicina, Valladolid, Spain
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Bin C, Li Q, Tang J, Dai C, Jiang T, Xie X, Qiu M, Chen L, Yang S. Machine learning models for predicting the risk factor of carotid plaque in cardiovascular disease. Front Cardiovasc Med 2023; 10:1178782. [PMID: 37808888 PMCID: PMC10556651 DOI: 10.3389/fcvm.2023.1178782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 09/12/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction Cardiovascular disease (CVD) is a group of diseases involving the heart or blood vessels and represents a leading cause of death and disability worldwide. Carotid plaque is an important risk factor for CVD that can reflect the severity of atherosclerosis. Accordingly, developing a prediction model for carotid plaque formation is essential to assist in the early prevention and management of CVD. Methods In this study, eight machine learning algorithms were established, and their performance in predicting carotid plaque risk was compared. Physical examination data were collected from 4,659 patients and used for model training and validation. The eight predictive models based on machine learning algorithms were optimized using the above dataset and 10-fold cross-validation. The Shapley Additive Explanations (SHAP) tool was used to compute and visualize feature importance. Then, the performance of the models was evaluated according to the area under the receiver operating characteristic curve (AUC), feature importance, accuracy and specificity. Results The experimental results indicated that the XGBoost algorithm outperformed the other machine learning algorithms, with an AUC, accuracy and specificity of 0.808, 0.749 and 0.762, respectively. Moreover, age, smoke, alcohol drink and BMI were the top four predictors of carotid plaque formation. It is feasible to predict carotid plaque risk using machine learning algorithms. Conclusions This study indicates that our models can be applied to routine chronic disease management procedures to enable more preemptive, broad-based screening for carotid plaque and improve the prognosis of CVD patients.
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Affiliation(s)
- Chengling Bin
- Health Management Section, The First People’s Hospital of Neijiang, Neijiang, China
| | - Qin Li
- Health Management Section, The First People’s Hospital of Neijiang, Neijiang, China
| | - Jing Tang
- Health Management Section, The First People’s Hospital of Neijiang, Neijiang, China
| | - Chaorong Dai
- Health Management Section, The First People’s Hospital of Neijiang, Neijiang, China
| | - Ting Jiang
- Health Management Section, The First People’s Hospital of Neijiang, Neijiang, China
| | - Xiufang Xie
- Department of Respiratory and Critical Care Medicine, The First People’s Hospital of Neijiang, Neijiang, China
| | - Min Qiu
- Special Inspection Department, The First People’s Hospital of Neijiang, Neijiang, China
| | - Lumiao Chen
- Laboratory Department, The First People’s Hospital of Neijiang, Neijiang, China
| | - Shaorong Yang
- Health Management Section, The First People’s Hospital of Neijiang, Neijiang, China
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Hassan AA, Abdelbagi O, Osman OE, Adam I. Association between serum 25-hydroxyvitamin D concentrations and hypertension among adults in North Sudan: a community-based cross-sectional study. BMC Cardiovasc Disord 2023; 23:402. [PMID: 37592222 PMCID: PMC10433536 DOI: 10.1186/s12872-023-03432-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 08/05/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND Globally, hypertension represents a major public health problem. The association between 25-hydroxyvitamin D (25[OH]D) levels and hypertension remains unclear. The current study aimed to investigate the association between serum 25(OH)D levels and hypertension among adults in Sudan. METHODS A community-based cross-sectional study was conducted among adults in North Sudan. Sociodemographic and clinical data were collected using a questionnaire and face-to-face interviews. Serum 25(OH)D was measured using an enzyme-linked immunosorbent assay. Multivariate logistic regression and multiple linear regression analyses were performed. RESULTS Of the total of 391 participants, 202 (51.7%) were females. The median (interquartile range [IQR]) of participants' ages was 45(32-55) years. Of the total, 219(56.0%) had hypertension. The median (IQR) of serum25(OH)D was 13.3(9.9-19.7) ng/mL, and 295 (75.4%) participants had vitamin D deficiency (< 20 ng/mL). In multivariable logistic regression, the adjusted odds ratio (AOR) for age = 1.05, 95% confidence interval (CI)1.03‒1.061, the AOR for being female = 2.02, 95% CI, 1.12‒3.66, and body mass index was AOR = 1.09, 95% CI, 1.05‒1.14, all of which were significantly associated with hypertension. However, serum 25(OH)D levels were not associated with hypertension (AOR = 1.01, 95% CI 0.99‒1.05, P = 0.317). In multiple linear regression, while systolic blood pressure was negatively associated with 25(OH)D (coefficient = - 0.28, P = 0.017), there was no significant association between serum 25(OH)D level and diastolic blood pressure (coefficient = - 0.10, P = 0.272) or mean blood pressure (coefficient =-0.03, P = 0.686). CONCLUSION The current study revealed a negative association between vitamin D and systolic blood pressure. The mechanism of such an association needs further study.
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Affiliation(s)
- Ahmed A. Hassan
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Omer Abdelbagi
- Department of Pathology, AlQunfudhah Faculty of Medicine, Umm Al-Qura University, Al Qunfudhah, Saudi Arabia
| | - Osman E. Osman
- Faculty of Medicine, Alneelain University, Khartoum, Sudan
| | - Ishag Adam
- Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia
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Kheriji N, Dakhlaoui T, Kamoun Rebai W, Maatoug S, Thabet MT, Mellah T, Mrad M, Trabelsi H, Soltani M, Kabbage M, Hassine HB, Hadj Salah Bahlous A, Mahjoub F, Jamoussi H, Abid A, Abdelhak S, Kefi R. Prevalence and risk factors of diabetes mellitus and hypertension in North East Tunisia calling for efficient and effective actions. Sci Rep 2023; 13:12706. [PMID: 37543635 PMCID: PMC10404238 DOI: 10.1038/s41598-023-39197-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 07/21/2023] [Indexed: 08/07/2023] Open
Abstract
Diabetes and hypertension are a serious public health problem worldwide. In the last decades, prevalence of these two metabolic diseases has dramatically increased in the Middle East and North Africa region, especially in Tunisia. This study aimed to determine the prevalence of type 2 diabetes (T2D) and High Blood Pressure (HBP) in Zaghouan, a North-East region of Tunisia. To this end, an exploratory study with stratified random sampling of 420 participants has been carried out. Various data were collected. Blood samples and urine were drawn for biochemical assay. Then, all data were analyzed using the statistical R software. Results showed an alarming situation with an inter-regional difference in prevalence of obesity (50.0%, CI 95.0%), HBP (39.0%, CI 95.0%) and T2D (32.0%, CI 95.0%). This study allowed the discovery of 24, 17 and 2 new cases of T2D, HBP and T2D&HBP respectively. The association of some socio-economic factors and biochemical parameters with these chronic diseases has been highlighted. To conclude, the health situation in the governorate of Zaghouan requires urgent interventions to better manage the growing epidemic of non-communicable diseases (NCD) in the region. This study demonstrated the importance of engaging health policy makers in road mapping and implementing national NCD prevention programs.
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Affiliation(s)
- Nadia Kheriji
- Laboratory of Biomedical Genomics and Oncogenetics, Institut Pasteur de Tunis, 13, Place Pasteur, Belvédère Tunisie, B.P. 74, 1002, Tunis, Tunisia
- University of Tunis El Manar, Tunis, Tunisia
- Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Thouraya Dakhlaoui
- Regional Association of Diabetics of Zaghouan-Regional Hospital of Zaghouan, Zaghouan, Tunisia
| | - Wafa Kamoun Rebai
- Laboratory of Biomedical Genomics and Oncogenetics, Institut Pasteur de Tunis, 13, Place Pasteur, Belvédère Tunisie, B.P. 74, 1002, Tunis, Tunisia
- University of Tunis El Manar, Tunis, Tunisia
| | - Sonia Maatoug
- University of Tunis El Manar, Tunis, Tunisia
- Science Shop (Communication, Science and Society Unit)"Science Together-العلم مع بعضنا", Institut Pasteur de Tunis, Tunis, Tunisia
| | - Mohamed Taher Thabet
- Regional Association of Diabetics of Zaghouan-Regional Hospital of Zaghouan, Zaghouan, Tunisia
| | - Thouraya Mellah
- Higher School of Digital Economy (ESEN-UMA), University of Manouba, Manouba, Tunisia
- Association La Recherche en Action (REACT), Tunis, Tunisia
| | - Mehdi Mrad
- University of Tunis El Manar, Tunis, Tunisia
- Faculty of Medicine of Tunis, Tunis, Tunisia
- Laboratory of Clinical Biochemistry and Hormonology, Institut Pasteur de Tunis, Tunis, Tunisia
| | - Hajer Trabelsi
- Laboratory of Clinical Biochemistry and Hormonology, Institut Pasteur de Tunis, Tunis, Tunisia
| | - Manel Soltani
- Laboratory of Clinical Biochemistry and Hormonology, Institut Pasteur de Tunis, Tunis, Tunisia
| | - Maria Kabbage
- Laboratory of Biomedical Genomics and Oncogenetics, Institut Pasteur de Tunis, 13, Place Pasteur, Belvédère Tunisie, B.P. 74, 1002, Tunis, Tunisia
- University of Tunis El Manar, Tunis, Tunisia
| | - Hichem Ben Hassine
- University of Tunis El Manar, Tunis, Tunisia
- Science Shop (Communication, Science and Society Unit)"Science Together-العلم مع بعضنا", Institut Pasteur de Tunis, Tunis, Tunisia
| | - Afef Hadj Salah Bahlous
- University of Tunis El Manar, Tunis, Tunisia
- Laboratory of Clinical Biochemistry and Hormonology, Institut Pasteur de Tunis, Tunis, Tunisia
| | - Faten Mahjoub
- University of Tunis El Manar, Tunis, Tunisia
- National Institute of Nutrition & Food Technology of Tunis, Tunis, Tunisia
- Research Unit UR18ES01 on "Obesity", Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Henda Jamoussi
- University of Tunis El Manar, Tunis, Tunisia
- National Institute of Nutrition & Food Technology of Tunis, Tunis, Tunisia
- Research Unit UR18ES01 on "Obesity", Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Abdelmajid Abid
- Laboratory of Biomedical Genomics and Oncogenetics, Institut Pasteur de Tunis, 13, Place Pasteur, Belvédère Tunisie, B.P. 74, 1002, Tunis, Tunisia
- University of Tunis El Manar, Tunis, Tunisia
| | - Sonia Abdelhak
- Laboratory of Biomedical Genomics and Oncogenetics, Institut Pasteur de Tunis, 13, Place Pasteur, Belvédère Tunisie, B.P. 74, 1002, Tunis, Tunisia
- University of Tunis El Manar, Tunis, Tunisia
| | - Rym Kefi
- Laboratory of Biomedical Genomics and Oncogenetics, Institut Pasteur de Tunis, 13, Place Pasteur, Belvédère Tunisie, B.P. 74, 1002, Tunis, Tunisia.
- University of Tunis El Manar, Tunis, Tunisia.
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Mostafa HK, El-Zayat AT, Abdullah A Alraddadi O, Abulaban M. Adherence to the Mediterranean Diet and Perceived Immunity Among the Saudi Population: A Cross-Sectional Study. Cureus 2023; 15:e34963. [PMID: 36938156 PMCID: PMC10019000 DOI: 10.7759/cureus.34963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2023] [Indexed: 02/16/2023] Open
Abstract
Background The Mediterranean diet (MedDiet) is a model of a sustainable dietary pattern. It has a protective role against coronary heart diseases, but nowadays it is hypothesized against many other diseases. Aim of the study This study aims to assess the prevalence of adherence to the Mediterranean diet and its association with immune status among the general Saudi population. Subjects and methods A cross-sectional study design was conducted over a sample size of 327 Saudi adults living in Jeddah. A self-administered online questionnaire was distributed in a digital Google Form via various social networks using the convenient sampling technique. The questionnaire had four major divisions: sociodemographic, general health characteristics, adherence to MedDiet, and immune status. The data were collected, validated, and subjected to statistical analysis. Results The study showed a statistically significant association between adherence to MedDiet and perceived immune status (p-value <0.05). However, the associations between adherence to MedDiet and having any chronic illness, and perceived general health were not statistically significant (p-value >0.05). Multivariable regression models showed that sex and occupation are significant predictors of adherence to MedDiet. Conclusion This study concluded that despite low adherence to MedDiet among Saudis, there was an association between adherence to MedDiet and immune status. This study recommends the implementation of MedDiet as an intervention for the management of chronic diseases to be considered by policymakers and guideline developers.
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Affiliation(s)
- Hany K Mostafa
- Histology and Cell Biology, Fakeeh College for Medical Sciences, Jeddah, SAU
- Medical Science, Ain Shams University, Cairo, EGY
| | - Ayat T El-Zayat
- Clinical Sciences, Fakeeh College for Medical Sciences, Jeddah, SAU
| | | | - Mohanad Abulaban
- Clinical Sciences, Fakeeh College for Medical Sciences, Jeddah, SAU
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AlRadini FA, El-Sheikh AAK, Al Shahrani AS, Alzamil NM, Fayed AA, Alsayed E, Alharbi SS, Altulihee MA, Andijani SA, AlShaiddi WK, Alamri FA. Independent Association of 25[OH]D Level on Reduced Glutathione and TNF-α in Patients with Diabetes and/or Hypertension. Int J Gen Med 2022; 15:7065-7075. [PMID: 36090702 PMCID: PMC9462432 DOI: 10.2147/ijgm.s375282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 08/19/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Oxidative and inflammatory pathways play a significant role in the pathophysiology of a wide variety of non-communicable diseases such as type 2 diabetes mellitus (T2DM) and hypertension. However, the effect of serum 25-hydroxyvitamin D (25[OH]D) on these pathways is still controversial. To evaluate the association of 25[OH]D on antioxidant and pro-inflammatory biomarkers, reduced glutathione (GSH) and tumor necrosis factor (TNF)-α, in T2DM and hypertensive patients. Patients and Methods This is a cross-sectional study of a consecutive sample of patients attending the the Family Medicine clinic at King Abdullah bin Abdulaziz University Hospital (KAAUH). Participants were screened for eligibility according to the following criteria: aged above 18 years and diagnosed with T2DM and/or hypertension for at least one year. Patients receiving any kind of vitamin D or calcium supplements within the last three months were excluded, as were those with a history of renal failure, cancer, liver, thyroid, or any other chronic inflammatory diseases. Results In total 424 T2DM and/or hypertensive patients (mean age 55±12 years) were recruited. In addition to routine physical and laboratory examinations, levels of serum 25[OH]D, GSH and TNF-α were measured. The prevalence of 25[OH]D deficiency (<50 nmol/L) was 35.1%, which was independent from GSH and TNF-α levels. In T2DM, hypertensive and patients having both diseases, GSH levels were 349.3±19, 355.4±19 and 428.8±20 μmol/L, respectively. Uncontrolled T2DM and hypertension patients showed significantly higher GSH compared with the controlled group. Males showed slightly higher level of TNF-α compared with females and uncontrolled hypertensive patients had relatively higher TNF-α level when evaluated against controlled hypertensive patients. Conclusion 25[OH]D level is independent of oxidative stress and inflammation, assessed by levels of GSH and TNF-α, respectively, in T2DM and hypertensive Saudi patients.
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Affiliation(s)
- Faten A AlRadini
- Department of Clinical Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Azza A K El-Sheikh
- Department of Basic Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
- Department of Pharmacology, Faculty of Medicine, Minia University, El-Minia, Egypt
| | - Abeer S Al Shahrani
- Department of Clinical Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
- Correspondence: Abeer S Al Shahrani, Department of Clinical Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia, Tel +966118239031, Email ;
| | - Norah M Alzamil
- Department of Clinical Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Amel A Fayed
- Department of Clinical Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Eman Alsayed
- Department of Clinical Pathology, Faculty of Medicine, Minia University, El-Minia, Egypt
| | - Shatha S Alharbi
- Department of Family and Community Health, King Abdullah bin Abdulaziz University Hospital, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Msaad A Altulihee
- Department of Family and Community Health, King Abdullah bin Abdulaziz University Hospital, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Shaimaa A Andijani
- Department of Family and Community Health, King Abdullah bin Abdulaziz University Hospital, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Wafa K AlShaiddi
- Department of Pathology and Laboratory Medicine, King Abdullah bin Abdulaziz University Hospital, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Fahad A Alamri
- Global Center of Mass Gathering Medicine, Ministry of Health, Family Medicine, Primary Health Center, Riyadh, Saudi Arabia
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Fayed A, Alzeidan R, Esmaeil S, Elmorshedy H, Ismail D, Elkouny R, Wahabi HA. Cardiovascular Risk Among Saudi Adults with Prediabetes: A Sub-Cohort Analysis from the Heart Health Promotion (HHP) Study. Int J Gen Med 2022; 15:6861-6870. [PMID: 36061959 PMCID: PMC9439057 DOI: 10.2147/ijgm.s374190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/01/2022] [Indexed: 11/23/2022] Open
Abstract
Background This study aimed to estimate the prevalence of prediabetes among Saudi adults and to evaluate their risk of developing cardiovascular diseases. Methods This is a cohort of 2470 Saudi adults attending employee clinics in the university hospital. WHO-STEPs approach was used to collect sociodemographic (age, gender, and education), clinical (body mass index and blood pressure) and laboratory data (HbA1c, lipid profile and vitamin D concentration). Prediabetes was defined according to HbA1c level of 5.7–6.4%. Cardiovascular risk (CVR) scores were evaluated using the Framingham Risk Score. SPSS was used for data analysis to investigate the relation between different CVR and prediabetes. Results Prediabetes affected 25.1% of the study population. Males had higher rates of prediabetes than females (27.5% versus 23.5%). The prevalence of prediabetes increased from 11.6% among young individuals (18–29 years) to 56.0% among participants 60 years and older. Prediabetes patients exhibited considerably higher levels of all cardiovascular risk factors and nearly half of them (49.3%) had at least two risk factors. The prevalence of intermediate CVR among prediabetics was 13.2% compared to just 2.9% among the normal group, and high CVR was defined in 3.7% among prediabetics compared to only 1.7% in the normal group. Having prediabetes increased the odds to develop higher CVR of 2.64 times compared to those without prediabetes (OR = 2.64, 95% CI = 1.51–4.64) and the level of vitamin D did not affect the odds of CVR. Conclusion Prediabetes is quite prevalent among Saudi adults, and they are at a higher risk of cardiovascular diseases. Patients with prediabetes have higher cardiac risk scores when compared to normal participants across the whole spectrum of (25(OH)D) concentrations. Additionally, no significant correlation was observed between HbA1c and (25(OH)D) levels in prediabetics or normoglycemic subjects.
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Affiliation(s)
- Amel Fayed
- College of Medicine, Clinical Department, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Rasmieh Alzeidan
- College of Medicine, Cardiac Sciences Department, King Saud University, Riyadh, Saudi Arabia
| | - Samia Esmaeil
- Research Chair of Evidence-Based Healthcare and Knowledge Translation, King Saud University, Riyadh, Saudi Arabia
- Correspondence: Samia Esmaeil, Research Chair of Evidence-Based Healthcare and Knowledge translation, King Saud University, P.O. Box: 145111, Riyadh, 11362, Saudi Arabia, Tel +966 500-243-112, Email
| | - Hala Elmorshedy
- College of Medicine, Clinical Department, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Doaa Ismail
- Department of Physical Medicine, Rheumatology & Rehabilitation, Tanta University, Faculty of Medicine, Tanta, Egypt
| | - Roaa Elkouny
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Hayfaa A Wahabi
- Research Chair of Evidence-Based Healthcare and Knowledge Translation, King Saud University, Riyadh, Saudi Arabia
- Department of Family and Community Medicine, King Saud University Medical City and College of Medicine, Riyadh, Saudi Arabia
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Chang Z, Chen Y, Zhao Y, Fu J, Liu Y, Tang S, Han Y, Fan Z. Association of sunshine duration with acute myocardial infarction hospital admissions in Beijing, China: A time-series analysis within-summer. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 828:154528. [PMID: 35292318 DOI: 10.1016/j.scitotenv.2022.154528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/16/2022] [Accepted: 03/08/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Over the years, various epidemiological studies found that acute myocardial infarction (AMI) often shows seasonal rhythm patterning, which is usually influenced by the variations of environmental factors, such as air pollution, ambient temperature, solar activity, relative humidity. However, there are few studies on the impact of sunlight-induced AMI especially in developing countries, and they had inconsistent results. This study aimed to examine within-summer variations in the temporal association between sun exposure and AMI. METHODS We obtained hospitalization data for AMI of Beijing during 2013-2019. We used a distributed lag non-linear model (DLNM) combined with a quasi-Poisson regression model to estimate the non-linear lag effects of sunshine duration on AMI incidences. We evaluated the overall effect of AMI admissions with exposure to sunshine duration in the lag 0-21 days. RESULTS A total of 45,301 AMI cases were enrolled in our study during summer (June-September). The minimum of the morbidity was during days with a sunshine duration of 3.9 h. We found significant and U-shaped associations between sunshine duration and AMI, and the overall estimated relative risk was 1.29 (95% CI: 1.02,1.62) and 1.69 (95% CI: 1.28,2.24) for short (1st percentile) and long (99th percentile) sunshine duration, respectively. The males and younger people (<65 years) were most susceptible to these effects. CONCLUSION Our results suggest that both short and long sunshine duration could increase the risk of AMI admissions, especially for males and younger people. We suggest that public health policymakers should fully consider the balance of the pros and cons of solar exposure, and provide appropriate public health recommendations accordingly to gain the greatest benefits from sunlight.
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Affiliation(s)
- Zhen'ge Chang
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Yuxiong Chen
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Yakun Zhao
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Jia Fu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Yijie Liu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Siqi Tang
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Yitao Han
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Zhongjie Fan
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China.
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Al-Hanawi MK, Ahmed MU, Alshareef N, Qattan AMN, Pulok MH. Determinants of Sugar-Sweetened Beverage Consumption Among the Saudi Adults: Findings From a Nationally Representative Survey. Front Nutr 2022; 9:744116. [PMID: 35392287 PMCID: PMC8981208 DOI: 10.3389/fnut.2022.744116] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 01/28/2022] [Indexed: 12/30/2022] Open
Abstract
Background Saudi Arabia is the fifth largest consumer of calories from sugar-sweetened beverages (SSBs) in the world. However, there is a knowledge gap to understand factors that could potentially impact SSB consumption in Saudi Arabia. This study is aimed to examine the determinants of SSBs in Saudi Arabia. Methods The participants of this study were from the Saudi Health Interview Survey (SHIS) of 2013, recruited from all regions of Saudi Arabia. Data of a total of 10,118 survey respondents were utilized in this study who were aged 15 years and older. Our study used two binary outcome variables: weekly SSB consumption (no vs. any amount) and daily SSB consumption (non-daily vs. daily). After adjusting for survey weights, multivariate logistic regression models were applied to assess the association of SSB consumption and study variables. Results About 71% of the respondents consumed SSB at least one time weekly. The higher likelihood of SSB consumption was reported among men, young age group (25–34 years), people with lower income (<3,000 SR), current smokers, frequent fast-food consumers, and individuals watching television for longer hours (≥4 h). Daily vegetable intake reduced the likelihood of SSB consumption by more than one-third. Conclusions Three out of four individuals aged 15 years and over in Saudi Arabia consume SSB at least one time weekly. A better understanding of the relationship between SSB consumption and demographic, socioeconomic, and behavioral factors is necessary for the reduction of SSB consumption. The findings of this study have established essential population-based evidence to inform public health efforts to adopt effective strategies to reduce the consumption of SSB in Saudi Arabia. Interventions directed toward education on the adverse health effect associated with SSB intake are needed.
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Affiliation(s)
- Mohammed Khaled Al-Hanawi
- Department of Health Services and Hospital Administration, Faculty of Economics and Administration, King Abdulaziz University, Jeddah, Saudi Arabia
- Health Economics Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
- *Correspondence: Mohammed Khaled Al-Hanawi
| | - Moin Uddin Ahmed
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia
- Institute of Health Economics, University of Dhaka, Dhaka, Bangladesh
| | - Noor Alshareef
- Department of Health Services and Hospital Administration, Faculty of Economics and Administration, King Abdulaziz University, Jeddah, Saudi Arabia
- Health Economics Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ameerah Mohammad Nour Qattan
- Department of Health Services and Hospital Administration, Faculty of Economics and Administration, King Abdulaziz University, Jeddah, Saudi Arabia
- Health Economics Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammad Habibullah Pulok
- Geriatric Medicine Research, Nova Scotia Health Authority, Halifax, NS, Canada
- School of Health Administration, Dalhousie University, Halifax, NS, Canada
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10
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Al-Sumaih I, Donnelly M, O’Neill C. The use of finite mixture models to examine the serum 25(OH)D levels among Saudis. PLoS One 2021; 16:e0260748. [PMID: 34847185 PMCID: PMC8631613 DOI: 10.1371/journal.pone.0260748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 11/16/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Recorded serum 25(OH)D in survey data varies with observed and unobserved respondent characteristics. The aim of this study was to expose latent population sub-groups and examine variation across groups regarding relationships between serum 25(OH)D and observable characteristics. METHODS This study explored the role of unobserved heterogeneity on associations between surveyed 25(OH)D and various factors using a sample (n = 2,641) extracted from the Saudi Health Interview Survey (2013). Linear regression and finite mixture models (FMM) were estimated and compared. The number of latent classes in the FMM was chosen based on BIC score. RESULT Three latent classes were identified. Class I (39.82%), class II (41.03%), and class III (19.15%) with mean 25(OH)D levels of 22.79, 34.88, and 57.45 ng/ml respectively. Distinct patterns of associations with nutrition, behaviour and socio-demographic variables were recorded across classes that were not revealed in pooled linear regression. CONCLUSION FMM has the potential to provide additional insights on the relationship between 25(OH)D levels and observable characteristics. It should be more widely considered as a method of investigation in this area.
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Affiliation(s)
- Ibrahim Al-Sumaih
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
- Ministry of Health, Riyadh, Saudi Arabia
| | - Michael Donnelly
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
| | - Ciaran O’Neill
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
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11
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The Association between Obesity and Chronic Conditions: Results from a Large Electronic Health Records System in Saudi Arabia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312361. [PMID: 34886087 PMCID: PMC8656736 DOI: 10.3390/ijerph182312361] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 11/19/2021] [Accepted: 11/21/2021] [Indexed: 01/02/2023]
Abstract
This cross-sectional study aimed to estimate the prevalence of obesity and its association with diabetes and hypertension among beneficiaries in the National Guard Health Affairs system of Saudi Arabia. We included individuals aged 17 years and older, and patients were classified as diabetic or hypertensive if they had any visit during the 4 years where the primary diagnosis was one of those conditions or they were taking diabetes or hypertension medications. The association between obesity (body mass index ≥30) and diabetes and hypertension were evaluated using a multiple logistic regression model, adjusting for age, gender, nationality, and region. A total of 616,092 individuals were included. The majority were Saudi nationals (93.1%). Approximately 68% of the population were either obese (38.9%) or overweight (29.30%). Obesity was more prevalent among Saudi nationals (39.8% vs. 26.7%, p < 0.01) and females (45.3% vs. 31.2%, p < 0.01). Obesity was independently associated with diabetes mellitus (OR = 2.24, p < 0.01) and hypertension (OR = 2.15, p < 0.01). The prevalence of obesity in the study population was alarming and more pronounced among women. Our findings call for efforts to intensify preventive measures to reduce obesity and associated conditions. Using electronic records to examine the impact of interventions to reduce obesity and chronic conditions may help monitor and improve population health.
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12
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Zhao H, Zhang X, Xu Y, Gao L, Ma Z, Sun Y, Wang W. Predicting the Risk of Hypertension Based on Several Easy-to-Collect Risk Factors: A Machine Learning Method. Front Public Health 2021; 9:619429. [PMID: 34631636 PMCID: PMC8497705 DOI: 10.3389/fpubh.2021.619429] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 08/26/2021] [Indexed: 11/13/2022] Open
Abstract
Hypertension is a widespread chronic disease. Risk prediction of hypertension is an intervention that contributes to the early prevention and management of hypertension. The implementation of such intervention requires an effective and easy-to-implement hypertension risk prediction model. This study evaluated and compared the performance of four machine learning algorithms on predicting the risk of hypertension based on easy-to-collect risk factors. A dataset of 29,700 samples collected through a physical examination was used for model training and testing. Firstly, we identified easy-to-collect risk factors of hypertension, through univariate logistic regression analysis. Then, based on the selected features, 10-fold cross-validation was utilized to optimize four models, random forest (RF), CatBoost, MLP neural network and logistic regression (LR), to find the best hyper-parameters on the training set. Finally, the performance of models was evaluated by AUC, accuracy, sensitivity and specificity on the test set. The experimental results showed that the RF model outperformed the other three models, and achieved an AUC of 0.92, an accuracy of 0.82, a sensitivity of 0.83 and a specificity of 0.81. In addition, Body Mass Index (BMI), age, family history and waist circumference (WC) are the four primary risk factors of hypertension. These findings reveal that it is feasible to use machine learning algorithms, especially RF, to predict hypertension risk without clinical or genetic data. The technique can provide a non-invasive and economical way for the prevention and management of hypertension in a large population.
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Affiliation(s)
- Huanhuan Zhao
- Institute of Intelligent Machines, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China.,Science Island Branch of Graduate School, University of Science and Technology of China, Hefei, China.,School of Computer and Information Engineering, Chuzhou University, Chuzhou, China
| | - Xiaoyu Zhang
- Institute of Intelligent Machines, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China.,Science Island Branch of Graduate School, University of Science and Technology of China, Hefei, China
| | - Yang Xu
- Institute of Intelligent Machines, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China
| | - Lisheng Gao
- Institute of Intelligent Machines, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China
| | - Zuchang Ma
- Institute of Intelligent Machines, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China
| | - Yining Sun
- Institute of Intelligent Machines, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China
| | - Weimin Wang
- Institute of Health Management, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China
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13
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Sari DK, Sari LM, Laksmi LI, Farhat. The Moderate Correlation Between 25(OH)D Serum and Saliva in Healthy People with Low Vitamin D Intake. Int J Gen Med 2021; 14:841-850. [PMID: 33737828 PMCID: PMC7961134 DOI: 10.2147/ijgm.s302912] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 02/26/2021] [Indexed: 01/22/2023] Open
Abstract
Purpose The routine examination of vitamin D levels is carried out by checking serum 25(OH)D levels, while serum 1.25(OH)D levels are less frequently utilized. The proposition that testing for salivary vitamin D can show a correlation with serum levels in healthy people is questionable, especially with low vitamin D intake. This study aimed to find the correlation between vitamin D levels, which were assessed as 25(OH)D and 1.25(OH)D in saliva, and serum 25(OH)D and 1.25(OH)D levels in people with low vitamin D intake. Patients and Methods This study is a cross-sectional study involving healthy men and women, aged 18–60 years, carried out from August to November, 2020, in North Sumatra Province, Indonesia. The parameters studied were the 25(OH)D and 1.25(OH)D levels in saliva and serum, and vitamin D intake. The statistical analysis used was the Spearman correlation test, performed to determine the correlation between each parameter. Results This study involved 56 study subjects, who were rural adults (male or female) with a 78.6% deficiency in 25(OH)D found by examining saliva, and a 76.8% deficiency found by examining the serum. All of the subjects were categorized as having low vitamin D intake (less than 15 micrograms per day). The analysis showed a moderate correlation between levels of saliva 25(OH)D and serum 25(OH)D (p = 0.424), and a weak correlation between levels of saliva 1.25(OH)D and serum 25(OH)D (p = 0.339). Conclusion In people with low vitamin D intake, there was a moderate correlation between serum 25(OH)D and saliva, but a weak correlation was found in the 1.25(OH)D assay. The use of saliva 25(OH)D levels to detect 25(OH)D in the circulation is a possible non-invasive alternative to serum testing. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/AxWZxKv9Tyo
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Affiliation(s)
- Dina Keumala Sari
- Nutrition Department, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Liza Meutia Sari
- Oral Medicine Department, Faculty of Dentistry, Universitas Syah Kuala, Banda Aceh, Indonesia
| | - Lidya Imelda Laksmi
- Anatomy Pathology Department, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Farhat
- Ear, Nose, Throat, Head and Neck Department, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
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Gazzaz ZJ. Knowledge, Attitudes, and Practices Regarding Diabetes Mellitus Among University Students in Jeddah, Saudi Arabia. Diabetes Metab Syndr Obes 2020; 13:5071-5078. [PMID: 33380816 PMCID: PMC7767699 DOI: 10.2147/dmso.s287459] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 12/02/2020] [Indexed: 12/30/2022] Open
Abstract
PURPOSE This study aimed to investigate knowledge, attitudes, and practices regarding diabetes mellitus (DM) among university students. MATERIAL AND METHODS This cross-sectional study was carried out at the Faculty of Medicine, Rabigh, King Abdulaziz University (KAU) Jeddah, Kingdom of Saudi Arabia (KSA), in 2018. All participants were the registered students at the foundation year in the branch of KAU, Rabigh. A questionnaire was developed that had questions related to knowledge, attitudes, and practices. RESULTS A total of 1428 participants (770 [53.9%] females and 658 [46.1%] males) were included in the study. Surprisingly, there were 315 (22.1%) students who had been diagnosed with hypertension or told by the healthcare professional that he/she has increased blood pressure, and 223 (15.6%) had high blood sugar. There were 785 (55%) participants who had one or more DM relative. Among our students, only 186 (13%) had good knowledge scores, while 569 (39.8%) and 673 (47.1%) had moderate and poor knowledge scores, respectively. Interestingly, 1190 (83.3%) participants had positive attitudes, while 238 (16.7%) had negative attitudes. More than half of the participants, 844 (59.1%), were practicing adequately for preventing DM. It was observed that females had significantly better general knowledge about DM, its risk factors, signs and symptoms, control and management, complications, and total knowledge scores. Our results showed that the female gender was associated with good knowledge and positive attitude and relatives diagnosed with DM were associated with good knowledge score. The participants who had DM relative and hypertension were more likely to have good attitudes and practices, respectively, in preventing DM. CONCLUSION Our students' knowledge score was not up to the mark. Interestingly, participants had positive attitudes and practicing adequately for preventing DM. The female gender was associated with good knowledge scores and positive attitudes.
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Affiliation(s)
- Zohair J Gazzaz
- Department of Internal Medicine, Faculty of Medicine, Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
- Correspondence: Zohair J Gazzaz Department of Internal Medicine, Faculty of Medicine, Rabigh, King Abdulaziz University, Jeddah, Saudi ArabiaTel + 966 505664144 Email
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