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Zhang J, Yao X, Chen Y, Feng Q, Zhang Y, Jiang T, Tang S, Zhang N, Dai F, Hu H, Zhang Q. Degree of Blood Glucose Control and Risk of Hypertension in Chinese Adults with T2DM: A Cross-Sectional Study. Diabetes Metab Syndr Obes 2024; 17:3227-3238. [PMID: 39224112 PMCID: PMC11368100 DOI: 10.2147/dmso.s462748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 05/31/2024] [Indexed: 09/04/2024] Open
Abstract
Background Diabetes mellitus and hypertension often coexist and share common risk factors. This study investigated the correlation between glycemic management and the prevalence of hypertension among Chinese adults diagnosed with type 2 diabetes mellitus (T2DM). Methods This study included 1715 patients with T2DM from four cities in Anhui Province, China. Sociodemographic characteristics of the sample participants were collected via questionnaires. A univariate analysis of variance (ANOVA) was utilized for continuous variables, and chi-square testing was used for categorical variables. Binary logistic regression was utilized to examine the relationship between blood pressure and variables including fasting plasma glucose (FPG), glycosylated haemoglobin (HbA1c), body mass index (BMI), waist circumference (WC), physical activity, dyslipidemia, and family history of hypertension. Results FPG levels did not increase the risk of hypertension, while HbA1c was significantly and negatively associated with hypertension risk. HbA1c levels ranged from 7.2 to 8.6%, with odds ratios (OR) of 0.68 and 95% confidence intervals (CI) of 0.48 to 0.97 and a significant p value of less than 0.05. For the HbA1c levels above 8.6%, the OR was 0.58 with a 95% CI of 0.39 to 0.87 and a significant p value of less than 0.01. Furthermore, advanced age, higher BMI, greater waist circumference, presence of dyslipidemia, and positive family history of hypertension were all found to be significantly and independently linked to a heightened risk of developing hypertension. These associations remain significant after further adjustment. Conclusion There was a negative association between HbA1c and the risk of hypertension, and the association remained significant after adjustment for antihypertensive drug use.
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Affiliation(s)
- Jie Zhang
- Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China
| | - Xuelin Yao
- Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China
| | - Yijing Chen
- Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China
| | - Qing Feng
- Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China
| | - Yi Zhang
- Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China
| | - Tian Jiang
- Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China
| | - Songtao Tang
- Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China
| | - Nan Zhang
- Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China
| | - Fang Dai
- Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China
| | - Honglin Hu
- Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China
| | - Qiu Zhang
- Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China
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Alharbi AA, Alharbi AA, Al-Dubai SA. Inter-relation between diabetes mellitus and hypertension in terms of incidence and prediction in Saudi Arabia: a retrospective cohort study. BMC Public Health 2024; 24:1956. [PMID: 39039489 PMCID: PMC11264413 DOI: 10.1186/s12889-024-19471-0] [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: 03/16/2024] [Accepted: 07/12/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND Hypertension (HTN) and type 2 diabetes mellitus (T2DM) are interconnected metabolic disorders with escalating global incidence and prevalence. However, no longitudinal studies have specifically examined the incidence of HTN and T2DM in the same study population. This study aimed to elucidate the association between HTN and T2DM and ascertain their respective roles in the development of each other. METHODS This retrospective cohort study encompassed 809 Saudi patients from primary healthcare centers in Al Madinah Al Munawarah, Saudi Arabia. The sample was stratified into three cohorts: 226 patients with HTN but without T2DM, 274 patients with T2DM but without HTN, and 309 patients devoid of both T2DM and HTN. Over a retrospective follow-up period of approximately 5 years, incidence density rates (IDR) were computed for HTN in the T2DM cohort, T2DM in the HTN cohort, and both HTN and T2DM in the control cohort. Multiple logistic regression analysis was employed to identify predictors of HTN and T2DM. RESULTS The IDR of T2DM among patients with HTN stood at 73.9 (95% confidence interval [CI] 56, 92) per 1000 person-years, in contrast to 33.9 (95% CI 24, 44) per 1000 person-years in the control cohort (adjusted odds ratio [OR] = 7.1, 95%CI 3.55, 14.13). Conversely, the IDR of HTN among patients with type-2 T2DM was 55.9 (95% CI 42, 70) per 1000 person-years, while in the control cohort, it was 20.8 (95% CI 13, 28) per 1000 person-years (adjusted OR = 5.8, 95% CI 3.11, 11.09). Significant predictors of HTN in the logistic regression model encompassed age, smoking status, family history of HTN, T2DM status, and body mass index (BMI). Similarly, significant predictors of T2DM in the logistic regression model included age, sex, family history of T2DM, HTN, and BMI. CONCLUSION This study unveils HTN and T2DM as mutually significant risk factors. The IDR of each condition in the presence of the other significantly exceeded that among individuals devoid of HTN or T2DM.
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Affiliation(s)
- Abdulhameed A Alharbi
- Preventive Medicine Post Graduate Studies, Al Madinah Health Cluster, Al Madinah Al Munawarah, Ministry of Health, Al Madinah, Saudi Arabia.
| | - Alwaleed A Alharbi
- Preventive Medicine Post Graduate Studies, Al Madinah Health Cluster, Al Madinah Al Munawarah, Ministry of Health, Al Madinah, Saudi Arabia.
| | - Sami Abdo Al-Dubai
- Preventive Medicine Post Graduate Studies, Al Madinah Health Cluster, Al Madinah Al Munawarah, Ministry of Health, Al Madinah, Saudi Arabia
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Abate TW, Genanew A, Gedamu H, Tegenaw A, Ayalew E, Berhie AY, Ergetie T, Shibesh BF. Unmasking the silent epidemic: a comprehensive systematic review and meta-analysis of undiagnosed diabetes in Ethiopian adults. Front Endocrinol (Lausanne) 2024; 15:1372046. [PMID: 39086906 PMCID: PMC11288971 DOI: 10.3389/fendo.2024.1372046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 07/03/2024] [Indexed: 08/02/2024] Open
Abstract
Background Undiagnosed diabetes mellitus poses a significant global public health concern, exerting a substantial impact on the well-being of individuals, their families, and societies at large. Those individuals with undiagnosed diabetes miss opportunities to maintain quality of life and prevent diabetes-related complications. Even if there are ample primary studies on undiagnosed diabetes in Ethiopia, the results reveal conflicting results. Therefore, a comprehensive national picture of undiagnosed diabetes is essential for designing effective strategies at the national level. Methods This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for prevalence studies (PROSPERO ID: CRD42021266676). PubMed, Web of Science and the World Health Organization's Hinari portal were searched using a strategy developed in collaboration with Liberians. The inclusion criteria comprised studies reporting undiagnosed diabetes in Ethiopia. Two independent reviewers conducted a quality assessment using a 10-item appraisal tool. Meta-analysis and meta-regression were performed using a random-effects model. Result Twenty-five studies with 22,193 participants met the inclusion criteria. The pooled prevalence of undiagnosed diabetes among the Ethiopian adult population was 5.68% (95% CI: 4.53 - 6.83, I2 = 75.4). Factors significantly associated with undiagnosed diabetes include age, waist circumference, overweight, family history of diabetes, and a history of hypertension. Conclusion Our systematic review found a noteworthy prevalence of undiagnosed diabetes in Ethiopia. The majority of factors linked with undiagnosed diabetes in this review were modifiable. This underscores the importance of targeted factors and public health interventions to improve early detection and reduce the burden of undiagnosed diabetes and its complications in Ethiopia. Systematic review registration https://www.crd.york.ac.uk/prospero, identifier CRD42021266676.
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Affiliation(s)
- Teshager Woldegiyorgis Abate
- Faculty of Nursing University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, Canada
- Department of Adult Health Nursing, Scholl of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Ashenafi Genanew
- Department of Pharmacy, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Haileyesus Gedamu
- Department of Adult Health Nursing, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Abebu Tegenaw
- Department of Adult Health Nursing, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Emiru Ayalew
- Department of Adult Health Nursing, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Alemeshet Yirga Berhie
- Department of Adult Health Nursing, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Temesgen Ergetie
- Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Belayneh Fentahun Shibesh
- Faculty of Medicine and Health Sciences, University of Oviedo, Oviedo, Spain
- Department of Public Health, Medical School of the University of Nicosia, Nicosia, Cyprus
- Nature, Climate and Health, United Nations University CRIS, Bruges, Belgium
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Ahmed W. Additive interaction of family medical history of diabetes with hypertension on the diagnosis of diabetes among older adults in India: longitudinal ageing study in India. BMC Public Health 2024; 24:999. [PMID: 38600575 PMCID: PMC11005278 DOI: 10.1186/s12889-024-18146-0] [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: 09/29/2023] [Accepted: 02/18/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND The present study aimed to estimate the additive interaction of family history of diabetes and hypertension on the diagnosis of diabetes among individuals aged 45 years and above in India. The coexistence of these two exposures may act synergistically on the risk of diabetes, leading to adverse health outcomes. METHODS The study utilized the data from the Longitudinal Ageing Study in India (LASI) Wave 1 (2017-2018). The total sample size for the current study was 58,612 individuals aged 45 years and above. Multivariable logistic regression models were employed to determine the individual and joint effect of a family history of diabetes with hypertension on diabetes. An additive model was applied to assess the interaction effect of the family medical history of diabetes with hypertension on the diagnosis of diabetes by calculating three different measures of additive interaction such as the relative excess risk ratio (RERI), attribution proportion due to interaction (AP), and synergy index (S). RESULTS The prevalence of diabetes was three times higher among individuals with family history of diabetes (27.8% vs. 9.2%) than those without family history. Individuals with family history of diabetes (AOR: 2.47, CI: 2.11 2.89) had 2.47 times higher odds of having diabetes than those without family history. The prevalence of diabetes was significantly higher among individuals with hypertension and family history of diabetes (46.6%, 95% CI: 39.7-53.6) than those without the coexistence of family history of diabetes and hypertension (9.9%, 95% CI: 9.5-10.4), individuals with hypertension and without a family history of diabetes (22.7%, 95% CI: 21.2-24.2), and individuals with family history of diabetes and without hypertension (16.5%, 95% CI: 14.5-18.7). Moreover, the adjusted odds ratio (AOR) of the joint effect between family medical history of diabetes and hypertension on diabetes was 9.28 (95% CI: 7.51-11.46). In the adjusted model, the RERI, AP, and S for diabetes were 3.5 (95% CI: 1.52-5.47), 37% (0.37; 95% CI: 0.22-0.51), and 1.69 (95% CI: 1.31-2.18) respectively, which indicates that there is a significant positive interaction between family history of diabetes and hypertension on the diagnosis of diabetes. The study findings on interaction effects further demonstrate consistent results for two models of hypertension (self-reported hypertension and hypertensive individuals receiving medication) even after adjustment with potential confounding factors on diabetes (self-reported diabetes and individuals with diabetes receiving medication). CONCLUSIONS The study findings strongly suggest that the interaction of family history of diabetes with hypertension has a positive and significant effect on the risk of diabetes even after adjustment with potential confounding factors. Furthermore, the findings indicate a synergistic effect, emphasizing the importance of considering both family medical history of diabetes and hypertension when assessing diabetes risk and designing preventive strategies or interventions.
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Affiliation(s)
- Waquar Ahmed
- School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai, India.
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Wu W, Zheng J, Wang R, Wang Y. Ion channels regulate energy homeostasis and the progression of metabolic disorders: Novel mechanisms and pharmacology of their modulators. Biochem Pharmacol 2023; 218:115863. [PMID: 37863328 DOI: 10.1016/j.bcp.2023.115863] [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: 09/12/2023] [Revised: 10/13/2023] [Accepted: 10/16/2023] [Indexed: 10/22/2023]
Abstract
The progression of metabolic diseases, featured by dysregulated metabolic signaling pathways, is orchestrated by numerous signaling networks. Among the regulators, ion channels transport ions across the membranes and trigger downstream signaling transduction. They critically regulate energy homeostasis and pathogenesis of metabolic diseases and are potential therapeutic targets for treating metabolic disorders. Ion channel blockers have been used to treat diabetes for decades by stimulating insulin secretion, yet with hypoglycemia and other adverse effects. It calls for deeper understanding of the largely elusive regulatory mechanisms, which facilitates the identification of new therapeutic targets and safe drugs against ion channels. In the article, we critically assess the two principal regulatory mechanisms, protein-channel interaction and post-translational modification on the activities of ion channels to modulate energy homeostasis and metabolic disorders through multiple novel mechanisms. Moreover, we discuss the multidisciplinary methods that provide the tools for elucidation of the regulatory mechanisms mediating metabolic disorders by ion channels. In terms of translational perspective, the mechanistic analysis of recently validated ion channels that regulate insulin resistance, body weight control, and adverse effects of current ion channel antagonists are discussed in details. Their small molecule modulators serve as promising new drug candidates to combat metabolic disorders.
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Affiliation(s)
- Wenyi Wu
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
| | - Jianan Zheng
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
| | - Ru Wang
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China; Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, China
| | - Yibing Wang
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China; Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, China.
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Ding H, Xu Y, Cheng Y, Zhou H, Dong S, Wu J, Lv J, Hu X, Tang O. Gut microbiome profile of Chinese hypertension patients with and without type 2 diabetes mellitus. BMC Microbiol 2023; 23:254. [PMID: 37689641 PMCID: PMC10492291 DOI: 10.1186/s12866-023-02967-x] [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: 09/03/2022] [Accepted: 08/02/2023] [Indexed: 09/11/2023] Open
Abstract
BACKGROUND The coexistence of hypertension and type 2 diabetes mellitus (T2DM) may largely increase the risk for cardiovascular disease. However, there is no clear consensus on the association between hypertension and the risk of diabetes. Gut microbiota plays important roles in the development of hypertension and T2DM, but whether there is difference between hypertension patients with or without T2DM has not been explored yet. METHODS We recruited 101 hypertension patients in this study (72 patients without T2DM named HT group and 29 patients with T2DM named HT-T2DM group). Their blood samples were collected for testing clinical characteristics and fecal samples were tested for bacterial DNA using 16 S ribosomal RNA gene sequencing targeting the V3 and V4 region. The data of 40 samples were downloaded from project PRJNA815750 as health control (HC group) in this study. The community composition and structure of the microbiome, taxonomic difference, co-occurrence network and functional enrichment were analyzed by alpha/beta diversity, LEfSe, Fruchterman Reingold's algorithm and PICRUSt2 functional analysis, respectively. RESULTS Alpha and beta diversity analysis showed significant differences in microbial community richness and composition among the three groups. The HC group had a significantly higher Simpson index and a distinct microbiota community compared to the HT and HT-T2DM groups, as demonstrated by significant differences in unweighted and weighted UniFrac distances. The LEfSe analysis identified specific taxa that had significantly different abundance among the groups, such as Bacteroides uniformis, Blautia wexlerae, Alistipes putredinis, and Prevotella stercorea in the HC group, Prevotella copri and Phascolarctobacterium faecium in the HT group, and Klebsiella pneumoniae in the HT-T2DM group. Co-occurrence network analysis indicates that Prevotella copri, Mediterraneibacter gnavus, Alistipes onderdonkii and some unidentified species act as key nodes in the network. Differentially functional pathway identified by PICRUSt2 were concentrated in nutrition and energy metabolism, as well as the biosynthesis of other secondary metabolites. CONCLUSIONS Our study found significant differences in microbial community richness, composition, and function among the healthy controls, hypertension patients with and without T2DM. Some specific taxa may explain this difference and serve as potential therapeutic targets for hypertension, T2DM, and their coexistence.
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Affiliation(s)
- Hongying Ding
- Department of Cardiovascular Medicine, Shaoxing Second hospital, Shaoxing, Zhejiang, China
| | - Yue Xu
- Shanghai Biotecan Pharmaceuticals Co., Ltd, Shanghai, China
- Shanghai Zhangjiang Institute of Medical Innovation, Shanghai, China
| | - Yinhong Cheng
- Department of Cardiovascular Medicine, Shaoxing Second hospital, Shaoxing, Zhejiang, China
| | - Haoliang Zhou
- Department of Cardiovascular Medicine, Shaoxing Second hospital, Shaoxing, Zhejiang, China
| | - Shiye Dong
- Shanghai Biotecan Pharmaceuticals Co., Ltd, Shanghai, China
- Shanghai Zhangjiang Institute of Medical Innovation, Shanghai, China
| | - Jian Wu
- Department of Cardiovascular Medicine, Shaoxing Second hospital, Shaoxing, Zhejiang, China
| | - Jin Lv
- Department of Cardiovascular Medicine, Shaoxing Second hospital, Shaoxing, Zhejiang, China
| | - Xiaosheng Hu
- The First Affiliated Hospital of Medical College of Zhejiang University, Hangzhou, China
| | - Oushan Tang
- Department of Cardiovascular Medicine, Shaoxing Second hospital, Shaoxing, Zhejiang, China.
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Zhang Q, Yang J, Wang W, Liu Z. Effect of extracurricular tutoring on adolescent students cognitive ability: A propensity score matching analysis. Medicine (Baltimore) 2023; 102:e35090. [PMID: 37682126 PMCID: PMC10489514 DOI: 10.1097/md.0000000000035090] [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: 07/05/2023] [Accepted: 08/15/2023] [Indexed: 09/09/2023] Open
Abstract
In recent years, there has been a substantial increase in the number of adolescent students attending extracurricular tutoring. However, extracurricular tutoring, being a distinct form of education, may have varying effects on cognitive capabilities compared to conventional education. Accordingly, the purpose of this paper is to conduct a thorough examination of the effects of extracurricular tutoring on cognitive abilities among adolescent students. The study utilized national data from the China Family Panel Study 2018 to explore the relationship between involvement in extracurricular tutoring among students and cognitive abilities. The study included 2567 valid respondents. A binary logistic regression model was built to determine the factors associated with tutoring involvement while controlling for 19 individual, family, and school factors. Furthermore, a propensity score-matched analysis was conducted in order to mitigate potential bias by using confounding variables identified in the previous step. The study results show that participation in extracurricular tutoring can significantly increase the level of cognitive ability of adolescent students, with adjustments made for age, gender, ethnicity, number of family members, net family income per capita, education and training expenditure in the past years, change of residence for enrollment, change of domicile address for enrollment, locality of the current school, class size, hold a position as a class cadre, average daily study time on weekdays, average study time per day during weekends. The findings imply that the government should provide tutorial subsidies to disadvantaged groups of adolescent students, allocate educational resources equitably, and invest more in education resources in less developed regions to foster fair and healthy development of education and improve the cognitive abilities of young students in the long-term.
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Affiliation(s)
- Qi Zhang
- School of Public Health, Ningxia Medical University, Yinchuan, China
| | - Jiafei Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, China
| | - Wenlong Wang
- School of Public Health, Ningxia Medical University, Yinchuan, China
| | - Zhihong Liu
- Department of Occupational and Environmental Health, School of Public Health, Ningxia Medical University, Yinchuan, China
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Ming L, Wang D, Zhu Y. Association of sodium intake with diabetes in adults without hypertension: evidence from the National Health and Nutrition Examination Survey 2009-2018. Front Public Health 2023; 11:1118364. [PMID: 37727604 PMCID: PMC10506081 DOI: 10.3389/fpubh.2023.1118364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 08/18/2023] [Indexed: 09/21/2023] Open
Abstract
Background Sodium is essential for human health, however the prevalence of various diseases is associated with excessive sodium intake, particularly cardiovascular disorders. However, in most countries, salt intake is much higher than the World Health Organization recommends. Several studies in recent years have revealed that high salt intake is associated with diabetes in the general population, but the association is uncertain in people who do not have hypertension. In this study, we aimed to find out whether high sodium intake increases the risk of diabetes in this particular population. Method Data were extracted from the National Health and Nutrition Examination Survey (NHANES; 2009-2018). Participants included adults aged over 20 years old who have undergone the diabetes questionnaire, and the hypertension population was excluded. In order to adjust the confounders, multivariate analysis models were built. Finally, subgroup analysis were conducted to investigate the association between sodium intake and diabetes separately. Result In the present study, 7,907 participants are included (3,920 female and 3,987 male), and 512 (6.48%) individuals reported diabetes. The median sodium intake of the participants was 3,341 mg/d (IQR: 2498, 4,364 mg/d). A linear association between sodium intake and the prevalence of diabetes was found (p = 0.003). According to the multivariate analysis models, the odds ratio of diabetes for every 1,000 mg sodium intake increment is 1.20 (OR: 1.20, 95% CI 1.07-1.35). The highest sodium intake quartile was 1.80-fold more likely to have diabetes than the lowest quartile (OR: 1.80, 95% CI 1.17-2.76). Conclusion Our results suggest that higher sodium intake is associated with an increased risk of diabetes in the population without hypertension, and for every 1,000 mg sodium intake increment, the risk of diabetes increased by 1.20-fold. To sum up, we have provided the clue to the etiology of diabetes and further prospective research is needed to contribute recommendations for the primary prevention of diabetes in the US.
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Affiliation(s)
- Li Ming
- Department of Pediatrics, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Duan Wang
- Department of Rehabilitation, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Yong Zhu
- Department of Pediatric Intensive Care Medicine, Zhangzhou Affiliated Hospital of Fujian Medical University, Fujian, China
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Chen L, He L, Zheng W, Liu Q, Ren Y, Kong W, Zeng T. High triglyceride glucose-body mass index correlates with prehypertension and hypertension in east Asian populations: A population-based retrospective study. Front Cardiovasc Med 2023; 10:1139842. [PMID: 37180805 PMCID: PMC10166815 DOI: 10.3389/fcvm.2023.1139842] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 04/03/2023] [Indexed: 05/16/2023] Open
Abstract
Background There is compelling evidence for an association between triglyceride glucose-body mass index (TyG-BMI) and cardiovascular disease (CVD). However, data on the relationship between TyG-BMI and prehypertension (pre-HTN) or hypertension (HTN) remains scant. The aim of this study was to characterize the association between TyG-BMI and pre-HTN or HTN risk, and to assess the ability of TyG-BMI in predicting pre-HTN and HTN in Chinese and Japanese populations. Methods A total of 214,493 participants were included in this study. The participants were divided into 5 groups based on quintiles of TyG-BMI index at baseline (Q1, Q2, Q3 Q4 and Q5). Logistic regression analysis was then employed to assess the relationship between TyG-BMI quintiles and pre-HTN or HTN. Results were presented as odds ratios (ORs) and 95% confidence intervals (CIs). Results Our restricted cubic spline analysis showed that TyG-BMI was linearly correlated with both pre-HTN and HTN. Multivariate logistic regression analysis indicated that TyG-BMI was independently correlated with pre-HTN [ORs and 95% CIs were 1.011 (1.011-1.012), 1.021 (1.02-1.023), 1.012 (1.012-1.012), respectively] and HTN [ORs and 95% CIs were 1.021 (1.02-1.021), 1.031 (1.028-1.033), 1.021 (1.02-1.021), respectively] in Chinese or Japanese individuals or both groups after adjusting for all variates. In addition, subgroup analyses showed that the relationship between TyG-BMI and pre-HTN or HTN was independent of age, sex, BMI, country, smoking and drinking status. Across all study populations, the areas under the TyG-BMI curve predicting pre-HTN and HTN were 0.667 and 0.762, respectively, resulting in cut-off values of 189.7 and 193.7, respectively. Conclusion Our analyses showed that TyG-BMI was independently correlated with both pre-HTN and HTN. Besides, TyG-BMI showed superior predictive power in predicting pre-HTN and HTN compared to TyG or BMI alone.
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Affiliation(s)
- Lu Chen
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Metabolic Abnormalities and Vascular Aging, Huazhong University of Science and Technology, Wuhan, China
| | - Linfeng He
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Metabolic Abnormalities and Vascular Aging, Huazhong University of Science and Technology, Wuhan, China
| | - Wenbin Zheng
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Metabolic Abnormalities and Vascular Aging, Huazhong University of Science and Technology, Wuhan, China
| | - Qiuying Liu
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Metabolic Abnormalities and Vascular Aging, Huazhong University of Science and Technology, Wuhan, China
| | - Yifan Ren
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Metabolic Abnormalities and Vascular Aging, Huazhong University of Science and Technology, Wuhan, China
| | - Wen Kong
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Metabolic Abnormalities and Vascular Aging, Huazhong University of Science and Technology, Wuhan, China
| | - Tianshu Zeng
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Metabolic Abnormalities and Vascular Aging, Huazhong University of Science and Technology, Wuhan, China
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Yang D, Lan J, Cen J, Han Y, Hu H. Association Between Hypertension and New-Onset Non-Alcoholic Fatty Liver Disease in Chinese Non-Obese People: A Longitudinal Cohort Study. Diabetes Metab Syndr Obes 2023; 16:345-363. [PMID: 36788988 PMCID: PMC9922508 DOI: 10.2147/dmso.s396011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 01/18/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Quantification of the relationship between hypertension and non-alcoholic fatty liver disease (NAFLD) risk is limited and controversial. This study aimed to investigate the relationship between hypertension and NAFLD in non-obese Chinese and to use different methods to demonstrate that hypertension is an independent risk factor for NAFLD. METHODS On 16,153 nonobese individuals, a retrospective cohort study was conducted in China to examine the impact of hypertension on incident NAFLD. We compared five methods: multivariable Cox proportional-hazards regression, propensity score-matched (PSM) analysis, propensity score adjustment method (considering the propensity score as a covariate in a multivariable Cox proportional-hazard regression), and two propensity score-based weighted methods-The first one estimated the hypertension effect in the overall study population-inverse probability of treatment weights (IPTW), the other in the hypertensive population-standardized mortality ratio (SMR) weights. We also used a genetic matching (GenMatch) algorithm to match the participants for sensitive analysis. RESULTS Between 2010 and 2014, 16,153 participants met our inclusion criteria, including 2427 (15.03%) with hypertension. A total of 2321 (14.37%) participants developed NAFLD during the median follow-up of 2.98 years. The crude hazard ratio (HR) between hypertension and incident NAFLD was 2.05 (95% confidence interval (CI): 1.87, 2.25). The adjusted HR depended on the different methods, ranging from 1.09 (95% CI: 0.77, 1.23) for the PSM method to 2.24 (95% CI: 2.05, 2.44) for the SMR weighted analysis. Hypertensive participants with high propensity scores had a higher risk of developing NAFLD in the future. Excluding participants with propensity scores <8% yielded comparable hazard ratios with a narrower range, from 1.04 to 1.80. After adjusting for the confounding variables, the relationship also existed in the GenMatch cohort as a sensitivity analysis (HR=1.06, 95% CI 1.01-1.13). CONCLUSION Hypertension is a significant cause of NAFLD in Chinese adults in non-obese Chinese adults, with the hazard ratio ranging from 1.09 to 2.24.
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Affiliation(s)
- Dezhi Yang
- Department of Cardiology Second Ward, Hechi People’s Hospital, Hechi, People’s Republic of China
| | - Jing Lan
- Department of Gastroenterology, Hechi People’s Hospital, Hechi, People’s Republic of China
| | - Ji Cen
- Department of Nephrology, Hechi People’s Hospital, Hechi, People’s Republic of China
| | - Yong Han
- Department of Emergency, Shenzhen Second People’s Hospital, Shenzhen, People’s Republic of China
- Department of Emergency, The First Affiliated Hospital of Shenzhen University, Shenzhen, People’s Republic of China
- Shenzhen University Health Science Center, Shenzhen University, Shenzhen, People’s Republic of China
- Correspondence: Yong Han, Department of Emergency, Shenzhen Second People’s Hospital, No. 3002 Sungang Road, Futian District, Shenzhen, Guangdong Province, People’s Republic of China, Tel +86-755-83366388, Email
| | - Haofei Hu
- Shenzhen University Health Science Center, Shenzhen University, Shenzhen, People’s Republic of China
- Department of Nephrology, Shenzhen Second People’s Hospital, Shenzhen, People’s Republic of China
- Department of Nephrology, The First Affiliated Hospital of Shenzhen University, Shenzhen, People’s Republic of China
- Haofei Hu, Department of Nephrology, Shenzhen Second People’s Hospital, No. 3002 Sungang Road, Futian District, Shenzhen, Guangdong Province, People’s Republic of China, Tel +86-755-83366388, Email
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11
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Deng H, Hu P, Li H, Zhou H, Wu X, Yuan M, Duan X, Lao M, Wu C, Zheng M, Lao XQ, Zhao W, Liu X. Novel lipid indicators and the risk of type 2 diabetes mellitus among Chinese hypertensive patients: findings from the Guangzhou Heart Study. Cardiovasc Diabetol 2022; 21:212. [PMID: 36243748 PMCID: PMC9571423 DOI: 10.1186/s12933-022-01660-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 10/03/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Data are limited on whether several easily measured indices are independent predictors of type 2 diabetes mellitus (T2DM) in hypertensive patients. This study aimed to assess the association of hypertriglyceridemic-waist phenotype, triglyceride glucose (TyG) index, lipid accumulation product (LAP), and visceral adiposity index (VAI) with T2DM risk in hypertensive patients. METHODS This cross-sectional study included 5321 hypertensive patients from the baseline survey of the Guangzhou Heart Study. Face-to-face questionnaire survey, physical examination, and fasting blood sample collection were completed for all subjects. Odds ratio (OR) with 95% confidence interval (95% CI) were calculated by using the logistic regression model. The potential nonlinear relationship was examined using restricted cubic spline regression. RESULTS The prevalence of T2DM was 19.98% among hypertensive patients. After adjusting for confounders, participants with elevated triglyceride levels and enlarged waist circumference (HTGW) were associated with a 2.57-fold risk of T2DM (OR 2.57, 95% CI 2.05, 3.23). When comparing with subjects within the lowest quartile of the indices, those in the highest quartile of TyG, LAP, and VAI were associated with 5.35-fold (95% CI 4.33, 6.64), 2.65-fold (95% CI 2.11, 3.34), and 2.17-fold (95% CI 1.77, 2.67) risk of T2DM after adjusting for confounders. Every 1-unit increment of TyG, LAP, and VAI was associated with 81%, 38%, and 31% increased risk of T2DM, respectively. The nonlinear association was observed for TyG, LAP, and VAI (all P Non-linear < 0.001). CONCLUSIONS The results found that among hypertensive patients, HTGW and a higher level of TyG, LAP, and VAI were associated with an elevated risk of T2DM. The findings suggested that HTGW, TyG, LAP, and VAI may serve as simple and effective tools for T2DM risk assessment in the prevention and management of main chronic diseases.
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Affiliation(s)
- Hai Deng
- grid.413405.70000 0004 1808 0686Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Science, Guangzhou, 510080 China
| | - Peng Hu
- grid.411847.f0000 0004 1804 4300School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Avenue, Haizhu District, Guangzhou, 510310 China ,grid.12981.330000 0001 2360 039XDepartment of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080 China
| | - Huoxing Li
- grid.284723.80000 0000 8877 7471The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515 China
| | - Huanning Zhou
- Guangzhou Yuexiu District Center for Disease Control and Prevention, Guangzhou, China
| | - Xiuyi Wu
- Nancun Community Health Service Center, Guangzhou, 511442 China
| | - Maohua Yuan
- Dadong Street Community Health Service Center, Guangzhou, 510080 China
| | - Xueru Duan
- grid.12981.330000 0001 2360 039XDepartment of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080 China
| | - Miaochao Lao
- Department of Sleep Center, Department of Geriatric Respiratory, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, 510080 China
| | - Chuchu Wu
- grid.411847.f0000 0004 1804 4300School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Avenue, Haizhu District, Guangzhou, 510310 China
| | - Murui Zheng
- grid.508371.80000 0004 1774 3337Department of Community Health, Guangzhou Center for Disease Control and Prevention, No. 1 Qide Road, Baiyun District, Guangzhou, 510440 China
| | - Xiang Qian Lao
- grid.10784.3a0000 0004 1937 0482JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, 999077 SAR China
| | - Wenjing Zhao
- grid.263817.90000 0004 1773 1790School of Public Health and Emergency Management, Southern University of Science and Technology, No. 1088 Xueyuan Avenue, Shenzhen, 518055 China
| | - Xudong Liu
- grid.411847.f0000 0004 1804 4300School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Avenue, Haizhu District, Guangzhou, 510310 China
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Chen Y, Pan M, He Y, Dong X, Hu Z, Hou J, Bao Y, Yang J, Yuchi Y, Li R, Zhu L, Kang N, Liao W, Li S, Wang C, Zhang L. Disease Burden and Accumulation of Multimorbidity of Non-communicable Diseases in Henan Rural Population: A Cross-Sectional Study (Preprint). JMIR Public Health Surveill 2022; 9:e43381. [DOI: 10.2196/43381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 03/07/2023] [Accepted: 03/18/2023] [Indexed: 03/19/2023] Open
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Cheng W, Kong F, Chen S. Comparison of the predictive value of four insulin resistance surrogates for the prevalence of hypertension: a population-based study. Diabetol Metab Syndr 2022; 14:137. [PMID: 36163185 PMCID: PMC9511744 DOI: 10.1186/s13098-022-00907-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 09/13/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Several studies have investigated the association of insulin resistance (IR) surrogates and the risk of hypertension. However, it is unclear whether there exist differences between different IR surrogates and hypertension risk. Therefore, this study aimed to explore the association of four IR surrogates (triglyceride-glucose index (TyG index), triglyceride-glucose index with body mass index (TyG-BMI), triglycerides/high-density lipoprotein cholesterol ratio (TG/HDL-c), and metabolic score for IR (METS-IR)) with the prevalence of hypertension. METHODS This is a cross-sectional study with a total of 117,056 participants. Data were extracted from a computerized database established by Rich Healthcare Group in China, which included all medical records of participants who received a health check-up from 2010 to 2016. IR surrogates were grouped into quartiles as continuous variables, and multivariate logistic regression was performed to estimate the association between different IR surrogate levels and the prevalence of hypertension. Results were expressed as odds ratios (ORs) and 95% confidence intervals (CIs). Missing data were accounted by multiple imputation. These analyses were considered as the sensitivity analysis. Meanwhile, the Bayesian network (BN) model was constructed to further evaluate the relationship between baseline characteristics and the four IR surrogates and the prevalence of hypertension, as well as the importance of every single variable for the prevalence of hypertension. RESULTS Multivariate logistic regression analysis revealed that TyG-BMI and METS-IR were independent risk factors for the prevalence of hypertension that increased significantly with increasing TyG-BMI and METS-IR (p for trend < 0.001). The area under the TyG-BMI curve (AUC) was 0.681 [95% CI: 0.677-0.685], and the cut-off value was 199.5, with a sensitivity and specificity of 65.57% and 61.18%, respectively. While the area under the METS-IR curve (AUC) was 0.679 [95% CI: 0.674-0.683], and the cut-off value was 33.61, with a sensitivity and specificity of 69.67% and 56.67%, respectively. The BN model presented that among these four IR surrogates and related variables, TyG-BMI was the most important predictor of hypertension prevalence, with a significance of 34%. The results before and after multiple imputation were similar. CONCLUSION TyG-BMI and METS-IR were independent risk factors for the prevalence of hypertension. TyG-BMI and METS-IR had good predictive value for the prevalence of hypertension, and TyG-BMI was superior to METS-IR.
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Affiliation(s)
- Wenke Cheng
- Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Fanliang Kong
- Department of Cardiology and Pneumology, University Medical Center of Göttingen, Georg-August University, Göttingen, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site, Göttingen, Germany
| | - Siwei Chen
- Department of Cardiovascular Medicine, The Third Hospital of Nanchang, No.1268, Jiuzhou Street, Chaoyang New District, Nanchang, Jiangxi, China.
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Tanaka A, Node K. Pathogenic connection between hypertension and type 2 diabetes: how do they mutually affect each other? Hypertens Res 2022; 45:1840-1842. [DOI: 10.1038/s41440-022-01014-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 08/07/2022] [Indexed: 11/09/2022]
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15
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Cheng W, Zhuang J, Chen S. Dyslipidemia and the Prevalence of Hypertension: A Cross-Sectional Study Based on Chinese Adults Without Type 2 Diabetes Mellitus. Front Cardiovasc Med 2022; 9:938363. [PMID: 35872884 PMCID: PMC9300889 DOI: 10.3389/fcvm.2022.938363] [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: 05/07/2022] [Accepted: 06/03/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundIn clinical practice, it is frequently observed that patients with hypertension often coexist with dyslipidemia. However, studies on atherosclerotic indices and the prevalence of hypertension are still limited. The purpose of this study was to assess the relationship between atherosclerotic indices and the prevalence of hypertension in Chinese adults without type 2 diabetes mellitus.MethodsIn this paper, a cross-sectional study was conducted based on 117,056 adults in 11 Chinese cities (Shanghai, Beijing, Wuhan, Suzhou, Shenzhen, Changzhou, Nantong, Guangzhou, Hefei, Nanjing, and Chengdu) from 2010 to 2016. Besides, the raw data was obtained from the public database (www.Datadryad.org), while eight atherosclerosis indices namely the atherogenic coefficient (AC), Castelli's risk index I (CRI-I) and II (CRI-II), the atherogenic index of plasma (AIP), the cholesterol index, the lipoprotein combined index (LCI), non-high-density lipoprotein cholesterol (non-HDL-C) and triglycerides/high-density lipoprotein cholesterol (TG/HDL-C) were analyzed in this study. Apart from that, two groups of continuous variables were measured using the Mann-Whitney test, and categorical variables were analyzed using the Chi-square test. Differences between multiple groups of continuous variables were investigated using Kruskal-Wallis one-way analysis of variance (ANOVA) and Dunn's test. Furthermore, Spearman correlation analysis and multivariate logistic regression analyses were performed to assess the relationship between atherosclerotic indices and blood pressure levels, and the prevalence of hypertension, respectively. The results of multivariate logistic regression analyses were expressed as the odds ratio (OR) and their corresponding 95% confidence intervals (CIs). Moreover, the receiver operating characteristic (ROC) curve was depicted to further analyze the predictive value of the atherosclerotic indices on the prevalence of hypertension.ResultsThe atherosclerosis indices were higher in the hypertensive population compared to those in the normotensive population. Meanwhile, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were linearly and positively correlated with atherosclerotic indices. In addition, multivariate logistic regression analysis showed that the cholesterol index and non-HDL-C were observed to be positively associated with the prevalence of hypertension (p for trend < 0.05). Moreover, the prevalence of hypertension increased by 3.7% (OR: 1.037; 95% CI: 1.009-1.065; p = 0.009) and 6.1% (OR: 1.06; 95% CI: 1.033–1.091; p < 0.001), respectively, as per 1-standard deviation (SD) increase in the cholesterol index and non-HDL-C. Beyond that, ROC analysis demonstrated that the cholesterol index and non-HDL-C have a good predictive value for the prevalence of hypertension in women, with under the ROC curve (AUC) of 0.659 and 0.684 and cut-off values of 47.94 and 134.34 mg/dl, accordingly.ConclusionsIn Chinese adults without type 2 diabetes mellitus, atherosclerotic indices were significantly higher in hypertensive populations compared with those in normotensive populations, regardless of hypertension levels. Meanwhile, SBP and DBP were linearly and positively related to atherosclerotic indices. Besides, the cholesterol index and non-HDL-C were independent risk factors for the prevalence of hypertension, and they could be adopted for effectively predicting the prevalence of hypertension in women.
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Affiliation(s)
- Wenke Cheng
- Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Jingqi Zhuang
- Department of Admission and Follow-Up, Lintong Rehabilitation and Recuperation Center, Xian, China
| | - Siwei Chen
- Department of Cardiovascular Medicine, The Third Hospital of Nanchang, Nanchang, China
- *Correspondence: Siwei Chen
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Amusa L, North D, Zewotir T. A tailored use of the mahalanobis distance matching for causal effects estimation: A simulation study. SCIENTIFIC AFRICAN 2022. [DOI: 10.1016/j.sciaf.2022.e01155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
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17
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Han Y, Hu H, Liu Y, Li Q, Huang Z, Wang Z, Liu D, Wei L. The Association Between Congestive Heart Failure and One-Year Mortality After Surgery in Singaporean Adults: A Secondary Retrospective Cohort Study Using Propensity-Score Matching, Propensity Adjustment, and Propensity-Based Weighting. Front Cardiovasc Med 2022; 9:858068. [PMID: 35783819 PMCID: PMC9247191 DOI: 10.3389/fcvm.2022.858068] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 05/27/2022] [Indexed: 11/13/2022] Open
Abstract
Background Although congestive heart failure (CHF) is considered a risk factor for postoperative mortality, reliable quantification of the relationship between CHF and postoperative mortality risk is limited. We aimed to investigate the association between CHF and 1-year mortality after surgery in a large cohort of the Singaporean population. Methods In this retrospective cohort study, the study population included 69,032 adult patients who underwent surgery at Singapore General Hospital between 1 January 2012 and 31 October 2016. The target independent and dependent variables were CHF and 1-year mortality after surgery, respectively. Propensity score was estimated using a non-parsimonious multivariable logistic regression model. Multivariable adjustment, propensity score matching, propensity score adjustment, and propensity score-based weighting Cox proportional-hazards regression were performed to investigate the association between CHF and 1-year mortality after surgery. Results The multivariate-adjusted hazard ratio (HR) in the original cohort was 1.39 (95% confidence interval (CI): 1.20–1.61, P < 0.001). In additional propensity score adjustment, the HR between CHF and 1-year mortality after surgery was 1.34 (95% CI: 1.15–1.56, P < 0.001). In the propensity score-matched cohort, the multivariate-adjusted Cox proportional hazard regression model analysis showed participants with CHF had a 54% increased risk of 1-year mortality after surgery (HR 1.54, 95% CI: 1.19–1.98, P < 0.001). The multivariate-adjusted HR of the inverse probability of treatment-weighted and standardised mortality ratio-weighted cohorts was 1.34 (95% CI: 1.10–1.62, P = 0.004) and 1.24 (95% CI: 1.17–1.32, P < 0.001), respectively. Conclusion CHF is an independent risk factor for 1-year mortality after surgery in patients undergoing surgery. Depending on the statistical method, patients with CHF had a 24–54% increased risk of 1-year all-cause mortality after surgery. This provides a reference for optimising clinical decision-making, improving preoperative consultation, and promoting clinical communication.
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Affiliation(s)
- Yong Han
- Department of Emergency, Shenzhen Second People’s Hospital, Shenzhen, China
| | - Haofei Hu
- Department of Nephrology, Shenzhen Second People’s Hospital, Shenzhen, China
| | - Yufei Liu
- Department of Neurosurgery, Shenzhen Second People’s Hospital, Shenzhen, China
| | - Qiming Li
- Department of Emergency, Shenzhen Second People’s Hospital, Shenzhen, China
| | - Zhiqiang Huang
- Department of Emergency, Shenzhen Second People’s Hospital, Shenzhen, China
| | - Zhibin Wang
- Department of Emergency, Shenzhen Second People’s Hospital, Shenzhen, China
| | - Dehong Liu
- Department of Emergency, Shenzhen Second People’s Hospital, Shenzhen, China
- *Correspondence: Dehong Liu,
| | - Longning Wei
- Department of Emergency, Hechi People’s Hospital, Hechi, China
- Longning Wei,
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Chen S, Cheng W. Relationship Between Lipid Profiles and Hypertension: A Cross-Sectional Study of 62,957 Chinese Adult Males. Front Public Health 2022; 10:895499. [PMID: 35664125 PMCID: PMC9159857 DOI: 10.3389/fpubh.2022.895499] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 04/11/2022] [Indexed: 12/05/2022] Open
Abstract
Background Patterns of dyslipidemia and incidence of hypertension have been rarely reported in Asian populations with inconsistent findings. To accumulate further evidence in Asian populations, the study aimed to investigate the relationship between lipid profiles and hypertension in Chinese adult males. Methods We conducted a cross-sectional study based on the data from the DATADRYAD database. The overall population was divided into hypertensive and non-hypertensive groups based on baseline blood pressure levels. For continuous variables, Mann-Whitney test was performed between two groups, while Kruskal-Wallis and Dunn tests were used among multiple groups. The chi-square test was carried out for dichotomous variables. Spearman's correlation coefficient was employed to assess the association between systolic blood pressure (SBP), diastolic blood pressure (DBP) and lipid profiles, whereas the relationship between lipid profiles and the incidence of hypertension was evaluated using multivariate logistic regression. The Bayesian network (BN) model was adopted to investigate the relationship between clinical characteristics and hypertension, and the importance of related predictor to the incidence of hypertension was obtained to make conditional probability analysis. Results Finally, totally 62,957 participants were included in this study. In the lipid profiles, total cholesterol (TC), low-density cholesterol (LDL-c), and non- high-density lipoprotein cholesterol (non-HDL-c) were higher in the hypertensive population (p <0.001). In the fully multivariate model, for every 1 mg/dl increase in TC, LDL-c and non-HDL, the risk of hypertension increased by 0.2% [1.002 (1.001–1.003)], 0.1% [1.001 (1.000–1.002)], and 0.1% [1.001 (1.000–1.002)]. Meanwhile, HDL-c became positively associated with the incidence of hypertension (p for trend < 0.001) after adjusting for the body mass index (BMI), and 1 mg/dl increment in HDL-c increased the risk of hypertension by 0.2% [1.002 (1.000–1.002)] after fully adjusting for multiple variables. Furthermore, the BN showed that the importance of age, BMI, fasting plasma glucose (FPG), and TC to the effect of hypertension is 43.3, 27.2, 11.8, and 5.1%, respectively. Conclusion Elevated TC, LDL-c, and non-HDL-c were related to incidence of hypertension in Chinese adult males, whereas triglycerides (TG) was not significantly associated. The relationship between HDL-c and hypertension incidence shifted from no association to a positive correlation after adjusting for the BMI. Moreover, the BN model displayed that age, the BMI, FPG, and TC were strongly associated with hypertension incidence.
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Affiliation(s)
- Siwei Chen
- Department of Cardiovascular Medicine, The Third Hospital of Nanchang, Nanchang, China
| | - Wenke Cheng
- Medical Faculty, University of Leipzig, Leipzig, Germany
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Cheng W, Wang L, Chen S. Differences in Lipid Profiles and Atherogenic Indices Between Hypertensive and Normotensive Populations: A Cross-Sectional Study of 11 Chinese Cities. Front Cardiovasc Med 2022; 9:887067. [PMID: 35656401 PMCID: PMC9152277 DOI: 10.3389/fcvm.2022.887067] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 04/11/2022] [Indexed: 12/11/2022] Open
Abstract
Background Several previous studies have reported that dyslipidemia is associated with the risk of hypertension, but these studies are mainly conducted in European and US populations, with a very few studies in the Asian population. Moreover, the effects of atherosclerotic indices, including atherogenic coefficient (AC) and atherogenic risk of plasma (AIP), on hypertension in Asians have not been well described so far. Methods From 2010 to 2016, altogether 211,833 Chinese adults were ultimately recruited at the health centers in 11 Chinese cities (including Shanghai, Beijing, Nanjing, Suzhou, Shenzhen, Changzhou, Chengdu, Guangzhou, Hefei, Wuhan, and Nantong). Differences in continuous variables between the two groups were analyzed by the Mann-Whitney test, while those in categorical variables were examined by the Chi-squared test. Logistic regression was applied to evaluate the association between lipid profiles and the risk of hypertension. The predictive values of AC and AIP for the incidence of hypertension were analyzed using the area under the receiver operating characteristic (ROC) curve. Meanwhile, Bayesian network (BN) models were performed to further analyze the associations between the different covariates and the incidence of hypertension. Results A total of 117,056 participants were included in the final analysis. There were significant differences in baseline characteristics between normotension and hypertension groups (p < 0.001). In multivariate logistic regression, the risk of hypertension increased by 0.2% (1.002 [1.001-1.003]), 0.2% (1.002 [1.001-1.003]), and 0.2% (1.002 [1.001-1.003]) per 1 mg/dl increase in total cholesterol (TC), low-density lipoprotein (LDL), and non-high-density lipoprotein cholesterol (non-HDL-c), respectively. However, after adjusting for body mass index (BMI), an increase in HDL level was associated with a higher risk of hypertension (p for a trend < 0.001), and the risk of hypertension increased by 0.6% per 1 mg/dl increase in HDL-c (1.006 [1.003-1.008]). In women, AC had the highest predictive value for the incidence of hypertension with an area under the curve (AUC) of 0.667 [95% confidence interval (CI): 0.659-0.674]. BN models suggested that TC and LDL were more closely related to the incidence of hypertension. Conclusions Overall, lipid profiles were significantly abnormal in the hypertensive population than in the normotensive population. TC and LDL were strongly associated with the incidence of hypertension. TC, LDL, and non-HDL-c levels show a positive association, HDL-c shows a negative association, while TG is not significantly associated with the risk of hypertension. After adjusting for BMI, HDL-c turns out to be positively associated with the risk of hypertension. In addition, AC has a good predictive value for the incidence of hypertension in women.
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Affiliation(s)
- Wenke Cheng
- Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Lili Wang
- Retirement Clinic, Tengzhou Central People's Hospital, Shandong, China.,Geriatric Medicine Clinic, Tengzhou Central People's Hospital, Shandong, China
| | - Siwei Chen
- Department of Cardiovascular Medicine, The Third Hospital of Nanchang, Jiangxi, China
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Deng G, Li Y, Cheng W. Association of Lipid Levels With the Prevalence of Hypertension in Chinese Women: A Cross-Sectional Study Based on 32 Health Check Centers. Front Endocrinol (Lausanne) 2022; 13:904237. [PMID: 35873005 PMCID: PMC9300912 DOI: 10.3389/fendo.2022.904237] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Dyslipidemia is strongly associated with the development of hypertension. In our previous study, it was shown that elevated TC, LDL-c, and non-HDL-c were associated with the prevalence of hypertension in Chinese men, whereas the relationship between HDL-c and hypertension shifted from no association to a positive association after adjusting for the BMI. To further accumulate epidemiological evidence in Asian women, this study aimed to investigate the relationship between lipid profile and prevalence of hypertension in Chinese adult women. METHODS This is a cross-sectional study including 54,099 Chinese women aged>20 years at 32 health screening centers in 11 cities from 2010-2016. The original data were obtained from DATADRYAD database (www.datadryad.org). Besides, the overall women were classified into non-hypertensive and hypertensive groups based on baseline blood pressure levels. Differences between the two groups were examined by Man-Whitney test or Chi-square test. Spearman's correlation coefficient was employed to evaluate the correlation between systolic blood pressure (SBP), diastolic blood pressure (DBP) and lipid profiles. Multivariate logistic regression was performed to estimate the relationship between different lipid levels and the prevalence of hypertension. Odds ratios (ORs) and 95% confidence intervals (CIs) indicated the risk of lipid and hypertension. Bayesian model (BN) model was constructed to further assess the relationship between baseline characteristics and the prevalence of hypertension, as well as the importance of each variable for the prevalence of hypertension. RESULTS Compared to the non-hypertensive population, the hypertensive population was older, and had the higher body mass index (BMI), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), serum creatinine (Scr), fasting blood glucose (FPG), blood urea nitrogen (BUN), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and non-high-density lipoprotein cholesterol (non-HDL-c), but HDL-c and the presence concerning the family history of diabetes were lower. Multivariate logistic regression analysis revealed that TC, LDL-c, and non-HDL-c showed a positive trend with hypertension risk (p for trend < 0.05) whereas TC and HDL-c were not significantly associated with hypertension prevalence. Moreover, each 1 mg/dl increase in TC, LDL, and non-HDL hypertension prevalence increased by 0.2% [1.002 (1.000-1.003)], 0.2% [1.002 (1.000-1.004)], and 0.2% [1.002(1.001-1.004)], respectively. BN suggested that the importance of age, BMI, FPG, non-HDL-c on the prevalence of hypertension was 52.73%, 24.98%, 11.22%, and 2.34%, respectively. CONCLUSION Overall, in Chinese adult women, TC, LDL-c and non-HDL-c levels were higher and HDL-c level was lower in the hypertensive population, whereas TG did not differ significantly from the non-hypertensive population. Meanwhile, TC, LDL-c, and non-HDL-c were positively associated with prevalence of hypertension, and HDL-c was negatively associated with prevalence of hypertension but became nonsignificant after full adjustment for variables. Moreover, BN model suggested that age, BMI, FPG, and non-HDL-c had a greater effect on the development of hypertension.
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Affiliation(s)
- Guizhi Deng
- Department of Cardiovascular Medicine, The Third Hospital of Nanchang, Nanchang, China
| | - Yunjie Li
- Department of Gastrointestinal Endoscopy, The Third Hospital of Nanchang, Nanchang, China
| | - Wenke Cheng
- Medical Faculty, University of Leipzig, Leipzig, Germany
- *Correspondence: Wenke Cheng,
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