Gender difference in components of metabolic syndrome among patients of type 2 diabetes

Sensorineural hearing loss among type 2 diabetic patients and its association with peripheral neuropathy: a cross-sectional study from a lower middle-income country

INTRODUCTION

Despite potential links between diabetes and sensorineural hearing loss (SNHL), routine hearing assessments for diabetic patients are not standard practice. Our study aimed to investigate the prevalence of SNHL and its association with diabetes-related factors among patients with type 2 diabetes mellitus (T2DM).

RESEARCH DESIGN AND METHODS

This cross-sectional study was conducted at the Diabetes Clinic, Jinnah Postgraduate Medical Centre, Karachi, Pakistan, from May to September 2021. A total of 396 patients fulfilling the inclusion criteria participated after informed consent. Data collection involved a sociodemographic profile, Michigan Neuropathy Screening Instrument examination followed by pure-tone audiometry and laboratory tests including haemoglobin A1C (HbA1c). HL was defined using better ear four-frequency pure-tone average of ≥26 dB HL and graded as per WHO criteria. Statistical analyses were performed using SPSS. χ2, independent t-test and multinomial logistic regression analyses were applied. P<0.05 at 95% CI was considered significant.

RESULTS

Our study revealed a high prevalence of SNHL among patients with T2DM. Mild HL was seen in 55.8%, while 18.7% suffered from moderate HL. Common audiological symptoms included difficulty understanding speech in noisy surroundings (44.2%), balance problems (42.9%), sentence repetition (35.9%), tinnitus (32.3%) and differentiating consonants (31.1%). Hearing impairment predominantly affected low (0.25-0.5 kHz) and high (4-8 kHz) frequencies with a significant difference at 4 kHz among both sexes (t (394)=2.8, p=0.004). Peripheral neuropathy was significantly associated with SNHL on multinomial logistic regression after adjusting with age, sex, body mass index and the presence of any comorbidities. Diabetes duration, HbA1c or family history of diabetes was found unrelated to SNHL severity.

CONCLUSIONS

The study highlights the substantial prevalence of SNHL among patients with T2DM and emphasises the importance of targeted audiological care as part of a holistic approach to diabetes management. Addressing HL early may significantly improve communication and overall quality of life.

Relationship of metabolic syndrome defined by IDF or revised NCEP ATP III with glycemic control among Malaysians with Type 2 Diabetes

BACKGROUND

The chronic complications of Type 2 Diabetes (T2D) such as macrovascular disease is amplified with the increase in the number of metabolic syndrome (MetS) risk factors. This research aims to study the relationship of MetS, diagnosed by the International Diabetes Federation (IDF) or revised National Cholesterol Education Programs Adult Treatment Panel III (NCEP ATP III) criteria, with glycemic control, fasting blood glucose (FBG), glycated hemoglobin (HbA1c), C-peptide, and insulin resistance in T2D patients.

METHODS

The study is a cross-sectional observational study which, involved 485 T2D patients who are receiving treatment at the University Kebangsaan Malaysia Medical Center (UKMMC), Kuala Lumpur, Malaysia. The MetS among the T2D patients was diagnosed based on IDF and revised NCEP ATP III criteria. C-peptide and HbA1c levels were determined by an automated quantitative immunoassay analyzer and high-performance liquid chromatography, respectively. The MetS factors; FBG, triglyceride, and high-density lipoprotein cholesterol were measured by spectrophotometer.

RESULTS

Application of the IDF and revised NCEP ATP III criteria respectively resulted in 73% and 85% of the T2D subjects being diagnosed with MetS. The concordance of these criteria in diagnosing MetS among T2D patients was low (κ = 0.33, P < 0.001). Both IDF and revised NCEP ATP III criteria indicated that T2D patients with 5 MetS factors had higher insulin resistance (P = 2.1 × 10-13; 1.4 × 10-11), C-peptide (P = 1.21 × 10-13; 4.1 × 10-11), FBG (P = 0.01; 0.021), and HbA1c (P = 0.039; 0.018) than those T2D patients without MetS, respectively.

CONCLUSION

Although there is a low concordance between IDF and revised NCEP ATP III criteria in the diagnosis of MetS among T2D patients, both criteria showed that T2D patients with 5 MetS factors had higher insulin resistance, C-peptide, FBG, and HbA1c.

Gender Differences in the Pattern of Socio-Demographics Relevant to Metabolic Syndrome Among Kenyan Adults with Central Obesity at a Mission Hospital in Nairobi, Kenya

INTRODUCTION

Metabolic syndrome (MetS) is a risk factor for cardiovascular-related morbidity and mortality. Although the risk factors for MetS are well documented, differences in gender-based demographics among Kenyan adults with central obesity are lacking.

AIM

Determine gender differences in the pattern of socio-demographics relevant to metabolic syndrome among Kenyan adults with central obesity at a mission hospital, Nairobi.

METHODS

A cross-sectional baseline survey involving adults (N = 404) with central obesity aged 18-64 years, as part of a community-based lifestyle intervention study. Respondents were systematically sampled using the International Diabetes Federation definition for MetS. Lifestyle characteristics, anthropometric, clinical and biochemical markers were measured and analyzed using SPSS.

RESULTS

High (87.2%) MetS prevalence associated with advanced age in males (p < 0.001) and females (p = 0.002) was observed. MetS was likely among divorced/separated/widowed (p = 0.021) and high income males (p = 0.002) and females (p = 0.017) with high income. Unemployed males (p = 0.008) and females with tertiary education (p = 0.019) were less likely to have MetS. Advanced age was likely to lead to high blood pressure, fasting blood glucose and triglycerides (p < 0.05). Males were more likely (p = 0.026) to have raised triglycerides, while females (p < 0.001) had low high density lipoproteins.

CONCLUSION

A high prevalence of MetS associated with social and gender differences among Kenyan adults with central obesity. These underscore the need to look beyond the behavioral and biological risks and focus on every nuance of gender differences in addressing MetS and CVDs.

The Prevalence of Metabolic Syndrome and Its Components among Type 2 Diabetes Mellitus Patients at a Tertiary Hospital, Northwest Ethiopia

Background

Metabolic syndrome is a cluster of risk factors that is responsible for the risk of coronary heart disease and stroke. Therefore, the aim of this study was to assess the prevalence of MetS and its components among T2DM patients.

Methods

A cross-sectional study was conducted at the Diabetes Clinic of the Hospital, from June to July, 2015. Data were entered into EPI INFO software and exported to SPSS 20 for analysis. MetS prevalence was estimated using NCEP ATPIII and IDF criteria. Anthropometric measurements, investigations of serum glucose and lipid profiles were done. Logistic regression analysis was used to evaluate associated factors. A P-value ≤ 0.05 was considered statistically significant.

Result

A total of 159 participants were included in the study; 119 (59.7%) were females with mean (±SD) age of (49.8±8.7) year. The prevalence of MetS was 66.7% in NCEP-ATP III and 53.5% in IDF definitions. The most prevalent component of MetS was elevated triglyceride (56.6% in ATPIII and 62.3% in IDF criteria), followed by abdominal obesity (61%) IDF and elevated blood pressure (55.4%) NCEP-ATPIII criteria. The regression analysis showed that increased age, being female, high BMI, having diabetes for over 5 years and poor glycemic control were significantly associated with metabolic syndrome.

Conclusion

The prevalence of MetS and its components among T2DM patients were high, suggesting that diabetic patients are at increased risk of CVD and other complications. Efforts should be geared towards addressing these abnormalities through lifestyle modification, health awareness and medications in order to reduce this complication.

Risk of Type 2 Diabetes Among the Pakistani Population: Results of a Cross-sectional Survey

Introduction

Diabetes is a global issue. The aim of this study was to identify the high-risk population and factors associated with the future development of type 2 diabetes mellitus (T2DM).

Methods

A cross-sectional study was conducted in the Family Medicine clinics of a tertiary care hospital in Karachi, Pakistan, from July 2016 to February 2017. Patients or patient care attendants aged 21 to 85 years visiting the clinics were included. Individuals with known diabetes or with serious comorbid conditions were excluded. A total of 600 participants were consecutively approached. QDiabetes (an online diabetes risk calculator) was used to measure the risk of developing T2DM. IBM SPSS Statistics for Windows, Version 19.0 (IBM Corp., Armonk, NY) was used for data analysis.

Results

Information from a total of 522 participants was included in the final analysis. Roughly 53% of them were between 25 and 44 years of age. There was a predominance of females (63%). Thirty-eight percent of patients were at high-risk. The factors associated with high risk of T2DM were as follows: age 65 years or greater (Relative risk [RR]: 5.81; 95% confidence interval [CI]: 2.01 to 16.76); female (RR: 1.86; 95% CI: 1.05 to 3.28, p = 0.03); a past history of hypertension (RR: 5.11; 95% CI: 2.49 to 10.49); a family history of diabetes (RR: 9.76; 95% CI: 5.49 to 13.35).

Conclusion

Controlling glucose levels and preventing hyperglycemia is a challenging task due to the increasing trend of a sedentary lifestyle and changes in dietary patterns. Counseling should be provided to caregivers and high-risk patients on the prevention of T2DM including lifestyle modifications.

Profiling of plasma metabolites in postmenopausal women with metabolic syndrome

Objective:

The aim of the study was to investigate the associations of amino acids and other polar metabolites with metabolic syndrome (MetS) in postmenopausal women in a lean Asian population.

Methods:

The participants were 1,422 female residents enrolled in a cohort study from April to August 2012. MetS was defined according to the National Cholesterol Education Program Adult Treatment Panel III modified for Japanese women. Associations were examined between MetS and 78 metabolites assayed in fasting plasma samples using capillary electrophoresis-mass spectrometry. Replication analysis was performed to confirm the robustness of the results in a separate population created by random allocation.

Results:

Analysis was performed for 877 naturally postmenopausal women, including 594 in the original population and 283 in the replication population. The average age, body mass index, and levels of high- and low-density lipoprotein cholesterol of the entire population were 64.6 years, 23.0 kg/m², 72.1 mg/dL, and 126.1 mg/dL, respectively. There was no significant difference in low-density lipoprotein cholesterol levels between women with and without MetS. Thirteen metabolites were significantly related to MetS: multiple plasma amino acids were elevated in women with MetS, including branched-chain amino acids, alanine, glutamate, and proline; and alpha-aminoadipate, which is generated by lysine degradation, was also significantly increased.

Conclusions:

Our large-scale metabolomic profiling indicates that Japanese postmenopausal women with MetS have abnormal polar metabolites, suggesting altered catabolic pathways. These results may help to understand metabolic disturbance, including in persons with normal body mass index and relatively high levels of high-density lipoprotein cholesterol, and may have clinical utility based on further studies.