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Sunday OG, Elsie AO. Impact of pubertal timing and socioeconomic status on adult height and body proportions in Igbo ethnicity. Am J Hum Biol 2023; 35:e23934. [PMID: 37278346 DOI: 10.1002/ajhb.23934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 05/16/2023] [Accepted: 05/26/2023] [Indexed: 06/07/2023] Open
Abstract
OBJECTIVES Age at menarche is a marker of pubertal timing that may influence adult height and body proportions. Previous studies have shown that socioeconomic status can affect age at menarche and growth patterns in different populations. This study aims to examine the associations between age at menarche, socioeconomic status, height, and leg length in a sample of Igbo ethnicity. METHODS The study used data from questionnaires and anthropometric measurements of 300 female students aged 18-25 years. Study tested the hypotheses that earlier menarche is associated with shorter stature and shorter leg length, and that these associations are modified by socioeconomic status using nonparametric analysis. RESULTS Mean age at menarche was fluctuating around 12.84 ± 1.40 and 13.59 ± 1.41 years with school girls and grew 3.0 cm taller per year birth cohort. The study also found that girls with earlier menarche were shorter adult height (162.51 ± 6.00) compared with girls who have menarche at a later age. The linear regression coefficients (bs) ranged from 0.37-0.49 in later year birth cohort and 0.37-0.44 in early year birth cohort for height. The effect of age at menarche on leg length was similar to the relation between age at menarche and birth cohort height. CONCLUSION The study will contribute to the understanding of how pubertal timing and socioeconomic status interact to shape adult health outcomes in a transitioning population.
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Affiliation(s)
- Obaje Godwin Sunday
- Department of Human Anatomy, Faculty of Basic Medical Sciences, College of Medical Sciences Alex Ekwueme Federal University, Abakaliki, Nigeria
| | - Ada Obi Elsie
- Department of Human Anatomy, Faculty of Basic Medical Sciences, College of Medical Sciences Alex Ekwueme Federal University, Abakaliki, Nigeria
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Loosen SH, Krieg S, Krieg A, Luedde T, Kostev K, Roderburg C. Adult Body Height Is Associated with the Risk of Type 2 but Not Type 1 Diabetes Mellitus: A Retrospective Cohort Study of 783,029 Individuals in Germany. J Clin Med 2023; 12:jcm12062199. [PMID: 36983200 PMCID: PMC10053566 DOI: 10.3390/jcm12062199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 03/09/2023] [Accepted: 03/10/2023] [Indexed: 03/16/2023] Open
Abstract
Background: Diabetes mellitus is a major global health burden associated with high morbidity and mortality. Although a short adult body height has been associated with increased risk of type 2 diabetes (T2D), there are large inconsistencies between the studies. Therefore, we aimed to investigate the association between body height and T2D in a large cohort of adult outpatients in Germany. Methods: A total of 783,029 adult outpatients with available body height data from the Disease Analyzer (IQVIA) database were included in Germany between 2010 and 2020. The incidence of diabetes mellitus (type 1 and type 2) was evaluated as a function of the patients’ body height stratified by age, sex, and body-mass-index (BMI). Results: In both women and men in all age groups, incidence of T2D decreased with the increasing body height (<50, 51–60, 61–70, and >70 years). There was no association between the body height and the individual HbA1c value. In multivariable Cox regression analyses adjusted for patient age and BMI, hazard ratios for the development of T2D were 1.15 (95% CI: 1.13–1.17) for each 10 cm decrease in body height in women and 1.10 (95% CI: 1.09–1.12) in men. No significant association was found between body height and the development of T1D. Conclusions: We present the first data from a large cohort of outpatients in Germany, providing strong evidence for an association between adult body height and T2D. These data add to the current literature and might help in implementing body height into existing diabetes risk stratification tools to further reduce morbidity and mortality worldwide.
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Affiliation(s)
- Sven H. Loosen
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Duesseldorf, Medical Faculty of Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany (C.R.)
- Correspondence: (S.H.L.); (S.K.); Tel.: +49-211-81-16630 (S.H.L. & S.K.); Fax: +49-211-81-04489 (S.H.L. & S.K.)
| | - Sarah Krieg
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Duesseldorf, Medical Faculty of Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany (C.R.)
- Correspondence: (S.H.L.); (S.K.); Tel.: +49-211-81-16630 (S.H.L. & S.K.); Fax: +49-211-81-04489 (S.H.L. & S.K.)
| | | | - Tom Luedde
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Duesseldorf, Medical Faculty of Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany (C.R.)
| | - Karel Kostev
- Department of Surgery (A), University Hospital Duesseldorf, Medical Faculty of Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany
| | - Christoph Roderburg
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Duesseldorf, Medical Faculty of Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany (C.R.)
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He B, Li Z, Xu L, Liu L, Wang S, Zhan S, Song Y. Upper arm length and knee height are associated with diabetes in the middle-aged and elderly: evidence from the China Health and Retirement Longitudinal Study. Public Health Nutr 2023; 26:190-198. [PMID: 35581171 PMCID: PMC11077445 DOI: 10.1017/s1368980022001215] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/23/2022] [Accepted: 04/01/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To determine if limb lengths, as markers of early life environment, are associated with the risk of diabetes in China. DESIGN We performed a cohort analysis using data from the China Health and Retirement Longitudinal Study (CHARLS), and multivariable-adjusted Cox proportional hazard regression models were used to examine the associations between baseline limb lengths and subsequent risk of diabetes. SETTING The CHARLS, 2011-2018. PARTICIPANTS The study confined the eligible subject to 10 711 adults aged over 45 years from the CHARLS. RESULTS During a mean follow-up period of 6·13 years, 1358 cases of incident diabetes were detected. When controlling for potential covariates, upper arm length was inversely related to diabetes (hazard ratio (HR) 0·95, 95 % CI (0·91, 0·99), P = 0·028), and for every 1-cm difference in knee height, the risk of diabetes decreased by about 4 % (HR 0·96, 95 % CI (0·93, 0·99), P = 0·023). The association between upper arm length and diabetes was only significant among females while the association between knee height and diabetes was only significant among males. In analyses stratified by BMI, significant associations between upper arm length/knee height and diabetes only existed among those who were underweight (HR 0·91, 95 % CI (0·83, 1·00), P = 0·049, HR 0·92, 95 % CI (0·86, 0·99), P = 0·031). CONCLUSIONS Inverse associations were observed between upper arm length, knee height and the risk for diabetes development in a large Asian population, suggesting early life environment, especially infant nutritional status, may play an important role in the determination of future diabetes risk.
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Affiliation(s)
- Bingjie He
- Department of Epidemiology and Biostatistics, School of Public
Health, Peking University, 38 Xueyuan Road, Haidian District,
Beijing100191, People’s Republic of China
| | - Zhengyang Li
- Department of Endocrinology, Shandong Provincial Hospital
Affiliated to Shandong First Medical University, Huaiyin
District, Jinan, People’s Republic of China
| | - Lu Xu
- Department of Epidemiology and Biostatistics, School of Public
Health, Peking University, 38 Xueyuan Road, Haidian District,
Beijing100191, People’s Republic of China
| | - Lili Liu
- Department of Epidemiology and Biostatistics, School of Public
Health, Peking University, 38 Xueyuan Road, Haidian District,
Beijing100191, People’s Republic of China
| | - Shengfeng Wang
- Department of Epidemiology and Biostatistics, School of Public
Health, Peking University, 38 Xueyuan Road, Haidian District,
Beijing100191, People’s Republic of China
| | - Siyan Zhan
- Department of Epidemiology and Biostatistics, School of Public
Health, Peking University, 38 Xueyuan Road, Haidian District,
Beijing100191, People’s Republic of China
- Research Center of Clinical Epidemiology, Peking
University Third Hospital, Haidian District, Beijing,
People’s Republic of China
- Center for Intelligent Public Health, Institute for Artificial
Intelligence, Peking University, Beijing,
People’s Republic of China
| | - Yongfeng Song
- Department of Endocrinology, Shandong Provincial Hospital
Affiliated to Shandong First Medical University, Huaiyin
District, Jinan, People’s Republic of China
- Shandong Institute of Endocrine & Metabolic Diseases,
Shandong First Medical University, Jinan,
People’s Republic of China
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Association of early menarche with elevated BMI, lower body height and relative leg length among 14- to 16-year-old post-menarcheal girls from a Maya community in Yucatan, Mexico. ANTHROPOLOGICAL REVIEW 2022. [DOI: 10.18778/1898-6773.85.1.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Human body segments have different timing and tempo of growth. Early menarche (EM) as an indicator of early reproductive maturity results in a shortened height and leg length. Relatively larger trunk may increase risk for more body fat deposit and higher body mass index (BMI) due to the allometry of total body fat with body proportions. The objective of the study was to assess the association of EM with BMI, absolute body size [height, sitting height (SH), subischial leg length (SLL)] and relative body dimensions [sitting height to subischial leg length ratio (SHSLLR), relative subischial leg length (RSLL)] among 14- to 16-year-old post-menarcheal girls from a rural Maya community in Quintana Roo, Yucatan, Mexico. In a cross-sectional study, post-menarcheal girls (n=51) aged 14 to 16 years had EM (n=22) (<12 years of age) and not early menarche (NEM, n=29). Anthropometric measurements of height, weight, and SH were recorded. Derived variables were BMI, height and BMI-for-age z-scores, SLL, SHSLLR, and RSLL. Mean value of age at menarche (AM) was 13 years (EM 11 years, NEM 14 years). Mean values of height (EM 159 cm, NEM 164 cm), BMI (EM 20 kg/m2, NEM 19 kg/m2), sitting height (EM 81 cm, NEM 78 cm), SLL (EM 79 cm, NEM 85 cm), SHSLLR (EM 102.93%, NEM 92.03%), and RSLL (EM 49%, NEM 52%) were different (p<0.05) in the two groups. BMI showed significant negative correlation with AM (Pearson’s r=-0.29, p<0.04). Linear regression models adjusted for age showed that EM had different interrelationships (p<0.05) with body dimensions: positive with BMI, SH, SHSLLR, and negative with height, SLL, and RSLL. Earlier AM was associated with higher BMI, SH, SHSLLR and lower SLL, RSLL, explaining lower body height and leg length among the participant EM girls. In the light of life history theory, EM results in a growth trade-off, short stature and larger trunk relative to leg length that might enhance risk for body fat gain.
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Mishra SR, Waller M, Chung HF, Mishra GD. Association between reproductive lifespan and risk of incident type 2 diabetes and hypertension in postmenopausal women: findings from a 20-year prospective study. Maturitas 2022; 159:52-61. [DOI: 10.1016/j.maturitas.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 12/24/2021] [Accepted: 01/07/2022] [Indexed: 11/30/2022]
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Song W, Hu Y, Yuan J, Wei Y, Cheng Z, Liu J, Xu J, Wang X. Gender Differences Between the Phenotype of Short Stature and the Risk of Diabetes Mellitus in Chinese Adults: A Population-Based Cohort Study. Front Endocrinol (Lausanne) 2022; 13:869225. [PMID: 35450422 PMCID: PMC9016201 DOI: 10.3389/fendo.2022.869225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 03/08/2022] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE Previous studies have shown that there are significant regional and gender differences in the association between the phenotype of short stature and diabetes mellitus (DM). The purpose of this study was to investigate the gender difference between the phenotype of short stature and the risk of DM in the Chinese population. METHODS The sample included 116,661 adults from 32 locations of 11 cities in China, of which the average height of men and women was 171.65 and 160.06 cm, respectively. Investigators retrospectively reviewed annual physical examination results for follow-up observations and set confirmed DM events as the outcome of interest. Multivariate Cox regression, restricted cubic spline, and piecewise regression models were used to check the association between height and DM risk. RESULTS During an average observation period of 3.1 years, there were 2,681 of 116,661 participants who developed new-onset DM, with a male to female ratio of 2.4 to 1. After full adjustment for confounders, we confirmed that there was a significant negative correlation between height and DM risk in Chinese women (HR per 10 cm increase: 0.85, 95% CI: 0.74-0.98), but not in men (HR per 10 cm increase: 1.16, 95% CI: 0.98-1.14). Additionally, through restricted cubic spline and piecewise regression analysis, we determined that the height of 157-158 cm may be the critical point for short stature used to assess the risk of DM in Chinese women. CONCLUSIONS In the Chinese population, female short stature phenotype is related to increased DM risk, among which 157-158 cm may be the saturation effect point of female short stature for predicting DM risk.
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Affiliation(s)
- Wei Song
- Department of Endocrinology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Yaqin Hu
- Department of Endocrinology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Jiao Yuan
- Department of Endocrinology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Ying Wei
- Department of Pharmacy, Nanchang First Hospital, Nanchang, China
| | - Zongyou Cheng
- Department of Endocrinology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Jingdong Liu
- Department of Endocrinology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Jixiong Xu
- Department of Endocrinology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiaoyu Wang
- Department of Endocrinology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
- *Correspondence: Xiaoyu Wang,
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Relationship between age at menarche and risk of glucose metabolism disorder: a systematic review and dose-response meta-analysis. ACTA ACUST UNITED AC 2021; 27:818-826. [PMID: 32217891 DOI: 10.1097/gme.0000000000001529] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Studies investigating the impact of age at menarche on glucose metabolism disorder have reached inconsistent conclusions, and a quantitative comprehensive assessment of the dose-response association between age at menarche and glucose metabolism disorder has not been reported. We performed a systematic review and meta-analysis of studies assessing the risk of glucose metabolism disorder by age at menarche. METHODS MEDLINE via PubMed and EMBASE databases were searched up to March 13, 2019. Restricted cubic splines were used to model the dose-response association. RESULTS Twenty-five publications (including 34 studies) were included in the meta-analysis. The summary risk ratios (RRs) and 95% confidence limit (CL) per 1-year increase in age at menarche were 0.98 (95% CL 0.98, 0.99) for type 2 diabetes mellitus (T2DM), 0.97 (95% CL 0.96, 0.99) for impaired fasting glucose (IFG), and 0.98 (95% CL 0.97, 0.99) for gestational diabetes mellitus (GDM). We identified linear negative correlations between age at menarche and T2DM (Pnonlinearity = 0.052) and IFG (Pnonlinearity = 0.145), a nonlinear dose-response between age at menarche and GDM (Pnonlinearity = 0.038). CONCLUSIONS Older age at menarche (range 8-18 years old) is associated with reduced risk of glucose metabolism disorder. The strongest reduction in risk of GDM is observed at menarche age of 14.5 years.
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Adiposity and insulin resistance as mediators between age at menarche and type 2 diabetes mellitus. ACTA ACUST UNITED AC 2020; 27:579-585. [PMID: 32068689 DOI: 10.1097/gme.0000000000001504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study aimed to explore the association between age at menarche and type 2 diabetes mellitus (T2DM) and whether the association is mediated by adiposity and insulin resistance (IR) in rural Chinese women. METHODS This cross-sectional study analyzed data for 7,460 women (median age 56 y) from a rural Chinese area from 2013 to 2014. Data were collected by standardized interviews and anthropometric and laboratory measurements. Adiposity was measured by body mass index (BMI), and IR was measured by the homeostasis model assessment of IR (HOMA-IR) index. Multivariate logistic regression models were used to estimate odds ratios (ORs) and 95% confidence limits (CLs) for the association between age at menarche and T2DM. Mediation analysis was performed to explore the contribution of BMI and HOMA-IR to the association between age at menarche and T2DM. RESULTS Among 7,460 women, 840 (11.26%) had T2DM. After adjusting for potential confounding factors, the odds of T2DM with the latest age at menarche 18 years or older versus 13 years was reduced (OR = 0.65, 95% CL: 0.47, 0.91), and age at menarche was negatively associated with T2DM (per additional year of menarche, OR = 0.95, 95% CL: 0.91, 0.99). BMI and HOMA-IR completely mediated the association between age at menarche and T2DM (total indirect effect: OR = 0.973, 95% CL: 0.961, 0.986; direct effect: OR = 0.974, 95% CL: 0.930, 1.021). CONCLUSIONS Late menarche may be negatively associated with T2DM. The potential mechanism is adiposity and IR completely mediating the association between age at menarche and T2DM.
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Cheng TS, Day FR, Lakshman R, Ong KK. Association of puberty timing with type 2 diabetes: A systematic review and meta-analysis. PLoS Med 2020; 17:e1003017. [PMID: 31905226 PMCID: PMC6944335 DOI: 10.1371/journal.pmed.1003017] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 12/10/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Emerging studies have investigated the association between puberty timing, particularly age at menarche (AAM), and type 2 diabetes. However, whether this association is independent of adiposity is unclear. We aimed to systematically review published evidence on the association between puberty timing and type 2 diabetes (T2D) or impaired glucose tolerance (IGT), with and without adjustment for adiposity, and to estimate the potential contribution of puberty timing to the burden of T2D in the United Kingdom (UK). METHODS AND FINDINGS We searched PubMed, Medline, and Embase databases for publications until February 2019 on the timing of any secondary sexual characteristic in boys or girls in relation to T2D/IGT. Inverse-variance-weighted random-effects meta-analysis was used to pool reported estimates, and meta-regression was used to explore sources of heterogeneity. Twenty-eight observational studies were identified. All assessed AAM in women (combined N = 1,228,306); only 1 study additionally included men. In models without adjustment for adult adiposity, T2D/IGT risk was lower per year later AAM (relative risk [RR] = 0.91, 95% CI 0.89-0.93, p < 0.001, 11 estimates, n = 833,529, I2 = 85.4%) and higher for early versus later menarche (RR = 1.39, 95% CI 1.25-1.55, p < 0.001, 23 estimates, n = 1,185,444, I2 = 87.8%). Associations were weaker but still evident in models adjusted for adiposity (AAM: RR = 0.97 per year, 95% CI 0.95-0.98, p < 0.001, 12 estimates, n = 852,268, I2 = 51.8%; early menarche: RR = 1.19, 95% CI 1.11-1.28, p < 0.001, 21 estimates, n = 890,583, I2 = 68.1%). Associations were stronger among white than Asian women, and in populations with earlier average AAM. The estimated population attributable risk of T2D in white UK women due to early menarche unadjusted and adjusted for adiposity was 12.6% (95% CI 11.0-14.3) and 5.1% (95% CI 3.6-6.7), respectively. Findings in this study are limited by residual and unmeasured confounding, and self-reported AAM. CONCLUSIONS Earlier AAM is consistently associated with higher T2D/IGT risk, independent of adiposity. More importantly, this research has identified that a substantial proportion of T2D in women is related to early menarche, which would be expected to increase in light of global secular trends towards earlier puberty timing. These findings highlight the need to identify the underlying mechanisms linking early menarche to T2D/IGT risk.
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Affiliation(s)
- Tuck Seng Cheng
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom
| | - Felix R. Day
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom
| | - Rajalakshmi Lakshman
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom
| | - Ken K. Ong
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom
- Department of Paediatrics, University of Cambridge, Cambridge, United Kingdom
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Wittenbecher C, Kuxhaus O, Boeing H, Stefan N, Schulze MB. Associations of short stature and components of height with incidence of type 2 diabetes: mediating effects of cardiometabolic risk factors. Diabetologia 2019; 62:2211-2221. [PMID: 31501920 PMCID: PMC6861343 DOI: 10.1007/s00125-019-04978-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 07/16/2019] [Indexed: 01/30/2023]
Abstract
AIMS/HYPOTHESIS This study aimed to evaluate associations of height as well as components of height (sitting height and leg length) with risk of type 2 diabetes and to explore to what extent associations are explainable by liver fat and cardiometabolic risk markers. METHODS A case-cohort study within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study comprising 26,437 participants who provided blood samples was designed. We randomly selected a subcohort of 2500 individuals (2029 diabetes-free at baseline and with anamnestic, anthropometrical and metabolic data for analysis). Of the 820 incident diabetes cases identified in the full cohort during 7 years of follow-up, 698 remained for analyses after similar exclusions. RESULTS After adjustment for age, potential lifestyle confounders, education and waist circumference, greater height was related to lower diabetes risk (HR per 10 cm, men 0.59 [95% CI 0.47, 0.75] and women 0.67 [0.51, 0.88], respectively). Leg length was related to lower risk among men and women, but only among men if adjusted for total height. Adjustment for liver fat and triacylglycerols, adiponectin and C-reactive protein substantially attenuated associations between height and diabetes risk, particularly among women. CONCLUSIONS/INTERPRETATION We observed inverse associations between height and risk of type 2 diabetes, which was largely related to leg length among men. The inverse associations may be partly driven by lower liver fat content and a more favourable cardiometabolic profile.
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Affiliation(s)
- Clemens Wittenbecher
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Olga Kuxhaus
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Norbert Stefan
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Department of Internal Medicine, Division of Endocrinology, Diabetology, and Nephrology, University of Tübingen, Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Centre Munich at the University of Tübingen, Tübingen, Germany
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany.
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany.
- Institute of Nutritional Sciences, University of Potsdam, Nuthetal, Germany.
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Shrestha S, Rasmussen SH, Pottegård A, Ängquist LH, Jess T, Allin KH, Bjerregaard LG, Baker JL. Associations between adult height and type 2 diabetes mellitus: a systematic review and meta-analysis of observational studies. J Epidemiol Community Health 2019; 73:681-688. [DOI: 10.1136/jech-2018-211567] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BackgroundAlthough short adult height is generally associated with increased risks of type 2 diabetes mellitus (T2DM), there are large inconsistencies across studies. The aims of this study were to describe and quantify currently available evidence on the association between adult height and T2DM, to examine whether the reported associations differ by sex, and to examine the shapes of the height and T2DM associations.MethodsRelevant literature was identified using PubMed (1966–May 2018), EMBASE (1947–May 2018) and Google Scholar (May 2018). We identified cross-sectional and cohort studies with original publications on human subjects, which were included in a random-effects meta-analysis.ResultsFrom 15 971 identified sources, 25 studies met the inclusion criteria for the systematic review (N=401 562 individuals). From these 25 studies, 16 (9 cross-sectional studies and 7 cohort studies) were included in the meta-analysis (n=261 496 individuals). The overall random-effects meta-analysis indicated an inverse association between adult height and T2DM (effect estimate=0.88, 95% CI 0.81 to 0.95). No sex differences in the associations between adult height and T2DM were found (effect estimate for men: 0.86, 95% CI 0.75 to 0.99; effect estimate for women: 0.90; 95% CI 0.80 to 1.01; p value for sex interaction=0.80). Due to lack of data, results on the shape of the association between height and T2DM were inconclusive.ConclusionsShorter height is associated with an increased risk of T2DM and the association does not significantly differ by sex. The currently available data are insufficient to support conclusions regarding the shape of the association between height and T2DM.Trial registration numberCRD42017062446.
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Clatici VG, Voicu C, Voaides C, Roseanu A, Icriverzi M, Jurcoane S. Diseases of Civilization - Cancer, Diabetes, Obesity and Acne - the Implication of Milk, IGF-1 and mTORC1. MAEDICA 2018; 13:273-281. [PMID: 30774725 PMCID: PMC6362881 DOI: 10.26574/maedica.2018.13.4.273] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Nutrition and food are one of the most complex aspects of human lives, being influenced by biochemical, psychological, social and cultural factors. The Western diet is the prototype of modern dietary pattern and is mainly characterized by the intake of large amounts of red meat, dairy products, refined grains and sugar. Large amounts of scientific evidence positively correlate Western diet to acne, obesity, diabetes, heart disease and cancer, the so-called "diseases of civilization". The pathophysiological common ground of all these pathologies is the IGF-1 and mTORC pathways, which will be disscussed further in this paper.
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Affiliation(s)
| | | | | | - Anca Roseanu
- Department of Ligand-Receptor Interaction, Institute of Biochemistry of the Romanian Academy, Bucharest, Romania
| | - Madalina Icriverzi
- Department of Ligand-Receptor Interaction, Institute of Biochemistry of the Romanian Academy, Bucharest, Romania
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Shen C, Wen J, Pan X, Su J, Du W, Pan E, Zhang Q, Zhang N, Sheng H, Liu C, Wang H, Wu M, Qin Y. Age at menarche and age at natural menopause as predictors of glycemic control in type 2 diabetic patients. J Diabetes Complications 2018; 32:623-629. [PMID: 29884473 DOI: 10.1016/j.jdiacomp.2018.04.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 03/20/2018] [Accepted: 04/24/2018] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To investigate the influence of age at menarche (AM) and age at natural menopause (ANM) on glycemic control in patients with type 2 diabetes mellitus (T2DM). METHODS A cross-sectional study was undertaken in Jiangsu, China. Logistic regression was used to evaluate the association between AM/ANM and glycemic control. RESULTS 1195 (14.3%) premenopausal and 7149 (85.7%) postmenopausal women were included in this study. With the increase of AM per 1 year, patients had a low risk of uncontrolled FPG (≥7 mmol/L) and uncontrolled HbA1c (≥7%), as well as poor glycemic control (FPG ≥7 mmol/L and HbA1c ≥7%) after adjusting for age and BMI (model I, P < 0.05) with odds ratio (OR) 0.965, 0.978 and 0.962 respectively. Whereas after adjusting for age, BMI, education, duration of diabetes, smoking, drinking and antidiabetic treatment (model II) as well as further plus diabetic familial history and physical activity (model III), the association between AM and glycemic control was not significant (P > 0.05). Compared with premenopausal women, postmenopausal women had a low risk of uncontrolled FPG and uncontrolled HbA1c after adjusting for confounders in model II (P < 0.05). Furthermore, both patients with early ANM (<45 years) and late ANM (>55 years) had a high risk of uncontrolled HbA1c as well as poor glycemic control even adjusted for full confounders in model III (P < 0.05 for all). CONCLUSION Early AM, early and late ANM were significantly associated with worse glycemic control. Ascertaining the AM and ANM in women with T2DM may help to identify the risk predisposed to worse glycemic control.
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Affiliation(s)
- Chong Shen
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Jinbo Wen
- Department of Chronic Disease Prevention and Control, Huai'an City Center for Disease Control and Prevention, Huai'an 223001, China
| | - Xiaoqun Pan
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - Jian Su
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - Wencong Du
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - Enchun Pan
- Department of Chronic Disease Prevention and Control, Huai'an City Center for Disease Control and Prevention, Huai'an 223001, China
| | - Qin Zhang
- Department of Chronic Disease Prevention and Control, Huai'an City Center for Disease Control and Prevention, Huai'an 223001, China
| | - Ning Zhang
- Changshu County Center for Disease Control and Prevention, Suzhou 215500, China
| | - Hongyan Sheng
- Changshu County Center for Disease Control and Prevention, Suzhou 215500, China
| | - Chunlan Liu
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Hui Wang
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Ming Wu
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China.
| | - Yu Qin
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China.
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Early-life nutritional status and metabolic syndrome: gender-specific associations from a cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Public Health Nutr 2018; 21:1546-1553. [PMID: 29455688 DOI: 10.1017/s1368980017004256] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE In the present study we investigated gender-specific associations of low birth weight (LBW) and shorter relative leg length with metabolic syndrome (MetS) after adjusting for sociodemographic characteristics and health-related behaviours. We also investigated whether these associations are independent of age at menarche and BMI at 20 years old. DESIGN Cross-sectional analysis. SUBJECTS Baseline data from 12 602 participants (35-74 years) of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), 2008-2010. SETTING MetS was defined according to the revised National Cholesterol Education Program Adult Treatment Panel III guidelines. LBW (<2·5 kg) and age- and sex-standardized relative leg length (high, medium and low) were the explanatory variables studied. The strength of the associations between the explanatory variables and MetS was estimated by Poisson regression with robust variance. RESULTS MetS prevalence was 34·2 %; it was more prevalent in men (36·8 %) than in women (32·2 %). In multivariate analysis, LBW was associated (prevalence ratio; 95 % CI) with MetS only in women (1·28; 1·24, 1·45). Shorter leg length was associated with MetS in both men (1·21; 1·09, 1·35 and 1·46; 1·29, 1·65 for low and medium lengths, respectively) and women (1·12; 1·00, 1·25 and 1·40; 1·22, 1·59 for low and medium lengths, respectively). Additional adjustments for age at menarche and BMI at 20 years old did not change the associations. CONCLUSIONS Poor nutritional status as estimated by LBW and lower leg length in childhood was associated with a higher prevalence of MetS, although LBW was a significant factor only among women.
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Yang L, Li L, Peters SAE, Clarke R, Guo Y, Chen Y, Bian Z, Sherliker P, Yin J, Tang Z, Wang C, Wang X, Zhang L, Woodward M, Chen Z. Age at Menarche and Incidence of Diabetes: A Prospective Study of 300,000 Women in China. Am J Epidemiol 2018; 187:190-198. [PMID: 28605451 PMCID: PMC5860078 DOI: 10.1093/aje/kwx219] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 04/12/2017] [Indexed: 01/19/2023] Open
Abstract
Previous studies of predominantly Western populations have reported inconsistent associations between age at menarche and risk of diabetes. We examined this relationship among Chinese women, who generally experience menarche at a later age than Western women. In 2004–2008, China Kadoorie Biobank recruited 302,632 women aged 30–79 years from 10 areas across China, and recorded 5,391 incident cases of diabetes during 7 years of follow-up among 270,345 women without baseline diabetes, cardiovascular disease or cancer. Cox regression models yielded adjusted hazard ratios for incident diabetes associated with age at menarche. Overall, the mean age at menarche was 15.4 years, and decreased across successive generations. Age at menarche was linearly and inversely associated with incident diabetes, with adjusted hazard ratio of 0.96 (95% confidence interval (CI): 0.94, 0.97) per year delay. Hazard ratios were greater in younger generations (for women born in the 1960s–1970s, hazard ratio (HR) = 0.93, 95% CI: 0.90, 0.97; for women born in the 1950s, HR = 0.95, 95% CI: 0.93, 0.98; and for women born in the 1920s–1940s, HR = 0.97, 95% CI: 0.95, 0.99). Further adjustment for adulthood body mass index significantly attenuated the association (HR = 0.99, 95% CI: 0.97, 1.00), especially among those born before 1950 (HR = 1.00, 95% CI: 0.97, 1.02). Much of the inverse association between age at menarche and incident diabetes was mediated through increased adiposity associated with early menarche, especially in older generations.
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Affiliation(s)
- Ling Yang
- Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- Clinical Trial Service Unit and Epidemiological Studies Unit
| | - Liming Li
- Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China
- Department of Public Health, School of Public Health, Peking University, Beijing, China
| | - Sanne A E Peters
- The George Institute for Global Health, University of Oxford, Oxford, United Kingdom
| | - Robert Clarke
- Clinical Trial Service Unit and Epidemiological Studies Unit
| | - Yu Guo
- Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China
| | - Yiping Chen
- Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- Clinical Trial Service Unit and Epidemiological Studies Unit
| | - Zheng Bian
- Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China
| | - Paul Sherliker
- Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- Clinical Trial Service Unit and Epidemiological Studies Unit
| | - Jiyuan Yin
- Heilongjiang Center for Disease Control and Prevention
| | | | - Chunmei Wang
- Tongxiang CDC NCDs Prevention and Control Department, Tongxiang, Zhejiang, China
| | - Xiaohuan Wang
- Hainan CDC NCDs Prevention and Control Department, Haikou, Hainan, China
| | - Libo Zhang
- Liuyang CDC NCDs Prevention and Control Department, Liuyang, Hunan, China
| | - Mark Woodward
- The George Institute for Global Health, University of Oxford, Oxford, United Kingdom
- The George Institute for Global Health, University of Sydney, Australia
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit
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Farahmand M, Tehrani FR, Dovom MR, Azizi F. Menarcheal Age and Risk of Type 2 Diabetes: A Community-Based Cohort Study. J Clin Res Pediatr Endocrinol 2017; 9:156-162. [PMID: 27840328 PMCID: PMC5463289 DOI: 10.4274/jcrpe.3370] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 11/05/2016] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE It has been reported that early menarche is associated with higher risk for type 2 diabetes. We aimed to explore the association between age at menarche and risk of type 2 diabetes in a population-based cohort study. METHODS For the purpose of the present study, 5191 subjects of reproductive age who were participants of the Tehran Lipid and Glucose Study and also met the eligibility criteria were selected. Demographic, lifestyle, reproductive, and anthropometric data as well as risk factors for metabolic diseases were collected. Menarcheal age was categorized into five categories, as <11 years, 11-12 years, 13-14 years, 15-16 years, and >17 years. Diabetes and pre-diabetes were defined according to the American Diabetes Association criteria. Logistic regression analysis was used to assess the risk of the menarcheal age group for type 2 diabetes and pre-diabetes. RESULTS Of 5625 participants, 673 women had pre-diabetes and 187 had diabetes. Early menarche was associated with higher risk of diabetes and pre-diabetes, compared to the reference group (13-14 years), (OR=3.55, 95% CI: 1.6-7.8 and OR=2.55, 95% CI:1.4-4.8, respectively), an association which remained after further adjustment for potential confounders including family history of diabetes, parity, education, age, body mass index, waist circumference, smoking history, physical activity, and duration of oral contraceptives use. CONCLUSION Results showed early menarche to be a potential risk factor for type 2 diabetes and pre-diabetes.
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Affiliation(s)
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center,Research Institute for Endocrine Sciences,Shahid Beheshti University of Medical Sciences, Tehran, Iran Phone:+98 212 243 25 00 E-mail:
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Schoenaker DAJM, Mishra GD. Association Between Age at Menarche and Gestational Diabetes Mellitus: The Australian Longitudinal Study on Women's Health. Am J Epidemiol 2017; 185:554-561. [PMID: 28338812 DOI: 10.1093/aje/kww201] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 04/18/2016] [Indexed: 12/14/2022] Open
Abstract
In this study, we aimed to examine the association between age at menarche and gestational diabetes mellitus (GDM). Data were from 4,749 women participating in the Australian Longitudinal Study on Women's Health between 2000 and 2012. Age at menarche was reported at baseline in 2000 when women were aged 22-27 years. During 12 years of follow-up, information on GDM diagnosis was obtained for each live birth. Log-binomial regression analysis was used to estimate relative risks and 95% confidence intervals. Analyses adjusted for mother's highest completed educational qualification, nulliparity, polycystic ovary syndrome, physical activity, and body mass index. Mean age at menarche was 12.9 years (standard deviation, 1.4). A first diagnosis of GDM was reported by 357 women (7.5%). Compared with women with menarche at age 13 years, women who had their first menstruation at age ≤11 years had a 51% higher risk of developing GDM (95% confidence interval: 1.10, 2.07) after adjustment for GDM risk factors. Our findings indicate that a young age at menarche may identify women at higher risk of GDM. Further prospective studies are needed to confirm our findings and to elucidate the role of early-life exposures in age at menarche and subsequent GDM risk.
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Zheng Y, Zhang G, Chen Z, Zeng Q. Association between Age at Menarche and Cardiovascular Disease Risk Factors in China: A Large Population-Based Investigation. Cardiorenal Med 2016; 6:307-16. [PMID: 27648012 DOI: 10.1159/000445506] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 01/29/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The association between age at menarche (AAM) and cardiovascular disease (CVD) has previously been investigated with controversial results. The relationship between the psychological characteristic of AAM and many cardiovascular risk factors remains unclear. PURPOSE To assess the association between AAM and CVD risk factors in a large population. DESIGN AND SETTING 13,242 women aged 24-79 years were recruited from China mainland during 2009-2013 for a cross-sectional, population-based study to investigate the association between AAM and CVD risk factors. Information on AAM was obtained from self-report and information on CVD risk factors from physical examination. RESULTS In age-, body-mass-index- and height-adjusted analyses, AAM was positively associated with hypertension and 'college or above' educational level and incident CVD events. The adjusted odds ratios (ORs) and 95% confidence intervals for hypertension across AAM categories (≤12, 13-14, 15-16, and ≥17 years) were 0.820 (0.70-0.96), 0.82 (0.70-0.96), 0.88 (0.79-0.99) and 1 (referent), respectively; adjusted ORs for high educational level ('college or above') were 0.29 (0.24-0.34), 0.60 (0.41-0.51), 0.69 (0.62-0.76), and 1 (referent), respectively; adjusted ORs for incident CVD events were 0.18 (0.08-0.41), 0.18 (0.08-0.41), 0.62 (0.41-0.93), 1 (referent), respectively. CONCLUSIONS Earlier AAM were positively associated with incident CVD events, hypertension and 'college or above' educational level.
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Affiliation(s)
| | - Guilan Zhang
- Central Hospital of Xiaogan Health Examination, Tongji Medical College, Huazhong University of Science and Technology, Xiaogan, China
| | | | - Qiang Zeng
- Health Management Institute, Beijing China; Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing China
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Abstract
OBJECTIVE To review trends in the prevalence and incidence of diabetes mellitus (DM) and related risk factors in China. METHODS We searched the literature using PubMed, China Knowledge Resource Integrated Database, and China Wanfang Digital Database for large epidemiologic studies and national surveys. RESULTS During the past 30 years (1980-2010), 7 national diabetes mellitus surveys were conducted in China mainland, indicating that the prevalence of DM has increased 17-fold, from 0.67 to 11.6% of the population. The prevalence of impaired glucose regulation (IGR, including impaired fasting glucose and impaired glucose tolerance) also increased, from 2.09 in 1994 to 27.2% in 2010. There was no national representative study of the incidence of diabetes to date; the reported incidence of type 2 diabetes during past 25 years in several cohort studies varied (2.7 to 15.8 per 1,000 person-years). Potential risk factors which could have contributed to the increasing prevalence and incidence of DM and IGR in the Chinese population include social and economic development, urbanization, dietary pattern, and Westernized lifestyle. Further, genetic studies have suggested that unique inheritable risk factors in the Chinese population may increase the risk for DM when compared to Caucasians. CONCLUSION DM and IGR have become epidemic in China. Public health strategies should focus on modifying lifestyle and dietary factors, particularly among those with a susceptible genetic background. ABBREVIATIONS BMI = body mass index DM = diabetes mellitus FBG = fasting blood glucose GWAS = genome-wide association study IGR = impaired glucose regulation IGT = impaired glucose tolerance OGTT = oral glucose tolerance test T2D = type 2 diabetes WC = waist circumference WHR = waist-hip ratio.
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Affiliation(s)
- Xiuhua Shen
- Department of Clinical Nutrition, Shanghai Xin Hua Hospital, Shanghai, China
- Department of Nutrition, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Anand Vaidya
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital & Harvard Medical School, Boston, Massachusetts
| | - Shoulin Wu
- Department of Internal Medicine, Kailuan Hospital, Tangshan, China
| | - Xiang Gao
- Department of Nutritional Sciences, Pennsylvania State University, University Park, Pennsylvania
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Abstract
Objective Recent studies have demonstrated that earlier menarche is associated with increased risks of prediabetes and diabetes in white women; however, the associations have not been fully explored in Asian populations. We investigated the associations between age at menarche and prediabetes and/or diabetes in Korean middle-aged women. Methods This was a cross-sectional study of 2,039 premenopausal and postmenopausal women aged 44 to 56 years who visited the health promotion center for medical checkups. Participants were divided into three groups based on age at menarche: early (<13 y), average (13-16 y), and late (>16 y). Results The mean (SD) age at menarche was 14.6 (1.6) years. Of 2,039 women, 820 and 85 women had prediabetes (impaired fasting glucose and/or 5.7%-6.4% glycated hemoglobin) and diabetes, respectively. On logistic regression analysis, earlier menarche was significantly associated with prediabetes (odds ratio [OR], 1.80; 95% CI, 1.24-2.61; P = 0.002), diabetes (OR, 2.43; 95% CI, 1.04-5.69; P = 0.04), and dysglycemia (OR, 1.85; 95% CI, 1.28-2.66; P = 0.001), after adjusting for a number of confounding factors, compared with average age at menarche. On linear regression analysis, earlier age at menarche was significantly associated with increased fasting insulin, homeostatic model assessment for insulin resistance, homeostatic model assessment for β-cell function, body mass index, and waist circumference. Conclusions Age at menarche is inversely associated with various forms of dysglycemia. A history of earlier menarche may be helpful in predicting prediabetes and subsequent diabetes in Korean women.
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Abstract
PURPOSE OF REVIEW Human leg length is determined by a complex interplay of genetics and environmental exposures during development, which may be associated with long-term metabolic disease risk. Here, we review recent literature on the link between relative leg length and type 2 diabetes in more and less economically developed societies, wherein the contextual influences on relative leg length are unique. We also hypothesize mechanisms underlying and mediating this association. RECENT FINDINGS Evidence from more economically prosperous Western populations and contemporary adult populations in China and Brazil indicates that lower relative leg length is associated with greater risk for impaired glucose homeostasis and type 2 diabetes. In Brazil, this association was stronger among women with early menarche. Although still poorly defined and in need of further research, the potential mechanisms likely involve suboptimal early-life net nutrition that simultaneously leads to retarded growth and impaired glucose regulation. An untested hypothesis is that the association is mediated by differences in skeletal muscle mass. SUMMARY Epidemiologic evidence from diverse settings points to humans with shorter legs relative to their stature having higher risk for type 2 diabetes. Although research is needed to test mechanistic hypotheses, the greatest potential for improving public health will come through identification of, and intervention upon, the upstream modifiable determinants of inadequate leg growth.
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Affiliation(s)
- Noel T Mueller
- aDepartment of Epidemiology, Mailman School of Public Health bDepartment of Medicine, Columbia University Medical Center, College of Physicians and Surgeons, Institute of Human Nutrition, New York, New York cDivision of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
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Yang S, Jin Y, He Y, Jiang C, Cheng KK, Zhang W, Lam TH. Childhood Passive Smoking Exposure and Age at Menarche in Chinese Women Who Had Never Smoked: The Guangzhou Biobank Cohort Study. PLoS One 2015; 10:e0130429. [PMID: 26186646 PMCID: PMC4506068 DOI: 10.1371/journal.pone.0130429] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 05/07/2015] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE We examined the associations between childhood passive smoking exposure and age at menarche in women who had never smoked in southern China. METHODS Among 30,518 participants in Guangzhou Biobank Cohort Study (GBCS) from 2003-2008, 20,061 women who had never smoked and had complete outcome data were included. Childhood passive smoking exposure was defined as living with 1 or more smokers in the same household during childhood. Data on the number of smokers in the household and frequency of exposure (density and frequency) were also obtained. Age at menarche was measured as a continuous variable. RESULTS 11,379 (56.7%) participants were exposed to passive smoking during childhood. Compared to those with no passive smoking exposure during childhood, those with exposure ≥ 5 days/week had menarche 0.19 year (95% confidence interval (CI): 0.13-0.25) earlier on average. Those exposed to more than two smokers had menarche 0.38 year earlier (95% CI: 0.29-0.47). Childhood exposure was associated with early age at menarche (≤ 13 vs. >13 years), with an adjusted odds ratio of 1.34 (95% CI: 1.21-1.48) for high density, and 1.17 (95% CI: 1.09-1.26) for high frequency of exposure. CONCLUSION Childhood passive smoking exposure was associated with earlier age at menarche, with a dose-response relationship in Chinese women who had never smoked. If causal, the results support the promotion of smoking cessation in families with children, particularly young girls.
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Affiliation(s)
- Shanshan Yang
- Institute of Geriatrics, Chinese PLA General Hospital, Beijing, China
- Jinan Military Area CDC, Jinan, Shandong, 250014, China
| | - Yali Jin
- Guangzhou Number 12 People’s Hospital, Guangzhou, China
| | - Yao He
- Institute of Geriatrics, Chinese PLA General Hospital, Beijing, China
- Beijing Key Laboratory of Aging and Geriatrics, Chinese PLA General Hospital, Beijing, China
- State Key Laboratory of Kidney Disease, Chinese PLA General Hospital, Beijing, China
| | | | - Kar Keung Cheng
- Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, United Kingdom
| | - Weisen Zhang
- Guangzhou Number 12 People’s Hospital, Guangzhou, China
| | - Tai Hing Lam
- School of Public Health, the University of Hong Kong, Hong Kong, China
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Lim JS, Lee HS, Kim EY, Yi KH, Hwang JS. Early menarche increases the risk of Type 2 diabetes in young and middle-aged Korean women. Diabet Med 2015; 32:521-5. [PMID: 25441051 DOI: 10.1111/dme.12653] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/25/2014] [Indexed: 01/27/2023]
Abstract
AIMS To investigate the association between early menarche (menarche age < 12 years) and Type 2 diabetes mellitus in young and middle-aged Korean women. METHODS We analysed data for 4657 women aged 20-50 years from the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV) (2007-2009). RESULTS The prevalence of Type 2 diabetes was 2.8%. Women with early menarche had a higher prevalence of impaired fasting glucose than did women with later menarche (age ≥ 12 years) in the 20-30 age group (7.4% vs. 3.0%), and a higher prevalence of diabetes in the 30-40 (6.3% vs. 1.7%) and 40-50 (18.5% vs. 4.4%) age groups. The odds ratio (OR) of Type 2 diabetes in women with early menarche was 3.61 [95% confidence interval (CI), 1.90-6.88] after adjusting for age. In multivariate regression, the OR of Type 2 diabetes decreased to 2.52 (95% CI, 1.29-4.94) after further adjusting for BMI. However, the OR decreased to 2.04 (95% CI, 0.95-4.39) without significance after adjusting for HOMA-IR. CONCLUSIONS Early menarche increased the risk of Type 2 diabetes in young and middle-aged Korean women although adulthood adiposity attenuated the relationship. Knowledge of age at menarche is important in identifying women at risk for diabetes.
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Affiliation(s)
- J S Lim
- Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea
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Hwang E, Lee KW, Cho Y, Chung HK, Shin MJ. Association between age at menarche and diabetes in Korean post-menopausal women: results from the Korea National Health and Nutrition Examination Survey (2007-2009). Endocr J 2015; 62:897-905. [PMID: 26194132 DOI: 10.1507/endocrj.ej15-0192] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Early menarche is known to be associated with diabetes, however this association remains controversial. Our study aimed to investigate the possible association between age at menarche and diabetes prevalence in post-menopausal Korean women. This study included 3,254 post-menopausal Korean women aged 50-85 years from the Korea National Health and Nutrition Examination Survey IV (KNHANES 2007-2009). Logistic regression analyses were used to estimate odds ratios (ORs) for diabetes prevalence. Levels of biochemical markers were compared according to groups by age at menarche. Women in the earlier menarche age group (10-12 years) showed higher levels of fasting blood glucose (FBG) and scores of homeostatic model assessment in the insulin resistance (HOMA-IR) index than other groups (p <0.05). After adjusting for potential confounding factors, early age at menarche was significantly associated with a higher prevalence of diabetes (OR 1.86, 95% confidence intervals [CI] 1.07-3.23). The observed association remained significant despite additional adjustment for body mass index and waist circumference (OR 1.82, 95% CI 1.03-3.23) and despite further adjustments for FBG levels and HOMA-IR index (OR 2.25, 95% CI 1.11-4.55). Our findings strengthen the hypothesis that younger age at menarche is associated with increased diabetes prevalence in the Korean population.
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Affiliation(s)
- Eunjung Hwang
- Department of Food and Nutrition, Korea University, Seoul 136-713, Republic of Korea
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Mueller NT, Duncan BB, Barreto SM, Chor D, Vigo A, Aquino EML, Demerath EW, Schmidt MI. Relative leg length is associated with type 2 diabetes differently according to pubertal timing: the Brazilian longitudinal study of adult health. Am J Hum Biol 2014; 27:219-25. [PMID: 25327531 DOI: 10.1002/ajhb.22641] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 09/15/2014] [Accepted: 09/18/2014] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES Studies from developed societies have shown that individuals with short legs relative to height have higher risk of type 2 diabetes. This has been much less explored in less developed populations where influences on relative leg length and diabetes may differ. The Brazilian Longitudinal Study of Adult Health (in Portuguese, ELSA-Brasil) allows us to test, in a cohort born (1934-1975) and raised when undernutrition was common, whether short legs relative to height is positively associated with diabetes, independent of early-life factors, including birth weight, age at menarche, and young-adult BMI. METHODS We used baseline, cross-sectional data from 15,105 participants aged 35-74 years participating in ELSA-Brasil. We created age-and-sex-specific Z scores for leg length index (leg length/height × 100) according to an external reference. Diabetes was defined by self-reported physician diagnosis, medication use, fasting and 2-h post-75-g-load glucose, and A1C. RESULTS A one-unit decrement in leg-length-index Z score was associated with 12% (8-17%) higher prevalence of diabetes in Brazilian adults, after adjustment through Poisson regression for confounders, including race, maternal education, and birth weight. This association persisted after further adjustment for menarche age, BMI (at age 20), buttocks circumference, and waist circumference. It was stronger among women with early menarche (P interaction = 0.02). Leg length index was also inversely associated with fasting glucose, fasting insulin, 2-h glucose, and A1C (P < 0.05). CONCLUSIONS In contemporary Brazilian adults, short legs relative to height is positively associated with diabetes independent of measures of intrauterine growth, pubertal timing, and young-adult adiposity. This association is stronger in women with early menarche.
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Affiliation(s)
- Noel T Mueller
- Postgraduate Studies Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York, New York; Institute of Human Nutrition and Department of Medicine, College of Physicians and Surgeons, Columbia University Medical Center, New York, New York
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Janghorbani M, Mansourian M, Hosseini E. Systematic review and meta-analysis of age at menarche and risk of type 2 diabetes. Acta Diabetol 2014; 51:519-28. [PMID: 24671509 DOI: 10.1007/s00592-014-0579-x] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Accepted: 03/08/2014] [Indexed: 11/27/2022]
Abstract
The relation of early menarche with type 2 diabetes mellitus (T2DM) remains inconsistent across studies. The objective of this systematic review and meta-analysis of published population-based observational studies was to assess the association between age at menarche and T2DM risk. We searched online data bases through December 2013 and examined the reference lists of pertinent articles. Summary relative risks (RRs) with 95 % confidence intervals (CIs) were calculated with a random-effects model. A total of 14 effect estimates from 10 eligible studies (three cross-sectional and seven cohort studies) included 315,428 participants and 22,085 cases of T2DM. Compared with the highest or middle category, women in the lowest category of age at menarche had higher risk of T2DM [summary RR (95 % CI) 1.22 (1.17, 1.28)]. These results were consistent between studies that conducted in the United States and in Europe. The association between age at menarche and T2DM was slightly stronger for cohort than for cross-sectional studies. These findings strongly support an association between younger age at menarche and increased risk of T2DM. Age at menarche may help identify women with increased risk of developing T2DM.
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Affiliation(s)
- Mohsen Janghorbani
- Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Esfahān, Iran,
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Mueller NT, Duncan BB, Barreto SM, Chor D, Bessel M, Aquino EML, Pereira MA, Schmidt MI. Earlier age at menarche is associated with higher diabetes risk and cardiometabolic disease risk factors in Brazilian adults: Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Cardiovasc Diabetol 2014; 13:22. [PMID: 24438044 PMCID: PMC3899384 DOI: 10.1186/1475-2840-13-22] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Accepted: 01/13/2014] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES Early menarche has been linked to higher risk of type 2 diabetes in Western and Asian societies, yet whether age at menarche is associated with diabetes in Latin America, where puberty and diabetes may have different life courses, is unknown. We tested the hypothesis that earlier menarche is associated with higher diabetes risk in Brazilian adults. METHODS We used data from 8,075 women aged 35-74 years in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) who had complete information on age at menarche, diabetes status, and covariates. Diabetes was defined based on self-reported physician diagnosis, medication use, and laboratory variables (fasting glucose, 2-hour glucose, and glycated hemoglobin). Poisson regression was used to generate risk ratios (RR) and 95% confidence intervals (CI). RESULTS Menarche onset < 11 years [vs. 13-14 years (referent)] was associated with higher risk of diabetes (RR = 1.34; 95% CI: 1.14-1.57) after adjusting for sociodemographic factors, maternal education, maternal and paternal diabetes, and birth weight. This persisted after further control for BMI at age 20 years and relative leg length. Additionally, among those not taking diabetes medications, earlier menarche [<11 years vs. 13-14 years (referent)] was associated with higher % glycated hemoglobin (p < 0.001), alanine aminotransferase (p < 0.001), triglycerides (p < 0.001), C-reactive protein (p = 0.003), waist circumference (p < 0.001), and BMI measured at baseline exam (p < 0.001). CONCLUSION These findings support the hypothesis that earlier menarche is associated with greater risk for adult diabetes and cardiometabolic disease in the Brazilian context.
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Affiliation(s)
- Noel T Mueller
- Postgraduate Studies Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos n, 2600, sala 414, Porto Alegre, Rio Grande do Sul, Porto Alegre 90035-003, Brazil.
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Johnston LW, Harris SB, Retnakaran R, Gerstein HC, Zinman B, Hamilton J, Hanley AJ. Short leg length, a marker of early childhood deprivation, is associated with metabolic disorders underlying type 2 diabetes: the PROMISE cohort study. Diabetes Care 2013; 36:3599-606. [PMID: 24089539 PMCID: PMC3816896 DOI: 10.2337/dc13-0254] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Short leg length, a marker of early childhood deprivation, has been used in studies of the association of early life conditions with adult chronic disease risk. The objective of this study was to determine the cross-sectional associations of leg length with measures of insulin sensitivity and β-cell function. RESEARCH DESIGN AND METHODS Subjects (n = 462) at risk for type 2 diabetes were recruited into the PROspective Metabolism and ISlet cell Evaluation (PROMISE) longitudinal cohort. Leg length was calculated from sitting and standing height at the 3-year clinical examination. Glucose tolerance status was determined using an oral glucose tolerance test. Insulin sensitivity was assessed using homeostasis model assessment of insulin resistance (HOMA-IR) and the Matsuda insulin sensitivity index (ISI), while the insulinogenic index over HOMA-IR (IGI/IR) and the insulin secretion sensitivity index 2 (ISSI-2) determined β-cell function. Multiple linear regression analysis was conducted, adjusting for covariates including age, sex, ethnicity, family history of diabetes, waist, and weight. RESULTS Leg length and leg-to-height ratio were significantly associated with HOMA-IR (β = -0.037, β = -10.49, respectively; P < 0.0001), ISI (β = 0.035, β = 8.83, respectively; P < 0.0001), IGI/IR (β = 0.021, P < 0.05; β = 7.60, P < 0.01, respectively), and ISSI-2 (β = 0.01, P < 0.03; β = 3.34, P < 0.01, respectively) after adjustment for covariates. The association of shorter leg length with lower insulin sensitivity was most evident for those with high waist circumferences. CONCLUSIONS Shorter legs were independently associated with lower insulin sensitivity and β-cell function, suggesting that early childhood deprivation may increase the risk of developing diabetes.
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Melnik BC, Schmitz G, John S, Carrera-Bastos P, Lindeberg S, Cordain L. Metabolic effects of milk protein intake strongly depend on pre-existing metabolic and exercise status. Nutr Metab (Lond) 2013; 10:60. [PMID: 24225036 PMCID: PMC3856498 DOI: 10.1186/1743-7075-10-60] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 09/28/2013] [Indexed: 02/08/2023] Open
Abstract
Milk protein intake has recently been suggested to improve metabolic health. This Perspective provides evidence that metabolic effects of milk protein intake have to be regarded in the context of the individual’s pre-existing metabolic and exercise status. Milk proteins provide abundant branched-chain amino acids (BCAAs) and glutamine. Plasma BCAAs and glutamine are increased in obesity and insulin resistance, but decrease after gastric bypass surgery resulting in weight loss and improved insulin sensitivity. Milk protein consumption results in postprandial hyperinsulinemia in obese subjects, increases body weight of overweight adolescents and may thus deteriorate pre-existing metabolic disturbances of obese, insulin resistant individuals.
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Talaei M, Sadeghi M, Marshall T, Thomas G, Iranipour R, Nazarat N, Sarrafzadegan N. Anthropometric indices predicting incident type 2 diabetes in an Iranian population: The Isfahan Cohort Study. DIABETES & METABOLISM 2013; 39:424-31. [PMID: 23867722 DOI: 10.1016/j.diabet.2013.04.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Revised: 03/11/2013] [Accepted: 04/07/2013] [Indexed: 12/20/2022]
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