1
|
Lin T, Zhao Y, Yang Q, Wang W, Jiang X, Qiu Y. Association between blood lipids and diabetes mellitus in older Chinese adults aged 65 years or older: a cross-sectional analysis of residents' electronic health records. Lipids Health Dis 2024; 23:167. [PMID: 38835037 PMCID: PMC11149314 DOI: 10.1186/s12944-024-02160-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 05/24/2024] [Indexed: 06/06/2024] Open
Abstract
AIM This study aimed to investigate how blood lipids are associated with diabetes among older Chinese adults. METHODS 3,268,928 older Chinese adults without known diabetes were included. Logistic regression and restricted cubic spline (RCS) models were conducted to study associations between blood lipids (total cholesterol [TC], triglycerides [TG], low-density lipoprotein cholesterol [LDL-C], and high-density lipoprotein cholesterol [HDL-C]) and diabetes. RESULTS 202,832 diabetes cases were included. Compared with the lowest quintiles, TC, TG, and LDL-C in the highest quintiles showed a higher diabetes prevalence risk and HDL-C presented a lower risk in multivariate-adjusted logistic regression models. Odds ratios (ORs) and 95% confidence intervals (95% CIs) for the highest quintiles of TC, TG, and HDL-C were 1.39 (1.37-1.41), 2.56 (2.52-2.60), and 0.73 (0.72-0.74), respectively. For LDL-C, 3-5% lower risk was found in the second and third quintiles, and 4-23% higher risk was found in the fourth and fifth quintiles. RCS curves showed a non-linear relationship between each blood lipid parameters and diabetes (P-non-linear < 0.001). TG and HDL-C curves presented monotonically increasing and L-shaped patterns, respectively, whereas TC and LDL-C curves exhibited a J-shaped pattern. When TC < 4.04 mmol/L or LDL-C < 2.33 mmol/L, ORs of diabetes increased with the decrease of corresponding indexes. However, after excluding participants with lower LDL-C, the J-shaped association with TC disappeared. CONCLUSIONS This study demonstrates non-linear associations between lipids and diabetes. Low cholesterol levels are associated with a high risk of diabetes. The cholesterol paradox should be considered during lipid-lowering treatments.
Collapse
Affiliation(s)
- Tianxiang Lin
- Zhejiang Provincial Center for Disease Control and Prevention, Dept. of Public Health Surveillance & Advisory, No.3399. Binsheng Road, Binjiang district, Hangzhou, 310051, PR China
| | - Yanrong Zhao
- Zhejiang Provincial Center for Disease Control and Prevention, Dept. of Public Health Surveillance & Advisory, No.3399. Binsheng Road, Binjiang district, Hangzhou, 310051, PR China
| | - Qing Yang
- Zhejiang Provincial Center for Disease Control and Prevention, Dept. of Public Health Surveillance & Advisory, No.3399. Binsheng Road, Binjiang district, Hangzhou, 310051, PR China
| | - Wei Wang
- Zhejiang Provincial Center for Disease Control and Prevention, Dept. of Public Health Surveillance & Advisory, No.3399. Binsheng Road, Binjiang district, Hangzhou, 310051, PR China
| | - Xuewen Jiang
- Zhejiang Provincial Center for Disease Control and Prevention, Dept. of Public Health Surveillance & Advisory, No.3399. Binsheng Road, Binjiang district, Hangzhou, 310051, PR China
| | - Yinwei Qiu
- Zhejiang Provincial Center for Disease Control and Prevention, Dept. of Public Health Surveillance & Advisory, No.3399. Binsheng Road, Binjiang district, Hangzhou, 310051, PR China.
| |
Collapse
|
2
|
Li B, Zhu G, Kang P, Chen J, He K, Wang X, Gao T, Li C, Li S. Influences of vitiligo-associated characteristics on the occurrence of diabetes mellitus: Interactive analysis of a cross-sectional study. Exp Dermatol 2023; 32:1805-1814. [PMID: 37584091 DOI: 10.1111/exd.14904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 07/02/2023] [Accepted: 07/24/2023] [Indexed: 08/17/2023]
Abstract
The risk of diabetes mellitus (DM) in vitiligo patients is higher than that in non-vitiligo population. Our goal was to explore the influencing factors for DM in vitiligo patients. A matched-pair design of 107 cases with DM and 428 controls without DM was conducted among vitiligo patients in Xijing hospital from January 2010 to October 2021. The baseline characteristics of patients were analysed based on standard descriptive statistics. The vitiligo-associated characteristics were analysed by logistic regression to identify influencing factors of DM. Interaction analysis was performed to explore the additive interactions between vitiligo-associated characteristics and baseline characteristics. After adjustment for the baseline characteristics, the severity of vitiligo [odds ratio (OR) = 2.47, 95% confidence interval (CI): 1.47-4.14] and onset age of vitiligo (OR = 0.98, 95% CI: 0.97-0.99) had a significant correlation with occurrence of DM. The severity of vitiligo had additive interaction with family history of diabetes [relative excess risk due to interaction (RERI) = 132.51 (95% CI: 5.51-1100.20), attributable proportion (AP) = 0.91 (95% CI: 0.17-0.95), synergy index (S) = 11.53 (95% CI: 1.32-100.5)] and with smoking history [RERI = 6.54 (95% CI: 0.67-19.83), AP = 0.64 (95% CI: 0.04-0.80), S = 3.48 (95% CI: 1.17-10.36)]. Earlier onset age of vitiligo and greater BSA involvement might be two independent risk factors for DM in vitiligo patients. Interaction assessment identified the severity of vitiligo as additive interaction factors with diabetes family history and with smoking history for the DM occurrence.
Collapse
Affiliation(s)
- Baizhang Li
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University Xi'an, Shaanxi, China
| | - Guannan Zhu
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University Xi'an, Shaanxi, China
| | - Pan Kang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University Xi'an, Shaanxi, China
| | - Jianru Chen
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University Xi'an, Shaanxi, China
| | - Kaiqiao He
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University Xi'an, Shaanxi, China
| | - Xinju Wang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University Xi'an, Shaanxi, China
| | - Tianwen Gao
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University Xi'an, Shaanxi, China
| | - Chunying Li
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University Xi'an, Shaanxi, China
| | - Shuli Li
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University Xi'an, Shaanxi, China
| |
Collapse
|
3
|
Huo W, Hou J, Nie L, Mao Z, Liu X, Chen G, Xiang H, Li S, Guo Y, Wang C. Combined effects of air pollution in adulthood and famine exposure in early life on type 2 diabetes. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:37700-37711. [PMID: 35066828 DOI: 10.1007/s11356-021-18193-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Abstract
Famine exposure or air pollution is linked to type 2 diabetes mellitus (T2DM). However, their combined effects on T2DM remain largely unknown. A total of 11,640 individuals were obtained from the Henan Rural Cohort Study. According to their birthdate, participants were divided into three famine exposure subgroups: fetal exposed, childhood exposed, and unexposed groups. The air pollutants (particles with aerodynamics diameters ≤ 1.0 µm (PM1), ≤ 2.5 µm, and ≤ 10 µm, and nitrogen dioxide) concentrations of each individual were estimated by a spatiotemporal model. Participants were divided into low or high air pollution exposure groups taking the 1st quartile value of air pollutants as the cut-off point. Logistic regression model was used to analyze independent and joint associations between air pollution exposure, famine exposure, and T2DM. Positive associations of air pollution and famine exposure with T2DM were found. Participants who experienced fetal or childhood famine and also were exposed to high concentrations of any kind of the air pollutants had a much higher risk for T2DM than those with no famine and low air pollutants exposure (taking PM1.0 for example, the odds ratio [OR]: 1.76, 95% confidence interval [CI]: 1.25, 2.47 for fetal famine, and OR: 1.64, 95%CI: 1.13, 2.40 for childhood famine). After stratified analysis, similar results were observed in women. The results indicated that both famine exposure in early life and air pollution exposure in adulthood are related to increased risk for prevalent T2DM, and they have combined effects on T2DM.
Collapse
Affiliation(s)
- Wenqian Huo
- Department of Occupational and Environmental Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue Henan, Zhengzhou, 450001, PR China
| | - Luting Nie
- Department of Occupational and Environmental Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Zhenxing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue Henan, Zhengzhou, 450001, PR China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue Henan, Zhengzhou, 450001, PR China
| | - Gongbo Chen
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, PR China
| | - Hao Xiang
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, PR China
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yuming Guo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue Henan, Zhengzhou, 450001, PR China.
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue Henan, Zhengzhou, 450001, PR China.
| |
Collapse
|
4
|
Lim JE, Kang JO, Ha TW, Jung HU, Kim DJ, Baek EJ, Kim HK, Chung JY, Rhee SY, Kim MK, Kim YJ, Park T, Oh B. Gene-environment interaction in type 2 diabetes in Korean cohorts: Interaction of a type 2 diabetes polygenic risk score with triglyceride and cholesterol on fasting glucose levels. Genet Epidemiol 2022; 46:285-302. [PMID: 35481584 DOI: 10.1002/gepi.22454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 02/18/2022] [Accepted: 03/15/2022] [Indexed: 11/08/2022]
Abstract
Type 2 diabetes (T2D) is caused by genetic and environmental factors as well as gene-environment interactions. However, these interactions have not been systematically investigated. We analyzed these interactions for T2D and fasting glucose levels in three Korean cohorts, HEXA, KARE, and CAVAS, using the baseline data with a multiple regression model. Two polygenic risk scores for T2D (PRST2D ) and fasting glucose (PRSFG ) were calculated using 488 and 82 single nucleotide polymorphisms (SNP) for T2D and fasting glucose, respectively, which were extracted from large-scaled genome-wide association studies with multiethnic data. Both lifestyle risk factors and T2D-related biochemical measurements were assessed. The effect of interactions between PRST2D -triglyceride (TG) and PRST2D -total cholesterol (TC) on fasting glucose levels was observed as follows: β ± SE = 0.0005 ± 0.0001, p = 1.06 × 10-19 in HEXA, β ± SE = 0.0008 ± 0.0001, p = 2.08 × 10-8 in KARE for TG; β ± SE = 0.0006 ± 0.0001, p = 2.00 × 10-6 in HEXA, β ± SE = 0.0020 ± 0.0004, p = 2.11 × 10-6 in KARE, β ± SE = 0.0007 ± 0.0004, p = 0.045 in CAVAS for TC. PRST2D -based classification of the participants into four groups showed that the fasting glucose levels in groups with higher PRST2D were more adversely affected by both the TG and TC. In conclusion, blood TG and TC levels may affect the fasting glucose level through interaction with T2D genetic factors, suggesting the importance of consideration of gene-environment interaction in the preventive medicine of T2D.
Collapse
Affiliation(s)
- Ji Eun Lim
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Ji-One Kang
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Tae-Woong Ha
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Hae-Un Jung
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Dong Jun Kim
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Eun Ju Baek
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Han Kyul Kim
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Ju Yeon Chung
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Sang Youl Rhee
- Department of Endocrinology and Metabolism, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Mi Kyung Kim
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea.,Institute for Health and Society, Hanyang University, Seoul, Republic of Korea
| | - Yeon-Jung Kim
- Division of Biobank for Health Science, Center for Genome Science, Korea National Institute of Health, Chungcheongbuk-do, Republic of Korea
| | - Taesung Park
- Department of Statistics, Seoul National University, Seoul, Republic of Korea
| | - Bermseok Oh
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| |
Collapse
|
5
|
Pham DD, Song J, Jeon Y, Hajar I, Leem CH. Variability, Mean, and Baseline Values of Metabolic Parameters in Predicting Risk of Type 2 Diabetes. J Clin Endocrinol Metab 2022; 107:1270-1279. [PMID: 35026007 DOI: 10.1210/clinem/dgac017] [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: 09/30/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT The effect of baseline (B) and alteration of metabolic parameters (MPs), including plasma glucose (PG) testing, insulin resistance surrogates, and lipid profile and their mutual interactions on the development of type 2 diabetes mellitus (T2DM), has not been investigated systematically. OBJECTIVE To access the association of the past variability (V), past mean (M), and B values of various MPs and their mutual interaction with the risk of T2DM. METHODS A community-based, longitudinal analysis was conducted using the Korean Genome and Epidemiology Study comprising 3829 nondiabetic participants with completed MPs measurements during 3 biannually visits who were followed over the next 10 years. Outcomes included the incidence of T2DM during follow-up. RESULTS Among predictors, PG concentrations measured during the oral glucose tolerance test were the most prominent T2DM determinants, in which the M of the average value of fasting PG (FPG), 1-hour, and 2-hour PGs had the strongest discriminative power (hazard ratios and 95% CI for an increment of SD: 3.00 (2.5-3.26), AUC: 0.82). The M values of MPs were superior to their B and V values in predicting T2DM, especially among postload PGs. Various mutual interactions between indices and among MPs were found. The most consistent interactants were the M values of high-density lipoprotein cholesterol and the M and V values of FPG. The findings were similar in normal glucose tolerance participants and were confirmed by sensitivity analyses. CONCLUSION Postload PG, past alteration of measurements, and mutual interactions among indices of MPs are important risk factors for T2DM development.
Collapse
Affiliation(s)
- Duong Duc Pham
- Department of Physiology, University of Ulsan College of Medicine, Songpa-gu, Seoul 05505, Republic of Korea
| | - Jaekyung Song
- Department of Physiology, University of Ulsan College of Medicine, Songpa-gu, Seoul 05505, Republic of Korea
| | - Yunwan Jeon
- Department of Physiology, University of Ulsan College of Medicine, Songpa-gu, Seoul 05505, Republic of Korea
| | - Ibrahimi Hajar
- Department of Physiology, University of Ulsan College of Medicine, Songpa-gu, Seoul 05505, Republic of Korea
| | - Chae Hun Leem
- Department of Physiology, University of Ulsan College of Medicine, Songpa-gu, Seoul 05505, Republic of Korea
| |
Collapse
|
6
|
Shrestha N, Karki K, Poudyal A, Aryal KK, Mahato NK, Gautam N, Kc D, Gyanwali P, Dhimal M, Jha AK. Prevalence of diabetes mellitus and associated risk factors in Nepal: findings from a nationwide population-based survey. BMJ Open 2022; 12:e060750. [PMID: 35193925 PMCID: PMC8867329 DOI: 10.1136/bmjopen-2022-060750] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES The burden of diabetes mellitus (DM) has increased globally, particularly in low-income and middle-income countries, including Nepal. Population-based nationally representative data on the prevalence of DM is limited. This paper presents the prevalence of DM and its associated risk factors in Nepal. RESEARCH DESIGNS AND METHODS This population-based study sampled 13 200 participants aged 20 years and above in 400 clusters of 72 districts of Nepal. The study used a standardised questionnaire adapted from the WHO STEPwise approach to non-communicable disease risk factor surveillance instrument and digitalised in Android-compatible mobile phones. Fasting and 2 hours postprandial blood samples were taken to test various biochemical parameters. Descriptive followed by multivariate analyses were done to assess the association between explanatory variables and the outcome variable. PRIMARY OUTCOME MEASURES Prevalence of DM. RESULTS The prevalence of DM was found to be 8.5% (95% CI 7.8% to 9.3%). The odds of DM occurrence were higher in the upper age groups (40-59 years at adjusted OR (AOR) 3.1 (95% CI2.3 to 4.2) and 60+ years at AOR 4.7 (95% CI 3.3 to 6.6)), compared with the group aged 20-39 years. Men were found to have higher odds of DM (AOR 1.3, 95% CI 1.1 to 1.6) compared with women. Urban residents had almost twice higher odds of DM (AOR 1.7, 95% CI 1.4 to 2.2) compared with rural residents. Participants with raised blood pressure (BP) (AOR 2.2, 95% CI 1.8 to 2.7), those who were overweight and obese (AOR 2.0, 95% CI 1.6 to 2.4) and those who had high triglycride level (≥150 mg/dL) (AOR 2.1, 95% CI 1.8 to 2.6) also had twice higher odds of DM compared with those with normal BP, an average body mass index and normal triglyceride level, respectively. CONCLUSIONS Targeted interventions to higher risk groups as well as prevention and control of other associated biological risk factors might help to reduce the prevalence of DM in Nepal.
Collapse
Affiliation(s)
- Namuna Shrestha
- Research Section, Nepal Health Research Council, Kathmandu, Nepal
| | - Khem Karki
- Department of Community Medicine, Maharajgunj Medical Campus, Kathmandu, Nepal
| | - Anil Poudyal
- Research Section, Nepal Health Research Council, Kathmandu, Nepal
| | - K K Aryal
- Public Health Promotion and Development Organization, Kathmandu, Nepal
| | | | - Nitisha Gautam
- Research Section, Nepal Health Research Council, Kathmandu, Nepal
| | - Dirghayu Kc
- Public Health Promotion and Development Organization, Kathmandu, Nepal
| | - Pradip Gyanwali
- Research Section, Nepal Health Research Council, Kathmandu, Nepal
| | - Meghnath Dhimal
- Research Section, Nepal Health Research Council, Kathmandu, Nepal
| | - Anjani Kumar Jha
- Research Section, Nepal Health Research Council, Kathmandu, Nepal
| |
Collapse
|
7
|
Charoensri S, Turnsaket S, Pongchaiyakul C. Hypertriglyceridemia as an Independent Predictor for Ten-Year Incidence of Diabetes in Thais. Vasc Health Risk Manag 2021; 17:519-525. [PMID: 34511921 PMCID: PMC8412820 DOI: 10.2147/vhrm.s326500] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 08/05/2021] [Indexed: 12/26/2022] Open
Abstract
Background Fasting hypertriglyceridemia commonly associates with insulin resistance and is frequently prevalent in type 2 diabetes mellitus (DM). However, hypertriglyceridemia has not been investigated as an independent predictor of incidence of DM, especially in Thais. Methods A 10-year hospital-based retrospective cohort study was conducted in a tertiary care setting in Thailand. Health check-up data in 2007 from healthy participants without underlying disease were extracted as baseline data. In 2017, 10 years following an initial examination, the diagnosis of DM and other laboratory data were identified. Hypertriglyceridemia was defined as fasting triglyceride level ≥ 150 mg/dL. A generalized additive model (GAM) was applied to demonstrate a relationship between fasting TG level and probability of incident DM in 10 years. An association between hypertriglyceridemia and 10-year incidence of DM was evaluated using univariable and multivariable logistic regression analysis. Results A total of 1342 non-diabetic adults with complete both baseline and 10-year follow-up data were included in the analysis. The incidence of DM in the study period was 10.3%. Baseline fasting triglyceride level is significantly higher in participants with incidence of DM, with a median difference of 45 mg/dL (P < 0.01). Univariable logistic regression showed that hypertriglyceridemia was associated with 10-year incidence of DM (odds ratio (OR) 3.03, 95% CI 2.12–4.35). After adjusting for potential confounders, hypertriglyceridemia remained significantly associated with incidence of DM (OR 2.33, 95% CI 1.61–3.39). Conclusion Fasting triglyceride level is an independent risk factor for the development of new-onset DM. Testing for hypertriglyceridemia in people without diabetes may be an alternative screening tool to identify populations at risk of developing future DM, as well as providing triglyceride as a new target for DM risk reduction.
Collapse
Affiliation(s)
- Suranut Charoensri
- Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Supatida Turnsaket
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Chatlert Pongchaiyakul
- Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| |
Collapse
|
8
|
Risk Factors of Undiagnosed Diabetes Mellitus among Korean Adults: A National Cross-Sectional Study Using the KNHANES Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031195. [PMID: 33572855 PMCID: PMC7908078 DOI: 10.3390/ijerph18031195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 01/22/2021] [Accepted: 01/23/2021] [Indexed: 11/17/2022]
Abstract
In this cross-sectional study, we investigated the baseline risk factors of diabetes mellitus (DM) in patients with undiagnosed DM (UDM). We utilized the Korean National Health and Nutrition Examination Survey (KNHANES) 2010–2017 data. Data regarding the participants’ demographic characteristics, health status, health determinants, healthcare accessibility, and laboratory tests were gathered to explore the differences between the DM, UDM, and without-DM groups. Among the 64,759 individuals who participated in the KNHANES 2010–2017, 32,611 individuals aged ≥20 years with fasting plasma glucose levels of <100 or ≥126 mg/dL were selected. The odds ratios (ORs) regarding family history of diabetes and the performance of national health and cancer screening tests were lower in the UDM group than in the DM group (adjusted OR: 0.54; 95% confidence interval (CI): 0.43, 0.66; adjusted OR: 0.74; 95% CI: 0.62, 0.89; adjusted OR: 0.71; 95% CI: 0.60, 0.85). The ORs of hypertension and obesity were higher in the UDM group than in the DM group (adjusted OR: 1.32; 95% CI: 1.06, 1.64; adjusted OR: 1.80; 95% CI: 1.37, 2.36, respectively). Patients with UDM were more likely to be exposed to DM-related risk factors than those with and without DM. Public health interventions to prevent UDM development are necessary.
Collapse
|
9
|
Cui N, Cui J, Sun J, Xu X, Aslam B, Bai L, Li D, Wu D, Ma Z, Gu H, Baloch Z. Triglycerides and Total Cholesterol Concentrations in Association with Hyperuricemia in Chinese Adults in Qingdao, China. Risk Manag Healthc Policy 2020; 13:165-173. [PMID: 32184687 PMCID: PMC7060026 DOI: 10.2147/rmhp.s243381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 02/13/2020] [Indexed: 12/22/2022] Open
Abstract
Objective To assess the association between triglycerides (TG), total cholesterol (TC) and hyperuricemia (HUA) in the general Chinese population. Methods A population-based cross-sectional survey included 9680 participants aged 35–74 years in 2006 and 2009 in Qingdao, China. TG, TC and uric acid (UA) were measured. The logistic regression model was performed to estimate the association between TG, TC, and HUA with an odds ratio (OR) and 95% confidence intervals (CI). Meanwhile, age stratification analysis (<55 years group and ≥55 years group) was performed to evaluate whether age potentially affects the association between TG, TC and HUA using multivariable logistic regression. Results Higher TG and TC showed significantly increased HUA prevalence in both men and women (Ptrend all <0.05). Multivariate logistic regression indicated that borderline high TG (OR: 1.68, 95% CI: 1.31, 2.15 and HTG (OR: 2.98, 95% CI: 2.39, 3.72) indicated increased risk for HUA in men, and borderline high TG (OR: 2.09; 95% CI: 1.68,2.62); HTG (OR: 3.62; 95% CI: 2.90,4.51), borderline high TC (OR: 2.09, 95% CI: 1.68, 2.62) and HTC (OR: 3.62, 95% CI: 2.90, 4.51) showed significant association with HUA in women after adjusted age, school years, marital status, geographic division, personal monthly income, BMI and HDL-C. Age stratification analyses demonstrated that the association between TG and HUA was stronger in males aged ≥55 years and female aged <55 years, and the association between TC and HUA was stronger in both gender aged <55 years. Conclusion This large cross-sectional study focusing on the association between single indictor of blood lipid as exposure and HUA as outcome on the east coast of China for the first time. From a sample of Chinese adults, this study demonstrated that elevated TG in men and women and TC in women were associated with increased HUA prevalence.
Collapse
Affiliation(s)
- Nan Cui
- Research Center for Health Policy and Management, Nanjing University, Nanjing, People's Republic of China
| | - Jing Cui
- Qingdao Centers for Disease Control and Prevention, Qingdao Institute for Preventive Medicine, Qingdao, People's Republic of China
| | - Jianping Sun
- Qingdao Centers for Disease Control and Prevention, Qingdao Institute for Preventive Medicine, Qingdao, People's Republic of China
| | - Xinping Xu
- Research Center for Health Policy and Management, Nanjing University, Nanjing, People's Republic of China
| | - Bilal Aslam
- Biomedical Research Center, Northwest Minzu University, Lanzhou 730030, People's Republic of China.,Department of Microbiology, Government College University Faisalabad, Faisalabad, Punjab, Pakistan
| | - Lan Bai
- Research Center for Health Policy and Management, Nanjing University, Nanjing, People's Republic of China
| | - Decheng Li
- Research Center for Health Policy and Management, Nanjing University, Nanjing, People's Republic of China
| | - Di Wu
- Research Center for Health Policy and Management, Nanjing University, Nanjing, People's Republic of China
| | - Zhongren Ma
- Biomedical Research Center, Northwest Minzu University, Lanzhou 730030, People's Republic of China
| | - Hai Gu
- Research Center for Health Policy and Management, Nanjing University, Nanjing, People's Republic of China
| | - Zulqarnain Baloch
- Biomedical Research Center, Northwest Minzu University, Lanzhou 730030, People's Republic of China
| |
Collapse
|
10
|
Endris T, Worede A, Asmelash D. Prevalence of Diabetes Mellitus, Prediabetes and Its Associated Factors in Dessie Town, Northeast Ethiopia: A Community-Based Study. Diabetes Metab Syndr Obes 2019; 12:2799-2809. [PMID: 32021343 PMCID: PMC6942533 DOI: 10.2147/dmso.s225854] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 12/06/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Diabetes mellitus is becoming an epidemic public health problem in developing countries such as Ethiopia. As the International Diabetes Federation indicates, the number of adults living with diabetes globally has been increasing from time to time. If early screening and follow-up are done, diabetes is a manageable disease. However, diabetes study at the community level in Ethiopia is limited and scarce. Therefore, the present study was conducted to assess the current prevalence of DM, prediabetes and its associated factors in Dessie Town, Northeast Ethiopia. METHODS A community-based cross-sectional study was conducted from January to March 2019 among people aged 18 years and above in Dessie Town, Northeast Ethiopia. A multistage sampling technique was used to select a total of 587 study participants. Sociodemographic and behavioral characteristic data were collected using a pretested semi-structured questionnaire. Venous blood samples were used to determine the level of blood glucose and lipid profile. Diagnosis and classification of diabetes mellitus and prediabetes were based on the criteria of the American Diabetes Association. RESULTS The prevalence of diabetes mellitus and prediabetes was 6.8% (95% CI 4.9-9.0) and 15.7% (95% CI 12.9-18.7), respectively. The prevalence of previously undiagnosed diabetes mellitus was 72.5%. Positive family history of diabetes mellitus (AOR: 20.24, 95% CI 4.74-86.43), smoking habit (AOR: 12.12, 95% CI 2.30-63.73), overweight (AOR: 21.95, 95% CI 6.73-71.603), systolic hypertension (AOR: 4.61, 95% CI 1.09-19.50) and hypercholesterolemia (AOR: 8.97, 95% CI 2.05-39.23) were significantly associated with diabetes mellitus. Prediabetes was associated with advanced age (AOR: 3.55, 95% CI 1.16-10.79), marital status (single) (AOR: 3.06, 95% CI 1.40-6.67), educational status (illiterate) (AOR: 2.35, 95% CI 1.04-5.35) and overweight (AOR: 2.11, 95% CI 1.05-4.23). CONCLUSION There was a higher prevalence of diabetes mellitus and prediabetes. In addition, the prevalence of undiagnosed diabetes mellitus was high in our study area. Therefore, targeting the control and prevention strategy to such modifiable risk factors associated with diabetes and prediabetes may contribute to the reduction of the prevalence and further complications of diabetes mellitus.
Collapse
Affiliation(s)
- Toyba Endris
- Department of Medical Laboratory Science, Dessie Referral Hospital, Dessie, Ethiopia
| | - Abebaw Worede
- Department of Clinical Chemistry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Daniel Asmelash
- Department of Clinical Chemistry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
11
|
Song J, Chen X, Jiang Y, Mi J, Zhang Y, Zhao Y, Wu X, Gao H. Association and Interaction Analysis of Lipid Accumulation Product with Impaired Fasting Glucose Risk: A Cross-Sectional Survey. J Diabetes Res 2019; 2019:9014698. [PMID: 31772946 PMCID: PMC6854969 DOI: 10.1155/2019/9014698] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 09/25/2019] [Accepted: 10/01/2019] [Indexed: 12/11/2022] Open
Abstract
AIMS Lipid accumulation product (LAP) is put forward as a powerful marker showing the accumulation of visceral fat. The present study is aimed at (i) analyzing the predictive performances of LAP in the identification of impaired fasting glucose (IFG) in Chinese population and (ii) exploring the potentially interactive effect between LAP and other factors on IFG risk. METHODS Analysis was conducted on the data obtained from a community-based cross-sectional survey in Chinese population, and all the participants enrolled were required to complete a face-to-face questionnaire survey and related health checks. Then, for the purpose of comparing predictive values between LAP and conventional obesity indices for IFG, relevant analysis was carried out on the receiver operating characteristic (ROC) curve. The assessment of interactive effects was conducted by employing the three indicators as follows: (1) RERI (the relative excess risk due to interaction), (2) AP (attributable proportion due to interaction), and (3) SI (synergy index). RESULTS A total of 1777 participants (748 males and 1029 females) were involved in the final analysis. It was finally obtained that the prevalence rate of IFG was 14.1% in total, 15.5% for males and 13.1% for females, respectively. In logistic regression analysis, individuals with LAP levels in the fourth quartile had a significant higher risk of getting IFG in comparison with that of the lowest quartile (crude OR: 4.58, 95% CI: 3.01-6.98; adjusted OR: 3.81, 95% CI: 2.33-6.23). In addition, it was indicated by the ROC curve analysis that LAP showed a better performance in discriminating IFG risk than BMI in both males (Z = 2.20, P = 0.028) and females (Z = 2.13, P = 0.033). However, LAP displayed a higher predictability in comparison with WC only in females (Z = 2.07, P = 0.038), but not in males (Z = 0.18, P = 0.860). Furthermore, LAP and family history of diabetes were able to impose significant synergistic interaction on the risk of IFG, which was indicated by all the parameters in females (RERI: 2.52, 95% CI: 0.19-4.84; AP: 0.47, 95% CI: 0.20-0.74; SI: 2.39, 95% CI: 1.17-4.87) and males (RERI: 2.18, 95% CI: 0.08-4.73; AP: 0.43, 95% CI: 0.07-0.79; SI: 2.15, 95% CI: 1.03-5.45). However, none of the indicators showed significant interaction between LAP and smoking on the risk of IFG in females (RERI: 0.92, 95% CI: -2.79-4.63; AP: 0.20, 95% CI: -0.50-0.92; SI: 1.37, 95% CI: 0.42-4.52). Meanwhile, there was also no significant interaction between LAP and smoking on the risk of IFG in males as indicated by the value of SI (2.22, 95% CI: 0.80-6.21). CONCLUSION It was concluded that LAP was significantly related to a higher risk of IFG in Chinese population, and its performance was superior to that of conventional obesity indices, especially in females. Apart from that, LAP with family history of diabetes may have an interactive effect that can impose a great influence on the development of IFG.
Collapse
Affiliation(s)
- Jian Song
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233000 Anhui Province, China
| | - Xue Chen
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233000 Anhui Province, China
| | - Yuhong Jiang
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233000 Anhui Province, China
| | - Jing Mi
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233000 Anhui Province, China
| | - Yuyuan Zhang
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233000 Anhui Province, China
| | - Yingying Zhao
- Bengbu Health Board, 568 Nanhu Road, Bengbu, 233000 Anhui Province, China
| | - Xuesen Wu
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233000 Anhui Province, China
| | - Huaiquan Gao
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233000 Anhui Province, China
| |
Collapse
|
12
|
Lin JS, Dong HL, Chen GD, Chen ZY, Dong XW, Zheng JS, Chen YM. Erythrocyte Saturated Fatty Acids and Incident Type 2 Diabetes in Chinese Men and Women: A Prospective Cohort Study. Nutrients 2018; 10:E1393. [PMID: 30275386 PMCID: PMC6212875 DOI: 10.3390/nu10101393] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 09/11/2018] [Accepted: 09/22/2018] [Indexed: 12/23/2022] Open
Abstract
The association between circulating saturated fatty acids (SFAs) and incident type 2 diabetes (T2D) is reported in Western populations with inconsistent results, while evidence from Asian populations is scarce. We aimed to examine the associations between erythrocyte SFAs and incident T2D in a Chinese population. Between 2008 and 2013, a total of 2683 participants, aged 40⁻75 years, free of diabetes were included in the present analyses. Incident T2D cases were ascertained during follow-up visits. Gas chromatography was used to measure erythrocyte fatty acids at baseline. The Cox proportional hazards model was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs). During 13,508 person years of follow-up, 216 T2D cases were identified. Compared with the first quartile, multivariable-adjusted HRs (95% CIs) of the fourth quartile were 1.20 (0.82⁻1.76; p = 0.242) for myristic acid (14-carbon tail, zero double bonds; 14:0), 0.69 (0.48⁻0.99; p = 0.080) for palmitic acid (16:0), 1.49 (1.02⁻2.19; p = 0.047) for stearic acid (18:0), 1.46 (1.00⁻2.12; p = 0.035) for arachidic acid (20:0), 1.48 (0.99⁻2.22; p = 0.061) for behenic acid (22:0), and 1.08 (0.74⁻1.56; p = 0.913) for lignoceric acid (24:0). Our findings indicate that individual erythrocyte SFAs are associated with T2D in different directions, with 18:0 and 20:0 SFAs positively associated with the risk, whereas no convincing inverse association for 16:0 SFAs.
Collapse
Affiliation(s)
- Jie-Sheng Lin
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health; Department of Medical Statistics & Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Hong-Li Dong
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health; Department of Medical Statistics & Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Geng-Dong Chen
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health; Department of Medical Statistics & Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Zhan-Yong Chen
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health; Department of Medical Statistics & Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Xiao-Wei Dong
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health; Department of Medical Statistics & Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Ju-Sheng Zheng
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Westlake University, Hangzhou 310024, China.
| | - Yu-Ming Chen
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health; Department of Medical Statistics & Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| |
Collapse
|
13
|
Cui J, Sun J, Wang W, Yasmeen N, Ke M, Xin H, Qiao Q, Ma A, Baloch Z. Triglycerides and total cholesterol concentrations in association with IFG/IGT in Chinese adults in Qingdao, China. BMC Public Health 2018; 18:444. [PMID: 29615002 PMCID: PMC5883258 DOI: 10.1186/s12889-018-5286-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 03/08/2018] [Indexed: 02/05/2023] Open
Abstract
Background To investigative the association of triglycerides (TG) and total cholesterol (TC) concentrations with impaired fasting glucose/ impaired glucose tolerance (IFG/IGT) in Chinese adults. Methods The population-based cross-sectional diabetes survey was conducted in 2006 and 2009 in Qingdao, separately. 4400 participants (1 793 men and 2607 women) were include in current analysis. IFG/IGT was defined according to fasting plasma glucose (FPG) and/or 2 h post-load plasma glucose (2 h PG). Logistic regression models and areas under receiver operating characteristic curves (AUROC) were performed to estimate the associations between TG, TC levels and IFG/IGT. Results Spearman analysis showed that serum TG and TC was independently and positively associated with FPG and 2 h PG. As compared with normoglycaemia, the odds ratio[(95% confidence intervals), OR(95%CI)] for IFG/IGT corresponding to hypertriglyceridemia (HTG) were 1.61 (1. 17, 2. 22) in men and 1.57(1.15, 2.14) in women for TG and accompany with Hypercholesterolemia (HTC) 1.56 (1.15, 2.13) and 1. 20 (0.93, 1.54) for TC, when adjusting for confounding factor. The AUROCs of TG, TC for IFG/IGT were relatively smaller (0.50 < AUROC< 0. 7) in both gender. The optimal cut-offs for TG and TC was 1.61, 4.91 in men and 1. 24, 5. 32 in women, respectively. Conclusions Evaluated TG in both gender and TC in men were independently associated with the present of the IFG/IGT, yet, could not be an authentic predictors of IFG/IGT in both men and women in current Chinese population.
Collapse
Affiliation(s)
- Jing Cui
- School of Public Health of Qingdao University, No. 38 Dengzhou Road, Qingdao, 266021, China.,Qingdao Municipal Center for Disease Control and Prevention, Qingdao, 266033, China.,Qingdao Institute of Preventive Medicine, Qingdao, 266033, China
| | - Jianping Sun
- School of Public Health of Qingdao University, No. 38 Dengzhou Road, Qingdao, 266021, China.,Qingdao Municipal Center for Disease Control and Prevention, Qingdao, 266033, China.,Qingdao Institute of Preventive Medicine, Qingdao, 266033, China
| | - Wei Wang
- School of Public Health of Qingdao University, No. 38 Dengzhou Road, Qingdao, 266021, China.,Key Laboratory of Food Safety Risk Assessment, Ministry of Health, China National Center for food safety Risk Assessment, Beijing, 100021, China
| | - Nafeesa Yasmeen
- Institute of Microbiology, University of Agriculture, Faisalabad, Pakistan
| | - Ma Ke
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, 250355, China
| | - Hualei Xin
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao, 266033, China.,Qingdao Institute of Preventive Medicine, Qingdao, 266033, China
| | - Qing Qiao
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Aiguo Ma
- School of Public Health of Qingdao University, No. 38 Dengzhou Road, Qingdao, 266021, China. .,Qingdao Municipal Center for Disease Control and Prevention, Qingdao, 266033, China.
| | - Zulqarnain Baloch
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, 510642, China.
| |
Collapse
|