1
|
Su W, Wang J, Chen K, Yan W, Gao Z, Tang X, Wan Q, Luo Z, Ning G, Mu Y. A higher TyG index level is more likely to have enhanced incidence of T2DM and HTN comorbidity in elderly Chinese people: a prospective observational study from the reaction study. Diabetol Metab Syndr 2024; 16:29. [PMID: 38287450 PMCID: PMC10826216 DOI: 10.1186/s13098-024-01258-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 01/03/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Triglyceride glucose index (TyG index) was related with both type 2 diabetes (T2DM) and hypertension (HTN). Prospective studies linking the TyG index to the incidence of T2DM and HTN comorbidity remain unclear. This study aimed to to explore the longitudinal association between TyG and new-onset T2DM with HTN. METHODS 4,434 subjects (1249 males and 3185 females) without initial T2DM and HTN were followed up for 7 years. This study was conducted from November 2011 to August 2018 in the Gucheng, Laoshan and Jinding communities of Beijing. The incidence of T2DM with HTN during the 7-year follow-up was identified as the endpoint. The TyG index was divided into four quartiles: the < 25% level, the 25-50% level, the 50-75% level and the ≥ 75% level. The relationships between the TyG index and T2DM with HTN were evaluated by Cox proportional hazards regression models. RESULTS During 7 years, the augmented trend of T2DM with HTN was observed in the participants. After adjusting for all confounding factors, compared with those in the lowest quartile of TyG index, the population in the highest quartile of TyG index had a higher risk of T2DM with HTN (hazard ratio (HR), 2.878; 95% confidence intervals (95% CI), 1.230-6.731, P = 0.015), however, the association remained significant only in the female population (HR 2.753, 95% CI, 1.061-7.139, p = 0.037). The TyG had superior predictive ability of increased risk of T2DM with HTN for the populations of older age (≥ 65 years) (HR 2.694, 95% CI 1.212-5.989, p = 0.015), higher eGFR (≥ 90 mL/(min·1.73 m2)) (HR 2.603, 95% CI 1.164-5.818, p = 0.020) or obesity (BMI ≥ 28 kg/m2) (HR 2.547, 95% CI 1.001-6.478, p = 0.020). CONCLUSION A population with a higher TyG index level was more likely to have an enhanced incidence of T2DM and HTN comorbidity. TyG index could have the significance of clinical in early protection against T2DM with HTN.
Collapse
Affiliation(s)
- Wanlu Su
- Department of Endocrinology, The First Clinical Medical Center of Chinese People's Liberation Army General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
- School of Medicine, Nankai University, No. 94 Weijin Road, Tianjin, 300071, China
| | - Jie Wang
- Department of Endocrinology, Affiliated Beijing Chaoyang Hospital of Capital Medical University, No. 8 Workers Stadium South Road, Chaoyang District, Beijing, 100853, China
| | - Kang Chen
- Department of Endocrinology, The First Clinical Medical Center of Chinese People's Liberation Army General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Wenhua Yan
- Department of Endocrinology, The First Clinical Medical Center of Chinese People's Liberation Army General Hospital, No. 28 Fuxing Road, Beijing, 100853, China
| | - Zhengnan Gao
- Department of Endocrinology, Dalian Municipal Central Hospital, No. 826 Southwest Shahekou District Road, Dalian, 116033, China
| | - Xulei Tang
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
- Department of Endocrinology, Center Hospital of Dalian, Dalian, Liaoning, China
| | - Qin Wan
- Department of Endocrinology, Affiliated Hospital of Luzhou Medical College, No. 25 Taiping Road, Luzhou, 646000, China
| | - Zuojie Luo
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Guang Ning
- State Key Laboratory of Medical Genomics, Department of Endocrinology, Shanghai National Research Center for Endocrine and Metabolic Disease, Shanghai Institute for Endocrine and Metabolic Disease, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yiming Mu
- Department of Endocrinology, The First Clinical Medical Center of Chinese People's Liberation Army General Hospital, No. 28 Fuxing Road, Beijing, 100853, China.
- School of Medicine, Nankai University, No. 94 Weijin Road, Tianjin, 300071, China.
| |
Collapse
|
2
|
Moazzeni SS, Dehghani S, Hasheminia M, Hizomi Arani R, Azizi F, Hadaegh F. Three-year change in glycemic state and the future risk of incident hypertension among Iranian adults: Tehran Lipid and Glucose Study. J Hum Hypertens 2023; 37:944-949. [PMID: 36473941 DOI: 10.1038/s41371-022-00788-5] [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: 05/09/2022] [Revised: 11/16/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022]
Abstract
The impact of 3-year change in glycemic state on the risk of hypertension among Tehranian adults aged ≥20 years was assessed. The study population included 1679 men and 2348 women who were non-diabetic normotensive at enrollment. The following categories were defined both at baseline visit and three years later (second visit): normoglycemia [normal fasting glucose (NFG) and normal glucose tolerance (NGT)] and prediabetes [impaired fasting glucose (IFG) or impaired glucose tolerance (IGT)]. Changes in the categories, i.e., regression to normoglycemia, remaining in previous status, and progression to diabetes were assessed. Changes in fasting plasma glucose (FPG) and 2-hour plasma glucose (2hPG) categories were also considered separately. We used the Cox models adjusted for traditional hypertension risk factors to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). During a median follow-up of 9.4 years, 485 men and 589 women developed hypertension. Among men, considering both FPG and 2hPG, compared to individuals remaining normoglycemic, changing from prediabetes to normoglycemia had a HR of 1.30 (95% CI: 0.98-1.71; P-value: 0.064). Defining changes by 2hPG showed that compared to remaining NGT, incident IGT (progression from NGT to IGT) had a significant association with increased risk of hypertension development by a HR of 1.61 (1.13-2.30). Among women, on the other hand, change in glycemic state generally didn't show a significant association with incident hypertension. To sum up, change in glycemic state hadn't a significant association with hypertension development among women; however, compared to remaining NGT, men with incident IGT had a significant higher risk.
Collapse
Affiliation(s)
- Seyyed Saeed Moazzeni
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soheil Dehghani
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mitra Hasheminia
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reyhane Hizomi Arani
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
3
|
Li B, Wang J, Zhou X, Wang W, Gao Z, Tang X, Yan L, Wan Q, Luo Z, Qin G, Chen L, Ning G, Mu Y. Lipid accumulation product is closely associated with hypertension and prehypertension in prediabetic population in China: results from the REACTION study. Hypertens Res 2023; 46:708-719. [PMID: 36513744 DOI: 10.1038/s41440-022-01113-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 12/15/2022]
Abstract
Prediabetes with hypertension or prehypertension increases the risk of cardiovascular events. Lipid accumulation product (LAP) is a powerful marker of visceral obesity. The current study aimed to explore the relationship between LAP and hypertension and prehypertension among prediabetic individuals. A total of 12,388 prediabetic participants from the REACTION study were recruited. LAP was calculated from waist circumference and fasting triglyceride levels. Multiple logistic regression models were conducted to assess the relationship between LAP and hypertension and prehypertension. Multiple logistic regression analysis showed that elevated LAP was associated with hypertension (Q2: odds ratio (OR): 1.263, P < 0.001; Q3: OR: 1.613, P < 0.001; Q4: OR: 1.754, P < 0.001) and prehypertension (Q2: OR: 1.255, P = 0.005; Q3: OR: 1.340, P = 0.002; Q4: OR: 1.765, P < 0.001). The results of the stratified analysis showed that prediabetic people with higher LAP levels and characterized by overweight, normal weight and a high waist-to-hip ratio (WHR) were more likely to have hypertension, and prediabetic people with higher LAP levels and characterized by overweight, normal weight, a high WHR, age <65, and low and high levels of physical activity were more likely to have prehypertension. In conclusion, visceral obesity assessed by LAP is significantly associated with hypertension and prehypertension in the Chinese prediabetic population.
Collapse
Affiliation(s)
- Binqi Li
- School of Medicine, Nankai University, No. 94 Weijin Road, Tianjin, 300071, China.,Department of Endocrinology, First Medical Center of PLA General Hospital, Beijing, China
| | - Jie Wang
- Department of Endocrinology, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, P. R. China
| | - Xin Zhou
- Graduate School, Chinese PLA General Hospital, Beijing, China.,Department of Medical Oncology, Senior Department of Oncology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China.,The Second Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Weiqing Wang
- Shanghai National Research Centre for Endocrine and Metabolic Diseases, State Key Laboratory of Medical Genomics, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhengnan Gao
- Dalian Central Hospital, Dalian, Liaoning, China
| | - Xulei Tang
- First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Li Yan
- Zhongshan University Sun Yat-sen Memorial Hospital, Guangzhou, Guangdong, China
| | - Qin Wan
- Southwest Medical University Affiliated Hospital, Luzhou, Sichuan, China
| | - Zuojie Luo
- First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Guijun Qin
- First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Lulu Chen
- Wuhan Union Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Guang Ning
- Shanghai National Research Centre for Endocrine and Metabolic Diseases, State Key Laboratory of Medical Genomics, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yiming Mu
- School of Medicine, Nankai University, No. 94 Weijin Road, Tianjin, 300071, China. .,Department of Endocrinology, First Medical Center of PLA General Hospital, Beijing, China. .,Graduate School, Chinese PLA General Hospital, Beijing, China.
| |
Collapse
|
4
|
Huang X, Qin C, Guo X, Cao F, Tang C. Association of hemoglobin A1c with the incidence of hypertension: A large prospective study. Front Endocrinol (Lausanne) 2023; 13:1098012. [PMID: 36726461 PMCID: PMC9884972 DOI: 10.3389/fendo.2022.1098012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 12/22/2022] [Indexed: 01/19/2023] Open
Abstract
Background Although hemoglobin A1c (HbA1c) is closely related to diabetes, its relationship with the incidence of hypertension is still unknown, so we aimed to evaluate the relationship between HbA1c and the incidence of hypertension in the general population. Method In this large prospective cohort study with a median follow-up of 2 years, we included 4,074 participants from the China Health and Nutrition Survey (CHNS). Multivariate COX regression, subgroup analysis, receiver operator characteristic (ROC) curve and restricted cubic spline (RCS) were used to evaluate the relationship between HbA1c and incidental hypertension. Results Compared with participants without incident hypertension, participants with incident hypertension had higher levels of HbA1c (P < 0.05). In univariate COX regression analysis, HbA1c was associated with the risk of hypertension (HR: 1.161, 95% CI: 1.105-1.221, P < 0.001). In multivariate COX regression analysis adjusted for confounding variables, HbA1c was still closely related to the risk of hypertension (HR: 1.102, 95% CI: 1.006-1.206, P = 0.037). And subgroup analysis showed that the relationship between HbA1c and hypertension remained significant in female, lower than high school and non-obese subgroups (P < 0.05). ROC curve also showed that HbA1c could predict the risk of hypertension (AUC = 0.583, 95% CI: 0.568-0.598, P < 0.001). Further RCS analysis showed that HbA1c was positively correlated with the risk of hypertension (P for nonlinearity = 0.642). Conclusion HbA1c was linearly and positively associated with the incidence of hypertension.
Collapse
Affiliation(s)
- Xu Huang
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Cheng Qin
- Department of Geriatric Cardiology, National Clinical Research Center for Geriatric Diseases, 2nd Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Xiaoxu Guo
- Department of Digestive Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Feng Cao
- Department of Geriatric Cardiology, National Clinical Research Center for Geriatric Diseases, 2nd Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Chengchun Tang
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| |
Collapse
|
5
|
Turner LV, MacDonald MJ, Riddell MC, Voth J, Hawke TJ. Decreased Diastolic Blood Pressure and Average Grip Strength in Adults With Type 1 Diabetes Compared With Controls: An Analysis of Data From the Canadian Longitudinal Study on Aging. Can J Diabetes 2022; 46:789-796. [PMID: 35835668 DOI: 10.1016/j.jcjd.2022.05.005] [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: 04/01/2022] [Revised: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Our aim in this study was to determine whether aging individuals with type 1 diabetes (T1D) have differences in cardiovascular health, assessed by blood pressure, and skeletal muscle function, assessed by grip strength, compared with matched nondiabetic controls (CON). METHODS This investigation was a retrospective cohort analysis using baseline and 3-year follow-up data from the Canadian Longitudinal Study on Aging. Bivariate and multivariate regression analyses were used to examine the association between sociodemographic, health, behavioural and T1D-specific variables on blood pressure and grip strength in T1D and CON groups. Generalized estimating equations were used to model the average population changes in blood pressure and grip strength from baseline to follow up. RESULTS The sample included 126 individuals (63 T1D and 63 CON). Systolic blood pressure was not significantly different between groups at baseline or follow up (p>0.05). However, compared with CON, diastolic blood pressure was significantly lower at both time-points in the T1D group (p<0.001). Grip strength was consistently lower among persons with T1D (p=0.03). In the multivariate regression model, body mass index, age and sex were significantly associated with diastolic blood pressure and grip strength in both groups. In the T1D group, disease duration accounted for a large proportion of the variance in diastolic blood pressure and grip strength (17% and 9%, respectively). The rate of decline in diastolic blood pressure and grip strength did not differ between groups (p>0.05). CONCLUSIONS Diastolic blood pressure and grip strength appear to be consistently lower and differentially regulated in individuals with T1D vs CON. Aging individuals with T1D may be at risk of premature morbidity and mortality.
Collapse
Affiliation(s)
- Lauren V Turner
- School of Kinesiology and Health Science, Muscle Health Research Centre, York University, Toronto, Ontario, Canada
| | | | - Michael C Riddell
- School of Kinesiology and Health Science, Muscle Health Research Centre, York University, Toronto, Ontario, Canada
| | - Jennifer Voth
- Department of Psychology, University of Windsor, Windsor, Ontario, Canada
| | - Thomas J Hawke
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada.
| |
Collapse
|
6
|
Lou Y, Zhang Y, Zhao P, Qin P, Wang C, Ma J, Peng X, Chen H, Zhao D, Xu S, Wang L, Zhang M, Hu D, Hu F. Association of fasting plasma glucose change trajectory and risk of hypertension: a cohort study in China. Endocr Connect 2022; 11:EC-21-0464.R1. [PMID: 34860174 PMCID: PMC8789013 DOI: 10.1530/ec-21-0464] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 12/03/2021] [Indexed: 11/28/2022]
Abstract
We aimed to assess the association between fasting plasma glucose (FPG) change trajectory and incident hypertension among Chinese population. This cohort study included 11,791 adults aged 18-80 years without hypertension at first entry and who completed at least four follow-ups between 2009 and 2016. Logistic regression was used to estimate odds ratios (ORs) and 95% CIs for the association between FPG change trajectory and probability of hypertension. During a median follow-up of 5.10 years (total person-years 61,887.76), hypertension developed in 2177 participants. After adjusting for baseline potential confounders, the probability of hypertension increased with the increasing FPG change trajectory (adjusted OR (aOR) 1.22, 95% CI 1.07-1.40), bell-shape trajectory (aOR 1.15, 95% CI 1.02-1.30) and other-shape trajectory (aOR 1.13, 95% CI 1.02-1.25) which showed a higher variability of FPG compared to the decreasing group. In addition, the increasing FPG change trajectory was associated with a higher probability of hypertension compared with the decreasing group regardless of age and BMI but was only significant in males and in those with normal FPG at baseline. Our study indicates that the increasing FPG change trajectory determines the highest risk of hypertension, demonstrating the importance of maintaining low and stable levels of FPG, especially in males and in those with normal FPG.
Collapse
Affiliation(s)
- Yanmei Lou
- Department of Health Management, Beijing Xiaotangshan Hospital, Beijing, People’s Republic of China
| | - Yanyan Zhang
- Department of Epidemiology and Health Statistics, Shenzhen University Health Science Center, Shenzhen, Guangdong, People’s Republic of China
| | - Ping Zhao
- Department of Health Management, Beijing Xiaotangshan Hospital, Beijing, People’s Republic of China
| | - Pei Qin
- Department of Epidemiology and Health Statistics, Shenzhen University Health Science Center, Shenzhen, Guangdong, People’s Republic of China
| | - Changyi Wang
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, Guangdong, People’s Republic of China
| | - Jianping Ma
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, Guangdong, People’s Republic of China
| | - Xiaolin Peng
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, Guangdong, People’s Republic of China
| | - Hongen Chen
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, Guangdong, People’s Republic of China
| | - Dan Zhao
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, Guangdong, People’s Republic of China
| | - Shan Xu
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, Guangdong, People’s Republic of China
| | - Li Wang
- Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease, Shenzhen, Guangdong, People’s Republic of China
| | - Ming Zhang
- Department of Epidemiology and Health Statistics, Shenzhen University Health Science Center, Shenzhen, Guangdong, People’s Republic of China
| | - Dongsheng Hu
- Department of Epidemiology and Health Statistics, Shenzhen University Health Science Center, Shenzhen, Guangdong, People’s Republic of China
| | - Fulan Hu
- Department of Epidemiology and Health Statistics, Shenzhen University Health Science Center, Shenzhen, Guangdong, People’s Republic of China
- Correspondence should be addressed to F Hu:
| |
Collapse
|
7
|
Pöstyéni E, Szabadfi K, Sétáló G, Gabriel R. A Promising Combination: PACAP and PARP Inhibitor Have Therapeutic Potential in Models of Diabetic and Hypertensive Retinopathies. Cells 2021; 10:cells10123470. [PMID: 34943979 PMCID: PMC8700737 DOI: 10.3390/cells10123470] [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] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/06/2021] [Accepted: 12/06/2021] [Indexed: 11/16/2022] Open
Abstract
Diabetes and hypertension are complex pathologies with increasing prevalence nowadays. Their interconnected pathways are frequently manifested in retinopathies. Severe retinal consequences and their tight connections as well as their possible treatments are particularly important to retinal research. In the present, work we induced diabetes with streptozotocin in spontaneously hypertensive rats and treated them either with PACAP or olaparib and alternatively with both agents. Morphological and immunohistochemical analyses were carried out to describe cell-specific changes during pathologies and after different treatments. Diabetes and hypertension caused massive structural and cellular changes especially when they were elicited together. Hypertension was crucial in the formation of ONL and OPL damage while diabetes caused significant differences in retinal thickness, OPL thickness and in the cell number of the GCL. In diabetes, double neuroprotective treatment ameliorated changes of calbindin-positive cells, rod bipolar cells and dopaminergic amacrine cells. Double treatment was curative in hypertensive diabetic rat retinas, especially in the case of rod bipolar and parvalbumin-positive cells compared to untreated or single-treated retinas. Our results highlighted the promising therapeutic benefits of olaparib and PACAP in these severe metabolic retinal disorders.
Collapse
Affiliation(s)
- Etelka Pöstyéni
- Department of Experimental Zoology and Neurobiology, University of Pécs, 7624 Pécs, Hungary; (E.P.); (K.S.)
| | - Krisztina Szabadfi
- Department of Experimental Zoology and Neurobiology, University of Pécs, 7624 Pécs, Hungary; (E.P.); (K.S.)
| | - György Sétáló
- Department of Medical Biology, Medical School, University of Pécs, 7624 Pécs, Hungary;
| | - Robert Gabriel
- Department of Experimental Zoology and Neurobiology, University of Pécs, 7624 Pécs, Hungary; (E.P.); (K.S.)
- Correspondence:
| |
Collapse
|
8
|
Liu J, Cheng NN, Zhou ZY, Zhang Y, Yang J, Liu LS, Song Y, Huang X, Tang GF, Wang BY, Qin XH, Xu XP, Kong XQ. Effect of fasting blood glucose on risk of new-onset hypertension in rural Chinese population: a 15-year follow-up cohort. BMC Cardiovasc Disord 2021; 21:531. [PMID: 34749652 PMCID: PMC8573915 DOI: 10.1186/s12872-021-02336-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 10/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to examine the correlation between fasting blood glucose and new-onset hypertension and examine any synergistically effect modification with multiple risk factors. METHODS We conducted post-hoc analyses of repeated-measures data in the original Dongzhi osteoporosis cohort study. In total, 3985 participants without hypertension aged 25-64 years were included in the current analyses. Generalized estimating equation models were used to assess the relationship between fasting blood glucose and risk of new-onset hypertension after adjusting for pertinent covariates and autocorrelations among siblings. RESULTS 393 men (19.4%) and 398 women (20.3%) without hypertension at the baseline developed hypertension by the end of the study period. Compared to lower baseline fasting blood glucose levels (Q1-Q3: < 5.74 mmol/L; clinical cut points: < 5.6 mmol/L), higher baseline fasting blood glucose levels (Q4: ≥ 5.74 mmol/L; clinical cut points: ≥ 5.6 mmol/L and < 7.0 mmol/L) increased the risk of new-onset hypertension significantly [(OR: 1.54, 95% CI 1.19-1.98, P < 0.001); (OR: 1.38, 95% CI 1.09-1.75, P = 0.008)] in women. Additionally, a stronger significant association was found in women with elevated fasting blood glucose on risk of new-onset of hypertension with higher total cholesterol (≥ 5.2 mmol/L) [(OR: 2.76; 95% CI: (1.54, 4.96), P < 0.001)]. However, no association was found between fasting blood glucose and risk of new-onset hypertension in men. CONCLUSIONS High fasting blood glucose may be significantly associated with risk of new-onset hypertension in Chinese women, especially in women with higher total cholesterol. Further randomized studies are needed to confirm our findings.
Collapse
Affiliation(s)
- Jing Liu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, People's Republic of China
| | - Nan N Cheng
- State Key Laboratory of Natural Medicines, Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, 210009, People's Republic of China
| | - Zi Y Zhou
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, People's Republic of China
| | - Yue Zhang
- State Key Laboratory of Natural Medicines, Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, 210009, People's Republic of China
| | - Jie Yang
- State Key Laboratory of Natural Medicines, Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, 210009, People's Republic of China
| | - Li S Liu
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, People's Republic of China
| | - Yun Song
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, People's Republic of China.,School of Health Administration, Anhui Medical University, Hefei, People's Republic of China
| | - Xiao Huang
- Department of Cardiovascular Medicine, Second Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China
| | - Gen F Tang
- School of Health Administration, Anhui Medical University, Hefei, People's Republic of China
| | - Bin Y Wang
- School of Health Administration, Anhui Medical University, Hefei, People's Republic of China
| | - Xian H Qin
- National Clinical Research Study Center for Kidney Disease, The State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Xi P Xu
- National Clinical Research Study Center for Kidney Disease, The State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Xiang Q Kong
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, People's Republic of China.
| |
Collapse
|
9
|
Si Y, Wang A, Yang Y, Liu H, Gu S, Mu Y, Lyu Z. Fasting Blood Glucose and 2-h Postprandial Blood Glucose Predict Hypertension: A Report from the REACTION Study. Diabetes Ther 2021; 12:1117-1128. [PMID: 33660197 PMCID: PMC7994488 DOI: 10.1007/s13300-021-01019-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 01/30/2021] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Although diabetes is associated with hypertension, whether high blood glucose levels promote hypertension remains controversial. In this study we compared the predictive power of fasting plasma glucose (FPG), 2-h postprandial blood glucose (2hPG), and glycated hemoglobin (HbA1c) for the development of hypertension. METHODS This study was a substudy of the REACTION study, an ongoing longitudinal cohort study investigating the relationship of prediabetes and type 2 diabetes with the risk of cancer in an urban Northern Chinese population in Beijing. Logistic regression analysis was used to calculate odds ratios (ORs) after adjustment for risk factors for hypertension, including age, sex, body mass index, and triglycerides. RESULTS Among the 3437 participants, 497 developed hypertension during the 4-year follow-up. The logistic regression analysis showed that elevated FPG and 2hPG levels (FPG: OR 1.529; 95% confidence interval [CI] 1.348-1.735; 2hPG: OR 1.144; 95% CI 1.100-1.191), but not HbA1c, were independent risk factors for the development of hypertension. In the highest quartile of FPG and 2hPG levels, the multivariable-corrected ORs were 2.115 (95% CI 1.612-2.777) and 2.346 (95% CI 1.787-3.080), respectively, compared with the lowest quartile. The adjusted models showed no significant correlations between quartile HbA1c levels and the development of hypertension. CONCLUSION Higher FPG and 2hPG levels, but not HbA1c levels, are independent risk factors for developing hypertension in an urban Northern Chinese population. TRIAL REGISTRATION ClinicalTrials.gov NCT01206869.
Collapse
Affiliation(s)
- Yingkui Si
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, China
- Department of Endocrinology, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, China
| | - Anping Wang
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, China
| | - Yunshuang Yang
- Department of Preventive Medicine, Beijing Longfu Hospital, Beijng, China
| | - Hongzhou Liu
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, China
| | - Shi Gu
- Department of Endocrinology, The First People's Hospital of Shuangliu District, Chengdu, China
| | - Yiming Mu
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, China.
| | - Zhaohui Lyu
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, China.
| |
Collapse
|
10
|
Aguiar L, Ferreira J, Matos A, Mascarenhas MR, Menezes Falcão L, Faustino P, Bicho M, Inácio Â. Interplay between glycemia and the genetics of eNOS and ACE for the susceptibility to the onset and development of hypertension on the Portuguese population. GENE REPORTS 2021. [DOI: 10.1016/j.genrep.2020.100975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
|
11
|
Ryu KS, Kang HYJ, Lee SW, Park HW, You NY, Kim JH, Hwangbo Y, Choi KS, Cha HS. Screening Model for Estimating Undiagnosed Diabetes among People with a Family History of Diabetes Mellitus: A KNHANES-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8903. [PMID: 33266117 PMCID: PMC7730533 DOI: 10.3390/ijerph17238903] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/22/2020] [Accepted: 11/26/2020] [Indexed: 12/14/2022]
Abstract
A screening model for estimating undiagnosed diabetes mellitus (UDM) is important for early medical care. There is minimal research and a serious lack of screening models for people with a family history of diabetes (FHD), especially one which incorporates gender characteristics. Therefore, the primary objective of our study was to develop a screening model for estimating UDM among people with FHD and enable its validation. We used data from the Korean National Health and Nutrition Examination Survey (KNHANES). KNAHNES (2010-2016) was used as a developmental cohort (n = 5939) and was then evaluated in a validation cohort (n = 1047) KNHANES (2017). We developed the screening model for UDM in male (SMM), female (SMF), and male and female combined (SMP) with FHD using backward stepwise logistic regression analysis. The SMM and SMF showed an appropriate performance (area under curve (AUC) = 76.2% and 77.9%) compared with SMP (AUC = 72.9%) in the validation cohort. Consequently, simple screening models were developed and validated, for the estimation of UDM among patients in the FHD group, which is expected to reduce the burden on the national health care system.
Collapse
Affiliation(s)
- Kwang Sun Ryu
- Cancer Big Data Center, National Cancer Center, Goyang-si 10408, Gyeonggi-do, Korea; (K.S.R.); (H.Y.J.K.); (S.W.L.); (N.Y.Y.); (J.H.K.); (K.S.C.)
| | - Ha Ye Jin Kang
- Cancer Big Data Center, National Cancer Center, Goyang-si 10408, Gyeonggi-do, Korea; (K.S.R.); (H.Y.J.K.); (S.W.L.); (N.Y.Y.); (J.H.K.); (K.S.C.)
| | - Sang Won Lee
- Cancer Big Data Center, National Cancer Center, Goyang-si 10408, Gyeonggi-do, Korea; (K.S.R.); (H.Y.J.K.); (S.W.L.); (N.Y.Y.); (J.H.K.); (K.S.C.)
| | - Hyun Woo Park
- Healthcare AI Team, National Cancer Center, Goyang-si 10408, Gyeonggi-do, Korea; (H.W.P.); (Y.H.)
| | - Na Young You
- Cancer Big Data Center, National Cancer Center, Goyang-si 10408, Gyeonggi-do, Korea; (K.S.R.); (H.Y.J.K.); (S.W.L.); (N.Y.Y.); (J.H.K.); (K.S.C.)
| | - Jae Ho Kim
- Cancer Big Data Center, National Cancer Center, Goyang-si 10408, Gyeonggi-do, Korea; (K.S.R.); (H.Y.J.K.); (S.W.L.); (N.Y.Y.); (J.H.K.); (K.S.C.)
| | - Yul Hwangbo
- Healthcare AI Team, National Cancer Center, Goyang-si 10408, Gyeonggi-do, Korea; (H.W.P.); (Y.H.)
- Division of Endocrinology, Department of Internal Medicine, National Cancer Center, Goyang-si 10408, Gyeonggi-do, Korea
| | - Kui Son Choi
- Cancer Big Data Center, National Cancer Center, Goyang-si 10408, Gyeonggi-do, Korea; (K.S.R.); (H.Y.J.K.); (S.W.L.); (N.Y.Y.); (J.H.K.); (K.S.C.)
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si 10408, Gyeonggi-do, Korea
| | - Hyo Soung Cha
- Cancer Big Data Center, National Cancer Center, Goyang-si 10408, Gyeonggi-do, Korea; (K.S.R.); (H.Y.J.K.); (S.W.L.); (N.Y.Y.); (J.H.K.); (K.S.C.)
- Healthcare AI Team, National Cancer Center, Goyang-si 10408, Gyeonggi-do, Korea; (H.W.P.); (Y.H.)
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si 10408, Gyeonggi-do, Korea
| |
Collapse
|
12
|
Liu K, Xie Z, Or CK. Effectiveness of Mobile App-Assisted Self-Care Interventions for Improving Patient Outcomes in Type 2 Diabetes and/or Hypertension: Systematic Review and Meta-Analysis of Randomized Controlled Trials. JMIR Mhealth Uhealth 2020; 8:e15779. [PMID: 32459654 PMCID: PMC7435643 DOI: 10.2196/15779] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 03/21/2020] [Accepted: 05/04/2020] [Indexed: 01/20/2023] Open
Abstract
Background Mobile app-assisted self-care interventions are emerging promising tools to support self-care of patients with chronic diseases such as type 2 diabetes and hypertension. The effectiveness of such interventions requires further exploration for more supporting evidence. Objective A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted to examine the effectiveness of mobile app-assisted self-care interventions developed for type 2 diabetes and/or hypertension in improving patient outcomes. Methods We followed the Cochrane Collaboration guidelines and searched MEDLINE, Cochrane Library, EMBASE, and CINAHL Plus for relevant studies published between January 2007 and January 2019. Primary outcomes included changes in hemoglobin A1c (HbA1c) levels, systolic blood pressure (SBP), and diastolic blood pressure (DBP). Changes in other clinical-, behavioral-, knowledge-, and psychosocial-related outcomes were included as secondary outcomes. Primary outcomes and objective secondary outcomes that were reported in at least two trials were meta-analyzed; otherwise, a narrative synthesis was used for data analysis. Results A total of 27 trials were identified and analyzed. For primary outcomes, the use of mobile app-assisted self-care interventions was associated with significant reductions in HbA1c levels (standardized mean difference [SMD] −0.44, 95% CI −0.59 to −0.29; P<.001), SBP (SMD −0.17, 95% CI −0.31 to −0.03, P=.02), and DBP (SMD −0.17, 95% CI −0.30 to −0.03, P=.02). Subgroup analyses for primary outcomes showed that several intervention features were supportive of self-management, including blood glucose, blood pressure, and medication monitoring, communication with health care providers, automated feedback, personalized goal setting, reminders, education materials, and data visualization. In addition, 8 objective secondary outcomes were meta-analyzed, which showed that the interventions had significant lowering effects on fasting blood glucose levels and waist circumference. A total of 42 secondary outcomes were narratively synthesized, and mixed results were found. Conclusions Mobile app-assisted self-care interventions can be effective tools for managing blood glucose and blood pressure, likely because their use facilitates remote management of health issues and data, provision of personalized self-care recommendations, patient–care provider communication, and decision making. More studies are required to further determine which combinations of intervention features are most effective in improving the control of the diseases. Moreover, evidence regarding the effects of these interventions on the behavioral, knowledge, and psychosocial outcomes of patients is still scarce, which warrants further examination.
Collapse
Affiliation(s)
- Kaifeng Liu
- Department of Industrial and Manufacturing Systems Engineering, University of Hong Kong, Hong Kong, Hong Kong
| | - Zhenzhen Xie
- Department of Industrial and Manufacturing Systems Engineering, University of Hong Kong, Hong Kong, Hong Kong
| | - Calvin Kalun Or
- Department of Industrial and Manufacturing Systems Engineering, University of Hong Kong, Hong Kong, Hong Kong
| |
Collapse
|
13
|
Cheung BMY, Or B, Fei Y, Tsoi MF. A 2020 Vision of Hypertension. Korean Circ J 2020; 50:469-475. [PMID: 32281321 PMCID: PMC7234844 DOI: 10.4070/kcj.2020.0067] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 02/23/2020] [Indexed: 12/22/2022] Open
Abstract
Hypertension is a common chronic disease affecting a large section of the general population. Hypertension is highly prevalent in the elderly because blood pressure (BP) rises with age. The risk of developing hypertension increases with predisposing genes, intrauterine growth retardation, prematurity and childhood obesity. BP is easier to control in the young. Non-pharmacological treatment through lifestyle changes, such as weight control and leisure-time physical activity, is more likely to be successful in young people. Hypertension in older adults is more difficult to control, requiring the use of more than one antihypertensive drug. Adverse effects and compliance become problematic. Much research is now directed at novel ways of controlling BP such as denervation. The change in definition of hypertension in the American guideline highlights the need to identify and manage hypertension early, at a stage when it is potentially reversible.
Collapse
Affiliation(s)
- Bernard M Y Cheung
- Division of Clinical Pharmacology and Therapeutics, Department of Medicine, The University of Hong Kong, Hong Kong, China.,State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Hong Kong, China.,Institute of Cardiovascular Science and Medicine, The University of Hong Kong, Hong Kong, China.
| | - Benjamin Or
- Division of Clinical Pharmacology and Therapeutics, Department of Medicine, The University of Hong Kong, Hong Kong, China
| | - Yue Fei
- Division of Clinical Pharmacology and Therapeutics, Department of Medicine, The University of Hong Kong, Hong Kong, China
| | - Man Fung Tsoi
- Division of Clinical Pharmacology and Therapeutics, Department of Medicine, The University of Hong Kong, Hong Kong, China
| |
Collapse
|
14
|
Woo YC, Gao B, Lee CH, Fong CH, Lui DT, Ming J, Wang L, Yeung KM, Cheung BM, Lam TH, Janus E, Ji Q, Lam KS. Three-component non-invasive risk score for undiagnosed diabetes in Chinese people: Development, validation and longitudinal evaluation. J Diabetes Investig 2020; 11:341-348. [PMID: 31495069 PMCID: PMC7078083 DOI: 10.1111/jdi.13144] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 08/30/2019] [Accepted: 09/03/2019] [Indexed: 01/30/2023] Open
Abstract
AIMS/INTRODUCTION To develop a new non-invasive risk score for undiagnosed diabetes in Chinese people, and to evaluate the incident diabetes risk in those with high-risk scores, but no diabetes on initial testing. MATERIALS AND METHODS A total of 2,609 participants with no known diabetes (aged 25-74 years) who underwent oral glucose tolerance tests in Hong Kong (HK) were investigated for independent risk factors of diabetes to develop a categorization point scoring system, the Non-invasive Diabetes Score (NDS). This NDS was validated in a cross-sectional study of 2,746 participants in Shaanxi, China. HK participants tested to not have diabetes at baseline were assessed for subsequent incident diabetes rates. RESULTS In the HK cohort, hypertension, age and body mass index were the key independent risk factors selected to develop the NDS, with ≥28 out of 50 NDS points considered as high risk. The area under the receiver operating characteristic curve for undiagnosed diabetes was 0.818 and 0.720 for the HK and Shaanxi cohort, respectively. The negative predictive value was 97.4% (HK) and 95.8% (Shaanxi); the number needed to screen to identify one case of diabetes was five (HK) and 11 (Shaanxi), respectively. Among those that tested non-diabetes at baseline, individuals with NDS ≥28 had a threefold risk of incident diabetes during the subsequent 20.9 years, compared with those with NDS <28 (P < 0.001), with a steeper rise in incident diabetes observed in those with NDS at higher tertiles. CONCLUSIONS This new three-component risk score is a user-friendly tool for diabetes screening, and might inform the subsequent testing interval for high-risk non-diabetes individuals.
Collapse
Affiliation(s)
- Yu Cho Woo
- Department of MedicineQueen Mary HospitalThe University of Hong KongHong KongHong Kong SAR
| | - Bin Gao
- Department of EndocrinologyXijing HospitalAir Force Medical UniversityXi'anChina
| | - Chi Ho Lee
- Department of MedicineQueen Mary HospitalThe University of Hong KongHong KongHong Kong SAR
| | - Carol Ho‐yi Fong
- Department of MedicineQueen Mary HospitalThe University of Hong KongHong KongHong Kong SAR
| | - David Tak‐wai Lui
- Department of MedicineQueen Mary HospitalThe University of Hong KongHong KongHong Kong SAR
| | - Jie Ming
- Department of EndocrinologyXijing HospitalAir Force Medical UniversityXi'anChina
| | - Li Wang
- Department of EndocrinologyXijing HospitalAir Force Medical UniversityXi'anChina
| | - Kristy Man‐yi Yeung
- Department of MedicineQueen Mary HospitalThe University of Hong KongHong KongHong Kong SAR
| | | | - Tai Hing Lam
- The School of Public HealthThe University of Hong KongHong KongHong Kong SAR
| | - Edward Janus
- Department of Medicine‐Western HealthMelbourne Medical SchoolThe University of MelbourneMelbourneVictoriaAustralia
- General Internal Medicine UnitWestern HealthSt AlbansVictoriaAustralia
| | - Qiuhe Ji
- Department of EndocrinologyXijing HospitalAir Force Medical UniversityXi'anChina
| | - Karen Siu‐ling Lam
- Department of MedicineQueen Mary HospitalThe University of Hong KongHong KongHong Kong SAR
| |
Collapse
|
15
|
Bergantin LB. Hypertension, Diabetes and Neurodegenerative Diseases: Is there a Clinical Link through the Ca2+/cAMP Signalling Interaction? Curr Hypertens Rev 2019; 15:32-39. [PMID: 30117399 DOI: 10.2174/1573402114666180817113242] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 08/08/2018] [Accepted: 08/10/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND Hypertension, diabetes and neurodegenerative diseases are among the most prevalent medical problems around the world, costing millions of dollars to the medical health systems. Indeed, hypertension has been associated with higher risk for decline of cognition, as evidenced in patients with Alzheimer´s disease (AD). Furthermore, there is a clear relationship between hypertension and diabetes, reflecting substantial overlap in their etiology. Calcium (Ca2+) channel blockers (CCBs) have been classically prescribed for treating hypertension because of their mechanism of action due to reducing the influx of Ca2+ into the smooth muscles cells. In addition, many clinical and experimental studies have been demonstrating pleiotropic effects for CCBs. For instance, in hypertensive patients treated with CCBs, it can be observed lower incidence of neurodegenerative diseases such as AD. The virtual mechanism of action could be attributed to a restoration and maintenance of Ca2+ homeostasis, which is dysregulated in the neurodegenerative diseases, including also a reduction of neuronal apoptosis as part of these CCBs pleiotropic effects. Similarly, in hypertensive patients treated with CCBs, it can be observed an improvement of diabetes status such as glycemic control. A possible mechanism of action under debate could be attributed to a restoration of insulin secretion, then achieving glycemic control, and reduction of pancreatic β-cell apoptosis. CONCLUSION Considering the discovery of our group entitled "calcium paradox" due to Ca2+/cAMP signalling interaction, in this review I discussed the virtual involvement of this interaction in the pleiotropic effects of CCBs, including the possible role of the Ca2+/cAMP signalling interaction in the association between hypertension and higher risk for the decline of cognition, and diabetes.
Collapse
Affiliation(s)
- Leandro Bueno Bergantin
- Department of Pharmacology-Universidade Federal de Sao Paulo-Escola Paulista de Medicina, Laboratory of Autonomic and Cardiovascular Pharmacology-55 11 5576-4973, Rua Pedro de Toledo, 669-Vila Clementino, Sao Paulo-SP, CEP: 04039-032, Brazil
| |
Collapse
|
16
|
Geva M, Shlomai G, Berkovich A, Maor E, Leibowitz A, Tenenbaum A, Grossman E. The association between fasting plasma glucose and glycated hemoglobin in the prediabetes range and future development of hypertension. Cardiovasc Diabetol 2019; 18:53. [PMID: 31029146 PMCID: PMC6486972 DOI: 10.1186/s12933-019-0859-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 04/18/2019] [Indexed: 12/16/2022] Open
Abstract
Background Prediabetes is a well-established risk factor for progression to overt diabetes mellitus (DM), which is in turn associated with development of hypertension (HTN) and vice versa. However, the role of prediabetes and HbA1c in particular as an independent risk factor for the development of hypertension is unclear. Aim In this current study, we aimed to evaluate the association between both fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) levels in the prediabetes range and development of HTN among a large cohort of normotensive subjects. Design and methods We investigated 5016 normotensive participants without DM and other cardiovascular risk factors who were annually screened in a tertiary medical center. Subjects were divided into normoglycemic and prediabetic groups. Normoglycemia was defined as HbA1c < 5.7% and FPG < 100 mg/dl. Prediabetes was defined according to the ADA criteria, i.e., 6.5% > HbA1c ≥ 5.7% or impaired fasting glucose (IFG):126 mg/dl > FPG ≥ 100 mg/dl. Subgroup analysis was made by dividing participants into four groups according to FPG and HbA1C levels, i.e., normoglycemia, impaired HbA1c only, IFG only, and both parameters impaired. Results During a follow-up of 3.7 ± 2.9 years, 318 (6.3%) subjects developed HTN. A cumulative hazard function for the development of hypertension showed a 2.89-fold ([95% CI 2.19–3.83], p < .0001) increased risk for HTN in the prediabetic population. In a multivariable Cox proportional hazard regression model adjusted to common confounding risk factors for HTN, prediabetes was found to be independently associated with a 1.95-fold ([95%, CI 1.43–2.52] p < .0001) increased risk for hypertension. Impaired HbA1C only was not found to be independently associated with HTN, while IFG only showed a 2.13-fold (95%, [CI 1.46–3.11] p < .0001) increased risk for HTN compared to normoglycemic, and a 2.55-fold ([95% CI 1.85–3.51] p < .0001) increased risk for HTN when both parameters impaired. Conclusion Our study demonstrates that FPG in the prediabetes range, albeit not glycated hemoglobin, is independently and significantly associated with future development of HTN. Therefore, our findings further highlight the pivotal predictive role of IFG for HTN development as opposed to the limited independent role of abnormal HbA1c levels. Electronic supplementary material The online version of this article (10.1186/s12933-019-0859-4) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Mika Geva
- Department of Internal Medicine D, Chaim Sheba Medical Center, Ramat Gan, Israel.,Sackler School of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel
| | - Gadi Shlomai
- Department of Internal Medicine D, Chaim Sheba Medical Center, Ramat Gan, Israel.,Sackler School of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel
| | - Anat Berkovich
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel.,Leviev Heart Center, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Elad Maor
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel.,Leviev Heart Center, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Avshalom Leibowitz
- Department of Internal Medicine D, Chaim Sheba Medical Center, Ramat Gan, Israel.,Sackler School of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel
| | - Alexander Tenenbaum
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel.,Leviev Heart Center, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Ehud Grossman
- Department of Internal Medicine D, Chaim Sheba Medical Center, Ramat Gan, Israel. .,Sackler School of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel.
| |
Collapse
|
17
|
Omar SM, Musa IR, ElSouli A, Adam I. Prevalence, risk factors, and glycaemic control of type 2 diabetes mellitus in eastern Sudan: a community-based study. Ther Adv Endocrinol Metab 2019; 10:2042018819860071. [PMID: 31275546 PMCID: PMC6598316 DOI: 10.1177/2042018819860071] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 06/03/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Diabetes mellitus (DM) constitutes a global health threat and burden, especially in developing countries. We conducted a cross-sectional study in Gadarif in eastern Sudan to evaluate the prevalence and glycaemic control of patients with type 2 diabetes mellitus (T2DM). METHODS We performed a cross-sectional community-based study. Data on blood glucose levels, and anthropometric, demographic and clinical history data were obtained. RESULTS Six hundred Sudanese adults with a mean (SD) age of 44.9 (16.5) years were enrolled. More than two-thirds (70.3%) of the study participants were women. The prevalence of T2DM, newly diagnosed T2DM and uncontrolled T2DM was 20.8%, 10.0% and 80.0%, respectively. Logistic regression analysis showed no significant association between education, marital status, body mass index, waist circumference and DM. However older age (AOR = 4.88, 95% CI = 3.09-7.70) and a family history of DM (AOR = 2.58, 95% CI = 1.59-4.20) were associated with T2DM. CONCLUSION The prevalence of T2DM is high among the Sudanese population, especially in older people and those with a family history of DM. The high prevalence of uncontrolled DM in this setting is another hidden burden.
Collapse
Affiliation(s)
- Saeed M. Omar
- Faculty of Medicine, Gadarif University, Gadarif, Sudan
| | - Imad R. Musa
- King Abdu Aziz Armed Forces Hospital at Air Base, Dhahran, Kingdom of Saudi Arabia
| | - Amir ElSouli
- Unaizah College of Medicine, Qassim University, Unaizah, Kingdom of Saudi Arabia
| | | |
Collapse
|
18
|
Lui MMS, Tse HF, Mak JCW, Lam DCL, Chan CWS, Chong PWC, Ip MSM. Untreated Obstructive Sleep Apnea Is Associated With Myocardial Injury Independent of Blood Pressure Control in Hypertension. J Clin Sleep Med 2018; 14:1841-1847. [PMID: 30373683 DOI: 10.5664/jcsm.7476] [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] [Received: 12/01/2017] [Accepted: 04/03/2018] [Indexed: 12/14/2022]
Abstract
STUDY OBJECTIVES Obstructive sleep apnea (OSA) and hypertension are independent risk factors of cardiovascular morbidities. This study aims to investigate the relationship between OSA, blood pressure (BP) control, and myocardial injury in patients with difficult-to-control hypertension. METHODS Patients with hypertension who required three or more medications were prospectively recruited at a tertiary referral center. In-laboratory polysomnography, followed by blood tests for fasting glucose, glycated hemoglobin, lipids, high-sensitivity troponin I (hsTnI), B-type natriuretic peptide (BNP), C-reactive protein, and advanced oxidation protein products were performed. After polysomnography, 24-hour ambulatory BP monitoring was arranged. RESULTS A total of 98 participants were analyzed, with mean age 51 ± 9 years and body mass index 30 ± 5 kg/m2. Previously undiagnosed severe OSA (apneahypopnea index [AHI] ≥ 30 events/h) was present in 51 patients (52%). hsTnI was negatively correlated with nocturnal dip in systolic BP (r = -.205, P = .048). After controlling for confounders, including BP control, AHI and oxygen desaturation index (ODI) were positively correlated with hsTnI (r = .282, P = .009 and r = .279, P = .010, respectively) and C-reactive protein (r = .302, P = .005 and r = .285, P = .008, respectively), but not with BNP or advanced oxidation protein products. Age, ODI, and loss of nocturnal systolic BP dip were significant determinants of hsTnI level (β = .225, P = .022; β = .293, P = .003; and β = -.215, P = .029; R2 = .151). Age, female sex, 24-hour mean diastolic BP, and metabolic syndrome, but not indices of apnea severity, were predictors of BNP level. CONCLUSIONS Unrecognized severe OSA was common in patients with difficult-to-control hypertension, and OSA severity was associated with myocardial injury, independent of BP control with medications. CLINICAL TRIAL REGISTRATION Registry: ClinicalTrials.gov, Title: A Cross-sectional Study of the Occurrence and Effect of Obstructive Sleep Apnea in Subjects With Resistant Hypertension, Identifier: NCT00843583, URL: https://clinicaltrials.gov/ct2/show/NCT00843583.
Collapse
Affiliation(s)
- Macy M S Lui
- Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Pokfulam Road, Hong Kong
| | - H F Tse
- Division of Cardiology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Pokfulam Road, Hong Kong
| | - Judith C W Mak
- Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Pokfulam Road, Hong Kong
| | - David C L Lam
- Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Pokfulam Road, Hong Kong
| | - Carmen W S Chan
- Division of Cardiology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Pokfulam Road, Hong Kong
| | - Peony W C Chong
- Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Pokfulam Road, Hong Kong
| | - Mary S M Ip
- Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Pokfulam Road, Hong Kong
| |
Collapse
|
19
|
Zhao Y, Sun H, Wang B, Zhang M, Luo X, Ren Y, Zhou J, Han C, Wang C, Li L, Zhang L, Pang C, Yin L, Feng T, Zhao J, Hu D. Impaired fasting glucose predicts the development of hypertension over 6years in female adults: Results from the rural Chinese cohort study. J Diabetes Complications 2017; 31:1090-1095. [PMID: 28433447 DOI: 10.1016/j.jdiacomp.2017.04.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 03/17/2017] [Accepted: 04/06/2017] [Indexed: 12/28/2022]
Abstract
AIMS To investigate whether impaired fasting glucose (IFG) is an independent risk factor for incident hypertension in a rural Chinese population. METHODS We selected 9583 eligible participants 18 to 75years old, who were without hypertension and diabetes at baseline (from 2007 to 2008) and were from a rural area in the middle of China. Concentration of fasting glucose at baseline was assessed in quartiles to predict hypertension risk by gender. Odds ratios (ORs) and 95% confidence intervals (CIs) for IFG (fasting glucose of 100 to 125mg/dl) associated with hypertension were estimated by logistic regression models. RESULTS Risk of hypertension was increased for females with glucose levels in quartile 2 (90-96mg/dl), quartile 3 (96-102mg/dl), and quartile 4 (102-125mg/dl) versus quartile 1 (<90mg/dl): OR=1.27 (95% CI=1.01-1.60), 1.30 (1.04-1.63), and 1.55 (1.24-1.93), respectively. During the 6-year follow-up, the cumulative incidence of hypertension was greater for people with IFG than normal fasting glucose (NFG) at baseline (23.9% vs 18.4%, p<0.001 for males and 23.8% vs 16.4%, p<0.001 for females). Risk of incident hypertension was significantly increased for females with IFG versus NFG (OR=1.23 95% CI=1.05-1.45). CONCLUSIONS IFG may be an independent risk factor for hypertension in normotensive nondiabetic Chinese females.
Collapse
Affiliation(s)
- Yang Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
| | - Haohang Sun
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
| | - Bingyuan Wang
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.
| | - Ming Zhang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.
| | - Xinping Luo
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.
| | - Yongcheng Ren
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.
| | - Junmei Zhou
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.
| | - Chengyi Han
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.
| | - Chongjian Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
| | - Linlin Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
| | - Lu Zhang
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.
| | - Chao Pang
- Department of Prevention and Health Care, Military Hospital of Henan Province, Zhengzhou, Henan, People's Republic of China.
| | - Lei Yin
- Department of Prevention and Health Care, Military Hospital of Henan Province, Zhengzhou, Henan, People's Republic of China.
| | - Tianping Feng
- Department of Prevention and Health Care, Military Hospital of Henan Province, Zhengzhou, Henan, People's Republic of China.
| | - Jingzhi Zhao
- Department of Prevention and Health Care, Military Hospital of Henan Province, Zhengzhou, Henan, People's Republic of China.
| | - Dongsheng Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
| |
Collapse
|
20
|
Owolabi EO, Goon DT, Adeniyi OV, Seekoe E. Social epidemiology of hypertension in Buffalo City Metropolitan Municipality (BCMM): cross-sectional study of determinants of prevalence, awareness, treatment and control among South African adults. BMJ Open 2017; 7:e014349. [PMID: 28600362 PMCID: PMC5623394 DOI: 10.1136/bmjopen-2016-014349] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 03/28/2017] [Accepted: 04/03/2017] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES This study examined hypertension prevalence, awareness, treatment and control and their determinants among adults attending health facilities in Buffalo City Metropolitan Municipality (BCMM) in the Eastern Cape. DESIGN A cross-sectional analytical study. SETTINGS The three largest outpatient clinics in BCMM. PARTICIPANTS Ambulatory adults (aged 18 years and over) attending the study settings during the study period (n=998). PRIMARY OUTCOME MEASURE The prevalence of hypertension (systolic blood pressure (BP) of ≥140 mm Hg and/or a diastolic BP of ≥90 mm Hg or current medication for hypertension), the awareness of it (prior diagnosis of it) and its treatment and control (Eighth Joint National Committee Criteria of BP <140/90/90 mm Hg). SECONDARY OUTCOME MEASURE Associated factors of hypertension, hypertension unawareness and uncontrolled hypertension. RESULTS Of the 998 participants included, the prevalence of hypertension was 49.2%. Hypertension unawareness was reported by 152 participants (23.1%) with significant gender difference (p=0.005). Male sex, age <45 years, higher level of education, single status, current employment, higher monthly income, current smoking, alcohol usage, absence of diabetes and non-obese were significantly associated (p<0.05) with hypertension unawareness.Of the participants who were aware of having hypertension (n=339), nearly all (91.7%, n=311) were on antihypertensive medication and only 121 participants (38.9%) achieved the BP treatment target. In the multivariate logistic regression model analysis, ageing (95% CI 1.9 to 4.4), being married (95% CI 1.0 to 2.0), male sex (95% CI 1.2 to 2.3), concomitant diabetes (95% CI 1.9 to 3.9), lower monthly income (95% CI 1.2 to 2.2), being unemployed (95% CI 1.0 to 1.9) and central obesity (95% CI 1.5 to 2.8) were the significant and independent determinants of prevalent hypertension. CONCLUSION The prevalence and awareness of hypertension was high in the study population. In addition, the suboptimal control of BP among treated individuals, as well as the significant cardiovascular risk factors, warrant the attention of health authorities of BCMM and the country.
Collapse
Affiliation(s)
- Eyitayo Omolara Owolabi
- Department of Nursing Science, Faculty of Health Sciences, University of Fort Hare, East London, South Africa
| | - Daniel Ter Goon
- Department of Nursing Science, Faculty of Health Sciences, University of Fort Hare, East London, South Africa
| | - Oladele Vincent Adeniyi
- Department of Family Medicine, Faculty of Health Sciences, Walter Sisulu University/Cecilia Makiwane Hospital, East London Hospital Complex, East London, South Africa
| | - Eunice Seekoe
- Department of Nursing Science, Faculty of Health Sciences, University of Fort Hare, East London, South Africa
| |
Collapse
|
21
|
Risk Factors of Hyperglycemia in Patients After a First Episode of Acute Pancreatitis: A Retrospective Cohort. Pancreas 2017; 46:209-218. [PMID: 27846145 DOI: 10.1097/mpa.0000000000000738] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the risk factors for hyperglycemia development after a first episode of acute pancreatitis (AP). METHODS Three hundred and ten patients treated for AP were retrospectively evaluated. Hyperglycemia was determined by fasting blood glucose. All data were collected from the medical records room database and a follow-up telephone call. RESULTS The incidence rate of hyperglycemia was obviously increased 5 years after the event. Hazard ratios (HRs) of developing hyperglycemia in patients with hyperlipidemia, fatty liver, and hypertension were 2.52 (P < 0.001), 1.87 (P = 0.01), and 1.78 (P = 0.017), respectively. Patients of biliary origin that underwent endoscopic retrograde cholangiopancreatography presented a 4.62-fold greater risk than those managed conservatively. Other risk factors were random blood glucose greater than 8.33 mmol/L (HR, 4.19; P < 0.001), lactate dehydrogenase greater than 350 U/L (HR, 1.99; P = 0.017), calcium less than 1.75 mmol/L (HR, 3.86; P = 0.004), and elevated creatine kinase (HR, 2.74; P = 0.001). Patients with AB blood type showed 2.92-fold greater risk compared with those with O blood type. Among them, hyperlipidemia and hyperglycemia on admission were the only independent risk factors (both P < 0.05). CONCLUSIONS Hyperlipidemia, fatty liver, hypertension, endoscopic retrograde cholangiopancreatography treatment, acute hyperglycemia, elevated lactate dehydrogenase and creatine kinase, decreased calcium, and AB blood type were risk factors for hyperglycemia development after AP.
Collapse
|
22
|
Fawwad A, Moin H, Siddiqui IA, Hydrie MZI, Basit A. Framingham risk score in impaired glucose tolerant population: A sub analysis of Diabetes Prevention and Awareness Program of Pakistan. Pak J Med Sci 2016; 32:1121-1125. [PMID: 27882006 PMCID: PMC5103118 DOI: 10.12669/pjms.325.10448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective: To assess the 10-year risk of coronary artery disease (CAD) in subjects with impaired glucose tolerance (IGT) using Framingham risk score. Methods: Data for this study was collected from Diabetes Prevention and Awareness Program. Primary prevention team visited different primary health care centers, factories, service organizations and offices within Karachi, Pakistan. IGT was diagnosed according to World Health Organization criteria after taking informed consent. Information regarding social-demography, dietary habits and physical activities were obtained by a designed questionnaire on one-to-one based interview. Framingham risk score (FRS) was used to assess risk of developing CAD. Results: A total of 315 subjects with IGT were recruited for the study. Mean age of subjects was 44.1 ± 9.8 years and mean BMI was 27.3 ± 5.0 kg/m2. Overall, 31.4% of the participants were at risk of having CAD. Males were 6.4 times and hypertensive subjects were 2.44 times more likely to have CAD in next 10 years. Conclusion: According to the findings of the study, male and hypertensive IGT subjects were more likely to develop CAD in next 10 years. Community based awareness programs are needed to educate people regarding healthy lifestyle in order to reduce the risk of IGT and CAD.
Collapse
Affiliation(s)
- Asher Fawwad
- Asher Fawwad, PhD. Associate Professor, Baqai Medical University, Senior Research Scientist, Research Department, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan
| | - Hassan Moin
- Hassan Moin, M.Sc. Statistician, Research Department, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan
| | - Iftikhar Ahmed Siddiqui
- Iftikhar Ahmed Siddiqui, PhD. Chairman & Professor of Biochemistry, Department of Biochemistry, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan
| | - Muhammad Zafar Iqbal Hydrie
- Muhammad Zafar Iqbal Hydrie, PhD, Postdoc. Assistant Professor, Department of Biochemistry, Hamdard College of Medicine and Dentistry, Hamdard University, Karachi, Pakistan
| | - Abdul Basit
- Abdul Basit, FRCP. Professor of Medicine, Department of Medicine, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan
| |
Collapse
|
23
|
Lam KSL, Chow CC, Tan KCB, Ma RCW, Kong APS, Tong PCY, Tsang MW, Chan TM, Tang SCW, Lee KK, So WY, Tomlinson B. Practical considerations for the use of sodium-glucose co-transporter type 2 inhibitors in treating hyperglycemia in type 2 diabetes. Curr Med Res Opin 2016; 32:1097-108. [PMID: 26933918 DOI: 10.1185/03007995.2016.1161608] [Citation(s) in RCA: 14] [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] [Indexed: 11/23/2022]
Abstract
Sodium-glucose co-transporter type 2 (SGLT2) inhibitors are a new class of oral anti-diabetic agents with a unique, insulin-independent mode of action. In patients with diabetes who have adequate renal function, SGLT2 inhibitors reduce hyperglycemia by blocking renal glucose reabsorption and increasing urinary glucose excretion. These agents are indicated for the treatment of hyperglycemia in type 2 diabetes mellitus (T2DM), as an adjunct to diet and exercise. In terms of efficacy, they are comparable to most other oral agents, and carry a low risk of hypoglycemia unless combined with sulfonylureas or insulin. They may be used in combination regimens with metformin, sulfonylureas, or insulin. Beyond glucose lowering, SGLT2 inhibitors are associated with modest weight loss and mild anti-hypertensive effects. Emerging cardiovascular and renal outcomes data suggest other potentially beneficial non-glycemic effects, although these findings await confirmation from further studies. The main adverse effects are increased risk of volume depletion and of genitourinary infections, although these can be managed with standard interventions. Rare cases of euglycemic ketoacidosis have been reported in a subset of patients treated with these agents, an issue currently under investigation. SGLT2 inhibitors represent a promising alternative treatment option for T2DM patients in whom the effectiveness of oral anti-hyperglycemic therapy is limited by the risk of hypoglycemia, weight gain, or other adverse effects. Safety and efficacy (up to 4 years) have been demonstrated in a range of T2DM patient populations, although more studies will be needed to determine whether treatment with SGLT2 inhibitors improves patient-important outcomes in the longer term.
Collapse
Affiliation(s)
- Karen S L Lam
- a Department of Medicine , Queen Mary Hospital, The University of Hong Kong , Hong Kong SAR , China
| | - Chun Chung Chow
- b Department of Medicine and Therapeutics , The Chinese University of Hong Kong, Prince of Wales Hospital , Hong Kong SAR, China
| | - Kathryn C B Tan
- a Department of Medicine , Queen Mary Hospital, The University of Hong Kong , Hong Kong SAR , China
| | - Ronald C W Ma
- b Department of Medicine and Therapeutics , The Chinese University of Hong Kong, Prince of Wales Hospital , Hong Kong SAR, China
| | - Alice P S Kong
- b Department of Medicine and Therapeutics , The Chinese University of Hong Kong, Prince of Wales Hospital , Hong Kong SAR, China
| | - Peter C Y Tong
- c Qualigenics Diabetes Centre, The Chinese University of Hong Kong , Hong Kong SAR , China
| | | | - Tak Mao Chan
- a Department of Medicine , Queen Mary Hospital, The University of Hong Kong , Hong Kong SAR , China
| | - Sydney C W Tang
- a Department of Medicine , Queen Mary Hospital, The University of Hong Kong , Hong Kong SAR , China
| | - Ka Kui Lee
- a Department of Medicine , Queen Mary Hospital, The University of Hong Kong , Hong Kong SAR , China
| | - Wing Yee So
- b Department of Medicine and Therapeutics , The Chinese University of Hong Kong, Prince of Wales Hospital , Hong Kong SAR, China
| | - Brian Tomlinson
- b Department of Medicine and Therapeutics , The Chinese University of Hong Kong, Prince of Wales Hospital , Hong Kong SAR, China
| |
Collapse
|
24
|
Ren J, Sun J, Ning F, Pang Z, Qie L, Qiao Q. Gender differences in the association of hypertension with gamma-glutamyltransferase and alanine aminotransferase levels in Chinese adults in Qingdao, China. ACTA ACUST UNITED AC 2015; 9:951-8. [PMID: 26542414 DOI: 10.1016/j.jash.2015.09.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 08/31/2015] [Accepted: 09/17/2015] [Indexed: 01/14/2023]
Abstract
The aim of the study was to study the associations of hypertension with gamma-glutamyltransferase (GGT) and alanine aminotransferase (ALT) levels. Data of 3575 men and 5504 women were analyzed. Multivariate logistic regression analysis was performed to estimate the odds ratio (OR) for hypertension with GGT and ALT. Compared with the lowest quartile, the multivariate adjusted ORs for hypertension were 0.97 (0.79, 1.19) in men and 0.88 (0.74, 1.04) in women for ALT and 2.29 (1.68, 3.14) and 1.52 (1.27, 1.83) for GGT in the highest quartile group. The ORs for hypertension in the low waist circumference category were 2.61 (1.56, 4.36) in men and 1.41 (0.94, 2.12) in women and in the high waist circumference category 4.01 (2.21, 7.29) and 2.26 (1.54, 3.32) for GGT. The elevated GGT, but not ALT, was associated with the presence of the hypertension in men and women. The association is stronger in obese men and women than in their lean counterparts.
Collapse
Affiliation(s)
- Jie Ren
- Department of Non-communicable Disease Prevention, Shandong Province Center for Disease Control and Prevention, Jinan, China
| | - Jianping Sun
- Department of Non-communicable Disease Prevention, Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China
| | - Feng Ning
- Department of Non-communicable Disease Prevention, Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China; Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland
| | - Zengchang Pang
- Department of Non-communicable Disease Prevention, Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China
| | - Liangyi Qie
- Department of Geriatrics, Qilu Hospital of Shandong University, Key Laboratory of Cardiovascular Proteomics of Shandong Province, Jinan, China.
| | - Qing Qiao
- Department of Research & Development, Astrazeneca, Mölndal, Sweden
| | | |
Collapse
|
25
|
Lee CJ, Lim NK, Kim HC, Ihm SH, Lee HY, Park HY, Park S. Impaired fasting glucose and impaired glucose tolerance do not predict hypertension: a community cohort study. Am J Hypertens 2015; 28:493-500. [PMID: 25267735 DOI: 10.1093/ajh/hpu186] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Insulin resistance has an important role in the pathogenesis of hypertension. We hypothesized that impaired fasting glucose (IFG) or impaired glucose tolerance (IGT) which represents insulin resistance would predict the development of hypertension. METHODS A total of 4,039 subjects without hypertension or diabetes (1,847 men and 2,192 women; age 49.9±8.2 years), from the Ansan-Ansung cohorts within the Korean Genome Epidemiology Study, were enrolled in 2001-2002 and restudied in 2005-2006. The association between the incidence of hypertension and IFG, IGT, or other metabolic factors was studied. RESULTS During the 4-year follow-up period, 582 of the 4,039 subjects developed hypertension. At baseline, the prevalence of abdominal obesity, dyslipidemia, and IGT was higher in subjects who became hypertensive compared to those that remained normotensive. The prevalence of IFG was not significantly different between the 2 groups. In a multivariate analysis, abdominal obesity and high serum triglyceride were significant risk factors for the development of hypertension. Neither IFG nor IGT were significantly associated with new-onset hypertension. Although the risk of hypertension was higher with the number of metabolic components present at baseline, IFG and IGT were not significant components compared to other metabolic components, especially when abdominal obesity was taken into account. CONCLUSIONS While metabolic syndrome components related to insulin resistance present at baseline are important risk factors of hypertension, we conclude that coexisting metabolic component, mainly abdominal obesity, rather than IFG and IGT have more predictive value for determining the development of hypertension in a Korean population.
Collapse
Affiliation(s)
- Chan Joo Lee
- Department of Biochemistry and Molecular Biology, Institute of Genetic Science, Integrated Genomic Research Center for Metabolic Regulation, BK21 PLUS project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Nam-Kyoo Lim
- Division of Cardiovascular and Rare diseases, Center for Biomedical Science, National Institute of Health, Cheongwon-gun, Chungbuk, Korea
| | - Hyeon-Chang Kim
- Department of Preventive medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sang-Hyun Ihm
- Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hae-Young Lee
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hyun Young Park
- Division of Cardiovascular and Rare diseases, Center for Biomedical Science, National Institute of Health, Cheongwon-gun, Chungbuk, Korea
| | - Sungha Park
- Division of Cardiology, Yonsei Cardiovascular Hospital, Yonsei Cardiovascular Research Institute, Yonsei University of Medicine, Seoul, Korea.
| |
Collapse
|
26
|
Glucose and the risk of hypertension in first-degree relatives of patients with type 2 diabetes. Hypertens Res 2015; 38:349-54. [PMID: 25693857 DOI: 10.1038/hr.2015.10] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 12/01/2014] [Accepted: 12/02/2014] [Indexed: 01/14/2023]
Abstract
To test the hypothesis that plasma glucose (PG) levels is associated with the incidence of hypertension (HT) in nondiabetic and non-hypertensive first-degree relatives (FDR) of people with type 2 diabetes (T2D). A total of 1089 FDR without diabetes and/or HT of consecutive patients with T2D 30-70 years old were examined and followed for a mean (s.d.) of 6.9 (1.7) years for HT incidence. At baseline and through follow-up, participants underwent a standard 75 gm 2-h oral glucose tolerance test. HT was defined according to the criteria of the Seventh Report of Joint National Committee. We used Cox proportional hazard models to estimate hazard ratio for incident HT and plotted a receiver operating characteristic curve to assess discrimination. The PG levels at baseline were associated with incidence of HT, independently of age, gender, obesity and high cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, education and systolic blood pressure. Those with impaired glucose tolerance were 54% (hazard ratio 1.54; 95% confidence interval (CI) 1.33, 1.77) more likely to develop HT than those with normal glucose tolerance. Those with impaired fasting glucose were also 23% (hazard ratio 1.23; 95% CI 1.01, 1.50) more likely to develop HT. High PG levels were consistently associated with incident HT.
Collapse
|
27
|
Cheung TT, Cheung BMY. Managing blood pressure control in Asian patients: safety and efficacy of losartan. Clin Interv Aging 2014; 9:443-50. [PMID: 24672231 PMCID: PMC3964028 DOI: 10.2147/cia.s39780] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Hypertension is common in Asian populations and is a major cause of cardiovascular diseases. The prevalence of hypertension is increasing in many Asian countries. The overall prevalence of hypertension in India and the People’s Republic of China has been estimated to be 20.6% in men and 22.6% in women. However, the rates of detection, treatment, and control of hypertension remain low in Asia. This reflects a low level of literacy and education, as well as a low level of access to medical care. To overcome these obstacles, strategies targeted at education, promotion, and optimization of medical care, are crucial to achieve target blood pressure control. Angiotensin receptor blockers are one of the first-line treatments for essential hypertension because they confer better cardiovascular outcomes. Losartan has been widely evaluated for the management of hypertension. Although some studies suggested that the blood pressure-lowering effect of losartan is perhaps lower than for other angiotensin receptor blockers, losartan has been demonstrated to be beneficial in terms of renal protection in patients with diabetes, heart failure resulting from either systolic or diastolic dysfunction, and diuretic-induced hyperuricemia. However, most of these data were obtained from Caucasian populations. The efficacy and safety of losartan in Asian populations may be different because of genetic and ethnic variations. Therefore, the efficacy and safety of losartan in Asian patients with hypertension warrant further study.
Collapse
Affiliation(s)
- Tommy Tsang Cheung
- Division of Clinical Pharmacology and Therapeutics, Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Bernard Man Yung Cheung
- Division of Clinical Pharmacology and Therapeutics, Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| |
Collapse
|
28
|
Morio M, Inoue M, Inoue K, Akimoto K. Impaired fasting glucose as an independent risk factor for hypertension among healthy middle-aged Japanese subjects with optimal blood pressure: the Yuport Medical Checkup Centre retrospective cohort study. Diabetol Metab Syndr 2013; 5:81. [PMID: 24360336 PMCID: PMC3878132 DOI: 10.1186/1758-5996-5-81] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Accepted: 12/16/2013] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND This study aimed at investigating whether impaired fasting glucose (IFG) is an independent risk factor for incident hypertension among middle-aged Japanese subjects with optimal blood pressure (OBP). FINDINGS This retrospective cohort study was conducted in 2943 non-diabetic and non-hypertensive subjects aged 40-64 years, who participated in a voluntary health check-up program during the baseline (1998-2002) and follow-up periods (2002-2006). A multiple logistic regression model was utilized to calculate the odds ratio (OR) of incident hypertension among men and women with IFG and OBP. OBP was defined as systolic blood pressure (SBP) <120 mmHg and diastolic blood pressure (DBP) <80 mmHg, with no known history of hypertension. In this study, hypertension was defined as SBP ≥140 mmHg and DBP ≥90 mmHg or by a self-reported clinical diagnosis of hypertension. After the mean follow-up period of 5.6 years, the incidence of hypertension in men and women was 5.7% (73/1270) and 3.8% (62/1673), respectively. The age-adjusted ORs for incident hypertension in men and women with IFG were 1.95 (95% CI, 1.21-3.15) and 3.54 (95% CI, 2.00-6.27), respectively. After adjusting for age, systolic blood pressure, body mass index, total cholesterol, triglyceride, high-density lipoprotein cholesterol, and uric acid, the ORs for hypertension were 1.66 (95% CI; 1.02-2.70) for men and 2.62 (95% CI, 1.45-4.73) for women. CONCLUSION The study results show that IFG may act as an independent risk factor for developing hypertension in individuals with OBP.
Collapse
Affiliation(s)
- Masaaki Morio
- Department of Family Medicine, Kochi Medical School, Kohasu, Oko-cho, Nankoku, Kochi, Japan
| | - Machiko Inoue
- Department of Community Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, Japan
| | - Kazuo Inoue
- Department of Community Medicine, Chiba Medical Center, Teikyo University School of Medicine, 3426-3, Anesaki, Ichihara, Chiba, Japan
| | - Kimihiko Akimoto
- Akimoto Occupational Health Consultant Office, 4-7-22 Kudan-minami, Chiyoda-ku, Tokyo, Japan
| |
Collapse
|
29
|
Jin CN, Yu CM, Sun JP, Fang F, Wen YN, Liu M, Lee APW. The healthcare burden of hypertension in Asia. HEART ASIA 2013; 5:238-43. [PMID: 27326143 DOI: 10.1136/heartasia-2013-010408] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Revised: 10/05/2013] [Accepted: 10/29/2013] [Indexed: 01/11/2023]
Abstract
As the leading global risk for mortality, hypertension (HT) is a common healthcare problem in the world. The total number of patients with HT is likely to grow in the next few decades as the population age and the prevalence of obesity and diabetes increase. HT, as a major modifiable risk factor for cardiovascular disease, results in more deaths than any other risk factors, including diabetes and cigarette smoking. High prevalence, inadequate awareness, suboptimal treatment and low rate of achieving guideline-recommended target blood pressure control are key factors leading to severe cardiovascular complications that impose a heavy socioeconomic burden, especially in developing countries. Asia is the world's largest and most populous continent with approximately 4.3 billion people, hosting 60% of the world's current human population, and has a high growth rate. Asia differs very widely from the West with regard to ethnic groups, cultures, environments, economics, historical ties and government systems. Therefore, the purpose of this review is to comprehensively summarise the epidemiology, treatment practice and the status of control of HT in different Asian countries in order to guide the future prevention and management in this part of the world.
Collapse
Affiliation(s)
- Chun-Na Jin
- Division of Cardiology, Department of Medicine and Therapeutics , Prince of Wales Hospital, The Chinese University of Hong Kong , Shatin, NT , Hong Kong
| | - Cheuk-Man Yu
- Division of Cardiology, Department of Medicine and Therapeutics , Prince of Wales Hospital, The Chinese University of Hong Kong , Shatin, NT , Hong Kong
| | - Jing-Ping Sun
- Division of Cardiology, Department of Medicine and Therapeutics , Prince of Wales Hospital, The Chinese University of Hong Kong , Shatin, NT , Hong Kong
| | - Fang Fang
- Division of Cardiology, Department of Medicine and Therapeutics , Prince of Wales Hospital, The Chinese University of Hong Kong , Shatin, NT , Hong Kong
| | - Yong-Na Wen
- Division of Cardiology, Department of Medicine and Therapeutics , Prince of Wales Hospital, The Chinese University of Hong Kong , Shatin, NT , Hong Kong
| | - Ming Liu
- Division of Cardiology, Department of Medicine and Therapeutics , Prince of Wales Hospital, The Chinese University of Hong Kong , Shatin, NT , Hong Kong
| | - Alex Pui-Wai Lee
- Division of Cardiology, Department of Medicine and Therapeutics , Prince of Wales Hospital, The Chinese University of Hong Kong , Shatin, NT , Hong Kong
| |
Collapse
|
30
|
Fu FH, Guo L, Zang Y. An overview of health fitness studies of Hong Kong residents from 2005 to 2011. J Exerc Sci Fit 2012. [DOI: 10.1016/j.jesf.2012.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
|
31
|
Chen C, Tso AWK, Cheung BMY, Law LSC, Ong KL, Wat NMS, Janus ED, Xu A, Lam KSL. Plasma concentration of pigment epithelium-derived factor is closely associated with blood pressure and predicts incident hypertension in Chinese: a 10-year prospective study. Clin Endocrinol (Oxf) 2012; 76:506-13. [PMID: 21777264 DOI: 10.1111/j.1365-2265.2011.04178.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Pigment epithelium-derived factor (PEDF) is secreted from the adipose tissue. It circulates at high concentrations, and was reported to play a causal role in obesity-induced insulin resistance and metabolic dysfunctions in mice. Previous cross-sectional studies also demonstrated plasma PEDF concentration correlated positively with systolic blood pressure (BP) and pulse pressure, and inversely with small artery elasticity. Here we investigated the relationship of plasma PEDF concentration with BP and incident hypertension in a 10-year prospective study. METHODS Baseline plasma PEDF concentrations were measured by ELISA in 520 Chinese subjects, aged 51 ± 12 years, followed up long-term from the population-based Hong Kong Cardiovascular Risk Factor Prevalence Study. The association between plasma PEDF concentration and BP was investigated in both cross-sectional and prospective studies, using multiple linear regression and path analyses. Cox proportional hazards analysis was used to determine whether baseline PEDF concentration was independently related to the subsequent development of hypertension over 10 years. RESULTS Baseline plasma concentrations of PEDF were higher in men (P < 0·001), and were directly related to systolic BP at 2 and 5 years, and to diastolic BP at 2 years, after adjustment for covariates. Of the 386 normotensive subjects at baseline, high baseline PEDF concentration was predictive of incident hypertension, independent of the effects of age, sex, baseline BP and obesity parameters (hazard ratio: 1·135; 95% CI: 1·039-1·241; P = 0·005). CONCLUSION Our data suggest that plasma PEDF concentration is significantly associated with BP, and incident hypertension. PEDF may be involved in the pathogenesis of hypertension in humans.
Collapse
Affiliation(s)
- Cheng Chen
- Department of Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Abstract
Diabetes and hypertension frequently occur together. There is substantial overlap between diabetes and hypertension in etiology and disease mechanisms. Obesity, inflammation, oxidative stress, and insulin resistance are thought to be the common pathways. Recent advances in the understanding of these pathways have provided new insights and perspectives. Physical activity plays an important protective role in the two diseases. Knowing the common causes and disease mechanisms allows a more effective and proactive approach in their prevention and treatment.
Collapse
Affiliation(s)
- Bernard M. Y. Cheung
- Department of Medicine, University of Hong Kong, Pokfulam, Hong Kong
- Department of Medicine, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, China
| | - Chao Li
- Department of Medicine, University of Hong Kong, Pokfulam, Hong Kong
| |
Collapse
|
33
|
|
34
|
Ong KL, Tso AWK, Cherny SS, Sham PC, Lam TH, Lam KSL, Cheung BMY. Role of Genetic Variants in the Gene Encoding Lipocalin-2 in the Development of Elevated Blood Pressure. Clin Exp Hypertens 2011; 33:484-91. [DOI: 10.3109/10641963.2010.549276] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
35
|
Cheung BMY, Ong KL, Tso AWK, Leung RYH, Cherny SS, Sham PC, Lam TH, Lam KSL. Plasma adrenomedullin level is related to a single nucleotide polymorphism in the adrenomedullin gene. Eur J Endocrinol 2011; 165:571-7. [PMID: 21798961 DOI: 10.1530/eje-11-0513] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Adrenomedullin (ADM) plays an important role in inflammation and is a marker of future cardiovascular events. We studied common single nucleotide polymorphisms (SNPs) in the gene encoding ADM and their relationship with the plasma levels of ADM and other inflammatory markers. DESIGN AND METHODS Plasma ADM, interleukin 6 (IL6), fibrinogen, and C-reactive protein (CRP) were measured in 476 subjects from the population-based Hong Kong Cardiovascular Risk Factor Prevalence Study-2. Four tag SNPs in ADM were genotyped. RESULTS Plasma ADM level increased with decreasing plasma IL6 level (β=-0.116, P=0.014). Plasma ADM level was not related to plasma levels of CRP and fibrinogen, and other clinical characteristics, except age (P=0.049). The four SNPs, rs3814700, rs11042725, rs34354539, and rs4910118, had minor allele frequencies of 31.1, 28.7, 33.8, and 23.4% respectively. Carriers of the minor allele of rs4910118 had a mean plasma ADM level that was 10.5% (95% confidential interval: 2.5-17.8%) lower than the non-carriers (β=-0.115, P=0.011). Haplotype analysis revealed a similar significant association with plasma ADM (P=0.040). In multivariate analysis, the presence of the minor allele of rs4910118, but not plasma IL6, was independently associated with plasma ADM (P=0.010). CONCLUSION Plasma ADM correlates with plasma IL6 level, consistent with its role in inflammation. It is related to an SNP common in Chinese, independent of other covariates. ADM genotype should be included in future studies of cardiovascular risk prediction.
Collapse
Affiliation(s)
- Bernard M Y Cheung
- Department of Medicine, Research Centre of Heart, Brain, Hormone and Healthy Aging, School of Public Health, University of Hong Kong, Hong Kong, People's Republic of China.
| | | | | | | | | | | | | | | |
Collapse
|
36
|
Cheung BMY, Ong KL, Tso AWK, Cherny SS, Sham PC, Lam TH, Lam KSL. Gamma-glutamyl transferase level predicts the development of hypertension in Hong Kong Chinese. Clin Chim Acta 2011; 412:1326-31. [PMID: 21466796 DOI: 10.1016/j.cca.2011.03.030] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2011] [Revised: 03/28/2011] [Accepted: 03/28/2011] [Indexed: 11/25/2022]
Abstract
BACKGROUND Plasma activities of alkaline phosphatase, alanine aminotransferase (ALT), aspartate aminotransferase, and γ-glutamyl transferase (GGT) are often increased in cardiometabolic diseases. We investigated if hypertension is associated with increased activities of these plasma markers. METHODS We included 235 hypertensive and 708 normotensive subjects (mean age 47.3±9.6 and 58.0±10.2 years respectively) from the Hong Kong Cardiovascular Risk Factor Prevalence Study-2 (CRISPS-2) in 2000-2004 who had drank <1/week. In the follow-up study in 2005-2008 (CRISPS-3), 126 out of the 708 subjects had developed hypertension. RESULTS Raised plasma ALT (OR=1.22 per SD of log-transformed level, P=0.045) and GGT (OR=1.38 per SD of log-transformed level, P=0.001) levels were associated with hypertension at baseline in CRISPS-2 after adjusting for covariates. Among subjects not on anti-hypertensive medications, plasma ALP, ALT and GGT were related to blood pressure (P<0.01). In subjects normotensive at CRISPS-2, plasma GGT, but not ALP, ALT and AST, was an independent predictor of new-onset hypertension at CRISPS-3 (OR=1.38 per SD of log-transformed level, P=0.020 and OR=2.68 for 3rd tertile vs. 1st tertile, P=0.004) after adjusting for covariates. CONCLUSIONS Among the 4 plasma markers, increased GGT activity is the strongest predictor for existing and new-onset hypertension in Hong Kong Chinese.
Collapse
Affiliation(s)
- Bernard M Y Cheung
- Department of Medicine, University of Hong Kong, Hong Kong; Research Centre of Heart, Brain, Hormone and Healthy Aging, University of Hong Kong, Hong Kong.
| | | | | | | | | | | | | |
Collapse
|
37
|
Ong KL, Jiang CQ, Liu B, Jin YL, Tso AWK, Tam S, Wong KS, Tomlinson B, Cheung BMY, Lin JM, Yue XJ, Lam KSL, Lam TH, Thomas GN. Association of a genetic variant in the apolipoprotein A5 gene with the metabolic syndrome in Chinese. Clin Endocrinol (Oxf) 2011; 74:206-13. [PMID: 21054477 DOI: 10.1111/j.1365-2265.2010.03899.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Single nucleotide polymorphisms (SNPs) in the apolipoprotein A5 gene (APOA5) are associated with hypertriglyceridaemia in our population. We studied the associations of SNPs in APOA5 with the metabolic syndrome (MetS) in the Hong Kong and Guangzhou Chinese. METHODS We genotyped five tagging SNPs in 1330 unrelated subjects from the Hong Kong Cardiovascular Risk Factor Prevalence Study cohort with follow-up after a median interval of 6·4 years; 1952 subjects from the Guangzhou Biobank Cohort Study-Cardiovascular Disease Subcohort were used to replicate the findings. The MetS was defined according to the consensus criteria proposed jointly by several organizations in 2009. RESULTS The SNP rs662799 (-1131T>C) was associated with the MetS (odds ratio = 1·47, P = 0·00082) and the number of its components present (regression coefficient = 0·204, P = 4·6 × 10(-5) ) after adjusting for age, sex, smoking, drinking and education in Hong Kong subjects at baseline. Similar association of this SNP was found in Hong Kong subjects at follow-up (P = 0·010 and 0·00021, respectively) and in Guangzhou subjects (P = 0·0041 and 0·017, respectively). The association of rs662799 with the number of the MetS components was significant regardless of age, sex, obesity and alcohol drinking, but almost disappeared after further adjusting for plasma triglycerides. CONCLUSION Our results showed that the -1131T>C polymorphism in APOA5 was associated with the MetS because of its strong effect on plasma triglycerides. This may partly explain the higher cardiovascular risk in people with this polymorphism.
Collapse
Affiliation(s)
- Kwok Leung Ong
- Department of Medicine, University of Hong Kong, Hong Kong
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Cheung BMY, Ong KL, Tso AWK, Leung RYH, Xu A, Cherny SS, Sham PC, Lam TH, Lam KSL. C-reactive protein as a predictor of hypertension in the Hong Kong Cardiovascular Risk Factor Prevalence Study (CRISPS) cohort. J Hum Hypertens 2011; 26:108-16. [DOI: 10.1038/jhh.2010.125] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
39
|
Ong KL, Tso AWK, Leung RYH, Cherny SS, Sham PC, Lam TH, Cheung BMY, Lam KSL. A genetic variant in the gene encoding adrenomedullin predicts the development of dysglycemia over 6.4 years in Chinese. Clin Chim Acta 2010; 412:353-7. [PMID: 21075100 DOI: 10.1016/j.cca.2010.11.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2010] [Revised: 11/04/2010] [Accepted: 11/04/2010] [Indexed: 12/20/2022]
Abstract
BACKGROUND Adrenomedullin, a vasodilatory peptide, facilitates the differentiation of pre-adipocytes, and affects lipolysis and glucose uptake. We investigated the association of common single nucleotide polymorphisms (SNPs) in the gene encoding adrenomedullin (ADM) with dysglycemia in the Hong Kong Chinese population. METHODS Four SNPs were genotyped in 1391 subjects without dysglycemia at baseline from the Hong Kong Cardiovascular Risk Factor Prevalence Study-2, which had a median follow-up time of 6.4 years. Dysglycemia included impaired fasting glucose, impaired glucose tolerance, and diabetes according to the WHO 1998 criteria. At follow-up, 382 subjects had developed dysglycemia. RESULTS In stepwise logistic regression, the SNP rs11042725 was a significant independent predictor of the development of dysglycemia (OR=1.31, P=0.012), together with baseline age (P<0.001), plasma triglycerides (P<0.001), body mass index (P=0.004), 2-h glucose after oral glucose tolerance test (P<0.001), homeostasis model assessment of insulin resistance index (P=0.045), and follow-up duration (P=0.009). The association was more significant in women (P=0.002) and in subjects without regular exercise (P=0.001). CONCLUSIONS Our study suggests a potential role of genetic variants in the ADM gene in the development of dysglycemia in our local Chinese population.
Collapse
Affiliation(s)
- Kwok Leung Ong
- Department of Medicine, University of Hong Kong, Hong Kong
| | | | | | | | | | | | | | | |
Collapse
|
40
|
Abstract
Hypertension and type 2 diabetes are both common chronic conditions that affect a major proportion of the general population. They tend to occur in the same individual, suggesting common predisposing factors, which can be genetic or environmental. Although the genes causing hypertension or diabetes await elucidation, the environmental causes of these diseases are well known. Obesity and physical activity are the 2 leading factors that predispose to both diseases. Individuals with abdominal obesity are likely to develop lipid abnormalities and elevation of blood pressure and glucose. In time, hypertension and diabetes ensue. Because of the shared etiology, there is substantial overlap between hypertension and diabetes. In the Hong Kong Cardiovascular Risk Factor Prevalence Study, 40% of the subjects in the community had either raised blood pressure or raised blood glucose. Only 42% of people with diabetes had normal blood pressure and only 56% of people with hypertension had normal glucose tolerance. The presence of hypertension or diabetes should alert the clinician to the possibility of the other condition. Obesity, lipid abnormalities, raised blood pressure, and glucose are all components of the metabolic syndrome. The syndrome therefore implies a pathologic process, which is potentially reversible in the early stages. Previous efforts targeting smoking, hypertension, and hypercholesterolemia have started to bear fruit. However, obesity is on the increase in developed and developing countries. It is now time to focus on obesity and the metabolic syndrome, which require more a public health than a pharmacologic approach.
Collapse
|
41
|
Jiang CQ, Liu B, Cheung BMY, Lam TH, Lin JM, Li Jin Y, Yue XJ, Ong KL, Tam S, Wong KS, Tomlinson B, Lam KSL, Thomas GN. A single nucleotide polymorphism in APOA5 determines triglyceride levels in Hong Kong and Guangzhou Chinese. Eur J Hum Genet 2010; 18:1255-60. [PMID: 20571505 DOI: 10.1038/ejhg.2010.93] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Single nucleotide polymorphisms (SNPs) in the apolipoprotein A5 (APOA5) gene have been associated with hypertriglyceridaemia. We investigated which SNPs in the APOA5 gene were associated with triglyceride levels in two independent Chinese populations. In all, 1375 subjects in the Hong Kong Cardiovascular Risk Factor Prevalence Study were genotyped for five tagging SNPs chosen from HapMap. Replication was sought in 1996 subjects from the Guangzhou Biobank Cohort Study. Among the five SNPs, rs662799 (-1131T>C) was strongly related to log-transformed triglyceride levels among Hong Kong subjects (β=0.192, P=2.6 × 10(-13)). Plasma triglyceride level was 36.1% higher in CC compared to TT genotype. This association was confirmed in Guangzhou subjects (β=0.159, P=1.3 × 10(-12)), and was significantly irrespective of sex, age group, obesity, metabolic syndrome, hypertension, diabetes, smoking and alcohol drinking. The odds ratios and 95% confidence interval for plasma triglycerides ≥1.7 mmol/l associated with TC and CC genotypes were, respectively, 1.81 (1.37-2.39) and 2.22 (1.44-3.43) in Hong Kong and 1.27 (1.05-1.54) and 1.97 (1.42-2.73) in Guangzhou. Haplotype analysis suggested the association was due to rs662799 only. The corroborative findings in two independent populations indicate that the APOA5-1131T>C polymorphism is an important and clinically relevant determinant of plasma triglyceride levels in the Chinese population.
Collapse
|
42
|
Fong MC, Huang CC, Leu HB, Wu TC, Lin SJ, Chen JW. Glucose and non-glucose predictors of future onset of type 2 diabetes in newly diagnosed essential hypertensives. J Chin Med Assoc 2009; 72:564-72. [PMID: 19948433 DOI: 10.1016/s1726-4901(09)70431-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Baseline fasting plasma glucose (FPG) level predicts the onset of type 2 diabetes mellitus (DM). Other predictors have been less investigated. This study aimed to investigate non-glucose predictors together with FPG for future onset of type 2 DM in fresh essential hypertensives. METHODS Consecutive nondiabetic patients with newly diagnosed essential hypertension were prospectively evaluated for diurnal blood pressure (BP) change by ambulatory BP monitoring, vascular endothelial function by plethysmography, and biomarkers by blood biochemistry. They were then given guideline-based treatment and followed-up regularly for more than 5 years. RESULTS During a mean follow-up period of 5.9 years, 6 of the 106 study patients developed DM. Baseline FPG, alanine aminotransferase (ALT) level, and day-night difference in diastolic BP were related to future onset of DM. FPG > 5.8 mmol/L (p = 0.034) and ALT > 31 U/L (p = 0.048) independently and day-night difference in diastolic BP < or = 2.9% potentially predicted new-onset DM (p = 0.089). Simultaneously having at least 2 of the indicators mentioned above at baseline is predictive of new-onset DM. Parameters of reactive hyperemia by plethysmography were not relevant. CONCLUSION In addition to FPG, baseline serum ALT level independently and diurnal diastolic BP changes potentially predicted future onset of type 2 DM in newly diagnosed hypertensives. Both glucose and non-glucose indicators could be examined together for early risk stratification of future DM.
Collapse
Affiliation(s)
- Man-Cai Fong
- Division of Cardiology, Department of Medicine, Taipei Hospital, Department of Health, Taipei, Taiwan, R.O.C
| | | | | | | | | | | |
Collapse
|
43
|
Current literature in diabetes. Diabetes Metab Res Rev 2009; 25:i-x. [PMID: 19219862 DOI: 10.1002/dmrr.918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|