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Wu S, Zhong Q, Song Q, Wang M. The role of sex hormone binding globulin levels in the association of surgical and natural premature menopause with incident type 2 diabetes. Maturitas 2024; 187:108063. [PMID: 38991416 DOI: 10.1016/j.maturitas.2024.108063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 06/18/2024] [Accepted: 07/01/2024] [Indexed: 07/13/2024]
Abstract
OBJECTIVE To examine associations of surgical and natural menopause before the age of 40 years with the risk of type 2 diabetes (T2D) in women. METHODS A total of 273,331 women from the United Kingdom were recruited between 2006 and 2010 in the UK Biobank (UKB) study, and 146,343 women aged 40 to 69 years who were postmenopausal at baseline were included in the analysis. Surgical menopause and natural premature menopause were defined as bilateral oophorectomy before the age of 40 and menopause before the age of 40 without oophorectomy, respectively. Multivariable Cox regression models were used to estimate the hazard ratios (HRs) and 95 % confidence intervals (CIs) for the association between premature menopause and the incidence of T2D. RESULTS During a median follow-up of 10.4 years, 47 women with surgical premature menopause, 244 women with natural premature menopause, and 4724 women without premature menopause developed T2D. Compared with women without premature menopause, both surgical premature menopause (adjusted HR = 1.46, 95 % CI: 1.09-1.95; P = 0.01) and natural premature menopause (adjusted HR = 1.20, 95 % CI: 1.06-1.37; P < 0.01) were associated with higher risks of incident T2D in the multivariable-adjusted models. Additionally, we observed a significant interaction between levels of sex hormone binding globulin (SHBG) (Pinteraction < 0.01) and the effects of premature menopause on incident T2D. The association between premature menopause and T2D risk appeared to be stronger in women with higher SHBG levels. Furthermore, a joint association was detected between premature menopause and the genetic risk score (GRS) of T2D, with a higher score indicating a higher risk of developingT2D. The highest risk of T2D was observed with higher T2D GRS and surgical premature menopause (adjusted HR = 2.61, 95 % CI: 1.65-4.12; P < 0.01). CONCLUSIONS Surgical menopause and natural menopause before the age of 40 years were associated with an increased risk of T2D among postmenopausal women. The findings also suggest potential interactions of premature menopause with SHBG levels, with the association appearing to be stronger in higher SHBG levels, as well as a joint association between menopause status and genetic risk factors on T2D incidence.
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Affiliation(s)
- Shuang Wu
- Department of Gynecology and Obstetrics, Affiliated Hospital of Hangzhou Normal University, China
| | - Qiong Zhong
- Department of Ggynaecology and Obstetrics, Shuyang Mercy Hospital, China
| | - Qiying Song
- Department of Child Healthcare, Shenzhen Baoan Women's and Children's Hospital, China.
| | - Mengying Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, China.
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Park J, Jung JH, Park H, Song YS, Kim SK, Cho YW, Han K, Kim KS. Association between exercise habits and incident type 2 diabetes mellitus in patients with thyroid cancer: nationwide population-based study. BMC Med 2024; 22:251. [PMID: 38886720 PMCID: PMC11184752 DOI: 10.1186/s12916-024-03472-2] [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: 01/12/2024] [Accepted: 06/10/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND We investigated the association between exercise habits before or after thyroidectomy and incident type 2 diabetes mellitus (T2DM) in patients with thyroid cancer. METHODS An observational cohort study of 69,526 thyroid cancer patients who underwent thyroidectomy for the treatment of thyroid cancer between 2010 and 2016 was performed using the Korean National Health Information Database. Regular exercise was defined as mid-term or vigorous exercise at least 1 day in a week based on a self-reported questionnaire. Patients were divided into four groups according to exercise habits before and after thyroidectomy: persistent non-exercisers, new exercisers, exercise dropouts, and exercise maintainers. RESULTS During a median follow-up of 4.5 years, 2,720 (3.91%) patients developed T2DM. The incidence of T2DM per 1,000 person years was lower in patients who performed regular exercise before or after thyroidectomy than in persistent non-exercisers (10.77 in persistent non-exerciser group, 8.28 in new exerciser group, 8.59 in exercise dropout group, and 7.61 in exercise maintainer group). Compared with the persistent non-exerciser group, the new exerciser group (hazard ratio [HR] 0.87, 95% confidence interval [CI] 0.78-0.97), the exercise dropout group (HR 0.81, 95% CI 0.72-0.91), and the exercise maintainer group (HR 0.84, 95% CI 0.76-0.93) had lower risks of incident T2DM. Exercising < 1,500 MET-minutes/week in the exercise maintainer group was associated with a lower risk of incident T2DM compared with persistent non-exercisers (< 500: HR 0.80, 95% CI 0.67-0.96, P = 0.002; 500 to < 1,000: HR 0.81, 95% CI 0.71-0.93, P < 0.001; 1,000 to < 1,500: HR 0.81, 95% CI 0.69-0.94, P < 0.001). CONCLUSIONS Regular exercise before or after thyroidectomy was associated with a lower risk of incident T2DM in patients with thyroid cancer.
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Affiliation(s)
- Jiyun Park
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, 59 Yatap-Ro, Bundang-Gu, Seongnam, 13496, Republic of Korea
| | - Jin-Hyung Jung
- Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
| | - Hyunju Park
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, 59 Yatap-Ro, Bundang-Gu, Seongnam, 13496, Republic of Korea
| | - Young Shin Song
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Soo-Kyung Kim
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, 59 Yatap-Ro, Bundang-Gu, Seongnam, 13496, Republic of Korea
| | - Yong-Wook Cho
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, 59 Yatap-Ro, Bundang-Gu, Seongnam, 13496, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Kyung-Soo Kim
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, 59 Yatap-Ro, Bundang-Gu, Seongnam, 13496, Republic of Korea.
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Chang YL, Nfor ON, Chou YH, Hsiao CH, Zhong JH, Huang CN, Liaw YP. Risk of diabetes mellitus based on the interactive association between G6PD rs72554664 polymorphism and sex in Taiwan Biobank individuals. Sci Rep 2024; 14:12802. [PMID: 38834682 PMCID: PMC11150262 DOI: 10.1038/s41598-024-63361-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 05/28/2024] [Indexed: 06/06/2024] Open
Abstract
The presence of glucose-6-phosphate dehydrogenase (G6PD) deficiency may increase the risk of type 2 diabetes mellitus (T2DM), with differing prevalence between males and females. Although G6PD deficiency is an X-linked genetic condition, its interaction with sex regarding T2DM risk among the Taiwanese population has not been fully explored. This study aimed to investigate the association between G6PD deficiency and T2DM risk in the Taiwanese population, focusing on the potential influence of sex. Data were obtained from the Taiwan Biobank (TWB) database, involving 85,334 participants aged 30 to 70 years. We used multiple logistic regression analysis to assess the interaction between G6PD rs72554664 and sex in relation to T2DM risk. The T2DM cohort comprised 55.35% females and 44.65% males (p < 0.001). The TC + TT genotype of rs72554664 was associated with an increased risk of T2DM, with an odds ratio (OR) of 1.95 (95% CI: 1.39-2.75), and males showed an OR of 1.31 (95% CI: 1.19-1.44). Notably, the G6PD rs72554664-T allelic variant in hemizygous males significantly elevated the T2DM risk (OR), 4.57; p < 0.001) compared to females with the CC genotype. Our findings suggest that the G6PD rs72554664 variant, in conjunction with sex, significantly affects T2DM risk, particularly increasing susceptibility in males. The association of the G6PD rs72554664-T allelic variant with a higher risk of T2DM highlights the importance of sex-specific mechanisms in the interplay between G6PD deficiency and T2DM.
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Affiliation(s)
- Yen-Lin Chang
- Department of Pharmacy, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, 40201, Taiwan
- Center of Evidence-Based Medicine, Taichung Veterans General Hospital, Taichung, 407219, Taiwan
| | - Oswald Ndi Nfor
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, 40201, Taiwan
| | - Ying-Hsiang Chou
- Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung, 40201, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, 40201, Taiwan
- School of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, 40201, Taiwan
| | - Chih-Hsuan Hsiao
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, 40201, Taiwan
| | - Ji-Han Zhong
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, 40201, Taiwan
| | - Chien-Ning Huang
- Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, 40201, Taiwan.
- Institute of Medicine, Chung Shan Medical University, Taichung, 40201, Taiwan.
| | - Yung-Po Liaw
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, 40201, Taiwan.
- Institute of Medicine, Chung Shan Medical University, Taichung, 40201, Taiwan.
- Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, 40201, Taiwan.
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Ahn SY, Lee SW, Shin HJ, Lee WJ, Kim JH, Kim HJ, Song W. Effects of a 2-Week Kinect-Based Mixed-Reality Exercise Program on Prediabetes: A Pilot Trial during COVID-19. J Obes Metab Syndr 2024; 33:54-63. [PMID: 38204191 PMCID: PMC11000517 DOI: 10.7570/jomes23040] [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: 06/21/2023] [Revised: 11/07/2023] [Accepted: 11/29/2023] [Indexed: 01/12/2024] Open
Abstract
Background Pre-diabetes can develop into type 2 diabetes mellitus, but can prevented by regular exercise. However, the outcomes when combining unsupervised Kinect-based mixed-reality (KMR) exercise with continuous glucose monitoring (CGM) remain unclear. Therefore, this single-arm pilot trial examined changes in blood glucose (BG) concentrations over 672 hours (4 weeks), including a 2-week period of KMR exercise and CGM in individuals with pre-diabetes. Methods This was a pre-and post-treatment case-control study with nine participants. General questionnaires were administered and body composition, fasting BG concentrations, and 2-hour oral glucose tolerance test (2-OGTT) results were measured pre-and post-treatment. Weekly average glucose concentrations, hyperglycemia rate, hypoglycemia rate, average glucose concentration over time, amount of physical activity, amount of food intake, and pre- and postprandial BG (immediately and 30, 60, 90, and 120 minutes after lunch) were measured over 4 weeks (pre-test, exercise, and post -test weeks). Glucose concentrations were measured before exercising, between sets, and 30 and 60 minutes after exercise during the 2 weeks of unsupervised exercise (3 days/week). Results In all participants, body mass index (27.16±2.92 kg/m2), fasting BG (108.00±7.19 mg/dL), 2-OGTT (162.56±18.12 mg/dL), hyperglycemia rate (P=0.040), and 90-minute postprandial BG (P=0.035) were significantly reduced during the 2 exercise weeks, and the 2-OGTT result (P=0.044) and diastolic blood pressure (DBP) (P=0.046) were significantly reduced at the post -test as compared with the pre-test. Conclusion This study found that 2 weeks of unsupervised KMR exercise reduced 2-OGTT, DBP, hyperglycemia rate, and 90-minute postprandial BG concentration. We believed this effect could be identified more clearly in studies involving a larger number of participants and longer durations of exercise.
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Affiliation(s)
- So Young Ahn
- Institute of Sports Science, Department of Physical Education, Seoul National University, Seoul, Korea
| | - Si Woo Lee
- Research Institute, Dr.EXSol Inc., Seoul, Korea
| | - Hye Jung Shin
- Institute of Sports Science, Department of Physical Education, Seoul National University, Seoul, Korea
- Research Institute, Dr.EXSol Inc., Seoul, Korea
| | - Won Jae Lee
- Department of Physical Education, Kyungnam University, Changwon, Korea
| | | | | | - Wook Song
- Institute of Sports Science, Department of Physical Education, Seoul National University, Seoul, Korea
- Research Institute, Dr.EXSol Inc., Seoul, Korea
- Institute on Aging, Seoul National University, Seoul, Korea
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Kwon Y, Kwon JW, Kim J, Kim D, Hwang J, Ha J, Park SH, Park S. Comparative Risk of Type 2 Diabetes after Gastrectomy and Endoscopic Resection for Gastric Cancer: A Nationwide Cohort Study. J Am Coll Surg 2023; 237:902-910. [PMID: 37725145 DOI: 10.1097/xcs.0000000000000868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
BACKGROUND Patients with gastric cancer (GC) experience 2 characteristic treatment modalities (gastrectomy or endoscopic resection), which may induce heterogeneity in the risk of post-cancer treatment type 2 diabetes (T2D). We investigated differences in the risk for T2D development in survivors of GC according to the 2 treatment methods. STUDY DESIGN This retrospective nationwide population-based cohort study included 14,646 patients with GC who underwent gastrectomy (n = 12,918) or endoscopic resection (n = 1,728). We enrolled patients who survived for at least 5 years after gastrectomy or endoscopic resection, had no history of diabetes, and had not received adjuvant chemotherapy. T2D risk was evaluated using Cox regression for the gastrectomy group and compared to that of the endoscopic resection group. Because of the competing risks of incident T2D and death, a competing risk regression was performed. RESULTS After a median follow-up duration of 8.1 years, the incidence rates of T2D in the endoscopic resection group and gastrectomy group were 7.58 and 6.98 per 1,000 person-years, respectively. Patients undergoing gastrectomy showed a significantly higher risk for developing T2D than patients undergoing endoscopic resection (hazard ratio [HR], 1.37; 95% CI 1.18 to 1.58; p < 0.0001). In subgroup analyses, gastrectomy was associated with increased T2D risk in female patients (HR, 1.72; 95% CI 1.22 to 2.43; p = 0.030 for interaction). CONCLUSIONS Among GC survivors, patients undergoing gastrectomy showed a 37% increased risk of T2D development compared to patients undergoing endoscopic resection. Subgroup analyses showed that T2D risk increased by up to 72% in female patients. These results provide insights for establishing screening and preventive strategies for GC survivors to prevent T2D according to different treatment modalities.
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Affiliation(s)
- Yeongkeun Kwon
- From the Division of Foregut Surgery (Y Kwon, J Kim, SH Park, S Park) Korea University, Seoul, Korea
| | - Jin-Won Kwon
- From the Division of Foregut Surgery (Y Kwon, J Kim, SH Park, S Park) Korea University, Seoul, Korea
| | - Jiyun Kim
- From the Division of Foregut Surgery (Y Kwon, J Kim, SH Park, S Park) Korea University, Seoul, Korea
| | - Dohyang Kim
- From the Division of Foregut Surgery (Y Kwon, J Kim, SH Park, S Park) Korea University, Seoul, Korea
| | - Jinseub Hwang
- From the Division of Foregut Surgery (Y Kwon, J Kim, SH Park, S Park) Korea University, Seoul, Korea
| | - Jane Ha
- From the Division of Foregut Surgery (Y Kwon, J Kim, SH Park, S Park) Korea University, Seoul, Korea
| | - Shin-Hoo Park
- From the Division of Foregut Surgery (Y Kwon, J Kim, SH Park, S Park) Korea University, Seoul, Korea
| | - Sungsoo Park
- From the Division of Foregut Surgery (Y Kwon, J Kim, SH Park, S Park) Korea University, Seoul, Korea
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Pataky MW, Dasari S, Michie KL, Sevits KJ, Kumar AA, Klaus KA, Heppelmann CJ, Robinson MM, Carter RE, Lanza IR, Nair KS. Impact of biological sex and sex hormones on molecular signatures of skeletal muscle at rest and in response to distinct exercise training modes. Cell Metab 2023; 35:1996-2010.e6. [PMID: 37939659 PMCID: PMC10659143 DOI: 10.1016/j.cmet.2023.10.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 05/09/2023] [Accepted: 10/13/2023] [Indexed: 11/10/2023]
Abstract
Substantial divergence in cardio-metabolic risk, muscle size, and performance exists between men and women. Considering the pivotal role of skeletal muscle in human physiology, we investigated and found, based on RNA sequencing (RNA-seq), that differences in the muscle transcriptome between men and women are largely related to testosterone and estradiol and much less related to genes located on the Y chromosome. We demonstrate inherent unique, sex-dependent differences in muscle transcriptional responses to aerobic, resistance, and combined exercise training in young and older cohorts. The hormonal changes with age likely explain age-related differential expression of transcripts. Furthermore, in primary human myotubes we demonstrate the profound but distinct effects of testosterone and estradiol on amino acid incorporation to multiple individual proteins with specific functions. These results clearly highlight the potential of designing exercise programs tailored specifically to men and women and have implications for people who change gender by altering their hormone profile.
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Affiliation(s)
- Mark W Pataky
- Division of Endocrinology and Metabolism, Mayo Clinic, Rochester, MN, USA
| | - Surendra Dasari
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Kelly L Michie
- Division of Endocrinology and Metabolism, Mayo Clinic, Rochester, MN, USA
| | - Kyle J Sevits
- Division of Endocrinology and Metabolism, Mayo Clinic, Rochester, MN, USA
| | - A Aneesh Kumar
- Division of Endocrinology and Metabolism, Mayo Clinic, Rochester, MN, USA
| | - Katherine A Klaus
- Division of Endocrinology and Metabolism, Mayo Clinic, Rochester, MN, USA
| | | | - Matthew M Robinson
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Rickey E Carter
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Ian R Lanza
- Division of Endocrinology and Metabolism, Mayo Clinic, Rochester, MN, USA
| | - K Sreekumaran Nair
- Division of Endocrinology and Metabolism, Mayo Clinic, Rochester, MN, USA.
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Pradeepa R, Shreya L, Anjana RM, Jebarani S, Venkatesan U, Kamal Raj N, Swami OC, Mohan V. Sex-Based Differences in Clinical Profile and Complications among Individuals with Type 2 Diabetes Seen at a Private Tertiary Diabetes Care Centre in India. Healthcare (Basel) 2023; 11:healthcare11111634. [PMID: 37297774 DOI: 10.3390/healthcare11111634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/25/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023] Open
Abstract
This study aimed to compare the clinical and biochemical profiles as well as the complications in males and females with type 2 diabetes (T2DM) presenting to a private tertiary diabetes care centre in India. This is a retrospective study, conducted between 1 January 2017 and 31 December 2019, and included 72,980 individuals with T2DM, aged ≥ 18 years (age and sex-matched-males-36,490; females-36,490). Anthropometric measurements, blood pressure, fasting plasma glucose (FPG), post-prandial plasma glucose (PPPG), glycated haemoglobin (HbA1c), lipids, urea, and creatinine were measured. Retinopathy was screened using retinal photography, neuropathy using biothesiometry, nephropathy measuring urinary albumin excretion, peripheral vascular disease (PVD) using Doppler, and coronary artery disease (CAD) based on the history of myocardial infarction and/or drug treatment for CAD and/or electrocardiographic changes. Obesity (73.6% vs. 59.0%) rates were significantly higher in females compared to males. FPG, PPPG, and HbA1c were higher among younger age groups among both sexes, with males having higher values compared to females. However, after the age of 44 years, control of diabetes was worse among females. In addition, only 18.8% of the females achieved glycemic control (HbA1c < 7%) compared to 19.9% in males (p < 0.001). Males had higher prevalence of neuropathy (42.9% vs. 36.9%), retinopathy (36.0% vs. 26.3%), and nephropathy (25.0% vs. 23.3%) compared to females. Males had 1.8- and 1.6-times higher risk of developing CAD and retinopathy compared to females. Hypothyroidism (12.5% vs. 3.5%) and cancers (1.3% vs. 0.6%) were significantly higher in females compared to males. In this large sample of T2DM seen at a chain of private tertiary diabetes centres, females had higher prevalence of metabolic risk factors and poorer diabetes control compared to males, emphasizing the need for better control of diabetes in females. However, males had higher prevalence of neuropathy, retinopathy, nephropathy, and CAD compared to females.
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Affiliation(s)
- Rajendra Pradeepa
- Madras Diabetes Research Foundation, ICMR Centre for Advanced Research on Diabetes, Chennai 600086, India
- Dr. Mohan's Diabetes Specialities Centre, Chennai 600086, India
| | - Lal Shreya
- Emcure Pharmaceuticals Ltd., Pune 411057, India
| | - Ranjit Mohan Anjana
- Madras Diabetes Research Foundation, ICMR Centre for Advanced Research on Diabetes, Chennai 600086, India
- Dr. Mohan's Diabetes Specialities Centre, Chennai 600086, India
| | - Saravanan Jebarani
- Madras Diabetes Research Foundation, ICMR Centre for Advanced Research on Diabetes, Chennai 600086, India
- Dr. Mohan's Diabetes Specialities Centre, Chennai 600086, India
| | - Ulagamathesan Venkatesan
- Madras Diabetes Research Foundation, ICMR Centre for Advanced Research on Diabetes, Chennai 600086, India
- Dr. Mohan's Diabetes Specialities Centre, Chennai 600086, India
| | - Nithyanantham Kamal Raj
- Madras Diabetes Research Foundation, ICMR Centre for Advanced Research on Diabetes, Chennai 600086, India
- Dr. Mohan's Diabetes Specialities Centre, Chennai 600086, India
| | | | - Viswanathan Mohan
- Madras Diabetes Research Foundation, ICMR Centre for Advanced Research on Diabetes, Chennai 600086, India
- Dr. Mohan's Diabetes Specialities Centre, Chennai 600086, India
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Al Wahbi MF, Al-fahhad NM. Type 2 diabetes mellitus risk assessment among Alrass city employees, Qassim, Saudi Arabia. J Family Med Prim Care 2023; 12:722-726. [PMID: 37312789 PMCID: PMC10259541 DOI: 10.4103/jfmpc.jfmpc_1801_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 12/08/2022] [Accepted: 01/16/2023] [Indexed: 06/15/2023] Open
Abstract
Background Diabetes mellitus (DM) is a serious chronic disease that can affect all parts of human body and associated with short-term and long-term complications such as retinopathy, nephropathy, and neuropathy. Age, obesity, family history, and hypertension are considered to be the most common risk factors for the incidence of DM. This study aimed to assess the risk of type 2 diabetes among governmental employee in Alrass city in Qassim, Saudi Arabia. Material and Methods A cross-sectional survey was done using health professional-administrated questionnaire. Two groups of data collectors were formed and trained to fill out the questionnaire, each group was consist of 1 family medicine doctor and 4 nurses. Data were entered and analyzed using SPSS v. 26. Results A total of 527 subjects participated in our study with a response rate of 100%. Of them, more than half (55%) were females. Approximately all of our participants were Saudi 92% regarding age, more than three quarters (79.5%) were aged less than 45 years, 15.6% were ranged from 45 to 50 years, and 4.9% were from 55 to 64 years. We reported no significant correlation between gender and nationality regarding the risk of DM. Conclusion Saudi females who aged less than 45 years and obese participants had a risk for developing DM.
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Affiliation(s)
- Muath Fahad Al Wahbi
- Unit of Diabetes and Endocrine, Ministry of Health, Alrass General Hospital, Qassim, Kingdom of Saudi Arabia
| | - Noor Mohammed Al-fahhad
- Department of Family Medicine, College of Medicine, Qassim University, Qassim, Kingdom of Saudi Arabia
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Lee SJ, Han MA, Park J, Ryu SY. Utilization of nutrition labels and related factors among patients with diabetes in Korea. Nutr Res Pract 2023; 17:297-306. [PMID: 37009140 PMCID: PMC10042708 DOI: 10.4162/nrp.2023.17.2.297] [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: 02/28/2022] [Revised: 07/01/2022] [Accepted: 08/08/2022] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND/OBJECTIVES The prevalence of diabetes has continued to increase globally. Changes in eating habits, lack of exercise, increased stress, and aging are major contributors. Glycemic control is the key strategy of diabetes management. The purpose of this study was to analyze the utilization of nutrition labels and related factors among patients with diabetes. MATERIALS/METHODS Data from the 7th Korea National Health and Nutrition Examination Survey were used. General, health-related, diabetes-related characteristics from 1,587 adults with diabetes history were included. Nutrition label utilization was assessed with awareness and use of nutrition labels and effects on food choice. For statistical analyses, chi-square test and multiple logistic regression analysis were performed. RESULTS The prevalence of awareness, use, and effects of nutrition labels on food choice among diabetic patients were 48.8%, 11.4%, and 9.6%, respectively. High monthly income, walking frequency, family history of diabetes, younger age at diagnosis, and shorter duration of diabetes were associated with higher nutrition label awareness. Nutrition label use and effect on food choice were higher in women, those with high monthly income, those diagnosed at younger than 45 yrs, those with diabetes for less than 10 yrs, those with meal therapy, or patients who had undergone a fundus examination. CONCLUSIONS Nutrition label utilization status was low in Korean patients with diabetes. Strategies are needed to promote nutrition label use as a diet management tool for patients with diabetes.
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Affiliation(s)
- So-Jung Lee
- Department of Public Health, Graduate School of Health Science, Chosun University, Gwangju 61452, Korea
- Department of Nutritional Management Service Team, Kwangju Christian Hospital, Gwangju 61452, Korea
| | - Mi Ah Han
- Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju 61452, Korea
| | - Jong Park
- Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju 61452, Korea
| | - So Yeon Ryu
- Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju 61452, Korea
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Tak J, Bok M, Rho H, Park JH, Lim Y, Chon S, Lim H. Effect of diabetes-specific oral nutritional supplements with allulose on weight and glycemic profiles in overweight or obese type 2 diabetic patients. Nutr Res Pract 2023; 17:241-256. [PMID: 37009137 PMCID: PMC10042715 DOI: 10.4162/nrp.2023.17.2.241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/30/2022] [Accepted: 09/06/2022] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND/OBJECTIVES Diabetes-specific oral nutritional supplements (ONS) have anti-hyperglycemic effects, while D-allulose exerts anti-diabetic and anti-obesity effects. In this study, we investigated the efficacy and safety of diabetes-specific ONS, including allulose, on glycemic and weight changes in overweight or obese patients with type 2 diabetes mellitus (T2DM). SUBJECTS/METHODS A single-arm, historical-control pilot clinical trial was conducted on 26 overweight or obese patients with T2DM (age range: 30-70 yrs). The participants were administered 2 packs of diabetes-specific ONS, including allulose (200 kcal/200 mL), every morning for 8 weeks. The glycemic profiles, obesity-related parameters, and lipid profiles were assessed to evaluate the efficacy of ONS. RESULTS After 8 weeks, fasting blood glucose (FBG) level significantly decreased from 139.00 ± 29.66 mg/dL to 126.08 ± 32.00 mg/dL (P = 0.007) and glycosylated hemoglobin (HbA1c) improved (7.23 ± 0.82% vs. 7.03 ± 0.69%, P = 0.041). Moreover, the fasting insulin (δ: -1.81 ± 3.61 μU/mL, P = 0.017) and homeostasis model assessment for insulin resistance (HOMA-IR) (δ: -0.87 ± 1.57, P = 0.009) levels decreased at 8 weeks, and body weight significantly decreased from 67.20 ± 8.29 kg to 66.43 ± 8.12 kg (P = 0.008). Body mass index (BMI) also decreased in accordance with this (from 25.59 ± 1.82 kg/m2 to 25.30 ± 1.86 kg/m2, P = 0.009), as did waist circumference (δ: -1.31 ± 2.04 cm, P = 0.003). CONCLUSIONS The consumption of diabetes-specific ONS with allulose in overweight or obese patients with T2DM improved glycemic profiles, such as FBG, HbA1c, and HOMA-IR, and reduced body weight and BMI.
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Affiliation(s)
- Jihye Tak
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Korea
| | - Minkyung Bok
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Korea
- Research Institute of Medical Nutrition, Kyung Hee University, Seoul 02447, Korea
| | - Hyunkyung Rho
- Department of Food and Nutrition, Kyung Hee University, Seoul 02447, Korea
| | - Ju Hyun Park
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Korea
- Research Institute of Medical Nutrition, Kyung Hee University, Seoul 02447, Korea
| | - Yunsook Lim
- Department of Food and Nutrition, Kyung Hee University, Seoul 02447, Korea
| | - Suk Chon
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul 02447, Korea
| | - Hyunjung Lim
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Korea
- Research Institute of Medical Nutrition, Kyung Hee University, Seoul 02447, Korea
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Sharma A, Lulu C, Song KH, Lee HJ. Differences in health behavior and nutrient intake status between diabetes-aware and unaware Korean adults based on the Korea national health and nutrition examination survey 2016-18 data: A cross-sectional study. Front Public Health 2022; 10:1005369. [PMID: 36408042 PMCID: PMC9669760 DOI: 10.3389/fpubh.2022.1005369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022] Open
Abstract
Background The aim of this study was to investigate the nutritional intakes and treatment regimens of Korean patients with type 2 diabetes who were aware of their condition. Methods Participants (n = 16582) aged ≥ 19 years from the 2016-18 National Health and Nutrition Survey were divided into diabetes-aware and unaware groups and the variables were compared. Results Among 1,906 (11.5%) diabetic adults, 1,433 (75.2%) were aware of their condition; 130 (9.1%) had nutrition education, and 1,340 (93.5%) were in the diabetes-aware treatment group. The diabetes-aware group had higher average age (P < 0.0001) and lower average BMI (P = 0.0015) than the unaware group. Intake of total fat (P = 0.0034), saturated fatty acids (P = 0.0021), riboflavin (P = 0.0035) and niacin (P = 0.0228) was significantly higher in the unaware group than in the diabetes-aware group, after adjusting energy intake for age and sex. Current smoking (P = 0.0046) and heavy drinking (P < 0.0001) rates were higher in the unaware group, whereas fiber intake (P = 0.0054) was lower in the unaware group. Higher levels of glycated hemoglobin were found in the group treated for diabetes (7.2%) than in the no-treatment (6.8%) group (P = 0.0048). Diabetes control was significantly better in the high income group. Conclusions There is a need to strengthen nutritional education to prevent diabetes and improve the health status of diabetic patients in Korea.
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Affiliation(s)
- Anshul Sharma
- Department of Food and Nutrition, College of Bionanotechnology, Gachon University, Seongnam-si, South Korea
| | - Chen Lulu
- Department of Food and Nutrition, College of Bionanotechnology, Gachon University, Seongnam-si, South Korea
| | - Kee-Ho Song
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, South Korea
| | - Hae-Jeung Lee
- Department of Food and Nutrition, College of Bionanotechnology, Gachon University, Seongnam-si, South Korea,Institute for Aging and Clinical Nutrition Research, Gachon University, Seongnam-si, South Korea,Department of Health Sciences and Technology, GAIHST, Gachon University, Seongnam-si, South Korea,*Correspondence: Hae-Jeung Lee ;
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12
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Phan DH, Vu TT, Doan VT, Le TQ, Nguyen TD, Van Hoang M. Assessment of the risk factors associated with type 2 diabetes and prediabetes mellitus: A national survey in Vietnam. Medicine (Baltimore) 2022; 101:e31149. [PMID: 36253989 PMCID: PMC9575745 DOI: 10.1097/md.0000000000031149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This study aims to estimating the prevalence of type 2 diabetes and prediabetes among adult from 30 to 69 years old and assess the association of risk factor with the conditions. A total of 5244 aged 30 to 69 years old were participated in this cross-sectional study, using nationally representative sampling frame. All participants were taking blood sample to measure fasting blood glucose level and 2-hour postload oral glucose tolerance test by National Hospital of Endocrinology, Vietnam. Multinomial logistic regressions with baseline-category logit models were conducted to identify factors associated with diabetes and prediabetes among respondents. The prediabetes prevalence was in 17.9% and diabetes in 7.3%. Patients who were male (reference group vs female OR = 0.79; 95% CI: 0.64, 0.97), in the 50 to 59 years old group (OR = 1.60; 95% CI: 1.28, 2.00), have hypertension and WHR risk have higher prevalence to have prediabetes (OR = 1.31; 95% CI: 1.12, 1.53; OR = 1.37; 95% CI: 1.11, 1.70, respectively). Male patients (reference group vs female OR = 0.62; 95% CI: 0.45, 0.84), patients who were in 40 to 49; 50 to 59; 60 to 69 years old, those who were housewife (OR = 2.17; 95% CI: 1.43, 3.28; OR = 2.85; 95% CI: 1.91, 4.27; OR = 3.12; 95% CI: 2.08, 4.69; OR = 1.71; 95% CI: 1.22, 2.40, respectively). Diabetes have significant associated with participants have hypertension (OR = 1.19; 95% CI: 1.72, 2.70). The common factor directly related to prediabetes and diabetes in both genders is age. Other factors directly associated with prediabetes and diabetes include BMI, WHR, hypertension, educational level, and job.
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Affiliation(s)
| | - Trang Thu Vu
- Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
- * Correspondence: Trang Thu Vu, Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam (e-mail: )
| | - Vu Tuan Doan
- National Hospital of Endocrinology, Hanoi, Vietnam
| | | | | | - Minh Van Hoang
- Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
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Lee SA, Park H, Kim W, Song SO, Lim H, Chun SY. The Effect of Chronic Disease Management Program on the Risk of Complications in Patients With Hypertension in Korea. J Korean Med Sci 2022; 37:e243. [PMID: 35942556 PMCID: PMC9359918 DOI: 10.3346/jkms.2022.37.e243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 06/28/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND A chronic disease management program was implemented in April 2012 to lower out-of-pocket costs for repeat visits to the same clinic. The aim of this study was to investigate the association between participating in this program and the onset of complications among patients with hypertension using whole-nation claims data. METHODS We used National Health Insurance Service data (2011-2018) and patients with newly detected hypertension from 2012 to 2014 were selected. Chronic disease management program reduces the out-of-pocket expenses of consultation fee from 30% to 20% when patients enroll in this program by agreeing to visit the same clinic for the treatment of hypertension or diabetes. As the dependent variable, acute myocardial infarction (MI), stroke, chronic kidney disease (CKD), and heart failure (HF) were selected. For analysis, cox proportional hazards model was used. RESULTS Total participants were 827,577, among which 102,831(12.6%) subjects participated in the chronic disease management. Participants of the chronic disease management program were more likely to show lower hazard ratios (HRs) than those of non-participants in terms of all complications (MI: HR, 0.75; 95% confidence interval [CI], 0.68-0.82; stroke: HR, 0.75; 95% CI, 0.72-0.78; CKD: HR, 0.90; 95% CI, 0.85-0.96; HF: HR, 0.56; 95% CI, 0.52-0.61). CONCLUSION The results showed that participants of the chronic disease management program were less likely to have hypertension complications compared to non-participants. Enhancing the participation rate may be related to better outcomes and reducing medical expenses among patients with chronic diseases.
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Affiliation(s)
- Sang Ah Lee
- BigData Strategy Department, National Health Insurance Service, Wonju, Korea
| | - Hyeki Park
- HIRA Research Institute, Health Insurance Review and Assessment Service, Wonju, Korea
- Department of Public Health, Graduate School, College of Medicine, Yonsei University, Seoul, Korea
| | - Woorim Kim
- Division of Cancer Control & Policy, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Sun Ok Song
- Division of Endocrinology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Hyunsun Lim
- Department of Research and Analysis, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Sung-Youn Chun
- Department of Research and Analysis, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
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14
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Delaney KZ, Santosa S. Sex differences in regional adipose tissue depots pose different threats for the development of Type 2 diabetes in males and females. Obes Rev 2022; 23:e13393. [PMID: 34985183 DOI: 10.1111/obr.13393] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 10/26/2021] [Accepted: 10/28/2021] [Indexed: 01/08/2023]
Abstract
Type 2 diabetes mellitus (T2DM) affects males and females disproportionately. In midlife, more males have T2DM than females. The sex difference in T2DM prevalence is, in part, explained by differences in regional adipose tissue characteristics. With obesity, changes to regional adipokine and cytokine release increases the risk of T2DM in both males and females with males having greater levels of TNFα and females having greater levels of leptin, CRP, and adiponectin. Regional immune cell infiltration appears to be pathogenic in both sexes via different routes as males with obesity have greater VAT ATM and a decrease in the protective Treg cells, whereas females have greater SAT ATM and T cells. Lastly, the ability of female adipose tissue to expand all regions through hyperplasia, rather than hypertrophy, protects them against the development of large insulin-resistant adipocytes that dominate male adipose tissue. The objective of this review is to discuss how sex may affect regional differences in adipose tissue characteristics and how these differences may distinguish the development of T2DM in males and females. In doing so, we will show that the origins of T2DM development differ between males and females.
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Affiliation(s)
- Kerri Z Delaney
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montréal, Québec, Canada.,Metabolism, Obesity and Nutrition Lab, PERFORM Centre, Concordia University, Montréal, Québec, Canada.,Centre de recherche - Axe maladies chroniques, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Ile-de-Montréal, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada
| | - Sylvia Santosa
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montréal, Québec, Canada.,Metabolism, Obesity and Nutrition Lab, PERFORM Centre, Concordia University, Montréal, Québec, Canada.,Centre de recherche - Axe maladies chroniques, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Ile-de-Montréal, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada
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Chandy G, Dhanapal S, Joseph J, Rajaram R, Madhiyazhagan M, Prabhakar Abhilash K. Acute diabetic complications and implications of glycated hemoglobin levels (HbA1c) in the emergency department – Experience from a tertiary care centre of South India. MEDICAL JOURNAL OF DR. D.Y. PATIL VIDYAPEETH 2022. [DOI: 10.4103/mjdrdypu.mjdrdypu_531_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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16
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Choi YJ, Shin HB, Park B, Kim DJ, Chung YS. Temporal change in the diagnosis and treatment rates of osteoporosis: results from the Korea National Health and Nutrition Examination Survey. Osteoporos Int 2021; 32:1777-1784. [PMID: 33630130 PMCID: PMC8387256 DOI: 10.1007/s00198-021-05864-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 01/28/2021] [Indexed: 12/25/2022]
Abstract
To compare the diagnosis andtreatment rates of osteoporosis and diabetes in Korea, a nationwide database was used. The results showed that although osteoporosis management is improving, it is still lower compared with that of diabetes; thus, further efforts are needed in this regard. INTRODUCTION This study aimed to re-evaluate the diagnosis and treatment of osteoporosis from the KNHANES 2016-2017 and compare the temporal change of the rate with those of diabetes as another prevalent chronic disease in South Korea. METHODS The prevalence of osteoporosis in 2016 was estimated using the previous data classified by age groups (50-59,60-69, and ≥70years) and the 2016 Korean census data. The physician diagnosis and treatment rates of osteoporosis in adults aged ≥50years were estimated using the 2016-2017 KNHANES data. The physician diagnosis and treatment rates of diabetes were evaluated using the KNHANES 2008-2009 and 2016-2017 data. RESULTS The estimated physician diagnosisrate of osteoporosis increased from 29.9% in females and 5.8% in males in 2008-2009 to 62.8% in females and 22.8% in males in 2016-2017. The treatment rate for the estimated total number of patients with osteoporosis increased from 14.4% in females and 3.8% in males in 2008-2009 to 32.2% in females and 9.0% in males in 2016-2017. An increasing trend in the estimated treatment rateof physician-diagnosed osteoporosis patients was not observed (48.3% [2008-2009] vs 51.5% [2016-2017] in females; 42.6% [2008-2009] vs 42.2% [2016-2017] in males). The physician diagnosis and treatment rates of diabetes were considerably better and more stable than those of osteoporosis. CONCLUSION Osteoporosis management in South Korea is improving but is insufficient compared with diabetes management. More extensive efforts are needed to improve the diagnosis and treatment rates of osteoporosis.
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Affiliation(s)
- Y J Choi
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, 164 Worldcup-ro, Suwon, 16499, South Korea
- Institute on Aging, Ajou University Medical Center, Suwon, South Korea
| | - H-B Shin
- Office of Biostatistics, Ajou Research Institute for Innovation Medicine, Ajou University Medical Center, Suwon, South Korea
| | - B Park
- Office of Biostatistics, Ajou Research Institute for Innovation Medicine, Ajou University Medical Center, Suwon, South Korea
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea
| | - D J Kim
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, 164 Worldcup-ro, Suwon, 16499, South Korea
- Institute on Aging, Ajou University Medical Center, Suwon, South Korea
| | - Y-S Chung
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, 164 Worldcup-ro, Suwon, 16499, South Korea.
- Institute on Aging, Ajou University Medical Center, Suwon, South Korea.
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Risk Factors of Undiagnosed Diabetes Mellitus among Korean Adults: A National Cross-Sectional Study Using the KNHANES Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031195. [PMID: 33572855 PMCID: PMC7908078 DOI: 10.3390/ijerph18031195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 01/22/2021] [Accepted: 01/23/2021] [Indexed: 11/17/2022]
Abstract
In this cross-sectional study, we investigated the baseline risk factors of diabetes mellitus (DM) in patients with undiagnosed DM (UDM). We utilized the Korean National Health and Nutrition Examination Survey (KNHANES) 2010–2017 data. Data regarding the participants’ demographic characteristics, health status, health determinants, healthcare accessibility, and laboratory tests were gathered to explore the differences between the DM, UDM, and without-DM groups. Among the 64,759 individuals who participated in the KNHANES 2010–2017, 32,611 individuals aged ≥20 years with fasting plasma glucose levels of <100 or ≥126 mg/dL were selected. The odds ratios (ORs) regarding family history of diabetes and the performance of national health and cancer screening tests were lower in the UDM group than in the DM group (adjusted OR: 0.54; 95% confidence interval (CI): 0.43, 0.66; adjusted OR: 0.74; 95% CI: 0.62, 0.89; adjusted OR: 0.71; 95% CI: 0.60, 0.85). The ORs of hypertension and obesity were higher in the UDM group than in the DM group (adjusted OR: 1.32; 95% CI: 1.06, 1.64; adjusted OR: 1.80; 95% CI: 1.37, 2.36, respectively). Patients with UDM were more likely to be exposed to DM-related risk factors than those with and without DM. Public health interventions to prevent UDM development are necessary.
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Seong HJ, Kim J, Song S, Son K, Park S, Chung EJ. Estimated Incidence and Projections of Treatment Cost for Vision-threatening Diabetic Retinopathy in Korea. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2021. [DOI: 10.3341/jkos.2021.62.1.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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19
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Jung CH, Son JW, Kang S, Kim WJ, Kim HS, Kim HS, Seo M, Shin HJ, Lee SS, Jeong SJ, Cho Y, Han SJ, Jang HM, Rho M, Lee S, Koo M, Yoo B, Moon JW, Lee HY, Yun JS, Kim SY, Kim SR, Jeong IK, Mok JO, Yoon KH. Diabetes Fact Sheets in Korea, 2020: An Appraisal of Current Status. Diabetes Metab J 2021; 45:1-10. [PMID: 33434426 PMCID: PMC7850879 DOI: 10.4093/dmj.2020.0254] [Citation(s) in RCA: 134] [Impact Index Per Article: 44.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 12/04/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND This study aimed to investigate the recent prevalence, management, and comorbidities of diabetes among Korean adults aged ≥30 years by analyzing nationally representative data. METHODS This study used data from the Korea National Health and Nutrition Examination Survey from 2016 to 2018, and the percentage and total number of people ≥30 years of age with diabetes and impaired fasting glucose (IFG) were estimated. RESULTS In 2018, 13.8% of Korean adults aged ≥30 years had diabetes, and adults aged ≥65 years showed a prevalence rate of 28%. The prevalence of IFG was 26.9% in adults aged ≥30 years. From 2016 to 2018, 35% of the subjects with diabetes were not aware of their condition. Regarding comorbidities, 53.2% and 61.3% were obese and hypertensive, respectively, and 72% had hypercholesterolemia as defined by low-density lipoprotein cholesterol (LDL-C) ≥100 mg/dL in people with diabetes. Of the subjects with diabetes, 43.7% had both hypertension and hypercholesterolemia. With regard to glycemic control, only 28.3% reached the target level of <6.5%. Moreover, only 11.5% of subjects with diabetes met all three targets of glycosylated hemoglobin, blood pressure, and LDL-C. The percentage of energy intake from carbohydrates was higher in diabetes patients than in those without diabetes, while that from protein and fat was lower in subjects with diabetes. CONCLUSION The high prevalence and low control rate of diabetes and its comorbidities in Korean adults were confirmed. More stringent efforts are needed to improve the comprehensive management of diabetes to reduce diabetes-related morbidity and mortality.
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Affiliation(s)
- Chan-Hee Jung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Jang Won Son
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
| | - Shinae Kang
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Won Jun Kim
- Department of Endocrinology and Metabolism, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Hun-Sung Kim
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hae Soon Kim
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Mihae Seo
- Department of Endocrinology and Metabolism, Soonchunhyang University Gumi Hospital, Soonchunhyang University College of Medicine, Gumi, Korea
| | - Hye-Jung Shin
- Department of Pediatrics, National Medical Center, Seoul, Korea
| | - Seong-Su Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
| | - Su Jin Jeong
- Department of Endocrinology and Metabolism, Sejong General Hospital, Bucheon, Korea
| | - Yongin Cho
- Department of Endocrinology and Metabolism, Inha University School of Medicine, Incheon, Korea
| | - Seung Jin Han
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - Hyang Mi Jang
- Department of Nursing, Gangnam Severance Hospital, Yonsei University, Seoul, Korea
| | - Mira Rho
- Department of Nutrition, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Shinbi Lee
- Department of Clinical Nutrition, Korea University Anam Hospital, Seoul, Korea
| | - Mihyun Koo
- Department of Social Work, Samsung Medical Center, Seoul, Korea
| | - Been Yoo
- Department of Social Work, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Jung-Wha Moon
- Department of Sports Medical Center, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Hye Young Lee
- Sport Health Medicine Center, Asan Medical Center, Seoul, Korea
| | - Jae-Seung Yun
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Sun Young Kim
- Department of Nursing, Samsung Medical Center, Seoul, Korea
| | - Sung Rae Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
| | - In-Kyung Jeong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Ji-Oh Mok
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
- Corresponding author: Ji-Oh Mok https://orcid.org/0000-0003-4882-1206 Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, 170 Jomaru-ro, Wonmi-gu, Bucheon 14584, Korea E-mail:
| | - Kun Ho Yoon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, the Catholic University of Korea, Seoul, Korea
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Yun JM, Choi S, Kim K, Kim SM, Son JS, Lee G, Jeong SM, Park SY, Kim YY, Park SM. All-cause mortality, cardiovascular mortality, and incidence of cardiovascular disease according to a screening program of cardiovascular risk in South Korea among young adults: a nationwide cohort study. Public Health 2020; 190:23-29. [PMID: 33338899 DOI: 10.1016/j.puhe.2020.10.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 08/03/2020] [Accepted: 10/29/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVES We aimed to determine whether there are any differences in all-cause and cause-specific mortality with cardiovascular disease (CVD) risk between health screening attenders and non-attenders among young adults. STUDY DESIGN We performed a retrospective cohort study using claim data from the Korean National Health Insurance Service database. METHODS Individuals aged 20-39 years who had received health screening at least once between 2002 and 2005 were classified as attenders, and the others were classified as non-attenders. After propensity score matching according to attendance of health screening, 2,060,409 attenders and 2,060,409 non-attenders were included. We estimated adjusted hazard ratios (HRs) and 95% confidence interval (CI) for all-cause mortality, cause-specific mortality, and hospitalization of CVD from 2006 to 2015. RESULTS Survival from all-cause mortality was greater among attenders than among non-attenders (log rank P < 0.001). Similarly, death from CVD (log rank P = 0.007) and CVD events (log rank P < 0.001) were less likely among attenders. The risk for all-cause mortality in attenders was significantly lower than that in non-attenders (HR = 0.83, 95% CI = 0.81 to 0.84). The risk for CVD mortality (HR = 0.80, 95% CI = 0.73 to 0.87) and hospitalization of CVD (HR = 0.92, 95% CI = 0.91 to 0.94) were lower in attenders. In stratified analyses, the risk for all-cause and cause-specific mortalities was lower among attenders regardless of insurance type. CONCLUSIONS Among young adults, the risk for all-cause mortality, CVD mortality, and hospitalization of CVD were lower for those who underwent health screenings. Future studies that evaluate the cost-effectiveness of health screening with additional consideration of psychosocial aspects are needed.
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Affiliation(s)
- J M Yun
- Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea
| | - S Choi
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea
| | - K Kim
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea
| | - S M Kim
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea
| | - J S Son
- Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea
| | - G Lee
- Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea
| | - S-M Jeong
- Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea
| | - S Y Park
- Big Data Steering Department, National Health Insurance Service, Wonju, South Korea
| | - Y-Y Kim
- Big Data Steering Department, National Health Insurance Service, Wonju, South Korea
| | - S M Park
- Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea; Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea.
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Luo HH, Feng XF, Yang XL, Hou RQ, Fang ZZ. Interactive effects of asparagine and aspartate homeostasis with sex and age for the risk of type 2 diabetes risk. Biol Sex Differ 2020; 11:58. [PMID: 33092635 PMCID: PMC7579815 DOI: 10.1186/s13293-020-00328-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 09/01/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Asparagine and aspartate homeostasis are linked with type 2 diabetes (T2D). This study aimed to explore whether asparagine and aspartate metabolism interacted with sex and age to increase the risk of T2D. METHODS From 27 May 2015 to 3 August 2016, we consecutively retrieved 1032 T2D patients and 1522 subjects without T2D from a tertiary care hospital in Liaoning, China. Restricted cubic spline nested in the logistic regression was used to draw odds ratio curves of plasma asparagine to aspartate ratio for T2D by sex and age. Cut-off point was selected where curves went apart, indicating possible interaction. Addictive interactions of asparagine to aspartate ratio with sex or age and secondary interaction with copresence of unfavorable sex and age were further estimated using relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and synergy index (S). RESULTS Ratio of asparagine to aspartate > 1.5 was associated with elevated risk of T2D (OR 7.99, 95%CI 5.50 to 11.6), which was enhanced by female gender to 13.6, (95%CI 8.10-22.9) and by > 50 years of age to 28.7 (14.6-56.3), with significant additive interactions. There was a significant secondary-interaction of copresence of female sex and > 50 years of age with high asparagine to aspartate ratio for increased T2D risk with the OR being further increased to 34.4 (20.5-57.5). CONCLUSIONS High asparagine to aspartate ratio was associated with markedly increased risk of T2D, which was further amplified by either female gender or > 50 years of age, and especially both.
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Affiliation(s)
- Hui-Huan Luo
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Xiao-Fei Feng
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Xi-Lin Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Rui-Qin Hou
- Department of Blood Transfusion, Peking University People's Hospital, Beijing, China.
| | - Zhong-Ze Fang
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, 300070, China. .,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.
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22
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Ha CW, Park YB. Underestimation and undertreatment of osteoporosis in patients awaiting primary total knee arthroplasty. Arch Orthop Trauma Surg 2020; 140:1109-1114. [PMID: 32358659 DOI: 10.1007/s00402-020-03462-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Osteoporosis is generally regarded as a risk factor for periprosthetic fracture during or after primary total knee arthroplasty (TKA). Despite this, little is known about osteoporosis in patients undergoing elective primary TKA Therefore, we sought to investigate the prevalence of osteoporosis and rates of pharmacologic osteoporosis treatment prior to primary TKA. We hypothesized that preoperative osteoporosis is underestimated and undertreated in the primary TKA population. MATERIALS AND METHODS This retrospective study included consecutive 1972 patients scheduled for elective primary TKA at a single tertiary hospital (age, 50-89 years). Charts were reviewed for patient demographics, prior pharmacologic osteoporosis treatment and Knee Society (KS) scoring system and WOMAC score. Dual energy X-ray absorptiometry (DEXA) measurement of the lumbar vertebrae and proximal femur was performed in all patients on the day before surgery. The associations of BMD with age, sex, body mass index (BMI), and clinical outcome were analyzed. RESULTS The prevalence of osteoporosis was 50.0% (53.4% in women and 7.0% in men). Among patients with osteoporosis, only 15.1% (149/986) of patients (15.0% in women and 30.0% in men) had pharmacological osteoporosis treatment prior to primary TKA. Age, sex and WOMAC stiffness showed association with osteoporosis. Sex (odds ratio (OR): 20.83, p < 0.001) was the most significant factor associated with osteoporosis. CONCLUSION Osteoporosis was highly prevalent in patients awaiting TKA, but the rates of diagnosis and pharmacologic osteoporosis treatment were low. Therefore, more attention needs to estimate and treat osteoporosis in patients awaiting primary TKA, especially in female patients.
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Affiliation(s)
- Chul-Won Ha
- Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Yong-Beom Park
- Department of Orthopedic Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul, 06973, South Korea.
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23
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De Paoli M, Werstuck GH. Role of Estrogen in Type 1 and Type 2 Diabetes Mellitus: A Review of Clinical and Preclinical Data. Can J Diabetes 2020; 44:448-452. [DOI: 10.1016/j.jcjd.2020.01.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 09/17/2019] [Accepted: 01/06/2020] [Indexed: 02/06/2023]
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Lin Z, Guo D, Chen J, Zheng B. A nomogram for predicting 5-year incidence of type 2 diabetes in a Chinese population. Endocrine 2020; 67:561-568. [PMID: 31820309 DOI: 10.1007/s12020-019-02154-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 11/27/2019] [Indexed: 02/08/2023]
Abstract
PURPOSE To develop a nomogram for predicting 5-year incidence of type 2 diabetes (T2D) in Chinese adults. METHODS This is a retrospective cohort study from a prospectively collected database. We included a total 32,766 adults free of T2D at baseline with a median follow-up of 3 years. Univariate and multivariate Cox regression analyses were applied to identify independent predictors. A nomogram was constructed to predict 5-year incident rate of T2D based on the multivariate analysis results. Harrell's C-indexes and calibration plots were used to evaluate the accuracy of the nomogram in both internal and external validations. RESULTS The overall prevalence of T2D was 2.1%. Participants were randomly divided into a training set (n = 21,844) and a validation set (n = 10,922). After multivariate analysis in the training set, age, sex, BMI, hypertension, dyslipidemia, smoking status, and family history were found as risk predictors and integrated into the nomogram. Harrell's C-indexes were 0.815 (95% CI: 0.797-0.834) and 0.779 (95% CI: 0.747-0.811) in the training and validation sets, respectively. The calibration plots demonstrated good agreement between the estimated probability and the actual observation. CONCLUSION Our nomogram could be a simple and reliable tool for predicting 5-year risk of developing T2D in high-risk Chinese. Through the model, early identifying high-risk individuals is helpful for timely intervention to reduce the incidence of T2D.
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Affiliation(s)
- Zeyin Lin
- Department of Ultrasound, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Dongming Guo
- Department of General Surgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Juntian Chen
- Department of General Surgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Baoqun Zheng
- Department of Ultrasound, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China.
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Male Sexual and Reproductive Health-Does the Urologist Have a Role in Addressing Gender Inequality in Life Expectancy? Eur Urol Focus 2019; 6:791-800. [PMID: 31711931 DOI: 10.1016/j.euf.2019.10.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 09/09/2019] [Accepted: 10/17/2019] [Indexed: 12/21/2022]
Abstract
Despite considerable public health initiatives in the past century, there remains a significant gender inequality in life expectancy. The Global Burden of Diseases study has highlighted that the life expectancy for men is 70.5years, compared with 75.6years for women. This discrepancy in mortality appears to be related to a disproportionately higher number of preventable and premature male deaths. Whilst there has been an increased focus on men's health, as evidenced by the establishment of men's health charities and governmental legislation promoting equality, a recent World Health Organization report has highlighted that there is still a prevailing misconception that the higher rate of premature mortality amongst men is a natural phenomenon. We explore the association of male sexual and reproductive health-related diseases and the potential role of a urologist in addressing gender inequality in life expectancy. PATIENT SUMMARY: In this report, we discuss the causes for the gender gap in life expectancy and highlight that men continue to have a higher rate of premature death than women, which is associated with diseases of the male reproductive system. Furthermore, this not only appears to be related to a number of metabolic and lifestyle factors, but may also be the result of the increased risk of cancer in men with sexual and reproductive health-related diseases.
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26
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Yoshinaga S, Shiomitsu T, Kamohara M, Fujii Y, Chosa E, Tsuruta K. Lifestyle-related signs of locomotive syndrome in the general Japanese population: A cross-sectional study. J Orthop Sci 2019; 24:1105-1109. [PMID: 31477343 DOI: 10.1016/j.jos.2019.08.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 06/27/2019] [Accepted: 08/08/2019] [Indexed: 02/09/2023]
Abstract
BACKGROUND This study aimed to estimate the prevalence of locomotive syndrome (LS) risk in age groups using the LS risk test proposed by the Japanese Orthopaedic Association. Based on this, this study identified the lifestyle-related signs that lead to LS, by clarifying the association between LS risk and lifestyle factors. METHODS A total of 728 individuals aged 20-91 years who were without specific mobility disorders were evaluated. Participants were asked to perform the LS risk test and complete a self-administered original questionnaire survey for this study. The Mann-Whitney U test was used to examine the relationships of sex and age with LS. The prevalence of LS by sex and age was compared using the Chi-squared test or Student's t-test, as appropriate. The Mantel-Haenszel test was used to examine the relationship of each component of the lifestyle factors. RESULTS Overall, 36.4% of males and 49.1% of females were classified into the LS group; the prevalence of LS was significantly higher in females than males (p < .001). The prevalence of LS tended to increase with age in both males and females (p < .05). As for health condition, pain in the locomotive organs, knees, back, and hip joints was significantly associated with LS (p < .05). Of the lifestyle-related diseases, only hypertension (p < .05) was significantly associated with LS, and drug treatment was significantly associated with LS (p < .05). As for lifestyle, anxiety about physical fitness, self-assessed poor health, irregular dietary habits, and lack of exercise were also associated with LS (p < .05). CONCLUSIONS Interventions to prevent LS are important during its early stages, especially for females, and lifestyle-related signs of LS, such as pain in the locomotive organs, lifestyle-related disease, drug treatment, and a lower subjective evaluation of health must not be overlooked.
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Affiliation(s)
- Saori Yoshinaga
- School of Nursing, Faculty of Medicine, University of Miyazaki, 5200, Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Tomoko Shiomitsu
- School of Nursing, Faculty of Makuhari Human Care, Tohto College of Health Sciences, 1-1 Hibino, Mihama-ku, Chiba-shi, Chiba, 261-0021, Japan
| | - Masumi Kamohara
- School of Nursing, Faculty of Medicine, University of Miyazaki, 5200, Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Yoshinori Fujii
- Faculty of Education, University of Miyazaki, 1-1 Gakuen Kibanadai Nishi, Miyazaki, 889-2192, Japan
| | - Etsuo Chosa
- Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, University of Miyazaki, 5200, Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Kurumi Tsuruta
- School of Nursing, Faculty of Medicine, University of Miyazaki, 5200, Kihara, Kiyotake, Miyazaki, 889-1692, Japan.
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Huebschmann AG, Huxley RR, Kohrt WM, Zeitler P, Regensteiner JG, Reusch JEB. Sex differences in the burden of type 2 diabetes and cardiovascular risk across the life course. Diabetologia 2019; 62:1761-1772. [PMID: 31451872 PMCID: PMC7008947 DOI: 10.1007/s00125-019-4939-5] [Citation(s) in RCA: 186] [Impact Index Per Article: 37.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 05/29/2019] [Indexed: 12/11/2022]
Abstract
By 2017 estimates, diabetes mellitus affects 425 million people globally; approximately 90-95% of these have type 2 diabetes. This narrative review highlights two domains of sex differences related to the burden of type 2 diabetes across the life span: sex differences in the prevalence and incidence of type 2 diabetes, and sex differences in the cardiovascular burden conferred by type 2 diabetes. In the presence of type 2 diabetes, the difference in the absolute rates of cardiovascular disease (CVD) between men and women lessens, albeit remaining higher in men. Large-scale observational studies suggest that type 2 diabetes confers 25-50% greater excess risk of incident CVD in women compared with men. Physiological and behavioural mechanisms that may underpin both the observed sex differences in the prevalence of type 2 diabetes and the associated cardiovascular burden are discussed in this review. Gender differences in social behavioural norms and disparities in provider-level treatment patterns are also highlighted, but not described in detail. We conclude by discussing research gaps in this area that are worthy of further investigation.
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Affiliation(s)
- Amy G Huebschmann
- Center for Women's Health Research, University of Colorado School of Medicine, MS C263, 12348 E. Montview Boulevard, Aurora, CO, 80045, USA
- Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Rachel R Huxley
- College of Science, Health and Engineering, La Trobe University, Melbourne, VIC, Australia
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Wendy M Kohrt
- Center for Women's Health Research, University of Colorado School of Medicine, MS C263, 12348 E. Montview Boulevard, Aurora, CO, 80045, USA
- Division of Geriatric Medicine, University of Colorado School of Medicine, Aurora, CO, USA
- Department of Medicine, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, USA
| | - Philip Zeitler
- Division of Pediatric Endocrinology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Judith G Regensteiner
- Center for Women's Health Research, University of Colorado School of Medicine, MS C263, 12348 E. Montview Boulevard, Aurora, CO, 80045, USA
- Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, CO, USA
- Division of Cardiology, University of Colorado School of Medicine (CU-SOM), Aurora, CO, USA
| | - Jane E B Reusch
- Center for Women's Health Research, University of Colorado School of Medicine, MS C263, 12348 E. Montview Boulevard, Aurora, CO, 80045, USA.
- Department of Medicine, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, USA.
- Division of Endocrinology, Metabolism and Diabetes, University of Colorado School of Medicine, Aurora, CO, USA.
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Kim BY, Won JC, Lee JH, Kim HS, Park JH, Ha KH, Won KC, Kim DJ, Park KS. Diabetes Fact Sheets in Korea, 2018: An Appraisal of Current Status. Diabetes Metab J 2019; 43:487-494. [PMID: 31339012 PMCID: PMC6712228 DOI: 10.4093/dmj.2019.0067] [Citation(s) in RCA: 97] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 05/26/2019] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The objective of this study was to investigate the prevalence, management, and comorbidities of diabetes among Korean adults aged 30 years and older. METHODS This study used 2013 to 2016 data from the Korea National Health and Nutrition Examination Survey, a nationally-representative survey of the Korean population. Diabetes was defined as fasting glucose ≥126 mg/dL, current use of antidiabetic medication, a previous history of diabetes, or glycosylated hemoglobin (HbA1c) ≥6.5%. RESULTS In 2016, 14.4% (approximately 5.02 million) of Korean adults had diabetes. The prevalence of impaired fasting glucose was 25.3% (8.71 million). From 2013 to 2016, the awareness, control, and treatment rates for diabetes were 62.6%, 56.7%, and 25.1%, respectively. People with diabetes had the following comorbidities: obesity (50.4%), abdominal obesity (47.8%), hypertension (55.3%), and hypercholesterolemia (34.9%). The 25.1%, 68.4%, and 44.2% of people with diabetes achieved HbA1c <6.5%, blood pressure <140/85 mm Hg, and low density lipoprotein cholesterol <100 mg/dL. Only 8.4% of people with diabetes had good control of all three targets. CONCLUSION This study confirms that diabetes is as an important public health problem. Efforts should be made to increase awareness, detection, and comprehensive management of diabetes to reduce diabetes-related morbidity and mortality.
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Affiliation(s)
- Bo Yeon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Jong Chul Won
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Cardiovascular and Metabolic Disease Center, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Jae Hyuk Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Myongji Hospital, Goyang, Korea
| | - Hun Sung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jung Hwan Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Kyoung Hwa Ha
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - Kyu Chang Won
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Dae Jung Kim
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea.
| | - Kyong Soo Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
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Shin JY. Trends in the prevalence and management of diabetes in Korea: 2007-2017. Epidemiol Health 2019; 41:e2019029. [PMID: 31319658 PMCID: PMC6702122 DOI: 10.4178/epih.e2019029] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 07/04/2019] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES This study analyzed Korea National Health and Nutrition Examination Survey data from 2007 to 2017 to assess trends in the prevalence, treatment, and control of diabetes in Korean adults ≥30 years of age. METHODS Prevalent diabetes was defined as a fasting plasma glucose level ≥126 mg/dL, self-reported use of anti-diabetic treatment (insulin or oral anti-diabetic drugs), or diabetes diagnosis by a physician. Target levels were defined as glycosylated hemoglobin <6.5% or <7.0%, blood pressure <130/80 mmHg, and total cholesterol <200 mg/dL. All survey waves were age-standardized to the 2005 Korean census population. RESULTS Diabetes prevalence increased from 9.6% in 2007-2009 to 10.8% in 2016-2017 (p<0.001). Impaired fasting glucose prevalence significantly increased in both genders and almost every age group. Diabetes awareness and glycemic control did not show an increasing trend; however, the treatment rate and proportion of people diagnosed with diabetes achieving target blood pressure and total cholesterol levels improved from 57.2% to 63.5% (p=0.008), from 41.1% to 53.2% (p<0.001), and from 65.0% to 78.0% (p<0.001), respectively. CONCLUSIONS From 2007 to 2017, the prevalence of diabetes increased moderately in Korea, whereas the diabetes treatment rate and the proportion of people diagnosed with diabetes achieving target blood pressure and total cholesterol levels improved. However, awareness of diabetes and glycemic control require significant improvements. A national-level action plan is required to raise awareness about diabetes and prediabetes, with the goal of improving glycemic control and minimizing the occurrence of adverse health outcomes.
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Affiliation(s)
- Ji-Yeon Shin
- Department of Preventive Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
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Koo BK. The Differential Association between Muscle Strength and Diabetes Mellitus According to the Presence or Absence of Obesity. J Obes Metab Syndr 2019; 28:46-52. [PMID: 31089579 PMCID: PMC6484941 DOI: 10.7570/jomes.2019.28.1.46] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 02/26/2019] [Accepted: 03/13/2019] [Indexed: 01/19/2023] Open
Abstract
Background Muscle strength can be affected by body mass index. In the present study, we compared the association between the diabetes mellitus (DM) and muscle strength according to obesity. Methods We analyzed the association between DM and muscle strength using the Korea National Health and Nutrition Examination Survey 2014 to 2016 data weighted to represent the Korean population aged between 30 and 79 years old. Muscle strength was classified into age- and sex-specific quartiles (Qs) of handgrip strength, with the lowest Q defined as “low muscle strength (LMS).” Results Muscle strength was positively associated with body mass index in both sexes (P<0.001); the prevalence of obesity increased by 30% in male (odds ratio [OR], 1.300; 95% confidence interval [CI], 1.231–1.373) and 12% in female (OR, 1.122; 95% CI, 1.062–1.185), respectively, per one Q of muscle strength. In contrast, the prevalence of DM decreased as muscle strength increased (OR per one Q, 0.926; 95% CI, 0.862–0.996 in male and OR per one Q, 0.917; 95% CI, 0.854–0.986 in female). LMS was significantly associated with DM even following adjustment for age, sex, family history of DM, abdominal obesity, dyslipidemia, and hypertension (OR, 1.328; 95% CI, 1.133–1.558). Stratified analysis according to obesity status showed that it remained significant only in nonobese populations (OR, 1.513; 95% CI, 1.224–1.870 in nonobese participants and OR, 1.124; 95% CI, 0.879–1.437 in obese participants). Conclusion LMS was independently associated with DM in the Korean population aged between 30 and 79 years. However, obesity-stratified analysis revealed that it was significant only in the nonobese population.
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Affiliation(s)
- Bo Kyung Koo
- Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
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Kwon HJ, Lee YA, Shin CH, Kim K. Association between physical activity and self-rated health in pediatric patients with type 1 diabetes mellitus. J Exerc Rehabil 2019; 15:155-159. [PMID: 30899752 PMCID: PMC6416507 DOI: 10.12965/jer.1836576.288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 01/08/2019] [Indexed: 01/09/2023] Open
Abstract
Patients with type 1 diabetes mellitus (T1DM) tend to experience poor self-rated health. However, few studies have examined the association between physical activity and self-rated health in pediatric patients with T1DM. The purpose of this study was to investigate the association between regular physical activity, regular muscle strength exercise, and self-rated health in pediatric patients with T1DM who lacked diabetes care. The eligible participants for this study were 37 pediatric patients with T1DM aged 9 to 17 years. Physical activity was divided into regular physical activity and regular muscle strength exercise to analyze the relationship with self-rated health using binomial logistic regression analysis. The results showed that self-rated health of pediatric patients with T1DM who did not engage in regular muscle strength exercise was significantly lower than those who did (odds ratio [OR], 0.100; 95% confidence interval [CI], 0.012-0.855; P<0.05). However, the association between regular physical activity and self-rated health was not statistically significant (OR, 0.211; 95% CI, 0.041-1.088; P=0.06). In conclusion, regular muscle strength exercise in pediatric patients with T1DM who lacked diabetes care was effective in contributing to optimal self-rated health. Future research is needed to collect physical activity data using objective assessment methods and to analyze the association between variables applying diverse factors for pediatric patients with T1DM, which might be able to effect on their health.
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Affiliation(s)
- Hyun Jin Kwon
- Department of Kinesiology and Health, College of Education Human Development, Georgia State University, Atlanta, GA, USA
| | - Young Ah Lee
- Department of Pediatrics, College of Medicine, Seoul National University Children's Hospital, Seoul, Korea
| | - Choong Ho Shin
- Department of Pediatrics, College of Medicine, Seoul National University Children's Hospital, Seoul, Korea
| | - Kijeong Kim
- School of Exercise & Sport Science, College of Natural Sciences, University of Ulsan, Ulsan, Korea
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Hwang IC, Bae JH, Kim JM. Relationship between body fat and diabetic retinopathy in patients with type 2 diabetes: a nationwide survey in Korea. Eye (Lond) 2019; 33:980-987. [PMID: 30760896 DOI: 10.1038/s41433-019-0352-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 11/09/2018] [Accepted: 11/16/2018] [Indexed: 01/04/2023] Open
Abstract
PURPOSE To evaluate the association of body mass index (BMI), waist circumference, and body fat with diabetic retinopathy (DR) in Korean patients with type 2 diabetes. METHODS Among the 1130 participants 19 years of age or older with type 2 diabetes enrolled in the nationwide survey, a total of 887 participants were included in the analyses after excluding patients with ungradable fundus images. The presence and severity of DR were graded with seven-field fundus photographs. The associations between DR and anthropometric parameters and total body fat, which was assessed by dual-energy X-ray absorptiometry, were analysed using multivariate logistic regression models. RESULTS Patients were divided into three groups according to severity of DR: no DR (n = 702, 79.1%), mild/moderate DR (n = 130, 14.7%), and vision-threatening DR (n = 55, 6.2%). In multivariate-adjusted analyses, higher BMI (adjusted odds ratio [aOR], 0.80; 95% confidence interval [CI], 0.70-0.92; P = 0.001), larger waist circumference (aOR, 0.96; 95% CI, 0.91-1.00; P = 0.047), and higher total body fat (aOR, 0.86; 95% CI, 0.79-0.92; P < 0.001) were significantly associated with a lower risk of vision-threatening DR. In sex-stratified analyses, however, only total body fat in women showed a significant inverse association with the presence of DR (aOR, 0.93; 95% CI, 0.88-0.98; P < 0.001) and independently with the severity of DR (P for trend = 0.004). CONCLUSION In Korean patients with type 2 diabetes, obese patients might be less likely to have vision-threatening DR. Total body fat in women appears to be inversely and independently associated with DR prevalence and progression.
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Affiliation(s)
- In Cheol Hwang
- Department of Family Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Jeong Hun Bae
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Joon Mo Kim
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Stancill JS, Osipovich AB, Cartailler JP, Magnuson MA. Transgene-associated human growth hormone expression in pancreatic β-cells impairs identification of sex-based gene expression differences. Am J Physiol Endocrinol Metab 2019; 316:E196-E209. [PMID: 30532991 PMCID: PMC6397359 DOI: 10.1152/ajpendo.00229.2018] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Fluorescent protein reporter genes are widely used to identify and sort murine pancreatic β-cells. In this study, we compared use of the MIP-GFP transgene, which exhibits aberrant expression of human growth hormone (hGH), with a newly derived Ins2Apple allele that lacks hGH expression on the expression of sex-specific genes. β-Cells from MIP-GFP transgenic mice exhibit changes in the expression of 7,733 genes, or greater than half of their transcriptome, compared with β-cells from Ins2Apple/+ mice. To determine how these differences might affect a typical differential gene expression study, we analyzed the effect of sex on gene expression using both reporter lines. Six hundred fifty-seven differentially expressed genes were identified between male and female β-cells containing the Ins2Apple allele. Female β-cells exhibit higher expression of Xist, Tmed9, Arpc3, Eml2, and several islet-enriched transcription factors, including Nkx2-2 and Hnf4a, whereas male β-cells exhibited a generally higher expression of genes involved in cell cycle regulation. In marked contrast, the same male vs. female comparison of β-cells containing the MIP-GFP transgene revealed only 115 differentially expressed genes, and comparison of the 2 lists of differentially expressed genes revealed only 17 that were common to both analyses. These results indicate that 1) male and female β-cells differ in their expression of key transcription factors and cell cycle regulators and 2) the MIP-GFP transgene may attenuate sex-specific differences that distinguish male and female β-cells, thereby impairing the identification of sex-specific variations.
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Affiliation(s)
- Jennifer S Stancill
- Department of Cell and Developmental Biology, Vanderbilt University , Nashville, Tennessee
- Center for Stem Cell Biology, Vanderbilt University , Nashville, Tennessee
| | - Anna B Osipovich
- Department of Molecular Physiology and Biophysics, Vanderbilt University , Nashville, Tennessee
- Center for Stem Cell Biology, Vanderbilt University , Nashville, Tennessee
| | | | - Mark A Magnuson
- Department of Cell and Developmental Biology, Vanderbilt University , Nashville, Tennessee
- Department of Molecular Physiology and Biophysics, Vanderbilt University , Nashville, Tennessee
- Center for Stem Cell Biology, Vanderbilt University , Nashville, Tennessee
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Kim W, Choy YS, Lee SA, Park EC. Implementation of the Chronic Disease Care System and its association with health care costs and continuity of care in Korean adults with type 2 diabetes mellitus. BMC Health Serv Res 2018; 18:991. [PMID: 30577787 PMCID: PMC6303987 DOI: 10.1186/s12913-018-3806-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 12/11/2018] [Indexed: 02/27/2023] Open
Abstract
Background The Chronic Disease Care System (CDCS) has been implemented in Korea to encourage treatment continuity in chronic disease patients. This study investigated the effect of the introduction of the CDCS on health care costs and continuity of care in individuals with type 2 diabetes mellitus (T2DM). Methods The National Health Insurance data from August, 2010 to March, 2012 (pre-policy) and from May, 2012 to December, 2013 (post-policy) were used. Introduction of the CDCS was defined as the intervention. The intervention group consisted of T2DM patients participating in the program and the control group patients not participating in the program. The Difference-in-Differences (DID) method was used to estimate the differences in total health care costs for outpatient services and continuity of care between the intervention and the control group before and after the intervention period. Results Implementation of the CDCS was associated with decreased health care costs (β = − 46,877 Korean Won, P < 0.0001) and improved continuity of care (β = 0.0536, P < 0.0001) in the intervention group with adjustment for covariates. Conclusion Findings confirm an association between the adoption of the CDCS and reduced health care costs and improved continuity of care. The results reveal the potential benefits of reinforcing effective chronic disease management strategies in reducing health care costs and improving treatment continuity.
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Affiliation(s)
- Woorim Kim
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Yoon Soo Choy
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Sang Ah Lee
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea. .,Department of Preventive Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
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Chan KTK, Kobayashi KM, Roy A, Fuller-Thomson E. Diabetes Care of Non-obese Korean Americans: Considerable Room for Improvement. Korean J Fam Med 2018; 40:72-79. [PMID: 30563310 PMCID: PMC6444083 DOI: 10.4082/kjfm.18.0002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 03/01/2018] [Indexed: 11/16/2022] Open
Abstract
Background Family doctors are increasingly managing the diabetes care of Korean-Americans. Little is known about the prevalence of diabetes among non-obese Korean-Americans, or the extent to which they receive timely and appropriate diabetes care. The purpose of this investigation is to: (1) identify the prevalence of diabetes and to determine the adjusted odds of diabetes among non-obese Korean-Americans compared to non-Hispanic White (NHW) Americans, (2) examine the factors associated with having diabetes in a large sample of non-obese Korean-Americans, and (3) determine the prevalence and adjusted odds of optimal frequency of eye care, foot care and A1C blood glucose level monitoring among non-obese Korean-Americans with diabetes in comparison to NHWs with diabetes. Methods Secondary analysis of population-based data from the combined 2007, 2009, and 2011 adult California Health Interview Survey. The sample included 74,361 respondents with body mass index (BMI) <30 kg/m2 (referred to as ‘non-obese BMI’), of whom 2,289 were Korean-Americans and 72,072 were NHWs, and 4,576 had diabetes. Results The prevalence and adjusted odds of diabetes among non-obese Korean-Americans are significantly higher than among their NHW peers. More than 90% of Korean-Americans with diabetes were non-obese. NHWs had substantially higher odds of having optimal frequency of eye care, foot care and A1C glucose level monitoring, even after adjusting for insulin dependence, sex, age, education, income, and BMI. Conclusion Non-obese Korean-Americans are at higher risk for diabetes and are much less likely to receive optimal diabetes care in comparison to NHWs. Targeted outreach is necessary.
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Affiliation(s)
| | - Karen M Kobayashi
- Department of Sociology, University of Victoria, Victoria, BC, Canada
| | - Adity Roy
- Institute for Life Course and Aging, University of Toronto, Toronto, ON, Canada
| | - Esme Fuller-Thomson
- Institute for Life Course and Aging, University of Toronto, Toronto, ON, Canada.,Faculties of Social Work & Medicine, University of Toronto, Toronto, ON, Canada
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Won JC, Lee JH, Kim JH, Kang ES, Won KC, Kim DJ, Lee MK. Diabetes Fact Sheet in Korea, 2016: An Appraisal of Current Status. Diabetes Metab J 2018; 42:415-424. [PMID: 30113146 PMCID: PMC6202557 DOI: 10.4093/dmj.2018.0017] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 05/02/2018] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND This report presents the recent prevalence and comorbidities related to diabetes in Korea by analyzing the nationally representative data. METHODS Using data from the Korea National Health and Nutrition Examination Survey for 2013 to 2014, the percentages and the total number of subjects over the age of 30 years with diabetes and prediabetes were estimated and applied to the National Population Census in 2014. Diagnosis of diabetes was based on fasting plasma glucose (≥126 mg/dL), current taking of antidiabetic medication, history of previous diabetes, or glycosylated hemoglobin (HbA1c) ≥6.5%. Impaired fasting glucose (IFG) was defined by fasting plasma glucose in the range of 100 to 125 mg/dL among those without diabetes. RESULTS About 4.8 million (13.7%) Korean adults (≥30 years old) had diabetes, and about 8.3 million (24.8%) Korean adults had IFG. However, 29.3% of the subjects with diabetes are not aware of their condition. Of the subjects with diabetes, 48.6% and 54.7% were obese and hypertensive, respectively, and 31.6% had hypercholesterolemia. Although most subjects with diabetes (89.1%) were under medical treatment, and mostly being treated with oral hypoglycemic agents (80.2%), 10.8% have remained untreated. With respect to overall glycemic control, 43.5% reached the target of HbA1c <7%, whereas 23.3% reached the target when the standard was set to HbA1c <6.5%, according to the Korean Diabetes Association guideline. CONCLUSION Diabetes is a major public health threat in Korea, but a significant proportion of adults were not controlling their illness. We need comprehensive approaches to overcome the upcoming diabetes-related disease burden in Korea.
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Affiliation(s)
- Jong Chul Won
- Department of Internal Medicine, Cardiovascular and Metabolic Disease Center, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Jae Hyuk Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Myongji Hospital, Goyang, Korea
| | - Jae Hyeon Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun Seok Kang
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Kyu Chang Won
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Dae Jung Kim
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea.
| | - Moon Kyu Lee
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Kim KJ, Kwon TY, Yu S, Seo JA, Kim NH, Choi KM, Baik SH, Choi DS, Kim SG, Park Y, Kim NH. Ten-Year Mortality Trends for Adults with and without Diabetes Mellitus in South Korea, 2003 to 2013. Diabetes Metab J 2018; 42:394-401. [PMID: 29885109 PMCID: PMC6202563 DOI: 10.4093/dmj.2017.0088] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Accepted: 03/14/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND To estimate and compare the trends of all-cause and cause-specific mortality rates for subjects with and without diabetes in South Korea, from 2003 to 2013. METHODS Using a population-based cohort (2003 to 2013), we evaluated annual mortality rates in adults (≥30 years) with and without diabetes. The number of subjects in this analysis ranged from 585,795 in 2003 to 670,020 in 2013. RESULTS Age- and sex-adjusted all-cause mortality rates decreased consistently in both groups from 2003 to 2013 (from 14.4 to 9.3/1,000 persons in subjects with diabetes and from 7.9 to 4.4/1,000 persons in those without diabetes). The difference in mortality rates between groups also decreased (6.61 per 1,000 persons in 2003 to 4.98 per 1,000 persons in 2013). The slope associated with the mortality rate exhibited a steeper decrease in subjects with diabetes than those without diabetes (regression coefficients of time: -0.50 and -0.33, respectively; P=0.004). In subjects with diabetes, the mortality rate from cardiovascular disease decreased by 53.5% (from 2.73 to 1.27 per 1,000 persons, P for trend <0.001). Notably, the decrease in mortality from ischemic stroke (79.2%, from 1.20 to 0.25 per 1,000 persowns) was more profound than that from ischemic heart disease (28.3%, from 0.60 to 0.43 per 1,000 persons). CONCLUSION All-cause and cardiovascular mortality rates decreased substantially from 2003 to 2013, and the decline in ischemic stroke mortality mainly contributed to the decreased cardiovascular mortality in Korean people with diabetes.
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Affiliation(s)
- Kyeong Jin Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Tae Yeon Kwon
- Department of International Finance, Hankuk University of Foreign Studies, Yongin, Korea
| | - Sungwook Yu
- Department of Neurology, Korea University College of Medicine, Seoul, Korea
| | - Ji A Seo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Nan Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Kyung Mook Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sei Hyun Baik
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Dong Seop Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sin Gon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Yousung Park
- Department of Statistics, Korea University, Seoul, Korea.
| | - Nam Hoon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
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Socioeconomic inequalities in the prevalence of biomarkers of cardio-metabolic disease in South Korea: Comparison of the Health Examinees Study to a nationally representative survey. PLoS One 2018; 13:e0195091. [PMID: 29668714 PMCID: PMC5906014 DOI: 10.1371/journal.pone.0195091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Accepted: 03/18/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND/OBJECTIVES This study aimed to examine socioeconomic inequalities in the prevalence of biomarkers of cardiovascular disease and diabetes in the newly developed large-scale genomic cohort study of Korean adults, the Health Examinees-Gem (HEXA-G), with a comparison of the nationally representative cross-sectional study, the Korea National Health and Nutrition Examination Survey (K-NHANES). SUBJECTS/METHODS Using the HEXA-G and the K-NHANES from 2007-2012, we analyzed the age-adjusted relative risk (RR) and prevalence of enlarged waist circumference (EWC), elevated triglycerides (ET), low HDL cholesterol (LHC), elevated blood pressure (EBP) and elevated blood glucose (EBG) by income and educational groups for adults at age 40-69. RESULTS For men, the prevalence of risk factors was similar across different income and educational groups (p>0.1), and between the K-NHANES and the HEXA-G. Among five risk factors, EBG showed the greatest discrepancy by 7 to 11 percentage points (i.e., the prevalence of 0.43 and 0.36 for college graduates, respectively, in K-NHANES and HEXA-G). For women, socioeconomic inequalities appeared for the five risk factors. Prevalence of risk factors was mostly lower in the HEXA-G than the K-NHANES, by approximately 11.0 percentage points. Especially, the discrepancy between K-NHANES and HEXA-G was largest in EBG (i.e., the prevalence of 0.31 and 0.20 for the lowest income groups, respectively). CONCLUSION The HEXA-G shows broadly similar socioeconomic inequality in prevalence of cardio-metabolic risk factors to the nationally representative sample with more modest socioeconomic inequality among women in the HEXA-G than the K-NHANES.
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Kim CS. Kidney transplantation in patients with diabetes: better than nothing. Korean J Intern Med 2018; 33:293-294. [PMID: 29506342 PMCID: PMC5840602 DOI: 10.3904/kjim.2018.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 01/24/2018] [Indexed: 01/23/2023] Open
Affiliation(s)
- Chang Seong Kim
- Correspondence to Chang Seong Kim, M.D. Department of Internal Medicine, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju 61469, Korea Tel: +82-62-220-6254 Fax: +82-62-225-8578 E-mail:
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Yu TY, Cho H, Kim TY, Ha YC, Jang S, Kim HY. Utilization of Osteoporosis-Related Health Services: Use of Data from the Korean National Health Insurance Database 2008-2012. J Korean Med Sci 2018; 33:e20. [PMID: 29215807 PMCID: PMC5729648 DOI: 10.3346/jkms.2018.33.e20] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 09/30/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Osteoporosis and its related fractures are increasingly being recognized as major health problems because of the rapidly increasing elderly population. In this study, we investigated the annual trend of osteoporosis-related health services utilization. METHODS Participants aged over 50 years were identified from the Korean National Health Insurance Service database between 2008 and 2012. Health service utilization rate and treatment rate were calculated through the operational definition. RESULTS In this period, the number of osteoporosis patients, aged over 50 years, using the medical service, increased by 33.2%. This increase was higher in males than in females. Moreover, the number of newly diagnosed osteoporosis patients increased by 4.3% in women and 20.4% in men. To estimate the proportion of osteoporosis patients who utilize medical services, we analyzed prevalence data from the Korea National Health and Nutrition Examination Survey from 2008 to 2010. Less than 60% of patients with osteoporosis were estimated to have utilized medical services because of osteoporosis. Drug treatment rates were 34.1%, 31.1%, and 33.5% in 2008, 2009, and 2010, respectively. CONCLUSION This study demonstrated an increasing trend in the utilization of the osteoporosis-related health services from 2008 to 2012 in Korea. The proportion of newly diagnosed osteoporosis patients and the prevalence of access to medical services increased more in men than in women. Therefore, an increasing need for prevention and treatment of male osteoporosis was observed. The osteoporosis treatment rate was lower than that for other chronic diseases; more efforts are needed to improve awareness regarding osteoporosis treatment.
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Affiliation(s)
- Tae Yang Yu
- Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Korea
| | - Hyemin Cho
- College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon, Korea
| | - Tae Young Kim
- Department of Orthopaedic Surgery, Hallym University School of Medicine, Anyang, Korea
| | - Yong Chan Ha
- Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - Sunmee Jang
- College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon, Korea
| | - Ha Young Kim
- Department of Internal Medicine, Wonkwang University Sanbon Hospital, Gunpo, Korea.
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Hwang HR, Jeong DW, Kim YJ, Lee S, Lee JG, Kang YH, Yi YH, Cho YH, Tak YJ, Zo A. Comparison of insulin resistance and metabolic syndrome criteria in metabolically obese, normal weight (MONW) individuals in the prediction of cardiovascular disease risk: analysis of the Korean National Health and Nutrition Examination Survey (KNHANES) in 2010–2012. Int J Diabetes Dev Ctries 2018; 38:88-94. [DOI: 10.1007/s13410-016-0543-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
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Aekplakorn W, Chariyalertsak S, Kessomboon P, Assanangkornchai S, Taneepanichskul S, Putwatana P. Prevalence of Diabetes and Relationship with Socioeconomic Status in the Thai Population: National Health Examination Survey, 2004-2014. J Diabetes Res 2018; 2018:1654530. [PMID: 29687009 PMCID: PMC5852889 DOI: 10.1155/2018/1654530] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Accepted: 01/09/2018] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE To determine the prevalence and trend of diabetes, related glycemic control, and influential socioeconomic (SES) factors in the Thai population aged ≥20 years during 2004-2014. METHODS Data from the Thai National Health Examination Survey 2004, 2009, and 2014 were used. Age-adjusted prevalence was calculated, and the associations of education levels with prevalence of diabetes and glycemic control were examined using logistic regression. RESULTS Age-adjusted prevalence of diabetes increased from 7.7% in 2004 to 7.8% in 2009 and 9.9% in 2014 (8.9% among men and 10.8% among women). Proportions of undiagnosed diabetes were slightly decreased but remained high in 2014 (51.2% for men and 41.3% for women). Diabetes prevalence was higher among those with primary education in both sexes; however, undiagnosed diabetes was higher among women with secondary and university educations. The percentages of those treated and controlled slightly improved among men (45.9%) but not among women (36.4%). Unmet glycemic control was also higher among women with secondary education levels and among men with university-level educations. CONCLUSIONS Epidemic diabetes continues to grow in the Thai population, particularly in individuals with lower educational attainment. Measures to detect new cases and strengthen glycemic control should be scaled up.
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Affiliation(s)
- Wichai Aekplakorn
- Department of Community Medicine, Faculty of Medicine, Ramathibodi Hospital, Rama VI Rd., Ratchathewi, Bangkok, Thailand
| | | | | | | | | | - Panwadee Putwatana
- Ramathibodi School of Nursing, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Cho HA, Jung YL, Lee YH, Lee YC, Lee JE, Lee SJ, Jeong SJ, Kim CH. Efficacy of Body Weight Reduction on the SGLT2 Inhibitor in People with Type 2 Diabetes Mellitus. J Obes Metab Syndr 2017; 26:107-113. [PMID: 31089504 PMCID: PMC6484898 DOI: 10.7570/jomes.2017.26.2.107] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 10/03/2016] [Accepted: 11/04/2016] [Indexed: 12/28/2022] Open
Abstract
Background Dapagliflozin, a sodium-glucose cotransporter-2 inhibitor, reduces hyperglycemia and body weight by inhibiting renal glucose reabsorption. However, only a few studies have demonstrated efficacy of dapagliflozin for type 2 diabetic patients in Korea. We evaluated the efficacy and safety of dapagliflozin for Korean type 2 diabetes patients. Methods This is a retrospective study that included data from 61 patients who received 12 months of dapagliflozin therapy and who visited a single medical center between January 2015 and July 2016. Patients were separated into three groups: dual combination of dapagliflozin and metformin, triple combination of dapagliflozin and metformin with sulfonylurea, or dipeptidyl peptidase IV inhibitors, and quadriple combination of dapagliflozin, metformin, and sulfonylurea with dipeptidyl peptidase IV inhibitors. Patients who achieved ≥5% body weight reduction were classified as responders, and those who achieved <5% body weight reduction were classified as non-responders. Results After 12 months, the mean change from baseline body weight was −3.4±2.6 kg (P<0.001) for all patients, −3.4±3.1 kg (P<0.001) for group 1, −2.7±2.0 kg (P=0.008) for group 2, and −4.0±2.3 kg (P<0.001) for group 3. Fasting C-peptide level was higher in the responder group than in the non-responder group (3.25±1.07 ng/mL vs. 2.62±1.02 ng/mL, P=0.023). In total, reductions in HbA1c, PP2, and FPG levels were −0.61±0.82% (P=0.000), −35.4±62 mg/dL (P=0.000), and −21.3±56.2 mg/dL (P=0.012), respectively. They had mild adverse events included orthostatic dizziness and urinary tract infection. Conclusion SGLT2 inhibitor improved glycemic control and reduced body weight in a safe manner for patients with type 2 diabetes mellitus.
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Affiliation(s)
- Hyun A Cho
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Sejong General Hospital, Bucheon, Korea
| | - Young Lee Jung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Sejong General Hospital, Bucheon, Korea
| | - Yong Hoon Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Sejong General Hospital, Bucheon, Korea
| | - Yu Chang Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Sejong General Hospital, Bucheon, Korea
| | - Jung Eun Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Sejong General Hospital, Bucheon, Korea
| | - Sol Jae Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Sejong General Hospital, Bucheon, Korea
| | - Su Jin Jeong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Sejong General Hospital, Bucheon, Korea
| | - Chong Hwa Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Sejong General Hospital, Bucheon, Korea
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Ikeda N, Nishi N, Noda H, Noda M. Trends in prevalence and management of diabetes and related vascular risks in Japanese adults: Japan National Health and Nutrition Surveys 2003-2012. Diabetes Res Clin Pract 2017; 127:115-122. [PMID: 28365558 DOI: 10.1016/j.diabres.2017.03.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 03/16/2017] [Indexed: 12/11/2022]
Abstract
AIMS To examine temporal changes in health system performance for the control of diabetes and related risks for vascular complications in Japan over a decade. METHODS Data of 51,128 individuals aged ≥20years were obtained from the National Health and Nutrition Surveys in 2003-2012. Diabetes was defined as currently being treated by insulin or oral hypoglycaemic agents or having a glycated haemoglobin (HbA1c) level ≥6.5% (≥48mmol/mol). We estimated the prevalence and proportions of people with diabetes being treated and achieving target goals of HbA1c <7.0% (<53mmol/mol), blood pressure <130/80mmHg, and non-high-density lipoprotein cholesterol <130mg/dL. All estimates were age-standardized using the Japanese population in 2010. RESULTS The age-standardized prevalence of diabetes remained constant at approximately 8% and was significantly higher in men (P<0.001) and in individuals age ≥65years (P<0.001) throughout the study period. The proportion of people with diabetes being treated significantly increased from 41.8% (95% confidence interval, 37.2-46.5%) in 2003 to 54.9% (51.9-57.8%) in 2012, and the proportion of those having controlled HbA1c significantly increased from 13.4% (10.3-17.3%) in 2003 to 28.8% (26.3-31.5%) in 2012. These two rates were significantly higher in age ≥65years compared with younger adults in most of the survey years (P<0.05). The control rates of blood pressure and non-high-density lipoprotein cholesterol remained around 20% and 30-40%, respectively. CONCLUSIONS Diabetes management in Japan has improved over the past decade but is still inadequate for prevention of vascular complications.
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Affiliation(s)
- Nayu Ikeda
- Center for International Collaboration and Partnership, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8636, Japan.
| | - Nobuo Nishi
- Center for International Collaboration and Partnership, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8636, Japan
| | - Hiroyuki Noda
- Department of Public Health, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan
| | - Mitsuhiko Noda
- Department of Endocrinology and Diabetes, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0495, Japan
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Trends in the pervasiveness of type 2 diabetes, impaired fasting glucose and co-morbidities during an 8-year-follow-up of nationwide Korean population. Sci Rep 2017; 7:46656. [PMID: 28425463 PMCID: PMC5397969 DOI: 10.1038/srep46656] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 03/28/2017] [Indexed: 01/19/2023] Open
Abstract
The prevalence and incidence of type 2 diabetes, impaired fasting glucose, and co-morbidities from 2006 to 2013 in the population aged ≥30 years were estimated using the Korean NHIS database. The prevalence of type 2 diabetes increased 0.2–0.5% annually, from 5.6% in 2006 to 8% in 2013. The prevalence of type 2 diabetes was higher in men than in women and increased with age. The incidence of type 2 diabetes was 0.81% in 2013 and was 1.4 times higher in men than in women and increased with age. An overall decrease in the incidence rate occurred from 2006 to 2013(from 0.95 to 0.81%), which was mirrored in all age groups except the 30–39-year-old group. The prevalence of IFG was 25% in 2013. The prevalence of hypertension(62.5 vs 16.9%) and dyslipidemia(49.5 vs 9.7%) were more prevalent in patients with type 2 diabetes compared to non-diabetic cases. This study shows that type 2 diabetes is both common and increasing and that one-quarter of the Korean adult population has IFG. We also confirmed that the prevalence of hypertension and dyslipidemia are 3.7-fold and 5.1-fold higher, respectively, in diabetic patients than in non-diabetic adults.
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Lai YK, Lai NM, Lee SWH. Glucose-6-phosphate dehydrogenase deficiency and risk of diabetes: a systematic review and meta-analysis. Ann Hematol 2017; 96:839-845. [PMID: 28197721 DOI: 10.1007/s00277-017-2945-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 02/02/2017] [Indexed: 10/20/2022]
Abstract
Emerging epidemiological evidence suggests that patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency may have a higher risk of developing diabetes. The aim of the review was to synthesise the evidence on the association between G6PD deficiency and diabetes. A systematic search on Medline, EMBASE, AMED and CENTRAL databases for studies published between January 1966 and September 2016 that assessed the association between G6PD deficiency and diabetes was conducted. This was supplemented by a review of the reference list of retrieved articles. We extracted data on study characteristics, outcomes and performed an assessment on the methodological quality of the studies. A random-effects model was used to compute the summary risk estimates. Fifteen relevant publications involving 949,260 participants were identified, from which seven studies contributed to the meta-analysis. G6PD deficiency was associated with a higher odd of diabetes (odds ratio 2.37, 95% confidence interval 1.50-3.73). The odds ratio of diabetes among men was higher (2.22, 1.31-3.75) compared to women (1.87, 1.12-3.12). This association was broadly consistent in the sensitivity analysis. Current evidence suggests that G6PD deficiency may be a risk factor for diabetes, with higher odds among men compared to women. Further research is needed to determine how G6PD deficiency moderates diabetes.
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Affiliation(s)
- Yin Key Lai
- School of Pharmacy, UCSI University, Jalan Menara Gading, Taman Connaught, 56000, Kuala Lumpur, Malaysia
| | - Nai Ming Lai
- School of Medicine, Taylor's University, Jalan Taylor's, 47500, Subang Jaya, Malaysia
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University Malaysia, 46150, Bandar Sunway, Malaysia.
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Park YS, Heo H, Ye BJ, Suh YW, Kim SH, Park SH, Lim KH, Lee SJ, Park SH, Baek SH. Prevalence and Factors Associated with the Use of Eye Care Services in South Korea: Korea National Health and Nutrition Examination Survey 2010-2012. KOREAN JOURNAL OF OPHTHALMOLOGY 2017; 31:58-70. [PMID: 28243025 PMCID: PMC5327176 DOI: 10.3341/kjo.2017.31.1.58] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 12/21/2015] [Indexed: 11/26/2022] Open
Abstract
Purpose To estimate the factors and prevalence of eye care service utilization in the South Korean population. Methods This cross-sectional, population-based study included data from 22,550 Koreans aged ≥5 years who participated in the Korea National Health and Nutrition Examination Survey from 2010 to 2012. For people aged 5 to 11 years (young children), information was based on self-reports of contact with eye care service in the past year; for people aged ≥12 years (older population), the information was based on the self-reported lifetime contact with eye care service. Univariate and multivariate logistic regression analyses of the complex sample survey data were performed. Results The prevalence of eye care service use in young children during the past year was 61.1% (95% confidence
interval, 58.1%–64.1%), while that in the older population during their lifetime was 73.5%. Subjects aged 7 to 11 years were more likely to have had an eye examination in the past year than subjects aged 5 to 6 years (odds ratio, 3.83; 95% confidence interval, 2.37–6.19). Multivariate logistic regression analysis indicated that higher monthly household income, being a National Health Insurance holder, and having private health insurance were related to more frequent use of eye care services in young children. For the older population and women, those living in an urban area and those with a best-corrected visual acuity less than 20 / 40 in the worse-seeing eye were more likely to have had an eye examination during their lifetime. Low education level was associated with low lifetime use of eye care services in the older population. Conclusions There are sociodemographic disparities with use of eye care services in South Korea. This population-based study provides information that is useful for determining different intervention programs based on sociodemographic disparities to promote eye care service utilization in South Korea.
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Affiliation(s)
- Yong Seok Park
- Department of Ophthalmology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Hwan Heo
- Department of Ophthalmology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Byeong Jin Ye
- Department of Occupational and Environmental Medicine, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea
| | - Young-Woo Suh
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Seung-Hyun Kim
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Shin Hae Park
- Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Key Hwan Lim
- Department of Ophthalmology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea
| | - Sung Jin Lee
- Department of Ophthalmology, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Song Hee Park
- Department of Ophthalmology, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Seung-Hee Baek
- Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea
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Yang SH, Chung HK, Lee SM. Effects of Activity-Based Personalized Nutrition Education on Dietary Behaviors and Blood Parameters in Middle-Aged and Older Type 2 Diabetes Korean Outpatients. Clin Nutr Res 2016; 5:237-248. [PMID: 27812513 PMCID: PMC5093221 DOI: 10.7762/cnr.2016.5.4.237] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 10/12/2016] [Accepted: 10/18/2016] [Indexed: 11/19/2022] Open
Abstract
This study aimed to compare the effects of activity-based personalized nutrition education (APNE) with a general instruction for diabetes (control, CTRL) in middle-aged and older Korean outpatients with type 2 diabetes. After an initial screening, 70 subjects were randomly assigned to APNE (n = 37) or CTRL (n = 33) group. APNE considered each patient's anthropometry, blood chemistry data, and dietary habits in addition to planning meal choices with the aid of registered dietitians. After 3 months, dietary behavior, food intake, and anthropometric and blood measurement results were evaluated. Fasting blood glucose, 2-hour postprandial blood glucose, and glycated hemoglobin levels decreased in the APNE group (n = 33) but not in the CTRL group (n = 23). In the APNE group, the meal intervals and number of days of consuming high-fat food were decreased, while the number of days following a meal plan and balanced diet that entailed consuming fruits, vegetables, and healthy food was increased. A lower consumption of carbohydrates, saccharides, grains, and tuber crops and a higher protein, pulses, and fat-derived calorie intake compared with the initial values were observed in the APNE group. In contrast, only the number of days following the meal plan and balanced diet was increased in the CRTL group, without significantly changing the individual macronutrient-derived calorie intake. The APNE approach appeared to effectively educate outpatients with type 2 diabetes about changing their dietary behavior and food intake and improving the clinical parameters related to diabetic conditions.
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Affiliation(s)
- Seung Hye Yang
- Program of Clinical Nutrition, Graduate School of Human Environmental Sciences, Yonsei University, Seoul 03722, Korea
| | - Hye-Kyung Chung
- Severance Institute for Vascular and Metabolic Research, College of Medicine, Yonsei University, Seoul 03722, Korea
| | - Seung-Min Lee
- Program of Clinical Nutrition, Graduate School of Human Environmental Sciences, Yonsei University, Seoul 03722, Korea.; Department of Food and Nutrition, College of Human Ecology, Yonsei University, Seoul 03722, Korea
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Abstract
Diabetes is one of the foremost public health issues worldwide that can lead to complications in many organ systems, and has become a significant cause of morbidity and mortality in Korea. According to data from the National Health Insurance Service (NHIS), about 2.7 million Koreans (8.0%) aged 30 years or older had type 2 diabetes mellitus (T2DM) in 2013. The prevalence of T2DM increased with age and rose from 5.6% in 2006 to 8.0% in 2013. Using data based on The Health Screening Service of the NHIS, 25% of Korean adults were reported to have prediabetes in 2013. The prevalence of an impaired fasting glucose tended to increase over time from 21.5% in 2006 to 25.0% in 2013. Even though nationwide health screening has been regularly conducted as a public service, the proportion of undiagnosed cases of diabetes was still reported to be on the higher side in the latest study. Based on the results of these epidemic studies, further actions will be needed to effectively implement lifestyle changes on a social level and increase measures for the early detection of diabetes to stem the tide of the epidemic.
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Affiliation(s)
- Junghyun Noh
- Department of Internal Medicine, Inje University College of Medicine, Goyang, Korea.
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Park J, Lim S, Yim E, Kim Y, Chung W. Factors Associated with Poor Glycemic Control among Patients with Type 2 Diabetes Mellitus: The Fifth Korea National Health and Nutrition Examination Survey (2010-2012). HEALTH POLICY AND MANAGEMENT 2016. [DOI: 10.4332/kjhpa.2016.26.2.125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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