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Bui TT, Park E, Kang HY, Oh JK. Combined effects of smoking and alcohol consumption on the risk of liver cancer according to metabolic syndrome: A nested case-control study in South Korea. Int J Cancer 2024; 155:654-665. [PMID: 38533737 DOI: 10.1002/ijc.34935] [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: 12/04/2023] [Revised: 02/15/2024] [Accepted: 03/05/2024] [Indexed: 03/28/2024]
Abstract
Tobacco and alcohol may interact to increase the risk of liver cancer, which might be modified by other risk factors. Their combined effects in the context of metabolic syndrome (MetS) remain unclear. Given the increasing prevalence of MetS, this nested case-control study was conducted to evaluate the combined effects of smoking and alcohol consumption on liver cancer risk with stratification by MetS. We included 15,352 liver cancer patients and 92,112 matched controls who attended the nationwide general health examination during 2009-2019, using a customized database (N = 5,545,835) from the Korean National Health Insurance Service. Liver cancer risk according to smoking and alcohol consumption was estimated using conditional multivariable logistic regression. Additive and multiplicative interactions between these two factors were assessed. Results showed that in men, dual current users were at a significantly higher risk of liver cancer compared with dual nonusers, adjusted odds ratio (aOR) = 1.61, 95% confidence interval: (1.50, 1.72). Interactions were detected between light-to-moderate alcohol consumption (0.1-28 g/day) and heavy smoking (>20 pack-years) on additive scale, relative excess risk due to interaction = 0.34 (0.16, 0.51), attributable proportion = 0.22 (0.11, 0.33), synergy index = 2.75 (1.85, 3.66), and multiplicative scale, aOR for the product term = 1.28 (1.11, 1.49). An additive interaction was also revealed between light-to-moderate drinking and light-to-moderate smoking in the MetS subgroup. In women, light-to-moderate drinking/nonsmoking was negatively associated with the risk in the non-MetS subgroup. In conclusion, a holistic health promotion program should target male dual users of tobacco cigarettes and alcohol, including light-to-moderate users, especially those with MetS.
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Affiliation(s)
- Thi Tra Bui
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Republic of Korea
| | - Eunjung Park
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Republic of Korea
| | - Hee-Yeon Kang
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Republic of Korea
| | - Jin-Kyoung Oh
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Republic of Korea
- Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
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2
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Cao C, Wei C, Han Y, Luo J, Xi P, Chen J, Xiao X, Hu H, Qi D. Association between excessive alcohol consumption and incident diabetes mellitus among Japanese based on propensity score matching. Sci Rep 2024; 14:17274. [PMID: 39068183 PMCID: PMC11283479 DOI: 10.1038/s41598-024-68202-3] [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: 02/07/2024] [Accepted: 07/22/2024] [Indexed: 07/30/2024] Open
Abstract
The available evidence on the connection between excessive alcohol consumption and diabetes is controversial. Therefore, the primary objective of this investigation was to examine the connection between excessive alcohol consumption and incident diabetes in a Japanese population through the utilization of propensity score matching (PSM) analysis. Our retrospective cohort study encompassed a sample of 15,464 Japanese individuals who were initially free of diabetes between the years 2004 and 2015. The study utilized comprehensive medical records of individuals who underwent a physical examination. Employing a one:one PSM analysis, the current research included 2298 individuals with and without excessive alcohol consumption. Furthermore, a doubly robust estimation method was employed to ascertain the connection between excessive alcohol consumption and diabetes. The findings revealed that individuals with excessive alcohol consumption exhibited a 73% higher likelihood of developing diabetes (HR = 1.73, 95% CI 1.08-2.77). Furthermore, upon adjusting for variables, the PSM cohort demonstrated that individuals with excessive alcohol consumption had a 78% increased risk of developing diabetes in comparison to those with non-excessive alcohol consumption (HR = 1.78, 95% CI 1.08-2.93). Individuals with excessive alcohol consumption were found to have a 73% higher risk of developing diabetes compared to those with non-excessive alcohol consumption, even after controlling for propensity score (HR = 1.73, 95% CI 1.08-2.78). Participants in the PSM cohort with excessive alcohol consumption had a 73% higher risk of developing diabetes than those with non-excessive alcohol consumption after controlling for confounding factors. These findings underscore the importance of alcohol consumption guidelines aimed at reducing excessive drinking. Clinicians should be vigilant in screening for alcohol use in patients, particularly those at risk for diabetes, and provide appropriate counseling and resources to support alcohol reduction.
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Affiliation(s)
- Changchun Cao
- Department of Rehabilitation, Shenzhen Dapeng New District Nan'ao People's Hospital, Shenzhen, 518000, Guangdong Province, China
| | - Cuimei Wei
- Department of Geriatrics, Futian District, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, No.3002, Sungang West Road, Shenzhen, 518000, Guangdong Province, China
| | - Yong Han
- Department of Emergency, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518000, Guangdong Province, China
| | - Jiao Luo
- Department of Rehabilitation, Shenzhen Dapeng New District Nan'ao People's Hospital, Shenzhen, 518000, Guangdong Province, China
| | - Ping Xi
- Department of Geriatrics, Futian District, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, No.3002, Sungang West Road, Shenzhen, 518000, Guangdong Province, China
| | - Jingying Chen
- Department of Geriatrics, Futian District, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, No.3002, Sungang West Road, Shenzhen, 518000, Guangdong Province, China
| | - Xiaohua Xiao
- Department of Geriatrics, Futian District, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, No.3002, Sungang West Road, Shenzhen, 518000, Guangdong Province, China.
| | - Haofei Hu
- Department of Nephrology, Futian District, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, No.3002, Sungang West Road, Shenzhen, 518000, Guangdong Province, China.
| | - Dongli Qi
- Department of Nephrology, Futian District, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, No.3002, Sungang West Road, Shenzhen, 518000, Guangdong Province, China.
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Yin X, Wang Y, Jiang J, Zhong F, Zhang Q. Association of blood urea nitrogen to creatinine ratio with incident type 2 diabetes mellitus: A retrospective cohort study in the Chinese population. Medicine (Baltimore) 2024; 103:e39003. [PMID: 39058804 PMCID: PMC11272234 DOI: 10.1097/md.0000000000039003] [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: 11/20/2023] [Accepted: 06/28/2024] [Indexed: 07/28/2024] Open
Abstract
Renal dysfunction can lead to insulin resistance and increase the incidence of type 2 diabetes mellitus (T2DM). The blood urea nitrogen to creatinine ratio (NCR) is a frequently used indicator to assess renal dysfunction and differentiate between prerenal and intrinsic renal injury. However, the association between NCR and T2DM in the Chinese population remains unclear. Hence, this study aimed to investigate the association between NCR and the incidence of T2DM in the Chinese population. The relationship between NCR and T2DM was examined using the Cox proportional hazards model and curve fitting techniques. In addition, a comprehensive set of sensitivity and subgroup analyses were performed. All results were presented as hazard ratios (HRs) and 95% confidence intervals (CIs). Between 2010 and 2016, 189,416 Chinese people were recruited from the Rich Healthcare Group for this retrospective cohort study. Of the participants, 3755 (19.8%) were diagnosed with T2DM during the follow-up period. After full adjustment, the Cox proportional hazards model revealed a positive connection between NCR and the incidence of T2DM (HR = 1.03, 95% CI: 1.02-1.04, P < .001). Compared with individuals with lower NCR Q1 (≤13.536), the multivariate HR for NCR and T2DM in Q2 (13.536-16.256), Q3 (16.256-19.638), Q4 (>19.638) were 1.08 (0.98-1.19), 1.16 (1.05-1.28), 1.39 (1.26-1.53). The higher NCR groups (≥20) had a higher ratio of T2DM (HR = 1.28, 95% CI: 1.18-1.38, P < .001) than the lowest NCR group (<20). These findings were validated using sensitivity and subgroup analyses. In conclusion, this study found a positive and independent association between NCR and the incidence of T2DM after adjusting for confounding variables.
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Affiliation(s)
- Xiuping Yin
- Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yiguo Wang
- Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jianjun Jiang
- Department of Traditional Chinese Medicine, ZhongCe Town Health Center, Jining, Shandong Province, China
| | - Fengxing Zhong
- Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing, China
| | - Qiming Zhang
- Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing, China
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Xiao R, Dong L, Xie B, Liu B. A diet-wide Mendelian randomization analysis: causal effects of dietary habits on type 2 diabetes. Front Nutr 2024; 11:1414678. [PMID: 39119465 PMCID: PMC11306177 DOI: 10.3389/fnut.2024.1414678] [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: 05/04/2024] [Accepted: 07/09/2024] [Indexed: 08/10/2024] Open
Abstract
Background Traditional clinical studies have indicated a link between certain food intakes and type 2 diabetes (T2D), but the causal relationships between different dietary habits and T2D remain unknown. Using Mendelian randomization (MR) approaches, we investigated the potential causal association between dietary habits and T2D risk. Methods We collected publicly available genome-wide association studies' summary statistics for 18 dietary habits from the UK Biobank and T2D data from the DIAbetes Genetics Replication And Meta-analysis (DIAGRAM) consortium. We applied the inverse variance weighted (IVW) method, supplemented with the MR-Egger method, weighted median method (WMM), simple method, weighted mode, MR-Egger regression, and the MR pleiotropy residual sum and outlier test to determine whether a particular diet was causal for T2D. Results Reliable and robust MR estimates demonstrated that poultry intake has a causal effect on a higher risk of T2D (IVW: OR 6.30, 95% CI 3.573-11.11, p = 2.02e - 10; WMM: OR 5.479, 95% CI 0.2758-10.88, p = 1.19e - 06). Conversely, dried fruit intake (IVW: OR 0.380, 95% CI 0.237-0.608, p = 5.57e - 05; WMM: OR 0.450, 95% CI 0.321-0.630, p = 3.33e - 06) and cereal intake (IVW: OR 0.455, 95% CI 0.317-0.653, p = 1.924e - 05; WMM: OR 0.513, 95% CI 0.379-0.694, p = 1.514e - 05) were causally associated with T2D as protective factors. Sensitivity analyses confirmed the reliability and robustness of these findings. Discussion Our study established the causal effects of poultry intake, dried fruit intake, and cereal intake on T2D, identifying poultry intake as a risk factor and the other two as protective factors. Further research into potential mechanisms is required to validate these novel findings.
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Affiliation(s)
- Rui Xiao
- Department of General Practice, Yongchuan Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China
| | - Li Dong
- Department of Nephrology and Rheumatology, Yongchuan Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China
| | - Bo Xie
- Department of General Practice, Yongchuan Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China
| | - Beizhong Liu
- Central Laboratory of Yongchuan Hospital, Chongqing Medical University, Chongqing, China
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Fernández Castro I, Marcos Martín M, Novo Veleiro I. Alcohol consumption in elderly people. What is the real magnitude of the problem? Rev Clin Esp 2024:S2254-8874(24)00101-2. [PMID: 39038787 DOI: 10.1016/j.rceng.2024.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 06/18/2024] [Indexed: 07/24/2024]
Abstract
The harmful effects of alcohol consumption have been well studied in the general population, but in the group of people over 80 years of age there is not much information regarding its relevance. It is estimated than 30%-40% of this population consumes alcohol regularly and around 10% engage in high-risk consumption. Furthermore, potential interactions between this substance and commonly consumed drugs in this age group, like oral antidiabetics, anticoagulants and antibiotics, may pose a risk of serious complications. In this sense, the aim of the present work was to analyze the magnitude of alcohol consumption within people over 80 years of age and the impact it has on their health. A narrative review of the available literature on the topic was carried out, which showed that alcohol consumption in people over 80 years of age is common in our environment and is associated with multiple complications and the development of different pathologies. The correct quantification of alcohol consumption in very elderly people must be integrated into the daily clinical practice of Medicine in general and Internal Medicine in particular.
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Affiliation(s)
- I Fernández Castro
- Servicio de Medicina Interna, Complejo Hospitalario Universitario de Santiago de Compostela, Spain; Grupo de Trabajo de Alcohol y otras Drogas. Sociedad Española de Medicina Interna, Spain
| | - M Marcos Martín
- Servicio de Medicina Interna, Hospital Universitario de Salamanca, Spain; Grupo de Trabajo de Alcohol y otras Drogas. Sociedad Española de Medicina Interna, Spain; Departamento de Medicina, Universidad de Salamanca, Spain
| | - I Novo Veleiro
- Servicio de Hospitalización a Domicilio, Complejo Hospitalario Universitario de Santiago de Compostela, Spain; Grupo de Trabajo de Alcohol y otras Drogas. Sociedad Española de Medicina Interna, Spain; Departamento de Medicina, Universidad de Santiago de Compostela, Spain.
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Kang J, Deng YT, Wu BS, Liu WS, Li ZY, Xiang S, Yang L, You J, Gong X, Jia T, Yu JT, Cheng W, Feng J. Whole exome sequencing analysis identifies genes for alcohol consumption. Nat Commun 2024; 15:5777. [PMID: 38982111 PMCID: PMC11233704 DOI: 10.1038/s41467-024-50132-3] [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: 05/15/2023] [Accepted: 06/26/2024] [Indexed: 07/11/2024] Open
Abstract
Alcohol consumption is a heritable behavior seriously endangers human health. However, genetic studies on alcohol consumption primarily focuses on common variants, while insights from rare coding variants are lacking. Here we leverage whole exome sequencing data across 304,119 white British individuals from UK Biobank to identify protein-coding variants associated with alcohol consumption. Twenty-five variants are associated with alcohol consumption through single variant analysis and thirteen genes through gene-based analysis, ten of which have not been reported previously. Notably, the two unreported alcohol consumption-related genes GIGYF1 and ANKRD12 show enrichment in brain function-related pathways including glial cell differentiation and are strongly expressed in the cerebellum. Phenome-wide association analyses reveal that alcohol consumption-related genes are associated with brain white matter integrity and risk of digestive and neuropsychiatric diseases. In summary, this study enhances the comprehension of the genetic architecture of alcohol consumption and implies biological mechanisms underlying alcohol-related adverse outcomes.
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Affiliation(s)
- Jujiao Kang
- Institute of Science and Technology for Brain-Inspired Intelligence (ISTBI), Fudan University, Shanghai, 200433, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, 200433, China
| | - Yue-Ting Deng
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, 200433, China
| | - Bang-Sheng Wu
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, 200433, China
| | - Wei-Shi Liu
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, 200433, China
| | - Ze-Yu Li
- Institute of Science and Technology for Brain-Inspired Intelligence (ISTBI), Fudan University, Shanghai, 200433, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, 200433, China
| | - Shitong Xiang
- Institute of Science and Technology for Brain-Inspired Intelligence (ISTBI), Fudan University, Shanghai, 200433, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, 200433, China
| | - Liu Yang
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, 200433, China
| | - Jia You
- Institute of Science and Technology for Brain-Inspired Intelligence (ISTBI), Fudan University, Shanghai, 200433, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, 200433, China
| | - Xiaohong Gong
- School of Life Sciences, Fudan University, Shanghai, 200433, China
| | - Tianye Jia
- Institute of Science and Technology for Brain-Inspired Intelligence (ISTBI), Fudan University, Shanghai, 200433, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, 200433, China
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- School of Psychology, University of Southampton, Southampton, UK
| | - Jin-Tai Yu
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, 200433, China.
| | - Wei Cheng
- Institute of Science and Technology for Brain-Inspired Intelligence (ISTBI), Fudan University, Shanghai, 200433, China.
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, 200433, China.
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, 200433, China.
- Fudan ISTBI-ZJNU Algorithm Centre for Brain-inspired Intelligence, Zhejiang Normal University, Zhejiang, China.
| | - Jianfeng Feng
- Institute of Science and Technology for Brain-Inspired Intelligence (ISTBI), Fudan University, Shanghai, 200433, China.
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, 200433, China.
- Fudan ISTBI-ZJNU Algorithm Centre for Brain-inspired Intelligence, Zhejiang Normal University, Zhejiang, China.
- Department of Computer Science, University of Warwick, Coventry, CV4 7AL, UK.
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Mori K, Akiyama Y, Tanaka M, Sato T, Endo K, Hosaka I, Hanawa N, Sakamoto N, Furuhashi M. Deciphering metabolic dysfunction-associated steatotic liver disease: insights from predictive modeling and clustering analysis. J Gastroenterol Hepatol 2024; 39:1382-1393. [PMID: 38629681 DOI: 10.1111/jgh.16552] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/12/2024] [Accepted: 03/20/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND AND AIM New nomenclature of steatotic liver disease (SLD) including metabolic dysfunction-associated SLD (MASLD), MASLD and increased alcohol intake (MetALD), and alcohol-associated liver disease (ALD) has recently been proposed. We investigated clustering analyses to decipher the complex landscape of SLD pathologies including the former nomenclature of nonalcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated fatty liver disease (MAFLD). METHODS Japanese individuals who received annual health checkups including abdominal ultrasonography (n = 15 788, men/women: 10 250/5538, mean age: 49 years) were recruited. RESULTS The numbers of individuals with SLD, MASLD, MetALD, ALD, NAFLD, and MAFLD were 5603 (35.5%), 4227 (26.8%), 795 (5.0%), 324 (2.1%), 3982 (25.8%), and 4946 (31.3%), respectively. Clustering analyses using t-distributed stochastic neighbor embedding and K-means to visually represent interconnections in SLDs uncovered five cluster formations. MASLD and NAFLD mainly shared three clusters including (i) low alcohol intake with relatively low-grade obesity; (ii) obesity with dyslipidemia; and (iii) dysfunction of glucose metabolism. Both MetALD and ALD displayed one distinct cluster intertwined with alcohol consumption. MAFLD widely shared all of the five clusters. In machine learning-based analyses using algorithms of random forest and extreme gradient boosting and receiver operating characteristic curve analyses, fatty liver index (FLI), calculated by body mass index, waist circumference, and levels of γ-glutamyl transferase and triglycerides, was selected as a useful feature for SLDs. CONCLUSIONS The new nomenclature of SLDs is useful for obtaining a better understanding of liver pathologies and for providing valuable insights into predictive factors and the dynamic interplay of diseases. FLI may be a noninvasive predictive marker for detection of SLDs.
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Affiliation(s)
- Kazuma Mori
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
- Department of Immunology and Microbiology, National Defense Medical College, Tokorozawa, Japan
| | - Yukinori Akiyama
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Marenao Tanaka
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tatsuya Sato
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
- Department of Cellular Physiology and Signal Transduction, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Keisuke Endo
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Itaru Hosaka
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Nagisa Hanawa
- Department of Health Checkup and Promotion, Keijinkai Maruyama Clinic, Sapporo, Japan
| | - Naoya Sakamoto
- Department of Gastroenterology and Hepatology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - Masato Furuhashi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
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Hu Y, Ding X, Chen L, Luo Y, Liu X, Tang X. Dietary Patterns and New-Onset Diabetes Mellitus in Southwest China: A Prospective Cohort Study in the China Multi-Ethnic Cohort (CMEC). Nutrients 2024; 16:1636. [PMID: 38892568 PMCID: PMC11174084 DOI: 10.3390/nu16111636] [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: 04/24/2024] [Revised: 05/21/2024] [Accepted: 05/22/2024] [Indexed: 06/21/2024] Open
Abstract
(1) Background: There is little known about the relationship between Dietary Approaches to Stop Hypertension (DASH) pattern and diabetes in cohort studies, and the dietary patterns in the Chongqing natural population are unknown. (2) Methods: 14,176 Chinese adults, aged 30-79 years old, participated in this prospective study, from September 2018 to October 2023. A dietary assessment was conducted using a food frequency questionnaire, and three main dietary patterns were extracted from the principal component analysis. DASH patterns were calculated by standards. (3) Results: During the 4.64 y follow-up, 875 developed diabetes (11.3/1000 person-years). Each posteriori diet pattern is named after its main dietary characteristics (meat pattern, dairy products-eggs pattern, and alcohol-wheat products pattern). The high consumption of DASH pattern diet reduced the risk of diabetes (Q5 vs. Q1 HR: 0.71; 95% CI: 0.40-0.56) while high consumption of alcohol-wheat product pattern diet was associated with a high risk of diabetes (Q5 vs. Q1 HR: 1.32; 95% CI: 1.04, 1.66). The other two dietary patterns were not associated with diabetes. In subgroup analysis, there was an interaction between DASH pattern and sex (P for interaction < 0.006), with a strong association in females. (4) Conclusions: DASH pattern may be associated with a reduced new-onset diabetes risk and Alcohol-wheat products pattern may be positively associated with new-onset diabetes. These findings may provide evidence for making dietary guidelines in southwest China to prevent diabetes.
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Affiliation(s)
- Yanqi Hu
- School of Public Health, Research Center for Medical and Social Development, Chongqing Medical University, Chongqing 400016, China; (Y.H.); (Y.L.); (X.L.)
| | - Xianbin Ding
- Institute of Chronic Non-Communicable Disease Control and Prevention, Chongqing Center for Disease Control and Prevention, Chongqing 400042, China; (X.D.); (L.C.)
| | - Liling Chen
- Institute of Chronic Non-Communicable Disease Control and Prevention, Chongqing Center for Disease Control and Prevention, Chongqing 400042, China; (X.D.); (L.C.)
| | - Youxing Luo
- School of Public Health, Research Center for Medical and Social Development, Chongqing Medical University, Chongqing 400016, China; (Y.H.); (Y.L.); (X.L.)
| | - Xin Liu
- School of Public Health, Research Center for Medical and Social Development, Chongqing Medical University, Chongqing 400016, China; (Y.H.); (Y.L.); (X.L.)
| | - Xiaojun Tang
- School of Public Health, Research Center for Medical and Social Development, Chongqing Medical University, Chongqing 400016, China; (Y.H.); (Y.L.); (X.L.)
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9
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Lei Y, Zhang L, Shan Z, Gan Q, Xie Q, Huang Y, Yan W, Xiao Z. Poor healthy lifestyle and life's essential 8 are associated with higher risk of new-onset migraine: a prospective cohort study. J Headache Pain 2024; 25:82. [PMID: 38760725 PMCID: PMC11100122 DOI: 10.1186/s10194-024-01785-4] [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: 03/04/2024] [Accepted: 05/06/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Lifestyle are closely related to migraine. However, there is a lack of studies investigating the association between Healthy lifestyle or Life's Essential 8 (LE8) and the risk of migraine. The objective of this research was to investigate the relationship between Healthy lifestyle scores and Life's essential 8 scores, and migraine. METHODS 332,895 UK Biobank participants without migraine were included. Healthy lifestyle were assessed using seven lifestyle factors, and categorized as poor, intermediate, or ideal. LE8, based on the American Heart Association (AHA) Guidelines for Cardiovascular Health (CVH), consist of eight indicators classified as low, moderate, or high CVH. The Cox proportional hazard model was employed to examine the association between Healthy lifestyle scores, LE8 scores, and migraine, with calculations for population-attributable fraction (PAF) and cumulative incidence. RESULTS During a median follow-up of 13.58 years, participants in intermediate (HR: 0.91; 95% CI: 0.85, 0.99) or ideal category of Healthy lifestyle (HR: 0.81; 95% CI: 0.73, 0.91) significantly reduced migraine risk compared to the poor category. Similarly, high CVH (HR: 0.73; 95% CI: 0.58, 0.92) also lowered migraine risk, while moderate CVH (HR: 0.93; 95% CI: 0.85, 1.02) did not show a difference compared to low CVH. If all individuals adhered to higher categories of Healthy lifestyle and LE8, approximately 11.38% and 22.05% of migraine cases could be prevented. Among individual lifestyle factors, maintaining an ideal body mass index (BMI), physical activity, sleep duration, sleep pattern, and sedentary time were associated with substantial reductions in migraine risk, by 5.65%, 0.81%, 10.16%, 16.39%, and 6.57%, respectively. CONCLUSION Our study provides evidence that poor Healthy lifestyle and Life's Essential 8 are associated with higher risk of new-onset migraine.
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Affiliation(s)
- Yuexiu Lei
- Department of Neurology, Renmin Hospital of Wuhan University, 99 Zhang Zhidong Road, Wuchang District, Wuhan, Hubei Province, 430060, China
| | - Lili Zhang
- Department of Neurology, Renmin Hospital of Wuhan University, 99 Zhang Zhidong Road, Wuchang District, Wuhan, Hubei Province, 430060, China
| | - Zhengming Shan
- Department of Neurology, Renmin Hospital of Wuhan University, 99 Zhang Zhidong Road, Wuchang District, Wuhan, Hubei Province, 430060, China
| | - Quan Gan
- Department of Neurology, Renmin Hospital of Wuhan University, 99 Zhang Zhidong Road, Wuchang District, Wuhan, Hubei Province, 430060, China
| | - Qingfang Xie
- Department of Neurology, Renmin Hospital of Wuhan University, 99 Zhang Zhidong Road, Wuchang District, Wuhan, Hubei Province, 430060, China
| | - Ying Huang
- Department of Neurology, Renmin Hospital of Wuhan University, 99 Zhang Zhidong Road, Wuchang District, Wuhan, Hubei Province, 430060, China
| | - Wen Yan
- Department of Neurology, Renmin Hospital of Wuhan University, 99 Zhang Zhidong Road, Wuchang District, Wuhan, Hubei Province, 430060, China
| | - Zheman Xiao
- Department of Neurology, Renmin Hospital of Wuhan University, 99 Zhang Zhidong Road, Wuchang District, Wuhan, Hubei Province, 430060, China.
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Xu Z, Feng J, Xing S, Liu Y, Chen Y, Li J, Feng Y. Global trends and spatial drivers of diabetes mellitus mortality, 1990-2019: a systematic geographical analysis. Front Endocrinol (Lausanne) 2024; 15:1370489. [PMID: 38681766 PMCID: PMC11045957 DOI: 10.3389/fendo.2024.1370489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 03/27/2024] [Indexed: 05/01/2024] Open
Abstract
Objective Diabetes mellitus is the leading cause of death worldwide, and multiple risk factors associated with diabetes mortality. Methods Employing spatial statistics, we characterized the spatial distribution and patterns of diabetes mortality, and revealed the spatial relationship between diabetes mortality and 11 socioeconomic and environmental risk factors at the country level, from 1990 to 2019. Results Globally, significantly high rates of diabetes mortality were primarily clustered in countries with limited land areas or located on islands, such as Fiji, Kiribati, Eswatini, and Trinidad and Tobago. Countries with weaker economic independence are more likely to have higher diabetes mortality rates. In addition, the impact of socioeconomic and environmental factors was significant at the country level, involving health expenditure, number of physicians, household and ambient air pollution, smoking, and alcohol consumption. Notably, the spatial relationship between diabetes mortality and ambient air pollution, as well as alcohol consumption, showed negative correlations. Countries with high diabetes mortality rates generally had lower levels of ambient air pollution and alcohol consumption. Conclusion The study highlights the spatial clustering of diabetes mortality and its substantial variation. While many risk factors can influence diabetes mortality, it's also essential to consider the level of these factors at the country level. Tailoring appropriate interventions based on specific national circumstances holds the potential to more effectively mitigate the burden of diabetes mortality.
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Affiliation(s)
- Zejia Xu
- School of Geographical Sciences and Remote Sensing, Guangzhou University, Guangzhou, China
| | - Jianheng Feng
- Faculty of Innovation and Design, City University of Macau, Macao, Macao SAR, China
| | - Siyi Xing
- School of Geographical Sciences and Remote Sensing, Guangzhou University, Guangzhou, China
| | - Yin Liu
- School of Geographical Sciences and Remote Sensing, Guangzhou University, Guangzhou, China
| | - Yuting Chen
- School of Geographical Sciences and Remote Sensing, Guangzhou University, Guangzhou, China
| | - Jie Li
- School of Geographical Sciences and Remote Sensing, Guangzhou University, Guangzhou, China
- Key Laboratory of Philosophy and Social Sciences in Guangdong Province of Maritime Silk Road of Guangzhou University (GD22TWCXGC15), Guangzhou, China
| | - Yunhui Feng
- Center for Interdisciplinary Health Management Studies, School of Physical Education & Sports Science, Guangzhou University, Guangzhou, China
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Thelle DS, Grønbæk M. Alcohol - a scoping review for Nordic Nutrition Recommendations 2023. Food Nutr Res 2024; 68:10540. [PMID: 38571916 PMCID: PMC10989238 DOI: 10.29219/fnr.v68.10540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 07/04/2022] [Accepted: 01/23/2024] [Indexed: 04/05/2024] Open
Abstract
The objective of this scoping review is to evaluate the updated evidence on the consumption of alcohol and health outcomes regarded as relevant for the Nordic and Baltic countries, including cardiovascular disease, cancer, and all-cause mortality. It is based on the previous Nordic Nutrition Recommendations of 2012 and relevant papers published until 31 May 2021. Current evidence from mainly observational epidemiological studies suggests that regular, moderate alcohol consumption may confer protective effects against myocardial infarction (MI) and type 2 diabetes. Mendelian randomization analyses do not fully support these findings, possibly because these analyses may fail to identify low alcohol intake. For several cancers, it is not possible to set any safe limit. All-cause mortality is not increased with light to moderate alcohol intake in middle-aged and older adults who do not engage in binge drinking. Total abstinence is associated with the lowest risk of mortality in young adults. Observational studies on alcohol consumption are hampered by a number of inherent methodological issues such as ascertainment of alcohol intake, selection of appropriate exposure groups, and insufficient control of confounding variables, colliders, and mediators. It should also be emphasized that there is a socio-economic contribution to the alcohol-health axis with a stronger detrimental effect of alcohol in the lower social classes. The above issues contribute to the complexity of unravelling the causal web between alcohol, mediators, confounders, and health outcome.
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Affiliation(s)
- Dag Steinar Thelle
- Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Morten Grønbæk
- National Institute of Public Health, Copenhagen, Denmark
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Tseng PY, Sung FC, Muo CH, Lan YC, Hser YI, Chien SHL, Wang JY. Risk of diabetes and hypertension in a population with alcohol use disorders. BMC Public Health 2024; 24:868. [PMID: 38515085 PMCID: PMC10956217 DOI: 10.1186/s12889-024-18318-y] [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: 12/06/2023] [Accepted: 03/10/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND A population-based follow-up study assessing the risk of developing hypertension and diabetes associated with alcohol use disorder (AUD) is crucial. We investigated this relationship by using insurance claims data from Taiwan. METHODS From the claims data, an AUD cohort (N = 60,590) diagnosed between 2000 and 2006 and a non-AUD comparison cohort (N = 60,590) without the diagnosis of hypertension or diabetes at baseline were established and matched by propensity scores estimated by baseline demographic status and the Charlson comorbidity index (CCI). We assessed the incidence rates of hypertension and/or diabetes at the end of 2016 and used Cox's method to estimate the related hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS Relative to the comparison cohort, the AUD cohort had an approximately 1.70-fold higher incidence of hypertension (35.1 vs. 20.7 per 1,000 person-years), with an adjusted HR (aHR) of 1.72 (95% CI: 1.68-1.76), 2.16-fold higher incidence of diabetes (20.2 vs. 9.36 per 1,000 person-years), with an aHR of 2.18 (95% CI: 2.11-2.24), and 1.91-fold higher incidence of both diabetes and hypertension (10.3 vs. 5.38 per 1,000 person-years) with an aHR of 2.02 (95% CI: 1.94-2.10). The incidence rates of all outcomes were greater in men than in women, whereas the HRs were greater for AUD in women than for AUD in men relative to the respective comparison patients. The risk increased further for subjects with CCI ≥ 1, which was higher in the AUD cohort. CONCLUSIONS The increased risk of developing diabetes and hypertension in patients with AUD, especially the differences noted according to gender, indicates that clinicians should address potential comorbidities in these patients.
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Affiliation(s)
- Pei-Ying Tseng
- Department of Public Health, China Medical University, 406, Taichung, Taiwan
- Department of Medicine, Lee's General Hospital, 358, Yuanli, Taiwan
| | - Fung-Chang Sung
- Management Office for Health Data, China Medical University Hospital, 404, Taichung, Taiwan
- Department of Health Services Administration, China Medical University College of Public Health, 406, Taichung, Taiwan
- Department of Food Nutrition and Health Biotechnology, Asia University, 413, Taichung, Taiwan
| | - Chih-Hsin Muo
- Management Office for Health Data, China Medical University Hospital, 404, Taichung, Taiwan
| | - Yu-Ching Lan
- Expert Labs, IBM Taiwan Corporation, 110, Taipei, Taiwan
| | - Yih-Ing Hser
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, 90095, Los Angeles, CA, USA
| | - Sarina Hui-Lin Chien
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
| | - Jong-Yi Wang
- Department of Health Services Administration, China Medical University, 100 Jingmao Rd. Sec. 1, Beitun Dist, 406, Taichung, Taiwan.
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Wändell P, Crump C, Li X, Stattin NS, Carlsson AC, Sundquist J, Sundquist K. Hypertension in Pregnancy Among Immigrant and Swedish Women: A Cohort Study of All Pregnant Women in Sweden. J Am Heart Assoc 2024; 13:e031125. [PMID: 38366326 PMCID: PMC10944082 DOI: 10.1161/jaha.123.031125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 01/03/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND Little is known about risks of hypertensive disorders of pregnancy in both first- and second-generation immigrant women in Europe and other Western countries; such knowledge may help elucidate the influence of genetic versus social factors on such risks. We aimed to study both first- and second-generation immigrant women for the presence of all types of hypertension (preexisting hypertension, gestational hypertension, preeclampsia, and eclampsia) during pregnancy. METHODS AND RESULTS A cohort study was conducted using data derived from the Swedish National Birth Register, the National Patient Register, and the Total Population Register. We used Cox regression analysis to compute hazard ratios (HRs) and 99% CIs while adjusting for sociodemographic factors and comorbidities. The first-generation study included a total of 1 084 212 deliveries and 68 311 hypertension cases, and the second-generation study included 989 986 deliveries and 67 505 hypertension cases. The fully adjusted HR (with 99% CI) for hypertension in pregnancy among first-generation immigrant women was 0.69 (0.66-0.72), and among second-generation immigrant women, it was 0.88 (0.86-0.91), compared with Swedish-born women with 2 Swedish-born parents. Women born in Finland or with parent(s) from Finland had higher risks, with fully adjusted HRs (99% CIs) of 1.30 (1.18-1.43) and 1.12 (1.07-1.17), respectively. CONCLUSIONS Both first- and second-generation immigrant women had overall lower risks of hypertension in pregnancy compared with other Swedish women. However, the risk reduction was less pronounced in second-generation compared with first-generation immigrant women, suggesting that environmental factors in Sweden may have an important influence on risk of hypertension during pregnancy.
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Affiliation(s)
- Per Wändell
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and SocietyKarolinska InstitutetHuddingeSweden
| | - Casey Crump
- Department of Family and Community Medicine and of Epidemiology, Human Genetics and Environmental SciencesThe University of Texas Health Science CenterHoustonTX
| | - Xinjun Li
- Center for Primary Health Care ResearchLund UniversityMalmöSweden
| | - Nouha Saleh Stattin
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and SocietyKarolinska InstitutetHuddingeSweden
- Academic Primary Health Care CentreStockholmSweden
| | - Axel C. Carlsson
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and SocietyKarolinska InstitutetHuddingeSweden
- Academic Primary Health Care CentreStockholmSweden
| | - Jan Sundquist
- Department of Family and Community Medicine and of Epidemiology, Human Genetics and Environmental SciencesThe University of Texas Health Science CenterHoustonTX
- Center for Primary Health Care ResearchLund UniversityMalmöSweden
- Center for Community‐Based Healthcare Research and Education, Department of Functional PathologySchool of Medicine, Shimane UniversityMatsueJapan
| | - Kristina Sundquist
- Department of Family and Community Medicine and of Epidemiology, Human Genetics and Environmental SciencesThe University of Texas Health Science CenterHoustonTX
- Center for Primary Health Care ResearchLund UniversityMalmöSweden
- Center for Community‐Based Healthcare Research and Education, Department of Functional PathologySchool of Medicine, Shimane UniversityMatsueJapan
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Li J, Zhao Y, Jiang Y, Zhang Y, Zhang P, Shen L, Chen Z. Prevalence and Risk Factors of Diabetes in Patients with Active Pulmonary Tuberculosis: A Cross-Sectional Study in Two Financially Affluent China Cities. Diabetes Metab Syndr Obes 2024; 17:1105-1114. [PMID: 38450415 PMCID: PMC10916512 DOI: 10.2147/dmso.s450507] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 02/23/2024] [Indexed: 03/08/2024] Open
Abstract
Background Tuberculosis (TB) and diabetes mellitus (DM) present a dual burden to public health. The screening of DM in TB patients may aid in the early detection and management of diabetes, ultimately improving treatment outcomes for those with the comorbidity of TB-DM. We aim to examine the prevalence and identify risk factors of diabetes in individuals with active pulmonary tuberculosis (PTB) in financially affluent China cities. Methods A cross-sectional survey was conducted in adult patients with highly suspected TB in two cities of China, spanning from May 9, 2023, to June 30, 2023. We compare the clinical characteristics, nutrition status, fasting blood glucose (FBG) level, living style, and knowledge of TB and DM at admission between patients with and without DM. Univariate and multivariate logistic regression analyses were employed to identify risk factors associated with TB-DM comorbidities. Results Of the 322 patients diagnosed with pulmonary tuberculosis (PTB), 54 individuals (16.8%) had comorbid diabetes mellitus (DM). This included 43 males (13.4%) and 11 females (3.4%). The average age was 55.44 ± 12.36 in DM patients and 46.09 ± 16.87 in non-DM patients. A multivariate logistic regression analysis revealed that male (adjusted odds ratio [aOR]=3.29, 95% confidence interval [CI]: 1.05-10.30), age older than 47 years (aOR = 1.04, 95% CI: 1.01-1.07), having a family history of diabetes (aOR = 5.09, 95% CI: 1.28-20.32), and an elevated random blood glucose level (aOR = 1.6, 95% CI: 1.38-1.86) were risk factors for DM in patients with PTB. Furthermore, it was found that diabetes awareness (aOR = 0.07, 95% CI: 0.03-0.21) and zero, light to moderate alcohol consumption were associated with a lower risk of diabetes. Conclusion Diabetes is prevalent in patients with active PTB. Screening and raising awareness of DM are recommended, particularly in men after middle age with a family history of diabetes and elevated random blood glucose. Early diagnosis of diabetes and effective diabetes prevention may reduce the dual burden of TB-DM comorbidity.
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Affiliation(s)
- Jing Li
- Department of Pulmonary Medicine and Tuberculosis, the Third People’s Hospital of Shenzhen, Shenzhen, Guangdong, People’s Republic of China
| | - Yanhong Zhao
- Department of Tuberculosis, the Third People’s Hospital of Kunming, Kunming, Yunnan, People’s Republic of China
| | - Youli Jiang
- Department of Neurology, People’s Hospital of Longhua, Shenzhen, 518109, People’s Republic of China
| | - Ying Zhang
- Department of Endocrinology, the Third People’s Hospital of Shenzhen, Shenzhen, Guangdong, People’s Republic of China
| | - Peize Zhang
- Department of Pulmonary Medicine and Tuberculosis, the Third People’s Hospital of Shenzhen, Shenzhen, Guangdong, People’s Republic of China
| | - Lingjun Shen
- Department of Tuberculosis, the Third People’s Hospital of Kunming, Kunming, Yunnan, People’s Republic of China
| | - Zijiao Chen
- Department of Pulmonary Medicine and Tuberculosis, the Third People’s Hospital of Shenzhen, Shenzhen, Guangdong, People’s Republic of China
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Zhu Y, Xu X, Fan Z, Ma X, Rui F, Ni W, Hu X, Gu Q, Shi J, Wu C, Yeo YH, Li J. Different minimal alcohol consumption in male and female individuals with metabolic dysfunction-associated fatty liver disease. Liver Int 2024; 44:865-875. [PMID: 38263792 DOI: 10.1111/liv.15849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/29/2023] [Accepted: 01/09/2024] [Indexed: 01/25/2024]
Abstract
BACKGROUND AND AIMS The relationship between moderate alcohol intake and health outcomes among individuals with metabolic dysfunction-associated fatty liver disease (MAFLD) is complex. Our aim was to investigate the association of minimal alcohol consumption with all-cause and cause-specific mortality among MAFLD individuals of different genders. METHODS Our study included 2630 MAFLD individuals from the Third National Health and Nutrition Examination Survey. Cox regression analysis was performed to assess the association between alcohol use measures and all-cause and cause-specific mortality. Restricted cubic spline curves were used to evaluate the relationship between alcohol consumption per week and all-cause mortality. RESULTS In the entire MAFLD cohort, we observed significant disparities in clinical characteristics between male and female individuals with MAFLD. Higher weekly alcohol consumption was significantly associated with all-cause and cause-specific mortality (male, hazard ratios [HRs]: 1.009, 95% CIs: 1.004-1.014; female, HRs: 1.032, 95% CIs: 1.022-1.042). In males with MAFLD, a linear association with all-cause mortality was observed for weekly alcohol consumption (p for non-linearity = .21). Conversely, in females with MAFLD, the risk of all-cause mortality remained relatively stable until 2 drinks per week, after which it rapidly increased with each additional drink consumed, and the increase in mortality risk was higher than that observed in males (p for non-linearity < .05). CONCLUSIONS Our findings indicate that any increase in weekly alcohol consumption was associated with increased all-cause mortality in men with MAFLD. Conversely, consuming less than 2 drinks per week had minimal impact on the risk of mortality among female.
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Affiliation(s)
- Yixuan Zhu
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xiaoming Xu
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Zhiwen Fan
- Department of Pathology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Xiaoyan Ma
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Fajuan Rui
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Wenjing Ni
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Xinyu Hu
- Department of Gastroenterology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Qi Gu
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Junping Shi
- The Department of Hepatology, The Affiliated Hospital & Institute of Hepatology and Metabolic Disease, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Chao Wu
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Yee Hui Yeo
- Karsh Division of Gastroenterology and Hepatology, Department of Medicine, CedarsSinai Medical Center, Los Angeles, California, USA
| | - Jie Li
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Department of Gastroenterology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
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Shao Y, Hu H, Cao C, Han Y, Wu C. Elevated triglyceride-glucose-body mass index associated with lower probability of future regression to normoglycemia in Chinese adults with prediabetes: a 5-year cohort study. Front Endocrinol (Lausanne) 2024; 15:1278239. [PMID: 38414822 PMCID: PMC10898590 DOI: 10.3389/fendo.2024.1278239] [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: 08/16/2023] [Accepted: 01/16/2024] [Indexed: 02/29/2024] Open
Abstract
Objective Despite the clear association of TyG-BMI with prediabetes and the progression of diabetes, no study to date has examined the relationship between TyG-BMI and the reversal of prediabetes to normoglycemia. Methods 25,279 participants with prediabetes who had physical examinations between 2010 and 2016 were enrolled in this retrospective cohort study. The relationship between baseline TyG-BMI and regression to normoglycemia from prediabetes was examined using the Cox proportional hazards regression model in this study. Additionally, the nonlinear association between TyG-BMI and the likelihood of regression to normoglycemia was investigated using the Cox proportional hazards regression with cubic spline function. Competing risk multivariate Cox regression analysis was conducted, with progression to diabetes as a competing risk for prediabetes reversal to normoglycemia. Furthermore, subgroup analyses and a series of sensitivity analyses were performed. Results After adjusting for covariates, the results showed that TyG-BMI was negatively associated with the probability of returning to normoglycemia (per 10 units, HR=0.970, 95% CI: 0.965, 0.976). They were also nonlinearly related, with an inflection point for TyG-BMI of 196.46. The effect size (HR) for TyG-BMI to the right of the inflection point (TyG-BMI ≥ 196.46) and the probability of return of normoglycemia was 0.962 (95% CI: 0.954, 0.970, per 10 units). In addition, the competing risks model found a negative correlation between TyG-BMI and return to normoglycemia (SHR=0.97, 95% CI: 0.96-0.98). Sensitivity analyses demonstrated the robustness of our results. Conclusion This study demonstrated a negative and nonlinear relationship between TyG-BMI and return to normoglycemia in Chinese adults with prediabetes. Through active intervention, the combined reduction of BMI and TG levels to bring TyG-BMI down to 196.46 could significantly increase the probability of returning to normoglycemia.
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Affiliation(s)
- Yang Shao
- Department of Laboratory Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
- Liaoning Clinical Research Center for Laboratory Medicine, Shenyang, Liaoning, China
| | - Haofei Hu
- Department of Nephrology, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, China
| | - Changchun Cao
- Department of Rehabilitation, Shenzhen Dapeng New District Nan’ao People’s Hospital, Shenzhen, Guangdong, China
| | - Yong Han
- Department of Emergency, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, China
| | - Cen Wu
- Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
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Wang X, Lin S, Wang X, Gao P, Chen J. Association between alcohol consumption and latent fasting blood glucose trajectories among midlife women. Front Public Health 2024; 12:1331954. [PMID: 38327583 PMCID: PMC10847307 DOI: 10.3389/fpubh.2024.1331954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/15/2024] [Indexed: 02/09/2024] Open
Abstract
Background This investigation sought to elucidate the correlations between alcohol intake and trajectories of fasting blood glucose (FBG) among American women in midlife. Methods Our analysis was rooted in the foundational data from the Study of Women's Health Across the Nation (SWAN), a comprehensive longitudinal study centered on US women during their midlife transition. We employed group-based trajectory modeling to chart the FBG trajectories spanning from 1996 to 2005. Employing logistic regression, we gauged the odds ratios (ORs) and 95% confidence intervals (CIs) to draw connections between initial alcohol consumption and FBG trajectory patterns, whilst controlling for predominant potential confounders. Results Our cohort comprised 2,578 women in midlife, ranging in age from 42 to 52, each having a minimum of three subsequent FPG assessments. We discerned two distinct FBG trajectories: a low-stable pattern (n = 2,467) and a high-decreasing pattern (n = 111). Contrasted with the low-stable group, our data showcased an inverse relationship between alcohol intake and the high-decreasing FBG trajectory in the fully adjusted model 3. The most pronounced reduction was evident in the highest tertile of daily servings of alcoholic beverages (OR: 0.23, 95% CI: 0.10-0.52, p < 0.001), percentage of kilocalories sourced from alcoholic beverages (OR: 0.30, 95% CI: 0.16-0.58, p < 0.001), and daily caloric intake from alcoholic beverages (OR: 0.31, 95% CI: 0.16-0.62, p < 0.001). Conclusion Moderate alcohol consumption may protect against high FPG trajectories in middle-aged women in a dose-response manner. Further researches are needed to investigate this causality in midlife women.
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Affiliation(s)
- Xingzhou Wang
- Department of Endocrinology, The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University, Huai’an, Jiangsu, China
| | - Song Lin
- Department of Clinical Nutrition, The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University, Huaian, Jiangsu, China
| | - Xiwei Wang
- Department of Mathmatics, University of Liverpool, Liverpool, United Kingdom
| | - Pengxia Gao
- Department of Endocrinology, The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University, Huai’an, Jiangsu, China
| | - Juan Chen
- Department of Endocrinology, The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University, Huai’an, Jiangsu, China
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Wang SY, Zhang WS, Jiang CQ, Jin YL, Zhu T, Zhu F, Xu L. Association of Measures of Glucose Metabolism with Colorectal Cancer Risk in Older Chinese: A 13-Year Follow-up of the Guangzhou Biobank Cohort Study-Cardiovascular Disease Substudy and Meta-Analysis. Diabetes Metab J 2024; 48:134-145. [PMID: 38173369 PMCID: PMC10850277 DOI: 10.4093/dmj.2022.0383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 02/13/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGRUOUND Abnormal glucose metabolism is a risk factor for colorectal cancer (CRC). However, association of glycosylated hemoglobin (HbA1c) with CRC risk remains under-reported. We examined the association between glycemic indicators (HbA1c, fasting plasma glucose, fasting insulin, 2-hour glucose, 2-hour insulin, and homeostasis model of risk assessment-insulin resistance index) and CRC risk using prospective analysis and meta-analysis. METHODS Participants (n=1,915) from the Guangzhou Biobank Cohort Study-Cardiovascular Disease Substudy were included. CRC events were identified through record linkage. Cox regression was used to assess the associations of glycemic indicators with CRC risk. A meta-analysis was performed to investigate the association between HbA1c and CRC risk. RESULTS During an average of 12.9 years follow-up (standard deviation, 2.8), 42 incident CRC cases occurred. After adjusting for potential confounders, the hazard ratio (95% confidence interval [CI]) of CRC for per % increment in HbA1c was 1.28 (95% CI, 1.01 to 1.63) in overall population, 1.51 (95% CI, 1.13 to 2.02) in women and 1.06 (95% CI, 0.68 to 1.68) in men. No significant association of other measures of glycemic indicators and baseline diabetes with CRC risk was found. Meta-analyses of 523,857 participants including our results showed that per % increment of HbA1c was associated with 13% higher risk of CRC, with the pooled risk ratio being 1.13 (95% CI, 1.01 to 1.27). Subgroupanalyses found stronger associations in women, colon cancer, Asians, and case-control studies. CONCLUSION Higher HbA1c was a significant predictor of CRC in the general population. Our findings shed light on the pathology of glucose metabolism and CRC, which warrants more in-depth investigation.
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Affiliation(s)
- Shu Yi Wang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Wei Sen Zhang
- Occupational Disease Prevention and Treatment Centre, Guangzhou Twelfth People’s Hospital, Guangzhou, China
| | - Chao Qiang Jiang
- Occupational Disease Prevention and Treatment Centre, Guangzhou Twelfth People’s Hospital, Guangzhou, China
| | - Ya Li Jin
- Occupational Disease Prevention and Treatment Centre, Guangzhou Twelfth People’s Hospital, Guangzhou, China
| | - Tong Zhu
- Occupational Disease Prevention and Treatment Centre, Guangzhou Twelfth People’s Hospital, Guangzhou, China
| | - Feng Zhu
- Occupational Disease Prevention and Treatment Centre, Guangzhou Twelfth People’s Hospital, Guangzhou, China
| | - Lin Xu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Division of Epidemiology and Biostatistics, School of Public Health, the University of Hong Kong, Hong Kong
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19
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Shield K, Paradis C, Butt P, Naimi T, Sherk A, Asbridge M, Myran D, Stockwell T, Wells S, Poole N, Heatley J, Hobin E, Thompson K, Young M. New perspectives on how to formulate alcohol drinking guidelines. Addiction 2024; 119:9-19. [PMID: 37680111 DOI: 10.1111/add.16316] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 07/04/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Low-Risk Alcohol Drinking Guidelines (LRDGs) aim to reduce the harms caused by alcohol. However, considerable discrepancies exist in the 'low-risk' thresholds employed by different countries. ARGUMENT/ANALYSIS Drawing upon Canada's LRDGs update process, the current paper offers the following propositions for debate regarding the establishment of 'low-risk' thresholds in national guidelines: (1) as an indicator of health loss, years of life lost (YLL) has several advantages that could make it more suitable for setting guidelines than deaths, premature deaths or disability adjusted years of life (DALYs) lost. (2) Presenting age-specific guidelines may not be the most appropriate way of providing LRDGs. (3) Given past overemphasis on the so-called protective effects of alcohol on health, presenting cause-specific guidelines may not be appropriate compared with a 'whole health' effect derived from a weighted composite risk function comprising conditions that are causally related to alcohol consumption. (4) To help people reduce their alcohol use, presenting different risk zones associated with alcohol consumption instead of a single low risk threshold may be advantageous. CONCLUSIONS National LRDGs should be based on years of life lost and should be neither age-specific nor cause-specific. We recommend using risk zones rather than a single drinking threshold to help people assess their own risk and encourage the adoption of behaviours with positive health impacts across the alcohol use spectrum.
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Affiliation(s)
- Kevin Shield
- Institute for Mental Health Policy Research, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Catherine Paradis
- Canadian Centre on Substance Use and Addiction, Ottawa, Ontario, Canada
| | - Peter Butt
- College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Tim Naimi
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| | - Adam Sherk
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| | - Mark Asbridge
- Department of Community Health and Epidemiology, Department of Emergency Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Daniel Myran
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Tim Stockwell
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| | - Samantha Wells
- Institute for Mental Health Policy Research, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Nancy Poole
- Centre of Excellence for Women's Health, Vancouver, British Columbia, Canada
| | - Jennifer Heatley
- Department of Health and Wellness, Government of Nova Scotia, Halifax, Nova Scotia, Canada
| | - Erin Hobin
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Public Health Ontario, Toronto, Ontario, Canada
| | - Kara Thompson
- Department of Psychology, St Francis Xavier University, Antigonish, Nova Scotia, Canada
| | - Matthew Young
- Gambling Research Exchange Ontario, Guelph, Ontario, Canada
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20
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Nguyen TH, De Leo G, Barefield A. Factors Associated with Controlled Glycemic Levels in Type 2 Diabetes Patients: Study from a Large Medical Center and Its Satellite Clinics in Southeast Region in the USA. Healthcare (Basel) 2023; 12:26. [PMID: 38200932 PMCID: PMC10779028 DOI: 10.3390/healthcare12010026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/19/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
Diabetes, including type 1, type 2, and gestational, is a significant public health issue responsible for various clinical, economic, and societal issues. Most of the consequences, if uncontrolled, can result in serious health problems, such as heart disease, vision loss, and kidney disease. Approximately 37.3 million Americans have diabetes, including 37.1 million adults 18 years or older, with 90-95% type 2 diabetes (T2D). The purpose of this study is (1) to explore the profile of patients with T2D and (2) to identify the associated factors of diabetic status. Examined factors included sociodemographic characteristics, social factors, and comorbidities. The study analyzed a primary dataset from a retrospective chart review of adult patients with T2D who were seen at a large medical center and its satellite clinics in the southeast region of the United States in 2019. Sex, dyslipidemia, and the number of concordant comorbidities were found to be significant associated factors of diabetic status. In the era of intertwined patient-centered approach and public health, the study's findings can guide treatment plans and interventions targeting individuals and communities.
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Affiliation(s)
- Tran Ha Nguyen
- Department of Health Management, Economics and Policy, Augusta University, Augusta, GA 30912, USA;
| | - Gianluca De Leo
- Department of Health Management, Economics and Policy, Augusta University, Augusta, GA 30912, USA;
| | - Amanda Barefield
- Department of Undergraduate Health Professions, Augusta University, Augusta, GA 30912, USA;
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21
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Minari TP, Tácito LHB, Yugar LBT, Ferreira-Melo SE, Manzano CF, Pires AC, Moreno H, Vilela-Martin JF, Cosenso-Martin LN, Yugar-Toledo JC. Nutritional Strategies for the Management of Type 2 Diabetes Mellitus: A Narrative Review. Nutrients 2023; 15:5096. [PMID: 38140355 PMCID: PMC10746081 DOI: 10.3390/nu15245096] [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: 11/20/2023] [Revised: 12/01/2023] [Accepted: 12/05/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Thinking about greater adherence to dietary planning, it is extremely important to be aware of all nutritional strategies and dietary prescriptions available in the literature, and of which of them is the most efficient for the management of T2DM. METHODS A search was carried out in 2023 for randomized clinical trials, systematic reviews, meta-analyses, and guidelines in the following databases: Pubmed, Scielo, Web of Science, CrossRef and Google Scholar. In total, 202 articles were collected and analyzed. The period of publications was 1983-2023. RESULTS There is still no consensus on what the best nutritional strategy or ideal dietary prescription is, and individuality is necessary. In any case, these references suggest that Mediterranean Diet may of greater interest for the management of T2DM, with the following recommended dietary prescription: 40-50% carbohydrates; 15-25% proteins; 25-35% fats (<7% saturated, 10% polyunsaturated, and 10% monounsaturated); at least 14 g of fiber for every 1000 kcal consumed; and <2300 mg sodium. CONCLUSIONS Individuality is the gold standard for dietary prescriptions, however, the Mediterranean diet with low levels of carbohydrates and fats seems to be the most promising strategy for the management of T2DM.
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Affiliation(s)
- Tatiana Palotta Minari
- Department of Hypertension, State Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto 15090-000, SP, Brazil
| | - Lúcia Helena Bonalume Tácito
- Department of Endocrinology, State Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto 15090-000, SP, Brazil
| | | | - Sílvia Elaine Ferreira-Melo
- Cardiovascular Pharmacology & Hypertension Laboratory, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas 13083-887, SP, Brazil
| | - Carolina Freitas Manzano
- Department of Hypertension, State Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto 15090-000, SP, Brazil
| | - Antônio Carlos Pires
- Department of Endocrinology, State Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto 15090-000, SP, Brazil
| | - Heitor Moreno
- Cardiovascular Pharmacology & Hypertension Laboratory, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas 13083-887, SP, Brazil
| | - José Fernando Vilela-Martin
- Department of Hypertension, State Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto 15090-000, SP, Brazil
| | - Luciana Neves Cosenso-Martin
- Department of Endocrinology, State Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto 15090-000, SP, Brazil
| | - Juan Carlos Yugar-Toledo
- Department of Hypertension, State Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto 15090-000, SP, Brazil
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22
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Maskarinec G, Kristal BS, Wilkens LR, Quintal G, Bogumil D, Setiawan VW, Le Marchand L. Risk Factors for Type 2 Diabetes in the Multiethnic Cohort. Can J Diabetes 2023; 47:627-635.e2. [PMID: 37406880 PMCID: PMC10761589 DOI: 10.1016/j.jcjd.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 06/21/2023] [Accepted: 06/23/2023] [Indexed: 07/07/2023]
Abstract
OBJECTIVES In this report, we investigated the association between established risk factors and type 2 diabetes (T2D) across 5 distinct ethnic groups and explored differences according to T2D definition within the Multiethnic Cohort (MEC) Study. METHODS Using the full MEC, with participants in Hawaii and Los Angeles (N=172,230), we applied Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). All participants completed questionnaires asking about demographics, anthropometrics, lifestyle factors, and regular diet. T2D status was determined from self-reported diagnosis/medication and Medicare claims. We assessed the associations between well-established risk factors and T2D in the full cohort, after stratification by ethnic group, according to the T2D definition, and in a biorepository subset. Effect modification by ethnicity was evaluated using Wald's tests. RESULTS Overall, 46,500 (27%) participants had an incident T2D diagnosis after a mean follow-up of 17.1±6.9 years. All predictors were significantly associated with T2D: overweight (HR=1.74), obesity (HR=2.90), red meat intake (HR=1.15), short (HR=1.04) and long (HR=1.08) sleep duration, and smoking (HR=1.26) predicted a significantly higher T2D incidence, whereas coffee (HR=0.90) and alcohol (HR=0.78) consumption, physical activity (HR=0.89), and diet quality (HR=0.96) were associated with lower T2D incidence. The strength of these associations was similar across ethnic groups with noteworthy disparities for overweight/obesity, physical activity, alcohol intake, coffee consumption, and diet quality. CONCLUSIONS These findings confirm the importance of known risk factors for T2D across ethnic groups, but small differences were detected that may contribute to disparate incidence rates in some ethnic groups, especially for obesity and physical activity.
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Affiliation(s)
- Gertraud Maskarinec
- Population Sciences in the Pacific, University of Hawaii Cancer Center, Honolulu, Hawaii, United States.
| | - Bruce S Kristal
- Division of Sleep Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Lynne R Wilkens
- Population Sciences in the Pacific, University of Hawaii Cancer Center, Honolulu, Hawaii, United States
| | - Gino Quintal
- Population Sciences in the Pacific, University of Hawaii Cancer Center, Honolulu, Hawaii, United States
| | - David Bogumil
- Preventive Medicine, University of Southern California, Los Angeles, California, United States
| | - Veronica W Setiawan
- Preventive Medicine, University of Southern California, Los Angeles, California, United States
| | - Loïc Le Marchand
- Population Sciences in the Pacific, University of Hawaii Cancer Center, Honolulu, Hawaii, United States
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23
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Carter N, Li J, Xu M, Li L, Xu S, Fan X, Zhu S, Chahal P, Chattopadhyay K. Lifestyle behaviours and associated factors among people with type 2 diabetes attending a diabetes clinic in Ningbo, China: A cross-sectional study. PLoS One 2023; 18:e0294245. [PMID: 37988393 PMCID: PMC10662728 DOI: 10.1371/journal.pone.0294245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 10/27/2023] [Indexed: 11/23/2023] Open
Abstract
The burden of type 2 diabetes (T2DM) in China is significant and growing, and this is reflected in high rates of T2DM in the city of Ningbo, China. Consequent impacts on morbidity, mortality, healthcare expenditure, and health-related quality of life, make this a problem of the utmost importance to address. One way to improve T2DM outcomes is to address lifestyle behaviours that may affect prognosis and complications, such as physical activity levels, dietary habits, smoking status, and alcohol intake. A cross-sectional survey was undertaken to describe the prevalence of being physically active, having a healthy diet, currently smoking, and currently drinking alcohol among people living with T2DM attending a diabetes clinic in Ningbo, China. Regression analysis was used to determine the factors associated with these lifestyle behaviours. We found a high prevalence of a healthy diet (97.8%, 95% CI 96.5-98.7%). Prevalence of being physically active (83.4%, 95% CI 80.6-85.9%), smoking (21.6%, 95% CI 18.8-24.6%), and alcohol drinking (32.9%. 95% CI 29.6-36.2%) appeared in keeping with those of the general population. Marked associations were demonstrated between male sex and smoking (OR 41.1, 95% CI 16.2-139.0), and male sex and alcohol drinking (OR 4.00, 95% CI 2.62-6.20). Correlation between lifestyle factors was demonstrated including between alcohol drinking and smoking, and between physical activity and reduced smoking. General diabetes self-management education programmes that address multiple lifestyle risk factors simultaneously may be beneficial in this population. Specific interventions targeting smoking cessation and reduction in alcohol drinking may be of benefit to men living with T2DM attending a diabetes clinic in Ningbo.
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Affiliation(s)
- Naomi Carter
- Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Jialin Li
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Ningbo University, Ningbo, People’s Republic of China
| | - Miao Xu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Ningbo University, Ningbo, People’s Republic of China
| | - Li Li
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Ningbo University, Ningbo, People’s Republic of China
| | - Shengnan Xu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Ningbo University, Ningbo, People’s Republic of China
| | - Xuelan Fan
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Ningbo University, Ningbo, People’s Republic of China
| | - Shuyan Zhu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Ningbo University, Ningbo, People’s Republic of China
| | - Prit Chahal
- Health Education England, Leeds, United Kingdom
| | - Kaushik Chattopadhyay
- Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- The Nottingham Centre for Evidence-Based Healthcare, A JBI Centre of Excellence, Nottingham, United Kingdom
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24
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Sano K, Terauchi R, Fukai K, Furuya Y, Nakazawa S, Kojimahara N, Hoshi K, Nakano T, Toyota A, Tatemichi M. Association Between Alcohol Consumption Patterns and Glaucoma in Japan. J Glaucoma 2023; 32:968-975. [PMID: 37748099 PMCID: PMC10621645 DOI: 10.1097/ijg.0000000000002308] [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: 12/26/2022] [Accepted: 08/25/2023] [Indexed: 09/27/2023]
Abstract
PRCIS In this case-control study of the Japanese population, including 3207 glaucoma cases, alcohol consumption patterns such as frequency and quantity showed a positive association with glaucoma prevalence. PURPOSE To examine the association between alcohol consumption patterns and glaucoma. SUBJECTS AND METHODS This case-control study evaluated 3207 cases with glaucoma and 3207 matched controls. Patients over 40 years of age were included from 1,693,611 patients admitted to 34 hospitals in Japan. Detailed alcohol consumption patterns (drinking frequency, average daily drinks, and total lifetime drinks) were obtained, as well as various confounding factors, including smoking history and lifestyle-related comorbidities. Conditional logistic regression models were used to calculate odds ratios (ORs) and 95% CIs for glaucoma prevalence. RESULTS Drinking frequency showed an association with glaucoma for "a few days/week" (OR, 1.19; 95% CI, 1.03-1.38) and "almost every day/week" (OR, 1.40; 95% CI, 1.18-1.66). Average daily drinks showed an association for ">0-2 drinks/day" (OR, 1.16; 95% CI, 1.03-1.32). Total lifetime drinks showed an association for ">60-90 drink-year" (OR, 1.23; 95% CI, 1.01-1.49) and ">90 drink-year" (OR, 1.23; 95% CI, 1.05-1.44). As alcohol consumption levels differed considerably between men and women, additional analyses were conducted separately for men and women. Among men, drinking frequency of "a few days/week" and "almost every day/week," average daily drinks of ">0-2 drinks/day" and ">2-4 drinks/day," and total lifetime drinks of ">60-90 drink-year" and ">90 drink-year" had an association with glaucoma. Conversely, among women, neither drinking frequency, average daily drinks, nor total lifetime drinks were associated. CONCLUSIONS Both the frequency and quantity of alcohol consumption were associated with glaucoma. Further research on gender differences is warranted.
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Affiliation(s)
- Kei Sano
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo
| | - Ryo Terauchi
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo
| | - Kota Fukai
- Department of Preventive Medicine, Tokai University School of Medicine, Isehara
| | - Yuko Furuya
- Department of Preventive Medicine, Tokai University School of Medicine, Isehara
| | - Shoko Nakazawa
- Department of Preventive Medicine, Tokai University School of Medicine, Isehara
| | - Noriko Kojimahara
- Department of Public Health, Shizuoka Graduate University of Public Health, Shizuoka
| | - Keika Hoshi
- Center for Health Informatics Policy, National Institute of Public Health, Wako
- Department of Hygiene, School of Medicine, Kitasato University, Sagamihara
| | - Tadashi Nakano
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo
| | - Akihiro Toyota
- Chugoku Rosai Hospital Research Center for the Promotion of Health and Employment Support, Japan Organization of Occupational Health and Safety, Hiroshima, Japan
| | - Masayuki Tatemichi
- Department of Preventive Medicine, Tokai University School of Medicine, Isehara
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25
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Llamosas-Falcón L, Rehm J, Bright S, Buckley C, Carr T, Kilian C, Lasserre AM, Lemp JM, Zhu Y, Probst C. The Relationship Between Alcohol Consumption, BMI, and Type 2 Diabetes: A Systematic Review and Dose-Response Meta-analysis. Diabetes Care 2023; 46:2076-2083. [PMID: 37890103 PMCID: PMC10620538 DOI: 10.2337/dc23-1015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 08/26/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Moderate alcohol use may be associated with lower risk of type 2 diabetes mellitus (T2DM). Previous reviews have reached mixed conclusions. PURPOSE To quantify the dose-response relationship between alcohol consumption and T2DM, accounting for differential effects by sex and BMI. DATA SOURCES Medline, Embase, Web of Science, and one secondary data source. STUDY SELECTION Cohort studies on the relationship between alcohol use and T2DM. DATA EXTRACTION Fifty-five studies, and one secondary data source, were included with a combined sample size of 1,363,355 men and 1,290,628 women, with 89,983 and 57,974 individuals, respectively, diagnosed with T2DM. DATA SYNTHESIS Multivariate dose-response meta-analytic random-effect models were used. For women, a J-shaped relationship was found with a maximum risk reduction of 31% (relative risk [RR] 0.69, 95% CI 0.64-0.74) at an intake of 16 g of pure alcohol per day compared with lifetime abstainers. The protective association ceased above 49 g per day (RR 0.82, 95% CI 0.68-0.99). For men, no statistically significant relationship was identified. When results were stratified by BMI, the protective association was only found in overweight and obese women. LIMITATIONS Our analysis relied on aggregate data. We included some articles that determined exposure and cases via self-report, and the studies did not account for temporal variations in alcohol use. CONCLUSIONS The observed reduced risk seems to be specific to women in general and women with a BMI ≥25 kg/m2. Our findings allow for a more precise prediction of the sex-specific relationship between T2DM and alcohol use, as our results differ from those of previous studies.
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Affiliation(s)
- Laura Llamosas-Falcón
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Institute of Clinical Psychology and Psychotherapy & Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Sophie Bright
- School of Health and Related Research (ScHARR), Faculty of Medicine, Dentistry & Health, University of Sheffield, Sheffield, U.K
| | - Charlotte Buckley
- Department of Automatic Control and Systems Engineering, University of Sheffield, Sheffield, U.K
| | - Tessa Carr
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Carolin Kilian
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Aurélie M. Lasserre
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Julia M. Lemp
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Yachen Zhu
- Alcohol Research Group, Public Health Institute, Emeryville, CA
| | - Charlotte Probst
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany
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26
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Tsukanov VV, Osipenko MF, Beloborodova EV, Livzan MA, Khlynov IB, Alekseenko SA, Sivolap YP, Tonkikh JL, Vasyutin AV. Practical Aspects of Clinical Manifestations, Pathogenesis and Therapy of Alcoholic Liver Disease and Non-alcoholic Fatty Liver Disease: Expert Opinion. RUSSIAN JOURNAL OF GASTROENTEROLOGY, HEPATOLOGY, COLOPROCTOLOGY 2023; 33:7-13. [DOI: 10.22416/1382-4376-2023-33-4-7-13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/12/2024]
Abstract
Aim: to present the results of an expert discussion of modern aspects of the clinical manifestations, pathogenesis and treatment of alcoholic liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD).Key points. ALD and NAFLD are characterized by high prevalence and have a significant impact on public health. For the diagnosis of liver pathology, it is important to determine the stage of fibrosis and the severity of the exacerbation of the disease. In the treatment of ALD, it is recommended to achieve abstinence, proper nutrition, the appointment of B vitamins, drugs with cytoprotective activity. In severe hepatitis, corticosteroids may be prescribed. In the treatment of NAFLD, diet and lifestyle modification, weight loss, the use of insulin sensitizers, vitamin E, statins (in the presence of hyperlipidemia) and drugs with metabolic activity are effective.Currently, a point of view is being actively expressed about the synergism of the action of alcohol and the metabolic syndrome on the development of fibrosis, cirrhosis, and hepatocellular carcinoma. The current international consensus recommends a change in the nomenclature of NAFLD and ALD and proposes the terms “metabolically associated steatotic liver disease” and “metabolically associated alcoholic liver disease”.Conclusion. The closeness of the clinical manifestations and pathogenesis of NAFLD and ALD justifies attention to drugs with metabolic activity, which are recommended by the Russian Gastroenterological Association and Russian Scientific Liver Society for the treatment of these diseases. The experts support the suggestion to quantify alcohol consumption in patients with NAFLD in order to change the management of patients, if necessary.
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Affiliation(s)
- V. V. Tsukanov
- Federal Research Centre “Krasnoyarsk Science Centre” of the Siberian Branch of Russian Academy of Science”, Scientific Research Institute of Medical Problems of the North
| | | | | | | | | | | | | | - J. L. Tonkikh
- Federal Research Centre “Krasnoyarsk Science Centre” of the Siberian Branch of Russian Academy of Science”, Scientific Research Institute of Medical Problems of the North
| | - A. V. Vasyutin
- Federal Research Centre “Krasnoyarsk Science Centre” of the Siberian Branch of Russian Academy of Science”, Scientific Research Institute of Medical Problems of the North
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27
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Hutton TM, Aaronson ST, Carpenter LL, Pages K, Krantz D, Lucas L, Chen B, Sackeim HA. Dosing transcranial magnetic stimulation in major depressive disorder: Relations between number of treatment sessions and effectiveness in a large patient registry. Brain Stimul 2023; 16:1510-1521. [PMID: 37827360 DOI: 10.1016/j.brs.2023.10.001] [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: 08/07/2023] [Revised: 09/19/2023] [Accepted: 10/01/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND The number of sessions in an acute TMS course for major depressive disorder (MDD) is greater than in the earlier randomized controlled trials. OBJECTIVE To compare clinical outcomes in groups that received differing numbers of TMS sessions. METHODS From a registry sample (N = 13,732), data were extracted for 7215 patients treated for MDD with PHQ-9 assessments before and after their TMS course. Groups were defined by number of acute course treatment sessions: 1-19 (N = 658), 20-29 (N = 616), 30-35 (N = 1375), 36 (N = 3591), 37-41 (N = 626), or >41 (N = 349) and compared in clinical outcomes at endpoint and at fixed intervals (after 10, 20, 30, and 36 sessions). The impact of additional treatments beyond 36 sessions was also examined. RESULTS Groups that received fewer than 30 sessions had inferior endpoint outcomes than all other groups. PHQ-9 symptom reduction was greatest in the group that ended treatment at 36 sessions. The extended treatment groups (>36 sessions) differed from all other groups by manifesting less antidepressant response early in the course and had a slower but steady rate of improvement over time. Extending treatment beyond 36 sessions was associated with further improvement without evidence of a plateau. CONCLUSIONS In real-world practice, there are strong relations between the number of TMS sessions in a course and the magnitude of symptom reduction. Courses with less than 30 sessions are associated with diminished benefit. Patients with longer than standard courses typically show less initial improvement and a more gradual trajectory, but meaningful benefit accrues with treatment beyond 36 sessions.
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Affiliation(s)
| | - Scott T Aaronson
- Sheppard Pratt Health System, Baltimore, MD, USA; Department of Psychiatry, University of Maryland, Baltimore, MD, USA
| | - Linda L Carpenter
- Butler Hospital, Providence, RI, USA; Brown University Department of Psychiatry and Human Behavior, Providence, RI, USA
| | | | | | | | | | - Harold A Sackeim
- Department of Psychiatry, Columbia University, NY, USA; Department of Radiology, Columbia University, NY, USA.
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Giri AK, Prasad G, Parekatt V, Rajashekar D, Tandon N, Bharadwaj D. Epigenome-wide methylation study identified two novel CpGs associated with T2DM risk and a network of co-methylated CpGs capable of patient's classifications. Hum Mol Genet 2023; 32:2576-2586. [PMID: 37184252 DOI: 10.1093/hmg/ddad084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 04/24/2023] [Accepted: 05/11/2023] [Indexed: 05/16/2023] Open
Abstract
Prevention of Type 2 diabetes mellitus (T2DM) pandemic needs markers that can precisely predict the disease risk in an individual. Alterations in DNA methylations due to exposure towards environmental risk factors are widely sought markers for T2DM risk prediction. To identify such individual DNA methylation signatures and their effect on disease risk, we performed an epigenome-wide association study (EWAS) in 844 Indian individuals of Indo-European origin. We identified and validated methylation alterations at two novel CpG sites in MIR1287 (cg01178710) and EDN2-SCMH1 (cg04673737) genes associated with T2DM risk at the epigenome-wide-significance-level (P < 1.2 × 10-7). Further, we also replicated the association of two known CpG sites in TXNIP, and CPT1A in the Indian population. With 535 EWAS significant CpGs (P < 1.2 × 10-7) identified in the discovery phase samples, we created a co-methylation network using weighted correlation network analysis and identified four modules among the CpGs. We observed that methylation of one of the module associates with T2DM risk factors (e.g. BMI, insulin and C-peptide) and can be used as markers to segregate T2DM patients with good glycemic control (e.g. low HbA1c) and dyslipidemia (low HDL and high TG) from the other patients. Additionally, an intronic SNP (rs6503650) in the JUP gene, a member of the same module, associated with methylation at all the 14 hub CpG sites of that module as methQTL. Our network-assisted EWAS is the first to systematically explore DNA methylation variations conferring risks to T2DM in Indians and use the identified risk CpG sites for patient segregation with different clinical outcomes. These findings can be useful for better stratification of patients to improve the clinical management and treatment effects.
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Affiliation(s)
- Anil K Giri
- Genomics and Molecular Medicine Unit, CSIR-Institute of Genomics and Integrative Biology, New Delhi 110025, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Gauri Prasad
- Genomics and Molecular Medicine Unit, CSIR-Institute of Genomics and Integrative Biology, New Delhi 110025, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Vaisak Parekatt
- Genomics and Molecular Medicine Unit, CSIR-Institute of Genomics and Integrative Biology, New Delhi 110025, India
| | - Donaka Rajashekar
- Genomics and Molecular Medicine Unit, CSIR-Institute of Genomics and Integrative Biology, New Delhi 110025, India
| | - Nikhil Tandon
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Dwaipayan Bharadwaj
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
- Systems Genomics Laboratory, School of Biotechnology, Jawaharlal Nehru University, New Delhi 110067, India
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Li L, Cheng Y, Ji W, Liu M, Hu Z, Yang Y, Wang Y, Zhou Y. Machine learning for predicting diabetes risk in western China adults. Diabetol Metab Syndr 2023; 15:165. [PMID: 37501094 PMCID: PMC10373320 DOI: 10.1186/s13098-023-01112-y] [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: 03/09/2023] [Accepted: 06/15/2023] [Indexed: 07/29/2023] Open
Abstract
OBJECTIVE Diabetes mellitus is a global epidemic disease. Long-time exposure of patients to hyperglycemia can lead to various type of chronic tissue damage. Early diagnosis of and screening for diabetes are crucial to population health. METHODS We collected the national physical examination data in Xinjiang, China, in 2020 (a total of more than 4 million people). Three types of physical examination indices were analyzed: questionnaire, routine physical examination and laboratory values. Integrated learning, deep learning and logistic regression methods were used to establish a risk model for type-2 diabetes mellitus. In addition, to improve the convenience and flexibility of the model, a diabetes risk score card was established based on logistic regression to assess the risk of the population. RESULTS An XGBoost-based risk prediction model outperformed the other five risk assessment algorithms. The AUC of the model was 0.9122. Based on the feature importance ranking map, we found that hypertension, fasting blood glucose, age, coronary heart disease, ethnicity, parental diabetes mellitus, triglycerides, waist circumference, total cholesterol, and body mass index were the most important features of the risk prediction model for type-2 diabetes. CONCLUSIONS This study established a diabetes risk assessment model based on multiple ethnicities, a large sample and many indices, and classified the diabetes risk of the population, thus providing a new forecast tool for the screening of patients and providing information on diabetes prevention for healthy populations.
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Affiliation(s)
- Lin Li
- Zhongshan School of Medicine, Sun Yat-sen University, No. 74, Zhongshan Second Road, Yuexiu District, Guangzhou, 510080, Guangdong, China
| | - Yinlin Cheng
- Zhongshan School of Medicine, Sun Yat-sen University, No. 74, Zhongshan Second Road, Yuexiu District, Guangzhou, 510080, Guangdong, China
| | - Weidong Ji
- Zhongshan School of Medicine, Sun Yat-sen University, No. 74, Zhongshan Second Road, Yuexiu District, Guangzhou, 510080, Guangdong, China
| | - Mimi Liu
- Zhongshan School of Medicine, Sun Yat-sen University, No. 74, Zhongshan Second Road, Yuexiu District, Guangzhou, 510080, Guangdong, China
| | - Zhensheng Hu
- Zhongshan School of Medicine, Sun Yat-sen University, No. 74, Zhongshan Second Road, Yuexiu District, Guangzhou, 510080, Guangdong, China
| | - Yining Yang
- People's Hospital of Xinjiang Uygur Autonomous Region, No. 91 Tianchi Road, Tianshan District, Urumqi, 830001, Xijiang, China.
| | - Yushan Wang
- Center of Health Management, The First Affiliated Hospital of Xinjiang Medical University, No. 393, Xinyi Road, Xinshi District, Urumqi, 830054, Xinjiang, China.
| | - Yi Zhou
- Zhongshan School of Medicine, Sun Yat-sen University, No. 74, Zhongshan Second Road, Yuexiu District, Guangzhou, 510080, Guangdong, China.
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Carrica LK, Choi CY, Walter FA, Noonan BL, Shi L, Johnson CT, Bradshaw HB, Liang NC, Gulley JM. Effects of combined use of alcohol and delta-9-tetrahydrocannibinol on working memory in Long Evans rats. Behav Brain Res 2023; 449:114475. [PMID: 37146720 PMCID: PMC10247469 DOI: 10.1016/j.bbr.2023.114475] [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: 02/01/2023] [Revised: 03/31/2023] [Accepted: 05/02/2023] [Indexed: 05/07/2023]
Abstract
The increase in social acceptance and legalization of cannabis over the last several years is likely to increase the prevalence of its co-use with alcohol. In spite of this, the potential for effects unique to co-use of these drugs, especially in moderate doses, has been studied relatively infrequently. We addressed this in the current study using a laboratory rat model of voluntary drug intake. Periadolescent male and female Long-Evans rats were allowed to orally self-administer ethanol, Δ9-tetrahydrocannibinol (THC), both drugs, or their vehicle controls from postnatal day (P) 30 to P47. They were subsequently trained and tested on an instrumental behavior task that assesses attention, working memory and behavioral flexibility. Similar to previous work, consumption of THC reduced both ethanol and saccharin intake in both sexes. Blood samples taken 14 h following the final self-administration session revealed that females had higher levels of the THC metabolite THC-COOH. There were modest effects of THC on our delayed matching to position (DMTP) task, with females exhibiting reduced performance compared to their control group or male, drug using counterparts. However, there were no significant effects of co-use of ethanol or THC on DMTP performance, and drug effects were also not apparent in the reversal learning phase of the task when non-matching to position was required as the correct response. These findings are consistent with other published studies in rodent models showing that use of these drugs in low to moderate doses does not significantly impact memory or behavioral flexibility following a protracted abstinence period.
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Affiliation(s)
- Lauren K Carrica
- Department of Psychology, University of Illinois at Urbana-Champaign, USA
| | - Chan Young Choi
- Department of Psychology, University of Illinois at Urbana-Champaign, USA
| | - Francis A Walter
- Neuroscience Program, University of Illinois at Urbana-Champaign, USA
| | - Brynn L Noonan
- Department of Psychology, University of Illinois at Urbana-Champaign, USA
| | - Linyuan Shi
- Department of Psychology, University of Illinois at Urbana-Champaign, USA
| | - Clare T Johnson
- Department of Psychological & Brain Science, Indiana University, Bloomington, IN, USA
| | - Heather B Bradshaw
- Department of Psychological & Brain Science, Indiana University, Bloomington, IN, USA
| | - Nu-Chu Liang
- Department of Psychology, University of Illinois at Urbana-Champaign, USA; Neuroscience Program, University of Illinois at Urbana-Champaign, USA
| | - Joshua M Gulley
- Department of Psychology, University of Illinois at Urbana-Champaign, USA; Neuroscience Program, University of Illinois at Urbana-Champaign, USA; Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, USA.
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Levesque C, Sanger N, Edalati H, Sohi I, Shield KD, Sherk A, Stockwell T, Butt PR, Paradis C. A systematic review of relative risks for the relationships between chronic alcohol use and the occurrence of disease. Alcohol Clin Exp Res 2023. [PMID: 37422765 DOI: 10.1111/acer.15121] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 05/10/2023] [Accepted: 05/14/2023] [Indexed: 07/11/2023]
Abstract
Alcohol use is causally linked to the development of and mortality from numerous diseases. The aim of this study is to provide an update to a previous systematic review of meta-analyses that quantify the sex-specific dose-response risk relationships between chronic alcohol use and disease occurrence and/or mortality. An updated systematic search of multiple databases was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria to identify meta-analyses published from January 1, 2017, to March 8, 2021, which quantified the risk relationships between chronic alcohol use and the risk of disease occurrence and/or mortality. This systematic review was not preregistered. The comparator was people who have never consumed at least one standard drink of alcohol. Measurements included relative risks, odds ratios, and hazard ratios of disease occurrence and/or mortality based on long-term alcohol intake measured in grams per day. The systematic search yielded 5953 articles, of which 14 were included in the narrative review. All diseases showed an increased risk of occurrence as alcohol use increased. At all doses examined, alcohol had a significant detrimental effect on tuberculosis, lower respiratory infections, oral cavity and pharyngeal cancers, esophageal cancer, colorectal cancer, liver cancer, laryngeal cancer, epilepsy, hypertension, liver cirrhosis, and pancreatitis (among men). For ischemic heart disease, ischemic stroke, and intracerebral hemorrhage, protective effects from low-dose chronic alcohol use among both men and women were observed. Low-dose alcohol consumption also had a protective effect for diabetes mellitus and pancreatitis among women (approximately to 50 g/day and 30 g/day, respectively). Alcohol use increases the risk of numerous infectious and noncommunicable diseases in a dose-response manner. Higher levels of alcohol use have a clear detrimental impact on health; however, at lower levels of use, alcohol can have both disease-specific protective and detrimental effects.
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Affiliation(s)
| | - Nitika Sanger
- Canadian Centre on Substance Use and Addiction, Ottawa, Ontario, Canada
| | - Hanie Edalati
- Canadian Centre on Substance Use and Addiction, Ottawa, Ontario, Canada
| | - Ivneet Sohi
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Kevin D Shield
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Adam Sherk
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| | - Tim Stockwell
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
- Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
| | - Peter R Butt
- College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Catherine Paradis
- Canadian Centre on Substance Use and Addiction, Ottawa, Ontario, Canada
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Chen Z, Khandpur N, Desjardins C, Wang L, Monteiro CA, Rossato SL, Fung TT, Manson JE, Willett WC, Rimm EB, Hu FB, Sun Q, Drouin-Chartier JP. Ultra-Processed Food Consumption and Risk of Type 2 Diabetes: Three Large Prospective U.S. Cohort Studies. Diabetes Care 2023; 46:1335-1344. [PMID: 36854188 PMCID: PMC10300524 DOI: 10.2337/dc22-1993] [Citation(s) in RCA: 45] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 02/01/2023] [Indexed: 03/02/2023]
Abstract
OBJECTIVE We examined the relationship between ultra-processed food (UPF) intake and type 2 diabetes (T2D) risk among 3 large U.S. cohorts, conducted a meta-analysis of prospective cohort studies, and assessed meta-evidence quality. RESEARCH DESIGN AND METHODS We included 71,871 women from the Nurses' Health Study, 87,918 women from the Nurses' Health Study II, and 38,847 men from the Health Professional Follow-Up Study. Diet was assessed using food frequency questionnaires and UPF was categorized per the NOVA classification. Associations of total and subgroups of UPF with T2D were assessed using Cox proportional hazards models. We subsequently conducted a meta-analysis of prospective cohort studies on total UPF and T2D risk, and assessed meta-evidence quality using the NutriGrade scoring system. RESULTS Among the U.S. cohorts (5,187,678 person-years; n = 19,503 T2D cases), the hazard ratio for T2D comparing extreme quintiles of total UPF intake (percentage of grams per day) was 1.46 (95% CI 1.39-1.54). Among subgroups, refined breads; sauces, spreads, and condiments; artificially and sugar-sweetened beverages; animal-based products; and ready-to-eat mixed dishes were associated with higher T2D risk. Cereals; dark and whole-grain breads; packaged sweet and savory snacks; fruit-based products; and yogurt and dairy-based desserts were associated with lower T2D risk. In the meta-analysis (n = 415,554 participants; n = 21,932 T2D cases), each 10% increment in total UPF was associated with a 12% (95% CI 10%-13%) higher risk. Per NutriGrade, high-quality evidence supports this relationship. CONCLUSIONS High-quality meta-evidence shows that total UPF consumption is associated with higher T2D risk. However, some UPF subgroups were associated with lower risk in the U.S. cohorts.
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Affiliation(s)
- Zhangling Chen
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Neha Khandpur
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
- Center for Epidemiological Studies in Health and Nutrition, Faculty of Public Health, University of São Paulo, São Paulo, Brazil
| | - Clémence Desjardins
- Centre Nutrition, Santé et Société, Institut sur la Nutrition et les Aliments Fonctionnels, Université Laval, Québec, Canada
- Faculté de Pharmacie, Université Laval, Québec, Canada
| | - Lu Wang
- Friedman School of Nutrition Science and Policy, Boston, MA
| | - Carlos A. Monteiro
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
- Center for Epidemiological Studies in Health and Nutrition, Faculty of Public Health, University of São Paulo, São Paulo, Brazil
| | - Sinara L. Rossato
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
- Institute of Geography, Universidade Federal de Uberlândia, Minas Gerais, Brazil
| | - Teresa T. Fung
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Nutrition, Simmons University, Boston, MA
| | - JoAnn E. Manson
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Walter C. Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Eric B. Rimm
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Frank B. Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Qi Sun
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
- Joslin Diabetes Center, Boston, MA
| | - Jean-Philippe Drouin-Chartier
- Centre Nutrition, Santé et Société, Institut sur la Nutrition et les Aliments Fonctionnels, Université Laval, Québec, Canada
- Faculté de Pharmacie, Université Laval, Québec, Canada
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Tian Y, Liu J, Zhao Y, Jiang N, Liu X, Zhao G, Wang X. Alcohol consumption and all-cause and cause-specific mortality among US adults: prospective cohort study. BMC Med 2023; 21:208. [PMID: 37286970 DOI: 10.1186/s12916-023-02907-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/24/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND Previous studies have shown inconsistent findings regarding the association of light to moderate alcohol consumption with cause-specific mortality. Therefore, this study sought to examine the prospective association of alcohol consumption with all-cause and cause-specific mortality in the US population. METHODS This was a population-based cohort study of adults aged 18 years or older in the National Health Interview Survey (1997 to 2014) with linkage to the National Death Index records through December 31, 2019. Self-reported alcohol consumption was categorized into seven groups (lifetime abstainers; former infrequent or regular drinkers; and current infrequent, light, moderate, or heavy drinkers). The main outcome was all-cause and cause-specific mortality. RESULTS During an average follow-up of 12.65 years, among the 918,529 participants (mean age 46.1 years; 48.0% male), 141,512 adults died from all causes, 43,979 from cardiovascular disease (CVD), 33,222 from cancer, 8246 from chronic lower respiratory tract diseases, 5572 from accidents (unintentional injuries), 4776 from Alzheimer's disease, 4845 from diabetes mellitus, 2815 from influenza and pneumonia, and 2692 from nephritis, nephrotic syndrome, or nephrosis. Compared with lifetime abstainers, current infrequent, light, or moderate drinkers were at a lower risk of mortality from all causes [infrequent-hazard ratio: 0.87; 95% confidence interval: 0.84 to 0.90; light: 0.77; 0.75 to 0.79; moderate 0.82; 0.80 to 0.85], CVD, chronic lower respiratory tract diseases, Alzheimer's disease, and influenza and pneumonia. Also, light or moderate drinkers were associated with lower risk of mortality from diabetes mellitus and nephritis, nephrotic syndrome, or nephrosis. In contrast, heavy drinkers had a significantly higher risk of mortality from all causes, cancer, and accidents (unintentional injuries). Furthermore, binge drinking ≥ 1 day/week was associated with a higher risk of mortality from all causes (1.15; 1.09 to 1.22), cancer (1.22; 1.10 to 1.35), and accidents (unintentional injuries) (1.39; 1.11 to 1.74). CONCLUSIONS Infrequent, light, and moderate alcohol consumption were inversely associated with mortality from all causes, CVD, chronic lower respiratory tract diseases, Alzheimer's disease, and influenza and pneumonia. Light or moderate alcohol consumption might also have a beneficial effect on mortality from diabetes mellitus and nephritis, nephrotic syndrome, or nephrosis. However, heavy or binge had a higher risk of all-cause, cancer, and accidents (unintentional injuries) mortality.
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Affiliation(s)
- Yalan Tian
- Department of Maternal and Child Health, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, 250012, China
| | - Jiahui Liu
- Department of Maternal and Child Health, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, 250012, China
| | - Yue Zhao
- Department of Maternal and Child Health, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, 250012, China
| | - Nana Jiang
- Department of Maternal and Child Health, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, 250012, China
| | - Xiao Liu
- Department of Maternal and Child Health, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, 250012, China
| | - Gang Zhao
- Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Xia Wang
- Department of Maternal and Child Health, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, 250012, China.
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Robinson DJ, Hanson K, Jain AB, Kichler JC, Mehta G, Melamed OC, Vallis M, Bajaj HS, Barnes T, Gilbert J, Honshorst K, Houlden R, Kim J, Lewis J, MacDonald B, MacKay D, Mansell K, Rabi D, Sherifali D, Senior P. Diabetes and Mental Health. Can J Diabetes 2023; 47:308-344. [PMID: 37321702 DOI: 10.1016/j.jcjd.2023.04.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
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Liu Y, Feng W, Lou J, Qiu W, Shen J, Zhu Z, Hua Y, Zhang M, Billong LF. Performance of a prediabetes risk prediction model: A systematic review. Heliyon 2023; 9:e15529. [PMID: 37215820 PMCID: PMC10196520 DOI: 10.1016/j.heliyon.2023.e15529] [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: 09/06/2022] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 05/24/2023] Open
Abstract
Backgrounds The prediabetes population is large and easily overlooked because of the lack of obvious symptoms, which can progress to diabetes. Early screening and targeted interventions can substantially reduce the rate of conversion of prediabetes to diabetes. Therefore, this study systematically reviewed prediabetes risk prediction models, performed a summary and quality evaluation, and aimed to recommend the optimal model. Methods We systematically searched five databases (Cochrane, PubMed, Embase, Web Of Science, and CNKI) for published literature related to prediabetes risk prediction models and excluded preprints, duplicate publications, reviews, editorials, and other studies, with a search time frame of March 01, 2023. Data were categorized and summarized using a standardized data extraction form that extracted data including author; publication date; study design; country; demographic characteristics; assessment tool name; sample size; study type; and model-related indicators. The PROBAST tool was used to assess the risk of bias profile of included studies. Findings 14 studies with a total of 15 models were eventually included in the systematic review. We found that the most common predictors of models were age, family history of diabetes, gender, history of hypertension, and BMI. Most of the studies (83.3%) had a high risk of bias, mainly related to under-reporting of outcome information and poor methodological design during the development and validation of models. Due to the low quality of included studies, the evidence for predictive validity of the available models is unclear. Interpretation We should pay attention to the early screening of prediabetes patients and give timely pharmacological and lifestyle interventions. The predictive performance of the existing model is not satisfactory, and the model building process can be standardized and external validation can be added to improve the accuracy of the model in the future.
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Affiliation(s)
- Yujin Liu
- Schools of Nursing and Medicine, Huzhou University, Huzhou, 313000, China
| | - Wenming Feng
- Huzhou First People's Hospital, Huzhou, 313000, China
| | - Jianlin Lou
- Huzhou Key Laboratory of Precise Prevention and Control of Major Chronic Diseases, Huzhou University, Huzhou, 313000, China
| | - Wei Qiu
- Department of Endocrinology, Huzhou Central Hospital, Huzhou, 313000, China
| | - Jiantong Shen
- Schools of Nursing and Medicine, Huzhou University, Huzhou, 313000, China
- Huzhou Key Laboratory of Precise Prevention and Control of Major Chronic Diseases, Huzhou University, Huzhou, 313000, China
| | - Zhichao Zhu
- Schools of Nursing and Medicine, Huzhou University, Huzhou, 313000, China
- Internal Medicine General Ward, Jinhua Municipal Central Hospital Medical Group, Jinhua, 321200, China
| | - Yuting Hua
- Schools of Nursing and Medicine, Huzhou University, Huzhou, 313000, China
| | - Mei Zhang
- Schools of Nursing and Medicine, Huzhou University, Huzhou, 313000, China
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Song J, Lin WQ. Association between alcohol consumption and incidence of type 2 diabetes mellitus in Japanese men: a secondary analysis of a Retrospective Cohort Study. BMC Endocr Disord 2023; 23:91. [PMID: 37098575 PMCID: PMC10127320 DOI: 10.1186/s12902-023-01350-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 04/19/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND Alcohol consumption is known to be associated with an increased risk of type 2 diabetes (T2DM). However, the effect of alcohol intake on the incidence of T2DM remains controversial due to inconsistent results across studies. This study aimed to bridge the gap among available literature in order to better define the association between alcohol consumption and incidence of T2DM. METHODS We performed a secondary analysis using open-access data from a retrospective Japanese cohort of 15,464 participants who underwent regular medical examinations at Murakami Memorial Hospital. All participants underwent an initial exam including a questionnaire survey, physical examination, and blood biochemical testing to establish a at baseline. The primary outcome was new-onset T2DM during the follow-up exam. Statistical analysis was conducted using Cox regression and Kaplan-Meier methods to assess the risk of alcohol consumption on T2DM. RESULTS During a median follow-up time of 5.39 years, 373 new-onset T2DM events were observed. The cumulative risk of T2DM incidence was higher in the heavy alcohol consumption group vs. the other three groups: none/minimal, light, and moderate consumption (log-rank test, P = 0.0002). Multivariate Cox regression analysis indicated incidental T2DM was independently associated with alcohol consumption. The adjusted hazard ratio relative to the none/minimal consumption group was as follows: 1.02 (95% confidence interval: 0.71, 1.48) for light consumption, 1.06 (0.71, 1.57) for moderate consumption, and 2.06 (1.30, 3.24) for heavy consumption (P value = 0.024). Subsequent subgroup analysis confirmed the association between alcohol consumption and T2DM incidence in men, but not in women. CONCLUSION Heavy alcohol consumption was independently associated with an increased risk of new-onset T2DM in Japanese men.
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Affiliation(s)
- Jing Song
- Department of Cardiology, the Second Affiliated Hospital, Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China
| | - Wei-Qian Lin
- Department of Cardiology, the Second Affiliated Hospital, Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China.
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Barrea L, Vetrani C, Verde L, Frias-Toral E, Ceriani F, Cernea S, Docimo A, Graziadio C, Tripathy D, Savastano S, Colao A, Muscogiuri G. Comprehensive Approach to Medical Nutrition Therapy in Patients with Type 2 Diabetes Mellitus: From Diet to Bioactive Compounds. Antioxidants (Basel) 2023; 12:904. [PMID: 37107279 PMCID: PMC10135374 DOI: 10.3390/antiox12040904] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/29/2023] [Accepted: 03/30/2023] [Indexed: 04/29/2023] Open
Abstract
In the pathogenesis of type 2 diabetes mellitus (T2DM), diet plays a key role. Individualized medical nutritional therapy, as part of lifestyle optimization, is one of the cornerstones for the management of T2DM and has been shown to improve metabolic outcomes. This paper discusses major aspects of the nutritional intervention (including macro- and micronutrients, nutraceuticals, and supplements), with key practical advice. Various eating patterns, such as the Mediterranean-style, low-carbohydrate, vegetarian or plant-based diets, as well as healthy eating plans with caloric deficits have been proven to have beneficial effects for patients with T2DM. So far, the evidence does not support a specific macronutrient distribution and meal plans should be individualized. Reducing the overall carbohydrate intake and replacing high glycemic index (GI) foods with low GI foods have been shown as valid options for patients with T2DM to improve glycemic control. Additionally, evidence supports the current recommendation to reduce the intake of free sugars to less than 10% of total energy intake, since their excessive intake promotes weight gain. The quality of fats seems to be rather important and the substitution of saturated and trans fatty acids with foods rich in monounsaturated and polyunsaturated fats lowers cardiovascular risk and improves glucose metabolism. There is no benefit of supplementation with antioxidants, such as carotene, vitamins E and C, or other micronutrients, due to the lack of consistent evidence showing efficacy and long-term safety. Some studies suggest possible beneficial metabolic effects of nutraceuticals in patients with T2DM, but more evidence about their efficacy and safety is still needed.
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Affiliation(s)
- Luigi Barrea
- Dipartimento di Scienze Umanistiche, Università Telematica Pegaso, Via Porzio, Centro Isola F2, 80143 Napoli, Italy
- Centro Italiano per la Cura e il Benessere del Paziente con Obesità (C.I.B.O), Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Claudia Vetrani
- Dipartimento di Scienze Umanistiche, Università Telematica Pegaso, Via Porzio, Centro Isola F2, 80143 Napoli, Italy
- Centro Italiano per la Cura e il Benessere del Paziente con Obesità (C.I.B.O), Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Ludovica Verde
- Department of Public Health, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Evelyn Frias-Toral
- School of Medicine, Universidad Católica Santiago de Guayaquil, Av. Pdte. Carlos Julio Arosemena Tola, Guayaquil 090615, Ecuador
| | - Florencia Ceriani
- Nutrition School, Universidad de la Republica (UdelaR), Montevideo 11100, Uruguay
| | - Simona Cernea
- Department M3/Internal Medicine I, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mures, 540146 Târgu Mureş, Romania
- Diabetes, Nutrition and Metabolic Diseases Outpatient Unit, Emergency County Clinical Hospital, 540146 Târgu Mureş, Romania
| | - Annamaria Docimo
- Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Chiara Graziadio
- Centro Italiano per la Cura e il Benessere del Paziente con Obesità (C.I.B.O), Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
- Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Devjit Tripathy
- Division of Diabetes UT Health and ALM VA Hospital, San Antonio, TX 78229, USA
| | - Silvia Savastano
- Centro Italiano per la Cura e il Benessere del Paziente con Obesità (C.I.B.O), Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
- Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Annamaria Colao
- Centro Italiano per la Cura e il Benessere del Paziente con Obesità (C.I.B.O), Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
- Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
- Cattedra Unesco “Educazione Alla Salute e Allo Sviluppo Sostenibile”, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Giovanna Muscogiuri
- Centro Italiano per la Cura e il Benessere del Paziente con Obesità (C.I.B.O), Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
- Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
- Cattedra Unesco “Educazione Alla Salute e Allo Sviluppo Sostenibile”, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
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Carrica LK, Choi CY, Walter FA, Noonan BL, Shi L, Johnson CT, Bradshaw HB, Liang NC, Gulley JM. Effects of combined use of alcohol and delta-9-tetrahydrocannibinol on working memory in Long Evans rats. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.02.02.526698. [PMID: 36778500 PMCID: PMC9915622 DOI: 10.1101/2023.02.02.526698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
The increase in social acceptance and legalization of cannabis over the last several years is likely to increase the prevalence of its co-use with alcohol. In spite of this, the potential for effects unique to co-use of these drugs, especially in moderate doses, has been studied relatively infrequently. We addressed this in the current study using a laboratory rat model of voluntary drug intake. Periadolescent male and female Long-Evans rats were allowed to orally self-administer ethanol, Î" 9 -tetrahydrocannibinol (THC), both drugs, or their vehicle controls from postnatal day (P) 30 to P47. They were subsequently trained and tested on an instrumental behavior task that assesses attention, working memory and behavioral flexibility. Similar to previous work, consumption of THC reduced both ethanol and saccharin intake in both sexes. Blood samples taken 14h following the final self-administration session revealed that females had higher levels of the THC metabolite THC-COOH. There were modest effects of THC on our delayed matching to position (DMTP) task, with females exhibiting reduced performance compared to their control group or male, drug using counterparts. However, there were no significant effects of co-use of ethanol or THC on DMTP performance, and drug effects were also not apparent in the reversal learning phase of the task when non-matching to position was required as the correct response. These findings are consistent with other published studies in rodent models showing that use of these drugs in low to moderate doses does not significantly impact memory or behavioral flexibility following a protracted abstinence period.
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Affiliation(s)
- Lauren K. Carrica
- Department of Psychology, University of Illinois at Urbana-Champaign
| | - Chan Young Choi
- Department of Psychology, University of Illinois at Urbana-Champaign
| | | | - Brynn L. Noonan
- Department of Psychology, University of Illinois at Urbana-Champaign
| | - Linyuan Shi
- Department of Psychology, University of Illinois at Urbana-Champaign
| | - Clare T. Johnson
- Department of Psychological & Brain Science, Indiana University, Bloomington, Indiana
| | - Heather B. Bradshaw
- Department of Psychological & Brain Science, Indiana University, Bloomington, Indiana
| | - Nu-Chu Liang
- Department of Psychology, University of Illinois at Urbana-Champaign
- Neuroscience Program, University of Illinois at Urbana-Champaign
| | - Joshua M. Gulley
- Department of Psychology, University of Illinois at Urbana-Champaign
- Neuroscience Program, University of Illinois at Urbana-Champaign
- Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign
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Yamamoto R, Li Q, Otsuki N, Shinzawa M, Yamaguchi M, Wakasugi M, Nagasawa Y, Isaka Y. A Dose-Dependent Association between Alcohol Consumption and Incidence of Proteinuria and Low Glomerular Filtration Rate: A Systematic Review and Meta-Analysis of Cohort Studies. Nutrients 2023; 15:nu15071592. [PMID: 37049433 PMCID: PMC10097279 DOI: 10.3390/nu15071592] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/21/2023] [Accepted: 03/21/2023] [Indexed: 03/29/2023] Open
Abstract
Previous cohort studies have reported conflicting associations between alcohol consumption and chronic kidney disease, characterized by proteinuria and low glomerular filtration rate (GFR). This systematic review, which included 14,634,940 participants from 11 cohort studies, assessed a dose-dependent association of alcohol consumption and incidence of proteinuria and low estimated GFR (eGFR) of <60 mL/min/1.73 m2. Compared with non-drinkers, the incidence of proteinuria was lower in drinkers with alcohol consumption of ≤12.0 g/day (relative risk 0.87 [95% confidence interval 0.83, 0.92]), but higher in drinkers with alcohol consumption of 36.1–60.0 g/day (1.09 [1.03, 1.15]), suggesting a J-shaped association between alcohol consumption and the incidence of proteinuria. Incidence of low eGFR was lower in drinkers with alcohol consumption of ≤12.0 and 12.1–36.0 than in non-drinkers (≤12.0, 12.1–36.0, and 36.1–60.0 g/day: 0.93 [0.90, 0.95], 0.82 [0.78, 0.86], and 0.89 [0.77, 1.03], respectively), suggesting that drinkers were at lower risk of low eGFR. In conclusion, compared with non-drinkers, mild drinkers were at lower risk of proteinuria and low eGFR, whereas heavy drinkers had a higher risk of proteinuria but a lower risk of low eGFR. The clinical impact of high alcohol consumption should be assessed in well-designed studies.
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Affiliation(s)
- Ryohei Yamamoto
- Health and Counseling Center, Osaka University, Toyonaka 560-0043, Japan
- Department of Nephrology, Graduate School of Medicine, Osaka University, Suita 565-0871, Japan
- Correspondence:
| | - Qinyan Li
- Health and Counseling Center, Osaka University, Toyonaka 560-0043, Japan
- Department of Nephrology, Graduate School of Medicine, Osaka University, Suita 565-0871, Japan
| | - Naoko Otsuki
- Health and Counseling Center, Osaka University, Toyonaka 560-0043, Japan
| | - Maki Shinzawa
- Department of Nephrology, Graduate School of Medicine, Osaka University, Suita 565-0871, Japan
| | - Makoto Yamaguchi
- Department of Nephrology and Rheumatology, Aichi Medical University, Nagakute 480-1195, Japan
| | - Minako Wakasugi
- Department of Inter-Organ Communication Research, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan
| | - Yasuyuki Nagasawa
- Department of General Internal Medicine, Hyogo Medical College, Nishinomiya 663-8501, Japan
| | - Yoshitaka Isaka
- Department of Nephrology, Graduate School of Medicine, Osaka University, Suita 565-0871, Japan
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Wang P, Song M, Eliassen AH, Wang M, Fung TT, Clinton SK, Rimm EB, Hu FB, Willett WC, Tabung FK, Giovannucci EL. Optimal dietary patterns for prevention of chronic disease. Nat Med 2023; 29:719-728. [PMID: 36914892 PMCID: PMC10294543 DOI: 10.1038/s41591-023-02235-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 01/26/2023] [Indexed: 03/16/2023]
Abstract
Multiple dietary patterns have been associated with different diseases; however, their comparability to improve overall health has yet to be determined. Here, in 205,852 healthcare professionals from three US cohorts followed for up to 32 years, we prospectively assessed two mechanism-based diets and six diets based on dietary recommendations in relation to major chronic disease, defined as a composite outcome of incident major cardiovascular disease (CVD), type 2 diabetes and cancer. We demonstrated that adherence to a healthy diet was generally associated with a lower risk of major chronic disease (hazard ratio (HR) comparing the 90th with the 10th percentile of dietary pattern scores = 0.58-0.80). Participants with low insulinemic (HR = 0.58, 95% confidence interval (CI) = 0.57, 0.60), low inflammatory (HR = 0.61, 95% CI = 0.60, 0.63) or diabetes risk-reducing (HR = 0.70, 95% CI = 0.69, 0.72) diet had the largest risk reduction for incident major CVD, type 2 diabetes and cancer as a composite and individually. Similar findings were observed across gender and diverse ethnic groups. Our results suggest that dietary patterns associated with markers of hyperinsulinemia and inflammation and diabetes development may inform on future dietary guidelines for chronic disease prevention.
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Affiliation(s)
- Peilu Wang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, China.
| | - Mingyang Song
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - A Heather Eliassen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Molin Wang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Teresa T Fung
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Simmons University, Boston, MA, USA
| | - Steven K Clinton
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine and Comprehensive Cancer Center, Columbus, OH, USA
| | - Eric B Rimm
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Frank B Hu
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Walter C Willett
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Fred K Tabung
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine and Comprehensive Cancer Center, Columbus, OH, USA
| | - Edward L Giovannucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Nagai M, Matsumoto S, Tanuma J, Nguyen DHT, Nguyen DT, Mizushima D, Oka S, Pham TN. Prevalence of and factors associated with diabetes mellitus among people living with HIV in Vietnam. Glob Health Med 2023; 5:15-22. [PMID: 36865893 PMCID: PMC9974227 DOI: 10.35772/ghm.2022.01061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/17/2023] [Accepted: 01/24/2023] [Indexed: 02/04/2023]
Abstract
Studies have shown that people living with HIV (PLWH) have a higher risk of having non-communicable diseases (NCDs) than do people without HIV. In Vietnam, HIV remains a major public health concern, and with recent rapid economic growth, NCDs such as diabetes mellitus (DM) have become a significant disease burden. This cross-sectional study was conducted to examine the prevalence of DM and the factors associated with DM among PLWH on antiretroviral therapy (ART). In total, 1,212 PLWH were included in the study. The age-standardized prevalence of DM and pre-diabetes were 9.29% and 10.32%, respectively. In the multivariate logistic regression analysis, male sex, age above 50 years, and body mass index ≥ 25 kg/m2 were associated with DM, and borderline p-value was found for associations with current smoking and years on ART. The results suggest higher DM prevalence among PLWH and that longer time on ART could be an important risk factor for DM among PLWH. These findings also suggest that interventions such as weight control and smoking cessation support could be provided at outpatient clinics. Integration of HIV/AIDS and NCDs services is essential to address health needs comprehensively and enhance health-related quality of life for PLWH.
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Affiliation(s)
- Moeko Nagai
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan;,Address correspondence to:Moeko Nagai, AIDS Clinical Center, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo 162-8655, Japan. E-mail:
| | - Shoko Matsumoto
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Junko Tanuma
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | | | | | - Daisuke Mizushima
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinichi Oka
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
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Alcohol Intake and Arterial Hypertension: Retelling of a Multifaceted Story. Nutrients 2023; 15:nu15040958. [PMID: 36839317 PMCID: PMC9963590 DOI: 10.3390/nu15040958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/10/2023] [Accepted: 02/12/2023] [Indexed: 02/17/2023] Open
Abstract
Alcoholic beverages are common components of diets worldwide and understanding their effects on humans' health is crucial. Because hypertension is the leading risk factor for cardiovascular diseases and all-cause mortality, the relationship of alcohol consumption with blood pressure (BP) has been the subject of extensive investigation. For the purpose of this review, we searched the terms "alcohol", "ethanol", and "arterial hypertension" on Pubmed MeSH and selected the most relevant studies. Short-term studies showed a biphasic BP response after ingestion of high doses of alcohol, and sustained alcohol consumption above 30 g/day, significantly, and dose-dependently, increased the risk for hypertension. These untoward effects of alcoholic beverages on BP can be mediated by a multiplicity of neurohormonal mechanisms. In addition to the effects on BP, excess alcohol intake might contribute to cardiac and renal hypertensive organ damage, although some studies suggest possible benefits of moderate alcohol consumption on additional cardiovascular risk factors, such as diabetes and lipoprotein(a). Some intervention studies and cumulative analyses support the evidence of a benefit of the reduction/withdrawal of alcohol consumption on BP and cardiovascular outcomes. This is why guidelines of scientific societies recommend avoidance or limitation of alcohol intake below one unit/day for women and two units/day for men. This narrative article overviews all these topics, providing an update of the current knowledge on the relationship between alcohol and BP.
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Han Y, Hu H, Li Q, Deng Z, Liu D. Triglyceride glucose-body mass index and the risk of progression to diabetes from prediabetes: A 5-year cohort study in Chinese adults. Front Public Health 2023; 11:1028461. [PMID: 36817911 PMCID: PMC9935616 DOI: 10.3389/fpubh.2023.1028461] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 01/12/2023] [Indexed: 02/05/2023] Open
Abstract
Objective Evidence regarding the relationship between the triglyceride glucose-body mass index (TyG-BMI) and the risk of progression from prediabetes to diabetes remains limited. Our study aimed to investigate the relationship between them in patients with prediabetes. Methods In this retrospective cohort study, data were collected from 25,279 patients with prediabetes who received health checks between 2010 and 2016. We used a Cox proportional-hazards regression model to examine the relationship between TyG-BMI and diabetes risk. We used Cox proportional hazards regression with cubic spline functions and smooth curve fitting to identify the nonlinear relationship between them. In addition, A series of sensitivity and subgroup analyses were also conducted. Results The mean age of the included participants was 49.29 ± 13.82 years old, and 1,6734 (66.2%) were male. The mean TyG-BMI was 219.47. The median follow-up time was 2.89 years, and 2,687 (10.63%) individuals had a final diagnosis of diabetes. After adjusting for covariates, TyG-BMI was positively linked with incident diabetes in patients with prediabetes (HR = 1.011, 95%CI 1.010-1.012). TyG-BMI had a non-linear connection with diabetes risk, and its inflection point was 231.66. Right and left effects sizes (HR) at the inflection point were 1.017 (95%CI:1.014-1.019) and 1.007 (95%CI:1.005-1.009), respectively. The sensitivity analysis demonstrated the robustness of these results. Conclusion This study demonstrated a positive, non-linear relationship between the TyG-BMI and diabetes risk in Chinese patients with prediabetes. When the TyG-BMI was <231.66, there was a significant positive association between TyG-BMI and the risk of progression from prediabetes to diabetes. This study serves as a reference to promote clinical consultation and optimize diabetes prevention decisions for patients with prediabetes.
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Affiliation(s)
- Yong Han
- Department of Emergency, Shenzhen Second People's Hospital, Shenzhen, Guangdong, China
| | - Haofei Hu
- Department of Nephrology, Shenzhen Second People's Hospital, Shenzhen, Guangdong, China
| | - Qiming Li
- Department of Emergency, Shenzhen Second People's Hospital, Shenzhen, Guangdong, China
| | - Zhe Deng
- Department of Emergency, Shenzhen Second People's Hospital, Shenzhen, Guangdong, China
| | - Dehong Liu
- Department of Emergency, Shenzhen Second People's Hospital, Shenzhen, Guangdong, China
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Han Y, Hu H, Huang Z, Liu D. Association between body mass index and reversion to normoglycemia from impaired fasting glucose among Chinese adults: a 5-year cohort study. Front Endocrinol (Lausanne) 2023; 14:1111791. [PMID: 37143738 PMCID: PMC10151769 DOI: 10.3389/fendo.2023.1111791] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/28/2023] [Indexed: 05/06/2023] Open
Abstract
Objective Evidence regarding the relationship between body mass index (BMI) and reversion to normoglycemia from prediabetes is still limited. The purpose of our study is to survey the link of BMI on reversion to normoglycemia among patients with impaired fasting glucose (IFG). Methods This study, a retrospective cohort, covered 32 regions and 11 cities in China and collected 258,74 IFG patients who underwent a health check from 2010 to 2016. We investigated the association between baseline BMI and reversion to normoglycemia in patients with IFG using the Cox proportional-hazards regression model. The nonlinear relationship between BMI and reversion to normoglycemia was determined using a Cox proportional hazards regression with cubic spline functions and smooth curve fitting. In addition, we also performed a series of sensitivity analyses and subgroup analyses. A competing risk multivariate Cox regression was performed using progression to diabetes as a competing risk for reversal of normoglycemic events. Results After adjusting covariates, the results showed that BMI was negatively related to the probability of reversion to normoglycemia (HR=0.977, 95%CI:0.971-0.984). Compared with participants with normal BMI(<24kg/m2), overweight (BMI:24-28kg/m2) participants with IFG had a 9.9% lower probability of returning to normoglycemia (HR=0.901,95%CI:0.863-0.939), while obese patients (BMI ≥ 28kg/m2) had a 16.9% decreased probability of reverting from IFG to normoglycemia (HR=0.831,95%CI:0.780-0.886). There was also a nonlinear relationship between them, and the inflection point of BMI was 21.7kg/m2. The effect sizes (HR) on the left sides of the inflection point were 0.972(95%CI:0.964-0.980). The competing risks multivariate Cox's regression and sensitivity analysis demonstrated the robustness of our results. Conclusion This study demonstrates a negative and nonlinear relationship between BMI and reversion to normoglycemia in Chinese patients with IFG. Minimizing BMI to 21.7 kg/m2 in patients with IFG through aggressive intervention may significantly increase the probability of returning to normoglycemia.
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Affiliation(s)
- Yong Han
- Department of Emergency, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, China
| | - Haofei Hu
- Department of Nephrology, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, China
| | - Zhiqiang Huang
- Department of Emergency, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, China
- *Correspondence: Zhiqiang Huang, ; Dehong Liu,
| | - Dehong Liu
- Department of Emergency, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, China
- *Correspondence: Zhiqiang Huang, ; Dehong Liu,
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45
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Fang L, Sheng H, Tan Y, Zhang Q. Prevalence of diabetes in the USA from the perspective of demographic characteristics, physical indicators and living habits based on NHANES 2009-2018. Front Endocrinol (Lausanne) 2023; 14:1088882. [PMID: 36960397 PMCID: PMC10028205 DOI: 10.3389/fendo.2023.1088882] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 02/21/2023] [Indexed: 03/09/2023] Open
Abstract
OBJECTIVE To determine differences in DM in the U.S. population according to demographic characteristics, physical indicators and living habits. METHODS 23 546 participants in the 2009 to 2018 National Health and Nutrition Examination Survey (NHANES) who were 20 year of age or older and not pregnant. All analyses used weighted samples and considered the stratification and clustering of the design. Specific indicators include length of leg (cm), BMI (kg/cm2), TCHOL (mg/dL), fasting plasma glucose (mg/dL) and comparison of means and the proportion of participants with DM. RESULTS The prevalence of DM in the USA has been rising modestly in the past decade, and were consistent and robust for the observed differences in age, sex, and ethnicity. Compared with white participants, black participants and Mexican-American were both more likely (P<0.001) to have diabetes: 14.6% (CI, 13.6% to 15.6%) among black participants, 10.6% (CI, 9.9% to 11.3%) among white participants, and 13.5% (CI, 11.9% to 15.2%) among Mexican-American participants. The prevalence of diabetes is increasing with age, males peaked around the 60s, and women around the 70s. The overall mean leg length and TCHOL was lower in diabetics than in non-diabetics (1.07 cm, 18.67 mg/dL, respectively), while mean BMI were higher in diabetics than in non-diabetics (4.27 kg/cm2). DM had the greatest effect on decline of TCHOL in white participants (23.6 mg/dL), less of an effect in black participants (9.67 mg/dL), and the least effect in Mexican-American participants (8.25 mg/dL). Notably, smoking had great effect on percent increment of DM in whites (0.2%), and have little effect on black and Mexican-Americans. CONCLUSIONS DM is more common in the general population than might be clinically recognized, and the prevalence of DM was associated to varying degrees with many indicators of demographic characteristics, physical indicators, and living habits. These indicators should be linked with medical resource allocation and scientific treatment methods to comprehensively implement the treatment of DM.
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Affiliation(s)
- Ling Fang
- Shaanxi Key Laboratory of Chinese Medicine Encephalopathy, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Huafang Sheng
- Department of Laboratory Medicine, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Yingying Tan
- Shaanxi Key Laboratory of Chinese Medicine Encephalopathy, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Qi Zhang
- Shaanxi Key Laboratory of Chinese Medicine Encephalopathy, Shaanxi University of Chinese Medicine, Xianyang, China
- *Correspondence: Qi Zhang,
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Alcohol consumption and metabolic syndrome: Clinical and epidemiological impact on liver disease. J Hepatol 2023; 78:191-206. [PMID: 36063967 DOI: 10.1016/j.jhep.2022.08.030] [Citation(s) in RCA: 74] [Impact Index Per Article: 74.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/04/2022] [Accepted: 08/19/2022] [Indexed: 02/01/2023]
Abstract
Alcohol use and metabolic syndrome are highly prevalent in the population and frequently co-exist. Both are implicated in a large range of health problems, including chronic liver disease, hepatocellular carcinoma, and liver-related outcomes (i.e. decompensation or liver transplantation). Studies have yielded mixed results regarding the effects of mild-moderate alcohol consumption on the risk of metabolic syndrome and fatty liver disease, possibly due to methodological differences. The few available prospective studies have indicated that mild-moderate alcohol use is associated with an increase in liver-related outcomes. This conclusion was substantiated by systems biology analyses suggesting that alcohol and metabolic syndrome may play a similar role in fatty liver disease, potentiating an already existing dysregulation of common vital homeostatic pathways. Alcohol and metabolic factors are independently and jointly associated with liver-related outcomes. Indeed, metabolic syndrome increases the risk of liver-related outcomes, regardless of alcohol intake. Moreover, the components of metabolic syndrome appear to have additive effects when it comes to the risk of liver-related outcomes. A number of population studies have implied that measures of central/abdominal obesity, such as the waist-to-hip ratio, can predict liver-related outcomes more accurately than BMI, including in individuals who consume harmful quantities of alcohol. Many studies even point to synergistic interactions between harmful alcohol use and many metabolic components. This accumulating evidence showing independent, combined, and modifying effects of alcohol and metabolic factors on the onset and progression of chronic liver disease highlights the multifactorial background of liver disease in the population. The available evidence suggests that more holistic approaches could be useful for risk prediction, diagnostics and treatment planning.
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Li WH, Zhang L, Li YY, Wang XY, Li JL, Zhao SN, Ni MQ, Li Q, Sun H. Apolipoprotein A-IV Has Bi-Functional Actions in Alcoholic Hepatitis by Regulating Hepatocyte Injury and Immune Cell Infiltration. Int J Mol Sci 2022; 24:ijms24010670. [PMID: 36614113 PMCID: PMC9820766 DOI: 10.3390/ijms24010670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/23/2022] [Accepted: 12/25/2022] [Indexed: 01/03/2023] Open
Abstract
Alcohol abuse can lead to alcoholic hepatitis (AH), a worldwide public health issue with high morbidity and mortality. Here, we identified apolipoprotein A-IV (APOA4) as a biomarker and potential therapeutic target for AH. APOA4 expression was detected by Gene Expression Omnibus (GEO) databases, Immunohistochemistry, and qRT-PCR in AH. Bioinformatics Methods (protein-protein interaction (PPI) network, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways and Gene Set Enrichment Analysis (GSEA) were used to show down-stream gene and pathways of APOA4 in AH. AML-12 cells were used to evaluate the biological function of APOA4 using an ELISA kit (AST, ALT, and IL-1β) and flow cytometry (ROS activity). Both in vivo and in vitro, APOA4 expression was significantly elevated in the AH model induced by alcohol (ETOH). AML-12 cell damage was specifically repaired by APOA4 deficiency, while AST, ALT, and IL-1β activity that was increased by ETOH (200 µmol, 12 h) were suppressed. APOA4 inhibition increased intracellular ROS induced by ETOH, which was detected by flow cytometry. Functional and PPI network analyses showed Fcgamma receptor (FCGR) and platelet activation signaling were potential downstream pathways. We identified CIDEC as a downstream gene of APOA4. The CIDEC AUC values for the ROC curves were 0.861. At the same time, APOA4 silencing downregulated the expression of CIDEC, whereas the knockdown of CIDEC did not influence the expression of APOA4 in AML-12 cells. Collectively, APOA4 regulates CIDEC expression and immune cell infiltration and may hold great potential as a biomarker and therapeutic target for AH.
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Affiliation(s)
- Wan-Hong Li
- Pharmaceutical Experiment Teaching Center, College of Pharmacy, Harbin Medical University, Harbin 150081, China
| | - Li Zhang
- Pharmaceutical Experiment Teaching Center, College of Pharmacy, Harbin Medical University, Harbin 150081, China
| | - Yue-Ying Li
- Pharmaceutical Experiment Teaching Center, College of Pharmacy, Harbin Medical University, Harbin 150081, China
| | - Xin-Yue Wang
- Pharmaceutical Experiment Teaching Center, College of Pharmacy, Harbin Medical University, Harbin 150081, China
| | - Jin-Liang Li
- Pharmaceutical Experiment Teaching Center, College of Pharmacy, Harbin Medical University, Harbin 150081, China
| | - Shu-Ning Zhao
- Pharmaceutical Experiment Teaching Center, College of Pharmacy, Harbin Medical University, Harbin 150081, China
| | - Ming-Qi Ni
- Pharmaceutical Experiment Teaching Center, College of Pharmacy, Harbin Medical University, Harbin 150081, China
| | - Qian Li
- Pharmaceutical Analysis and Analytical Chemistry, College of Pharmacy, Harbin Medical University, Harbin 150081, China
- Correspondence: (Q.L.); (H.S.); Tel./Fax: +86-451-86699347 (Q.L.)
| | - Hui Sun
- Pharmaceutical Experiment Teaching Center, College of Pharmacy, Harbin Medical University, Harbin 150081, China
- Correspondence: (Q.L.); (H.S.); Tel./Fax: +86-451-86699347 (Q.L.)
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Ma H, Wang X, Li X, Heianza Y, Qi L. Moderate alcohol drinking with meals is related to lower incidence of type 2 diabetes. Am J Clin Nutr 2022; 116:1507-1514. [PMID: 36250602 PMCID: PMC9761774 DOI: 10.1093/ajcn/nqac207] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 07/26/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Previous studies on alcohol drinking and health largely have ignored the potential impact of the timing of drinking. OBJECTIVES We aimed to investigate the joint associations of the timing of alcohol intake with respect to meals (i.e., with meals or outside of meals) and the amount of alcohol consumed with the risk of type 2 diabetes (T2D). METHODS A total of 312,388 current drinkers from the UK Biobank without T2D at baseline were included. Cox proportional hazards models were used to examine the association between the timing of alcohol intake with respect to meals and the risk of T2D. RESULTS During a median of 10.9 y of follow-up, 8598 incident cases of T2D were documented. After adjustment for covariates and the amount of alcohol consumed, consuming alcohol with meals was significantly associated with a 12% lower risk of T2D (HR: 0.88; 95% CI: 0.83, 0.93) than was consuming alcohol outside of meals. In addition, we found that the timing of alcohol intake with respect to meals significantly modified the relations between the amount of alcohol consumed and risk of T2D (P-interaction = 0.017); the beneficial association of moderate drinking with T2D risk was only observed in participants who consumed alcohol with meals, but not in others. Further analyses on various types of alcoholic beverages indicated that the beneficial associations between alcohol drinking with meals and T2D were mainly driven by wine consumption. Moreover, we found that when consumed together with meals, drinking more wine, rather than other alcoholic beverages, was related to lower concentrations of C-reactive protein. CONCLUSIONS In current drinkers, moderate drinking of alcohol, especially wine, with meals is associated with a lower risk of T2D.
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Affiliation(s)
- Hao Ma
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Xuan Wang
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Xiang Li
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Yoriko Heianza
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Lu Qi
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
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Xie J, Wang M, Long Z, Ning H, Li J, Cao Y, Liao Y, Liu G, Wang F, Pan A. Global burden of type 2 diabetes in adolescents and young adults, 1990-2019: systematic analysis of the Global Burden of Disease Study 2019. BMJ 2022; 379:e072385. [PMID: 36740855 PMCID: PMC9727920 DOI: 10.1136/bmj-2022-072385] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To estimate the global burden of type 2 diabetes in adolescents and young adults (aged 15-39 years) from 1990 to 2019. DESIGN Systematic analysis. DATA SOURCE Global Burden of Disease Study 2019. Participants aged 15-39 years from 204 countries and territories, 1990-2019. MAIN OUTCOMES MEASURES Age standardised incidence rate, age standardised disability adjusted life years (DALY) rate, and age standardised mortality rate for type 2 diabetes in people aged 15-39 years from 1990 to 2019, and proportional DALY attributable to different risk factors. RESULTS From 1990 to 2019, significant increases in age standardised incidence rate and age standardised DALY rate were found for type 2 diabetes in adolescents and young adults globally (P<0.001). Age standardised incidence rate (per 100 000 population) increased from 117.22 (95% confidence interval 117.07 to 117.36) in 1990 to 183.36 (183.21 to 183.51) in 2019, and age standardised DALY rate (per 100 000 population) increased from 106.34 (106.20 to 106.48) in 1990 to 149.61 (149.47 to 149.75) in 2019. The age standardised mortality rate (per 100 000 population) was modestly increased from 0.74 (0.72 to 0.75) in 1990 to 0.77 (0.76 to 0.78) in 2019. When grouped by countries with different sociodemographic indexes, countries with a low-middle and middle sociodemographic index had the highest age standardised incidence rate and age standardised DALY rate in 2019, whereas countries with a low sociodemographic index had the lowest age standardised incidence rate but the highest age standardised mortality rate. Women generally had higher mortality and DALY rates than men at ages <30 years, but differences between the sexes were reversed in those aged >30 years except in countries with a low sociodemographic index. The main attributable risk factor for DALY for early onset type 2 diabetes was high body mass index in all regions by sociodemographic index. The proportional contribution of other risk factors varied across regions, however, with higher proportions of ambient particulate air pollution and smoking in countries with a high sociodemographic index and higher proportions of household air pollution from solid fuels and diet low in fruit in countries with a low sociodemographic index. CONCLUSIONS Early onset type 2 diabetes is a growing global health problem in adolescents and young adults, especially in countries with a low-middle and middle sociodemographic index. A greater disease burden in women aged <30 years was found. Specific measures are needed in countries with different levels of socioeconomic development because of the variable attributable risk factors for type 2 diabetes in adolescents and young adults.
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Affiliation(s)
- Jinchi Xie
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, China
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Maoqing Wang
- National Key Disciplines of Nutrition and Food Hygiene, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Zhiping Long
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Hua Ning
- National Key Disciplines of Nutrition and Food Hygiene, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Jingkuo Li
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Yukun Cao
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Yunfei Liao
- Department of Endocrinology, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Gang Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Fan Wang
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, China
| | - An Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
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Diet, Lifestyle Behaviours and Other Risk Factors Associated With Type 2 Diabetes Beyond Body Mass Index: A Mendelian Randomization Study. Can J Diabetes 2022; 46:822-828. [PMID: 35835669 DOI: 10.1016/j.jcjd.2022.06.001] [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: 10/02/2021] [Revised: 03/10/2022] [Accepted: 06/01/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Our aim in this study was to identify promising targets for the prevention of type 2 diabetes in addition to weight loss. We conducted a Mendelian randomization (MR) study to investigate the body mass index (BMI)-independent associations of 16 risk factors, including diet, lifestyle behaviours and others, with type 2 diabetes. METHODS We selected genetic variants as instrumental variables for diet, sleep traits, smoking, physical activity, education and blood pressure (BP) from European-descent genome-wide association studies (GWASs). Summary statistics for type 2 diabetes were derived from a recent GWAS with 74,124 European cases and 824,006 European controls. The inverse-variance weighted MR method was used to assess the associations of the risk factors with type 2 diabetes, followed by validation of robustness using different MR methods in sensitivity analyses. RESULTS Genetically predicted insomnia (odds ratio [OR], 1.10; 95% confidence interval [CI], 1.06 to 1.15), smoking initiation (OR, 1.14; 95% CI, 1.06 to 1.21), educational level (OR, 0.69; 95% CI, 0.65 to 0.74), hypertension (OR, 6.50; 95% CI, 3.13 to 13.50), systolic BP (OR, 1.02; 95% CI, 1.02 to 1.03) and diastolic BP (OR, 1.03; 95% CI, 1.02 to 1.03) had BMI-independent effects on type 2 diabetes risk. In addition, alcohol dependence (OR, 1.10; 95% CI, 1.05 to 1.16; BMI-adjusted OR, 1.04; 95% CI, 0.98 to 1.09) and vegetarian diet (OR, 0.50; 95% CI, 0.33 to 0.74; BMI-adjusted OR, 0.78; 95% CI, 0.57 to 1.06) appeared to be correlated with type 2 diabetes via a BMI-mediated pathway. Sensitivity analyses further confirmed the relationship between these factors and type 2 diabetes. CONCLUSIONS In this systematic MR study, insomnia, smoking, education and BP had BMI-independent causal effects on the risk of type 2 diabetes, whereas alcohol dependence and vegetarian diet were associated with type 2 diabetes through BMI.
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