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Blomqvist M, Nuotio M, Sääksjärvi K, Koskinen S, Stenholm S. Osteosarcopenia in Finland: prevalence and associated factors. Arch Osteoporos 2024; 19:80. [PMID: 39212839 PMCID: PMC11364597 DOI: 10.1007/s11657-024-01439-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 08/12/2024] [Indexed: 09/04/2024]
Abstract
This cross-sectional study investigated osteosarcopenia prevalence and its correlates among 2142 adults aged 55 and older in Finland. Findings show 3.9% had osteosarcopenia, while 13.8% and 11.1% had probable sarcopenia only or osteoporosis only, respectively. Osteosarcopenia was associated with low BMI, impaired mobility, ADL limitations and depression. Sarcopenia appeared to drive these associations more than osteoporosis. Osteosarcopenia may be a risk factor for functional decline, hospitalization, and institutionalization, warranting further research. PURPOSE Osteosarcopenia is a disorder consisting of concurrent osteoporosis and sarcopenia. This cross-sectional study using nationally representative data from Finland in 2000 aimed to determine the prevalence of osteosarcopenia in Finland. In addition, associations of sociodemographic, lifestyle, anthropometric, physical and mental function indicators, chronic conditions and various biomarkers with osteosarcopenia were examined. METHODS The study included 2142 subjects aged 55 and over (mean age 68.0 years, SD 9.0). Probable sarcopenia was defined as grip strength < 27 kg for men and < 16 kg for women. Osteoporosis was defined as either ultrasound-based bone density measurement of T < -2.5, or self-reported, pre-existing diagnosis of osteoporosis. Participants were categorized into 4 groups: no sarcopenia and no osteoporosis, probable sarcopenia only, osteoporosis only, and osteosarcopenia. Information on sociodemographic, lifestyle, anthropometric, physical and mental function indicators, chronic conditions and various biomarkers were collected via structured interview, questionnaires, clinical examination, and blood and urine samples. RESULTS The prevalence of probable sarcopenia, osteoporosis and osteosarcopenia was 13.8%, 11.1%, and 3.9%, respectively. Osteosarcopenia was associated with low BMI, slow gait speed, impaired mobility, impaired ability in the activities of daily living and depression. Of the two components, probable sarcopenia appeared to contribute to these associations more than osteoporosis. CONCLUSION According to representative population-based study, about every fifth person with probable sarcopenia also has osteoporosis. Mobility and ADL limitations were more common among people with osteosarcopenia than those with osteoporosis or probable sarcopenia alone. Future studies are needed to examine osteosarcopenia as an independent risk factor for functional decline, hospitalization, and institutionalization.
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Affiliation(s)
- Matias Blomqvist
- University of Turku, Turun Yliopisto, Turku, Finland.
- Department of Geriatric Medicine, University of Turku, Turku, Finland.
| | - Maria Nuotio
- University of Turku, Turun Yliopisto, Turku, Finland
- Department of Geriatric Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Katri Sääksjärvi
- University of Turku, Turun Yliopisto, Turku, Finland
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Seppo Koskinen
- University of Turku, Turun Yliopisto, Turku, Finland
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Sari Stenholm
- University of Turku, Turun Yliopisto, Turku, Finland
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Research Services, Turku University Hospital and University of Turku, Turku, Finland
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Lu J, Wang Y, Shen Y, Mo Y, Ma X, Hu G, Zhou J. Potential modifying effect of grip strength on the association between glycated hemoglobin (HbA1c) and all-cause mortality in older adults with type 2 diabetes: Evidence from UK Biobank. Chin Med J (Engl) 2024; 137:1501-1503. [PMID: 38775178 PMCID: PMC11188863 DOI: 10.1097/cm9.0000000000003066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Indexed: 06/21/2024] Open
Affiliation(s)
- Jingyi Lu
- Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Yaxin Wang
- Shanghai Diabetes Institute, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Yun Shen
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA
| | - Yifei Mo
- Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Xiaojing Ma
- Shanghai Diabetes Institute, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Gang Hu
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA
| | - Jian Zhou
- Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
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Jia X, Zhang L, Yang Z, Cao X, Yao Z, Zhang J, Chen Z, Liu Z. Impact of sarcopenic obesity on heart failure in people with type 2 diabetes and the role of metabolism and inflammation: A prospective cohort study. Diabetes Metab Syndr 2024; 18:103038. [PMID: 38749096 DOI: 10.1016/j.dsx.2024.103038] [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: 12/03/2023] [Revised: 05/05/2024] [Accepted: 05/08/2024] [Indexed: 07/15/2024]
Abstract
AIMS We aimed to prospectively evaluate the association of sarcopenic obesity (SO) with the incidence risk of heart failure (HF), and the mediating role of metabolomics and inflammation in people with type 2 diabetes (T2D). METHODS 22,496 participants with T2D from the UK Biobank were included. SO was defined as the combination of obesity (body mass index ≥30 kg/m2) and sarcopenia (grip strength <27 kg in male or <16 kg in female). The incident HF was identified through linked hospital records. Cox proportional hazard regression models were used to estimate the associations. Mediation analysis was conducted to evaluate the mediating effect of the "metabolomic risk score" of HF, which was derived from 168 plasma metabolites through LASSO regression, and five inflammatory markers (e.g., C-reactive protein [CRP] level) on the aforementioned associations. RESULTS 1946 (8.7 %) participants developed HF during a median follow-up of 12.0 years. Compared to participants with neither obesity nor sarcopenia, those with obesity & non-sarcopenia (hazard ratio [HR]: 1.80, 95 % confidence interval [CI]: 1.62, 2.00), sarcopenia & non-obesity (HR: 1.90, 95 % CI: 1.56, 2.31) and SO (HR: 2.29, 95 % CI: 1.92, 2.73) showed a higher risk of HF. The metabolomic risk score (20.0 %) and CRP (20.4 %) meditated this association. CONCLUSIONS SO was associated with an increased risk of HF in people with T2D and metabolomics and inflammation partially mediated this association. Our findings suggest the importance of managing obesity and muscle strength simultaneously in preventing HF among people with T2D and shed light on the underlying mechanisms.
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Affiliation(s)
- Xueqing Jia
- Center for Clinical Big Data and Analytics Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China
| | - Liming Zhang
- Center for Clinical Big Data and Analytics Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China
| | - Zhenqing Yang
- Center for Clinical Big Data and Analytics Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China
| | - Xingqi Cao
- Center for Clinical Big Data and Analytics Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China
| | - Zhao Yao
- The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Jingyun Zhang
- Center for Clinical Big Data and Analytics Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China
| | - Zuobing Chen
- The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China; Department of Rehabilitation Medicine, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang, China.
| | - Zuyun Liu
- Center for Clinical Big Data and Analytics Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China.
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Yao T, Wang H, Lin K, Wang R, Guo S, Chen P, Wu H, Liu T, Wang R. Exercise-induced microbial changes in preventing type 2 diabetes. SCIENCE CHINA. LIFE SCIENCES 2024; 67:892-899. [PMID: 36795181 DOI: 10.1007/s11427-022-2272-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 01/10/2023] [Indexed: 02/17/2023]
Abstract
The metabolic benefits associated with long-term physical activity are well appreciated and growing evidence suggests that it involves the gut microbiota. Here we re-evaluated the link between exercise-induced microbial changes and those associated with prediabetes and diabetes. We found that the relative abundances of substantial amounts of diabetes-associated metagenomic species associated negatively with physical fitness in a Chinese athlete students cohort. We additionally showed that those microbial changes correlated more with handgrip strength, a simple but valuable biomarker suggestive of the diabetes states, than maximum oxygen intake, one of the key surrogates for endurance training. Moreover, the causal relationships among exercise, risks for diabetes, and gut microbiota were explored based on mediation analysis. We propose that the protective roles of exercise against type 2 diabetes are mediated, at least partly, by the gut microbiota.
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Affiliation(s)
- Ting Yao
- School of Exercise and Health, Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, 200438, China
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Xi'an Jiaotong University School of Medicine, Xi'an, 710061, China
| | - Hui Wang
- Shanghai Key Laboratory of Metabolic Remodeling and Health, Institute of Metabolism & Integrative Biology, Fudan University, Shanghai, 200433, China
| | - Kaiqing Lin
- School of Exercise and Health, Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, 200438, China
| | - Ruwen Wang
- School of Exercise and Health, Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, 200438, China
| | - Shanshan Guo
- School of Exercise and Health, Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, 200438, China
| | - Peijie Chen
- School of Exercise and Health, Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, 200438, China
| | - Hao Wu
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, Fudan Microbiome Center, and Department of Bariatric and Metabolic Surgery, Huashan Hospital, Fudan University, Shanghai, 201203, China.
| | - Tiemin Liu
- School of Exercise and Health, Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, 200438, China.
- Shanghai Key Laboratory of Metabolic Remodeling and Health, Institute of Metabolism & Integrative Biology, Fudan University, Shanghai, 200433, China.
- State Key Laboratory of Genetic Engineering, Department of Endocrinology and Metabolism, Human Phenome Institute, and School of Life Sciences, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
| | - Ru Wang
- School of Exercise and Health, Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, 200438, China.
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Boonpor J, Pell JP, Ho FK, Celis-Morales C, Gray SR. In people with type 2 diabetes, sarcopenia is associated with the incidence of cardiovascular disease: A prospective cohort study from the UK Biobank. Diabetes Obes Metab 2024; 26:524-531. [PMID: 37881162 DOI: 10.1111/dom.15338] [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: 07/20/2023] [Revised: 09/22/2023] [Accepted: 10/04/2023] [Indexed: 10/27/2023]
Abstract
AIM To investigate the association of sarcopenia with cardiovascular disease (CVD) incidence in people with type 2 diabetes. MATERIALS AND METHODS A prospective cohort study with 11 974 White European UK Biobank participants with type 2 diabetes, aged 40-70 years, included. Sarcopenia was defined based on the European Working Group on Sarcopenia in Older People as either non-sarcopenic or sarcopenic. Outcomes included CVD, stroke, heart failure (HF) and myocardial infarction (MI). The association between sarcopenia and the incidence of outcomes was investigated using Cox proportional hazard models adjusted for sociodemographic and lifestyle factors. The rate advancement period was used to estimate the time period by which CVD is advanced because of sarcopenia. RESULTS Over a median follow-up of 10.7 years, 1957 participants developed CVDs: 373 had a stroke, 307 had an MI and 742 developed HF. Compared with non-sarcopenia, those with sarcopenia had higher risks of CVD (HR 1.89 [95% CI 1.61; 2.21]), HF (HR 2.59 [95% CI 2.12; 3.18]), stroke (HR 1.90 [95% CI 1.38; 2.63]), and MI (HR 1.56 [95% CI 1.04; 2.33]) after adjustment for all covariates. Those with sarcopenia had CVD incidence rates equivalent to those without sarcopenia who were 14.5 years older. Similar results were found for stroke, HF and MI. CONCLUSIONS In people with type 2 diabetes, sarcopenia increased the risk of developing CVD, which might occur earlier than in those without sarcopenia. Therefore, sarcopenia screening and prevention in patients with type 2 diabetes may be useful to prevent the complications of CVD.
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Affiliation(s)
- Jirapitcha Boonpor
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Faculty of Public Health, Chalermphrakiat Sakon Nakhon Province Campus, Kasetsart University, Sakon Nakhon, Thailand
| | - Jill P Pell
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Frederick K Ho
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Carlos Celis-Morales
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca, Chile
| | - Stuart R Gray
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
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Ahmad A, Lim LL, Morieri ML, Tam CHT, Cheng F, Chikowore T, Dudenhöffer-Pfeifer M, Fitipaldi H, Huang C, Kanbour S, Sarkar S, Koivula RW, Motala AA, Tye SC, Yu G, Zhang Y, Provenzano M, Sherifali D, de Souza RJ, Tobias DK, Gomez MF, Ma RCW, Mathioudakis N. Precision prognostics for cardiovascular disease in Type 2 diabetes: a systematic review and meta-analysis. COMMUNICATIONS MEDICINE 2024; 4:11. [PMID: 38253823 PMCID: PMC10803333 DOI: 10.1038/s43856-023-00429-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 12/14/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Precision medicine has the potential to improve cardiovascular disease (CVD) risk prediction in individuals with Type 2 diabetes (T2D). METHODS We conducted a systematic review and meta-analysis of longitudinal studies to identify potentially novel prognostic factors that may improve CVD risk prediction in T2D. Out of 9380 studies identified, 416 studies met inclusion criteria. Outcomes were reported for 321 biomarker studies, 48 genetic marker studies, and 47 risk score/model studies. RESULTS Out of all evaluated biomarkers, only 13 showed improvement in prediction performance. Results of pooled meta-analyses, non-pooled analyses, and assessments of improvement in prediction performance and risk of bias, yielded the highest predictive utility for N-terminal pro b-type natriuretic peptide (NT-proBNP) (high-evidence), troponin-T (TnT) (moderate-evidence), triglyceride-glucose (TyG) index (moderate-evidence), Genetic Risk Score for Coronary Heart Disease (GRS-CHD) (moderate-evidence); moderate predictive utility for coronary computed tomography angiography (low-evidence), single-photon emission computed tomography (low-evidence), pulse wave velocity (moderate-evidence); and low predictive utility for C-reactive protein (moderate-evidence), coronary artery calcium score (low-evidence), galectin-3 (low-evidence), troponin-I (low-evidence), carotid plaque (low-evidence), and growth differentiation factor-15 (low-evidence). Risk scores showed modest discrimination, with lower performance in populations different from the original development cohort. CONCLUSIONS Despite high interest in this topic, very few studies conducted rigorous analyses to demonstrate incremental predictive utility beyond established CVD risk factors for T2D. The most promising markers identified were NT-proBNP, TnT, TyG and GRS-CHD, with the highest strength of evidence for NT-proBNP. Further research is needed to determine their clinical utility in risk stratification and management of CVD in T2D.
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Affiliation(s)
- Abrar Ahmad
- Department of Clinical Sciences, Lund University Diabetes Centre, Lund University, Malmö, Sweden
| | - Lee-Ling Lim
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
- Asia Diabetes Foundation, Hong Kong SAR, China
| | - Mario Luca Morieri
- Metabolic Disease Unit, University Hospital of Padova, Padova, Italy
- Department of Medicine, University of Padova, Padova, Italy
| | - Claudia Ha-Ting Tam
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
- Laboratory for Molecular Epidemiology in Diabetes, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Feifei Cheng
- Health Management Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China
| | - Tinashe Chikowore
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Hugo Fitipaldi
- Department of Clinical Sciences, Lund University Diabetes Centre, Lund University, Malmö, Sweden
| | - Chuiguo Huang
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
- Laboratory for Molecular Epidemiology in Diabetes, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong SAR, China
| | | | - Sudipa Sarkar
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Robert Wilhelm Koivula
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, United Kingdom
| | - Ayesha A Motala
- Department of Diabetes and Endocrinology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Sok Cin Tye
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, Groningen, the Netherlands
- Sections on Genetics and Epidemiology, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Gechang Yu
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
- Laboratory for Molecular Epidemiology in Diabetes, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yingchai Zhang
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
- Laboratory for Molecular Epidemiology in Diabetes, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Michele Provenzano
- Nephrology, Dialysis and Renal Transplant Unit, IRCCS-Azienda Ospedaliero-Universitaria di Bologna, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Diana Sherifali
- Heather M. Arthur Population Health Research Institute, McMaster University, Ontario, Canada
| | - Russell J de Souza
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Population Health Research Institute, Hamilton Health Sciences Corporation, Hamilton, Ontario, Canada
| | | | - Maria F Gomez
- Department of Clinical Sciences, Lund University Diabetes Centre, Lund University, Malmö, Sweden.
- Faculty of Health, Aarhus University, Aarhus, Denmark.
| | - Ronald C W Ma
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China.
- Laboratory for Molecular Epidemiology in Diabetes, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China.
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Nestoras Mathioudakis
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
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Wei L, Zeng J, Fan M, Chen B, Li X, Li Y, Xu S. Associations between handgrip strength and skeletal muscle mass with all-cause mortality and cardiovascular mortality in people with type 2 diabetes: A prospective cohort study of the UK Biobank. J Diabetes 2024; 16:e13464. [PMID: 37608605 PMCID: PMC10809293 DOI: 10.1111/1753-0407.13464] [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: 04/13/2023] [Revised: 07/13/2023] [Accepted: 08/08/2023] [Indexed: 08/24/2023] Open
Abstract
AIMS To explore the associations between handgrip strength (HGS) and skeletal muscle mass (SMM) with all-cause and cardiovascular disease (CVD) mortality risk in type 2 diabetes (T2DM) patients. MATERIALS AND METHODS Data were obtained from the UK Biobank. Baseline survey was conducted between 2006 and 2010, and followed up for a median of 12.52 years. HGS was measured using dynamometer, and SMM was measured using bioelectrical impedance method. Mortality was available via links to the National Health Service Information Centre. Sex-specific analyses were conducted. RESULTS A total of 13 392 T2DM participants were included, with a mean age of 60.39 years and 52.35% men. During the follow-up, there were 3006 (22.45%) deaths, including 746 (5.57%) CVD deaths. The risk for all-cause mortality and CVD mortality among both men and women increased progressively with decreasing HGS quartiles (p trend <.05). A 1 SD decrease in HGS was found to both increase the all-cause risk (HR: 1.31 [95% CI: 1.24-1.38]) and CVD mortality risk (HR: 1.35 [95% CI: 1.22-1.50]) for men, and all-cause risk (HR: 1.26 [95% CI: 1.11-1.42]) and CVD mortality risk (HR: 1.43 [95% CI: 1.09-1.89]) for women. There was no statistically significant trend association between SMM/height2 and mortality risk, and the restricted cubic regression splines indicated that SMM/height2 showed a U-shaped nonlinear relationship (pnonlinear <.05). CONCLUSIONS Grip strength displayed a linear downward trend with mortality risk among T2DM patients, whereas muscle mass showed a U-shaped relationship. Low grip strength seemed to be a better predictor for mortality compared to low muscle mass.
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Affiliation(s)
- Lingqi Wei
- College of Medicine, Wuhan University of Science & TechnologyWuhanChina
- Department of EndocrinologyXiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and ScienceXiangyangChina
| | - Jingjing Zeng
- Center for Clinical Evidence‐Based and Translational MedicineXiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and ScienceXiangyangChina
| | - Menglin Fan
- Center for Clinical Evidence‐Based and Translational MedicineXiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and ScienceXiangyangChina
| | - Bo Chen
- Center for Clinical Evidence‐Based and Translational MedicineXiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and ScienceXiangyangChina
| | - Xiaying Li
- College of Medicine, Wuhan University of Science & TechnologyWuhanChina
- Department of EndocrinologyXiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and ScienceXiangyangChina
| | - Ying Li
- College of Medicine, Wuhan University of Science & TechnologyWuhanChina
- Department of EndocrinologyXiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and ScienceXiangyangChina
| | - Shaoyong Xu
- Department of EndocrinologyXiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and ScienceXiangyangChina
- Center for Clinical Evidence‐Based and Translational MedicineXiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and ScienceXiangyangChina
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MacGregor KA, Ho FK, Celis-Morales CA, Pell JP, Gallagher IJ, Moran CN. Association between menstrual cycle phase and metabolites in healthy, regularly menstruating women in UK Biobank, and effect modification by inflammatory markers and risk factors for metabolic disease. BMC Med 2023; 21:488. [PMID: 38066548 PMCID: PMC10709933 DOI: 10.1186/s12916-023-03195-w] [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: 06/08/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Preliminary evidence demonstrates some parameters of metabolic control, including glycaemic control, lipid control and insulin resistance, vary across the menstrual cycle. However, the literature is inconsistent, and the underlying mechanisms remain uncertain. This study aimed to investigate the association between the menstrual cycle phase and metabolites and to explore potential mediators and moderators of these associations. METHODS We undertook a cross-sectional cohort study using UK Biobank. The outcome variables were glucose; triglyceride; triglyceride to glucose index (TyG index); total, HDL and LDL cholesterol; and total to HDL cholesterol ratio. Generalised additive models (GAM) were used to investigate non-linear associations between the menstrual cycle phase and outcome variables. Anthropometric, lifestyle, fitness and inflammatory markers were explored as potential mediators and moderators of the associations between the menstrual cycle phase and outcome variables. RESULTS Data from 8694 regularly menstruating women in UK Biobank were analysed. Non-linear associations were observed between the menstrual cycle phase and total (p < 0.001), HDL (p < 0.001), LDL (p = 0.012) and total to HDL cholesterol (p < 0.001), but not glucose (p = 0.072), triglyceride (p = 0.066) or TyG index (p = 0.100). Neither anthropometric, physical fitness, physical activity, nor inflammatory markers mediated the associations between the menstrual cycle phase and metabolites. Moderator analysis demonstrated a greater magnitude of variation for all metabolites across the menstrual cycle in the highest and lowest two quartiles of fat mass and physical activity, respectively. CONCLUSIONS Cholesterol profiles exhibit a non-linear relationship with the menstrual cycle phase. Physical activity, anthropometric and fitness variables moderate the associations between the menstrual cycle phase and metabolite concentration. These findings indicate the potential importance of physical activity and fat mass as modifiable risk factors of the intra-individual variation in metabolic control across the menstrual cycle in pre-menopausal women.
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Affiliation(s)
- Kirstin A MacGregor
- Physiology, Exercise and Nutrition Research Group, University of Stirling, Stirling, Scotland, UK
| | - Frederick K Ho
- School of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK
| | - Carlos A Celis-Morales
- School Cardiovascular and Metabolic Health, University of Glasgow, BHF Glasgow Cardiovascular Research Centre, Glasgow, Scotland, UK
- Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca, Chile
| | - Jill P Pell
- Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca, Chile
| | - Iain J Gallagher
- Physiology, Exercise and Nutrition Research Group, University of Stirling, Stirling, Scotland, UK
- Centre for Biomedicine and Global Health, School of Applied Sciences, Edinburgh Napier University, Sighthill Campus, Sighthill Court, Edinburgh, UK
| | - Colin N Moran
- Physiology, Exercise and Nutrition Research Group, University of Stirling, Stirling, Scotland, UK.
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Gerber M, Filippou K, Knappe F, Morres ID, Tzormpatzakis E, Havas E, Seelig H, Colledge F, Ludyga S, Meier M, Theodorakis Y, von Känel R, Pühse U, Hatzigeorgiadis A. Associations between grip strength, cardiorespiratory fitness, cardiovascular risk and mental health in forcibly displaced people from a Greek refugee camp. Sci Rep 2023; 13:20970. [PMID: 38017094 PMCID: PMC10684690 DOI: 10.1038/s41598-023-48032-5] [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: 06/12/2023] [Accepted: 11/21/2023] [Indexed: 11/30/2023] Open
Abstract
Muscular strength represents a specific component of health-related fitness. Hand grip strength is used as a simple and dynamic marker of maximum voluntary force of the hand and to estimate overall strength. Today, little is known about the relationship between grip strength and health in forcibly displaced populations. In the present study, we examined whether grip strength is associated with various health outcomes in a sample of forcibly displaced people living in a Greek refugee camp. The present analyses are part of a larger pragmatic randomized controlled trial. In this paper, cross-sectional baseline data of 143 participants (71 men, 72 women) will be presented. In addition to grip strength, the following physical and mental health outcomes were assessed: body weight and body composition, blood pressure, total cholesterol, low- and high-density lipoprotein cholesterol, triglycerides, blood glucose levels (HbA1c), post-traumatic stress disorder (PTSD) symptoms, depressive and anxiety symptoms, pain, and quality of life. Linear regression analyses were carried out to examine how grip strength is associated with the health outcomes, separately for absolute and normalized grip strength scores. Grip strength was positively and strongly associated with percentage muscle mass (normalized grip strength: Stand. B = 0.58, p < .001), whereas a negative association existed for percentage body fat (normalized grip strength: Stand. B = - 0.58, p < .001). No statistically significant associations occurred between grip strength and the other cardiovascular risk markers. In contrast, we found that participants with higher normalized grip strength reported higher levels of PTSD (normalized grip strength: Stand. B = 0.36, p < .05) and depressive symptoms (normalized grip strength: Stand. B = 0.29, p < .05). No significant association occurred between grip strength, anxiety, pain and quality of life. Measuring grip strength in forcibly displaced people can be a useful way to assess their overall muscle strength. Grip strength tests are easy to implement, and results can be used to assess the effects of specific intervention measures. Nevertheless, our results question the usefulness of grip strength as a marker of cardiovascular health and mental wellbeing in a refugee camp setting.
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Affiliation(s)
- Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland.
| | - Konstantinia Filippou
- Department of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | - Florian Knappe
- Department of Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
| | - Ioannis D Morres
- Department of Nutrition and Dietetics, University of Thessaly, Trikala, Greece
| | - Emmanouil Tzormpatzakis
- Department of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | - Elsa Havas
- Department of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | - Harald Seelig
- Department of Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
| | - Flora Colledge
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Sebastian Ludyga
- Department of Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
| | - Marianne Meier
- Interdisciplinary Center for Gender Studies, University of Bern, Bern, Switzerland
| | - Yannis Theodorakis
- Department of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Uwe Pühse
- Department of Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
| | - Antonis Hatzigeorgiadis
- Department of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
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Gyasi RM, Odei J, Hambali MG, Gyasi-Boadu N, Obeng B, Asori M, Hajek A, Jacob L, Adjakloe YAD, Opoku-Ware J, Smith L, Koyanagi A. Diabetes mellitus and functional limitations among older adults: Evidence from a large, representative Ghanaian aging study. J Psychosom Res 2023; 174:111481. [PMID: 37677886 DOI: 10.1016/j.jpsychores.2023.111481] [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: 10/26/2022] [Revised: 08/04/2023] [Accepted: 08/29/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVES Literature linking diabetes mellitus (DM) to functional status is limited in low- and middle-income countries. Importantly, factors influencing this association are even less understood. This study aims to examine the association of DM with functional limitations (FL) in older adults and to identify potential factors influencing this association. METHODS In a cross-sectional analysis, we examined the association between DM and basic and instrumental activities of daily living-related FL in 1201 adults aged ≥50 years from the Aging, Health, Psychological Well-being, and Health-seeking Behavior Study. DM was defined as a self-report of physician diagnosis. The associations were assessed using hierarchical regression estimates and bootstrapping technique via the Hayes PROCESS macro program. RESULTS The prevalence of DM and FL was 10.1% and 36.1%, respectively, with OR = 2.50 (95%CI = 1.59-3.92) after accounting for sociodemographic factors, smoking, alcohol use, self-rated health, loneliness, and sleep quality. After full adjustment, polytomous regressions showed that the association of DM with FL increased with the number of FL (i.e., OR = 1.60 for 1-2, OR = 1.88 for 3-5, and OR = 2.0o for >5 FL compared with no FL). However, this association was attenuated after controlling for physical activity (OR = 2.06, 95%CI = 1.28-3.31), hypertension (OR = 1.87, 95%CI = 1.14-2.99), stroke (OR = 1.82, 95%CI = 1.20-2.93), and pain facets (OR = 1.80, 95%CI = 1.04-3.02). PA thus mediated 40.39% of the DM-FL association. CONCLUSIONS In this representative study, older adults with DM showed higher odds for FL, and this association was partially explained by physical activity and health variables. Investing in a holistic management approach might be helpful for public health planning efforts to address DM-induced FL in old age.
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Affiliation(s)
- Razak M Gyasi
- African Population and Health Research Center, Nairobi, Kenya; National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, Australia.
| | - Julius Odei
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Mohammed Gazali Hambali
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Nelson Gyasi-Boadu
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Bernard Obeng
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Moses Asori
- Department of Geography and Earth Sciences, University of North Carolina at Charlotte, Charlotte, NC, United States of America
| | - André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Martinistr. 52, Hamburg 20246, Germany
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, Spain; Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | | | - Jones Opoku-Ware
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Lee Smith
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge CB1 1PT, United Kingdom
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA), Pg. Lluis Companys 23, Barcelona, Spain
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11
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Ahmad A, Lim LL, Morieri ML, Tam CHT, Cheng F, Chikowore T, Dudenhöffer-Pfeifer M, Fitipaldi H, Huang C, Kanbour S, Sarkar S, Koivula RW, Motala AA, Tye SC, Yu G, Zhang Y, Provenzano M, Sherifali D, de Souza R, Tobias DK, Gomez MF, Ma RCW, Mathioudakis NN. Precision Prognostics for Cardiovascular Disease in Type 2 Diabetes: A Systematic Review and Meta-analysis. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.26.23289177. [PMID: 37162891 PMCID: PMC10168509 DOI: 10.1101/2023.04.26.23289177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Background Precision medicine has the potential to improve cardiovascular disease (CVD) risk prediction in individuals with type 2 diabetes (T2D). Methods We conducted a systematic review and meta-analysis of longitudinal studies to identify potentially novel prognostic factors that may improve CVD risk prediction in T2D. Out of 9380 studies identified, 416 studies met inclusion criteria. Outcomes were reported for 321 biomarker studies, 48 genetic marker studies, and 47 risk score/model studies. Results Out of all evaluated biomarkers, only 13 showed improvement in prediction performance. Results of pooled meta-analyses, non-pooled analyses, and assessments of improvement in prediction performance and risk of bias, yielded the highest predictive utility for N-terminal pro b-type natriuretic peptide (NT-proBNP) (high-evidence), troponin-T (TnT) (moderate-evidence), triglyceride-glucose (TyG) index (moderate-evidence), Genetic Risk Score for Coronary Heart Disease (GRS-CHD) (moderate-evidence); moderate predictive utility for coronary computed tomography angiography (low-evidence), single-photon emission computed tomography (low-evidence), pulse wave velocity (moderate-evidence); and low predictive utility for C-reactive protein (moderate-evidence), coronary artery calcium score (low-evidence), galectin-3 (low-evidence), troponin-I (low-evidence), carotid plaque (low-evidence), and growth differentiation factor-15 (low-evidence). Risk scores showed modest discrimination, with lower performance in populations different from the original development cohort. Conclusions Despite high interest in this topic, very few studies conducted rigorous analyses to demonstrate incremental predictive utility beyond established CVD risk factors for T2D. The most promising markers identified were NT-proBNP, TnT, TyG and GRS-CHD, with the highest strength of evidence for NT-proBNP. Further research is needed to determine their clinical utility in risk stratification and management of CVD in T2D.
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12
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Arhab A, Junod N, Rossel JB, Giet O, Sittarame F, Beer S, Sofra D, Durrer D, Delgado H, Castellsague M, Laimer M, Puder JJ. Effectiveness of a real-life program (DIAfit) to promote physical activity in patients with type 2 diabetes: a pragmatic cluster randomized clinical trial. Front Endocrinol (Lausanne) 2023; 14:1155217. [PMID: 37484961 PMCID: PMC10359883 DOI: 10.3389/fendo.2023.1155217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/08/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction The aim of this study was to evaluate the effectiveness of a real-life clinical physical activity program (DIAfit) on improving physical fitness, body composition, and cardiometabolic health in an unselected population with type 2 diabetes mellitus, and to compare the effects of two variants a different exercise frequencies on the same outcomes. Research design and methods This was a cluster randomized-controlled assessor-blind trial conducted in 11 clinical centres in Switzerland. All participants in the clinical program with type 2 diabetes were eligible and were randomized to either standard (3 sessions/week for 12 weeks) or alternative (1 session/week for the first four weeks, then 2 sessions/week for the rest of 16 weeks) physical activity program each consisting of 36 sessions of combined aerobic and resistance exercise. Allocation was concealed by a central office unrelated to the study. The primary outcome was aerobic fitness. Secondary outcome measures included: body composition, BMI, HbA1c, muscle strength, walking speed, balance, flexibility, blood pressure, lipid profile. Results All 185 patients with type 2 diabetes (mean age 59.7 +-10.2 years, 48% women) agreed to participate and were randomized in two groups: a standard group (n=88) and an alternative group (n=97)). There was an 11% increase in aerobic fitness after the program (12.5 Watts; 95% CI 6.76 to 18.25; p<0.001). Significant improvements in physical fitness, body composition, and cardiometabolic parameters were observed at the end of the DIAfit program (improvements between 2-29%) except for lean body mass, triglycerides and cholesterol. No differences were observed between both programs, except for a larger weight reduction of -0.97kg (95% CI -0.04 to -1.91; p=0.04) in the standard program. Conclusions Both frequency variants of the nation-wide DIAfit program had beneficial effects on physical fitness, HbA1c, body composition, and blood pressure in type 2 diabetes patients and differences were negligible. Clinical trial registration clinicaltrials.gov, identifier NCT01289587.
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Affiliation(s)
- Amar Arhab
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Lausanne, Switzerland
| | - Nicolas Junod
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Lausanne, Switzerland
- La Lignière Clinic, Department of Medicine, Cardiovascular and Metabolic Rehabilitation Service, Gland, Switzerland
- Lavaux Hospital, Cully, Switzerland
| | - Jean-Benoit Rossel
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Lausanne, Switzerland
| | - Olivier Giet
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Lausanne, Switzerland
- Socio-medical Centre, Sierre, Switzerland
| | - Frederic Sittarame
- Cardiac Rehabilitation and Heart Failure Unity, Cardiology Service, Department of Medicine, University Hospitals Geneva, Geneva, Switzerland
| | - Sandra Beer
- Private Practice for Diabetes and Endocrinology, Lausanne, Switzerland
| | - Daniela Sofra
- Private Practice for Diabetes and Endocrinology, Lausanne, Switzerland
| | - Dominique Durrer
- European Association for the Study of Obesity (EASO), Collaborating Centre for Obesity Management (COMs), Vevey, Switzerland
| | - Humberto Delgado
- La Lignière Clinic, Department of Medicine, Cardiovascular and Metabolic Rehabilitation Service, Gland, Switzerland
| | | | - Markus Laimer
- Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital Bern University Hospital, Bern, Switzerland
| | - Jardena J. Puder
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Lausanne, Switzerland
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13
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Boonpor J, Parra-Soto S, Petermann-Rocha F, Lynskey N, Cabanas-Sánchez V, Sattar N, Gill JMR, Welsh P, Pell JP, Gray SR, Ho FK, Celis-Morales C. Dose-response relationship between device-measured physical activity and incident type 2 diabetes: findings from the UK Biobank prospective cohort study. BMC Med 2023; 21:191. [PMID: 37226202 DOI: 10.1186/s12916-023-02851-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 03/27/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Most studies investigating the association between physical activity (PA) and the risk of type 2 diabetes are derived from self-reported questionnaires, with limited evidence using device-based measurements. Therefore, this study aimed to investigate the dose-response relationship between device-measured PA and incident type 2 diabetes. METHODS This prospective cohort study included 40,431 participants of the UK Biobank. Wrist-worn accelerometers were used to estimate total, light, moderate, vigorous and moderate-to-vigorous PA. The associations between PA and incident type 2 diabetes were analysed using Cox-proportional hazard models. The mediating role of body mass index (BMI) was tested under a causal counterfactual framework. RESULTS The median follow-up period was 6.3 years (IQR: 5.7-6.8), with 591 participants developing type 2 diabetes. Compared to those achieving < 150 min/week of moderate PA, people achieving 150-300, 300-600 and > 600 min/week were at 49% (95% CI 62-32%), 62% (95% CI 71-50%) and 71% (95% CI 80-59%) lower risk of type 2 diabetes, respectively. For vigorous PA, compared to those achieving < 25 min/week, individuals achieving 25-50, 50-75 and > 75 min/week were at 38% (95% CI 48-33%), 48% (95% CI 64-23%) and 64% (95% CI 78-42%) lower type 2 diabetes risk, respectively. Twelve per cent and 20% of the associations between vigorous and moderate PA and type 2 diabetes were mediated by lower BMI, respectively. CONCLUSIONS PA has clear dose-response relationship with a lower risk of type 2 diabetes. Our findings support the current aerobic PA recommendations but suggest that additional PA beyond the recommendations is associated with even greater risk reduction. TRIAL REGISTRATION The UK Biobank study was approved by the North West Multi-Centre Research Ethics Committee (Ref 11/NW/0382 on June 17, 2011).
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Affiliation(s)
- Jirapitcha Boonpor
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Faculty of Public Health, Kasetsart University, Chalermphrakiat Sakon Nakhon Province Campus, Sakon Nakhon, Thailand
| | - Solange Parra-Soto
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Department of Nutrition and Public Health, Universidad del Bío-Bío, Chillan, Chile
| | - Fanny Petermann-Rocha
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Facultad de Medicina, Universidad Diego Portales, Santiago, Chile
| | - Nathan Lynskey
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Verónica Cabanas-Sánchez
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- IMDEA Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Naveed Sattar
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Jason M R Gill
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Paul Welsh
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Jill P Pell
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Stuart R Gray
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Frederick K Ho
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Carlos Celis-Morales
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.
- Human Performance Lab, Education, Physical Activity and Health Research Unit, Universidad Católica del Maule, Talca, Chile.
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Li G, Lu Y, Shao L, Wu L, Qiao Y, Ding Y, Ke C. Handgrip strength is associated with risks of new-onset stroke and heart disease: results from 3 prospective cohorts. BMC Geriatr 2023; 23:268. [PMID: 37142986 PMCID: PMC10161641 DOI: 10.1186/s12877-023-03953-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 04/05/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Stroke and heart disease are two major contributors to the global disease burden. We aimed to evaluate and compare the roles of different handgrip strength (HGS) expressions in predicting stroke and heart disease in three nationally representative cohorts. METHODS This longitudinal study used data from the Health and Retirement Study (HRS), the Survey of Health, Ageing, and Retirement in Europe (SHARE), and the China Health and Retirement Longitudinal Study (CHARLS). The Cox proportional hazard model was applied to analyze the relationship between HGS and stroke and heart disease, and Harrell's C index was used to assess the predictive abilities of different HGS expressions. RESULTS A total of 4,407 participants suffered from stroke and 9,509 from heart disease during follow-up. Compared with the highest quartile, participants in the lowest quartile of dominant HGS, absolute HGS and relative HGS possessed a significantly higher risk of new-onset stroke in Europe, America, and China (all P < 0.05). After adding HGS to office-based risk factors, there were minimal or no differences in the increases of Harrell's C indexes among three HGS expressions. In contrast, the modest association between HGS and heart disease was only seen in SHARE and HRS, but not in CHARLS. CONCLUSION Our findings support that HGS can be used as an independent predictor of stroke in middle-aged and older European, American and Chinese populations, and the predictive ability of HGS may not depend on how it is expressed. The relationship between HGS and heart disease calls for further validation.
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Affiliation(s)
- Guochen Li
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 215123, Suzhou, P. R. China
| | - Yanqiang Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 215123, Suzhou, P. R. China
| | - Liping Shao
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 215123, Suzhou, P. R. China
| | - Luying Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 215123, Suzhou, P. R. China
| | - Yanan Qiao
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 215123, Suzhou, P. R. China
| | - Yi Ding
- Department of Preventive Medicine, College of Clinical Medicine, Suzhou Vocational Health College, 215009, Suzhou, P. R. China.
| | - Chaofu Ke
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 215123, Suzhou, P. R. China.
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15
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He P, Gan X, Ye Z, Liu M, Zhou C, Wu Q, Zhang Y, Yang S, Zhang Y, Qin X. Combined handgrip strength and walking pace, genetic susceptibility, and incident hypertension: A prospective study in UK Biobank. Scand J Med Sci Sports 2023; 33:989-999. [PMID: 36775263 DOI: 10.1111/sms.14336] [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: 09/16/2022] [Revised: 01/25/2023] [Accepted: 02/06/2023] [Indexed: 02/14/2023]
Abstract
INTRODUCTION We aimed to investigate the relations of handgrip strength, walking pace and the combination of handgrip strength and walking pace with incident hypertension, and to explore whether this association was modified by the genetic risk of hypertension. METHODS 214 214 participants without prior hypertension in the UK Biobank were included. Handgrip strength was assessed by dynamometer. Walking pace was self-defined as slow, average, or brisk. The study outcome was incident hypertension. A genetic risk score for hypertension was generated using a Bayesian approach applied to meta-analyzed summary statistics GWAS data. RESULTS Over a median follow-up of 11.9 years, 13 344 (6.2%) participants developed incident hypertension. When handgrip strength was assessed as sex-specific quartiles, compared with those with the lowest handgrip strength (quartile 1), the adjusted HRs (95% CI) of incident hypertension in quartile 2, quartile 3, and quartile 4 were 0.80 (0.69, 0.93), 0.74 (0.64, 0.86), and 0.72 (0.61, 0.84), respectively. Compared with those with slow walking pace, participants with average (HR, 0.52; 95% CI: 0.40, 0.67) or brisk (HR, 0.43; 95% CI: 0.32, 0.56) walking pace had significantly lower risks of hypertension. Moreover, compared with those with both lower handgrip strength (quartile 1) and slow walking pace, the lowest risk of incident hypertension was observed in participants with both high handgrip strength (quartiles 2-4) and fast (average or brisk) walking pace (HR, 0.36; 95% CI: 0.25, 0.52). Genetic risks of hypertension did not significantly modify the association (p-interaction = 0.300). CONCLUSION Both higher handgrip strength and faster walking pace were significantly associated with a lower risk of incident hypertension, independent of genetic risks of hypertension.
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Affiliation(s)
- Panpan He
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China
| | - Xiaoqin Gan
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China
| | - Ziliang Ye
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China
| | - Mengyi Liu
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China
| | - Chun Zhou
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China
| | - Qimeng Wu
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China
| | - Yanjun Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China
| | - Sisi Yang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China
| | - Yuanyuan Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China
| | - Xianhui Qin
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China
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Weng SC, Lin CF, Hsu CY, Lin SY. Effect of frailty, physical performance, and chronic kidney disease on mortality in older patients with diabetes : a retrospective longitudinal cohort study. Diabetol Metab Syndr 2023; 15:7. [PMID: 36650566 PMCID: PMC9843852 DOI: 10.1186/s13098-022-00972-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 12/24/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Declined renal function is associated with physical function impairment and frailty in a graded fashion. This study aimed to examine the relationship between renal function, frailty and physical performance with mortality in older patients with diabetes, while also determining their combined effects on patient outcome. METHODS A retrospective longitudinal study was conducted in elderly patients with diabetes. Kidney disease staging was based on clinical practice guidelines of the International Society of Nephrology, and chronic kiney disease (CKD) was defined as urinary albumin to creatinine ratio (UACR) > 30 mg/g, persistent reduction in estimated glomerular filtration rate (eGFR) below 60 mL/min per 1.73 m2 or both. The modified Rockwood frailty index (RFI) was composed of cumulative health deficits, and physical function was determined by handgrip strength (HGS). Additionally, a timed up and go (TUG) test was assessed at baseline. Kaplan-Meier survival and Cox proportional hazard analyses were used to analyze the association between CKD, frailty, physical function and mortality. RESULTS For the 921 enrolled patients, their mean age was 82.0 ± 6.7 years. After a median 2.92 (interquartile range [IQR] 1.06-4.43) year follow-up, the survival rate was 67.6% and 85.5% in patients with and without CKD, respectively. The mortality hazard ratio (crude HR) with CKD was 5.92 for those with an RFI higher than 0.313 (95% CI 3.44-10.18), 2.50 for a TUG time longer than 21 s (95% CI 1.22-5.13), and 2.67 for an HGS lower than 10.57 kg in females or 20.4 kg in males (95% CI 1.12-6.37). After multivariate adjustment, the mortality hazard ratio for an RFI ≥ 0.313 was 5.34 (95% CI 2.23-12.80) in CKD patients, but not in patients without CKD. In subgroup analysis, patients experiencing CKD and frailty, or physical function impairment, had the lowest survival proportion followed by only frailty/declined physical function, only CKD, without CKD, and non-frailty/non-physical impairment. CONCLUSION CKD, frailty and physical function impairment were all associated with an increased mortality risk in older patients with diabetes, while the combined effects of these 3 factors were seen on patient outcome.
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Affiliation(s)
- Shuo-Chun Weng
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Research Center for Geriatrics and Gerontology, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Center for Geriatrics and Gerontology, Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Institute of Clinical Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Cheng-Fu Lin
- Research Center for Geriatrics and Gerontology, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Center for Geriatrics and Gerontology, Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Institute of Clinical Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of Occupational Medicine, Department of Emergency, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chiann-Yi Hsu
- Biostatistics Task Force of Taichung Veterans General Hospital, Taichung, Taiwan
| | - Shih-Yi Lin
- Research Center for Geriatrics and Gerontology, College of Medicine, National Chung Hsing University, Taichung, Taiwan.
- Institute of Clinical Medicine, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Center for Geriatrics and Gerontology, Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
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17
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Hamrouni M, Roberts MJ, Bishop NC. High grip strength attenuates risk of severe COVID-19 in males but not females with obesity: A short communication of prospective findings from UK Biobank. Obes Res Clin Pract 2023; 17:82-85. [PMID: 36639298 PMCID: PMC9829605 DOI: 10.1016/j.orcp.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 01/04/2023] [Accepted: 01/06/2023] [Indexed: 01/11/2023]
Abstract
We examined the joint associations of BMI category and grip strength tertile with risk of severe COVID-19 (inpatient COVID-19 or COVID-19 mortality) in 327 500 UK Biobank participants. Compared to normal-weight males with high grip strength, the odds ratio (95 % confidence interval) for males with obesity with low grip strength was 2.39 (1.59-3.60), but 1.52 (0.98-2.35) for males with obesity with a high grip strength. A higher grip strength did not appear to be associated with lower risk of severe COVID-19 in females. Muscle mass and strength development should be considered as a means to reduce risk of severe COVID-19 for males with obesity.
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Affiliation(s)
- Malik Hamrouni
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Epinal Way, Loughborough LE11 3TU, UK.
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18
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Fernández-Rodríguez R, Monedero-Carrasco S, Bizzozero-Peroni B, Garrido-Miguel M, Mesas AE, Martínez-Vizcaíno V. Effectiveness of Resistance Exercise on Inflammatory Biomarkers in Patients with Type 2 Diabetes Mellitus: A Systematic Review with Meta-Analysis. Diabetes Metab J 2023; 47:118-134. [PMID: 35487508 PMCID: PMC9925155 DOI: 10.4093/dmj.2022.0007] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 02/10/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is related to increased inflammatory processes. The effects of resistance exercise on inflammatory biomarkers in T2DM are controversial. Our purpose was to determine the effectiveness of resistance exercise on inflammatory biomarkers in patients diagnosed with T2DM. METHODS We searched four databases until September 2021. We included randomized clinical trials (RCTs) of the effects of resistance exercise on inflammatory biomarkers (C-reactive protein [CRP], tumor necrosis factor alpha, interleukin-6, and interleukin-10) in patients with T2DM. A random effects meta-analysis was conducted to determine the standardized mean difference (SMD) and the raw mean difference (MD) for CRP. RESULTS Thirteen RCTs were included in the review, and 11 in the meta-analysis for CRP. Lower CRP levels were observed when resistance exercise was compared with the control groups (SMD=-0.20; 95% confidence interval [CI], -0.37 to -0.02). When conducting the MD meta-analysis, resistance exercise showed a significant decrease in CRP of -0.59 mg/dL (95% CI, -0.88 to -0.30); otherwise, in the control groups, the CRP values increased 0.19 mg/dL (95% CI, 0.17 to 0.21). CONCLUSION Evidence supports resistance exercise as an effective strategy to manage systemic inflammation by decreasing CRP levels in patients with T2DM. The evidence is still inconclusive for other inflammatory biomarkers.
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Affiliation(s)
| | | | - Bruno Bizzozero-Peroni
- University of Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- University of the Republic, Higher Institute of Physical Education, Rivera, Uruguay
| | - Miriam Garrido-Miguel
- University of Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- University of Castilla-La Mancha, Faculty of Nursing, Albacete, Spain
| | - Arthur Eumann Mesas
- University of Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- State University of Londrina, Health Science Center, Londrina, Brazil
- Corresponding author: Arthur Eumann Mesas https://orcid.org/0000-0002-0088-8607 Universidad de Castilla La-Mancha, Health and Social Research Center, Santa Teresa Jornet s/n, 16071 Cuenca, Spain E-mail:
| | - Vicente Martínez-Vizcaíno
- University of Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- University Autonomous of Chile, Faculty of Health Sciences, Talca, Chile
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19
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[Malnutrition management of hospitalized patients with diabetes/hyperglycemia and concurrent pathologies]. NUTR HOSP 2022; 39:1-8. [PMID: 36546334 DOI: 10.20960/nh.04505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Introduction Type 2 diabetes mellitus is a highly prevalent disease worldwide, generating an increasing clinical and economic burden due to its micro- and macrovascular complications. Frequently, people with diabetes are hospitalized for various pathologies. These patients generally have higher risk of complications, prolonged hospitalizations and mortality. An additional factor that worsens the prognosis in these patients is the concurrence of malnutrition, especially in elderly people. All this makes the management of these patients challenging and requires a specific nutritional approach, whose purpose is to cover the nutritional requirements while always maintaining glycemic control. The purpose of this work is to provide, based on the evidence available in the literature and clinical experience, consensus recommendations by eighteen experts in Endocrinology and Nutrition on the nutritional approach of hospitalized patients with diabetes/ hyperglycemia and compare the optimal management, based on these recommendations with bedside usual care according to a panel of Spanish doctors surveyed about their daily clinical practice. This first article of this extraordinary issue of the journal Nutrición Hospitalaria describes the methodology of the study and the results obtained regarding common issues for all pathologies.
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20
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Deng L, Wu Q, Ding F, Liu Y, Shen J, Lin Y, Shi K, Zeng B, Wu L, Tong H. The effect of telemedicine on secondary prevention of atherosclerotic cardiovascular disease: A systematic review and meta-analysis. Front Cardiovasc Med 2022; 9:1020744. [PMID: 36440018 PMCID: PMC9683074 DOI: 10.3389/fcvm.2022.1020744] [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: 09/02/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022] Open
Abstract
Aim The purpose of this systematic review was to evaluate the efficiency of telemedicine on the secondary level of prevention of patients with arteriosclerotic cardiovascular disease (ASCVD), provide evidence for the application of telemedicine in secondary prevention and promote the development of telemedicine in secondary prevention. Methods A computer-based search was conducted in MEDLINE, Embase, Pubmed, EBSCO, CINAHL, the Cochrane Library, and Web of Science. Randomized controlled trials regarding the effect of telemedicine on secondary prevention of ASCVD were included from inception to May, 2022. Meta-analysis was used to compare the results of the included studies by RevMan5.4 software. The Cochrane Collaboration bias risk tool was used to perform risk of bias assessment in this study. Outcomes included risk factors, physical activity and exercise, muscle function, exercise compliance, medication adherence, healthy diet, depression and anxiety, self-efficacy, knowledge score, economy, and safety endpoints. Subgroup analysis was carried out for different main intervention measures included in the literature. Results A total of 32 randomized clinical studies (n = 10 997 participants) were included in the meta-analysis. Compared with usual secondary prevention (USP) group, participants in telemedicine of secondary prevention (TOSP) group showed significant improvement in some risk factors including BMI (MD -0.87, p = 0.002), SBP (MD -4.09, p = 0.007) and DBP (MD -2.91, p = 0.0002) when they use the telephone as the intervention. In physical activity and exercise, Patients in TOSP showed an improvement in VO2 Peak (mL⋅kg-1⋅min-1) (OR 1.58, p = 0.02), 6MWT (MD 21.41, p = 0.001), GSLTPA score (MD 2.89, p = 0.005). Effects on medication adherence, exercise compliance, muscle function, healthy diet, economy and self-efficacy were synthesized narratively. Patients in TOSP did not show a reduction in knowledge score, depression, anxiety and safety endpoints. Conclusion There is a net benefit of secondary prevention supported by telemedicine (especially when using the telephone as an intervention) in patients with ASCVD in the terms of some risk factors, physical activity and exercise. There are still controversies in the improvement of medication adherence, exercise compliance, muscle function, healthy diet, knowledge score, self-efficacy and economy via telemedicine, which is worth exploring. Larger samples size and longer-term follow-ups are needed in future studies. Systematic review registration [https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=330478], identifier [CRD42022330478].
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Affiliation(s)
- Liangying Deng
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Nanjing Lishui District Hospital of Traditional Chinese Medicine, Nanjing, China
| | - Qing Wu
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Feng Ding
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Yanfeng Liu
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Jianping Shen
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yan Lin
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Kaihu Shi
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Bailin Zeng
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Lixing Wu
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Nanjing Lishui District Hospital of Traditional Chinese Medicine, Nanjing, China
| | - Huangjin Tong
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
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21
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Boonpor J, Parra-Soto S, Petermann-Rocha F, Ho FK, Celis-Morales C, Gray SR. Combined association of walking pace and grip strength with incident type 2 diabetes. Scand J Med Sci Sports 2022; 32:1356-1365. [PMID: 35612725 PMCID: PMC9544034 DOI: 10.1111/sms.14197] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 05/04/2022] [Accepted: 05/09/2022] [Indexed: 11/28/2022]
Abstract
The current study aims to investigate the combined association of walking pace and grip strength with incident type 2 diabetes (T2D). A total of 205 738 participants (mean age 56.6 ± 8.1 years, 115 139 [56.0%] women) without diagnosed or unknown diabetes at baseline from the UK Biobank study were included in this prospective study. Walking pace was self-reported as slow, average, or brisk. Grip strength was measured using a dynamometer and classified as weak, average, and strong. The combined association of walking pace and grip strength with incident T2D was investigated using Cox-proportional hazards models with a 2-year landmark analysis. The additive interaction was conducted by estimating relative excess risk due to interaction (RERI). After the median follow-up period of 5.4 years (interquartile range: 4.8-6.5), 5082 (2.5%) participants were diagnosed with T2D. Compared to brisk-strong individuals (reference group), people who were slow-weak had a higher risk of T2D (hazard ratio: 1.64 [95% CI, 1.42-1.89]) after adjusting for all covariates. There were dose-response gradients across both walking pace and grip strength variables. There was a modest amount of negative additive interaction (RERI; -0.06 [95% CI, -0.16; -0.01]. To conclude, slower pace and weaker grip strength were associated with a higher risk of developing T2D, independent of sociodemographics, lifestyle, and adiposity. Combining walking pace and grip strength might be a practical approach to screening people who are at increased risk of developing T2D.
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Affiliation(s)
- Jirapitcha Boonpor
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.,Faculty of Public Health, Chalermphrakiat Sakon Nakhon Province Campus, Kasetsart University, Sakon Nakhon, Thailand
| | - Solange Parra-Soto
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.,Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Fanny Petermann-Rocha
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.,Facultad de Medicina, Universidad Diego Portales, Santiago, Chile
| | - Frederick K Ho
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Carlos Celis-Morales
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.,Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca, Chile
| | - Stuart R Gray
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
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22
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Boonpor J, Ho FK, Gray SR, Celis-Morales CA. Association of Self-reported Walking Pace With Type 2 Diabetes Incidence in the UK Biobank Prospective Cohort Study. Mayo Clin Proc 2022; 97:1631-1640. [PMID: 36058577 DOI: 10.1016/j.mayocp.2022.02.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 01/20/2022] [Accepted: 02/24/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate the association between self-reported walking pace and type 2 diabetes (T2D) incidence and whether it differed by physical activity levels and walking time. METHODS There were 162,155 participants (mean age, 57.1 years; 54.9% women) from the UK Biobank prospective study, recruited between 2006 and 2010, included in the study. Walking pace was self-reported and classified as brisk, average, or slow. Total physical activity and walking time were self-reported using the International Physical Activity Questionnaire. Association between walking pace and T2D incidence and the potential moderating role of physical activity and walking time were investigated using Cox proportional hazards models. RESULTS The median follow-up was 7.4 (interquartile range, 6.7 to 8.2) years. There were 4442 participants in whom T2D developed during the follow-up period. In the fully adjusted model (sociodemographic factors, diet, body mass index, and physical activity), average walking pace (hazard ratio [HR], 1.28; 95% CI, 1.14 to 1.44) and slow walking pace (HR, 1.91; 95% CI, 1.62 to 2.24) were associated with a higher T2D risk compared with brisk walking among women. Among men, average walking pace (HR, 1.28; 95% CI, 1.17 to 1.40) and slow walking pace (HR, 1.73; 95% CI, 1.50 to 1.99) were also associated with higher T2D risk. Compared with slow walkers, brisk walkers have the same diabetes incidence rate 18.6 and 16.0 years later, for women and men, respectively. CONCLUSION Average and slow walking pace was associated with a higher risk of incident T2D in both men and women, independent of major confounding factors. The associations were consistent across different physical activity levels and walking time.
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Affiliation(s)
- Jirapitcha Boonpor
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Frederick K Ho
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Stuart R Gray
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Carlos A Celis-Morales
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom; Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca, Chile.
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23
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Alwafi H, Wong ICK, Naser AY, Banerjee A, Mongkhon P, Whittlesea C, Alsharif A, Wei L. Concurrent Use of Oral Anticoagulants and Sulfonylureas in Individuals With Type 2 Diabetes and Risk of Hypoglycemia: A UK Population-Based Cohort Study. Front Med (Lausanne) 2022; 9:893080. [PMID: 36082271 PMCID: PMC9445245 DOI: 10.3389/fmed.2022.893080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 06/15/2022] [Indexed: 11/19/2022] Open
Abstract
Objective To investigate the association of concurrent use of oral anticoagulants (OACs) and sulfonylureas and the risk of hypoglycemia in individuals with type 2 diabetes mellitus (T2DM). Research Design and Methods A retrospective cohort study was conducted between 2001 and 2017 using electronic primary healthcare data from the IQVIA Medical Research Data (IMRD) that incorporates data supplied by The Health Improvement Network (THIN), a propriety database of Cegedim SA. Individuals with T2DM who received OAC prescription and sulfonylureas were included. We compared the risk of hypoglycemia with sulfonylureas and OACs using propensity score matching and Cox regression. Results 109,040 individuals using warfarin and sulfonylureas and 77,296 using direct oral anticoagulants (DOACs) and sulfonylureas were identified and included. There were 285 hypoglycemia events in the warfarin with sulfonylureas group (incidence rate = 17.8 per 1,000 person-years), while in the sulfonylureas only, 304 hypoglycemia events were observed (incidence rate = 14.4 per 1,000 person-years). There were 14 hypoglycemic events in the DOACs with sulfonylureas group (incidence rates = 14.8 per 1,000 person-years), while in the sulfonylureas alone group, 60 hypoglycemia events were observed (incidence rate =23.7 per 1,000 person-years). Concurrent use of warfarin and sulfonylureas was associated with increased risk of hypoglycemia compared with sulfonylureas alone (HR 1.38; 95% CI 1.10-1.75). However, we found no evidence of an association between concurrent use of DOACs and sulfonylureas and risk of hypoglycemia (HR 0.54; 95% CI, 0.27-1.10) when compared with sulfonylureas only. Conclusions We provide real-world evidence of possible drug-drug interactions between warfarin and sulfonylureas. The decision to prescribe warfarin with coexistent sulfonylureas to individuals with T2DM should be carefully evaluated in the context of other risk factors of hypoglycemia, and availability of alternative medications.
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Affiliation(s)
- Hassan Alwafi
- Research Department of Practice and Policy, School of Pharmacy, University College London, London, United Kingdom
- Faculty of Medicine, Umm Al Qura University, Mecca, Saudi Arabia
| | - Ian C. K. Wong
- Research Department of Practice and Policy, School of Pharmacy, University College London, London, United Kingdom
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
- Department of Pharmacy, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China
- Laboratory of Data Discovery for Health, Hong Kong Science Park, Pak Shek Kok, Hong Kong SAR, China
- Centre for Medicines Optimisation Research and Education, University College London Hospitals National Health Service (NHS) Foundation Trust, London, United Kingdom
| | - Abdallah Y. Naser
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan
| | - Amitava Banerjee
- Institute of Health Informatics, University College London, London, United Kingdom
- Department of Cardiology, University College London Hospitals NHS Trust, London, United Kingdom
- Department of Cardiology, Barts Health NHS Trust, London, United Kingdom
| | - Pajaree Mongkhon
- Department of Pharmacy Practice, School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand
- Pharmacoepidemiology and Statistics Research Center (PESRC), Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand
| | - Cate Whittlesea
- Research Department of Practice and Policy, School of Pharmacy, University College London, London, United Kingdom
| | - Alaa Alsharif
- Research Department of Practice and Policy, School of Pharmacy, University College London, London, United Kingdom
| | - Li Wei
- Research Department of Practice and Policy, School of Pharmacy, University College London, London, United Kingdom
- Laboratory of Data Discovery for Health, Hong Kong Science Park, Pak Shek Kok, Hong Kong SAR, China
- Centre for Medicines Optimisation Research and Education, University College London Hospitals National Health Service (NHS) Foundation Trust, London, United Kingdom
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24
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Hiromine Y, Noso S, Rakugi H, Sugimoto K, Takata Y, Katsuya T, Fukuda M, Akasaka H, Osawa H, Tabara Y, Ikegami H. Poor glycemic control rather than types of diabetes is a risk factor for sarcopenia in diabetes mellitus: The MUSCLES-DM study. J Diabetes Investig 2022; 13:1881-1888. [PMID: 35796583 DOI: 10.1111/jdi.13882] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/21/2022] [Accepted: 07/05/2022] [Indexed: 11/28/2022] Open
Abstract
AIMS/INTRODUCTION poor glycemic control and insulin treatment are reported to be associated with sarcopenia in type 2 diabetes, type 1 diabetes may be a stronger risk for sarcopenia. We therefore studied the effect of the type of diabetes, glycemic control, and insulin therapy on the prevalence and characteristics of sarcopenia. MATERIALS AND METHODS A total of 812 Japanese patients with diabetes (type 1: n=57; type 2: n=755) were enrolled in this study. Sarcopenia was defined as low handgrip strength or slow gait speed and low appendicular skeletal muscle mass. RESULTS Among participants aged ≥65 years, the sarcopenia prevalence rate was higher among patients with type 1 diabetes (20.0%) than among those with type 2 diabetes (8.1%). The prevalence rate of low handgrip strength was higher in type 1 diabetes (50.0%) than in type 2 diabetes (28.7%). In logistic regression analysis, type 1 diabetes was significantly associated with the prevalence of low handgrip strength. In logistic regression analysis, medication with insulin was significantly associated with the prevalence of sarcopenia; this association was not retained after adjusting for HbA1c. CONCLUSIONS The prevalence of sarcopenia in older adult patients was higher in those with type 1 diabetes than in those with type 2 diabetes. Among the components of sarcopenia, the difference was most prominent in the frequency of low handgrip strength. Poor glycemic control rather than type of diabetes or insulin treatment was revealed to be a primary risk factor for sarcopenia in diabetes mellitus.
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Affiliation(s)
- Yoshihisa Hiromine
- Department of Endocrinology, Metabolism and Diabetes, Kindai University Faculty of Medicine, Osaka-sayama, Japan
| | - Shinsuke Noso
- Department of Endocrinology, Metabolism and Diabetes, Kindai University Faculty of Medicine, Osaka-sayama, Japan
| | - Hiromi Rakugi
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Ken Sugimoto
- Department of General and Geriatric Medicine, Kawasaki Medical University, Okayama, Okayama, Japan
| | - Yasunori Takata
- Department of Diabetes and Molecular Genetics, Ehime University Graduate School of Medicine, Toon, Japan
| | - Tomohiro Katsuya
- Katsuya Clinic, Amagasaki, Japan.,Department of Clinical Gene Therapy, Osaka University Graduate School of Medicine, Suita, Japan
| | | | - Hiroshi Akasaka
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Haruhiko Osawa
- Department of Diabetes and Molecular Genetics, Ehime University Graduate School of Medicine, Toon, Japan
| | - Yasuharu Tabara
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan
| | - Hiroshi Ikegami
- Department of Endocrinology, Metabolism and Diabetes, Kindai University Faculty of Medicine, Osaka-sayama, Japan
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25
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Lu Y, Li G, Ferrari P, Freisling H, Qiao Y, Wu L, Shao L, Ke C. Associations of handgrip strength with morbidity and all-cause mortality of cardiometabolic multimorbidity. BMC Med 2022; 20:191. [PMID: 35655218 PMCID: PMC9164350 DOI: 10.1186/s12916-022-02389-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 04/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cardiometabolic multimorbidity (CM) is an increasing public health and clinical concern. However, predictors for the development and prognosis of CM are poorly understood. The aims of this study were to investigate the relation between handgrip strength (HGS) and the risk of CM and to examine the association of HGS with all-cause mortality risk among patients with CM. METHODS This prospective cohort study involved 493,774 participants from the UK Biobank. CM was defined as the simultaneous occurrence of two or more of the following conditions: type 2 diabetes, stroke, and coronary heart disease (CHD). Cox proportional hazards models were performed to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs). RESULTS During a median follow-up of 12.1 years, 4701 incident CM cases were documented among participants with none cardiometabolic disease at baseline. Compared with the fourth quartile (Q4), the multivariable adjusted HR (95% CI) value of Q1 of HGS for developing CM was 1.46 (1.34-1.60). In participants with one cardiometabolic disease at baseline, participants in Q1 of HGS also possessed higher risk of CM than those in Q4, with HRs (95% CIs) being 1.35 (1.23-1.49) in patients with type 2 diabetes, 1.23 (1.04-1.46) in patients with stroke, and 1.23 (1.11-1.36) in patients with CHD. For participants with CM at recruitment, HGS was also associated with the risk of all-cause mortality (Q1 vs. Q4 HR: 1.57, 95% CI: 1.36-1.80). CONCLUSIONS Our study provided novel evidence that HGS could be an independent predictor of morbidity and all-cause mortality of CM.
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Affiliation(s)
- Yanqiang Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, People's Republic of China
| | - Guochen Li
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, People's Republic of China
| | - Pietro Ferrari
- Nutrition and Metabolism Branch, International Agency for Research On Cancer (IARC/WHO), Lyon, France
| | - Heinz Freisling
- Nutrition and Metabolism Branch, International Agency for Research On Cancer (IARC/WHO), Lyon, France
| | - Yanan Qiao
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, People's Republic of China
| | - Luying Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, People's Republic of China
| | - Liping Shao
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, People's Republic of China
| | - Chaofu Ke
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, People's Republic of China.
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Mazidi M, Davies IG, Penson P, Rikkonen T, Isanejad M. Lifetime serum concentration of 25-hydroxyvitamin D 25(OH) is associated with hand grip strengths: insight from a Mendelian randomisation. Age Ageing 2022; 51:6565794. [PMID: 35397158 PMCID: PMC9122526 DOI: 10.1093/ageing/afac079] [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: 07/29/2021] [Indexed: 11/26/2022] Open
Abstract
Clinical trials have suggested that increased 25-hydroxyvitamin D (25(OH)D) has positive effect on hand grip strength. This Mendelian randomisation (MR) was implemented using summary-level data from the largest genome-wide association studies on vitamin D (n = 73,699) and hand grip strength. Inverse variance weighted method (IVW) was used to estimate the causal estimates. Weighted median (WM)-based method, MR-Egger and leave-one-out were applied as sensitivity analysis. Results showed that genetically higher-serum 25(OH)D levels had a positive effect on both right hand grip (IVW = Beta: 0.038, P = 0.030) and left hand grip (IVW = Beta: 0.034, P = 0.036). There was a low likelihood (statistically insignificant) of heterogeneity and pleiotropy, and the observed associations were not driven by single single-nucleotide polymorphisms. Furthermore, MR pleiotropy residual sum and outlier did not highlight any outliers. In conclusion, our results highlighted the causal and beneficial effect of serum 25(OH) D on right- and left-hand grip strengths.
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Affiliation(s)
- Mohsen Mazidi
- King’s College London, Department of Twin Research & Genetic Epidemiology, South Wing St Thomas', London, UK
| | - Ian G Davies
- School of Sports and Exercise Sciences, Faculty of Science, Liverpool John Moores University, Liverpool L3 3AF, UK
| | - Peter Penson
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK
| | - Toni Rikkonen
- Institute of Life Course and Medical Sciences, Department of Musculoskeletal and Ageing Sciences, University of Liverpool, Liverpool L7 8TX, UK
| | - Masoud Isanejad
- Institute of Life Course and Medical Sciences, Department of Musculoskeletal and Ageing Sciences, University of Liverpool, Liverpool L7 8TX, UK
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Xiao-dong Z, Shao-zhao Z, Xun H, Xin-xue L, Li-zhen L. Association of Residential Proximity to the Coast With Incident Myocardial Infarction: A Prospective Cohort Study. Front Cardiovasc Med 2022; 9:752964. [PMID: 35252375 PMCID: PMC8891518 DOI: 10.3389/fcvm.2022.752964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 01/10/2022] [Indexed: 12/02/2022] Open
Abstract
Background Little is known about how the residential distance to the coast is associated with incident myocardial infarction (MI) and which mechanisms may explain the association. We aim to explore this association using data from a prospective, population-based cohort with unprecedented sample size, and broad geographical coverage. Methods In this study, 377,340 participants from the UK Biobank were included. Results It was shown that 4,059 MI occurred during a median 8.0 years follow-up. Using group (<1 km) as reference, group (20–50 km) was associated with a lower risk of MI (hazard ratio, HR 0.79, 95% CI 0.64–0.98) and a U-shaped relation between distance to the coast and MI was shown with the low-risk interval between 32 and 64 km (pnon−linear = 0.0012). Using participants of the intermediate region (32–64 km) as a reference, participants of the offshore region (<32 km) and inland region (>64 km) were both associated with a higher risk of incident MI (HR 1.12, 95% CI 1.04–1.21 and HR 1.09, 95% CI 1.01–1.18, respectively). HR for offshore region (<32 km) was larger in subgroup with low total physical activity (<24 h/week) (HR 1.24, 95% CI 1.09–1.42, pinteraction = 0.043). HR for inland region (>64 km) was larger in subgroup in urban area (HR 1.12, 95% CI 1.03–1.22, pinteraction = 0.065) and in subgroup of high nitrogen dioxide (NO2) air pollution (HR 1.29, 95% CI 1.11–1.50, pinteraction = 0.021). Conclusion We found a U-shaped association between residential distance to the coast and incident MI, and the association was modified by physical activity, population density, and air pollution.
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Alkhayl FFA, Ismail AD, Celis-Morales C, Wilson J, Radjenovic A, Johnston L, Welsh P, Sattar N, Gill JMR, Preston T, Gray SR. Muscle protein synthesis and muscle/metabolic responses to resistance exercise training in South Asian and White European men. Sci Rep 2022; 12:2469. [PMID: 35169204 PMCID: PMC8847359 DOI: 10.1038/s41598-022-06446-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 01/14/2022] [Indexed: 11/08/2022] Open
Abstract
The aims of the current study, therefore, were to compare (1) free-living MPS and (2) muscle and metabolic adaptations to resistance exercise in South Asian and white European adults. Eighteen South Asian and 16 White European men were enrolled in the study. Free-living muscle protein synthesis was measured at baseline. Muscle strength, body composition, resting metabolic rate, VO2max and metabolic responses (insulin sensitivity) to a mixed meal were measured at baseline and following 12 weeks of resistance exercise training. Free-living muscle protein synthesis was not different between South Asians (1.48 ± 0.09%/day) and White Europeans (1.59 ± 0.15%/day) (p = 0.522). In response to resistance exercise training there were no differences, between South Asians and White Europeans, muscle mass, lower body strength or insulin sensitivity. However, there were differences between the ethnicities in response to resistance exercise training in body fat, resting carbohydrate and fat metabolism, blood pressure, VO2max and upper body strength with responses less favourable in South Asians. In this exploratory study there were no differences in muscle protein synthesis or anabolic and metabolic responses to resistance exercise, yet there were less favourable responses in several outcomes. These findings require further investigation.
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Affiliation(s)
- Faris F Aba Alkhayl
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8TA, UK
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah, Saudi Arabia
| | - Ahmad D Ismail
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8TA, UK
- Faculty of Sports Science and Recreation, Universiti Teknologi MARA, Perlis Branch, Arau, Malaysia
| | - Carlos Celis-Morales
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | - John Wilson
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | - Aleksandra Radjenovic
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | | | - Paul Welsh
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | - Naveed Sattar
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | - Jason M R Gill
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | - Tom Preston
- Scottish Universities Environmental Research Centre, University of Glasgow, Glasgow, UK
| | - Stuart R Gray
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8TA, UK.
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Sánchez-Borrego R. A strong handshake! Do not forget to measure grip strength in menopause: a simple way to predict general frailty/impairment. Menopause 2021; 29:3-5. [PMID: 34873107 DOI: 10.1097/gme.0000000000001904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Park S, Kim SH, Shin JY. Combined association of skeletal muscle mass and grip strength with cardiovascular diseases in patients with type 2 diabetes. J Diabetes 2021; 13:1015-1024. [PMID: 34288415 DOI: 10.1111/1753-0407.13216] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 07/05/2021] [Accepted: 07/16/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Appendicular skeletal muscle mass (ASM) and grip strength (GS) have been suggested to be related to cardiovascular diseases (CVDs), but their association with type 2 diabetes (T2D) remains unclear. Therefore, we examined the combined association of ASM and GS with the prevalence of CVD in patients with T2D. METHODS A total of 1230 patients with T2D were recruited and divided into four groups based on the sex-specific median values of ASM adjusted for body mass index (ASM/BMI; short: SM) and GS: high SM/high GS (HSM/HGS), high SM/low GS (HSM/LGS), low SM/high GS (LSM/HGS), and low SM/low GS (LSM/LGS). RESULTS The LSM/LGS group was older and had higher values of systolic blood pressure, homeostasis model assessment of insulin resistance, waist circumference, and C-reactive protein but lower high-density lipoprotein cholesterol concentrations than the HSM/HGS group. After adjusting for potential confounders, the odds ratios (ORs) and 95% CIs for CVD, coronary heart disease (CHD), ischemic stroke, and peripheral arterial disease (PAD) in the LSM/LGS group were 2.90 (1.89-4.47), 2.39 (1.46-3.92), 1.77 (0.84-3.71), and 5.83 (1.58-21.48), respectively. After adjusting for variable confounders among patients with higher glycosylated hemoglobin (HbA1c) (≥7.1%), the ORs and 95% CIs for CVD and CHD in the LSM/LGS group were 7.27 (3.37-15.67) and 6.17 (2.65-14.37), respectively. CONCLUSIONS The combination of low SM and GS was strongly associated with CVD, CHD, and PAD in patients with T2D, especially in those with higher HbA1c levels.
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Affiliation(s)
- Sunmin Park
- Department of Food & Nutrition, Hoseo University, Asan, Republic of Korea
| | - Sung-Hoon Kim
- Department of Internal Medicine, MizMedi Hospital, Seoul, Republic of Korea
| | - Jang Yel Shin
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea
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Liu W, Leong DP, Hu B, AhTse L, Rangarajan S, Wang Y, Wang C, Lu F, Li Y, Yusuf S, Liu L, Li W. The association of grip strength with cardiovascular diseases and all-cause mortality in people with hypertension: Findings from the Prospective Urban Rural Epidemiology China Study. JOURNAL OF SPORT AND HEALTH SCIENCE 2021; 10:629-636. [PMID: 33091627 PMCID: PMC8724607 DOI: 10.1016/j.jshs.2020.10.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 08/15/2020] [Accepted: 09/14/2020] [Indexed: 05/04/2023]
Abstract
BACKGROUND Both hypertension and grip strength (GS) are predictors of mortality and cardiovascular disease (CVD), but whether these risk factors interact to affect CVD and all-cause mortality is unknown. This study sought to investigate the associations of GS with the risk of major CVD incidence, CVD mortality, and all-cause mortality in patients with hypertension. METHODS GS was measured using a Jamar dynamometer (Sammons Preston, Bolingbrook, IL, USA) in participants aged 35-70 years from 12 provinces included in the Prospective Urban Rural Epidemiology China Study. Cox frailty proportional hazards models were used to examine the associations of GS and hypertension and the outcomes of all-cause mortality and CVD incidence/mortality. RESULTS Among 39,862 participants included in this study, 15,964 reported having hypertension, and 9095 had high GS at baseline. After a median follow-up of 8.9 years (interquartile range, 6.7-9.9 years), 1822 participants developed major CVD, and 1250 deaths occurred (388 as a result of CVD). Compared with normotensive participants with high GS, hypertensive patients with high GS had a higher risk of major CVD incidence (hazard ratio (HR) = 2.39; 95% confidence interval (95%CI): 1.86-3.06; p < 0.001) or CVD mortality (HR = 3.11; 95%CI: 1.59-6.06; p < 0.001) but did not have a significantly increased risk of all-cause mortality (HR = 1.24; 95%CI: 0.92-1.68; p = 0.159). These risks were further increased if hypertensive participants whose GS level was low (major CVD incidence, HR = 3.31, 95%CI: 2.60-4.22, p < 0.001; CVD mortality, HR = 4.99, 95%CI: 2.64-9.43, p < 0.001; and all-cause mortality, HR = 1.93, 95%CI: 1.47-2.53, p < 0.001). CONCLUSION The present study demonstrates that low GS is associated with the highest risk of major CVD incidence, CVD mortality, and all-cause mortality among hypertensive patients. High levels of GS appear to mitigate long-term mortality risk among hypertensive patients.
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Affiliation(s)
- Weida Liu
- Medical Research & Biometrics Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 102300, China
| | - Darryl P Leong
- The Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, L8S4L8, Canada
| | - Bo Hu
- Medical Research & Biometrics Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 102300, China
| | - Lap AhTse
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Sumathy Rangarajan
- The Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, L8S4L8, Canada
| | - Yang Wang
- Medical Research & Biometrics Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 102300, China
| | - Chuangshi Wang
- Medical Research & Biometrics Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 102300, China
| | - Fanghong Lu
- Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan 250002, China
| | - Yindong Li
- Shunyi Center for Disease Control and Prevention, Beijing 101300, China
| | - Salim Yusuf
- The Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, L8S4L8, Canada
| | - Lisheng Liu
- Medical Research & Biometrics Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 102300, China
| | - Wei Li
- Medical Research & Biometrics Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 102300, China.
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Choi H, Sung H, Kim GH, Lee O, Moon HY, Kim YS. Associations between Grip Strength and Glycemic Control in Type 2 Diabetes Mellitus: the 2014-2019 Korea National Health and Nutrition Examination Survey. Epidemiol Health 2021; 43:e2021080. [PMID: 34645204 PMCID: PMC8859497 DOI: 10.4178/epih.e2021080] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/08/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Glycemic control is essential for preventing severe complications in patients with diabetes mellitus. This study investigated the association between grip strength and glycemic control in Korean adults with type 2 diabetes mellitus. METHODS From the Korea National Health and Nutrition Examination Survey, 2,498 participants aged over 19 years that patients with diabetes mellitus who did not have a history of cardiovascular disease or cancer were selected for analysis. Grip strength was assessed using a handheld dynamometer and was represented as age-specific and sex-specific tertiles. Multivariable logistic regression was performed to calculate the odds ratio (OR) and 95% confidence interval (CI) of glycemic control according to the grip strength tertiles. RESULTS A significantly lower probability (OR, 0.67; 95% CI, 0.47 to 0.97) for glycemic control was found in the lowest tertile of grip strength compared to the highest tertile. Furthermore, a subgroup analysis by sex only found significant associations between grip strength and glycemic control in males. CONCLUSIONS Lower grip strength was associated with poor glycemic control in patients with diabetes mellitus, especially in males. However, further studies are needed to confirm the causal relationship between grip strength and glycemic control.
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Affiliation(s)
- Harim Choi
- Department of Physical Education, College of Education, Seoul National University, Seoul, Korea
| | - Hoyong Sung
- Department of Physical Education, College of Education, Seoul National University, Seoul, Korea
| | - Geon Hui Kim
- Department of Physical Education, College of Education, Seoul National University, Seoul, Korea
| | - On Lee
- Korea Institute of Sport Science, Seoul, Korea
| | - Hyo Youl Moon
- Department of Physical Education, College of Education, Seoul National University, Seoul, Korea.,Institute of Sports Science, Seoul National University, Seoul, Korea
| | - Yeon Soo Kim
- Department of Physical Education, College of Education, Seoul National University, Seoul, Korea.,Institute of Sports Science, Seoul National University, Seoul, Korea
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Liu W, Chen R, Song C, Wang C, Chen G, Hao J, Wang Y, Yu C. A Prospective Study of Grip Strength Trajectories and Incident Cardiovascular Disease. Front Cardiovasc Med 2021; 8:705831. [PMID: 34604349 PMCID: PMC8481887 DOI: 10.3389/fcvm.2021.705831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 07/26/2021] [Indexed: 11/13/2022] Open
Abstract
Background: A single measurement of grip strength (GS) could predict the incidence of cardiovascular disease (CVD). However, the long-term pattern of GS and its association with incident CVD are rarely studied. We aimed to characterize the GS trajectory and determine its association with the incidence of CVD (myocardial infarction, angina, stroke, and heart failure). Methods: This study included 5,300 individuals without CVD from a British community-based cohort in 2012 (the baseline). GS was repeatedly measured in 2004, 2008, and 2012. Long-term GS patterns were identified by the group-based trajectory model. Cox proportional hazard models were used to examine the associations between GS trajectories and incident CVD. We identified three GS trajectories separately for men and women based on the 2012 GS measurement and change patterns during 2004-2012. Results: After a median follow-up of 6.1 years (during 2012-2019), 392 participants developed major CVD, including 114 myocardial infarction, 119 angina, 169 stroke, and 44 heart failure. Compared with the high stable group, participants with low stable GS was associated with a higher incidence of CVD incidence [hazards ratio (HR): 2.17; 95% confidence interval (CI): 1.52-3.09; P <0.001], myocardial infarction (HR: 2.01; 95% CI: 1.05-3.83; P = 0.035), stroke (HR: 1.96; 95% CI: 1.11-3.46; P = 0.020), and heart failure (HR: 6.91; 95% CI: 2.01-23.79; P = 0.002) in the fully adjusted models. Conclusions: The low GS trajectory pattern was associated with a higher risk of CVD. Continuous monitoring of GS values could help identify people at risk of CVD.
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Affiliation(s)
- Weida Liu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Runzhen Chen
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Chenxi Song
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Chuangshi Wang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Ge Chen
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Jun Hao
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Yang Wang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Chenxi Yu
- Department of Joint Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.,Orthopaedic Research Laboratory, Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
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Tiainen K, Raitanen J, Strandberg T, Koskinen S, Stenholm S. Type 2 Diabetes as a Predictor of Muscle Strength Decline over 11 years among Men and Women Aged 55 Years and Older. Gerontology 2021; 68:635-643. [PMID: 34818235 DOI: 10.1159/000518268] [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: 12/17/2020] [Accepted: 07/04/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Long-term associations between type 2 diabetes, prediabetes, and muscle strength are obscure in older adults. The aim of this study was to examine type 2 diabetes as a predictor of handgrip strength decline during an 11-year follow-up among men and women aged 55 years. METHODS We used Finnish population-based Health 2000 Survey and its follow-up measurements in 2011. The study population consisted of 1,200 individuals, aged 55-86 years at baseline. Baseline fasting glucose level or use of diabetes medication was used to categorize the participants into diabetes (≥7.0 mmol/L), prediabetes (≥6.1 mmol/L but <7.0 mmol/L), and nondiabetes (<6.1 mmol/L) groups. Handgrip strength was measured at baseline and during 11-year follow-up. RESULTS Mean handgrip strength at baseline did not differ between diabetes groups in men or women. Among men during the 11-year follow-up, decline in muscle strength was significantly greater among diabetes group (-131.5 Newtons [N], 95% confidence interval (CI) -182.7 to -80.4) than nondiabetes group (-98.9 N, 95% CI -139.5 to -58.3) after adjusting for age, education, lifestyle factors, chronic conditions, and diabetes status at follow-up. Among women, muscle strength decline did not differ between diabetes, prediabetes, or nondiabetes groups after adjusting for all potential covariates, the results being -45.0 N (95% CI -73.2 to -16.7), -29.4 N (95% CI -59.7 to 0.9), and -42.3 N (95% CI -70.5 to -14.1), respectively. CONCLUSIONS The presence of type 2 diabetes was associated with greater muscle strength decline among older men but not among older women.
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Affiliation(s)
- Kristina Tiainen
- Faculty of Social Sciences, Unit of Health Sciences and Gerontology Research Center, Tampere University, Tampere, Finland
| | - Jani Raitanen
- Faculty of Social Sciences, Unit of Health Sciences and Gerontology Research Center, Tampere University, Tampere, Finland.,UKK Institute for Health Promotion Research, Tampere, Finland
| | - Timo Strandberg
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Clinicum, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Seppo Koskinen
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Sari Stenholm
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
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Visseren FLJ, Mach F, Smulders YM, Carballo D, Koskinas KC, Bäck M, Benetos A, Biffi A, Boavida JM, Capodanno D, Cosyns B, Crawford C, Davos CH, Desormais I, Di Angelantonio E, Franco OH, Halvorsen S, Hobbs FDR, Hollander M, Jankowska EA, Michal M, Sacco S, Sattar N, Tokgozoglu L, Tonstad S, Tsioufis KP, van Dis I, van Gelder IC, Wanner C, Williams B. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur J Prev Cardiol 2021; 29:5-115. [PMID: 34558602 DOI: 10.1093/eurjpc/zwab154] [Citation(s) in RCA: 211] [Impact Index Per Article: 70.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | | | | | | | | | | | | | - Alessandro Biffi
- European Federation of Sports Medicine Association (EFSMA).,International Federation of Sport Medicine (FIMS)
| | | | | | | | | | | | | | | | | | | | - F D Richard Hobbs
- World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA) - Europe
| | | | | | | | | | | | | | | | | | | | | | - Christoph Wanner
- European Renal Association - European Dialysis and Transplant Association (ERA-EDTA)
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Visseren FLJ, Mach F, Smulders YM, Carballo D, Koskinas KC, Bäck M, Benetos A, Biffi A, Boavida JM, Capodanno D, Cosyns B, Crawford C, Davos CH, Desormais I, Di Angelantonio E, Franco OH, Halvorsen S, Hobbs FDR, Hollander M, Jankowska EA, Michal M, Sacco S, Sattar N, Tokgozoglu L, Tonstad S, Tsioufis KP, van Dis I, van Gelder IC, Wanner C, Williams B. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J 2021; 42:3227-3337. [PMID: 34458905 DOI: 10.1093/eurheartj/ehab484] [Citation(s) in RCA: 2443] [Impact Index Per Article: 814.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | - Alessandro Biffi
- European Federation of Sports Medicine Association (EFSMA)
- International Federation of Sport Medicine (FIMS)
| | | | | | | | | | | | | | | | | | | | - F D Richard Hobbs
- World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA) - Europe
| | | | | | | | | | | | | | | | | | | | | | - Christoph Wanner
- European Renal Association - European Dialysis and Transplant Association (ERA-EDTA)
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Hamasaki H. What can hand grip strength tell us about type 2 diabetes?: mortality, morbidities and risk of diabetes. Expert Rev Endocrinol Metab 2021; 16:237-250. [PMID: 34402694 DOI: 10.1080/17446651.2021.1967743] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 08/02/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Hand grip strength (HGS) has been determined as a simple and cost effective method for evaluating overall skeletal muscle strength and quality. It has been used in numerous clinical studies to examine the association between skeletal muscle and type 2 diabetes (T2D). Previous studies have shown that HGS is significantly associated with mortality and cardiovascular disease (CVD) in patients with T2D. As the prevalence of T2D has seen a steady increase globally, HGS measurement can be useful and essential in managing T2D. AREAS COVERED This narrative review summarizes the current evidence regarding the association between HGS and T2D. HGS has been considered a useful tool for identifying risks for T2D, CVD, and mortality and evaluating skeletal muscle strength and quality. OPINION HGS should be measured in all patients with T2D together with height, weight, and waist circumference. However, there is yet no standard method used in measuring for HGS. T2D patients with a low HGS can engage in resistance training more effectively with appropriate advice based on HGS. Future studies clarifying the genetic association between skeletal muscle and T2D are needed to provide individualized exercise therapy.
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Boonpor J, Parra-Soto S, Petermann-Rocha F, Ferrari G, Welsh P, Pell JP, Sattar N, Gill JMR, Ho FK, Gray SR, Celis-Morales C. Associations between grip strength and incident type 2 diabetes: findings from the UK Biobank prospective cohort study. BMJ Open Diabetes Res Care 2021; 9:9/1/e001865. [PMID: 34353878 PMCID: PMC8344322 DOI: 10.1136/bmjdrc-2020-001865] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 01/24/2021] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Grip strength has been associated with chronic diseases and mortality. However, current evidence of the association between grip strength and incident type 2 diabetes mellitus (T2DM) is controversial. The aim of this study was to investigate the associations of absolute and relative grip strength with incident T2DM and whether these associations differ by sociodemographic, lifestyle and adiposity-related factors. RESEARCH DESIGN AND METHODS This was a prospective cohort study of 166 894 participants in the UK Biobank (mean age 56.5 years, 54.4% women). The outcome was T2DM incidence and the exposure was grip strength, expressed in absolute (kg) and relative (kg per kg of body weight) values. The association between grip strength and T2DM incidence was investigated using Cox-proportional regression. RESULTS The median follow-up was 5.3 years (IQR: 4.7-6.1). During this time, 3713 participants developed T2DM. Lower grip strength was associated with a higher risk of T2DM in both sexes. Those in the lowest quintile of absolute grip strength had a 50% higher risk in men (HR: 1.50 (95% CI: 1.30 to 1.73)) and 25% higher risk in women (HR: 1.25 (95% CI: 1.06 to 1.47)) compared with those in the highest quintile. For relative grip strength, risk of diabetes was more than double for men (HR: 2.22 (95% CI: 1.84 to 2.67)) and 96% higher for women (HR: 1.96 (95% CI: 1.52 to 2.53)) in the lowest compared with highest quintiles. CONCLUSIONS Grip strength is associated with a higher risk of T2DM incidence in both men and women independent of important confounding factors including age, deprivation, adiposity and lifestyle. However, the associations were stronger when grip strength is expressed relative to body weight, which could reflect the importance of muscle quality.
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Affiliation(s)
- Jirapitcha Boonpor
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Solange Parra-Soto
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Fanny Petermann-Rocha
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Gerson Ferrari
- Sciences of Physical Activity, Sports and Health School, University of Santiago Chile, Santiago, Chile
| | - Paul Welsh
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Jill P Pell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | | | - Frederick K Ho
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Stuart Robert Gray
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Carlos Celis-Morales
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
- Education, Physical Activity and Health Research Unit (GEEAFyS), Department of Physical Activity, Universidad Catolica del Maule, Talca, Chile
- Center for Exercise Physiology Research (CIFE), Universidad Mayor, Santiago, Chile
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Lin MH, Chang CY, Wu DM, Lu CH, Kuo CC, Chu NF. Relationship of Multimorbidity, Obesity Status, and Grip Strength among Older Adults in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147540. [PMID: 34299990 PMCID: PMC8307394 DOI: 10.3390/ijerph18147540] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 07/09/2021] [Accepted: 07/13/2021] [Indexed: 01/16/2023]
Abstract
Background: The combination of multiple disease statuses, muscle weakness, and sarcopenia among older adults is an important public health concern, and a health burden worldwide. This study evaluates the association between chronic disease statuses, obesity, and grip strength (GS) among older adults in Taiwan. Methods: A community-based survey was conducted every 3 years among older adults over age 65, living in Chiayi County, Taiwan. Demographic data and several diseases statuses, such as diabetes mellitus, hypertension, cerebrovascular disease, cardiovascular disease, and certain cancers, were collected using a questionnaire. Anthropometric characteristics were measured using standard methods. Grip strength was measured using a digital dynamometer (TKK5101) method. Results: A total of 3739 older individuals were recruited (1600 males and 2139 females) with the mean age of 72.9 years. The mean GS was 32.8 ± 7.1 kg for males and 21.6 ± 4.8 kg for females. GS significantly decreased most in males with cerebrovascular disease (from 33.0—29.5 kg, p < 0.001) and in females with diabetes mellitus (from 21.8—21.0 kg, p < 0.01). GS was highest in older adults with obesity (body mass index ≥ 27 kg/m2); however, there was no significant change of GS as the disease number increased. Conclusion: Older adults who have two, rather than one or greater than three chronic diseases, have significantly lower GSs than those who are healthy. Stroke and CKD for males, and hypertension and diabetes for females, are important chronic diseases that are significantly associated with GS. Furthermore, being overweight may be a protective factor for GS in older adults of both sexes.
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Affiliation(s)
- Ming-Hsun Lin
- National Defense Medical Center, Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, Taipei 114, Taiwan; (M.-H.L.); (C.-Y.C.); (C.-H.L.)
| | - Chun-Yung Chang
- National Defense Medical Center, Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, Taipei 114, Taiwan; (M.-H.L.); (C.-Y.C.); (C.-H.L.)
- Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung City 802, Taiwan
| | - Der-Min Wu
- National Defense Medical Center, School of Public Health, Taipei 114, Taiwan;
| | - Chieh-Hua Lu
- National Defense Medical Center, Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, Taipei 114, Taiwan; (M.-H.L.); (C.-Y.C.); (C.-H.L.)
| | - Che-Chun Kuo
- Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taoyuan City 325, Taiwan;
| | - Nain-Feng Chu
- National Defense Medical Center, School of Public Health, Taipei 114, Taiwan;
- Department of Internal Medicine, Tri-Service General Hospital, Taipei 114, Taiwan
- Correspondence: or ; Tel.: +886-2-8791-0506; Fax: +886-2-8792-0590
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Wen Y, Liao J, Yin Y, Liu C, Gong R, Wu D. Risk of falls in 4 years of follow-up among Chinese adults with diabetes: findings from the China Health and Retirement Longitudinal Study. BMJ Open 2021; 11:e043349. [PMID: 34103310 PMCID: PMC8190046 DOI: 10.1136/bmjopen-2020-043349] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES This study was to determine the incidence of falls and identify baseline factors increased risk for incident falls over time among people with diabetes. DESIGN This study was a secondary analysis using the baseline and 4 years of follow-up data from the China Health and Retirement Longitudinal Study (CHARLS). SETTING A nationally representative survey of 17 500 Chinese residents aged 45 years and older were recruited in the baseline national survey in 2011. These participants were followed up every 2 years. PARTICIPANTS A total of 1238 middle-aged and older adults with diabetes and no history of falls at baseline were included in the current study. PRIMARY AND SECONDARY OUTCOME MEASURES Information on incidence of falls and medical treatment resulting from falls were determined by self-report. RESULTS The findings showed that the incidence of falls was 29.4% during 4 years of follow-up. Participants with incident falls were younger, were more likely to be women, had lower education level and were less likely to be current drinkers. In addition, former drinkers were 2.22 times more likely to fall. Socially active individuals were 47% less likely to fall compared with those without social activities. Every 5 kg increase in grip strength was associated with a 13% lower risk of falls. A 10 mg/dL higher total cholesterol and 1 mg/dL higher blood urea nitrogen were associated with a 4% and 6% higher risk of falls. Finally, participants with depressive symptoms were 1.47 times more likely to fall compared with those without depressive symptoms. CONCLUSIONS These findings underscore the importance of developing a fall prevention programme for those with diabetes, and this programme should address potentially modifiable risk factors, including levels of total cholesterol, blood urea nitrogen, social activity, depressive symptoms and grip strength.
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Affiliation(s)
- Yue Wen
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Liao
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yiqiong Yin
- Gastrointestinal Department, West China Hospital, Sichuan University, Chengdu, China
| | - Chunjuan Liu
- West China School of Nursing, Sichuan University/ West China Hospital, Sichuan University, Chengdu, China
| | - Renrong Gong
- Department of Surgery, West China Hospital, Sichuan University/ Department of Surgery, West China School of Nursing, Sichuan University /Nursing Key Laboratory of Sichuan Province, Chengdu, China
| | - Dongmei Wu
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
- Department of Nursing, The Fourth People's Hospital of Chengdu & Chengdu Mental Health Center, Chengdu, China
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Chung SM, Moon JS, Chang MC. Prevalence of Sarcopenia and Its Association With Diabetes: A Meta-Analysis of Community-Dwelling Asian Population. Front Med (Lausanne) 2021; 8:681232. [PMID: 34095184 PMCID: PMC8174659 DOI: 10.3389/fmed.2021.681232] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 04/27/2021] [Indexed: 12/25/2022] Open
Abstract
Purpose: Sarcopenia is a major disease affecting mortality and quality of life in the elderly population. We performed a meta-analysis of studies on the community-dwelling population to investigate the prevalence of sarcopenia and its association with diabetes. Methods: Databases were searched for studies published up to February 3, 2021, reporting the prevalence of sarcopenia in patients with and without diabetes. Data extraction and quality assessment were performed according to the Newcastle-Ottawa scale. Results: Six articles were included in the systematic review. All the patients were Asian, aged ≥60 years (women 53.4%), and the diabetic and non-diabetic population was 1,537 and 5,485, respectively. In all six studies, the Asian Working Group for Sarcopenia criteria were used to diagnose sarcopenia. The prevalence of sarcopenia was 15.9% in diabetics and 10.8% in non-diabetics. Diabetics showed a significantly higher risk of sarcopenia than non-diabetics (pooled OR = 1.518, 95% CI = 1.110 to 2.076, Z-value = 2.611, p = 0.009). Conclusion: Among the Asian community-dwelling geriatric population, the prevalence of sarcopenia was significantly higher in diabetics than in non-diabetics. These results suggest that strategies for the management of sarcopenia are required in Asian elderly patients, especially with diabetes.
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Affiliation(s)
- Seung Min Chung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeungnam University, Daegu, South Korea
| | - Jun Sung Moon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeungnam University, Daegu, South Korea
| | - Min Cheol Chang
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu, South Korea
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Kandola AA, Osborn DPJ. Physical activity as an intervention in severe mental illness. BJPSYCH ADVANCES 2021. [DOI: 10.1192/bja.2021.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARYPhysical activity is a modifiable risk factor for several physical and mental health conditions. It is well established that people with severe mental illness have increased risk of physical health complications, particularly cardiovascular disease. They are also more likely to be physically inactive, contributing to the elevated cardiovascular and metabolic risks, which are further compounded by antipsychotic medication use. Interventions involving physical activity are a relatively low risk and accessible way of reducing physical health problems and weight in people with severe mental illness. They also have wider benefits for mental health symptoms and quality of life. However, many barriers still exist to the widespread implementation of physical activity interventions in the treatment of severe mental illness. A more concerted effort is needed to facilitate their translation into routine practice and to increase adherence to activity interventions.
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Sable‐Morita S, Tanikawa T, Satake S, Okura M, Tokuda H, Arai H. Microvascular complications and frailty can predict adverse outcomes in older patients with diabetes. Geriatr Gerontol Int 2021; 21:359-363. [DOI: 10.1111/ggi.14142] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 12/24/2020] [Accepted: 01/17/2021] [Indexed: 01/12/2023]
Affiliation(s)
- Sayuri Sable‐Morita
- Department of Nursing National Center for Geriatrics and Gerontology Obu Japan
| | - Takahisa Tanikawa
- Department of Metabolic Medicine National Center for Geriatrics and Gerontology Obu Japan
| | - Shosuke Satake
- Geriatric Medicine National Center for Geriatrics and Gerontology Obu Japan
| | - Mika Okura
- School of Human and Environmental Studies Kyoto University Kyoto Japan
| | - Haruhiko Tokuda
- Department of Metabolic Medicine National Center for Geriatrics and Gerontology Obu Japan
| | - Hidenori Arai
- Geriatric Medicine National Center for Geriatrics and Gerontology Obu Japan
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Heberle I, Tonelli DC, Benedetti TB, Delevatti RS. Similar functional capacity and handgrip strength of trained elderly women with and without type 2 diabetes mellitus: A cross-sectional study. Complement Ther Clin Pract 2021; 43:101318. [PMID: 33545576 DOI: 10.1016/j.ctcp.2021.101318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 01/08/2021] [Accepted: 01/21/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND This study compares the functional capacity and handgrip strength of older women with and without type 2 diabetes (T2D) who practiced physical exercises. METHODS Twenty-six older women who practiced physical exercises participated in the study (13 with T2D - DM; 13 without T2D - CON). Functional capacity and handgrip strength were assessed. RESULTS The groups were similar in age. Regarding functional capacity, there were no significant differences between the groups in any of the tests performed (p > 0.05): chair stand (rep); arm curl (rep); chair sit and reach (cm); 8-foot up-and-go (sec); back scratch (cm) and 6-min walk (m). There was also no difference in handgrip strength (kg) between groups (p > 0.05). CONCLUSION The functional capacity and handgrip strength of older women with T2D who practice exercise seems similar to that of older women without the disease who practice regular exercise.
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Affiliation(s)
- Isabel Heberle
- Universidade Federal de Santa Catarina (UFSC), Departamento de Educação Física, Florianópolis, Santa Catarina, Brazil.
| | - Débora Cristina Tonelli
- Universidade Federal de Santa Catarina (UFSC), Departamento de Educação Física, Florianópolis, Santa Catarina, Brazil.
| | - Tânia Bertoldo Benedetti
- Universidade Federal de Santa Catarina (UFSC), Departamento de Educação Física, Florianópolis, Santa Catarina, Brazil.
| | - Rodrigo Sudatti Delevatti
- Universidade Federal de Santa Catarina (UFSC), Departamento de Educação Física, Florianópolis, Santa Catarina, Brazil.
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Al-Ozairi E, Alsaeed D, Alroudhan D, Voase N, Hasan A, Gill JMR, Sattar N, Welsh P, Gray CM, Boonpor J, Celis-Morales C, Gray SR. Skeletal Muscle and Metabolic Health: How Do We Increase Muscle Mass and Function in People with Type 2 Diabetes? J Clin Endocrinol Metab 2021; 106:309-317. [PMID: 33336682 DOI: 10.1210/clinem/dgaa835] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Whilst skeletal muscles' primary role is allowing movement, it has important metabolic roles, including in glycemic control. Indeed, evidence indicates that low muscle mass and function are associated with an increased risk of type 2 diabetes, highlighting its importance in the development of metabolic disease. METHODS In this mini-review, we detail the evidence highlighting the importance of muscle in type 2 diabetes and the efficacy of resistance exercise in improving glycemic control alongside our approach to increase uptake of such exercise in people with type 2 diabetes. This summary is based in the authors' knowledge of the filed supplemented by a Pubmed search using the terms "muscle," "glycemic control," "HbA1c," "type 2 diabetes," and "resistance exercise." RESULTS The main strategy to increases muscle mass is to perform resistance exercise and, although the quality of evidence is low, such exercise appears effective in reducing Glycated Haemoglobin (HbA1c) in people with type 2 diabetes. However, to increase participation we need to improve our understanding of barriers and facilitators to such exercise. Current data indicate that barriers are similar to those reported for aerobic exercise, with additional resistance exercise specific barriers of looking to muscular, increase risk of cardiovascular event, having access to specialized equipment and knowledge of how to use it. CONCLUSIONS The development of simple resistance exercises that can be performed anywhere, that use little or no equipment and are effective in reducing HbA1c will be, in our opinion, key to increasing the number of people with type 2 diabetes performing resistance exercise.
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Affiliation(s)
- Ebaa Al-Ozairi
- Clinical Research Unit, Dasman Diabetes Institute, Dasman, Kuwait City, Kuwait
- Department of Medicine, Faculty of Medicine, Kuwait University, Jabirya, Kuwait
| | - Dalal Alsaeed
- Clinical Research Unit, Dasman Diabetes Institute, Dasman, Kuwait City, Kuwait
- Ministry of Health, Kuwait City, Kuwait
| | - Dherar Alroudhan
- Clinical Research Unit, Dasman Diabetes Institute, Dasman, Kuwait City, Kuwait
| | - Nia Voase
- Clinical Research Unit, Dasman Diabetes Institute, Dasman, Kuwait City, Kuwait
| | - Amal Hasan
- Department of Immunology and Microbiology, Dasman Diabetes Institute, Dasman, Kuwait City, Kuwait
| | - Jason M R Gill
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland
| | - Paul Welsh
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland
| | - Cindy M Gray
- Institute of Health and Wellbeing, University of Glasgow, Scotland
| | - Jirapitcha Boonpor
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland
| | - Carlos Celis-Morales
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland
| | - Stuart R Gray
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland
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Berry A, Yung AR, Carr MJ, Webb RT, Ashcroft DM, Firth J, Drake RJ. Prevalence of Major Cardiovascular Disease Events Among People Diagnosed With Schizophrenia Who Have Sleep Disturbance, Sedentary Behavior, or Muscular Weakness. ACTA ACUST UNITED AC 2021; 2:sgaa069. [PMID: 34901860 PMCID: PMC8650069 DOI: 10.1093/schizbullopen/sgaa069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Objective To estimate prevalence of major cardiovascular events among people with schizophrenia who had experience of sleep disturbance, sedentary behavior or muscular weakness, and assess evidence for raised prevalence in these individuals compared to people with schizophrenia without these characteristics. Methods UK Biobank data on individuals diagnosed with schizophrenia (n = 1544) were used to examine the prevalence of major cardiovascular events, specifically myocardial infarction, stroke, heart failure and cardiovascular death, among participants with candidate risk factors. Generalized linear models were fitted to estimate prevalence ratios (PRs) for major cardiovascular events among participants with self-reported sleep disturbance, self-reported sedentary behavior, and muscular weakness measured using a handgrip dynamometer. These ratios were adjusted for QRISK3 score—a validated cardiovascular risk prediction algorithm for the UK population. Results Prevalence of major cardiovascular events was significantly higher among participants with daytime sleepiness, independent of QRISK3 score, and snoring, a proxy for sleep-disordered breathing (adjusted PR 1.26; 95% CI 1.03, 1.55, P = .03). Prevalence was also independently higher among participants with low muscular strength (adjusted PR1.36; 95% CI 1.05, 1.75, P = .02). The adjusted prevalence ratios among participants with short or prolonged sleep duration, insomnia, or sedentary behavior did not indicate independently raised prevalence among these groups. Conclusion Prevalence of major cardiovascular events among people with schizophrenia was higher in participants with muscular weakness and sleep disturbance evidenced by daytime sleepiness. Further research is required to determine how these factors can be routinely identified and addressed in the clinical management of cardiovascular risk among patients with schizophrenia.
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Affiliation(s)
- Alexandra Berry
- Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC), Manchester, UK
| | - Alison R Yung
- Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC), Manchester, UK
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Matthew J Carr
- Division of Pharmacy & Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC), Manchester, UK
- NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK
| | - Roger T Webb
- Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC), Manchester, UK
- NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK
| | - Darren M Ashcroft
- Division of Pharmacy & Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC), Manchester, UK
- NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK
| | - Joseph Firth
- Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC), Manchester, UK
| | - Richard J Drake
- Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC), Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
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Takeuchi T, Kitamura Y, Ishizuka S, Yamada S, Aono H, Kawahara T, Sobue T. Mortality of Japanese Olympic athletes in 1964 Tokyo Olympic Games. BMJ Open Sport Exerc Med 2021; 7:e000896. [PMID: 33520254 PMCID: PMC7816928 DOI: 10.1136/bmjsem-2020-000896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2021] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES To compare the mortality of Japanese athletes in the 1964 Tokyo Olympic Games with that of the Japanese population, and to elucidate factors associated with their mortality. METHODS We obtained from the Japan Sport Association study subjects' biographical information, information on lifestyles and medical data. Missing data were obtained from online databases. Standardised mortality ratio (SMR) was calculated to compare athletes' mortality with the Japanese population. Cox proportional hazards model was applied to estimate the HR for each category of body mass index (BMI), smoking history and handgrip strength. This analysis was limited to male athletes due to the small number of female athletes. RESULTS Among 342 (283 men, 59 women) athletes, deaths were confirmed for 70 (64 men, 6 women) athletes between September 1964 and December 2017. Total person years was 15 974.8, and the SMR was 0.64 (95% CI 0.50 to 0.81). Multivariate analysis performed on 181 male athletes. Mortality was significantly higher for BMI≥25 kg/m2 than for 21-23 kg/m2 (HR: 3.03, 95% CI 1.01 to 9.07). We found no statistically significant associations between smoking history and mortality; the HR (95% CI) for occasional and daily smokers were 0.82 (0.26 to 2.57) and 1.30 (0.55 to 3.03) compared with never smokers. We also found no statistically significant associations between handgrip strength and mortality (P for trend: 0.51). CONCLUSION Japanese athletes in the 1964 Tokyo Olympic Games lived longer than the Japanese population. BMI≥25 kg/m2 was associated with higher mortality, but smoking history and handgrip strength were not associated with mortality.
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Affiliation(s)
- Taro Takeuchi
- Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yuri Kitamura
- Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Soya Ishizuka
- Sport Sciences Laboratory, Japan Sport Association, Shinjuku-ku, Japan
| | - Sachiko Yamada
- Sport Sciences Laboratory, Japan Sport Association, Shinjuku-ku, Japan
| | - Hiroshi Aono
- Sport Sciences Laboratory, Japan Sport Association, Shinjuku-ku, Japan
| | - Takashi Kawahara
- Sport Medicine and Science Research Committee, Japan Sport Association, Shinjuku-ku, Japan
| | - Tomotaka Sobue
- Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
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Association of metabolic phenotypes, grip strength and diabetes risk: The 15-year follow-up of The North West Adelaide Health Study, Australia. Obes Res Clin Pract 2020; 14:536-541. [PMID: 33041220 DOI: 10.1016/j.orcp.2020.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 08/11/2020] [Accepted: 09/12/2020] [Indexed: 01/20/2023]
Abstract
BACKGROUND The association of diabetes risk in the long-term, metabolic phenotypes (MP) and muscle strength is unclear. We aimed to investigate the association between strictly defined MP, grip strength (GS) and diabetes. MATERIAL AND METHODS MP were defined according to BMI and presence of any individual metabolic abnormality for ≥18 years, in participants of the North West Adelaide Health Study (Australia) free of diabetes at baseline. The association of MP and dominant hand GS with incident diabetes over 15-years follow-up and the moderation effect of GS on the association between diabetes and MP were investigated by logistic regression models. RESULTS Of 3039 participants followed over 13.3 years (SD 2.6), 236 (7.8%) developed diabetes. Compared to the metabolically healthy (MH) normal weight phenotype, the metabolically unhealthy (MU) overweight (OR 6.15, 95%CI 2.43-15.59) and obese (OR 12.32, 95%CI 4.97-30.52) phenotypes were associated with a high risk of diabetes, but not the MU normal weight (OR 1.73, 95%CI 0.57-5.25), MH overweight (OR 1.15, 95%CI 0.31-4.31) or MH obese phenotypes (OR 0.77, 0.07-8.89). GS was inversely associated with diabetes (OR 0.97, 95% CI 0.95-0.99) and attenuated the risk associated with MU overweight (beta = -0.296, p = 0.039) and MU normal weight (beta = -0.773; p for interaction = 0.009). CONCLUSION Strictly defined MP (rather than based on metabolic syndrome criteria) and GS, a proxy of muscle strength, might be useful for stratifying the risk of diabetes in the long-term. Improving muscle strength might be an important strategy to reduce diabetes risk.
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Someya Y, Tamura Y, Takeno K, Kakehi S, Funayama T, Furukawa Y, Eshima H, Watanabe K, Kurihara T, Yanagiya T, Kaga H, Suzuki R, Sugimoto D, Kadowaki S, Kawamori R, Watada H. Decreased Muscle Strength of Knee Flexors is Associated with Impaired Muscle Insulin Sensitivity in Non-Diabetic Middle-Aged Japanese Male Subjects. Diabetes Ther 2020; 11:2401-2410. [PMID: 32767276 PMCID: PMC7509026 DOI: 10.1007/s13300-020-00895-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Reduced muscle strength is a high risk factor for type 2 diabetes mellitus, and this association is especially strong in non-obese male individuals. However, it remains unclear how reduced muscle strength affects susceptibility to diabetes. We have examined whether lower limb muscle strength is associated with insulin resistance in non-obese Japanese male subjects. METHODS Measurements from 64 non-diabetic, non-obese, middle-aged Japanese men were analyzed. Insulin sensitivity in muscle was measured using the hyperinsulinemic-euglycemic clamp. Isometric muscle strength of the knee extensor and flexor muscles was evaluated using a dynameter. RESULTS Lower muscle strength of knee flexors, but not knee extensors, was associated with impaired muscle insulin sensitivity (knee flexor muscles: low, medium, and high strength was 6.6 ± 2.2, 7.3 ± 2.0, and 8.8 ± 2.2 mg/kg per minute, respectively, p for trend < 0.05; knee extensor muscles: low, medium, and high strength was 7.3 ± 2.5, 7.5 ± 2.2, and 7.8 ± 2.3 mg/kg per minute, respectively, p for trend = 0.73). Knee flexor muscle strength was also identified as an independent determinant of insulin sensitivity in the multiple regression analysis (β = 0.274, p = 0.036). CONCLUSIONS Diminished strength of knee flexor muscles, but not knee extensor muscles, was associated with muscle insulin sensitivity in non-diabetic, non-obese Japanese male subjects.
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Affiliation(s)
- Yuki Someya
- Sportology Center, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
- Graduate School of Health and Sports Science, Juntendo University, 1-1 Hiraga-gakuendai, Inzai City, Chiba, 270-1695, Japan
| | - Yoshifumi Tamura
- Sportology Center, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
- Faculty of International Liberal Arts, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
| | - Kageumi Takeno
- Sportology Center, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Saori Kakehi
- Sportology Center, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Takashi Funayama
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Yasuhiko Furukawa
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Hiroaki Eshima
- Sportology Center, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Keisuke Watanabe
- Graduate School of Health and Sports Science, Juntendo University, 1-1 Hiraga-gakuendai, Inzai City, Chiba, 270-1695, Japan
| | - Toshiyuki Kurihara
- Graduate School of Health and Sports Science, Juntendo University, 1-1 Hiraga-gakuendai, Inzai City, Chiba, 270-1695, Japan
| | - Toshio Yanagiya
- Graduate School of Health and Sports Science, Juntendo University, 1-1 Hiraga-gakuendai, Inzai City, Chiba, 270-1695, Japan
| | - Hideyoshi Kaga
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Ruriko Suzuki
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Daisuke Sugimoto
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Satoshi Kadowaki
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Ryuzo Kawamori
- Sportology Center, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Hirotaka Watada
- Sportology Center, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
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