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Soleymani Y, Batouli SAH, Ahangar AA, Pourabbasi A. Association of glycosylated hemoglobin concentrations with structural and functional brain changes in the normoglycemic population: A systematic review. J Neuroendocrinol 2024:e13437. [PMID: 39099230 DOI: 10.1111/jne.13437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 06/30/2024] [Accepted: 07/18/2024] [Indexed: 08/06/2024]
Abstract
Optimal glucose control is crucial for maintaining brain health and preventing metabolic and cognitive disorders in the general population. Glycosylated hemoglobin (HbA1c) serves as a key marker for assessing glucose intolerance and its impact on brain structure and function in healthy individuals. However, existing literature presents conflicting findings, necessitating a systematic review to consolidate current knowledge in this domain. This systematic review examines 26 English-language studies involving participants aged 15 years and above, investigating the relationship between HbA1c levels and brain health. Studies focusing on normal/general populations and utilizing magnetic resonance imaging (MRI) as the imaging modality were included. Exclusion criteria encompassed review articles, abstracts, letters, animal studies, and research involving neuropsychiatric or metabolic diseases. Data were gathered from PubMed, Scopus, and Web of Science databases up to November 2023. Analysis reveals significant associations between HbA1c levels and various brain metrics, including volume, cortical thickness, fractional anisotropy, mean diffusivity, activity, and connectivity. However, findings exhibit inconsistency, likely attributed to disparities in sample characteristics and study sizes. Notably, hippocampal volume, white matter hyperintensity, and ventral attention network connectivity emerge as frequently affected structures and functions, mirroring trends observed in diabetic populations. Despite inconclusive evidence, glucose intolerance appears to exert considerable influence on select brain structures and functions in individuals without diagnosed metabolic disorders. Understanding these associations is critical for mitigating the risk of cognitive decline and dementia in healthy populations. Future investigations should aim to elucidate the intricate relationship between HbA1c concentrations and brain health parameters in normoglycemic individuals.
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Affiliation(s)
- Yunus Soleymani
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Amir Hossein Batouli
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Amin Akbari Ahangar
- Department of BioMolecular Sciences, School of Pharmacy, The University of Mississippi, Oxford, Mississippi, USA
| | - Ata Pourabbasi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Chung SM, Kim KH, Moon JS, Won KC. Association between mixed exposure to per- and polyfluoroalkyl substances and metabolic syndrome in Korean adults: Data from the Korean National environmental health survey cycle 4. Int J Hyg Environ Health 2024; 261:114427. [PMID: 39032326 DOI: 10.1016/j.ijheh.2024.114427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 07/15/2024] [Accepted: 07/16/2024] [Indexed: 07/23/2024]
Abstract
AIM To explore the effect of mixed exposure to per- and polyfluoroalkyl substances (PFAS) on metabolic syndrome (MetS). METHODS This cross-sectional study used data from the Korean National Environmental Health Survey Cycle 4 (2018-2020). The serum concentrations of five PFAS (perfluorooctanoic acid [PFOA], perfluorooctanesulfonic acid [PFOS], perfluorohexanesulfonic acid, perfluorononanoic acid [PFNA], and perfluorodecanoic acid [PFDeA]) were measured, and the relative potency factor approach was employed for the mixture of PFAS (Cmix) assessment. MetS was diagnosed if the patient satisfied three of five criteria: central obesity, elevated triglycerides, reduced high-density lipoprotein cholesterol, elevated blood pressure (BP), and elevated glycated hemoglobin (HbA1c). Age, sex, smoking, drinking, and exercise status were considered as covariates. The risk of MetS for single and mixed exposure to PFAS was analyzed using binomial regression and Bayesian kernel machine regression (BKMR). RESULTS A total of 2984 (male:female = 1:1.3; age range, 19-80 years) adults were enrolled. The prevalence of MetS was 45.6%. Each PFAS and Cmix levels were higher in participants with MetS than in those without MetS. Cmix increased the risk of elevated BP and HbA1c, and eventually MetS (odds ratio [OR] = 2.00, 95% confidence interval [CI] 1.11-3.60 per log10Cmix; OR = 1.57, 95% CI 1.07-2.31 in the highest quartile of Cmix [Q4] vs. the lowest [Q1]). Sex-specific analyses revealed that the impact of Cmix was valid in females but not in males (Cmix Q4 vs. Q1: OR = 1.01, 95% CI 0.57-1.8 in males; OR = 2.30, 95% CI 1.38-3.84 in females). In the BKMR analysis, mixed exposure to PFAS dose-dependently increased the risk of MetS, particularly in females. Among single exposures, PFNA contributed significantly to the cumulative effect. CONCLUSION Mixed exposure to PFAS was associated with a higher risk of MetS in females. Further studies on potential health concerns associated with PFAS mixtures are warranted.
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Affiliation(s)
- Seung Min Chung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Republic of Korea.
| | - Kyun Hoo Kim
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon, 34141, Republic of Korea
| | - Jun Sung Moon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Republic of Korea
| | - Kyu Chang Won
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Republic of Korea
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Zahedi AS, Zarkesh M, Sedaghati-khayat B, Hedayati M, Azizi F, Daneshpour MS. Insulin resistance-related circulating predictive markers in the metabolic syndrome: a systematic review in the Iranian population. J Diabetes Metab Disord 2024; 23:199-213. [PMID: 38932859 PMCID: PMC11196549 DOI: 10.1007/s40200-023-01347-6] [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: 09/27/2023] [Accepted: 11/08/2023] [Indexed: 06/28/2024]
Abstract
Background Specific biomarkers for metabolic syndrome (MetS) may improve diagnostic specificity for clinical information. One of the main pathophysiological mechanisms of MetS is insulin resistance (IR). This systematic review aimed to summarize IR-related biomarkers that predict MetS and have been investigated in Iranian populations. Methods An electronic literature search was done using the PubMed and Scopus databases up to June 2022. The risk of bias was assessed for the selected articles using the instrument suggested by the Joanna Briggs Institute (JBI). This systematic review protocol was registered with PROSPERO (registration number CRD42022372415). Results Among the reviewed articles, 46 studies investigated the association between IR biomarkers and MetS in the Iranian population. The selected studies were published between 2009 and 2022, with the majority being conducted on adults and seven on children and adolescents. The adult treatment panel III (ATP III) was the most commonly used criteria to define MetS. At least four studies were conducted for each IR biomarker, with LDL-C being the most frequently evaluated biomarker. Some studies have assessed the diagnostic potency of markers using the area under the curve (AUC) with sensitivity, specificity, and an optimal cut-off value. Among the reported values, lipid ratios and the difference between non-HDL-C and LDL-C levels showed the highest AUCs (≥ 0.80) for predicting MetS. Conclusions Considering the findings of the reviewed studies, fasting insulin, HOMA-IR, leptin, HbA1c, and visfatin levels were positively associated with MetS, whereas adiponectin and ghrelin levels were negatively correlated with this syndrome. Among the investigated IR biomarkers, the association between adiponectin levels and components of MetS was well established. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-023-01347-6.
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Affiliation(s)
- Asiyeh Sadat Zahedi
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Zarkesh
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahar Sedaghati-khayat
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Hedayati
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam S Daneshpour
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Park B, Kim B, Kim CH, Oh HJ, Park B. Association between endocrine-disrupting chemical mixtures and non-alcoholic fatty liver disease with metabolic syndrome as a mediator among adults: A population-based study in Korea. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 276:116310. [PMID: 38614002 DOI: 10.1016/j.ecoenv.2024.116310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/03/2024] [Accepted: 04/06/2024] [Indexed: 04/15/2024]
Abstract
Endocrine-disrupting chemicals (EDCs) may play a role in non-alcoholic fatty liver disease (NAFLD); however, studies on the combined effects of EDC mixtures on NAFLD development are limited. Here, we explored the association between exposure to EDC mixtures and NAFLD and investigated the potential mediating role of metabolic syndrome (MetS). We included participants from the Korean National Environmental Health Survey Cycle 4 (2018-2020) and quantified the urinary concentrations of various EDCs-eight phthalate metabolites, three phenols, one antibacterial compound, four parabens, four polycyclic aromatic hydrocarbons, and one pyrethroid pesticide metabolite-as well as serum concentrations of five perfluorinated compounds (PFCs). NAFLD was defined as a hepatic steatosis index (HSI) ≥36 or a fatty liver index (FLI) ≥60. Weighted quantile sum (WQS) regression was employed to evaluate the associations between EDC mixtures and the risk of MetS or NAFLD. Causal mediation analysis was conducted to explore the potential mediating effect of MetS on the association between mixtures of EDCs and NAFLD risk. All estimates were adjusted for age, sex, educational level, physical activity, smoking status, involuntary smoking, and drinking habits. A total of 2942 adults were included in the analysis. Moderate-to-high positive correlations were identified between phthalate metabolites and PFCs. Higher WQS scores were associated with an elevated risk of MetS and NAFLD. The sex-stratified WQS regression model showed that the interactions between the WQS index and sex were significant for MetS and NAFLD. According to the causal mediation analysis, both the direct and indirect effects of EDC mixtures on NAFLD, with MetS as a mediator, were significant in females. Collectively, these findings highlight the need for interventions that could address both EDC mixture exposure and metabolic status to effectively reduce the risks associated with NAFLD and its related complications.
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Affiliation(s)
- Bohyun Park
- National Cancer Control Institute, National Cancer Center, Goyang, the Republic of Korea.
| | - Byungmi Kim
- National Cancer Control Institute, National Cancer Center, Goyang, the Republic of Korea.
| | - Chung Ho Kim
- Department of Preventive Medicine, College of Medicine, Chung-Ang University, Seoul, the Republic of Korea.
| | - Hyun Jin Oh
- Division of Gastroenterology, Department of Internal Medicine, Center for Cancer Prevention and Detection, National Cancer Center, Goyang, the Republic of Korea.
| | - Bomi Park
- Department of Preventive Medicine, College of Medicine, Chung-Ang University, Seoul, the Republic of Korea.
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Mezhal F, Ahmad A, Abdulle A, Leinberger-Jabari A, Oulhaj A, AlJunaibi A, Alnaeemi A, Al Dhaheri AS, AlZaabi E, Al-Maskari F, AlAnouti F, Alsafar H, Alkaabi J, Wareth LA, Aljaber M, Kazim M, Alblooshi M, Al-Houqani M, Hag Ali M, Oumeziane N, El-Shahawy O, Al-Rifai RH, Sherman S, Shah SM, Loney T, Almahmeed W, Idaghdour Y, Ahmed LA, Ali R. Metabolic Syndrome in Fasting and Non-Fasting Participants: The UAE Healthy Future Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13757. [PMID: 36360639 PMCID: PMC9654954 DOI: 10.3390/ijerph192113757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/26/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Metabolic syndrome (MetS) is a multiplex of risk factors that predispose people to the development of diabetes and cardiovascular disease (CVD), two of the major non-communicable diseases that contribute to mortality in the United Arab Emirates (UAE). MetS guidelines require the testing of fasting samples, but there are evidence-based suggestions that non-fasting samples are also reliable for CVD-related screening measures. In this study, we aimed to estimate MetS and its components in a sample of young Emiratis using HbA1c as another glycemic marker. We also aimed to estimate the associations of some known CVD risk factors with MetS in our population. METHODS The study was based on a cross-sectional analysis of baseline data of 5161 participants from the UAE Healthy Future Study (UAEHFS). MetS was identified using the NCEP ATP III criteria, with the addition of HbA1c as another glycemic indicator. Fasting blood glucose (FBG) and HbA1c were used either individually or combined to identify the glycemic component of MetS, based on the fasting status. Multivariate regression analysis was used to test for associations of selected social and behavioral factors with MetS. RESULTS Our sample included 3196 men and 1965 women below the age of 40 years. Only about 21% of the sample were fasting at the time of recruitment. The age-adjusted prevalence of MetS was estimated as 22.7% in males and 12.5% in females. MetS prevalence was not statistically different after substituting FBG by HbA1c in the fasting groups (p > 0.05). Age, increased body mass index (BMI), and family history of any metabolic abnormality and/or heart disease were consistently strongly associated with MetS. CONCLUSION MetS is highly prevalent in our sample of young Emirati adults. Our data showed that HbA1c may be an acceptable tool to test for the glycemic component of MetS in non-fasting samples. We found that the most relevant risk factors for predicting the prevalence of MetS were age, BMI, and family history.
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Affiliation(s)
- Fatima Mezhal
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi 129188, United Arab Emirates
| | - Amar Ahmad
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi 129188, United Arab Emirates
| | - Abdishakur Abdulle
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi 129188, United Arab Emirates
| | - Andrea Leinberger-Jabari
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi 129188, United Arab Emirates
| | - Abderrahim Oulhaj
- Department of Epidemiology and Public Health, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi 127788, United Arab Emirates
| | - Abdulla AlJunaibi
- Department of Pediatrics, Zayed Military Hospital, Abu Dhabi 72763, United Arab Emirates
| | - Abdulla Alnaeemi
- Department of Cardiology, Zayed Military Hospital, Abu Dhabi 72763, United Arab Emirates
| | - Ayesha S. Al Dhaheri
- Department of Nutrition and Health, College of Medicine and Health Sciences, UAE University, Al-Ain 15551, United Arab Emirates
| | - Eiman AlZaabi
- Department of Pathology, Sheikh Shakhbout Medical City, Abu Dhabi 11001, United Arab Emirates
| | - Fatma Al-Maskari
- Institute of Public Health, College of Medicine and Health Sciences, UAE University, Al-Ain 15551, United Arab Emirates
- Zayed Center for Health Sciences, UAE University, Al-Ain 15551, United Arab Emirates
| | - Fatme AlAnouti
- College of Natural and Health Sciences, Zayed University, Abu Dhabi 144534, United Arab Emirates
| | - Habiba Alsafar
- Center for Biotechnology, Khalifa University, Abu Dhabi 127788, United Arab Emirates
- Department of Genetics and Molecular Biology, Khalifa University, Abu Dhabi 127788, United Arab Emirates
- Department of Biomedical Engineering, Khalifa University, Abu Dhabi 127788, United Arab Emirates
| | - Juma Alkaabi
- Department of Internal Medicine, College of Medicine and Health Sciences, UAE University, Al-Ain 15551, United Arab Emirates
| | - Laila Abdel Wareth
- Pathology and Laboratory Medicine Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi 112412, United Arab Emirates
| | - Mai Aljaber
- Healthpoint Hospital, Abu Dhabi 112308, United Arab Emirates
| | - Marina Kazim
- Abu Dhabi Blood Bank Services, SEHA, Abu Dhabi 109090, United Arab Emirates
| | - Manal Alblooshi
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi 129188, United Arab Emirates
| | - Mohammad Al-Houqani
- Department of Medicine, College of Medicine and Health Sciences, UAE University, Al-Ain 15551, United Arab Emirates
| | - Mohammad Hag Ali
- Department of Health Science, Higher Colleges of Technology, Abu Dhabi 25026, United Arab Emirates
| | - Naima Oumeziane
- Abu Dhabi Blood Bank Services, SEHA, Abu Dhabi 109090, United Arab Emirates
| | - Omar El-Shahawy
- Department of Population Health, New York University School of Medicine, New York, NY 10595, USA
| | - Rami H. Al-Rifai
- Institute of Public Health, College of Medicine and Health Sciences, UAE University, Al-Ain 15551, United Arab Emirates
| | - Scott Sherman
- Department of Population Health, New York University School of Medicine, New York, NY 10595, USA
| | - Syed M. Shah
- Institute of Public Health, College of Medicine and Health Sciences, UAE University, Al-Ain 15551, United Arab Emirates
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 505055, United Arab Emirates
| | - Wael Almahmeed
- Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi 112412, United Arab Emirates
| | - Youssef Idaghdour
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi 129188, United Arab Emirates
| | - Luai A. Ahmed
- Institute of Public Health, College of Medicine and Health Sciences, UAE University, Al-Ain 15551, United Arab Emirates
- Zayed Center for Health Sciences, UAE University, Al-Ain 15551, United Arab Emirates
| | - Raghib Ali
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi 129188, United Arab Emirates
- MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0SL, UK
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Hung CC, Zhen YY, Niu SW, Lin KD, Lin HYH, Lee JJ, Chang JM, Kuo IC. Predictive Value of HbA1c and Metabolic Syndrome for Renal Outcome in Non-Diabetic CKD Stage 1-4 Patients. Biomedicines 2022; 10:biomedicines10081858. [PMID: 36009406 PMCID: PMC9404918 DOI: 10.3390/biomedicines10081858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/26/2022] [Accepted: 07/28/2022] [Indexed: 11/16/2022] Open
Abstract
Glycated hemoglobin (HbA1c) levels are commonly used to indicate long-term glycemic control. An HbA1c level of 6.5−5.7% is defined as pre-diabetes and is proposed as a criterion for diagnosing metabolic syndrome (MetS). However, HbA1c levels can be affected by chronic kidney disease (CKD). Whether HbA1c is associated with clinical outcomes in nondiabetic CKD patients with or without MetS is still unknown. This study included 1270 nondiabetic CKD stage 1−4 Asian patients, divided by HbA1c and MetS. Through linear regression, HbA1c was positively associated with age, waist circumference, hemoglobin levels, and C-reactive protein and was negatively associated with malnutrition−inflammation. HbA1c levels were 5.5% (0.6%) and 5.7% (0.6%) in non-MetS and MetS, respectively (p < 0.001). In Cox regression, higher-level HbA1c was associated with worse composite renal outcome in MetS patients, but with better renal outcome in non-MetS patients: Hazard ratio (HR) (95% confidence interval [CI]) of HbA1c ≥5.7%, compared with HbA1c <5%, was 2.00 (1.06−3.78) in MetS and 0.25 (0.14−0.45) in non-MetS. An association between HbA1c and all-cause mortality was not found. In conclusion, higher HbA1c levels are associated with worse renal outcomes in nondiabetic CKD stage 1−4 patients modified by the presence of MetS.
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Affiliation(s)
- Chi-Chih Hung
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (C.-C.H.); (Y.-Y.Z.); (S.-W.N.); (H.Y.-H.L.); (J.-J.L.); (J.-M.C.)
| | - Yen-Yi Zhen
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (C.-C.H.); (Y.-Y.Z.); (S.-W.N.); (H.Y.-H.L.); (J.-J.L.); (J.-M.C.)
| | - Sheng-Wen Niu
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (C.-C.H.); (Y.-Y.Z.); (S.-W.N.); (H.Y.-H.L.); (J.-J.L.); (J.-M.C.)
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung 801, Taiwan
| | - Kun-Der Lin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
| | - Hugo You-Hsien Lin
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (C.-C.H.); (Y.-Y.Z.); (S.-W.N.); (H.Y.-H.L.); (J.-J.L.); (J.-M.C.)
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung 801, Taiwan
| | - Jia-Jung Lee
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (C.-C.H.); (Y.-Y.Z.); (S.-W.N.); (H.Y.-H.L.); (J.-J.L.); (J.-M.C.)
| | - Jer-Ming Chang
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (C.-C.H.); (Y.-Y.Z.); (S.-W.N.); (H.Y.-H.L.); (J.-J.L.); (J.-M.C.)
| | - I-Ching Kuo
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (C.-C.H.); (Y.-Y.Z.); (S.-W.N.); (H.Y.-H.L.); (J.-J.L.); (J.-M.C.)
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung 801, Taiwan
- Correspondence:
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Jiang X, Yang Z, Wang S, Deng S. “Big Data” Approaches for Prevention of the Metabolic Syndrome. Front Genet 2022; 13:810152. [PMID: 35571045 PMCID: PMC9095427 DOI: 10.3389/fgene.2022.810152] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 03/28/2022] [Indexed: 11/21/2022] Open
Abstract
Metabolic syndrome (MetS) is characterized by the concurrence of multiple metabolic disorders resulting in the increased risk of a variety of diseases related to disrupted metabolism homeostasis. The prevalence of MetS has reached a pandemic level worldwide. In recent years, extensive amount of data have been generated throughout the research targeted or related to the condition with techniques including high-throughput screening and artificial intelligence, and with these “big data”, the prevention of MetS could be pushed to an earlier stage with different data source, data mining tools and analytic tools at different levels. In this review we briefly summarize the recent advances in the study of “big data” applications in the three-level disease prevention for MetS, and illustrate how these technologies could contribute tobetter preventive strategies.
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Affiliation(s)
- Xinping Jiang
- Department of United Ultrasound, The First Hospital of Jilin University, Changchun, China
| | - Zhang Yang
- Department of Vascular Surgery, The First Hospital of Jilin University, Changchun, China
| | - Shuai Wang
- Department of Vascular Surgery, The First Hospital of Jilin University, Changchun, China
| | - Shuanglin Deng
- Department of Oncological Neurosurgery, The First Hospital of Jilin University, Changchun, China
- *Correspondence: Shuanglin Deng,
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Yeo LF, Lee SC, Palanisamy UD, Khalid BAK, Ayub Q, Lim SY, Lim YAL, Phipps ME. The Oral, Gut Microbiota and Cardiometabolic Health of Indigenous Orang Asli Communities. Front Cell Infect Microbiol 2022; 12:812345. [PMID: 35531342 PMCID: PMC9074829 DOI: 10.3389/fcimb.2022.812345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 03/23/2022] [Indexed: 11/13/2022] Open
Abstract
The Orang Asli (OA) of Malaysia have been relatively understudied where little is known about their oral and gut microbiomes. As human health is closely intertwined with the human microbiome, this study first assessed the cardiometabolic health in four OA communities ranging from urban, rural to semi-nomadic hunter-gatherers. The urban Temuan suffered from poorer cardiometabolic health while rural OA communities were undergoing epidemiological transition. The oral microbiota of the OA were characterised by sequencing the V4 region of the 16S rRNA gene. The OA oral microbiota were unexpectedly homogenous, with comparably low alpha diversity across all four communities. The rural Jehai and Temiar PP oral microbiota were enriched for uncharacterised bacteria, exhibiting potential for discoveries. This finding also highlights the importance of including under-represented populations in large cohort studies. The Temuan oral microbiota were also elevated in opportunistic pathogens such as Corynebacterium, Prevotella, and Mogibacterium, suggesting possible oral dysbiosis in these urban settlers. The semi-nomadic Jehai gut microbiota had the highest alpha diversity, while urban Temuan exhibited the lowest. Rural OA gut microbiota were distinct from urban-like microbiota and were elevated in bacteria genera such as Prevotella 2, Prevotella 9, Lachnospiraceae ND3007, and Solobacterium. Urban Temuan microbiota were enriched in Odoribacter, Blautia, Parabacetroides, Bacteroides and Ruminococcacecae UCG-013. This study brings to light the current health trend of these indigenous people who have minimal access to healthcare and lays the groundwork for future, in-depth studies in these populations.
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Affiliation(s)
- Li-Fang Yeo
- Jeffrey Cheah School of Medicine & Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
- Tropical Medicine and Biology Multidisciplinary Platform, School of Science, Monash University Malaysia, Bandar Sunway, Malaysia
- *Correspondence: Maude Elvira Phipps, ; Li-Fang Yeo,
| | - Soo Ching Lee
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Uma Devi Palanisamy
- Jeffrey Cheah School of Medicine & Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
- Tropical Medicine and Biology Multidisciplinary Platform, School of Science, Monash University Malaysia, Bandar Sunway, Malaysia
| | - BAK. Khalid
- Jeffrey Cheah School of Medicine & Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Qasim Ayub
- Tropical Medicine and Biology Multidisciplinary Platform, School of Science, Monash University Malaysia, Bandar Sunway, Malaysia
- Monash University Malaysia Genomics Facility, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Shu Yong Lim
- Monash University Malaysia Genomics Facility, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Yvonne AL. Lim
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Maude Elvira Phipps
- Jeffrey Cheah School of Medicine & Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
- Tropical Medicine and Biology Multidisciplinary Platform, School of Science, Monash University Malaysia, Bandar Sunway, Malaysia
- *Correspondence: Maude Elvira Phipps, ; Li-Fang Yeo,
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Guzmán M, Zbella E, Alvarez SS, Nguyen JL, Imperial E, Troncale FJ, Holub C, Mallhi AK, VanWyk S. Effect of an intensive lifestyle intervention on the prevalence of metabolic syndrome and its components among overweight and obese adults. J Public Health (Oxf) 2021; 42:828-838. [PMID: 31840755 PMCID: PMC7685849 DOI: 10.1093/pubmed/fdz170] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 10/07/2019] [Accepted: 11/21/2019] [Indexed: 12/13/2022] Open
Abstract
Background Despite the fact that up to a third of the global population has metabolic syndrome (MetS), it has been overlooked in clinical settings. This study assesses the impact of a physician-supervised nonsurgical weight management program on the prevalence of MetS and its key indicators. Methods Four-hundred seventy-nine overweight and obese participants aged 19 years or older were included in a prospective longitudinal study. Changes in MetS and its key indicators were assessed using the binomial exact, chi-square and Wilcoxon signed-rank tests in an intent-to-treat study population. Differences in age strata were assessed using a generalized linear model. Results Fifty-two percent of participants (n = 249) had MetS at baseline. Prevalence of MetS decreased steadily with significant changes from baseline observed at weeks 13 (31.8%, P < 0.0001), 26 (28.7%, P < 0.0012) and 39 (21.6%, P < 0.0002); changes from baseline were observed at week 52 as statistically significant (16.7%, P < 0.0012). Improvements in anthropometrics and levels of key indicators of MetS were observed throughout the study. Conclusion These findings confirm that weight loss is inversely associated with prevalence of MetS and its key indicators among overweight and obese individuals. Future studies may benefit from a larger sample size and better retention (ClinicalTrials.gov ID: NCT03588117).
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Affiliation(s)
- M Guzmán
- Division of Research & Development, Department of Medical Affairs, Medi-Weightloss, 509 South Hyde Park Avenue, Tampa, FL 33606, USA
| | - E Zbella
- Florida Fertility Institute, 2454 N. McMullen Booth Road Suite 601, Clearwater, FL 33759, USA
| | - S Shah Alvarez
- Department of Medical Affairs, Medi-Weightloss, 509 South Hyde Park Avenue, Tampa, FL 33606, USA
| | - J L Nguyen
- Department of Pharmacy Practice, College of Pharmacy, Mercer University, 3001 Mercer University Drive, Atlanta, GA 30341, USA
| | - E Imperial
- Iredell Primary Care for Women, 114 Gateway Blvd, Suite B, Mooresville, NC 28117, USA
| | - F J Troncale
- Section of Gastroenterology, Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510, USA
| | - C Holub
- Department of Public Health, College of Education, Health and Human Services, California State University, 333 S. Twin Oaks Valley Road, San Marcos, CA 92096, USA
| | - A K Mallhi
- Division of Research & Development, Department of Medical Affairs, Medi-Weightloss, 509 South Hyde Park Avenue, Tampa, FL 33606, USA
| | - S VanWyk
- Independent Consultant, 2518 69th Ave S, St. Petersburg, FL 33712, USA
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Moon JS, Jin MH, Koh HM. Association between Serum Osteocalcin Levels and Metabolic Syndrome according to the Menopausal Status of Korean Women. J Korean Med Sci 2021; 36:e56. [PMID: 33650335 PMCID: PMC7921371 DOI: 10.3346/jkms.2021.36.e56] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 12/16/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Osteocalcin is known to regulate energy metabolism. Recently, metabolic syndrome (MetS) has been found to be associated with reduced levels of osteocalcin in men, as well as in postmenopausal women. The aim of this study was to investigate the association between serum osteocalcin and MetS in premenopausal women, compared with that in postmenopausal women. METHODS This cross-sectional study was based on 5,896 participants who completed a health screening examination. They were classified according to their menopausal status. Each group was subdivided into non-MetS and MetS groups according to the modified National Cholesterol Education Program-Adult Treatment Panel III criteria. Serum osteocalcin levels were measured using the electrochemiluminescence immunoassay. RESULTS Serum osteocalcin level was significantly lower in women with MetS than in those without MetS, after adjusting for confounders (14.12 ± 0.04 vs. 13.17 ± 0.13 [P = 0.004] in premenopausal women, and 20.34 ± 0.09 vs. 19.62 ± 0.21 [P < 0.001] in postmenopausal women), regardless of their menopausal status. Serum osteocalcin levels decreased correspondingly with an increasing number of MetS elements (P for trend < 0.001). Multiple regression analysis demonstrated that waist circumference (β = -0.085 [P < 0.001] and β = -0.137 [P < 0.001]) and hemoglobin A1c (β = -0.09 [P < 0.001] and β = -0.145 [P < 0.001]) were independent predictors of osteocalcin in premenopausal and postmenopausal women. Triglyceride levels were also independently associated with osteocalcin levels in premenopausal women (β = -0.004 [P < 0.013]). The odds ratio (OR) for MetS was significantly higher in the lowest quartile than in the highest quartile of serum osteocalcin levels after adjusting for age, alkaline phosphatase, uric acid, high sensitivity C-reactive protein, and body mass index in all women (OR, 2.00; 95% confidence interval [CI], 1.49-2.68) as well as in premenopausal (OR, 2.23; 95% CI, 1.39-3.58) and postmenopausal (OR, 2.01; 95% CI, 1.26-3.23) subgroups. CONCLUSION Lower serum osteocalcin concentrations were significantly associated with MetS in both premenopausal and postmenopausal women and were therefore independent of menopausal status.
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Affiliation(s)
- Jin Sook Moon
- Department of Family Medicine, Samsung Changwon Hospital, School of Medicine, Sungkyunkwan University, Changwon, Korea
- Department of Family Medicine, Pusan National University Graduate School of Medicine, Busan, Korea
| | - Mi Hyeon Jin
- Department of Research Support, Samsung Changwon Hospital, School of Medicine, Sungkyunkwan University, Changwon, Korea
| | - Hyun Min Koh
- Department of Family Medicine, Samsung Changwon Hospital, School of Medicine, Sungkyunkwan University, Changwon, Korea.
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Cavero-Redondo I, Martínez-Vizcaíno V, Álvarez-Bueno C, Agudo-Conde C, Lugones-Sánchez C, García-Ortiz L. Metabolic Syndrome Including Glycated Hemoglobin A1c in Adults: Is It Time to Change? J Clin Med 2019; 8:jcm8122090. [PMID: 31805696 PMCID: PMC6947260 DOI: 10.3390/jcm8122090] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 11/21/2019] [Accepted: 11/23/2019] [Indexed: 12/25/2022] Open
Abstract
(1) Background: To assess the suitability of replacing conventional markers used for insulin resistance and dysglycemia by HbA1c in both the quantitative and qualitative metabolic syndrome (MetS) definition criteria; (2) Methods: Confirmatory factorial analysis was used to compare three quantitative definitions of MetS that consisted of many single-factor models, one of which included HbA1c as the dysglycemia indicator. After that, the model with the better goodness-of-fit was selected. Furthermore, a new MetS qualitative definition was proposed by replacing fasting plasma glucose with HbA1c > 5.7% in the International Diabetes Federation (IDF) definition. The clinical performance of these two MetS criteria (IDF and IDF-modified including HbA1c as the dysglycemia indicator) to predict vascular damage (pulse wave velocity [PWv], intima media thickness [IMT] and albumin-to-creatinine ratio [ACR]) was estimated; (3) Results: The single-factor model including HbA1c showed the better goodness-of-fit (χ2 = 2.45, df = 2, p = 0.293, CFI = 0.999, SRMR = 0.010). Additionally, the IDF-modified criteria gained in clinical performance to predict vascular damage (diagnostic Odds Ratio: 6.94, 1.34 and 1.90) for pulse wave velocity (PWv), intima media thickness (IMT) and albumin-to-creatinine ratio (ACR), respectively; and (4) Conclusions: These data suggest that HbA1c could be considered as a useful component to be included in the MetS definition.
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Affiliation(s)
- Iván Cavero-Redondo
- Universidad de Castilla-La Mancha, Health and Social Research Center, 16071 Cuenca, Spain; (I.C.-R.); (V.M.-V.)
- Universidad Politécnica y Artísitica del Paraguay, 001518 Asunción, Paraguay
| | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Health and Social Research Center, 16071 Cuenca, Spain; (I.C.-R.); (V.M.-V.)
- Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, 3460000 Talca, Chile
| | - Celia Álvarez-Bueno
- Universidad de Castilla-La Mancha, Health and Social Research Center, 16071 Cuenca, Spain; (I.C.-R.); (V.M.-V.)
- Universidad Politécnica y Artísitica del Paraguay, 001518 Asunción, Paraguay
- Correspondence:
| | - Cristina Agudo-Conde
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castilla y León (SACyL), 37003 Salamanca, Spain; (C.A.-C.); (C.L.-S.); (L.G.-O.)
| | - Cristina Lugones-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castilla y León (SACyL), 37003 Salamanca, Spain; (C.A.-C.); (C.L.-S.); (L.G.-O.)
| | - Luis García-Ortiz
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castilla y León (SACyL), 37003 Salamanca, Spain; (C.A.-C.); (C.L.-S.); (L.G.-O.)
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, 37003 Salamanca, Spain
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Comparative Abilities of Fasting Plasma Glucose and Haemoglobin A1c in Predicting Metabolic Syndrome among Apparently Healthy Normoglycemic Ghanaian Adults. Int J Chronic Dis 2019; 2019:2578171. [PMID: 31428625 PMCID: PMC6681621 DOI: 10.1155/2019/2578171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 06/01/2019] [Accepted: 07/16/2019] [Indexed: 01/21/2023] Open
Abstract
There are arguments as to whether haemoglobin A1c (HbA1c) better predicts Metabolic syndrome (MetS) than fasting plasma glucose. The aim of the study was to explore the comparative abilities of HbA1c and Fasting plasma glucose (FPG) in predicting cardiometabolic risk among apparently healthy adults in the Tamale metropolis. This study was a cross-sectional study conducted in the Tamale metropolis from September, 2017, to January, 2018, among one hundred and sixty (160) apparently healthy normoglycemic adults. A self-designed questionnaire was administered to gather sociodemographic data. Anthropometric and haemodynamic data were also taken and blood samples collected for haemoglobin A1c (HbA1c), fasting plasma glucose (FPG), and lipid profile. MetS was classified using the harmonised criteria as indicated in the joint interim statement (JIS). Out of the 160 participants, 42.5% were males and 57.5% were females. FPG associated better with MetS and other cardiovascular risk markers, compared to HbA1c. FPG had the largest area under curve for predicting MetS and its components. This study shows a stronger association between FPG and MetS compared with haemoglobin A1c; it also provides evidence of a superior ability of FPG over HbA1c in predicting MetS and other adverse cardiovascular outcomes in apparently heathy normoglycemic individuals.
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13
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Jung JY, Ryoo JH, Chung PW, Oh CM, Choi JM, Park SK. Association of fasting glucose and glycated hemoglobin with the long-term risk of incident metabolic syndrome: Korean Genome and Epidemiology Study (KoGES). Acta Diabetol 2019; 56:551-559. [PMID: 30900026 DOI: 10.1007/s00592-019-01290-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 01/12/2019] [Indexed: 10/27/2022]
Abstract
AIMS Previous studies have proposed potential benefit of glycated hemoglobin (HbA1c) supplementary to fasting glucose in detecting metabolic syndrome (MetS). This study was to investigate an association of incident MetS with levels of HbA1c and fasting glucose. METHODS In a cohort of Korean Genome and Epidemiology Study, 5515 non-diabetic adults were grouped by the levels of baseline fasting glucose and HbA1c, and followed-up for 10 years. Using multivariate Cox proportional hazards assumption, hazards ratios (HRs) and 95% confidence interval (CI) for incident MetS (adjusted HRs [95% CI]) were calculated according to baseline fasting glucose and HbA1c. In individuals with normal fasting glucose, subgroup analysis was conducted to evaluate an association of HbA1c levels with MetS. RESULTS The risk for MetS significantly increased proportionally to fasting glucose ≥ 80 mg/dL and HbA1c ≥ 5.5%, compared with fating glucose < 80 mg/dL and HbA1c < 5.3%, respectively. In subgroups of normal fasting glucose, HbA1c ≥ 5.7% had the increased risk of MetS in fasting glucose < 80 mg/dL (5.7-5.9%: 1.41 [1.07-1.86] and 6.0-6.4%: 2.20 [1.40-2.92]), and HbA1c ≥ 5.5% had the increased risk of MetS in fasting glucose of 80-99 mg/dL (5.5-5.6%: 1.33 [1.08-1.64], 5.7-5.9%: 1.57 (1.27-1.93), and 6.0-6.4%: 2.37 [1.87-3.00]). CONCLUSIONS Both elevated fasting glucose and HbA1c were significantly associated with the increased risk of MetS even within normal range. HbA1c is effective in identifying high-risk group for MetS in individuals with normal fasting glucose.
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Affiliation(s)
- Ju Young Jung
- Total Healthcare Center, School of medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, Seoul, Republic of Korea
| | - Jae-Hong Ryoo
- Department of Occupational and Environmental Medicine, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Pil-Wook Chung
- Department of Neurology, College of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Chang-Mo Oh
- Departments of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Joong-Myung Choi
- Departments of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Sung Keun Park
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital,, Sungkyunkwan University School of Medicine, 78 Saemunan-gil, Jongro-Gu, Seoul, 110-746, Republic of Korea.
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14
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Mammadova A, Yilmaz Isikhan S, Acikgoz A, Yildiz BO. Prevalence of Metabolic Syndrome and Its Relation to Physical Activity and Nutrition in Azerbaijan. Metab Syndr Relat Disord 2019; 17:160-166. [DOI: 10.1089/met.2018.0096] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- Afruz Mammadova
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
- Azerbaijan Medical University Therapeutic Training Clinic, Baku, Azerbaijan
| | - Selen Yilmaz Isikhan
- Department of Biostatistics, Hacettepe University School of Medicine, Ankara, Turkey
| | - Aylin Acikgoz
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Bulent Okan Yildiz
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Hacettepe University School of Medicine, Ankara, Turkey
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15
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Sevoyan A, Davison B, Rumbold A, Moore V, Singh G. Examining the relationship between body mass index and adverse cardio-metabolic profiles among Australian Indigenous and non-Indigenous young adults. Sci Rep 2019; 9:3385. [PMID: 30833627 PMCID: PMC6399243 DOI: 10.1038/s41598-019-40083-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 01/30/2019] [Indexed: 12/22/2022] Open
Abstract
Australian Indigenous young people have a 10-fold excess of deaths from ischaemic heart disease compared with non-Indigenous Australians, yet the reasons behind this remain understudied. This paper aims to describe cardio-metabolic profiles among Australian Indigenous (n = 459) and non-Indigenous (n = 117) young adults (21-27 years). The association between body size and an adverse cardio-metabolic profile (≥3 abnormal cardio-metabolic markers) is assessed by gender and urban/rural residence, employing regression analyses. The prevalence of obesity was highest among urban Indigenous participants, both males and females (22% and 23%, respectively). Overall, BMI showed a significant positive association with an adverse cardio-metabolic profile. Moreover, adverse cardio-metabolic profile was present in a substantial proportion of Indigenous participants even in overweight and normal BMI categories. Among females, this could reflect elevated waist circumference, which was present in half of those of normal weight. Remote Indigenous females had the highest predicted probability of having an adverse cardio-metabolic profile across all BMI categories (13% for underweight, 54% for normal BMI, 93% for overweight, and 99% for obese). Our findings highlight the associations between obesity and adverse cardio-metabolic profiles among Indigenous and non-Indigenous youth. Culturally-relevant strategies that address lifestyle risks, including access to healthy food, are urgently needed in this age group.
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Affiliation(s)
- Arusyak Sevoyan
- School of Public Health, University of Adelaide, Adelaide, SA, Australia.
- Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia.
| | - Belinda Davison
- Menzies School of Health Research, Casuarina, NT, 0811, Australia
| | - Alice Rumbold
- Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia
- School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Vivienne Moore
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
- Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia
| | - Gurmeet Singh
- Menzies School of Health Research, Casuarina, NT, 0811, Australia
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Kang SH, Jung DJ, Cho KH, Park JW, Lee KY, Do JY. Association Between HbA1c Level and Hearing Impairment in a Nondiabetic Adult Population. Metab Syndr Relat Disord 2016; 14:129-34. [DOI: 10.1089/met.2015.0092] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Seok Hui Kang
- Division of Nephrology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Republic of Korea
| | - Da Jung Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Kyu Hyang Cho
- Division of Nephrology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Republic of Korea
| | - Jong Won Park
- Division of Nephrology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Republic of Korea
| | - Kyu-Yup Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Jun-Young Do
- Division of Nephrology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Republic of Korea
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17
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Choi SI, Kim SK, Park S, Kim JH, Ihm SH, Kim GI, Kim WS, Pyun WB, Kim YM, Shin J. Prevalence of resistant hypertension and associated factors for blood pressure control status with optimal medical therapy using Korean ambulatory blood pressure monitoring registry data. Clin Hypertens 2016; 22:8. [PMID: 26893941 PMCID: PMC4750808 DOI: 10.1186/s40885-016-0045-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 01/21/2016] [Indexed: 12/29/2022] Open
Abstract
Background Resistant hypertension (RH) may be one of the cause of the plateau in improving the control rate in hypertension (HT) management. The misdiagnosis of RH by clinic blood pressure (BP) is important clinical problem. Aim of the study were to investigate the prevalence of RH by ambulatory blood pressure monitoring (ABPM) and the factor associated with control status of ambulatory BPs. Methods For 1230 subjects taking one or more antihypertensive medication (AHM) enrolled in the Korean Ambulatory Blood Pressure Monitoring (Kor-ABP) registry, the prevalence of RH was calculated which was defined as uncontrolled BP by three AHM classes including diuretic or BP in need of four or more AHM classes. The prevalence determined by clinic versus ambulatory BP was compared. Results The age was 59.3 ± 12.5 years, and 44.3 % were female (n = 1230). Among them 72 subjects were taking three AHM drugs including diuretics and 105 subjects were taking four or more AHM classes. With uncontrolled daytime ambulatory BP in 41 among 72 subjects, prevalence of RH was 11.9 % (146/1230). By using nighttime BP criteria, there was significant difference in the prevalence of RH for clinic versus nighttime BP (146/177 vs. 159/177, p = 0.0124). For control status of daytime BP, masked uncontrolled BP was 16.9 % and controlled BP with white-coat effect was 14.1 %. For nighttime BP control status, odd ratios for smoking (0.624), drinking (1.512), coronary artery disease (0.604), calcium antagonist (1.705), and loop diuretics (0.454) were all significant. Conclusion The prevalence itself was 11.9 % by daytime BP and it was significantly higher when using nighttime BP criteria. Control status of daytime BP was misclassified in 31.0 %. Smoking, drinking, coronary artery disease, calcium antagonist, and loop diuretics were associated with nighttime BP control status.
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Affiliation(s)
- Sung Il Choi
- Cardiology division, Department of Internal Medicine, Hanyang University, College of Medicine, 222 Wangsimni-ro Sungdong-Ku, Seoul, #133-792 South Korea
| | - Soon Kil Kim
- Cardiology division, Department of Internal Medicine, Hanyang University, College of Medicine, 222 Wangsimni-ro Sungdong-Ku, Seoul, #133-792 South Korea
| | - Sungha Park
- Department of Internal Medicine, Yonsei University, School of Medicine, Seoul, Korea
| | - Ju Han Kim
- Department of Internal Medicine, Chonnam University, School of Medicine, GwangJu, Korea
| | - Sang Hyun Ihm
- Department of Internal Medicine, Catholic University, College of Medicine, Bucheon, Korea
| | - Gwang-Il Kim
- Department of Internal Medicine, Seoul National University, School of Medicine, Bundang, Korea
| | - Woo Shik Kim
- Department of Internal Medicine, Kyung Hee University, School of Medicine, Seoul, Korea
| | - Wook Bum Pyun
- Department of Internal Medicine, Ewha Womans University, School of Medicine, Seoul, Korea
| | - Yu-Mi Kim
- Department of Preventive Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Jinho Shin
- Cardiology division, Department of Internal Medicine, Hanyang University, College of Medicine, 222 Wangsimni-ro Sungdong-Ku, Seoul, #133-792 South Korea
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18
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Robberecht H, Hermans N. Biomarkers of Metabolic Syndrome: Biochemical Background and Clinical Significance. Metab Syndr Relat Disord 2016; 14:47-93. [PMID: 26808223 DOI: 10.1089/met.2015.0113] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Biomarkers of the metabolic syndrome are divided into four subgroups. Although dividing them in groups has some limitations, it can be used to draw some conclusions. In a first part, the dyslipidemias and markers of oxidative stress are discussed, while inflammatory markers and cardiometabolic biomarkers are reviewed in a second part. For most of them, the biochemical background and clinical significance are discussed, although here also a well-cut separation cannot always be made. Altered levels cannot always be claimed as the cause, risk, or consequence of the syndrome. Several factors are interrelated to each other and act in a concerted, antagonistic, synergistic, or modulating way. Most important conclusions are summarized at the end of every reviewed subgroup. Genetic biomarkers or influences of various food components on concentration levels are not included in this review article.
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Affiliation(s)
- Harry Robberecht
- Department of Pharmaceutical Sciences, NatuRA (Natural Products and Food Research and Analysis), University of Antwerp , Wilrijk, Antwerp, Belgium
| | - Nina Hermans
- Department of Pharmaceutical Sciences, NatuRA (Natural Products and Food Research and Analysis), University of Antwerp , Wilrijk, Antwerp, Belgium
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Kang SH, Jung DJ, Choi EW, Cho KH, Park JW, Do JY. HbA1c Levels Are Associated with Chronic Kidney Disease in a Non-Diabetic Adult Population: A Nationwide Survey (KNHANES 2011-2013). PLoS One 2015; 10:e0145827. [PMID: 26716684 PMCID: PMC4696727 DOI: 10.1371/journal.pone.0145827] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 12/09/2015] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Many studies have reported an association between glycated hemoglobin A1c (HbA1c) and metabolic syndrome (MetS) in non-diabetes patients. Each component of MetS is in fact related to chronic kidney disease (CKD) incidence and progression. Therefore, HbA1c in non-diabetic mellitus (DM) may be intrinsically associated with the prevalence of CKD. The hypothesis of the present study was that high HbA1c in non-DM patients is associated with CKD. PATIENTS AND METHODS The total number of participants in this study was 24,594. The participants were divided into three groups according to their HbA1c levels: a Low group (<5.7% or <39 mmol/mol), a Middle group (5.7-6.0% or 39-42 mmol/mol), and a High group (>6.0% or >42 mmol/mol). The estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. RESULTS The number of participants allocated to the Low, Middle, and High groups was 8,651, 4,634, and 1,387, respectively. Linear regression analyses were performed to evaluate the association between variables. Standardized β ± standard error was 0.25 ± 0.22 for waist circumference, 0.44 ± 0.20 for fasting glucose, -0.14 ± 0.30 for high-density lipoprotein cholesterol levels, 0.15 ± 2.31 for triglyceride levels, 0.21 ± 0.00 for systolic blood pressure, 0.10 ± 0.00 for diastolic blood pressure, and -0.22 ± 0.42 for eGFR (P < 0.001 for all variables). eGFR in non-diabetes participants was inversely associated with the HbA1c level, where eGFR decreased as HbA1c levels increased. Standardized βs were -0.04 ± 0.42 in multivariable analysis (P < 0.001). The proportion of participants with only MetS, only CKD, or both MetS and CKD was higher in the High group than in the Low and Middle groups. CONCLUSION High HbA1c in non-DM patients may be associated with CKD. Renal function in patients with high HbA1c levels may need to be monitored.
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Affiliation(s)
- Seok Hui Kang
- Division of Nephrology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Republic of Korea
| | - Da Jung Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Eun Woo Choi
- Division of Nephrology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Republic of Korea
| | - Kyu Hyang Cho
- Division of Nephrology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Republic of Korea
| | - Jong Won Park
- Division of Nephrology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Republic of Korea
| | - Jun Young Do
- Division of Nephrology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Republic of Korea
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Shin J, Park SH, Kim JH, Ihm SH, Kim KI, Kim WS, Pyun WB, Kim YM, Choi SI, Kim SK. Discordance between ambulatory versus clinic blood pressure according to global cardiovascular risk group. Korean J Intern Med 2015; 30:610-9. [PMID: 26354055 PMCID: PMC4578037 DOI: 10.3904/kjim.2015.30.5.610] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Revised: 07/22/2014] [Accepted: 09/04/2014] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND/AIMS The detection of white coat hypertension (WCH), treated normalized hypertension, and masked hypertension (MH) is important to improve the effectiveness of hypertension management. However, whether global cardiovascular risk (GCR) profile has any effect on the discordance between ambulatory blood pressure (ABP) and clinic blood pressure (CBP) is unknown. METHODS Data from 1,916 subjects, taken from the Korean Multicenter Registry for ABP monitoring, were grouped according to diagnostic and therapeutic thresholds for CBP and ABP (140/90 and 135/85 mmHg, respectively). GCR was assessed using European Society of Hypertension 2007 guidelines. RESULTS The mean subject age was 54.1 ± 14.9 years, and 48.9% of patients were female. The discordancy rate between ABP and CBP in the untreated and treated patients was 32.5% and 26.5%, respectively (p = 0.02). The prevalence of WCH or treated normalized hypertension and MH was 14.4% and 16.0%, respectively. Discordance between ABP and CBP was lower in the very high added-risk group compared to the moderate added-risk group (odds ratio [OR], 0.649; 95% confidence interval [CI], 0.487 to 0.863; p = 0.003). The prevalence of WCH or treated normalized hypertension was also lower in the very high added-risk group (OR, 0.451; 95% CI, 0.311 to 0.655). CONCLUSIONS Discordance between ABP and CBP was observed more frequently in untreated subjects than in treated subjects, and less frequently in the very high added-risk group, which was due mainly to the lower prevalence of WCH or treated normalized hypertension.
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Affiliation(s)
- Jinho Shin
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Sung Ha Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Ju Han Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Sang Hyun Ihm
- Department of Internal Medicine, College of Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea, Bucheon, Korea
| | - Kwang-il Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Woo Shik Kim
- Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Wook Bum Pyun
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Yu-Mi Kim
- Department of Preventive Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Sung-il Choi
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Soon Kil Kim
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
- Correspondence to Soon Kil Kim, M.D. Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, 153 Gyeongchun-ro, Guri 11923, Korea Tel: +82-31-560-2233 Fax: +82-31-560-2182 E-mail:
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Saravia G, Civeira F, Hurtado-Roca Y, Andres E, Leon M, Pocovi M, Ordovas J, Guallar E, Fernandez-Ortiz A, Casasnovas JA, Laclaustra M. Glycated Hemoglobin, Fasting Insulin and the Metabolic Syndrome in Males. Cross-Sectional Analyses of the Aragon Workers' Health Study Baseline. PLoS One 2015; 10:e0132244. [PMID: 26241903 PMCID: PMC4524641 DOI: 10.1371/journal.pone.0132244] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 06/11/2015] [Indexed: 11/18/2022] Open
Abstract
Background and Aims Glycated hemoglobin (HbA1c) is currently used to diagnose diabetes mellitus, while insulin has been relegated to research. Both, however, may help understanding the metabolic syndrome and profiling patients. We examined the association of HbA1c and fasting insulin with clustering of metabolic syndrome criteria and insulin resistance as two essential characteristics of the metabolic syndrome. Methods We used baseline data from 3200 non-diabetic male participants in the Aragon Workers' Health Study. We conducted analysis to estimate age-adjusted odds ratios (ORs) across tertiles of HbA1c and insulin. Fasting glucose and Homeostatic model assessment - Insulin Resistance were used as reference. Here we report the uppermost-to-lowest tertile ORs (95%CI). Results Mean age (SD) was 48.5 (8.8) years and 23% of participants had metabolic syndrome. The ORs for metabolic syndrome criteria tended to be higher across HbA1c than across glucose, except for high blood pressure. Insulin was associated with the criteria more strongly than HbA1c and similarly to Homeostatic model assessment - Insulin Resistance (HOMA-IR). For metabolic syndrome, the OR of HbA1c was 2.68, of insulin, 11.36, of glucose, 7.03, and of HOMA-IR, 14.40. For the clustering of 2 or more non-glycemic criteria, the OR of HbA1c was 2.10, of insulin, 8.94, of glucose, 1.73, and of HOMA-IR, 7.83. All ORs were statistically significant. The areas under the receiver operating characteristics curves for metabolic syndrome were 0.670 (across HbA1c values) and 0.770 (across insulin values), and, for insulin resistance, 0.647 (HbA1c) and 0.995 (insulin). Among non-metabolic syndrome patients, a small insulin elevation identified risk factor clustering. Conclusions HbA1c and specially insulin levels were associated with metabolic syndrome criteria, their clustering, and insulin resistance. Insulin could provide early information in subjects prone to develop metabolic syndrome.
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Affiliation(s)
- Gabriela Saravia
- Department of Epidemiogy, Atherothrombosis and Imaging, Spanish National Center for Cardiovascular Research (CNIC), Madrid, Spain
| | - Fernando Civeira
- Instituto Aragonés de Ciencias de la Salud (I+CS), Zaragoza, Spain
| | - Yamilee Hurtado-Roca
- Department of Epidemiogy, Atherothrombosis and Imaging, Spanish National Center for Cardiovascular Research (CNIC), Madrid, Spain
- Boca Raton Clinical Research Global Peru, Lima, Peru
| | - Eva Andres
- Instituto de Investigación 12 de Octubre. CIBER-Epidemiología y Salud Pública, Madrid, Spain
| | - Montserrat Leon
- Instituto Aragonés de Ciencias de la Salud (I+CS), Zaragoza, Spain
| | - Miguel Pocovi
- Instituto Aragonés de Ciencias de la Salud (I+CS), Zaragoza, Spain
| | - Jose Ordovas
- Department of Epidemiogy, Atherothrombosis and Imaging, Spanish National Center for Cardiovascular Research (CNIC), Madrid, Spain
| | - Eliseo Guallar
- Departments of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Antonio Fernandez-Ortiz
- Department of Epidemiogy, Atherothrombosis and Imaging, Spanish National Center for Cardiovascular Research (CNIC), Madrid, Spain
- Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain
| | | | - Martin Laclaustra
- Department of Epidemiogy, Atherothrombosis and Imaging, Spanish National Center for Cardiovascular Research (CNIC), Madrid, Spain
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
- Department of Epidemiology, St. Louis University, St Louis, Missouri, United States of America
- * E-mail:
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Shin JH, Kang JI, Jung Y, Choi YM, Park HJ, So JH, Kim JH, Kim SY, Bae HY. Hemoglobin a1c is positively correlated with framingham risk score in older, apparently healthy nondiabetic korean adults. Endocrinol Metab (Seoul) 2013; 28:103-9. [PMID: 24396663 PMCID: PMC3811715 DOI: 10.3803/enm.2013.28.2.103] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Accepted: 03/21/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Several studies have suggested that elevated levels of hemoglobin A1c (HbA1c) are associated with cardiovascular disease (CVD) in nondiabetic individuals. However, it is unclear whether HbA1c levels can serve as a simple screening marker for increased CVD risk in nondiabetic individuals. Our objective was to evaluate the relationship between HbA1c levels and CVD risk using the Framingham risk score (FRS) in older, apparently healthy nondiabetic Korean adults. METHODS We retrospectively studied 2,879 Korean adults between the ages of 40 and 79 who underwent voluntary health check-ups at the Health Promotion Center of our hospital from July 2009 to June 2011. Subjects were subdivided based on their HbA1c levels into four groups: tertiles within the HbA1c normal tolerance range and a group for subjects with an increased risk for diabetes (IRD). RESULTS The mean FRS for the upper tertile (9.6±3.8) group was significantly higher than that of the middle tertile (8.4±4.0) and lower tertile (7.6±3.8) groups. In addition, FRS was highest in the IRD group (10.5±3.7). Multiple linear regression analysis demonstrated that HbA1c levels exhibited a significant positive correlation with FRS when adjusted for confounding variables in all subjects (β±standard error [SE], 0.018±0.002; R (2), 0.131), women (β±SE, 0.023±0.003; R (2), 0.170), and men (β±SE, 0.016±0.004; R (2), 0.109). CONCLUSION HbA1c levels were positively correlated with FRS in older, apparently healthy nondiabetic Korean adults. We propose that HbA1c levels may reflect CVD risk in nondiabetic individuals.
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Affiliation(s)
| | - Ji In Kang
- Department of Endocrinology and Metabolism, Chosun University Hospital, Chosun University School of Medicine, Gwangju, Korea
| | - Yun Jung
- Department of Endocrinology and Metabolism, Chosun University Hospital, Chosun University School of Medicine, Gwangju, Korea
| | - Young Min Choi
- Department of Endocrinology and Metabolism, Chosun University Hospital, Chosun University School of Medicine, Gwangju, Korea
| | - Hyun Jung Park
- Department of Endocrinology and Metabolism, Chosun University Hospital, Chosun University School of Medicine, Gwangju, Korea
| | - Jung Hae So
- Department of Endocrinology and Metabolism, Chosun University Hospital, Chosun University School of Medicine, Gwangju, Korea
| | - Jin Hwa Kim
- Department of Endocrinology and Metabolism, Chosun University Hospital, Chosun University School of Medicine, Gwangju, Korea
| | - Sang Yong Kim
- Department of Endocrinology and Metabolism, Chosun University Hospital, Chosun University School of Medicine, Gwangju, Korea
| | - Hak Yeon Bae
- Department of Endocrinology and Metabolism, Chosun University Hospital, Chosun University School of Medicine, Gwangju, Korea
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