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Wang X, Yan N, Pan R, Dang Y, Wang L. Examining the Links Between Physical Activity, Sitting Time, and Renal Function in T2DM Patients. Diabetes Metab Syndr Obes 2023; 16:2469-2476. [PMID: 37608849 PMCID: PMC10440599 DOI: 10.2147/dmso.s408677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 08/09/2023] [Indexed: 08/24/2023] Open
Abstract
Background Sitting time and physical activity are related to renal function among type 2 diabetes mellitus (T2DM); however, the mechanism of how it contributes to renal function is not well understood. The current study attempts to explore the relationship between sitting time and renal function among T2DM patients, with a particular focus on the mediating role of physical activity. Methods This research uses the data of 1761 Chinese T2DM patients from Ningxia Province. Sitting time and physical activity were obtained during a face-to-face survey, and renal function was assessed by the estimated glomerular filtration rate (eGFR). The bootstrap method is used to test the mediating effect. Results The research found that sitting time was negatively associated with eGFR and physical activity after controlling for covariates. Physical activity was positively associated with eGFR. Physical activity has mediated the relationship between sitting time and eGFR among T2DM patients (explaining 16.1% of the total variance). Conclusion The present findings suggest that sitting time negatively affects eGFR among T2DM patients and provides new evidence that physical activity could attenuate the association between sitting time and eGFR. Hence, intervention strategies focusing on sitting time and physical activity should be paid more attention in the future.
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Affiliation(s)
- Xiaoyu Wang
- School of Traditional Chinese Medicine, Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Ning Yan
- Heart Centre & Department of Cardiovascular Diseases, General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Ruiping Pan
- Department of Chinese Medicine, The Second People’s Hospital of Shizuishan, Shizuishan, People’s Republic of China
| | - Yuqi Dang
- Department of Endocrinology, Yinchuan Hospital of Traditional Chinese Medicine, Yinchuan, People’s Republic of China
| | - Liqun Wang
- Department of Epidemiology and Statistics, School of Public Health at Ningxia Medical University, Yinchuan, People’s Republic of China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, People’s Republic of China
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Yan N, Chen D, Pan R, Zhang L, Ma J, Zhang Z, Dang Y, Wang L, Ma X, Jia S. The Relationship Between Social Capital and Hypertension Among Type 2 Diabetes Mellitus Patients: The Moderating Effect of Depressive Symptoms. Patient Prefer Adherence 2023; 17:209-216. [PMID: 36713973 PMCID: PMC9875576 DOI: 10.2147/ppa.s396383] [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: 11/17/2022] [Accepted: 01/07/2023] [Indexed: 01/21/2023] Open
Abstract
PURPOSE This study aimed to evaluate the relationship between social capital (SC) and hypertension among type 2 diabetes mellitus (T2DM) patients, considering the moderation effects of depressive symptoms. PATIENTS AND METHODS A total of 1761 Chinese T2DM patients completed measure scales of social capital and epidemiological survey depression scale (CES-D). The Bootstrap methods PROCESS program is employed to test the moderation model. RESULTS The prevalence of hypertension among T2DM patients was 39.3%. The SC was negatively correlated with the CES-D score (r=-0.18, P<0.01); the SC was also negatively correlated with diastolic blood pressure (r=-0.05, P<0.05); and the CES-D score was positively correlated with systolic blood pressure (r=0.05, P<0.05). Both logistic regression analysis and the Bootstrap method showed that depressive symptoms weakened the protective effect of SC on hypertension, there existed a moderating effect of depressive symptoms on the relationship between SC and hypertension among T2DM patients. CONCLUSION Depressive symptoms may be one crucial moderator of the relationship between SC and hypertension in a representative sample of Chinese diabetes patients. The findings indicate that improving SC and mental health may help manage hypertension among T2DM patients.
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Affiliation(s)
- Ning Yan
- Heart Centre & Department of Cardiovascular Diseases, General Hospital of Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
| | - Dapeng Chen
- Heart Centre & Department of Cardiovascular Diseases, General Hospital of Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
| | - Ruiping Pan
- Department of Chinese Medicine, The Second People’s Hospital of Shizuishan, Shizuishan, 753000, People’s Republic of China
| | - Li Zhang
- Department of Endocrinology, General Hospital of Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
| | - Juan Ma
- Clinical Medical College, Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
| | - Zhengjun Zhang
- Heart Centre & Department of Cardiovascular Diseases, General Hospital of Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
| | - Yuqi Dang
- Department of Endocrinology, Yinchuan Hospital of Traditional Chinese Medicine, Yinchuan, 750001, People’s Republic of China
| | - Liqun Wang
- Department of Epidemiology and Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
| | - Xueping Ma
- Heart Centre & Department of Cardiovascular Diseases, General Hospital of Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
- Ningxia Key Laboratory of Vascular Injury and Repair Research, Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
- Correspondence: Xueping Ma; Shaobin Jia, Heart Centre & Department of Cardiovascular Diseases, General Hospital of Ningxia Medical University, Yinchuan, 750004, People’s Republic of China, Tel +8613519290991; +8613995078969, Email ;
| | - Shaobin Jia
- Heart Centre & Department of Cardiovascular Diseases, General Hospital of Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
- Ningxia Key Laboratory of Vascular Injury and Repair Research, Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
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Xu L, Chen S, Xu K, Wang Y, Zhang H, Wang L, He W. Prevalence and associated factors of depression and anxiety among Chinese diabetic retinopathy patients: A cross-sectional study. PLoS One 2022; 17:e0267848. [PMID: 35482738 PMCID: PMC9049521 DOI: 10.1371/journal.pone.0267848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 04/14/2022] [Indexed: 01/18/2023] Open
Abstract
The purposes of this study were to evaluate the mental health among patients with diabetic retinopathy (DR) and to explore its' influencing factors. A cross-sectional survey was conducted in Liaoning Province, China. A total of 200 patients volunteered to participate in the survey. Psycho-social variables included stress, self-efficacy, resilience, and social support. logistic regression analysis was used to explore the effect of psycho-social factors on depression and anxiety in DR patients. The prevalence of depression and anxiety was 25% and 13.5% among DR patients. Regression analysis showed that social support had a significant protective effect on depression (95%CI 0.931-0.997) and anxiety (95%CI 0.900-0.995). Stress had a significant acceleration of depression (95%CI 1.055-1.253) and anxiety (95%CI 1.120-1.457). Family history of diabetes (95%CI 1.856-18.057) and other chronic diseases (95%CI 1.485-12.508) were risk factors for anxiety. The high prevalence of depression (25.0%) and anxiety (13.5%) among DR patients should receive more attention in Chinese medical settings. Stress, social support, family history of diabetes and other chronic diseases seemed to be crucial in relation to depressive symptoms. Efficient interventions such as improving social support and decreasing stress with patients should be considered by health administrators aiming at alleviating depressive and anxiety among Chinese DR patients.
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Affiliation(s)
- Ling Xu
- He Eye Specialist Hospital, Shenyang, China
| | - Siqi Chen
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, Liaoning, People’s Republic of China
| | - Kai Xu
- He Eye Specialist Hospital, Shenyang, China
| | - Yixin Wang
- He Eye Specialist Hospital, Shenyang, China
| | | | - Lie Wang
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, Liaoning, People’s Republic of China
| | - Wei He
- He Eye Specialist Hospital, Shenyang, China
- * E-mail:
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Wang L, Yan N, Guo R, Pu L, Dang Y, Pan R, Niu Y. Mediating Role of Depressive Symptoms on the Association Between Neighborhood Social Cohesion and Quality of Life in Individuals with Type 2 Diabetes Mellitus. Patient Prefer Adherence 2022; 16:1085-1092. [PMID: 35479653 PMCID: PMC9037707 DOI: 10.2147/ppa.s354181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 04/13/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Few studies have explored the association between neighborhood social cohesion (NSC), a type of social capital, and the quality of life of patients with type 2 diabetes mellitus (T2DM). In addition, the potential mechanism for this association remains unclear. The current study examined the mediation effect of depressive symptoms on the relationship between NSC and quality of life among diabetes patients in China. PATIENTS AND METHODS A cross-sectional study of 1747 T2DM patients was conducted. The specific quality of life (DSQL), Center for Epidemiological Survey Depression (CES-D), and social capital scales were administered using a face-to-face survey. Partial correlation analysis and a linear regression model were employed to explore the relationship between NSC, depressive symptoms, and quality of life. Bootstrap analysis using PROCESS was used to test the mediation model. RESULTS After controlling for covariates, NSC was negatively correlated with depressive symptoms (r=-0.24, P<0.01) and DSQL score (r=-0.20, P<0.01) while depressive symptoms were positively correlated with DSQL score (r=0.46, P<0.01). Linear regression analysis also found that NSC was negatively associated with the DSQL score, while depressive symptoms were positively associated with the DSQL score. Depressive symptoms mediated the relationship between NSC and quality of life in T2DM patients (explaining 50.7% of the total variance). CONCLUSION NSC was positively associated with improved quality of life among Chinese T2DM patients in this study, and depressive symptoms were likely to partially explain this relationship. These findings may be used to help maintain a good quality of life among at-risk individuals. Additional prospective studies are needed to confirm these findings.
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Affiliation(s)
- Liqun Wang
- Department of Epidemiology and Statistics, School of Public Health and Management at Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
| | - Ning Yan
- Heart Centre & Department of Cardiovascular Diseases, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750004, People’s Republic of China
| | - Rongrong Guo
- School of traditional Chinese Medicine, Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
| | - Lining Pu
- Department of Epidemiology and Statistics, School of Public Health and Management at Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
| | - Yuqi Dang
- Department of Endocrinology, Yinchuan Hospital of Traditional Chinese Medicine, Yinchuan, 750001, People’s Republic of China
| | - Ruiping Pan
- Department of Chinese Medicine, The Second People’s Hospital of Shizuishan, Shizuishan, 753000, People’s Republic of China
| | - Yang Niu
- School of traditional Chinese Medicine, Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
- Key Laboratory of the Ningxia Ethnomedicine Modernization, Ministry of Education, Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
- Correspondence: Yang Niu, Key Laboratory of the Ningxia Ethnomedicine Modernization, Ministry of Education, Ningxia Medical University, Yinchuan, 750004, People’s Republic of China, Tel +8613909574577, Email
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Wang L, Yan N, Zhang M, Pan R, Dang Y, Niu Y. The association between blood glucose levels and lipids or lipid ratios in type 2 diabetes patients: A cross-sectional study. Front Endocrinol (Lausanne) 2022; 13:969080. [PMID: 36147575 PMCID: PMC9485560 DOI: 10.3389/fendo.2022.969080] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Lipids and lipid ratios are associated with complications of diabetes mellitus type 2 (T2DM), such as cardiovascular disease, but the relationship between blood glucose levels and lipid or lipid ratios is not fully understood in T2DM patients. This study assesses the association between blood glucose levels and lipid or lipid ratios in a cohort of T2DM patients. METHODS A total of 1,747 Chinese T2DM patients from the Ningxia province of China were included in this cross-sectional study. Lipid parameters, including triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C), and fasting blood glucose levels were measured quantitatively using standard methods. Fasting blood glucose was divided into three groups. A multiple mixed-effect linear regression model was conducted to identify a potential association between blood glucose and lipid parameters. RESULTS There was a positive association between blood glucose and TG levels (β=0.34, 95% CI: (0.20, 0.48), p<0.01); every 1 mmol/L increase in blood glucose levels resulted in a 0.34 mmol/L increase in TG. Blood glucose levels were also associated with high LDL (β=0.08, 95% CI: (0.02, 0.14), p<0.01), TG/HDL-C (β=0.31, 95% CI: (0.13, 0.49), p<0.01), and LDL-C/HDL-C (β=0.13, 95% CI: (0.06, 0.20), p<0.01) levels. After controlling for demographic variables, health-related behaviors, and physical health variables, a positive association between blood glucose levels and TG (β=0.31, 95% CI: (0.17, 0.45), p<0.01) and LDL-C (β=0.08, 95% CI: (0.02, 0.13), p<0.01) levels and an in increase in TG/HDL-C (β=0.28, 95% CI: (0.09, 0.46), p<0.01) and LDL-C/HDL-C (β=0.11, 95% CI: (0.04, 0.18), p<0.01) ratios was found. CONCLUSION A correlation between blood glucose levels and serum lipids or lipid ratios has been established in this study. Blood glucose levels were positively associated with TG and LDL-C levels and elevated TG/HDL-C and LDL-C/HDL-C ratios.
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Affiliation(s)
- Liqun Wang
- Ningxia Regional Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Regional High Incidence Disease, Ningxia Medical University, Yinchuan, China
- Key Laboratory of the Ningxia Ethnomedicine Modernization, Ministry of Education, Ningxia Medical University, Yinchuan, China
- Department of Epidemiology and Statistics, School of Public Health and Management at Ningxia Medical University, Yinchuan, China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, China
| | - Ning Yan
- Heart Centre & Department of Cardiovascular Diseases, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Min Zhang
- Department of Rehabilitation Medicine, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Ruiping Pan
- Department of Chinese Medicine, The Second People’s Hospital of Shizuishan, Shizuishan, China
| | - Yuqi Dang
- Department of Endocrinology, Yinchuan Hospital of Traditional Chinese Medicine, Yinchuan, China
| | - Yang Niu
- Ningxia Regional Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Regional High Incidence Disease, Ningxia Medical University, Yinchuan, China
- Key Laboratory of the Ningxia Ethnomedicine Modernization, Ministry of Education, Ningxia Medical University, Yinchuan, China
- *Correspondence: Yang Niu,
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Abstract
Type two diabetes mellitus (T2DM) represents a chronic condition with increasing prevalence worldwide among the older population. The T2DM condition increases the risk of micro and macrovascular complications as well as the risk of geriatric syndromes such as falls, fractures and cognitive impairment. The management of T2DM in the older population represents a challenge for the clinician, and a Comprehensive Geriatric Assessment should always be prioritized, in order to tailor the glycated hemoglobin target according to functional and cognitive status comorbidities, life expectancy and type of therapy. According to the most recent guidelines, older adults with T2DM should be categorized into three groups: healthy patients with good functional status, patients with complications and reduced functionality and patients at the end of life; for each group the target for glycemic control is different, also according to the type of treatment drug. The therapeutic approach should always begin with lifestyle changes; after that, several lines of therapy are available, with different mechanisms of action and potential effects other than glucose level reduction. Particular interest is growing in sodium-glucose cotransporter-2 inhibitors, due to their effect on the cardiovascular system. In this review, we evaluate the therapeutic options available for the treatment of older diabetic patients, to ensure a correct treatment approach.
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