Insulin Resistance Is Associated with Multiple Chemical Sensitivity in a Danish Population-Based Study-DanFunD

Diabetes quality of life, Chemical Intolerance, and generational status in a Latino sample: an RRNeT study

Objectives

The impact of diabetes on quality of life (QoL) includes deficits in physical functioning and emotional and mental health. Individuals with diabetes can experience significant distress related to diabetes management and burden. Comorbid conditions can contribute to QoL among individuals with diabetes. Chemical Intolerance (CI) has received minimal attention in the context of diabetes. CI is characterized by multi-systemic symptoms initiated by a one-time high dose or persistent low-dose exposure to environmental toxins. Latinos experience diabetes distress and are exposed to environmental factors at disproportionate rates. This study sought to investigate generational differences in diabetes QoL and CI in a Latino sample across generational status.

Methods

To assess the modifying effect of CI between QoL and generations, the analysis was stratified by those with and without CI.

Results

Compared to 2nd generation Latinos, Latino immigrants were more likely to indicate that without diabetes, their life would be better across several QoL domains. Latino immigrants had a lower A1C and BMI than2nd generation Latinos. Additionally, they were less likely to have scores indicative of CI than U.S.-born Latinos. QoL varied by generational status and suggested a greater emphasis on family and social relationships among immigrants than U.S.-born Latinos. There were no differences in health services measures across generations.

Conclusions

This study highlights generational differences in the impact of diabetes on QoL. It is one of the few studies to seek to understand the impact of CI on QoL in the context of a chronic condition such as type 2 diabetes.

Lipid metabolism and functional somatic disorders in the general population. The DanFunD study

OBJECTIVES

Earlier studies on the association between plasma lipid profiles and functional somatic disorders (FSD) are mainly small case control studies hampered by selection bias and do not consider the great overlap between the various FSDs. The aim of the present study was to investigate the associations between various FSDs and plasma lipid profiles (total cholesterol, HDL cholesterol, non-HDL cholesterol and triglycerides) in a large, unselected population.

DESIGN

A cross-sectional general population-based study.

SETTING

The Danish Study of Functional Somatic Disorders (DanFunD) conducted in 2011-2015 in 10 municipalities in the western part of greater Copenhagen, Denmark.

PARTICIPANTS

A total of 8,608 men and women aged 18-76 years were included in the analyses. Various delimitations of FSD such as chronic fatigue, chronic widespread pain, irritable bowel, and bodily distress syndrome were measured using validated self-administrated questionnaires. Lipid parameters were measured from fasting plasma samples using colorimetric slide methods with Vitros 4600/5600 Ortho Clinical Diagnostics.

OUTCOME MEASURES

Logistic regression analyses were used to calculate possible associations between plasma lipids and the various delimitations of FSD. Associations are presented by OR (95% CI) and shown in boxplots.

RESULTS

We found a positive association between bodily distress syndrome and triglycerides and non-HDL cholesterol and a negative association with HDL-cholesterol, but no consistent association with total cholesterol. A similar pattern was observed for persons with chronic fatigue, and to some degree for persons with chronic widespread pain, whereas persons with irritable bowel did not show a clear association with the lipid profiles.

CONCLUSION

This is the first major study on plasma lipid profiles and FSD indicating an association between some delimitations of FSD and an unfavorable lipid profile. Due to the cross-sectional design, it cannot be determined whether the findings are consequences or determinants of FSD. Further studies-preferable prospective studies-are needed.

Multiple Chemical Sensitivity: It's time to catch up to the science

Multiple chemical sensitivity (MCS) is a complex medical condition associated with low dose chemical exposures. MCS is characterized by diverse features and common comorbidities, including fibromyalgia, cough hypersensitivity, asthma, and migraine, and stress/anxiety, with which the syndrome shares numerous neurobiological processes and altered functioning within diverse brain regions. Predictive factors linked to MCS comprise genetic influences, gene-environment interactions, oxidative stress, systemic inflammation, cell dysfunction, and psychosocial influences. The development of MCS may be attributed to the sensitization of transient receptor potential (TRP) receptors, notably TRPV1 and TRPA1. Capsaicin inhalation challenge studies demonstrated that TRPV1 sensitization is manifested in MCS, and functional brain imaging studies revealed that TRPV1 and TRPA1 agonists promote brain-region specific neuronal variations. Unfortunately, MCS has often been inappropriately viewed as stemming exclusively from psychological disturbances, which has fostered patients being stigmatized and ostracized, and often being denied accommodation for their disability. Evidence-based education is essential to provide appropriate support and advocacy. Greater recognition of receptor-mediated biological mechanisms should be incorporated in laws, and regulation of environmental exposures.

Examine the public health impacts of functional somatic disorders using the DanFunD study

Background: Persistent physical symptoms (e.g. pain, fatigue) are prevalent in the population and some persons may develop a functional somatic disorder (FSD). We still need to explore the limits between general bodily sensations and FSD, and great controversies exist as regard delimitation, occurrence, risk factors, prognosis, and costs of FSD in the general population. This is mainly due to the lack of focused, sufficient powered, population-based epidemiological studies. Material and Methods: The DanFunD study is the largest focused population-based study on FSD and has the potential to answer these crucial questions regarding the FSD disorders. DanFunD has its origin in the Copenhagen area of Denmark and was initiated in 2009 by an interdisciplinary team of researchers including basic scientists, clinical researchers, epidemiologists, and public health researchers. A population-based cohort of nearly 10,000 people have filled in detailed questionnaires, gone through a thorough health examination, and a biobank is established. The cohort was re-examined after five years. Results:The prevalence of FSD in the Danish population is about 10-15% and is twice as common in women as in men. Persons with FSD report impaired daily activities and low self-perceived health, which qualifies FSD as a major public health problem. The research plan to unravel the risk factors for FSD employs a bio-psycho-social approach according to a detailed plan. Preliminary results are presented, and work is in progress. Likewise, plans for assessing prognosis and health care costs are provided. Conclusion: We invite researchers in the field to collaborate on this unique data material.

Effect of a Community Gerontology Program on the Control of Metabolic Syndrome in Mexican Older Adults

Background: Metabolic syndrome (MS) is highly prevalent in older adults; it constitutes a risk factor for cognitive deterioration, frailty, and Alzheimer’s disease. For this reason, the WHO has pointed out the importance of the implementation of community programs for the training of healthy aging. The aim of this study was to evaluate the effect of a community gerontology program framed in active aging on the control of metabolic syndrome in older adults. Methods: An experimental study was carried out in a convenience sample of 80 older adults diagnosed with MS according to the ATPIII criteria, comprising (1) experimental group (EG), n = 40; (2) control group (CG), n = 40. During a 6-month period, the EG participated in a supervised community gerontology program, and the CG was assessed monthly. Results: A statistically significant decrease was observed in the number of components for the diagnosis of MS. In this regard, of the total of participants with a diagnosis of MS in EG, only 28% maintained the diagnosis of MS (ATPIII ≥ 3 criteria), in contrast to 83% of the CG participants (p < 0.0001). Conclusions: Our findings suggest that health self-care training within the framework of active aging is effective for the control of MS in older adults.