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Arabi A, Nasrallah D, Mohsen S, Abugharbieh L, Al-Hashimi D, AlMass S, Albasti S, Al-Ajmi SA, Zughaier SM. The interplay between vitamin D status, subclinical inflammation, and prediabetes. Heliyon 2024; 10:e35764. [PMID: 39170232 PMCID: PMC11337041 DOI: 10.1016/j.heliyon.2024.e35764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 07/11/2024] [Accepted: 08/02/2024] [Indexed: 08/23/2024] Open
Abstract
Vitamin D's role extends beyond classical calcium and phosphate homeostasis to encompass a pivotal influence on immune modulation and metabolic health. The mechanisms by which vitamin D exerts these effects involve its conversion to hormonally active calcitriol, which binds intracellular vitamin D receptors, initiating various downstream cascades. In this review, we tease out the evidence showing the relationship between vitamin D deficiency and prediabetes within the context of subclinical inflammation, with a special focus on the novel monocyte-to-HDL ratio (MHR), a novel inflammatory marker reflecting subclinical inflammation. This was based on a thorough literature review using reputable databases covering the period from 1980 to 2024. In light of this, we discuss calcitriol's anti-inflammatory effects and consequently link vitamin D deficiency to both overt and subclinical inflammation. Additionally, the utility of several biomarkers, notably MHR, in investigating this association is also discussed. We further reviewed the role of vitamin D deficiency in precipitating prediabetes and type 2 diabetes mellitus (T2DM) via insulin resistance, decreased insulin synthesis and secretion, and subclinical inflammation. Taken together, this mini review highlights that vitamin D deficiency is significantly associated with subclinical inflammation, playing a critical role in the development of prediabetes and the progression to T2DM. Addressing vitamin D deficiency through appropriate interventions may serve as a preventative measure against the development of prediabetes and T2DM.
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Affiliation(s)
| | | | - Sara Mohsen
- College of Medicine, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Lana Abugharbieh
- College of Medicine, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Dana Al-Hashimi
- College of Medicine, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Shaikha AlMass
- College of Medicine, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Shahd Albasti
- College of Medicine, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Saeed A. Al-Ajmi
- College of Medicine, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Susu M. Zughaier
- College of Medicine, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
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Sharma P, Dilip TR, Kulkarni A, Mishra US, Shejul Y. Risk of diabetes and expected years in life without diabetes among adults from an urban community in India: findings from a retrospective cohort. BMC Public Health 2024; 24:1048. [PMID: 38622601 PMCID: PMC11020643 DOI: 10.1186/s12889-024-18465-2] [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: 01/15/2024] [Accepted: 03/27/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Diabetes prevalence has increased over the past few decades, and the shift of the burden of diabetes from the older population to the younger population has increased the exposure of longer durations in a morbid state. The study aimed at ascertaining the likelihood of progression to diabetes and to estimate the onset of diabetes within the urban community of Mumbai. METHODS This study utilized an observational retrospective non-diabetic cohort comprising 1629 individuals enrolled in a health security scheme. Ten years of data were extracted from electronic medical records, and the life table approach was employed to assess the probability of advancing to diabetes and estimate the expected number of years lived without a diabetes diagnosis. RESULTS The study revealed a 42% overall probability of diabetes progression, with age and gender variations. Males (44%) show higher probabilities than females (40%) of developing diabetes. Diabetes likelihood rises with age, peaking in males aged 55-59 and females aged 65-69. Males aged 30-34 exhibit a faster progression (10.6 years to diagnosis) compared to females (12.3 years). CONCLUSION The study's outcomes have significant implications for the importance of early diabetes detection. Progression patterns suggest that younger cohorts exhibit a comparatively slower rate of progression compared to older cohorts.
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Affiliation(s)
- Palak Sharma
- Department of Family and Generations, International Institute for Population Sciences, Mumbai, 400088, India.
| | - T R Dilip
- Department of Family and Generations, International Institute for Population Sciences, Mumbai, 400088, India
| | - Anjali Kulkarni
- Medical Division, Bhabha Atomic Research Center, Mumbai, 400088, India
| | - Udaya Shankar Mishra
- Department of Bio-statistics and Epidemiology, International Institute for Population Sciences, Mumbai, 400088, India
| | - Yogesh Shejul
- Medical Division, Bhabha Atomic Research Center, Mumbai, 400088, India
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Deschênes SS, Nearchou F, McInerney A, Schmitz N, Pouwer F, Nouwen A. Childhood maltreatment and the risk of impaired glucose metabolism or type 2 diabetes in young adults: Findings from the Lifelines Cohort Study. J Health Psychol 2024:13591053241243285. [PMID: 38600690 DOI: 10.1177/13591053241243285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024] Open
Abstract
We examined the associations between childhood maltreatment and the risk of impaired glucose metabolism (IGM) or type 2 diabetes (T2D) in young adults aged 18-35. Participants (N = 8506) from the Lifelines Cohort Study without IGM or diabetes at baseline (2007-2013) were included. Childhood maltreatment was assessed by the Childhood Trauma Questionnaire (CTQ) and incident IGM/T2D was assessed by haemoglobin A1c levels (≥5.7%) in 2014-2017. There were 223 (2.6%) cases of IGM/T2D during the follow-up period. After adjusting for sociodemographic and health/lifestyle covariates and follow-up time, only the CTQ Sexual Abuse subscale was significantly associated with IGM/T2D (RR = 1.05 [95% CI = 1.01, 1.10]). The association remained when additionally accounting for depressive and anxiety symptoms (RR = 1.05 [95% CI = 1.00, 1.09]). Childhood sexual abuse was associated with an increased risk of IGM/T2D in young adults, highlighting the long-term metabolic consequences of childhood maltreatment.
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Affiliation(s)
| | | | | | | | - Frans Pouwer
- University of Southern Denmark, Denmark
- Steno Diabetes Center Odense, Denmark
- Vrije Universiteit Amsterdam, The Netherlands
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Iriarte-Campo V, de Burgos-Lunar C, Mostaza J, Lahoz C, Cárdenas-Valladolid J, Gómez-Campelo P, Taulero-Escalera B, San-Andrés-Rebollo FJ, Rodriguez-Artalejo F, Salinero-Fort MA. Incidence of T2DM and the role of baseline glycaemic status as a determinant in a metropolitan population in northern Madrid (Spain). Diabetes Res Clin Pract 2024; 209:111119. [PMID: 38307139 DOI: 10.1016/j.diabres.2024.111119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 01/16/2024] [Accepted: 01/25/2024] [Indexed: 02/04/2024]
Abstract
AIM To estimate the incidence of T2DM and assess the effect of pre-T2DM (isolated impaired fasting glucose [iIFG], isolated impaired glucose tolerance [iIGT] or both) on progress to T2DM in the adult population of Madrid. METHODS Population-based cohort comprising 1,219 participants (560 normoglycaemic and 659 preT2DM [418 iIFG, 70 iIGT or 171 IFG-IGT]). T2DM was defined based on fasting plasma glucose or HbA1c or use of glucose-lowering medication. We used a Cox model with normoglycaemia as reference category. RESULTS During 7.26 years of follow-up, the unadjusted incidence of T2DM was 11.21 per 1000 person-years (95 %CI, 9.09-13.68) for the whole population, 5.60 (3.55-8.41) for normoglycaemic participants and 16.28 (12.78-20.43) for pre-T2DM participants. After controlling for potential confounding factors, the baseline glycaemic status was associated with higher primary effect on developing T2DM was iIGT (HR = 3.96 [95 %CI, 1.93-8.10]) and IFG-IGT (3.42 [1.92-6.08]). The HR for iIFG was 1.67 (0.96-2.90). Obesity, as secondary effect, was strongly significantly associated (HR = 2.50 [1.30-4.86]). CONCLUSIONS Our incidence of T2DM is consistent with that reported elsewhere in Spain. While baseline iIGT and IFG-IGT behaved a primary effect for progression to T2DM, iIFG showed a trend in this direction.
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Affiliation(s)
- V Iriarte-Campo
- Foundation for Biosanitary Research and Innovation in Primary Care (FIIBAP), Madrid, Spain; Frailty, Multimorbidity Patterns and Mortality in the Elderly Population Residing in the Community - Hospital La Paz Institute for Health Research IdiPAZ, Madrid, Spain
| | - C de Burgos-Lunar
- Department of Preventive Medicine, San Carlos Clinical University Hospital, Madrid, Spain; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain
| | - J Mostaza
- Lipid and Vascular Risk Unit, Department of Internal Medicine, Hospital Carlos III, Madrid, Spain
| | - C Lahoz
- Lipid and Vascular Risk Unit, Department of Internal Medicine, Hospital Carlos III, Madrid, Spain
| | - J Cárdenas-Valladolid
- Frailty, Multimorbidity Patterns and Mortality in the Elderly Population Residing in the Community - Hospital La Paz Institute for Health Research IdiPAZ, Madrid, Spain; Alfonso X El Sabio University, Madrid, Spain
| | - P Gómez-Campelo
- Frailty, Multimorbidity Patterns and Mortality in the Elderly Population Residing in the Community - Hospital La Paz Institute for Health Research IdiPAZ, Madrid, Spain; La Paz University Hospital Biomedical Research Foundation, Madrid, Spain
| | - B Taulero-Escalera
- Foundation for Biosanitary Research and Innovation in Primary Care (FIIBAP), Madrid, Spain; Frailty, Multimorbidity Patterns and Mortality in the Elderly Population Residing in the Community - Hospital La Paz Institute for Health Research IdiPAZ, Madrid, Spain
| | - F J San-Andrés-Rebollo
- Frailty, Multimorbidity Patterns and Mortality in the Elderly Population Residing in the Community - Hospital La Paz Institute for Health Research IdiPAZ, Madrid, Spain; Centro de Salud Las Calesas, Madrid, Spain
| | - F Rodriguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain; CIBERESP, Madrid, Spain; IMDEA-Food, CEI UAM+CSIC Madrid, Spain
| | - M A Salinero-Fort
- Foundation for Biosanitary Research and Innovation in Primary Care (FIIBAP), Madrid, Spain; Frailty, Multimorbidity Patterns and Mortality in the Elderly Population Residing in the Community - Hospital La Paz Institute for Health Research IdiPAZ, Madrid, Spain; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain.
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Bennasar-Veny M, Malih N, Galmes-Panades AM, Hernandez-Bermudez IC, Garcia-Coll N, Ricci-Cabello I, Yañez AM. Effect of physical activity and different exercise modalities on glycemic control in people with prediabetes: a systematic review and meta-analysis of randomized controlled trials. Front Endocrinol (Lausanne) 2023; 14:1233312. [PMID: 37842295 PMCID: PMC10569497 DOI: 10.3389/fendo.2023.1233312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 08/14/2023] [Indexed: 10/17/2023] Open
Abstract
Background Numerous studies have shown the beneficial effects of exercise on glycemic control in people with prediabetes. However, the most effective exercise modality for improving glycemic control remains unclear. We aimed to assess which exercise training modality is most effective in improving glycemic control in a population with prediabetes. Methods We conducted searches in Pubmed/MEDLINE, EMBASE, SPORTDiscus, Web of Science, PEDro, BVS, and the Cochrane Library from inception to June 2022. Included studies reported fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), and 2-hour postprandial (2hPP) levels and implemented an exercise program lasting at least 12 weeks in adults with prediabetes. We performed a direct meta-analysis using a random-effects model and a network meta-analysis. Cochran's Q statistic and the inconsistency I2 test were used to assess the heterogenicity between studies. Results Twenty trials were included, with 15 trials (comprising 775 participants with prediabetes) combined in the meta-analysis, and 13 in the network meta-analysis. The meta-analysis results did not show a statistically significant reduction in fasting plasma glucose (FPG) after aerobic training (AT) intervention compared to a control group (mean (95%CI) difference = -5.18 (-13.48; 3.12) mg/dL, Z=1.22, p=0.22). However, a difference of -7.25 (-13.79; -0.71) mg/dL, p=0.03, in FPG after interval training (IT) intervention was detected compared to a control group. After resistance training (RT) intervention, FPG was significantly lower -6.71 (-12.65,-0.77) mg/dL, Z=2.21, p=0.03, and HbA1c by -0.13 (-0.55, 0.29), p=0.54, compared to the control group. The impact of RT compared to no intervention on 2hPP was not statistically significant (p=0.26). The network meta-analysis did not show statistical significance. Most of the studies presented an unclear risk of bias, and a low and very low-quality of evidence. According to the GRADE criteria, the strength of the body of evidence was low. Conclusion Resistance training and IT had demonstrated benefits on glycemic indices, especially on FPG, in a population with prediabetes. Further studies with larger sample sizes and a more robust methodology that compare different types of exercise modalities, frequencies, and durations, are needed to establish a beneficial exercise intervention. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=370688, identifier CRD42022370688.
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Affiliation(s)
- Miquel Bennasar-Veny
- Global Health and Lifestyles Research Group, Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), Palma, Spain
| | - Narges Malih
- Research Group on Global Health, University of the Balearic Islands (UIB), Palma, Spain
| | - Aina M. Galmes-Panades
- Global Health and Lifestyles Research Group, Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Research Group on Global Health, University of the Balearic Islands (UIB), Palma, Spain
- CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Physical Activity and Sport Sciences Research Group (GICAFE), Institute for Educational Research and Innovation (IRIE), University of the Balearic Islands, Palma, Spain
| | | | - Natalia Garcia-Coll
- Research Group on Global Health, University of the Balearic Islands (UIB), Palma, Spain
| | - Ignacio Ricci-Cabello
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- Research Group in Primary Care and Promotion—Balearic Islands Community (GRAPP-caIB), Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Primary Care Research Unit of Mallorca (IB-Salut), Balearic Health Service, Palma de Mallorca, Spain
| | - Aina M. Yañez
- Global Health and Lifestyles Research Group, Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), Palma, Spain
- Research Group on Global Health, University of the Balearic Islands (UIB), Palma, Spain
- Research Network on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, Madrid, Spain
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Li L, Wan Z, Geng T, Lu Q, Zhu K, Qiu Z, Zhang X, Liu Y, Tian Q, Liu L, Pan A, Shan Z, Liu G. Associations of healthy dietary patterns with mortality among people with prediabetes. Eur J Nutr 2023; 62:1377-1387. [PMID: 36574039 DOI: 10.1007/s00394-022-03078-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 12/16/2022] [Indexed: 12/28/2022]
Abstract
PURPOSE To examine the associations of healthy dietary patterns with cardiometabolic biomarkers and all-cause mortality among individuals with prediabetes. METHODS This cohort study included 8363 adults with prediabetes from the National Health and Nutrition Examination Survey 1999-2014. Healthy dietary patterns including Alternate Healthy Eating Index-2010 (AHEI-2010), Alternate Mediterranean Diet score (AMED), Dietary Approaches to Stop Hypertension score (DASH), and Healthy Eating Index-2015 (HEI-2015) were calculated based on 24-h dietary recall data. Mortality status was obtained by linkage to National Death Index records. Cardiometabolic biomarkers, including blood glucose, insulin, HbA1c, C-reactive protein (CRP), and lipids, were measured at recruitment. RESULTS During 61,991 person-years of follow-up, 991 deaths occurred. Comparing the extreme quartiles, the multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality were 0.65 (0.49, 0.85) for AHEI-2010 (P-trend = 0.002), 0.68 (0.50, 0.92) for AMED (P-trend = 0.004), 0.72 (0.53, 0.98) for DASH (P-trend = 0.03), and 0.78 (0.58, 1.05) for HEI-2015 (P-trend = 0.08). Besides, the HRs (95% CIs) for all-cause mortality per 20-percentile increment in scores were 0.78 (0.67, 0.90) for AHEI-2010 (P = 0.001), 0.73 (0.62, 0.86) for AMED (P < 0.001), 0.84 (0.69, 1.02) for DASH (P = 0.08), and 0.86 (0.74, 1.00) for HEI-2015 (P = 0.04). In addition, higher dietary scores were associated with favorable blood glucose, insulin, HOMA-IR, blood lipids, and CRP (all P-trend < 0.05). The high-density lipoprotein cholesterol and CRP explained 1.53-9.21% of the associations between dietary patterns and all-cause mortality (P < 0.05). CONCLUSIONS Diets with higher AHEI-2010, AMED, DASH, and HEI-2015 were associated with improved cardiometabolic factors and lower all-cause mortality among individuals with prediabetes. These findings suggest that multiple healthy dietary patterns instead of a one-size-fits-all diet plan might be beneficial and acceptable for individuals with prediabetes.
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Affiliation(s)
- Lin Li
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety (Huazhong University of Science and Technology), Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
| | - Zhenzhen Wan
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety (Huazhong University of Science and Technology), Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
| | - Tingting Geng
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety (Huazhong University of Science and Technology), Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qi Lu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety (Huazhong University of Science and Technology), Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
| | - Kai Zhu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety (Huazhong University of Science and Technology), Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
| | - Zixin Qiu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety (Huazhong University of Science and Technology), Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
| | - Xuena Zhang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety (Huazhong University of Science and Technology), Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
| | - Yujie Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety (Huazhong University of Science and Technology), Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
| | - Qingying Tian
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety (Huazhong University of Science and Technology), Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
| | - Liegang Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety (Huazhong University of Science and Technology), Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
| | - An Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhilei Shan
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety (Huazhong University of Science and Technology), Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China.
| | - Gang Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety (Huazhong University of Science and Technology), Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China.
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Nabila S, Kim JE, Choi J, Park J, Shin A, Lee SA, Lee JK, Kang D, Choi JY. Associations Between Modifiable Risk Factors and Changes in Glycemic Status Among Individuals With Prediabetes. Diabetes Care 2023; 46:535-543. [PMID: 36625739 DOI: 10.2337/dc22-1042] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 12/03/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To examine the associations between modifiable risk factors and glycemic status changes in individuals with prediabetes. RESEARCH DESIGN AND METHODS A total of 10,358 individuals with prediabetes defined by their fasting blood glucose and HbA1c levels from the Health Examinees-Gem study were included in the present study. Modifiable factors, including BMI, abdominal obesity, smoking status, physical activity, alcohol consumption, diet quality, hypertension, and dyslipidemia, were examined to determine their associations with changes in glycemic status during follow-up. In addition, modifiable-factor scores were calculated, and their association with changes in glycemic status was also analyzed. RESULTS The median follow-up time for this study was 4 years (range, 1-7 years). BMI ≥25 kg/m2 (adjusted odds ratio [OR] 0.71 [95% CI 0.63-0.79]), abdominal obesity (OR 0.76 [95% CI 0.68-0.86]), heavy drinking (OR 0.74 [95% CI 0.60-0.91]), hypertension (OR 0.71 [95% CI 0.64-0.79]), and dyslipidemia (OR 0.78 [95% CI 0.70-0.85]) were associated with a lower possibility of normoglycemia reversion. BMI ≥25 kg/m2 (OR 1.58 [95% CI 1.29-1.94]), abdominal obesity (OR 1.31 [95% CI 1.11-1.55]), current smoking (OR 1.43 [95% CI 1.07-1.91]), and hypertension (OR 1.26 [95% CI 1.07-1.49]) were associated with a higher probability of type 2 diabetes progression. Having more favorable modifiable factors was also associated with normoglycemia reversion (OR 1.46 [95% CI 1.30-1.64]) and type 2 diabetes progression (OR 0.62 [95% CI 0.49-0.77]). CONCLUSIONS More favorable modifiable factors were related to a higher probability of returning to normoglycemia and a lower probability of progression to type 2 diabetes.
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Affiliation(s)
- Salma Nabila
- 1Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea
- 2BK21plus Biomedical Science Project, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ji-Eun Kim
- 1Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea
- 2BK21plus Biomedical Science Project, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jaesung Choi
- 2BK21plus Biomedical Science Project, Seoul National University College of Medicine, Seoul, Republic of Korea
- 3Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - JooYong Park
- 1Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea
- 2BK21plus Biomedical Science Project, Seoul National University College of Medicine, Seoul, Republic of Korea
- 4Department of Big Data Medical Convergence, Eulji University, Seongnam-Si, Gyeonggi-Do, Republic of Korea
| | - Aesun Shin
- 5Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- 6Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Sang-Ah Lee
- 7Department of Preventive Medicine, Kangwon National University School of Medicine, Gangwon, Republic of Korea
| | - Jong-Koo Lee
- 8Department of Family Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Daehee Kang
- 1Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea
- 5Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- 6Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
- 9Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Ji-Yeob Choi
- 1Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea
- 2BK21plus Biomedical Science Project, Seoul National University College of Medicine, Seoul, Republic of Korea
- 3Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Republic of Korea
- 6Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
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Dietary Intervention on Overweight and Obesity after Confinement by COVID-19. Nutrients 2023; 15:nu15040912. [PMID: 36839270 PMCID: PMC9960430 DOI: 10.3390/nu15040912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Obesity has become a public health problem in our society and is associated with many diseases, including type 2 diabetes mellitus, cardiovascular diseases, dyslipidemia, respiratory diseases, and cancer. Several studies relate weight loss in obese patients to improved anthropometric measurements and cardiometabolic risk. The objective of our study was to evaluate anthropometric changes, analytical parameters, insulin resistance, fatty liver, and metabolic scales, after a personalized weight loss program, through dietary advice to increase adherence to the Mediterranean diet and a motivational booster via mobile SMS messaging. METHODS Intervention study on a sample of 1964 workers, in which different anthropometric parameters were evaluated before and after dietary intervention: the metabolic score of insulin resistance; non-alcoholic fatty liver disease using different scales; metabolic syndrome; atherogenic dyslipidemia; and the cardiometabolic index. A descriptive analysis of the categorical variables was performed, by calculating the frequency and distribution of the responses for each one. For quantitative variables, the mean and standard deviation were calculated, since they followed a normal distribution. Bivariate association analysis was performed by applying the chi-squared test (corrected by Fisher's exact statistic when conditions required it) and Student's t-test for independent samples (for comparison of means). RESULTS The population subjected to the Mediterranean diet improved in all the variables evaluated at 12 months of follow-up and compliance with the diet. CONCLUSIONS Dietary advice on a Mediterranean diet and its reinforcement with reminder messages through the use of mobile phones may be useful to improve the parameters evaluated in this study and reduce the cardiometabolic risk of patients.
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Fuster-Parra P, Yañez AM, López-González A, Aguiló A, Bennasar-Veny M. Identifying risk factors of developing type 2 diabetes from an adult population with initial prediabetes using a Bayesian network. Front Public Health 2023; 10:1035025. [PMID: 36711374 PMCID: PMC9878341 DOI: 10.3389/fpubh.2022.1035025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 12/15/2022] [Indexed: 01/14/2023] Open
Abstract
Background It is known that people with prediabetes increase their risk of developing type 2 diabetes (T2D), which constitutes a global public health concern, and it is associated with other diseases such as cardiovascular disease. Methods This study aimed to determine those factors with high influence in the development of T2D once prediabetes has been diagnosed, through a Bayesian network (BN), which can help to prevent T2D. Furthermore, the set of features with the strongest influences on T2D can be determined through the Markov blanket. A BN model for T2D was built from a dataset composed of 12 relevant features of the T2D domain, determining the dependencies and conditional independencies from empirical data in a multivariate context. The structure and parameters were learned with the bnlearn package in R language introducing prior knowledge. The Markov blanket was considered to find those features (variables) which increase the risk of T2D. Results The BN model established the different relationships among features (variables). Through inference, a high estimated probability value of T2D was obtained when the body mass index (BMI) was instantiated to obesity value, the glycosylated hemoglobin (HbA1c) to more than 6 value, the fatty liver index (FLI) to more than 60 value, physical activity (PA) to no state, and age to 48-62 state. The features increasing T2D in specific states (warning factors) were ranked. Conclusion The feasibility of BNs in epidemiological studies is shown, in particular, when data from T2D risk factors are considered. BNs allow us to order the features which influence the most the development of T2D. The proposed BN model might be used as a general tool for prevention, that is, to improve the prognosis.
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Affiliation(s)
- Pilar Fuster-Parra
- Department of Mathematics and Computer Sciences, Balearic Islands University, Palma, Spain,Institut d'Investigació Sanitària Illes Balears (IdISBa), Hospital Universitari Son Espases, Palma, Spain
| | - Aina M. Yañez
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Hospital Universitari Son Espases, Palma, Spain,Department of Nursing and Physiotherapy, Balearic Islands University, Palma, Spain,Research Group on Global Health and Human Development, Balearic Islands University, Palma, Spain,*Correspondence: Aina M. Yañez ✉
| | - Arturo López-González
- Escuela Universitaria ADEMA, Palma, Spain,Prevention of Occupational Risk in Health Services, Balearic Islands Health Service, Palma, Spain
| | - A. Aguiló
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Hospital Universitari Son Espases, Palma, Spain,Department of Nursing and Physiotherapy, Balearic Islands University, Palma, Spain
| | - Miquel Bennasar-Veny
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Hospital Universitari Son Espases, Palma, Spain,Department of Nursing and Physiotherapy, Balearic Islands University, Palma, Spain,CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
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Efficacy of Different Modalities and Frequencies of Physical Exercise on Glucose Control in People with Prediabetes (GLYCEX Randomised Trial). Metabolites 2022; 12:metabo12121286. [PMID: 36557324 PMCID: PMC9785307 DOI: 10.3390/metabo12121286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
To assess the efficacy of different modalities and frequencies of physical exercise on glycaemic control in adults with prediabetes. A two-phase, parallel, randomised, controlled clinical trial will be carried out, in 210 participants. In phase 1, 120 participants will be randomized into four arms: (1) aerobic exercise, (2) aerobic exercise combined with resistance, (3) high-intensity intervallic exercise and (4) control group. In phase 2, 90 new participants will be randomized into three arms, using the exercise modality that showed the best glycaemic control in phase 1 in the following manner: (1) frequency of 5 days/week, (2) frequency of 3 days/week and (3) frequency of 2 days/week. The control group (n = 30) will be included in phase 1 to evaluate the effect of any type of intervention versus no intervention. Data collection will be performed at baseline and after 15 weeks of follow up. Sociodemographic data, medication, comorbidity, blood biochemical parameters, blood pressure, anthropometric measurements, body composition, physical activity, sedentary lifestyle, diet, smoking, alcohol consumption, quality of life and sleep questionnaires will be collected. Physical activity, sedentary behaviour and sleep will be further determined with an accelerometer, and continuous glycaemia will be determined with a glycaemic monitor, both during seven days, at two time points. The main dependent variable will be the reduction in the mean amplitude of glycaemic excursions. The impact of these interventions on health will also be evaluated through gene expression analysis in peripheral blood cells. The results of this study will contribute to a better understanding of the mechanisms behind the glucose response to physical exercise in a population with prediabetes as well as improve physical exercise prescriptions for diabetes prevention. Increasing glycaemic control in people with prediabetes through physical exercise offers an opportunity to prevent diabetes and reduce associated comorbidities and health costs.
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Galmes-Panades AM, Angullo E, Mira-Martínez S, Bennasar-Veny M, Zamanillo-Campos R, Gómez-Juanes R, Konieczna J, Jiménez R, Serrano-Ripoll MJ, Fiol-deRoque MA, Miralles J, Yañez AM, Romaguera D, Vidal-Thomas MC, Llobera-Canaves J, García-Toro M, Vicens C, Gervilla-García E, Oña JI, Malih N, Leiva A, Bulilete O, Montaño JJ, Gili M, Roca M, Ricci-Cabello I. Development and Evaluation of a Digital Health Intervention to Prevent Type 2 Diabetes in Primary Care: The PREDIABETEXT Study Protocol for a Randomised Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14706. [PMID: 36429423 PMCID: PMC9690330 DOI: 10.3390/ijerph192214706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a highly prevalent disease associated with an increased risk of comorbidities, premature death, and health costs. Prediabetes is a stage of glucose alteration previous to T2DM, that can be reversed. The aim of the study is to develop and evaluate a low-intensity, multifaceted, digital intervention to prevent T2DM. The intervention comprises: (1) the use of mobile health technology to send tailored text messages promoting lifestyle changes to people at risk of T2DM and (2) the provision of online education to primary healthcare physicians and nurses about management of prediabetes. METHODS In stages 1-4 we will design, develop and pilot-test the intervention. In Stage 5 we will conduct a phase II, six-month, three-arm, cluster randomized, clinical trial with 42 primary care professionals and 420 patients at risk of T2DM. Patients will be allocated to a control group (usual care), intervention A (patient messaging intervention), or intervention B (patient messaging intervention plus online education to their primary healthcare professionals). The primary outcome will be glycated haemoglobin. All the procedures obtained ethical approval in June 2021 (CEI-IB Ref No: IB4495/21PI). DISCUSSION Digital health interventions can effectively prevent T2DM and reduce important T2DM risk factors such as overweight or hypertension. In Spain, this type of intervention is understudied. Moreover, there is controversy regarding the type of digital health interventions that are more effective. Findings from this study may contribute to address T2DM prevention, through a low-cost and easily implementable intervention.
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Affiliation(s)
- Aina M. Galmes-Panades
- Global Health and Lifestyle (EVES Group), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), 07120 Palma, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), 07120 Palma, Spain
| | - Escarlata Angullo
- Escola Graduada Primary Health Care Center, Balearic Health Service, 07002 Palma de Mallorca, Spain
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands-IUNICS, IDISBA & CIBEROBN (Physiopathology of Obesity and Nutrition), 07120 Palma de Mallorca, Spain
| | - Sofía Mira-Martínez
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Group in Primary Care and Promotion—Balearic Islands Community (GRAPP-caIB), 07120 Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca (IB-Salut), Balearic Health Service, 07002 Palma de Mallorca, Spain
| | - Miquel Bennasar-Veny
- Global Health and Lifestyle (EVES Group), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), 07120 Palma, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), 07120 Palma, Spain
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07120 Palma de Mallorca, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Rocío Zamanillo-Campos
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Group in Primary Care and Promotion—Balearic Islands Community (GRAPP-caIB), 07120 Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca (IB-Salut), Balearic Health Service, 07002 Palma de Mallorca, Spain
| | - Rocío Gómez-Juanes
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07120 Palma de Mallorca, Spain
- Department of Medicine, University of the Balearic Islands, 07122 Palma, Spain
| | - Jadwiga Konieczna
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), 07120 Palma de Mallorca, Spain
| | - Rafael Jiménez
- Statistical and Psychometric Procedures Applied in Health Sciences (PSICOMEST), Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
- Department of Psychology, University of the Balearic Islands (UIB), 07120 Palma, Spain
| | - Maria Jesús Serrano-Ripoll
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Group in Primary Care and Promotion—Balearic Islands Community (GRAPP-caIB), 07120 Palma de Mallorca, Spain
- Research Network on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Maria Antonia Fiol-deRoque
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Group in Primary Care and Promotion—Balearic Islands Community (GRAPP-caIB), 07120 Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca (IB-Salut), Balearic Health Service, 07002 Palma de Mallorca, Spain
| | - Jerónima Miralles
- Research Group in Primary Care and Promotion—Balearic Islands Community (GRAPP-caIB), 07120 Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca (IB-Salut), Balearic Health Service, 07002 Palma de Mallorca, Spain
| | - Aina M. Yañez
- Global Health and Lifestyle (EVES Group), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), 07120 Palma, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), 07120 Palma, Spain
- Research Group on Global Health and Human Development, University of the Balearic Islands (UIB), 07120 Palma, Spain
| | - Dora Romaguera
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), 07120 Palma de Mallorca, Spain
| | - Maria Clara Vidal-Thomas
- Research Group in Primary Care and Promotion—Balearic Islands Community (GRAPP-caIB), 07120 Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca (IB-Salut), Balearic Health Service, 07002 Palma de Mallorca, Spain
| | - Joan Llobera-Canaves
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Group in Primary Care and Promotion—Balearic Islands Community (GRAPP-caIB), 07120 Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca (IB-Salut), Balearic Health Service, 07002 Palma de Mallorca, Spain
- Research Network on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Mauro García-Toro
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07120 Palma de Mallorca, Spain
- Department of Medicine, University of the Balearic Islands, 07122 Palma, Spain
- Research Network on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Catalina Vicens
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Department of Medicine, University of the Balearic Islands, 07122 Palma, Spain
- Son Serra-La Vileta Primary Health Care Center, Balearic Health Service, 07013 Palma, Spain
| | - Elena Gervilla-García
- Statistical and Psychometric Procedures Applied in Health Sciences (PSICOMEST), Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
- Department of Psychology, University of the Balearic Islands (UIB), 07120 Palma, Spain
| | - José Iván Oña
- Dra. Teresa Piqué Primary Health Care Center, Balearic Health Service, 07003 Palma, Spain
| | - Narges Malih
- Research Group on Global Health and Human Development, University of the Balearic Islands (UIB), 07120 Palma, Spain
| | - Alfonso Leiva
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Group in Primary Care and Promotion—Balearic Islands Community (GRAPP-caIB), 07120 Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca (IB-Salut), Balearic Health Service, 07002 Palma de Mallorca, Spain
- Research Network on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Oana Bulilete
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Group in Primary Care and Promotion—Balearic Islands Community (GRAPP-caIB), 07120 Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca (IB-Salut), Balearic Health Service, 07002 Palma de Mallorca, Spain
- Research Network on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Juan José Montaño
- Statistical and Psychometric Procedures Applied in Health Sciences (PSICOMEST), Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
- Department of Psychology, University of the Balearic Islands (UIB), 07120 Palma, Spain
| | - Margalida Gili
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07120 Palma de Mallorca, Spain
- Department of Medicine, University of the Balearic Islands, 07122 Palma, Spain
- Statistical and Psychometric Procedures Applied in Health Sciences (PSICOMEST), Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
- Research Network on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Miquel Roca
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07120 Palma de Mallorca, Spain
- Department of Medicine, University of the Balearic Islands, 07122 Palma, Spain
- Research Network on Chronicity, Primary Care, and Health Promotion (RICAPPS), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Ignacio Ricci-Cabello
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Group in Primary Care and Promotion—Balearic Islands Community (GRAPP-caIB), 07120 Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca (IB-Salut), Balearic Health Service, 07002 Palma de Mallorca, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, 28029 Madrid, Spain
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Fresneda S, Abbate M, Busquets-Cortés C, López-González A, Fuster-Parra P, Bennasar-Veny M, Yáñez AM. Sex and age differences in the association of fatty liver index-defined non-alcoholic fatty liver disease with cardiometabolic risk factors: a cross-sectional study. Biol Sex Differ 2022; 13:64. [PMID: 36333736 PMCID: PMC9636717 DOI: 10.1186/s13293-022-00475-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022] Open
Abstract
Background Despite the extensive scientific evidence accumulating on the epidemiological risk factors for non-alcoholic fatty liver disease (NAFLD), evidence exploring sex- and age-related differences remains insufficient. The present cross-sectional study aims to investigate possible sex differences in the prevalence of FLI-defined NAFLD as well as in its association with common risk factors across different age groups, in a large sample of Spanish working adults. Methods This cross-sectional study included data from 33,216 Spanish adult workers (18–65 years) randomly selected during voluntary routine occupational medical examinations. Sociodemographic characteristics (age and social class), anthropometric (height, weight, and waist circumference) and clinical parameters (blood pressure and serum parameters) were collected. NAFLD was determined by the validated fatty liver index (FLI) with a cut-off value of ≥ 60. The presence of metabolic syndrome (MetS) was assessed according to the diagnostic criteria of the International Diabetes Federation. Cardiovascular risk was determined using the REGICOR-Framingham equation. The association between FLI-defined NAFLD and risk factors by sex and age was evaluated by multivariate logistic regression. Results The prevalence of FLI-defined NAFLD (FLI ≥ 60) was 19.1% overall, 27.9% (95% CI 23.3–28.5%) for men and 6.8% (95% CI 6.4–7.3%) for women and increasing across age intervals. As compared to women, men presented worse cardiometabolic and anthropometric profiles. The multivariate analysis model showed that hepatic steatosis assessed by FLI was strongly associated with age, HDL-cholesterol, social class, prediabetes, diabetes, prehypertension, hypertension, and smoking status for both men and women. The association between diabetes and hypertension with FLI-defined NAFLD was stronger in women than in men at both univariate and multivariate analyses. Conclusions Men presented a higher prevalence of NAFLD than women across all age intervals, as well as a worse cardiometabolic profile and a higher cardiovascular risk. Nevertheless, the association between FLI-defined NAFLD and diabetes or hypertension was significantly stronger in women than in men, possibly indicating that the presence of a dysmetabolic state might affect women more than men with regard to liver outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s13293-022-00475-7. There is a lack of evidence exploring sex- and age-related differences on the epidemiological risk factors for non-alcoholic fatty liver disease. In our sample, hepatic steatosis assessed by FLI is more prevalent in men than women and is associated with age, lower social class and a dysmetabolic state characterized by prediabetes or diabetes, prehypertension or hypertension and low HDL-cholesterol. Importantly, we observed that although FLI-defined NAFLD is strongly associated with cardiometabolic imbalances in both sexes, its association with diabetes and hypertension is stronger in women than in men, regardless of age. We also observed that such association in women is evident even at stages preceding diabetes and hypertension and at younger ages.
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Affiliation(s)
- Sergio Fresneda
- Department of Nursing and Physiotherapy, Balearic Islands University, Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears Spain ,Research Group on Global Health and Lifestyle, Instituto de Investigación Sanitaria Illes Balears (IdISBa), Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears Spain ,Research Group on Global Health & Human Development, Balearic Islands University, Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears Spain
| | - Manuela Abbate
- Research Group on Global Health and Lifestyle, Instituto de Investigación Sanitaria Illes Balears (IdISBa), Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears Spain ,Research Group on Global Health & Human Development, Balearic Islands University, Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears Spain ,Escuela Universitaria ADEMA, C/ Gremi de Passamaners, 11, 07009 Palma, Illes Balears Spain
| | - Carla Busquets-Cortés
- Research Group on Global Health and Lifestyle, Instituto de Investigación Sanitaria Illes Balears (IdISBa), Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears Spain ,Escuela Universitaria ADEMA, C/ Gremi de Passamaners, 11, 07009 Palma, Illes Balears Spain
| | - Arturo López-González
- Research Group on Global Health and Lifestyle, Instituto de Investigación Sanitaria Illes Balears (IdISBa), Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears Spain ,Escuela Universitaria ADEMA, C/ Gremi de Passamaners, 11, 07009 Palma, Illes Balears Spain ,Prevention of Occupational Risk in Health Services, Balearic Islands Health Service, C/ Reina Esclaramunda, 9, 07003 Palma, Illes Balears Spain
| | - Pilar Fuster-Parra
- Department of Mathematics and Computer Science, Balearic Islands University, Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears Spain
| | - Miquel Bennasar-Veny
- Department of Nursing and Physiotherapy, Balearic Islands University, Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears Spain ,Research Group on Global Health and Lifestyle, Instituto de Investigación Sanitaria Illes Balears (IdISBa), Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears Spain ,Research Group on Global Health & Human Development, Balearic Islands University, Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears Spain ,grid.413448.e0000 0000 9314 1427CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Aina M. Yáñez
- Department of Nursing and Physiotherapy, Balearic Islands University, Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears Spain ,Research Group on Global Health and Lifestyle, Instituto de Investigación Sanitaria Illes Balears (IdISBa), Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears Spain ,Research Group on Global Health & Human Development, Balearic Islands University, Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears Spain
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Busquets-Cortés C, López C, Paublini H, Arroyo Bote S, López-González ÁA, Ramírez-Manent JI. Relationship between Atherogenic Dyslipidaemia and Lipid Triad with Different Scales of Overweight and Obesity in 418,343 Spanish Workers. J Nutr Metab 2022; 2022:9946255. [PMID: 35982945 PMCID: PMC9381295 DOI: 10.1155/2022/9946255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 06/16/2022] [Accepted: 07/03/2022] [Indexed: 11/18/2022] Open
Abstract
Obesity induces alterations in lipid biochemistry, evolving toward dyslipidaemia atherogenesis, a critical factor in the development of cardiovascular events. Two relevant forms of lipid abnormalities are atherogenic dyslipidaemia (AD) and lipid triad (LT), which involve alterations in triglyceride levels, HDL-c, and LDL-c. The aim of this study was to assess the linkage of atherogenic AD and LT with different scales of overweight and obesity. We carried out a cross-sectional study including 418,343 Spanish adult workers, recruited from workplace health assessments. Atherogenic dyslipidaemia was defined as triglyceride levels ≥ 150 mg/dL, HDL values < 40 mg/dL in men and <45 mg/dL in women, and normal LDL. Additionally, if LDL levels were >160 mg/dL, LT was considered. Subjects affected by AD and LT in the study exhibited significantly higher mean values than those without AD and LT in all overweight, obesity, and body fat related scales studied. VAI (visceral adiposity index) was the strongest predictor of AD (AUC = 0.934, 95% CI: 0.933 to 0.936) and LT (AUC = 0.926, 95% CI: 0.923 to 0.928). Atherogenic dyslipidaemia and LT positively correlate with different scales of overweight and obesity. Further studies should aim to identify other contributory factors. Our obtained data might be useful in laying the groundwork for future works on AD and LT.
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Affiliation(s)
- Carla Busquets-Cortés
- ADEMA University School, Carrer de Passamaners 11, Palma 07009, Balearic Islands, Spain
| | - Carlos López
- ADEMA University School, Carrer de Passamaners 11, Palma 07009, Balearic Islands, Spain
| | - Hernán Paublini
- ADEMA University School, Carrer de Passamaners 11, Palma 07009, Balearic Islands, Spain
| | | | - Ángel Arturo López-González
- ADEMA University School, Carrer de Passamaners 11, Palma 07009, Balearic Islands, Spain
- Prevention of Occupational Risks in Health Services, Balearic Islands Health Service, Palma, Spain
| | - José Ignacio Ramírez-Manent
- Balearic Islands Health Service, Family Medicine, Calvià, Spain
- Faculty of Medicine, University of the Balearic Islands, Palma, Spain
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Li M, Wang S, Liu X, Sheng Z, Li B, Li J, Zhang J, Zhang Z. Cadmium exposure decreases fasting blood glucose levels and exacerbates type-2 diabetes in a mouse model. Endocrine 2022; 76:53-61. [PMID: 35041127 DOI: 10.1007/s12020-021-02974-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 12/22/2021] [Indexed: 01/12/2023]
Abstract
PURPOSE Although the effects of cadmium (Cd) on the development of diabetes have been extensively investigated, the relationship between Cd exposure and the severity of established diabetes is unclear. Herein, we investigate the effects of long-term exposure to Cd in a streptozotocin-induced mouse model of type-2 diabetes mellitus (T2DM) and the underlying mechanism. METHODS C57BL/6 Mice were divided into the following four groups: (1) control group; (2) Cd-exposed group; (3) diabetic group; (4) Cd-exposed diabetic group. Cd exposure was established by the administration of 155 ppm CdCl2 in drinking water. After 25 weeks of treatment, serum fasting glucose and insulin were measured. Meanwhile, the liver and pancreas specimens were sectioned and stained with Hematoxylin and eosin. Gluconeogenesis, glycolysis, lactate concentration, and fibrosis in liver were evaluated. RESULTS Clinical signs attributable to diabetes were more apparent in Cd-exposed diabetic mice, while no effects of Cd exposure were found on non-diabetic mice. Cd exposure significantly decreased fasting blood glucose (FBG) levels in diabetic group. We further demonstrated that the glycolysis related hepatic enzymes, pyruvate kinase M2 (PKM-2) and lactic dehydrogenase A (LDHA) were both increased, while the gluconeogenesis related hepatic enzymes, phosphoenolpyruvate-1 (PCK-1) and glucose-6-phosphatase (G6Pase) were both decreased in Cd exposed diabetic mice, indicating that Cd increased glycolysis and inhibited gluconeogenesis in diabetic model. Moreover, lactate accumulation was noted accompanied by the increased inflammation and fibrosis in the livers of diabetic mice following Cd exposure. CONCLUSIONS Cd exposure disturbed glucose metabolism and exacerbated diabetes, providing a biological relevance that DM patients are at greater risk when exposed to Cd.
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Affiliation(s)
- Mengyang Li
- School of Public Health, Soochow University, 215123, Suzhou, China
| | - Shuai Wang
- The Shishan Community Hospital of SND in Suzhou, 215011, Suzhou, China
| | - Xiuxiu Liu
- School of Public Health, Soochow University, 215123, Suzhou, China
| | - Zhijie Sheng
- The Fifth People's Hospital in Suzhou, 215007, Suzhou, China
| | - Bingyan Li
- School of Public Health, Soochow University, 215123, Suzhou, China
| | - Jiafu Li
- School of Public Health, Soochow University, 215123, Suzhou, China
| | - Jie Zhang
- School of Public Health, Soochow University, 215123, Suzhou, China.
| | - Zengli Zhang
- School of Public Health, Soochow University, 215123, Suzhou, China.
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Veronese N, Noale M, Sinclair A, Barbagallo M, Dominguez LJ, Smith L, Pizzol D, Maggi S. Risk of progression to diabetes and mortality in older people with prediabetes: The English longitudinal study on ageing. Age Ageing 2022; 51:afab222. [PMID: 35134845 PMCID: PMC8824760 DOI: 10.1093/ageing/afab222] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Indexed: 02/04/2023] Open
Abstract
AIMS Prediabetes is used to identify people at increased risk for diabetes. However, the importance of prediabetes in older populations is still poorly explored. Therefore, we aimed to investigate the prevalence of prediabetes, based on either glycated haemoglobin (HbA1c) levels or fasting glucose (FG) levels, or both and the progression of prediabetes to diabetes or to mortality in older participants of the English Longitudinal Study on Ageing. MATERIALS AND METHODS Prediabetes was categorized based on HbA1c levels (5.7%-6.4%) and/or FG levels (5.6-7.0 mmol/L). Information regarding mortality and incident diabetes were recorded during follow-up period of 10 years. RESULTS In 2027 participants (mean age: 70.6 years, 55.2% females), the prevalence of prediabetes ranged between 5.9% and 31.1%. Over 8 years of follow-up, 189 participants (5.4% of the initial population) developed diabetes and 606 (17.4%) died. Among 1,403 people with HbA1c at the baseline <5.7%, 33 developed diabetes and 138 died; in contrast, among 479 participants with a diagnosis of prediabetes using a value of HbA1c between 5.7% and 6.4%, 62 developed diabetes and 56 died. Similarly, among 1,657 people with normal values of FG at baseline 60 had a diagnosis of diabetes during follow-up and 163 died, compared to 225 with FG between 5.6 mmol/L and 7.0 mmol/L in which 35 developed diabetes and 31 died. CONCLUSION The prevalence of prediabetes in older adults is high, but the progression from prediabetes to diabetes is uncommon, whereas the regression to normoglycemia or the progression to death was more frequent.
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Affiliation(s)
- Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Marianna Noale
- Aging Branch, Neuroscience Institute, National Research Council, Padua, Italy
| | - Alan Sinclair
- Foundation for Diabetes Research in Older People (fDROP) and King's College London, London, UK
| | - Mario Barbagallo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Ligia J Dominguez
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
- Faculty of Medicine and Surgery, University of Enna ``Kore'', Enna, Italy
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Damiano Pizzol
- Italian Agency for Development Cooperation, Khartoum, Sudan
| | - Stefania Maggi
- Aging Branch, Neuroscience Institute, National Research Council, Padua, Italy
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Alizadeh Z, Baradaran HR, Kohansal K, Hadaegh F, Azizi F, Khalili D. Are the determinants of the progression to type 2 diabetes and regression to normoglycemia in the populations with pre-diabetes the same? Front Endocrinol (Lausanne) 2022; 13:1041808. [PMID: 36277718 PMCID: PMC9585180 DOI: 10.3389/fendo.2022.1041808] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 09/23/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND We aimed to determine the predictors of regression to normoglycemia and progression to diabetes among subjects with pre-diabetes in a single model concurrently. METHODS The present study included 1329 participants aged 20 to 70 years with prediabetes from the population-based cohort of the Tehran Lipid and Glucose Study, with a 10-year follow-up. Glycemic status at follow-up was categorized as regression to normoglycemia: fasting plasma glucose [FPG] of <5.55 and 2h-plasma glucose [PG] of <7.77 mmol/L, and not taking antidiabetic medications. Glycemic status at follow-up was categorized as progression to diabetes: FPG ≥7 or 2h-PG of ≥11.1 mmol/L, or taking antidiabetic medications. Glycemic status determined whether the patients remained in prediabetes category (isolated impaired fasting glycaemia [iIFG] [(5.55≤FPG<7 and 2h-PG<7.77 mmol/L); isolated impared glucose tolarence [iIGT] (7.77 ≤ 2h-PG<11.1 and FGP<5.55 mmol/L)]. With prediabetes as a reference, multinomial logistic regression was utilized to identify the determinants of glycemic changes. RESULTS Approximately 40% of participants returned to normoglycemia (n = 578), and similar percentage of participants progressed to diabetes (n = 518). Based on the multivariable multinomial model, regression to normoglycemia was associated with age (relative risk ratio [RRR] = 0.97; 95% CI, 0.95-0.99), female sex (RRR = 1.72; 95% CI, 1.18-2.50), high education level of ≥12 years (RRR = 2.10; 95% CI, 1.19-3.70), and combined IFG/impaired glucose tolerance (IGT) versus IFG (RRR = 0.45; 95% CI, 0.29-0.70). The risk of progression to diabetes increased with body mass index (RRR = 1.10; 95% CI, 1.05-1.15), waist circumference (RRR = 0.97; 95% CI, 0.96-0.99), positive familial history of diabetes (RRR = 1.62; 95% CI, 1.07-2.45), and combined IFG/IGT versus IFG (RRR = 2.54; 95% CI, 1.71-3.77). CONCLUSION A small percentage of patients with prediabetes remain in this condition, but the majority go on to develop diabetes or regress to normoglycemia. Both directions had distinct predictors.
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Affiliation(s)
- Zeinab Alizadeh
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Baradaran
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
- Ageing Clinical and Experimental Research Team, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition University of Aberdeen, Aberdeen, United Kingdom
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
- *Correspondence: Hamid Reza Baradaran, ; ; Davood Khalili,
| | - Karim Kohansal
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders 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
| | - Davood Khalili
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Biostatistics and Epidemiology, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- *Correspondence: Hamid Reza Baradaran, ; ; Davood Khalili,
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Thamakaison S, Anothaisintawee T, Sukhato K, Unwanatham N, Rattanasiri S, Reutrakul S, Thakkinstian A. Hemoglobin A1c in combination with fasting plasma glucose trumps fasting plasma glucose alone as predictive indicators for diabetes mellitus: an ambidirectional cohort study of Thai people with impaired fasting glucose. BMJ Open Diabetes Res Care 2021; 9:9/2/e002427. [PMID: 34845059 PMCID: PMC8634022 DOI: 10.1136/bmjdrc-2021-002427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 11/05/2021] [Indexed: 01/16/2023] Open
Abstract
INTRODUCTION This ambidirectional cohort study aimed to assess the performance of combining hemoglobin A1c (HbA1c) to fasting plasma glucose (FPG) for estimation of progression rate to diabetes mellitus (DM) and to explore the risk factors of DM in patients with impaired fasting glucose (IFG). RESEARCH DESIGN AND METHODS Patients with IFG were eligible for this study. IFG was defined as FPG of 100-125 mg/dL. Progression rates to DM were estimated using Kaplan-Meier analysis. Risk factors of DM were explored by Cox regression analysis. RESULTS 3011 patients were enrolled with median follow-up time of 8 years (range: 6 months-29 years). Progression rates to DM in patients with FPG 100-109 mg/dL and 110-125 mg/dL were 2.64 and 4.79 per 100 person-years. After adjusting covariables, compared with patients with FPG 100-109 mg/dL plus normal HbA1c (<5.7%), hazard ratios (95% CI) of patients with FPG 110-125 plus normal HbA1c, FBG 100-109 plus abnormal HbA1c (5.7%-6.49%), and FPG 110-125 plus abnormal HbA1c were 5.89 (2.37 to 14.63), 16.30 (8.59 to 30.92), and 33.84 (16.41 to 69.78), respectively. Body mass index ≥27.5 kg/m2, serum triglyceride level ≥150 mg/dL, family history of DM, and low level of high-density lipoprotein-cholesterol were independently associated with risk of DM in patients with IFG. CONCLUSIONS Patients with both IFG and abnormal HbA1c had higher risk of DM than patients with IFG alone. Therefore, performing HbA1c in combination with FPG helps to identify subgroups of people with IFG at highest risk of DM. These patients should have the highest priority in diabetes prevention programs, especially in countries with low and limited resources.
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Affiliation(s)
- Sangsulee Thamakaison
- Department of Family Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Thunyarat Anothaisintawee
- Department of Family Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kanokporn Sukhato
- Department of Family Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Nattawut Unwanatham
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sasivimol Rattanasiri
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sirimon Reutrakul
- Department of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Ammarin Thakkinstian
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Busquets-Cortés C, Bennasar-Veny M, López-González AA, Fresneda S, Aguiló A, Yanez A. Fatty liver index and progression to type 2 diabetes: a 5-year longitudinal study in Spanish workers with pre-diabetes. BMJ Open 2021; 11:e045498. [PMID: 34433590 PMCID: PMC8388308 DOI: 10.1136/bmjopen-2020-045498] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE The main aim of the study was to evaluate the association between non-alcoholic fatty liver disease (NAFLD), estimated by fatty liver index (FLI), and the development of type 2 diabetes (T2D) in a large cohort of adult workers with pre-diabetes. DESIGN Prospective cohort study. SETTING Occupational health services from Spain. PARTICIPANTS 16 648 adult workers (aged 20-65 years) with pre-diabetes (fasting plasma glucose (FPG) of 100-125 mg/dL). OUTCOME AND MEASURES FLI was calculated based on measurements of triglycerides, body mass index, waist circumference and γ-glutamyltransferase. The population was classified into three categories: FLI<30 (no hepatic steatosis), FLI 30-60 (intermediate status) and FLI>60 (hepatic steatosis). Sociodemographic, anthropometric, dietary habits, physical activity and clinical data were collected from all subjects. The incidence rate of T2D was determined after 5 years of follow-up. RESULTS After 5 years of follow-up, 3706 of the 16 648 participants (22.2%) were diagnosed with T2D, corresponding to an annual rate of progression of 4.5%. FLI was strongly associated with T2D conversion. The incidence rates of T2D in the FLI<30, FLI 30-60 and FLI>60 groups were significantly different after 5 years of follow-up were 19/6,421 (0.3%), 338/4,318 (7.8%) and 3,349/5,909 (56.7%), respectively. This association remained significant for FLI>60 after adjustment for, age, diet, physical activity, FPG, blood pressure, social class and smoking habits (adjusted HR=6.879; 95% CI 5.873 to 8.057 for men, and HR=5.806; 95% CI 4.863 to 6.932 for women). CONCLUSION NAFLD assessed by FLI independently predicted the risk of conversion to T2D among people with pre-diabetes. FLI may be an easily determined and valuable early predictor for T2D in people with pre-diabetes. FLI-based assessment of NAFLD in subjects with pre-diabetes in routine clinical practice could allow the adoption of effective measures to prevent and reduce their progression to T2D.
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Affiliation(s)
- Carla Busquets-Cortés
- Nursing and Physiotherapy Department, University of the Balearic Islands, Palma de Mallorca, Illes Balears, Spain
- Escuela Universitaria ADEMA, Palma, Illes Balears, Spain
| | - Miquel Bennasar-Veny
- Nursing and Physiotherapy Department, University of the Balearic Islands, Palma de Mallorca, Illes Balears, Spain
- Global Health and Lifestyles research group, Insitut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Angel-Arturo López-González
- Escuela Universitaria ADEMA, Palma, Illes Balears, Spain
- Prevention of Occupational Risks in Health Services, Balearic Islands Health Services, Palma de Mallorca, Illes Balears, Spain
| | - Sergio Fresneda
- Nursing and Physiotherapy Department, University of the Balearic Islands, Palma de Mallorca, Illes Balears, Spain
- Global Health and Lifestyles research group, Insitut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Spain
| | - Antoni Aguiló
- Nursing and Physiotherapy Department, University of the Balearic Islands, Palma de Mallorca, Illes Balears, Spain
- Global Health and Lifestyles research group, Insitut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Spain
| | - Aina Yanez
- Nursing and Physiotherapy Department, University of the Balearic Islands, Palma de Mallorca, Illes Balears, Spain
- Global Health and Lifestyles research group, Insitut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Spain
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Kazeminasab F, Marandi SM, Baharlooie M, Nasr-Esfahani MH, Ghaedi K. Modulation and bioinformatics screening of hepatic mRNA-lncRNAs (HML) network associated with insulin resistance in prediabetic and exercised mice. Nutr Metab (Lond) 2021; 18:75. [PMID: 34284789 PMCID: PMC8290563 DOI: 10.1186/s12986-021-00600-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 07/08/2021] [Indexed: 12/25/2022] Open
Abstract
Background Insulin resistance is associated with prediabetes and further progression to type 2 diabetes mellitus (T2DM). This study aims to investigate novel hepatic lncRNAs associated with key genes in insulin resistance in prediabetes.
Methods In the bioinformatics phase, we have collected screened a pool of lncRNAs and mRNAs according to their potential association to prediabetic condition. We performed pathway analysis of mRNAs, using DAVID tool based on KEGG repository data. Then, we used Python programming language to get a subset of lncRNAs located in 50 kb proximity with high-fat (HF)-responsive mRNAs. In the experimental phase, prediabetic mice model was established by the treatment of HF diets for 12 weeks. After this treatment, HF-fed animals were divided into two groups of endurance exercised or sedentary, both continuing on the HF diet for 8 weeks. Besides, a group of diabetic mice was treated using a HF diet for 8 weeks followed by injection with STZ solution and then a HF diet for another 4 weeks. Results We found three genes having paired lncRNAs annotated in insulin resistance pathway. Their hepatic expression levels were altered in prediabetic condition as upregulation of Srebf1 was associated with GM38501, upregulation of Pck1 was associated with Ctcflos and GM36691, downregulation of Cpt1b was associated with GM44502. All of these expression patterns were replicated in diabetic mice, correlated positively with their predicted lncRNAs. Interestingly, exercise reversed their expression patterns. Conclusions We suggest that the expression pattern of the hepatic mRNA-lncRNA (HML) network in prediabetic state undergoes similar modification to that of diabetes. Supplementary Information The online version contains supplementary material available at 10.1186/s12986-021-00600-0.
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Affiliation(s)
- Fatemeh Kazeminasab
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Isfahan, Hezar Jerib Avenue, Azadi Sq., Isfahan, 81746-73441, Iran. .,Department of Physical Education and Sport Sciences, Faculty of Human Sciences, University of Kashan, Ravand Street, Kashan, 87317-35153, Iran.
| | - Sayed Mohammad Marandi
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Isfahan, Hezar Jerib Avenue, Azadi Sq., Isfahan, 81746-73441, Iran.
| | - Maryam Baharlooie
- Department of Cell and Molecular Biology and Microbiology, Faculty of Biological Science and Technology, University of Isfahan, Hezar Jerib Avenue, Azadi Sq., Isfahan, 81746-73441, Iran
| | - Mohammad Hossein Nasr-Esfahani
- Department of Animal Biotechnology, Cell Science Research Center, Royan Institute for Biotechnology, ACECR, Royan Street, Salman Ave, Khorasgan Square, Jey Ave, Isfahan, 81593-58686, Iran.
| | - Kamran Ghaedi
- Department of Cell and Molecular Biology and Microbiology, Faculty of Biological Science and Technology, University of Isfahan, Hezar Jerib Avenue, Azadi Sq., Isfahan, 81746-73441, Iran.
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Kim MK, Han K, Koh ES, Hong OK, Baek KH, Song KH, Kwon HS. Cumulative exposure to impaired fasting glucose and future risk of type 2 diabetes mellitus. Diabetes Res Clin Pract 2021; 175:108799. [PMID: 33845053 DOI: 10.1016/j.diabres.2021.108799] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 03/16/2021] [Accepted: 04/07/2021] [Indexed: 12/11/2022]
Abstract
AIMS The status of metabolic abnormalities including impaired fasting glucose (IFG) can change over time, yet little is known about how exposure duration to IFG is related to diabetes risk. METHODS Using nationally representative data from the Korean National Health Insurance system, 2,513,127 people who were free of diabetes and who received four consecutive annual health examinations commencing in 2006 or 2007 were followed up at the end of 2016. IFG was defined as fasting blood glucose levels of 100-125 mg/dL. Participants were classified numerically according to the cumulative number of IFG diagnoses. RESULTS Over 4 years, 53% of the population participants remained normoglycemic, while 3% had persistent IFG and 44% had intermittent IFG. The risk of type 2 diabetes mellitus (DM) increased gradually with increasing IFG exposure score. Subjects with an IFG exposure score of 2, 3, or 4 had a 3.75- to 9.77-fold increased hazard ratio (HR) for incident diabetes (IFG exposure score 0 reference; score 2, HR 3.75, 95% confidence interval [CI] 3.67-3.83; score 3, HR 6.21, 95% CI 6.08-6.36; score 4, HR 9.77, 95% CI 9.53-10.02). CONCLUSIONS Cumulative IFG exposure was associated with a higher risk of type 2 DM in a dose-response fashion.
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Affiliation(s)
- Mee Kyoung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, South Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, South Korea
| | - Eun Sil Koh
- Division of Nephrology, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, South Korea
| | - Oak-Kee Hong
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea
| | - Ki-Hyun Baek
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, South Korea
| | - Ki-Ho Song
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, South Korea
| | - Hyuk-Sang Kwon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, South Korea.
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The Role of Lifestyle, Eating Habits and Social Environment in the Prevention and Treatment of Type 2 Diabetes and Hypertension. Nutrients 2021; 13:nu13051460. [PMID: 33922994 PMCID: PMC8146863 DOI: 10.3390/nu13051460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 04/22/2021] [Indexed: 12/05/2022] Open
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Utility of Fatty Liver Index to predict reversion to normoglycemia in people with prediabetes. PLoS One 2021; 16:e0249221. [PMID: 33822783 PMCID: PMC8023449 DOI: 10.1371/journal.pone.0249221] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/12/2021] [Indexed: 01/05/2023] Open
Abstract
Background Fatty Liver Index (FLI) is strongly associated with changes in glycemic status and incident Type 2 Diabetes (T2D). The probability of reverting to normoglycemia from a state prediabetes could be determined by FLI, however such relationship remains poorly understood. Aim To determine the clinical interest of using FLI to estimate prediabetes reversion at 5 years in patients with impaired fasting plasma glucose at baseline, and identify those factors associated with changes in FLI, that could contribute to the reversion of prediabetes. Methods This 5-year cohort study included 16,648 Spanish working adults with prediabetes. Prediabetes was defined as fasting plasma glucose (FPG) between 100 and 125 mg/dl according to the ADA criteria, while prediabetes reversion was defined as a FPG <100 mg/dL. The population was classified as: FLI <30 (no hepatic steatosis), FLI 30–59 (intermediate status), and FLI ≥60 (hepatic steatosis). Results At 5 years follow-up, 33.7% of subjects reverted to normoglycemia (annual rate of 6.7%). The adjusted binomial logistic regression model showed that scoring FLI <30 (OR 1.544; 95% CI 1.355–1.759), performing at least 150 min/week of physical activity (OR 4.600; 95% CI 4.088–5.177) and consuming fruits and vegetables daily (OR 1.682; 95% CI 1.526–1.855) were associated with the probability of reverting form prediabetes to normoglycemia. The ROC curve for prediction of reversion showed that FLI (AUC 0.774;95% CI 0.767–0.781) was a better predictor than FPG (AUC 0.656; 95% CI 0.648–0.664). Conclusions Regular physical activity, healthy dietary habits and absence of hepatic steatosis are independently associated with the probability of reversion to normoglycemia in adult workers with prediabetes at baseline. Low FLI values (especially FLI< 30) may be useful to predict the probability of prediabetes reversion, especially in active subjects with healthy eating habits, and thus identify those who might benefit from early lifestyle intervention.
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Abbate M, Fresneda S, Yañez A, Ricci-Cabello I, Galmes-Panades AM, Aguilo A, Bennasar-Veny M. Nurse-led telephone intervention for lifestyle changes on glycaemic control in people with prediabetes: Study protocol for a randomized controlled trial. J Adv Nurs 2021; 77:3204-3217. [PMID: 33769603 DOI: 10.1111/jan.14842] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 03/15/2021] [Indexed: 01/01/2023]
Abstract
AIM To evaluate the effectiveness of a nurse-led personalized telephone lifestyle intervention versus automated SMSs in the reduction of fasting plasma glucose in adults with prediabetes. DESIGN The PREDIPHONE is a randomized controlled, parallel, two arms, superiority trial with 15 months of follow-up. Participants will be randomized to either the intervention group (teleconsultations) or the active control group (SMSs). METHODS A total of 428 participants will be randomized in a 1:1 ratio to one of the two arms and followed up during 9 months. The teleconsultations group will receive nurse-led personalized advice, while the SMSs group will receive 4-5 brief SMSs a week. Participants in both groups will receive evidence-based recommendations for diet and physical activity (PA). Outcome measures will be collected at baseline, months 4 and 9 and at month 15, to evaluate post-intervention effects. DISCUSSION Prevention of diabetes through the implementation of lifestyle interventions remains an important priority. The current pandemic situation has magnified its urgency as it heavily affected the functionality of the healthcare system. Moreover, it created the need of remotely delivering preventative interventions. This study will provide insights on the effectiveness and feasibility of a telephone-based intervention led by nurses in the amelioration of risk factors associated with diabetes. IMPACT Findings from this study will offer health services decision-makers sound evidence regarding an alternative method to face-to-face consultations that could be practical, acceptable and inexpensive, and that concretely answers the need for easily implementable prevention strategies. TRIAL REGISTRATION NCT04735640 (ClinicalTrials.gov identifier). PROTOCOL VERSION V1.0, 18/02/2021.
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Affiliation(s)
- Manuela Abbate
- Research group on Global Health and Human Development, University of the Balearic Islands (UIB), Palma, Spain.,Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Sergio Fresneda
- Research group on Global Health and Human Development, University of the Balearic Islands (UIB), Palma, Spain.,Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), Palma, Spain.,Research Group on Global Health & Lifestyles, Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Aina Yañez
- Research group on Global Health and Human Development, University of the Balearic Islands (UIB), Palma, Spain.,Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), Palma, Spain.,Research Group on Global Health & Lifestyles, Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Ignacio Ricci-Cabello
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain.,Balearic Islands Health Service, Primary Care Research Unit of Mallorca, Palma, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Aina M Galmes-Panades
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Antoni Aguilo
- Research group on Global Health and Human Development, University of the Balearic Islands (UIB), Palma, Spain.,Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), Palma, Spain.,Research Group on Global Health & Lifestyles, Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Miquel Bennasar-Veny
- Research group on Global Health and Human Development, University of the Balearic Islands (UIB), Palma, Spain.,Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), Palma, Spain.,Research Group on Global Health & Lifestyles, Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
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Longkumer I, Devi NK, Murry B, Saraswathy KN. Differential risk factors and morbidity/mortality pattern in type 2 diabetes: A study among two Mendelian populations with different ancestry (India). Diabetes Metab Syndr 2020; 14:1769-1776. [PMID: 32942252 DOI: 10.1016/j.dsx.2020.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 06/29/2020] [Accepted: 09/06/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND AIMS Association studies of type 2 diabetes mellitus (T2DM) with risk factors have shown variable results. Moreover, population-specific comparative investigations are negligible. Therefore, the present study aimed to evaluate the association of dyslipidemia and obesity with impaired fasting glucose (IFG) and T2DM among two ethnically, geographically and culturally different populations in India. METHODS This was a cross-sectional study among Jats and Meiteis, each inhabiting a separate geographical region. A total of 2371 individuals, age ≥30 years were recruited through household survey. Obesity variables were captured using anthropometric measurements while fasting blood (2.5 mL) was drawn to measure lipid and glucose levels using enzymatic assay by spectrophotometer. Participants were categorized under normal, IFG and T2DM groups, indicative of diabetes progression stages. Statistical analysis was performed using SPSS 16.0 version. RESULTS Significant differential distribution of lipid and obesity variables among IFG and T2DM in both populations were observed. Odds ratio revealed high TC and all obesity variables except BMI posed significant increased risk for T2DM among Jats. Abnormal TG, VLDL, WC, and WHtR posed significant increased risk for T2DM among Meiteis. Age-cohort wise prevalence of T2DM showed increasing trend at ≥60 years among Jats and decreasing trend at ≥60 years among Meiteis, suggesting a potential higher morbidity in the former and mortality in latter because of T2DM. CONCLUSIONS The present study observed a differential association of risk factors for T2DM among Jats and Meiteis. This study emphasize the need to implement community-specific intervention programs for prevention, treatment and management of T2DM.
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Affiliation(s)
- Imnameren Longkumer
- Laboratory of Biochemical and Molecular Anthropology, Department of Anthropology, University of Delhi, Delhi, 110007, India
| | | | - Benrithung Murry
- Department of Anthropology, University of Delhi, Delhi, 110007, India
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