Obesity in the Pediatric Population of the National (Nationwide) Inpatient Sample (NIS), USA

Temporal Patterns of Diabetes: Analyzing Disease Burden Among Adults Over 18 (2000-2021) Using the U.S. Diabetes Surveillance System (USDDS) Database

Background This study investigates the temporal patterns of diagnosed diabetes cases among adults aged 18 and above in the United States from 2000 to 2021, using data from the U.S. Diabetes Surveillance System (USDDS) database. The study analyzed variations in diagnosed diabetes cases based on gender, age, education, location, and race to provide insights into the changing disease burden over two decades. Methods A retrospective observational design was employed in analyzing data from the USDDS database. The study population comprised adults aged 18 and above with diagnosed diabetes. Descriptive statistical analysis and subgroup comparisons were performed to identify temporal trends and disparities in diagnosed diabetes cases among different demographic groups. Results The study uncovered significant temporal patterns in diagnosed diabetes cases among US adults. Males consistently reported higher diabetes cases (8.44%) than females (7.45%). Variations existed among age groups, with the 65-74 age group having the highest cases (19.69%) and the 18-44 age group having the lowest cases (2.34%). Disparities by race/ethnicity were evident, with non-Hispanic black individuals (11.80%) and Hispanics (11.07%) having the highest percentages, while Asians (7.84%) and whites (6.81%) had lower rates. Distinct temporal patterns emerged based on education levels, with the less than high school education group having the highest cases (11.77%), followed by those with a high school education (8.50%), and the lowest among those with higher than a high school education (6.60%). Conclusion The study has revealed a complex and evolving landscape of this chronic disease. Over these two decades, we observed significant fluctuations, with an overall upward trend in diagnosed diabetes cases. These findings underscore the need for a multifaceted approach to tackle diabetes effectively. Tailored interventions that consider age, gender, education, and geographic location are crucial to addressing the observed disparities in diabetes prevalence.

The Role of Childhood Obesity in Early-Onset Type 2 Diabetes Mellitus: A Scoping Review

Childhood obesity is a growing concern worldwide, with significant implications for public health. Of particular interest is its association with the early onset of type 2 diabetes mellitus in children. Exploring this relationship and identifying contributing factors may help strengthen understanding of this complex relationship. Factors such as family history, gender, and sedentary lifestyle, and poor dietary habits, insulin resistance in adipose tissue have been identified as significant contributors to early-onset type 2 diabetes. The rising prevalence of childhood obesity and its association with diabetes necessitates early interventions to mitigate this concerning trend and ensure a lasting impact on public health. This scoping review aims to investigate the relationship between childhood obesity and early-onset type 2 diabetes mellitus while also exploring other contributing factors. We employed a standardized framework for reviews to analyze relevant literature published in English between 2000 and 2021. Only primary research, systematic reviews, and meta-analyses addressing the association between childhood obesity and early-onset type 2 diabetes mellitus were included. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) format. Out of the 3614 articles assessed, 17 were ultimately incorporated into this scoping review as they met the inclusion criteria. The majority of the literature primarily represented North American studies, with no inclusion of studies from South America. The findings from these studies have highlighted several factors contributing to type 2 diabetes mellitus development. Most of the studies associated obesity development with hypertension and unfavorable lipid profiles. It is important to acknowledge that these findings are derived from the available literature and may not encompass the entirety of research on childhood obesity and early-onset type 2 diabetes mellitus. Furthermore, the limited regional diversity in the selected studies may restrict the generalizability of these findings to other geographic regions. Additional research involving diverse populations is imperative for a comprehensive understanding of the link between childhood obesity and early-onset type 2 diabetes mellitus. Insulin resistance in adipose tissue among obese individuals contributes to the transition from obesity to type 2 diabetes mellitus. Notably, this transition occurs at approximately half the duration in obese youths compared to obese adults, where it typically takes around a decade. The increasing prevalence of childhood obesity and diabetes mellitus in high-income, low-income, and middle-income countries necessitate collective efforts to reduce the increasing rates of early-onset type 2 diabetes in children. This scoping review, therefore, seeks to underscore the importance of early interventions with regard to ensuring a lasting impact capable of extending into adulthood.

Berberine for Adjunct/Alternative Treatment of Dyslipidemia: A Literature Review

Berberine (BBR) is an ancient plant popular in China and is used to treat dyslipidemia, among other cardiovascular and metabolic-related diseases. BBR has historically been regarded as having multiple benefits, with a few clinical trials indicating this fact. We searched PubMed, Embase, and Google Scholar with the following keywords: Berberidaceae, berberine, Berberis spp., dyslipidemia, atherosclerosis, and inflammation. We synthesized the information within the literature to provide an updated review of BBR, its potential, and its applicability in real-world medicine in the future. This review sought to evaluate the literature and advancement in BBR's efficacy regarding dyslipidemia, inflammation, and atherosclerosis.

Trends of Cardiovascular Interventions Stratified by Body Mass Index: An Analysis of the 2016-2020 Nationwide Inpatient Sample Population

Background There is a scarcity of studies delineating the trends of cardiovascular interventions in the hospitalized population stratified by body mass index (BMI). Our study aimed to study the burden of cardiovascular interventions and outcomes by BMI. Methods We retrospectively analyzed the Nationwide Inpatient Sample (NIS) database between January 2016 and December 2020. We identified the population of interest using the International Classification of Diseases, Tenth Revision (ICD-10) code. We studied the BMI in five categories: "healthy weight" (HW; BMI < 19.9-24.9 kg/m2), "overweight" (OV; BMI = 25-29.9 kg/m2), "obesity class one" (OB1; BMI = 30-34.9 kg/m2), "obesity class two" (OB2; BMI = 35-39.9 kg/m2), and "obesity class three" (OB3; BMI > 40 kg/m2). Results There were 5,654,905 hospitalizations with an ICD-10 code related to BMI within this study period. The HW group had 1,103,659 (19.5%) hospitalizations, the OV group had 462,464 (8.2%), the OB1 group had 1,095,325 (19.4%), the OB2 group had 1,036,682 (18.3%), and the OB3 group had 1,956,775 (34.6%) hospitalizations. The mean age of the population with obesity was as follows: OB1 = 61 years (SD = 16); OB2 = 58 years (SD = 15.9); and OB3 = 55 years (SD = 15.5). The mean ages of the HW and OV groups were 68 years (SD = 16.6) and 65 years (SD = 16.1), respectively. In the HW group, there were 948 (8.1%) hospital admissions for aortic valve replacement (AVR), 54 (11%) for aortic valve repair (AVRr), 737 (15.9%) for mitral valve replacement (MVRr), 12 (17.1%) for mitral valve repair (MVR), 79 (2.2%) for left atrial appendage (LAA) closure, and 3390 (5.2%) for percutaneous coronary intervention (PCI). The OV group had 1049 (8.9%) hospital admissions for AVRs, 42 (9%) for AVRr, 461 (10%) for MVRr, four (5.7%) for MVR, 307 (8.6%) for LAA closure, and 5703 (8.8%) for PCIs. The OB1 group had 3326 (28.4%) hospital admissions for AVR, 125 (26.9%) for AVRr, 1229 (26.7%) for MVRr, 23 (32.9%) for MVR, 1173 (32.9%) for LAA, and 20,255 (31.3%) for PCI, while the OB2 group had 2725 (23.3%) hospital admissions for AVR, 105 (22.6%) for AVRr, 898 (19.4%) for MVRr, 11 (15.7%) for MVR, 933 (26.2%) for LAA, and 16,773 (25.9%) for PCI. Lastly, the OB3 group had 3626 (31%) hospital admissions for AVR, 139 (29.9%) for AVRr, 1285 (27.8%) for MVRr, 20 (28.6%) for MVR, 1063 (29.9%) for LAA, and 18,589 (28.7%) for PCI. Conclusion Our study supports the evidence of increased cardiovascular interventions with increasing BMI. Albeit, an inconsistent presentation across the spectrum of cardiovascular diseases and outcomes, for example, equal or better outcomes in obese cohorts compared to the healthy weight population undergoing PCI. However, the increasing cardiovascular intervention burden in the youngest studied population suggests a rise in the cardiovascular disease burden among the young and partially explains their better outcomes. Steps to include weight management for these patients are paramount.