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Alwan H, Ribero VA, Efthimiou O, Del Giovane C, Rodondi N, Duntas L. A systematic review and meta-analysis investigating the relationship between metabolic syndrome and the incidence of thyroid diseases. Endocrine 2024; 84:320-327. [PMID: 37688711 DOI: 10.1007/s12020-023-03503-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 08/19/2023] [Indexed: 09/11/2023]
Abstract
PURPOSE To assess the prospective association between metabolic syndrome (MetS), its components, and incidence of thyroid disorders by conducting a systematic review and meta-analysis. METHODS A systematic search was performed in Ovid Medline, Embase.com, and Cochrane CENTRAL from inception to February 22, 2023. Publications from prospective studies were included if they provided data on baseline MetS status or one of its components and assessed the incidence of thyroid disorders over time. A random effects meta-analysis was conducted to calculate the odds ratio (OR) for developing thyroid disorders. RESULTS After full-text screening of 2927 articles, seven studies met our inclusion criteria. Two of these studies assessed MetS as an exposure (N = 71,727) and were included in our meta-analysis. The association between MetS at baseline and incidence of overt hypothyroidism at follow-up yielded an OR of 0.78 (95% confidence interval [CI]: 0.52-1.16 for two studies, I2 = 0%). Pooled analysis was not possible for subclinical hypothyroidism, due to large heterogeneity (I2 = 92.3%), nor for hyperthyroidism, as only one study assessed this association. We found evidence of an increased risk of overt (RR: 3.10 (1.56-4.64, I2 = 0%) and subclinical hypothyroidism (RR 1.50 (1.05-1.94), I2 = 0%) in individuals with obesity at baseline. There was a lower odds of developing overt hyperthyroidism in individuals with prediabetes at baseline (OR: 0.68 (0.47-0.98), I2 = 0%). CONCLUSIONS We were unable to draw firm conclusions regarding the association between MetS and the incidence of thyroid disorders due to the limited number of available studies and the presence of important heterogeneity in reporting results. However, we did find an association between obesity at baseline and incidence of overt and subclinical hypothyroidism.
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Affiliation(s)
- Heba Alwan
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
- Graduate School for Health Sciences, University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland.
| | - Valerie Aponte Ribero
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland
| | - Orestis Efthimiou
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Cinzia Del Giovane
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Nicolas Rodondi
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Leonidas Duntas
- Thyroid Section, Unit of Endocrinology, Diabetes and Metabolism, Evgenideion Hospital, National and Kapodistrian University of Athens, PC 11528, Athens, Greece
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van der Spoel E, van Vliet NA, Poortvliet RKE, Du Puy RS, den Elzen WPJ, Quinn TJ, Stott DJ, Sattar N, Kearney PM, Blum MR, Alwan H, Rodondi N, Collet TH, Westendorp RGJ, Ballieux BE, Jukema JW, Dekkers OM, Gussekloo J, Mooijaart SP, van Heemst D. Incidence and Determinants of Spontaneous Normalization of Subclinical Hypothyroidism in Older Adults. J Clin Endocrinol Metab 2024; 109:e1167-e1174. [PMID: 37862463 PMCID: PMC10876405 DOI: 10.1210/clinem/dgad623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 09/29/2023] [Accepted: 10/18/2023] [Indexed: 10/22/2023]
Abstract
CONTEXT With age, the prevalence of subclinical hypothyroidism rises. However, incidence and determinants of spontaneous normalization remain largely unknown. OBJECTIVE To investigate incidence and determinants of spontaneous normalization of TSH levels in older adults with subclinical hypothyroidism. DESIGN Pooled data were used from the (1) pretrial population and (2) in-trial placebo group from 2 randomized, double-blind, placebo-controlled trials (Thyroid Hormone Replacement for Untreated Older Adults With Subclinical Hypothyroidism Trial and Institute for Evidence-Based Medicine in Old Age thyroid 80-plus thyroid trial). SETTING Community-dwelling 65+ adults with subclinical hypothyroidism from the Netherlands, Switzerland, Ireland, and the United Kingdom. PARTICIPANTS The pretrial population (N = 2335) consisted of older adults with biochemical subclinical hypothyroidism, defined as ≥1 elevated TSH measurement (≥4.60 mIU/L) and a free T4 within the laboratory-specific reference range. Individuals with persistent subclinical hypothyroidism, defined as ≥2 elevated TSH measurements ≥3 months apart, were randomized to levothyroxine/placebo, of which the in-trial placebo group (N = 361) was included. MAIN OUTCOME MEASURES Incidence of spontaneous normalization of TSH levels and associations between participant characteristics and normalization. RESULTS In the pretrial phase, TSH levels normalized in 60.8% of participants in a median follow-up of 1 year. In the in-trial phase, levels normalized in 39.9% of participants after 1 year of follow-up. Younger age, female sex, lower initial TSH level, higher initial free T4 level, absence of thyroid peroxidase antibodies, and a follow-up measurement in summer were independent determinants for normalization. CONCLUSION Because TSH levels spontaneously normalized in a large proportion of older adults with subclinical hypothyroidism (also after confirmation by repeat measurement), a third measurement may be recommended before considering treatment. TRIAL REGISTRATION ClinicalTrials.gov, NCT01660126 and Netherlands Trial Register, NTR3851.
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Affiliation(s)
- Evie van der Spoel
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Nicolien A van Vliet
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Rosalinde K E Poortvliet
- Department of Public Health and Primary Care, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Robert S Du Puy
- Department of Public Health and Primary Care, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Wendy P J den Elzen
- Amsterdam UMC, University of Amsterdam, Department of Clinical Chemistry, Amsterdam Public Health Research Institute, 1081 HV Amsterdam, The Netherlands
| | - Terence J Quinn
- Department of Geriatric Medicine, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G4 0SF, UK
| | - David J Stott
- Department of Geriatric Medicine, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G4 0SF, UK
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK
| | - Patricia M Kearney
- School of Public Health, University College Cork, Cork T12 K8AF, Ireland
| | - Manuel R Blum
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, 3008 Bern, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, 3012 Bern, Switzerland
| | - Heba Alwan
- Institute of Primary Health Care (BIHAM), University of Bern, 3012 Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland
| | - Nicolas Rodondi
- Institute of Primary Health Care (BIHAM), University of Bern, 3012 Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland
| | - Tinh-Hai Collet
- Service of Endocrinology, Diabetes, Nutrition and Therapeutic Education, Department of Medicine, Geneva University Hospitals, 1205 Geneva, Switzerland
- Diabetes Centre, Faculty of Medicine, University of Geneva, 1206 Geneva, Switzerland
| | - Rudi G J Westendorp
- Department of Public Health, University of Copenhagen, 1353 Copenhagen, Denmark
- Center for Healthy Aging, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Bart E Ballieux
- Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Netherlands Heart Institute, 3511 EP Utrecht, The Netherlands
| | - Olaf M Dekkers
- Department of Internal Medicine, Section of Endocrinology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Department Clinical Epidemiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Jacobijn Gussekloo
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Simon P Mooijaart
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Diana van Heemst
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
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Nwokolo M, Lakshman R, Hartnell S, Alwan H, Ware J, Allen JM, Wilinska ME, Evans ML, Hovorka R, Boughton CK. CamAPS FX Hybrid Closed-Loop with Ultra-Rapid Lispro Compared with Standard Lispro in Adults with Type 1 Diabetes: A Double-Blind, Randomized, Crossover Study. Diabetes Technol Ther 2023; 25:856-863. [PMID: 37823892 DOI: 10.1089/dia.2023.0262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
Introduction: To evaluate hybrid closed-loop with ultra-rapid insulin lispro (Lyumjev) compared with hybrid closed-loop with standard insulin lispro in adults with type 1 diabetes. Materials and Methods: In a single-center, double-blind, randomized, crossover study, 28 adults with type 1 diabetes (mean ± standard deviation [SD]: age 44.5 ± 10.7 years, glycated hemoglobin (HbA1c) 7.1 ± 0.9% [54 ± 10 mmol/mol]) underwent two 8-week periods comparing hybrid closed-loop with ultra-rapid insulin lispro and hybrid closed-loop with standard insulin lispro in random order. The same CamAPS FX closed-loop algorithm was used in both periods. Results: In an intention-to-treat analysis, the proportion of time sensor glucose was in target range (3.9-10 mmol/L [70-180 mg/dL]; primary endpoint) was greater with ultra-rapid lispro compared with standard insulin lispro (mean ± SD: 78.7 ± 9.8% vs. 76.2 ± 9.6%; mean difference 2.5 percentage points [95% confidence interval 0.8 to 4.2]; P = 0.005). Mean sensor glucose was lower with ultra-rapid lispro compared with standard insulin lispro (7.9 ± 0.8 mmol/L [142 ± 14 mg/dL] vs. 8.1 ± 0.9 mmol/L [146 ± 16 mg/dL]; P = 0.048). The proportion of time with sensor glucose <3.9 mmol/L [70 mg/dL] was similar between interventions (median [interquartile range] ultra-rapid lispro 2.3% [1.3%-2.7%] vs. standard insulin lispro 2.1% [1.4%-3.3%]; P = 0.33). No severe hypoglycemia or ketoacidosis occurred. Conclusions: The use of ultra-rapid lispro with CamAPS FX hybrid closed-loop increases time in range and reduces mean glucose with no difference in hypoglycemia compared with standard insulin lispro in adults with type 1 diabetes. ClinicalTrials.gov: Trial registration number NCT05257460.
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Affiliation(s)
- Munachiso Nwokolo
- Wellcome-MRC Institute of Metabolic Science, Metabolic Research Laboratories, University of Cambridge, Cambridge, United Kingdom
- Department of Diabetes, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Rama Lakshman
- Wellcome-MRC Institute of Metabolic Science, Metabolic Research Laboratories, University of Cambridge, Cambridge, United Kingdom
| | - Sara Hartnell
- Cambridge University Hospitals NHS Foundation Trust, Wolfson Diabetes and Endocrine Clinic, Cambridge, United Kingdom
| | - Heba Alwan
- Wellcome-MRC Institute of Metabolic Science, Metabolic Research Laboratories, University of Cambridge, Cambridge, United Kingdom
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Julia Ware
- Wellcome-MRC Institute of Metabolic Science, Metabolic Research Laboratories, University of Cambridge, Cambridge, United Kingdom
- Department of Paediatrics, University of Cambridge, Cambridge, United Kingdom
| | - Janet M Allen
- Wellcome-MRC Institute of Metabolic Science, Metabolic Research Laboratories, University of Cambridge, Cambridge, United Kingdom
- Department of Paediatrics, University of Cambridge, Cambridge, United Kingdom
| | - Malgorzata E Wilinska
- Wellcome-MRC Institute of Metabolic Science, Metabolic Research Laboratories, University of Cambridge, Cambridge, United Kingdom
- Department of Paediatrics, University of Cambridge, Cambridge, United Kingdom
| | - Mark L Evans
- Wellcome-MRC Institute of Metabolic Science, Metabolic Research Laboratories, University of Cambridge, Cambridge, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Wolfson Diabetes and Endocrine Clinic, Cambridge, United Kingdom
| | - Roman Hovorka
- Wellcome-MRC Institute of Metabolic Science, Metabolic Research Laboratories, University of Cambridge, Cambridge, United Kingdom
- Department of Paediatrics, University of Cambridge, Cambridge, United Kingdom
| | - Charlotte K Boughton
- Wellcome-MRC Institute of Metabolic Science, Metabolic Research Laboratories, University of Cambridge, Cambridge, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Wolfson Diabetes and Endocrine Clinic, Cambridge, United Kingdom
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Baretella O, Alwan H, Feller M, Aubert CE, Del Giovane C, Papazoglou D, Christiaens A, Meinders AJ, Byrne S, Kearney PM, O'Mahony D, Knol W, Boland B, Gencer B, Aujesky D, Rodondi N. Overtreatment and associated risk factors among multimorbid older patients with diabetes. J Am Geriatr Soc 2023; 71:2893-2901. [PMID: 37286338 DOI: 10.1111/jgs.18465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 04/21/2023] [Accepted: 05/16/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND In multimorbid older patients with type 2 diabetes mellitus (T2DM), the intensity of glucose-lowering medication (GLM) should be focused on attaining a suitable level of glycated hemoglobin (HbA1c ) while avoiding side effects. We aimed at identifying patients with overtreatment of T2DM as well as associated risk factors. METHODS In a secondary analysis of a multicenter study of multimorbid older patients, we evaluated HbA1c levels among patients with T2DM. Patients were aged ≥70 years, with multimorbidity (≥3 chronic diagnoses) and polypharmacy (≥5 chronic medications), enrolled in four university medical centers across Europe (Belgium, Ireland, Netherlands, and Switzerland). We defined overtreatment as HbA1c < 7.5% with ≥1 GLM other than metformin, as suggested by Choosing Wisely and used prevalence ratios (PRs) to evaluate risk factors of overtreatment in age- and sex-adjusted analyses. RESULTS Among the 564 patients with T2DM (median age 78 years, 39% women), mean ± standard deviation HbA1c was 7.2 ± 1.2%. Metformin (prevalence 51%) was the most frequently prescribed GLM and 199 (35%) patients were overtreated. The presence of severe renal impairment (PR 1.36, 1.21-1.53) and outpatient physician (other than general practitioner [GP], i.e. specialist) or emergency department visits (PR 1.22, 1.03-1.46 for 1-2 visits, and PR 1.35, 1.19-1.54 for ≥3 visits versus no visits) were associated with overtreatment. These factors remained associated with overtreatment in multivariable analyses. CONCLUSIONS In this multicountry study of multimorbid older patients with T2DM, more than one third were overtreated, highlighting the high prevalence of this problem. Careful balancing of benefits and risks in the choice of GLM may improve patient care, especially in the context of comorbidities such as severe renal impairment, and frequent non-GP healthcare contacts.
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Affiliation(s)
- Oliver Baretella
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Department of General Internal Medicine, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Heba Alwan
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Martin Feller
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Department of General Internal Medicine, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Carole E Aubert
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Department of General Internal Medicine, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Cinzia Del Giovane
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Dimitrios Papazoglou
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Department of General Internal Medicine, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Antoine Christiaens
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, INSERM, Paris, France
- Clinical Pharmacy research group, Louvain Drug Research Institute (LDRI), Université catholique de Louvain, Brussels, Belgium
| | - Arend-Jan Meinders
- Department of Internal Medicine, St Antonius Hospital, Nieuwegein, the Netherlands
| | - Stephen Byrne
- School of Pharmacy, University College Cork - National University of Ireland, Cork, Republic of Ireland
| | - Patricia M Kearney
- School of Public Health, University College Cork, Cork, Republic of Ireland
- Department of Medicine Cork, University College Cork - National University of Ireland, Cork, Republic of Ireland
| | - Denis O'Mahony
- Department of Medicine Cork, University College Cork - National University of Ireland, Cork, Republic of Ireland
- Department of Geriatric Medicine Cork, Cork University Hospital Group, Cork, Republic of Ireland
| | - Wilma Knol
- Department of Geriatrics and Expertise Centre Pharmacotherapy in Old Persons (EPHOR), University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Benoît Boland
- Clinical Pharmacy research group, Louvain Drug Research Institute (LDRI), Université catholique de Louvain, Brussels, Belgium
- Department of Geriatric Medicine, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
| | - Baris Gencer
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Service de cardiologie, Hôpitaux Universitaires de Genève (HUG), Geneva, Switzerland
| | - Drahomir Aujesky
- Department of General Internal Medicine, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Nicolas Rodondi
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Department of General Internal Medicine, Inselspital, Bern University Hospital, Bern, Switzerland
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Newman C, Hartnell S, Wilinska M, Alwan H, Hovorka R. Real-World Evidence of the Cambridge Hybrid Closed-Loop App With a Novel Real-Time Continuous Glucose Monitoring System. J Diabetes Sci Technol 2023:19322968231187915. [PMID: 37503893 DOI: 10.1177/19322968231187915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
We evaluated the performance of the interoperable Cambridge hybrid closed-loop app with FreeStyle Libre 3 glucose sensor, and YpsoPump insulin pump in a real-world setting. Data from 100 users (63 adults [mean ± SD age 41.9 ± 14.0 years], 15 children [8.6 ± 5.2 years)] and 22 users of unreported age) for a period of 28 days were analyzed. Time in range (3.91- 10.0mmol/L) was 72.6 ± 11.1% overall. Time below range (<3.9mmol/L) was 3.1% (1.4-5.1) (median [interquartile range]). Auto-mode was active for 95.8% (91.8-97.9) of time. This real-world analysis suggests that the performance of Cambridge hybrid closed-loop app with this glucose sensor is comparable to other commercially available hybrid closed-loop systems.
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Affiliation(s)
- Christine Newman
- Wolfson Diabetes and Endocrinology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Sara Hartnell
- Wolfson Diabetes and Endocrinology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Malgorzata Wilinska
- Wellcome-MRC Institute of Metabolic Science-Metabolic Research Laboratories, University of Cambridge, Cambridge, UK
- Department of Paediatrics, University of Cambridge, Cambridge, UK
| | - Heba Alwan
- Wellcome-MRC Institute of Metabolic Science-Metabolic Research Laboratories, University of Cambridge, Cambridge, UK
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Roman Hovorka
- Wellcome-MRC Institute of Metabolic Science-Metabolic Research Laboratories, University of Cambridge, Cambridge, UK
- Department of Paediatrics, University of Cambridge, Cambridge, UK
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Alwan H, Wilinska ME, Ruan Y, Da Silva J, Hovorka R. Real-World Evidence Analysis of a Hybrid Closed-Loop System. J Diabetes Sci Technol 2023:19322968231185348. [PMID: 37421250 DOI: 10.1177/19322968231185348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/10/2023]
Abstract
BACKGROUND We analyzed real-world evidence to assess the performance of the mylife CamAPS FX hybrid closed-loop system. METHODS Users from 15 countries across different age groups who used the system between May 9, 2022, and December 3, 2022, and who had ≥30 days of continuous glucose monitor data, and ≥30% of closed-loop usage were included in the current analysis (N = 1805). RESULTS Time in range (3.9-10 mmol/L) was 72.6 ± 11.5% (mean ± SD) for all users and increased by age from 66.9 ± 11.7% for users ≤6 years old to 81.8 ± 8.7% for users ≥65 years. Time spent in hypoglycemia (<3.9 mmol/L) was 2.3% [1.3, 3.6] (median [interquartile range]). Mean glucose and glucose management indicator were 8.4 ± 1.1 mmol/L and 6.9%, respectively. Time using closed-loop was high at 94.7% [90.0, 96.9]. CONCLUSIONS Glycemic outcomes from the present real-world evidence are comparable to results obtained from previous randomized controlled studies and confirm the efficacy of this hybrid closed-loop system in real-world settings.
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Affiliation(s)
- Heba Alwan
- Wellcome-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | | | - Yue Ruan
- Wellcome-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | | | - Roman Hovorka
- Wellcome-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK
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7
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Alwan H, Ware J, Boughton CK, Wilinska M, Allen JM, Lakshman R, Nwokolo M, Hartnell S, Bally L, de Beaufort C, Besser REJ, Campbell F, Davis N, Denver L, Evants ML, Fröhlich-Reiterer E, Ghatak A, Hofer SE, Kapellen TM, Leelarathna L, Mader JK, Narendran P, Rami-Merhar B, Tauschmann M, Thabit H, Thankamony A, Hovorka R. Time spent in hypoglycemia according to age and time-of-day: Observations during closed-loop insulin delivery. Diabetes Technol Ther 2023. [PMID: 37229591 DOI: 10.1089/dia.2023.0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE We aimed to assess whether percentage of time spent in hypoglycemia during closed-loop insulin delivery differs by age-group and time-of-day. METHODS We retrospectively analyzed data from hybrid closed-loop studies involving young children (2-7 years), children and adolescents (8-18 years), adults (19-59 years), and older adults (≥60 years) with type 1 diabetes. Main outcome was time spent in hypoglycemia <3.9mmol/l. Eight weeks of data for 88 participants were analyzed. RESULTS Median time spent in hypoglycemia over the 24-hour period was highest in children and adolescents (4.4%; [IQR 2.4-5.0]) and very young children (4.0% [3.4-5.2]), followed by adults (2.7% [1.7-4.0]), and older adults (1.8% [1.2-2.2]); p<0.001 for difference between age-groups. Time spent in hypoglycemia during nighttime (midnight-05:59) was lower than during daytime (06:00-23:59) across all age-groups. CONCLUSION Time in hypoglycemia was highest in the pediatric age-group during closed-loop insulin delivery. Hypoglycemia burden was lowest overnight across all age-groups.
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Affiliation(s)
- Heba Alwan
- University of Cambridge, 2152, Wellcome Trust- MRC Institute of Metabolic Science, Cambridge, United Kingdom of Great Britain and Northern Ireland
- University of Bern, 27210, Institute of Primary Health Care (BIHAM), Bern, Bern, Switzerland
- University of Bern, 27210, Graduate School for Health Sciences, Bern, Bern, Switzerland;
| | - Julia Ware
- University of Cambridge, 2152, Wellcome-MRC Institute of Metabolic Science, Cambridge, Cambridgeshire, United Kingdom of Great Britain and Northern Ireland
- University of Cambridge, 2152, Department of Paediatrics, Cambridge, Cambridgeshire, United Kingdom of Great Britain and Northern Ireland;
| | - Charlotte K Boughton
- University of Cambridge, 2152, Wellcome-MRC Institute of Metabolic Science, Cambridge, United Kingdom of Great Britain and Northern Ireland
- Cambridge University Hospitals NHS Foundation Trust, 2153, Department of Diabetes and Endocrinology, Cambridge, Cambridgeshire, United Kingdom of Great Britain and Northern Ireland;
| | - Malgorzata Wilinska
- University of Cambridge, 2152, Wellcome-MRC Institute of Metabolic Science, Cambridge, Cambridgeshire, United Kingdom of Great Britain and Northern Ireland
- University of Cambridge, 2152, Department of Paediatrics, Cambridge, Cambridgeshire, United Kingdom of Great Britain and Northern Ireland;
| | - Janet M Allen
- University of Cambridge, 2152, Wellcome-MRC Institute of Metabolic Science, Cambridge, Cambridgeshire, United Kingdom of Great Britain and Northern Ireland;
| | - Rama Lakshman
- University of Cambridge, 2152, Wellcome-MRC Institute of Metabolic Science, Cambridge, United Kingdom of Great Britain and Northern Ireland;
| | - Munachiso Nwokolo
- University of Cambridge, 2152, Wellcome-MRC Institute of Metabolic Science, Cambridge, Cambridgeshire, United Kingdom of Great Britain and Northern Ireland;
| | - Sara Hartnell
- University of Cambridge, 2152, Wellcome-MRC Institute of Metabolic Science, Cambridge, Cambridgeshire, United Kingdom of Great Britain and Northern Ireland;
| | - Lia Bally
- Bern University Hospital and University of Bern, Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Bern, Switzerland;
| | - Carine de Beaufort
- UZ-VUB, Department of Paediatric Endocrinology, Jette, Belgium
- Centre Hospitalier de Luxembourg, DECCP, Clinique Pédiatrique, Luxembourg, Luxembourg;
| | - Rachel Elizabeth Jane Besser
- Oxford University Hospitals NHS Trust, 6397, NIHR Oxford Biomedical Research Centre, Oxford, Oxfordshire, United Kingdom of Great Britain and Northern Ireland
- University of Oxford, 6396, Department of Paediatrics, Oxford, Oxfordshire, United Kingdom of Great Britain and Northern Ireland;
| | - Fiona Campbell
- Leeds Children's Hospital, Department of Paediatric Diabetes, Leeds, United Kingdom of Great Britain and Northern Ireland;
| | - Nikki Davis
- Southampton Children's Hospital, 567681, Department of Paediatric Endocrinology and Diabetes, Southampton, United Kingdom of Great Britain and Northern Ireland;
| | - Louise Denver
- Nottingham University Hospitals NHS Trust, 9820, Department of Paediatric Diabetes and Endocrinology, Nottingham, United Kingdom of Great Britain and Northern Ireland;
| | - Mark L Evants
- University of Cambridge, 2152, Wellcome-MRC Institute of Metabolic Science, Cambridge, Cambridgeshire, United Kingdom of Great Britain and Northern Ireland
- Cambridge University Hospitals NHS Foundation Trust, 2153, Department of Diabetes and Endocrinology, Cambridge, Cambridgeshire, United Kingdom of Great Britain and Northern Ireland;
| | - Elke Fröhlich-Reiterer
- Medical University of Graz, 31475, Department of Pediatrics and Adolescent Medicine, Graz, Steiermark, Austria;
| | - Atrayee Ghatak
- Alder Hey Children's NHS Foundation Trust, 4593, Department of Paediatrics, Liverpool, Liverpool, United Kingdom of Great Britain and Northern Ireland;
| | - Sabine E Hofer
- Medical University of Innsbruck, 27280, Department of Pediatrics, Innsbruck, Tirol, Austria;
| | - Thomas M Kapellen
- University of Leipzig, Hospital for Children and Adolescents, Leipzig, Germany
- Median Kinderklinik am Nicolausholz, Naumburg, Germany;
| | - Lalantha Leelarathna
- Manchester University NHS Foundation Trust, 5293, Diabetes, Endocrinology and Metabolism Centre, Manchester, Greater Manchester, United Kingdom of Great Britain and Northern Ireland
- University of Manchester, Division of Diabetes, Endocrinology and Gastroenterology, Manchester, United Kingdom of Great Britain and Northern Ireland;
| | - Julia K Mader
- Medical University of Graz, 31475, , Division of Endocrinology and Diabetology, Graz, Steiermark, Austria;
| | - Parth Narendran
- Queen Elizabeth Hospital, 156807, Department of Endocrinology and Diabetes, Birmingham, United Kingdom , Birmingham, United Kingdom of Great Britain and Northern Ireland
- University of Birmingham, 1724, Institute of Immunology and Immunotherapy, Birmingham, Birmingham, United Kingdom of Great Britain and Northern Ireland;
| | - Birgit Rami-Merhar
- Medical University of Vienna, 27271, Department of Paediatrics and Adolescent Medicine, Wien, Wien, Austria;
| | - Martin Tauschmann
- Medical University of Vienna, 27271, Department of Pediatrics and Adolescent Medicine, Wien, Wien, Austria;
| | - Hood Thabit
- Manchester University NHS Foundation Trust, 5293, Diabetes, Endocrinology and Metabolism Centre, Manchester, Greater Manchester, United Kingdom of Great Britain and Northern Ireland
- Manchester Academic Health Science Centre, 158986, Diabetes, Endocrinology and Metabolism Centre, Manchester, Manchester, United Kingdom of Great Britain and Northern Ireland;
| | - Ajay Thankamony
- University of Cambridge, 2152, Department of Paediatrics, Cambridge, United Kingdom of Great Britain and Northern Ireland;
| | - Roman Hovorka
- University of Cambridge, 2152, Wellcome-MRC Institute of Metabolic Science, Cambridge, Cambridgeshire, United Kingdom of Great Britain and Northern Ireland
- University of Cambridge, 2152, Department of Paediatrics, Cambridge, Cambridgeshire, United Kingdom of Great Britain and Northern Ireland;
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Ribero VA, Alwan H, Efthimiou O, Abolhassani N, Bauer DC, Henrard S, Christiaens A, Waeber G, Rodondi N, Gencer B, Del Giovane C. Cardiovascular disease and type 2 diabetes in older adults: a combined protocol for an individual participant data analysis for risk prediction and a network meta-analysis of novel anti-diabetic drugs. medRxiv 2023:2023.03.13.23287105. [PMID: 36993427 PMCID: PMC10055459 DOI: 10.1101/2023.03.13.23287105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
Introduction Older and multimorbid adults with type 2 diabetes (T2D) are at high risk of cardiovascular disease (CVD) and chronic kidney disease (CKD). Estimating risk and preventing CVD is a challenge in this population notably because it is underrepresented in clinical trials. Our study aims to (1) assess if T2D and haemoglobin A1c (HbA1c) are associated with the risk of CVD events and mortality in older adults, (2) develop a risk score for CVD events and mortality for older adults with T2D, (3) evaluate the comparative efficacy and safety of novel antidiabetics. Methods and analysis For Aim 1, we will analyse individual participant data on individuals aged ≥65 years from five cohort studies: the Optimising Therapy to Prevent Avoidable Hospital Admissions in Multimorbid Older People study; the Cohorte Lausannoise study; the Health, Aging and Body Composition study; the Health and Retirement Study; and the Survey of Health, Ageing and Retirement in Europe. We will fit flexible parametric survival models (FPSM) to assess the association of T2D and HbA1c with CVD events and mortality. For Aim 2, we will use data on individuals aged ≥65 years with T2D from the same cohorts to develop risk prediction models for CVD events and mortality using FPSM. We will assess model performance, perform internal-external cross validation, and derive a point-based risk score. For Aim 3, we will systematically search randomized controlled trials of novel antidiabetics. Network meta-analysis will be used to determine comparative efficacy in terms of CVD, CKD, and retinopathy outcomes, and safety of these drugs. Confidence in results will be judged using the CINeMA tool. Ethics and dissemination Aims 1 and 2 were approved by the local ethics committee (Kantonale Ethikkommission Bern); no approval is required for Aim 3. Results will be published in peer-reviewed journals and presented in scientific conferences.
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Affiliation(s)
- Valerie Aponte Ribero
- Institute of Primary Health Care (BIHAM), University of Bern, 3012, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland
| | - Heba Alwan
- Institute of Primary Health Care (BIHAM), University of Bern, 3012, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland
| | - Orestis Efthimiou
- Institute of Primary Health Care (BIHAM), University of Bern, 3012, Bern, Switzerland
- Institute of Social and Preventive Medicine, University of Bern, 3012, Bern, Switzerland
| | - Nazanin Abolhassani
- Institute of Primary Health Care (BIHAM), University of Bern, 3012, Bern, Switzerland
- Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisante), University of Lausanne, Switzerland
| | - Douglas C Bauer
- Departments of Medicine and Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Séverine Henrard
- Clinical Pharmacy research group, Louvain Drug Research Institute (LDRI), Université catholique de Louvain, 1200, Brussels, Belgium
- Institute of Health and Society (IRSS), Université catholique de Louvain, 1200 Brussels, Belgium
| | - Antoine Christiaens
- Clinical Pharmacy research group, Louvain Drug Research Institute (LDRI), Université catholique de Louvain, 1200, Brussels, Belgium
- Fonds de la Recherche Scientifique – FNRS, 1000 Brussels, Belgium
| | - Gérard Waeber
- Department of Medicine, Lausanne University Hospital (CHUV), University of Lausanne, 1011, Lausanne, Switzerland
| | - Nicolas Rodondi
- Institute of Primary Health Care (BIHAM), University of Bern, 3012, Bern, Switzerland
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, 3010, Bern, Switzerland
| | - Baris Gencer
- Institute of Primary Health Care (BIHAM), University of Bern, 3012, Bern, Switzerland
- Cardiology Division, Geneva University Hospitals, 1205, Geneva, Switzerland
| | - Cinzia Del Giovane
- Institute of Primary Health Care (BIHAM), University of Bern, 3012, Bern, Switzerland
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9
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Alwan H, Villoz F, Feller M, Dullaart RPF, Bakker SJL, Peeters RP, Kavousi M, Bauer DC, Cappola AR, Yeap BB, Walsh JP, Brown SJ, Ceresini G, Ferrucci L, Gussekloo J, Trompet S, Iacoviello M, Moon JH, Razvi S, Bensenor IM, Azizi F, Amouzegar A, Valdés S, Colomo N, Wareham NJ, Jukema JW, Westendorp RGJ, Kim KW, Rodondi N, Del Giovane C. Subclinical thyroid dysfunction and incident diabetes: a systematic review and an individual participant data analysis of prospective cohort studies. Eur J Endocrinol 2022; 187:S35-S46. [PMID: 36070417 PMCID: PMC7613845 DOI: 10.1530/eje-22-0523] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 09/07/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Few prospective studies have assessed whether individuals with subclinical thyroid dysfunction are more likely to develop diabetes, with conflicting results. In this study, we conducted a systematic review of the literature and an individual participant data analysis of multiple prospective cohorts to investigate the association between subclinical thyroid dysfunction and incident diabetes. METHODS We performed a systematic review of the literature in Medline, Embase, and the Cochrane Library from inception to February 11, 2022. A two-stage individual participant data analysis was conducted to compare participants with subclinical hypothyroidism and subclinical hyperthyroidism vs euthyroidism at baseline and the adjusted risk of developing diabetes at follow-up. RESULTS Among 61 178 adults from 18 studies, 49% were females, mean age was 58 years, and mean follow-up time was 8.2 years. At the last available follow-up, there was no association between subclinical hypothyroidism and incidence of diabetes (odds ratio (OR) = 1.02, 95% CI: 0.88-1.17, I2 = 0%) or subclinical hyperthyroidism and incidence of diabetes (OR = 1.03, 95% CI: 0.82-1.30, I2 = 0%), in age- and sex-adjusted analyses. Time-to-event analysis showed similar results (hazard ratio for subclinical hypothyroidism: 0.98, 95% CI: 0.87-1.11; hazard ratio for subclinical hyperthyroidism: 1.07, 95% CI: 0.88-1.29). The results were robust in all sub-group and sensitivity analyses. CONCLUSIONS This is the largest systematic review and individual participant data analysis to date investigating the prospective association between subclinical thyroid dysfunction and diabetes. We did not find an association between subclinical thyroid dysfunction and incident diabetes. Our results do not support screening patients with subclinical thyroid dysfunction for diabetes. SIGNIFICANCE STATEMENT Evidence is conflicting regarding whether an association exists between subclinical thyroid dysfunction and incident diabetes. We therefore aimed to investigate whether individuals with subclinical thyroid dysfunction are more prone to develop diabetes in the long run as compared to euthyroid individuals. We included data from 18 international cohort studies with 61 178 adults and a mean follow-up time of 8.2 years. We did not find an association between subclinical hypothyroidism or subclinical hyperthyroidism at baseline and incident diabetes at follow-up. Our results have clinical implications as they neither support screening patients with subclinical thyroid dysfunction for diabetes nor treating them in the hope of preventing diabetes in the future.
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Affiliation(s)
- Heba Alwan
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland
| | - Fanny Villoz
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Martin Feller
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Robin P F Dullaart
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Stephan J L Bakker
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Robin P Peeters
- Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Douglas C. Bauer
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Departments of Medicine and Epidemiology & Biostatistics, University of California, San Francisco, California, United States
| | - Anne R Cappola
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States
| | - Bu B Yeap
- Medical School, University of Western Australia, Perth, Australia
- Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Australia
| | - John P Walsh
- Discipline of Internal Medicine, Medical School, University of Western Australia, Perth, Australia
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Suzanne J Brown
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | | | - Luigi Ferrucci
- National Institute on Aging, National Institutes of Health, Baltimore, Maryland, United States
| | - Jacobijn Gussekloo
- Section Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
| | - Stella Trompet
- Section Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Massimo Iacoviello
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Jae Hoon Moon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Soeul, South Korea
| | - Salman Razvi
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Isabela M. Bensenor
- Center for Clinical and Epidemiologic Research, University Hospital of São Paulo, São Paulo, Brazil
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atieh Amouzegar
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sergio Valdés
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain
- CIBERDEM, Instituto de Salud Carlos III Spain
| | - Natalia Colomo
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain
- CIBERDEM, Instituto de Salud Carlos III Spain
| | - Nick J Wareham
- MRC Epidemiology Unit, Institute of Metabolic Sciences, University of Cambridge, Cambridge, UK
| | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
- Netherlands Heart Institute, Utrecht, the Netherlands
| | - Rudi G J Westendorp
- Department of Public Health and Center of Healthy Ageing, University of Copenhagen, Denmark
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, South Korea
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea
| | - Nicolas Rodondi
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Cinzia Del Giovane
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
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Barleany DR, Heriyanto H, Alwan H, Kurniawati V, Muyassaroh A, Erizal E. Effect of Starch and Chitosan Addition on Swelling Properties of Neutralized Poly(Acrylic Acid)-Based Superabsorbent Hydrogels Prepared by Using γ-Irradiation Technique. Atom Indo 2022. [DOI: 10.17146/aij.2022.1171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Korobov Y, Alwan H, Soboleva N, Makarov A, Lezhnin N, Shumyakov V, Antonov M, Deviatiarov M. Cavitation Resistance of WC-10Co4Cr and WC-20CrC-7Ni HVAF Coatings. J Therm Spray Technol 2021; 31:234-246. [PMID: 38624694 PMCID: PMC8360761 DOI: 10.1007/s11666-021-01242-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 04/17/2024]
Abstract
Machines operating in aqueous environments may be subjected to cavitation damage during operation. This study aims to evaluate the cavitation resistance of WC-10Co4Cr and WC-20CrC-7Ni coatings under cavitation erosion conditions with additional electrochemical effects. The coatings were deposited on AISI 1040 steel substrates using a high velocity air fuel thermal spray process. The microstructure of the coatings was observed by a scanning electron microscope, while their phase composition was analyzed using an energy-dispersive microanalysis system. In addition, the microhardness of the coatings and substrate was measured, and the surface topography of the eroded surface layers was observed using a 3D optical profilometer. The results revealed that the cavitation resistance of the WC-20CrC-7Ni coatings was better than that of the WC-10Co4Cr coatings. The observation of the structure and surface topography made it possible to identity the reasons for the differences between the cavitation resistance of both coatings: The WC-20CrC-7Ni coatings had a finer grain structure, lower pore density, and lower as-sprayed surface roughness. These differences, along with the presence of a high Cr and Ni content in the feedstock powder, that increased the coating corrosion resistance, contributed to improving the cavitation resistance and reducing the material loss of the WC-20CrC-7Ni coatings.
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Affiliation(s)
- Yu. Korobov
- M. N. Miheev Institute of Metal Physics, Ural Branch of the Russian Academy of Sciences, Yekaterinburg, Russian Federation
- Ural Federal University, Yekaterinburg, Russian Federation
| | - H. Alwan
- Ural Federal University, Yekaterinburg, Russian Federation
- University of Technology, Baghdad, Republic of Iraq
| | - N. Soboleva
- Ural Federal University, Yekaterinburg, Russian Federation
- Institute of Engineering Science, Ural Branch of the Russian Academy of Sciences, Yekaterinburg, Russian Federation
| | - A. Makarov
- M. N. Miheev Institute of Metal Physics, Ural Branch of the Russian Academy of Sciences, Yekaterinburg, Russian Federation
| | - N. Lezhnin
- M. N. Miheev Institute of Metal Physics, Ural Branch of the Russian Academy of Sciences, Yekaterinburg, Russian Federation
| | - V. Shumyakov
- Ural Federal University, Yekaterinburg, Russian Federation
| | - M. Antonov
- Tallinn University of Technology, Tallinn, Estonia
| | - M. Deviatiarov
- Ural Welding Institute-Metallurgy, Yekaterinburg, Russian Federation
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Roukain A, Alwan H, Bongiovanni M, Sykiotis GP, Kopp PA. Denosumab for the Treatment of Hypercalcemia in a Patient With Parathyroid Carcinoma: A Case Report. Front Endocrinol (Lausanne) 2021; 12:794988. [PMID: 35173680 PMCID: PMC8842631 DOI: 10.3389/fendo.2021.794988] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 12/30/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Refractory hypercalcemia is one of the major complications of parathyroid carcinoma. CASE REPORT An 84-year old female patient presented with an acute confusional state due to hypercalcemia. This led to the diagnosis of primary hyperparathyroidism for which she underwent surgery. The initial histological diagnosis was interpreted as atypical parathyroid adenoma; the resection was microscopically incomplete. One year later, the patient presented with elevated calcium levels up to 3.89 mmol/l. Recurrent severe hypercalcemia required multiple hospitalizations. Review of the histology slides revealed that the initially resected lesion was in fact a parathyroid carcinoma. Treatment with the calcimimetic drug cinacalcet was poorly tolerated. Repeated administration of zoledronic acid only had transient effects on calcium levels, and bisphosphonate treatment was ultimately discontinued because of chronic renal failure. The patient then received denosumab (60 or 120 mg) when needed (nine doses over twenty months), the last dose in November 2020, which led to a reduction and control of here calcium levels. Currently, at three years after initial surgery, calcium levels are stable between 2.7-2.8 mmol/l and the patient has not required hospitalization for hypercalcemia for 10 months. DISCUSSION In case of parathyroid carcinoma, en-bloc resection is the first treatment. Denosumab has proven its efficiency in treating hypercalcemia in malignancy. Several case reports studied denosumab in hypercalcemia due to parathyroid carcinoma, and the treatment were efficient to decrease levels of calcium when repeated as needed or monthly. We report another case of refractory hypercalcemia treated with several doses of denosumab in a patient with parathyroid carcinoma.
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Affiliation(s)
- Abdallah Roukain
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
- *Correspondence: Abdallah Roukain,
| | - Heba Alwan
- Institute of Primary Health Care, University of Bern, Bern, Switzerland
| | | | - Gerasimos P. Sykiotis
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
| | - Peter A. Kopp
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
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Alwan H, La Rosa S, Andreas Kopp P, Germann S, Maspoli-Conconi M, Sempoux C, Bulliard JL. Incidence trends of lung and gastroenteropancreatic neuroendocrine neoplasms in Switzerland. Cancer Med 2020; 9:9454-9461. [PMID: 33078908 PMCID: PMC7774736 DOI: 10.1002/cam4.3524] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/19/2020] [Accepted: 09/21/2020] [Indexed: 12/25/2022] Open
Abstract
The incidence of neuroendocrine neoplasms (NENs) seems to increase worldwide. Long-term, population-based series that consider tumor differentiation are, however, sparse. We assessed the incidence trend of lung and gastroenteropancreatic (GEP) NENs according to the latest International Agency for Research on Cancer/World Health Organization classification over a 41-year time period in two Swiss regions. All cases of lung and GEP NENs recorded in the Vaud and Neuchâtel Cancer Registries from 1976 to 2016 were included. NENs were stratified into well-differentiated neuroendocrine tumors (NETs) and poorly differentiated neuroendocrine carcinomas (NECs). Changes in annual age-standardized incidence rates were calculated for lung and GEP NETs and NECs by sex. Of 4,141 patients diagnosed with NENs, 65% were men. The incidence of lung NETs among men and women increased by 3.9%/year (95% CI: -5.3, 14.1%) and 4.9%/year (0.1, 9.9%), respectively, between 1976 and 2016. The incidence of lung NECs decreased by 2.6%/year (-3.1,-1.8%) in men from 1985 to 2016 whereas it increased in women between 1976 and 1998 by 6%/year (4.2, 7.9%). For GEP NETs, a steady annual increase in incidence occurred between 1976 and 2016 with a magnitude of 1.7% (0.7, 2.7%) in men and 1.3% (0.5, 2.1%) in women. No significant trend in incidence of GEP NECs was found for both sexes. The incidence trends of lung NECs in men and women parallel changes in smoking prevalence in the population. Causes of the increase in incidence of GEP NETs are likely multifactorial. Our study supports the importance of evaluating the epidemiology of NENs by tumor differentiation.
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Affiliation(s)
- Heba Alwan
- Vaud Cancer Registry, Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Stefano La Rosa
- Institute of Pathology, University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Peter Andreas Kopp
- Division of Endocrinology, Diabetology and Metabolism, University Hospital and University of Lausanne, Lausanne, Switzerland.,Division of Endocrinology, Metabolism and Molecular Medicine, Northwestern University, Chicago, IL, USA
| | - Simon Germann
- Vaud Cancer Registry, Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | | | - Christine Sempoux
- Institute of Pathology, University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jean-Luc Bulliard
- Vaud Cancer Registry, Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.,Neuchâtel and Jura Cancer Registry, Neuchâtel, Switzerland
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14
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Alwan H, Rosa SL, Kopp P, Germann S, Maspoli-Conconi M, Sempoux C, Bulliard JL. SUN-302 Incidence Trends in Lung and Gastroenteropancreatic Neuroendocrine Neoplasms. J Endocr Soc 2020. [PMCID: PMC7208587 DOI: 10.1210/jendso/bvaa046.309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract Introduction The incidence of neuroendocrine neoplasms (NENs) seems to increase worldwide. However, long-term, population-based data that consider differentiation levels are sparse. Objective To evaluate the incidence trend of lung and gastroenteropancreatic (GEP) NENs according to the latest International Agency for Research on Cancer/World Health Organization classification over a 41-year time period in two Swiss regions. Methods All cases of lung and GEP NENs recorded in the Vaud and Neuchâtel Cancer Registries from 1976–2016 were included. NENs were stratified into well-differentiated neuroendocrine tumors (NETs) and poorly differentiated neuroendocrine carcinomas (NECs). Changes in annual age-standardized incidence rates were calculated for lung and GEP NETs and NECs by sex. Results There were 4141 patients diagnosed with NENs, of which 65% were men. The incidence of lung NETs did not reveal any statistically significant trend in men, but increased in women by 4.9%/year between 1976–2016. The incidence of lung NECs in men decreased significantly by 2.6%/year from 1985–2016 whereas the incidence of lung NECs in women increased significantly between 1976–1998 by 6%/year. For GEP NETs, a steady annual increase in incidence occurred between 1976–2016 with a magnitude of 1.7% in men and 1.3% in women. No trend in incidence of GEP NECs was found for both sexes. Conclusions The incidence trends of lung NECs in men and women parallel changes in smoking prevalence in the population whereas causes of the increase in incidence of GEP NETs are not fully understood. Our study supports the importance of evaluating the epidemiology of NENs by their differentiation level.
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Affiliation(s)
| | - Stefano La Rosa
- Institute of Pathology, University Hospital and University of Lausanne (CHUV), Lausanne, Switzerland
| | - Peter Kopp
- Division of Endocrinology, Diabetology and Metabolism, University Hospital and University of Lausanne (CHUV), Lausanne, Switzerland
| | | | | | - Christine Sempoux
- Institute of Pathology, University Hospital and University of Lausanne (CHUV), Lausanne, Switzerland
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Uçkay I, Kressmann B, Di Tommaso S, Portela M, Alwan H, Vuagnat H, Maître S, Paoli C, Lipsky BA. A randomized controlled trial of the safety and efficacy of a topical gentamicin-collagen sponge in diabetic patients with a mild foot ulcer infection. SAGE Open Med 2018. [PMID: 29785265 DOI: 10.1177/2050312118773950.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives The initial phase of infection of a foot ulcer in a person with diabetes is often categorized as mild. Clinicians usually treat these infections with antimicrobial therapy, often applied topically. Some experts, however, believe that mild diabetic foot ulcer infections will usually heal with local wound care alone, without antimicrobial therapy or dressings. Methods To evaluate the potential benefit of treatment with a topical antibiotic, we performed a single-center, investigator-blinded pilot study, randomizing (1:1) adult patients with a mild diabetic foot ulcer infection to treatment with a gentamicin-collagen sponge with local care versus local care alone. Systemic antibiotic agents were prohibited. Results We enrolled a total of 22 patients, 11 in the gentamicin-collagen sponge arm and 11 in the control arm. Overall, at end of therapy, 20 (91%) patients were categorized as achieving clinical cure of infection, and 2 (9%) as significant improvement. At the final study visit, only 12 (56%) of all patients achieved microbiological eradication of all pathogens. There was no difference in either clinical or microbiological outcomes in those who did or did not receive the gentamicin-collagen sponge, which was very well tolerated. Conclusion The results of this pilot trial suggest that topical antibiotic therapy with gentamicin-collagen sponge, although very well tolerated, does not appear to improve outcomes in mild diabetic foot ulcer infection.
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Affiliation(s)
- Ilker Uçkay
- Service of Infectious Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Benjamin Kressmann
- Service of Infectious Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Sébastien Di Tommaso
- Wound Care Team, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Marina Portela
- Service of Diabetology and Endocrinology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Heba Alwan
- Service of Diabetology and Endocrinology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Hubert Vuagnat
- Wound Care Team, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Sophie Maître
- Service of Diabetology and Endocrinology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Christophe Paoli
- Podiatric School, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Benjamin A Lipsky
- Service of Infectious Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Medical Sciences, Green Templeton College, University of Oxford, Oxford, UK
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16
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Uçkay I, Kressmann B, Di Tommaso S, Portela M, Alwan H, Vuagnat H, Maître S, Paoli C, Lipsky BA. A randomized controlled trial of the safety and efficacy of a topical gentamicin-collagen sponge in diabetic patients with a mild foot ulcer infection. SAGE Open Med 2018; 6:2050312118773950. [PMID: 29785265 PMCID: PMC5954574 DOI: 10.1177/2050312118773950] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 04/02/2018] [Indexed: 01/22/2023] Open
Abstract
Objectives: The initial phase of infection of a foot ulcer in a person with diabetes is
often categorized as mild. Clinicians usually treat these infections with
antimicrobial therapy, often applied topically. Some experts, however,
believe that mild diabetic foot ulcer infections will usually heal with
local wound care alone, without antimicrobial therapy or dressings. Methods: To evaluate the potential benefit of treatment with a topical antibiotic, we
performed a single-center, investigator-blinded pilot study, randomizing
(1:1) adult patients with a mild diabetic foot ulcer infection to treatment
with a gentamicin–collagen sponge with local care versus local care alone.
Systemic antibiotic agents were prohibited. Results: We enrolled a total of 22 patients, 11 in the gentamicin–collagen sponge arm
and 11 in the control arm. Overall, at end of therapy, 20 (91%) patients
were categorized as achieving clinical cure of infection, and 2 (9%) as
significant improvement. At the final study visit, only 12 (56%) of all
patients achieved microbiological eradication of all pathogens. There was no
difference in either clinical or microbiological outcomes in those who did
or did not receive the gentamicin–collagen sponge, which was very well
tolerated. Conclusion: The results of this pilot trial suggest that topical antibiotic therapy with
gentamicin–collagen sponge, although very well tolerated, does not appear to
improve outcomes in mild diabetic foot ulcer infection.
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Affiliation(s)
- Ilker Uçkay
- Service of Infectious Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Benjamin Kressmann
- Service of Infectious Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Sébastien Di Tommaso
- Wound Care Team, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Marina Portela
- Service of Diabetology and Endocrinology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Heba Alwan
- Service of Diabetology and Endocrinology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Hubert Vuagnat
- Wound Care Team, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Sophie Maître
- Service of Diabetology and Endocrinology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Christophe Paoli
- Podiatric School, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Benjamin A Lipsky
- Service of Infectious Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Medical Sciences, Green Templeton College, University of Oxford, Oxford, UK
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17
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Jaafar J, Fernandez E, Alwan H, Philippe J. Programmed cell death-1 and programmed cell death ligand-1 antibodies-induced dysthyroidism. Endocr Connect 2018; 7:R196-R211. [PMID: 29739808 PMCID: PMC5937198 DOI: 10.1530/ec-18-0079] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Accepted: 04/09/2018] [Indexed: 12/28/2022]
Abstract
BACKGROUND Monoclonal antibodies blocking the programmed cell death-1 (PD-1) or its ligand (PD-L1) are a group of immune checkpoints inhibitors (ICIs) with proven antitumor efficacy. However, their use is complicated by immune-related adverse events (irAEs), including endocrine adverse events (eAEs). PURPOSE We review the incidence, time to onset and resolution rate of dysthyroidism induced by PD-1/PD-L1 Ab, and the clinical, biological and radiological findings. We aim to discuss the potential mechanisms of PD-1/PD-L1 Ab-induced dysthyroidism, and to propose a management algorithm. METHODS We performed a literature search of available clinical trials regarding PD-1/PD-L1 Ab in the PubMed database. We selected all English language clinical trials that included at least 100 patients. We also present selected case series or reports, retrospective studies and reviews related to this issue. FINDINGS In patients treated with PD-1 Ab, hypothyroidism occurred in 2-10.1% and hyperthyroidism occurred in 0.9-7.8%. When thyroiditis was reported separately, it occurred in 0.34-2.6%. Higher rates were reported when PD-1 Ab were associated with other ICI or chemotherapy. The median time to onset of hyperthyroidism and hypothyroidism after PD-1 Ab initiation was 23-45 days and 2-3.5 months, respectively. Regarding PD-L1 Ab, hypothyroidism occurred in 0-10% and hyperthyroidism in 0.5-2% of treated patients. The average time to onset of dysthyroidism after PD-L1 Ab was variable and ranged from 1 day after treatment initiation to 31 months. CONCLUSION Dysthyroidism occurs in up to 10% of patients treated with PD-1/PD-L1 Ab. Hypothyroidism and reversible destructive thyroiditis are the most frequent endocrine adverse events (eAE) in PD-1/PD-L1 treated patients. Immune and non-immune mechanisms are potentially involved, independently of the presence of thyroid antibodies.
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Affiliation(s)
- Jaafar Jaafar
- Division of Endocrinology and DiabetologyGeneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Eugenio Fernandez
- Department of OncologyGeneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Heba Alwan
- Division of Endocrinology and DiabetologyGeneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Jacques Philippe
- Division of Endocrinology and DiabetologyGeneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
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18
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Ponte B, Pruijm M, Ackermann D, Vuistiner P, Guessous I, Ehret G, Alwan H, Youhanna S, Paccaud F, Mohaupt M, Péchère-Bertschi A, Vogt B, Burnier M, Martin PY, Devuyst O, Bochud M. Copeptin is associated with kidney length, renal function, and prevalence of simple cysts in a population-based study. J Am Soc Nephrol 2014; 26:1415-25. [PMID: 25270071 DOI: 10.1681/asn.2014030260] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 07/30/2014] [Indexed: 12/31/2022] Open
Abstract
Arginine vasopressin (AVP) has a key role in osmoregulation by facilitating water transport in the collecting duct. Recent evidence suggests that AVP may have additional effects on renal function and favor cyst growth in polycystic kidney disease. Whether AVP also affects kidney structure in the general population is unknown. We analyzed the association of copeptin, an established surrogate for AVP, with parameters of renal function and morphology in a multicentric population-based cohort. Participants from families of European ancestry were randomly selected in three Swiss cities. We used linear multilevel regression analysis to explore the association of copeptin with renal function parameters as well as kidney length and the presence of simple renal cysts assessed by ultrasound examination. Copeptin levels were log-transformed. The 529 women and 481 men had median copeptin levels of 3.0 and 5.2 pmol/L, respectively (P<0.001). In multivariable analyses, the copeptin level was associated inversely with eGFR (β=-2.1; 95% confidence interval [95% CI], -3.3 to -0.8; P=0.002) and kidney length (β=-1.2; 95% CI, -1.9 to -0.4; P=0.003) but positively with 24-hour urinary albumin excretion (β=0.11; 95% CI, 0.01 to 0.20; P=0.03) and urine osmolality (β=0.08; 95% CI, 0.05 to 0.10; P<0.001). A positive association was found between the copeptin level and the presence of renal cysts (odds ratio, 1.6; 95% CI, 1.1 to 2.4; P=0.02). These results suggest that AVP has a pleiotropic role in renal function and may favor the development of simple renal cysts.
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Affiliation(s)
- Belen Ponte
- Divisions of Nephrology and Institute of Social and Preventive Medicine and
| | - Menno Pruijm
- Division of Nephrology, University Hospital of Lausanne, Lausanne, Switzerland
| | - Daniel Ackermann
- Department of Nephrology, Hypertension, and Clinical Pharmacology, University Hospital, University of Bern, Bern, Switzerland; and
| | | | - Idris Guessous
- Institute of Social and Preventive Medicine and Units of Populational Epidemiology and Department of Community Medicine and Primary Care, University Hospital of Geneva, Geneva, Switzerland
| | | | - Heba Alwan
- Institute of Social and Preventive Medicine and
| | - Sonia Youhanna
- Institute of Physiology, Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | | | - Markus Mohaupt
- Department of Nephrology, Hypertension, and Clinical Pharmacology, University Hospital, University of Bern, Bern, Switzerland; and
| | - Antoinette Péchère-Bertschi
- Department of Community Medicine and Primary Care, University Hospital of Geneva, Geneva, Switzerland; Hypertension
| | - Bruno Vogt
- Department of Nephrology, Hypertension, and Clinical Pharmacology, University Hospital, University of Bern, Bern, Switzerland; and
| | - Michel Burnier
- Division of Nephrology, University Hospital of Lausanne, Lausanne, Switzerland
| | | | - Olivier Devuyst
- Institute of Physiology, Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
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19
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El-Shahawy MA, Rasmussen HS, Lavin PT, Yang A, Packham DK, Singh B, Rasmussen HS, Lavin PT, Yang A, Roger SD, Fusaro M, Dalle Carbonare L, Dusso A, Arcidiacono MV, Pasho S, Gallieni M, Ormanji MS, Korkes F, Meca R, Baia LC, Ferraz RR, Heilberg IP, Roger SD, Rasmussen HS, Lavin PT, Yang A, El-Shahawy MA, Nistor I, Bararu I, Apavaloaie MC, Voroneanu L, Donciu MD, Nagler EV, Covic A, Gil HW, Park SH, Hong SY, Ponte B, Alwan H, Pruijm M, Ackermann D, Guessous I, Ehret G, Paccaud F, Mohaupt M, Pechere-Bertschi A, Burnier M, Martin PY, Bochud M, Filiopoulos V, Biblaki D, Manolios N, Karatzas I, Arvanitis D, Vlassopoulos D, Altuntas A, Kidir V, Inal S, Diker S, Cil N, Orhan H, Sezer MT, Verdelho M, Rodrigues N, Ribeiro F, Roger SD, Rasmussen HS, Lavin PT, Yang A, Qunibi WY, Azar H, Ossman R, Flamant M, Chelala D, Ria P, Fabris A, Branco C, Gambaro G, Lupo A, Hao J, Qiu L, Li Y, Li R, Li X, Chen L, Verdesca S, Cucchiari D, Podesta M, Badalamenti S, Veldhuijzen NMH, Gerritsen KGF, Boer WH, Abrahams AC, Packham DK, Rasmussen HS, Lavin PT, Yang A, Qunibi WY, Mangione F, Albrizio P, Sepe V, Esposito P, Manini A, Muciaccia S, Dal Canton A. ACID BASE, ION DISORDERS, LITHISASIS. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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20
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Alwan H, Pruijm M, Ponte B, Ackermann D, Guessous I, Ehret G, Staessen JA, Asayama K, Vuistiner P, Younes SE, Paccaud F, Wuerzner G, Pechere-Bertschi A, Mohaupt M, Vogt B, Martin PY, Burnier M, Bochud M. Epidemiology of masked and white-coat hypertension: the family-based SKIPOGH study. PLoS One 2014; 9:e92522. [PMID: 24663506 PMCID: PMC3963885 DOI: 10.1371/journal.pone.0092522] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 02/23/2014] [Indexed: 12/12/2022] Open
Abstract
Objective We investigated factors associated with masked and white-coat hypertension in a Swiss population-based sample. Methods The Swiss Kidney Project on Genes in Hypertension is a family-based cross-sectional study. Office and 24-hour ambulatory blood pressure were measured using validated devices. Masked hypertension was defined as office blood pressure<140/90 mmHg and daytime ambulatory blood pressure≥135/85 mmHg. White-coat hypertension was defined as office blood pressure≥140/90 mmHg and daytime ambulatory blood pressure<135/85 mmHg. Mixed-effect logistic regression was used to examine the relationship of masked and white-coat hypertension with associated factors, while taking familial correlations into account. High-normal office blood pressure was defined as systolic/diastolic blood pressure within the 130–139/85–89 mmHg range. Results Among the 652 participants included in this analysis, 51% were female. Mean age (±SD) was 48 (±18) years. The proportion of participants with masked and white coat hypertension was respectively 15.8% and 2.6%. Masked hypertension was associated with age (odds ratio (OR) = 1.02, p = 0.012), high-normal office blood pressure (OR = 6.68, p<0.001), and obesity (OR = 3.63, p = 0.001). White-coat hypertension was significantly associated with age (OR = 1.07, p<0.001) but not with education, family history of hypertension, or physical activity. Conclusions Our findings suggest that physicians should consider ambulatory blood pressure monitoring for older individuals with high-normal office blood pressure and/or who are obese.
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Affiliation(s)
- Heba Alwan
- Institute of Social and Preventive Medicine (IUMSP), University Hospital of Lausanne, Lausanne, Switzerland
| | - Menno Pruijm
- Service of Nephrology, University Hospital of Lausanne, Lausanne, Switzerland
| | - Belen Ponte
- Service of Nephrology, Department of Specialties, University Hospital of Geneva, Geneva, Switzerland
| | - Daniel Ackermann
- Clinic for Nephrology, Hypertension and Clinical Pharmacology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Idris Guessous
- Institute of Social and Preventive Medicine (IUMSP), University Hospital of Lausanne, Lausanne, Switzerland
- Unit of Population Epidemiology, University Hospital of Geneva, Geneva, Switzerland
| | - Georg Ehret
- Department of Cardiology, University Hospital of Geneva, Geneva, Switzerland
| | - Jan A. Staessen
- Studies Coordinating Centre, Division of Hypertension and Cardiovascular Rehabilitation, Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
| | - Kei Asayama
- Studies Coordinating Centre, Division of Hypertension and Cardiovascular Rehabilitation, Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
- Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan
| | - Philippe Vuistiner
- Institute of Social and Preventive Medicine (IUMSP), University Hospital of Lausanne, Lausanne, Switzerland
| | - Sandrine Estoppey Younes
- Institute of Social and Preventive Medicine (IUMSP), University Hospital of Lausanne, Lausanne, Switzerland
| | - Fred Paccaud
- Institute of Social and Preventive Medicine (IUMSP), University Hospital of Lausanne, Lausanne, Switzerland
| | - Grégoire Wuerzner
- Service of Nephrology, University Hospital of Lausanne, Lausanne, Switzerland
| | - Antoinette Pechere-Bertschi
- Department of Community Medicine and Primary Care and Emergency Medicine, University Hospital of Geneva, Geneva, Switzerland
| | - Markus Mohaupt
- Clinic for Nephrology, Hypertension and Clinical Pharmacology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Bruno Vogt
- Clinic for Nephrology, Hypertension and Clinical Pharmacology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Pierre-Yves Martin
- Service of Nephrology, Department of Specialties, University Hospital of Geneva, Geneva, Switzerland
| | - Michel Burnier
- Service of Nephrology, University Hospital of Lausanne, Lausanne, Switzerland
| | - Murielle Bochud
- Institute of Social and Preventive Medicine (IUMSP), University Hospital of Lausanne, Lausanne, Switzerland
- * E-mail:
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21
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Ponte B, Pruijm M, Ackermann D, Vuistiner P, Eisenberger U, Guessous I, Rousson V, Mohaupt MG, Alwan H, Ehret G, Pechere-Bertschi A, Paccaud F, Staessen JA, Vogt B, Burnier M, Martin PY, Bochud M. Reference Values and Factors Associated With Renal Resistive Index in a Family-Based Population Study. Hypertension 2014; 63:136-42. [DOI: 10.1161/hypertensionaha.113.02321] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Increased renal resistive index (RRI) has been recently associated with target organ damage and cardiovascular or renal outcomes in patients with hypertension and diabetes mellitus. However, reference values in the general population and information on familial aggregation are largely lacking. We determined the distribution of RRI, associated factors, and heritability in a population-based study. Families of European ancestry were randomly selected in 3 Swiss cities. Anthropometric parameters and cardiovascular risk factors were assessed. A renal Doppler ultrasound was performed, and RRI was measured in 3 segmental arteries of both kidneys. We used multilevel linear regression analysis to explore the factors associated with RRI, adjusting for center and family relationships. Sex-specific reference values for RRI were generated according to age. Heritability was estimated by variance components using the ASSOC program (SAGE software). Four hundred women (mean age±SD, 44.9±16.7 years) and 326 men (42.1±16.8 years) with normal renal ultrasound had mean RRI of 0.64±0.05 and 0.62±0.05, respectively (
P
<0.001). In multivariable analyses, RRI was positively associated with female sex, age, systolic blood pressure, and body mass index. We observed an inverse correlation with diastolic blood pressure and heart rate. Age had a nonlinear association with RRI. We found no independent association of RRI with diabetes mellitus, hypertension treatment, smoking, cholesterol levels, or estimated glomerular filtration rate. The adjusted heritability estimate was 42±8% (
P
<0.001). In a population-based sample with normal renal ultrasound, RRI normal values depend on sex, age, blood pressure, heart rate, and body mass index. The significant heritability of RRI suggests that genes influence this phenotype.
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Affiliation(s)
- Belén Ponte
- From the Division of Nephrology (B.P., P.-Y.M.), Division of Cardiology (G.E.), Unit of Populational Epidemiology, Division of Primary Care Medicine (I.G.), and Hypertension Unit (A.P.-B.), University Hospital of Geneva, Switzerland; Institute of Social and Preventive Medicine (B.P., P.V., I.G., V.R., H.A., F.P., M.B.) and Division of Nephrology (M.P., M.B.), University Hospital of Lausanne, Lausanne, Switzerland; Department of Nephrology, Hypertension, and Clinical Pharmacology, Inselspital, Bern
| | - Menno Pruijm
- From the Division of Nephrology (B.P., P.-Y.M.), Division of Cardiology (G.E.), Unit of Populational Epidemiology, Division of Primary Care Medicine (I.G.), and Hypertension Unit (A.P.-B.), University Hospital of Geneva, Switzerland; Institute of Social and Preventive Medicine (B.P., P.V., I.G., V.R., H.A., F.P., M.B.) and Division of Nephrology (M.P., M.B.), University Hospital of Lausanne, Lausanne, Switzerland; Department of Nephrology, Hypertension, and Clinical Pharmacology, Inselspital, Bern
| | - Daniel Ackermann
- From the Division of Nephrology (B.P., P.-Y.M.), Division of Cardiology (G.E.), Unit of Populational Epidemiology, Division of Primary Care Medicine (I.G.), and Hypertension Unit (A.P.-B.), University Hospital of Geneva, Switzerland; Institute of Social and Preventive Medicine (B.P., P.V., I.G., V.R., H.A., F.P., M.B.) and Division of Nephrology (M.P., M.B.), University Hospital of Lausanne, Lausanne, Switzerland; Department of Nephrology, Hypertension, and Clinical Pharmacology, Inselspital, Bern
| | - Philippe Vuistiner
- From the Division of Nephrology (B.P., P.-Y.M.), Division of Cardiology (G.E.), Unit of Populational Epidemiology, Division of Primary Care Medicine (I.G.), and Hypertension Unit (A.P.-B.), University Hospital of Geneva, Switzerland; Institute of Social and Preventive Medicine (B.P., P.V., I.G., V.R., H.A., F.P., M.B.) and Division of Nephrology (M.P., M.B.), University Hospital of Lausanne, Lausanne, Switzerland; Department of Nephrology, Hypertension, and Clinical Pharmacology, Inselspital, Bern
| | - Ute Eisenberger
- From the Division of Nephrology (B.P., P.-Y.M.), Division of Cardiology (G.E.), Unit of Populational Epidemiology, Division of Primary Care Medicine (I.G.), and Hypertension Unit (A.P.-B.), University Hospital of Geneva, Switzerland; Institute of Social and Preventive Medicine (B.P., P.V., I.G., V.R., H.A., F.P., M.B.) and Division of Nephrology (M.P., M.B.), University Hospital of Lausanne, Lausanne, Switzerland; Department of Nephrology, Hypertension, and Clinical Pharmacology, Inselspital, Bern
| | - Idris Guessous
- From the Division of Nephrology (B.P., P.-Y.M.), Division of Cardiology (G.E.), Unit of Populational Epidemiology, Division of Primary Care Medicine (I.G.), and Hypertension Unit (A.P.-B.), University Hospital of Geneva, Switzerland; Institute of Social and Preventive Medicine (B.P., P.V., I.G., V.R., H.A., F.P., M.B.) and Division of Nephrology (M.P., M.B.), University Hospital of Lausanne, Lausanne, Switzerland; Department of Nephrology, Hypertension, and Clinical Pharmacology, Inselspital, Bern
| | - Valentin Rousson
- From the Division of Nephrology (B.P., P.-Y.M.), Division of Cardiology (G.E.), Unit of Populational Epidemiology, Division of Primary Care Medicine (I.G.), and Hypertension Unit (A.P.-B.), University Hospital of Geneva, Switzerland; Institute of Social and Preventive Medicine (B.P., P.V., I.G., V.R., H.A., F.P., M.B.) and Division of Nephrology (M.P., M.B.), University Hospital of Lausanne, Lausanne, Switzerland; Department of Nephrology, Hypertension, and Clinical Pharmacology, Inselspital, Bern
| | - Markus G. Mohaupt
- From the Division of Nephrology (B.P., P.-Y.M.), Division of Cardiology (G.E.), Unit of Populational Epidemiology, Division of Primary Care Medicine (I.G.), and Hypertension Unit (A.P.-B.), University Hospital of Geneva, Switzerland; Institute of Social and Preventive Medicine (B.P., P.V., I.G., V.R., H.A., F.P., M.B.) and Division of Nephrology (M.P., M.B.), University Hospital of Lausanne, Lausanne, Switzerland; Department of Nephrology, Hypertension, and Clinical Pharmacology, Inselspital, Bern
| | - Heba Alwan
- From the Division of Nephrology (B.P., P.-Y.M.), Division of Cardiology (G.E.), Unit of Populational Epidemiology, Division of Primary Care Medicine (I.G.), and Hypertension Unit (A.P.-B.), University Hospital of Geneva, Switzerland; Institute of Social and Preventive Medicine (B.P., P.V., I.G., V.R., H.A., F.P., M.B.) and Division of Nephrology (M.P., M.B.), University Hospital of Lausanne, Lausanne, Switzerland; Department of Nephrology, Hypertension, and Clinical Pharmacology, Inselspital, Bern
| | - Georg Ehret
- From the Division of Nephrology (B.P., P.-Y.M.), Division of Cardiology (G.E.), Unit of Populational Epidemiology, Division of Primary Care Medicine (I.G.), and Hypertension Unit (A.P.-B.), University Hospital of Geneva, Switzerland; Institute of Social and Preventive Medicine (B.P., P.V., I.G., V.R., H.A., F.P., M.B.) and Division of Nephrology (M.P., M.B.), University Hospital of Lausanne, Lausanne, Switzerland; Department of Nephrology, Hypertension, and Clinical Pharmacology, Inselspital, Bern
| | - Antoinette Pechere-Bertschi
- From the Division of Nephrology (B.P., P.-Y.M.), Division of Cardiology (G.E.), Unit of Populational Epidemiology, Division of Primary Care Medicine (I.G.), and Hypertension Unit (A.P.-B.), University Hospital of Geneva, Switzerland; Institute of Social and Preventive Medicine (B.P., P.V., I.G., V.R., H.A., F.P., M.B.) and Division of Nephrology (M.P., M.B.), University Hospital of Lausanne, Lausanne, Switzerland; Department of Nephrology, Hypertension, and Clinical Pharmacology, Inselspital, Bern
| | - Fred Paccaud
- From the Division of Nephrology (B.P., P.-Y.M.), Division of Cardiology (G.E.), Unit of Populational Epidemiology, Division of Primary Care Medicine (I.G.), and Hypertension Unit (A.P.-B.), University Hospital of Geneva, Switzerland; Institute of Social and Preventive Medicine (B.P., P.V., I.G., V.R., H.A., F.P., M.B.) and Division of Nephrology (M.P., M.B.), University Hospital of Lausanne, Lausanne, Switzerland; Department of Nephrology, Hypertension, and Clinical Pharmacology, Inselspital, Bern
| | - Jan A. Staessen
- From the Division of Nephrology (B.P., P.-Y.M.), Division of Cardiology (G.E.), Unit of Populational Epidemiology, Division of Primary Care Medicine (I.G.), and Hypertension Unit (A.P.-B.), University Hospital of Geneva, Switzerland; Institute of Social and Preventive Medicine (B.P., P.V., I.G., V.R., H.A., F.P., M.B.) and Division of Nephrology (M.P., M.B.), University Hospital of Lausanne, Lausanne, Switzerland; Department of Nephrology, Hypertension, and Clinical Pharmacology, Inselspital, Bern
| | - Bruno Vogt
- From the Division of Nephrology (B.P., P.-Y.M.), Division of Cardiology (G.E.), Unit of Populational Epidemiology, Division of Primary Care Medicine (I.G.), and Hypertension Unit (A.P.-B.), University Hospital of Geneva, Switzerland; Institute of Social and Preventive Medicine (B.P., P.V., I.G., V.R., H.A., F.P., M.B.) and Division of Nephrology (M.P., M.B.), University Hospital of Lausanne, Lausanne, Switzerland; Department of Nephrology, Hypertension, and Clinical Pharmacology, Inselspital, Bern
| | - Michel Burnier
- From the Division of Nephrology (B.P., P.-Y.M.), Division of Cardiology (G.E.), Unit of Populational Epidemiology, Division of Primary Care Medicine (I.G.), and Hypertension Unit (A.P.-B.), University Hospital of Geneva, Switzerland; Institute of Social and Preventive Medicine (B.P., P.V., I.G., V.R., H.A., F.P., M.B.) and Division of Nephrology (M.P., M.B.), University Hospital of Lausanne, Lausanne, Switzerland; Department of Nephrology, Hypertension, and Clinical Pharmacology, Inselspital, Bern
| | - Pierre-Yves Martin
- From the Division of Nephrology (B.P., P.-Y.M.), Division of Cardiology (G.E.), Unit of Populational Epidemiology, Division of Primary Care Medicine (I.G.), and Hypertension Unit (A.P.-B.), University Hospital of Geneva, Switzerland; Institute of Social and Preventive Medicine (B.P., P.V., I.G., V.R., H.A., F.P., M.B.) and Division of Nephrology (M.P., M.B.), University Hospital of Lausanne, Lausanne, Switzerland; Department of Nephrology, Hypertension, and Clinical Pharmacology, Inselspital, Bern
| | - Murielle Bochud
- From the Division of Nephrology (B.P., P.-Y.M.), Division of Cardiology (G.E.), Unit of Populational Epidemiology, Division of Primary Care Medicine (I.G.), and Hypertension Unit (A.P.-B.), University Hospital of Geneva, Switzerland; Institute of Social and Preventive Medicine (B.P., P.V., I.G., V.R., H.A., F.P., M.B.) and Division of Nephrology (M.P., M.B.), University Hospital of Lausanne, Lausanne, Switzerland; Department of Nephrology, Hypertension, and Clinical Pharmacology, Inselspital, Bern
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Alwan H, Viswanathan B, Rousson V, Paccaud F, Bovet P. Association between substance use and psychosocial characteristics among adolescents of the Seychelles. BMC Pediatr 2011; 11:85. [PMID: 21985036 PMCID: PMC3198680 DOI: 10.1186/1471-2431-11-85] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2010] [Accepted: 10/11/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We examined the associations between substance use (cigarette smoking, alcohol drinking, and cannabis use) and psychosocial characteristics at the individual and family levels among adolescents of the Seychelles, a rapidly developing small island state in the African region. METHODS A school survey was conducted in a representative sample of 1432 students aged 11-17 years from all secondary schools. Data came from a self-administered anonymous questionnaire conducted along a standard methodology (Global School-based Health Survey, GSHS). Risk behaviors and psychosocial characteristics were dichotomized. Association analyses were adjusted for a possible classroom effect. RESULTS The prevalence of cigarette smoking, alcohol drinking and cannabis use was higher in boys than in girls and increased with age. Age-adjusted and multivariate analyses showed that several individual level characteristics (e.g. suicidal ideation and truancy) and family level characteristics (e.g. poor parental monitoring) were associated with substance use among students. CONCLUSIONS Our results suggest that health promotion programs should simultaneously address multiple risk behaviors and take into account a wide range of psychosocial characteristics of the students at the individual and family levels.
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Affiliation(s)
- Heba Alwan
- Institute of Social and Preventive Medicine (IUMSP), University Hospital Center and University of Lausanne, Lausanne, Switzerland
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23
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Alwan H, Viswanathan B, Paccaud F, Bovet P. Is Accurate Perception of Body Image Associated with Appropriate Weight-Control Behavior among Adolescents of the Seychelles. J Obes 2011; 2011:817242. [PMID: 21603277 PMCID: PMC3092647 DOI: 10.1155/2011/817242] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2010] [Accepted: 01/26/2011] [Indexed: 11/17/2022] Open
Abstract
Background. We examined body image perception and its association with reported weight-control behavior among adolescents in the Seychelles. Methods. We conducted a school-based survey of 1432 students aging 11-17 years in the Seychelles. Perception of body image was assessed using both a closed-ended question (CEQ) and Stunkard's pictorial silhouettes (SPS). Voluntary attempts to change weight were also assessed. Results. A substantial proportion of the overweight students did not consider themselves as overweight (SPS: 24%, CEQ: 34%), and a substantial proportion of the normal-weight students considered themselves as too thin (SPS: 29%, CEQ: 15%). Logistic regression analysis showed that students with an accurate weight perception were more likely to have appropriate weight-control behavior. Conclusions. We found that substantial proportions of students had an inaccurate perception of their weight and that weight perception was associated with weight-control behavior. These findings point to forces that can drive the upwards overweight trends.
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Affiliation(s)
- Heba Alwan
- Institute of Social and Preventive Medicine (IUMSP), University Hospital Centre and University of Lausanne, Rue du Bugnon 17, 1005 Lausanne, Switzerland
| | - Bharathi Viswanathan
- Unit for Prevention and Control of Cardiovascular Disease, Department of Public Health, Ministry of Health, Victoria, Seychelles
| | - Fred Paccaud
- Institute of Social and Preventive Medicine (IUMSP), University Hospital Centre and University of Lausanne, Rue du Bugnon 17, 1005 Lausanne, Switzerland
| | - Pascal Bovet
- Institute of Social and Preventive Medicine (IUMSP), University Hospital Centre and University of Lausanne, Rue du Bugnon 17, 1005 Lausanne, Switzerland
- Unit for Prevention and Control of Cardiovascular Disease, Department of Public Health, Ministry of Health, Victoria, Seychelles
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Alwan H, Viswanathan B, Williams J, Paccaud F, Bovet P. Association between weight perception and socioeconomic status among adults in the Seychelles. BMC Public Health 2010; 10:467. [PMID: 20696072 PMCID: PMC2924291 DOI: 10.1186/1471-2458-10-467] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2010] [Accepted: 08/09/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Few studies have examined the association between weight perception and socioeconomic status (SES) in sub-Saharan Africa, and none made this association based on education, occupation and income simultaneously. METHODS Based on a population-based survey (n = 1255) in the Seychelles, weight and height were measured and self-perception of one's own body weight, education, occupation, and income were assessed by a questionnaire. Individuals were considered to have appropriate weight perception when their self-perceived weight matched their actual body weight. RESULTS The prevalence of overweight and obesity was 35% and 28%, respectively. Multivariate analysis among overweight/obese persons showed that appropriate weight perception was directly associated with actual weight, education, occupation and income, and that it was more frequent among women than among men. In a model using all three SES indicators together, only education (OR = 2.5; 95% CI: 1.3-4.8) and occupation (OR = 2.3; 95% CI: 1.2-4.5) were independently associated with appropriate perception of being overweight. The OR reached 6.9 [95% CI: 3.4-14.1] when comparing the highest vs. lowest categories of SES based on a score including all SES indicators and 6.1 [95% CI: 3.0-12.1] for a score based on education and occupation. CONCLUSIONS Appropriately perceiving one's weight as too high was associated with different SES indicators, female sex and being actually overweight. These findings suggest means and targets for clinical and population-based interventions for weight control. Further studies should examine whether these differences in weight perception underlie differences in cognitive skills, healthy weight norms, or body size ideals.
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Affiliation(s)
- Heba Alwan
- Institute of Social and Preventive Medicine IUMSP, University Hospital Centre and University of Lausanne, Rue du Bugnon 17, 1005 Lausanne, Switzerland
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