1
|
Zamanian H, Shalbaf A, Zali MR, Khalaj AR, Dehghan P, Tabesh M, Hatami B, Alizadehsani R, Tan RS, Acharya UR. Application of artificial intelligence techniques for non-alcoholic fatty liver disease diagnosis: A systematic review (2005-2023). Comput Methods Programs Biomed 2024; 244:107932. [PMID: 38008040 DOI: 10.1016/j.cmpb.2023.107932] [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] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 11/13/2023] [Accepted: 11/15/2023] [Indexed: 11/28/2023]
Abstract
BACKGROUND AND OBJECTIVES Non-alcoholic fatty liver disease (NAFLD) is a common liver disease with a rapidly growing incidence worldwide. For prognostication and therapeutic decisions, it is important to distinguish the pathological stages of NAFLD: steatosis, steatohepatitis, and liver fibrosis, which are definitively diagnosed on invasive biopsy. Non-invasive ultrasound (US) imaging, including US elastography technique, and clinical parameters can be used to diagnose and grade NAFLD and its complications. Artificial intelligence (AI) is increasingly being harnessed for developing NAFLD diagnostic models based on clinical, biomarker, or imaging data. In this work, we systemically reviewed the literature for AI-enabled NAFLD diagnostic models based on US (including elastography) and clinical (including serological) data. METHODS We performed a comprehensive search on Google Scholar, Scopus, and PubMed search engines for articles published between January 2005 and June 2023 related to AI models for NAFLD diagnosis based on US and/or clinical parameters using the following search terms: "non-alcoholic fatty liver disease", "non-alcoholic steatohepatitis", "deep learning", "machine learning", "artificial intelligence", "ultrasound imaging", "sonography", "clinical information". RESULTS We reviewed 64 published models that used either US (including elastography) or clinical data input to detect the presence of NAFLD, non-alcoholic steatohepatitis, and/or fibrosis, and in some cases, the severity of steatosis, inflammation, and/or fibrosis as well. The performances of the published models were summarized, and stratified by data input and algorithms used, which could be broadly divided into machine and deep learning approaches. CONCLUSION AI models based on US imaging and clinical data can reliably detect NAFLD and its complications, thereby reducing diagnostic costs and the need for invasive liver biopsy. The models offer advantages of efficiency, accuracy, and accessibility, and serve as virtual assistants for specialists to accelerate disease diagnosis and reduce treatment costs for patients and healthcare systems.
Collapse
Affiliation(s)
- H Zamanian
- Department of Biomedical Engineering and Medical Physics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - A Shalbaf
- Department of Biomedical Engineering and Medical Physics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - M R Zali
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - A R Khalaj
- Tehran obesity treatment center, Department of Surgery, Faculty of Medicine, Shahed University, Tehran, Iran
| | - P Dehghan
- Department of Radiology, Imaging Department, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M Tabesh
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research, Tehran University of Medical Sciences, Tehran, Iran
| | - B Hatami
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - R Alizadehsani
- Institute for Intelligent Systems Research and Innovation (IISRI), Deakin University, Waurn Ponds, VIC, Australia
| | - Ru-San Tan
- National Heart Centre Singapore, Singapore 169609, Singapore; Duke-NUS Medical School, Singapore
| | - U Rajendra Acharya
- School of Mathematics, Physics and Computing, University of Southern Queensland, Toowoomba, QLD, Australia; Centre for Health Research, University of Southern Queensland, Australia
| |
Collapse
|
2
|
Fairley JL, Hansen D, Ross L, Proudman S, Sahhar J, Ngian GS, Walker J, Host LV, Morrisroe K, Apostolopoulous D, Ferdowsi N, Wilson M, Tabesh M, Stevens W, Nikpour M. Clinical characteristics and survival of pulmonary arterial hypertension with or without interstitial lung disease in systemic sclerosis. Arthritis Res Ther 2023; 25:77. [PMID: 37173780 PMCID: PMC10176744 DOI: 10.1186/s13075-023-03059-x] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 04/29/2023] [Indexed: 05/15/2023] Open
Abstract
OBJECTIVES To describe the clinical phenotype and prognosis of people in the Australian Scleroderma (SSc) Cohort Study with pulmonary arterial hypertension (PAH) with or without interstitial lung disease (ILD). METHODS Participants meeting ACR/EULAR criteria for SSc were divided into four mutually exclusive groups: those meeting criteria for PAH (PAH-only), ILD (ILD-only), concurrent PAH and ILD (PAH-ILD) or neither PAH nor ILD (SSc-only). Logistic or linear regression analyses were used for associations between clinical features, health-related quality of life (HRQoL) and physical function. Survival analysis was performed using Kaplan-Meier estimates and Cox-regression modelling. RESULTS Of 1561 participants, 7% fulfilled criteria for PAH-only, 24% ILD-only, 7% PAH-ILD and 62% SSc-only. People with PAH-ILD were more frequently male, with diffuse skin involvement, higher inflammatory markers, older age of SSc onset and higher frequency of extensive ILD than the cohort overall (p < 0.001). People of Asian race more frequently developed PAH-ILD (p < 0.001). People with PAH-ILD or PAH-only had worse WHO functional class and 6-min-walk-distance than ILD-only (p < 0.001). HRQoL scores were worst in those with PAH-ILD (p < 0.001). Survival was reduced in the PAH-only and PAH-ILD groups (p < 0.01). Multivariable hazard modelling demonstrated the worst prognosis in extensive ILD and PAH (HR = 5.65 95% CI 3.50-9.12 p < 0.01), followed by PAH-only (HR = 4.21 95% CI 2.89-6.13 p < 0.01) and PAH with limited ILD (HR = 2.46 95% CI 1.52-3.99 p < 0.01). CONCLUSIONS The prevalence of concurrent PAH-ILD in the ASCS is 7%, with poorer survival in those patients with PAH-ILD compared to ILD or SSc alone. The presence of PAH confers a poorer overall prognosis than even extensive ILD; however, further data are required to better understand the clinical outcomes of this high-risk patient group.
Collapse
Affiliation(s)
- Jessica L Fairley
- The University of Melbourne at St. Vincent's Hospital, 41 Victoria Parade Fitzroy, Melbourne, VIC, 3065, Australia
- St. Vincent's Hospital Melbourne, Melbourne, VIC, Australia
| | - Dylan Hansen
- St. Vincent's Hospital Melbourne, Melbourne, VIC, Australia
| | - Laura Ross
- The University of Melbourne at St. Vincent's Hospital, 41 Victoria Parade Fitzroy, Melbourne, VIC, 3065, Australia
- St. Vincent's Hospital Melbourne, Melbourne, VIC, Australia
| | - Susanna Proudman
- University of Adelaide, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Joanne Sahhar
- Monash Health, Melbourne, VIC, Australia
- Monash University, Melbourne, VIC, Australia
| | - Gene-Siew Ngian
- Monash Health, Melbourne, VIC, Australia
- Monash University, Melbourne, VIC, Australia
| | - Jennifer Walker
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | | | - Kathleen Morrisroe
- The University of Melbourne at St. Vincent's Hospital, 41 Victoria Parade Fitzroy, Melbourne, VIC, 3065, Australia
- St. Vincent's Hospital Melbourne, Melbourne, VIC, Australia
| | - Diane Apostolopoulous
- Monash Health, Melbourne, VIC, Australia
- Monash University, Melbourne, VIC, Australia
| | - Nava Ferdowsi
- St. Vincent's Hospital Melbourne, Melbourne, VIC, Australia
| | - Michelle Wilson
- St. Vincent's Hospital Melbourne, Melbourne, VIC, Australia
- Monash University, Melbourne, VIC, Australia
| | - Maryam Tabesh
- St. Vincent's Hospital Melbourne, Melbourne, VIC, Australia
| | - Wendy Stevens
- St. Vincent's Hospital Melbourne, Melbourne, VIC, Australia
| | - Mandana Nikpour
- The University of Melbourne at St. Vincent's Hospital, 41 Victoria Parade Fitzroy, Melbourne, VIC, 3065, Australia.
- St. Vincent's Hospital Melbourne, Melbourne, VIC, Australia.
| |
Collapse
|
3
|
Tabesh M, Sh ME, Etemadi M, Naddaf F, Heidari F, Alizargar J. The antibacterial activity of nasturtium officinale extract on common oral pathogenic bacteria. Niger J Clin Pract 2022; 25:1466-1475. [PMID: 36149206 DOI: 10.4103/njcp.njcp_1887_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background The oral cavity is colonized by a myriad of microorganisms, some of which are proven to be detrimental to human health. There have been numerous efforts to control the population of pathogenic agents in the oral cavity, including the usage of natural phytochemicals obtained from medicinal plants. Nasturtium officinale has long been used in traditional medicine for the management of hypertension, respiratory infections, and hyperglycemia, and its effectiveness against some microbes has been reported. Aims To evaluate antimicrobial properties of a hydro-alcoholic extract of N. officinale against common oral pathogens namely Streptococcus mutans, Staphylococcus aureus, Lactobacillus acidophilus, Enterococcus faecalis, and Pseudomonas aeruginosa. Experimental laboratory study. Different dilutions of N. officinale hydro-alcoholic extract were the test solutions, the positive control was a bacterial suspension in sterile phosphate-buffered saline, whereas the negative control was the herbal extract only, without any bacterial inoculation. Hydro-alcoholic extract of N. officinale prepared in five different concentrations (105, 52.5, 26.25, 13.12, 6.56 mg.mL-1) was tested separately against Streptococcus mutans, Lactobacillus acidophilus, Pseudomonas aeruginosa, Enterococcus faecalis, and Staphylococcus aureus in a test of microdilution assay. Spectrophotometry was used to assess bacterial growth after 24 and 48 h. Materials and Methods The data of optical absorbance reads from spectrophotometry were analyzed using repeated-measures analysis followed by Least Significant Differences (LSD) post hoc. Results The highest growth inhibitory effect against S. mutans, E. faecalis, and S. aureus was observed at a concentration of 13.12 mg.mL-1; for L. acidophilus and P. aeruginosa, the most significant inhibition was observed at a concentration of 105 mg.mL-1. Conclusion N. officinale extract effectively inhibited the growth of the tested oral bacteria at different concentrations but was more effective against S. mutans, E. faecalis, and S. aureus and so may be effective in managing some oral microbial infections.
Collapse
Affiliation(s)
- M Tabesh
- Dental Research Center, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - M Etemadi Sh
- Department of Oral and Maxillofacial Surgery, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - M Etemadi
- Department of Horticultural Science, School of Agriculture, Shiraz University, Shiraz, Iran
| | - F Naddaf
- Department of Horticultural Science, School of Agriculture, Shiraz University, Shiraz, Iran
| | - F Heidari
- Dental Research Center, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - J Alizargar
- Research Center for Healthcare Industry Innovation, National Taipei University of Nursing and Health Sciences, Taipei City; School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan
| |
Collapse
|
4
|
Chen L, Islam RM, Wang J, Hird TR, Pavkov ME, Gregg EW, Salim A, Tabesh M, Koye DN, Harding JL, Sacre JW, Barr ELM, Magliano DJ, Shaw JE. A systematic review of trends in all-cause mortality among people with diabetes. Diabetologia 2020; 63:1718-1735. [PMID: 32632526 PMCID: PMC11000245 DOI: 10.1007/s00125-020-05199-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [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: 01/16/2020] [Accepted: 04/29/2020] [Indexed: 01/18/2023]
Abstract
AIMS/HYPOTHESIS We examined all-cause mortality trends in people with diabetes and compared them with trends among people without diabetes. METHODS MEDLINE, EMBASE and CINAHL databases were searched for observational studies published from 1980 to 2019 reporting all-cause mortality rates across ≥2 time periods in people with diabetes. Mortality trends were examined by ethnicity, age and sex within comparable calendar periods. RESULTS Of 30,295 abstracts screened, 35 studies were included, providing data on 69 separate ethnic-specific or sex-specific populations with diabetes since 1970. Overall, 43% (3/7), 53% (10/19) and 74% (32/43) of the populations studied had decreasing trends in all-cause mortality rates in people with diabetes in 1970-1989, 1990-1999 and 2000-2016, respectively. In 1990-1999 and 2000-2016, mortality rates declined in 75% (9/12) and 78% (28/36) of predominantly Europid populations, and in 14% (1/7) and 57% (4/7) of non-Europid populations, respectively. In 2000-2016, mortality rates declined in 33% (4/12), 65% (11/17), 88% (7/8) and 76% (16/21) of populations aged <40, 40-54, 55-69 and ≥70 years, respectively. Among the 33 populations with separate mortality data for those with and without diabetes, 60% (6/10) of the populations with diabetes in 1990-1999 and 58% (11/19) in 2000-2016 had an annual reduction in mortality rates that was similar to or greater than in those without diabetes. CONCLUSIONS/INTERPRETATION All-cause mortality has declined in the majority of predominantly Europid populations with diabetes since 2000, and the magnitude of annual mortality reduction matched or exceeded that observed in people without diabetes in nearly 60% of populations. Patterns of diabetes mortality remain uncertain in younger age groups and non-Europid populations. REGISTRATION PROSPERO registration ID CRD42019095974. Graphical abstract.
Collapse
Affiliation(s)
- Lei Chen
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Rakibul M Islam
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Joanna Wang
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Thomas R Hird
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Meda E Pavkov
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Edward W Gregg
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Agus Salim
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia
- Department of Mathematics and Statistics, La Trobe University, Bundoora, VIC, Australia
| | - Maryam Tabesh
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Digsu N Koye
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Jessica L Harding
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Julian W Sacre
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Elizabeth L M Barr
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Darwin, NT, Australia
| | - Dianna J Magliano
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia.
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
| | - Jonathan E Shaw
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- School of Life Sciences, La Trobe University, Bundoora, VIC, Australia
| |
Collapse
|
5
|
Sareban Hassanabadi M, Mirhosseini SJ, Mirzaei M, Namayandeh SM, Beiki O, Gannar F, Boffetta P, Pakseresht M, Tabesh M, Ahmadi N, Kazeminasab M, Salehi-Abargouei A. The Most Important Predictors of Metabolic Syndrome Persistence after 10-year Follow-Up: YHHP Study. Int J Prev Med 2020; 11:33. [PMID: 32363020 PMCID: PMC7187548 DOI: 10.4103/ijpvm.ijpvm_215_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 02/12/2019] [Indexed: 11/21/2022] Open
Abstract
Background: Metabolic syndrome (MetS) is one of the world's largest health epidemics, and its management is a major challenge worldwide. The aim of this 10-year follow-up study was to assess the most important predictors of MetS persistence among an Iranian adult population. Methods: In this cohort study, 887 out of 2000 participants with MetS aged 20–74 years in the central part of Iran were followed-up for about 10 years from 2005–2006 to 2015–2016. MetS was defined based on the criteria of NCEP-ATP III adopted for the Iranian population. Cox proportional hazards regression was conducted to evaluate the predictors of MetS persistence in crude- and multivariate-adjusted models. Results: Our analyses showed that 648 out of 887 participants (73%) completed the follow-up and 565 (87.2%) of them had persistence of MetS after 10-year follow-up. There was a significant association between age, weight, body mass index, triglyceride, and waist circumference in participants who had MetS compared to those without MetS after 10-year follow-up (P < 0.05). There was a direct association between increases in the mean changes of systolic/diastolic blood pressure, waist circumference, and low HDL-C and risk of MetS persistence after adjusting the model for sex and age in the total population (Ptrend < 0.05). The trends were the same for women except in diastolic blood pressure. After adjustment for potential confounders, the risk of MetS persistence in men was significantly higher than women (HR = 1.98, 95% CI: 1.38–2.85, Ptrend = 0.001). Conclusions: Most of the risk factors of MetS were positively associated with persistence of MetS. Therefore, modification of lifestyle is recommended to reduce MetS.
Collapse
Affiliation(s)
| | - Seyed Jalil Mirhosseini
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Masoud Mirzaei
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Omid Beiki
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.,Department of Epidemiology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fadoua Gannar
- Research Unit "Integrated Physiology", Laboratory of Biochemistry- Human Nutrition, Faculty of Sciences of Bizerte, Carthage University, Tunis, Tunisia
| | - Paolo Boffetta
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.,Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Mohammadreza Pakseresht
- Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Maryam Tabesh
- Baker Heart and Diabetes Institute, Melbourne, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Nastaran Ahmadi
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahmood Kazeminasab
- Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Amin Salehi-Abargouei
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| |
Collapse
|
6
|
Abstract
OBJECTIVE To assess what proportions of studies reported increasing, stable, or declining trends in the incidence of diagnosed diabetes. DESIGN Systematic review of studies reporting trends of diabetes incidence in adults from 1980 to 2017 according to PRISMA guidelines. DATA SOURCES Medline, Embase, CINAHL, and reference lists of relevant publications. ELIGIBILITY CRITERIA Studies of open population based cohorts, diabetes registries, and administrative and health insurance databases on secular trends in the incidence of total diabetes or type 2 diabetes in adults were included. Poisson regression was used to model data by age group and year. RESULTS Among the 22 833 screened abstracts, 47 studies were included, providing data on 121 separate sex specific or ethnicity specific populations; 42 (89%) of the included studies reported on diagnosed diabetes. In 1960-89, 36% (8/22) of the populations studied had increasing trends in incidence of diabetes, 55% (12/22) had stable trends, and 9% (2/22) had decreasing trends. In 1990-2005, diabetes incidence increased in 66% (33/50) of populations, was stable in 32% (16/50), and decreased in 2% (1/50). In 2006-14, increasing trends were reported in only 33% (11/33) of populations, whereas 30% (10/33) and 36% (12/33) had stable or declining incidence, respectively. CONCLUSIONS The incidence of clinically diagnosed diabetes has continued to rise in only a minority of populations studied since 2006, with over a third of populations having a fall in incidence in this time period. Preventive strategies could have contributed to the fall in diabetes incidence in recent years. Data are limited in low and middle income countries, where trends in diabetes incidence could be different. SYSTEMATIC REVIEW REGISTRATION Prospero CRD42018092287.
Collapse
Affiliation(s)
- Dianna J Magliano
- Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Rakibul M Islam
- Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | | | - Edward W Gregg
- Centres for Diseases Control and Prevention, Division of Diabetes Translation, Atlanta, GA, USA
- School of Public Health, Epidemiology and Biostatistics, Imperial College London, London, UK
| | - Meda E Pavkov
- Centres for Diseases Control and Prevention, Division of Diabetes Translation, Atlanta, GA, USA
| | - Jessica L Harding
- Centres for Diseases Control and Prevention, Division of Diabetes Translation, Atlanta, GA, USA
| | - Maryam Tabesh
- Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Digsu N Koye
- Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Jonathan E Shaw
- Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| |
Collapse
|
7
|
Tabesh M, Magliano DJ, Tanamas SK, Surmont F, Bahendeka S, Chiang CE, Elgart JF, Gagliardino JJ, Kalra S, Krishnamoorthy S, Luk A, Maegawa H, Motala AA, Pirie F, Ramachandran A, Tayeb K, Vikulova O, Wong J, Shaw JE. Diabetes management and treatment approaches outside of North America and West Europe in 2006 and 2015. Acta Diabetol 2019; 56:889-897. [PMID: 30963308 DOI: 10.1007/s00592-018-01284-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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] [Received: 09/14/2018] [Accepted: 12/29/2018] [Indexed: 02/06/2023]
Abstract
AIMS The impact of introducing new classes of glucose-lowering medication (GLM) on diabetes management remains unclear, especially outside North America and Western Europe. Therefore, we aimed to analyse trends in glycaemic control and the usage of new and old GLMs in people with type 2 diabetes from 2006 to 2015. METHODS Summary data from clinical services from nine countries outside North America and Western Europe were collected and pooled for statistical analysis. Each site summarized individual-level data from out-patient medical records for 2006 and 2015. Data included: demographics; HbA1c and fasting plasma glucose levels; and the proportions of patients taking GLM as monotherapy, combination therapy and/or insulin. RESULTS Between 2006 and 2015, glycaemic control remained stable, although body mass index and duration of diabetes increased in most sites. The proportion of people on GLM increased, and the therapeutic regimens became more complex. There were increases in the use of insulin and triple therapy in most sites, while monotherapy, particularly in relation to sulphonylureas, decreased. Despite the introduction of new GLMs, such as DPP-4 inhibitors, insulin use increased over time. CONCLUSIONS There was no clear evidence that the use of new classes of GLMs was associated with improvements in glycaemic control or reduced the reliance on insulin. These findings were consistent across a range of economic and geographic settings.
Collapse
Affiliation(s)
- Maryam Tabesh
- Baker Heart and Diabetes Institute, Level 4, Alfred Centre, 99 Commercial Road, Melbourne, VIC, 3004, Australia.
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Dianna J Magliano
- Baker Heart and Diabetes Institute, Level 4, Alfred Centre, 99 Commercial Road, Melbourne, VIC, 3004, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Stephanie K Tanamas
- Baker Heart and Diabetes Institute, Level 4, Alfred Centre, 99 Commercial Road, Melbourne, VIC, 3004, Australia
| | | | - Silver Bahendeka
- MKPGMS-Uganda Martyrs University and St. Francis Hospital Nsambya, Kampala, Uganda
| | - Chern-En Chiang
- General Clinical Research Center, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jorge F Elgart
- Facultad de Ciencias Médicas UNLP, CENEXA, Centro de Endocrinología Experimental y Aplicada (UNLP-CONICET), La Plata, Argentina
| | - Juan J Gagliardino
- Facultad de Ciencias Médicas UNLP, CENEXA, Centro de Endocrinología Experimental y Aplicada (UNLP-CONICET), La Plata, Argentina
| | - Sanjay Kalra
- Bharti Research Institute of Diabetes and Endocrinology, Bharti Hospital, Karnal, Haryana, India
| | | | - Andrea Luk
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Sha Tin, Hong Kong SAR, China
| | | | - Ayesha A Motala
- Department of Diabetes and Endocrinology, University of KwaZulu Natal, Durban, South Africa
| | - Fraser Pirie
- Department of Diabetes and Endocrinology, University of KwaZulu Natal, Durban, South Africa
| | | | - Khaled Tayeb
- Diabetes Center at Al-Noor Specialist Hospital, Mecca, Saudi Arabia
| | - Olga Vikulova
- FGBU "Endocrinology Research Center" Ministry of Health, Moscow, Russia
| | - Jencia Wong
- Royal Prince Alfred Hospital Diabetes Centre, University of Sydney, Sydney, Australia
| | - Jonathan E Shaw
- Baker Heart and Diabetes Institute, Level 4, Alfred Centre, 99 Commercial Road, Melbourne, VIC, 3004, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| |
Collapse
|
8
|
Tabesh M, Magliano DJ, Tanamas SK, Surmont F, Bahendeka S, Chiang C, Elgart JF, Gagliardino JJ, Kalra S, Krishnamoorthy S, Luk A, Maegawa H, Motala AA, Pirie F, Ramachandran A, Tayeb K, Vikulova O, Wong J, Shaw JE. Cardiovascular disease management in people with diabetes outside North America and Western Europe in 2006 and 2015. Diabet Med 2019; 36:878-887. [PMID: 30402961 PMCID: PMC6618273 DOI: 10.1111/dme.13858] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/02/2018] [Indexed: 01/07/2023]
Abstract
AIM Optimal treatment of cardiovascular disease is essential to decrease mortality among people with diabetes, but information is limited on how actual treatment relates to guidelines. We analysed changes in therapeutic approaches to anti-hypertensive and lipid-lowering medications in people with Type 2 diabetes from 2006 and 2015. METHODS Summary data from clinical services in seven countries outside North America and Western Europe were collected for 39 684 people. Each site summarized individual-level data from outpatient medical records for 2006 and 2015. Data included: demographic information, blood pressure (BP), total cholesterol levels and percentage of people taking statins, anti-hypertensive medication (angiotensin-converting enzyme inhibitors, calcium channel blockers, angiotensin II receptor blockers, thiazide diuretics) and antiplatelet drugs. RESULTS From 2006 to 2015, mean cholesterol levels decreased in six of eight sites (range: -0.5 to -0.2), whereas the proportion with BP levels > 140/90 mmHg increased in seven of eight sites. Decreases in cholesterol paralleled increases in statin use (range: 3.1 to 47.0 percentage points). Overall, utilization of anti-hypertensive medication did not change. However, there was an increase in the use of angiotensin II receptor blockers and a decrease in angiotensin-converting enzyme inhibitors. The percentage of individuals receiving calcium channel blockers and aspirin remained unchanged. CONCLUSIONS Our findings indicate that control of cholesterol levels improved and coincided with increased use of statins. The percentage of people with BP > 140/90 mmHg was higher in 2015 than in 2006. Hypertension treatment shifted from using angiotensin-converting enzyme inhibitors to angiotensin II receptor blockers. Despite the potentially greater tolerability of angiotensin II receptor blockers, there was no associated improvement in BP levels.
Collapse
Affiliation(s)
- M. Tabesh
- Baker Heart and Diabetes InstituteMelbourneAustralia
- Department of Epidemiology and Preventive MedicineSchool of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
| | - D. J. Magliano
- Baker Heart and Diabetes InstituteMelbourneAustralia
- Department of Epidemiology and Preventive MedicineSchool of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
| | - S. K. Tanamas
- Baker Heart and Diabetes InstituteMelbourneAustralia
| | | | - S. Bahendeka
- MKPGMS‐Uganda Martyrs University & St. Francis Hospital NsambyaKampalaUganda
| | - C.‐E. Chiang
- General Clinical Research CenterTaipei Veterans General HospitalTaipeiTaiwan
| | - J. F. Elgart
- CENEXA. Centro de Endocrinología Experimental y Aplicada (UNLP‐CONICET)La PlataArgentina
| | - J. J. Gagliardino
- CENEXA. Centro de Endocrinología Experimental y Aplicada (UNLP‐CONICET)La PlataArgentina
| | - S. Kalra
- Bharti Research Institute of Diabetes & EndocrinologyBharti HospitalKarnalHaryanaIndia
| | | | - A. Luk
- Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina
| | - H. Maegawa
- Shiga University of Medical ScienceShigaJapan
| | - A. A. Motala
- Department of Diabetes and EndocrinologyUniversity of KwaZulu NatalDurbanSouth Africa
| | - F. Pirie
- Department of Diabetes and EndocrinologyUniversity of KwaZulu NatalDurbanSouth Africa
| | | | - K. Tayeb
- Diabetes Center at AlNoor Specialist HospitalMakkahSaudi Arabia
| | - O. Vikulova
- FGBU ‘Endocrinology Research Center’Ministry of HealthMoscowRussia
| | - J. Wong
- Royal Prince Alfred Hospital Diabetes Centre and the University of SydneySydneyAustralia
| | - J. E. Shaw
- Baker Heart and Diabetes InstituteMelbourneAustralia
- Department of Epidemiology and Preventive MedicineSchool of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
| |
Collapse
|
9
|
Tabesh M, Shaw JE, Zimmet PZ, Söderberg S, Koye DN, Kowlessur S, Timol M, Joonas N, Sorefan A, Gayan P, Alberti KGMM, Tuomilehto J, Magliano DJ. Association between type 2 diabetes mellitus and disability: What is the contribution of diabetes risk factors and diabetes complications? J Diabetes 2018; 10:744-752. [PMID: 29508937 DOI: 10.1111/1753-0407.12659] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [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] [Received: 12/22/2017] [Revised: 02/18/2018] [Accepted: 02/28/2018] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The aim of this study was to evaluate the association between type 2 diabetes and disability in Mauritius and to assess the extent to which the effect of diabetes is explained by diabetes risk factors and concomitant complications. METHODS Data from a national survey in the multiethnic nation of Mauritius, which comprises South Asians and African Creoles, were analyzed. Disability was measured using the Katz activities of daily living questionnaire in participants aged >50 years. RESULTS Among 3692 participants, 487 (13.2%) had some level of disability. Diabetes was associated with significantly higher risk of disability (odds ratio [OR] 1.67; 95% confidence interval [CI] 1.34-2.08). After adjusting for demographic, behavioral, and metabolic factors, as well as comorbidities, disability was significantly associated with diabetes among African Creoles (OR 2.03; 95% CI 1.16-3.56), but not South Asians (OR 1.27; 95% CI 0.98-1.66). Obesity explained much of the association between diabetes and disability (excess percentage of risk: 26.3% in South Asians and 12.1% in African Creoles). Obesity, history of cardiovascular disease (CVD), asthma-like symptoms, and depression together explained 46.5% and 29.0% of the excess risk in South Asians and African Creoles, respectively. CONCLUSIONS Diabetes is associated with a 67% increased risk of disability. Diabetes risk factors and comorbidities explain more of the association between diabetes and disability among South Asians than Africans. Obesity and history of CVD explained the largest percentage of the relationship between diabetes and disability, indicating that weight and CVD management may be helpful in controlling disability related to diabetes.
Collapse
Affiliation(s)
- Maryam Tabesh
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jonathan E Shaw
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Paul Z Zimmet
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Department of Medicine, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Stefan Söderberg
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Digsu N Koye
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | | | - Maryam Timol
- Ministry of Health and Quality of Life, Port Louis, Mauritius
| | | | - Ameena Sorefan
- Ministry of Health and Quality of Life, Port Louis, Mauritius
| | - Praneel Gayan
- Ministry of Health and Quality of Life, Port Louis, Mauritius
| | - K George M M Alberti
- Department of Endocrinology and Metabolism, St Mary's Hospital and Imperial College, London, UK
| | - Jaakko Tuomilehto
- Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
- Dasman Diabetes Institute, Dasman, Kuwait
- Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Dianna J Magliano
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| |
Collapse
|
10
|
Tabesh M, Shaw JE, Zimmet PZ, Soderberg S, Kowlessur S, Timol M, Joonas N, Alberti GMM, Tuomilehto J, Shaw BJ, Magliano DJ. Meeting American Diabetes Association diabetes management targets: trends in Mauritius. Diabet Med 2017; 34:1719-1727. [PMID: 28792634 DOI: 10.1111/dme.13447] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/04/2017] [Indexed: 12/19/2022]
Abstract
AIMS To examine the proportion of people with diabetes in the multi-ethnic country of Mauritius meeting American Diabetes Association targets in 2009 and 2015. METHODS Data from independent population-based samples of 858 and 656 adults with diagnosed diabetes in 2009 and 2015, respectively, were analysed with regard to recommended American Diabetes Association targets for HbA1c , blood pressure and LDL cholesterol. RESULTS In 2015 compared with 2009, the proportion of people achieving American Diabetes Association targets for glycaemic control in Mauritius was higher in women (P≤0.01) and in those with only a primary education level (P=0.07), but not in men or people with a higher level of education. Achievement of blood pressure <140/90 mmHg was higher in 2015 compared with 2009 (60% vs 42%) in people of South Asian ethnicity (P<0.001), but not in those of African ethnicity (P=0.16). The percentages of people with LDL cholesterol <2.59 mmol/l were 42.1% and 50.4%, in 2009 and 2015, respectively (P=0.27). Better control of HbA1c and blood pressure was observed in groups in which that control was poorest in 2009. The use of glucose-, blood pressure- and LDL cholesterol-lowering medication was higher in 2015 than in 2009. CONCLUSIONS In certain subgroups, namely women, those with poorer education and those of South Asian ethnicity, whose target achievement was the poorest in 2009, control of glycaemia and blood pressure was better in 2015 as compared with 2009. While these findings are encouraging, further work is required to improve outcomes.
Collapse
Affiliation(s)
- M Tabesh
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - J E Shaw
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - P Z Zimmet
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Department of Medicine, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - S Soderberg
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Department of Public Health and Clinical Medicine, Umeå University and Heart Center, Umeå, Sweden
| | - S Kowlessur
- Ministry of Health and Quality of Life, Republic of Mauritius
| | - M Timol
- Ministry of Health and Quality of Life, Republic of Mauritius
| | - N Joonas
- Ministry of Health and Quality of Life, Republic of Mauritius
| | - G M M Alberti
- Department of Endocrinology and Metabolism, St Mary's Hospital and Imperial College, London, UK
| | - J Tuomilehto
- Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
- Dasman Diabetes Institute, Dasman, Kuwait
- Department of Neurosciences and Preventive Medicine, Danube-University Krems, Austria
- Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
| | - B J Shaw
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - D J Magliano
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| |
Collapse
|
11
|
Tabesh M, Magliano DJ, Koye DN, Shaw JE. The effect of nurse prescribers on glycaemic control in type 2 diabetes: A systematic review and meta-analysis. Int J Nurs Stud 2017; 78:37-43. [PMID: 28939342 DOI: 10.1016/j.ijnurstu.2017.08.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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: 06/30/2017] [Revised: 08/28/2017] [Accepted: 08/28/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND The creation of advanced nursing roles in diabetes management, with specific skills such as nurse prescribing, has resulted in nurses taking on roles that have traditionally been associated with doctors. OBJECTIVES We aimed to examine the effectiveness of nurse-led clinics, in which nurses were involved in prescribing, on haemoglobin A1c (HbA1c) among people with type 2 diabetes. METHODS We systematically searched the literature, Medline, the Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE and Allied Health Literature database guide (CINAHL) databases, to identify randomised controlled trials (RCTs) assessing the effect of nurse prescribers on HbA1c. We focused on randomised controlled trials which compared nurse prescriber interventions with usual care in adults aged 18 years or over with a diagnosis of type 2 diabetes. The main outcome measure was change in HbA1c levels. We performed a random effects model meta-analysis to assess the pooled effect size of the intervention. Studies were divided into two groups according to the role of nurses in the intervention. In one group, the nurses supplemented a team, as an add-on to usual care; in the other group, they worked independently, and were compared directly to a doctor. RESULTS Nine RCTs were identified and included in this study. All studies were from developed countries, with a medium risk of bias and a moderate heterogeneity between studies. In the five RCTs in which nurse prescribers supplemented a team, there was no significant difference in change of HbA1c compared to usual care (-0.34 percentage points; 95% CI: -0.71, 0.02). In the four RCTs in which nurses replaced doctors, the outcomes of nurse prescribers were comparable to those of doctors. No data on adverse events were available. CONCLUSION There was no clear evidence of benefit on glycaemic control, when nurses who undertake prescribing work alongside a doctor and other practitioners. However, in those studies in which nurses replaced physicians, the glycaemic control was comparable between nurses and doctors. Therefore, there may be value in providing nurse-led prescribing services where there is limited access to doctor-led services.
Collapse
Affiliation(s)
- Maryam Tabesh
- Baker Heart and Diabetes Institute, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Dianna J Magliano
- Baker Heart and Diabetes Institute, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Digsu N Koye
- Baker Heart and Diabetes Institute, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Jonathan E Shaw
- Baker Heart and Diabetes Institute, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| |
Collapse
|
12
|
Tabesh M, Azadbakht L, Faghihimani E, Tabesh M, Esmaillzadeh A. Effects of Calcium Plus Vitamin D Supplementation on Anthropometric Measurements and Blood Pressure in Vitamin D Insufficient People with Type 2 Diabetes: A Randomized Controlled Clinical Trial. J Am Coll Nutr 2015; 34:281-9. [DOI: 10.1080/07315724.2014.905761] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
13
|
Tabesh M, Azadbakht L, Faghihimani E, Tabesh M, Esmaillzadeh A. Calcium-vitamin D cosupplementation influences circulating inflammatory biomarkers and adipocytokines in vitamin D-insufficient diabetics: a randomized controlled clinical trial. J Clin Endocrinol Metab 2014; 99:E2485-93. [PMID: 25215557 DOI: 10.1210/jc.2014-1977] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
CONTEXT To the best of our knowledge, no study has examined the effects of vitamin D-calcium cosupplementation on inflammatory biomarkers and adipocytokines in vitamin D-insufficient type 2 diabetics. OBJECTIVE This study was performed to assess the effects of vitamin D and calcium supplementation on inflammatory biomarkers and adipocytokines in vitamin D-insufficient people with type 2 diabetes. METHODS Totally, 118 diabetic patients were enrolled in this randomized, placebo-controlled clinical trial. After matching for age, sex, body mass index, type and dose of hypoglycemic agents, and duration of diabetes, subjects were randomly assigned into 4 groups receiving the following: 1) 50000 IU/wk vitamin D + calcium placebo; 2) 1000 mg/d calcium + vitamin D placebo; 3) 50 000 IU/wk vitamin D + 1000 mg/d calcium; or 4) vitamin D placebo + calcium placebo for 8 weeks. Blood sampling was done for the quantification of inflammatory biomarkers and adipocytokines at the study baseline and after 8 weeks of intervention. RESULTS Calcium (changes from baseline: -75 ± 19 ng/ml, P = .01) and vitamin D alone (-56 ± 19 ng/mL, P = .01) and joint calcium-vitamin D supplementation (-92 ± 19 ng/mL, P = .01) resulted in a significant reduction in serum leptin levels compared with placebo (-9 ± 18 ng/mL). This was also the case for serum IL-6, such that calcium (-2 ± 1 pg/mL, P < .001) and vitamin D alone (-4 ± 1 pg/mL, P < .001) and their combination (-4 ± 1 pg/mL, P < .001) led to significant reductions compared with placebo (3 ± 1 pg/mL). After adjustment for potential confounders, individuals in the calcium (-3.1 ± 1.3, P < .05), vitamin D (-3.1 ± 1.3, P < .05), and joint calcium-vitamin D groups (-3.4 ± 1.3, P < .05) had greater reductions in serum TNF-α concentrations compared with placebo (0.1 ± 1.2). Individuals who received joint calcium-vitamin D supplements tended to have a decrease in serum high-sensitivity C-reactive protein levels compared with placebo after controlling for baseline levels (-1.14 ± 0.25 vs 0.02 ± 0.24 ng/mL, P = .09). CONCLUSION Joint calcium-vitamin D supplementation might improve systemic inflammation through decreasing IL-6 and TNF-α concentrations in vitamin D-insufficient people with type 2 diabetes.
Collapse
Affiliation(s)
- Maryam Tabesh
- Food Security Research Center (Marj.T., L.A., Mary.T., A.E.), Department of Community Nutrition (Marj.T., L.A., A.E.), School of Nutrition and Food Science, and Isfahan Endocrine and Metabolism Research Center (E.F.), Isfahan University of Medical Sciences, Isfahan 81745-151, Iran
| | | | | | | | | |
Collapse
|
14
|
Tabesh M, Azadbakht L, Faghihimani E, Tabesh M, Esmaillzadeh A. Effects of calcium-vitamin D co-supplementation on metabolic profiles in vitamin D insufficient people with type 2 diabetes: a randomised controlled clinical trial. Diabetologia 2014; 57:2038-47. [PMID: 25005333 DOI: 10.1007/s00125-014-3313-x] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Accepted: 05/27/2014] [Indexed: 02/06/2023]
Abstract
AIMS/HYPOTHESIS This study was performed to assess the effects of vitamin D and calcium supplementation on the metabolic profiles of vitamin D insufficient persons with type 2 diabetes. METHODS In a parallel designed randomised placebo-controlled clinical trial, a total of 118 non-smoker individuals with type 2 diabetes and insufficient 25-hydroxyvitamin D, aged >30 years, were recruited from the Isfahan Endocrine and Metabolism Research Centre. Participants were randomly assigned to four groups receiving: (1) 50,000 U/week vitamin D + calcium placebo; (2) 1,000 mg/day calcium + vitamin D placebo; (3) 50,000 U/week vitamin D + 1,000 mg/day calcium; or (4) vitamin D placebo + calcium placebo for 8 weeks. A study technician carried out the random allocations using a random numbers table. All investigators, participants and laboratory technicians were blinded to the random assignments. All participants provided 3 days of dietary records and 3 days of physical activity records throughout the intervention. Blood samples were taken to quantify glycaemic and lipid profiles at study baseline and after 8 weeks of intervention. RESULTS 30 participants were randomised in each group. During the intervention, one participant from the calcium group and one from the vitamin D group were excluded because of personal problems. Calcium-vitamin D co-supplementation resulted in reduced serum insulin (changes from baseline: -14.8 ± 3.9 pmol/l, p = 0.01), HbA1c [-0.70 ± 0.19% (-8.0 ± 0.4 mmol/mol), p = 0.02], HOMA-IR (-0.46 ± 0.20, p = 0.001), LDL-cholesterol (-10.36 ± 0.10 mmol/l, p = 0.04) and total/HDL-cholesterol levels (-0.91 ± 0.16, p = 0.03) compared with other groups. We found a significant increase in QUICKI (0.025 ± 0.01, p = 0.004), HOMA of beta cell function (HOMA-B; 11.8 ± 12.17, p = 0.001) and HDL-cholesterol (0.46 ± 0.05 mmol/l, p = 0.03) in the calcium-vitamin D group compared with others. CONCLUSIONS/INTERPRETATION Joint calcium and vitamin D supplementation might improve the glycaemic status and lipid profiles of vitamin D insufficient people with type 2 diabetes. TRIAL REGISTRATION ClinicalTrials.gov NCT01662193 FUNDING: Clinical Research Council, Isfahan University of Medical Sciences, Isfahan, Iran.
Collapse
Affiliation(s)
- Marjan Tabesh
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | | | | | | |
Collapse
|
15
|
Abstract
This study was aimed to assess the effect of dietary energy density (kcal/g) on serum levels of adipocytokines of type 2 diabetic women. In this randomized parallel design clinical trial, a total of 60 diabetic women (aged 30-60 years; BMI>25 kg/m²) were assigned to consume either a low-energy dense (LED) (65% of energy from carbohydrates and 25% from fats), normal-energy dense (NED) (60% from carbohydrates, 30% from fats), or high-energy dense (HED) diet (55% from carbohydrates and 35% from fats) for 8 weeks. The low-energy dense diet was rich in fruits, vegetables, whole grains, and water, while the high-energy dense diet was rich in fats and oils and limited in fruits and vegetables as compared with the normal-dense diet. At baseline and at the end of intervention fasting blood samples were taken to assess metabolic profile. Women in the LED group consumed significantly more dietary fiber (p<0.001), fruits (p<0.001) and vegetables (p<0.001) than those in the NED and HED groups. We failed to find a significant effect of dietary energy density (kcal/g) on serum adiponectin and visfatin levels. Even the within-group changes in serum adiponectin and visfatin levels were not significant. Consumption of LED and NED diets resulted in a significant increase in serum chemerin levels (p=0.04). Comparison of mean changes of serum chemerin levels across 3 groups revealed a significant difference (p=0.04). Our study provides evidence indicating that consumption of HED diet for 8 weeks among diabetic patients prevented the increase in serum chemerin levels compared with LED and NED diets. Furthermore, we found no significant effect of dietary energy density (kcal/g) on serum adiponectin and visfatin concentrations in the current study.
Collapse
Affiliation(s)
- M Tabesh
- Department of Community Nutrition, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | | | | |
Collapse
|
16
|
Abstract
BACKGROUND Although several studies have investigated the association between maternal serum vitamin D levels and risk of pre-eclampsia, findings are inconsistent. This systematic review and meta-analysis of published observational studies was conducted to summarize the evidence on the association between maternal serum vitamin D levels and risk of pre-eclampsia. METHODS PubMed, ISI (Web of science), SCOPUS, SCIRUS, Google Scholar, and EMBASE databases were searched to identify related articles published through December 2012. For systematic review, we found 15 articles that assessed the association between maternal serum vitamin D levels and risk of pre-eclampsia. The meta-analysis was done on 8 studies that reported odds ratios or relative risks for pre-eclampsia. Between-study heterogeneity was examined using Cochran's Q test and I(2). Subgroup analysis and meta-regression were used to find possible sources of heterogeneity. RESULTS The meta-analysis on 8 relevant papers revealed an overall significant association between vitamin D deficiency and risk of pre-eclampsia; however, there was significant between-study heterogeneity (I(2) = 52.7%; P = .039). In the subgroup analysis, we found that the overall effect was significant for studies that defined vitamin D deficiency as 25(OH)D ≤ 50 nmol/L (20 ng/mL), but not for those that considered it as <38 nmol/L (15.2 ng/mL). The association was seen for "cohort or nested case-control studies" as well as for "cross-sectional or case-control studies" (2.78; 1.45-5.33; P = .002). When the analysis was done by study location, the associations remained significant only for studies that came from the United States. CONCLUSION There was a significant relationship between vitamin D deficiency and increased risk of pre-eclampsia. Further studies are required, particularly in developing countries.
Collapse
Affiliation(s)
- Marjan Tabesh
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan 81745-151, Iran
| | | | | | | |
Collapse
|
17
|
Tabesh M, Hariri M, Askari G, Ghiasvand R, Tabesh M, Heydari A, Darvishi L, Khorvash F. The Relationship Between Vegetables and Fruits Intake and Glycosylated Hemoglobin Values, Lipids Profiles and Nitrogen Status in Type II Inactive Diabetic Patients. Int J Prev Med 2013; 4:S63-7. [PMID: 23717773 PMCID: PMC3665029] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Accepted: 06/10/2012] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The prevalence of obesity and associated chronic disease such as diabetes is rapidly increasing in all part of the world. The World Health Organization has predicted that between 1997 and 2025 the number of diabetic patients will increase from 143 million to about 300 million. In diabetic patients, oxidative stress leads to non-enzymatic glycosylation of proteins such as hemoglobin and albumin, these proteins can play a significant role in pathogenesis of diabetes and development of chronic disorders in diabetic patients. Antioxidant nutrients can reduce the chronic disorders and complications of diabetes by inhibiting the oxidative reactions. Some important antioxidant such as vitamin A, vitamin C, vitamin E and selenium occur in vegetables and fruits. Our objective of this study was investigation of the relationship between vegetables and fruits intake ssand glycosylated hemoglobin (HbA1C) values in diabetic patients. METHODS One hundred and five diabetic patients participated in this cross-sectional study. The patients were referred to health center in Khomeini shahr. Glycosylated hemoglobin (HbA1C) values were measured by chromatography method. Data on dietary intake and vegetables and fruits consumption were obtained from validated food frequency questionnaires. RESULTS The unadjusted mean glycosylated hemoglobin (HbA1C) is significantly associated with the amount of vegetables and fruits intake (P = 0.014), but the relationship between consumption of fruits and HbA1C is not significant and the relationship between consumption of vegetables and HbA1C was roughly significant (P = 0.049). There were no significant relationship between vegetables and fruits intake and lipids profiles, BUN/creatinine and 24 h urinary protein (P > 0.05). CONCLUSIONS Intake of vegetables and fruits may reduce the glycosylated hemoglobin, therefore choosing the appropriate diet with high fruits and vegetables may help to develop antioxidant defense and reduce the HbA1C in diabetic patients but it did not have any impact on lipids profiles, BUN/creatinine and urine protein 24 h.
Collapse
Affiliation(s)
- Marjan Tabesh
- Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mitra Hariri
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran,Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gholamreza Askari
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran,Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reza Ghiasvand
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran,Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Tabesh
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran,Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Asieh Heydari
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran,Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Leila Darvishi
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran,Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran,Correspondence to: Mrs. Leila Darvishi, Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran, P.O. Box 8174673461, Hezar Jarib Street, Isfahan, Iran. E-mail:
| | - Fariba Khorvash
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran,Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
18
|
McLeod DG, Quinn DI, Whitmore JB, Tabesh M. Sipuleucel-T in African Americans: A subgroup analysis of three phase III sipuleucel-T trials in advanced prostate cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e15148] [Citation(s) in RCA: 4] [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: 11/20/2022] Open
|
19
|
Antonarakis ES, Kibel AS, Lin DW, Tyler RC, Tabesh M, Drake CG. Design of an open-label randomized phase II trial examining the effect of sequencing of sipuleucel-T and androgen deprivation therapy (ADT) on immune markers in prostate cancer patients with a rising prostate specific antigen (PSA) after primary therapy. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.tps189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
20
|
Shi Y, Tabesh M, Sugrue SP. Role of cell adhesion-associated protein, pinin (DRS/memA), in corneal epithelial migration. Invest Ophthalmol Vis Sci 2000; 41:1337-45. [PMID: 10798648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
PURPOSE To determine whether the cellular distribution of cell adhesion-associated protein, pinin, is altered during corneal epithelial migration in response to debridement wounding and to determine the effect of overexpression of pinin in cultured epithelial cells. METHODS Corneas from guinea pig and embryonic (day 17) chickens were excised, wounded, and placed on organ-culture rafts. At time points from 0 to 24 hours, corneas were cryosectioned and subsequently analyzed by immunofluorescence or immunoelectron microscopy for the presence and distribution of pinin. Cultured epithelial cell line MDCK (Madin Darby canine kidney) confluent monolayers were wounded by scraping and examined by immunofluorescence for pinin and desmoplakin. MDCK cells were transfected with full-length pinin cDNA. After selection in Geneticin, clones of pinin-transfected cells were isolated. Monolayers of transfected cells were scrape-wounded and assayed for their ability to migrate. RESULTS Within 2 hours after wounding, although morphologically identifiable desmosomes were present on migrating epithelial cells, the association of pinin to desmosomes was greatly reduced. Finally, after completion of wound closure, pinin returned to the corneal epithelial desmosome. Wounding of confluent epithelial monolayers (MDCK) in vitro demonstrated a very similar change in the distribution of pinin, whereas desmoplakin remained cell boundary-associated. Transfection of pinin into cultured epithelial cells resulted in an overexpression of pinin. Clones of cells expressing high levels of pinin exhibited marked reduction in their ability to migrate after wounding. CONCLUSIONS Pinin is involved in corneal epithelium migration. The localization of pinin at or near the desmosome is correlated with the epithelial quiescence. The loss of pinin from the cell boundary correlates with the transition from quiescence to actively migrating. Overexpressing pinin in cultured epithelial cells affects epithelial homeostasis and, in turn, drives the epithelial cells to a hyperstable epithelial adhesive state and inhibits the transition from quiescence to migratory.
Collapse
Affiliation(s)
- Y Shi
- Department of Anatomy and Cell Biology, University of Florida College of Medicine, Gainesville 32610-0235, USA
| | | | | |
Collapse
|
21
|
Emeson EE, Manaves V, Singer T, Tabesh M. Chronic alcohol feeding inhibits atherogenesis in C57BL/6 hyperlipidemic mice. Am J Pathol 1995; 147:1749-58. [PMID: 7495299 PMCID: PMC1869960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Although there is abundant clinical evidence that the consumption of alcohol (ethanol) in moderate amounts has a protective effect on coronary artery disease, the mechanism of this effect is not understood. The prevailing theory supported by a limited number of clinical and experimental animal studies indicates that the ability of alcohol to elevate serum high-density lipoprotein cholesterol levels is an important mechanism. Although there have been a large number of studies on the effects of alcohol on serum lipoprotein and apolipoproteins on coronary artery disease, there have been very few that have, at the same time, looked directly and systematically at its effects on the histopathological development of atherosclerotic lesions. In the following studies we employed the hyperlipidemic C57BL/6 female mouse model and formulated an all liquid high fat atherogenic diet to provide the mice with the 3% or 6% alcohol. After 22 weeks on this diet, alcohol markedly inhibited the development of fatty streak atherosclerotic lesions in a dose-dependent fashion. Surprisingly, there was a dose-dependent decrease in plasma high-density lipoprotein cholesterol values, which suggests that high-density lipoprotein alterations play little or no role in the amelioration of atherosclerosis in this model.
Collapse
Affiliation(s)
- E E Emeson
- Department of Pathology, University of Illinois, Chicago College of Medicine 60612-7342, USA
| | | | | | | |
Collapse
|