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Fottrell E, King C, Ahmed N, Shaha SK, Morrison J, Pires M, Kuddus A, Nahar T, Haghparast-Bidgoli H, Khan AA, Azad K. Intermediate hyperglycaemia, diabetes and blood pressure in rural Bangladesh: five-year post-randomisation follow-up of the DMagic cluster-randomised controlled trial. Lancet Reg Health Southeast Asia 2023; 10:100122. [PMID: 36938333 PMCID: PMC10015271 DOI: 10.1016/j.lansea.2022.100122] [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] [Received: 07/08/2022] [Revised: 11/11/2022] [Accepted: 11/15/2022] [Indexed: 12/14/2022]
Abstract
Background The DMagic trial showed that participatory learning and action (PLA) community mobilisation delivered through facilitated community groups, and mHealth voice messaging interventions improved diabetes knowledge in Bangladesh and the PLA intervention reduced diabetes occurrence. We assess intervention effects three years after intervention activities stopped. Methods Five years post-randomisation, we conducted a cross-sectional survey among a random sample of adults aged ≥30-years living in the 96 DMagic villages, and a cohort of individuals identified with intermediate hyperglycaemia at the start of the DMagic trial in 2016. Primary outcomes were: 1) the combined prevalence of intermediate hyperglycaemia and diabetes; 2) five-year cumulative incidence of diabetes among the 2016 cohort of individuals with intermediate hyperglycaemia. Secondary outcomes were: weight, BMI, waist and hip circumferences, blood pressure, knowledge and behaviours. Primary analysis compared outcomes at the cluster level between intervention arms relative to control. Findings Data were gathered from 1623 (82%) of the randomly selected adults and 1817 (87%) of the intermediate hyperglycaemia cohort. 2018 improvements in diabetes knowledge in mHealth clusters were no longer observable in 2021. Knowledge remains significantly higher in PLA clusters relative to control but no difference in primary outcomes of intermediate hyperglycaemia and diabetes prevalence (OR (95%CI) 1.23 (0.89, 1.70)) or five-year incidence of diabetes were observed (1.04 (0.78, 1.40)). Hypertension (0.73 (0.54, 0.97)) and hypertension control (2.77 (1.34, 5.75)) were improved in PLA clusters relative to control. Interpretation PLA intervention effect on intermediate hyperglycaemia and diabetes was not sustained at 3 years after intervention end, but benefits in terms of blood pressure reduction were observed. Funding Medical Research Council UK: MR/M016501/1 (DMagic trial); MR/T023562/1 (DClare study), under the Global Alliance for Chronic Diseases (GACD) Diabetes and Scale-up Programmes, respectively.
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Key Words
- ADS, Appraisal of Diabetes Scale
- BADAS, Diabetic Association of Bangladesh
- BMI, Body Mass Index
- Bangladesh
- CVD, Cardiovascular disease(s)
- Cardiovascular risk
- Cluster randomised controlled trial
- Community intervention
- Control
- DBP, Diastolic blood pressure
- DDS, Dietary Diversity Score
- Diabetes
- GAD-7, Generalised Anxiety Disorder Assessment
- IQR, Inter-quartile range
- NCD, Non-communicable disease(s)
- PHQ-9, Patient Health Questionnaire 9
- PLA, Participatory Learning and Action
- PP, Pulse pressure
- Prevention
- Rural
- SBP, Systolic blood pressure
- T2DM, Type-2 diabetesmellitus
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Affiliation(s)
- Edward Fottrell
- UCL Institute for Global Health, University College London, London, UK
- Corresponding author. UCL Institute for Global Health, 30 Guilford Street, London, WC1N 1EH, UK.
| | - Carina King
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Naveed Ahmed
- Centre for Health Research & Implementation, Diabetic Association of Bangladesh, Dhaka, Bangladesh
| | - Sanjit Kumer Shaha
- Centre for Health Research & Implementation, Diabetic Association of Bangladesh, Dhaka, Bangladesh
| | - Joanna Morrison
- UCL Institute for Global Health, University College London, London, UK
| | - Malini Pires
- UCL Institute for Global Health, University College London, London, UK
| | - Abdul Kuddus
- Centre for Health Research & Implementation, Diabetic Association of Bangladesh, Dhaka, Bangladesh
| | - Tasmin Nahar
- Centre for Health Research & Implementation, Diabetic Association of Bangladesh, Dhaka, Bangladesh
| | | | - A.K. Azad Khan
- Centre for Health Research & Implementation, Diabetic Association of Bangladesh, Dhaka, Bangladesh
| | - Kishwar Azad
- Centre for Health Research & Implementation, Diabetic Association of Bangladesh, Dhaka, Bangladesh
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Ibrahim AO, Shabi OM, Agbesanwa TA, Olowoyo P. Five-year analysis of clinical presentations and predictors of stroke mortality in rural Southwestern Nigeria: A retrospective observational study. Afr J Emerg Med 2022; 12:12-18. [PMID: 35004136 PMCID: PMC8718731 DOI: 10.1016/j.afjem.2021.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 09/15/2021] [Accepted: 10/26/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction Stroke mortality and its predictors are important outcome measures in stroke epidemiological studies and clinical trials. There is an observed paucity of data regarding the clinical presentations and predictors of stroke mortality in Southwestern Nigeria. Few available related studies have centred on hospitals in the urban and sub-urban areas; however, none in the rural settings. This study, therefore, focuses on the clinical presentations and predictors of stroke mortality at the adult Emergency Centre of a tertiary hospital situated in rural Southwestern Nigeria. Methods A retrospective survey, using data form and standardized questionnaire, was used to study the patients admitted for stroke between January 2015 and December 2019. The data were analysed using SPSS Version 22.0. The results were presented in descriptive and tabular formats. Results A total of 276 patients were studied. Their mean age was 67.3 ± 11.1 years. The most common clinical presentations were hemiparesis and cranial nerve deficit. The case of fatality was 10.1%. The predictors of stroke mortality were age ≥65 years [(AOR = 12.752; 95% CI: (1.022–159.190), p = 0.048)], Glascow coma score <8 [(AOR = 50.348; 95% CI: (7.779–325.866), p < 0.001)], uncontrolled blood pressure [(AOR = 23.321; 95% CI: (2.449–221.927), p = 0.006)], presence of atrial fibrillation [(AOR = 16.456; 95% CI: (2.169–169.336), p = 0.009)], convulsion [(AOR = 25.889; 95% CI: (2.374–282.296), p = 0.008)], heart failure [(AOR = 30.284; 95% CI: (3.265–256.347), p < 0.001)], and a repeat stroke [(AOR = 32.617; 95% CI: (2.410–441.381), p = 0.009)]. Conclusion The 7-day fatality was 10.1%. The predictors of stroke mortality were poor Glascow coma score, uncontrolled blood pressure, atrial fibrillation, heart failure, convulsion and a repeat stroke. This study strengthens the argument on the higher prevalence of stroke and its mortality in rural Southwestern Nigeria. Our findings may provide an impetus for prospective research on this outcome.
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Key Words
- AED, Accident and Emergency Department
- AF, Atrial fibrillation
- BMI, Body Mass Index
- DBP, Diastolic blood pressure
- FETHI, Federal teaching hospital, Ido-Ekiti
- GCS, Glascow Coma Score
- HR, Heart rate
- HS, Haemorrhagic Stroke
- IS, Ischemic Stroke
- Mortality
- Nigeria
- Predictors
- RR, Respiratory rate
- Rural
- SBP, Systolic blood pressure
- SSA, Sub- Saharan Africa
- Stroke
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Wei H, Feng H, Lv M, Zhong Y, Yang X, Zhou X, Lei Z, Xia J. Smoking Status Affects the Association Between Hematoma Heterogeneity and Hematoma Expansion. World Neurosurg X 2020; 9:100095. [PMID: 33225256 PMCID: PMC7666337 DOI: 10.1016/j.wnsx.2020.100095] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 10/03/2020] [Indexed: 11/26/2022] Open
Abstract
Objective The purpose of this study was to verify the relationship between hematoma heterogeneity and hematoma expansion and explore any effect modifiers through subgroup analyses. Methods Clinical records of 357 patients with spontaneous cerebral hemorrhage at Shenzhen Second People’s Hospital from March 2016 to October 2018 were included in the study. Hematoma heterogeneity was measured on the first noncontrast computed tomography image according to the Barras scale. Hematoma expansion was defined as an absolute hematoma volume increase of 6 mL, or a 33% increase. We performed univariate and multivariate logistic regression analyses, as well as subgroup analyses, to assess the relationship between the presence of heterogeneity on noncontrast computed tomography and hematoma expansion. Results Hematoma expansion occurred in 79 (22.13%) of the 357 patients with intracerebral hemorrhage (ICH). Among the patients with ICH, there were 83 smokers, accounting for 23.24%. The average patient age was 56.21 ± 13.75 years, and 74.51% were male. Compared with the absence of heterogeneity, the risk of hematoma expansion increased by 1.06 times (odds ratio, 2.06; 95% confidence interval, 1.10–3.86). Based on the subgroup analysis, smoking status was found to modify the association between heterogeneity and hematoma expansion; the association was stronger in smokers than in nonsmokers (odds ratio, 10.23; 95% confidence interval, 2.15–48.65). Conclusions Heterogeneity independently predicts hematoma expansion, especially in smoking patients.
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Affiliation(s)
- Haihua Wei
- Department of Radiology, Shenzhen Second People's Hospital/the First Affiliated Hospital of Shenzhen University, Shenzhen, China.,The First Clinical Medical College, Guangdong Medical University, Zhanjiang, China
| | - Hongye Feng
- Department of Neurology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Minrui Lv
- Department of Radiology, Shenzhen Second People's Hospital/the First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Ying Zhong
- The First Clinical Medical College, Guangdong Medical University, Zhanjiang, China
| | - Xiaolin Yang
- Department of Radiology, Shenzhen Second People's Hospital/the First Affiliated Hospital of Shenzhen University, Shenzhen, China.,The First Clinical Medical College, Guangdong Medical University, Zhanjiang, China
| | - Xi Zhou
- Department of Radiology, Shenzhen Second People's Hospital/the First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Zhihao Lei
- Department of Neurology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Jun Xia
- Department of Radiology, Shenzhen Second People's Hospital/the First Affiliated Hospital of Shenzhen University, Shenzhen, China
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Palozi RAC, Guarnier LP, Romão PVM, Nocchi SR, Dos Santos CC, Lourenço ELB, Silva DB, Gasparotto FM, Gasparotto Junior A. Pharmacological safety of Plinia cauliflora (Mart.) Kausel in rabbits. Toxicol Rep 2019; 6:616-624. [PMID: 31316897 PMCID: PMC6611835 DOI: 10.1016/j.toxrep.2019.06.017] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 06/19/2019] [Accepted: 06/27/2019] [Indexed: 12/27/2022] Open
Abstract
Fruit peels of Plinia cauliflora are widely used in Brazilian traditional medicine. No studies have proved the safety of its pharmacological effects. We assessed the safety pharmacology of P. cauliflora extract (EEPC) in rabbits. EEPC did not cause any significant changes in several physiological systems. These data provide important safety data for its clinical use.
Fruit peels of Plinia cauliflora (Mart.) Kausel are widely used in Brazilian traditional medicine, but no studies have proved the safety of its pharmacological effects on the respiratory, cardiovascular, and central nervous systems. The present study assessed the safety pharmacology of P. cauliflora in New Zealand rabbits. First, an ethanol extract (EEPC) was selected for the pharmacological experiments and chemical characterization. Then, different groups of rabbits were orally treated with EEPC (200 and 2000 mg/kg) or vehicle. Acute behavioral and physiological alterations in the modified Irwin test, respiratory rate, arterial blood gas, and various cardiovascular parameters (i.e., heart rate, blood pressure, and electrocardiography) were evaluated. The main secondary metabolites that were identified in EEPC were ellagic acid, gallic acid, O-deoxyhexosyl quercetin, and the anthocyanin O-hexosyl cyanidin. No significant behavioral or physiological changes were observed in any of the groups. None of the doses of EEPC affected respiratory rate or arterial blood gas, with no changes on blood pressure or electrocardiographic parameters. The present study showed that EEPC did not cause any significant changes in respiratory, cardiovascular, or central nervous system function. These data provide scientific evidence of the effects of this species and important safety data for its clinical use.
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Key Words
- ABG, Arterial blood gas
- ANOVA, One-way analysis of variance
- ASE, Accelerated solvent extraction
- BB, Buffer Base
- BE, Base Excess
- BEecf, Base excess in the extracellular fluid compartment
- CNS, Central nervous system
- Ca++, Calcium
- Cardiovascular
- Cl, Chloride
- DBP, Diastolic blood pressure
- ECG, Electrocardiography
- EEPC, Ethanol extract of Plinia cauliflora
- GAE, Gallic acid equivalent
- H+, Hydrogen ion dissociated
- HHb, Deoxyhemoglobin
- Hct, Hematocrit
- Irwin test
- K+, Potassium
- LA, Left arm
- LC-DAD-MS, Liquid chromatography coupled to a diode array detector and mass spectrometer
- LL, Left leg
- MAP, Mean arterial pressure
- Myrtaceae
- Na+, Sodium
- Na₂CO₃, Sodium carbonate
- O2Hb, Oxyhemoglobin
- P50, Half of the maximum hemoglobin saturation
- PCO2, Partial pressure of carbon dioxide
- PO2, Partial pressure of oxygen
- RA, Right arm
- RL, Right leg
- Respiratory
- S.E.M, Standard error of the mean
- SBP, Systolic blood pressure
- SO2, Level of hemoglobin-saturation by oxygen
- Toxicology
- UFLC, Ultra fast liquid chromatograph
- cHCO3, Bicarbonate concentration
- ctCO2 (B), Concentration of total carbon dioxide of whole blood
- ctCO2 (P), Concentration of total carbon dioxide in plasma
- ctO2, Concentration of total oxygen
- pH, Potential of hydrogen
- tHb, Hemoglobin
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Affiliation(s)
- Rhanany Alan Calloi Palozi
- Laboratório de Eletrofisiologia e Farmacologia Cardiovascular (LEFaC), Faculdade de Ciências da Saúde, Universidade Federal da Grande Dourados, Dourados, MS, Brazil
| | - Lucas Pires Guarnier
- Laboratório de Eletrofisiologia e Farmacologia Cardiovascular (LEFaC), Faculdade de Ciências da Saúde, Universidade Federal da Grande Dourados, Dourados, MS, Brazil
| | - Paulo Vitor Moreira Romão
- Laboratório de Eletrofisiologia e Farmacologia Cardiovascular (LEFaC), Faculdade de Ciências da Saúde, Universidade Federal da Grande Dourados, Dourados, MS, Brazil
| | - Samara Requena Nocchi
- Laboratório de Produtos Naturais e Espectrometria de Massas (LaPNEM), Faculdade de Ciências Farmacêuticas, Alimentos e Nutrição (FACFAN), Universidade Federal do Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Carlos Calixto Dos Santos
- Laboratório de Pesquisa Pré-Clínica de Produtos Naturais, Universidade Paranaense, Umuarama, PR, Brazil
| | | | - Denise Brentan Silva
- Laboratório de Produtos Naturais e Espectrometria de Massas (LaPNEM), Faculdade de Ciências Farmacêuticas, Alimentos e Nutrição (FACFAN), Universidade Federal do Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Francielly Mourão Gasparotto
- Laboratório de Eletrofisiologia e Farmacologia Cardiovascular (LEFaC), Faculdade de Ciências da Saúde, Universidade Federal da Grande Dourados, Dourados, MS, Brazil
| | - Arquimedes Gasparotto Junior
- Laboratório de Eletrofisiologia e Farmacologia Cardiovascular (LEFaC), Faculdade de Ciências da Saúde, Universidade Federal da Grande Dourados, Dourados, MS, Brazil
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Al Kibria GM. Racial/ethnic disparities in prevalence, treatment, and control of hypertension among US adults following application of the 2017 American College of Cardiology/American Heart Association guideline. Prev Med Rep 2019; 14:100850. [PMID: 31061780 PMCID: PMC6488531 DOI: 10.1016/j.pmedr.2019.100850] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [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: 02/11/2019] [Revised: 03/02/2019] [Accepted: 03/14/2019] [Indexed: 01/09/2023] Open
Abstract
The 2017 American College of Cardiology/American Heart Association (ACC/AHA) Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults recommends reduced systolic/diastolic blood pressure (SBP/DBP) cutoffs to define hypertension (i.e., by changing these from ≥140/90 to ≥130/80 mmHg), including new recommendations about indications and goals of antihypertensive treatment. This study reported the differences in age-adjusted prevalence and treatment status of hypertension according to race among US adults per the 2017 ACC/AHA guideline. The National Health and Nutrition Examination Survey 2011-16 data was analyzed. The main outcomes were age-adjusted prevalence and treatment status of hypertension among adults aged ≥20 years. After prevalence estimation, other proportions were obtained. The analysis included 16,103 adults (mean age: 47.6 years, 51.8% women). The age-adjusted proportions of adults with hypertension (59.0%, 95% confidence interval [CI]: 57.4%-60.6%), treatment-eligible for hypertension (49.3%, 95% CI: 47.7%-50.8%), and unmet treatment goals (63.8%, 95% CI: 60.0%-67.5%) among the treated were highest among non-Hispanic blacks. A large proportion of Mexican-Americans (46.5%, 95% CI: 42.0%-51.0%) and people of other races/ethnicities (49.3%, 95% CI: 45.5%-53.0%) were not receiving treatment despite having indication. Non-Hispanic blacks also had the highest prevalence of stage 2 hypertension. Among all races, prevalence, treatment-eligibility, and unmet treatment goals were higher among people with older age, male gender, diabetes, higher body weight, and higher cardiovascular disease risk while the majority of younger, lower/normal body weight, or non-diabetic people were untreated despite being eligible for treatment. The prevalence, treatment-eligibility, and unmet goals were substantially higher among non-Hispanic blacks. Moreover, disparities exist in treatment where Mexican-Americans and people of 'other races/ethnicities' were largely untreated despite having indication.
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Key Words
- 2017 ACC/AHA
- ACC/AHA, American College of Cardiology/American Heart Association
- BP, Blood pressure
- Blood pressure
- Blood pressure control
- CI, Confidence interval
- CKD, Chronic kidney disease
- CVD, Cardiovascular disease
- DBP, Diastolic blood pressure
- Hypertension
- Hypertension treatment
- JNC, Joint National Committee
- NHANES
- NHANES, National Health and Nutrition Examination Survey
- Race
- Racial/ethnic disparities
- SBP, Systolic blood pressure
- SE, Standard error
- US
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Rizwan F, Rashid HU, Yesmine S, Monjur F, Chatterjee TK. Preliminary analysis of the effect of Stevia ( Stevia rebaudiana) in patients with chronic kidney disease (stage I to stage III). Contemp Clin Trials Commun 2018; 12:17-25. [PMID: 30211340 PMCID: PMC6129687 DOI: 10.1016/j.conctc.2018.08.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 06/04/2018] [Revised: 07/24/2018] [Accepted: 08/20/2018] [Indexed: 11/24/2022] Open
Abstract
Background Stevia, Stevia rebaudiana (Bertoni), has become an important economic plant for its commercial use as a sweetener. Stevia plays a significant role in the healthcare practice of different cultures and in population. Previous animal and clinical studies demonstrated the efficacy of Stevia against chronic diseases like diabetes and hypertension. This study aimed to investigate the beneficial effect of Stevia in chronic kidney disease (CKD) patients after three (3) months of treatment along with the conventional antihypertensive and anti diabetic medications. Methods A prospective, interventional, randomized, single-blind, placebo-controlled trial has been done with 97 participants. Stevia capsule (250 mg) or matching placebo was given to the participants twice daily along with Angiotensin-II Receptor Blocker (ARB) and/or Ca2+ Channel Blocker (CCB). First follow up visits were done after 3 months of the interval. Blood and urine samples were collected for the biochemical tests. A structured questionnaire was used for the baseline assessment. Informed consent was taken from each participant. Results Both hypertension and diabetes were found to be associated with CKD. Most of the participants (52.3%) of Stevia group were in CKD Stage II. Significant changes were found in Serum creatinine (p < 0.027), Serum Uric acid (p < 0.009), Fasting blood sugar (p < 0.041) and Postprandial blood sugar (p < 0.013) and Microalbumin (p < 0.041) level in the treatment group. Conclusion The initial result demonstrated that Stevia has the potential for a significant improvement of some biochemical parameters in CKD patients. After completion of the nine (9) months clinical trial, the constructive effect of Stevia can be confirmed in this group of patients.
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Key Words
- ACR, Albumin: Creatinine
- ARB, Angiotensin-II Receptor Blocker
- Angiotensin-II receptor blocker (ARB)
- BMI, Body mass index
- CCB, Ca2+ Channel Blocker
- CKD, Chronic Kidney Disease
- CL, Control (Healthy participant)
- Ca2+ channel blocker (CCB)
- Chronic kidney disease (CKD)
- DBP, Diastolic blood pressure
- Diabetes mellitus
- FBS, Fasting blood sugar
- Hypertension
- In. phos., Inorganic phosphate
- M. albumin, Microalbumin
- PBS, Postprandial blood sugar
- PCR, Protein: Creatinine
- PLC, Placebo
- S uric acid, Serum uric acid
- SBP, Systolic blood pressure
- STP, Serum total protein
- STV, Stevia
- Se. Cr., Serum creatinine
- Stevia
- TCO2, Total CO2
- UTP, Urinary total protein
- eGFR, estimated glomerular filtration rate
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Affiliation(s)
- Farhana Rizwan
- Department of Pharmaceutical Technology, Jadavpur University, Kolkata, 700032, India
- Department of Pharmacy, East West University, Aftabnagar, Dhaka, 1212, Bangladesh
| | - Harun Ur Rashid
- Kidney Foundation Hospital and Research Institute, Mirpur-2, Dhaka, 1216, Bangladesh
| | - Saquiba Yesmine
- Department of Pharmacy, Jahangirnagar University, Savar, Bangladesh
| | - Forhad Monjur
- Department of Clinical Pathology, Institute of Child Health and Shishu Sasthya Foundation Hospital, Mirpur-2, Dhaka, 1216, Bangladesh
| | - Tapan Kumar Chatterjee
- Department of Pharmaceutical Technology, Jadavpur University, Kolkata, 700032, India
- Department of Pharmaceutical Science and Technology, JIS University, Kolkata, West Bengal, 700109, India
- Corresponding author. Dept. of Pharmaceutical Science and Technology, JIS University, Kolkata, India.
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Abstract
Objective: Skipping breakfast and consuming fast food are related to the risk of obesity and are common adolescent behaviors. The relationship between these behaviors and biomarkers related to diabetes and CVD is understudied in this population. Methods: Data are from a study of the etiologic factors related to obesity risk in adolescents. Breakfast and fast food consumption were assessed using a self-report survey. Anthropometrics, fasting lipids, glucose, insulin, and homeostatic model assessment for insulin resistance (HOMA-IR) were assessed. Multivariate analyses were used to examine the relationship between dietary behaviors and selected biomarkers, controlling for calories consumed, body mass index (BMI), and demographic covariates. Results: 367 adolescents (11 to 18-years; mean 14.7 ± 1.8 years) were assessed at the University of Minnesota-Twin Cities from 2006–2008. Breakfast consumption was significantly associated with lower BMI, body fat, insulin, HOMA-IR, and metabolic syndrome (MetS) cluster score, while fast food consumption was associated with higher BMI, body fat, low-density lipoprotein cholesterol, triglycerides, glucose, insulin, HOMA-IR, and MetS cluster score. Some gender differences were observed. Conclusion: Breakfast and fast food consumption appear to be related to important metabolic syndrome biomarkers for chronic disease in a sample of healthy adolescents. The importance of this finding needs to be validated by examining the stability of this pattern over time and to assess the pattern in other populations. Risk factor clustering may create metabolic dysfunction. Eating breakfast is related to decrease metabolic risk in adolescents. Eating fast food is related to increased metabolic risk in adolescents.
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Key Words
- BMI, Body mass index
- CVD, Cardiovascular disease
- Children
- DBP, Diastolic blood pressure
- Dietary Behavior
- HDL, High-density lipoprotein cholesterol
- HOMA-IR, Homeostasis model assessment for insulin resistance
- LDL, Low-density lipoprotein cholesterol
- MetS, Metabolic syndrome
- PBF, Percent body fat
- Risk Factors
- SBP, Systolic blood pressure
- TG, Triglycerides
- Youth
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Affiliation(s)
- Kara L Marlatt
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, United States
| | - Kian Farbakhsh
- Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, MN 55455, United States
| | - Donald R Dengel
- Laboratory of Integrative Human Physiology, School of Kinesiology, University of Minnesota, Minneapolis, MN 55455, United States; Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN 55455, United States
| | - Leslie A Lytle
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, United States
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