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Magkos F, Lee MH, Lim M, Cook AR, Chhay V, Loh TP, Chia KS, Baig S, Ang IYH, Tay JYY, Khoo CM, Halter JB, Toh SA. Dynamic assessment of insulin secretion and insulin resistance in Asians with prediabetes. Metabolism 2022; 128:154957. [PMID: 34942192 DOI: 10.1016/j.metabol.2021.154957] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 05/22/2021] [Revised: 12/03/2021] [Accepted: 12/13/2021] [Indexed: 11/18/2022]
Abstract
AIMS/HYPOTHESIS Prediabetes and type 2 diabetes are highly prevalent in Asia. Understanding the pathophysiology of abnormal glucose homeostasis in Asians will have important implications for reducing disease burden, but there have been conflicting reports on the relative contributions of insulin secretion and action in disease progression. In this study, we aimed to assess the contribution of β-cell dysfunction and insulin resistance in the Asian prediabetes phenotype. METHODS We recruited 1679 Asians with prediabetes (n = 659) or normoglycemia (n = 1020) from a multi-ethnic population in Singapore. Participants underwent an oral glucose tolerance test, an intravenous glucose challenge, and a hyperinsulinemic-euglycemic clamp procedure to determine glucose tolerance, β-cell responsivity, insulin secretion, insulin clearance and insulin sensitivity. RESULTS Participants with prediabetes had significantly higher glucose concentrations in the fasting state and after glucose ingestion than did normoglycemic participants. Insulin sensitivity (M/I ratio) was ~15% lower, acute insulin response (AIR) to intravenous glucose and β-cell responsivity to oral glucose were ~35% lower, but total insulin secretion rate in the fasting state and after glucose ingestion was ~10% greater in prediabetic than in normoglycemic participants. The decrease in β-cell function with worsening glucose homeostasis in Asians with prediabetes was associated with progressively greater defects in AIR rather than M/I. However, analysis using static surrogate measures (HOMA indices) of insulin resistance and β-cell function revealed a different pattern. CONCLUSIONS Lower AIR to intravenous glucose and β-cell responsivity to oral glucose, on a background of mild insulin resistance, are the major contributors to the dysregulation of glucose homeostasis in Asians with prediabetes.
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Affiliation(s)
- Faidon Magkos
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark
| | - Michelle H Lee
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Maybritte Lim
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Alex R Cook
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Vanna Chhay
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Tze Ping Loh
- Department of Laboratory Medicine, National University Hospital, Singapore
| | - Kee Seng Chia
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Sonia Baig
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ian Yi Han Ang
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | | | - Chin Meng Khoo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Medicine, National University Hospital, Singapore
| | - Jeffrey B Halter
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Geriatric and Palliative Medicine, University of Michigan, USA
| | - Sue-Anne Toh
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; NOVI Health, Singapore; Department of Medicine, National University Hospital, Singapore; Regional Health System Office, National University Health System, Singapore; Singapore Population HEalth ImpRovement Centre (SPHERiC), National University Health System, Singapore.
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Akhtar S, Nasir JA, Ali A, Asghar M, Majeed R, Sarwar A. Prevalence of type-2 diabetes and prediabetes in Malaysia: A systematic review and meta-analysis. PLoS One 2022; 17:e0263139. [PMID: 35085366 PMCID: PMC8794132 DOI: 10.1371/journal.pone.0263139] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 01/12/2022] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE The main purpose of this study was to investigate the pooled prevalence of prediabetes and type-2 diabetes in the general population of Malaysia. METHOD We systematically searched Medline (PubMed), Embase, Web of Science, Google Scholar and Malaysian Journals Online to identify relevant studies published between January 1, 1995, and November 30, 2021, on the prevalence of type-2 diabetes in Malaysia. Random-effects meta-analyses were used to obtain the pooled prevalence of diabetes and prediabetes. Subgroup analyses also used to analyze to the potential sources of heterogeneity. Meta- regression was carried to assess associations between study characteristics and diabetes prevalence. Three independent authors selected studies and conducted the quality assessment. The quality of the final evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS Of 2689 potentially relevant studies, 786 titles and abstract were screened. Fifteen studies with 103063 individuals were eligible to be included in the meta-analyses. The pooled prevalence of diabetes was 14.39% (95% CI, 12.51%-16.38%; I2 = 98.4%, 103063 participants from 15 studies). The pooled prevalence of prediabetes was 11.62% (95% CI, 7.17%-16.97%; I2 = 99.8, 88702 participants from 9 studies). The subgroup analysis showed statistically significant differences in diabetes prevalence by the ethical sub-populations with highest in Indians (25.10%; 95% CI, 20.19%-30.35%), followed by Malays (15.25%; 95% CI, 11.59%-19.29%), Chinese (12.87%; 95% CI, 9.73%-16.37%), Bumiputeras (8.62%; 95% CI, 5.41%-12.47%) and others (6.91%; 95% CI, 5.71%-8.19%). There was no evidence of publication bias, although heterogeneity was high (I2 ranged from 0.00% to 99·8%). The quality of evidence based on GRADE was low. CONCLUSIONS Results of this study suggest that a high prevalence of prediabetes and diabetes in Malaysia. The diabetes prevalence is associated with time period and increasing age. The Malaysian government should develop a comprehensive approach and strategy to enhance diabetes awareness, control, prevention, and treatment. TRIAL REGISTRATION Trial registration no. PROSPERO CRD42021255894; https://clinicaltrials.gov/.
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Affiliation(s)
- Sohail Akhtar
- Department of Mathematics and Statistics, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | | | - Aqsa Ali
- Department of Statistics, GC University Lahore, Lahore, Pakistan
| | - Mubeen Asghar
- Department of Statistics, GC University Lahore, Lahore, Pakistan
| | - Rizwana Majeed
- Department of Statistics, GC University Lahore, Lahore, Pakistan
| | - Aqsa Sarwar
- Department of Statistics, GC University Lahore, Lahore, Pakistan
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Khan MS, Cuda S, Karere GM, Cox LA, Bishop AC. Breath biomarkers of insulin resistance in pre-diabetic Hispanic adolescents with obesity. Sci Rep 2022; 12:339. [PMID: 35013420 PMCID: PMC8748903 DOI: 10.1038/s41598-021-04072-3] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 12/15/2021] [Indexed: 12/14/2022] Open
Abstract
Insulin resistance (IR) affects a quarter of the world's adult population and is a major factor in the pathogenesis of cardio-metabolic disease. In this pilot study, we implemented a non-invasive breathomics approach, combined with random forest machine learning, to investigate metabolic markers from obese pre-diabetic Hispanic adolescents as indicators of abnormal metabolic regulation. Using the ReCIVA breathalyzer device for breath collection, we have identified a signature of 10 breath metabolites (breath-IR model), which correlates with Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) (R = 0.95, p < 0.001). A strong correlation was also observed between the breath-IR model and the blood glycemic profile (fasting insulin R = 0.91, p < 0.001 and fasting glucose R = 0.80, p < 0.001). Among tentatively identified metabolites, limonene, undecane, and 2,7-dimethyl-undecane, significantly cluster individuals based on HOMA-IR (p = 0.003, p = 0.002, and p < 0.001, respectively). Our breath-IR model differentiates between adolescents with and without IR with an AUC-ROC curve of 0.87, after cross-validation. Identification of a breath signature indicative of IR shows utility of exhaled breath metabolomics for assessing systemic metabolic dysregulation. A simple and non-invasive breath-based test has potential as a diagnostic tool for monitoring IR progression, allowing for earlier detection of IR and implementation of early interventions to prevent onset of type 2 diabetes mellitus.
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Affiliation(s)
- Mohammad S Khan
- Department of Internal Medicine, Section on Molecular Medicine, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA
- Center for Precision Medicine, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA
| | - Suzanne Cuda
- Health and Weight Management Clinic, Children's Hospital of San Antonio, San Antonio, TX, 78207, USA
- Baylor College of Medicine, Houston, TX, 77030, USA
| | - Genesio M Karere
- Department of Internal Medicine, Section on Molecular Medicine, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA
- Center for Precision Medicine, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA
| | - Laura A Cox
- Department of Internal Medicine, Section on Molecular Medicine, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA
- Center for Precision Medicine, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA
| | - Andrew C Bishop
- Department of Internal Medicine, Section on Molecular Medicine, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA.
- Center for Precision Medicine, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA.
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Anderson JJ, Welsh P, Ho FK, Ferguson LD, Welsh CE, Pellicori P, Cleland JGF, Forbes J, Iliodromiti S, Boyle J, Lindsay R, Celis-Morales C, Gray SR, Katikireddi SV, Gill JMR, Pell JP, Sattar N. Ethnic differences in prevalence of actionable HbA1c levels in UK Biobank: implications for screening. BMJ Open Diabetes Res Care 2021; 9:9/1/e002176. [PMID: 34353880 PMCID: PMC8344314 DOI: 10.1136/bmjdrc-2021-002176] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 07/17/2021] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Early detection and treatment of diabetes as well as its prevention help lessen longer-term complications. We determined the prevalence of pre-diabetes and undiagnosed diabetes in the UK Biobank and standardized the results to the UK general population. RESEARCH DESIGN AND METHODS This cross-sectional study analyzed baseline UK Biobank data on plasma glycated hemoglobin (HbA1c) to compare the prevalence of pre-diabetes and undiagnosed diabetes mellitus in white, South Asian, black, and Chinese participants. The overall and ethnic-specific results were standardized to the UK general population aged 40-70 years of age. RESULTS Within the UK Biobank, the overall crude prevalence was 3.6% for pre-diabetes, 0.8% for undiagnosed diabetes, and 4.4% for either. Following standardization to the UK general population, the results were similar at 3.8%, 0.8%, and 4.7%, respectively. Crude prevalence was much higher in South Asian (11.0% pre-diabetes; 3.6% undiagnosed diabetes; 14.6% either) or black (13.8% pre-diabetes; 3.0% undiagnosed diabetes; 16.8% either) participants. Only six middle-aged or old-aged South Asian individuals or seven black would need to be tested to identify an HbA1c result that merits action. CONCLUSIONS Single-stage population screening for pre-diabetes or undiagnosed diabetes in middle-old or old-aged South Asian and black individuals using HbA1c could be efficient and should be considered.
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Affiliation(s)
- Jana J Anderson
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Paul Welsh
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Frederick K Ho
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Lyn D Ferguson
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Claire E Welsh
- Population and Health Sciences, Newcastle University, Newcastle upon Tyne, UK
| | | | - John G F Cleland
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - John Forbes
- Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Stamatina Iliodromiti
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
- Centre of Women's Health, Yvonne Carter Building, Queen Mary University of London, London, UK
| | - James Boyle
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Robert Lindsay
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Carlos Celis-Morales
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Stuart Robert Gray
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | | | | | - Jill P Pell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
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Pavlovska I, Polcrova A, Mechanick JI, Brož J, Infante-Garcia MM, Nieto-Martínez R, Maranhao Neto GA, Kunzova S, Skladana M, Novotny JS, Pikhart H, Urbanová J, Stokin GB, Medina-Inojosa JR, Vysoky R, González-Rivas JP. Dysglycemia and Abnormal Adiposity Drivers of Cardiometabolic-Based Chronic Disease in the Czech Population: Biological, Behavioral, and Cultural/Social Determinants of Health. Nutrients 2021; 13:nu13072338. [PMID: 34371848 PMCID: PMC8308692 DOI: 10.3390/nu13072338] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 06/28/2021] [Accepted: 07/05/2021] [Indexed: 12/12/2022] Open
Abstract
In contrast to the decreasing burden related to cardiovascular disease (CVD), the burden related to dysglycemia and adiposity complications is increasing in Czechia, and local drivers must be identified. A comprehensive literature review was performed to evaluate biological, behavioral, and environmental drivers of dysglycemia and abnormal adiposity in Czechia. Additionally, the structure of the Czech healthcare system was described. The prevalence of obesity in men and diabetes in both sexes has been increasing over the past 30 years. Possible reasons include the Eastern European eating pattern, high prevalence of physical inactivity and health illiteracy, education, and income-related health inequalities. Despite the advanced healthcare system based on the compulsory insurance model with free-for-service healthcare and a wide range of health-promoting initiatives, more effective strategies to tackle the adiposity/dysglycemia are needed. In conclusion, the disease burden related to dysglycemia and adiposity in Czechia remains high but is not translated into greater CVD. This discordant relationship likely depends more on other factors, such as improvements in dyslipidemia and hypertension control. A reconceptualization of abnormal adiposity and dysglycemia into a more actionable cardiometabolic-based chronic disease model is needed to improve the approach to these conditions. This review can serve as a platform to investigate causal mechanisms and secure effective management of cardiometabolic-based chronic disease.
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Affiliation(s)
- Iuliia Pavlovska
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
- Department of Public Health, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic;
- Correspondence: ; Tel.: +4-207-770-90433
| | - Anna Polcrova
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
- Research Centre for Toxic Compounds in the Environment (RECETOX), Masaryk University, 62500 Brno, Czech Republic;
| | - Jeffrey I. Mechanick
- The Marie-Josée and Henry R. Kravis Center for Cardiovascular Health at Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
- Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Jan Brož
- Department of Internal Medicine, Charles University Second Faculty of Medicine, 10506 Prague, Czech Republic;
| | - Maria M. Infante-Garcia
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Barquisimeto 3001, Lara, Venezuela;
| | - Ramfis Nieto-Martínez
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Barquisimeto 3001, Lara, Venezuela;
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Harvard University, Boston, MA 02115, USA
- LifeDoc Health, Memphis, TN 38119, USA
| | - Geraldo A. Maranhao Neto
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
| | - Sarka Kunzova
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
| | - Maria Skladana
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
- Second Department of Internal Medicine, St. Anne’s University Hospital in Brno and Faculty of Medicine, Masaryk University, 65691 Brno, Czech Republic
| | - Jan S. Novotny
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
| | - Hynek Pikhart
- Research Centre for Toxic Compounds in the Environment (RECETOX), Masaryk University, 62500 Brno, Czech Republic;
- Department of Epidemiology and Public Health, University College London, London WC1E6BT, UK
| | - Jana Urbanová
- Center for Research in Diabetes, Metabolism and Nutrition, Second Department of Internal Medicine, Third Faculty of Medicine, University Hospital Královské Vinohrady, 10000 Prague, Czech Republic;
| | - Gorazd B. Stokin
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
| | - Jose R. Medina-Inojosa
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA;
- Marriott Heart Disease Research Program, Mayo Clinic, Rochester, MN 55905, USA
| | - Robert Vysoky
- Department of Public Health, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic;
- Department of Health Support, Faculty of Sport Studies, Masaryk University, 62500 Brno, Czech Republic
| | - Juan P. González-Rivas
- International Clinical Research Centre (ICRC), St Anne’s University Hospital Brno (FNUSA), 65691 Brno, Czech Republic; (A.P.); (M.M.I.-G.); (G.A.M.N.); (S.K.); (M.S.); (J.S.N.); (G.B.S.); (J.P.G.-R.)
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Barquisimeto 3001, Lara, Venezuela;
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Harvard University, Boston, MA 02115, USA
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Roy A, Kamalanathan S, Sahoo J, Kar SS, Naik D, Narayanan N, Merugu C, Patel D. Comparison of islet cell function, insulin sensitivity, and incretin axis between Asian-Indians with either impaired fasting glucose or impaired glucose tolerance, and normal healthy controls. Diabetes Res Clin Pract 2021; 176:108846. [PMID: 33951481 DOI: 10.1016/j.diabres.2021.108846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 03/07/2021] [Revised: 04/24/2021] [Accepted: 04/28/2021] [Indexed: 01/06/2023]
Abstract
AIMS The objective of this study was to compare the islet cell function, insulin sensitivity, and incretin axis between Asian-Indian subjects with either impaired fasting glucose (IFG), or impaired glucose tolerance (IGT), and normal glucose tolerance (NGT). MATERIALS AND METHODS Prediabetes subjects underwent a mixed meal tolerance test(MMTT) after overnight fasting. Samples for glucose, insulin, glucagon, and glucagon-like peptide-1 (GLP-1) were collected at 0, 30, 60, and 120 min. Insulin secretion sensitivity index -2 (ISSI-2) for beta-cell function and Matsuda index for insulin sensitivity were assessed. Alpha cell function was assessed by measuring the area under the curve (AUC) 0-120 glucagon/AUC0-120 glucose. RESULTS A total of sixty subjects were recruited with 20 in each group. The beta-cell function represented by ISSI-2 was impaired in prediabetes subjects as compared to NGT group (IFG: 2.09 ± 0.44 vs. NGT: 3.04 ± 0.80, P < 0.0001, and IGT: 2.33 ± 0.59 vs. NGT: 3.04 ± 0.80, P = 0.002). Similarly, AUC0-120 glucagon/AUC0-120 glucose was also lower in prediabetes group as compared to healthy controls (IFG: 0.41(0.54) vs. NGT: 1.07(0.39), P = 0.003 and IGT: 0.57(0.38) vs. NGT: 1.07(0.39), P = 0.001). CONCLUSION Asian-Indian prediabetes subjects have reduced beta-cell function with lesser glucagon secretion during MMTT as compared to normal healthy controls.
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Affiliation(s)
- Ayan Roy
- Department of Endocrinology, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Puducherry, India; Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, Jodhpur, Rajasthan, 342005, India
| | - Sadishkumar Kamalanathan
- Department of Endocrinology, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Puducherry, India
| | - Jayaprakash Sahoo
- Department of Endocrinology, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Puducherry, India.
| | - Sitanshu Sekhar Kar
- Department of Preventive and Social Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Puducherry, India
| | - Dukhabandhu Naik
- Department of Endocrinology, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Puducherry, India
| | - Niya Narayanan
- Department of Endocrinology, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Puducherry, India
| | - Chandhana Merugu
- Department of Endocrinology, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Puducherry, India
| | - Deepika Patel
- Department of Endocrinology, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Puducherry, India
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Jamieson EL, Spry EP, Kirke AB, Griffiths E, Porter C, Roxburgh C, Singleton S, Sterry K, Atkinson DN, Marley JV. Prediabetes and pregnancy: Early pregnancy HbA 1c identifies Australian Aboriginal women with high-risk of gestational diabetes mellitus and adverse perinatal outcomes. Diabetes Res Clin Pract 2021; 176:108868. [PMID: 34023341 DOI: 10.1016/j.diabres.2021.108868] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/06/2021] [Accepted: 05/18/2021] [Indexed: 10/21/2022]
Abstract
AIMS To assess whether early pregnancy HbA1c can predict gestational diabetes mellitus (GDM) and adverse birth outcomes in Australian women. METHODS Prospective study of 466 women without diabetes, aged ≥16-years at first antenatal presentation. Recruitment was from 27 primary healthcare sites in rural and remote Australia from 9-January 2015 to 31-May 2018. HbA1c was measured with first antenatal investigations (<20-weeks gestation). Primary outcome measure was predictive value of HbA1c for GDM, by routine 75 g oral glucose tolerance test (OGTT; ≥24-weeks gestation), and for large-for-gestational-age (LGA) newborn. RESULTS Of 396 (129 Aboriginal) women with routine OGTT, 28.8% had GDM (24.0% Aboriginal). HbA1c ≥5.6% (≥38 mmol/mol) was highly predictive (71.4%, 95% CI; 47.8-88.7%) for GDM in Aboriginal women, and in the total cohort increased risk for LGA newborn (RR 2.04, 95% CI; 1.03-4.01, P = 0.040). There were clear differences between Aboriginal and non-Aboriginal women: 16.3% v 5.2% (P < 0.001) had elevated HbA1c whereas 12.4% v 29.6% (P < 0.001) developed hyperglycemia during pregnancy. CONCLUSIONS Early pregnancy HbA1c ≥5.6% (≥38 mmol/mol) identifies Aboriginal women with apparent prediabetes and elevated risk of having an LGA newborn. Universal HbA1c at first antenatal presentation could facilitate earlier management of hyperglycemia and improved perinatal outcome in this high-risk population.
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Affiliation(s)
- Emma L Jamieson
- The University of Western Australia, Medical School, The Rural Clinical School of Western Australia, Building 3 Edith Cowan University, Robertson Drive, PO Box 412, Bunbury, WA 6230, Australia
| | - Erica P Spry
- The University of Western Australia, Medical School, The Rural Clinical School of Western Australia, 12 Napier Terrace, PO Box 1377, Broome, WA 6725, Australia; Kimberley Aboriginal Medical Services, 12 Napier Terrace, Broome, WA 6725, Australia
| | - Andrew B Kirke
- The University of Western Australia, Medical School, The Rural Clinical School of Western Australia, Building 3 Edith Cowan University, Robertson Drive, PO Box 412, Bunbury, WA 6230, Australia
| | - Emma Griffiths
- The University of Western Australia, Medical School, The Rural Clinical School of Western Australia, 12 Napier Terrace, PO Box 1377, Broome, WA 6725, Australia
| | - Cynthia Porter
- Geraldton Regional Aboriginal Medical Service, Rifle Range Road, Rangeway, WA 6530, Australia
| | - Carly Roxburgh
- The University of Western Australia, Medical School, The Rural Clinical School of Western Australia, 31 Stirling Terrace, Albany, WA 6330, Australia
| | - Sally Singleton
- The University of Western Australia, Medical School, The Rural Clinical School of Western Australia, 12 Napier Terrace, PO Box 1377, Broome, WA 6725, Australia
| | - Kylie Sterry
- The University of Western Australia, Medical School, The Rural Clinical School of Western Australia, St Alban's Road (rear Kalgoorlie Hospital), Kalgoorlie, WA 6433, Australia
| | - David N Atkinson
- The University of Western Australia, Medical School, The Rural Clinical School of Western Australia, 12 Napier Terrace, PO Box 1377, Broome, WA 6725, Australia
| | - Julia V Marley
- The University of Western Australia, Medical School, The Rural Clinical School of Western Australia, 12 Napier Terrace, PO Box 1377, Broome, WA 6725, Australia; Kimberley Aboriginal Medical Services, 12 Napier Terrace, Broome, WA 6725, Australia.
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Kaze AD, Musani SK, Bidulescu A, Joseph JJ, Correa A, Ndumele CE, Bertoni AG, Ahima RS, Golden SH, Echouffo-Tcheugui JB. Plasma adipokines and glycaemic progression among African Americans: Findings from the Jackson Heart Study. Diabet Med 2021; 38:e14465. [PMID: 33236370 PMCID: PMC9023067 DOI: 10.1111/dme.14465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/10/2020] [Accepted: 11/16/2020] [Indexed: 11/28/2022]
Abstract
AIM To evaluate the association between plasma biomarkers including leptin, adiponectin, adiponectin-to-leptin ratio and high-sensitivity C-reactive protein (hsCRP) with risk of glycaemic progression and incident dysglycaemia (pre-diabetes or diabetes) in a community-based sample of African American (AAs). METHODS We analysed data from 3223 participants without type 2 diabetes at baseline (2000-2004) who attended ≥1 follow-up visit. Poisson regression was used to generate risk ratios (RRs) for glycaemic progression and incident dysglycaemia. RESULTS Over a median of 7 years, 46.4% developed glycaemic progression (n=1495). After adjusting for demographic and lifestyle variables, the RRs (95% CI) for glycaemic progression comparing highest (Q4) to lowest (Q1) quartiles were 1.30 (1.10-1.54), 0.74 (0.65-0.84), 0.70 (0.62-0.80) and 1.22 (1.07-1.38) for leptin, adiponectin, adiponectin-leptin ratio and hsCRP, respectively. Upon additional adjustment for BMI, the corresponding RRs (95% CIs) were 1.15 (0.94-1.42), 0.76 (0.67-0.86), 0.72 (0.62-0.84) and 1.14 (0.99-1.31) respectively. Among participants with normal glycaemia, the RRs (95% CIs) for incident pre-diabetes in Q4 vs Q1 were 1.37 (1.13-1.67), 0.73 (0.63-0.85), 0.70 (0.59-0.82) and 1.28 (1.10-1.48) for leptin, adiponectin, adiponectin-leptin ratio and hsCRP, respectively; equivalent RRs for incident diabetes were 5.15 (2.63-10.10), 0.36 (0.20-0.68), 0.21 (0.12-0.38) and 3.04 (1.70-5.44), respectively. CONCLUSIONS In this large community-based cohort of AAs, our results suggest that high plasma leptin and hsCRP, as well as low adiponectin and adiponectin-to-leptin ratio, are associated with higher risks of glycaemic progression. The findings point to the potential utility of these biomarkers in predicting and preventing glycaemic progression in this high-risk population.
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Affiliation(s)
- Arnaud D. Kaze
- Department of Medicine, University of Maryland Medical Center, Baltimore, MD, USA
| | - Solomon K. Musani
- Department of Medicine, University of Mississippi Medical Center, Jackson, USA
| | - Aurelian Bidulescu
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN, USA
| | - Joshua J. Joseph
- Department of Medicine, Division of Endocrinology, Diabetes & Metabolism, Ohio State University, Columbus, OH, USA
| | - Adolfo Correa
- Department of Medicine, University of Mississippi Medical Center, Jackson, USA
| | - Chiadi E. Ndumele
- Department of Medicine, Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Alain G. Bertoni
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Rexford S. Ahima
- Department of Medicine, University of Mississippi Medical Center, Jackson, USA
| | - Sherita H. Golden
- Department of Medicine, Division of Endocrinology, Diabetes & Metabolism, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Welch Prevention Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
| | - Justin B. Echouffo-Tcheugui
- Department of Medicine, Division of Endocrinology, Diabetes & Metabolism, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Welch Prevention Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
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9
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Lee JR, Maruthur NM, Yeh HC. Nativity and prevalence of cardiometabolic diseases among U.S. Asian immigrants. J Diabetes Complications 2020; 34:107679. [PMID: 32900593 PMCID: PMC9078065 DOI: 10.1016/j.jdiacomp.2020.107679] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 07/08/2020] [Accepted: 07/13/2020] [Indexed: 11/17/2022]
Abstract
AIMS Acculturation has been shown to be an important factor for immigrants' health in the United States. We investigate whether nativity is associated with a greater risk for cardiometabolic diseases among Asian Americans (Asians) vs. non-Hispanic whites (whites). METHODS Based on data from the U.S. National Health Interview Survey in 2006-2015, 146,862 Asians and whites aged ≥30 years were evaluated. Nativity as a proxy for acculturation was defined using a combination of birthplace and the duration of U.S. residency. Cardiometabolic diseases were defined based on self-reported diagnoses of diabetes, prediabetes, or cardiovascular diseases (CVD). Using 10-year pooled data accounting for complex sampling designs and weights, multiple logistic regression models were used to assess associations. Four Asian subgroups, including Chinese, Filipinos, Asian Indians and other Asians, were evaluated in subgroup analyses. RESULTS Compared to U.S.-born whites, prevalent type 2 diabetes and prediabetes were higher among Asians depending on nativity. However, the prevalence of CVD was lower among Asians than among whites regardless of nativity (OR≥15 years = 0.5 [95% CI:0.5-0.6], ORU.S-born = 0.7 [95% CI:0.6-0.8]). In addition, compared to U.S.-born whites, prevalent type 2 diabetes and prediabetes increased with an increasing length of U.S. residency for foreign-born Asians among Asians overall (≥15 years: ORdiabetes = 1.5 [95% CI:1.3-1.7]; ORprediabetes = 1.3 [95% CI:1.2-1.6]) and Asian Indians and Filipinos. Furthermore, a significant graded association between prediabetes and length of U.S. residency was found among foreign-born Asians. CONCLUSIONS The prevalence of diabetes and prediabetes is higher among Asian immigrants who have spent more years in the U.S., than those in U.S.-born whites. Monitoring and prevention efforts for diabetes should target this group.
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Affiliation(s)
- Jiwon R Lee
- Samsung Health Research Institute, Samsung Electronics Co., Ltd., Hwaseong 18448, Republic of Korea.
| | - Nisa M Maruthur
- Department of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA; Department of Epidemiology, Johns Hopkins University, Baltimore, MD 21205, USA.
| | - Hsin-Chieh Yeh
- Department of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA; Department of Epidemiology, Johns Hopkins University, Baltimore, MD 21205, USA.
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10
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Ng BP, Cheng YJ, Rutledge S, Cannon MJ, Zhang P, Smith BD. Estimated number of eligible Part B beneficiaries for the medicare diabetes prevention program at the county level and by urban-rural classification. PLoS One 2020; 15:e0241757. [PMID: 33170867 PMCID: PMC7654820 DOI: 10.1371/journal.pone.0241757] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 10/20/2020] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Diabetes imposes large health and financial burdens on Medicare beneficiaries. Type 2 diabetes can be prevented or delayed through lifestyle modification programs. In 2018, Medicare began to offer the Medicare Diabetes Prevention Program (MDPP), a lifestyle intervention, to eligible beneficiaries nationwide. The number of MDPP-eligible beneficiaries is not known, but this information is essential in efforts to expand the program and increase enrollment. This study aimed to estimate the number and spatial variation of MDPP-eligible Part B beneficiaries at the county level and by urban-rural classification. METHODS Data from 2011-2016 National Health and Nutrition Examination Surveys and a survey-weighted logistic regression model were used to estimate proportions of prediabetes in the United States by sex, age, and race/ethnicity based on the MDPP eligibility criteria. The results from the predictive model were applied to 2015 Medicare Part B beneficiaries to estimate the number of MDPP-eligible beneficiaries. The National Center for Health Statistics' Urban-Rural Classification Scheme for Counties from 2013 were used to define urban and rural categories. RESULTS An estimated 5.2 million (95% CI = 3.5-7.0 million) Part B beneficiaries were eligible for the MDPP. By state, estimates ranged from 13,000 (95% CI = 8,500-18,000) in Alaska to 469,000 (95% CI = 296,000-641,000) in California. There were 2,149 counties with ≤1,000 eligible beneficiaries and 11 with >25,000. Consistent with demographic patterns, urban counties had more eligible beneficiaries than rural counties. CONCLUSIONS These estimates could be used to plan locations for new MDPPs and reach eligible Part B beneficiaries for enrollment.
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Affiliation(s)
- Boon Peng Ng
- College of Nursing and Disability, Aging and Technology Cluster, University of Central Florida, Orlando, Florida, United States of America
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Yiling J. Cheng
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Stephanie Rutledge
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Michael J. Cannon
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Ping Zhang
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Bryce D. Smith
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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Frediani JK, Bienvenida AF, Li J, Higgins MK, Lobelo F. Physical fitness and activity changes after a 24-week soccer-based adaptation of the U.S diabetes prevention program intervention in Hispanic men. Prog Cardiovasc Dis 2020; 63:775-785. [PMID: 32603753 PMCID: PMC8650220 DOI: 10.1016/j.pcad.2020.06.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 06/22/2020] [Indexed: 12/26/2022]
Abstract
PURPOSE One third of the U.S. adult population is estimated to have prediabetes. Hispanics have a 50% higher type 2 diabetes (T2DM) death rate compared to non-Hispanic whites, yet low participation in lifestyle change programs, making this subgroup an important target for prevention efforts. The purpose of this study was to determine the effects of an exercise intervention implementing the Center for Disease Control and Prevention National Diabetes Prevention Program (NDPP) plus recreational soccer (RS) in Hispanic men. METHODS Overweight and obese Hispanic men, aged 30-57 years with prediabetes at screening were recruited from the community. Trained soccer coaches led 30-min facilitated discussion of the NDPP modules after each RS session, with two weekly sessions delivered over 12 wks, then once a wk until 24 wks. The 1-h RS sessions followed the Football Fitness curriculum structure. Standardized study assessments included objectively measured physical activity via fitness tracker, physical fitness via validated field tests, global positional system soccer specific metrics and behavior change questionnaires. Mixed models assessed the outcomes as a function of time and cohort and incorporated an unstructured covariance structure to examine the difference between baseline, 12 and 24 wks. All analyses were conducted as intent-to-treat and generated using SAS v 9.4. RESULTS Hispanic males (n = 41; mean age 41.9 [6.2 SD] years) were obese at baseline (mean BMI 32.7, standard error [0.7]). After 24 wks of the NDPP+RS intervention, there were significant beneficial changes in vertical jump (2.8 [1.3] cm; p = 0.048), agility and lower extremity muscular power (figure 8-run) at 12 wks (-4.7% change; p = 0.001) and 24 wks (-7.2% change; p < 0.0001), predicted VO2 max (12 wks: 1.9%; p = 0.007; 24 wks 1.0%; p = 0.036), modified push-ups increased 22% (p < 0.0001) at 12 wks and 31% (p < 0.0001) at 24 wks, dynamic sit-ups increased 10% (p = 0.005) at 12 wks and 15% (p < 0.0001) at 24 wks. CONCLUSION Among middle-aged Latino men, broad-ranging significant improvements in physical fitness were observed after 24 wks participating in lifestyle education plus RS in a single arm feasibility trial.
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Affiliation(s)
| | | | - Jianheng Li
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Melinda K Higgins
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Felipe Lobelo
- Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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12
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Runge CR, Ng M, Herman WH, Gebremariam A, Hirschfeld E, Lee JM. Racial differences in prediabetes prevalence by test type for the US pediatric and adult population: NHANES 1999-2016. Pediatr Diabetes 2020; 21:1110-1115. [PMID: 32681534 PMCID: PMC10771709 DOI: 10.1111/pedi.13083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/29/2020] [Accepted: 07/13/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Previous studies have shown that US estimates of prediabetes or diabetes differ depending on test type, fasting plasma glucose (FPG) vs hemoglobin A1c (HbA1c). Given age, race, and test differences reported in the literature, we sought to further examine these differences in prediabetes detection using a nationally representative sample. METHODS Using the National Health and Nutrition Examination Survey (NHANES) 1999-2016, individuals were identified as having prediabetes with an HbA1c of 5.7% to 6.4% or a FPG of 100 to 125 mg/dL. We excluded individuals with measurements in the diabetic range. We ran generalized estimating equation logistic regressions to examine the relationship between age, race, and test type with interactions, controlling for sex and body mass index. We compared the difference in predicted prediabetes prevalence detected by impaired fasting glycemia (IFG) vs HbA1c by race/ethnicity among children and adults separately using adjusted Wald tests. RESULTS The absolute difference in predicted prediabetes detected by IFG vs HbA1c was 19.9% for white adolescents, 0% for black adolescents, and 20.1% for Hispanic adolescents; 21.4% for white adults, -1.2% for black adults, and 19.2% for Hispanic adults. Using adjusted Wald tests, we found the absolute differences between black vs white and black vs Hispanic individuals to be significant, but, not between Hispanic and white individuals among children and adults separately. CONCLUSIONS These observations highlight differences in test performance among racial/ethnic groups. Our findings corroborate the need for further studies to determine appropriate HbA1c cutoff levels for diagnosis of prediabetes by age group and race.
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Affiliation(s)
- Carly R. Runge
- Department of Nutritional Sciences, School of Public Health, University of Michigan
- Susan B. Meister Child Health Evaluation and Research Center (CHEAR), Division of General Pediatrics, University of Michigan
| | - Michelle Ng
- Susan B. Meister Child Health Evaluation and Research Center (CHEAR), Division of General Pediatrics, University of Michigan
| | - William H. Herman
- Department of Internal Medicine, University of Michigan
- Department of Epidemiology, University of Michigan
| | - Acham Gebremariam
- Susan B. Meister Child Health Evaluation and Research Center (CHEAR), Division of General Pediatrics, University of Michigan
| | - Emily Hirschfeld
- Susan B. Meister Child Health Evaluation and Research Center (CHEAR), Division of General Pediatrics, University of Michigan
| | - Joyce M. Lee
- Department of Nutritional Sciences, School of Public Health, University of Michigan
- Susan B. Meister Child Health Evaluation and Research Center (CHEAR), Division of General Pediatrics, University of Michigan
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Abstract
BACKGROUND The optimal approach to screening and diagnosis of prediabetes and diabetes in youth is uncertain. METHODS We conducted a cross-sectional analysis of 14 119 youth aged 10 to 19 years in the 1999-2016 NHANES. First, we examined the performance of American Diabetes Association risk-based screening criteria. Second, we evaluated the performance of current clinical definitions of prediabetes and diabetes based on hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), either HbA1c or FPG, or both HbA1c and FPG (confirmatory definition) to identify youth at high cardiometabolic risk. RESULTS Overall, 25.5% of US youth (10.6 million in 2016) were eligible for screening. Sensitivity and specificity of the screening criteria for detecting any hyperglycemia were low for both HbA1c ≥5.7% (sensitivity = 55.5%, specificity = 76.3%) and FPG ≥100 mg/dL (sensitivity = 35.8%, specificity = 77.1%). Confirmed undiagnosed diabetes (HbA1c ≥6.5% and FPG ≥126 mg/dL) was rare, <0.5% of youth. Most (>85%) cases of diabetes were diagnosed. Associations with cardiometabolic risk were consistently stronger and more specific for HbA1c-defined hyperglycemia (specificity = 98.6%; sensitivity = 4.0%) than FPG-defined hyperglycemia (specificity = 90.1%; sensitivity = 19.4%). CONCLUSIONS One-quarter of US youth are eligible for screening for diabetes and prediabetes; however, few will test positive, especially for diabetes. Most cases of diabetes in US youth are diagnosed. Regardless of screening eligibility, we found that HbA1c is a specific and useful nonfasting test to identify high-risk youth who could benefit from lifestyle interventions to prevent diabetes and cardiovascular risk in adulthood.
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Affiliation(s)
- Amelia S Wallace
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, John Hopkins University, Baltimore, Maryland; and
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland
| | - Dan Wang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, John Hopkins University, Baltimore, Maryland; and
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland
| | - Jung-Im Shin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, John Hopkins University, Baltimore, Maryland; and
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland
| | - Elizabeth Selvin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, John Hopkins University, Baltimore, Maryland; and
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland
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James D, Umekwe N, Edeoga C, Nyenwe E, Dagogo-Jack S. Multi-year reproducibility of hyperinsulinemic euglycemic clamp-derived insulin sensitivity in free-living adults: Association with incident prediabetes in the POP-ABC study. Metabolism 2020; 109:154263. [PMID: 32445642 PMCID: PMC7387175 DOI: 10.1016/j.metabol.2020.154263] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 04/17/2020] [Revised: 05/15/2020] [Accepted: 05/16/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The hyperinsulinemic euglycemic clamp (HEC) is the "gold standard" for measuring insulin sensitivity (Si-clamp). Here, we determined the reproducibility of serial HEC data in healthy subjects. RESEARCH DESIGN AND METHODS The Pathobiology of Prediabetes in A Biracial Cohort study assessed incident prediabetes in healthy African Americans (AA) and European Americans (EA) with parental type 2 diabetes mellitus during 5.5 years of follow-up. Assessments included anthropometry, OGTT, and HEC. Ninety subjects (44 AA, 46 EA) who underwent Year-1HEC consented to Year-3 HEC. We calculated coefficients of variation (CVs), 95% limits of agreement, and repeatability coefficients for Year-1 and Year-3 data, and assessed the association of change in Si-clamp with incident prediabetes. RESULTS The mean (SD) baseline age was 47.5 ± 8.13y, body mass index was 30.4 ± 9.16 kg/m2, fasting plasma glucose was 93.7 ± 7.82 mg/dL and 2-hrPG was 126 ± 26.8 mg/dL. Si-clamp (umol/kg/min·pmol/L-1) was 0.071 ± 0.04 in Year 1 and 0.067 ± 0.04 in Year 3 (P = 0.22). Year 1 and Year 3 values were strongly correlated (r = 0.81, P < 0.0001); the CV was 13.6% and repeatability coefficient was ±0.025. Intrasubject differences in serial Si-clamp were less than the repeatability coefficients and within the 95% limits of agreement. After 5.5 years of follow-up, 40 subjects progressed to prediabetes and 50 were nonprogressors. The change in Si-clamp was greater in progressors than nonprogressors (-10% vs. -2.5%, P = 0.02). CONCLUSIONS The HEC is reproducible over ~2 years in free-living individuals, with a temporal decline in Si-clamp that predicts prediabetes risk.
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Affiliation(s)
- Deirdre James
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Nkiru Umekwe
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Chimaroke Edeoga
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Ebenezer Nyenwe
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Sam Dagogo-Jack
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN 38163, USA.
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Chen Z, Zhang C, Fan G. Interrelationship between Interpersonal Interaction Intensity and Health Self-Efficacy in People with Diabetes or Prediabetes on Online Diabetes Social Platforms: An In-Depth Survey in China. Int J Environ Res Public Health 2020; 17:ijerph17155375. [PMID: 32722561 PMCID: PMC7432193 DOI: 10.3390/ijerph17155375] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/20/2020] [Accepted: 07/21/2020] [Indexed: 02/05/2023]
Abstract
Objective: The peer interaction-based online model has been influential in the recent development of diabetes management. This model "extends and innovates" the traditional mode of doctor-patient guidance, transforming it into a mode in which both doctor-patient guidance and patient-patient interaction coexist; this new mode has the added advantage of offering "extended continual intervention." This study contributes to research on extending diabetes management models by investigating how patients with diabetes or prediabetes interact in online health communities, focusing on the interrelationship between self-efficacy characteristics and online participation during patient-patient interactions. Methods: In this cross-sectional study, participants with diabetes of various severities completed an electronic questionnaire, which was formulated with a revised classical scale. The questionnaire was disseminated through diabetes online health communities. Its content covered the respondent's general condition, self-evaluation of their self-efficacy, and participation in online health communities, specifically with respect to factors such as the time spent in online information each day, the number of groups joined, and the extent of interaction in diabetes online health communities, etc. The main observation indicators were the participants' self-efficacy, their extent of online participation, and the characteristics of online health communities. Descriptive statistics, chi-square test, linear trend estimation, and ordinal logistic regression were used to explore the relationship between the three indicators. Results: The self-efficacy scores ( x ¯ ± s) were 51.9 ± 9.12, and 59.1% of interviewed participants had self-efficacy scores greater than the mean. Overall, most participants (96%) considered online diabetes social platforms to be helpful. Groups differed with respect to interaction mode, which indicated that people with high self-efficacy tend to employ various modes of interaction. Participants with high self-efficacy were also more likely to live in cities (p < 0.05) and be married (p < 0.05) and tended to spend more time paying attention to group information (p < 0.05), spend more time viewing group information (p < 0.05), and have a greater degree of interaction with group members (p < 0.05). Information sources for the different grades of participants was primarily obtained from social media. Conclusion: Among people with diabetes, the frequency and intensity of online interaction might positively affect self-efficacy and, by implication, diabetes self-management. Diabetics with high self-efficacy also tend to have positive online interaction and adopt different ways of interaction. In addition, the diabetes information sources of the respondents mainly come from social networks, most of the respondents think that online social networking sites have a positive impact on diabetes self-management, which shows that social network plays an important role in diabetes information source of diabetics. However, the design of online health communities has room for improvement, specifically with respect to the provision of information that patients require. As an interesting side note, among people with diabetes or prediabetes, those who lived in urban area and were married, those who paid more attention to group information, and those who actively participated in interactions tended to have relatively high self-efficacy. The results suggest that people with diabetes have higher-quality self-care when they engage in online health community interactions; such benefits cannot be obtained from treatment in a hospital. In general, enhanced self-efficacy in people with diabetes enables them to more readily acquire diabetes-related knowledge. Online interaction with diabetics, who has the same experience, can not only get more information, but also have a sense of identity and belonging, which enhances self-efficacy and further urges them to actively participate in online interaction. Therefore, online health communities are an important supplement to the clinical treatment of diabetes mellitus and clinicians can take advantage of the educational function of online diabetes groups in their provision of tailored diabetes interventions and take into account the factors that affect the self-efficacy of diabetics (including the frequency and intensity of online interaction, age, marital status, residential area, etc.), to provide tailored diabetes interventions for diabetics. Such a use of online diabetes groups can strengthen diabetes self-management.
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Lindberg NM, Vega-López S, Arias-Gastelum M, Stevens VJ. Alternative Medicine Methods Used for Weight Loss and Diabetes Control by Overweight and Obese Hispanic Immigrant Women. Hisp Health Care Int 2020; 18:49-54. [PMID: 31234651 DOI: 10.1177/1540415319858075] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Middle-aged Hispanic women have the highest prevalence of overweight and lifetime risk for diabetes of all gender/racial groups. This study examines use of alternative medicine for weight loss and diabetes management among overweight and obese Mexican American women with or at risk for diabetes. METHOD As part of a diabetes risk-reduction intervention targeting overweight and obese Hispanic women at a federally qualified health center in Hillsboro, Oregon, we administered a survey of different treatment modalities, including alternative medicine, traditional Mexican medicine, and home remedies to 85 Hispanic women. We also asked participants how often they disclosed their use of alternative methods to their providers. RESULTS Nearly all participants with diabetes (97%) reported using at least one alternative strategy for diabetes control, with home remedies, commercial weight-loss products, and herbal teas being the most endorsed. Most participants with diabetes and half of those without diabetes reported never telling their provider. CONCLUSION This group of women reported a high prevalence of use of alternative methods for weight control and diabetes management. Yet most participants with diabetes never reported this use to a health care provider. To ensure patient safety, providers treating Hispanic women need to probe for complementary and alternative medicine practices.
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Affiliation(s)
- Nangel M Lindberg
- Kaiser Permanente Northwest Center for Health Research, Portland, OR, USA
| | | | | | - Victor J Stevens
- Kaiser Permanente Northwest Center for Health Research, Portland, OR, USA
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Razavi LN, Ebenibo S, Edeoga C, Wan J, Dagogo-Jack S. Five-Year Glycemic Trajectories Among Healthy African-American and European-American Offspring of Parents With Type 2 Diabetes. Am J Med Sci 2020; 359:266-270. [PMID: 32359533 DOI: 10.1016/j.amjms.2020.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 03/02/2020] [Accepted: 03/04/2020] [Indexed: 01/21/2023]
Abstract
BACKGROUND Cross-sectional surveys report a higher prevalence of diagnosed type 2 diabetes mellitus (T2DM) in African Americans (AA) than European Americans (EA). We studied 5-year glycemic excursions among AA and EA in the Pathobiology of Prediabetes in A Biracial Cohort study, to assess ethnic disparities. MATERIALS AND METHODS Pathobiology of Prediabetes in A Biracial Cohort followed normoglycemic offspring of parents with T2DM for 5 years, with serial assessments of oral glucose tolerance test , anthropometry, body fat, insulin sensitivity and beta-cell function. The primary outcome was progression to prediabetes (impaired fasting glucose and/or impaired glucose tolerance). We further analyzed 5-year changes in fasting (FPG) and 2-hour plasma glucose (2hrPG). RESULTS One hundred and one (52 AA, 49 EA) out of 343 subjects developed prediabetes during follow-up. The change in FPG ranged from -24 mg/dl to +38 mg/dl. The FPG remained stable (± 5 mg/dl from baseline) in 50% of EA and 46.8% of AA and the 2hrPG remained stable (± 25 mg/dl from baseline) in 73.7% of EA and 71.0 % of AA during follow-up. The proportions with change in FPG of 5mg/dl to >25 mg/dl and 2hrPG of 25 mg/dl to >50 mg/dl were similar in EA and AA offspring, as were the 10th - 90th percentiles of the distribution of 5-year changes in FPG and 2hrPG. CONCLUSIONS During 5 years of follow-up, black and white offspring of parents with T2DM exhibited remarkable phenotypic concordance of glycemic trajectories. Thus, parental history of T2DM may be a stronger factor than race/ethnicity in the prediction of longitudinal glycemic trends.
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Affiliation(s)
- Laleh N Razavi
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, Tennessee; Division of Endocrinology, Case Western Reserve University, Cleveland, Ohio
| | - Sotonte Ebenibo
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Chimaroke Edeoga
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Jim Wan
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Samuel Dagogo-Jack
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, Tennessee; General Clinical Research Center, University of Tennessee Health Science Center, Memphis, Tennessee.
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Ding J, Chen X, Bao K, Yang J, Liu N, Huang W, Huang P, Huang J, Jiang N, Cao J, Cheng N, Wang M, Hu X, Zheng S, Bai Y. Assessing different anthropometric indices and their optimal cutoffs for prediction of type 2 diabetes and impaired fasting glucose in Asians: The Jinchang Cohort Study. J Diabetes 2020; 12:372-384. [PMID: 31642584 DOI: 10.1111/1753-0407.13000] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 10/06/2019] [Accepted: 10/16/2019] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND To study the association between anthropometric measurements and the risk of diabetes and impaired fasting glucose (IFG) and compare body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) to determine the best indicator and its optimal cutoffs for predicting type 2 diabetes and IFG. METHODS A Chinese prospective (2011-2019) cohort named the Jingchang cohort that included 48 001 participants was studied. Using Cox proportional hazard models, hazard ratios (HRs) for incident type 2 diabetes or IFG per 1 SD change in BMI, WC, and WHtR were calculated. Area under the curve (AUC) was compared to identify the best anthropometric variable and its optimal cutoff for predicting diabetes. RESULTS The association of BMI, WC, and WHtR with type 2 diabetes or IFG risk was positive in the univariate and multivariable-adjusted Cox proportional hazard models. Of all three indexes, the AUC of BMI was largest and that of WC was smallest. The derived cutoff values for BMI, WC, and WHtR were 24.6 kg/m2 , 89.5 cm, and 0.52 in men and 23.4 kg/m2 , 76.5 cm, and 0.47 in women for predicting diabetes, respectively. The derived cutoff values for BMI, WC, and WHtR were 23.4 kg/m2 , 87.5 cm, and 0.50 in men and 22.5 kg/m2 , 76.5 cm, and 0.47 in women for predicting IFG, respectively. [Correction added on 14 April 2020, after first online publication: '0' has been deleted from 'WC,0' in the first sentence.]. CONCLUSIONS Our derived cutoff points were lower than the values specified in the most current Asian diabetes guidelines. We recommend a cutoff point for BMI in Asians of 23 kg/m2 and for WC a cutoff point of 89 cm in men and 77 cm in women to define high-risk groups for type 2 diabetes; screening should be considered for these populations.
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Affiliation(s)
- Jie Ding
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Xiaoliang Chen
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Kaifang Bao
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Jingli Yang
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Nian Liu
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Wenya Huang
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Peiyao Huang
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Junjun Huang
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Nan Jiang
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Jianing Cao
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Ning Cheng
- Department of Basic Medicine, Lanzhou University, Lanzhou, China
| | - Minzhen Wang
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Xiaobin Hu
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Shan Zheng
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Yana Bai
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
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19
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Janssen LGM, Van Dam AD, Hanssen MJW, Kooijman S, Nahon KJ, Reinders H, Jazet IM, Van Marken Lichtenbelt WD, Rensen PCN, Appelman-Dijkstra NM, Boon MR. Higher Plasma Sclerostin and Lower Wnt Signaling Gene Expression in White Adipose Tissue of Prediabetic South Asian Men Compared with White Caucasian Men. Diabetes Metab J 2020; 44:326-335. [PMID: 31701693 PMCID: PMC7188965 DOI: 10.4093/dmj.2019.0031] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Accepted: 04/15/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND South Asians generally have an unfavourable metabolic phenotype compared with white Caucasians, including central obesity and insulin resistance. The Wnt protein family interacts with insulin signaling, and impaired Wnt signaling is associated with adiposity and type 2 diabetes mellitus. We aimed to investigate Wnt signaling in relation to insulin signaling in South Asians compared with white Caucasians. METHODS Ten Dutch South Asian men with prediabetes and overweight or obesity and 10 matched Dutch white Caucasians were included. Blood samples were assayed for the Wnt inhibitor sclerostin. Subcutaneous white adipose tissue (WAT) and skeletal muscle biopsies were assayed for Wnt and insulin signaling gene expression with quantitative reverse transcription polymerase chain reaction (Clinicaltrials.gov NCT02291458). RESULTS Plasma sclerostin was markedly higher in South Asians compared with white Caucasians (+65%, P<0.01). Additionally, expression of multiple Wnt signaling genes and key insulin signaling genes were lower in WAT in South Asians compared with white Caucasians. Moreover, in WAT in both ethnicities, Wnt signaling gene expression strongly positively correlated with insulin signaling gene expression. In skeletal muscle, WNT10B expression in South Asians was lower, but expression of other Wnt signaling and insulin signaling genes was comparable between ethnicities. Wnt and insulin signaling gene expression also positively correlated in skeletal muscle, albeit less pronounced. CONCLUSION South Asian men with overweight or obesity and prediabetes have higher plasma sclerostin and lower Wnt signaling gene expression in WAT compared with white Caucasians. We interpret that reduced Wnt signaling could contribute to impaired insulin signaling in South Asians.
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Affiliation(s)
- Laura G M Janssen
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands.
| | - Andrea D Van Dam
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Mark J W Hanssen
- Department of Human Biology and Movement Sciences, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Sander Kooijman
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Kimberly J Nahon
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Hanneke Reinders
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Ingrid M Jazet
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Wouter D Van Marken Lichtenbelt
- Department of Human Biology and Movement Sciences, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Patrick C N Rensen
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Natasha M Appelman-Dijkstra
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands
- Center for Bone Quality, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
| | - Mariëtte R Boon
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
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Venkatrao M, Nagarathna R, Patil SS, Singh A, Rajesh SK, Nagendra H. A composite of BMI and waist circumference may be a better obesity metric in Indians with high risk for type 2 diabetes: An analysis of NMB-2017, a nationwide cross-sectional study. Diabetes Res Clin Pract 2020; 161:108037. [PMID: 32004696 DOI: 10.1016/j.diabres.2020.108037] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 10/13/2019] [Revised: 12/26/2019] [Accepted: 01/27/2020] [Indexed: 11/28/2022]
Abstract
AIMS Obesity measurement is a vital component of most type 2 diabetes screening tests; while studies had shown that waist circumference (WC) is a better predictor in South Asians, there is evidence that BMI is also effective. Our objective was to evaluate the efficacy of BMIWC, a composite measure, against BMI and WC. METHODS Using data from a nationwide randomized cluster sample survey (NMB-2017), we analyzed 7496 adults at high risk for type 2 diabetes. WC, BMI, and BMIWC were evaluated using Odds Ratio (OR), and Classification scores (Sensitivity, Specificity, and Accuracy). These were validated using Indian Diabetes Risk Score (IDRS) by replacing WC with BMI and BMIWC, and calculating Sensitivity, Specificity, and Accuracy. RESULTS BMIWC had higher OR (2·300) compared to WC (1·87) and BMI (2·26). WC, BMI, and BMIWC were all highly Sensitive (0·75, 0·81, 0·70 resp.). But BMIWC had significantly higher Specificity (0.36) when compared to WC and BMI (0.27 each). IDRSWC, IDRSBMI, and IDRSBMIWC were all highly Sensitive (0·87, 0·88, 0·82 resp.). But IDRSBMIWC had significantly higher Specificity (0·39) compared to IDRSWC and IDRSBMI (0·30, 0·31 resp.). CONCLUSIONS Both WC and BMI are good predictors of risk for T2DM, but BMIWC is a better predictor, with higher Specificity; this may indicate that Indians with high values of both central (high WC) and general (BMI > 23) obesity carry higher risk for type 2 diabetes than either one in isolation. Using BMIWC in IDRS improves its performance on Accuracy and Specificity.
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Affiliation(s)
- Murali Venkatrao
- Division of Yoga and Life Sciences, SVYASA University, Prashanti Kutiram, Vivekananda Road, Kalluballu Post, Jigani, Bengaluru 560015, India
| | - Raghuram Nagarathna
- Division of Yoga and Life Sciences, SVYASA University, Prashanti Kutiram, Vivekananda Road, Kalluballu Post, Jigani, Bengaluru 560015, India
| | - Suchitra S Patil
- Division of Yoga and Life Sciences, SVYASA University, Prashanti Kutiram, Vivekananda Road, Kalluballu Post, Jigani, Bengaluru 560015, India
| | - Amit Singh
- Division of Yoga and Life Sciences, SVYASA University, Prashanti Kutiram, Vivekananda Road, Kalluballu Post, Jigani, Bengaluru 560015, India
| | - S K Rajesh
- Division of Yoga and Life Sciences, SVYASA University, Prashanti Kutiram, Vivekananda Road, Kalluballu Post, Jigani, Bengaluru 560015, India
| | - Hongasandra Nagendra
- Division of Yoga and Life Sciences, SVYASA University, Prashanti Kutiram, Vivekananda Road, Kalluballu Post, Jigani, Bengaluru 560015, India.
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Fazli GS, Moineddin R, Bierman AS, Booth GL. Ethnic variation in the conversion of prediabetes to diabetes among immigrant populations relative to Canadian-born residents: a population-based cohort study. BMJ Open Diabetes Res Care 2020; 8:e000907. [PMID: 32071198 PMCID: PMC7039599 DOI: 10.1136/bmjdrc-2019-000907] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 11/21/2019] [Accepted: 12/20/2019] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE The aim of this study was to compare absolute and relative rates of conversion from prediabetes to diabetes among non-European immigrants to Europeans and Canadian-born residents, overall, and by age and level of glycemia. RESEARCH DESIGN AND METHODS We conducted a retrospective cohort population-based study using administrative health databases from Ontario, Canada, to identify immigrants (n=23 465) and Canadian born (n=1 11 085) aged ≥20 years with prediabetes based on laboratory tests conducted between 2002 and 2011. Individuals were followed until 31 December 2013 for the development of diabetes using a validated algorithm. Immigration data was used to assign ethnicity based on country of origin, mother tongue, and surname. Fine and Gray's survival models were used to compare diabetes incidence across ethnic groups overall and by age and glucose category. RESULTS Over a median follow-up of 5.2 years, 8186 immigrants and 39 722 Canadian-born residents developed diabetes (7.1 vs 6.1 per 100 person-years, respectively). High-risk immigrant populations such as South Asians (HR: 1.72, 95% CI 1.55 to 1.99) and Southeast Asians (HR: 1.65, 95% CI 1.46 to 1.86) had highest risk of converting to diabetes compared with Western Europeans (referent). Among immigrants aged 20-34 years, the adjusted cumulative incidence ranged from 18.4% among Eastern Europeans to 52.3% among Southeast Asians. Conversion rates increased with age in all groups but were consistently high among South Asians, Southeast Asians and Sub-Saharan African/Caribbeans after the age of 35 years. On average, South Asians converted to diabetes 3.1-4.6 years earlier than Western Europeans and at an equivalent rate of conversion to Western Europeans who had a 0.5 mmol/L higher baseline fasting glucose value. CONCLUSIONS High-risk ethnic groups converted to diabetes more rapidly, at younger ages, and at lower fasting glucose values than European populations, leading to a shorter window for diabetes prevention.
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Affiliation(s)
- Ghazal S Fazli
- MAP- Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Rahim Moineddin
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Arlene S Bierman
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Gillian L Booth
- MAP- Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Yuan X, Dai X, Liu L, Hsue C, Miller JD, Fang Z, Li J, Feng J, Huang Y, Liu C, Shen J, Chen T, Liu Y, Mordes J, Lou Q. Comparing the effects of 6 months aerobic exercise and resistance training on metabolic control and β-cell function in Chinese patients with prediabetes: A multicenter randomized controlled trial. J Diabetes 2020; 12:25-37. [PMID: 31141300 DOI: 10.1111/1753-0407.12955] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 05/15/2019] [Accepted: 05/26/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND It is clear that aerobic training (AT) can delay pancreatic exhaustion and slow the progression from prediabetes to type 2 diabetes (T2D), but there is little information regarding the effects of resistance training (RT) in people with prediabetes. This study compared the effectiveness of RT and AT in improving metabolic control and protecting β-cell function in people with prediabetes. METHODS Chinese subjects (n = 248) with prediabetes were randomized to three groups: AT (n = 83), RT (n = 82) and control (n = 83). Subjects in the RT group performed 13 different resistance exercises per session using an elastic string. Those in the AT group performed aerobic exercises at 60%-70% of maximum heart rate. In both cases, exercises were performed three times per week for a period of 6 months. The primary outcome was improvement in metabolic control. Longitudinal changes between groups were tested using repeated-measures analysis of variance. RESULTS Of the initial 248 participants, 217 finished the study, but all participants were included in the intention-to-treat analyses. There were no significant differences in demographic characteristics among the RT, AT, and control groups (P > 0.05). Changes in HbA1c were not significantly greater in RT than AT cohort (P = 0.059), but the decrease in HbA1c in both exercise groups was higher than in the control group (P < 0.05). CONCLUSIONS In subjects with prediabetes, RT appears to improve metabolic control and preserve β-cell function comparable to AT.
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Affiliation(s)
- Xiaodan Yuan
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xia Dai
- The First Affiliated Hospital of Guangxi Medical University, Guangxi, China
| | - Lin Liu
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Department of Nursing, Yangzhou University, Yangzhou, China
| | - Cunyi Hsue
- Department of Nature Science, University of Massachusetts Amherst, Amherst, Massachusetts
| | | | - Zhaohui Fang
- The First Affiliated Hospital of Anhui University of Chinese Medicine, Anhui, China
| | - Jianing Li
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Jitao Feng
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yong Huang
- Danyang People's Hospital of Jiangsu Province, Danyang, China
| | - Chao Liu
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Jianping Shen
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Tao Chen
- Liverpool School of Tropical Medicine, Liverpool, UK
| | - Yanjun Liu
- Lanzhou Ruijing Diabetes Hospital, Lanzhou, China
| | - John Mordes
- University of Massachusetts Medical School, Worcester, Massachusetts
| | - Qingqing Lou
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
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Abstract
UNLABELLED This cross-sectional study assessed cortical bone properties via impact microindentation in adults with normoglycemia, prediabetes, and early-stage T2D. Bone material strength index was stable across the glycemia categories in whites but it declined in blacks. Blacks may be more susceptible than whites to impaired cortical bone properties in early diabetes. INTRODUCTION Individuals with long-standing type 2 diabetes (T2D) have altered cortical bone material properties as determined by impact microindentation. This cross-sectional study was done to determine whether altered cortical bone material properties could be detected in adults with prediabetes or early-stage T2D. METHODS Men and postmenopausal women aged ≥ 50 years with no diabetes (50 white, 6 black), prediabetes (75 white, 13 black), and T2D of ≤ 5 years duration (24 white and 16 black) had assessments of bone material strength index (BMSi) by impact microindentation, trabecular bone score (TBS), and bone mineral density (BMD) by DXA and the advanced glycation end product, urine pentosidine. RESULTS The association between glycemia category and BMSi differed by race (interaction p = 0.037). In the whites, BMSi did not differ across the glycemia categories, after adjustment for age, sex, and BMI (no diabetes 76.3 ± 1.6 (SEM), prediabetes 77.2 ± 1.3, T2D 76.2 ± 2.5, ANCOVA p = 0.887). In contrast, in the blacks, BMSi differed (ANCOVA p = 0.020) and was significantly lower in subjects with T2D than in those with prediabetes (p < 0.05) and no diabetes (p < 0.05) (mean ± SEM BMSi in no diabetes 86.0 ± 4.3, prediabetes 91.0 ± 3.2, and T2D 71.6 ± 2.9). Neither TBS nor urine pentosidine differed significantly across the glycemia categories in either whites or blacks. CONCLUSIONS These findings suggest different associations of glycemia with cortical bone material properties in blacks and whites, with blacks possibly being more susceptible to impaired cortical bone properties than whites in early diabetes. A larger study is needed to verify these observations.
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Affiliation(s)
- B Dawson-Hughes
- Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA.
| | - M Bouxsein
- Department of Orthopedic Surgery, Harvard Medical School, Boston, MA, USA
- Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - K Shea
- Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
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Ford CN, Leet RW, Kipling LM, Rhee MK, Jackson SL, Wilson PWF, Phillips LS, Staimez LR. Racial differences in performance of HbA 1c for the classification of diabetes and prediabetes among US adults of non-Hispanic black and white race. Diabet Med 2019; 36:1234-1242. [PMID: 31187544 PMCID: PMC7282707 DOI: 10.1111/dme.13979] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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] [Accepted: 04/18/2019] [Indexed: 01/21/2023]
Abstract
AIM To characterize differences between black and white people in optimal HbA1c thresholds for diagnoses of diabetes and prediabetes. METHODS Data were included from the National Health and Nutrition Examination Survey, 2005-2014. Black and white adults (age 18-70 years) who underwent an oral glucose tolerance test and had available fasting plasma glucose, 2-h plasma glucose and HbA1c measurements were eligible for inclusion. Diabetes or prediabetes status was defined by fasting plasma glucose and 2-h plasma glucose using American Diabetes Association criteria. Classification of diabetes, prediabetes and dysglycaemia by HbA1c was evaluated for a range of HbA1c thresholds, with optimal thresholds defined as those values that maximized the sum of sensitivity and specificity (Youden's index). RESULTS In 5324 black (32.3%) and white (67.7%) individuals, Youden's index (optimal) thresholds for HbA1c were ≥42 mmol/mol (6.0%) and ≥39 mmol/mol (5.7%) for discriminating diabetes vs non-diabetes, ≥ 44 mmol/mol (6.2%) and ≥39 mmol/mol (5.7%) for discriminating diabetes vs prediabetes (excluding normoglycaemia), ≥39 mmol/mol (5.7%) and ≥37 mmol/mol (5.5%) for discriminating dysglycaemia vs normoglycaemia, and ≥39 mmol/mol (5.7%) and ≥37 mmol/mol (5.5%) for discriminating prediabetes vs normoglycaemia (excluding diabetes), in black and white people, respectively. CONCLUSIONS Consistently higher optimal HbA1c thresholds in black people than in white people suggest a need to individualize HbA1c relative to glucose levels if HbA1c is used to diagnose diabetes and prediabetes.
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Affiliation(s)
- C N Ford
- Emory Global Diabetes Research Centre, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - R W Leet
- Emory Global Diabetes Research Centre, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Nutrition and Health Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - L M Kipling
- Emory Global Diabetes Research Centre, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - M K Rhee
- Atlanta VA Medical Centre, Decatur, GA, USA
- Division of Endocrinology and Metabolism, Department of Medicine, Emory University, Atlanta, GA, USA
| | - S L Jackson
- Division for Heart Disease and Stroke Prevention, National Centre for Chronic Disease Prevention and Health Promotion, Centres for Disease Control and Prevention, Atlanta, GA, USA
| | - P W F Wilson
- Atlanta VA Medical Centre, Decatur, GA, USA
- Division of Endocrinology and Metabolism, Department of Medicine, Emory University, Atlanta, GA, USA
- Division of Cardiology, Department of Medicine, School of Medicine, Emory University, Atlanta, GA, USA
| | - L S Phillips
- Atlanta VA Medical Centre, Decatur, GA, USA
- Division of Endocrinology and Metabolism, Department of Medicine, Emory University, Atlanta, GA, USA
| | - L R Staimez
- Emory Global Diabetes Research Centre, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Nutrition and Health Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Zheng G, Family L, Hsu S, Rivera J, Mondy C, Cloud J, Frye D, Smith LV, Kuo T. Prediabetes, diabetes, and other CVD-related conditions among Asian populations in Los Angeles County, 2014. Ethn Health 2019; 24:779-789. [PMID: 31343279 DOI: 10.1080/13557858.2017.1373076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 10/23/2016] [Accepted: 08/21/2017] [Indexed: 06/10/2023]
Abstract
Objective: To assess the prevalence of four common health conditions related to cardiovascular disease risk among Asians in Los Angeles County. Methods: A survey of Asians in Los Angeles County was conducted utilizing purposive sampling to recruit from the region's Service Planning Areas 3 and 4; these underserved areas contain high density of Asian populations. Descriptive and multivariable regression analyses were performed to explore and describe potential associations between self-reported diagnoses of prediabetes, diabetes, hypertension, and high cholesterol and body mass index (measured with non-Asian versus Asian cut points) by race/ethnicity (Chinese/Filipino/Korean/Taiwanese/Thai/Vietnamese). Results: The survey response rate was nearly 60%. The analysis included 1,377 Asians, self-identified as either Chinese (n = 700), Filipino (n = 69), Korean (n = 339), Taiwanese (n = 48), Thai (n = 115), or Vietnamese (n = 106). Results showed that, in comparison to other Asians, Filipinos had the highest risks for two of the four conditions described. Other results by subgroup affirmed a similar heterogeneous pattern of Asian health locally. Conclusions: These and other results from the survey point to potential gaps in healthcare needs of Asians, and to opportunities where local public health efforts could help increase these populations' access to cardiovascular disease-related health and social services.
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Affiliation(s)
- Guili Zheng
- a Los Angeles County Department of Health Services, Office of Planning and Data Analytics , Los Angeles , CA , USA
| | - Leila Family
- b Los Angeles County Department of Public Health, Office of Health Assessment and Epidemiology , Los Angeles , CA , USA
| | - Shelly Hsu
- c Los Angeles County Department of Public Health, Division of Community Health Services , Los Angeles , CA , USA
| | - Jennifer Rivera
- c Los Angeles County Department of Public Health, Division of Community Health Services , Los Angeles , CA , USA
| | - Cristin Mondy
- c Los Angeles County Department of Public Health, Division of Community Health Services , Los Angeles , CA , USA
| | - Jennifer Cloud
- b Los Angeles County Department of Public Health, Office of Health Assessment and Epidemiology , Los Angeles , CA , USA
| | - Douglas Frye
- b Los Angeles County Department of Public Health, Office of Health Assessment and Epidemiology , Los Angeles , CA , USA
| | - Lisa V Smith
- b Los Angeles County Department of Public Health, Office of Health Assessment and Epidemiology , Los Angeles , CA , USA
- d Department of Epidemiology, University of California, Los Angeles (UCLA) Jonathan and Karin Fielding School of Public Health , Los Angeles , CA , USA
| | - Tony Kuo
- d Department of Epidemiology, University of California, Los Angeles (UCLA) Jonathan and Karin Fielding School of Public Health , Los Angeles , CA , USA
- e Department of Family Medicine, David Geffen School of Medicine at UCLA , Los Angeles , CA , USA
- f Los Angeles County Department of Public Health, Division of Chronic Disease and Injury Prevention , Los Angeles , CA , USA
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Razieh C, Khunti K, Davies MJ, Edwardson CL, Henson J, Darko N, Comber A, Jones A, Yates T. Association of depression and anxiety with clinical, sociodemographic, lifestyle and environmental factors in South Asian and white European individuals at high risk of diabetes. Diabet Med 2019; 36:1158-1167. [PMID: 31081286 DOI: 10.1111/dme.13986] [Citation(s) in RCA: 2] [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: 05/10/2019] [Indexed: 11/27/2022]
Abstract
AIM To investigate the prevalence and correlates of depressive and anxiety symptoms within South Asian and white European populations at high risk of developing Type 2 diabetes. METHODS Data were collected at baseline, and at 12, 24 and 36 months from 1429 white European individuals (age 64±7 years, 35.8% women) and 160 South Asian individuals (age 59±9 years, 30.6% women) who were at high risk of Type 2 diabetes and who took part in two Type 2 diabetes prevention trials in Leicestershire, UK. The Hospital Anxiety and Depression Scale was administered during each study visit. Clinical, sociodemographic, lifestyle and environmental data were collected. RESULTS At baseline, the burden of depressive symptoms varied by ethnic group and gender, with 9.9% of white European men, 14.9% of white European women, 23.6% of South Asian men and 29.2% of South Asian women exceeding the cut-off score for mild-to-severe depression. During the course of the study and after adjustment for clinical, sociodemographic, lifestyle and environmental factors, depressive symptoms remained higher in the South Asian compared to the white European participants [score higher by 1.5, 95% CI 0.9-2.1]. Levels of anxiety were also higher in the South Asian participants, although associations were attenuated after adjustment. Social deprivation, BMI, proximity to fast-food outlets and physical activity were correlates for depression in both the South Asian and white European participants. CONCLUSIONS A higher burden of depressive symptoms was consistently evident among the South Asian individuals, even after adjustment for multiple covariates. It is important to understand both the reasons why these differences are present, to help reduce health inequalities, and whether higher levels of depressive symptoms affect the uptake of and retention rates in diabetes prevention programmes in South Asian communities.
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Affiliation(s)
- C Razieh
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
- National Institute for Health Research, Leicester Biomedical Research Centre (BRC), Leicester General Hospital, Leicester, UK
| | - K Khunti
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
- Leicester Diabetes Centre, University Hospitals of Leicester, Leicester General Hospital, Leicester, UK
- NIHR Collaboration for Leadership in Applied Health Research and Care - East Midlands, Leicester General Hospital, Leicester, UK
| | - M J Davies
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
- National Institute for Health Research, Leicester Biomedical Research Centre (BRC), Leicester General Hospital, Leicester, UK
- Leicester Diabetes Centre, University Hospitals of Leicester, Leicester General Hospital, Leicester, UK
| | - C L Edwardson
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
- National Institute for Health Research, Leicester Biomedical Research Centre (BRC), Leicester General Hospital, Leicester, UK
| | - J Henson
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
- National Institute for Health Research, Leicester Biomedical Research Centre (BRC), Leicester General Hospital, Leicester, UK
| | - N Darko
- Centre of Black and Minority Ethnic Health, University of Leicester, Leicester General Hospital, Leicester, UK
| | - A Comber
- School of Geography, University of Leeds, Leeds, UK
| | - A Jones
- Norwich Medical School, University of East Anglia, Chancellor's Drive, Norwich, UK
| | - T Yates
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
- National Institute for Health Research, Leicester Biomedical Research Centre (BRC), Leicester General Hospital, Leicester, UK
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Pratte KA, Johnson A, Beals J, Bullock A, Manson SM, Jiang L. Regression to Normal Glucose Regulation in American Indians and Alaska Natives of a Diabetes Prevention Program. Diabetes Care 2019; 42:1209-1216. [PMID: 31177184 PMCID: PMC6609959 DOI: 10.2337/dc18-1964] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 01/13/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This study evaluated whether regression from impaired glucose regulation (IGR) to normal glucose regulation (NGR) after 1 year of a lifestyle intervention reduces diabetes risk in American Indians and Alaska Natives (AI/ANs). In addition, we sought to identify predictors for regression to NGR and understand possible mechanisms for the association between NGR and future diabetes risk. RESEARCH DESIGN AND METHODS Data from participants enrolled from 2006 to 2009 in the Special Diabetes Program for Indians Diabetes Prevention Program with IGR at baseline and an oral glucose tolerance test at year 1 were analyzed (N = 1,443). Cox regression models were used to estimate the subsequent diabetes risk (year 1 to year 3) by year 1 glucose status. Mediation analysis was used to estimate the proportions of the association between year 1 glycemic status and diabetes risk explained by specific factors. RESULTS Those who reverted to NGR at year 1 (38%) had lower diabetes risk than those with sustained IGR (adjusted hazard ratio 0.28, 95% CI 0.12-0.67). The lower risk associated with regression to NGR was explained by both baseline risk factors and differences in weight loss. Metformin use, weight loss, and an increase in exercise were modifiable risk factors associated with higher odds of regression to NGR. CONCLUSIONS Patients with prediabetes who reverted to NGR had a reduced risk of developing type 2 diabetes over the next 2 years. Both baseline and modifiable risk factors explained the risk reduction associated with NGR.
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Affiliation(s)
- Katherine A Pratte
- Department of Epidemiology, School of Medicine, University of California, Irvine, Irvine, CA
| | - Ann Johnson
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Janette Beals
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Ann Bullock
- Division of Diabetes Treatment and Prevention, Indian Health Service, Rockville, MD
| | - Spero M Manson
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Luohua Jiang
- Department of Epidemiology, School of Medicine, University of California, Irvine, Irvine, CA
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Tricò D, Galderisi A, Mari A, Santoro N, Caprio S. One-hour post-load plasma glucose predicts progression to prediabetes in a multi-ethnic cohort of obese youths. Diabetes Obes Metab 2019; 21:1191-1198. [PMID: 30663201 PMCID: PMC6459710 DOI: 10.1111/dom.13640] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [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: 11/19/2018] [Revised: 01/15/2019] [Accepted: 01/16/2019] [Indexed: 01/11/2023]
Abstract
AIMS One-hour post-load hyperglycaemia has been proposed as an independent predictor of type 2 diabetes in adults. We examined whether 1-hour plasma glucose (1hPG) during an oral glucose tolerance test (OGTT) can predict changes in the glucose tolerance status of a multi-ethnic cohort of youths with normal glucose tolerance (NGT). MATERIALS AND METHODS A total of 202 obese youths with NGT (33.7% Caucasian, 31.1% Hispanic, 32.2% African American) underwent a 3-hour OGTT at baseline and after a 2-year follow-up period. Whole-body insulin sensitivity, insulin secretion, β-cell function and insulin clearance were estimated by modeling plasma glucose, insulin and C-peptide levels. RESULTS Obese youths with 1hPG ≥7.4 mmol/L (or 133 mg/dL; n = 83) exhibited higher body mass index (BMI), plasma triglycerides and fasting and post-load glucose concentrations than individuals with 1hPG <7.4 mmol/L. Also, 1hPG ≥7.4 mmol/L was associated with a lower disposition index (DI) (P < 0.0001) and with alterations in whole-body insulin sensitivity, β-cell function and insulin clearance. Adolescents with 1hPG ≥7.4 mmol/L were approximately three times more likely to develop prediabetes (ie, impaired glucose tolerance and/or impaired fasting glucose) over time (OR, 2.92 [1.22-6.98]; P = 0.02), independent of age, sex, race/ethnicity, BMI, insulin sensitivity, DI and plasma glucose concentrations. No differences emerged in the risk of prediabetes related to 1-hour hyperglycaemia among different ethnic groups. CONCLUSIONS A plasma glucose concentration ≥ 7.4 mmol/L at 1 hour during an OGTT is associated with a worse clinical and metabolic phenotype and may be an independent predictor of progression to prediabetes in obese youths with NGT.
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Affiliation(s)
- Domenico Tricò
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- Institute of Life Sciences, Sant’Anna School of Advanced Studies, Pisa, Italy
| | - Alfonso Galderisi
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT
| | - Andrea Mari
- Institute of Neuroscience, National Research Council, Padua, Italy
| | - Nicola Santoro
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT
| | - Sonia Caprio
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT
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Saeed A, Sun W, Agarwala A, Virani SS, Nambi V, Coresh J, Selvin E, Boerwinkle E, Jones PH, Ballantyne CM, Hoogeveen RC. Lipoprotein(a) levels and risk of cardiovascular disease events in individuals with diabetes mellitus or prediabetes: The Atherosclerosis Risk in Communities study. Atherosclerosis 2019; 282:52-56. [PMID: 30685442 PMCID: PMC6699162 DOI: 10.1016/j.atherosclerosis.2018.12.022] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 11/19/2018] [Accepted: 12/14/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND AND AIMS Diabetes increases risk for atherosclerotic cardiovascular disease (ASCVD). Current guidelines do not recommend measuring lipoprotein(a), another ASCVD risk factor, in these individuals. We examined the association of lipoprotein(a) levels with incident ASCVD events in persons with and without diabetes or prediabetes. METHODS Lipoprotein(a) and other ASCVD risk factors were measured at baseline (1996-1998) in the biracial Atherosclerosis Risk in Communities study; participants without prevalent ASCVD (coronary heart disease or stroke) were monitored ∼15 years for incident ASCVD events. RESULTS Of 9871 eligible participants (mean age 63 years; 5816 women; 2155 African Americans), 1543 had diabetes and 3615 had prediabetes. Cumulative ASCVD incidence rates (event/1000-person years) were higher in participants with diabetes (26%) or prediabetes (13%) than in nondiabetic individuals (10%, p < 0.001). When comparing highest to lowest lipoprotein(a) categories (≥50 mg/dL vs. ≤10 mg/dL), increasing lipoprotein(a) levels were significantly associated with increasing incident ASCVD events in Caucasian participants with prediabetes (hazard ratio [HR] = 1.35; 95% confidence interval [CI] 1.07-1.69); p = 0.03) and diabetes (HR = 1.42; 95% CI 1.10-1.84; p < 0.01), but not those with normal fasting blood glucose. Adding lipoprotein(a) to Pooled Cohort Equation variables improved risk prediction in persons with diabetes (Δ in area under the receiver operating characteristic curve [AUC] 0.0087, net reclassification index [NRI] 0.1761) and prediabetes (ΔAUC 0.0025, NRI 0.0938). CONCLUSIONS In this biracial cohort, elevated lipoprotein(a) levels in Caucasian individuals with diabetes or prediabetes were associated with further increased ASCVD risk. Adding lipoprotein(a) to traditional risk factors improved ASCVD risk prediction.
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Affiliation(s)
- Anum Saeed
- Baylor College of Medicine, Houston, TX, USA
| | | | | | - Salim S Virani
- Baylor College of Medicine, Houston, TX, USA; Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
| | - Vijay Nambi
- Baylor College of Medicine, Houston, TX, USA; Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
| | | | | | - Eric Boerwinkle
- The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Peter H Jones
- Baylor College of Medicine, Houston, TX, USA; Houston Methodist Hospital, Houston, TX, USA
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Zhang W, Yang X, Han P, Ma Y, Fu L, Jia L, Yu H, Chen X, Wang L, Hou L, Yu X, Kohzuki M, Guo Q. Risk factors for developing diabetes after 3 years among community-dwelling elderly with impaired fasting glucose. J Diabetes 2019; 11:107-114. [PMID: 29943517 DOI: 10.1111/1753-0407.12816] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 03/08/2018] [Revised: 06/14/2018] [Accepted: 06/20/2018] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND The aim of the present study was to examine the risk factors for developing diabetes after 3 years in an elderly Chinese suburban population with impaired fasting glucose (IFG). METHODS The study population comprised residents of the Hangu area of Tianjin, China, with IFG, aged ≥60 years, who joined the national free physical examination program (n = 328; mean [±SD] age 68.0 ±6.1 years; 48.2% men). Diabetes was defined by self-report of a physician's diagnosis or fasting plasma glucose (FPG) ≥7.0 mmol/L; IFG was defined as FPG ≥5.6 and < 7.0 mmol/L. Risk factors of incident diabetes at the 3-year follow-up were analyzed individually using logistic regression analysis. RESULTS Between baseline and the 3-year follow-up, 56 subjects with IFG at baseline had developed diabetes. After multivariate adjustment for demographic and clinical factors, the incidence of diabetes increased with higher FPG (odds ratio [OR] 9.30, 95% confidence interval [CI] 2.84-30.48), but decreased with the grip strength/weight ratio (OR 0.88, 95% CI 0.82-0.94). Moreover, the combination of higher FPG and lower grip strength/weight was associated with a higher incidence of diabetes than higher FPG only or lower grip strength/weight (P < 0.05). CONCLUSION The present study indicates that higher FPG and lower muscle strength are associated with glycemic deterioration among subjects with IFG after 3 years. The results suggest that not only glucose levels, but also physical performance may be useful markers of the risk of diabetes in this population.
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Affiliation(s)
- Wen Zhang
- Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, China
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Xiaolong Yang
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Peipei Han
- Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, China
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Yixuan Ma
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Liyuan Fu
- Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, China
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Liye Jia
- Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, China
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Hairui Yu
- Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, China
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Xiaoyu Chen
- Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, China
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Lu Wang
- Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, China
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Lin Hou
- Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, China
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Xing Yu
- Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, China
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Masahiro Kohzuki
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Qi Guo
- Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, China
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Tohoku University, Sendai, Japan
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Soltero EG, Ramos C, Williams AN, Hooker E, Mendez J, Wildy H, Davis K, Hernandez V, Contreras OA, Silva M, Lish E, Shaibi GQ. ¡Viva Maryvale!: A Multilevel, Multisector Model to Community-Based Diabetes Prevention. Am J Prev Med 2019; 56:58-65. [PMID: 30573148 PMCID: PMC6815673 DOI: 10.1016/j.amepre.2018.07.034] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 05/05/2018] [Accepted: 07/24/2018] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Latino communities are disproportionately affected by type 2 diabetes and experience disparities in access to diabetes prevention programs. The purpose of this study was to test the preliminary efficacy of a culturally grounded, diabetes prevention program for high-risk Latino families delivered through an integrated research-practice partnership. STUDY DESIGN The integrated research-practice partnership was established in a predominantly Latino community and consisted of a Federally Qualified Health Center, a YMCA, an accredited diabetes education program, and an academic research center. Data were collected and analyzed from 2015 to 2018. SETTING/PARTICIPANTS Latino families consisting of a parent with an obese child between age 8 and 12 years. INTERVENTION The 12-week lifestyle intervention included nutrition education and behavioral skills training (60 minutes, once/week) and physical activity classes (60 minutes, three times/week) delivered at a YMCA. MAIN OUTCOME MEASURES Outcomes included measures of adiposity (BMI, waist circumference, and body fat); HbA1c; and weight-specific quality of life. RESULTS Over the course of the 2-year project period, 58 families (parents n=59, children n=68) were enrolled with 36% of parents and 29% of children meeting the criteria for prediabetes at baseline. Feasibility and acceptability were high, with 83% of enrolled families completing the program, 91% of the intervention sessions attended, and 100% of families stating they would recommend the program. The intervention led to significant decreases in percentage body fat among parents (46.4% [SD=10.8] to 43.5% [SD=10.5], p=0.001) as well as children (43.1% [SD=8.0] to 41.8% [SD=7.2], p=0.03). Additionally, HbA1c was significantly reduced in parents (5.6% [SD=0.4] to 5.5% [SD=0.3], p=0.03), and remained stable in children (5.5% [SD=0.3] vs 5.5% [SD=0.3], p>0.05). Significant improvements in quality of life were reported in parents (64.6 [SD=15.8] to 71.0 [SD=13.7], p=0.001) and children (69.7 [SD=15.8] to 72.6 [SD=13.7], p=0.05). CONCLUSIONS These findings support the preliminary efficacy of an integrated research-practice partnership to meet the diabetes prevention needs of high-risk Latino families within a vulnerable community.
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Affiliation(s)
- Erica G Soltero
- Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix, Arizona
| | - Crystal Ramos
- Integrated Behavioral Health, Mountain Park Health Center, Phoenix, Arizona
| | - Allison N Williams
- Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix, Arizona
| | - Elva Hooker
- Family Wellness Program, St. Vincent De Paul Medical and Dental Clinic, Phoenix, Arizona
| | | | | | | | | | - Omar A Contreras
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Maria Silva
- Family Wellness Program, St. Vincent De Paul Medical and Dental Clinic, Phoenix, Arizona
| | - Elvia Lish
- Family Wellness Program, St. Vincent De Paul Medical and Dental Clinic, Phoenix, Arizona
| | - Gabriel Q Shaibi
- Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix, Arizona.
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Restrepo BI, Kleynhans L, Salinas AB, Abdelbary B, Tshivhula H, Aguillón-Durán GP, Kunsevi-Kilola C, Salinas G, Stanley K, Malherbe ST, Maasdorp E, Garcia-Viveros M, Louw I, Garcia-Oropesa EM, Lopez-Alvarenga JC, Prins JB, Walzl G, Schlesinger LS, Ronacher K. Diabetes screen during tuberculosis contact investigations highlights opportunity for new diabetes diagnosis and reveals metabolic differences between ethnic groups. Tuberculosis (Edinb) 2018; 113:10-18. [PMID: 30514492 PMCID: PMC6284235 DOI: 10.1016/j.tube.2018.08.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 08/11/2018] [Accepted: 08/14/2018] [Indexed: 12/12/2022]
Abstract
Type 2 diabetes (T2D) is a prevalent risk factor for tuberculosis (TB), but most studies on TB-T2D have focused on TB patients, been limited to one community, and shown a variable impact of T2D on TB risk or treatment outcomes. We conducted a cross-sectional assessment of sociodemographic and metabolic factors in adult TB contacts with T2D (versus no T2D), from the Texas-Mexico border to study Hispanics, and in Cape Town to study South African Coloured ethnicities. The prevalence of T2D was 30.2% in Texas-Mexico and 17.4% in South Africa, with new diagnosis in 34.4% and 43.9%, respectively. Contacts with T2D differed between ethnicities, with higher smoking, hormonal contraceptive use and cholesterol levels in South Africa, and higher obesity in Texas-Mexico (p < 0.05). PCA analysis revealed striking differences between ethnicities in the relationships between factors defining T2D and dyslipidemias. Our findings suggest that screening for new T2D in adult TB contacts is effective to identify new T2D patients at risk for TB. Furthermore, studies aimed at predicting individual TB risk in T2D patients, should take into account the heterogeneity in dyslipidemias that are likely to modify the estimates of TB risk or adverse treatment outcomes that are generally attributed to T2D alone.
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Affiliation(s)
- Blanca I Restrepo
- University of Texas Health Houston, School of Public Health, Brownsville Campus, Brownsville, TX, 78520 USA; University of Texas Rio Grande Valley, South Texas Diabetes and Obesity Institute and Department of Human Genetics, Edinburg, TX, 78541 USA.
| | - Léanie Kleynhans
- DST-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
| | - Alejandra B Salinas
- University of Texas Health Houston, School of Public Health, Brownsville Campus, Brownsville, TX, 78520 USA.
| | - Bassent Abdelbary
- University of Texas Rio Grande Valley, Department of Physician Assistant, College of Health Affairs, Edinburg Campus, Edinburg, TX, 78541 USA.
| | - Happy Tshivhula
- DST-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
| | - Genesis P Aguillón-Durán
- University of Texas Health Houston, School of Public Health, Brownsville Campus, Brownsville, TX, 78520 USA.
| | - Carine Kunsevi-Kilola
- DST-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
| | - Gloria Salinas
- Hidalgo County Department of Health and Human Services, Edinburg, TX, 78542 USA.
| | - Kim Stanley
- DST-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
| | - Stephanus T Malherbe
- DST-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
| | - Elizna Maasdorp
- DST-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
| | | | - Ilze Louw
- DST-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
| | | | - Juan Carlos Lopez-Alvarenga
- University of Texas Rio Grande Valley, South Texas Diabetes and Obesity Institute and Department of Human Genetics, Edinburg, TX, 78541 USA.
| | - John B Prins
- Mater Research Institute - The University of Queensland, Translational Research Institute, Brisbane, QLD, Australia.
| | - Gerhard Walzl
- DST-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
| | | | - Katharina Ronacher
- DST-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; Mater Research Institute - The University of Queensland, Translational Research Institute, Brisbane, QLD, Australia.
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Sandoval-Rosario M, Nayeri BM, Rascon A, Boring M, Aseret-Manygoats T, Helmick CG, Murphy LB, Hootman JM, Imperatore G, Barbour KE. Prevalence of Arthritis Among Adults with Prediabetes and Arthritis-Specific Barriers to Important Interventions for Prediabetes - United States, 2009-2016. MMWR Morb Mortal Wkly Rep 2018; 67:1238-1241. [PMID: 30408017 PMCID: PMC6223955 DOI: 10.15585/mmwr.mm6744a4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Roh E, Kim KM, Park KS, Kim YJ, Chun EJ, Choi SH, Park KS, Jang HC, Lim S. Comparison of pancreatic volume and fat amount linked with glucose homeostasis between healthy Caucasians and Koreans. Diabetes Obes Metab 2018; 20:2642-2652. [PMID: 29934972 DOI: 10.1111/dom.13447] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 06/13/2018] [Accepted: 06/20/2018] [Indexed: 02/06/2023]
Abstract
AIM To compare pancreatic volume and fat amount, and their associations with glucose homeostasis, in a Korean and a white population. MATERIALS AND METHODS In 43 healthy Korean and 43 healthy white people, matched for age (±3 years) and body mass index (BMI; ±1 kg/m2 ), we measured pancreatic volume and fat amount in the pancreas and abdomen using computed tomography. Pancreatic β-cell function and insulin resistance were estimated according to biochemical characteristics and a 75-g oral glucose tolerance test. Body composition and resting energy expenditure (REE) were examined using bioimpedance and indirect calorimetry, respectively. RESULTS The mean ±SD age of the participants was 29.9 ± 5.9 years and 30.0 ± 5.2 years, and BMI was 24.0 ±3.7 and 24.1 ±3.2 kg/m2 in the white participants and the Korean participants, respectively. Pancreatic volume in the white participants was greater than that in Korean participants (77.8 ±11.6 vs 68.2 ±12.1 cm3 ; P < .001). Pancreatic fat content in Korean participants was 22.8% higher than in white participants (P = .051). Insulinogenic index, disposition index, muscle mass and REE were significantly lower in Korean participants. Pancreatic volume was positively associated with indices linked to β-cell function; fat content in the pancreas was negatively associated with such indices, and positively with insulin resistance after adjusting for relevant variables including REE. CONCLUSIONS A smaller pancreas and higher fat deposition might be crucial determinants of vulnerability to diabetes in Korean people compared with white people with similar BMI and body fat levels.
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Affiliation(s)
- Eun Roh
- Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, South Korea
| | - Kyoung M Kim
- Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Kyeong S Park
- Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Internal Medicine, Daerim Saint Mary's Hospital, Seoul, South Korea
| | - Yoon J Kim
- Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Internal Medicine, Mediplex Sejong Hospital, Incheon, South Korea
| | - Eun J Chun
- Department of Radiology, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Sung H Choi
- Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Kyong S Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Hak C Jang
- Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Soo Lim
- Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, South Korea
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Costa-Urrutia P, Abud C, Franco-Trecu V, Colistro V, Rodríguez-Arellano ME, Granados J, Seelaender M. Genetic susceptibility to pre diabetes mellitus and related association with obesity and physical fitness components in Mexican-Mestizos. Prim Care Diabetes 2018; 12:416-424. [PMID: 30041843 DOI: 10.1016/j.pcd.2018.07.005] [Citation(s) in RCA: 5] [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: 05/17/2017] [Revised: 05/19/2018] [Accepted: 07/01/2018] [Indexed: 12/16/2022]
Abstract
Pre diabetes mellitus (pre-DM) is considered an early-reversible condition that can progress to Type 2 diabetes mellitus (T2DM) which is the main cause of death for adult Mexican population. Gene variants influencing fasting glucose levels may constitute helpful tool for prevention purposes in pre-DM condition. Physically active Mexican-Mestizo adults (n=565) were genotyped for 6 single nucleotide polymorphisms (SNPs) (ADIPOQ rs2241766, ACSL1 rs9997745, LIPC rs1800588, PPARA rs1800206, PPARG rs1801282 and PPARGC1A rs8192678) related to lipid and carbohydrate metabolism. Fasting glucose was measured and values classified as pre-DM (≥100mg/dL) or normal fasting glucose. Logistic models were used to test associations between pre-DM condition and SNPs, and interaction with Body Mass Index (BMI) and physical fitness components. The A allele of ASCL1 rs9997745 conferred increased risk (OR=3.39, p=0.001) of pre-DM which is modulated by BMI. The A allele of the PPARGC1A rs8192678 showed significant SNP*BMI (OR=1.10, p=0.008) interaction effect for pre-DM risk, meaning that obese subjects showed higher pre-DM risk but normal weight subjects showed lower risk. The effect increased with age and was attenuated by higher cardiorespiratory values. We found that both ACSL1 rs9997745 and PPARGC1A rs8192678 are associated with pre-DM, and that BMI significantly modified their association.
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Affiliation(s)
- Paula Costa-Urrutia
- Department of Cell and Developmental Biology Institute of Biomedical Sciences, Faculty of Medicine, University of São Paulo, Av. Prof. Lineu Prestes, 2415, São Paulo, Brazil; Sport City, SA de CV, Grupo Marti, Blvd Adolfo López Mateos 1181, San Pedro de los Pinos, ZC: 01180 Álvaro Obregón, Mexico City, Mexico.
| | - Carolina Abud
- Sport City, SA de CV, Grupo Marti, Blvd Adolfo López Mateos 1181, San Pedro de los Pinos, ZC: 01180 Álvaro Obregón, Mexico City, Mexico
| | - Valentina Franco-Trecu
- Departamento de Ecología y Evolución, Facultad de Ciencias, Universidad de la República, Iguá 4225, ZC: 11400 Montevideo, Uruguay
| | - Valentina Colistro
- Departamento de Genética, Facultad de Medicina, Universidad de la República, Av. Gral. Flores 2125, ZC: 11800 Montevideo, Uruguay
| | - Martha Eunice Rodríguez-Arellano
- Laboratorio de Medicina Genómica del Hospital Regional Lic, Adolfo López Mateos, ISSSTE, Av. Universidad 1321, Florida, ZC: 01030 Álvaro Obregón, Mexico City, Mexico
| | - Julio Granados
- División de Inmunogenética, Departamento de Trasplantes, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Tlalpan, ZC: 14080, Mexico City, Mexico
| | - Marilia Seelaender
- Department of Cell and Developmental Biology Institute of Biomedical Sciences, Faculty of Medicine, University of São Paulo, Av. Prof. Lineu Prestes, 2415, São Paulo, Brazil
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Zhang Z, Monro J, Venn BJ. Carbohydrate Knowledge and Expectations of Nutritional Support among Five Ethnic Groups Living in New Zealand with Pre- and Type 2 Diabetes: A Qualitative Study. Nutrients 2018; 10:nu10091225. [PMID: 30181471 PMCID: PMC6163622 DOI: 10.3390/nu10091225] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 09/03/2018] [Accepted: 09/03/2018] [Indexed: 01/29/2023] Open
Abstract
Despite availability of diabetes and nutrition information for people with pre- and type 2 diabetes, the uptake and understanding of these resources may differ among ethnic groups. Our objective was to explore dietary knowledge and diabetes experiences amongst Māori, European, Pacific Island, Indian and East Asian people living in New Zealand with a focus on carbohydrate-containing foods. A registered diabetes dietitian led ethnic-specific discussions in groups involving 29 people with pre- or type 2 diabetes. Discussions were audio-recorded, fully transcribed and coded independently by two investigators. Themes were developed using deductive and inductive techniques. Five themes emerged: knowledge, concerns, achievements, simplicity and self-determination. Nutritional knowledge was lacking and a greater awareness of trustworthy dietary resources was needed. There were concerns about diabetes complications and appropriate carbohydrate-containing foods and portions. Contrary to this, people felt proud when achieving dietary goals and grateful for support from health care providers and family. Participants were willing to engage in self-care if advice from health professionals was given in plain language, and in a culturally appropriate manner. Given the desire to take an active role in diabetes self-management and willingness to use electronic devices, an ethnic-specific nutrition education resource could be a valuable tool.
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Affiliation(s)
- Zhuoshi Zhang
- Department of Human Nutrition, University of Otago, PO Box 56, Dunedin 9054, New Zealand.
| | - John Monro
- New Zealand Institute for Plant & Food Research Ltd., Private Bag 11600, Palmerston North 4442, New Zealand.
| | - Bernard J Venn
- Department of Human Nutrition, University of Otago, PO Box 56, Dunedin 9054, New Zealand.
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Lemaitre RN, Yu C, Hoofnagle A, Hari N, Jensen PN, Fretts AM, Umans JG, Howard BV, Sitlani CM, Siscovick DS, King IB, Sotoodehnia N, McKnight B. Circulating Sphingolipids, Insulin, HOMA-IR, and HOMA-B: The Strong Heart Family Study. Diabetes 2018; 67:1663-1672. [PMID: 29588286 PMCID: PMC6054436 DOI: 10.2337/db17-1449] [Citation(s) in RCA: 115] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 03/20/2018] [Indexed: 12/12/2022]
Abstract
Experimental studies suggest ceramides may play a role in insulin resistance. However, the relationships of circulating ceramides and related sphingolipids with plasma insulin have been underexplored in humans. We measured 15 ceramide and sphingomyelin species in fasting baseline samples from the Strong Heart Family Study (SHFS), a prospective cohort of American Indians. We examined sphingolipid associations with both baseline and follow-up measures of plasma insulin, HOMA of insulin resistance (HOMA-IR), and HOMA of β-cell function (HOMA-B) after adjustment for risk factors. Among the 2,086 participants without diabetes, higher levels of plasma ceramides carrying the fatty acids 16:0 (16 carbons, 0 double bond), 18:0, 20:0, or 22:0 were associated with higher plasma insulin and higher HOMA-IR at baseline and at follow-up an average of 5.4 years later. For example, a twofold higher baseline concentration of ceramide 16:0 was associated with 14% higher baseline insulin (P < 0.0001). Associations between sphingomyelin species carrying 18:0, 20:0, 22:0, or 24:0 and insulin were modified by BMI (P < 0.003): higher levels were associated with lower fasting insulin, HOMA-IR, and HOMA-B among those with normal BMI. Our study suggests lowering circulating ceramides might be a target in prediabetes and targeting circulating sphingomyelins should take into account BMI.
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Affiliation(s)
- Rozenn N Lemaitre
- Cardiovascular Health Research Unit, Department of Medicine, School of Medicine, University of Washington, Seattle, WA
| | - Chaoyu Yu
- Department of Biostatistics, University of Washington, Seattle, WA
| | - Andrew Hoofnagle
- Department of Laboratory Medicine, University of Washington, Seattle, WA
| | - Nair Hari
- Boston Heart Diagnostics, Framingham, MA
| | - Paul N Jensen
- Cardiovascular Health Research Unit, Department of Medicine, School of Medicine, University of Washington, Seattle, WA
| | - Amanda M Fretts
- Cardiovascular Health Research Unit, Department of Epidemiology, University of Washington, Seattle, WA
| | - Jason G Umans
- MedStar Health Research Institute, Hyattsville, MD, and Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC
| | - Barbara V Howard
- MedStar Health Research Institute, Hyattsville, MD, and Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC
| | - Colleen M Sitlani
- Cardiovascular Health Research Unit, Department of Medicine, School of Medicine, University of Washington, Seattle, WA
| | | | - Irena B King
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM
| | - Nona Sotoodehnia
- Cardiovascular Health Research Unit, Department of Medicine, School of Medicine, University of Washington, Seattle, WA
| | - Barbara McKnight
- Department of Biostatistics, University of Washington, Seattle, WA
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Nahon KJ, Kantae V, den Haan R, Hanssen MJW, Harms AC, van der Stelt M, Hankemeier T, Jazet IM, van Marken Lichtenbelt WD, Rensen PCN, Boon MR. Gene Expression of Endocannabinoid System Components in Skeletal Muscle and Adipose Tissue of South Asians and White Caucasians with Overweight. Obesity (Silver Spring) 2018; 26:1332-1337. [PMID: 30070030 DOI: 10.1002/oby.22245] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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] [Received: 01/19/2018] [Revised: 05/25/2018] [Accepted: 05/28/2018] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The study aimed to investigate whether markers of endocannabinoid signaling differed between men with overweight of South Asian and white Caucasian descent. METHODS We included South Asian (n = 10) and white Caucasian (n = 10) men with overweight and prediabetes aged 35 to 50 years. Plasma samples were analyzed for endocannabinoids, their congeners, and lipids. In white adipose tissue (WAT) and skeletal muscle biopsies, mRNA expression of genes involved in the endocannabinoid system (ECS) was assessed using quantitative reverse-transcription polymerase chain reaction (qRT-PCR). Fasting lipid oxidation and glucose oxidation were determined with indirect calorimetry. RESULTS Compared to white Caucasians, South Asians had higher levels of plasma 2-linoleoyl glycerol (P < 0.01) and N-linoleoylethanolamine (P < 0.05). Interestingly, in skeletal muscle of South Asians, expression of cannabinoid receptors CB1 and CB2 was 10-fold lower (P < 0.001) and that of the endocannabinoid degradation enzyme fatty acid amide hydrolase 2 (FAAH2) was 5-fold lower (P < 0.001) compared to white Caucasians. Expression of genes involved in the ECS in WAT were not different between the two ethnicities. After pooling of both ethnicities, plasma 2-arachidonoylglycerol (2-AG) positively correlated with plasma triglycerides (R = 0.77, P < 0.001) and lipid oxidation (R = 0.55, P < 0.05). CONCLUSIONS South Asian men with overweight have higher plasma 2-linoleoyl glycerol and N-linoleoylethanolamine levels and lower expression of CB receptors and the endocannabinoid degradation enzyme FAAH2 in skeletal muscle compared to white Caucasians.
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Affiliation(s)
- Kimberly J Nahon
- Department of Medicine, Division of Endocrinology Leiden University Medical Center, Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Vasudev Kantae
- Division of Systems Biomedicine and Pharmacology, Leiden Academic Center for Drug Research, Leiden University, Leiden, the Netherlands
| | - Roy den Haan
- Department of Medicine, Division of Endocrinology Leiden University Medical Center, Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Mark J W Hanssen
- Department of Human Biology & Human Movement Sciences, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Amy C Harms
- Division of Systems Biomedicine and Pharmacology, Leiden Academic Center for Drug Research, Leiden University, Leiden, the Netherlands
| | - Mario van der Stelt
- Department of Molecular Physiology, Leiden Institute of Chemistry, Leiden University, Leiden, the Netherlands
| | - Thomas Hankemeier
- Division of Systems Biomedicine and Pharmacology, Leiden Academic Center for Drug Research, Leiden University, Leiden, the Netherlands
| | - Ingrid M Jazet
- Department of Medicine, Division of Endocrinology Leiden University Medical Center, Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Wouter D van Marken Lichtenbelt
- Department of Human Biology & Human Movement Sciences, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Patrick C N Rensen
- Department of Medicine, Division of Endocrinology Leiden University Medical Center, Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Mariëtte R Boon
- Department of Medicine, Division of Endocrinology Leiden University Medical Center, Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
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Jiang L, Johnson A, Pratte K, Beals J, Bullock A, Manson SM. Long-term Outcomes of Lifestyle Intervention to Prevent Diabetes in American Indian and Alaska Native Communities: The Special Diabetes Program for Indians Diabetes Prevention Program. Diabetes Care 2018; 41:1462-1470. [PMID: 29915128 PMCID: PMC6014547 DOI: 10.2337/dc17-2685] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 04/21/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Evidence for long-term translational effectiveness of lifestyle interventions in minority populations is scarce. This article reports long-term outcomes, for up to 10 years, of such an intervention to prevent diabetes in American Indian and Alaska Native (AI/AN) communities. RESEARCH DESIGN AND METHODS From January 2006 to July 2016, the Special Diabetes Program for Indians Diabetes Prevention Program implemented the Diabetes Prevention Program lifestyle intervention among 46 AI/AN health care programs. Enrolled participants underwent a thorough clinical assessment at baseline, after completing the Lifestyle Balance Curriculum (postcurriculum assessment), and annually thereafter. Proportional hazards regression was used to estimate the association between diabetes incidence and postcurriculum weight loss status. RESULTS Of 8,652 enrolled participants, 65% finished the postcurriculum assessment. The assessment completion rate diminished over time to 13% in year 10. Among those with postcurriculum weight measurements, 2,028 (36%) lost >5% of their initial weight, 978 (17%) lost 3-5%, whereas 2,604 (47%) had <3% weight loss (average weight loss 3.8%). Compared with those with <3% weight loss, participants with >5% weight loss had a 64% (95% CI 54-72) lower risk of developing diabetes during the first 6 years of follow-up, whereas those with 3-5% weight loss had 40% (95% CI 24-53) lower risk. CONCLUSIONS Moderate to small weight loss was associated with substantially reduced long-term risk of diabetes in diverse AI/AN communities. High participant attrition rates and nonoptimal postcurriculum weight loss are important challenges found in this translational effort implemented in an underserved population.
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Affiliation(s)
- Luohua Jiang
- Department of Epidemiology, School of Medicine, University of California, Irvine, Irvine, CA
| | - Ann Johnson
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Katherine Pratte
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Janette Beals
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Ann Bullock
- Division of Diabetes Treatment and Prevention, Indian Health Service, Rockville, MD
| | - Spero M Manson
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
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Abstract
Purpose The purpose of this study was to examine associations between perceived risk and actual risk of type 2 diabetes by race and/or ethnicity. Methods The study sample included 10 999 adults from the 2011 to 2014 National Health and Nutrition Examination Survey. Sociodemographic, clinical, and behavioral data were collected using interviews and physical examinations. Participants were asked if they felt at risk for diabetes or prediabetes and then asked the reasons why. Data analyses were conducted with SAS to properly analyze complex survey data. Results About 86% of the sample (n = 9496) answered the risk perception question for diabetes, and among those, 28.4% indicated having a high perceived risk. Among this subsample, 38.3% were identified as having an actual risk for prediabetes or diabetes according to the American Diabetes Association guidelines. Across all race groups, the most frequently reported risk factors participants believed to contribute to their risk for diabetes were family history of diabetes, obesity, and poor diet habits. When the percentage of participants with an actual risk factor who correctly perceived it as a risk factor was examined, fewer Asians correctly perceived weight status and physical activity level as a risk for diabetes in contrast to the other racial/ethnic groups. Conclusions Our study showed that when perception was compared to actual risks, associations differed statistically by race. It will be essential to discuss their risk perception to proper screening for diabetes and relevant lifestyle modifications to prevent and delay the onset of diabetes.
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Affiliation(s)
- Kyeongra Yang
- School of Nursing, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - Lynn M Baniak
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - JiYeon Choi
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Eileen R Chasens
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
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Yin X, Liu Q, Wei J, Meng X, Jia C. Association of daytime napping with prediabetes and diabetes in a Chinese population: Results from the baseline survey of the China Health and Retirement Longitudinal Study. J Diabetes 2018; 10:302-309. [PMID: 28851083 DOI: 10.1111/1753-0407.12605] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 06/05/2017] [Revised: 08/19/2017] [Accepted: 08/22/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Only a few studies have investigated the effects of daytime napping on diabetes, and these studies have reported conflicting results. The aim of the present study was to examine whether daytime napping is associated with a higher risk of prediabetes and diabetes. METHODS The present cross-sectional study of napping duration in relation to prediabetes and diabetes was conducted in 12 277 participants. Data from the first wave (2011) of the China Health and Retirement Longitudinal Study were used. Daytime napping was divided into four groups: no napping (reference) and napping for 1-30, 31-90, and >90 min. Multinomial logistic regression was used to obtain odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS Individuals who reported taking daily afternoon naps accounted for 53.39% of all participants. Nappers had a higher prevalence of prediabetes and diabetes than non-nappers. Compared with the reference group, the weighted fully adjusted ORs (95% CI) were 1.36 (1.10-1.68) and 1.61 (1.22-2.13) for napping >90 min in prediabetic and diabetic patients, respectively. CONCLUSIONS Long daytime napping duration was positively associated with prediabetes and diabetes. Further physiological and cohort studies are needed to confirm these results and elucidate potential mechanisms.
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Affiliation(s)
- Xin Yin
- Department of Epidemiology, Shandong University, Jinan, China
| | - Qi Liu
- Department of Epidemiology, Shandong University, Jinan, China
| | - Jiate Wei
- Department of Epidemiology, Shandong University, Jinan, China
| | - Xin Meng
- Department of Epidemiology, Shandong University, Jinan, China
| | - Chongqi Jia
- Department of Epidemiology, Shandong University, Jinan, China
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Alfawaz HA, Wani K, Alnaami AM, Al-Saleh Y, Aljohani NJ, Al-Attas OS, Alokail MS, Kumar S, Al-Daghri NM. Effects of Different Dietary and Lifestyle Modification Therapies on Metabolic Syndrome in Prediabetic Arab Patients: A 12-Month Longitudinal Study. Nutrients 2018; 10:nu10030383. [PMID: 29558423 PMCID: PMC5872801 DOI: 10.3390/nu10030383] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 03/05/2018] [Accepted: 03/15/2018] [Indexed: 12/14/2022] Open
Abstract
This three-arm, randomized, controlled study aimed to determine the differences in the effects of general advice (GA) on lifestyle change, intensive lifestyle modification programme (ILMP) and GA + metformin (GA + Met) in reducing the prevalence of full metabolic syndrome (MetS) in subjects with prediabetes; 294 Saudis with prediabetes (fasting glucose 5.6–6.9 mmol/L) were initially randomized, 263 completed 6 months and 237 completed 12 months. They were allocated into three groups: GA group which received a standard lifestyle change education; ILMP which followed a rigorous lifestyle modification support on diet and physical activity; and a GA + Met group. Anthropometric and biochemical estimations were measured. Full MetS (primary endpoint) and its components (secondary endpoint) were screened at baseline, 6 and 12 months. Full MetS in the ILMP group decreased by 26% (p < 0.001); in GA + Met group by 22.4% (p = 0.01) and in GA group by 8.2% (p = 0.28). The number of MetS components decreased significantly in the ILMP and GA + Met groups (mean change 0.81, p < 0.001 and 0.35, p = 0.05, respectively). Between-group comparison revealed a clinically significant decrease in MetS components in favor of the ILMP group (−0.58 (−0.88–0.28), p < 0.001). This study highlights the clinical potency of ILMP versus other diabetes prevention options in reducing MetS in Saudi adults with elevated fasting glucose.
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Affiliation(s)
- Hanan A Alfawaz
- Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia.
- Department of Food Science and Nutrition, College of Food Science & Agriculture, King Saud University, Riyadh 11451, Saudi Arabia.
| | - Kaiser Wani
- Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia.
- Biomarkers Research Program, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia.
| | - Abdullah M Alnaami
- Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia.
- Biomarkers Research Program, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia.
| | - Yousef Al-Saleh
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11461, Saudi Arabia.
| | - Naji J Aljohani
- Specialized Diabetes and Endocrine Center, King Fahad Medical City, Faculty of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11525, Saudi Arabia.
| | - Omar S Al-Attas
- Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia.
- Biomarkers Research Program, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia.
| | - Majed S Alokail
- Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia.
- Biomarkers Research Program, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia.
| | - Sudhesh Kumar
- Division of Metabolic and Vascular Health, Clinical Sciences Research Institute, University Hospitals Coventry and Warwickshire Trust, Walsgrave, Coventry CV2 2DX, UK.
| | - Nasser M Al-Daghri
- Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia.
- Biomarkers Research Program, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia.
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Agarwal G, Jiang Y, Rogers Van Katwyk S, Lemieux C, Orpana H, Mao Y, Hanley B, Davis K, Leuschen L, Morrison H. Effectiveness of the CANRISK tool in the identification of dysglycemia in First Nations and Métis in Canada. Health Promot Chronic Dis Prev Can 2018; 38:55-63. [PMID: 29443485 PMCID: PMC5833636 DOI: 10.24095/hpcdp.38.2.02] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
INTRODUCTION First Nations/Métis populations develop diabetes earlier and at higher rates than other Canadians. The Canadian diabetes risk questionnaire (CANRISK) was developed as a diabetes screening tool for Canadians aged 40 years or over. The primary aim of this paper is to assess the effectiveness of the existing CANRISK tool and risk scores in detecting dysglycemia in First Nations/Métis participants, including among those under the age of 40. A secondary aim was to determine whether alternative waist circumference (WC) and body mass index (BMI) cut-off points improved the predictive ability of logistic regression models using CANRISK variables to predict dysglycemia. METHODS Information from a self-administered CANRISK questionnaire, anthropometric measurements, and results of a standard oral glucose tolerance test (OGTT) were collected from First Nations and Métis participants (n = 1479). Sensitivity and specificity of CANRISK scores using published risk score cut-off points were calculated. Logistic regression was conducted with alternative ethnicity-specific BMI and WC cut-off points to predict dysglycemia using CANRISK variables. RESULTS Compared with OGTT results, using a CANRISK score cut-off point of 33, the sensitivity and specificity of CANRISK was 68% and 63% among individuals aged 40 or over; it was 27% and 87%, respectively among those under 40. Using a lower cut-off point of 21, the sensitivity for individuals under 40 improved to 77% with a specificity of 44%. Though specificity at this threshold was low, the higher level of sensitivity reflects the importance of the identification of high risk individuals in this population. Despite altered cut-off points of BMI and WC, logistic regression models demonstrated similar predictive ability. CONCLUSION CANRISK functioned well as a preliminary step for diabetes screening in a broad age range of First Nations and Métis in Canada, with an adjusted CANRISK cutoff point for individuals under 40, and with no incremental improvement from using alternative BMI/WC cut-off points.
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Affiliation(s)
- Gina Agarwal
- Departments of Family Medicine and Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Ying Jiang
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | | | - Chantal Lemieux
- Public Health Agency of Canada, Ottawa, Ontario, Canada
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Heather Orpana
- Public Health Agency of Canada, Ottawa, Ontario, Canada
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Yang Mao
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Brandan Hanley
- Yukon Health and Social Services, Whitehorse, Yukon, Canada
| | - Karen Davis
- Saskatoon Health Region, Saskatoon, Saskatchewan, Canada
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Marlatt KL, White UA, Beyl RA, Peterson CM, Martin CK, Marco ML, Keenan MJ, Martin RJ, Aryana KJ, Ravussin E. Role of resistant starch on diabetes risk factors in people with prediabetes: Design, conduct, and baseline results of the STARCH trial. Contemp Clin Trials 2018; 65:99-108. [PMID: 29274892 PMCID: PMC5857355 DOI: 10.1016/j.cct.2017.12.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 12/11/2017] [Accepted: 12/20/2017] [Indexed: 01/01/2023]
Abstract
Dietary resistant starch (RS) might alter gastrointestinal tract function in a manner that improves human health, particularly among adults at risk for diabetes. Here, we report the design and baseline results (with emphasis on race differences) from the STARCH trial, the first comprehensive metabolic phenotyping of people with prediabetes enrolled in a randomized clinical trial testing the effect of RS on risk factors for diabetes. Overweight/obese participants (BMI≥27kg/m2 and weight≤143kg), age 35-75y, with confirmed prediabetes were eligible. Participants were randomized to consume 45g/day of RS (RS=amylose) or amylopectin (Control) for 12weeks. The study was designed to evaluate the effect of RS on insulin sensitivity and secretion, ectopic fat, and inflammatory markers. Secondary outcomes included energy expenditure, substrate oxidation, appetite, food intake, colonic microbial composition, fecal and plasma levels of short-chain fatty acids, fecal RS excretion, and gut permeability. Out of 280 individuals screened, 68 were randomized, 65 started the intervention, and 63 were analyzed at baseline (mean age 55y, BMI 35.6kg/m2); 2 were excluded from baseline analyses due to abnormal insulin and diabetes. Sex and race comparisons at baseline were reported. African-Americans had higher baseline acute insulin response to glucose (AIRg measured by frequently sampled intravenous glucose tolerance test) compared to Caucasians, despite having less visceral adipose tissue mass and intrahepatic lipid; all other glycemic variables were similar between races. Sleep energy expenditure was ~90-100kcal/day lower in African-Americans after adjusting for insulin sensitivity and secretion. This manuscript provides an overview of the strategy used to enroll people with prediabetes into the STARCH trial and describes methodologies used in the assessment of risk factors for diabetes. Clinicaltrials.gov identifier: STARCH (NCT01708694). The present study reference can be found here: https://clinicaltrials.gov/ct2/show/NCT01708694. Submission Category: "Study Design, Statistical Design, Study Protocols".
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Affiliation(s)
- Kara L Marlatt
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, United States
| | - Ursula A White
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, United States
| | - Robbie A Beyl
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, United States
| | - Courtney M Peterson
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, United States; Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35233, United States
| | - Corby K Martin
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, United States
| | - Maria L Marco
- School of Food Science and Technology, College of Agriculture and Environmental Sciences, University of California-Davis, Davis, CA 95616, United States
| | - Michael J Keenan
- School of Nutrition & Food Sciences, College of Agriculture, Louisiana State University, Baton Rouge, LA 70803, United States
| | - Roy J Martin
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, United States; School of Nutrition & Food Sciences, College of Agriculture, Louisiana State University, Baton Rouge, LA 70803, United States
| | - Kayanush J Aryana
- School of Nutrition & Food Sciences, College of Agriculture, Louisiana State University, Baton Rouge, LA 70803, United States
| | - Eric Ravussin
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, United States.
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Kim YM, Kim SH, Shim YS. Association of sodium intake with insulin resistance in Korean children and adolescents: the Korea National Health and Nutrition Examination Survey 2010. J Pediatr Endocrinol Metab 2018; 31:117-125. [PMID: 29303781 DOI: 10.1515/jpem-2017-0362] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 09/14/2017] [Accepted: 11/16/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND This study aimed to evaluate the relationship between sodium intake and insulin resistance indices. METHODS A total of 718 Korean children and adolescents (411 boys) aged 10-18 years who participated in the Korea National Health and Nutrition Examination Survey (KNHANES) were included in the study. The urinary sodium to urinary creatinine ratio was used as a surrogate for sodium intake. The homeostatic model assessment of insulin resistance (HOMA-IR) and the quantitative insulin sensitivity check index (QUICKI) were used as indices of insulin resistance. RESULTS The mean urinary sodium to urinary creatinine ratio was 11.34 in males and 10.17 in females. The urinary sodium to urinary creatinine ratio was significantly positively correlated with HOMA-IR (r=0.165, p<0.001) and inversely correlated with QUICKI (r=-0.181, p<0.001) in Pearson's correlation analyses. In a multivariate linear regression analysis, the urinary sodium to urinary creatinine ratio was independently and significantly positively associated with HOMA-IR (β=0.073, p=0.018) and significantly inversely associated with QUICKI (β=-0.080, p=0.007) after adjustment for possible confounders. HOMA-IR was independently and significantly positively associated with the urinary sodium to urinary creatinine ratio (β=0.087, p=0.018), whereas QUICKI was independently and significantly negatively associated with the urinary sodium to urinary creatinine ratio (β=-0.097, p=0.009) after controlling for confounders. CONCLUSIONS Our results suggest that sodium intake, as estimated by the urinary sodium to urinary creatinine ratio, may be independently associated with insulin resistance in children and adolescents.
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Affiliation(s)
- Yong Min Kim
- Department of Pediatrics, Hallym University College of Medicine, Seoul, Republic of Korea
| | - So Hyun Kim
- Department of Pediatrics, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Young Suk Shim
- Department of Pediatrics, Hallym University College of Medicine, Seoul, Republic of Korea
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Zhao K, Yang SS, Wang HB, Chen K, Lu ZH, Mu YM. Association between the Hypertriglyceridemic Waist Phenotype and Prediabetes in Chinese Adults Aged 40 Years and Older. J Diabetes Res 2018; 2018:1031939. [PMID: 30046615 PMCID: PMC6036789 DOI: 10.1155/2018/1031939] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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] [Received: 03/14/2018] [Revised: 05/21/2018] [Accepted: 05/27/2018] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE To investigate the association between the hypertriglyceridemic waist (HTGW) phenotype and prediabetes in Chinese adults aged 40 years and older. METHODS 12757 adults (4101 men and 8656 women) without diabetes or cardiovascular and cerebrovascular diseases, free of using lipid-modified agents, were enrolled in this cross-sectional study. The HTGW phenotype was defined as elevated serum triglyceride concentrations and enlarged waist circumference. A two-hour post 75 g oral glucose tolerance test was performed in all participants. Multiple logistic regression analysis was used to evaluate the relationship of the HTGW phenotype with prediabetes. RESULTS Individuals with the HTGW phenotype had a higher adjusted odds ratio (OR: 1.70; 95% CI: 1.48-1.95) of prediabetes than those without the phenotype. There existed a strong relationship of the HTGW phenotype with impaired glucose tolerance (IGT) (OR: 1.83; 95% CI: 1.57-2.13), but not with impaired fasting glucose (IFG) (OR: 0.87; 95% CI: 0.65-1.17). Only women with the HTGW phenotype are significantly associated with the combined IFG and IGT (OR: 1.83; 95% CI: 1.28-2.62). CONCLUSIONS The HTGW phenotype was a useful risk indicator and a practical screening tool to benefit in the early diagnosis and intervention for prediabetes, particularly for IGT and the combined IFG and IGT.
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Affiliation(s)
- Kun Zhao
- Department of Endocrinology, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing 100853, China
| | - Shan-Shan Yang
- Institute of Geriatrics, Beijing Key Laboratory of Ageing and Geriatrics, and State Key Laboratory of Kidney Disease, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing 100853, China
| | - Hai-Bin Wang
- Department of Endocrinology, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing 100853, China
| | - Kang Chen
- Department of Endocrinology, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing 100853, China
| | - Zhao-Hui Lu
- Department of Endocrinology, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing 100853, China
| | - Yi-Ming Mu
- Department of Endocrinology, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing 100853, China
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Silvestre MP, Jiang Y, Volkova K, Chisholm H, Lee W, Poppitt SD. Evaluating FINDRISC as a screening tool for type 2 diabetes among overweight adults in the PREVIEW:NZ cohort. Prim Care Diabetes 2017; 11:561-569. [PMID: 28801192 DOI: 10.1016/j.pcd.2017.07.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 02/26/2017] [Revised: 06/16/2017] [Accepted: 07/08/2017] [Indexed: 01/26/2023]
Abstract
AIMS This study aimed to evaluate the efficacy of a high (≥12) Finnish diabetes risk (FINDRISC) score in identifying undiagnosed prediabetes and type 2 diabetes (T2D) in an New Zealand population of overweight and obese individuals, across a variety of ethnic groups. METHODS We estimated the efficacy of elevated FINDRISC scores in predicting prediabetes and T2D in 424 overweight adults with no prior diagnosis recruited for the PREVention of diabetes through lifestyle Interventions in Europe and Worldwide (PREVIEW) study. All participants who completed the FINDRISC questionnaire during a pre-screening phase with a score of ≥12 were then screened using a 2h oral glucose tolerance test (2h-OGTT) to identify undiagnosed dysglycaemia. RESULTS Of the 424 participants, 65% (n=280) were pre-diabetic and 7% (n=32) had undiagnosed T2D. A higher FINDRISC score was significantly associated with prediabetes and T2D (P=0.02). There was a significant association between ethnicity and glycaemic status (normal vs prediabetes/T2D, P=0.02). Increasing the FINDRISC cut-off to ≥15 resulted in a non-significant increase in the proportion of participants correctly classified with dysglycaemia. ROC-AUC=0.6 with sensitivity=0.6026 (95% CI: 0.5459-0.6573) and specificity=0.5536 (95% CI: 0.4567-0.6476). Isolated impaired fasting glucose (IFG) was more efficient in predicting dysglycaemia than isolated impaired glucose tolerance (IGT). CONCLUSIONS The FINDRISC questionnaire is a useful and efficacious screening tool to identify unknown prediabetes and T2D in overweight New Zealanders, particularly in Maori individuals.
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Affiliation(s)
- Marta Paulino Silvestre
- Human Nutrition Unit, University of Auckland, Auckland, New Zealand; School of Biological Sciences, University of Auckland, Auckland, New Zealand.
| | - Yannan Jiang
- Department of Statistics, University of Auckland, Auckland, New Zealand
| | - Katya Volkova
- Human Nutrition Unit, University of Auckland, Auckland, New Zealand; School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | - Hannah Chisholm
- Human Nutrition Unit, University of Auckland, Auckland, New Zealand
| | - Wonjoo Lee
- Human Nutrition Unit, University of Auckland, Auckland, New Zealand
| | - Sally Diana Poppitt
- Human Nutrition Unit, University of Auckland, Auckland, New Zealand; School of Biological Sciences, University of Auckland, Auckland, New Zealand; Department of Medicine, University of Auckland, Auckland, New Zealand
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Gao YX, Man Q, Jia S, Li Y, Li L, Zhang J. The fasting serum triglyceride levels of elderly population with different progression stages of diabetes mellitus in China. J Diabetes Complications 2017; 31:1641-1647. [PMID: 28993003 DOI: 10.1016/j.jdiacomp.2017.08.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 07/10/2017] [Revised: 08/19/2017] [Accepted: 08/22/2017] [Indexed: 01/19/2023]
Abstract
AIMS This cross-sectional study aimed to investigate triglyceride level among Chinese elderly population with different diabetic progressions and related factors of triglyceride. METHODS Study participants (≥65years) were recruited from a nationwide cross-sectional surveillance and were divided into four subgroups according to diabetic progression. Their information was obtained via questionnaire and physical examination. Their lipids in fasting serum samples were analyzed. RESULTS The serum triglyceride levels (mmol/L, mean±SD) were 1.3±0.8 (subgroup of no prediabetes and no DM), 1.5±1.0 (subgroup of prediabetes), 1.6±1.1 (subgroup of newly diagnosed DM) and 1.7±1.1 (subgroup of previously diagnosed DM), respectively. Only one female participant had a higher triglyceride than upper limit for prevention of acute pancreatitis (11.0mmol/L). However, 23.1% of participants and 34.8% of DM participants had higher triglyceride than upper limit for prevention of cardiovascular diseases (1.7mmol/L). Triglyceride level was positively correlated with diabetic progression (rs=0.17, p<0.01). Age, gender, waist-to-height ratio (rather than BMI), systolic pressure, serum total cholesterol and HDL-C levels were statistically correlated with triglyceride level for total participants (R2=0.39, p<0.01). CONCLUSIONS Aggravation of serum triglyceride level was related to diabetic progression in Chinese elderly population. Triglyceride control was unsatisfactory in Chinese elderly population, especially in elderly population with DM.
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Affiliation(s)
- Yi-Xiong Gao
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29, Nanwei Road, Peking 100050, China
| | - Qingqing Man
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29, Nanwei Road, Peking 100050, China
| | - Shanshan Jia
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29, Nanwei Road, Peking 100050, China
| | - Yuqian Li
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29, Nanwei Road, Peking 100050, China
| | - Lixiang Li
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29, Nanwei Road, Peking 100050, China
| | - Jian Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29, Nanwei Road, Peking 100050, China.
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Yin P, Shao P, Liu H, Li W, Wang L, Wang J, Zhang S, Leng J, Li N, Tian H, Yang X, Yu Z, Hu G. C-peptide levels and the risk of diabetes and pre-diabetes among Chinese women with gestational diabetes. J Diabetes Complications 2017; 31:1658-1662. [PMID: 28919328 PMCID: PMC5679088 DOI: 10.1016/j.jdiacomp.2017.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 07/10/2017] [Revised: 08/09/2017] [Accepted: 08/11/2017] [Indexed: 01/21/2023]
Abstract
AIMS To examine the association of connecting peptide (C-peptide) and the risks of postpartum diabetes and pre-diabetes among women with prior gestational diabetes. METHODS A cross-sectional study of 1263 women with prior gestational diabetes was carried out at 1-5years after delivery in Tianjin, China. Logistic regression was used to assess the associations of C-peptide and the risks of diabetes and pre-diabetes. RESULTS The multivariable-adjusted odds ratios based on different levels of C-peptide (0-33%, 34-66%, 67-90%, and >90% as C-peptide cutpoints) were 1.00, 1.93 (95% confidence interval [CI] 0.85-4.39), 2.49 (95% CI 1.06-5.87), and 3.88 (95% CI 1.35-11.1) for diabetes (P for trend <0.0001), and 1.00, 1.66 (95% CI 1.18-2.36), 2.38 (95% CI 1.56-3.62) and 2.35 (95% CI 1.27-4.37) for pre-diabetes (P for trend <0.0001), respectively. Restricted cubic splines models showed a positive linear association of C-peptide as a continuous variable with the risks of type 2 diabetes and pre-diabetes. The positive association was significant when stratified by healthy weight and overweight participants. CONCLUSIONS We found a positive association between serum C-peptide levels and the risks of diabetes and pre-diabetes among Chinese women with prior gestational diabetes. Our finding suggested that elevated C-peptide levels may be a predictor of diabetes and pre-diabetes.
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Affiliation(s)
- Ping Yin
- Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Ping Shao
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Huikun Liu
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Weiqin Li
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Leishen Wang
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Jing Wang
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Shuang Zhang
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Junhong Leng
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Nan Li
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Huiguang Tian
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Xilin Yang
- Department of Epidemiology and Biostatistics, Tianjin Medical University, Tianjin, China
| | - Zhijie Yu
- Population Cancer Research Program, Dalhousie University, Halifax, NS, Canada
| | - Gang Hu
- Pennington Biomedical Research Center, Baton Rouge, LA, USA.
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50
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Edeoga C, Owei I, Siwakoti K, Umekwe N, Ceesay F, Wan J, Dagogo-Jack S. Relationships between blood pressure and blood glucose among offspring of parents with type 2 diabetes: Prediction of incident dysglycemia in a biracial cohort. J Diabetes Complications 2017; 31:1580-1586. [PMID: 28890305 DOI: 10.1016/j.jdiacomp.2017.07.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 07/27/2017] [Accepted: 07/28/2017] [Indexed: 01/11/2023]
Abstract
AIMS We assessed blood pressure (BP) and blood glucose (BG) values in healthy subjects, and examined baseline BP as a predictor of incident prediabetes during follow-up. METHODS Participants in the Pathobiology of Prediabetes in a Biracial Cohort (POP-ABC) study underwent screening assessments (anthropometry, BP, OGTT) and were stratified into normal BP (NBP), prehypertension, or hypertension, and normal glucose regulation (NGR), prediabetes (IFG/IGT), or type 2 diabetes (T2D) status. NGR subjects who met all inclusion criteria were enrolled in a 5-yr prospective study, with the primary outcome of incident prediabetes. RESULTS We screened 602 adults (341 black, 261 white) and enrolled 343 (193 black, 150 white) for prospective follow-up. Systolic and diastolic BP correlated significantly with fasting and nonfasting BG (P=0.003-<0.0001). Compared to NGR group, more prediabetic subjects had prehypertension (42.5% vs. 36.2%) and fewer had NBP (35.9% vs. 48.6%) (P=0.009). During ~5years of follow-up, 26.3% of NBP and 35.7% of prehypertensive subjects developed prediabetes (P=0.02). Kaplan-Meier analysis showed higher probability of incident prediabetes among participants with prehypertension compared to NBP during ~5years of follow-up (P=0.0012). CONCLUSIONS In our biracial cohort, BP and BG values were significantly correlated, and BP status predicted incident prediabetes among initially normoglycemic individuals. These findings suggest co-evolution of factors involved in the dysregulation of BP and BG.
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Affiliation(s)
- Chimaroke Edeoga
- Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Ibiye Owei
- Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Krishmita Siwakoti
- Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Nkiru Umekwe
- Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Fatoumatta Ceesay
- Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Jim Wan
- Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Sam Dagogo-Jack
- Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN, United States.
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