Associations of Clusters of Cardiovascular Risk Factors with Insulin Resistance and Β-Cell Functioning in a Working-Age Diabetic-Free Population in Kazakhstan

Cardiovascular risk factors aggregate in determined individuals. Patients with Type 2 diabetes mellitus (T2DM) have higher cardiovascular This study aimed to investigate insulinresistance (IR) and β-cell function using the homeostasis model assessment (HOMA) indexes in a general Kazakh population and determine the effect he effect that cardiovascular factors may have on those indexes. We conducted a cross-sectional study among employees of the Khoja Akhmet Yassawi International Kazakh-Turkish University (Turkistan, Kazakhstan) aged between 27 and 69 years. Sociodemographic variables, anthropometric measurements (body mass, height, waist circumference, hip circumference), and blood pressure were obtained. Fasting blood samples were collected to measure insulin, glucose, total cholesterol (TC), triglycerides (TG), and high- (HDL) andlow-density lipoprotein (LDL) levels. Oral glucose tolerance tests were performed. Hierarchical and K-means cluster analyses were obtained. The final sample was composed of 427 participants. Spearmen correlation analysis showed that cardiovascular parameters were statistically associated with HOMA-β (p < 0.001) and not with HOMA IR. Participants were aggregated into the three clusters where the cluster with a higher age and cardiovascular risk revealed deficient β-cell functioning, but not IR (p < 0.000 and p = 0.982). Common and easy to obtain biochemical and anthropometric measurements capturing relevant cardiovascular risk factors have been demonstrated to be associated with significant deficiency in insulin secretion. Although further longitudinal studies of the incidence of T2DM are needed, this study highlights that cardiovascular profiling has a significant role not just for risk stratification of patients for cardiovascular prevention but also for targeted vigilant glucose monitoring.

Understanding the impact of endometriosis on women's life: an integrative review of systematic reviews

BACKGROUND

Endometriosis is a challenging chronic condition with a significant impact on women's well-being. This systematic review of systematic reviews aims to assess the evidence investigating the intricate interplay between endometriosis and quality of life (QoL).

METHODS

A systematic review was performed for English-language studies up to January 2022 to identify systematic reviews with and without meta-analysis analyzing quantitative or qualitative data The following databases were searched: Scopus, PubMed, Embase, Web of Science and Cochrane Central Register of Controlled Trials. Participants/population were women with endometriosis, and the outcomes included were all reported outcomes evaluating the impact of endometriosis on women's QoL (PROSPERO 2021 CRD42021289347).

RESULTS

15 systematic reviews were identified. 8 included meta-analysis: 4 explored the prevalence of mental health problems, and 1 analyzed, respectively, the overall impact of endometriosis, headache migraine, and sexual function. 7 articles reported on the mental consequences, and three sexual functioning. One was a qualitative review. The impact of the relationships with the healthcare system was analyzed in 3 reviews. Pain is a hallmark of endometriosis. Infertility and sexual problems are also frequent. Depression, anxiety, and stress represent significant contributors to lessening women's QoL. Women have frustrating relationships with the healthcare system: the complex and long diagnostic process, lack of treatment effectiveness, and persistence of symptoms contribute to emotional challenges. Negative cognitive patterns developed by women with emotional distress, such as catastrophizing and fear-avoidance behaviors, amplify the experience of pain.

CONCLUSION

The limitations of this review are the high degree of heterogeneity of papers that include many factors, including comorbidities, and use of medical care that may impact QoL, and that most of them were cross-sectional. Endometriosis is a chronic disease that significantly impacts all domains of women's lifes. Pain, infertility, and stress linked with depression, and anxiety significantly influence QoL. Women are dissatisfied with the care they receive.

The rate of medication nonadherence and influencing factors: A systematic Review

Lack of adherence to recommended therapy will reduce its effectiveness and can subsequently lead to disease progression, disabilities or even death. A vast number of research studies have emphasized the magnitude of medication nonadherence and its effect on treatment outcomes, patient’s health, healthcare providers and the associated costs; medication nonadherence remains a major concern that is believed to be widely practiced amongst medication taking patients. The current systemic review aims to cohere the available evidence regarding medication nonadherence rate, practices, and potential affecting factors and predictors. A search through different databases was conducted, including PubMed, Medline, and CINHAL for recently published research articles, within five years. The terms used for the search include medication nonadherence, medication nonadherence, factors affecting medication nonadherence and predictors of medication nonadherence. The search was limited to human subjects, English language journal articles and exclusion of review articles, case studies, and data from clinical trials as patient adherence is closely observed.<br /> The search resulted in 667 articles and only 65 articles were included and further screened. However, according to our exclusion criteria, 15 articles only were included in this review. The three most reported practices of medication nonadherence are prescription abandonment, nonconforming, and non-persistence. There are five reported factors that may lead to nonadherence practices such as socioeconomic-related factors, healthcare system-related factors, patient-related factors, disease-related factors, and therapy-related factors. In conclusion, medication nonadherence practice is a multi-dimensional phenomenon that requires a multi-targeted solution.

A Longitudinal Assessment of Metabolic Syndrome

Background/Objectives: Metabolic syndrome (MetS) is a combination of conditions including central obesity, high blood pressure, high glucose levels, and abnormal triglycerides and cholesterol, which together increase the chances of heart disease, diabetes, and even death. The rates of MetS are different around the world, with 20-30% in Europe and 21.8-23.9% in Kazakhstan. Because MetS changes over time, it is important to study the dynamics of their components to improve prevention and treatments. This work aims to obtain the incidence of MetS and to evaluate the specific components associated with the emergence of new MetS cases in this population. Methods: This is a longitudinal study with a 10-year follow-up in Turkestan city between 2012 and 2024. Information was collected through physical exams, blood tests, and anthropometric measurements. Logistic regression and ROC curve analysis were used to find which factors increase the incidence of MetS. Results: Among 434 participants analyzed (78.8% women, and mean age 40.87, 66% < 2 MetS components, 20% had MetS blood pressure, and 65.9% had MetS waist circumference), the incidence of MetS at follow-up was 40%. The key risk factors for newly diagnosed MetS included elevated blood pressure and increased waist circumference. Multivariate analyses highlighted these components as the strongest predictors of MetS, with significant associations observed for participants with two or more MetS components at baseline. Conclusions: Elevated blood pressure and central obesity were identified as pivotal contributors to MetS progression. Given the rising prevalence of Mets and its implications, these results show the need to start treatment and check these risks early to prevent serious health problems.