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Pérez S, German-Labaume C, Mathiot S, Goix S, Chamaret P. Using Bayesian networks for environmental health risk assessment. ENVIRONMENTAL RESEARCH 2022; 204:112059. [PMID: 34536371 DOI: 10.1016/j.envres.2021.112059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 09/09/2021] [Accepted: 09/10/2021] [Indexed: 06/13/2023]
Abstract
The study investigated the potential relationships between air pollution, socio-economy, and proven pathologies (e.g., respiratory, cardiovascular) within an industrial area in Southern France (Etang de Berre), gathering steel industries, oil refineries, shipping, road traffic and experiencing a Mediterranean climate. A total of 178 variables were simultaneously integrated within a Bayesian model at intra-urban scale. Various unsupervised and supervised algorithms (maximum spanning tree, tree-augmented naive classifier) as well as sensitivity analyses were used to better understand the links between all variables, and highlighted correlations between population exposure to air pollutants and some pathologies. Adverse health effects (bronchus and lung cancers for 15-65 years old people) were observed for hydrofluoric acid at low background concentration (<0.003 μg m-3) while exposure to particulate cadmium (0.210-0.250 μg m-3) disrupts insulin metabolism for people over 65 years-old leading to diabetes. Bronchus and lung cancers for people over 65 years-old occurred at low background SO2 concentration (6 μg m-3) below European limit values. When benzo[k]fluoranthene exceeded 0.672 μg m-3, we observed a high number of hospital admissions for respiratory diseases for 15-65 years-old people. The study also revealed the important influence of socio-economy (e.g., single-parent family, people with no qualification at 15 years-old) on pathologies (e.g., cardiovascular diseases). Finally, a diffuse polychlorinated biphenyl (PCB) pollution was observed in the study area and can potentially cause lung cancers.
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Affiliation(s)
- Sandra Pérez
- University Côte d'Azur, UMR, 7300, Boulevard E. Herriot, Nice, France.
| | - Catherine German-Labaume
- Centre Intercommunal de l'Action Sociale du Pays de Martigues, Health and Handicap Department, Avenue Louis Sammut, Martigues, France
| | | | - Sylvaine Goix
- Institut Ecocitoyen pour la Connaissance des Pollutions, Centre de vie, La Fossette, Fos-sur-Mer, France
| | - Philippe Chamaret
- Institut Ecocitoyen pour la Connaissance des Pollutions, Centre de vie, La Fossette, Fos-sur-Mer, France
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Amiri S. Obesity and overweight prevalence in immigration: A meta-analysis. OBESITY MEDICINE 2021; 22:100321. [DOI: 10.1016/j.obmed.2021.100321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/28/2023]
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Yezli S, Mushi A, Almuzaini Y, Balkhi B, Yassin Y, Khan A. Prevalence of Diabetes and Hypertension among Hajj Pilgrims: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031155. [PMID: 33525524 PMCID: PMC7908531 DOI: 10.3390/ijerph18031155] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 01/10/2021] [Accepted: 01/15/2021] [Indexed: 02/05/2023]
Abstract
The Hajj mass gathering is attended by over two million Muslims each year, many of whom are elderly and have underlying health conditions. Data on the number of pilgrims with health conditions would assist public health planning and improve health services delivery at the event. We carried out a systematic review of literature based on structured search in the MEDLINE/PubMed, SCOPUS and CINAHL databases, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, to estimate the prevalence of diabetes and hypertension among Hajj pilgrims. Twenty-six studies conducted between 1993 and 2018 with a total of 285,467 participants were included in the review. The weighted pooled prevalence rates of hypertension and diabetes among Hajj pilgrims in all included studies were 12.2% (95% CI: 12.0-12.3) and 5.0% (95% CI: 4.9-5.1), respectively. The reported prevalence of other underlying health conditions such as chronic respiratory, kidney or liver disease, cardiovascular disease, cancer and immune deficiency were generally low. Potentially a large number of pilgrims each Hajj have diabetes and/or hypertension and other underlying health conditions. Hajj could be a great opportunity to reduce the burden of these diseases within the over 180 countries participating in the event by identifying undiagnosed cases and optimizing patients' knowledge and management of their conditions. Prospero registration number: CRD42020171082.
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Affiliation(s)
- Saber Yezli
- The Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh 12341, Saudi Arabia; (A.M.); (Y.A.); (Y.Y.); (A.K.)
- Correspondence:
| | - Abdulaziz Mushi
- The Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh 12341, Saudi Arabia; (A.M.); (Y.A.); (Y.Y.); (A.K.)
| | - Yasir Almuzaini
- The Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh 12341, Saudi Arabia; (A.M.); (Y.A.); (Y.Y.); (A.K.)
| | - Bander Balkhi
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh 12372, Saudi Arabia;
| | - Yara Yassin
- The Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh 12341, Saudi Arabia; (A.M.); (Y.A.); (Y.Y.); (A.K.)
| | - Anas Khan
- The Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh 12341, Saudi Arabia; (A.M.); (Y.A.); (Y.Y.); (A.K.)
- Department of Emergency Medicine, College of Medicine, King Saud University, Riyadh 12372, Saudi Arabia
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Fuentes S, Mandereau-Bruno L, Regnault N, Bernillon P, Bonaldi C, Cosson E, Fosse-Edorh S. Is the type 2 diabetes epidemic plateauing in France? A nationwide population-based study. DIABETES & METABOLISM 2020; 46:472-479. [PMID: 31923577 DOI: 10.1016/j.diabet.2019.12.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 12/19/2019] [Accepted: 12/27/2019] [Indexed: 12/15/2022]
Abstract
AIM Nationwide data on the evolution of diabetes incidence and prevalence are scarce in France. For this reason, our objectives were to determine type 2 diabetes prevalence and incidence rates between 2010 and 2017, stratified by gender, age and region, and to assess annual time trends over the study period in adults aged≥45 years. METHODS Diabetes cases in the National Health Data System (SNDS), which covers the entire French population (66 million people), were identified through a validated algorithm. Gender- and age-specific prevalence and incidence rates were estimated. Negative binomial models, adjusted for gender, age and region, were used to assess annual time trends for prevalence and incidence throughout the study period. RESULTS During 2017, 3,144,225 diabetes cases aged≥45 years were identified. Over the study period, prevalence increased slightly (men from 11.5% to 12.1%, women from 7.9% to 8.4%) whereas incidence decreased (men from 11 to 9.7, women from 7.2 to 6.2 per 1000 person-years). In only four groups did prevalence rates decrease: men aged 45-65 years; women aged 45-60 years; women in Reunion; and women in Martinique. An increasing annual time trend was observed for prevalence (men: +0.9% [95% CI: +0.7%, +1%]; women: +0.4% [95% CI: +0.2%, +0.6%]) with a decreasing annual time trend for incidence in both genders (men: -2.6% [95% CI: -3.1%, -2.0%]; women: -3.9% [95% CI: -4.5%, -3.4%]). CONCLUSION Further efforts towards diabetes prevention are required to ensure that incidence rates in France continue to diminish, as the disorder continues to represent an important public-health burden.
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Affiliation(s)
- S Fuentes
- Santé publique France, the French National Public Health Agency, 12, rue du Val d'Osne, 94415 Saint-Maurice, France.
| | - L Mandereau-Bruno
- Santé publique France, the French National Public Health Agency, 12, rue du Val d'Osne, 94415 Saint-Maurice, France
| | - N Regnault
- Santé publique France, the French National Public Health Agency, 12, rue du Val d'Osne, 94415 Saint-Maurice, France
| | - P Bernillon
- Santé publique France, the French National Public Health Agency, 12, rue du Val d'Osne, 94415 Saint-Maurice, France
| | - C Bonaldi
- Santé publique France, the French National Public Health Agency, 12, rue du Val d'Osne, 94415 Saint-Maurice, France
| | - E Cosson
- Department of diabetology, endocrinology and metabolism, CRNH-IdF, CINFO, Paris 13 university, Sorbonne Paris cité, Avicenne hospital, AP-HP, 93000 Bobigny, France; UMR U1153 Inserm, U1125 Inra, Cnam, Paris 13 university, Sorbonne Paris cité, 93000 Bobigny, France
| | - S Fosse-Edorh
- Santé publique France, the French National Public Health Agency, 12, rue du Val d'Osne, 94415 Saint-Maurice, France
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Tran AT, Berg TJ, Gjelsvik B, Mdala I, Thue G, Cooper JG, Nøkleby K, Claudi T, Bakke Å, Sandberg S, Jenum AK. Ethnic and gender differences in the management of type 2 diabetes: a cross-sectional study from Norwegian general practice. BMC Health Serv Res 2019; 19:904. [PMID: 31779621 PMCID: PMC6883677 DOI: 10.1186/s12913-019-4557-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 09/24/2019] [Indexed: 01/08/2023] Open
Abstract
Background Ethnic minority groups from Asia and Africa living in Western countries have a higher prevalence of type 2 diabetes (T2DM) than the general population. We aimed to assess ethnic differences in diabetes care by gender. Methods Population-based, cross-sectional study identified 10,161 individuals with T2DM cared for by 282 General Practitioners (GP) in Norway. Ethnicity was based on country of birth. Multilevel regression models adjusted for individual and GP factors were applied to evaluate ethnic differences by gender. Results Diabetes was diagnosed at a younger mean age in all other ethnic groups compared with Westerners (men: 45.9–51.6 years vs. 56.4 years, women: 44.9–53.8 years vs. 59.1 years). Among Westerners mean age at diagnosis was 2.7 years higher in women compared with men, while no gender difference in age at diagnosis was found in any minority group. Daily smoking was most common among Eastern European, South Asian and Middle East/North African men. In both genders, we found no ethnic differences in processes of care (GPs’ measurement of HbA1c, blood pressure, LDL-cholesterol, creatinine). The proportion who achieved the HbA1c treatment target was higher in Westerners (men: 62.3%; women: 66.1%), than in ethnic minorities (men 48.2%; women 53.5%). Compared with Western men, the odds ratio (OR) for achieving the target was 0.45 (95% CI 0.27 to 0.73) in Eastern European; 0.67 (0.51 to 0.87) in South Asian and 0.62 (0.43 to 0.88) in Middle Eastern/North African men. Compared with Western women, OR was 0.49 (0.28 to 0.87) in Eastern European and 0.64 (0.47 to 0.86) South Asian women. Compared with Westerners, the blood pressure target was more often achieved in South Asians and Middle Easterners/North Africans in both genders. Small ethnic differences in achieving the LDL-cholesterol treatment target by gender were found. Conclusion Diabetes was diagnosed at a considerably earlier age in both minority men and minority women compared with Westerners. Several minority groups had worse glycaemic control compared with Westerners in both genders, which implies that it is necessary to improve glucose lowering treatment for the minority groups. Smoking cessation advice should particularly be offered to men in most minority groups.
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Affiliation(s)
- Anh Thi Tran
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway.
| | - Tore Julsrud Berg
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Bjørn Gjelsvik
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Ibrahimu Mdala
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Geir Thue
- Norwegian Quality Improvement of Laboratory Examinations, Haraldsplass Deaconess Hospital, Bergen, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - John Graham Cooper
- Norwegian Quality Improvement of Laboratory Examinations, Haraldsplass Deaconess Hospital, Bergen, Norway.,Department of Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Kjersti Nøkleby
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Tor Claudi
- Department of Medicine, Nordland Hospital, Bodø, Norway
| | - Åsne Bakke
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Department of Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Sverre Sandberg
- Norwegian Quality Improvement of Laboratory Examinations, Haraldsplass Deaconess Hospital, Bergen, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Department of Clinical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
| | - Anne Karen Jenum
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway.,General Practice Research Unit (AFE), Department of General Practice, University of Oslo, Institute of Health and Society, Post Box 1130, Blindern, 0318, Oslo, Norway
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Alloh FT, Hemingway A, Turner-Wilson A. Systematic review of diabetes management among black African immigrants, white and South Asian populations. JOURNAL OF GLOBAL HEALTH REPORTS 2019. [DOI: 10.29392/joghr.3.e2019020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Liu L, Guan X, Yuan Z, Zhao M, Li Q, Zhang X, Zhang H, Zheng D, Xu J, Gao L, Guan Q, Zhao J. Different Contributions of Dyslipidemia and Obesity to the Natural History of Type 2 Diabetes: 3-Year Cohort Study in China. J Diabetes Res 2019; 2019:4328975. [PMID: 30949514 PMCID: PMC6425409 DOI: 10.1155/2019/4328975] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Accepted: 11/05/2018] [Indexed: 01/08/2023] Open
Abstract
AIM It is known that different stages of type 2 diabetes represent distinct pathophysiological changes, but how the spectrum of risk factors varies at different stages is not yet clarified. Hence, the aim of this study was to compare the effect of different metabolic variables on the natural history of type 2 diabetes. METHODS A total of 5,213 nondiabetic (normal glucose tolerance (NGT) and prediabetes) Chinese older than 40 years participated this prospective cohort study, and 4,577 completed the 3-year follow-up. Glycemic status was determined by standard oral glucose tolerance test both at enrollment and follow-up visit. Predictors for conversion in glycemic status were studied in a corresponding subcohort using the multiple logistic regression analysis. RESULTS The incidence of prediabetes and diabetes of the cohort was 93.6 and 42.2 per 1,000 person-years, respectively. After a 3-year follow-up, 33.1% of prediabetes patients regressed to NGT. The predictive weight of body mass index (BMI), serum triglyceride, total cholesterol, and systolic blood pressure in different paths of conversions among diabetes, prediabetes, and NGT differed. Specifically, BMI was the strongest predictor for regression from prediabetes to NGT, while triglyceride was most prominent for onset of diabetes. One SD increase in serum triglyceride was associated with a 1.29- (95% CI 1.10-1.52; P = 0.002) or 1.12- (95% CI 1.01-1.27; P = 0.039) fold higher risk of diabetes for individuals with NGT or prediabetes, respectively. CONCLUSION Risk factors for different stages of diabetes differed, suggesting personalized preventive strategies for individuals with different basal glycemic statuses.
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Affiliation(s)
- Lu Liu
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, China
- Shandong Clinical Medical Center of Endocrinology and Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, 250021, China
- Department of Senior Officials Health Care, China-Japan Friendship Hospital, 100029, China
| | - Xiaoling Guan
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, China
- Shandong Clinical Medical Center of Endocrinology and Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, 250021, China
- Department of Endocrinology, Shandong Provincial Qianfoshan Hospital, Shandong University, 250014, China
| | - Zhongshang Yuan
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, 250012, China
| | - Meng Zhao
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, China
- Shandong Clinical Medical Center of Endocrinology and Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, 250021, China
| | - Qiu Li
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, China
- Shandong Clinical Medical Center of Endocrinology and Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, 250021, China
| | - Xu Zhang
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, China
- Shandong Clinical Medical Center of Endocrinology and Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, 250021, China
| | - Haiqing Zhang
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, China
- Shandong Clinical Medical Center of Endocrinology and Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, 250021, China
| | - Dongmei Zheng
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, China
- Shandong Clinical Medical Center of Endocrinology and Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, 250021, China
| | - Jin Xu
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, China
- Shandong Clinical Medical Center of Endocrinology and Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, 250021, China
| | - Ling Gao
- Shandong Clinical Medical Center of Endocrinology and Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, 250021, China
- Scientific Center, Shandong Provincial Hospital Affiliated to Shandong University, 250021, China
| | - Qingbo Guan
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, China
- Shandong Clinical Medical Center of Endocrinology and Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, 250021, China
| | - Jiajun Zhao
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, China
- Shandong Clinical Medical Center of Endocrinology and Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, 250021, China
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Diverging patterns of cardiovascular diseases across immigrant groups in Northern Italy. Int J Cardiol 2017; 254:362-367. [PMID: 29246427 DOI: 10.1016/j.ijcard.2017.12.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 11/15/2017] [Accepted: 12/05/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND Only fragmentary data are available on the burden of non-communicable diseases among immigrants in Europe, mostly limited to mortality by cause. Aim of the study is to investigate the prevalence of cardiovascular diseases across different immigrant groups in the Veneto Region (North-Eastern Italy). METHODS The resident population aged 20-59 was classified according to country of citizenship. The Adjusted Clinical Groups System was adopted to identify selected cardiovascular conditions by linkage of Hospital Discharge Records, Emergency Room visits, Chronic disease registry for copayment exemptions, the Home care database, and drugs reimbursed by the Regional Health Service. Age standardized prevalence rates were compared across population groups, and rate ratios (RR) with 95% confidence intervals (CI) were computed taking the Italian population as reference. RESULTS The prevalence of diabetes was higher across all immigrant groups compared to Italians. Specific risk patterns could be identified associated to different ethnicities: South Asian immigrants were at very high risk of diabetes, dyslipidemia, and ischemic heart disease (males RR 2.3, CI 1.9-2.8; females RR 2.0, CI 1.2-3.5). Immigrants from Africa were affected by high rates of hypertension, cerebrovascular diseases, and heart failure, with a more pronounced unfavorable profile among females (hypertension RR 3.0, CI 2.6-3.3; cerebrovascular diseases RR 1.7, CI 1.1-2.7). CONCLUSIONS Wide differences in the prevalence of cardiovascular diseases could be detected across immigrant groups. These findings represent a first step towards systematic chronic disease surveillance by ethnicity, a fundamental tool for shaping culturally-tailored prevention strategies.
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Shen JZ, Ge WH, Fang Y, Liu H. A novel polymorphism in protein kinase AMP-activated catalytic subunit alpha 2 (PRKAA2) is associated with type 2 diabetes in the Han Chinese population. J Diabetes 2017; 9:606-612. [PMID: 27427333 DOI: 10.1111/1753-0407.12449] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 05/24/2016] [Accepted: 07/12/2016] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND It has been proposed that the energy-sensing enzyme AMP-activated protein kinase (AMPK) is a key agent in the pathophysiology of type 2 diabetes mellitus (T2DM). The gene encoding protein kinase AMP-activated catalytic subunit alpha 2 (PRKAA2) is located at one of the Asian T2DM loci (1p32). Therefore, the aim of the present study was to test for the association of common variants in PRKAA2 with T2DM in the Han Chinese population. METHODS We genotyped 221 T2DM patients and 111 controls to assess possible associations of two tagging single nucleotide polymorphisms (tSNPs) in the PRKAA2 gene with T2DM. RESULTS The clinical characteristics of T2DM cases compared with controls differed significantly. No significant association was observed with the rs2143754 polymorphism whereas the rs2746342 polymorphism exhibited a highly significant association with T2DM. Fasting plasma glucose (FPG) of subjects carrying the G/G genotype of the rs2746342 polymorphism was higher than that of subjects carrying the T allele (P = 0.0049). These associations were magnified in the presence of the G/G genotype of the rs2143754 polymorphism. CONCLUSIONS The rs2746342 polymorphism is significantly associated with susceptibility to T2DM and seems to interact with the rs2143754 polymorphism in the modulation of FPG in the Han Chinese population.
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Affiliation(s)
- Ji-Zhong Shen
- Department of Pharmacy, Drum Tower Hospital Affiliated to Medical School of Nanjing University, Nanjing, China
| | - Wei-Hong Ge
- Department of Pharmacy, Drum Tower Hospital Affiliated to Medical School of Nanjing University, Nanjing, China
| | - Yun Fang
- Department of Pharmacy, Drum Tower Hospital Affiliated to Medical School of Nanjing University, Nanjing, China
| | - Hang Liu
- Department of Pharmacy, Drum Tower Hospital Affiliated to Medical School of Nanjing University, Nanjing, China
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Migrant adults with diabetes in France: Influence of family migration. JOURNAL OF CLINICAL AND TRANSLATIONAL ENDOCRINOLOGY 2016; 7:28-32. [PMID: 29067247 PMCID: PMC5651293 DOI: 10.1016/j.jcte.2016.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 12/07/2016] [Accepted: 12/08/2016] [Indexed: 11/24/2022]
Abstract
There is a high prevalence of poorly controlled diabetes in migrants. Family gathering is associated with a better control of diabetes. Exploration of migration’ story is important in the health care process.
Aim To explore the influence of migration and this parameters on the control of diabetes. Methods A cohort of migrant patients with type 2 diabetes was recruited in a center affiliated to the French national insurance system situated in a department with important migratory phenomenon. Patients fulfilled a questionnaire about diabetes, their migration history, and the EPICES score (deprivation score). We have explored by univariate and multivariate analysis if any of the characteristics of migration could be related to the control of diabetes. This cohort was compared to a non-migrant control group of age and sex-matched patients. Results We included 72 patients, 36 women and 36 men from 20 different countries. The mean age was 57.7 ± 9.6 years. A migration for family reunification was associated with better diabetes equilibrium (Risk of having an HbA1c ⩾8% (63.9 mmol/mol): OR 0.07 (95% IC [0.005–0.86], p = 0.04). The migrant patients who wished to share their time between France and country of origin during their retirement had a better glycaemic control than the migrant patients who would like to go alone into their country (OR 0.08 [0.01–0.78], p = 0.03). Compared to the non migrant group, the EPICES score was higher in the migrant group (52.8 vs. 28.3, p < 0.05), HbA1c was also higher in the migrant group (8.4 vs. 6.7% (68 vs. 50 mmol/mol)). Conclusions We may fear that migrants share an increased risk of uncontrolled diabetes. Individual migration could be a risk factor of uncontrolled diabetes. Knowing the migration history of migrant patients is fundamental to understand some barriers of care.
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Sarría-Santamera A, Hijas-Gómez AI, Carmona R, Gimeno-Feliú LA. A systematic review of the use of health services by immigrants and native populations. Public Health Rev 2016; 37:28. [PMID: 29450069 PMCID: PMC5810113 DOI: 10.1186/s40985-016-0042-3] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 11/09/2016] [Indexed: 12/02/2022] Open
Abstract
Background Changes in migration patterns that have occurred in recent decades, both quantitative, with an increase in the number of immigrants, and qualitative, due to different causes of migration (work, family reunification, asylum seekers and refugees) require constant u pdating of the analysis of how immigrants access health services. Understanding of the existence of changes in use patterns is necessary to adapt health services to the new socio-demographic reality. The aim of this study is to describe the scientific evidence that assess the differences in the use of health services between immigrant and native populations. Methods A systematic review of the electronic database MEDLINE (PubMed) was conducted with a search of studies published between June 2013 and February 2016 that addressed the use of health services and compared immigrants with native populations. MeSH terms and key words comprised Health Services Needs and Demands/Accessibility/Disparities/Emigrants and Immigrants/Native/Ethnic Groups. The electronic search was supplemented by a manual search of grey literature. The following information was extracted from each publication: context of the study (place and year), characteristics of the included population (definition of immigrants and their sub-groups), methodological domains (design of the study, source of information, statistical analysis, variables of health care use assessed, measures of need, socio-economic indicators) and main results. Results Thirty-six publications were included, 28 from Europe and 8 from other countries. Twenty-four papers analysed the use of primary care, 17 the use of specialist services (including hospitalizations or emergency care), 18 considered several levels of care and 11 assessed mental health services. The characteristics of immigrants included country of origin, legal status, reasons for migration, length of stay, different generations and socio-demographic variables and need. In general, use of health services by the immigrants was less than or equal to the native population, although some differences between immigrants were also identified. Conclusions This review has identified that immigrants show a general tendency towards a lower use of health services than native populations and that there are significant differences within immigrant sub-groups in terms of their patterns of utilization. Further studies should include information categorizing and evaluating the diversity within the immigrant population.
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Affiliation(s)
- Antonio Sarría-Santamera
- Red de Investigación en Servicios de Salud y Enfermedades Crónicas, Madrid, Spain.,2National School of Public Health, Institute of Health Carlos III, Madrid, Spain.,IMIENS, UNED, Madrid, Spain.,4Faculty of Medicine, University of Alcalá, Alcalá, Spain
| | - Ana Isabel Hijas-Gómez
- University Hospital Fundación Alcorcón, Alcorcón, Spain.,6Agency for Health Technology Assessment, Institute of Health Carlos III, Madrid, Spain
| | - Rocío Carmona
- 2National School of Public Health, Institute of Health Carlos III, Madrid, Spain.,IMIENS, UNED, Madrid, Spain
| | - Luís Andrés Gimeno-Feliú
- Red de Investigación en Servicios de Salud y Enfermedades Crónicas, Madrid, Spain.,7EpiChron Research Group on Chronic Diseases, Aragon Health Sciences Institute (IACS), IIS Aragón, Zaragoza, Spain.,San Pablo Health Centre, Aragonese Health Service, Zaragoza, Spain.,9Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain
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12
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Fosse-Edorh S, Fagot-Campagna A, Detournay B, Bihan H, Eschwege E, Gautier A, Druet C. Impact of socio-economic position on health and quality of care in adults with Type 2 diabetes in France: the Entred 2007 study. Diabet Med 2015; 32:1438-44. [PMID: 25884777 DOI: 10.1111/dme.12783] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/15/2015] [Indexed: 11/26/2022]
Abstract
AIM To describe the association between socio-economic position, health status and quality of diabetes care in people with Type 2 diabetes in France, where people may receive full healthcare coverage for chronic disease. METHODS Data from a national cross-sectional survey performed in people pharmacologically treated for diabetes were used. They combined data from medical claims, hospital discharge, questionnaires for patients (n = 3894 with Type 2 diabetes) and their physicians (n = 2485). Socio-economic position was assessed using educational level (low, intermediate, high) and ability to make ends meet (financial difficulties vs. financially comfortable). RESULTS People with diabetes reporting financial difficulties were more likely to be smokers (adjusted odds ratio 1.4; 95% CI 1.1-1.6) and obese (adjusted odds ratio 1.3; 95% CI 1.2-1.6) and to have poorer glycaemic control (HbA1c > 64 mmol/mol (8%); adjusted odds ratio 1.4; 95% CI 1.1-1.8), than those who were financially comfortable. They were more likely to have their diabetes diagnosed because of complications (adjusted odds ratio 1.6; 95% CI 1.3-2.0). They were also more likely to have coronary and podiatric complications (adjusted odds ratios 1.3; 95% CI 1.1-1.6 and 1.7; 95% CI 1.4-2.2, respectively). They benefited more often from full coverage (adjusted odds ratio 1.3; 95% CI 1.1-1.6), visited general practitioners more often (ratio of estimated marginal means 1.2; 95% CI 1.1-1.2) but specialists less often (adjusted odds ratio 0.7; 95% CI 0.6-0.8 for a visit to private ophthalmologist). They also felt less well informed about their condition. CONCLUSIONS Despite frequent access to full healthcare coverage, socio-economic position has an impact on the diagnosis of diabetes, health status and quality of diabetes care in France.
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Affiliation(s)
- S Fosse-Edorh
- Department of Chronic Diseases and Injuries, French Institute for Public Health Surveillance, Saint-Maurice, France
| | - A Fagot-Campagna
- Strategy and Research Department, National Health Insurance, Île-de-France, Paris, France
| | | | - H Bihan
- Department of Endocrinology, Diabetology and Metabolic Disease, Avicenne Hospital, Paris XIII University and Assistance Publique-Hôpitaux de Paris, Bobigny, France
| | | | - A Gautier
- National Institute for Prevention and Health Education, Saint-Denis, France
| | - C Druet
- Department of Chronic Diseases and Injuries, French Institute for Public Health Surveillance, Saint-Maurice, France
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13
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Fedeli U, Casotto V, Ferroni E, Saugo M, Targher G, Zoppini G. Prevalence of diabetes across different immigrant groups in North-eastern Italy. Nutr Metab Cardiovasc Dis 2015; 25:924-930. [PMID: 26231618 DOI: 10.1016/j.numecd.2015.06.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 05/25/2015] [Accepted: 06/24/2015] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND AIMS Type 2 diabetes, one of the most important non-communicable diseases, represents a major health problem worldwide. Immigrants may contribute relevantly to the increase in diabetes. The aim of the study was to investigate variability in diabetes prevalence across different immigrant groups in the Veneto Region (northeastern Italy). METHODS AND RESULTS Diabetic subjects on January 2013 were identified by record linkage of hospital discharge records, drug prescriptions, and exemptions from medical charges for diabetes. Immigrant groups were identified based on citizenship. Age-standardized prevalence rates were obtained for residents aged 20-59 years by the direct method, taking the whole regional population as reference. Prevalence rate ratios (RR) with 95% Confidence Intervals (CI) were computed with respect to Italian citizens. Among residents aged 20-59 years, 45280 Italian and 7782 foreign subjects affected by diabetes were identified. Prevalence rates were highest among immigrants from South-East Asia, RR 4.9 (CI 4.7-5.1) among males, and 7.6 (7.2-8.1) among females, followed by residents from both North and Sub-Saharan Africa. Citizens from Eastern Europe (the largest immigrant group) showed rates similar to Italians. Most South-Asian patients aged 20-39 years were not insulin-treated, suggesting a very high risk of early onset type 2 diabetes in this ethnic group. CONCLUSION Large variations in diabetes prevalence by ethnicity should prompt tailored strategies for primary prevention, diabetes screening, and disease control. An increased demand for prevention and health care in selected population groups should guide appropriate resource allocation.
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Affiliation(s)
- U Fedeli
- Epidemiological Department, Veneto Region, Italy
| | - V Casotto
- Epidemiological Department, Veneto Region, Italy
| | - E Ferroni
- Epidemiological Department, Veneto Region, Italy
| | - M Saugo
- Epidemiological Department, Veneto Region, Italy
| | - G Targher
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona, Italy
| | - G Zoppini
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona, Italy.
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14
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Adeniyi OV, Longo-Mbenza B, Ter Goon D. Female sex, poverty and globalization as determinants of obesity among rural South African type 2 diabetics: a cross-sectional study. BMC Public Health 2015; 15:298. [PMID: 25880927 PMCID: PMC4380244 DOI: 10.1186/s12889-015-1622-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Accepted: 03/09/2015] [Indexed: 02/06/2023] Open
Abstract
Background Countries in Sub-Saharan Africa have recently been experiencing increases in the prevalence of obesity, type 2 diabetes mellitus (T2DM) and other non-communicable diseases in both urban and rural areas. Despite their growing influence on population health in the region, there is a paucity of epidemiological studies on the twin epidemic of obesity and T2DM, particularly in the rural communities in South Africa. We investigated the prevalence and the determinants of overall obesity among patients with T2DM in rural and semi-urban areas surrounding the town of Mthatha, South Africa. Methods This hospital-based cross-sectional study was conducted among patients with T2DM attending the outpatient department at Mthatha General Hospital, Eastern Cape Province, South Africa. Data were obtained from 327 participants using standardized questionnaires that included items on sex, age, level of education, type of residence, employment status, smoking status, physical activity, diet and alcohol intake. After taking measurements of height and weight, participants were defined as obese if their body mass index exceeded 30 kg/m2. Univariate and multivariate logistic regression analyses were performed to identify the determinants of obesity in our sample population. Results We found that 60.2% of our sample population were defined as obese. In our univariate analyses, female sex (p < 0.001), age ≥50 years (p = 0.023), rural residence (p < 0.001), excessive alcohol intake (p = 0.002), current cigarette smoking (p < 0.001), level of education (p < 0.001), regular consumption of soft drinks (p < 0.001) and unemployment (p = 0.043) were found to be positively and significantly associated with obesity. In the multivariate logistic regression analysis, female sex (p < 0.001), unemployment (p = 0.012) and level of education (p < 0.001) were found to be independent determinants of obesity. Conclusion We found that female sex, educational attainment, unemployment and current cigarette smoking were positively associated with obesity among the study participants. Lifestyle changes, poverty reduction and public education are urgently needed to address the growing obesity epidemic in rural areas of South Africa.
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Affiliation(s)
- Oladele Vincent Adeniyi
- Department of Family Medicine, Senior Specialist, Faculty of Health Sciences, Walter Sisulu University, Cecilia Makiwane Hospital, East London Hospital Complex, Private Bag X 9047, Mdantsane, East London, South Africa, 5200.
| | - Benjamin Longo-Mbenza
- Department of Community Medicine, Research Champion Professor, Faculty of Health Sciences, Walter Sisulu University, Private Bag X1, Mthatha, South Africa, 5117.
| | - Daniel Ter Goon
- Department of Nursing Science, Senior Researcher, School of Health Sciences, University of Fort Hare, Private Bag X9083, East London, South Africa, 5201.
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15
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Ballotari P, Caroli S, Ferrari F, Romani G, Marina G, Chiarenza A, Manicardi V, Giorgi Rossi P. Differences in diabetes prevalence and inequalities in disease management and glycaemic control by immigrant status: a population-based study (Italy). BMC Public Health 2015; 15:87. [PMID: 25884923 PMCID: PMC4334763 DOI: 10.1186/s12889-015-1403-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 01/12/2015] [Indexed: 11/29/2022] Open
Abstract
Background The diabetes prevalence increases at an alarming rate around the world and understanding disparities in occurrence, care management, and health outcomes may be a starting point towards achieving more effective strategies to prevent and manage it. The aims of this study are to compare immigrants and Italians in terms of the differences in diabetes prevalence and to evaluate inequalities in disease management and glycaemic control by using information included in Reggio Emilia diabetes register. Methods We retrieved from the diabetes register subjects aged 20–74 on December 31st, 2009. Using citizenship, we created three main groups: Italy, High Developed Countries (HDC), and High Migration Pressure Countries (HMPC). These were split into sub-regions of origin. We calculated age-adjusted prevalence by gender and sub-region. Using logistic regression model, we analyzed the association between area of origin and following indicators: 1) not being in care of diabetes clinics; 2) not having glycated haemoglobin (HbA1c) test in 2010; 3) among those tested, having a HbA1c value > = 9% (75 mmol/mol). Results We found 15,889 Italian and 1,295 HMPC citizens with diabetes. HMPC citizens had higher age-adjusted prevalence of diabetes than Italians (females 5.0% vs 3.6%; males 6.5% vs 5.5%). The excess was mostly due to a strong excess in immigrants from Southern Asia (females 9.7%, males 10.2%) and Northern Africa (females 9.3%, males 5.9%). HMPC citizens were cared for by diabetes clinics in a similar proportion than Italians (OR: 1.08; 95% CI: 0.93-1.25), but had a greater odds of not being tested for HbA1c (OR: 1.51; 95% CI: 1.34-1.71), as well as of having HbA1c values equal to or over 9% (OR: 2.06; 95% CI: 1.80-3.14). The outcomes were poorer in HMPC females for the first two outcomes, while there was no difference for the HbA1c values (Wald test for heterogeneity p = 0.0850; p = 0.0156; p = 0.6635, respectively). Conclusions Our findings highlight the need for gender-oriented actions for prevention and early diagnosis of the diabetes to contrast the higher risk in Northern Africans and Southern Asians. Further studies are required to determine whether the protocols in use are adequate for different immigrant groups. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-1403-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Paola Ballotari
- Servizio Interaziendale di Epidemiologia, Local Health Authority, Via Amendola 2, Reggio Emilia, Italy. .,IRCCS, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.
| | - Stefania Caroli
- Servizio Interaziendale di Epidemiologia, Local Health Authority, Via Amendola 2, Reggio Emilia, Italy. .,IRCCS, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.
| | - Francesca Ferrari
- Servizio Interaziendale di Epidemiologia, Local Health Authority, Via Amendola 2, Reggio Emilia, Italy. .,IRCCS, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.
| | | | - Greci Marina
- Primary Health Care, Local Health Authority, Reggio Emilia, Italy.
| | - Antonio Chiarenza
- Research and Innovation Unit, Local Health Authority, Reggio Emilia, Italy.
| | - Valeria Manicardi
- Department of Internal Medicine, Hospital of Montecchio, Local Health Authority, Reggio Emilia, Italy.
| | - Paolo Giorgi Rossi
- Servizio Interaziendale di Epidemiologia, Local Health Authority, Via Amendola 2, Reggio Emilia, Italy. .,IRCCS, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.
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