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Moosazadeh M, Ebrahimnejad P, Sohrab M, Rafiei A, Abastabar M, Khazaee-Pool M, Mahboubi S, Kheradmand M. Undiagnosed hypertension and diabetes mellitus in the Tabari cohort: a population-based study. BMC Public Health 2024; 24:3199. [PMID: 39558296 PMCID: PMC11571944 DOI: 10.1186/s12889-024-20701-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 11/11/2024] [Indexed: 11/20/2024] Open
Abstract
BACKGROUND Undiagnosed hypertension (HTN) and diabetes mellitus (DM) are major public health challenges worldwide. We aimed to investigate the prevalence of undiagnosed HTN and DM, and their correlates, in a large-scale population-based cohort study. METHODS In this cross-sectional study, data collected during the enrollment phase of the Tabari Cohort study (TCS) were utilized. Data were collected in the TCS using a standard questionnaire, blood collection, and measurement of anthropometric indices and blood pressure. Data were analyzed using the chi-squared test and univariate and multivariate logistic regression analyses. Undiagnosed HTN included those who were not aware of HTN at the time of enrollment but had systolic and diastolic blood pressures ≥ 140 mm or ≥ 90 mmHg, respectively. Undiagnosed DM included participants who were unaware of their DM at the time of enrollment and had FBS levels ≥ 126 mg/dL. RESULTS The total prevalence of undiagnosed HTN and DM were 5% (508) and 4.7% (485), respectively. The findings of multivariable logistic regression analysis showed that young age (OR: 0.40, P < 0.001), residents of urban regions (OR: 0.70, P = 0.03), lower Body Mass Index kg/m2 (BMI) (OR: 0.51, P = 0.002), waist-to-hip ratio (WHR)(OR: 0.70, P = 0.023), total cholesterol (TC) ≥ 200 mg/dL (OR: 0.1.83, P < 0.001), lack of history of DM (OR: 0.38,P < 0.001), cardiovascular diseases (CVD)(OR: 0.12, P < 0.001), and lack of a positive family history of HTN in first-(OR: 0.39, P < 0.001) and second-degree(OR: 0.56, P = 0.009) relatives were the main predictors of undiagnosed HTN. Accordingly, male sex(OR: 0.52, P = 0.004), young age(OR: 0.28, P < 0.001), residence in urban regions(OR: 0.30, P < 0.001), BMI ≥ 30 (OR: 1.51, P = 0.044), low-density lipoprotein (LDL) ≥ 130 mg/dL (OR:1.93, P < 0.001), TC ≥ 200 mg/dL (95% CI, 1.47-2.51, P < 0.001), positive history of chronic kidney disease (OR:1.39, P = 0.010 ), and lack of family history of first-(OR: 0.38, P < 0.001) and second-degree (OR: 0.62, P < 0.015) DM were the main predictors of undiagnosed DM. CONCLUSION Overall, younger participants, those residing in urban areas, those with TC ≥ 200 mg/dL, and those without a positive family history of HTN or DM were at a greater risk of undiagnosed HTN/DM.
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Affiliation(s)
- Mahmood Moosazadeh
- Gastrointestinal Cancer Research Center, Non- Communicable Diseases Research Institute, Mazandaran University of Medical Sciences, Mazandaran, Iran
| | - Pedram Ebrahimnejad
- Department of Pharmaceutics, Pharmaceutical Sciences Research Center, Hemoglobinopathy Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mehrnoush Sohrab
- Department of Internal Medicine, Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Alireza Rafiei
- Department of Immunology, School of Medicine, Molecular and Cell Biology Research Center, Hemoglobinopathy Institute, Mazandaran University of Medical Sciences, Mazandaran, Iran
| | - Mahdi Abastabar
- Department of Medical Mycology, School of Medicine, Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Maryam Khazaee-Pool
- Department of Public Health, School of Health, Health Sciences Research Center, Associate Professor of Health Education and Promotion, Mazandaran University of Medical Sciences, Sari, Iran
| | - Shamim Mahboubi
- Deputy of Research and Technology, Mazandaran University of Medical Sciences, Sari, Iran
| | - Motahareh Kheradmand
- Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
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Mitchell CM, Davy BM, Ponder MA, McMillan RP, Hughes MD, Hulver MW, Neilson AP, Davy KP. Prebiotic Inulin Supplementation and Peripheral Insulin Sensitivity in adults at Elevated Risk for Type 2 Diabetes: A Pilot Randomized Controlled Trial. Nutrients 2021; 13:nu13093235. [PMID: 34579112 PMCID: PMC8471706 DOI: 10.3390/nu13093235] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/01/2021] [Accepted: 09/03/2021] [Indexed: 12/28/2022] Open
Abstract
Prediabetes affects 84.1 million adults, and many will progress to type 2 diabetes (T2D). The objective of this proof-of-concept trial was to determine the efficacy of inulin supplementation to improve glucose metabolism and reduce T2D risk. Adults (n = 24; BMI: 31.3 ± 2.9 kg/m2; age: 54.4 ± 8.3 years) at risk for T2D were enrolled in this controlled feeding trial and consumed either inulin (10 g/day) or placebo (maltodextrin, 10 g/day) for six weeks. Assessments included peripheral insulin sensitivity, fasting glucose, and insulin, HOMA-IR, in vivo skeletal muscle substrate preference, Bifidobacteria copy number, intestinal permeability, and endotoxin concentrations. Participant retention was 92%. There were no baseline group differences except for fasting insulin (p = 0.003). The magnitude of reduction in fasting insulin concentrations with inulin (p = 0.003, inulin = Δ-2.9, placebo = Δ2.3) was attenuated after adjustment for baseline concentrations (p = 0.04). After adjusting for baseline values, reduction in HOMA-IR with inulin (inulin = Δ-0.40, placebo=Δ0.27; p = 0.004) remained significant. Bifidobacteria 16s increased (p = 0.04; inulin = Δ3.1e9, placebo = Δ-8.9e8) with inulin supplementation. Despite increases in gut Bifidobacteria, inulin supplementation did not improve peripheral insulin sensitivity. These findings question the need for larger investigations of inulin and insulin sensitivity in this population.
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Affiliation(s)
- Cassie M. Mitchell
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA 24061, USA; (C.M.M.); (B.M.D.); (R.P.M.); (M.W.H.)
- Translational Obesity Research Interdisciplinary Graduate Education Program, Virginia Tech, Blacksburg, VA 24061, USA;
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ 85016, USA
| | - Brenda M. Davy
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA 24061, USA; (C.M.M.); (B.M.D.); (R.P.M.); (M.W.H.)
- Translational Obesity Research Interdisciplinary Graduate Education Program, Virginia Tech, Blacksburg, VA 24061, USA;
| | - Monica A. Ponder
- Translational Obesity Research Interdisciplinary Graduate Education Program, Virginia Tech, Blacksburg, VA 24061, USA;
- Department of Food Science and Technology, Virginia Tech, Blacksburg, VA 24060, USA;
| | - Ryan P. McMillan
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA 24061, USA; (C.M.M.); (B.M.D.); (R.P.M.); (M.W.H.)
| | - Michael D. Hughes
- Department of Food Science and Technology, Virginia Tech, Blacksburg, VA 24060, USA;
| | - Matthew W. Hulver
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA 24061, USA; (C.M.M.); (B.M.D.); (R.P.M.); (M.W.H.)
- Translational Obesity Research Interdisciplinary Graduate Education Program, Virginia Tech, Blacksburg, VA 24061, USA;
| | - Andrew P. Neilson
- Plants for Human Health Institute, North Carolina Research Campus, North Carolina State University, Kannapolis, NC 28081, USA;
| | - Kevin P. Davy
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA 24061, USA; (C.M.M.); (B.M.D.); (R.P.M.); (M.W.H.)
- Translational Obesity Research Interdisciplinary Graduate Education Program, Virginia Tech, Blacksburg, VA 24061, USA;
- Correspondence:
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3
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Akhavan NS, Pourafshar S, Johnson SA, Foley EM, George KS, Munoz J, Siebert S, Clark EA, Basiri R, Hickner RC, Navaei N, Levenson CW, Panton LB, Daggy BP, Arjmandi BH. The Relationship between Protein Intake and Source on Factors Associated with Glycemic Control in Individuals with Prediabetes and Type 2 Diabetes. Nutrients 2020; 12:nu12072031. [PMID: 32650580 PMCID: PMC7400940 DOI: 10.3390/nu12072031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 06/23/2020] [Accepted: 07/03/2020] [Indexed: 11/17/2022] Open
Abstract
Type 2 diabetes (T2D) is a major contributor to morbidity and mortality largely due to increased cardiovascular disease risk. This study examined the relationships among protein consumption and sources on glycemic control and cardiovascular health in individuals with prediabetes and T2D. Sixty-two overweight or obese participants with prediabetes or T2D, aged 45–75 years were stratified into the following three groups based on protein intake: <0.8 g (gram)/kg (kilogram) body weight (bw), ≥0.8 but <1.0 g/kg bw, and ≥1.0 g/kg bw as below, meeting, and above the recommended levels of protein intake, respectively. Body mass, body mass index (BMI), hip circumference (HC), waist circumference (WC), lean mass, and fat mass (FM) were significantly higher in participants who consumed below the recommended level of protein intake as compared with other groups. Higher animal protein intake was associated with greater insulin secretion and lower triglycerides (TG). Total, low-density, and high-density cholesterol were significantly higher in participants who met the recommended protein intake as compared with the other groups. These data suggest that high protein consumption is associated with lower BMI, HC, WC, and FM, and can improve insulin resistance without affecting lipid profiles in this population. Furthermore, higher intake of animal protein can improve β-cell function and lower plasma TG.
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Affiliation(s)
- Neda S. Akhavan
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32304, USA; (N.S.A.); (E.M.F.); (J.M.); (S.S.); (E.A.C.); (R.B.); (R.C.H.); (L.B.P.); (B.P.D.)
- Center for Advancing Exercise and Nutrition Research on Aging, Florida State University, Tallahassee, FL 32304, USA; (S.P.); (K.S.G.); (N.N.)
| | - Shirin Pourafshar
- Center for Advancing Exercise and Nutrition Research on Aging, Florida State University, Tallahassee, FL 32304, USA; (S.P.); (K.S.G.); (N.N.)
- Department of Medicine, Division of Nephrology, University of Virginia, Charlottesville, VA 22903, USA
| | - Sarah A. Johnson
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO 80526, USA;
| | - Elizabeth M. Foley
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32304, USA; (N.S.A.); (E.M.F.); (J.M.); (S.S.); (E.A.C.); (R.B.); (R.C.H.); (L.B.P.); (B.P.D.)
- Center for Advancing Exercise and Nutrition Research on Aging, Florida State University, Tallahassee, FL 32304, USA; (S.P.); (K.S.G.); (N.N.)
| | - Kelli S. George
- Center for Advancing Exercise and Nutrition Research on Aging, Florida State University, Tallahassee, FL 32304, USA; (S.P.); (K.S.G.); (N.N.)
- Division of Animal and Nutritional Sciences, West Virginia University, Morgantown, WV 26506, USA
| | - Joseph Munoz
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32304, USA; (N.S.A.); (E.M.F.); (J.M.); (S.S.); (E.A.C.); (R.B.); (R.C.H.); (L.B.P.); (B.P.D.)
- Center for Advancing Exercise and Nutrition Research on Aging, Florida State University, Tallahassee, FL 32304, USA; (S.P.); (K.S.G.); (N.N.)
| | - Shalom Siebert
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32304, USA; (N.S.A.); (E.M.F.); (J.M.); (S.S.); (E.A.C.); (R.B.); (R.C.H.); (L.B.P.); (B.P.D.)
- Center for Advancing Exercise and Nutrition Research on Aging, Florida State University, Tallahassee, FL 32304, USA; (S.P.); (K.S.G.); (N.N.)
| | - Elizabeth A. Clark
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32304, USA; (N.S.A.); (E.M.F.); (J.M.); (S.S.); (E.A.C.); (R.B.); (R.C.H.); (L.B.P.); (B.P.D.)
- Center for Advancing Exercise and Nutrition Research on Aging, Florida State University, Tallahassee, FL 32304, USA; (S.P.); (K.S.G.); (N.N.)
| | - Raedeh Basiri
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32304, USA; (N.S.A.); (E.M.F.); (J.M.); (S.S.); (E.A.C.); (R.B.); (R.C.H.); (L.B.P.); (B.P.D.)
- Center for Advancing Exercise and Nutrition Research on Aging, Florida State University, Tallahassee, FL 32304, USA; (S.P.); (K.S.G.); (N.N.)
| | - Robert C. Hickner
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32304, USA; (N.S.A.); (E.M.F.); (J.M.); (S.S.); (E.A.C.); (R.B.); (R.C.H.); (L.B.P.); (B.P.D.)
| | - Negin Navaei
- Center for Advancing Exercise and Nutrition Research on Aging, Florida State University, Tallahassee, FL 32304, USA; (S.P.); (K.S.G.); (N.N.)
- Department of Nutrition, Life University, Marietta, GA 30060, USA
| | - Cathy W. Levenson
- Department of Biomedical Sciences and Program in Neuroscience, Florida State University, Tallahassee, FL 32304, USA;
| | - Lynn B. Panton
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32304, USA; (N.S.A.); (E.M.F.); (J.M.); (S.S.); (E.A.C.); (R.B.); (R.C.H.); (L.B.P.); (B.P.D.)
- Center for Advancing Exercise and Nutrition Research on Aging, Florida State University, Tallahassee, FL 32304, USA; (S.P.); (K.S.G.); (N.N.)
- Institute for Successful Longevity, Florida State University, Tallahassee, FL 32304, USA
| | - Bruce P. Daggy
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32304, USA; (N.S.A.); (E.M.F.); (J.M.); (S.S.); (E.A.C.); (R.B.); (R.C.H.); (L.B.P.); (B.P.D.)
| | - Bahram H. Arjmandi
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32304, USA; (N.S.A.); (E.M.F.); (J.M.); (S.S.); (E.A.C.); (R.B.); (R.C.H.); (L.B.P.); (B.P.D.)
- Center for Advancing Exercise and Nutrition Research on Aging, Florida State University, Tallahassee, FL 32304, USA; (S.P.); (K.S.G.); (N.N.)
- Institute for Successful Longevity, Florida State University, Tallahassee, FL 32304, USA
- Correspondence: ; Tel.: +1-850-645-1517
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MOLZ PATRÍCIA, MOLZ WALTERA, DALLEMOLE DANIELIR, SANTOS LUCIANAF, SALVADOR MIRIAN, CRUZ DENNISB, PRÁ DANIEL, FRANKE SILVIAI. Invert sugar induces glucose intolerance but does not cause injury to the pancreas nor permanent DNA damage in rats. AN ACAD BRAS CIENC 2020; 92:e20191423. [DOI: 10.1590/0001-3765202020191423] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 02/07/2020] [Indexed: 12/21/2022] Open
Affiliation(s)
- PATRÍCIA MOLZ
- Universidade de Santa Cruz do Sul/UNISC, Brazil; Universidade de Santa Cruz do Sul/UNISC, Brazil; Pontifícia Universidade Católica do Rio Grande do Sul/PUCRS, Brazil
| | | | - DANIELI R. DALLEMOLE
- Universidade de Santa Cruz do Sul/UNISC, Brazil; Universidade Federal do Rio Grande do Sul, Brazil
| | | | | | | | - DANIEL PRÁ
- Universidade de Santa Cruz do Sul/UNISC, Brazil
| | - SILVIA I.R. FRANKE
- Universidade de Santa Cruz do Sul/UNISC, Brazil; Universidade de Santa Cruz do Sul/UNISC, Brazil
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Silva G, Ferraresi C, de Almeida RT, Motta ML, Paixão T, Ottone VO, Fonseca IA, Oliveira MX, Rocha-Vieira E, Dias-Peixoto MF, Esteves EA, Coimbra CC, Amorim FT, de Castro Magalhães F. Infrared photobiomodulation (PBM) therapy improves glucose metabolism and intracellular insulin pathway in adipose tissue of high-fat fed mice. Lasers Med Sci 2017; 33:559-571. [PMID: 29247431 DOI: 10.1007/s10103-017-2408-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 11/29/2017] [Indexed: 12/16/2022]
Abstract
Obesity represents a continuously growing global epidemic and is associated with the development of type 2 diabetes mellitus. The etiology of type 2 diabetes is related to the resistance of insulin-sensitive tissues to its action leading to impaired blood glucose regulation. Photobiomodulation (PBM) therapy might be a non-pharmacological, non-invasive strategy to improve insulin resistance. It has been reported that PBM therapy in combination with physical exercise reduces insulin resistance. Therefore, the aim of this study was to investigate the effects of PBM therapy on insulin resistance in obese mice. Male Swiss albino mice received low-fat control diet (n = 16, LFC) or high-fat diet (n = 18, HFD) for 12 weeks. From 9th to 12th week, the mice received PBM therapy (LASER) or Sham (light off) treatment and were allocated into four groups: LFC Sham (n = 8), LFC PBM (n = 8), HFD Sham (n = 9), and HFD PBM (n = 9). The PBM therapy was applied in five locations: to the left and right quadriceps muscle, upper limbs and center of the abdomen, during 40 s at each point, once a day, 5 days a week, for 4 weeks (780 nm, 250 mW/cm2, 10 J/cm2, 0.4 J per site; 2 J total dose per day). Insulin signaling pathway was evaluated in the epididymal adipose tissue. PBM therapy improved glucose tolerance and phosphorylation of Akt (Ser473) and reversed the HFD-induced reduction of GLUT4 content and phosphorylation of AS160 (Ser588). Also, PBM therapy reversed the increased area of epididymal and mesenteric adipocytes. The results showed that chronic PBM therapy improved parameters related to obesity and insulin resistance in HFD-induced obesity in mice.
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Affiliation(s)
- Gabriela Silva
- Programa Multicêntrico de Pós-Graduação em Ciências Fisiológicas, Faculdade de Ciências Básicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Cleber Ferraresi
- Post-graduation Program in Physical Therapy in Functional Health, Physical Therapy Department, Universidade do Sagrado Coração, São Paulo, Brazil
- Post-Graduation Program in Biomedical Engineering, Universidade Brasil, São Paulo, Brazil
| | - Rodrigo Teixeira de Almeida
- Programa Multicêntrico de Pós-Graduação em Ciências Fisiológicas, Faculdade de Ciências Básicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Mariana Lopes Motta
- Programa Multicêntrico de Pós-Graduação em Ciências Fisiológicas, Faculdade de Ciências Básicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Thiago Paixão
- Programa Multicêntrico de Pós-Graduação em Ciências Fisiológicas, Faculdade de Ciências Básicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Vinicius Oliveira Ottone
- Programa Multicêntrico de Pós-Graduação em Ciências Fisiológicas, Faculdade de Ciências Básicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Ivana Alice Fonseca
- Programa Multicêntrico de Pós-Graduação em Ciências Fisiológicas, Faculdade de Ciências Básicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Murilo Xavier Oliveira
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Physiotherapy Department, Faculdade de Ciências Básicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Etel Rocha-Vieira
- Programa Multicêntrico de Pós-Graduação em Ciências Fisiológicas, Faculdade de Ciências Básicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Marco Fabrício Dias-Peixoto
- Programa Multicêntrico de Pós-Graduação em Ciências Fisiológicas, Faculdade de Ciências Básicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Elizabethe Adriana Esteves
- Programa Multicêntrico de Pós-Graduação em Ciências Fisiológicas, Faculdade de Ciências Básicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Cândido Celso Coimbra
- Programa Multicêntrico de Pós-Graduação em Ciências Fisiológicas, Faculdade de Ciências Básicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
- Endocrinology Laboratory, Biological Sciences Institute, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Fabiano Trigueiro Amorim
- Programa Multicêntrico de Pós-Graduação em Ciências Fisiológicas, Faculdade de Ciências Básicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
- University of New Mexico, Albuquerque, NM, USA
| | - Flávio de Castro Magalhães
- Programa Multicêntrico de Pós-Graduação em Ciências Fisiológicas, Faculdade de Ciências Básicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil.
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Derks IPM, Koster A, Schram MT, Stehouwer CDA, Dagnelie PC, Groffen DAI, Bosma H. The association of early life socioeconomic conditions with prediabetes and type 2 diabetes: results from the Maastricht study. Int J Equity Health 2017; 16:61. [PMID: 28381297 PMCID: PMC5382485 DOI: 10.1186/s12939-017-0553-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 03/20/2017] [Indexed: 02/06/2023] Open
Abstract
Background Using cross-sectional data from The Maastricht Study, we examined the association of socioeconomic conditions in early life with prediabetes and T2DM in adulthood. We also examined potential mediating pathways via both adulthood socioeconomic conditions and adult BMI and health behaviours. Methods Of the 3263 participants (aged 40–75 years), 493 had prediabetes and 906 were diagnosed with T2DM. By using logistic regression analyses, the associations and possible mediating pathways were examined. Results Participants with low early life socioeconomic conditions had a 1.56 times higher odds of prediabetes (95% confidence interval (CI) = 1.21-2.02) and a 1.61 times higher odds of T2DM (95% CI = 1.31-1.99). The relation between low early life socioeconomic conditions and prediabetes was independent of current socioeconomic conditions (OR = 1.38, 95% CI = 1.05-1.80), whereas the relation with T2DM was not independent of current socioeconomic conditions (OR = 1.10, 95% CI = 0.87-1.37). BMI party mediated the association between early life socioeconomic conditions and prediabetes. Conclusions Socioeconomic inequalities starting in early life were associated with diabetes-related outcomes in adulthood and suggest the usefulness of early life interventions aimed at tackling these inequalities. Electronic supplementary material The online version of this article (doi:10.1186/s12939-017-0553-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ivonne P M Derks
- Department of Social Medicine, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.,CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.,The Generation R Study Group, Erasmus Medical Centre, Rotterdam, The Netherlands.,Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands
| | - Annemarie Koster
- Department of Social Medicine, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.,CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Miranda T Schram
- Department of Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands.,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Coen D A Stehouwer
- Department of Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands.,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Pieter C Dagnelie
- CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands.,Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
| | - Danielle A I Groffen
- Department of Social Medicine, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.,CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Hans Bosma
- Department of Social Medicine, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands. .,CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
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7
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Bjerggaard M, Philipsen A, Jørgensen ME, Charles M, Witte DR, Sandbæk A, Lauritzen T, Færch K. Association of self-perceived body image with body mass index and type 2 diabetes-The ADDITION-PRO study. Prev Med 2015; 75:64-9. [PMID: 25838208 DOI: 10.1016/j.ypmed.2015.03.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Revised: 02/14/2015] [Accepted: 03/23/2015] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Weight loss is important for prevention of type 2 diabetes and an accurate self-perceived body image can promote weight reduction. We evaluated the association of self-perceived body image with body mass index (BMI) and type 2 diabetes. METHODS Data from the Danish ADDITION-PRO cohort study (2009-2011) were used. A total of 2082 men and women attended a health examination including assessment of BMI, waist circumference, the Stunkard scale of self-perceived obesity and an oral glucose tolerance test for assessment of diabetes risk. RESULTS Mean (SD) age was 66.2 (6.9) years and 24% were obese (BMI ≥30kg/m(2)). However, only 7% of obese men and 11% of obese women perceived themselves as obese. Among obese women, for a given level of BMI and waist circumference, one unit higher self-perceived body image was associated with 52% (95% CI: 14-73) lower risk of having type 2 diabetes and 45% (95% CI: 12-65) lower risk of having pre-diabetes. Overweight, but not obese, men had a 35% (95% CI: 36-56) lower risk of type 2 diabetes per unit increase in body image. CONCLUSIONS Obese individuals seem to underestimate their body shape. However, having a realistic body image (higher self-perceived obesity) is independently associated with lower diabetes risk. Self-perceived body image might serve as a valuable tool for type 2 diabetes risk assessment.
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Affiliation(s)
- Mette Bjerggaard
- Steno Diabetes Center A/S, Gentofte, Denmark; Department of Public Health, Section of General Practices, University of Aarhus, Aarhus, Denmark.
| | | | | | - Morten Charles
- Department of Public Health, Section of General Practices, University of Aarhus, Aarhus, Denmark
| | - Daniel R Witte
- Department of Public Health, Section of General Practices, University of Aarhus, Aarhus, Denmark
| | - Annelli Sandbæk
- Department of Public Health, Section of General Practices, University of Aarhus, Aarhus, Denmark
| | - Torsten Lauritzen
- Department of Public Health, Section of General Practices, University of Aarhus, Aarhus, Denmark
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Ureña-Bogarín EL, Martínez-Ramírez HR, Torres-Sánchez JR, Hernández-Herrera A, Cortés-Sanabria L, Cueto-Manzano AM. Prevalence of pre-diabetes in young Mexican adults in primary health care. Fam Pract 2015; 32:159-64. [PMID: 25199520 DOI: 10.1093/fampra/cmu047] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Pre-diabetes in young people is frequently unrecognized or not treated on time, with the consequent loss of opportunity for diabetes prevention. In Mexico, there is scarce information about the prevalence of pre-diabetes in young adults. OBJECTIVE To determine the prevalence and risk factors for pre-diabetes in young Mexican adults in primary health care. METHODS In a cross-sectional study, 288 subjects, aged 18-30 years, from a primary care unit were included. Pre-diabetes was diagnosed (according to the criteria of the American Diabetes Association) as impaired fasting glucose (8-12 hours fasting plasma glucose level: 100-125 mg/dl) or impaired glucose tolerance (140-199 mg/dl after a 2-hour oral glucose tolerance test). RESULTS Prevalence of pre-diabetes was 14.6% [95% confidence interval (CI): 10.7-19.2], whereas that of diabetes was 2.4% (95% CI: 1.0-4.9). A high proportion of patients had history of obesity, diabetes, hypertension and consumption of tobacco and alcohol. Pre-diabetic patients were older than normoglycaemics (pre-diabetic patients: 26±4 years versus normoglycaemic subjects: 24±3 years, P = 0.003) and had higher body mass index (BMI; pre-diabetic patients: 29.4±6.8 kg/m(2) versus normoglycaemic subjects: 26.8±5.8 kg/m(2); P = 0.009), particularly in the case of men (pre-diabetic men: 29.3±7.0 kg/m(2) versus normoglycaemic men: 26.4±5.1 kg/m(2); P = 0.03). Although waist circumference showed a trend to be higher among pre-diabetics, no significant differences were found according to gender (among males: pre-diabetics: 99.5±18.8 cm versus normoglycaemics: 93.3±14.4 cm, P = 0.09; among females: pre-diabetics: 91.5±13.8 cm versus normoglycaemics: 85.8±15.9 cm, P = 0.16). Only age and BMI were significantly associated with the presence of pre-diabetes. CONCLUSIONS Almost 15% of these young adults had pre-diabetes. Many modifiable and non-modifiable risk factors were present in these patients, but only age and a higher BMI were independent variables significantly associated with pre-diabetes. Timely interventions in primary health care are needed to prevent or delay the progression to diabetes.
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Affiliation(s)
- Enrique L Ureña-Bogarín
- Medical Research Unit in Renal Disease, Specialities Hospital, Mexican Institute of Social Security, Guadalajara, Jalisco, Mexico
| | - Héctor R Martínez-Ramírez
- Medical Research Unit in Renal Disease, Specialities Hospital, Mexican Institute of Social Security, Guadalajara, Jalisco, Mexico
| | - José R Torres-Sánchez
- Medical Research Unit in Renal Disease, Specialities Hospital, Mexican Institute of Social Security, Guadalajara, Jalisco, Mexico
| | - Aurora Hernández-Herrera
- Medical Research Unit in Renal Disease, Specialities Hospital, Mexican Institute of Social Security, Guadalajara, Jalisco, Mexico
| | - Laura Cortés-Sanabria
- Medical Research Unit in Renal Disease, Specialities Hospital, Mexican Institute of Social Security, Guadalajara, Jalisco, Mexico
| | - Alfonso M Cueto-Manzano
- Medical Research Unit in Renal Disease, Specialities Hospital, Mexican Institute of Social Security, Guadalajara, Jalisco, Mexico.
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