1
|
Jasem ZA. Profile of paediatric occupational therapy practice in Eastern Mediterranean countries. Scand J Occup Ther 2024; 31:2342536. [PMID: 38631391 DOI: 10.1080/11038128.2024.2342536] [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: 04/17/2023] [Accepted: 04/08/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Paediatric occupational therapy (OT) is considered the largest practice area in OT in several regions, including the Eastern Mediterranean (EM) countries. AIMS/OBJECTIVES This study aimed to establish a profile of paediatric occupational therapists in EM countries to identify theoretical models, assessments and interventions employed. It also investigated the therapists' usage of evidence-based practice in their practice. MATERIAL AND METHODS We conducted a cross-sectional survey using a questionnaire which was distributed electronically to occupational therapists working with children. RESULTS The participants included 118 therapists. Majority of the participants were working at rehabilitation centres. The primary client groups were pre- and school-age children with autism spectrum disorder and cerebral palsy. The most frequently used assessments were sensory-related tools. Activities of daily living and play were the most often targeted interventional area. Participants highlighted some of the challenges faced in implementing evidence in their practice. CONCLUSION Paediatric occupational therapists are usually exposed to specific age groups and conditions. However, a lack of knowledge practice in some areas and challenges in others exist. SIGNIFICANCE Within the EM region, knowledge regarding therapists' practices is lacking. Actions should be taken to improve current practice and meet the current needs of clients, and utilise evidence-based practices.
Collapse
Affiliation(s)
- Zainab A Jasem
- Occupational Therapy Department, Kuwait University, Sulaibikhat, Kuwait
| |
Collapse
|
2
|
Karsli N, Tuhan Kutlu E. Effect of body mass index on soft tissues in adolescents with skeletal class I and normal facial height. PeerJ 2023; 11:e16196. [PMID: 37810775 PMCID: PMC10557952 DOI: 10.7717/peerj.16196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 09/06/2023] [Indexed: 10/10/2023] Open
Abstract
Background The evaluation of soft tissues in patients undergoing orthodontic treatment plays a critical role in diagnosis and treatment planning. This study aims to evaluate the effect of body mass index (BMI) on facial soft tissues in skeletal Class I patients with normal vertical growth. Methods The study included 72 patients with a normal vertical growth pattern (SN-GoGn 26-38°) and skeletal Class I (ANB 2‒4°) malocclusion. According to their BMI (kg/m2) values, the patients were divided into three groups of 24 individuals each: underweight (>5th percentile) (13 females, 11 males; mean age, 11.58 ± 1.95 years), normal weight (5‒85th percentile) (12 females, 12 males; mean age, 11.54 ± 1.95 years), overweight (85‒95th percentile) (12 females, 12 males; mean age, 11.62 ± 2.01 years). Soft tissue thickness and height measurements were made on lateral cephalometric radiographs. Results In all soft tissue thickness measurements, except for the nasion, the overweight weight group had higher values. In comparing the underweight and normal weight groups, statistically significant differences were found in the thickness measurements at the nasion and gnathion (p < 0.05). The differences in thickness measurements at the glabella, labiale superius, stomion, labiale inferius, pogonion, gnathion, and menton are statistically significant between the underweight and overweight groups (p < 0.005). Comparing the normal and overweight groups revealed statistically significant differences the thickness measurements at the glabella, labiale superius, stomion, pogonion and menton (p < 0.05).
Collapse
Affiliation(s)
- Nurver Karsli
- Department of Orthodontics, Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey
| | - Esra Tuhan Kutlu
- Department of Orthodontics, Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey
| |
Collapse
|
3
|
Hebbar P, Nizam R, John SE, Antony D, Dashti M, Channanath A, Shaltout A, Al-Khandari H, Koistinen HA, Tuomilehto J, Alsmadi O, Thanaraj TA, Al-Mulla F. Linkage analysis using whole exome sequencing data implicates SLC17A1, SLC17A3, TATDN2 and TMEM131L in type 1 diabetes in Kuwaiti families. Sci Rep 2023; 13:14978. [PMID: 37696853 PMCID: PMC10495342 DOI: 10.1038/s41598-023-42255-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 09/07/2023] [Indexed: 09/13/2023] Open
Abstract
Type 1 diabetes (T1D) is characterized by the progressive destruction of pancreatic β-cells, leading to insulin deficiency and lifelong dependency on exogenous insulin. Higher estimates of heritability rates in monozygotic twins, followed by dizygotic twins and sib-pairs, indicate the role of genetics in the pathogenesis of T1D. The incidence and prevalence of T1D are alarmingly high in Kuwait. Consanguineous marriages account for 50-70% of all marriages in Kuwait, leading to an excessive burden of recessive allele enrichment and clustering of familial disorders. Thus, genetic studies from this Arab region are expected to lead to the identification of novel gene loci for T1D. In this study, we performed linkage analyses to identify the recurrent genetic variants segregating in high-risk Kuwaiti families with T1D. We studied 18 unrelated Kuwaiti native T1D families using whole exome sequencing data from 86 individuals, of whom 37 were diagnosed with T1D. The study identified three potential loci with a LOD score of ≥ 3, spanning across four candidate genes, namely SLC17A1 (rs1165196:pT269I), SLC17A3 (rs942379: p.S370S), TATDN2 (rs394558:p.V256I), and TMEM131L (rs6848033:p.R190R). Upon examination of missense variants from these genes in the familial T1D dataset, we observed a significantly increased enrichment of the genotype homozygous for the minor allele at SLC17A3 rs56027330_p.G279R accounting for 16.2% in affected children from 6 unrelated Kuwaiti T1D families compared to 1000 genomes Phase 3 data (0.9%). Data from the NephQTL database revealed that the rs1165196, rs942379, rs394558, and rs56027330 SNPs exhibited genotype-based differential expression in either glomerular or tubular tissues. Data from the GTEx database revealed rs942379 and rs394558 as QTL variants altering the expression of TRIM38 and IRAK2 respectively. Global genome-wide association studies indicated that SLC17A1 rs1165196 and other variants from SLC17A3 are associated with uric acid concentrations and gout. Further evidence from the T1D Knowledge portal supported the role of shortlisted variants in T1D pathogenesis and urate metabolism. Our study suggests the involvement of SLC17A1, SLC17A3, TATDN2, and TMEM131L genes in familial T1D in Kuwait. An enrichment selection of genotype homozygous for the minor allele is observed at SLC17A3 rs56027330_p.G279R variant in affected members of Kuwaiti T1D families. Future studies may focus on replicating the findings in a larger T1D cohort and delineate the mechanistic details of the impact of these novel candidate genes on the pathophysiology of T1D.
Collapse
Affiliation(s)
- Prashantha Hebbar
- Department of Genetics and Bioinformatics, Dasman Diabetes Institute, 15462, Kuwait City, Kuwait
| | - Rasheeba Nizam
- Department of Genetics and Bioinformatics, Dasman Diabetes Institute, 15462, Kuwait City, Kuwait
| | - Sumi Elsa John
- Department of Genetics and Bioinformatics, Dasman Diabetes Institute, 15462, Kuwait City, Kuwait
| | - Dinu Antony
- Department of Genetics and Bioinformatics, Dasman Diabetes Institute, 15462, Kuwait City, Kuwait
| | - Mohammad Dashti
- Department of Genetics and Bioinformatics, Dasman Diabetes Institute, 15462, Kuwait City, Kuwait
| | - Arshad Channanath
- Department of Genetics and Bioinformatics, Dasman Diabetes Institute, 15462, Kuwait City, Kuwait
| | - Azza Shaltout
- Department of Population Health, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Hessa Al-Khandari
- Department of Population Health, Dasman Diabetes Institute, Kuwait City, Kuwait
- Department of Pediatrics, Farwaniya Hospital, Ministry of Health, Kuwait City, Kuwait
| | - Heikki A Koistinen
- Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Jaakko Tuomilehto
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | | | - Fahd Al-Mulla
- Department of Genetics and Bioinformatics, Dasman Diabetes Institute, 15462, Kuwait City, Kuwait.
| |
Collapse
|
4
|
Al-Haifi AR, Al-Awadhi BA, Bumaryoum NY, Alajmi FA, Ashkanani RH, Al-Hazzaa HM. The association between academic performance indicators and lifestyle behaviors among Kuwaiti college students. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:27. [PMID: 37016438 PMCID: PMC10071657 DOI: 10.1186/s41043-023-00370-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 03/24/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND Lifestyle behaviors are developed during young adulthood and carried through life. Accordingly, early detection of unhealthy behaviors can help prevent the increase in non-communicable diseases in the population. College students are an especially vulnerable group who, upon entering a new environment, tend to engage in unhealthy behaviors. OBJECTIVE The present study aims to evaluate the lifestyle behaviors of Kuwaiti college students and their association with markers of academic achievements. METHODS One thousand two hundred fifty-nine students participated in the present study and answered an online questionnaire pertaining to their sociodemographic status, academic performance indicators, body weight and height, and lifestyle behaviors. Data were collected from November 2020 to February 2021. RESULTS Results of the present study showed that obesity was significantly more prevalent among male participants than among females even though males were more physically active. Alternatively, females had a greater grade point average in college, slept more, and had more screen time. Interestingly, we were unable to detect a significant correlation between lifestyle behaviors and academic achievements. CONCLUSION The observed differences in body mass index between genders may have been attributed to energy intake rather than energy expenditure.
Collapse
Affiliation(s)
- Ahmad R Al-Haifi
- Department of Food and Nutrition Sciences, College of Health Sciences, PAAET, Showaikh, Kuwait.
| | - Balqees A Al-Awadhi
- Department of Food and Nutrition Sciences, College of Health Sciences, PAAET, Showaikh, Kuwait
| | - Nayef Y Bumaryoum
- Department of Food and Nutrition Sciences, College of Health Sciences, PAAET, Showaikh, Kuwait
| | - Fahhad A Alajmi
- Department of Food and Nutrition Sciences, College of Health Sciences, PAAET, Showaikh, Kuwait
| | - Rasha H Ashkanani
- Department of Home Economics, Basic Education Collage, PAAET, Showaikh, Kuwait
| | - Hazzaa M Al-Hazzaa
- Lifestyle and Health Research Center, Health Sciences Research Center, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| |
Collapse
|
5
|
Bjornstad P, Chao LC, Cree-Green M, Dart AB, King M, Looker HC, Magliano DJ, Nadeau KJ, Pinhas-Hamiel O, Shah AS, van Raalte DH, Pavkov ME, Nelson RG. Youth-onset type 2 diabetes mellitus: an urgent challenge. Nat Rev Nephrol 2023; 19:168-184. [PMID: 36316388 PMCID: PMC10182876 DOI: 10.1038/s41581-022-00645-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2022] [Indexed: 11/05/2022]
Abstract
The incidence and prevalence of youth-onset type 2 diabetes mellitus (T2DM) and its complications are increasing worldwide. Youth-onset T2DM has been reported in all racial and ethnic groups, but Indigenous peoples and people of colour are disproportionately affected. People with youth-onset T2DM often have a more aggressive clinical course than those with adult-onset T2DM or those with type 1 diabetes mellitus. Moreover, the available treatment options for children and adolescents with T2DM are more limited than for adult patients. Intermediate complications of youth-onset T2DM, such as increased albuminuria, often develop in late childhood or early adulthood, and end-stage complications, including kidney failure, develop in mid-life. The increasing frequency, earlier onset and greater severity of childhood obesity in the past 50 years together with increasingly sedentary lifestyles and an increasing frequency of intrauterine exposure to diabetes are important drivers of the epidemic of youth-onset T2DM. The particularly high risk of the disease in historically disadvantaged populations suggests an important contribution of social and environmental factors, including limited access to high-quality health care, healthy food choices and opportunities for physical activity as well as exposure to stressors including systemic racism and environmental pollutants. Understanding the mechanisms that underlie the development and aggressive clinical course of youth-onset T2DM is key to identifying successful prevention and management strategies.
Collapse
Affiliation(s)
| | - Lily C Chao
- Children's Hospital Los Angeles, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | | | - Allison B Dart
- Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Canada
| | - Malcolm King
- University of Saskatchewan College of Medicine, Saskatoon, Saskatchewan, Canada
| | - Helen C Looker
- National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, USA
| | - Dianna J Magliano
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Monash University, School of Public Health and Preventive Medicine, Melbourne, Australia
| | | | - Orit Pinhas-Hamiel
- Paediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Amy S Shah
- Cincinnati Children's Hospital and The University of Cincinnati, Cincinnati, OH, USA
| | | | - Meda E Pavkov
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Robert G Nelson
- National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, USA.
| |
Collapse
|
6
|
Treister-Goltzman Y, Peleg R. Adolescent Obesity and Type Two Diabetes in Young Adults in the Minority Muslim Bedouin Population in Southern Israel. J Community Health 2022; 48:420-429. [DOI: 10.1007/s10900-022-01178-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2022] [Indexed: 12/24/2022]
|
7
|
Alazmi A, Viktor S, Erjavec M. Exploring the determinants of mental health, wellbeing, and lifestyle in 8-11 year old children with type 1 diabetes and their healthy counterparts in Kuwait. PLoS One 2022; 17:e0272948. [PMID: 36508408 PMCID: PMC9744296 DOI: 10.1371/journal.pone.0272948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 07/28/2022] [Indexed: 12/14/2022] Open
Abstract
Type 1 diabetes is a chronic disease with an early onset, but little is known about its psychological effects in middle childhood. The present study was the first to explore the relationship between mental health, wellbeing, and lifestyle of 8-11 years old children with Type 1 diabetes and their parents, and a healthy comparison group. A total of 200 parent-child dyads were recruited in diabetic clinics and from primary schools in Kuwait. Both groups completed a series of behavioural and physical assessments relating to health, wellbeing, and lifestyle. A significant relationship was found between higher Body Mass Index (BMI) and poorer mental health, including low academic self-esteem, depression, and anxiety, in the diabetes group. This group had significantly higher mean scores in mental health problems, and lower scores in wellbeing, compared with control group. Both groups had poor dietary habits and low levels of physical activity. Unlike previous studies, no differences were found between parents' mental health for children with Type 1 diabetes and parents of the control group. Although elevated problem scores on a variety of indices remained within normal range, the pattern of results indicates that children with diabetes would profit from early screening and preventative intervention to reduce the likelihood of psychological and behavioural difficulties later on.
Collapse
Affiliation(s)
- Afrah Alazmi
- School of Human and Behavioural Sciences, Bangor University, Bangor, United Kindom
| | - Simon Viktor
- School of Human and Behavioural Sciences, Bangor University, Bangor, United Kindom
| | - Mihela Erjavec
- School of Human and Behavioural Sciences, Bangor University, Bangor, United Kindom
- * E-mail:
| |
Collapse
|
8
|
Al-Farhan AK, Weatherspoon LJ, Pfeiffer KA, Li W, Carlson JJ. Sex differences in the prevalence of multiple cardiovascular disease risk factors in schoolchildren: A cross-sectional study. Clin Nutr ESPEN 2022; 52:131-137. [PMID: 36513445 DOI: 10.1016/j.clnesp.2022.10.013] [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: 06/14/2022] [Revised: 09/14/2022] [Accepted: 10/23/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND & AIMS Childhood obesity is linked to adulthood cardiovascular disease (CVD) risk and mortality. Approximately 32% of Kuwaiti children are obese, particularly boys. Data on other CVD risk factors are limited. This study aimed to determine the prevalence and sex differences of CVD risks in Kuwaiti schoolchildren. METHODS Kuwaiti fifth-grade schoolchildren (n = 367, 53% girls, age 10.4 ± 0.4 years) were evaluated. Informed parent/guardian consent and child assent were obtained for all participants. Outcome variables included (i) anthropometric: body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), percentage body fat (%BF); (ii) blood lipids: total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), non-HDL, TC:HDL ratio, triglycerides; and (iii) blood pressure (BP): systolic BP (SBP) and diastolic BP (DBP) measurements. ANOVA was conducted, while controlling for moderate-to-vigorous physical activity and screen time (ST); significance level was set at p ≤ 0.05. RESULTS Overall prevalence of CVD risks included: overweight (21.6%), obesity (39%), WC (10.2%), WHtR (43.3%), %BF (10.1%), TC (26.4%), LDL (13.2%), HDL (36.9%), non-HDL (22.5%), TC:HDL ratio (25.9%), triglycerides (45.5%), and BP (23.3%). More girls (27.1%) than boys (15.5%) were overweight (p = 0.007). More girls than boys were at greater risk of elevated triglycerides (52.3% vs. 37.7%, p = 0.032), low HDL (20.7% vs. 12.2%, p = 0.032) and elevated SBP (21% vs. 10.7%, p = 0.008) and DBP (21% vs. 8.8%, p = 0.001), respectively. CONCLUSIONS CVD risks are a concern overall in children, especially in girls relative to overweight, dyslipidemia, and prehypertension. Intervention programs for Kuwaiti schoolchildren are recommended to prevent CVD risks.
Collapse
Affiliation(s)
- Abdulaziz Kh Al-Farhan
- Department of Food Science and Human Nutrition, Michigan State University 469 Wilson Rd, East Lansing, MI 48824, USA; The Public Authority for Applied Education and Training, College of Nursing, Suwaikh, Al-Jahedh Street, P.O. Box 64923, Kuwait.
| | - Lorraine J Weatherspoon
- Department of Food Science and Human Nutrition, Michigan State University 469 Wilson Rd, East Lansing, MI 48824, USA
| | - Karin A Pfeiffer
- Department of Kinesiology, Michigan State University 308 W. Circle Drive, East Lansing, MI 48824-1034, USA
| | - Wei Li
- Department of Dietetics & Nutrition, The University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, AR 72205, USA
| | - Joseph J Carlson
- Department of Food Science and Human Nutrition, Michigan State University 469 Wilson Rd, East Lansing, MI 48824, USA; Department of Radiology, Michigan State University 846 Service Road, East Lansing, MI 48824, USA
| |
Collapse
|
9
|
Alhammad R, Abu-Farha M, Hammad MM, Thanaraj TA, Channanath A, Alam-Eldin N, Al-Sabah R, Shaban L, Alduraywish A, Al-Mulla F, Rahman A, Abubaker J. Increased LRG1 Levels in Overweight and Obese Adolescents and Its Association with Obesity Markers, Including Leptin, Chemerin, and High Sensitivity C-Reactive Protein. Int J Mol Sci 2022; 23:ijms23158564. [PMID: 35955698 PMCID: PMC9369195 DOI: 10.3390/ijms23158564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 02/05/2023] Open
Abstract
Leucine-rich α-2 glycoprotein1 (LRG1) is a member of the leucine-rich repeat (LRR) family that is implicated in multiple diseases, including cancer, aging, and heart failure, as well as diabetes and obesity. LRG1 plays a key role in diet-induced hepatosteatosis and insulin resistance by mediating the crosstalk between adipocytes and hepatocytes. LRG1 also promotes hepatosteatosis by upregulating de novo lipogenesis in the liver and suppressing fatty acid β-oxidation. In this study, we investigated the association of LRG1 with obesity markers, including leptin and other adipokines in adolescents (11−14 years; n = 425). BMI-for-age classification based on WHO growth charts was used to define obesity. Plasma LRG1 was measured by ELISA, while other markers were measured by multiplexing assay. Median (IQR) of LRG1 levels was higher in obese (30 (25, 38) µg/mL) and overweight (30 (24, 39) µg/mL) adolescents, compared to normal-weight participants (27 (22, 35) µg/mL). The highest tertile of LRG1 had an OR [95% CI] of 2.55 [1.44, 4.53] for obesity. LRG1 was positively correlated to plasma levels of high sensitivity c-reactive protein (HsCRP) (ρ = 0.2), leptin (ρ = 0.2), and chemerin (ρ = 0.24) with p < 0.001. Additionally, it was positively associated with plasma level of IL6 (ρ = 0.17) and IL10 (ρ = 0.14) but not TNF-α. In conclusion, LRG1 levels are increased in obese adolescents and are associated with increased levels of adipogenic markers. These results suggest the usefulness of LRG1 as an early biomarker for obesity and its related pathologies in adolescents.
Collapse
Affiliation(s)
- Rashed Alhammad
- Department of Pharmacology, Faculty of Medicine, Kuwait University, Safat 13110, Kuwait;
| | - Mohamed Abu-Farha
- Biochemistry and Molecular Biology Department, Dasman Diabetes Institute, Kuwait City 15462, Kuwait; (M.A.-F.); (M.M.H.); (N.A.-E.)
| | - Maha M. Hammad
- Biochemistry and Molecular Biology Department, Dasman Diabetes Institute, Kuwait City 15462, Kuwait; (M.A.-F.); (M.M.H.); (N.A.-E.)
| | - Thangavel Alphonse Thanaraj
- Genetics and Bioinformatics Department, Dasman Diabetes Institute, Kuwait City 15462, Kuwait; (T.A.T.); (A.C.); (F.A.-M.)
| | - Arshad Channanath
- Genetics and Bioinformatics Department, Dasman Diabetes Institute, Kuwait City 15462, Kuwait; (T.A.T.); (A.C.); (F.A.-M.)
| | - Nada Alam-Eldin
- Biochemistry and Molecular Biology Department, Dasman Diabetes Institute, Kuwait City 15462, Kuwait; (M.A.-F.); (M.M.H.); (N.A.-E.)
| | - Reem Al-Sabah
- Department of Community Medicine and Behavioural Sciences, Faculty of Medicine, Kuwait University, Safat 13110, Kuwait;
| | - Lemia Shaban
- Department of Food Science and Nutrition, College of Life Sciences, Kuwait University, Safat 13060, Kuwait;
| | - Abdulrahman Alduraywish
- Department of Internal Medicine, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia;
| | - Fahd Al-Mulla
- Genetics and Bioinformatics Department, Dasman Diabetes Institute, Kuwait City 15462, Kuwait; (T.A.T.); (A.C.); (F.A.-M.)
| | - Abdur Rahman
- Department of Food Science and Nutrition, College of Life Sciences, Kuwait University, Safat 13060, Kuwait;
- Correspondence: (A.R.); (J.A.); Tel.: +965-2463-3321 (A.R.); +965-2224-2999 (ext. 3563) (J.A.)
| | - Jehad Abubaker
- Biochemistry and Molecular Biology Department, Dasman Diabetes Institute, Kuwait City 15462, Kuwait; (M.A.-F.); (M.M.H.); (N.A.-E.)
- Correspondence: (A.R.); (J.A.); Tel.: +965-2463-3321 (A.R.); +965-2224-2999 (ext. 3563) (J.A.)
| |
Collapse
|
10
|
Identification of Maturity-Onset-Diabetes of the Young (MODY) mutations in a country where diabetes is endemic. Sci Rep 2021; 11:16060. [PMID: 34373539 PMCID: PMC8352960 DOI: 10.1038/s41598-021-95552-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 07/13/2021] [Indexed: 01/02/2023] Open
Abstract
Genetic variants responsible for Maturity-Onset-Diabetes of the Young (MODY) in Kuwait were investigated. A newly established a National Referral Clinic, the Dasman Diabetes Institute (DDI-NRC), assessed forty-five members from 31 suspected MODY families by whole exome sequencing. Thirty-three of the 45 samples were independently sequenced at the DDI-NRI, Exeter University, UK (https://www.diabetesgenes.org/) using targeted 21-gene panel approach. Pathogenic mutations in GCK, HNF1A, HNF1B, HNF4A, and PDX1 confirmed MODY in 7 families, giving an overall positivity rate of 22.6% in this cohort. Novel variants were identified in three families in PDX1, HNF1B, and HNF1B. In this cohort, Multiplex Ligation-dependent Probe Amplification assay did not add any value to MODY variant detection rate in sequencing negative cases. In highly selected familial autoantibody negative diabetes, known MODY genes represent a minority and 77.3% of the familial cases have yet to have a causal variant described.
Collapse
|
11
|
Time trends of overweight and obesity among schoolchildren in Kuwait over a 13-year period (2007-2019): repeated cross-sectional study. Public Health Nutr 2021; 24:5318-5328. [PMID: 34342262 DOI: 10.1017/s1368980021003177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES This study aimed to examine age-specific trends in the prevalence of overweight and obesity in schoolchildren in Kuwait over a 13-year period (2007 to 2019) using the WHO, the Centers for Disease Control and Prevention (CDC) and the International Obesity Taskforce (IOTF) definitions. DESIGN Using cross-sectional approach, Kuwait Nutrition Surveillance System (KNSS) objectively measured weight and height of schoolchildren over a 13-year period. Log-binomial regression models were used to examine age-specific trends of obesity and overweight over the study period. SETTING Public primary, middle and high schools in all provinces of Kuwait. PARTICIPANTS Schoolchildren aged 5-19 years (n 172 603). RESULTS According to the WHO definition, the prevalence of overweight and obesity in schoolchildren, respectively, increased from 17·73 % and 21·37 % in 2007 to 20·19 % and 28·39 % in 2019 (Pfor trend < 0·001). There is evidence that the obesity in females (but not males) has levelled off in the period 2014-2019 according to the three definitions of obesity, which is corroborated by a similar trend in the mean of BMI-for-age Z-score. CONCLUSION The prevalence of obesity and overweight in schoolchildren in Kuwait has risen over the last 13 years and trends are similar across all definitions. Obesity is no longer increasing at the same pace and there is evidence that the prevalence of obesity in females has plateaued. The current level of childhood overweight and obesity is too high and requires community-based and school-based interventions.
Collapse
|
12
|
Gasana J, Vainio H, Longenecker J, Loney T, Ádám B, Al-Zoughool M. Identification of public health priorities, barriers, and solutions for Kuwait using the modified Delphi method for stakeholder consensus. Int J Health Plann Manage 2021; 36:1830-1846. [PMID: 34176157 DOI: 10.1002/hpm.3270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 06/17/2021] [Accepted: 06/18/2021] [Indexed: 11/05/2022] Open
Abstract
The rapid modernization and economic developments in Kuwait, have been accompanied by substantial lifestyle changes such as unhealthy diet and physical inactivity. These modifiable behaviours have contributed to increased rates of non-communicable diseases including diabetes and cardiovascular diseases. Delphi Consensus Method was implemented in the current study to draw stakeholders from all sectors together to develop a consensus on the major public health priorities, barriers and solutions. The process involves administration of a series of questions to selected stakeholders through an iterative process that ends when a consensus has been reached among participants. Results of the iteration process identified obesity, diabetes, cardiovascular diseases along with lack of enforcement of laws and regulation as priority health issues. Results also identified lack of national vision for the development of a public health system, lack of multidisciplinary research investigating sources of disease and methods of prevention and improving efficiency with existing resources in implementation and efficiency as the main barriers identified were. Solutions suggested included investing in healthcare prevention, strengthening communication between all involved sectors through intersectoral collaboration, awareness at the primary healthcare setting and use of electronic health records. The results offer an important opportunity for stakeholders in Kuwait to tackle these priority health issues employing the suggested approaches and solution.
Collapse
Affiliation(s)
- Janvier Gasana
- Department of Environmental and Occupational Health, Faculty of Public Health, Kuwait University, Kuwait, Kuwait
| | - Harri Vainio
- Department of Environmental and Occupational Health, Faculty of Public Health, Kuwait University, Kuwait, Kuwait
| | - Joseph Longenecker
- Department of Epidemiology, Faculty of Public Health, Kuwait University, Kuwait, Kuwait
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University for Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Balázs Ádám
- Department of Public Health and Preventive Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Mustafa Al-Zoughool
- Department of Environmental and Occupational Health, Faculty of Public Health, Kuwait University, Kuwait, Kuwait
| |
Collapse
|
13
|
Al-Farhan AK, Becker TB, Petushek E, Weatherspoon L, Carlson JJ. Reliability of the Block Kid's Food Frequency Questionnaire translated to Arabic and adapted for Kuwaiti children. Nutrition 2021; 90:111289. [PMID: 34198008 DOI: 10.1016/j.nut.2021.111289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 04/07/2021] [Accepted: 04/16/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Little is known about the nutrient intakes of Kuwaiti children; this is partly due to a lack of culture-specific dietary assessment instruments to estimate the usual food and nutrient intake of Arab children. The aim of this study was to describe the methodology used in translating the 2004 Block Kid's Food Frequency Questionnaire (Block FFQ) to Arabic using adapted food choices commonly consumed by Kuwaiti children, and to evaluate the reliability of the FFQ in a population of fifth-grade Kuwaiti children. METHODS The 2004 Block FFQ was translated from English to Arabic, and food options were replaced with culturally appropriate foods. The modified FFQ was administered to 367 male and female Kuwaiti fifth graders (10.4 ± 0.4 y of age; 53% girls). The FFQ was retested 1 wk later in 26 male students, and 4 wk later in 32 female students. Intraclass correlations (ICC) assessed the reliability between the participants' first and second FFQs for food groups, macronutrients, and five key micronutrients. RESULTS The combined analysis of boys and girls indicated a moderate reliability for food groups (ICC, 0.68; 95% confidence interval [CI]; 0.52-0.80) and micronutrients (ICC, 0.54; 95% CI, 0.29-0.72), but was poor for macronutrients (ICC, 0.43; 95% CI, 0.21-0.62). CONCLUSIONS The modified FFQ is a modestly reliable instrument for measuring usual dietary intake in Kuwaiti children. The ICC was higher in boys than in girls, probably due to the disparity in the FFQ retest time.
Collapse
Affiliation(s)
- Abdulaziz Kh Al-Farhan
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, Michigan, USA; Department of Radiology, Michigan State University, East Lansing, Michigan, USA; The Public Authority for Applied Education and Training (PAAET), College of Nursing Kuwait.
| | - Tyler Brian Becker
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, Michigan, USA; Department of Cognitive and Learning Sciences, Michigan Technological University, Houghton, Michigan, USA
| | - Erich Petushek
- Department of Cognitive and Learning Sciences, Michigan Technological University, Houghton, Michigan, USA
| | - Lorraine Weatherspoon
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, Michigan, USA
| | - Joseph J Carlson
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, Michigan, USA; Department of Radiology, Michigan State University, East Lansing, Michigan, USA
| |
Collapse
|
14
|
Alawadhi B, Fallaize R, Franco RZ, Hwang F, Lovegrove J. Web-Based Dietary Intake Estimation to Assess the Reproducibility and Relative Validity of the EatWellQ8 Food Frequency Questionnaire: Validation Study. JMIR Form Res 2021; 5:e13591. [PMID: 33650974 PMCID: PMC7967232 DOI: 10.2196/13591] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 06/08/2020] [Accepted: 11/16/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The web-based EatWellQ8 food frequency questionnaire (FFQ) was developed as a dietary assessment tool for healthy adults in Kuwait. Validation against reliable instruments and assessment of its reproducibility are required to ensure the accuracy of the EatWellQ8 FFQ in computing nutrient intake. OBJECTIVE This study aims to assess the reproducibility and relative validity of the EatWellQ8 146-item FFQ, which included images of food portion sizes based on The Composition of Foods by McCance and Widdowson and food composition tables from Kuwait and the Kingdom of Bahrain, against a paper-based FFQ (PFFQ) and a 4-day weighed food record (WFR). METHODS Reproducibility of the EatWellQ8 FFQ was assessed using a test-retest methodology. Participants were required to complete the FFQ at 2 time points, 4 weeks apart. To assess the relative validity of the EatWellQ8 FFQ, a subset of the participants were asked to complete a PFFQ or a 4-day WFR 1 week after the administration of the EatWellQ8 FFQ. The level of agreement between nutrient and food group intakes was estimated by repeated EatWellQ8 FFQ administration. The EatWellQ8 FFQ, PFFQ, and 4-day WFR were also evaluated using the Bland-Altman methodology and classified into quartiles of daily intake. Crude unadjusted correlation coefficients were also calculated for nutrients and food groups. RESULTS A total of 99 Kuwaiti participants (64/99, 65% female and 35/99, 35% male) completed the study-53 participated in the reproducibility study and the 4-day WFR validity study (mean age 37.1 years, SD 9.9) and 46 participated in the PFFQ validity study (mean age 36.2 years, SD 8.3). Crude unadjusted correlations for repeated EatWellQ8 FFQs ranged from 0.37 to 0.93 (mean r=0.67, SD 0.14; 95% CI 0.11-0.95) for nutrients and food groups (P=.01). Mean cross-classification into exact agreement plus adjacent was 88% for nutrient intakes and 86% for food groups, and Bland-Altman plots showed good agreement for energy-adjusted macronutrient intakes. The association between the EatWellQ8 FFQ and PFFQ varied, with crude unadjusted correlations ranging from 0.42 to 0.73 (mean r=0.46, SD 0.12; 95% CI -0.02 to 0.84; P=.046). Mean cross-classification into exact agreement plus adjacent was 84% for nutrient intake and 74% for food groups. Bland-Altman plots showed moderate agreement for both energy and energy-controlled nutrient intakes. Crude unadjusted correlations for the EatWellQ8 FFQ and the 4-day WFR ranged from 0.40 to 0.88 (mean r=0.58, SD 0.13; 95% CI 0.01-0.58; P=.01). Mean cross-classification into exact agreement plus adjacent was 85% for nutrient intake and 83% for food groups. Bland-Altman plots showed moderate agreement for energy-adjusted macronutrient intakes. CONCLUSIONS The results indicate that the web-based EatWellQ8 FFQ is reproducible for assessing nutrient and food group intake and has moderate agreement compared with a PFFQ and a 4-day WFR for measuring energy and nutrient intakes.
Collapse
Affiliation(s)
- Balqees Alawadhi
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, Department of Food and Nutritional Sciences, University of Reading, Reading, United Kingdom
| | - Rosalind Fallaize
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, Department of Food and Nutritional Sciences, University of Reading, Reading, United Kingdom.,School of Life and Medical Science, University of Hertfordshire, Hertfordshire, United Kingdom
| | - Rodrigo Zenun Franco
- Biomedical Engineering Section, School of Biological Sciences, University of Reading, Reading, United Kingdom
| | - Faustina Hwang
- Biomedical Engineering Section, School of Biological Sciences, University of Reading, Reading, United Kingdom
| | - Julie Lovegrove
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, Department of Food and Nutritional Sciences, University of Reading, Reading, United Kingdom
| |
Collapse
|
15
|
Aslani Z, Bahreynian M, Namazi N, Shivappa N, Hébert JR, Asayesh H, Motlagh ME, Pourmirzaei MA, Kasaeian A, Mahdavi-Gorabi A, Qorbani M, Kelishadi R. Association of dietary acid load with anthropometric indices in children and adolescents. Eat Weight Disord 2021; 26:555-567. [PMID: 32172506 DOI: 10.1007/s40519-020-00883-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 02/26/2020] [Indexed: 10/24/2022] Open
Abstract
PURPOSE High dietary acid load (DAL) may have an influence on anthropometric indices. Given that there was no study on the association between DAL and anthropometric indices children and adolescents, the current study was aimed to examine the association between DAL and anthropometric indices in Iranian children and adolescents. METHODS Students aged 6-18 years were recruited using a multi-stage, cluster sampling method from 30 provinces of Iran. Dietary intake was assessed through a validated food frequency questionnaire. Height (Ht), weight (Wt), neck circumference (NC), waist circumference (WC), wrist circumference, and hip circumference (HC) were measured. WC-to-HC ratio (WHR), WC-to-Ht ratio (WHtR), body mass index (BMI) z-score, tri-ponderal mass index (TMI), and parental BMI were computed. Potential renal acid load (PRAL) and net endogenous acid production (NEAP) were used to estimate DAL. The association between DAL and anthropometric indices was evaluated using linear regression models. RESULTS In total, 5326 students (46.92% girls), with mean (standard deviations (SD)) age of 12.50 (3.14) years participated in the study (response rate: 98.13%). After adjusting for confounders, there was a significant association between NEAP and NC (P < 0.05). Also, an inverse association was observed between PRAL and NEAP with parental BMI (P < 0.05). CONCLUSION Our findings showed a direct association between diet-induced acid load and NC and an inverse association between DAL indices and parental BMI. More well-designed clinical studies are warranted to confirm our results and the underlying mechanisms. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
Collapse
Affiliation(s)
- Zahra Aslani
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.,Students Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Bahreynian
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.,Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nazli Namazi
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA.,Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA.,Connecting Health Innovations, LLC, Columbia, SC, USA
| | - James R Hébert
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA.,Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA.,Connecting Health Innovations, LLC, Columbia, SC, USA
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | | | - Mohammad Ali Pourmirzaei
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amir Kasaeian
- Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Hematologic Malignancies Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Armita Mahdavi-Gorabi
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran. .,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
16
|
Davidsson L, Alkhabbaz E, Vijayan V, Alhubail A, Shaltout A, Alkandari H. Intermediate hyperglycaemia, insulin resistance and metabolic syndrome among obese Arab children (12-17 years old) in Kuwait. Prim Care Diabetes 2021; 15:191-193. [PMID: 32085984 DOI: 10.1016/j.pcd.2020.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 01/29/2020] [Accepted: 02/02/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To screen 97 obese Arab adolescents for metabolic risk factors. RESULTS Insulin resistance, metabolic syndrome and intermediate hyperglycaemia was found in 56.7 %, 14.4 % and 27.8 % (HbA1c) while fasting plasma glucose was impaired in 0-16.5 %, using different cut-offs. Interventions to prevent obesity and diabetes are needed.
Collapse
Affiliation(s)
- Lena Davidsson
- Department of Population Health, Dasman Diabetes Institute, Kuwait.
| | - Emma Alkhabbaz
- Department of Population Health, Dasman Diabetes Institute, Kuwait
| | - Vidya Vijayan
- National Dasman Diabetes BioBank, Special Services Facility, Dasman Diabetes Institute, Kuwait
| | - Asma Alhubail
- Clinical Laboratory, Medical Division, Dasman Diabetes Institute, Kuwait
| | - Azza Shaltout
- Department of Population Health, Dasman Diabetes Institute, Kuwait
| | - Hessa Alkandari
- Department of Population Health, Dasman Diabetes Institute, Kuwait
| |
Collapse
|
17
|
Almari M, Mohammad A, Abubaker J, Ziyab AH. Obesity and Prediabetes are Jointly Associated with Lipid Abnormalities Among Adolescents: A Cross-Sectional Study. Diabetes Metab Syndr Obes 2021; 14:345-353. [PMID: 33519222 PMCID: PMC7837585 DOI: 10.2147/dmso.s290383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 12/24/2020] [Indexed: 01/21/2023] Open
Abstract
PURPOSE Obesity and prediabetes are common among adolescents; however, it is unclear whether they jointly influence lipid levels. Hence, this study sought to assess whether obesity and prediabetes independently or jointly influence lipid levels among adolescents. METHODS A cross-sectional study enrolled school students aged 14-19 years (n = 1584). Body mass index (BMI)-for-age z-scores were estimated, and glycated hemoglobin A1c (HbA1c) and lipid profile were measured in capillary blood. Prediabetes was defined as 5.7≤ HbA1c% ≤6.4. Geometric means of lipids were calculated, and linear regression was used to estimate the ratio of geometric means (RoGM) and their 95% confidence intervals (CI). All analyses were stratified by sex. RESULTS Of the total study participants, 52.1% (826/1584) were females and the majority were aged between 14.0 (5th percentile) and 18.0 (95th percentile) years. Based on BMI-for-age categories, 356 (22.5%) and 494 (31.2%) participants were classified as overweight and obese, respectively. Moreover, 34.3% (543/1584) of the study participants met the prediabetes definition. Compared to those with normal BMI and no prediabetes (reference category), participants classified as obese and having prediabetes had elevated levels of total cholesterol (TC; RoGM=1.09, 95% CI: 1.06-1.13), low-density lipoprotein cholesterol (LDL-C; 1.21, 1.13-1.29), non-high-density lipoprotein cholesterol (non-HDL-C; 1.20, 1.14-1.26), and triglycerides (TG; 1.18, 1.09-1.27) and reduced HDL-C (0.91, 0.88-0.95) levels. Independent of prediabetes, obesity was associated with all the investigated lipids. Prediabetes alone was associated with reduced levels of LDL-C and increased levels of HDL-C only among females. CONCLUSION Obesity independently and in combination with prediabetes demonstrated unfavorable effects on lipids among male and female adolescents, whereas prediabetes independently influenced LDL-C and HDL-C favorably only among females.
Collapse
Affiliation(s)
- Mohammad Almari
- Department of Health Policy and Management, Faculty of Public Health, Kuwait University, Safat, Kuwait
| | - Anwar Mohammad
- Department of Biochemistry and Molecular Biology, Research Division, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Jehad Abubaker
- Department of Biochemistry and Molecular Biology, Research Division, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Ali H Ziyab
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait
- Correspondence: Ali H Ziyab Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait, P. O. Box 24923, Safat13110, Kuwait Tel +96524636545 Fax +96525338948 Email
| |
Collapse
|
18
|
Al-Taiar A, Alqaoud N, Sharaf Alddin R, Alanezi F, Subhakaran M, Dumadag A, Albatineh AN. Stunting and Combined Overweight with Stunting among Schoolchildren in Kuwait: Trends over a 13-Year Period. Med Princ Pract 2021; 30:515-521. [PMID: 34348312 PMCID: PMC8739943 DOI: 10.1159/000518533] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 07/15/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES This study aimed to investigate the sex- and age-specific trends of stunting and combined overweight with stunting among schoolchildren over a 13-year period in Kuwait. SUBJECTS AND METHODS The Kuwait Nutrition Surveillance System objectively measured the height of 172,573 schoolchildren (5-19 years) over a 13-year period (2007-2019). Data on gender and date of birth were extracted from school records. Stunting was defined as height 2 standard deviations (SD) below the World Health Organization growth reference median. Logistic regression models were used to examine the trends of stunting over the study period while stratifying by gender. RESULTS In males, the prevalence of stunting increased from 2.46% in 2007 to 4.18% in 2019 (p for trend <0.001). In females, the prevalence of stunting fluctuated but remained around 3.80% in both 2007 and 2019. The odds of stunting significantly increased in the period 2017-2019 compared to the period 2007-2010 among males, adjusted odds ratio (AOR) 1.04 (95% confidence interval [CI]: 1.14-1.76); p = 0.009, but not females, AOR 0.89 (95% CI: 0.73-1.07); p = 0.176. Although not statistically significant, there was a tendency for the odds of combined overweight with stunting to increase in males, AOR 1.65 (95% CI: 0.90-3.04); p = 0.087, but not females, AOR 1.13 (95% CI: 0.88-1.45); p = 0.248. CONCLUSION Although the prevalence of stunting and combined stunting with overweight is low, there is an emerging upward trend in schoolboys that warrants further investigation and monitoring. This highlights the need for gender-specific interventions to reduce nutritional abnormalities in high-income countries in the Middle East countries like Kuwait.
Collapse
Affiliation(s)
- Abdullah Al-Taiar
- School of Community and Environmental Health, College of Health Sciences, Old Dominion University, Norfolk, Virginia, USA
- *Abdullah Al-Taiar,
| | - Nawal Alqaoud
- Food and Nutrition Administration, Ministry of Health, Kuwait City, Kuwait
| | - Reem Sharaf Alddin
- HealthCare Analytics and Delivery Science Institute, Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Faheema Alanezi
- Food and Nutrition Administration, Ministry of Health, Kuwait City, Kuwait
| | - Monica Subhakaran
- Food and Nutrition Administration, Ministry of Health, Kuwait City, Kuwait
| | - Anne Dumadag
- School of Community and Environmental Health, College of Health Sciences, Old Dominion University, Norfolk, Virginia, USA
| | - Ahmed N. Albatineh
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| |
Collapse
|
19
|
Alkandari A, Alarouj M, Elkum N, Sharma P, Devarajan S, Abu-Farha M, Al-Mulla F, Tuomilehto J, Bennakhi A. Adult Diabetes and Prediabetes Prevalence in Kuwait: Data from the Cross-Sectional Kuwait Diabetes Epidemiology Program. J Clin Med 2020; 9:E3420. [PMID: 33113867 PMCID: PMC7694112 DOI: 10.3390/jcm9113420] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 10/13/2020] [Accepted: 10/22/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND This study aimed to estimate the prevalence of diabetes and prediabetes in adults in Kuwait. METHODS The Kuwait Diabetes Epidemiology Program was a nationally representative, cross-sectional study of diabetes and obesity in Kuwait conducted between 2011 and 2014. The survey sampled 4937 adults in Kuwait aged 20 years or more and recorded participants' demographics, behaviours, medical history, physical measurements and blood biochemical measurements. Prediabetes was defined as fasting plasma glucose between 6.1 and 6.9 mmol/L or HbA1c between 6 and 6.4% (42-47 mmol/mol). Diabetes was defined as self-reported history with prescribed glucose-lowering medication or FPG ≥7mmol/L or HbA1c level ≥6.5% (≥48 mmol/mol). RESULTS The overall adjusted prevalence of diabetes was 19.1%. The overall adjusted prevalence of prediabetes was 13.5%. Diabetes prevalence was 5.4%, 14.2%, 38.7% and 64.8% in adults aged 20-29, 30-44, 45-59 and 60 years or more, respectively. Diabetes prevalence was 22.4% in men and 14.4% in women. Prediabetes prevalence was 14.8% in men and 11.5% in women. In Kuwaitis, diabetes and prediabetes prevalence was 21.8% and 11.1%, respectively, while prevalence in non-Kuwaitis was 18.2% for diabetes and 14.3% for prediabetes. CONCLUSION These findings illustrate the severe public health challenge posed by diabetes in Kuwait.
Collapse
Affiliation(s)
- Abdullah Alkandari
- Dasman Diabetes Institute, Kuwait City 15462, Kuwait; (M.A.); (P.S.); (S.D.); (M.A.-F.); (F.A.-M.); (A.B.)
| | - Monira Alarouj
- Dasman Diabetes Institute, Kuwait City 15462, Kuwait; (M.A.); (P.S.); (S.D.); (M.A.-F.); (F.A.-M.); (A.B.)
| | - Naser Elkum
- Sidra Medical and Research Center, Doha 26999, Qatar;
| | - Prem Sharma
- Dasman Diabetes Institute, Kuwait City 15462, Kuwait; (M.A.); (P.S.); (S.D.); (M.A.-F.); (F.A.-M.); (A.B.)
| | - Sriraman Devarajan
- Dasman Diabetes Institute, Kuwait City 15462, Kuwait; (M.A.); (P.S.); (S.D.); (M.A.-F.); (F.A.-M.); (A.B.)
| | - Mohamed Abu-Farha
- Dasman Diabetes Institute, Kuwait City 15462, Kuwait; (M.A.); (P.S.); (S.D.); (M.A.-F.); (F.A.-M.); (A.B.)
| | - Fahd Al-Mulla
- Dasman Diabetes Institute, Kuwait City 15462, Kuwait; (M.A.); (P.S.); (S.D.); (M.A.-F.); (F.A.-M.); (A.B.)
| | - Jaakko Tuomilehto
- Public Health Prevention Unit, Finnish Institute for Health and Welfare, FI-00271 Helsinki, Finland;
| | - Abdullah Bennakhi
- Dasman Diabetes Institute, Kuwait City 15462, Kuwait; (M.A.); (P.S.); (S.D.); (M.A.-F.); (F.A.-M.); (A.B.)
| |
Collapse
|
20
|
Differences in educational attainment between obese and non-obese Kuwaiti female university students. J Nutr Sci 2020; 9:e30. [PMID: 32913642 PMCID: PMC7443771 DOI: 10.1017/jns.2020.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 06/23/2020] [Accepted: 06/26/2020] [Indexed: 11/16/2022] Open
Abstract
Individuals with obesity tend to perform less well than their non-obese peers in tertiary education, but there is little evidence from non-Western countries and recent studies. The present study aimed to test whether academic attainment differed between female undergraduates with obesity (defined by body mass index (BMI)), and those who were non-obese in Kuwait, a country with very high obesity prevalence. In 400 female Kuwaiti first- and second-year Social Science students (mean age 18⋅0, sd 0⋅6 years), educational attainment was defined as the Grade Point Average (GPA) across all subjects (from 1⋅00 to 4⋅00). The mean GPA (2⋅51, sd 0⋅53) among students defined as obese by the BMI (n 163) was significantly lower than among the students defined as non-obese by the BMI (n 237; 2⋅80, sd 0⋅63; P < 0⋅001), and those defined as obese were more likely to be in the lowest quartile for the GPA (OR 3⋅03; 95% CI 1⋅90, 4⋅85), independent of socio-economic status. Similar differences were observed between students defined as having high versus normal body fatness. Female undergraduates in Kuwait with obesity have lower academic attainment than their non-obese peers, and universities should consider measures to mitigate reduced attainment among their female undergraduates.
Collapse
|
21
|
Ziyab AH, Karmaus W, AlShatti KA, Al-Kandari M, Hussein SH, Ali YM. Psoriasis Among Adolescents in Kuwait and the Role of Siblings, Breastfeeding, and Household Cat and Secondhand Smoke Exposure: A Cross-Sectional Study. Dermatol Ther (Heidelb) 2020; 10:1137-1153. [PMID: 32844373 PMCID: PMC7477028 DOI: 10.1007/s13555-020-00437-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Indexed: 10/29/2022] Open
Abstract
INTRODUCTION Globally, the epidemiology of psoriasis is poorly understood, and most countries lack essential epidemiologic data regarding disease burden and its determinants. This study sought to estimate the prevalence of psoriasis among adolescents in Kuwait and assess its association with different risk factors, including obesity, sibship size, breastfeeding, and exposure to household secondhand smoke (SHS) and pets. METHODS Schoolchildren aged 11-14 years (n = 3864) were enrolled in a cross-sectional study. Lifetime and current (past 12 months) prevalence of psoriasis were ascertained according to ever having a history of doctor-diagnosis plus current active lesion(s) and/or current use of treatment of psoriasis. Associations were assessed using Poisson regression with robust variance estimation, and adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) were estimated. RESULTS The lifetime and current prevalence of psoriasis were estimated to be 3.6% (136/3806) and 1.1% (42/3806), respectively. Commonly reported anatomical sites affected by psoriasis included scalp (47.6%) and the extensor surface of the knees (50%) and elbows (38.1%). Household SHS exposure was associated with increased lifetime psoriasis (aPR = 1.41, 95% CI 1.07-1.98), and showed a trend for association with current psoriasis (1.77, 0.89-3.53). Similarly, cat-keeping during infancy was associated with lifetime psoriasis (1.96, 1.14-3.37), and demonstrated a trend for association with current psoriasis (1.49, 0.52-1.98). In contrast, breastfeeding was associated with a decreased lifetime psoriasis (0.62, 0.44-0.89), but was not associated with current psoriasis. Trend analyses showed that the prevalence of lifetime and current psoriasis increased with increasing numbers of total, older, and younger siblings. CONCLUSIONS Psoriasis affects a considerable proportion of schoolchildren in Kuwait. Interestingly, psoriasis prevalence was related to risk factors also found in allergic diseases, such as exposure to SHS, cat-keeping in infancy, breastfeeding, and sibship size, possibly suggesting a role of immune dysregulation.
Collapse
Affiliation(s)
- Ali H Ziyab
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait.
| | - Wilfried Karmaus
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA
| | | | - Manal Al-Kandari
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Shaimaa H Hussein
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Yaser M Ali
- Department of Internal Medicine, Mubarak Al-Kabeer Hospital, Ministry of Health, Kuwait City, Kuwait
| |
Collapse
|
22
|
Enhancing Research and Development in the Health Sciences as a Strategy to Establish a Knowledge-Based Economy in the State of Kuwait: A Call for Action. Healthcare (Basel) 2020; 8:healthcare8030264. [PMID: 32806569 PMCID: PMC7551608 DOI: 10.3390/healthcare8030264] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/28/2020] [Accepted: 08/07/2020] [Indexed: 11/16/2022] Open
Abstract
Kuwait Vision 2035 is an initiative that was launched in 2017 by His Highness the Emir of the State of Kuwait Sheikh Sabah Al-Ahmad Al-Jaber Al-Sabah. This initiative includes the implementation of a detailed development plan aimed at transforming the state of Kuwait into a regional leader in science, technology, and innovation. Health research will arguably prove to be one of the most impactful research arenas when it comes to accomplishing the goals set forth by the Kuwait Vision 2035 Development Plan. The high impact of health research is derived from its capacity to aid in the establishment of a knowledge-based health industry. The state of Kuwait lacks a system for promoting and managing national R&D efforts. At present, the research and development (R&D) expenditure in the state of Kuwait is far below the international standards that have been shown to lead to innovation and the subsequent development of a knowledge-based economy. Improvement of the weak and unstructured existing R&D apparatus in the State of Kuwait is among the most urgent challenges facing the nation as it strives toward innovation and development of a knowledge-based economy. Developing health research capacities in the State of Kuwait can significantly contribute toward improving public health, health promotion, disease prevention and treatment, and overall human welfare. Importantly, the positive impacts of such extensive benefits will not be restricted to the state of Kuwait and its citizens, but may in fact reap benefits for the global society as a whole. This article first analyzes the current status of healthcare services and health science research in the State of Kuwait, and then summarizes some essential R&D design principles that Kuwait needs to implement in order to achieve the milestones set forth in the Kuwait Vision 2035 Development Plan.
Collapse
|
23
|
AlShatti KA, Ziyab AH. Pet-Keeping in Relation to Asthma, Rhinitis, and Eczema Symptoms Among Adolescents in Kuwait: A Cross-Sectional Study. Front Pediatr 2020; 8:331. [PMID: 32656169 PMCID: PMC7324793 DOI: 10.3389/fped.2020.00331] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 05/20/2020] [Indexed: 11/30/2022] Open
Abstract
Background: Findings on the associations between household pet-keeping and allergic diseases, including asthma, rhinitis, and eczema, have been contradictory, with investigations reporting positive, negative, and null associations. This study sought to estimate the prevalence of pet-keeping among families in Kuwait and to assess the associations between pet-keeping and symptoms of allergic diseases among adolescents. Methods: Schoolchildren aged 11-14 years (n = 3,864) were enrolled in this cross-sectional study. The children's parents completed questionnaires regarding their child's environmental exposures, including pet-keeping in the past 12 months, and clinical history and symptoms of allergic diseases. Associations were assessed using Poisson regression with robust variance estimation, and adjusted prevalence ratios (aPRs) and their 95% confidence intervals (CIs) were estimated. Results: Pet-keeping in the past 12 months was reported by 42.8% of the participating families. Birds, cats, rabbits, fish, and dogs were kept by 28.3, 13.2, 7.8, 3.9, and 3.1% of all households, respectively. Current cat ownership was significantly associated with current wheezing (aPR 1.29, 95% CI 1.05-1.58), current rhinitis symptoms (aPR 1.18, 95% CI 1.02-1.36), and ever doctor-diagnosed eczema (aPR 1.25, 95% CI 1.03-1.50). Current rabbit-keeping was positively associated with multiple symptoms of asthma (e.g., study-defined current asthma: aPR 1.38, 95% CI 1.04-1.82) and eczema (e.g., severe eczema: aPR 1.94, 95% CI 1.02-3.71). Similarly, current bird-keeping was associated with study-defined current rhinitis (aPR 1.19, 95% CI 1.05-1.41) and current itchy rash (aPR 1.27, 95% CI 1.10-1.46). Conclusions: Household pet-keeping is very common and diverse in Kuwait and was found to be positively associated with symptoms of allergic diseases among adolescents. The findings of associations between rabbit-keeping and symptoms of asthma and eczema add to the existing literature and further highlight the importance of considering the pet type when assessing such associations.
Collapse
Affiliation(s)
| | - Ali H Ziyab
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait
| |
Collapse
|
24
|
Emamian MH, Hashemi H, Fotouhi A. Obesity and underweight: Serious health problems in Iranian primary school children. Pediatr Int 2019; 61:1030-1035. [PMID: 31325396 DOI: 10.1111/ped.13978] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 05/12/2019] [Accepted: 07/11/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Childhood obesity is increasing around the world. Compared with developed countries, the rate of increase is 30% higher in developing countries, where the monitoring of obesity and overweight is essential. This study investigated the prevalence of obesity, overweight, thinness, and stunting in primary school students in Shahroud, Iran. METHODS A total of 5,620 primary students were enrolled during 2015. In rural areas all students were invited to participate, while cluster sampling was used in urban areas and 200 classrooms were selected randomly as clusters. Height, weight and body mass index Z-scores for age (HAZ, WAZ and BAZ) were calculated based on World Health Organization standard. The mean indices and prevalence of obesity, overweight, thinness, and stunting were calculated by education level, gender, and place of residence. Prevalence of obesity and overweight was estimated also by international obesity task force definition. RESULTS The mean WAZ, HAZ, and BAZ were 0.050 ± 1.25, 0.005 ± 0.98, and 0.076 ± 1.35, respectively. These indices in rural areas were significantly lower than those in urban areas (P < 0.001). Overall, 25.7% of children in urban areas (95%CI: 24.1-27.4) and 14.8% in rural areas (95%CI: 12.3-17.3) were overweight or obese, and 5.1% of rural girls (95%CI: 3.1-7.0) were stunted. CONCLUSIONS Compared with previous studies, obesity and overweight are still rising in Iranian school children, thus more serious interventions are needed. These interventions must also deal with underweight and stunting, particularly in rural areas.
Collapse
Affiliation(s)
- Mohammad Hassan Emamian
- Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
25
|
Hashem R, Rey-Lόpez JP, Hamer M, McMunn A, Rowlands A, Whincup PH, Owen CG, Ding D, Powell L, Stamatakis E. Associations between objectively assessed and questionnaire-based sedentary behaviour with body mass index and systolic blood pressure in Kuwaiti adolescents. BMC Res Notes 2019; 12:588. [PMID: 31533859 PMCID: PMC6751576 DOI: 10.1186/s13104-019-4626-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 09/10/2019] [Indexed: 11/29/2022] Open
Abstract
Objective Kuwait has one of the highest obesity rates in the world. This study examined the associations between sedentary behaviour (objectively measured and self-reported), adiposity and systolic blood pressure in a sample of adolescents residing in Kuwait. Data was obtained from the Study of Health and Activity among adolescents in Kuwait (2012–2013). The sample included a total of 435 adolescents (201 boys). Outcomes were age- and sex specific body mass index Z-scores and systolic blood pressure. Exposures were total sedentary behaviour measured by accelerometry and time spent in some sedentary behaviours (television viewing, video games, computer use and total screen-time). We used multiple linear regression analyses, adjusted for age, governorate, maternal education and physical activity, to examine associations between sedentary behaviour and adiposity and systolic blood pressure. Results Only 2 statistically significant associations were found between sedentary behaviour and the study outcomes: body mass in boys was directly associated with higher sedentary time [β (95% CIs) 0.003 (0.00 to 0.06)]; body mass index was inversely associated with videogames in both sexes [girls: β (95% CIs) − 0.17 (− 0.48 to − 0.04); boys: − 0.24 (− 0.57 to − 0.12)]. In this sample of Kuwaiti adolescents, sedentary behaviour showed limited deleterious associations with adiposity and systolic blood pressure.
Collapse
Affiliation(s)
- Rawan Hashem
- Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, UK
| | - Juan Pablo Rey-Lόpez
- Charles Perkins Centre, Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Mark Hamer
- Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, UK.,School of Sport Exercise & Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK
| | - Anne McMunn
- Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, UK
| | - Alex Rowlands
- Diabetes Research Centre, University of Leicester, Leicester, UK.,NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester, UK.,Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, Division of Health Sciences, University of South Australia, Adelaide, Australia
| | - Peter H Whincup
- Population Health Research Institute, St George's University of London, London, UK
| | - Christopher G Owen
- Population Health Research Institute, St George's University of London, London, UK
| | - Ding Ding
- Charles Perkins Centre, Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Lauren Powell
- Charles Perkins Centre, Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Emmanuel Stamatakis
- Charles Perkins Centre, Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, NSW, Australia.
| |
Collapse
|
26
|
Khoursheed M, Al-Bader I, Mouzannar A, Ashraf A, Al-Haddad A, Sayed A, Alsalim A, Fingerhut A. Laparoscopic Sleeve Gastrectomy for Morbid Obesity in Kuwaiti Adolescents. Bariatr Surg Pract Patient Care 2019. [DOI: 10.1089/bari.2018.0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Mousa Khoursheed
- Department of Surgery, Health Sciences Center, Kuwait University, Kuwait City, Kuwait
| | - Ibtisam Al-Bader
- Department of Surgery, Health Sciences Center, Kuwait University, Kuwait City, Kuwait
| | - Ali Mouzannar
- Department of Surgery, Mubarak Hospital, Kuwait City, Kuwait
| | - Aqeel Ashraf
- Department of Surgery, Mubarak Hospital, Kuwait City, Kuwait
| | | | - Ali Sayed
- Department of Surgery, Mubarak Hospital, Kuwait City, Kuwait
| | - Ahmad Alsalim
- Department of Surgery, Mubarak Hospital, Kuwait City, Kuwait
| | - Abe Fingerhut
- Department of Surgery, Surgical Research Unit Graz, Medical University of Graz, Graz, Austria
| |
Collapse
|
27
|
Elkum N, Alarouj M, Bennakhi A, Shaltout A. The Complex Etiology of Childhood Obesity in Arabs Is Highlighted by a Combination of Biological and Socio-Economic Factors. Front Public Health 2019; 7:72. [PMID: 31001508 PMCID: PMC6455072 DOI: 10.3389/fpubh.2019.00072] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 03/12/2019] [Indexed: 11/17/2022] Open
Abstract
Objectives: To identify predictors of childhood and adolescent obesity in Kuwaitis with Arab ethnicity. Methods: A cross-sectional sample of 6–18 year-old schoolchildren was randomly selected from 244 public schools across all six governorates in the State of Kuwait. Anthropometric data were measured from 6,574 Arab Kuwaiti schoolchildren, and a structured questionnaire was used to collect information on possible risk factors associated with obesity. Overweight and obesity were defined in accordance with the Center for Disease Control and Prevention criteria. Results: The prevalence of overweight and obesity in children (aged 6–18 years) were 17.7% and 33.7%, respectively. The likelihood of childhood obesity increased with birth weights >4.0 Kg [odds ratio (OR) = 2.3; p < 0.0001], maternal employment (OR = 1.26, p = 0.0006), maternal age at pregnancy >30 years (OR = 1.24; p = 0.0016) and family size of <6 members (OR = 1.16, p = 0.0106). Conclusions: Public health professionals should be aware that advanced maternal age, maternal employment, smaller family size, and high birthweight may predict the risk of obesity in Kuwaiti Arab children and adolescents.
Collapse
Affiliation(s)
- Naser Elkum
- Research Department, Sidra Medicine, Doha, Qatar.,Department of Clinical Services, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Monira Alarouj
- Department of Clinical Services, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Abdullah Bennakhi
- Department of Clinical Services, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Azza Shaltout
- Department of Clinical Services, Dasman Diabetes Institute, Kuwait City, Kuwait
| |
Collapse
|
28
|
Ziyab AH. Prevalence of food allergy among schoolchildren in Kuwait and its association with the coexistence and severity of asthma, rhinitis, and eczema: A cross-sectional study. World Allergy Organ J 2019; 12:100024. [PMID: 30976380 PMCID: PMC6441753 DOI: 10.1016/j.waojou.2019.100024] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 12/25/2018] [Accepted: 03/11/2019] [Indexed: 11/09/2022] Open
Abstract
Background Food allergy (FA) is a common public health problem that affects both children and adults. Empirical knowledge of the burden of FA in Kuwait is limited. This study sought to estimate the prevalence of FA among schoolchildren in Kuwait and assess associations between FA and the coexistence and severity of asthma, rhinitis, and eczema. Methods Schoolchildren aged 11–14 years (n = 3,864) were enrolled in a cross-sectional study. Parents completed questionnaires regarding their children's early life exposures and clinical history of FA and allergic diseases. Study-defined FA was ascertained by a convincing clinical history. Associations were assessed using Poisson regression with robust variance estimation, and adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) were estimated. Results The 12-month prevalence of study-defined FA was estimated to be 4.1% (154/3,738), with more girls being affected than boys (aPR = 1.44, 95% CI: 1.04–1.99). Egg (2.7%), fish (1.6%), shellfish (1.3%), peanut (1.3%), and tree nut (1.2%) were the most reported offending food allergens. Underweight and adiposity, cesarean section delivery, exposure to household dogs during infancy, and parental history of doctor-diagnosed FA were associated with an increased prevalence of study-defined FA. However, later birth order was associated with a reduced prevalence of study-defined FA. The prevalence of eczema only was higher in children with study-defined FA than in those without study-defined FA (aPR = 3.49, 95% CI: 2.37–5.14). In contrast, this association was not pronounced for children who had asthma only (aPR = 1.56, 95% CI: 0.94–2.57) or rhinitis only (aPR = 1.40, 95% CI: 0.86–2.28). Study-defined FA was associated with a 9.20-fold (95% CI: 4.50–18.78) higher prevalence of coexisting asthma, rhinitis, and eczema. Moreover, study-defined FA was associated with increased severity of symptoms of asthma, rhinitis, and eczema. Conclusions FA affects a considerable proportion of schoolchildren in Kuwait, and the most reported offending food allergens are similar to those reported in Western countries. Study-defined FA was associated with the coexistence and increased severity of asthma, rhinitis, and eczema, indicating that FA may link the comanifestations of allergic diseases and contribute to their chronicity and severity.
Collapse
Affiliation(s)
- Ali H Ziyab
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait
| |
Collapse
|
29
|
Prevalence of obesity among school-age children and adolescents in the Gulf cooperation council (GCC) states: a systematic review. BMC OBESITY 2019; 6:3. [PMID: 30637108 PMCID: PMC6323696 DOI: 10.1186/s40608-018-0221-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 12/12/2018] [Indexed: 12/14/2022]
Abstract
Background The Gulf Cooperation Council (GCC) countries have among the highest prevalence of adult obesity and type 2 diabetes in the world. This study aimed to estimate the recent prevalence of obesity among school-age children and adolescents in the GCC States. Methods The literature search for obesity prevalence data was carried out in July 2017 in Google Scholar, Physical education index, Medline, SCOPUS, WHO, 2007-2017, and updated in November 2018.In addition, 22 experts from the GCC were contacted to check the search results, and to suggest studies or grey literature which had been missed. Eligible studies were assessed for quality by using the Joanna Briggs Institute (JBI) tool for prevalence studies. Conduct of the systematic review followed the Assessment of Multiple Systematic Reviews Tool (AMSTAR) guidance. A narrative synthesis was conducted. Results Out of 392 studies identified, 41 full-text reports were screened for eligibility; 11 of which were eligible and so were included, from 3 of the 6 GCC countries (United Arab Emirates, Kuwait, Saudi Arabia). Surveillance seems good in Kuwait in compared to other countries, with one recent national survey of prevalence. Quality of the eligible studies was generally low-moderate according to the JNBI tool: representative samples were rare; participation rates low; power calculations were mentioned by only 3/11 studies and confidence intervals around prevalence estimates provided by only 3/11 eligible studies; none of the studies acknowledged that prevalence estimates were conservative (being based on BMI-for-age). There was generally a very high prevalence of obesity (at least one quarter-one third of study or survey participants obese according to BMI-for-age), prevalence increased with age, and was consistently higher in boys than girls. Conclusions The prevalence of obesity among school-age children and adolescents appears to have reached alarming levels in the GCC, but there are a number of major gaps and limitations in obesity surveillance in the GCC states. More national surveys of child and adolescent obesity prevalence are required for the GCC states. Trial registration PROSPERO registration number CRD42017073692.
Collapse
|
30
|
Al-Kandari H, Al-Abdulrazzaq D, Davidsson L, Sharma P, Al-Tararwa A, Mandani F, Al-Shawaf F, Al-Hussaini F, Qabazard M, Haddad D, Al-Mahdi M, Al-Jasser F, Alanezi A, Al-Sanea H, Al-Basari I, Al-Adsani A, Shaltout A, AbdulRasoul M. Incidence of Type 2 Diabetes in Kuwaiti Children and Adolescents: Results From the Childhood-Onset Diabetes Electronic Registry (CODeR). Front Endocrinol (Lausanne) 2019; 10:836. [PMID: 31866943 PMCID: PMC6904274 DOI: 10.3389/fendo.2019.00836] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 11/18/2019] [Indexed: 01/06/2023] Open
Abstract
Background: Type 2 Diabetes (T2D) in children and adolescents has become an important public health concern due to the increase in childhood obesity worldwide. The urgency to address T2D is evident as children and adolescents are at a higher risk of complications due to prolonged disease duration. We aimed to estimate the incidence rate (IR) of T2D in Kuwaiti children and adolescents aged 14 years and younger between 2011 and 2013 and to describe their clinical characteristics at the time of diagnosis. Material and Methods: All newly diagnosed patients were registered through the Childhood-Onset Diabetes electronic Registry implemented in Kuwait. Cases who met the 2018 ISPAD guidelines for diagnosis of T2D were included. Results: A total of 32 patients were included, equally distributed gender-wise, with a mean age 12.2 years (±1.7 SD), lower for females than males (11.5 vs. 12.2, p < 0.025). Data ascertainment was 94.1% (95%CI; 91.6-96.6%). Overall IR was 2.56 (95% CI; 1.78-3.56) per 100,000 Kuwaiti children and adolescents per year. Most of the patients (n = 30; 93.8%) presented with T2D between the ages 10-14 years, with age-specific IR of 8.0 (95%CI; 5.5-11.3). No statistically significant difference between males and females with regards to BMI z scores or HbA1C at diagnosis. Conclusion: The true incidence of T2D in Kuwaiti children and adolescents is expected to be considerably higher as we have reported only symptomatic cases. Future research should focus on screening children and adolescents at risk to enable accurate estimates. More efforts are needed to better understand the clinical course of T2D early in life to improve management, prevent complications and improve quality of life.
Collapse
Affiliation(s)
- Hessa Al-Kandari
- Department of Population Health, Dasman Diabetes Institute, Kuwait City, Kuwait
- Department of Pediatrics, Farwaniya Hospital, Ministry of Health, Sabah Al Nasser, Kuwait
| | - Dalia Al-Abdulrazzaq
- Department of Population Health, Dasman Diabetes Institute, Kuwait City, Kuwait
- Department of Pediatrics, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
- Department of Pediatrics, Mubarak Al-Kabeer Hospital, Ministry of Health, Jabriya, Kuwait
- *Correspondence: Dalia Al-Abdulrazzaq ;
| | - Lena Davidsson
- Department of Population Health, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Prem Sharma
- Special Services Facilities, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Abeer Al-Tararwa
- Department of Pediatrics, Farwaniya Hospital, Ministry of Health, Sabah Al Nasser, Kuwait
| | - Fawziya Mandani
- Department of Pediatrics, Sabah Hospital, Ministry of Health, Kuwait City, Kuwait
| | - Faisal Al-Shawaf
- Department of Pediatrics, Mubarak Al-Kabeer Hospital, Ministry of Health, Jabriya, Kuwait
| | - Fatma Al-Hussaini
- Department of Pediatrics, Adan Hospital, Ministry of Health, Hadiya, Kuwait
| | - Mariam Qabazard
- Department of Pediatrics, Amiri Hospital, Ministry of Health, Kuwait City, Kuwait
| | - Dania Haddad
- Department of Population Health, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Maria Al-Mahdi
- Department of Pediatrics, Adan Hospital, Ministry of Health, Hadiya, Kuwait
| | - Fahad Al-Jasser
- Department of Population Health, Dasman Diabetes Institute, Kuwait City, Kuwait
- Department of Pediatrics, Amiri Hospital, Ministry of Health, Kuwait City, Kuwait
| | - Ayed Alanezi
- Department of Pediatrics, Jahra Hospital, Ministry of Health, Al Jahra, Kuwait
| | - Hala Al-Sanea
- Department of Pediatrics, Amiri Hospital, Ministry of Health, Kuwait City, Kuwait
| | - Iman Al-Basari
- Department of Pediatrics, Mubarak Al-Kabeer Hospital, Ministry of Health, Jabriya, Kuwait
| | - Afaf Al-Adsani
- Department of Medicine, Sabah Hospital, Ministry of Health, Kuwait City, Kuwait
| | - Azza Shaltout
- Department of Population Health, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Mejedah AbdulRasoul
- Department of Pediatrics, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
- Department of Pediatrics, Adan Hospital, Ministry of Health, Hadiya, Kuwait
| |
Collapse
|
31
|
Nizam R, Al-Ozairi E, Goodson JM, Melhem M, Davidsson L, Alkhandari H, Al Madhoun A, Shamsah S, Qaddoumi M, Alghanim G, Alhasawi N, Abu-Farha M, Abubaker J, Shi P, Hartman ML, Tavares M, Bitar M, Ali H, Arefanian H, Devarajan S, Al-Refaei F, Alsmadi O, Tuomilehto J, Al-Mulla F. Caveolin-1 Variant Is Associated With the Metabolic Syndrome in Kuwaiti Children. Front Genet 2018; 9:689. [PMID: 30622557 PMCID: PMC6308323 DOI: 10.3389/fgene.2018.00689] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 12/11/2018] [Indexed: 12/18/2022] Open
Abstract
Caveolin-1 (CAV1) variants have been suggested to be associated with obesity and related metabolic disorders, but information based on human studies is limited. In the present study, we aimed to investigate the potential association between the CAV1 rs1997623 C/A variant and metabolic syndrome (MetS) in Kuwaiti children. DNA from saliva samples collected from 1313 Kuwaiti children (mean age: 12 years) were genotyped using the TaqMan SNP genotyping assay. The classification of MetS was based on the presence/absence of four indicators; (1) central obesity, (2) elevated systolic or diastolic blood pressure, (3) low salivary high-density lipoprotein cholesterol (HDLC), and (4) high salivary glucose. In this study, children with MetS scored ≥3, children in the intermediate metabolic group scored 1 or 2 and children without MetS scored 0. About one-third of the children were obese. A total of 246 children (18.7%) were classified as having MetS; 834 children (63.5%) were in the intermediate metabolic group, and 233 children (17.7%) had no indication of MetS. Obesity was highly prevalent in the MetS group (91.9%) while 26.8% of children were obese in the intermediate metabolic group. None of the children were obese in the group without MetS. Analysis of the CAV1 rs1997623 variant revealed a significant association of the A-allele (p = 0.01, Odds Ratio (OR) = 1.66) and the heterozygous CA-genotype (p = 0.005, OR = 1.88) with MetS. Consistently, the A-allele (p = 0.002, OR = 1.71) and CA-genotype (p = 0.005, OR = 1.70) also showed significant association with the intermediate metabolic group. Furthermore, the A-allele (p = 0.01, OR = 1.33) and the CA-genotype (p = 0.008, OR = 1.55) were associated with low levels of saliva HDLC. Individuals who were heterozygous or homozygous for the variant (CA/AA) showed significantly lower levels of high HDLC compared to those harboring the CC-genotype (p = 0.023). Our study revealed a novel association of the CAV1 rs1997623 variant with the MetS and with low saliva HDLC levels in young Kuwaiti children and indicated the need for further in-depth studies to unravel the role of CAV1 gene in the genetic etiology of MetS.
Collapse
Affiliation(s)
- Rasheeba Nizam
- Functional Genomics Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Ebaa Al-Ozairi
- Clinical Division, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Jo Max Goodson
- Applied Oral Sciences, The Forsyth Institute, Cambridge, MA, United States
| | - Motesam Melhem
- Functional Genomics Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Lena Davidsson
- Family Medicine and Pediatric Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Hessa Alkhandari
- Family Medicine and Pediatric Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Ashraf Al Madhoun
- Functional Genomics Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Sara Shamsah
- Faculty of Allied Health Sciences, Kuwait University, Kuwait City, Kuwait
| | - Malak Qaddoumi
- Functional Genomics Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Ghazi Alghanim
- Functional Genomics Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Nouf Alhasawi
- Functional Genomics Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Mohamed Abu-Farha
- Biochemistry and Molecular Biology Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Jehad Abubaker
- Biochemistry and Molecular Biology Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Ping Shi
- Applied Oral Sciences, The Forsyth Institute, Cambridge, MA, United States
| | - Mor-Li Hartman
- Applied Oral Sciences, The Forsyth Institute, Cambridge, MA, United States
| | - Mary Tavares
- Applied Oral Sciences, The Forsyth Institute, Cambridge, MA, United States
| | - Milad Bitar
- Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Hamad Ali
- Faculty of Allied Health Sciences, Kuwait University, Kuwait City, Kuwait
| | | | - Sriraman Devarajan
- National Dasman Diabetes Biobank, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Faisal Al-Refaei
- Clinical Division, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Osama Alsmadi
- Cell Therapy and Applied Genomics, King Hussein Cancer Center, Amman, Jordan
| | | | - Fahd Al-Mulla
- Functional Genomics Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| |
Collapse
|
32
|
Almari M, Alsaedi S, Mohammad A, Ziyab AH. Associations of adiposity and parental diabetes with prediabetes among adolescents in Kuwait: A cross-sectional study. Pediatr Diabetes 2018; 19:1362-1369. [PMID: 30255624 DOI: 10.1111/pedi.12780] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 09/03/2018] [Accepted: 09/17/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Prediabetes, a high-risk state for developing diabetes, has become more prevalent among children and adolescents in recent decades. This study sought to estimate the prevalence of prediabetes and assess its association with adiposity among adolescents in Kuwait. Also, to determine whether maternal and paternal history of diabetes associate with offspring prediabetes in a sex-specific manner. METHODS A cross-sectional study was conducted by enrolling students (n = 1959; aged 14-19 years) attending high schools across Kuwait. Body mass index-for-age z-scores were estimated using the World Health Organization growth reference. Glycated hemoglobin A1c (HbA1c) was measured in capillary blood using point-of-care testing. Prediabetes was defined according to the diagnostic criteria of the American Diabetes Association (ADA; 5.7 ≤ HbA1c% ≤ 6.4) and the International Expert Committee (IEC; 6.0 ≤ HbA1c% ≤ 6.4). Adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) were estimated using Poisson regression with robust variance estimation. RESULTS According to the ADA criteria, 33.3% (620/1845) of participants had prediabetes; whereas, 8.5% (157/1845) met the IEC definition for prediabetes. Subjects classified as obese had higher prevalence of prediabetes compared to children in the thinness/normal group (aPR = 1.68, 95% CI: 1.44-1.95). Analysis stratified by offspring sex showed that maternal history of diabetes is associated with prediabetes among male offspring (aPR = 1.29, 95% CI: 1.02-1.63). In contrast, paternal history of diabetes showed an association with prediabetes among female offspring (aPR = 1.22, 95% CI: 1.01-1.48). CONCLUSIONS Prediabetes affects a substantial proportion of adolescents in Kuwait and adiposity and parental diabetes being the main associated factors with prediabetes.
Collapse
Affiliation(s)
- Mohammad Almari
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait.,Medical Services Directorate, Kuwait National Guard, Safat, Kuwait
| | - Saad Alsaedi
- Medical Services Directorate, Kuwait National Guard, Safat, Kuwait
| | - Anwar Mohammad
- Epidemiology and Public Health Unit, Dasman Diabetes Institute, Safat, Kuwait
| | - Ali H Ziyab
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait.,Epidemiology and Public Health Unit, Dasman Diabetes Institute, Safat, Kuwait
| |
Collapse
|
33
|
Alkandari A, Longenecker JC, Barengo NC, Alkhatib A, Weiderpass E, Al-Wotayan R, Al Duwairi Q, Tuomilehto J. The prevalence of pre-diabetes and diabetes in the Kuwaiti adult population in 2014. Diabetes Res Clin Pract 2018; 144:213-223. [PMID: 30179683 DOI: 10.1016/j.diabres.2018.08.016] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 08/09/2018] [Accepted: 08/29/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Kuwait ranks among the top 20 countries worldwide in diabetes prevalence. This study's objectives were to assess the prevalence of pre-diabetes and diabetes in Kuwaiti adults. METHODS Kuwaiti citizens aged 18-69 years (n = 3915) were studied using the WHO's STEPwise survey methodology, including its Instrument for Chronic Disease Risk Factor Surveillance. Participants' demographics, medical history, physical measurements and blood biochemistry were assessed. A subset of 2561 individuals completed all three survey steps, including fasting plasma glucose (FPG) and HbA1c assays. The study assessed the prevalence of pre-diabetes (FPG 6.1-6.9 mmol/L or HbA1c level 5.7-6.4%) and diabetes (self-reported history of diabetes with prescription of diabetes medications or FPG ≥ 7 mmol/L or HbA1c level ≥6.5%). RESULTS The prevalence of pre-diabetes was 19.4% [95% CI: 17.9-21.0%] (By sex: Men, 19.3%; Women, 19.5%; p = 0.92; By age (years): 18-29 y, 13.9%; 30-44 y, 22.6%; 45-59 y, 25.8%; 60-69 y, 16.4%; p < 0.001). The prevalence of diabetes was 18.8% [17.3-20.4%] (By sex: Men, 20.4%; Women, 17.4%; p = 0.055; By age: 18-29 y, 6.6%; 30-44 y, 14.0%; 45-59 y, 36.7%; 60-69 y, 62.8%; p < 0.001), of whom 41.5% were previously undiagnosed. Diabetes prevalence was 27.4% among those with body mass index (BMI) ≥ 30 kg/m2, 29% among those with elevated waist-hip ratio and 36% among those with hypertension. Diabetes was positively associated with BMI, waist-hip ratio and blood pressure level. Pre-diabetes was positively associated with BMI and waist-hip ratio, but not blood pressure level. CONCLUSIONS Almost 40% of Kuwaiti citizens had pre-diabetes or diabetes. Urgent public health action is needed to decrease diabetes prevalence and thus avoid associated morbidity and mortality.
Collapse
Affiliation(s)
| | | | - Noël C Barengo
- Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, USA
| | | | - Elisabete Weiderpass
- Dasman Diabetes Institute, Kuwait City, Kuwait; Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway; Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
| | | | | | | |
Collapse
|
34
|
Al Mutairi N, Alrqobah D, Haji Hussain N. Prevalence of metabolic syndrome in children with moderate to severe psoriasis treated with TNF inhibitors in comparison to conventional agents. Dermatol Ther 2018; 31. [DOI: 10.1111/dth.12566] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 10/02/2017] [Indexed: 12/16/2022]
Affiliation(s)
- Nawaf Al Mutairi
- Department of Medicine, Faculty of Medicine; Kuwait University, Jabriya, Kuwait
| | - Dhuha Alrqobah
- Department of Dermatology; Farwaniya Hospital, Ardiya, Kuwait
| | | |
Collapse
|
35
|
Alqaderi H, Redline S, Tavares M, Goodson JM. Effect of late bedtime on salivary glucose and abdominal obesity in children. Sleep Biol Rhythms 2017. [DOI: 10.1007/s41105-017-0105-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
|
36
|
Channanath AM, Elkum N, Al-Abdulrazzaq D, Tuomilehto J, Shaltout A, Thanaraj TA. Ethnic differences in association of high body mass index with early onset of Type 1 diabetes - Arab ethnicity as case study. PLoS One 2017; 12:e0175728. [PMID: 28406962 PMCID: PMC5391107 DOI: 10.1371/journal.pone.0175728] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 03/30/2017] [Indexed: 11/18/2022] Open
Abstract
Objective The “accelerator hypothesis” predicts early onset of Type 1 diabetes (T1D) in heavier children. Studies testing direction of correlation between body mass index (BMI) and age at onset of T1D in different continental populations have reported differing results–inverse, direct, and neutral. Evaluating the correlation in diverse ethnic populations is required to generalize the accelerator hypothesis. Methods The study cohort comprised 474 Kuwaiti children of Arab ethnicity diagnosed with T1D at age 6 to 18 years during 2011–2013. Age- and sex-adjusted BMI z-scores were calculated by comparing the BMI measured at diagnosis with Kuwaiti pediatric population reference data recorded during comparable time-period. Multiple linear regression and Pearson correlation analyses were performed. Results BMI z-score was seen inversely associated with onset age (r,-0.28; p-value<0.001). Children with BMI z-score>0 (i.e. BMI >national average) showed a stronger correlation (r,-0.38; p-value<0.001) than those with BMI z-score<0 (r,-0.19; p-value<0.001); the former group showed significantly lower mean onset age than the latter group (9.6±2.4 versus 10.5±2.7; p-value<0.001). Observed inverse correlation was consistent with that seen in Anglo-saxon, central european, caucasian, and white children while inconsistent with that seen in Indian, New Zealander, and Australian children. Conclusions The accelerator hypothesis generalizes in Arab pediatric population from Kuwait.
Collapse
|
37
|
Hebbar P, Elkum N, Alkayal F, John SE, Thanaraj TA, Alsmadi O. Genetic risk variants for metabolic traits in Arab populations. Sci Rep 2017; 7:40988. [PMID: 28106113 PMCID: PMC5247683 DOI: 10.1038/srep40988] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 12/14/2016] [Indexed: 12/11/2022] Open
Abstract
Despite a high prevalence of metabolic trait related diseases in Arabian Peninsula, there is a lack of convincingly identified genetic determinants for metabolic traits in this population. Arab populations are underrepresented in global genome-wide association studies. We genotyped 1965 unrelated Arab individuals from Kuwait using Cardio-MetaboChip, and tested SNP associations with 13 metabolic traits. Models based on recessive mode of inheritance identified Chr15:40531386-rs12440118/ZNF106/W->R as a risk variant associated with glycated-hemoglobin at close to ‘genome-wide significant’ p-value and five other risk variants ‘nominally’ associated (p-value ≤ 5.45E-07) with fasting plasma glucose (rs7144734/[OTX2-AS1,RPL3P3]) and triglyceride (rs17501809/PLGRKT; rs11143005/LOC105376072; rs900543/[THSD4,NR2E3]; and Chr12:101494770/IGF1). Furthermore, we identified 33 associations (30 SNPs with 12 traits) with ‘suggestive’ evidence of association (p-value < 1.0E-05); 20 of these operate under recessive mode of inheritance. Two of these ‘suggestive’ associations (rs1800775-CETP/HDL; and rs9326246-BUD13/TGL) showed evidence at genome-wide significance in previous studies on Euro-centric populations. Involvement of many of the identified loci in mediating metabolic traits was supported by literature evidences. The identified loci participate in critical metabolic pathways (such as Ceramide signaling, and Mitogen-Activated Protein Kinase/Extracellular Signal Regulated Kinase signaling). Data from Genotype-Tissue Expression database affirmed that 7 of the identified variants differentially regulate the up/downstream genes that mediate metabolic traits.
Collapse
Affiliation(s)
| | - Naser Elkum
- Dasman Diabetes Institute, P.O. Box 1180, Dasman 15462, Kuwait
| | - Fadi Alkayal
- Dasman Diabetes Institute, P.O. Box 1180, Dasman 15462, Kuwait
| | - Sumi Elsa John
- Dasman Diabetes Institute, P.O. Box 1180, Dasman 15462, Kuwait
| | | | - Osama Alsmadi
- Dasman Diabetes Institute, P.O. Box 1180, Dasman 15462, Kuwait
| |
Collapse
|
38
|
Current status on obesity in childhood and adolescence: Prevalence, etiology, co-morbidities and management. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.obmed.2016.05.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|