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Du Q, Li T, Yi X, Song S, Kang J, Jiang Y. Prevalence of new-onset diabetes mellitus after kidney transplantation: a systematic review and meta-analysis. Acta Diabetol 2024; 61:809-829. [PMID: 38507083 DOI: 10.1007/s00592-024-02253-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 02/01/2024] [Indexed: 03/22/2024]
Abstract
AIMS Post-transplant diabetes is a prevalent and consequential complication following kidney transplantation, which significantly augments the risk of cardiovascular disease, graft loss, infection, and mortality, thereby profoundly impacting both graft and patient survival. However, the early stages of post-transplant diabetes often go unnoticed or receive inadequate management. Consequently, this study systematically assesses the incidence of new-onset diabetes after kidney transplantation with the aim to enhance medical staff awareness regarding post-transplantation diabetes and provide clinical management guidance. METHODS We conducted a comprehensive search across multiple databases including PubMed, Web of Science, Embase, The Cochrane Library, CNKI, Wanfang, VIP, and SinoMed until September 21, 2023. Data extraction was performed using standardized tables and meta-analysis was conducted using Stata 16.0 software. A random effects model was employed to estimate the combined prevalence along with its corresponding 95% confidence interval. The source of heterogeneity was explored using subgroup analysis and sensitivity analysis, while publication bias was assessed through funnel plot and Egger's test. This study has been registered with PROSPERO under the registration number CRD42023465768. RESULTS This meta-analysis comprised 39 studies with a total sample size of 16,584 patients. The prevalence of new-onset diabetes after transplantation was found to be 20% [95% CI (18.0, 22.0)]. Subgroup analyses were conducted based on age, gender, body mass index, family history of diabetes, type of kidney donor, immunosuppressive regimen, acute rejection episodes, hepatitis C infection status and cytomegalovirus infection. CONCLUSIONS The incidence of post-kidney transplantation diabetes is substantial, necessitating early implementation of preventive and control measures to mitigate its occurrence, enhance prognosis, and optimize patients' quality of life. CLINICAL TRIAL REGISTRATION PROSPERO: CRD42023465768.
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Affiliation(s)
- Qiufeng Du
- College of Nursing, Chengdu University of Traditional Chinese Medicine, No.37 Shi-er-qiao Road, Chengdu City, 610075, Sichuan Province, China
| | - Tao Li
- College of Nursing, Chengdu University of Traditional Chinese Medicine, No.37 Shi-er-qiao Road, Chengdu City, 610075, Sichuan Province, China
| | - Xiaodong Yi
- College of Nursing, Chengdu University of Traditional Chinese Medicine, No.37 Shi-er-qiao Road, Chengdu City, 610075, Sichuan Province, China
| | - Shuang Song
- College of Nursing, Chengdu University of Traditional Chinese Medicine, No.37 Shi-er-qiao Road, Chengdu City, 610075, Sichuan Province, China
| | - Jing Kang
- College of Nursing, Chengdu University of Traditional Chinese Medicine, No.37 Shi-er-qiao Road, Chengdu City, 610075, Sichuan Province, China
| | - Yunlan Jiang
- Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, No.39 Shi-er-qiao Road, Chengdu City, 610072, Sichuan Province, China.
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Yoshimura E, Hamada Y, Hatanaka M, Nanri H, Nakagata T, Matsumoto N, Shimoda S, Tanaka S, Miyachi M, Hatamoto Y. Relationship between intra-individual variability in nutrition-related lifestyle behaviors and blood glucose outcomes under free-living conditions in adults without type 2 diabetes. Diabetes Res Clin Pract 2023; 196:110231. [PMID: 36565723 DOI: 10.1016/j.diabres.2022.110231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/25/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022]
Abstract
AIMS This study determined the relationship between intra-individual variability in day-to-day nutrition-related lifestyle behaviors (meal timing, eating window, food intake, movement behaviors, sleep conditions, and body weight) and glycemic outcomes under free-living conditions in adults without type 2 diabetes. METHODS We analyzed 104 adults without type 2 diabetes. During the 7-day measurement period, dietary intake, movement behaviors, sleep conditions, and glucose outcomes were assessed. Daily food intake was assessed using a mobile-based health application. Movement behaviors and sleep conditions were assessed using a tri-axial accelerometer. Meal timing was assessed from the participant's daily life record. Blood glucose levels were measured continuously using a glucose monitor. Statistical analyses were conducted using a linear mixed-effects model, with mealtime, food intake, body weight, movement behaviors, and sleep conditions as fixed effects and participants as a random effect. RESULTS Dinner time and eating window were positively significantly correlated with mean (dinner time, p = 0.003; eating window, p = 0.001), standard deviation (SD; both at p < 0.001), and maximum (both at p < 0.001) blood glucose levels. Breakfast time was negatively associated with glucose outcomes (p < 0.01). Sedentary time was positively significantly associated with blood glucose SD (p = 0.040). Total sleep time was negatively significantly correlated with SD (p = 0.035) and maximum (p = 0.032) blood glucose levels. Total daily energy intake (p = 0.001), carbohydrate intake (p < 0.001), and body weight (p < 0.05) were positively associated with mean blood glucose levels. CONCLUSION Intra-individual variations in nutrition-related lifestyle behaviors, especially morning and evening body weight, and food intake, were associated with mean blood glucose levels, and a long sedentary time and total sleep time were associated with glucose variability. Earlier dinner times and shorter eating windows per day resulted in better glucose control.
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Affiliation(s)
- Eiichi Yoshimura
- Department of Nutrition and Metabolism, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan; Collaborative Research Center for Health and Medicine, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka 566-0002, Japan.
| | - Yuka Hamada
- Department of Nutrition and Metabolism, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan
| | - Mana Hatanaka
- Department of Nutrition and Metabolism, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan
| | - Hinako Nanri
- Collaborative Research Center for Health and Medicine, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka 566-0002, Japan; Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan
| | - Takashi Nakagata
- Collaborative Research Center for Health and Medicine, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka 566-0002, Japan; Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan
| | - Naoyuki Matsumoto
- Faculty of Environmental & Symbiotic Sciences, Prefectural University of Kumamoto, 3-1-100 Tsukide, Higashi-ku, Kumamoto 862-8502, Japan
| | - Seiya Shimoda
- Faculty of Environmental & Symbiotic Sciences, Prefectural University of Kumamoto, 3-1-100 Tsukide, Higashi-ku, Kumamoto 862-8502, Japan
| | - Shigeho Tanaka
- Kagawa Nutrition University, 3-9-21 Chiyoda, Sakado, Saitama 350-0288, Japan
| | - Motohiko Miyachi
- Department of Nutrition and Metabolism, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan; Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan; Faculty of Sport Sciences, Waseda University, 2-579-1 Mikajima, Tokorozawa, Saitama 359-1192, Japan
| | - Yoichi Hatamoto
- Department of Nutrition and Metabolism, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan; Collaborative Research Center for Health and Medicine, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka 566-0002, Japan
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Khajebishak Y, Faghfouri AH, Soleimani A, Madani S, Payahoo L. Exploration of meteorin-like peptide (metrnl) predictors in type 2 diabetic patients: the potential role of irisin, and other biochemical parameters. Horm Mol Biol Clin Investig 2022:hmbci-2022-0037. [PMID: 36181729 DOI: 10.1515/hmbci-2022-0037] [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: 04/12/2022] [Accepted: 08/21/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Meteorin-like peptide (Metrnl), the newly discovered adipokines involves in glucose and lipid metabolism and energy homeostasis. The aim of the present study was to explore the potential predictors of Metrnl by emphasizing the Irisin, glycemic indices, and lipid profile biomarkers in type 2 diabetic patients. METHODS This cross-sectional study was carried out on 32 obese types 2 diabetic patients, 31 healthy obese, and 30 healthy normal weight people between August 2020 and March 2021. Serum Metrnl and Irisin, fasting blood glucose (FBS), fasting insulin (FI), fasting insulin (FI), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), HbA1c and eAG levels were measured in a standard manner. To assay insulin resistance and insulin sensitivity, the homeostatic model assessment insulin resistance (HOMA-IR) and quantitative check index (QUICKI) model were used. Quantile regression analysis with the backward elimination method was used to explore predictors. The significant level was defined as p<0.05. RESULTS Between variables entered into the model, only the group item showed to be the main predictor of Metrnl in type 2 diabetic patients. Besides, the serum level of Irisin was lower in diabetic patients, and a significant difference was detected between obese diabetic patients and the normal weight group (p=0.024). CONCLUSIONS Given the multi-causality of diabetes and also the possible therapeutic role of Metrnl in the management of type 2 diabetic patients' abnormalities, designing future studies are needed to discover other predictors of Metrnl and the related mechanisms of Metrnl in the management of diabetes.
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Affiliation(s)
- Yaser Khajebishak
- Department of Nutrition and Food Sciences, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Amir Hossein Faghfouri
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.,Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Ali Soleimani
- Department of Public Health, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Sadra Madani
- Department of Nutrition and Food Sciences, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Laleh Payahoo
- Department of Nutrition and Food Sciences, Maragheh University of Medical Sciences, Maragheh, Iran
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Metabolomic Analysis of Serum and Tear Samples from Patients with Obesity and Type 2 Diabetes Mellitus. Int J Mol Sci 2022; 23:ijms23094534. [PMID: 35562924 PMCID: PMC9105607 DOI: 10.3390/ijms23094534] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 12/14/2022] Open
Abstract
Metabolomics strategies are widely used to examine obesity and type 2 diabetes (T2D). Patients with obesity (n = 31) or T2D (n = 26) and sex- and age-matched controls (n = 28) were recruited, and serum and tear samples were collected. The concentration of 23 amino acids and 10 biogenic amines in serum and tear samples was analyzed. Statistical analysis and Pearson correlation analysis along with network analysis were carried out. Compared to controls, changes in the level of 6 analytes in the obese group and of 10 analytes in the T2D group were statistically significant. For obesity, the energy generation, while for T2D, the involvement of NO synthesis and its relation to insulin signaling and inflammation, were characteristic. We found that BCAA and glutamine metabolism, urea cycle, and beta-oxidation make up crucial parts of the metabolic changes in T2D. According to our data, the retromer-mediated retrograde transport, the ethanolamine metabolism, and, consequently, the endocannabinoid signaling and phospholipid metabolism were characteristic of both conditions and can be relevant pathways to understanding and treating insulin resistance. By providing potential therapeutic targets and new starting points for mechanistic studies, our results emphasize the importance of complex data analysis procedures to better understand the pathomechanism of obesity and diabetes.
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Hong JS, Kang HC. Body mass index and all-cause mortality in patients with newly diagnosed type 2 diabetes mellitus in South Korea: a retrospective cohort study. BMJ Open 2022; 12:e048784. [PMID: 35365507 PMCID: PMC8977808 DOI: 10.1136/bmjopen-2021-048784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The lower risk of death in overweight or obese patients, compared with normal-weight individuals, has caused confusion for patients with diabetes and healthcare providers. This study investigated the relationship between body mass index (BMI) and mortality in patients with type 2 diabetes. DESIGN A retrospective cohort study. SETTING We established a national population database by merging the Korea National Health Insurance (KNHI) claims database, the National Health Check-ups Database and the KNHI Qualification Database of South Korea. PARTICIPANTS A total of 53 988 patients who were newly diagnosed with type 2 diabetes (E11 in International Classification of Diseases, 10th Edition) in 2007, had available BMI data, lacked a history of any serious comorbidity, received diabetes medication and did not die during the first 2 years were followed up for a median of 8.6 years. PRIMARY OUTCOME MEASURES All-cause mortality. RESULTS The mean BMI was 25.2 (SD 3.24) kg/m2, and the largest proportion of patients (29.4%) had a BMI of 25-27.4 kg/m2. Compared with a BMI of 27.5-29.9 kg/m2 (the reference), mortality risk continuously increased as BMI decreased while the BMI score was under 25 (BMI <18.5 kg/m2: adjusted HR (aHR) 2.71, 95% CI 2.24 to 3.27; BMI 18.5-20.9 kg/m2: aHR 1.94, 95% CI 1.70 to 2.22; BMI 21-22.9 kg/m2: aHR 1.51, 95% CI 1.34 to 1.70; and BMI 23-24.9 kg/m2: aHR 1.14, 95% CI 1.01 to 1.28). For patients aged ≥65 years, the inverse association was connected up to a BMI ≥30 kg/m2 group (aHR 0.76, 95% CI 0.59 to 0.98). However, the associations for men, patients aged <65 years and ever smokers resembled a reverse J curve, with a significantly greater risk of death in patients with a BMI ≥30 kg/m2. CONCLUSIONS This study suggests that, for patients with type 2 diabetes at a normal weight, distinct approaches are needed in terms of promoting muscle mass improvement or cardiorespiratory fitness, rather than maintaining weight status. Improved early diagnosis considering the inverse association between BMI and mortality is also needed.
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Affiliation(s)
- Jae-Seok Hong
- Division of Health Administration and Healthcare, Cheongju University College of Health and Medical Sciences, Cheongju, Republic of Korea
| | - Hee-Chung Kang
- Department of Health Care Policy Research, Korea Institute for Health and Social Affairs (KIHASA), Sejong, Republic of Korea
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The Multifunctional Role of Herbal Products in the Management of Diabetes and Obesity: A Comprehensive Review. Molecules 2022; 27:molecules27051713. [PMID: 35268815 PMCID: PMC8911649 DOI: 10.3390/molecules27051713] [Citation(s) in RCA: 69] [Impact Index Per Article: 34.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/01/2022] [Accepted: 03/02/2022] [Indexed: 02/04/2023] Open
Abstract
Obesity and diabetes are the most demanding health problems today, and their prevalence, as well as comorbidities, is on the rise all over the world. As time goes on, both are becoming big issues that have a big impact on people’s lives. Diabetes is a metabolic and endocrine illness set apart by hyperglycemia and glucose narrow-mindedness because of insulin opposition. Heftiness is a typical, complex, and developing overall wellbeing worry that has for quite some time been connected to significant medical issues in individuals, all things considered. Because of the wide variety and low adverse effects, herbal products are an important hotspot for drug development. Synthetic compounds are not structurally diverse and lack drug-likeness properties. Thus, it is basic to keep on exploring herbal products as possible wellsprings of novel drugs. We conducted this review of the literature by searching Scopus, Science Direct, Elsevier, PubMed, and Web of Science databases. From 1990 until October 2021, research reports, review articles, and original research articles in English are presented. It provides top to bottom data and an examination of plant-inferred compounds that might be utilized against heftiness or potentially hostile to diabetes treatments. Our expanded comprehension of the systems of activity of phytogenic compounds, as an extra examination, could prompt the advancement of remedial methodologies for metabolic diseases. In clinical trials, a huge number of these food kinds or restorative plants, as well as their bioactive compounds, have been shown to be beneficial in the treatment of obesity.
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Saeedi M, Mehranfar F, Ghorbani F, Eskandari M, Ghorbani M, Babaeizad A. Review of pharmaceutical and therapeutic approaches for type 2 diabetes and related disorders. Recent Pat Biotechnol 2022; 16:188-213. [PMID: 35088682 DOI: 10.2174/1872208316666220128102934] [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: 09/12/2021] [Revised: 11/05/2021] [Accepted: 11/30/2021] [Indexed: 11/22/2022]
Abstract
One of the essential diseases that are increasing in the world is type 2 diabetes (T2D), which many people around the world live with this disease. Various studies have revealed that insulin resistance, lessened insulin production has been associated with T2D, and they also show that this disease can have a genetic origin and is associated with different genes such as KCNQ1, PPAR-γ, calpain-10, ADIPOR2, TCF7L2 that can be utilized as a therapeutic target. Different therapeutic approaches and strategies such as exercise and diet, pharmacological approaches, and utilization of nanoparticles in drug delivery and gene therapy can be effective in the treatment and control of T2D. Glucagon-like peptide 1 (GLP-1) and sodium glucose cotransporter-2 (SGLT2) have both been considered as drug classes in the treatment of T2D and T2D-related diseases such as cardiovascular disease and renal disease, and have considerable influences such as diminished cardiovascular mortality in individuals with T2D, ameliorate postprandial glycaemia, ameliorate fasting glycaemia, and diminish body weight on disease treatment and improvement process. In the present review article, we have made an attempt to explore the risk factors, Genes, and diseases associated with T2D, therapeutic approaches in T2D, the influences of drugs such as Dapagliflozin, Metformin, Acarbose, Januvia (Sitagliptin), and Ertugliflozin on T2D in clinical trials and animal model studies. Research in clinical trials has promising results that support the role of these drug approaches in T2D prophylaxis and ameliorate safety even though additional clinical research is still obligatory.
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Affiliation(s)
- Mohammad Saeedi
- Department of Hematology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Mehranfar
- Department of Laboratory Science, Faculty of medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Fateme Ghorbani
- Department of immunology, Semnan university of Medical sciences, Semnan, Iran
| | - Mohammadali Eskandari
- Student Research Committee, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Majid Ghorbani
- Department of Hematology, Mashhad University of Medical sciences, Mashhad, Iran
| | - Ali Babaeizad
- Student Research Committee, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran
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OUP accepted manuscript. J Pharm Pharmacol 2022; 74:1125-1132. [DOI: 10.1093/jpp/rgac022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 03/17/2022] [Indexed: 11/12/2022]
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Zeru MA, Tesfa E, Mitiku AA, Seyoum A, Bokoro TA. Prevalence and risk factors of type-2 diabetes mellitus in Ethiopia: systematic review and meta-analysis. Sci Rep 2021; 11:21733. [PMID: 34741064 PMCID: PMC8571297 DOI: 10.1038/s41598-021-01256-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 10/26/2021] [Indexed: 01/09/2023] Open
Abstract
Diabetes mellitus (DM) is a public health problem in developing as well as developed nations. DM leads to many complications that are associated with higher morbidity and mortality worldwide. Therefore, the current study was planned to assess the prevalence and risk factors of type-2 DM in Ethiopian population. Six electronic databases such as: PubMed, Scopus, Hinari, Web of science, Google Scholar, and African Journals Online were searched for studies published in English up December 30, 2020. Newcastle-Ottawa Scale was used for quality assessment of the included studies. The data was extracted by Microsoft excel and analyzed through Stata version 16 software. The random effect meta-regression analysis was computed at 95% CI to assess the pooled prevalence and risk factors of type-2 DM. Forty observational studies were included in this systematic review and meta-analysis. The pooled prevalence of DM in Ethiopia was 6.5% (95% CI (5.8, 7.3)). The sub-group analysis revealed that the highest prevalence of DM was found in Dire Dawa city administration (14%), and the lowest prevalence was observed in Tigray region (2%). The pooled prevalence of DM was higher (8%) in studies conducted in health facility. Factors like: Age ≥ 40 years ((Adjusted Odds Ratio (AOR): 1.91 (95% CI: 1.05, 3.49)), Illiterate (AOR: 2.74 (95% CI: 1.18, 6.34)), Cigarette smoking (AOR: 1.97 (95% CI: 1.17, 3.32)), Body mass index (BMI) ≥ 25 kg/m2 (AOR: 2.01 (95 CI: 1.46, 2.27)), family history of DM (AOR: 6.14 (95% CI: 2.80, 13.46)), history of hypertension (AOR: 3.00 (95% CI: 1.13, 7.95)) and physical inactivity (AOR: 5.79 (95% CI: 2.12, 15.77)) were significantly associated with type-2 DM in Ethiopian population. In this review, the prevalence of type-2 DM was high. Factors like: Older age, illiteracy, cigarette smoking, MBI ≥ 25, family history of DM, history of hypertension and physical inactivity were an identified risk factors of type-2 DM. Therefore, health education and promotion will be warranted. Further, large scale prospective studies will be recommended to address possible risk factors of type-2 DM in Ethiopian population.
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Affiliation(s)
- Melkamu A. Zeru
- grid.442845.b0000 0004 0439 5951Department of Statistics, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Endalamaw Tesfa
- grid.442845.b0000 0004 0439 5951Department of Biochemistry, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Aweke A. Mitiku
- grid.442845.b0000 0004 0439 5951Department of Statistics, College of Science, Bahir Dar University, Bahir Dar, Ethiopia ,grid.16463.360000 0001 0723 4123School of Mathematics, Statistics and Computer Science, College of Agriculture Engineering and Science, University of KwaZulu-Natal, Durban, South Africa
| | - Awoke Seyoum
- grid.442845.b0000 0004 0439 5951Department of Statistics, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tesfaye Abera Bokoro
- grid.192267.90000 0001 0108 7468Department of Statistics, College Computing and Informatics, Haramaya University, Dire Dawa, Ethiopia
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Liao YY, Chu C, Wang Y, Zheng WL, Ma Q, Hu JW, Yan Y, Wang KK, Yuan Y, Chen C, Mu JJ. Long-term burden of higher body mass index from childhood on adult cardiometabolic biomarkers: A 30-year cohort study. Nutr Metab Cardiovasc Dis 2021; 31:439-447. [PMID: 33223402 DOI: 10.1016/j.numecd.2020.09.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/25/2020] [Accepted: 09/07/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIMS Data are limited regarding the association between long-term burden of higher body mass index (BMI) from childhood and cardiometabolic biomarkers. METHODS AND RESULTS A total of 1553 individuals aged 6-15 years, who were examined 4 or more times for BMI since childhood and followed for 30 years were included in our analysis. Total area under the curve (AUCt) and incremental AUC (AUCi) were calculated as the long-term burden and trends of BMI. Cardiometabolic biomarkers including serum uric acid (SUA), fasting blood-glucose (FBG), and triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C) were obtained from venous blood samples. The results showed a positive association of BMI AUCt and AUCi with cardiometabolic biomarkers. After adjusting for demographic variables, the AUCt and AUCi of BMI were significantly associated with a higher level of SUA (β = 3.71; 2.87), FBG (β = 0.09; 0.09), and TG/HDL-C (β = 0.14; 0.11). We performed further studies after dividing subjects into four groups according to AUCt and AUCi of BMI by quartiles. Compared with the lowest quartile group, the highest quartile group had significantly increased risk ratios of hyperuricemia (RR = 2.01; 1.74), type 2 diabetes mellitus (RR = 8.18; 3.96), and high-risk TG/HDL-C (RR = 4.05; 3.26). CONCLUSION Our study identifies all subjects' BMI growth curve from childhood and indicates that the long-term burden of higher BMI significantly increases the cardiometabolic risk, and the impact of excessive body weight on cardiometabolic health originates in early life. We emphasize the importance of weight control from childhood for cardiometabolic health.
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Affiliation(s)
- Yue-Yuan Liao
- Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China; Xi'an Jiaotong University Medical College, First Affiliated Hospital, Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi, 710061, China
| | - Chao Chu
- Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China; Xi'an Jiaotong University Medical College, First Affiliated Hospital, Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi, 710061, China
| | - Yang Wang
- Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China; Xi'an Jiaotong University Medical College, First Affiliated Hospital, Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi, 710061, China
| | - Wen-Ling Zheng
- Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China; Xi'an Jiaotong University Medical College, First Affiliated Hospital, Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi, 710061, China
| | - Qiong Ma
- Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China; Xi'an Jiaotong University Medical College, First Affiliated Hospital, Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi, 710061, China
| | - Jia-Wen Hu
- Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China; Xi'an Jiaotong University Medical College, First Affiliated Hospital, Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi, 710061, China
| | - Yu Yan
- Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China; Xi'an Jiaotong University Medical College, First Affiliated Hospital, Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi, 710061, China
| | - Ke-Ke Wang
- Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China; Xi'an Jiaotong University Medical College, First Affiliated Hospital, Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi, 710061, China
| | - Yue Yuan
- Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China; Xi'an Jiaotong University Medical College, First Affiliated Hospital, Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi, 710061, China
| | - Chen Chen
- Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China; Xi'an Jiaotong University Medical College, First Affiliated Hospital, Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi, 710061, China
| | - Jian-Jun Mu
- Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China; Xi'an Jiaotong University Medical College, First Affiliated Hospital, Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi, 710061, China.
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11
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Liu W, Liu J, Shao S, Lin Q, Wang C, Zhang X, Tu J, Wang J, Ning X. Obesity at a young age is associated with development of diabetes mellitus: A prospective cohort study in rural China. Postgrad Med 2020; 132:709-713. [PMID: 32500799 DOI: 10.1080/00325481.2020.1778383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES We aimed to assess the age-dependent association of obesity with the risk of developing diabetes mellitus (DM) among a low-income population in China. METHODS In this prospective cohort study, we estimated the hazard ratios (HR) for the association of body mass index (BMI) with DM risk from 1991 to 2014, after adjusting for other possible risk factors, using Cox-regression analysis. RESULTS A total of 971 participants were followed up for 23 years in this study. The incidence of DM in this population was as high as 467.0/100,000 person-years. Compared with normal weight, the HR (and 95% confidence interval [CI]) for overweight affecting DM risk was 2.23 (1.45-3.41) overall, including 2.43 (1.05-5.63) for men and 2.17 (1.31-3.59) for women. The HR associated with the impact of obesity was 3.59 (2.06-6.27) overall, including 6.04 (1.84-19.81) for men and 3.23 (1.69-6.16) for women. Being overweight had a significant association with DM for people aged 40-49 years (HR, 1.99; 95% CI, 1.03-3.84); the HR for an association between DM and obesity was the highest among individuals aged 30-39 years (HR, 4.43; 95% CI, 1.84-10.67). There was no statistical significance between BMI and DM among individuals aged ≥50 years. CONCLUSIONS These findings suggest that obesity is associated with developing DM in rural China, especially among adults aged <50 years. Weight management is the highest priority for reducing the heavy burden of DM.
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Affiliation(s)
- Wei Liu
- Department of Neurology, Tianjin Medical University General Hospital , Tianjin, China
| | - Jie Liu
- Department of Neurology, Tianjin Medical University General Hospital , Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute , Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City , Tianjin, China
| | - Shuang Shao
- Department of Endocrinology and Metabolism, The Second Hospital of Tianjin Medical University , Tianjin, China
| | - Qiuxing Lin
- Department of Neurology, Tianjin Medical University General Hospital , Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute , Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City , Tianjin, China
| | - Conglin Wang
- Department of Geriatrics, Tianjin Medical University General Hospital , Tianjin, China
| | - Xinxin Zhang
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital , Tianjin, China
| | - Jun Tu
- Department of Neurology, Tianjin Medical University General Hospital , Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute , Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City , Tianjin, China
| | - Jinghua Wang
- Department of Neurology, Tianjin Medical University General Hospital , Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute , Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City , Tianjin, China
| | - Xianjia Ning
- Department of Neurology, Tianjin Medical University General Hospital , Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute , Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City , Tianjin, China
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12
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Ding J, Chen X, Bao K, Yang J, Liu N, Huang W, Huang P, Huang J, Jiang N, Cao J, Cheng N, Wang M, Hu X, Zheng S, Bai Y. Assessing different anthropometric indices and their optimal cutoffs for prediction of type 2 diabetes and impaired fasting glucose in Asians: The Jinchang Cohort Study. J Diabetes 2020; 12:372-384. [PMID: 31642584 DOI: 10.1111/1753-0407.13000] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 10/06/2019] [Accepted: 10/16/2019] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND To study the association between anthropometric measurements and the risk of diabetes and impaired fasting glucose (IFG) and compare body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) to determine the best indicator and its optimal cutoffs for predicting type 2 diabetes and IFG. METHODS A Chinese prospective (2011-2019) cohort named the Jingchang cohort that included 48 001 participants was studied. Using Cox proportional hazard models, hazard ratios (HRs) for incident type 2 diabetes or IFG per 1 SD change in BMI, WC, and WHtR were calculated. Area under the curve (AUC) was compared to identify the best anthropometric variable and its optimal cutoff for predicting diabetes. RESULTS The association of BMI, WC, and WHtR with type 2 diabetes or IFG risk was positive in the univariate and multivariable-adjusted Cox proportional hazard models. Of all three indexes, the AUC of BMI was largest and that of WC was smallest. The derived cutoff values for BMI, WC, and WHtR were 24.6 kg/m2 , 89.5 cm, and 0.52 in men and 23.4 kg/m2 , 76.5 cm, and 0.47 in women for predicting diabetes, respectively. The derived cutoff values for BMI, WC, and WHtR were 23.4 kg/m2 , 87.5 cm, and 0.50 in men and 22.5 kg/m2 , 76.5 cm, and 0.47 in women for predicting IFG, respectively. [Correction added on 14 April 2020, after first online publication: '0' has been deleted from 'WC,0' in the first sentence.]. CONCLUSIONS Our derived cutoff points were lower than the values specified in the most current Asian diabetes guidelines. We recommend a cutoff point for BMI in Asians of 23 kg/m2 and for WC a cutoff point of 89 cm in men and 77 cm in women to define high-risk groups for type 2 diabetes; screening should be considered for these populations.
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Affiliation(s)
- Jie Ding
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Xiaoliang Chen
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Kaifang Bao
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Jingli Yang
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Nian Liu
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Wenya Huang
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Peiyao Huang
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Junjun Huang
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Nan Jiang
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Jianing Cao
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Ning Cheng
- Department of Basic Medicine, Lanzhou University, Lanzhou, China
| | - Minzhen Wang
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Xiaobin Hu
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Shan Zheng
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Yana Bai
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
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13
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Yuan Y, Chu C, Zheng WL, Ma Q, Hu JW, Wang Y, Yan Y, Liao YY, Mu JJ. Body Mass Index Trajectories in Early Life Is Predictive of Cardiometabolic Risk. J Pediatr 2020; 219:31-37.e6. [PMID: 32061408 DOI: 10.1016/j.jpeds.2019.12.060] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 12/21/2019] [Accepted: 12/27/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To identify distinct body mass index (BMI) trajectories across the life-course and explore the effects of BMI trajectories on the adult cardiovascular disease outcomes using a dataset with 30 years of follow-up in northern China. STUDY DESIGN A total of 2839 participants aged 6-18 years whose BMIs were measured 3-6 times during the Hanzhong Adolescent Hypertension Study were included in our analysis. Latent mixture modeling was used to clarify distinct BMI trajectories in longitudinal analyses. RESULTS Three groups with distinct trajectories in BMI were identified by the latent mixed models: a low-increasing group (n = 1324 [36.64%]), a moderate-increasing group (n = 1178 [16.89%]), and a high-increasing group (n = 337 [39.46%]). Compared with the participants in the low-increasing group, the risk ratios of hypertension, type 2 diabetes mellitus, high-risk triglycerides, and high-risk high-density lipoprotein cholesterol were more than 3.0 in the high-increasing group (all P < .001) after being fully adjusted. Increased risks existed in high brachial-ankle pulse wave velocity for the high-increasing group compared with the low-increasing group (RR, 2.75; 95% CI, 1.94-3.91; P < .001). Additionally, participants in the moderate-increasing group had a 2.31-fold increased risks of left ventricular hypertrophy (95% CI, 1.25-4.30; P = .008). CONCLUSIONS Our study indicates that BMI trajectories from childhood to adulthood vary and that an elevated BMI trajectory in early life is predictive of an increased the risk of developing cardiovascular disease risks. TRIAL REGISTRATION ClinicalTrials.gov: NCT02734472.
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Affiliation(s)
- Yue Yuan
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Chao Chu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Wen-Ling Zheng
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Qiong Ma
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Jia-Wen Hu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Yang Wang
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Yu Yan
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Yue-Yuan Liao
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China
| | - Jian-Jun Mu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China.
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14
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Zhang H, Qi D, Gu H, Wang T, Wu Y, Li J, Ni J, Liu J, Tu J, Ning X, Wang J. Trends in the prevalence, awareness, treatment and control of diabetes in rural areas of northern China from 1992 to 2011. J Diabetes Investig 2020; 11:241-249. [PMID: 31172682 PMCID: PMC6944834 DOI: 10.1111/jdi.13095] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 05/27/2019] [Accepted: 06/04/2019] [Indexed: 01/06/2023] Open
Abstract
AIMS/INTRODUCTION The worldwide prevalence of diabetes mellitus has been increasing over the past decades, particularly in developing countries. Because of the lack of information regarding changes in diabetes mellitus prevalence, awareness, treatment and control in rural China, we assessed these trends - overall and in the context of related health conditions - to explore the impact of these primary health issues on these rates in a poorly educated, rural population. MATERIALS AND METHODS Diabetes mellitus prevalence, awareness, treatment and control rates were compared between two surveys carried out in 1992 and 2011. The residents of three villages, aged 35-64 years, were recruited for this study. RESULTS In 1992, 1,091 individuals were interviewed and, in 2011, 2,338 individuals were interviewed. Between the two surveys, the overall diabetes mellitus prevalence in the study population was lower in 1992 than that in 2011 (P < 0.001); among men, the prevalence was 5.2-fold higher in 2011 than in 1992 (10.5 vs 1.7%) and nearly 4.3-fold higher (11.2 vs 2.1%) among women. Men aged 35-44 years, with >6 years of education, stage I hypertension and being overweight, had a higher prevalence of diabetes mellitus in 2011 than in 1992. Similarly, for the same time periods, there was also a higher diabetes mellitus prevalence among women aged 55-64 years, with 1-6 years of education, stage III hypertension and who were overweight. However, there were no significant changes in diabetes mellitus awareness, treatment or control in this population. CONCLUSIONS These results suggest that particular efforts must be made to enhance diabetes mellitus prevention, control and public awareness in rural communities in China.
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Affiliation(s)
- Hongyan Zhang
- Department of Endocrinology and MetabolismTianjin Medical University General HospitalTianjinChina
| | - Dongwang Qi
- Department of Endocrinology and MetabolismTianjin Medical University General HospitalTianjinChina
| | - Hongfei Gu
- Department of NeurologyTianjin Haibin People's HospitalTianjinChina
| | - Tao Wang
- Department of NeurologyTianjin Haibin People's HospitalTianjinChina
| | - Yanan Wu
- Department of NeurologyTianjin Medical University General HospitalTianjinChina
- Laboratory of EpidemiologyTianjin Neurological InstituteTianjinChina
- Key Laboratory of Post‐Neuroinjury Neuro‐Repair and Regeneration in Central Nervous SystemTianjin Neurological InstituteMinistry of Education and Tianjin CityTianjinChina
| | - Jingyan Li
- Department of Endocrinology and MetabolismTianjin Medical University General HospitalTianjinChina
| | - Jingxian Ni
- Department of NeurologyTianjin Medical University General HospitalTianjinChina
- Laboratory of EpidemiologyTianjin Neurological InstituteTianjinChina
- Key Laboratory of Post‐Neuroinjury Neuro‐Repair and Regeneration in Central Nervous SystemTianjin Neurological InstituteMinistry of Education and Tianjin CityTianjinChina
| | - Jie Liu
- Department of NeurologyTianjin Medical University General HospitalTianjinChina
- Laboratory of EpidemiologyTianjin Neurological InstituteTianjinChina
- Key Laboratory of Post‐Neuroinjury Neuro‐Repair and Regeneration in Central Nervous SystemTianjin Neurological InstituteMinistry of Education and Tianjin CityTianjinChina
| | - Jun Tu
- Department of NeurologyTianjin Medical University General HospitalTianjinChina
- Laboratory of EpidemiologyTianjin Neurological InstituteTianjinChina
- Key Laboratory of Post‐Neuroinjury Neuro‐Repair and Regeneration in Central Nervous SystemTianjin Neurological InstituteMinistry of Education and Tianjin CityTianjinChina
| | - Xianjia Ning
- Department of NeurologyTianjin Medical University General HospitalTianjinChina
- Laboratory of EpidemiologyTianjin Neurological InstituteTianjinChina
- Key Laboratory of Post‐Neuroinjury Neuro‐Repair and Regeneration in Central Nervous SystemTianjin Neurological InstituteMinistry of Education and Tianjin CityTianjinChina
| | - Jinghua Wang
- Department of NeurologyTianjin Medical University General HospitalTianjinChina
- Laboratory of EpidemiologyTianjin Neurological InstituteTianjinChina
- Key Laboratory of Post‐Neuroinjury Neuro‐Repair and Regeneration in Central Nervous SystemTianjin Neurological InstituteMinistry of Education and Tianjin CityTianjinChina
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15
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Remission of Type 2 Diabetes Mellitus after Bariatric Surgery: Fact or Fiction? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173171. [PMID: 31480306 PMCID: PMC6747427 DOI: 10.3390/ijerph16173171] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 08/20/2019] [Accepted: 08/29/2019] [Indexed: 02/07/2023]
Abstract
Although type 2 diabetes mellitus (T2DM) has been traditionally viewed as an intractable chronic medical condition, accumulating evidence points towards the notion that a complete remission of T2DM is feasible following a choice of medical and/or surgical interventions. This has been paralleled by increasing interest in the establishment of a universal definition for T2DM remission which, under given circumstances, could be considered equivalent to a “cure”. The efficacy of bariatric surgery in particular for achieving glycemic control has highlighted surgery as a candidate curative intervention for T2DM. Herein, available evidence regarding available surgical modalities and the mechanisms that drive metabolic amelioration after bariatric surgery are reviewed. Furthermore, reports from observational and randomized studies with regard to T2DM remission are reviewed, along with concepts relevant to the variety of definitions used for T2DM remission and other potential sources of discrepancy in success rates among different studies.
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16
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Xu C, Zhong J, Zhu H, Hu R, Fang L, Wang M, Zhang J, Guo Y, Bian Z, Chen Z, Li L, Yu M. Independent and interactive associations of heart rate and body mass index or blood pressure with type 2 diabetes mellitus incidence: A prospective cohort study. J Diabetes Investig 2019; 10:1068-1074. [PMID: 30592161 PMCID: PMC6626957 DOI: 10.1111/jdi.12999] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 12/10/2018] [Accepted: 12/26/2018] [Indexed: 02/05/2023] Open
Abstract
AIMS/INTRODUCTION An elevated heart rate has been reported to be associated with an increased incidence of type 2 diabetes mellitus. We investigated whether heart rate independently and interactively with body mass index or blood pressure was associated with the incidence of type 2 diabetes mellitus in a rural Chinese population. MATERIALS AND METHODS We measured the association between heart rate and type 2 diabetes mellitus in the Tongxiang China Kadoorie Biobank prospective cohort study using Cox proportional hazard models. Analyses included 53,817 participants without any history of diabetes, cancer, cardiovascular or rheumatic heart disease at baseline. Incident type 2 diabetes mellitus cases were identified through linkage with established Disease Registries and the China National Health Insurance System. RESULTS After a mean follow-up period of 6.9 years, 1,766 people had developed type 2 diabetes mellitus with an incidence of 4.75 per 1,000 person-years. Multivariable-adjusted hazard ratios and for type 2 diabetes mellitus across increasing quintiles of heart rate were 1.00 (reference), 1.24 (95% confidence interval [CI] 1.05-1.45), 1.21 (95% CI 1.03-1.41), 1.24 (95% CI 1.05-1.47) and 1.49 (95% CI 1.28-1.74), respectively, with a Ptrend <0.001. This relationship was particularly evident among non-overweight/obese participants. A significant interaction between heart rate and body mass index on incident type 2 diabetes mellitus was observed with a P for interaction = 0.005. CONCLUSIONS Elevated heart rate is independently, in interaction with a higher body mass index, associated with a higher incidence of type 2 diabetes mellitus.
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Affiliation(s)
- Chunxiao Xu
- Department of Chronic Non‐Communicable Diseases Control and PreventionZhejiang Provincial Center for Disease Control and PreventionHangzhouChina
| | - Jieming Zhong
- Department of Chronic Non‐Communicable Diseases Control and PreventionZhejiang Provincial Center for Disease Control and PreventionHangzhouChina
| | - Honghong Zhu
- Preventive Medicine InstituteLouisianaMissouriUSA
| | - Ruying Hu
- Department of Chronic Non‐Communicable Diseases Control and PreventionZhejiang Provincial Center for Disease Control and PreventionHangzhouChina
| | - Le Fang
- Department of Chronic Non‐Communicable Diseases Control and PreventionZhejiang Provincial Center for Disease Control and PreventionHangzhouChina
| | - Meng Wang
- Department of Chronic Non‐Communicable Diseases Control and PreventionZhejiang Provincial Center for Disease Control and PreventionHangzhouChina
| | - Jie Zhang
- Department of Chronic Non‐Communicable Diseases Control and PreventionZhejiang Provincial Center for Disease Control and PreventionHangzhouChina
| | - Yu Guo
- Chinese Academy of Medical SciencesBeijingChina
| | - Zheng Bian
- Chinese Academy of Medical SciencesBeijingChina
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU)Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Liming Li
- Chinese Academy of Medical SciencesBeijingChina
- School of Public HealthPeking University Health Sciences CenterBeijingChina
| | - Min Yu
- Department of Chronic Non‐Communicable Diseases Control and PreventionZhejiang Provincial Center for Disease Control and PreventionHangzhouChina
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17
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Could the high consumption of high glycaemic index carbohydrates and sugars, associated with the nutritional transition to the Western type of diet, be the common cause of the obesity epidemic and the worldwide increasing incidences of Type 1 and Type 2 diabetes? Med Hypotheses 2019; 125:41-50. [PMID: 30902150 DOI: 10.1016/j.mehy.2019.02.027] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 12/07/2018] [Accepted: 02/08/2019] [Indexed: 12/30/2022]
Abstract
The globally increasing incidences of Type 1 diabetes (T1DM) and Type 2 diabetes (T2DM) can have a common background. If challenged by the contemporary high level of nutritional glucose stimulation, the β-cells in genetically predisposed individuals are at risk for damage which can lead to the diseases. The fat to carbohydrate dietary shift can also contribute to the associated obesity epidemic.
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18
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Zhang H, Ni J, Yu C, Wu Y, Li J, Liu J, Tu J, Ning X, He Q, Wang J. Sex-Based Differences in Diabetes Prevalence and Risk Factors: A Population-Based Cross-Sectional Study Among Low-Income Adults in China. Front Endocrinol (Lausanne) 2019; 10:658. [PMID: 31608013 PMCID: PMC6773800 DOI: 10.3389/fendo.2019.00658] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Accepted: 09/11/2019] [Indexed: 12/25/2022] Open
Abstract
Aims: The prevalence of diabetes mellitus (DM) among adults has reached epidemic proportions worldwide, including China. In China, sex-based differences in the prevalence and risk factors of DM may exist, particularly among low-income individuals. Thus, we assessed these differences in the prevalence of DM and its risk factors in a low-income Chinese population. Materials and Methods: Residents aged ≥45 years without histories of strokes or cardiovascular disease were recruited for this study. Multivariate logistic regression analyses were performed to assess the association of risk factors with DM prevalence. Results: This study included 3,725 participants (41.2%, men; 58.8%, women). The mean age of the women (61.12 years) was higher than that of the men (59.14 years, P < 0.001). There was no significant sex-based difference in DM prevalence (men, 14.1%; women, 14.5%). Overweight, obesity, high triglyceride levels, and hypertension were independent risk factors for DM in both sexes. However, high-density lipoprotein-cholesterol levels were negatively associated with DM risk among men [odds ratio (OR), 0.544; 95% confidence interval (CI), 0.355-0.833; P = 0.005]. Among women, advanced age and high low-density lipoprotein-cholesterol levels were independent risk factors for DM; there was a higher DM risk for women aged 55-74 years than for those aged 45-54 years; however, physical activity was associated with an increased risk of DM (OR, 1.705; 95% CI, 1.195-2.432; P = 0.003). Conclusions: These findings suggest a crucial need to implement individualized blood pressure, weight, and lipid managements in low-income populations in China to reduce the burden of DM, especially among older women.
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Affiliation(s)
- Hongyan Zhang
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - Jingxian Ni
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin Neurological Institute, Tianjin, China
| | - Changshen Yu
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Yanan Wu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin Neurological Institute, Tianjin, China
| | - Jingyan Li
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - Jie Liu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin Neurological Institute, Tianjin, China
| | - Jun Tu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin Neurological Institute, Tianjin, China
| | - Xianjia Ning
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin Neurological Institute, Tianjin, China
- *Correspondence: Xianjia Ning
| | - Qing He
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
- Qing He
| | - Jinghua Wang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin Neurological Institute, Tianjin, China
- Jinghua Wang
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19
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Li J, Ni J, Wu Y, Zhang H, Liu J, Tu J, Cui J, Ning X, Wang J. Sex Differences in the Prevalence, Awareness, Treatment, and Control of Diabetes Mellitus Among Adults Aged 45 Years and Older in Rural Areas of Northern China: A Cross-Sectional, Population-Based Study. Front Endocrinol (Lausanne) 2019; 10:147. [PMID: 30923514 PMCID: PMC6426742 DOI: 10.3389/fendo.2019.00147] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 02/19/2019] [Indexed: 01/03/2023] Open
Abstract
Aims: Diabetes mellitus (DM) has reached epidemic proportions among adults worldwide, with China having the world's largest population of individuals with the disease. Although the consequences of low rates of awareness, treatment, and control of DM are understood, sex-related differences in these rates remain unknown. We assessed sex-related differences in the prevalence, awareness, treatment, and control of DM in a low-income, rural population in China. Materials and Methods: Individuals ≥45 years old without cardiovascular disease were recruited into this study. The prevalence, awareness, treatment, and control of DM in both men and women were assessed after accounting for age, educational level, body mass index, and blood pressure. Results: A total of 3,725 participants (women, 58.8%) were included. A male preponderance in the prevalence of DM was found among individuals aged 45-54 years, whereas there was a female preponderance among patients aged 65-74 years and among those who were illiterate. Among individuals with >6 years of formal education, overweight individuals, and normotensive individuals, there was greater DM awareness among women than among men. There was also a higher DM treatment rate among overweight women than among overweight men. However, better disease control was observed among men than among women for individuals aged 55-64-years, those with 1-6 years of education, and those with stage II hypertension. Conclusions: These results suggest that DM awareness should be improved among men and that regular DM screening should be implemented for men, especially young men. In addition, disease education and management should be strengthened for elderly women, especially those with low levels of education. Further studies are necessary to explore this situation among a representative population sample in China in order to establish a valid protocol against DM.
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Affiliation(s)
- Jingyan Li
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - Jingxian Ni
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Ministry of Education, Tianjin, China
| | - Yanan Wu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Ministry of Education, Tianjin, China
| | - Hongyan Zhang
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - Jie Liu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Ministry of Education, Tianjin, China
| | - Jun Tu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Ministry of Education, Tianjin, China
| | - Jingqiu Cui
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
- *Correspondence: Jingqiu Cui
| | - Xianjia Ning
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Ministry of Education, Tianjin, China
- Xianjia Ning
| | - Jinghua Wang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Ministry of Education, Tianjin, China
- Jinghua Wang
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Mirzaei M, Khajeh M. Comparison of anthropometric indices (body mass index, waist circumference, waist to hip ratio and waist to height ratio) in predicting risk of type II diabetes in the population of Yazd, Iran. Diabetes Metab Syndr 2018; 12:677-682. [PMID: 29680518 DOI: 10.1016/j.dsx.2018.04.026] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Accepted: 04/09/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND OBJECTIVES The purpose of this study was to determine the best anthropometric index and calculate the cut-off point for each anthropometric index in predicting the risk of type II diabetes in the population of Yazd city in Iran. MATERIALS AND METHODS The present analytical cross-sectional study was performed using the data from Yazd Health Study (YaHS) with a sample size of 9293. All required data including anthropometric indices BMI, WC, WHR, and WHtR were extracted from the YAHS questionnaire. The ROC curve was employed to compare the predictive power of each anthropometric index in the risk of developing the type II diabetes. RESULTS WHtR in both genders had better predictive power for the risk of type II diabetes (AUC = 0.692 for males and AUC = 0.708 for females), and BMI showed a weaker predictive power (AUC = 0.603 for males and AUC = 0.632 for females), WC and WHR also revealed similar predictive power in the risk of type II diabetes. The cut-off point of BMI for predicting the risk of diabetes was almost identical in both genders (26.2 in males and 25.9 in females), the cut-off point of WC (91 cm), and WHtR (0.56) in males was lower than in the females (96 cm for WC and 0.605 for WHtR). The cut-off point of WHR in males (0.939) was higher than in females (0.892). CONCLUSION The WHtR showed the best predictor of diabetes risk compared to other indices, and the BMI was the weakest predictor of the risk for diabetes.
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Affiliation(s)
- Masoud Mirzaei
- Department of Statistics and Epidemiology, Yazd Cardiovascular Research Centre, Shahid SadoughiUniversity, Yazd, Iran
| | - Mohammad Khajeh
- Department of Statistics and Epidemiolog, Faculty of Health, Shahid Sadoughi University, Yazd, Iran.
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Han SJ, Boyko EJ. The Evidence for an Obesity Paradox in Type 2 Diabetes Mellitus. Diabetes Metab J 2018; 42:179-187. [PMID: 29885111 PMCID: PMC6015958 DOI: 10.4093/dmj.2018.0055] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 05/16/2018] [Indexed: 12/12/2022] Open
Abstract
Although overweight/obesity is a major risk factor for the development of type 2 diabetes mellitus, there is increasing evidence that overweight or obese patients with type 2 diabetes mellitus experience lower mortality compared with patients of normal weight. This paradoxical finding, known as the "obesity paradox," occurs in other chronic diseases, and in type 2 diabetes mellitus is particularly perplexing given that lifestyle intervention with one goal being weight reduction is an important feature of the management of this condition. We summarize in this review the findings from clinical and epidemiologic studies that have investigated the association between overweight and obesity (usually assessed using body mass index [BMI]) and mortality in type 2 diabetes mellitus and discuss potential causes of the obesity paradox. We conclude that most studies show evidence of an obesity paradox, but important conflicting findings still exist. We also evaluate if potential bias might explain the obesity paradox in diabetes, including, for example, the presence of confounding factors, measurement error due to use of BMI as an index of obesity, and reverse causation.
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Affiliation(s)
- Seung Jin Han
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - Edward J Boyko
- Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, WA, USA.
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Ye M, Robson PJ, Eurich DT, Vena JE, Xu JY, Johnson JA. Changes in body mass index and incidence of diabetes: A longitudinal study of Alberta's Tomorrow Project Cohort. Prev Med 2018; 106:157-163. [PMID: 29117506 DOI: 10.1016/j.ypmed.2017.10.036] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 09/11/2017] [Accepted: 10/30/2017] [Indexed: 02/08/2023]
Abstract
Although obesity is a known risk factor for diabetes, the impact of body mass index (BMI) changes over time, especially BMI reduction, on diabetes development is less than clear. The objective of this study is to characterize the association between BMI changes over time and incidence of diabetes in a cohort of adults in Alberta. From 2000 to 2008, Alberta's Tomorrow Project (ATP) enrolled participants aged 35-69 to a population-based prospective cohort study. BMI was calculated from self-reported height and weight; change in BMI (∆BMI) was calculated as the difference between baseline and follow-up measurements. Diabetes cases were identified using the Canadian National Diabetes Surveillance System algorithm applied to linked administrative data (2000-2015). Multivariable Cox regression was used to examine the association between ∆BMI and incidence of diabetes. In a subset of the ATP cohort (n=19,164), 1168 incident cases of diabetes were identified during 198,853person-years of follow-up. Overall, BMI increase was associated with increased risk and BMI reduction was associated with reduced risk of diabetes. Particularly, compared to minimal BMI change (±5%), moderate (5%-10%) reduction in BMI was associated with 34% (95% CI: 12%-51%) reduction in risk of diabetes in participants with obesity; whereas 10% or greater increase in BMI was associated with an increased risk of diabetes of 64% or more in participants with overweight and obesity; in participants with normal and underweight, BMI changes was not apparently associated with risk of diabetes. Public health programs promoting weight loss, even at a moderate extent, would reduce risk of diabetes.
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Affiliation(s)
- Ming Ye
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Paula J Robson
- Alberta's Tomorrow Project, CancerControl Alberta, Alberta Health Services, Alberta, Canada; Department of Agricultural, Food and Nutritional Science, Faculty of Agricultural, Life and Environmental Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Dean T Eurich
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Jennifer E Vena
- Alberta's Tomorrow Project, CancerControl Alberta, Alberta Health Services, Alberta, Canada
| | - Jian-Yi Xu
- Alberta's Tomorrow Project, CancerControl Alberta, Alberta Health Services, Alberta, Canada
| | - Jeffrey A Johnson
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
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Zhao Q, Laukkanen JA, Li Q, Li G. Body mass index is associated with type 2 diabetes mellitus in Chinese elderly. Clin Interv Aging 2017; 12:745-752. [PMID: 28496312 PMCID: PMC5422331 DOI: 10.2147/cia.s130014] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background There is limited information on the association between metabolic syndrome components including body mass index (BMI) and type 2 diabetes mellitus in elderly Chinese population. Therefore, we investigated whether components of metabolic syndrome are associated with type 2 diabetes mellitus in elderly. Methods A total of 479 hospitalized patients (aged 65–95 years) with recently diagnosed type 2 diabetes mellitus were studied retrospectively in a cross-sectional study and compared with 183 subjects with prediabetes and 62 subjects without glucose metabolism abnormalities. Results BMI (24.69±3.59 versus 23.92±3.08 and 23.56±3.25 kg/m2), blood pressure, cholesterol, triglyceride, liver enzymes and prevalence of fatty liver were higher in patients with type 2 diabetes mellitus as compared with elderly subjects with prediabetes or normal glucose metabolism separately (all P<0.05). Multivariable regression analysis showed that BMI was associated positively with insulin resistance and inversely with insulin sensitivity in type 2 diabetes mellitus group (all P<0.05). Conclusion Higher BMI was associated with increased insulin resistance and decreased insulin sensitivity in elderly Asian population with type 2 diabetes mellitus.
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Affiliation(s)
- Qianping Zhao
- Division of Cardiology, Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Jari A Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Department of Medicine, Central Finland Central Hospital, Jyväskylä, Finland
| | - Qifu Li
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Gang Li
- Division of Cardiology, Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
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Su Y, Ma Y, Rao W, Yang G, Wang S, Fu Y, Liu Y, Zhang Y, You Y, Yu Y, Kou C. Association Between Body Mass Index and Diabetes in Northeastern China: Based on Dose-Response Analyses Using Restricted Cubic Spline Functions. Asia Pac J Public Health 2016; 28:486-97. [PMID: 27390023 DOI: 10.1177/1010539516656436] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
A high body mass index (BMI) is a major risk factor for diabetes, although little is known about the characterization of a dose-response association adjusted for potential confounders. This cross-sectional study was conducted from June 2012 to August 2012; a total of 21 435 inhabitants in Jilin Province aged between 18 and 79 years were selected randomly based on multistage, stratified cluster sampling. The estimated prevalence of diabetes was 9.1% overall, 9.4% in males and 8.9% in females. After adjusting for potential confounders, the multivariable-adjusted odds ratios for the BMI-diabetes association were 1.337 (95% confidence interval = 1.185-1.508) and 1.696 (95% confidence interval = 1.429-2.042), respectively, for overweight and obesity. Through multivariable restricted cubic spline regression, continuous variation in BMI was found to be related to diabetes in a nonlinear manner (P < .001) after adjustment for confounders in both different gender and different age groups, suggesting that there is an adjusted dose-response association between continuous BMI and diabetes, with substantial population-level effects.
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Affiliation(s)
- Yingying Su
- Jilin University, Changchun, Jilin Province, China
| | - Yue Ma
- Jilin University, Changchun, Jilin Province, China
| | - Wenwang Rao
- Jilin University, Changchun, Jilin Province, China
| | - Guang Yang
- Jilin University, Changchun, Jilin Province, China
| | - Shibin Wang
- Jilin University, Changchun, Jilin Province, China
| | - Yingli Fu
- Jilin University, Changchun, Jilin Province, China
| | - Yingyu Liu
- Jilin University, Changchun, Jilin Province, China
| | - Yangyu Zhang
- Jilin University, Changchun, Jilin Province, China
| | - Yueyue You
- Jilin University, Changchun, Jilin Province, China
| | - Yaqin Yu
- Jilin University, Changchun, Jilin Province, China
| | - Changgui Kou
- Jilin University, Changchun, Jilin Province, China
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Peeters GMEEG, Herber-Gast GCM, Dobson AJ, Brown WJ. Changes in the Relationships Between Body Mass Index and Health Outcomes Across Middle Age and Older Adulthood. Mayo Clin Proc 2015; 90:903-10. [PMID: 26141330 DOI: 10.1016/j.mayocp.2015.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 03/30/2015] [Accepted: 04/03/2015] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To examine patterns of the incidence of diabetes, hypertension, and mortality by single units of body mass index (BMI) and 5-year age groups using longitudinal data from middle-aged and older women. PATIENTS AND METHODS Middle-aged (born between 1946 and 1951; N = 13,715) and older (born between 1921 and 1926; N = 12,432) participants in the Australian Longitudinal Study on Women's Health completed surveys in 1996 and at approximately 3-year intervals thereafter until 2011. Proportions of women with diabetes, hypertension, and mortality over 3-year intervals were estimated for each unit of BMI and 5-year age group (45 to < 50, 50 to < 55, 55 to < 60, 70 to < 75, 75 to < 80, and 80 to < 85 years) using generalized additive modeling with adjustment for time-varying covariates. RESULTS Three-year incidence of diabetes (1.2%-3.6%), hypertension (5.2%-17.8%), and death (0.4%-9.5%) increased with age. For both diabetes and hypertension, the associations with BMI were curvilinear in middle-aged women and became almost linear in older women. With increasing age, the slope became steeper, and the increase started at lower BMI values. For hypertension, there was a marked increase in intercept from 75 years onward. In contrast, mortality risks were highest for low BMI (≤ 20) in all age groups. A clear U-shaped curve was observed only in the oldest age group. CONCLUSION The shapes of the relationships between BMI and incidence of diabetes, hypertension, and mortality change with age, suggesting that weight management interventions should be tailored for different age groups.
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Affiliation(s)
- G M E E Geeske Peeters
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia; School of Public Health, University of Queensland, Brisbane, Australia.
| | | | - Annette J Dobson
- School of Public Health, University of Queensland, Brisbane, Australia
| | - Wendy J Brown
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia
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Patient Understanding of Body Mass Index (BMI) in Primary Care Practices: A Two-State Practice-based Research (PBR) Collaboration. J Am Board Fam Med 2015; 28:475-80. [PMID: 26152438 PMCID: PMC4612633 DOI: 10.3122/jabfm.2015.04.140279] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The concept of body mass index (BMI) may not be well understood by patients. The purpose of this study was to evaluate patients' knowledge of BMI in the primary care setting. METHODS Adult patients seen in 18 practices in West Virginia and New Jersey were invited to complete a voluntary survey. The survey assessed the patient's baseline knowledge of BMI as well as demographic information and whether the patient had known chronic conditions associated with increased BMI, including hypertension, hyperlipidemia, diabetes mellitus, and sleep apnea. RESULTS While the majority (59.9%) of primary care patients knew the meaning of BMI and that it is related to obesity, there was little knowledge of BMI cutoff values; more than 80% of responses were incorrect when asked to define specific BMI levels and their meaning. Self-awareness of obesity was limited as well, with only 16.4% aware of their own personal BMI. Furthermore, nearly 70% of patients could not recall having discussed BMI with their physician. CONCLUSION Findings indicate low comprehension of the term BMI. Increasing awareness of BMI may help patients address this key risk factor and significantly affect public health.
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Ochiai M, Kuroda T, Gohtani S, Matsuo T. Dietary protein derived from dried bonito fish improves type-2 diabetes mellitus-induced bone frailty in Goto-Kakizaki rats. J Food Sci 2015; 80:H848-56. [PMID: 25716219 DOI: 10.1111/1750-3841.12797] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 12/24/2014] [Indexed: 11/28/2022]
Abstract
Type-2 diabetes mellitus (T2DM) induces bone frailty. Protein and polyunsaturated fatty acids (PUFA) contained in fish can be effective in enhancing bone quality, but the bone developing effect of fish protein containing less PUFA has not been evaluated in young animals with T2DM. We prepared a bonito fish (BF) and defatted BF (DBF) and hypothesized that protein contained in BF and DBF would be effective for mitigating the effects of T2DM-induced bone frailty. We mainly evaluated the effect of dietary BF and DBF on bone and apparent calcium absorption in young Goto-Kakizaki (GK) rats with T2DM. GK rats were divided into 3 groups based on diets (casein, BF, and DBF) and fed with each diet for 6 wk. Wistar rats were fed with the casein diet as a non-T2DM control. Bone mass, bone strength, apparent calcium absorption, and serum biochemical parameters were determined. The dry weight and strength of the femurs were lower in the GK rats than in the Wistar rats fed with the casein diet. Dietary intake of the BF and DBF diets enhanced the maximum load and dry weight of the femurs and suppressed the serum alkaline phosphatase activity although the apparent calcium absorption was lower in the GK rats fed with the BF and DBF diets than in those fed with the casein diet. These parameters were not different between the rats fed with the BF and DBF diets. Our data suggest that protein contained in the BF and DBF diets improved T2DM-induced bone frailty.
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Affiliation(s)
- Masaru Ochiai
- Faculty of Agriculture, Kagawa Univ, 2393 Ikenobe, Miki, Kita, Kagawa, 761-0795, Japan
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Mandai N, Akazawa K, Hara N, Ide Y, Ide K, Dazai U, Chishaki A, Chishaki H. Body Weight Reduction Results in Favorable Changes in Blood Pressure, Serum Lipids, and Blood Sugar in Middle-Aged Japanese Persons: A 5-Year Interval Observational Study of 26,824 Cases. Glob J Health Sci 2015; 7:159-70. [PMID: 26156922 PMCID: PMC4803925 DOI: 10.5539/gjhs.v7n5p159] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 12/30/2014] [Indexed: 11/16/2022] Open
Abstract
Objective: We investigated the relationships between body weight (BWt) and metabolic syndrome (MS) risk factors to elucidate the effect of BWt (ΔBWt) change and body mass index (BMI) on these factors in the Japanese population. Methods: Data were collected on MS-related parameters measured during two annual examinations of 16,640 men (mean age: 41.7±11.6 years) and 10,184 women (mean age: 45.0±12.2 years) without prior treatment of hypertension, diabetes mellitus, or dyslipidemia in 2006 and 2011 in Fukuoka, Japan. The subjects were divided into three groups according to BMI in 2006 (low, middle and high BMI) and into three groups according to change in BMI between 2006 and 2011 (decreased, stable, and increased BMI). Mean values for blood pressure (BP), systolic BP (SBP), diastolic BP (DBP), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), hemoglobin A1c (HbA1c), and fasting blood glucose (FBG) for each group were determined by sex and subjected to statistical analysis for comparison. Results: High BMI (>26) was associated with higher SBP, LDL-C, FBG, and TG in both sexes. An increase ≥ 1.1 BMI units in 5 years was associated with increased DBP, LDL-C, TG, HbA1c, and FBG and decreased HDL-C. In contrast, decreased BMI was associated with decreased BP and LDL-C and increased HDL-C in both sexes, and decreased TG in men and FBG in women. Conclusions: Maintaining a desirable weight or losing weight may help prevent hypertension and MS, even in non-obese individuals.
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Matsumoto M, Ibuki A, Minematsu T, Sugama J, Horii M, Ogai K, Nishizawa T, Dai M, Sato A, Fujimoto Y, Okuwa M, Nakagami G, Nakatani T, Sanada H. Structural changes in dermal collagen and oxidative stress levels in the skin of Japanese overweight males. Int J Cosmet Sci 2014; 36:477-84. [PMID: 24893563 DOI: 10.1111/ics.12145] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Accepted: 05/31/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVE It has been reported that obese people have poorly organized dermal collagen structure because of the degradation of collagen fibers, which is caused by an increase in oxidative stress levels associated with the hypertrophy of subcutaneous adipose cells. However, it is unclear whether an increase in oxidative stress levels caused by the accumulation of subcutaneous adipose tissue and a change in the dermal structure also occur in overweight and obese Japanese people. The objectives of this study are to identify structural changes that occur in the dermis and to measure the levels of oxidative stress in Japanese overweight males. METHODS The overweight group included 43 Japanese male volunteers aged between 25 and 64 years and with a body mass index (BMI) of ≥25 and <30. The control group included 47 male volunteers aged between 22 and 64 years and with BMI of <25. The 20-MHz Dermascan C® ultrasound scanner with software for image analyses was used. Echogenicity of the upper and lower dermis was measured. The mRNA expression level of heme oxygenase-1 (HMOX1) in hair follicles was quantitatively analyzed by real-time reverse transcription polymerase chain reaction (RT-PCR) and was used as a marker of oxidative stress. Ultrasonographic imaging and collection of hair follicles were performed at the same site on the thigh, abdomen, and upper arm. RESULTS The HMOX1 mRNA expression level in the abdomen and thigh was significantly lower in the overweight group than in the control group. Moreover, the echogenicity of the upper dermis of the abdomen and the lower dermis of the abdomen and thigh was significantly lower in the overweight group than in the control group. CONCLUSION We detected an increase in oxidative stress levels and a decrease in the density of dermal collagen at the same site on the thigh, abdomen, and upper arm of Japanese overweight males. These findings suggest the fragility of the dermis of Japanese overweight males, which might have been caused by the accumulation of subcutaneous adipose tissue.
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Affiliation(s)
- M Matsumoto
- Department of Clinical Nursing, Division of Health Science, Graduate School of Medicine, Kanazawa University, Ishikawa, Japan
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Abstract
OBJECTIVE To examine the relationship between long-term weight gain and risk of metabolic syndrome (MetS) in non-obese and obese subjects. METHODS Cross-sectional data from 3342 participants (1614 men, 1728 women) were obtained from a Specific Medical Checkup and a self-reported questionnaire survey conducted by a health insurance society between April 2009 and March 2010. Subjects were divided into four groups based on body mass index (BMI) and experience of weight gain since the age of 20 years using a self-reported questionnaire: non-obese/non-gain, non-obese/gain, obese/non-gain, and obese/gain. Relationships between weight gain and risk of MetS were investigated using logistic regression analysis, with the four groups as a dependent variable. RESULTS There were 2103 (62.9%) subjects in the non-obese/non-gain, 545 (16.3%) in the non-obese/gain, 125 (3.7%) in the obese/non-gain, and 569 (17.0%) in the obese/gain groups. The obese/gain group showed the highest risk of MetS in men (odds ratio [OR]: 37.45, 95% confidence interval [95% CI]: 25.32-55.40) and women (OR: 163.13, 95% CI: 56.22-473.32). Even the non-obese/gain group had an increased risk of MetS, in men (OR: 4.98, 95% CI: 3.47-7.15) and women (OR: 6.28, 95% CI: 1.53-25.83). CONCLUSION The data show that the obese/gain group had the highest risk of MetS, and that those who gained weight were at risk of MetS, even the non-obese.
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Affiliation(s)
- Akiko Suzuki
- Graduate School of Humanities and Sciences, Ochanomizu University, Japan
| | - Rie Akamatsu
- Graduate School of Humanities and Sciences, Ochanomizu University, Japan.
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Job Burnout, Mood State, and Cardiovascular Variable Changes of Doctors and Nurses in a Children's Hospital in China. ISRN NURSING 2014; 2014:386719. [PMID: 24734196 PMCID: PMC3964732 DOI: 10.1155/2014/386719] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 12/05/2013] [Indexed: 01/13/2023]
Abstract
Aims. This study examines mood and cardiovascular variables related to job stress and burnout in hospital personnel. Main Methods. 400 nurses and physicians from a children's hospital in China were recruited. Participants completed job stress, burnout, and mood state questionnaires. Cardiovascular variables such as body mass index (BMI), triglyceride (TG), and high density lipoprotein (HDL) were measured. Key Findings. Job stress and burnout were significantly associated with mood state. Statistically significant correlations were found between triglyceride levels and job stress scores (r = 0.175, P < 0.01), BMI and job stress scores (r = 0.121, P < 0.05), and HDL levels and job stress scores (r = −0.117, P < 0.05). Significance. Mood state changes may be related to job stress and job burnout, in turn, associated with triglycerides and HDL levels. Public health implications and interventions are discussed.
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Esteghamati A, Etemad K, Koohpayehzadeh J, Abbasi M, Meysamie A, Noshad S, Asgari F, Mousavizadeh M, Rafei A, Khajeh E, Neishaboury M, Sheikhbahaei S, Nakhjavani M. Trends in the prevalence of diabetes and impaired fasting glucose in association with obesity in Iran: 2005-2011. Diabetes Res Clin Pract 2014; 103:319-27. [PMID: 24447808 DOI: 10.1016/j.diabres.2013.12.034] [Citation(s) in RCA: 173] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2013] [Revised: 11/08/2013] [Accepted: 12/21/2013] [Indexed: 01/25/2023]
Abstract
AIMS To estimate the prevalence and trends of diabetes mellitus (DM) and impaired fasting glucose (IFG), 2005-2011, and to determine the contribution of obesity to DM prevalence. PATIENTS AND METHODS Data from Surveillance of Risk Factors of Non-communicable Diseases (SuRFNCD) conducted in 2005, 2007, and 2011 were gathered. DM was defined as presence of self-reported previous diagnosis or a fasting plasma glucose (FPG)≥7 mmol/L. IFG was diagnosed with FPG levels between 5.6 and 6.9 mmol/L. Prevalence rates for 2011 and trends for 2005-2011 were determined by extrapolating survey results to Iran's adult population. Population attributable fraction (PAF) of obesity was also calculated. RESULTS In 2011, IFG and total DM prevalence rates were 14.60% (95%CI: 12.41-16.78) and 11.37% (95%CI: 9.86-12.89) among 25-70 years, respectively. DM was more common in older age (p < 0.0001), in women (p = 0.0216), and in urban-dwellers (p = 0.0001). In 2005-2011, trend analysis revealed a 35.1% increase in DM prevalence (OR: 1.04, 95%CI: 1.01-1.07, p = 0.011); albeit, IFG prevalence remained relatively unchanged (OR: 0.98, 95%CI: 0.95-1.00, p = 0.167). In this period, DM awareness improved; undiagnosed DM prevalence decreased from 45.7% to 24.7% (p < 0.001). PAF analysis demonstrated that 33.78%, 10.25%, and 30.56% of the prevalent DM can be attributed to overweight (BMI≥25kg/m(2)), general obesity (BMI≥30 kg/m(2)), and central obesity (waist circumference≥90 cm), respectively. Additionally, the DM increase rate in 2005-2011, was 20 times higher in morbidly obese compared with lean individuals. CONCLUSION More than four million Iranian adults have DM which has increased by 35% over the past seven years, owing in large part, to expanding obesity epidemic.
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Affiliation(s)
- Alireza Esteghamati
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | | | | | - Mehrshad Abbasi
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Alipasha Meysamie
- Department of Preventive Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Sina Noshad
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | | | - Mostafa Mousavizadeh
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ali Rafei
- Center for Disease Control, Tehran, Iran.
| | - Elias Khajeh
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mohamadreza Neishaboury
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Sara Sheikhbahaei
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Manouchehr Nakhjavani
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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Fajardo RJ, Karim L, Calley VI, Bouxsein ML. A review of rodent models of type 2 diabetic skeletal fragility. J Bone Miner Res 2014; 29:1025-40. [PMID: 24585709 PMCID: PMC5315418 DOI: 10.1002/jbmr.2210] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Revised: 02/21/2014] [Accepted: 02/25/2014] [Indexed: 12/21/2022]
Abstract
Evidence indicating that adult type 2 diabetes (T2D) is associated with increased fracture risk continues to mount. Unlike osteoporosis, diabetic fractures are associated with obesity and normal to high bone mineral density, two factors that are typically associated with reduced fracture risk. Animal models will likely play a critical role in efforts to identify the underlying mechanisms of skeletal fragility in T2D and to develop preventative treatments. In this review we critically examine the ability of current rodent models of T2D to mimic the skeletal characteristics of human T2D. We report that although there are numerous rodent models of T2D, few have undergone thorough assessments of bone metabolism and strength. Further, we find that many of the available rodent models of T2D have limitations for studies of skeletal fragility in T2D because the onset of diabetes is often prior to skeletal maturation and bone mass is low, in contrast to what is seen in adult humans. There is an urgent need to characterize the skeletal phenotype of existing models of T2D, and to develop new models that more closely mimic the skeletal effects seen in adult-onset T2D in humans.
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Affiliation(s)
- Roberto J. Fajardo
- Department of Orthopaedics, University of Texas Health Science Center at San Antonio
| | - Lamya Karim
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center and Harvard Medical School
| | - Virginia I. Calley
- Department of Orthopaedics, University of Texas Health Science Center at San Antonio
| | - Mary L. Bouxsein
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center and Harvard Medical School
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Kaneto C, Toyokawa S, Miyoshi Y, Suyama Y, Kobayashi Y. Long-term weight change in adulthood and incident diabetes mellitus: MY Health Up Study. Diabetes Res Clin Pract 2013; 102:138-46. [PMID: 24139847 DOI: 10.1016/j.diabres.2013.08.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 01/28/2013] [Accepted: 08/23/2013] [Indexed: 11/29/2022]
Abstract
AIM To investigate whether long-term weight/BMI change in adulthood has a significant impact on the incidence of diabetes, independent of attained weight status. METHODS A number of 13,700 participants (2962 men and 10,738 women) aged 36 to 55 years were followed for up to 5 years using data from annual health checkups. Incident cases of diabetes were identified from self-reports or single fasting plasma glucose measurements (≥7.0 mmol/l). Weight/BMI change was calculated from participants' weight/BMI values at age 20 years and weight/BMI values at a given point during follow-up and used as a time-dependent variable in age-stratified multivariate Cox proportional hazards models. RESULTS During the 5 year follow-up, 408 participants (137 men and 271 women) developed diabetes. Even after adjusting for BMI during follow-up and other possible confounders, weight/BMI gain since age 20 years was significantly associated with an increased risk of developing diabetes. The hazard ratios were: 2.30 (95% confidence interval (CI): 1.31-4.04) for those who gained 6.0 to <10.0 kg and 3.09 (95% CI: 1.79-5.34) for those who gained ≥10.0 kg [reference: <2.0 kg change]; and 2.61 (95% CI: 1.58-4.31) for those who gained 3.0 to <5.0 kg/m(2) and 3.70 (95% CI: 2.22-6.16) for those who gained ≥5.0 kg/m(2) [reference: <1.0 kg/m(2) change]. CONCLUSIONS The results indicate that long-term weight/BMI gain in adulthood is a significant predictor for the development of diabetes, independent of attained weight status. Because weight gain within the normal weight range could increase the risk of diabetes, non-obese people should also be warned against possible weight gain.
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Affiliation(s)
- Chie Kaneto
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan
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Nagao H, Kashine S, Nishizawa H, Okada T, Kimura T, Hirata A, Fukuda S, Kozawa J, Maeda N, Kitamura T, Yasuda T, Okita K, Hibuse T, Tsugawa M, Imagawa A, Funahashi T, Shimomura I. Vascular complications and changes in body mass index in Japanese type 2 diabetic patients with abdominal obesity. Cardiovasc Diabetol 2013; 12:88. [PMID: 23773268 PMCID: PMC3698109 DOI: 10.1186/1475-2840-12-88] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 06/13/2013] [Indexed: 11/23/2022] Open
Abstract
Background Although many Asian type 2 diabetic patients have been considered to be not obese and have low capacity of insulin secretion, the proportion of obese patients with visceral fat accumulation has increased in recent years. We found previously considerable number of Japanese non-obese subjects (body mass index (BMI) < 25 kg/m2) with visceral fat accumulation and multiple cardiovascular risk factors. The aim of the study was to investigate the difference in clinical features of type 2 diabetic patients with and without visceral fat accumulation, focusing on vascular complications and changes in BMI. Methods We enrolled 88 Japanese hospitalized type 2 diabetic patients. Abdominal obesity represented waist circumference (WC) of ≥85 cm for males and ≥90 cm for females (corresponding to visceral fat area of 100 cm2). Subjects were divided into two groups; with or without abdominal obesity. Results Hypertension, dyslipidemia and cardiovascular diseases were significantly more in the patients with abdominal obesity. The prevalence of cardiovascular disease in the non-obese patients (BMI < 25 kg/m2) with abdominal obesity were similar in obese patients (BMI ≥25 kg/m2). The mean BMI of the patients with abdominal obesity was < 25 kg/m2 at 20 years of age, but reached maximum to more than 30 kg/m2 in the course. Furthermore, substantial portion of the type 2 diabetic patients (52% in males and 43% in females) were not obese at 20 year-old (BMI < 25 kg/m2), but developed abdominal obesity by the time of admission. Conclusion These results emphasize the need to control multiple risk factors and prevent atherosclerotic disease in patients with abdominal obesity. The significant weight gain after 20 years of age in patients with abdominal obesity stresses the importance of lifestyle modification in younger generation, to prevent potential development of type 2 diabetes and future atherosclerotic cardiovascular disease.
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Kamada C. [Nutritional intake and the relationship between diet and diabetes]. Nihon Ronen Igakkai Zasshi 2013; 50:68-71. [PMID: 23925096 DOI: 10.3143/geriatrics.50.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Yoshimura Y, Kamada C, Takahashi K, Kaimoto T, Iimuro S, Ohashi Y, Araki A, Umegaki H, Sakurai T, Ito H. Relations of nutritional intake to age, sex and body mass index in Japanese elderly patients with type 2 diabetes: The Japanese Elderly Diabetes Intervention Trial. Geriatr Gerontol Int 2012; 12 Suppl 1:29-40. [DOI: 10.1111/j.1447-0594.2011.00810.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Prevalence and risk factors of obesity among school-aged children in Xi'an, China. Eur J Pediatr 2012; 171:389-94. [PMID: 21912892 DOI: 10.1007/s00431-011-1566-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Accepted: 09/01/2011] [Indexed: 10/17/2022]
Abstract
UNLABELLED The purpose of this study was to examine the prevalence and the risk factors associated with obesity among school-aged children in Xi'an city. The body mass index of 6,740 children aged 7-18 years was compared with the Working Group on Obesity in China cut-off value to estimate the prevalence of obesity. A case-control study of obese and non-obese children was carried out to study risk factors for obesity. A standardized questionnaire was used to collect information on possible risk factors causing obesity. Univariate analysis was performed first to compare the distribution of risk factors between cases and controls. Conditional logistic regression analysis was used to assess independent risk factors of obesity. The results showed that the overall prevalence of obesity among school-aged children was 4.11% (4.63% for males and 3.57% for females). A total of 516 subjects (258 pairs of cases and controls) were included in the final analysis. High maternal education and a longer sleeping time were shown to be protective factors against obesity (odds ratio [OR] 0.148, 95% confidence interval [CI] 0.074-0.296 and OR 0.472, 95% CI 0.342-0.652, respectively). Whereas family history of diabetes (OR 5.498, 95% CI 2.606-11.600), parental overweight (OR 3.720, 95% CI 2.068-6.689), and watching television, playing video games, and using computers (OR 1.564, 95% CI 1.133-2.159) were associated with a higher obesity risk. CONCLUSION The prevalence of childhood obesity in Xi'an has become a concern, and sleeping time, sedentary behavior, and family factors have pronounced effects on the prevalence of obesity.
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Sanada H, Yokokawa H, Yoneda M, Yatabe J, Yatabe MS, Williams SM, Felder RA, Jose PA. High body mass index is an important risk factor for the development of type 2 diabetes. Intern Med 2012; 51:1821-6. [PMID: 22821094 PMCID: PMC3540801 DOI: 10.2169/internalmedicine.51.7410] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE The aim of this study was to establish a causal relationship between excess body weight and the onset of diabetes in a retrospective cohort study. METHODS This 10-year observational cohort study investigated 969 men and 585 women (23 to 80 years of age), who underwent voluntary complete medical check-ups and an annual 75-g oral glucose tolerance test (75 g-OGTT). Participants with fasting plasma glucose ≥126 mg/dL, 2-h glucose level in a 75 g-OGTT ≥200 mg/dL and/or received medical treatment for type 2 diabetes during the previous year were considered as new-onset diabetics. We assessed the independent contribution of increased BMI to the risk of developing type 2 diabetes with Cox proportional hazard model. RESULT During the follow-up period, we diagnosed 86 men and 49 women with new-onset type 2 diabetes. In the Cox proportional hazards model, the risk of diabetes mellitus increased with increasing BMI, even after adjusting for age, sex, blood pressure, metabolic profiles, and insulin resistance. In the final model, setting BMI less than 25 as a reference group, the Hazard ratios for diabetes mellitus was 3.12 for those with a BMI of 25-27.4 and it was increased to 3.80 for participants with a BMI of 27.5 or higher. CONCLUSION Overweight/obesity (high BMI) is an independent and dose-dependent risk factor for type 2 diabetes in overweight Japanese patients. Our results confirmed the usefulness of BMI as a classic parameter, and the importance of lifestyle modification and better management among people with overweight/obesity for prevention of type 2 diabetes mellitus.
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Affiliation(s)
- Hironobu Sanada
- Division of Health Science Research, Fukushima Welfare Federation of Agricultural Cooperatives, 50, Sakamizu, Aizubange Town, Fukushima, 969-6593, Japan
| | - Hirohide Yokokawa
- Department of General Medicine, Juntendo University School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Minoru Yoneda
- Division of Health Science Research, Fukushima Welfare Federation of Agricultural Cooperatives, 50, Sakamizu, Aizubange Town, Fukushima, 969-6593, Japan
| | - Junichi Yatabe
- Division of Health Science Research, Fukushima Welfare Federation of Agricultural Cooperatives, 50, Sakamizu, Aizubange Town, Fukushima, 969-6593, Japan
- Department of Pharmacology, Fukushima Medical University School of Medicine, 1, Hikarigaoka, Fukushima City, Fukushima 960-1295, Japan
| | - Midori Sasaki Yatabe
- Department of Pharmacology, Fukushima Medical University School of Medicine, 1, Hikarigaoka, Fukushima City, Fukushima 960-1295, Japan
| | - Scott M. Williams
- Division of Cardiovascular Medicine, Center for Human Genetics Research, Department of Medicine, Vanderbilt University School of Medicine, 519A Light Hall, Nashville, TN 37232, USA
| | - Robin A Felder
- Department of Pathology, The University of Virginia Health Sciences Center, 1215 Lee Street, Charlottesville, VA 22908, USA
| | - Pedro A Jose
- Division of Nephrology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD21201, USA
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Fukutomi Y, Taniguchi M, Nakamura H, Konno S, Nishimura M, Kawagishi Y, Okada C, Tanimoto Y, Takahashi K, Akasawa A, Akiyama K. Association between body mass index and asthma among Japanese adults: risk within the normal weight range. Int Arch Allergy Immunol 2011; 157:281-7. [PMID: 22042357 DOI: 10.1159/000327555] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Accepted: 03/14/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Increasing amounts of data have shown that some Asian populations are more susceptible to increased weight and development of noncommunicable disease than Western populations. However, little is known about the association between increased weight, particularly within the normal range, and the development of asthma among Asian populations. METHODS To examine the association between increased body mass index (BMI) and asthma among Japanese adults, data from a nationwide population-based cross-sectional survey of asthma prevalence in Japan were analyzed (n = 22,962; age range 20-79 years). BMIs were classified into 7 categories considering WHO recommendations (cutoff points: 17.00, 18.50, 23.00, 25.00, 27.50 and 30.00), and the association between BMI and the prevalences of asthma as well as asthma symptoms were assessed by multivariate logistic regression. RESULTS The prevalences of obesity (BMI ≥ 30.00) in this population were relatively low (males 3.0%, females 2.3%). BMI categories of 25.00 or higher in both genders were significantly associated with an increased risk of asthma compared with the reference category (BMI 18.50-22.99). Even in females with a BMI of 23.00-24.99, the prevalence of asthma significantly increased (adjusted odds ratio 1.49, 95% confidence interval 1.16-1.92) compared with that in the reference category. CONCLUSIONS An increase in the prevalence of asthma among Japanese females starts at a BMI of 23.00, which was relatively lower than those reported from Western countries. This finding suggests that the Japanese population is likely to have asthma with a lesser degree of obesity than Western populations.
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Affiliation(s)
- Yuma Fukutomi
- Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan.
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Fukutomi Y, Taniguchi M, Tsuburai T, Tanimoto H, Oshikata C, Ono E, Sekiya K, Higashi N, Mori A, Hasegawa M, Nakamura H, Akiyama K. Obesity and aspirin intolerance are risk factors for difficult-to-treat asthma in Japanese non-atopic women. Clin Exp Allergy 2011; 42:738-46. [PMID: 22092552 DOI: 10.1111/j.1365-2222.2011.03880.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2010] [Revised: 08/23/2011] [Accepted: 08/25/2011] [Indexed: 11/30/2022]
Abstract
BACKGROUND Asthma is a clinical syndrome characterized by variabilities in disease expression and severity. The pathophysiological mechanism underlying anti-asthma treatment resistance is also assumed to be different between disease phenotypes. OBJECTIVE To elucidate the effect of gender and atopic phenotype on the relationship between clinical factors and the risk of treatment resistance. METHODS We compared outpatients with difficult-to-treat asthma (DTA; n = 486) in a tertiary hospital for allergic diseases in central Japan with those with controlled severe asthma (n = 621) with respect to clinical factors including body mass index (BMI) and aspirin intolerance using multivariate logistic regression analysis stratified by gender and atopic phenotype. RESULTS When analysis was performed on the entire study populations, obesity (BMI ≥ 30 kg/m(2); adjusted odds ratio (OR) 1.92; 95% confidence interval (95% CI: 1.07-3.43) and aspirin intolerance (OR: 2.56, 95% CI: 1.44-4.57) were found to be the significant risk factors for DTA. However, after the stratification by gender and atopic phenotype, the association between obesity and DTA was significant only in women (OR: 2.76, 95% CI: 1.31-5.78), but not in men (OR: 1.03, 95% CI: 0.38-2.81), and only in non-atopics (OR: 4.03, 95% CI: 1.15-14.08), but not in atopics (OR: 1.54, 95% CI: 0.79-3.02). The similar gender and phenotypic differences were also observed in the association between aspirin intolerance and DTA: namely, the association was significant only in women (OR: 3.96, 95% CI: 1.84-8.50), but not in men (OR: 1.19, 95% CI: 0.46-3.05); and only in non-atopics (OR: 5.49, 95% CI: 1.98-15.19), but not in atopics (OR: 1.39, 95% CI: 0.65-2.98). CONCLUSIONS AND CLINICAL RELEVANCE Significant associations of obesity and aspirin intolerance with DTA were observed only in women and in non-atopics. These findings suggest that a phenotype-specific approach is needed to treat patients with DTA.
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Affiliation(s)
- Y Fukutomi
- Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Kanagawa, Japan.
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Maddah M, Shoiili AG, Karandish M, Sheyoie R. Weight loss in diabetic obese women in comparison to non-diabetic women. Int J Cardiol 2011; 150:347-8. [DOI: 10.1016/j.ijcard.2011.05.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Accepted: 05/13/2011] [Indexed: 11/16/2022]
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EZAKI O. The Optimal Dietary Fat to Carbohydrate Ratio to Prevent Obesity in the Japanese Population: A Review of the Epidemiological, Physiological and Molecular Evidence. J Nutr Sci Vitaminol (Tokyo) 2011; 57:383-93. [DOI: 10.3177/jnsv.57.383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Lee J, Yee ST, Kim JJ, Choi MS, Kwon EY, Seo KI, Lee MK. Ursolic acid ameliorates thymic atrophy and hyperglycemia in streptozotocin-nicotinamide-induced diabetic mice. Chem Biol Interact 2010; 188:635-42. [PMID: 20869956 DOI: 10.1016/j.cbi.2010.09.019] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Revised: 09/15/2010] [Accepted: 09/17/2010] [Indexed: 12/26/2022]
Abstract
The purpose of this study was to assess the effects of low-dose ursolic acid (UA) on glycemic regulation and immune responses in streptozotocin-nicotinamide (STZ/NA)-induced diabetic mice. Diabetic mice were supplemented with two different doses of UA (0.01 and 0.05%, w/w) or metformin (0.5%, w/w) for 4 weeks. Compared with the untreated diabetic group, UA and metformin significantly improved blood glucose, glycosylated hemoglobin, glucose tolerance, insulin tolerance and plasma leptin levels as well as aminotransferase activity. The plasma and pancreatic insulin concentrations were significantly higher in both UA groups than in the untreated diabetic group. Supplementation with metformin increased the pancreatic insulin level without a change in the plasma insulin level. The relative thymus weights were lower in the untreated diabetic group compared to the non-diabetic group; however, the UA or metformin group had significantly improved thymus weights. Mice receiving UA or metformin supplementation had increased CD4(+)CD8(+) subpopulations in the thymus compared to the untreated diabetic mice. Concanavalin A-stimulated splenic T-lymphocyte proliferation and single-positive (CD4(+) and CD8(+)) subpopulations were significantly higher in the UA-supplemented diabetic groups than in the untreated diabetic group, but lipopolysaccharide-stimulated B-lymphocyte proliferation and the CD19(+) subpopulation were not significantly different among the groups. In the STZ/NA-induced diabetic mice, metformin increased the splenic T-lymphocyte CD4(+) and CD8(+) cell numbers without any change in T-lymphocyte proliferation. Both doses of UA lowered splenic IL-6 levels, whereas metformin increased IFN-γ, IL-6 and TNF-α levels compared to the untreated diabetic mice. These results suggest that low-dose UA may be used as a hypoglycemic agent and immune modulator in non-obese type 2 diabetic mice.
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Affiliation(s)
- Jin Lee
- Department of Food and Nutrition, Sunchon National University, Suncheon 540-742, Republic of Korea
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Nagaya T, Yoshida H, Takahashi H, Kawai M. Heart rate-corrected QT interval in resting ECG predicts the risk for development of type-2 diabetes mellitus. Eur J Epidemiol 2010; 25:195-202. [PMID: 20066475 DOI: 10.1007/s10654-009-9423-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2009] [Accepted: 12/31/2009] [Indexed: 02/05/2023]
Abstract
Chronic and subclinical sympathetic over-activity may underlie development of type-2 diabetes mellitus (DM). Since longer heart rate-corrected QT interval (QTc) represents predominance of sympathetic activity within autonomic balance, we investigated influences of QTc on the incidence of DM in a follow-up study. The subjects were 12,530 men and 7,163 women aged 30-59 years and apparently healthy at baseline. QTc in resting ECG was obtained using Bazett's formula (QTcB), Fridericia's formula (QTcF) and the linear regression technique (QTcLR). Incident DM was identified by 'fasting serum glucose > or =7.00 mmol l(-1) (126 mg dl(-1))' or/and 'on medication for DM'. Using Cox proportional hazard models, hazard ratio (HR) for incident DM was estimated according to the quartiles (Q1-Q4) of QTcB, QTcF or QTcLR, and its linear trends across the quartiles were checked. Baseline age, BMI, smoking, drinking, exercise and education were computed as conventional confounders. During the follow-up of 93,337 person-years for men and 51,517 person-years for women, 637 men and 192 women developed DM. The multivariate-adjusted HRs(95% confidence interval) for Q4 of QTcB, QTcF and QTcLR against corresponding Q1 were 1.85(1.46, 2.34), 1.31(1.04, 1.65) and 1.58(1.26, 1.99), respectively, for men, and 2.03(1.31, 3.16), 1.34(0.91, 2.00) and 1.58(1.04, 2.38), respectively, for women. Both sexes showed increasing trends in the HRs across the quartiles of QTcB, QTcF and QTcLR. In conclusion, QTc in resting ECG moderately but proportionally predicts the risk for development of DM in middle-aged healthy men and women. Moreover, the adverse effects of prolonged QTc are independent of those of conventional risk factors.
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Affiliation(s)
- Teruo Nagaya
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Nagoya, Japan.
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Yamada T, Fukatsu M, Suzuki S, Wada T, Yoshida T, Joh T. Fatty liver predicts impaired fasting glucose and type 2 diabetes mellitus in Japanese undergoing a health checkup. J Gastroenterol Hepatol 2010; 25:352-6. [PMID: 19817963 DOI: 10.1111/j.1440-1746.2009.05998.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND AIM The question of whether fatty liver might predict impaired fasting glucose or type 2 diabetes mellitus in a longitudinal manner was assessed in Japanese subjects undergoing a health checkup. METHODS A total of 12 375 individuals (6799 men and 5576 women) without hyperglycemia or type 2 diabetes mellitus in 2000 and participating in 2005 were included. Multiple logistic regression analyses were performed for both sexes, adjusted for age, body mass index, elevated blood pressure or hypertension, family history of diabetes mellitus, alcohol drinking and smoking. RESULTS Impaired fasting glucose and type 2 diabetes mellitus were newly diagnosed in 7.6% and 1.0% of men and 3.8% and 0.5% of women, respectively, within the 5-year period. The prevalence of newly diagnosed impaired fasting glucose and type 2 diabetes mellitus was significantly higher in the participants with fatty liver than without fatty liver in both sexes. Fatty liver adjusted for the other factors was thus a risk factor for impaired fasting glucose and/or type 2 diabetes mellitus in both sexes (men odds ratio [OR] 1.91, 95% confidence interval [CI] 1.56-2.34 and women OR 2.15, 95% CI 1.53-3.01). The impact of fatty liver was stronger among the participants with a lower body mass index (men OR 0.92, 95% CI 0.86-0.99 and women OR 0.90, 95% CI 0.81-0.99, for one increment of body mass index). CONCLUSION Fatty liver is an independent risk factor for impaired fasting glucose and type 2 diabetes mellitus, having a stronger impact in those Japanese with a lower body mass index undergoing a health checkup.
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Affiliation(s)
- Tamaki Yamada
- Okazaki City Medical Association, Public Health Center, Okazaki, Japan.
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Sasai H, Sairenchi T, Iso H, Irie F, Otaka E, Tanaka K, Ota H, Muto T. Relationship between obesity and incident diabetes in middle-aged and older Japanese adults: the Ibaraki Prefectural Health Study. Mayo Clin Proc 2010; 85:36-40. [PMID: 20042559 PMCID: PMC2800296 DOI: 10.4065/mcp.2009.0230] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To investigate the age-specific relationship between body mass index (BMI) and risk of diabetes in a Japanese general population. PARTICIPANTS AND METHODS A cohort of Japanese men (N=19,926) and women (N=41,489) (aged 40-79 years) who under went community-based health checkups in 1993 and were free of diabetes was followed up by annual examinations with measurement of blood glucose concentrations until the end of 2006. Incident diabetes mellitus was defined as a blood glucose concentration of 126 mg/dL or greater under fasting conditions, 200 mg/dL or greater under nonfasting conditions, or diabetic medication use at baseline. Hazard ratios (HRs) for diabetes according to BMI were estimated using a Cox proportional hazard model. The model was adjusted for possible confounding variables. RESULTS A total of 4429 participants (7.2%) developed diabetes (2065 men and 2364 women) during a mean follow-up of 5.5 years. Compared with those with a BMI of less than 25.0, the multivariate HRs for diabetes among participants with a BMI of 30.0 or greater were 1.40 (95% confidence interval [CI], 0.89-2.20) for men aged 40 to 59 years and 1.26 (95% CI, 0.81-1.96) for men aged 60 to 79 years (P=.002 for interaction). The HRs were 2.50 (95% CI, 2.01-3.11) for women aged 40 to 59 years and 1.80 (95% CI, 1.41-2.30) for women aged 60 to 79 years (P=.04 for interaction). CONCLUSION The effect of obesity on the risk of diabetes is greater for middle-aged than for older adults.
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Affiliation(s)
| | - Toshimi Sairenchi
- Address reprint requests and correspondence to Toshimi Sairenchi, PhD, Department of Public Health, Dokkyo Medical University School of Medicine, 880 Kita-kobayashi, Mibu, Tochigi 321-0293, Japan ()
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Nagaya T, Yoshida H, Takahashi H, Kawai M. Resting heart rate and blood pressure, independent of each other, proportionally raise the risk for type-2 diabetes mellitus. Int J Epidemiol 2009; 39:215-22. [PMID: 19564246 DOI: 10.1093/ije/dyp229] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Fast heart rate and high blood pressure (BP) at rest may raise risk for the development of type-2 diabetes mellitus (DM). We therefore investigated dose-response and interactive effects of resting heart rate and BP on the incidence of DM in a Japanese population. METHODS A follow-up study was conducted for 16 828 men and 8368 women aged 30-59 years and apparently healthy at baseline. Incident DM was identified by 'fasting serum glucose > or =7.00 mmol/l (126 mg/dl)' or/and 'under medical treatment for DM'. Using Cox proportional hazard models, hazard ratio (HR) for incident DM were estimated according to the quartiles of heart rate, systolic or diastolic BP (SBP, DBP), and its linear trends were checked by computing the three indices as continuous variables. Subsequently, interactive effects of slow/fast heart rate (dichotomized by the median) and low/high SBP or DBP (dichotomized by the median) on HR were examined. Baseline age, body mass index, smoking, drinking, exercise and education were computed as conventional confounders. RESULTS During the follow-up of 125 106 person-years for men and 59 616 person-years for women, 869 men and 224 women developed DM. The multivariate-adjusted HR for incident DM increased across quartiles of heart rate, SBP and DBP in both sexes (linear trend P<0.001 for all). Neither sex showed any significant interactive effects of heart rate and SBP or DBP on HR. CONCLUSIONS Resting heart rate and BP proportionally raise the risk for DM in middle-aged healthy men and women. Moreover, the adverse effects of fast heart rate and high BP are independent of each other as well as of the influences of conventional confounders.
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Affiliation(s)
- Teruo Nagaya
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
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Odegaard AO, Koh WP, Vazquez G, Arakawa K, Lee HP, Yu MC, Pereira MA. BMI and diabetes risk in Singaporean Chinese. Diabetes Care 2009; 32:1104-6. [PMID: 19324946 PMCID: PMC2681015 DOI: 10.2337/dc08-1674] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Increased BMI is a robust risk factor for type 2 diabetes. Paradoxically, South Asians have relatively low BMIs despite their high prevalence of type 2 diabetes. We examined the association between BMI and incident type 2 diabetes because detailed prospective cohort data on this topic in Asians are scarce. RESEARCH DESIGN AND METHODS This study was a prospective analysis of 37,091 men and women aged 45-74 years in the Singapore Chinese Health Study, using Cox regression analysis. RESULTS Risk of incident type 2 diabetes significantly increased beginning with BMIs 18.5-23.0 kg/m(2)(relative risk 2.47 [95% CI 1.75-3.48]) and continued in a monotonic fashion across the spectrum of BMI. Results were stronger for younger than for older adults. CONCLUSIONS BMIs considered lean and normal in Singaporean Chinese are strongly associated with increased risk of incident type 2 diabetes. This association weakened with advanced age but remained significant.
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Affiliation(s)
- Andrew O Odegaard
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
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Dilla T, Costi M, Boye KS, Reviriego J, Yurgin N, Badia X, Lara-Suriñach N. [The impact of obesity in the management and evolution of diabetes mellitus]. Rev Clin Esp 2009; 208:437-43. [PMID: 19000471 DOI: 10.1157/13127604] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVES To assess both management and evolution of diabetes mellitus type 2 (DM2) in Primary Care centers in Spain and the related factors, especially obesity. METHODOLOGY Epidemiological, cross-sectional, multicenter, retrospective study. PATIENTS Patients suffering from DM2, over 20 years of age, were consecutively enrolled from 30 Primary Care centers in 16 autonomous communities. Métodos. Data was collected on age, gender, educational level, DM2 duration, HbA1c, treatment and body measurement index (BMI). RESULTS A total of 294 patients, 50% male, with a mean age (SD) of 67.5 years (10.2) and BMI 28.9 (4.5) kg/m(2) were included. Of them, 58.16% had HbA1c levels >6.5%, 38% being obese or severely obese. A total of 93.9% were under drug treatment for DM2. Significant differences in the mean value of HbA1c were shown between the over-weight and severely obese groups (Tukey-Kramer test). Differences were observed in the presence of macrovascular complications between patients with normal weight and patients with obesity (p=0.006). Patients with low educational level had 3.39 more probability of being obese or severely obese than patients with secondary school or university studies (p=0.0041; 95% CI 1.47-7.80), and patients with primary school 2.22 more probability (p= 0.038; 95% CI 1.04-4.73). A total of 47.8% reported high compliance. Obese and severely obese patients showed 2.2 more probability of having low or mild compliance than non-obese patients (p=0.002; 95% CI 1.31-3.74). CONCLUSIONS Results obtained in this population suggest that obesity is related with more macro-vascular complications, worst metabolic control and worst compliance.
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Affiliation(s)
- T Dilla
- Clinical Research Department, Eli Lilly and Company, Madrid, España
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