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Lule SA, Kushitor SB, Grijalva-Eternod CS, Adjaye-Gbewonyo K, Sanuade OA, Kushitor MK, Okoibhole L, Awuah R, Baatiema L, Kretchy IA, Arhinful D, de-Graft Aikins A, Koram K, Fottrell E. The contextual awareness, response and evaluation (CARE) diabetes project: study design for a quantitative survey of diabetes prevalence and non-communicable disease risk in Ga Mashie, Accra, Ghana. Glob Health Action 2024; 17:2297513. [PMID: 38323339 PMCID: PMC10851827 DOI: 10.1080/16549716.2023.2297513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 12/16/2023] [Indexed: 02/08/2024] Open
Abstract
Diabetes is estimated to affect between 3.3% and 8.3% of adults in Ghana, and prevalence is expected to rise. The lack of cost-effective diabetes prevention programmes designed specifically for the Ghanaian population warrants urgent attention. The Contextual Awareness, Response and Evaluation (CARE): Diabetes Project in Ghana is a mixed methods study that aims to understand diabetes in the Ga Mashie area of Accra, identify opportunities for community-based intervention and inform future diabetes prevention and control strategies. This paper presents the study design for the quantitative survey within the CARE project. This survey will take place in the densely populated Ga Mashie area of Accra, Ghana. A household survey will be conducted using simple random sampling to select households from 80 enumeration areas identified in the 2021 Ghana Population and Housing Census. Trained enumerators will interview and collect data from permanent residents aged ≥ 25 years. Pregnant women and those who have given birth in the last six months will be excluded. Data analysis will use a combination of descriptive and inferential statistics, and all analyses will account for the cluster sampling design. Analyses will describe the prevalence of diabetes, other morbidities, and associated risk factors and identify the relationship between diabetes and physical, social, and behavioural parameters. This survey will generate evidence on drivers and consequences of diabetes and facilitate efforts to prevent and control diabetes and other NCDs in urban Ghana, with relevance for other low-income communities.
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Affiliation(s)
| | - Sandra Boatemaa Kushitor
- Department of Community Health, Ensign Global College, Kpong, Ghana
- Department of Food Science and Centre for Sustainability Studies, Stellenbosch University, Stellenbosch, South Africa
| | - Carlos S. Grijalva-Eternod
- Institute for Global Health, University College London, London, UK
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Olutobi Adekunle Sanuade
- Department of Population Health Sciences, Division of Health System Innovation and Research, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA
| | - Mawuli Komla Kushitor
- Department of Health Policy, Fred Binka School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Lydia Okoibhole
- Institute for Global Health, University College London, London, UK
| | - Raphael Awuah
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Leonard Baatiema
- Department of Health Policy, Planning and Management, School of Public Health, University of Ghana, Accra, Ghana
- Center for Tropical Medicine and Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Irene Akwo Kretchy
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, University of Ghana, Accra, Ghana
| | - Daniel Arhinful
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | | | - Kwadwo Koram
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Edward Fottrell
- Institute for Global Health, University College London, London, UK
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Herrera D, Sanz M, Shapira L, Brotons C, Chapple I, Frese T, Graziani F, Hobbs FDR, Huck O, Hummers E, Jepsen S, Kravtchenko O, Madianos P, Molina A, Ungan M, Vilaseca J, Windak A, Vinker S. Periodontal diseases and cardiovascular diseases, diabetes, and respiratory diseases: Summary of the consensus report by the European Federation of Periodontology and WONCA Europe. Eur J Gen Pract 2024; 30:2320120. [PMID: 38511739 PMCID: PMC10962307 DOI: 10.1080/13814788.2024.2320120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 02/05/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Periodontitis is a chronic inflammatory non-communicable disease (NCD) characterised by the destruction of the tooth-supporting apparatus (periodontium), including alveolar bone, the presence of periodontal pockets, and bleeding on probing. OBJECTIVES To outline, for family doctors, the implications of the association between periodontal and systemic diseases; to explore the role of family doctors in managing periodontitis as an ubiquitous non-communicable disease (NCD). METHODS The consensus reports of previous focused collaborative workshops between WONCA Europe and the European Federation of Periodontology (using previously undertaken systematic reviews), and a specifically commissioned systematic review formed the technical papers to underpin discussions. Working groups prepared proposals independently, and the proposals were subsequently discussed and approved at plenary meetings. RESULTS Periodontitis is independently associated with cardiovascular diseases, diabetes, chronic obstructive pulmonary disease, obstructive sleep apnoea, and COVID-19 complications. Treatment of periodontitis has been associated with improvements in systemic health outcomes. The article also presents evidence gaps. Oral health care professionals (OHPs) and family doctors should collaborate in managing these conditions, including implementing strategies for early case detection of periodontitis in primary medical care centres and of systemic NCDs in oral/dental care settings. There is a need to raise awareness of periodontal diseases, their consequences, and the associated risk factors amongst family doctors. CONCLUSION Closer collaboration between OHPs and family doctors is important in the early case detection and management of NCDs like cardiovascular diseases, diabetes mellitus, and respiratory diseases. Strategies for early case detection/prevention of NCDs, including periodontitis, should be developed for family doctors, other health professionals (OHPs), and healthcare funders. Evidence-based information on the reported associations between periodontitis and other NCDs should be made available to family doctors, OHPs, healthcare funders, patients, and the general population.
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Affiliation(s)
- David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Lior Shapira
- Department of Periodontology, Faculty of Dental Medicine, Hadassah and the Hebrew University Medical Center, Jerusalem, Israel
| | - Carlos Brotons
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Sardenya Primary Health Care Center, Barcelona, Spain
| | - Iain Chapple
- Periodontal Research Group, and Birmingham NIHR Biomedical Research Centre in Inflammation, Institute of Clinical Sciences, College of Medical & Dental Sciences, The University of Birmingham, Birmingham, UK
- Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK
| | - Thomas Frese
- Institut für Allgemeinmedizin, Medizinische Fakultät der Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Germany
| | - Filippo Graziani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, School of Dentistry, University of Pisa, Pisa, Italy
| | - F. D. Richard Hobbs
- Oxford Primary Care, Radcliffe Primary Care Building, ROQ, University of Oxford, Oxford, UK
| | - Olivier Huck
- Dental Faculty, University of Strasbourg, Strasbourg, France
| | - Eva Hummers
- Department of General Practice and Family Medicine, University Medical Center Göttingen, Göttingen, Germany
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Bonn, Germany
| | | | - Phoebus Madianos
- Department of Periodontology, Faculty of Dentistry, National & Kapodistrian University of Athens, Athens, Greece
| | - Ana Molina
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Mehmet Ungan
- Department of Family Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Josep Vilaseca
- Department of Medicine, University of Vic–Central Catalonia University, Vic, Spain
- Primary Health Care Service, Althaia Foundation–Healthcare and University Network, Manresa, Spain
| | - Adam Windak
- Department of Family Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Shlomo Vinker
- Department of Family Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Khattak M, Rehman AU, Muqaddas T, Hussain R, Rasool MF, Saleem Z, Almalki MS, Alturkistani SA, Firash SZ, Alzahrani OM, Bahauddin AA, Abuhussain SA, Najjar MF, Elsabaa HMA, Haseeb A. Tuberculosis (TB) treatment challenges in TB-diabetes comorbid patients: a systematic review and meta-analysis. Ann Med 2024; 56:2313683. [PMID: 38346381 PMCID: PMC10863515 DOI: 10.1080/07853890.2024.2313683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 01/29/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND The Directly Observed Treatment-Short Course (DOTS) Programme was implemented by WHO and includes a combination of four anti-tuberculosis (TB) drugs (isoniazid, pyrazinamide, ethambutol and rifampicin) for a period of six months to eradicate the TB infection completely. Diabetes mellitus (DM) is recognized as one of a strong contributor of TB according to World Health Organization (WHO). The presence of diabetes mellitus type 2 (DM type 2) makes TB treatment complicated. Thus, the objective of the current meta-analysis was to identify and quantify the impact of type 2 DM on treatment outcomes of TB patients treated under the DOTS Programme. METHODS This meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Through a systematic review of relevant literature, we focused on studies investigating treatment outcomes including extended treatment duration and recurrence for individuals with both TB and DM undergoing DOTS therapy. The extracted information included study designs, sample sizes, patient characteristics and reported treatment results. RESULTS In 44 studies from different parts of the world, the pooled HR for the impact of DM on extended treatment duration and reoccurrence were HR 0.72, 95% CI 0.56-0.83, p < .01 and HR 0.93, 95% CI 0.70-1.04, p = .08, respectively. The pooled HR for impact of DM on composite TB treatment outcomes was calculated as 0.76 (95% CI 0.60-0.87), p < .01 with an effect size of 41.18. The heterogeneity observed among the included studies was moderate (I2 = 55.79%). CONCLUSIONS A negative impact of DM was found on recurrence and extended treatment duration in TB patients treated with DOTS therapy. DM type 2 is responsible for the TB treatment prolongation and TB recurrence rates. By implementing effective management strategies and advancing research, the challenges can be mitigated, arising due to the complex interaction between DM and TB.
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Affiliation(s)
- Mahnoor Khattak
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | - Anees ur Rehman
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | - Tuba Muqaddas
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | - Rabia Hussain
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Penang, Malaysia
| | - Muhammad Fawad Rasool
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | - Zikria Saleem
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | | | | | - Shuruq Zuhair Firash
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | | | | | | | - Muath Fahmi Najjar
- Department of Clinical Pharmacy, Al Rayan Private College of Health Sciences and Nursing, Madinah, Saudi Arabia
| | | | - Abdul Haseeb
- Department of Clinical Pharmacy, Al Rayan Private College of Health Sciences and Nursing, Madinah, Saudi Arabia
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Wan H, Yu G, He Y, Liu S, Chen X, Jiang Y, Duan H, Lin X, Liu L, Shen J. Associations of thyroid feedback quantile-based index with diabetes in euthyroid adults in the United States and China. Ann Med 2024; 56:2318418. [PMID: 38382636 PMCID: PMC10883085 DOI: 10.1080/07853890.2024.2318418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND We aimed to investigate the associations between thyroid hormone sensitivity indices and diabetes in euthyroid adults in the United States and China. METHODS 2296 euthyroid adults from the NHANES in the United States and 8319 euthyroid adults from the SPEED-Shunde in China were involved. The thyroid sensitivity indices, namely TFQIFT4 and TFQIFT3, were calculated. Multivariable logistic regression, restricted cubic spline analysis, and general ordinal logit regression were utilized. RESULTS In the NHANES, compared with participants in quartile 1st (Q1), those in Q4 of TFQIFT3 (OR 2.12, 95% CI (1.18, 3.81)) and those in Q3 of TFQIFT4 (OR 2.31, 95% CI (1.18, 4.53)) (both P for trend < 0.05) were associated with a greater prevalence of diabetes. In the SPEED-Shunde, compared with participants in Q1, those in Q4 of TFQIFT3 had a greater prevalence of diabetes (OR 1.36, 95% CI (1.11, 1.66) (P for trend < 0.05), while no significant associations between TFQIFT4 and diabetes were found. CONCLUSIONS TFQIFT3 was associated with a higher prevalence of diabetes both in the United States and China. However, TFQIFT4 was only associated with a higher prevalence of diabetes in the United States, not in China. Further prospective cohort studies are necessary to validate these findings.
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Affiliation(s)
- Heng Wan
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, Guangdong, China
| | - Genfeng Yu
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, Guangdong, China
| | - Yajun He
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, Guangdong, China
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Siyang Liu
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, Guangdong, China
| | - Xingying Chen
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, Guangdong, China
| | - Yuqi Jiang
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, Guangdong, China
| | - Hualin Duan
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, Guangdong, China
| | - Xu Lin
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, Guangdong, China
| | - Lan Liu
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, Guangdong, China
| | - Jie Shen
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, Guangdong, China
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Cai J, Zhang S, Wu R, Huang J. Association between depression and diabetes mellitus and the impact of their comorbidity on mortality: Evidence from a nationally representative study. J Affect Disord 2024; 354:11-18. [PMID: 38447915 DOI: 10.1016/j.jad.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 01/16/2024] [Accepted: 03/03/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Depression and diabetes mellitus (DM) are major chronic noncommunicable diseases that impair one's mental and physical well-being and impose substantial burdens on the health system. Depressed individuals have an increased risk of impaired blood glucose, weight gain and dyslipidemia which could induce poorer long-term survival. METHODS 37,040 individuals from the National Health and Nutrition Examination Survey (NHANES) were included. Depressive symptoms were assessed by the Patient Health Questionnaire (PHQ-9) and classified by the total scores as no (0-4), mild (5-9), moderate (10-14), and severe (15-27). DM was determined based on self-reported medical history, clinical test results, and medication use. Logistic and Cox regression were the main statistical models. All analyses were based on weighted data from complex sampling. RESULTS The prevalence of DM was higher in depressed than non-depressed individuals (21.26 % vs. 13.75 %). The adjusted odds ratio (OR) (95 % CI) of comorbid DM increased with depression severity, from 1.00 (reference) for no depression, to 1.22 (1.09,1.36) for mild, 1.62 (1.37,1.92) for moderate, and 1.52(1.28,1.82) for severe depression. Comorbidity of DM and depression significantly associated with a higher risk of all-cause mortality, with a hazard ratio (HR) (95 % CI) = 2.09 (1.64,2.66). LIMITATIONS Dynamic demographic and metabolic data were not available. CONCLUSION Depression is associated with a higher risk of DM, which may be related to biological, socioeconomic, and medication-related factors. Comorbidity of the two worsens long-term survival. Therefore, blood glucose management and prevention of DM should be emphasized in depressed patients.
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Affiliation(s)
- Jingda Cai
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Songyan Zhang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Renrong Wu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Jing Huang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
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Renehan AG, Tipping O, Wang M. Diabetes and cancer: Doubts of a causal link. Int J Cancer 2024; 154:1875-1876. [PMID: 38450768 DOI: 10.1002/ijc.34862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2024] [Indexed: 03/08/2024]
Affiliation(s)
- Andrew G Renehan
- Division of Cancer Sciences, School of Medical Science, University of Manchester, Manchester, UK
| | - Owen Tipping
- Division of Cancer Sciences, School of Medical Science, University of Manchester, Manchester, UK
| | - Mengying Wang
- Division of Cancer Sciences, School of Medical Science, University of Manchester, Manchester, UK
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Xie Q, Nie M, Zhang F, Shao X, Wang J, Song J, Wang Y. An unexpected interaction between diabetes and cardiovascular diseases on cognitive function: A cross-sectional study. J Affect Disord 2024; 354:688-693. [PMID: 38521139 DOI: 10.1016/j.jad.2024.03.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 03/03/2024] [Accepted: 03/09/2024] [Indexed: 03/25/2024]
Abstract
OBJECTIVE Impaired cognitive function in older individuals significantly affects quality of life. The interaction between comorbid diabetes and cardiovascular disease (CVD) and its impact on cognitive impairment remains unclear. METHODS This study analyzed 2564 subjects from the National Health and Nutrition Examination Survey dataset. Cognitive function was measured using various scores, including CERAD Total Score, CERAD Delayed Recall Score (CDRS), Animal Fluency Total Score, and Digit Symbol Score. Multiple regression models were constructed to explore the relationship between different diseases and cognitive function, considering covariates such as age, sex, education, body mass index, alcohol intake, smoking, physical activity, kidney function, and hypertension. RESULTS After adjusting for multiple factors, the presence of CVD, diabetes, or both showed a significant negative association with the total cognitive score. The CDRS was associated with both CVD and diabetes. The Digit Symbol score was associated with the presence of CVD, diabetes, or both. No significant differences were found between patients with diabetes and CVD in cognitive test results. An interaction between CVD and diabetes was observed in relation to the CDRS but not in other test scores or the total score. CONCLUSION The individual impact of each disease on cognitive function was not significant. However, an interaction between CVD and diabetes was found when both diseases coexisted, specifically in relation to delayed learning ability.
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Affiliation(s)
- Qifei Xie
- Nuclear Medicine Department, the Third Affiliated Hospital of Soochow University, Soochow University, China; Xiamen Cardiovascular Hospital, Xiamen University, Xiamen, China
| | - Meiling Nie
- Xiamen Cardiovascular Hospital, Xiamen University, Xiamen, China
| | - Feifei Zhang
- Nuclear Medicine Department, the Third Affiliated Hospital of Soochow University, Soochow University, China
| | - Xiaoliang Shao
- Nuclear Medicine Department, the Third Affiliated Hospital of Soochow University, Soochow University, China
| | - Jianfeng Wang
- Nuclear Medicine Department, the Third Affiliated Hospital of Soochow University, Soochow University, China
| | - Juan Song
- Xiamen Cardiovascular Hospital, Xiamen University, Xiamen, China.
| | - Yuetao Wang
- Nuclear Medicine Department, the Third Affiliated Hospital of Soochow University, Soochow University, China.
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Lohi P, Auvinen A, Niskanen L, Partonen T, Haukka J. Does the duration of diabetes increase the risk of cancer? A nationwide population-based cohort of patients with new-onset diabetes and a matched reference cohort. Int J Cancer 2024; 154:1940-1947. [PMID: 38450737 DOI: 10.1002/ijc.34858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/05/2023] [Accepted: 12/29/2023] [Indexed: 03/08/2024]
Abstract
Diabetes mellitus and cancer are both common health issues, but the correlation between these two diseases remains unclear. We investigated the association of cumulative exposure of diabetes mellitus as an indication of hyperglycemia in terms of disease duration on multiple cancer types. We hypothesized that the risk of cancer would increase over time after the onset of diabetes. The study population consisted of a population-based cohort of 398,708 people and it was constructed from the Finnish CARING project. The Diabetes group consisted of 185,258 individuals, and the non-diabetic reference group comprised 187,921 individuals. Over 4.1 million person-years were accumulated, and the median follow-up time was 10.55 years. In the diabetes group, 25,899 cancer cases were observed compared with 23,900 cancers in the non-diabetic group. We did not find a clear relationship between the duration of diabetes mellitus and most cancer types examined. However, for cancers of the pancreas, prostate gland, bronchus, and lungs, a temporal relationship was found. Furthermore, even within the cancer types where the relationship was detected, it did not change over time. These findings indicate that diabetes does not independently increase the risk of cancer. Instead, the development of diabetes may be attributed to shared risk factors with cancer, such as obesity and/or insulin resistance accompanied by hyperinsulinemia. Thus, it is likely that the clock for increased cancer risk starts ticking already before onset of diabetes and hyperglycemia.
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Affiliation(s)
- Petrus Lohi
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Anssi Auvinen
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Leo Niskanen
- Department of Endocrinology, Päijät-Häme Central Hospital, Lahti, Finland
- University of Eastern Finland, Kuopio, Finland
| | - Timo Partonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Jari Haukka
- Faculty of Social Sciences, Tampere University, Tampere, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
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9
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Shell AL, Crawford CA, Cyders MA, Hirsh AT, Stewart JC. Depressive disorder subtypes, depressive symptom clusters, and risk of obesity and diabetes: A systematic review. J Affect Disord 2024; 353:70-89. [PMID: 38432462 DOI: 10.1016/j.jad.2024.02.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 02/09/2024] [Accepted: 02/13/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Overlapping but divided literatures suggest certain depression facets may pose greater obesity and diabetes risk than others. Our objectives were to integrate the major depressive disorder (MDD) subtype and depressive symptom cluster literatures and to clarify which facets are associated with the greatest cardiometabolic disease risk. METHODS We conducted a systematic review of published studies examining associations of ≥2 MDD subtypes or symptom clusters with obesity or diabetes risk outcomes. We report which facets the literature is "in favor" of (i.e., having the strongest or most consistent results). RESULTS Forty-five articles were included. Of the MDD subtype-obesity risk studies, 14 were in favor of atypical MDD, and 8 showed similar or null associations across subtypes. Of the symptom cluster-obesity risk studies, 5 were in favor of the somatic cluster, 1 was in favor of other clusters, and 5 were similar or null. Of the MDD subtype-diabetes risk studies, 7 were in favor of atypical MDD, 3 were in favor of other subtypes, and 5 were similar or null. Of the symptom cluster-diabetes risk studies, 7 were in favor of the somatic cluster, and 5 were similar or null. LIMITATIONS Limitations in study design, sample selection, variable measurement, and analytic approach in these literatures apply to this review. CONCLUSIONS Atypical MDD and the somatic cluster are most consistently associated with obesity and diabetes risk. Future research is needed to establish directionality and causality. Identifying the depression facets conferring the greatest risk could improve cardiometabolic disease risk stratification and prevention programs.
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Affiliation(s)
- Aubrey L Shell
- Department of Psychiatry, Indiana University Health, United States of America
| | | | - Melissa A Cyders
- Department of Psychology, Indiana University-Indianapolis, United States of America
| | - Adam T Hirsh
- Department of Psychology, Indiana University-Indianapolis, United States of America
| | - Jesse C Stewart
- Department of Psychology, Indiana University-Indianapolis, United States of America.
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Zhou X, Liu S, Zhang M, Shi C, Chen M, Hou C, Di B. Wastewater-based estimation of diabetes mellitus prevalence in 237 cities: A cross-China study. Sci Total Environ 2024; 924:171659. [PMID: 38490426 DOI: 10.1016/j.scitotenv.2024.171659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 02/25/2024] [Accepted: 03/09/2024] [Indexed: 03/17/2024]
Abstract
Diabetes mellitus, a metabolic disease characterized by hyperglycemia, has been witnessed as a rapidly escalating worldwide health crisis. China currently had 140.9 million diabetic population in 2021, which was the largest globally. DM has witnessed a significant surge in the past few decades, leading to an alarming rise in the overall burden caused by this disease. To monitor the near real-time DM prevalence and the consumption of first-line anti-diabetic drugs, a wastewater-based epidemiology (WBE) approach based on the back-calculation of metformin concentration was implemented in 237 cities in China. The quantitative analysis of metformin in wastewater was conducted by LC-MS/MS with satisfactory results of method validation. The average concentration of metformin in wastewater was 14.07 ± 13.16 μg/L, and the per capita consumption was 5.16 ± 2.08 mg/day/inh, ranging from 0.90 to 10.36 ± 4.63 mg/day/inh. The calculated metformin prevalence was found to be 0.52 % ± 0.28 %, and the final estimated DM prevalence was 11.33 % ± 4.99 %, which was nearly consistent with the result of the International Diabetes Federation survey of 9.98 %. The results suggested that metformin might be one of the suitable WBE biomarkers in DM monitoring and WBE strategy could potentially enable the estimation of DM prevalence in most of Chinese cities after reasonable correction of associated parameters.
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Affiliation(s)
- Xinxin Zhou
- Department of Pharmacy, China Pharmaceutical University, No. 24 Tongjiaxiang Road, Nanjing 210009, PR China
| | - Shucheng Liu
- Department of Pharmacy, China Pharmaceutical University, No. 24 Tongjiaxiang Road, Nanjing 210009, PR China
| | - Manlei Zhang
- Department of Pharmacy, China Pharmaceutical University, No. 24 Tongjiaxiang Road, Nanjing 210009, PR China
| | - Chen Shi
- Department of Pharmacy, China Pharmaceutical University, No. 24 Tongjiaxiang Road, Nanjing 210009, PR China
| | - Mengyi Chen
- Department of Pharmacy, China Pharmaceutical University, No. 24 Tongjiaxiang Road, Nanjing 210009, PR China; China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing 210009, PR China
| | - Chenzhi Hou
- Department of Pharmacy, China Pharmaceutical University, No. 24 Tongjiaxiang Road, Nanjing 210009, PR China; China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing 210009, PR China.
| | - Bin Di
- Department of Pharmacy, China Pharmaceutical University, No. 24 Tongjiaxiang Road, Nanjing 210009, PR China; China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing 210009, PR China.
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11
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Dymm B, Goldstein LB, Unnithan S, Al-Khalidi HR, Koltai D, Bushnell C, Husseini NE. Depression following small vessel stroke is common and more prevalent in women. J Stroke Cerebrovasc Dis 2024; 33:107646. [PMID: 38395097 DOI: 10.1016/j.jstrokecerebrovasdis.2024.107646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 01/19/2024] [Accepted: 02/20/2024] [Indexed: 02/25/2024] Open
Abstract
OBJECTIVES We sought to examine the frequency of depression after small vessel-type stroke (SVS) and associated risk factors. MATERIALS AND METHODS We conducted a retrospective analysis of a prospective cohort of patients enrolled in the American Stroke Association-Bugher SVS Study, which included 200 participants within 2-years of SVS and 79 controls without a history of stroke from 2007 to 2012 at four sites. The primary outcome was PHQ-8, with scores ≥10 consistent with post-stroke depression (PSD). A logistic regression adjusted for age, race, sex, history of diabetes and Short-Form Montreal Cognitive Assessment score (SF-MoCA) was used to compare the risk of having depression after SVS compared to controls. Another logistic regression, adjusted for age, sex, race, level of education, SF-MoCA, white matter disease (WMD) burden, stroke severity (NIHSS), time between stroke and depression screen, history of diabetes, and history of hypertension was used to identify factors independently associated with depression in participants with SVS. RESULTS The cohort included 161 participants with SVS (39 excluded due to missing data) and 79 controls. The mean interval between stroke and depression screening was 74 days. Among participants with SVS, 31.7% (n = 51) had PSD compared to 6.3% (n = 5) of controls (RR = 5.44, 95% CI = 2.21-13.38, p = 0.0002). The only two variables independently associated with PSD in participants with SVS were female sex (RR = 1.84, 95% CI = 1.09-3.09, p = 0.020) and diabetes (RR 1.69, 95% CI 1.03-2.79). CONCLUSIONS After adjusting for several demographic and clinical variables, having a SVS was associated with an approximate 5-fold increased risk of depression and was more frequent in women and in those with diabetes. The extent of WMD was not independently associated with PSD, suggesting that small vessel disease in the setting of an overt SVS may not account for the increased prevalence of depression.
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Affiliation(s)
- Braydon Dymm
- Duke University Hospital, Department of Neurology, 2301 Erwin Rd, Durham, NC 27705, United States.
| | | | - Shakthi Unnithan
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, United States
| | - Hussein R Al-Khalidi
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, United States
| | - Deborah Koltai
- Duke University Hospital, Department of Neurology, 2301 Erwin Rd, Durham, NC 27705, United States
| | - Cheryl Bushnell
- Wake Forest Atrium Health, Department of Neurology, United States
| | - Nada El Husseini
- Duke University Hospital, Department of Neurology, 2301 Erwin Rd, Durham, NC 27705, United States
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de Vries SAG, Bak JCG, Mul D, Wouters MWJM, Nieuwdorp M, Verheugt CL, Sas TCJ. Does size matter? Hospital volume and resource use in paediatric diabetes care. Diabet Med 2024; 41:e15260. [PMID: 38018287 DOI: 10.1111/dme.15260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 11/13/2023] [Accepted: 11/14/2023] [Indexed: 11/30/2023]
Abstract
AIMS Paediatric diabetes care has become increasingly specialised due to the multidisciplinary approach and technological developments. Guidelines recommend sufficient experience of treatment teams. This study evaluates associations between hospital volume and resource use and hospital expenditure in Dutch children with diabetes. METHODS Retrospective cohort study using hospital claims data of 5082 children treated across 44 Dutch hospitals (2019-2020). Hospitals were categorised into three categories; small (≥20-100 patients), medium (≥100-200 patients) and large (≥200 patients). All-cause hospitalisations, consultations, technology and hospital expenditure were analysed and adjusted for age, sex, socio-economic status (SES) and hospital of treatment. RESULTS Fewer hospitalisations were observed in large hospitals compared to small hospitals (OR 0.48; [95% CI 0.32-0.72]; p < 0.001). Median number of yearly paediatrician visits was 7 in large and 6 in small hospitals, the significance of which was attenuated in multilevel analysis (OR ≥7 consultations: 1.89; [95%CI 0.74-4.83]; p = 0.18). Technology use varies between individual hospitals, whereas pump usage and real-time continuous glucose monitoring showed no significant differences between hospital volumes. Mean overall expenditure was highest in medium-sized centres with €6434 per patient (IQR €2555-7955); the difference in diabetes care costs was not significant between hospital patient volumes. CONCLUSIONS Care provision patterns vary by hospital patient volume. Large hospitals had the lowest hospitalisation rates. The use of diabetes technology was not different between hospital patient volumes. Medium-sized hospitals showed the highest overall expenditure, but diabetes care costs were similar across hospital volumes.
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Affiliation(s)
- Silvia A G de Vries
- Department of Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Dutch Institute for Clinical Auditing, Leiden, The Netherlands
| | - Jessica C G Bak
- Department of Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Dutch Institute for Clinical Auditing, Leiden, The Netherlands
| | - Dick Mul
- Diabeter, Center for Pediatric and Adult Diabetes Care and Research, Rotterdam, The Netherlands
| | - Michel W J M Wouters
- Dutch Institute for Clinical Auditing, Leiden, The Netherlands
- Department of Biomedical Data Sciences, Leiden University Medical Center, The Netherlands
| | - Max Nieuwdorp
- Department of Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Carianne L Verheugt
- Department of Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Theo C J Sas
- Diabeter, Center for Pediatric and Adult Diabetes Care and Research, Rotterdam, The Netherlands
- Department of Pediatrics, Division of Pediatric Endocrinology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands
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13
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Choi W, Moon JH, Choi H, Lee H, Kim HK, Kang HC, Cho NH. Trajectory of lung function in diabetic adults: A 16-year follow-up study of community-based prospective cohorts. Respirology 2024; 29:413-420. [PMID: 38185765 DOI: 10.1111/resp.14658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 12/19/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND AND OBJECTIVE To investigate the difference in lung function according to diabetes status in a community-based prospective study. METHODS Individuals aged 40-69 years from two community-based cohorts were followed prospectively for 16 years. A spirometer was used to evaluate lung function at baseline, and lung function tests were carried out biennially thereafter. Multivariable linear regression analysis was performed for the cross-sectional and longitudinal analyses based on diabetes status. RESULTS Among the 6483 subjects, 2114 (32.6%) had prediabetes and 671 (10.4%) had diabetes. The prediabetes and diabetes groups had lower baseline % predicted values of forced expiratory volume in 1 s (FEV1) (mean, -1.853; 95% confidence interval [CI] -2.715 to -0.990 for prediabetes and mean, -4.088; 95% CI -5.424 to -2.752 for diabetes) and forced vital capacity (FVC) (mean, -2.087; 95% CI -2.837 to -1.337 for prediabetes and mean, -4.622; 95% CI -5.784 to -3.460 for diabetes) compared to the normoglycemia group after adjusting for relevant covariates. The rate of decline in FEV1% predicted (mean, -0.227; 95% CI -0.366 to -0.089) and FVC % predicted (mean, -0.232; 95% CI -0.347 to -0.117) during follow-up were faster in the diabetes group than in the normoglycemia group. The diabetes group had a lower proportion of normal ventilation (ptrend = 0.048) and higher proportions of restrictive (ptrend = 0.001) and mixed (ptrend = 0.035) ventilatory disorders at the last follow-up. CONCLUSION Diabetes is associated with a lower baseline lung function and a faster rate of deterioration.
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Affiliation(s)
- Wonsuk Choi
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Joon Ho Moon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Hayoung Choi
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Hyun Lee
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Hee Kyung Kim
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Ho-Cheol Kang
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Nam H Cho
- Department of Preventive Medicine, Ajou University School of Medicine, Suwon, Korea
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14
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Steiger K, Herrin J, Swarna KS, Davis EM, McCoy RG. Disparities in Acute and Chronic Complications of Diabetes Along the U.S. Rural-Urban Continuum. Diabetes Care 2024; 47:818-825. [PMID: 38387066 DOI: 10.2337/dc23-1552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 01/24/2024] [Indexed: 02/24/2024]
Abstract
OBJECTIVE To determine the relative hazards of acute and chronic diabetes complications among people with diabetes across the U.S. rural-urban continuum. RESEARCH DESIGN AND METHODS This retrospective cohort study used the OptumLabs Data Warehouse, a deidentified data set of U.S. commercial and Medicare Advantage beneficiaries, to follow 2,901,563 adults (age ≥18 years) with diabetes between 1 January 2012 and 31 December 2021. We compared adjusted hazard ratios (HRs) of diabetes complications in remote areas (population <2,500), small towns (population 2,500-50,000), and cities (population >50,000). RESULTS Compared with residents of cities, residents of remote areas had greater hazards of myocardial infarction (HR 1.06 [95% CI 1.02-1.10]) and revascularization (HR 1.04 [1.02-1.06]) but lower hazards of hyperglycemia (HR 0.90 [0.83-0.98]) and stroke (HR 0.91 [0.88-0.95]). Compared with cities, residents of small towns had greater hazards of hyperglycemia (HR 1.06 [1.02-1.10]), hypoglycemia (HR 1.15 [1.12-1.18]), end-stage kidney disease (HR 1.04 [1.03-1.06]), myocardial infarction (HR 1.10 [1.08-1.12]), heart failure (HR 1.05 [1.03-1.06]), amputation (HR 1.05 [1.02-1.09]), other lower-extremity complications (HR 1.02 [1.01-1.03]), and revascularization (HR 1.05 [1.04-1.06]) but a smaller hazard of stroke (HR 0.95 [0.94-0.97]). Compared with small towns, residents of remote areas had lower hazards of hyperglycemia (HR 0.85 [0.78-0.93]), hypoglycemia (HR 0.92 [0.87-0.97]), and heart failure (HR 0.94 [0.91-0.97]). Hazards of retinopathy and atrial fibrillation/flutter did not vary geographically. CONCLUSIONS Adults in small towns are disproportionately impacted by complications of diabetes. Future studies should probe for the reasons underlying these disparities.
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Affiliation(s)
- Kyle Steiger
- Internal Medicine Residency, Mayo Clinic, Rochester, MN
| | - Jeph Herrin
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT
| | - Kavya Sindhu Swarna
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
- OptumLabs, Eden Prairie, MN
| | - Esa M Davis
- Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD
- Institute for Health Computing, University of Maryland, Bethesda, MD
| | - Rozalina G McCoy
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
- OptumLabs, Eden Prairie, MN
- Institute for Health Computing, University of Maryland, Bethesda, MD
- Division of Endocrinology, Diabetes, and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD
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15
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Sullivan VK, Kim H, Caulfield LE, Steffen LM, Selvin E, Rebholz CM. Plant-Based Dietary Patterns and Incident Diabetes in the Atherosclerosis Risk in Communities (ARIC) Study. Diabetes Care 2024; 47:803-809. [PMID: 38349856 DOI: 10.2337/dc23-2013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 01/03/2024] [Indexed: 02/15/2024]
Abstract
OBJECTIVE Plant-based dietary patterns emphasize plant foods and minimize animal-derived foods. We investigated the association between plant-based dietary patterns and diabetes in a community-based U.S. sample of Black and White adults. RESEARCH DESIGN AND METHODS We included middle-aged adults from the Atherosclerosis Risk in Communities (ARIC) study without diabetes at baseline who completed a food-frequency questionnaire (n = 11,965). We scored plant-based diet adherence according to three indices: overall, healthy, and unhealthy plant-based diet indices. Higher overall plant-based diet index (PDI) scores represent greater intakes of all plant foods and lower intakes of animal-derived foods. Higher healthy plant-based diet index (hPDI) scores represent greater healthy plant food intake and lower intakes of animal-derived and unhealthy plant foods. Higher unhealthy plant-based diet index (uPDI) scores represent greater unhealthy plant food intake and lower intakes of animal-derived and healthy plant foods. We used Cox regression to estimate hazard ratios (HRs) for incident diabetes (defined according to self-reported diagnosis, medication use, or elevated blood glucose) associated with each index. RESULTS Over a median follow-up of 22 years, we identified 4,208 cases of diabetes among subjects. Higher PDI scores were associated with a lower risk of diabetes (quintile 5 vs. 1 HR 0.89 [95% CI 0.80, 0.98]; Ptrend = 0.01). hPDI scores were also inversely associated with diabetes risk (quintile 5 vs. 1 HR 0.85 [95% CI 0.77, 0.94]; Ptrend < 0.001). uPDI scores were not associated with diabetes risk. CONCLUSIONS A dietary pattern that minimizes animal-derived foods and emphasizes plant foods may reduce diabetes risk.
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Affiliation(s)
- Valerie K Sullivan
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Hyunju Kim
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Laura E Caulfield
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Lyn M Steffen
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN
| | - Elizabeth Selvin
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Casey M Rebholz
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
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Peppas S, Doumas S, Suvarnakar A, Chou J, Arafat A, Ahmad AI, Lewis JH. Clinical outcomes with metformin use in diabetic patients with compensated cirrhosis: a systematic review and meta-analysis. Eur J Gastroenterol Hepatol 2024; 36:674-682. [PMID: 38477839 DOI: 10.1097/meg.0000000000002754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
BACKGROUND Previous studies have demonstrated a beneficial effect of metformin in patients with cirrhosis, but no improvement in liver histology. AIM To investigate the impact of metformin on mortality and hepatic decompensation in people with diabetes with compensated cirrhosis. METHODS Medline, Embase and Cochrane databases were searched from inception to February 2023 for studies reporting results regarding the impact of metformin on all-cause mortality and hepatic decompensation in people with diabetes with compensated cirrhosis. The risk of bias was assessed by ROBINS-I Cochrane tool. R software 4.3.1 was used for all analyses. RESULTS Six observational studies were included in the final analysis. Metformin use was associated with reduced all-cause mortality or liver transplantation [hazard ratio (HR): 0.55; 95% confidence interval (CI) 0.37-0.82], while no benefit was shown in the prevention of hepatic decompensation (HR: 0.97; 95% CI: 0.77-1.22). In the subgroup analysis, metformin use was associated with reduced all-cause mortality or liver transplantation (HR: 0.50; 95% CI 0.38-0.65) in patients with metabolic-associated steatohepatitis cirrhosis, while two studies reported no survival benefit in patients with cirrhosis due to hepatitis C (HR: 0.39; 95% CI 0.12-1.20). CONCLUSION Metformin use is associated with reduced all-cause mortality, but not with the prevention of hepatic decompensation in people with diabetes with compensated cirrhosis. The mortality benefit is most likely driven by better diabetes and cardiovascular health control.
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Affiliation(s)
- Spyros Peppas
- Department of Medicine, MedStar Washington Hospital Center
| | - Stavros Doumas
- Department of Internal Medicine, MedStar Georgetown University Medical Center
| | | | - Jiling Chou
- MedStar Research Health Institute, Hyattsville, Maryland
| | - Ayah Arafat
- MedStar Research Health Institute, Hyattsville, Maryland
| | - Akram I Ahmad
- Divsion of Gastroenterology & Hepatology, Cleveland Clinic Florida, Weston, Florida
| | - James H Lewis
- Division of Gastroenterology & Hepatology, MedStar Georgetown University Medical Center, Washington, DC, USA
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Shemesh S, Laks A, Cohen I, Turjeman A, Blecher R, Kadar A. Diabetes Mellitus and Poor Glycemic Control Are Associated With a Higher Risk of Lumbar Spinal Stenosis: An Analysis of a Large Nationwide Database. Spine (Phila Pa 1976) 2024; 49:595-600. [PMID: 38095111 DOI: 10.1097/brs.0000000000004900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/06/2023] [Indexed: 04/11/2024]
Abstract
STUDY DESIGN A large-scale retrospective case-control study. OBJECTIVE Examine diabetes as a risk factor for lumbar spinal stenosis (LSS) development and evaluate the impact of diabetes duration, glycemic control, and associated complications on this risk. SUMMARY OF BACKGROUND DATA Diabetes mellitus, a multiorgan disorder impacting various connective tissues, induces histological changes in spinal structures, particularly the ligamentum flavum. While clinical studies suggest a higher incidence of LSS in diabetic patients, substantial epidemiological research on the likelihood of LSS diagnosis in individuals with diabetes is scarce. MATERIALS AND METHODS Using nationwide data, a total of 49,576 patients diagnosed with LSS based on International Classification of Diseases-10 codes were matched with controls of the same number based on age and sex. Employing a multivariable logistic regression model, the study assessed for the association between spinal stenosis and diabetes, while adjusting for confounders. RESULTS We found a higher likelihood of LSS diagnosis in diabetic patients [odds ratio (OR) 1.39, 95% CI: 1.36 - 1.43, P <0.001]. Those with hemoglobin A1c ≥7% and ≥1 diabetes-related complication also had an elevated likelihood (OR: 1.19, 95% CI: 1.08-1.31, P =0.001). Prolonged diabetes exposure increased the risk. Diabetes diagnosis reduced median survival by around 4.5 years for both stenosis and nonstenosis patients; spinal stenosis diagnosis alone minimally impacted survival. Relative to individuals diagnosed with diabetes mellitus at the age of 65 or older, the OR for developing LSS were 1.22 (95% CI: 1.18-1.27, P <0.001) when DM was diagnosed at 50 to 65 years old and 1.67 (95% CI: 1.56-1.79, P <0.001) for those under 50 years old. Multivariate analysis revealed a significantly increased risk of all-cause mortality in patients with DM and spinal stenosis (hazard ratio: 1.36, 95% CI: 1.29-1.44, P <0.001) and those with DM without stenosis (hazard ratio: 1.49, 95% CI: 1.41-1.57, P <0.001) compared with controls. CONCLUSIONS Diabetic patients with prolonged disease, poor glycemic control, and diabetes-related complications face an elevated risk of developing LSS. Recognizing the reciprocal adverse relationship between these conditions is crucial in clinical practice and designing public health measures for managing both conditions. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Shai Shemesh
- Department of Orthopaedic Surgery, Samson Assuta Ashdod University Hospital, Ashdod, Israel
- Faculty of Health Sciences, Ben Gurion University, Beer-Sheva, Israel
| | - Asaf Laks
- Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | | | - Adi Turjeman
- Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
- Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel
| | - Ronen Blecher
- Department of Orthopaedic Surgery, Samson Assuta Ashdod University Hospital, Ashdod, Israel
- Faculty of Health Sciences, Ben Gurion University, Beer-Sheva, Israel
| | - Assaf Kadar
- Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel
- Roth | McFarlane Hand & Upper Limb Centre, St. Joseph's Hospital and Western University
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18
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Rha SW, Lee K, Choi SY, Byun JK, Cha J, Hyun S, Ahn WJ, Park S, Kang DO, Park EJ, Choi CU, Choi BG. Long-term prognostic factors for cardiovascular events in patients with chest pain without diabetes mellitus nor significant coronary stenosis. Heart Vessels 2024; 39:382-391. [PMID: 38324195 DOI: 10.1007/s00380-023-02348-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 12/07/2023] [Indexed: 02/08/2024]
Abstract
Chest pain is the most common symptom of coronary artery disease (CAD) and diabetes mellitus (DM) is a well-known single strongest risk factor for cardiovascular diseases. Thus, the impact of CAD nor DM on long-term clinical effects is reported widely, but the prognostic factors of non-DM patients presenting with chest pain without significant CAD are limited. A total of 1,046 patients with chest pain without DM and significant CAD who underwent coronary angiography (CAG) and acetylcholine (ACH) provocation tests were finally enrolled. Propensity score matching and multivariate Cox-proportional hazard ratio analysis were performed to adjust for baseline potential confounders. Major adverse cardiac and cerebrovascular events (MACCE) were defined as the composite of total death, myocardial infarction (MI), revascularization, stroke, and recurrent angina. This study aimed to evaluate the long-term prognostic factors for MACCE in patients with chest pain without DM and CAD up to 5 years. Coronary artery spasm (CAS) was the most common cause of chest pain. However, long-term MACCE of CAS was not worse than those of patients with chest pain without CAS when patients with CAS had subsequent optimal antianginal medication therapy. However, a recurrent chest pain remains a problem even with continuous antianginal medication therapy. Up to 5 years, the incidence of MACCE was in 7.3%, including recurrent angina 6.9%. Dyslipidemia (HR: 2.010, 95% CI 1.166-3.466, P = 0.012), mild-moderate (30-70%) coronary stenosis (HR: 2.369, 95% CI 1.118-5.018, P = 0.024), the use of aspirin (HR: 2.885, 95% CI 1.588-5.238, P < 0.001), and the use of nitrates (HR: 1.938, 95% CI 1.094-3.433, P = 0.023) were independent risk factors for MACCE. Among the patients with chest pain without DM and significant CAD, the incidence of MACE were rare, but recurrent angina was still a challenging problem who had treated with antianginal medications.
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Affiliation(s)
- Seung-Woon Rha
- Cardiovascular Center, Korea University Guro Hospital, 148, Gurodong-ro, Guro-gu, Seoul, 08308, Korea.
| | - Kyuho Lee
- Division of Cardiology, Department of Internal Medicine, Hwahong Hospital, Suwon, Korea
- Division of Cardiology, Department of Internal Medicine, Hwahong Hospital, Seoul, Korea
| | - Se Yeon Choi
- Cardiovascular Research Institute, Korea University, 198, Gamasan-ro, Guro-gu, Seoul, 08309, Korea
| | - Jae Kyeong Byun
- Cardiovascular Research Institute, Korea University, 198, Gamasan-ro, Guro-gu, Seoul, 08309, Korea
| | - Jinah Cha
- Cardiovascular Research Institute, Korea University, 198, Gamasan-ro, Guro-gu, Seoul, 08309, Korea
| | - Sujin Hyun
- Cardiovascular Research Institute, Korea University, 198, Gamasan-ro, Guro-gu, Seoul, 08309, Korea
| | - Woo Jin Ahn
- Cardiovascular Research Institute, Korea University, 198, Gamasan-ro, Guro-gu, Seoul, 08309, Korea
| | - Soohyung Park
- Cardiovascular Research Institute, Korea University, 198, Gamasan-ro, Guro-gu, Seoul, 08309, Korea
| | - Dong Oh Kang
- Cardiovascular Research Institute, Korea University, 198, Gamasan-ro, Guro-gu, Seoul, 08309, Korea
| | - Eun Jin Park
- Cardiovascular Research Institute, Korea University, 198, Gamasan-ro, Guro-gu, Seoul, 08309, Korea
| | - Cheol Ung Choi
- Cardiovascular Research Institute, Korea University, 198, Gamasan-ro, Guro-gu, Seoul, 08309, Korea
| | - Byoung Geol Choi
- Cardiovascular Research Institute, Korea University, 198, Gamasan-ro, Guro-gu, Seoul, 08309, Korea.
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Baldawi M, Ghaleb N, McKelvey G, Ismaeil YM, Saasouh W. Preoperative ultrasound assessment of gastric content in patients with diabetes: A meta-analysis based on a systematic review of the current literature. J Clin Anesth 2024; 93:111365. [PMID: 38134485 DOI: 10.1016/j.jclinane.2023.111365] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 12/09/2023] [Accepted: 12/15/2023] [Indexed: 12/24/2023]
Abstract
STUDY OBJECTIVE To conduct a systematic literature review of the current evidence on the effect of diabetes mellitus on gastric volume observed during a preoperative ultrasound examination. Using the results of this systematic literature review, a meta-analysis was performed to investigate whether there was an association between diabetes mellitus and an increased risk of presenting with a high-risk stomach (gastric volume associated with an increased risk of pulmonary aspiration). DESIGN Review article and meta-analysis. SETTING Review of published literature. PATIENTS A total of 3366 patients underwent surgery. INTERVENTION Gastric ultrasound examination. MEASUREMENTS Data for the meta-analysis and literature review were collected from the PubMed/Medline, Embase, Web of Science, and Google Scholar databases of the National Library of Medicine from the date of inception to January 2023. All included studies measured the gastric antral cross-sectional area and/or gastric residual volume in patients with diabetes and those without diabetes. The data utilized in the meta-analysis included all studies that evaluated the incidence of high-risk stomachs based on ultrasonographic measurements of the gastric antral cross-sectional area or gastric residual volume. MAIN RESULTS Most collated studies revealed that diabetes mellitus was associated with increased antral cross-sectional area and gastric residual volume. A meta-analysis of published reports indicated that patients with diabetes have an increased rate of high-risk stomachs. CONCLUSIONS Diabetes mellitus is associated with an increased rate of high-risk stomachs. The authors recommend large prospective trials to ascertain the safety of the current fasting guidelines for patients with diabetes undergoing surgery.
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Affiliation(s)
- Mohanad Baldawi
- Wayne State University/Detroit Medical Center, Department of Anesthesiology, 3990 John R. Street, Detroit, MI 48201, USA.
| | - Nancy Ghaleb
- Wayne State University/Detroit Medical Center, Department of Anesthesiology, 3990 John R. Street, Detroit, MI 48201, USA
| | - George McKelvey
- Wayne State University/Detroit Medical Center, Department of Anesthesiology, 3990 John R. Street, Detroit, MI 48201, USA; NorthStar Anesthesia, 6225 State Hwy 161 #200, Irving, TX 75038, USA
| | - Yara M Ismaeil
- Eastern Michigan University, Division of Cellular and Molecular Biology, 900 Oakwood St, Ypsilanti, MI 48197, USA
| | - Wael Saasouh
- Wayne State University/Detroit Medical Center, Department of Anesthesiology, 3990 John R. Street, Detroit, MI 48201, USA; NorthStar Anesthesia, 6225 State Hwy 161 #200, Irving, TX 75038, USA; Outcomes Research Consortium, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
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Yang Q, Yang W, Liu F. The associations of weekend warrior and other physical activity patterns with the risk of all-cause and cardiovascular disease mortality in people with diabetes mellitus and chronic kidney disease: from NHANES 2007-2020. Int Urol Nephrol 2024; 56:1703-1712. [PMID: 37955818 DOI: 10.1007/s11255-023-03863-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 10/23/2023] [Indexed: 11/14/2023]
Abstract
AIM To investigate the associations of the weekend warrior and other physical activity (PA) patterns with all-cause, cardiovascular disease (CVD) mortality risk in people with diabetes mellitus (DM) and chronic kidney disease (CKD). METHODS This study pooled the data from NHANES 2007-2020. Participants with DM and CKD were included. PA was assessed using a self-reported questionnaire. According to the characteristics of recreational activities, individuals were categorized as inactive (no activities), insufficiently active (total PA duration < 150 min/week), weekend warrior (total PA duration ≥ 150 min/week for 1-2 sessions), and regularly active (total PA duration ≥ 150 min/week for ≥ 3 sessions). Weighted Cox regression models with adjusting sociodemographic, behavioral, and metabolic factors were performed to investigate the relationship of PA patterns with all-cause and CVD mortality risk. Stratification and interaction analyses were further performed. RESULTS Among 1702 participants (46.53% female; 64 ± 0.46 years old), 536 died (163 cardiovascular) during the follow-up of 68 (39-104) months. The hazard ratio (HR) of all-cause death was 0.618 (95% CI 0.406-0.942) for insufficiently active PA pattern, 0.338 (95% CI 0.116-0.988) for weekend warrior PA pattern, and 0.536 (95% CI 0.395-0.726) for regularly active PA pattern compared with inactive PA pattern. HR of CVD death was 0.545 (95% CI 0.250-1.189) for the PA pattern of insufficiently active, 0.165 (95% CI 0.020-1.343) for weekend warrior, and 0.393 (95% CI 0.218-0.710) for regularly active compared with the inactive PA pattern. The associations present no difference in subgroups. Moreover, there was no discernible difference between weekend warrior and regularly active PA patterns for all-cause and CVD deaths. The risk of death declined relatively quickly When exercise was initiated and to a total of 450 min or 4 times per week. CONCLUSION In a population of DM and CKD, the weekend warrior pattern was similar to regular activity to lower the risk of all-cause mortality, compared with inactivity. The weekend warrior pattern was recommended for people who only have time to exercise on the weekend. However, longer and larger sample cohort studies are needed to validate our findings.
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Affiliation(s)
- Qing Yang
- Department of Nephrology, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China
- Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, China
| | - Wenjie Yang
- Department of Project Design and Statistics, West China Hospital of Sichuan University, Chengdu, China
| | - Fang Liu
- Department of Nephrology, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan Province, China.
- Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, China.
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Tretiakov PS, Thomas Z, Krol O, Joujon-Roche R, Williamson T, Imbo B, Dave P, McFarland K, Mir J, Vira S, Diebo B, Schoenfeld AJ, Passias PG. The Predictive Potential of Nutritional and Metabolic Burden: Development of a Novel Validated Metric Predicting Increased Postoperative Complications in Adult Spinal Deformity Surgery. Spine (Phila Pa 1976) 2024; 49:609-614. [PMID: 37573568 DOI: 10.1097/brs.0000000000004797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 07/29/2023] [Indexed: 08/15/2023]
Abstract
STUDY DESIGN A retrospective cohort review. OBJECTIVE To develop a scoring system for predicting increased risk of postoperative complications in adult spinal deformity (ASD) surgery based on baseline nutritional and metabolic factors. BACKGROUND Endocrine and metabolic conditions have been shown to adversely influence patient outcomes and may increase the likelihood of postoperative complications. The impact of these conditions has not been effectively evaluated in patients undergoing ASD surgery. MATERIALS AND METHODS ASD patients 18 years or above with baseline and two-year data were included. An internally cross-validated weighted equation using preoperative laboratory and comorbidity data correlating to increased perioperative complications was developed via Poisson regression. Body mass index (BMI) categorization (normal, over/underweight, and obese) and diabetes classification (normal, prediabetic, and diabetic) were used per the Centers for Disease Control and Prevention and the American Diabetes Associates parameters. A novel ASD-specific nutritional and metabolic burden score (ASD-NMBS) was calculated via Beta-Sullivan adjustment, and Conditional Inference Tree determined the score threshold for experiencing ≥1 complication. Cohorts were stratified into low-risk and high-risk groups for comparison. Logistic regression assessed correlations between increasing burden score and complications. RESULTS Two hundred one ASD patients were included (mean age: 58.60±15.4, sex: 48% female, BMI: 29.95±14.31, Charlson Comorbidity Index: 3.75±2.40). Significant factors were determined to be age (+1/yr), hypertension (+18), peripheral vascular disease (+37), smoking status (+21), anemia (+1), VitD hydroxyl (+1/ng/mL), BMI (+13/cat), and diabetes (+4/cat) (model: P <0.001, area under the curve: 92.9%). Conditional Inference Tree determined scores above 175 correlated with ≥1 post-op complication ( P <0.001). Furthermore, HIGH patients reported higher rates of postoperative cardiac complications ( P =0.045) and were more likely to require reoperation ( P =0.024) compared with low patients. CONCLUSIONS The development of a validated novel nutritional and metabolic burden score (ASD-NMBS) demonstrated that patients with higher scores are at greater risk of increased postoperative complications and course. As such, surgeons should consider the reduction of nutritional and metabolic burden preoperatively to enhance outcomes and reduce complications in ASD patients.
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Affiliation(s)
- Peter S Tretiakov
- Departments of Orthopedic and Neurological Surgery, NYU Langone Orthopedic Hospital, New York Spine Institute, New York, NY
| | - Zach Thomas
- Department of Orthopedic Surgery, New York Medical College, Westchester Medical Center, Valhalla, NY
| | - Oscar Krol
- Departments of Orthopedic and Neurological Surgery, NYU Langone Orthopedic Hospital, New York Spine Institute, New York, NY
| | - Rachel Joujon-Roche
- Departments of Orthopedic and Neurological Surgery, NYU Langone Orthopedic Hospital, New York Spine Institute, New York, NY
| | - Tyler Williamson
- Departments of Orthopedic and Neurological Surgery, NYU Langone Orthopedic Hospital, New York Spine Institute, New York, NY
| | - Bailey Imbo
- Departments of Orthopedic and Neurological Surgery, NYU Langone Orthopedic Hospital, New York Spine Institute, New York, NY
| | - Pooja Dave
- Departments of Orthopedic and Neurological Surgery, NYU Langone Orthopedic Hospital, New York Spine Institute, New York, NY
| | - Kimberly McFarland
- Departments of Orthopedic and Neurological Surgery, NYU Langone Orthopedic Hospital, New York Spine Institute, New York, NY
| | - Jamshaid Mir
- Departments of Orthopedic and Neurological Surgery, NYU Langone Orthopedic Hospital, New York Spine Institute, New York, NY
| | - Shaleen Vira
- Departments of Orthopaedic and Neurological Surgery, University of Arizona College of Medicine, Phoenix, AZ
| | - Bassel Diebo
- Department of Orthopaedics, Warren Alpert School of Medicine, Brown University, Providence, RI
| | - Andrew J Schoenfeld
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Peter G Passias
- Departments of Orthopedic and Neurological Surgery, NYU Langone Orthopedic Hospital, New York Spine Institute, New York, NY
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Bradford BF, Cronin RS, Okesene-Gafa KA, Apaapa-Timu THS, Shashikumar A, Oyston CJ. Diabetes in pregnancy: Women's views of care in a multi-ethnic, low socioeconomic population with midwifery continuity-of-care. Women Birth 2024; 37:101579. [PMID: 38296743 DOI: 10.1016/j.wombi.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 12/10/2023] [Accepted: 01/14/2024] [Indexed: 02/02/2024]
Abstract
BACKGROUND Diabetes in pregnancy is diagnosed in 6% of pregnancies annually in Aotearoa-New Zealand, disproportionately affecting multi-ethnic, low socio-economic women. Little is known about the care experience of this population within the model of midwifery continuity-of-care, including views of telehealth care. AIM Increase understanding of the experience of diabetes in pregnancy care, including telehealth, among multi-ethnic, low socio-economic women receiving midwifery continuity-of-care. METHODS Qualitative interview study with primarily indigenous and migrant women who had diabetes in pregnancy and gave birth 6-18 months previously. Interviewers were matched with participants by ethnicity. Transcripts were analysed using Framework analysis. RESULTS Participants were 19 women (5 Māori, 5 Pacific Peoples, 5 Asian, 4 European). Data analysis revealed three key themes: 1) 'shock, shame, and adjustment' to the diagnosis 2) 'learning to manage diabetes in pregnancy' and 3) 'preparation for birth and beyond' to the postpartum period. DISCUSSION Receiving the diagnosis of diabetes in pregnancy was a shock. Managing diabetes during pregnancy was particularly challenging for indigenous and migrant women, who wished for better access to culturally appropriate dietary and lifestyle information. Women appreciated having options of telehealth and face-to-face consultations. Preparation for birth and postpartum diabetes follow-up were areas requiring significant improvement. Challenges were mitigated through care from a consistent diabetes specialist midwife and community-based midwifery continuity-of-care. CONCLUSION Midwives were the backbone of diabetes in pregnancy care for this multi-ethnic, low socio-economic population. Care could be improved with more culturally appropriate diet and lifestyle information, better birth preparation, and expanded postpartum diabetes support.
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Affiliation(s)
- Billie F Bradford
- Obstetrics & Gynaecology, Monash Health, Monash University, Australia
| | - Robin S Cronin
- Te Whatu Ora Counties Manukau, Health New Zealand, New Zealand; Department of Obstetrics and Gynecology, University of Auckland, New Zealand
| | - Karaponi A Okesene-Gafa
- Te Whatu Ora Counties Manukau, Health New Zealand, New Zealand; Department of Obstetrics and Gynecology, University of Auckland, New Zealand
| | - Te Hao S Apaapa-Timu
- Te Whatu Ora Counties Manukau, Health New Zealand, New Zealand; Department of Obstetrics and Gynecology, University of Auckland, New Zealand
| | - Asha Shashikumar
- Department of Obstetrics and Gynecology, University of Auckland, New Zealand
| | - Charlotte J Oyston
- Te Whatu Ora Counties Manukau, Health New Zealand, New Zealand; Department of Obstetrics and Gynecology, University of Auckland, New Zealand.
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Adam HS, Molinsky R, Bohn B, Roy S, Rosenbaum M, Paster B, Yuzefpolskaya M, Colombo PC, Papapanou PN, Desvarieux M, Jacobs DR, Demmer RT. Clinical attachment loss is cross-sectionally associated with elevated glucose among adults without diabetes. J Clin Periodontol 2024; 51:522-535. [PMID: 38343130 PMCID: PMC11023769 DOI: 10.1111/jcpe.13945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 12/19/2023] [Accepted: 01/01/2024] [Indexed: 04/18/2024]
Abstract
AIM We investigated whether periodontal measures are cross-sectionally associated with prediabetes and cardiometabolic biomarkers among non-diabetic younger adults. MATERIALS AND METHODS One thousand seventy-one participants (mean age = 32.2 years [SE = 0.3]; 73% female) from the Oral Infections, Glucose Intolerance and Insulin Resistance Study were enrolled. Full-mouth clinical attachment loss (fm-CAL), probing depth (fm-PD) and bleeding on probing were ascertained. Interproximal CAL (i-CAL) and probing depths (i-PD) served as our primary exposures. Glucose, HbA1c, insulin and insulin resistance (HOMA-IR) outcomes were assessed from fasting blood. Prediabetes was defined per American Diabetes Association guidelines. Prediabetes prevalence ratios (PR [95% CI]) and mean [SE] cardiometabolic biomarkers were regressed on periodontal variables via multivariable robust variance Poisson regression or multivariable linear regression. RESULTS Prevalence of prediabetes was 12.5%. Fully adjusted prediabetes PR in Tertiles 3 versus 1 of mean i-CAL was 2.42 (1.77, 3.08). Fully adjusted fasting glucose estimates across i-CAL tertiles were 83.29 [0.43], 84.31 [0.37], 86.48 [0.46]; p for trend <.01. Greater percent of sites with i-PD ≥3 mm showed elevated natural-log-HOMA-IR after adjustment (0%-12% of sites = 0.33 [0.03], 13%-26% of sites = 0.39 [0.03], ≥27% of sites = 0.42 [0.03]; p for trend = .04). CONCLUSIONS i-CAL (vs. fm-CAL) was associated with elevated fasting glucose and prediabetes, whereas i-PD (vs. fm-PD) was associated with insulin resistance. Future studies are needed to examine periodontal disease and incident prediabetes.
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Affiliation(s)
- Hamdi S. Adam
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Rebecca Molinsky
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Bruno Bohn
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
- Department of Epidemiology, School of Public Health, University of Colorado, Aurora, CO, USA
| | - Sumith Roy
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Michael Rosenbaum
- Division of Molecular Genetics, Departments of Pediatrics and Medicine, Columbia University, New York, NY, USA
| | | | - Melana Yuzefpolskaya
- Division of Cardiology, Department of Medicine, New York Presbyterian Hospital, Columbia University, New York, NY, USA
| | - Paolo C. Colombo
- Division of Cardiology, Department of Medicine, New York Presbyterian Hospital, Columbia University, New York, NY, USA
| | - Panos N. Papapanou
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, Columbia University, New York, NY, USA
| | - Moïse Desvarieux
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - David R. Jacobs
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Ryan T. Demmer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Division of Epidemiology, Department of Quantitative Health Sciences, College of Medicine and Science, Mayo Clinic, Rochester, MN, USA
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Matsushita K, Harada K, Kohno T, Nakano H, Kitano D, Matsuda J, Takei M, Yoshino H, Yamamoto T, Nagao K, Takayama M. Prevalence and clinical characteristics of diabetic cardiomyopathy in patients with acute heart failure. Nutr Metab Cardiovasc Dis 2024; 34:1325-1333. [PMID: 38218713 DOI: 10.1016/j.numecd.2023.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 12/02/2023] [Accepted: 12/15/2023] [Indexed: 01/15/2024]
Abstract
BACKGROUND AND AIMS Diabetic cardiomyopathy refers to cases of diabetes mellitus (DM) complicated by cardiac dysfunction in the absence of cardiovascular disease and hypertension. Its epidemiology remains unclear due to the high rate of coexistence between DM and hypertension. Therefore, this study aimed to examine the prevalence and clinical characteristics of diabetic cardiomyopathy among patients with acute heart failure (HF). METHODS AND RESULTS This multicenter, retrospective study included 17,614 consecutive patients with acute HF. DM-related HF was defined as HF complicating DM without known manifestations of coronary artery disease, significant valvular heart disease, or congenital heart disease, while diabetic cardiomyopathy was defined as DM-related HF without hypertension. Univariable and multivariable logistic regression analyses were performed to identify factors associated with in-hospital mortality. Diabetic cardiomyopathy prevalence was 1.6 % in the entire cohort, 5.2 % in patients with acute HF complicating DM, and 10 % in patients with DM-related HF. Clinical characteristics, including the presence of comorbidities, laboratory data on admission, and factors associated with in-hospital mortality, significantly differed between the diabetic cardiomyopathy group and the DM-related HF with hypertension group. The in-hospital mortality rate was significantly higher in patients with diabetic cardiomyopathy than in patients with DM-related HF with hypertension (7.7 % vs. 2.8 %, respectively; P < 0.001). CONCLUSION The prevalence of diabetic cardiomyopathy was 1.6 % in patients with acute HF, and patients with diabetic cardiomyopathy were at high risk for in-hospital mortality. The clinical characteristics of patients with diabetic cardiomyopathy were significantly different than those of patients with DM-related HF with hypertension.
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Affiliation(s)
| | | | - Takashi Kohno
- Tokyo CCU Network Scientific Committee, Tokyo, Japan
| | - Hiroki Nakano
- Tokyo CCU Network Scientific Committee, Tokyo, Japan
| | | | - Junya Matsuda
- Tokyo CCU Network Scientific Committee, Tokyo, Japan
| | - Makoto Takei
- Tokyo CCU Network Scientific Committee, Tokyo, Japan
| | | | | | - Ken Nagao
- Tokyo CCU Network Scientific Committee, Tokyo, Japan
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Gurudas S, Vasconcelos JC, Prevost AT, Raman R, Rajalakshmi R, Ramasamy K, Mohan V, Rani PK, Das T, Conroy D, Tapp RJ, Sivaprasad S. National prevalence of vision impairment and blindness and associated risk factors in adults aged 40 years and older with known or undiagnosed diabetes: results from the SMART-India cross-sectional study. Lancet Glob Health 2024; 12:e838-e847. [PMID: 38430915 DOI: 10.1016/s2214-109x(24)00035-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 01/13/2024] [Accepted: 01/16/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND National estimates of the prevalence of vision impairment and blindness in people with diabetes are required to inform resource allocation. People with diabetes are more susceptible to conditions such as diabetic retinopathy that can impair vision; however, these are often missed in national studies. This study aims to determine the prevalence and risk factors of vision impairment and blindness in people with diabetes in India. METHODS Data from the SMART-India study, a cross-sectional survey with national coverage of 42 147 Indian adults aged 40 years and older, collected using a complex sampling design, were used to obtain nationally representative estimates for the prevalence of vision impairment and blindness in people with diabetes in India. Vulnerable adults (primarily those who did not have capacity to provide consent); pregnant and breastfeeding women; anyone deemed too ill to be screened; those who did not provide consent; and people with type 1 diabetes, gestational diabetes, or secondary diabetes were excluded from the study. Vision impairment was defined as presenting visual acuity of 0·4 logMAR or higher and blindness as presenting a visual acuity of 1·0 logMAR or higher in the better-seeing eye. Demographic, anthropometric, and laboratory data along with geographic distribution were analysed in all participants with available data. Non-mydriatic retinal images were used to grade diabetic retinopathy, and risk factors were also assessed. FINDINGS A total of 7910 people with diabetes were included in the analysis, of whom 5689 had known diabetes and 2221 were undiagnosed. 4387 (55·5%) of 7909 participants with available sex data were female and 3522 (44·5%) participants were male. The estimated national prevalence of vision impairment was 21·1% (95% CI 15·7-27·7) and blindness 2·4% (1·7-3·4). A higher prevalence of any vision impairment (29·2% vs 19·6%; p=0·016) and blindness (6·7% vs 1·6%; p<0·0001) was observed in those with ungradable images. In known diabetes, diabetic retinopathy (adjusted odds ratio [aOR] 3·06 [95% CI 1·25-7·51]), vision-threatening diabetic retinopathy (aOR 7·21 [3·52-14·75]), and diabetic macular oedema (aOR 5·41 [2·20-13·33]) were associated with blindness in adjusted analysis. Common sociodemographic risk factors for vision impairment and blindness include older age, lower educational attainment, and unemployment. INTERPRETATION Based on the estimated 101 million people with diabetes in 2021 and the interpretation of the data from this study, approximately 21 million people with diabetes have vision impairment in India, of whom 2·4 million are blind. Higher prevalence is observed in those from lower socio-economic strata and policy makers should focus on these groups to reduce inequalities in health care. FUNDING Global Challenge Research Fund of United Kingdom Research and Innovation through the Medical Research Council.
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Affiliation(s)
- Sarega Gurudas
- Vision Sciences, UCL Institute of Ophthalmology, London, UK; Centre for Intelligent Healthcare, Coventry University, Coventry, UK; NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Joana C Vasconcelos
- Nightingale-Saunders Clinical Trials and Epidemiology Unit, King's College London, London, UK
| | - A Toby Prevost
- Nightingale-Saunders Clinical Trials and Epidemiology Unit, King's College London, London, UK
| | - Rajiv Raman
- Retina Department, Vision Research Foundation, Sankara Nethralaya, Chennai, India
| | - Ramachandran Rajalakshmi
- Department of Diabetology and Ophthalmology, Madras Diabetes Research Foundation, Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | - Kim Ramasamy
- Retina Department, Aravind Medical Research Foundation, Madurai, India
| | - Viswanathan Mohan
- Department of Diabetology and Ophthalmology, Madras Diabetes Research Foundation, Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | - Padmaja K Rani
- Srimati Kanuri Santhamma Centre for Vitreoretinal Diseases, Hyderabad Eye Research Foundation, LV Prasad Eye Institute, Hyderabad, India
| | - Taraprasad Das
- Srimati Kanuri Santhamma Centre for Vitreoretinal Diseases, Hyderabad Eye Research Foundation, LV Prasad Eye Institute, Hyderabad, India
| | - Dolores Conroy
- Vision Sciences, UCL Institute of Ophthalmology, London, UK
| | - Robyn J Tapp
- Centre for Intelligent Healthcare, Coventry University, Coventry, UK
| | - Sobha Sivaprasad
- Vision Sciences, UCL Institute of Ophthalmology, London, UK; NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UK.
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Romero-Gómez M, Lara C. Looking for the best algorithm in the diabetes population for advanced fibrosis detection: The best is the enemy of the good. Hepatology 2024; 79:976-978. [PMID: 38016042 DOI: 10.1097/hep.0000000000000703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 11/13/2023] [Indexed: 11/30/2023]
Affiliation(s)
- Manuel Romero-Gómez
- Digestive Diseases Department, CIBEREHD, Virgen del Rocío University Hospital, Institute of Biomedicine of Seville (HUVR/CSIC/US), University of Seville, Seville, Spain
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James A. Diabetes and lung function: Linked, but how? Respirology 2024; 29:361-362. [PMID: 38379119 DOI: 10.1111/resp.14674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 02/22/2024]
Abstract
See related article
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Affiliation(s)
- Alan James
- Respiratory Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
- School of Medicine, The University of Western Australia, Perth, Western Australia, Australia
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Mozaffarian D. Plant-Based Diets and Diabetes Risk: Which Foods, What Mechanisms? Diabetes Care 2024; 47:787-789. [PMID: 38640411 DOI: 10.2337/dci24-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/21/2024]
Affiliation(s)
- Dariush Mozaffarian
- Food Is Medicine Institute, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
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Gomes CM, Hisano M, Souza JD, Henriques JVT, de Bessa J, Moromizato J, Bosi T, Mazoni R, Gismondi J, Camargo B, Sammour ZM, Bruschini H, Battistella LR, Nahas WC. Lower Urinary Tract Symptoms in a prospective cohort of COVID-19 survivors. Int Braz J Urol 2024; 50:287-295. [PMID: 38498685 DOI: 10.1590/s1677-5538.ibju.2023.0546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 02/07/2024] [Indexed: 03/20/2024] Open
Abstract
PURPOSE To analyze the prevalence of lower urinary tract symptoms (LUTS) in patients who survived moderate and severe forms of COVID-19 and the risk factors for LUTS six months after hospitalization. MATERIALS AND METHODS In this prospective cohort study, patients were evaluated six months after hospitalization due to COVID-19. LUTS were assessed using the International Prostate Symptom Score. General health was assessed through the Hospital Anxiety and Depression Scale and the EQ5D-L5 scale, which evaluates mobility, ability to perform daily activities, pain and discomfort and completed a self-perception health evaluation. RESULTS Of 255 participants, 54.1% were men and the median age was 57.3 [44.3 - 66.6] years. Pre-existing comorbidities included diabetes (35.7%), hypertension (54.5%), obesity (30.2%) and physical inactivity (65.5%). One hundred and twenty-four patients (48.6%) had a hospital stay >15 days, 181 (71.0%) were admitted to an ICU and 124 (48.6%) needed mechanical ventilation. Median IPSS was 6 [3-11] and did not differ between genders. Moderate to severe LUTS affected 108 (42.4%) patients (40.6% men and 44.4% women; p=0.610). Nocturia (58.4%) and frequency (45.9%) were the most prevalent symptoms and urgency was the only symptom that affected men (29.0%) and women (44.4%) differently (p=0.013). LUTS impacted the quality of life of 60 (23.5%) patients with women more severely affected (p=0.004). Diabetes, hypertension, and self-perception of worse general health were associated with LUTS. CONCLUSIONS LUTS are highly prevalent and bothersome six months after hospitalization due to COVID-19. Assessment of LUTS may help ensure appropriate diagnosis and treatment in these patients.
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Affiliation(s)
- Cristiano M Gomes
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Marcelo Hisano
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Julia D Souza
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | | | - Jose de Bessa
- Departamento de Cirurgia, Universidade Estadual de Feira de Santana, Bahia, Brasil
| | - Julyana Moromizato
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Thulio Bosi
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Rachel Mazoni
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - João Gismondi
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Bruno Camargo
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Zein M Sammour
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Homero Bruschini
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Linamara R Battistella
- Instituto de Medicina Física e de Reabilitação, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - William C Nahas
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
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Feter N, Feter JS, Borelli WV, Rombaldi AJ, Castilhos RM. Potentially modifiable risk factors for dementia in six low-income and middle-income countries: A multinational, population-based survey. Maturitas 2024; 183:107968. [PMID: 38484600 DOI: 10.1016/j.maturitas.2024.107968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 02/09/2024] [Accepted: 03/08/2024] [Indexed: 04/08/2024]
Abstract
OBJECTIVES We aimed to determine the proportion of dementia cases potentially preventable in six low-income and middle-income countries. STUDY DESIGN We analyzed data from 19,278 adults aged 50 years or more from China, South Africa, Ghana, India, Russia, and Mexico included in the WHO's Study on global AGEing and adult health. MAIN OUTCOME MEASURES We calculated the population attributable fraction for ten potentially modifiable risk factors: less education, hearing loss, hypertension, diabetes, depression, heavy drinking, obesity, smoking, physical inactivity, and social isolation. Weighted attributable fraction was calculated considering communality among risk factors. RESULTS We estimated that 37.6 % of the burden of dementia might be attributable to these risk factors. The highest and lowest overall weighted attributable fractions were 38.3 % and 22.9 % in China and Ghana, respectively. Less education (8.3 %), smoking (6.3 %), and physical inactivity (5.7 %) showed the highest attributable fraction for dementia. The overall attributable fraction was higher in the poorest (38.1 %) than in the richest (30.9 %) income quintile. The burden of obesity, diabetes, and hypertension was 61 % higher in the wealthiest than in the poorest population. A total of 7.2 million cases of dementia in these six low- and middle-income countries are potentially caused by these ten potentially modifiable risk factors. CONCLUSIONS Overall, 38 % of cases of dementia in China, South Africa, Ghana, India, Russia, and Mexico can be attributable to ten potentially modifiable risk factors. Cardiometabolic risk factors account for a more significant burden of dementia in the wealthiest population. Less education had the highest population attributable fraction independent of living area and income.
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Affiliation(s)
- Natan Feter
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Av. Protásio Alves, 211, Rio Branco, Porto Alegre, Rio Grande do Sul 90410-000, Brazil.
| | - Jayne S Feter
- Postgraduate Program in Health Sciences, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, Santa Cecília, Porto Alegre, Rio Grande do Sul 90035-007, Brazil
| | - Wyllians V Borelli
- Centro de Neurologia Cognitiva e do Comportamento, Serviço de Neurologia, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, RS 90035-903, Brazil.
| | - Airton J Rombaldi
- Postgraduate Program in Physical Education, Universidade Federal de Pelotas, Rua Luiz de Camões, 625, Três Vendas, Pelotas, Rio Grande do Sul 96055-630, Brazil
| | - Raphael M Castilhos
- Centro de Neurologia Cognitiva e do Comportamento, Serviço de Neurologia, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, RS 90035-903, Brazil.
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Senjam SS. Diabetes and diabetic retinopathy: the growing public health concerns in India. Lancet Glob Health 2024; 12:e727-e728. [PMID: 38430917 DOI: 10.1016/s2214-109x(24)00075-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 03/05/2024]
Affiliation(s)
- Suraj Singh Senjam
- Department of Community Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India.
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Oh JI, Lee KJ, Hipp A. Food deserts exposure, density of fast-food restaurants, and park access: Exploring the association of food and recreation environments with obesity and diabetes using global and local regression models. PLoS One 2024; 19:e0301121. [PMID: 38635494 PMCID: PMC11025848 DOI: 10.1371/journal.pone.0301121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 03/11/2024] [Indexed: 04/20/2024] Open
Abstract
To prevent obesity and diabetes environmental interventions such as eliminating food deserts, restricting proliferation of food swamps, and improving park access are essential. In the United States, however, studies that examine the food and park access relationship with obesity and diabetes using both global and local regression are lacking. To guide county, state, and federal policy in combating obesity and diabetes, there is a need for cross-scale analyses to identify that relationship at national and local levels. This study applied spatial regression and geographically weighted regression to the 3,108 counties in the contiguous United States. Global regression show food deserts exposure and density of fast-food restaurants have non-significant association with obesity and diabetes while park access has a significant inverse association with both diseases. Geographically weighted regression that takes into account spatial heterogeneity shows that, among southern states that show high prevalence of obesity and diabetes, Alabama and Mississippi stand out as having opportunity to improve park access. Results suggest food deserts exposure are positively associated with obesity and diabetes in counties close to Alabama, Georgia, and Tennessee while density of fast-food restaurants show positive association with two diseases in counties of western New York and northwestern Pennsylvania. These findings will help policymakers and public health agencies in determining which geographic areas need to be prioritized when implementing public interventions such as promoting healthy food access, limiting unhealthy food options, and increasing park access.
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Affiliation(s)
- Jae In Oh
- Department of Parks, Recreation & Tourism Management, North Carolina State University, Raleigh, North Carolina, United States of America
| | - KangJae Jerry Lee
- Department of Parks, Recreation & Tourism Management, North Carolina State University, Raleigh, North Carolina, United States of America
- Department of Parks, Recreation & Tourism, University of Utah, Salt Lake City, Utah, United States of America
| | - Aaron Hipp
- Department of Parks, Recreation & Tourism Management, North Carolina State University, Raleigh, North Carolina, United States of America
- Center for Geospatial Analytics, North Carolina State University, Raleigh, North Carolina, United States of America
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Sanjari E, Raeisi Shahraki H, G. Khachatryan L, Mohammadian-Hafshejani A. Investigating the association between diabetes and carpal tunnel syndrome: A systematic review and meta-analysis approach. PLoS One 2024; 19:e0299442. [PMID: 38626071 PMCID: PMC11020394 DOI: 10.1371/journal.pone.0299442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/11/2024] [Indexed: 04/18/2024] Open
Abstract
INTRODUCTION In recent years, several studies have reported on the relationship between diabetes and carpal tunnel syndrome (CTS). However, due to their contradictory results, a systematic review and meta-analysis were conducted to investigate this subject. METHODS This study is a systematic review and meta-analysis of studies published in ISI Web of Science, Scopus, PubMed, Cochrane, Google Scholar, and Embase databases. Heterogeneity in the studies included in the meta-analysis was evaluated using statistical tests such as the Chi-square test, I2, and forest plots. Publication bias was assessed using Begg's and Egger's tests. RESULTS This investigation analyzed data from 42 studies conducted between 1985 and 2022, with a total of 3,377,816 participants. The meta-analysis demonstrated that the odds ratio (OR) of CTS in participants with a history of diabetes compared to those without was 1.90 (95% CI: 1.64-2.21; P-value < 0.001). Given that publication bias was observed in this study (Begg's test P-value = 0.01), the modified OR was calculated with consideration of missed studies, which was 1.68 (95% CI: 1.45-1.94; P-value < 0.001). CONCLUSION The results of this study suggest that diabetic patients have 90% higher odds of developing CTS compared to non-diabetic individuals, which is statistically significant.
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Affiliation(s)
- Elaheh Sanjari
- Student Research Committee, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Hadi Raeisi Shahraki
- Department of Epidemiology and Biostatistics, School of Public Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Lusine G. Khachatryan
- Department of Pediatric Diseases, N.F.Filatov Clinical Institute of Children’s Health, I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Abdollah Mohammadian-Hafshejani
- Assistant Professor of Epidemiology, Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
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Zhu AL, Le AD, Li Y, Palaniappan LP, Srinivasan M, Shah NS, Wong SS, Valero-Elizondo J, Elfassy T, Yang E. Social Determinants of Cardiovascular Risk Factors Among Asian American Subgroups. J Am Heart Assoc 2024; 13:e032509. [PMID: 38567660 DOI: 10.1161/jaha.123.032509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 01/30/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Social determinants of health (SDOH) play a significant role in the development of cardiovascular risk factors. We investigated SDOH associations with cardiovascular risk factors among Asian American subgroups. METHODS AND RESULTS We utilized the National Health Interview Survey, a nationally representative survey of US adults, years 2013 to 2018. SDOH variables were categorized into economic stability, neighborhood and social cohesion, food security, education, and health care utilization. SDOH score was created by categorizing 27 SDOH variables as 0 (favorable) or 1 (unfavorable). Self-reported cardiovascular risk factors included diabetes, high cholesterol, high blood pressure, obesity, insufficient physical activity, suboptimal sleep, and nicotine exposure. Among 6395 Asian adults aged ≥18 years, 22.1% self-identified as Filipino, 21.6% as Asian Indian, 21.0% as Chinese, and 35.3% as other Asian. From multivariable-adjusted logistic regression models, each SD increment of SDOH score was associated with higher odds of diabetes among Chinese (odds ratio [OR], 1.45; 95% CI, 1.04-2.03) and Filipino (OR, 1.24; 95% CI, 1.02-1.51) adults; high blood pressure among Filipino adults (OR, 1.28; 95% CI, 1.03-1.60); insufficient physical activity among Asian Indian (OR, 1.42; 95% CI, 1.22-1.65), Chinese (OR, 1.58; 95% CI, 1.33-1.88), and Filipino (OR, 1.24; 95% CI, 1.06-1.46) adults; suboptimal sleep among Asian Indian adults (OR, 1.20; 95% CI, 1.01-1.42); and nicotine exposure among Chinese (OR, 1.56; 95% CI, 1.15-2.11) and Filipino (OR, 1.50; 95% CI, 1.14-1.97) adults. CONCLUSIONS Unfavorable SDOH are associated with higher odds of cardiovascular risk factors in Asian American subgroups. Culturally specific interventions addressing SDOH may help improve cardiovascular health among Asian Americans.
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Affiliation(s)
- Alicia L Zhu
- Stanford University Center for Asian Healthcare Research and Education Stanford CA
- College of Arts and Sciences, School of Global Public Health New York University New York NY
| | - Austin D Le
- Stanford University Center for Asian Healthcare Research and Education Stanford CA
- Environmental Health Sciences Division University of California, Berkeley, School of Public Health Berkeley CA
| | - Yuemeng Li
- Stanford University Center for Asian Healthcare Research and Education Stanford CA
- Nell Hodgson Woodruff School of Nursing Emory University Atlanta GA
| | - Latha P Palaniappan
- Stanford University Center for Asian Healthcare Research and Education Stanford CA
- Division of Primary Care and Population Health Stanford University School of Medicine Stanford CA
| | - Malathi Srinivasan
- Stanford University Center for Asian Healthcare Research and Education Stanford CA
- Division of Primary Care and Population Health Stanford University School of Medicine Stanford CA
| | - Nilay S Shah
- Departments of Medicine (Cardiology) and Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL
| | - Sally S Wong
- American Heart Association, Office of Science, Medicine, and Health Dallas TX
| | - Javier Valero-Elizondo
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center Houston TX
| | - Tali Elfassy
- Stanford University Center for Asian Healthcare Research and Education Stanford CA
- Department of Medicine, Division of Nephrology and Hypertension University of Miami Miller School of Medicine Miami FL
| | - Eugene Yang
- Stanford University Center for Asian Healthcare Research and Education Stanford CA
- Division of Cardiology University of Washington School of Medicine Seattle WA
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Tanner R, Farhan S, Giustino G, Sartori S, Feng Y, Hooda A, Vinayak M, Dangas G, Mehran R, Kini AS, Sharma SK. Impact of diabetes mellitus on clinical outcomes after first episode in-stent restenosis PCI: Results from a large registry. Int J Cardiol 2024; 401:131856. [PMID: 38360097 DOI: 10.1016/j.ijcard.2024.131856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 02/02/2024] [Accepted: 02/10/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Diabetes mellitus (DM) is associated with a high rate of major adverse cardiac events (MACE) after de novo coronary artery percutaneous coronary intervention (PCI). Whether patients with DM undergoing PCI for in-stent restenosis (ISR) experience a similar heightened risk of MACE is not known. Hence, we sought to compare the clinical outcomes of patients with and without DM undergoing PCI for ISR. METHODS Patients undergoing first episode ISR PCI between January 2015 and December 2021 were included. The primary outcome of interest was MACE (all-cause death, myocardial infarction [MI], and target lesion revascularization [TVR]) at 1-year. RESULTS A total of 3156 patients (56.7% with DM) underwent PCI for ISR during the study period. Patients with DM were younger, more likely to be female, and had a higher prevalence of comorbidities. At 1-year follow-up, DM was associated with a higher rate of MACE (22.4% vs. 18.7%, unadjusted HR 2.03, 95%CI(1.27-3.25), p = 0.003). All-cause mortality and MI were significantly more frequent among people with DM at 1-year follow-up. The rate of TVR was similar in both groups (17.9% vs. 16.0%, unadjusted HR 1.14, 95%CI (0.94-1.37), p = 0.180). On adjusted analysis, there was no significant difference in the rate of MACE (AHR 1.07, 95%CI(0.90 - -1.29), p = 0.444), all-cause death (AHR 1.54, 95%CI(0.93-2.54), p = 0.095) or MI (AHR 1.10, 95%CI(0.74-1.63), p = 0.652). CONCLUSION ISR PCI in patients with DM was associated with a higher rate of MACE at 1-year follow-up. However, this increased risk was no longer significant after adjusting for baseline characteristics.
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Affiliation(s)
- Richard Tanner
- Department of Cardiology, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai Hospital, New York, USA
| | - Serdar Farhan
- Department of Cardiology, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai Hospital, New York, USA
| | - Gennaro Giustino
- Department of Cardiology, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai Hospital, New York, USA
| | - Samantha Sartori
- Department of Cardiology, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai Hospital, New York, USA
| | - Yihan Feng
- Department of Cardiology, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai Hospital, New York, USA
| | - Amit Hooda
- Department of Cardiology, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai Hospital, New York, USA
| | - Manish Vinayak
- Department of Cardiology, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai Hospital, New York, USA
| | - George Dangas
- Department of Cardiology, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai Hospital, New York, USA
| | - Roxana Mehran
- Department of Cardiology, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai Hospital, New York, USA
| | - Annapoorna S Kini
- Department of Cardiology, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai Hospital, New York, USA
| | - Samin K Sharma
- Department of Cardiology, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai Hospital, New York, USA.
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Abelman RA, Schneider MF, Cox C, Messerlian G, Cohen M, Gustafson D, Plankey M, Sharma A, Price J, Grunfeld C, Tien PC. Association of Androgen Hormones, Sex Hormone-Binding Globulin, and the Menopausal Transition With Incident Diabetes Mellitus in Women With and Without HIV. J Acquir Immune Defic Syndr 2024; 95:486-493. [PMID: 38180885 PMCID: PMC10947917 DOI: 10.1097/qai.0000000000003380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 12/01/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND HIV is associated with alterations in androgen hormone levels and sex hormone-binding globulin (SHBG) in women. Higher SHBG has been associated with a lower risk of diabetes in the general population, but the contribution of HIV, androgen hormones, SHBG, and menopausal phase to diabetes is unclear. METHODS From April 2003 through February 2020, 896 women with HIV (WWH) and 343 women without HIV (WWOH) from the Women's Interagency HIV Study with morning total testosterone, dehydroepiandrosterone sulfate (DHEAS), and SHBG levels were followed to assess for incident diabetes. Parametric regression models were used with age as the time scale and relative times (RT) as the measure of association of hormone level and menopausal phase with incident diabetes. Analyses incorporated time-dependent androgen hormone, SHBG levels, and menopausal phase and were adjusted for race/ethnicity, enrollment year, smoking status, BMI, hepatitis C virus status, and HIV-related factors. RESULTS In total, 128 (14%) WWH and 47 (14%) WWOH developed diabetes. In WWH, a doubling of SHBG and DHEAS were associated with a 7% (RT = 1.07 [95% CI: 0.82 to 1.40] and 15% (RT = 1.15 [95% CI: 0.95 to 1.39]) longer time to diabetes, respectively; in WWOH, a doubling of SHBG and DHEAS were associated with 84% (RT = 1.84 [95% CI: 0.89 to 3.82]) and 41% (RT= 1.41 [95% CI: 0.82 to 2.44]) longer times to diabetes. Total testosterone was not associated. In WWH, later menopausal phase was associated with shorter times to diabetes. CONCLUSIONS Despite alterations in androgen hormone and SHBG levels in HIV, regardless of HIV status, higher SHBG and DHEAS were associated with nonstatistically significant slower progression to diabetes. The menopausal transition may be a better hormonal indicator of diabetes risk in WWH.
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Affiliation(s)
- Rebecca A Abelman
- Department of Medicine, University of California San Francisco, San Francisco, CA
| | - Michael F Schneider
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Christopher Cox
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Geralyn Messerlian
- Department of Pathology and Laboratory Medicine, Brown University, Providence, RI
| | - Mardge Cohen
- Department of Medicine, Stroger Hospital, Cook County Health, Chicago, IL
| | - Deborah Gustafson
- Department of Neurology, State University of New York Downstate Health Sciences University, Brooklyn, NY
| | - Michael Plankey
- Department of Medicine, Georgetown University Medical Center, Washington, DC
| | - Anjali Sharma
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY; and
| | - Jennifer Price
- Department of Medicine, University of California San Francisco, San Francisco, CA
| | - Carl Grunfeld
- Department of Medicine, University of California San Francisco, San Francisco, CA
- Medical Service, Department of Veteran Affairs Medical Center, San Francisco, CA
| | - Phyllis C Tien
- Department of Medicine, University of California San Francisco, San Francisco, CA
- Medical Service, Department of Veteran Affairs Medical Center, San Francisco, CA
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Yazdanpanah L, Shahbazian H, Hesam S, Ahmadi B, Zamani AM. Two-year incidence and risk factors of diabetic foot ulcer: second phase report of Ahvaz diabetic foot cohort (ADFC) study. BMC Endocr Disord 2024; 24:46. [PMID: 38622562 PMCID: PMC11017491 DOI: 10.1186/s12902-024-01572-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/26/2024] [Indexed: 04/17/2024] Open
Abstract
AIM/INTRODUCTION This study was designed as the second phase of a prospective cohort study to evaluate the incidence and risk factors of diabetic foot ulcers (DFU). MATERIALS AND METHODS The study was conducted in a university hospital in Iran. Each participant was checked and followed up for two years in terms of developing newfound DFU as ultimate outcome. We investigated the variables using univariate analysis and then by backward elimination multiple logistic regression. RESULTS We followed up 901 eligible patients with diabetes for two years. The mean age of the participants was 53.24 ± 11.46 years, and 58.53% of them were female. The two-year cumulative incidence of diabetic foot ulcer was 8% (95% CI 0.071, 0.089) [Incidence rate: 49.9 /1000 person-years]. However, the second-year incidence which was coincident with the COVID-19 pandemic was higher than the first-year incidence (4.18% and 1.8%, respectively). Based on our analysis, the following variables were the main risk factors for DFU incidence: former history of DFU or amputation [OR = 76.5, 95% CI(33.45,174.97), P value < 0.001], ill-fitting foot-wear [OR = 10.38, 95% CI(4.47,24.12), P value < 0.001], smoking [OR = 3.87,95%CI(1.28, 11.71),P value = 0.016], lack of preventive foot care [OR = 2.91%CI(1.02,8.29),P value = 0.045], and insufficient physical activity[OR = 2.25,95% CI(0.95,5.35),P value = 0.066]. CONCLUSION Overall, the two-year cumulative incidence of diabetic foot ulcer was 8% [Incidence rate: 49.9 /1000 person-years]; however, the second-year incidence was higher than the first-year incidence which was coincident with the COVID-19 pandemic (4.18% and 1.8%, respectively). Independent risk factors of DFU occurrence were prior history of DFU or amputation, ill-fitting footwear, smoking, lack of preventive foot care, and insufficient physical activity.
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Affiliation(s)
- Leila Yazdanpanah
- Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, 61357-15794, Ahvaz, Iran.
| | - Hajieh Shahbazian
- Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, 61357-15794, Ahvaz, Iran
| | - Saeed Hesam
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnam Ahmadi
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Amir Mohammad Zamani
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Nong Y, Wu G, Lu J, Wei X, Yu D. The mediating role of obesity in the development of depression in individuals with diabetes: A population-based study from NHANES 2005-2014. J Affect Disord 2024; 351:977-982. [PMID: 38355056 DOI: 10.1016/j.jad.2024.02.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 01/27/2024] [Accepted: 02/11/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVE Depression is one of the common manifestations of diabetes population, and previous studies have shown that there is a correlation between depression and diabetes. This study was conducted retrospectively through the large National Health and Nutrition Examination Survey (NHANES) to explore the risk of depression in different individuals with diabetes. METHODS We collected data on a total of 33,001 individuals in 5 cycles of NHANES and compared the incidence of depression in the individuals with diabetes, pre-diabetes or without diabetes groups after weighting. A weighted logistic review was used to assess the association between diabetes and depression at different BMI, sex, and age levels. Mediating analysis was used to assess the risk of depression in people with obesity-mediated diabetes. In addition, the non-linear relationship between BMI and depression at different factor levels was evaluated using restricted cubic strips (RCS). RESULTS Diabetes was significantly associated with depression in obesity, especially for female (OR: 1.45, 95 % CI: 1.20-1.75, P < 0.001) and young ( CONCLUSIONS There is a significant correlation between diabetes and depression, and obesity as a mediating variable mediates the correlation between diabetes and depression. Especially in obese, young (age < 60) and women, the phenomenon is more pronounced.
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Affiliation(s)
- Yuxin Nong
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 510080 Guangzhou, China
| | - Guangyu Wu
- Department of Neurology, Guangzhou Key Laboratory of Diagnosis and Treatment for Neurodegenerative Diseases, Guangdong Neuroscience Institute, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 510080 Guangzhou, China
| | - Junquan Lu
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 510080 Guangzhou, China
| | - Xuebiao Wei
- Department of Geriatric Intensive Medicine, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 51080 Guangzhou, China.
| | - Danqing Yu
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 510080 Guangzhou, China.
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Sharma P, Dilip TR, Kulkarni A, Mishra US, Shejul Y. Risk of diabetes and expected years in life without diabetes among adults from an urban community in India: findings from a retrospective cohort. BMC Public Health 2024; 24:1048. [PMID: 38622601 PMCID: PMC11020643 DOI: 10.1186/s12889-024-18465-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 03/27/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Diabetes prevalence has increased over the past few decades, and the shift of the burden of diabetes from the older population to the younger population has increased the exposure of longer durations in a morbid state. The study aimed at ascertaining the likelihood of progression to diabetes and to estimate the onset of diabetes within the urban community of Mumbai. METHODS This study utilized an observational retrospective non-diabetic cohort comprising 1629 individuals enrolled in a health security scheme. Ten years of data were extracted from electronic medical records, and the life table approach was employed to assess the probability of advancing to diabetes and estimate the expected number of years lived without a diabetes diagnosis. RESULTS The study revealed a 42% overall probability of diabetes progression, with age and gender variations. Males (44%) show higher probabilities than females (40%) of developing diabetes. Diabetes likelihood rises with age, peaking in males aged 55-59 and females aged 65-69. Males aged 30-34 exhibit a faster progression (10.6 years to diagnosis) compared to females (12.3 years). CONCLUSION The study's outcomes have significant implications for the importance of early diabetes detection. Progression patterns suggest that younger cohorts exhibit a comparatively slower rate of progression compared to older cohorts.
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Affiliation(s)
- Palak Sharma
- Department of Family and Generations, International Institute for Population Sciences, Mumbai, 400088, India.
| | - T R Dilip
- Department of Family and Generations, International Institute for Population Sciences, Mumbai, 400088, India
| | - Anjali Kulkarni
- Medical Division, Bhabha Atomic Research Center, Mumbai, 400088, India
| | - Udaya Shankar Mishra
- Department of Bio-statistics and Epidemiology, International Institute for Population Sciences, Mumbai, 400088, India
| | - Yogesh Shejul
- Medical Division, Bhabha Atomic Research Center, Mumbai, 400088, India
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Marušić J, Hasković E, Mujezinović A, Đido V. Correlation of pre-existing comorbidities with disease severity in individuals infected with SARS-COV-2 virus. BMC Public Health 2024; 24:1053. [PMID: 38622590 PMCID: PMC11020189 DOI: 10.1186/s12889-024-18457-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 03/26/2024] [Indexed: 04/17/2024] Open
Abstract
Shortly after the first publication on the new disease called Coronavirus Disease 2019 (Covid-19), studies on the causal consequences of this disease began to emerge, initially focusing only on transmission methods, and later on its consequences analyzed in terms of gender, age, and the presence of comorbidities. The aim of our research is to determine which comorbidities have the greatest negative impact on the worsening of the disease, namely which comorbidities indicate a predisposition to severe Covid-19, and to understand the gender and age representation of participants and comorbidities. The results of our study show that the dominant gender is male at 54.4% and the age of 65 and older. The most common comorbidities are arterial hypertension, diabetes mellitus, and cardiovascular diseases. The dominant group is recovered participants aged 65 and older, with comorbidities most frequently present in this group. The highest correlation between patients with different severity of the disease was found with cardiovascular diseases, while the coefficient is slightly lower for the relationship between patients with different disease severity and urinary system diseases and hypertension. According to the regression analysis results, we showed that urinary system diseases have the greatest negative impact on the worsening of Covid-19, with the tested coefficient b being statistically significant as it is 0.030 < 0.05. An increase in cardiovascular diseases affects the worsening of Covid-19, with the tested coefficient b being statistically significant as it is 0.030 < 0.05. When it comes to arterial hypertension, it has a small impact on the worsening of Covid-19, but its tested coefficient b is not statistically significant as it is 0.169 > 0.05. The same applies to diabetes mellitus, which also has a small impact on the worsening of Covid-19, but its tested coefficient b is not statistically significant as it is 0.336 > 0.05. Our study has shown that comorbidities such as urinary system diseases and cardiovascular diseases tend to have a negative impact on Covid-19, leading to a poor outcome resulting in death, while diabetes mellitus and hypertension have an impact but without statistical significance.
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Affiliation(s)
- Jasmina Marušić
- Department of Health Care, Faculty of Medicine, University of Zenica, Zenica, Bosnia and Herzegovina.
- , Marjanovića put 39, 72000, Zenica, Bosnia and Herzegovina.
| | - Edhem Hasković
- Department of Biology, Faculty of Science, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Adnan Mujezinović
- Department of Health Care, Faculty of Medicine, University of Zenica, Zenica, Bosnia and Herzegovina
| | - Vedran Đido
- Department of Public Health, Faculty of Health Studies, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
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Wang Z, Du Z, Lu R, Zhou Q, Jiang Y, Zhu H. Causal relationship between diabetes and depression: A bidirectional Mendelian randomization study. J Affect Disord 2024; 351:956-961. [PMID: 38355055 DOI: 10.1016/j.jad.2024.02.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 01/29/2024] [Accepted: 02/08/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVE This study explores the causal relationship between diabetes and depression using a two-sample Mendelian Randomization (TSMR) method. METHODS The study selected single nucleotide polymorphisms (SNPs) closely associated with diabetes and depression in European populations from the Genome-Wide Association Study (GWAS) database, to serve as instrumental variables (IVs). The main evaluation method was inverse variance weighted analysis (IVW), supplemented by verification using Weighted median, Weighted mode, and MR Egger methods. The Odds Ratio (OR) and 95 % Confidence Interval (CI) were used as the main evaluation indicators, along with sensitivity analysis. RESULTS This study found a negative correlation between diabetes and depression, suggesting that diabetes may reduce the risk of depression [IVW(FE): OR: 0.901, 95 % CI: 0.823 to 0.987; P = 0.025 < 0.05]. This finding was further confirmed by the Weighted median [OR: 0.844, 95 % CI: 0.730 to 0.974; P = 0.021 < 0.05] and Weighted mode method [OR: 0.766, 95 % CI: 0.637 to 0.921; P = 0.006 < 0.05]. However, the reverse showed no causal relationship between depression and diabetes (P > 0.05). Sensitivity analysis found no pleiotropy, and there were no large influences from individual SNPs on the result's robustness; the results are stable and reliable. CONCLUSION For the first time, this study using TSMR analysis found a negative correlation between diabetes and the risk of depression onset in European populations, suggesting that diabetes might reduce the risk of depression. But as the mechanisms are still unclear, these findings warrant further study.
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Affiliation(s)
- Zhe Wang
- Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China
| | - Zhiqiang Du
- Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China
| | - Rongrong Lu
- Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China
| | - Qin Zhou
- Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China
| | - Ying Jiang
- Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China.
| | - Haohao Zhu
- Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China.
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Tran DT, Falster MO, Pearse J, Mazevska D, McElduff P, Pearson S, van Gool KC, Hall J, Jorm L. The Australian Health Care Homes trial: quality of care and patient outcomes. A propensity score-matched cohort study. Med J Aust 2024; 220:372-378. [PMID: 38514449 DOI: 10.5694/mja2.52266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 10/18/2023] [Indexed: 03/23/2024]
Abstract
OBJECTIVE To assess the impact of the Health Care Homes (HCH) primary health care initiative on quality of care and patient outcomes. DESIGN, SETTING Quasi-experimental, matched cohort study; analysis of general practice data extracts and linked administrative data from ten Australian primary health networks, 1 October 2017 - 30 June 2021. PARTICIPANTS People with chronic health conditions (practice data extracts: 9811; linked administrative data: 10 682) enrolled in the HCH 1 October 2017 - 30 June 2019; comparison groups of patients receiving usual care (1:1 propensity score-matched). INTERVENTION Participants were involved in shared care planning, provided enhanced access to team care, and encouraged to seek chronic condition care at the HCH practice where they were enrolled. Participating practices received bundled payments based on clinical risk tier. MAIN OUTCOME MEASURES Access to care, processes of care, diabetes-related outcomes, hospital service use, risk of death. RESULTS During the first twelve months after enrolment, the mean numbers of general practitioner encounters (rate ratio, 1.14; 95% confidence interval [CI], 1.11-1.17) and Medicare Benefits Schedule claims for allied health services (rate ratio, 1.28; 95% CI, 1.24-1.33) were higher for the HCH than the usual care group. Annual influenza vaccinations (relative risk, 1.20; 95% CI, 1.17-1.22) and measurements of blood pressure (relative risk, 1.09; 95% CI, 1.08-1.11), blood lipids (relative risk, 1.19; 95% CI, 1.16-1.21), glycated haemoglobin (relative risk, 1.06; 95% CI, 1.03-1.08), and kidney function (relative risk, 1.13; 95% CI, 1.11-1.15) were more likely in the HCH than the usual care group during the twelve months after enrolment. Similar rate ratios and relative risks applied in the second year. The numbers of emergency department presentations (rate ratio, 1.09; 95% CI, 1.02-1.18) and emergency admissions (rate ratio, 1.13; 95% CI, 1.04-1.22) were higher for the HCH group during the first year; other differences in hospital use were not statistically significant. Differences in glycaemic and blood pressure control in people with diabetes in the second year were not statistically significant. By 30 June 2021, 689 people in the HCH group (6.5%) and 646 in the usual care group (6.1%) had died (hazard ratio, 1.07; 95% CI, 0.96-1.20). CONCLUSIONS The HCH program was associated with greater access to care and improved processes of care for people with chronic diseases, but not changes in diabetes-related outcomes, most measures of hospital use, or risk of death.
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Affiliation(s)
- Duong T Tran
- Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW
| | - Michael O Falster
- Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW
| | | | | | - Patrick McElduff
- Health Policy Analysis, Sydney, NSW
- University of Newcastle, Newcastle, NSW
| | - Sallie Pearson
- Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW
| | - Kees C van Gool
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, NSW
| | - Jane Hall
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, NSW
| | - Louisa Jorm
- Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW
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Moawad MHED, Mohamed Shalaby MM, Hamouda E, Mahfouz A, Mouffokes A, Hamouda H, Abbas A, Abdelgawad HAH. Risk of Stroke Among HIV Patients: A Systematic Review and Meta-analysis of Global Studies and Associated Comorbidities. J Acquir Immune Defic Syndr 2024; 95:399-410. [PMID: 38489489 DOI: 10.1097/qai.0000000000003382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 12/20/2023] [Indexed: 03/17/2024]
Abstract
BACKGROUND Despite advancements in the management of HIV infection, the factors contributing to stroke development among HIV-positive individuals remain unclear. This systematic review and meta-analysis aim to identify and evaluate the relative risk factors associated with stroke susceptibility in the HIV population. METHODS A comprehensive search was conducted in PubMed, Scopus, and Web of Science databases to identify studies investigating the risk of stroke development in HIV patients and assessing the role of different risk factors, including hypertension, diabetes, dyslipidemia, smoking, sex, and race. The quality assessment of case-control studies was conducted using the Newcastle-Ottawa Scale, whereas cohort studies were assessed using the National Institute of Health tool. Meta-analyses were performed using a random-effects model to determine pooled hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS A total of 18 observational studies involving 116,184 HIV-positive and 3,184,245 HIV-negative patients were included. HIV-positive patients exhibited a significantly higher risk of stroke compared with HIV-negative patients [OR (95% CI): 1.31 (1.20 to 1.44)]. Subgroup analyses revealed increased risks for both ischemic stroke [OR (95% CI): 1.32 (1.19 to 1.46)] and hemorrhagic stroke [OR (95% CI): 1.31 (1.09 to 1.56)]. Pooled adjusted HRs showed a significant association between stroke and HIV positivity (HR: 1.37, 95% CI: 1.22 to 1.54). Among HIV-positive patients with stroke, hypertension [OR (95% CI): 3.5 (1.42 to 8.65)], diabetes [OR (95% CI): 5 (2.12 to 11.95)], hyperlipidemia, smoking, male gender, and black race were associated with an increased risk. DISCUSSION Our study revealed a significant increased risk of stroke development among people with HIV. A multitude of factors, encompassing sociodemographic characteristics, racial background, underlying health conditions, and personal behaviors, significantly elevate the risk of stroke in individuals living with HIV. The use of observational studies introduces inherent limitations, and further investigations are necessary to explore the underlying mechanisms of stroke in people with HIV for potential treatment strategies. CONCLUSION HIV patients face a higher risk of stroke development, either ischemic and hemorrhagic strokes. Hypertension, diabetes, hyperlipidemia, smoking, male gender, and black race were identified as significant risk factors. Early identification and management of these risk factors are crucial in reducing stroke incidence among patients living with HIV.
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Affiliation(s)
- Mostafa Hossam El Din Moawad
- Faculty of Pharmacy Clinical Department Alexandria University, Alexandria, Egypt
- Faculty of Medicine Suez Canal University, Ismailia, Egypt
| | | | - Esraa Hamouda
- Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Amany Mahfouz
- Faculty of Medicine, Kafrelsheikh University, Kafr El-Sheikh, Egypt
| | - Adel Mouffokes
- Faculty of Medicine, University of Oran 1 Ahmed Ben Bella, Oran, Algeria
| | - Heba Hamouda
- Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Abdallah Abbas
- Faculty of Medicine, Al-Azhar University, Damietta, Egypt; and
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Cho Y, Kim B, Kwon HS, Han K, Kim MK. Diabetes severity and the risk of depression: A nationwide population-based study. J Affect Disord 2024; 351:694-700. [PMID: 38302066 DOI: 10.1016/j.jad.2024.01.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND In consideration of the substantial occurrence rates of diabetes mellitus (DM) and depression, it is imperative to identify patients with DM who are at an elevated risk of developing depression. Accordingly, this study aimed to examine whether the risk of depression escalated proportionally with the severity of diabetes. METHODS 2,067,017 adults diagnosed with type 2 DM, with the exception of those diagnosed with depression either before or within one year of the index date, were identified from a nationwide population-based cohort in Korea. Severity scores for DM were established based on various factors, including insulin use, DM duration of at least 5 years, use of three or more oral hypoglycemic agents, the presence of chronic kidney disease (CKD), cardiovascular diseases (CVD), or diabetic retinopathy. Each of these attributes was assigned a score of one point for diabetes severity, and their cumulative sum was defined as a diabetes severity score, ranging from 0 to 6. RESULTS During a median follow-up of 6.2 years, 407,047 cases of major depression were identified. Each component contributing to the DM severity score was significantly associated with an increased risk of depression (all P-values <0.001), with insulin use and the presence of CVD demonstrating the most significant correlation with depression risk. As the DM severity score increased, the risk of depression was observed to significantly escalate (P for trend <0.001). After adjusting for potential confounding variables, the hazard ratios (95% confidence intervals) of depression were 1.15 (1.14-1.16) in 1 point, 1.28 (1.27-1.29) in 2 points, 1.45 (1.43-1.47) in 3 points, 1.70 (1.67-1.73) in 4 points, 1.91 (1.84-1.98) in 5 points, and 2.01 (1.79-2.26) in 6 points, respectively. CONCLUSION The results of this study indicate that diabetes severity is positively associated with an elevated risk of developing major depression. Based on these findings, it is feasible to consider targeting depression screening efforts towards individuals with higher diabetes severity scores.
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Affiliation(s)
- Yunjung Cho
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Bongsung Kim
- Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, Republic of Korea
| | - Hyuk-Sang Kwon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, Republic of Korea.
| | - Mee Kyoung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
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Zhang L, Zhang P, Chen W. Can family doctor system improve health service utilization for patients with hypertension and diabetes in China? A difference-in-differences study. BMC Health Serv Res 2024; 24:454. [PMID: 38605337 PMCID: PMC11007929 DOI: 10.1186/s12913-024-10903-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 03/26/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Family doctors, serving as gatekeepers, are the core of primary health care to meet basic health needs, provide accessible care, and improve attainable health. The study objective was to evaluate the impact of the family doctor system on health service utilization among patients with hypertension and diabetes in China. METHODS Difference-in-Differences (DID) models are constructed to estimate the net effect of the family doctor system, based on the official health management records and medical insurance claim data of patients with hypertension and diabetes in an eastern city of China. RESULTS The family doctor system significantly increases follow-up visits (hypertension patients coef. = 0.13, diabetes patients coef. = 0.08, both p < 0.001) and outpatient visits (hypertension patients coef. = 0.08, diabetes patients coef. = 0.05, both p < 0.001) among the contracted compared to the non-contracted. The proportion of outpatient visits in community health centers among the contracted significantly rose (hypertension patients coef. = 0.02, diabetes patients coef. = 0.04, both p < 0.001) due to significantly more outpatient visits in community health centers and fewer in secondary and tertiary hospitals. It also significantly mitigates the increase in inpatient admissions among hypertension patients but not among diabetes patients. CONCLUSIONS The examined family doctor system strengthens primary care, both by increasing follow-up visits and outpatient visits and promoting a rationalized structure of outpatient utilization in China.
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Affiliation(s)
- Luying Zhang
- School of Public Health, Fudan University, Shanghai, China
| | - Peng Zhang
- School of Humanities, Shanghai Institute of Technology, 100 Haiquan Road, Fengxian District, Shanghai, China
| | - Wen Chen
- School of Public Health, Fudan University, Shanghai, China.
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Harooni J, Joukar F, Goujani R, Sikaroudi MK, Hatami A, Zolghadrpour MA, Hejazi M, Karimi Z, Rahmanpour F, Askari Shahid S, Jowshan MR. Cohort profile: the PERSIAN Dena Cohort Study (PDCS) of non-communicable diseases in Southwest Iran. BMJ Open 2024; 14:e079697. [PMID: 38604628 PMCID: PMC11015286 DOI: 10.1136/bmjopen-2023-079697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 03/07/2024] [Indexed: 04/13/2024] Open
Abstract
PURPOSE This study conducted in Dena County is a population-based cohort study as part of the Prospective Epidemiological Research Studies in Iran (PERSIAN). The specific objectives of this study were to estimate the prevalence of region-specific modifiable risk factors and their associations with the incidence of major non-communicable diseases (NCDs). PARTICIPANTS This PERSIAN Dena Cohort Study (PDCS) was conducted on 1561 men and 2069 women aged 35-70 years from October 2016 in Dena County, Kohgiluyeh and Boyer-Ahmad Province, Southwest Iran. The overall participation rate was 82.7%. FINDINGS TO DATE Out of 3630 participants, the mean age was 50.16 years, 2069 (56.9%) were women and 2092 (57.6%) were rural residents. Females exhibited higher prevalence rates of diabetes, hypertension, fatty liver, psychiatric disorders, thyroiditis, kidney stones, gallstones, rheumatic disease, chronic lung disease, depression and osteoporosis compared with males (p<0.05). Furthermore, the urban population showed elevated rates of diabetes, thyroiditis, kidney stones and epilepsy, whereas psychiatric disorders and lupus were more prevalent in rural areas (p<0.05). According to laboratory findings, 418 (13.0%), 1536 (48.1%) and 626 (19.3%) of the participants had fasting blood sugar >126 mg/dL, low-density lipoprotein >100 mg/dL and haematuria, respectively; most of them were female and urban people (p<0.05). FUTURE PLANS PDCS will be planned to re-evaluate NCD-related incidence, all-cause and cause-specific mortality every 5 years, along with annual follow-up for 15 years. Some examples of additional planned studies are evaluation of genetic, environmental risk, spirometry and ECG tests.
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Affiliation(s)
- Javad Harooni
- Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Farahnaz Joukar
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Reza Goujani
- Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Masoumeh Khalighi Sikaroudi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Hatami
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad-Amin Zolghadrpour
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Hejazi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Karimi
- Students Research Committee, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Fatemeh Rahmanpour
- Students Research Committee, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Sakineh Askari Shahid
- Department of Public Health, School of Health, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Mohammad-Reza Jowshan
- Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
- Department of Nutrition, School of Health, Yasuj University of Medical Sciences, Yasuj, Iran
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Ahmed W. Additive interaction of family medical history of diabetes with hypertension on the diagnosis of diabetes among older adults in India: longitudinal ageing study in India. BMC Public Health 2024; 24:999. [PMID: 38600575 PMCID: PMC11005278 DOI: 10.1186/s12889-024-18146-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 02/18/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND The present study aimed to estimate the additive interaction of family history of diabetes and hypertension on the diagnosis of diabetes among individuals aged 45 years and above in India. The coexistence of these two exposures may act synergistically on the risk of diabetes, leading to adverse health outcomes. METHODS The study utilized the data from the Longitudinal Ageing Study in India (LASI) Wave 1 (2017-2018). The total sample size for the current study was 58,612 individuals aged 45 years and above. Multivariable logistic regression models were employed to determine the individual and joint effect of a family history of diabetes with hypertension on diabetes. An additive model was applied to assess the interaction effect of the family medical history of diabetes with hypertension on the diagnosis of diabetes by calculating three different measures of additive interaction such as the relative excess risk ratio (RERI), attribution proportion due to interaction (AP), and synergy index (S). RESULTS The prevalence of diabetes was three times higher among individuals with family history of diabetes (27.8% vs. 9.2%) than those without family history. Individuals with family history of diabetes (AOR: 2.47, CI: 2.11 2.89) had 2.47 times higher odds of having diabetes than those without family history. The prevalence of diabetes was significantly higher among individuals with hypertension and family history of diabetes (46.6%, 95% CI: 39.7-53.6) than those without the coexistence of family history of diabetes and hypertension (9.9%, 95% CI: 9.5-10.4), individuals with hypertension and without a family history of diabetes (22.7%, 95% CI: 21.2-24.2), and individuals with family history of diabetes and without hypertension (16.5%, 95% CI: 14.5-18.7). Moreover, the adjusted odds ratio (AOR) of the joint effect between family medical history of diabetes and hypertension on diabetes was 9.28 (95% CI: 7.51-11.46). In the adjusted model, the RERI, AP, and S for diabetes were 3.5 (95% CI: 1.52-5.47), 37% (0.37; 95% CI: 0.22-0.51), and 1.69 (95% CI: 1.31-2.18) respectively, which indicates that there is a significant positive interaction between family history of diabetes and hypertension on the diagnosis of diabetes. The study findings on interaction effects further demonstrate consistent results for two models of hypertension (self-reported hypertension and hypertensive individuals receiving medication) even after adjustment with potential confounding factors on diabetes (self-reported diabetes and individuals with diabetes receiving medication). CONCLUSIONS The study findings strongly suggest that the interaction of family history of diabetes with hypertension has a positive and significant effect on the risk of diabetes even after adjustment with potential confounding factors. Furthermore, the findings indicate a synergistic effect, emphasizing the importance of considering both family medical history of diabetes and hypertension when assessing diabetes risk and designing preventive strategies or interventions.
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Affiliation(s)
- Waquar Ahmed
- School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai, India.
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Andrees V, Bei der Kellen R, Augustin M, Gallinat J, Harth V, Hoven H, Kühn S, Lautenbach A, Magnussen C, Mohr N, Twerenbold R, Schäfer I, Waschki B, Zyriax BC, Augustin J. Spatial characteristics of non-communicable diseases and their associations to social conditions in a large urban cohort in Germany-Results from the Hamburg City Health Study. PLoS One 2024; 19:e0301475. [PMID: 38593150 PMCID: PMC11003678 DOI: 10.1371/journal.pone.0301475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 03/07/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Non-communicable diseases (NCDs) are responsible for many deaths. They are associated with several modifiable and metabolic risk factors and are therefore prone to significant regional variations on different scales. However, only few intra-urban studies examined spatial variation in NCDs and its association with social circumstances, especially in Germany. Thus, the present study aimed to identify associations of personal risk factors and local social conditions with NCDs in a large German city. METHODS This study is based on a population-based cohort of the Hamburg City Health Study including 10,000 probands. Six NCDs were analyzed (chronic obstructive pulmonary disease [COPD], coronary heart disease [CHD], diabetes mellitus, heart failure, depression, and hypertension) in 68 city district clusters. As risk factors, we considered socio-demographic variables (age, sex, education) and risk behaviour variables (smoking, alcohol consumption). Logistic regression analyses identified associations between the district clusters and the prevalence rates for each NCD. Regional variation was detected by Gini coefficients and spatial cluster analyses. Local social condition indexes were correlated with prevalence rates of NCDs on city district level and hot-spot analyses were performed for significant high or low values. RESULTS The analyses included 7,308 participants with a mean age of 63.1 years (51.5% female). The prevalence of hypertension (67.6%) was the highest. Risk factor associations were identified between smoking, alcohol consumption and education and the prevalence of NCDs (hypertension, diabetes, and COPD). Significant regional variations were detected and persisted after adjusting for personal risk factors. Correlations for prevalence rates with the local social conditions were significant for hypertension (r = 0.294, p < 0.02), diabetes (r = 0.259, p = 0.03), and COPD (r = 0.360, p < 0.01). CONCLUSIONS The study shows that regional differences in NCD prevalence persist even after adjusting for personal risk factors. This highlights the central role of both personal socio-economic status and behaviors such as alcohol and tobacco consumption. It also highlights the importance of other potential regional factors (e.g. the environment) in shaping NCD prevalence. This knowledge helps policy- and decision-makers to develop intervention strategies.
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Affiliation(s)
- Valerie Andrees
- Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Ramona Bei der Kellen
- Epidemiological Study Center, Hamburg City Health Study, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Matthias Augustin
- Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Jürgen Gallinat
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Volker Harth
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Hanno Hoven
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Simone Kühn
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Berlin, Germany
| | - Anne Lautenbach
- Department Endocrinology, Diabetology, Obesity and Lipids, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Christina Magnussen
- University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Center for Population Health Innovation (POINT), University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- German Centre for Cardiovascular Research (DZHK), Hamburg, Kiel, Luebeck, Germany
| | - Nicole Mohr
- Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Raphael Twerenbold
- Epidemiological Study Center, Hamburg City Health Study, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Ines Schäfer
- Epidemiological Study Center, Hamburg City Health Study, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Benjamin Waschki
- Department of Pneumology, Hospital Itzehoe, Itzehoe, Germany
- Airway Research Center North (ARCN), German Center for Lung Research (DZL), LungenClinic Grosshansdorf, Großhansdorf, Germany
| | - Birgit-Christiane Zyriax
- Midwifery Science – Health Service Research and Prevention, Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Jobst Augustin
- Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Chen Q, Zhu S, Shang J, Fang Q, Xue Q, Hua J. Trends in Cognitive Function Before and After Diabetes Onset: The China Health and Retirement Longitudinal Study. Neurology 2024; 102:e209165. [PMID: 38447106 DOI: 10.1212/wnl.0000000000209165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 11/30/2023] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Individuals with prevalent diabetes were known to have a higher risk of dementia and lower cognitive function. However, trends of cognitive function before diabetes and in the short term after new-onset diabetes remain unclear. METHODS This study included participants without baseline diabetes from the China Health and Retirement Longitudinal Study. Cognitive tests were conducted at baseline (wave 1) and at least one time from wave 2 (2013) to wave 4 (2018). Cognitive function was assessed using a global cognition score which was the summary measure of 4 cognitive tests. A linear mixed model was constructed to fit the trends in cognitive function before and after diabetes onset and the trends among nondiabetes. The threshold of statistical significance was p < 0.05. RESULTS During the 7-year follow-up, 1,207 (9.7% of 12,422, 59.1 ± 8.6 years, 39.9% male participants) participants developed new-onset diabetes. The cognitive function of both the without diabetes group and the diabetes group declined annually during the follow-up. The annual decline rate of the diabetes group before diabetes onset was similar to that of the without diabetes group during the whole follow-up period. After diabetes onset, participants experienced statistically significant faster cognitive declines in global cognition (-0.023 SD/year; 95% CI -0.043 to -0.004; p = 0.019) and visuospatial abilities test (-0.036 SD/year; -0.061 to -0.011; p = 0.004), but not in tests of episodic memory (-0.018 SD/year; -0.041 to 0.004; p = 0.116), attention and calculation (-0.017 SD/year; -0.037 to 0.003; p = 0.090), or orientation (0.001 SD/year; -0.018 to 0.020; p = 0.894), compared with the cognitive slope before diabetes. In subgroup analysis, compared with those who developed diabetes between 45-54 years, those developing diabetes older (55-64 years, p for interaction = 0.701; 65-74 years, p for interaction = 0.996) did not demonstrate different rates of global cognitive decline after diabetes. DISCUSSION Individuals experienced faster rate of cognitive decline in a few years after diabetes onset, but not during the prediabetes period. Age did not modify the effect of diabetes on postdiabetes cognitive decline. Efforts in eliminating the adverse impacts on cognition should be started on diagnosis of diabetes.
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Affiliation(s)
- Qingmei Chen
- From the Departments of Physical Medicine and Rehabilitation (Q.C.), Psychiatry (J.S.), and Neurology (Q.F., Q.X., J.H.), The First Affiliated Hospital of Soochow University, Suzhou; Department of Neurology (S.Z.), The Fourth Affiliated Hospital of Soochow University, Medical Center of Soochow University, Suzhou Dushu Lake Hospital; and Department of Epidemiology and Biostatistics (J.H.), School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Sijia Zhu
- From the Departments of Physical Medicine and Rehabilitation (Q.C.), Psychiatry (J.S.), and Neurology (Q.F., Q.X., J.H.), The First Affiliated Hospital of Soochow University, Suzhou; Department of Neurology (S.Z.), The Fourth Affiliated Hospital of Soochow University, Medical Center of Soochow University, Suzhou Dushu Lake Hospital; and Department of Epidemiology and Biostatistics (J.H.), School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Jing Shang
- From the Departments of Physical Medicine and Rehabilitation (Q.C.), Psychiatry (J.S.), and Neurology (Q.F., Q.X., J.H.), The First Affiliated Hospital of Soochow University, Suzhou; Department of Neurology (S.Z.), The Fourth Affiliated Hospital of Soochow University, Medical Center of Soochow University, Suzhou Dushu Lake Hospital; and Department of Epidemiology and Biostatistics (J.H.), School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Qi Fang
- From the Departments of Physical Medicine and Rehabilitation (Q.C.), Psychiatry (J.S.), and Neurology (Q.F., Q.X., J.H.), The First Affiliated Hospital of Soochow University, Suzhou; Department of Neurology (S.Z.), The Fourth Affiliated Hospital of Soochow University, Medical Center of Soochow University, Suzhou Dushu Lake Hospital; and Department of Epidemiology and Biostatistics (J.H.), School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Qun Xue
- From the Departments of Physical Medicine and Rehabilitation (Q.C.), Psychiatry (J.S.), and Neurology (Q.F., Q.X., J.H.), The First Affiliated Hospital of Soochow University, Suzhou; Department of Neurology (S.Z.), The Fourth Affiliated Hospital of Soochow University, Medical Center of Soochow University, Suzhou Dushu Lake Hospital; and Department of Epidemiology and Biostatistics (J.H.), School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Jianian Hua
- From the Departments of Physical Medicine and Rehabilitation (Q.C.), Psychiatry (J.S.), and Neurology (Q.F., Q.X., J.H.), The First Affiliated Hospital of Soochow University, Suzhou; Department of Neurology (S.Z.), The Fourth Affiliated Hospital of Soochow University, Medical Center of Soochow University, Suzhou Dushu Lake Hospital; and Department of Epidemiology and Biostatistics (J.H.), School of Public Health, Medical College of Soochow University, Suzhou, China
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Bashir AO, Elimam MA, Elimam MA, Adam I. Snoring is associated with hypertension and diabetes mellitus among adults in north Sudan: a cross-sectional study. BMC Public Health 2024; 24:974. [PMID: 38584276 PMCID: PMC11000284 DOI: 10.1186/s12889-024-18505-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 04/02/2024] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND Different levels of association between snoring, hypertension, and diabetes mellitus (DM) are reported. There are few published studies on this topic in African countries, and no investigation was conducted in Sudan. This study aimed to assess the prevalence and factors associated with snoring and the association between snoring, hypertension, and type 2 DM (T2DM) in northern Sudan. METHODS A community-based cross-sectional study using a multistage sampling technique was conducted in four villages in the River Nile state of northern Sudan from July to September 2021. Sociodemographic characteristics were collected using a questionnaire. Body mass index (BMI) was measured using standard methods, and a multivariate analysis was conducted using the Statistical Package for the Social Sciences® (SPSS®) for Windows, version 22.0. RESULTS Of the 384 adults, 193 (50.3%) were males and 191 (49.7%) were females. Of the adults, 38 (9.9%) were underweight, 121 (31.5%) had average weight, 113 (29.4%) were overweight, and 112 (29.2%) were obese. One hundred and six (27.6%) adults were snorers. Multivariate analysis showed that increasing age (adjusted odds ratio [AOR] = 1.02, 95% confidence interval [CI] = 1.01‒1.04), increasing BMI (AOR = 1.04, 95 CI = 1.01‒1.08), obesity (AOR = 2.0, 95% CI = 1.10‒3.69), and alcohol consumption (AOR = 2.32, 95% CI = 1.14‒4.74) were positively associated with snoring. Of the 384 adults, 215 (56.0%) had hypertension. Multivariate analysis showed that increasing age (AOR = 1.04, 95% CI = 1.02‒1.06), increasing BMI (AOR = 1.08, 95% CI = 1.04‒1.13), female sex (AOR = 1.7, 95% CI = 1.08‒2.73), and snoring (AOR = 1.69, 95% CI = 1.02‒2.82) were positively associated with hypertension. One hundred and six (27.6%) adults had T2DM. Multivariate analysis showed that increasing age (AOR = 1.03, 95% CI = 1.01‒1.05) and snoring (AOR = 1.78, 95% CI = 1.09‒2.91) were associated with T2DM. CONCLUSION Around one-fourth of the adults in Northern Sudan are snorers. Snoring is more common among obese adults. Snoring is associated with increased odds of hypertension and T2DM. Adults who snore must pay close attention to their blood pressure and blood glucose levels to prevent hypertension and DM.
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Affiliation(s)
- Amal O Bashir
- Faculty of Public Health and Health Informatics, University of Umm Al Qura, Mekkah, Saudi Arabia
| | - Mousab A Elimam
- Faculty of Medicine, Alzaiem Alazhari University, Khartoum North, Sudan
| | - Mohamed A Elimam
- Faculty of Medicine, Alzaiem Alazhari University, Khartoum North, Sudan
| | - Ishag Adam
- Department of Obstetrics and Gynecology, College of Medicine, Qassim University, Buraidah, Saudi Arabia.
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