Hospital admission for type 2 diabetes mellitus under the Universal Coverage Scheme in Thailand: A time- and geographical-trend analysis, 2009-2016.

BACKGROUND: Descriptive analyses of 2009-2016 were performed using the data of the Universal Coverage Scheme (UCS) which covers nearly 70 percent of the Thai population. The analyses described the time and geographical trends of nationwide admission rates of type 2 diabetes mellitus (T2DM) and its complications, including chronic kidney disease (CKD), myocardial infarction, cerebrovascular diseases, retinopathy, cataract, and diabetic foot amputation. METHODS AND FINDINGS: The database of T2DM patients aged 15-100 years who were admitted between 2009 and 2016 under the UCS and that of the UCS population were retrieved for the analyses. The admitted cases of T2DM were extracted from the database using disease codes of principal and secondary diagnoses defined by the International Classification of Diseases 9th and 10th Revisions. The T2DM admission rates in 2009-2016 were the number of admissions divided by the number of the UCS population. The standardized admission rates (SARs)were further estimated in contrast to the expected number of admissions considering age and sex composition of the UCS population in each region. A linearly increased trend was found in T2DM admission rates from 2009 to 2016. Female admission rates were persistently higher than that of males. In 2016, an increase in the T2DM admission rates was observed among the older ages relative to that in 2009. Although the SARs of T2DM were generally higher in Bangkok and central regions in 2009, except that with CKD and foot amputation which had higher trends in northeastern regions, the geographical inequalities were fairly reduced by 2016. CONCLUSION: Admission rates of T2DM and its major complications increased in Thailand from 2009 to 2016. Although the overall geographical inequalities in the SARs of T2DM were reduced in the country, further efforts are required to improve the health system and policies focusing on risk factors and regions to manage the increasing T2DM.

Factors associated with early age at menarche among Thai adolescents in Bangkok: A cross-sectional study.

BACKGROUND: The age at menarche in the Thai population has not been determined since 1997. This study recruited adolescents in Bangkok Metropolis to determine the age at menarche and its associations with health and socioeconomic status. METHODS: This cross-sectional study used a two-step stratified sampling strategy to recruit 1,020 female students, aged 10-16 years, from schools in Dusit district, Bangkok, Thailand. Self-reported data on age at menarche and social determinants of health were collected from participants and their parents. A trained research nurse collected anthropometric data. RESULTS: Mean age at menarche was 11.8 ± 1.0 years, and age at menarche was significantly correlated with year of birth (r = -0.4, p < 0.001). Students from schools that are part of Bangkok Metropolis had the lowest mean age at menarche. Participants born in 2000-2003 having their first period at < 11.8 years numbered 5.5 times (95% CI: 3.80-8.18) and 5.0 times (95% CI: 3.6-8.0) greater than those born in 1997-1999 by univariate and multivariate analysis, respectively. Year of birth significantly associated with age at menarche in univariate and multivariate analysis (p = 0.001). CONCLUSION: The mean age at menarche among female adolescents in Bangkok Metropolis was occurring earlier and was inversely associated with year of birth in this cohort. Only year of birth were associated with age at menarche in the multivariate regression models to adjust for potential confounders.

Age at menarche and performance intelligence quotients of adolescents in Bangkok, Thailand: a cross-sectional study.

BACKGROUND: The presence of an association between age at the onset of puberty and intelligence quotient (IQ) in young adolescents remains controversial. The aim of this study was to explore the association between age at menarche and performance IQ scores of young female adolescents in Bangkok, Thailand. METHODS: A cross-sectional study was conducted among 537 students aged 11-15 years attending primary and secondary schools in the Dusit district of Bangkok, Thailand. The participants were selected based on two-step stratified sampling. Age at menarche and health and socioeconomic status were determined using a self-report questionnaire completed by participants. Performance IQ scores were determined using the Standard Progressive Matrices intelligence test (Thai version) administered by registered clinical psychologists. RESULTS: Of the 537 participants, 0.4 had reached menarche at 8 years of age, 1.9 at 9 years, 10.1 at 10 years, 36.1 at 11 years, 37.6 at 12 years, 10.4 at 13 years, 3.4 at 14 years, and 0.2 % at 15 years. Age at menarche was inversely correlated with performance IQ (Pearson correlation -0.087, p = 0.047). The regression equation predicting performance IQ by age at menarche was performance IQ = 128.06 - 1.16*age at menarche (R (2) = 0.008). In univariate analysis, performance IQ was inversely correlated with age at menarche, body mass index (BMI), time spent watching television, and time sleeping, but was directly correlated with maternal age at birth (all p < 0.05). In multivariate analysis, age at menarche and BMI remained significantly inversely correlated with performance IQ (p < 0.05), while maternal age at birth was directly correlated with performance IQ. The model consisting of age at menarche, BMI, and maternal age at birth best predicted performance IQ. CONCLUSION: After adjusting for confounders, multiple regression analysis showed that age at menarche and BMI of young female adolescents living in the Dusit district of Bangkok, Thailand, were inversely correlated with performance IQ, whereas maternal age at birth was directly correlated with performance IQ.