Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 912
Filter
1.
Diabetol Metab Syndr ; 13(1): 143, 2021 Dec 07.
Article in English | MEDLINE | ID: mdl-34876211

ABSTRACT

BACKGROUND: This study aims to examine the cross-sectional association between serum total bilirubin (STB) and type 2 diabetes (T2D) risk in the general population, and whether obesity could moderate this association. METHODS: We used data from the 1999-2018 National Health and Nutrition Examination Surveys (NHANES), including a total of 38,641 US adult participants who were 18 years or older. The STB was classified as the low, moderate, and high groups according to tertiles. RESULTS: We found that participants with lower STB had a significantly higher risk of T2D than those with moderate (OR = 0.81; 95% CI 0.74, 0.89; P < 0.001) and high (OR = 0.65; 95% CI 0.59, 0.73; P < 0.001) STB. Also, a significant interaction between body mass index (BMI) and STB on T2D was observed (P < 0.001). Stratified analysis showed that low STB was associated with a 20% and 27% decrease of T2D risk for moderate and high STB groups in obese patients, however, these effect estimates were smaller in the population with lower BMI (< 30 kg/m2). Similar associations of STB with glycohemoglobin and insulin resistance were observed. CONCLUSION: This study suggests that STB is associated with an elevated risk of T2D. More importantly, we reported for the first time that BMI may moderate the association between bilirubin and T2D.

2.
Article in English | MEDLINE | ID: mdl-34877881

ABSTRACT

BACKGROUND: Excessive weight gain associated with integrase strand transfer inhibitor (InSTI) antiretrovirals is an emerging issue, however, the metabolic consequences of this effect have not been established. Our objective was to evaluate for InSTI-emergent weight gain and potential associated type 2 diabetes mellitus (T2DM) amongst a diverse HIV patient cohort. METHODS: For this retrospective cohort study, we obtained clinical warehouse data for HIV+ patients between fiscal years 2007-17. We compared patients initiated on an InSTI to those started on an alternate regimen. Our primary outcome was percentage weight change from baseline at 24-months post-initiation using linear mixed effects model fit by restricted maximum likelihood (REML). Our secondary outcome was incident T2DM as defined by new prescription for antihyperglycemic medication within 18 months after ART start. Diabetes-free survival was estimated using Kaplan-Meier method, log-rank test, and Cox proportional-hazards model. RESULTS: The cohort included 1235 individuals initiating ART, 136 (11.0%) with an InSTI. InSTI use in women was significantly associated with greater weight gain compared to non-InSTIs (11.0%, 95% CI 5.22-16.8% p < 0.01) after adjusting for potential confounding variables. InSTI use was associated with more incident T2DM diagnoses compared to non-InSTI regimens (unadjusted hazard ratio = 3.27, p = 0.01) though incident T2DM was not associated with weight gain. CONCLUSION: InSTIs were significantly associated with weight gain among females. We also observed an increased risk of incident DM amongst both sexes, however, unrelated to weight changes. Further prospective studies will be necessary to confirm this finding and investigate its mechanism.

3.
World J Gastroenterol ; 27(41): 7065-7079, 2021 Nov 07.
Article in English | MEDLINE | ID: mdl-34887628

ABSTRACT

Coronavirus disease 2019 (COVID-19) is a disease produced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and it is currently causing a catastrophic pandemic affecting humans worldwide. This disease has been lethal for approximately 3.12 million people around the world since January 2020. Globally, among the most affected countries, Mexico ranks third in deaths after the United States of America and Brazil. Although the high number of deceased people might also be explained by social aspects and lifestyle customs in Mexico, there is a relationship between this high proportion of deaths and comorbidities such as high blood pressure (HBP), type 2 diabetes, obesity, and metabolic syndrome. The official epidemiological figures reported by the Mexican government have indicated that 18.4% of the population suffers from HBP, close to 10.3% of adults suffer from type 2 diabetes, and approximately 36.1% of the population suffers from obesity. Disbalances in the gut microbiota (GM) have been associated with these diseases and with COVID-19 severity, presumably due to inflammatory dysfunction. Recent data about the association between GM dysbiosis and metabolic diseases could suggest that the high levels of susceptibility to SARS-CoV-2 infection and COVID-19 morbidity in the Mexican population are primarily due to the prevalence of type 2 diabetes, obesity, and metabolic syndrome.

4.
Rev Diabet Stud ; 17(2): 68-74, 2021 Nov 01.
Article in English | MEDLINE | ID: mdl-34852897

ABSTRACT

BACKGROUND: Much evidence is available on the relationship between type 2 diabetes mellitus (T2D) and obesity, but less on T2D in lean individuals. AIM: This study was conducted in 12,069 T2D patients from northern India to find out which clinical and biochemical features are related to lean, normal weight, and overweight/obese T2D patients. METHODS: The study was conducted at two endocrine clinics in northern India as a retrospective cross-sectional study. The records of all patients who attended these clinics from January 2018 to December 2019 were screened. After screening 13,400 patients, 12,069 were labelled as type 2 diabetes mellitus according to the criteria of the American Diabetes Association, 2020, and were included in the study. The patients were subdivided into the three groups by their body mass index (BMI): lean (BMI < 18), normal weight (BMI = 18-22.9), overweight/obese (BMI ≥ 23). The study evaluated how the three subgroups responded to standard diabetes management, including antidiabetic medication and lifestyle interventions. RESULTS: Of a total of 12,069 patients 327 (2.7%) were lean, 1,841 (15.2%) of normal weight, and 9,906 (82.1%) overweight/obese. Lean patients were younger, but had more severe episodes of hyperglycemia. All three subgroups experienced significant improvements in glycemic control during follow-up; HbA1c values were significantly lowered in the overweight/obese group during follow-up compared with baseline. CONCLUSIONS: While overweight/obese patients could benefit from the improvements in glycemic control achieved by lowering HbA1c, lean and normal-weight patients had more severe and difficult-to-control hyperglycemia.

5.
J Diabetes Complications ; : 108082, 2021 Nov 05.
Article in English | MEDLINE | ID: mdl-34865986

ABSTRACT

AIM: To identify family background characteristics and cardiovascular disease (CVD) risk factors linked to overweight and obesity in Brazilian with type 1 diabetes (T1D). METHODS: We performed cross-sectional anthropometric and laboratory analyses in young individuals with T1D. RESULTS: Among 181 participants, 87 were women and 94 were men (64%/78% normal weight, 27%/15% overweight and 9%/7% obese). Obese men were older; were more likely to be Black; had higher triglyceride levels and diastolic blood pressure (BP), lower estimated glucose disposal rate (eGDR) and higher prevalence of first-degree relatives (FDR) with hypertension and early CVD. Overweight and obese women were more likely to have lower eGDR, and obese women were more likely to have FDR with obesity. CONCLUSION: One third of young people with T1D were overweight or obese. Excess weight was associated with family history (FH) of obesity for women and FH of early CVD or hypertension for men. BMI was related to decreased insulin sensitivity in both genders, but only men with T1D had metabolic impairment. Our data highlight the importance of considering family background in individuals with T1D.

6.
Surg Obes Relat Dis ; 2021 Oct 18.
Article in English | MEDLINE | ID: mdl-34866016

ABSTRACT

BACKGROUND: The prevalence of obesity in type 1 diabetes has been increasing over the past decades. Multiple studies have demonstrated suboptimal outcomes with dietary control and medical management for obesity and type 2 diabetes. This study's objective was to evaluate insulin and diabetic medication requirements in patients with type 1 diabetes 2 years after bariatric surgery. METHODS: This was a retrospective medical-record review study from 2002 to 2019 at Geisinger Health System. Of 4549 total bariatric surgeries, 38 bariatric surgery patients were confirmed to have type 1 diabetes. Type 1 diabetes was confirmed by medical-record review and/or the presence of C-peptide <5 ng/mL. RESULTS: The patient cohort had a mean age of 41 years, with 87% being female. The mean body mass index was 43.0 kg/m2, with a mean HbA1C of 8.4% before surgery. During follow-up, the insulin requirements improved from 114 units preoperatively to 60 units at 1 year postoperatively (SD = 54.5, P = .0018) and 60 units at 2 years postoperatively (SD = 60.3, P = .0033). Though not significant, the number of patients on more than 1 diabetic medication decreased from 66% preoperatively to 53% 1 year postoperatively (P = .343) and 52% at 2 years (P = .149). CONCLUSION: This study demonstrated significant improvement in the insulin and total number of diabetic medication requirements after bariatric surgery, suggesting that bariatric surgery may be a viable treatment for patients with type 1 diabetes.

7.
Front Cardiovasc Med ; 8: 736073, 2021.
Article in English | MEDLINE | ID: mdl-34869638

ABSTRACT

Objective: Individuals with both hypertension and diabetes have been confirmed to significantly increase the risk of cardiovascular disease morbidity and mortality compared with those with only hypertension or diabetes. This study aimed to evaluate the potential of different anthropometric indices for predicting diabetes risk among hypertensive patients. Methods: The study group consisted of 6,990 hypertensive adults without diabetes who were recruited in China. Demographic and clinical assessment, physical examinations, laboratory tests, and anthropometric measurements, including body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and novel indices (ABSI, AVI, BAI, BRI, CI, WWI, and WHHR), were performed at baseline and during the (median) 3-year follow-up. Cox regression analyses were conducted to estimate effects from these indices for the onset of diabetes. Receiver operator characteristic (ROC) analyses were conducted to assess the predictive capacities of the anthropometric indices and determine the optimal cut-points. Results: A total of 816 (11.7%) developed diabetes during our prospective study. Multivariate Cox regression analyses revealed weight, WC, WHR, WHtR, BAI, BRI, and WWI as the independent risk factor for diabetes among hypertensive patients, regardless of whether it was treated as a continuous or categorical variable (P < 0.05). Further Cox analyses combining BMI and different central obesity indices showed that elevated WC, WHR, WHtR, AVI, BRI, CI, regardless of the general obesity status, were found to be each independently associated with increased diabetes risk (P < 0.05). Dynamic increases of BRI < 5.24 to BRI ≥ 5.24 were associated with increased risk (HR = 1.29; 95% CI, 1.02, 1.64), and its reversal was associated with reduced risk (HR = 1.56; 95% CI, 1.23, 1.98) compared with the others (HR = 1.95; 95% CI, 1.63, 2.32). ROC analysis indicated that the areas under the ROC curves (AUC) of the anthropometric indices ranged from 0.531 to 0.63, with BRI (cut-off value = 4.62) and WHtR having the largest area. Conclusions: Based on this novel study, BRI was the most superior predictor and independent determinant for diabetes onset among the hypertensive population. Hypertensive patients with BRI > 4.62, regardless of general obesity status, were at high risk of diabetes. Thus, the prompt screening and diagnosis of diabetes should be carried out among these patients for timely integrated intervention.

8.
Endocrinol Diabetes Nutr (Engl Ed) ; 68(8): 527-533, 2021 Oct.
Article in English | MEDLINE | ID: mdl-34872635

ABSTRACT

INTRODUCTION: The prevalence of type 2 diabetes mellitus (T2DM) is increasing among young people worldwide. The American Diabetes Association has defined the risk factors that are associated with this increased risk for developing T2DM in youths. OBJECTIVE: To explore school children at high-risk for T2DM in Jordan. MATERIALS AND METHODS: A descriptive cross-sectional study was conducted. The children were 10-14.9 years old. Weight, height, and waist circumference were measured, and the body mass index Z score (BMI) was determined. The waist to height ratio (WHtR) was calculated. Blood pressure was measured and three child́s risk factors were identified. RESULTS: Eight hundred and seventy-one schoolchildren were screened; 26.0% were overweight and 19.3% were obese. The most common risk factor among overweight and obese children, accounting for 80.4%, was a positive family history of type 2 diabetes mellitus in first- or second-degree relatives. Children born to mothers with diabetes or gestational diabetes mellitus during the child's gestation represented 17.3%, and around 26.8% were found to have hypertension (stage 1 or 2). In relation to the risk factors, 12.6% presented no risk factors; 54.0% had at least one factor; 29.1% two risk factors and 4.3% had three risk factors. CONCLUSION: Risk factors for T2DM are very common. Around 54% had one risk factor. Strategies aimed at reducing risk factors for T2DM, especially obesity, among Jordanian school children are urgently needed.

9.
Eur J Endocrinol ; 2021 Dec 01.
Article in English | MEDLINE | ID: mdl-34874895

ABSTRACT

OBJECTIVES: To prospectively assess the association of metabolic health status and its transition with incident diabetes risk across body mass index (BMI) categories. DESIGN: Cohort study based on the China Kadoorie Biobank (CKB) Methods: The CKB study enrolled 512,715 adults aged 30-79 years from 10 diverse areas in China during 2004-2008. After exclusion, 432,763 participants were cross-classified by BMI categories and the metabolic status during followed-up for incident diabetes disease. The changes in BMI and metabolic health status were defined from baseline to the second resurvey. RESULTS: Type 2 diabetes risk is higher for metabolically healthy obese (MHO) subjects than metabolically healthy normal weight (MHN) individuals (HR: 3.97, 95% CI: 3.64-3.66), and it is highest for those affected by metabolically healthy obese (MUO) (HR: 6.47, 95% CI: 6.17-6.79). About 15.26% of participants with MHN converted to metabolically healthy overweight or obesity (MHOO), whereas 48.40% of MHOO remained unconverted throughout the follow-up. In obese or overweight people, the conversion from metabolically healthy to unhealthy might increase the chances of developing diabetes as compared to those with a stable metabolic healthy state (HR: 3.70, 95% CI: 2.99-4.59), while those with persistent metabolic disorders are most likely to have diabetes (HR: 8.32, 95% CI: 7.08-9.78). CONCLUSIONS: Metabolic healthy is a transient state, and individuals converted from metabolically healthy status to unhealthy phenotypes across all BMI categories might raise the risk of diabetes.

10.
Diabetes Care ; 2021 Dec 08.
Article in English | MEDLINE | ID: mdl-34880065

ABSTRACT

OBJECTIVE: We examined lifestyle factors with midlife weight change according to history of gestational diabetes mellitus (GDM) in a large longitudinal female cohort. RESEARCH DESIGN AND METHODS: In the Nurses' Health Study II, we categorized changes in lifestyle within 4-year periods and estimated their associations with concurrent changes in body weight (kilograms) among parous women after age 40 years by GDM history status (N = 54,062; 5.3% with a history of GDM) for the following: diet quality (Alternate Healthy Eating Index [AHEI]), leisure-time physical activity (PA), alcohol consumption, and smoking status. RESULTS: Over a median follow-up of 13 years, average 4-year weight gain was 1.10 and 1.33 kg for women with and without prior GDM, respectively. Women with improved diet quality had favorable 4-year weight change, particularly those with a history of GDM (AHEI change [95% CI] from low to high -2.97 kg [-4.34, -1.60] vs. -1.19 kg [-1.41, -0.96] for GDM vs. non-GDM, respectively; P heterogeneity = 0.04). Increasing PA was associated with weight maintenance for GDM women only (PA increase [95% CI] from low to high 0.26 kg [-0.25, 0.77] vs. 0.90 kg [0.80, 1.01] for GDM vs. non-GDM, respectively; P heterogeneity = 0.02). For both GDM and non-GDM women, weight change did not differ significantly with change in alcohol consumption, while women who quit smoking had significant weight gain (4.38 kg for GDM and 3.85 kg for non-GDM). CONCLUSIONS: Improvements in diet quality and PA were related to less weight gain in midlife among parous women, and the benefit of such improvements on weight management was particularly pronounced among women with a history of GDM.

11.
Diabetes Metab Syndr Obes ; 14: 4691-4703, 2021.
Article in English | MEDLINE | ID: mdl-34880638

ABSTRACT

Purpose: We aimed to investigate whether urine uric acid excretion (UUAE) levels are associated with obesity and abdominal obesity in patients with type 2 diabetes (T2D). Methods: There were 2785 type 2 diabetic patients in this cross-sectional study. Obesity was defined as BMI ≥ 25 kg/m2, and abdominal obesity was defined as waist circumference (WC) ≥90 cm for men and WC ≥ 80 cm for women based on World Health Organization (WHO) recommendations for Asians. Chronic kidney disease (CKD) was defined as the estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m2 and/or urinary albumin excretion (UAE) ≥300 mg/24h. 24-h UUAE was determined enzymatically using a single 24-hour urine collection. All the subjects were stratified into quartiles based on UUAE levels. Both obesity and abdominal obesity were compared among the UUAE quartile groups, respectively. Furthermore, the associations of UUAE with obesity and abdominal obesity were analyzed in both CKD and non-CKD patients, respectively. Results: There was an obvious increased trend in both obesity prevalence (36.2%, 41.5%, 46.3%, and 63.4%, respectively, p < 0.001 for trend) and abdominal obesity prevalence (58.1%, 61.2%, 64.7%, and 75.8%, respectively, p < 0.001 for trend) in patients with T2D across the UUAE quartiles after controlling for age, sex and diabetes duration. Multiple logistic regression analyses revealed independent associations between UUAE quartiles and obesity (p < 0.001) and abdominal obesity (p < 0.001) in all patients. However, UUAE was significantly associated with obesity and abdominal obesity only in the T2D patients without CKD (p < 0.001 in model 1, model 2, model 3 and model 4, respectively). Conclusion: Increased UUAE levels were significantly associated with the presence of obesity, especially abdominal obesity in T2D patients without CKD.

12.
J Clin Med ; 10(23)2021 Nov 30.
Article in English | MEDLINE | ID: mdl-34884364

ABSTRACT

BACKGROUND AND AIM: Heart failure (HF) is a clinical syndrome associated with poor quality of life and prognosis, and premature mortality. The aim of this study was to assess the prevalence of depression and its risk factors in HF patients. METHODS: The study included 151 HF patients (mean age of 66.6 ± 11 years, 52.3% female). Based on ejection fraction (EF), the study cohort was divided into the following two groups: group-I: HFpEF patients (EF ≥ 50%, n = 47) and group-II: HFrEF patients (EF < 40%, n = 104). For the enrolled patients, demographic, clinic and echocardiographic indices, and depression scale results were collected. RESULTS: The patients with HF and depression were older, mostly females, more obese, and had a higher glycemic level and higher NYHA functional class compared with the patients without depression (p < 0.05 for all). The left ventricle (LV) and left atrial (LA) dimensions were larger, and EF was lower, in patients with depression compared to those without depression (p < 0.05 for all), while the right ventricle (RV) measurements did not differ (p > 0.05). The same parameters remained significantly different when the patients were divided into HFpEF and HFrEF. The depression scale correlated with glycemic level (r = 0.51, p = 0.01), obesity (rpb = 0.53, p = 0.001), age (r = 0.47, p = 0.02), and severity of NYHA class (rpb = 0.54, p = 0.001). On a multivariate model, BMI ≥ 30 kg/m2, OR 1.890 (1.199 to 3.551; 0.02) glycemic level ≥ 8.5 mmol/L, OR 2.802 (1.709 to 5.077; p = 0.01), and NYHA class > 2, OR 2.103 (1.389 to 4.700; p = 0.01), proved to be the most powerful independent predictors of depression, in the group as a whole. Obesity and uncontrolled diabetes predicted depression, irrespective of EF. CONCLUSIONS: In this modest cohort of HF patients, obesity and uncontrolled diabetes were independent predictors of depression, irrespective of LV systolic function. This emphasizes the important role of medical education for better control of such risk factors.

13.
J Am Coll Cardiol ; 78(24): 2471-2482, 2021 Dec 14.
Article in English | MEDLINE | ID: mdl-34886969

ABSTRACT

Obesity and type 2 diabetes mellitus are highly prevalent and increasing in the United States among racial/ethnic minority groups. Type 2 diabetes mellitus, which is driven by many factors including elevated levels of adiposity, is an exemplar health disparities disease. Pervasive disparities exist at every level from risk factors through outcomes for U.S. racial/ethnic minority groups, including African American, Hispanic/LatinX American, and Asian American populations. Disparities in clinical care exist including hemoglobin A1c control, lower prescription rates of newer antihyperglycemic medications, along with greater rates of complications postbariatric surgery. Underpinning these disparities are the social determinants of health affecting provider-patient interactions, access to resources, and healthy built environments. We review the best practices to address cardiometabolic disparities in the current cardiovascular guidelines and describe recommendations for cross-cutting strategies to advance equity in obesity and type 2 diabetes across U.S. racial/ethnic groups.

14.
Circulation ; 2021 Dec 03.
Article in English | MEDLINE | ID: mdl-34860539

ABSTRACT

BACKGROUND: Obesity and diabetes are associated with a higher risk of heart failure (HF). The inter-relationships between different measures of adiposity-overall obesity, central obesity, fat mass (FM)-and diabetes status for HF risk are not well-established. METHODS: Participant-level data from ARIC(visit-5) and CHS(visit-1) cohorts were obtained from the NHLBI BioLINCC, harmonized, and pooled for the present analysis, excluding individuals with prevalent HF. FM was estimated in all participants using established anthropometric prediction equations additionally validated using the bioelectrical impedance-based FM in the ARIC subgroup. Incident HF events on follow-up were captured across both cohorts using similar adjudication methods. Multivariable-adjusted Fine-Gray models were created to evaluate the associations of body mass index (BMI), waist circumference (WC), and FM with risk of HF in the overall cohort as well as among those with vs. without diabetes at baseline. The population attributable risk of overall obesity (BMI≥30 kg/m2), abdominal obesity (WC>88 and 102 cm in women and men, respectively), and high FM (above sex-specific median) for incident HF was evaluated among participants with and without diabetes. RESULTS: The study included 10,387 participants (52.9% ARIC; 25.1% diabetes; median age: 74 years). The correlation between predicted and bioelectrical impedance-based FM was high (R2=0.90; n=5,038). Over a 5-year follow-up, 447 participants developed HF (4.3%). Higher levels of each adiposity measure were significantly associated with higher HF risk (HR [95% CI] per 1-SD higher BMI=1.19[1.09-1.31], WC=1.27[1.14-1.41]; FM=1.17[1.06-1.29]). A significant interaction was noted between diabetes status and measures of BMI (p-interaction=0.04) and WC (p-interaction=0.004) for the risk of HF. In stratified analysis, higher measures of each adiposity parameter were significantly associated with higher HF risk in individuals with diabetes (HR[95% CI] per 1-SD higher BMI=1.29[1.14-1.47], WC=1.48[1.29-1.70]; FM=1.25[1.09-1.43]) but not those without diabetes, including participants with prediabetes and euglycemia. The population attributable risk percentage of overall obesity, abdominal obesity, and high FM for incident HF was higher among participants with diabetes (12.8%, 29.9%, 13.7%, respectively) vs. those without diabetes (≤1% for each). CONCLUSIONS: Higher BMI, WC, and FM are strongly associated with greater risk of HF among older adults, particularly among those with prevalent diabetes.

15.
Article in English | MEDLINE | ID: mdl-34893411

ABSTRACT

BACKGROUND AND AIMS: To compare biventricular and biatrial myocardial strain indices assessed by two-dimensional speckle tracking echocardiography (2D-STE) in women with gestational diabetes mellitus (GDM) and those with uncomplicated pregnancy at the third trimester of pregnancy and in post-partum. METHODS AND RESULTS: 30 consecutive GDM women and 30 age-, ethnicity- and gestational week-matched controls without any comorbidity were examined in this prospective case-control study. All women underwent obstetric visit, blood tests and transthoracic echocardiography (TTE) implemented with 2D-STE analysis of all cardiac chambers at 36-38 weeks' gestation. TTE and 2D-STE were repeated at 6-10 weeks after delivery. At 36-38 weeks' gestation, GDM women, compared to controls, had significantly higher body mass index (BMI), blood pressure values and inflammatory markers. TTE showed increased left ventricular (LV) mass and impaired LV diastolic function in GDM women, whereas there was no significant difference between the groups in ejection fraction. 2D-STE revealed that biventricular global longitudinal strain (GLS) and biatrial reservoir strain indices were significantly lower in GDM women than controls. Third trimester BMI was inversely correlated with LV-GLS (r = -0.86) and was independently associated with reduced LV-GLS (less negative than -20%) in GDM women in post-partum (OR 1.81, 95%CI 1.14-2.89). A BMI value ≥ 30 kg/m2 had 100% sensitivity and 99.5% specificity for identifying GDM women with impaired LV-GLS in post-partum (AUC = 0.97). CONCLUSION: Women with GDM, compared to women with uncomplicated pregnancy, have significantly lower biventricular and biatrial myocardial deformation indices. These abnormalities may be persistent in post-partum in GDM women with obesity.

16.
Int J Hyg Environ Health ; 240: 113886, 2021 Dec 02.
Article in English | MEDLINE | ID: mdl-34864598

ABSTRACT

Environmental pollutants have been known to increase the risks of not only respiratory and cardiovascular disease but also metabolic diseases such as obesity and diabetes mellitus (DM). Polycyclic aromatic hydrocarbons (PAHs) and volatile organic compounds (VOCs) such as benzene and toluene are major constituents of environmental pollution. In the present study, we employed the population of the Korean National Environmental Health Survey (KoNEHS) Cycle 3 conducted between 2015 and 2017, and assessed the associations of urinary biomarkers for PAHs and VOCs exposure with obesity and DM. A total of 3787 adult participants were included and the urinary concentrations of four PAH metabolites and two VOC metabolites were measured. For correcting urine dilution, a covariate-adjusted standardization method was used. The highest quartiles of urinary 2-hydroxynaphthalene (2-NAP) [OR (95% confidence interval (CI)) = 1.46 (1.13, 1.87)] and sum of PAH metabolites [OR (95% CI) = 1.45 (1.13, 1.87)] concentrations were associated with a higher risk of obesity [body mass index (BMI)≥25 kg/m2]. BMI was positively associated with urinary 2-NAP [ß (95% CI) = 0.25 (0.09, 0.41), p = 0.003] and sum of PAH metabolites [ß (95% CI) = 0.29 (0.08, 0.49), p = 0.006] concentrations. The risk of DM was increased with increasing quartile of 2-hydroxyfluorene (2-OHFlu) and trans, trans-muconic acid (t,t-MA) (p for trend<0.05 and < 0.001, respectively). The highest quartile of t,t-MA showed a significantly higher risk of DM [OR (95% CI) = 2.77 (1.74, 4.42)] and obesity [OR (95% CI) = 1.42 (1.06, 1.90)]. Urinary t,t,-MA level was positively associated with BMI [(ß (95% CI) = 0.51 (0.31, 0.71), p < 0.001] and non-alcoholic fatty liver disease index [(ß (95% CI) = 0.09 (0.06, 0.12), p < 0.001]. In conclusion, the benzene metabolites t,t-MA and PAH metabolite 2-OHFlu were associated with an increased risk of DM. Urinary biomarkers for PAHs and VOCs were positively associated with BMI in the Korean adult population. Further studies to validate these observations in other populations are warranted.

17.
Washington, D.C.; PAHO; 2021-12-08. (PAHO/NMH/NV/21-0041).
in English | PAHO-IRIS | ID: phr-55326

ABSTRACT

Diabetes is a major public health problem in the Americas and worldwide, demanding special attention and integrated response. It is estimated that more than 62 million adults are living with diabetes in the Americas. The projections show that diabetes prevalence will continue to increase to at least 2025. Its steady rise has been mainly due to the high prevalence of risk factors, especially overweight/obesity and physical inactivity. Diabetes also is one of the leading causes of mortality and disability worldwide and across our Region. Moreover, its disability complications generate poor quality of life for people living with diabetes. This scorecard provides rapid visualization of the status of diabetes, its risk factors, and the response capacity of the countries. Showing the age-standardized prevalence of raised fasting blood glucose/diabetes, overweight/obesity, physical inactivity, and raised blood pressure in adults. It also includes crude estimates prevalence of overweight/obesity in adolescents. The data is shown by sex, country, and the regional mean. It also presents the diabetes deaths for countries in the Americas region, including information on the age-standardized per 100,000 population death rates and population disability-adjusted life year (DALY) due to diabetes. The data are from the World Health Organization (WHO) estimates (Global Health Estimates (2010,2016) to ensure the comparison between countries and with previous country data. This tool also includes a summary of the country’s health system response to diabetes, including national plans, targets, surveillance, guidelines, and access to essential drugs and technologies from the WHO Capacity Country Survey 2019. This tool highlighted the ten countries with the highest values for the prevalence of raised fasting blood glucose/ diabetes, overweight/obesity, physical inactivity, raised blood pressure, and age-standardized mortality and DALYs rates from diabetes. It also shows the relative change in the prevalence of diabetes and risk factors between 2010 and the latest year available for comparable estimates. Its purpose is to build awareness of the need to prevent and control diabetes and strengthen strategies and interventions by countries that address the challenge that diabetes implies.


Subject(s)
Diabetes Mellitus , Blood Glucose , Overweight , Obesity , Blood Pressure , Risk Factors , Access to Essential Medicines and Health Technologies , Americas
18.
Andrology ; 2021 Nov 29.
Article in English | MEDLINE | ID: mdl-34842357

ABSTRACT

BACKGROUND: The causal effects of individual risk factors of metabolic syndrome on erectile dysfunction (ED) are still unclear OBJECTIVES: To evaluate the causal effect of risk factors of metabolic syndrome on ED through Mendelian randomization (MR). MATERIALS AND METHODS: Data for risk factors were obtained from multiple databases with 173,082 to 757,601 individuals, and that for ED were collected from a genome-wide association study including 223,805 Europeans. We performed univariate MR analysis using inverse-variance weighted, MR-Egger, weighted-median, weighted mode methods and multivariable MR analysis to evaluate the total and direct causal effects. RESULTS: The univariable MR supported that type 2 diabetes mellitus (T2D) (OR = 1.14, 95% CI: 1.08-1.21, p < 0.001) and body mass index (BMI) (OR = 1.27, 95% CI: 1.12-1.44, p < 0.001) were associated with ED. After excluding the SNPs associated with BMI and other risk factors, the results of multivariable MR for T2D (OR = 1.15, 95% CI: 1.05 -1.25, p = 0.001) remained consistent. However, the results of multivariable MR provided limited evidence for the causality between BMI and ED (OR = 1.06, 95% CI: 0.88 -1.29, p = 0.532). For systolic blood pressure and lipid components (low-density lipoprotein, high-density lipoprotein and triglycerides), both univariable and multivariable MR failed to offer sufficient evidence to confirm their causal effect on ED. DISCUSSION AND CONCLUSION: T2D showed a direct causal effect on ED independent of obesity and dyslipidemia. This article is protected by copyright. All rights reserved.

19.
J Diabetes Investig ; 2021 Nov 30.
Article in English | MEDLINE | ID: mdl-34845867

ABSTRACT

AIMS/INTRODUCTION: We investigated the association between gestational diabetes mellitus (GDM) and perinatal outcomes stratified by pre-pregnancy body mass index (BMI) and/or gestational weight gain (GWG). MATERIALS AND METHODS: Data from the national birth cohort in the Japan Environment and Children's Study from 2011 to 2014 (n = 85,228) were used. Japan uses GDM guidelines of the International Association of Diabetes and Pregnancy Study Groups. The odds ratios (ORs) of perinatal outcomes were compared between women with and those without GDM. RESULTS: The OR (95% confidence interval [CI]) of having an SGA infant in the GDM group with a pre-pregnancy BMI of ≥25.0 kg/m2 and insufficient GWG (<2.75 kg) was 1.78 (1.02-3.12). The OR of having a large-for-gestational-age (LGA) infant of same BMI group with excessive GWG (>7.25 kg) was 2.04 (1.56-2.67). The OR of hypertensive disorders of pregnancy (HDP) was higher in women with a BMI ≥18.5 kg/m2 in the GDM group than in the non-GDM group. CONCLUSIONS: LGA and HDP were associated with pre-pregnancy BMI and GWG in either normal weight or overweight/obese women, and the relationship was strengthened when GDM was present. Women with GDM and a BMI of ≥25.0 kg/m2 are at risk of having SGA and LGA infants depending on GWG.

20.
Diabetes Metab J ; 45(6): 799-812, 2021 Nov.
Article in English | MEDLINE | ID: mdl-34847640

ABSTRACT

Rates of obesity and diabetes have increased significantly over the past decades and the prevalence is expected to continue to rise further in the coming years. Many observations suggest that obesity and diabetes are associated with an increased risk of developing several types of cancers, including liver, pancreatic, endometrial, colorectal, and post-menopausal breast cancer. The path towards developing obesity and diabetes is affected by multiple factors, including adipokines, inflammatory cytokines, growth hormones, insulin resistance, and hyperlipidemia. The metabolic abnormalities associated with changes in the levels of these factors in obesity and diabetes have the potential to significantly contribute to the development and progression of cancer through the regulation of distinct signaling pathways. Here, we highlight the cellular and molecular pathways that constitute the links between obesity, diabetes, cancer risk and mortality. This includes a description of the existing evidence supporting the obesity-driven morphological and functional alternations of cancer cells and adipocytes through complex interactions within the tumor microenvironment.

SELECTION OF CITATIONS
SEARCH DETAIL
...