Asthma Prevalence and its Risk Factors Among a Multi-Ethnic Adult Population.

Asthma is a substantial global health problem characterized by chronic airway inflammation, leading to intermittent symptoms. This study aims to establish the prevalence and risk factors of asthma in a multi-ethnic adult population. Data for the study were extracted from the Singapore Mental Health Study 2016, a population-based, cross-sectional, epidemiological study of Singapore residents aged 18 years and above. The data relating to asthma prevalence was captured using the modified World Mental Health Composite International Diagnostic Interview (CIDI) version 3.0 chronic conditions checklist. The prevalence of lifetime asthma in this population was 11.9% (95% CI, 10.83-13.12). Those of Malay and Indian ethnicity (versus Chinese), ex-smokers (versus never smoked) and those who were overweight and obese (versus normal weight) were more likely to be associated with asthma. Participants belonging to the age group of 35 years and above (versus 18-34 years of age), male gender (versus female) were less likely to be associated with lifetime asthma. Asthma was also more likely to be associated with bipolar disorder. Those with current asthma (ie, those who had received treatment during the past 12 months) were significantly associated with lower health-related quality of life in the physical component score (PCS) than those without asthma. The high prevalence and association with lowered health-related quality of life makes asthma a significant public health concern. Our study's findings can help create awareness and encourage integrated approaches for managing asthma in the health sector.

Arterial Stiffness Modulates the Association of Resting Heart Rate With Rapid Renal Function Decline in Individuals With Type 2 Diabetes Mellitus.

OBJECTIVE: Resting heart rate (RHR) has been associated with cardiovascular risk, but data on renal outcomes are still scarce. We aimed to study the association of RHR with rapid renal function decline (RRFD) and to explore whether the association of RHR with RRFD is modulated by arterial stiffness in individuals with type 2 diabetes mellitus. Approach and Results: One thousand one hundred forty-two Asian people with type 2 diabetes mellitus were followed for 3.9±0.9 years in a regional hospital and a primary care facility. RRFD was defined as eGFR decline of 5 mL/min per 1.73 m2 or greater per year. Arterial stiffness was assessed by carotid-femoral pulse wave velocity. One hundred sixty-eight participants (15%) were classified as having RRFD. Participants with elevated RHR were younger, had higher levels of HbA1c, albuminuria, C-reactive protein, and pulse wave velocity. Compared with the lowest quartile, participants in quartile 4 had a higher risk for RRFD after adjustment for known risk factors (adjusted odds ratio 1.91 [1.11-3.28]). RHR improved discrimination and net reclassification for prediction of RRFD above traditional risk factors. Remarkably, arterial stiffness modulated the association of RHR with RRFD (P for interaction =0.03). RHR was significantly associated with risk of RRFD only in those with increased arterial stiffness (pulse wave velocity above age-reference value 7.7 m/s). CONCLUSIONS: RHR independently predicts RRFD, and the association is modulated by arterial stiffness. An elevated heart rate may be one factor in the spectrum of cardiovascular risk factors associated with renal functional impairment, especially in those with type 2 diabetes mellitus and an increased arterial stiffness.

Leucine-rich α-2-glycoprotein predicts proliferative diabetic retinopathy in type 2 diabetes.

AIM: We aim to examine the association of plasma leucine-rich-α-2-glycoprotein 1 (LRG1) with diabetic retinopathy (DR) in type 2 diabetes. METHODS: At baseline visit, plasma LRG1 levels were assessed using ELISA. Central arterial stiffness was estimated by carotid-femoral pulse wave velocity (PWV). At follow-up visit (median = 3.2 years), digital color fundus photographs were assessed for DR. DR severity was categorized into non-proliferative DR (NPDR) and proliferative DR (PDR). RESULTS: DR was diagnosed in 396 (32.8%) of 1206 patients. DR has higher LRG1 than non-DR (19.5 ±â€¯11.3vs.16.9 ±â€¯8.9 µg/ml, p ≪ 0.001). After adjustment, LRG1 was not associated with DR (OR = 1.2, [95% CI, 0.96-1.30], p = 0.16). LRG1 was higher in PDR (n = 107) than NPDR (n = 270) (23.2 ±â€¯15.4vs.18.1 ±â€¯8.9 µg/ml, n = 270, p ≪ 0.001). After adjustment, with 1-SD increase in LRG1, the relative risk of NPDR and PDR was 0.99 ([0.83-1.18], p = 0.91) and 1.42 ([95% CI, 1.14-1.76], p = 0.002) (p-trend = 0.01), respectively. We didn't observe significant improvement in AUC after adding LRG1 into the model. Baseline PWV mediated 12.0% of the association between LRG1 and PDR (p = 0.03). CONCLUSION: Baseline plasma LRG1 is associated with PDR, suggesting it maybe a promising biomarker for prediction for advanced proliferative stages of DR. The mediation result indicates the potential benefit of ameliorating central arterial stiffness to prevent PDR.