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1.
Medicine (Baltimore) ; 98(44): e17736, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689819

RESUMO

To explore associated risk factors and their interactions with type 2 diabetes (T2DM) among the elderly with prediabetes in rural areas in China.A nested case-control study was conducted in a fixed cohort to identify the risk factors for T2DM among the elderly with prediabetes in rural areas of Yiyang City in China. A total of 37 elderly with T2DM were included in the cases group and 111 elderly subjects with prediabetes were matched in the control group. Data related to sociodemographic characteristics, lifestyle behavior, and anthropometric variables were collected by trained staff using standard tools. The risk factors for T2DM were determined using conditional logistic regression analysis, and their additive interactions were also explored.Multivariable conditional logistic regression analysis results showed that overweight/obesity (odds ratio [OR] = 4.80, 95% confidence interval [CI]: 1.20-12.28), family history of diabetes (OR = 3.63, 95% CI: 1.03-12.81), physically inactive (OR = 3.08, 95% CI: 1.14-8.30), high waist-to-hip ratio (WHR) (OR = 3.15, 95% CI: 1.27-7.80), and inadequate diabetes-specific health literacy (DSHL) (OR = 3.92, 95% CI: 1.14-13.48) increased the risk for T2DM. Additive interactions for T2DM were observed between a family history of diabetes and high WHR with a relative excess risk of interaction (RERI) of 10.02 (95% CI: 4.25, 15.78), and between high WHR and overweight or obesity, with an RERI of 3.90 (95% CI: 0.36, 7.44).The independent risk factors for T2DM are overweight or obesity, high WHR, family history of diabetes, physically inactive, and inadequate DSHL. High WHR as a risk factor for T2DM has additive interactions with family history of diabetes and overweight or obesity.


Assuntos
Diabetes Mellitus Tipo 2/etiologia , Estado Pré-Diabético/etiologia , População Rural/estatística & dados numéricos , Idoso , Antropometria , Estudos de Casos e Controles , China/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/fisiopatologia , Exercício , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Estado Pré-Diabético/epidemiologia , Estado Pré-Diabético/fisiopatologia , Risco , Fatores de Risco , Comportamento Sedentário , Relação Cintura-Quadril
2.
Pan Afr Med J ; 33: 322, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31692874

RESUMO

Introduction: Diabetic ketoacidosis (DKA) is a severe metabolic complication of diabetes. Recent years have seen a marked increase in prevalence of diabetic ketoacidosis, but mortality is low. This study aimed to describe the epidemiological, clinical, therapeutic and prognostic features of patients with severe or moderate DKA admitted to the Emergency Department. Methods: He conducted a prospective, descriptive study including patients with moderate or severe DKA. Standardized care protocol. We studied the epidemiological, clinical, therapeutic and prognostic features of these patients. Results: The study involved 185 patients with moderate or severe DKA. The average age of patients was 38+/-18 years, with a sex ratio of 0.94. Known diabetes was reported in 159 patients (85%) of whom 116 had type 1 diabetes. The most common factors of decompensation were treatment discontinuation in 42% and infection in 32%. Average blood glucose was 32.7+/-12 mmol/L, pH =7.14+/-0.13, HCO3- =7.2+/-3.56 mmol/L. The mean duration of intravenous insulin was 17.3 +/- 16 hours. Hypoglycaemia was reported in 26 patients (14%), hypokalemia in 80 (43%) patients and hyperchloraemic mineral acidosis in 43 patients (23%). Intrahospital mortality was 2.1%. Conclusion: Diabetic ketoacidosis occurs in young subjects treated with insulin therapy. Treatment is based on intravenous insulin associated with correction of fluid deficit. Complications mainly include hypokalemia and hypoglycemia and mortality is low.


Assuntos
Diabetes Mellitus Tipo 1/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Cetoacidose Diabética/epidemiologia , Insulina/administração & dosagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Glicemia/metabolismo , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/complicações , Cetoacidose Diabética/tratamento farmacológico , Serviço Hospitalar de Emergência , Feminino , Humanos , Hipoglicemia/epidemiologia , Hipoglicemia/etiologia , Hipoglicemiantes/administração & dosagem , Hipopotassemia/epidemiologia , Hipopotassemia/etiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto Jovem
3.
Orv Hetil ; 160(40): 1591-1602, 2019 Oct.
Artigo em Húngaro | MEDLINE | ID: mdl-31565976

RESUMO

Introduction: Liver cirrhosis (20-25%), hepatocellular carcinoma (1.5-3%), insulin resistance (30-40%) and type 2 diabetes (25-30%) are common complications in patients with chronic hepatitis C virus (HCV) infection; however, data are missing from Hungary. Aim: To determine the prevalence of diabetes and insulin resistance in Hungarian HCV patients; to evaluate treatment-induced metabolic changes in relation to diabetes/insulin resistance and virological response and to perform a sustained follow-up for hepatocellular carcinoma detection. Method: We enrolled 150 Hungarian HCV genotype 1 patients (mean age: 48.55 ± 8.55 years, male/female ratio: 45/55%) from 2007-2012. We analysed their baseline, week 12, and end of therapeutic follow-up (24 weeks after interferon-based therapy completion) laboratory data. We performed a 5-year follow-up (2012-2017). Results: The prevalence of insulin sensitivity, insulin resistance and diabetes was 37.4%, 35.3% and 27.3%, respectively. Insulin resistant and diabetic patients showed a decrease in fasting glucose from baseline to end of follow-up (5.47 ± 0.66 vs. 5.08 ± 0.60, p<0.001; 7.90 ± 2.67 vs. 7.04 ± 2.75, p = 0.006), as did both the sustained responder and non-responder groups. Treatment efficacy rate was poor in diabetic vs. insulin sensitive and insulin resistant groups (17% vs. 46% and 40%); insulin sensitivity was not a predictor of virological response. Three participants with diabetes were diagnosed with hepatocellular carcinoma during follow-up by regular ultrasound examinations. Conclusion: Hungarian HCV patients showed high prevalence of diabetes and insulin resistance, though antiviral therapy caused favourable changes in their carbohydrate metabolism. Antiviral therapy was less effective in diabetic patients. Follow-up ultrasound examinations are required for hepatocellular carcinoma in HCV patients, especially those with diabetes. Orv Hetil. 2019; 160(40): 1591-1602.


Assuntos
Antivirais/uso terapêutico , Glicemia/metabolismo , Carcinoma Hepatocelular/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Hepatite C Crônica/complicações , Hepatite C Crônica/terapia , Resistência à Insulina , Neoplasias Hepáticas/complicações , Adulto , Idoso , Complicações do Diabetes/terapia , Diabetes Mellitus Tipo 2/tratamento farmacológico , Feminino , Hepacivirus/efeitos dos fármacos , Hepatite C Crônica/tratamento farmacológico , Hepatite C Crônica/virologia , Humanos , Hungria/epidemiologia , Cirrose Hepática/complicações , Cirrose Hepática/epidemiologia , Neoplasias Hepáticas/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência
4.
Wei Sheng Yan Jiu ; 48(5): 723-727, 2019 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-31601311

RESUMO

OBJECTIVE: To investigate the prevalence and relevant factors of type 2 diabetes mellitus among urban and rural residents over 18 years old in Guizhou Province in 2010-2012. METHODS: A total of 3073 residents over 18 years old were sampled by multi-stage and stratified random cluster sampling in Guizhou Province from"2010-2012 Chinese nutrition and health surveillance", including 1576 people in urban areas and 1497 people in rural areas, 1362 males and 1711 females. The participants were investigated for their basic conditions, lifestyle and behavior, and physical indicators, blood pressure, blood glucose, TC, and TG were also measured, and then the prevalence was calculated. Multivariate analysis was performed using an unconditional logistic regression model. RESULTS: Among the 3073 residents aged 18 years and over in Guizhou Province, 151 were diagnosed with type 2 diabetes mellitus, with a prevalence of4. 9%, among which 80 were urban residents and 71 were rural residents, with a prevalence of 5. 1% and 4. 7%, respectively. There was no statistically significant difference between urban and rural areas( χ~2= 0. 183, P = 0. 669). Age was associated with type 2 diabetes mellitus, and the prevalence increased with age( χ_()~2= 55. 478, P =0. 001). The result of multivariate Logistic regression analysis showed that family history, abdominal obesity, hypertension, abnormal TC and abnormal TG all had statistically significant influences on the prevalence of type 2 diabetes mellitus( OR values were2. 377, 1. 721, 1. 666, 1. 619 and 1. 982, respectively, all P <0. 05). CONCLUSION: The prevalence of type 2 diabetes mellitus in residents aged 18 and over in Guizhou Province was lower than the national average level. The prevention of type 2 diabetes in Guizhou residents should be targeted at middle-aged and elderly people, people with family history, people with abdominal obesity, people with hypertension and dyslipidemia.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Adolescente , Adulto , Idoso , China/epidemiologia , Diabetes Mellitus , Feminino , Humanos , Hipertensão , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , População Rural , Inquéritos e Questionários
5.
Medicine (Baltimore) ; 98(39): e17298, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574854

RESUMO

Recently, studies have shown significant association between the rs2000999 polymorphism in the haptoglobin-encoding gene (HP) and low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC) levels, which are important risk factors for cardiovascular diseases. However, the association of rs2000999 with serum lipids in Latin American diabetic populations is still uncharacterized. Here, we analyzed the association of rs2000999 with TC, high-density lipoprotein cholesterol (HDL-C), and LDL-C levels in 546 Mexican adults with type 2 diabetes (T2D) and in 654 controls without T2D. In this observational case-control study we included adults from 4 centers of the Mexican Social Security Institute in Mexico City recruited from 2012 to 2015. TC, HDL-C, LDL-C, triglycerides (TG), and glucose levels were measured by an enzymatic colorimetric method. The variant rs2000999 was genotyped using TaqMan real time polymerase chain reaction. The percentage of Native-American ancestry showed a negative association with the rs2000999 A allele. In contrast, the rs2000999 A allele had a strong positive association with European ancestry, and to a lesser extent, with African ancestry. Linear regression was used to estimate the association between the variant rs2000999 and lipid concentrations, using different genetic models. Under codominant and recessive models, rs2000999 was significantly associated with TC and LDL-C levels in the T2D group and in controls without T2D. In addition, the group with T2D showed a significant association between the variant and HDL-C levels. In summary, the rs2000999 A allele in Mexican population is positively associated with the percentage of European and negatively associated with Native American ancestry. Carriers of the A allele have increased levels of TC and LDL-C, independently of T2D diagnosis, and also increased concentrations of HDL-C in the T2D sample.


Assuntos
Doenças Cardiovasculares , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Colesterol/sangue , Diabetes Mellitus Tipo 2 , Haptoglobinas , Adulto , Biomarcadores/análise , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/genética , Estudos de Casos e Controles , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/genética , Feminino , Haptoglobinas/análise , Haptoglobinas/genética , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Fatores de Risco
6.
Niger J Clin Pract ; 22(9): 1180-1188, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31489851

RESUMO

Background: Assessment of health-related quality of life (HRQOL) in resource-limited settings is critical to evaluate and improve the burden of morbidity and mortality associated with chronic medical disorders. There is a dearth of data on HRQOL among patients suffering from chronic medical disorders in Nigeria. This study assessed the HRQOL of participants with diabetes mellitus (DM), human immunodeficiency virus (HIV) infection, and cancer in a hospital setting with limited resources and highlighted associated factors. Methods: The WHOQOL-BREF instrument was used to study a cross section of the participants at the University of Nigeria Teaching Hospital, Enugu. Data were analyzed using Statistical Package for Social Sciences (SPSS). Results: The distribution of the 613 study population was diabetes mellitus 120, HIV 389, and various cancers 104. Majority (67.9%) earned less than $1 per day and only 7.5% had any form of health insurance. The HIV group had higher QoL scores. Younger age, higher educational status, being employed, and having a care giver were positively associated with higher QoL. Patients with no comorbidities (76.6%) had an overall higher QoL score. Conclusion: Majority of the patients living with chronic medical diseases in Enugu, Nigeria were poor, vulnerable, and without access to health insurance. People living HIV generally had better quality life than those with other health conditions. There is a huge unmet need for people living with chronic medical conditions in Nigeria, which require strategies to counteract.


Assuntos
Doença Crônica/terapia , Assistência à Saúde/métodos , Diabetes Mellitus Tipo 2/psicologia , Infecções por HIV/psicologia , Neoplasias/psicologia , Qualidade de Vida , Adolescente , Adulto , Idoso , Doença Crônica/psicologia , Comorbidade , Estudos Transversais , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Infecções por HIV/epidemiologia , Recursos em Saúde , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Nigéria/epidemiologia , Inquéritos e Questionários , Adulto Jovem
8.
J Ayub Med Coll Abbottabad ; 31(3): 432-435, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31535522

RESUMO

BACKGROUND: Vitamin D has been the focus of attention in the recent past owing to its multitude of effects on various organ systems including immune system, endocrine, cardiovascular etc. Diabetes mellitus and obesity are widely prevalent in our region. The present study was designed with an objective to determine the vitamin D status in relation to diabetes mellitus and obesity in our area. METHODS: This cross-sectional study was conducted at the Medical C Unit of Department of Medicine, Ayub Teaching Hospital from January to December 2017. Approval of ethical committee was taken. A total of 117 patients were enrolled in this study of which 109 were finalized for analysis owing to incomplete data in 8 cases. Patients' characteristics were recorded on a structured proforma. Type 2 diabetes was confirmed using HbA1C Levels. Using ADA 2016 criteria. Vitamin D status was assessed using 25-OH-Vit D levels from the same laboratory. Height and weight of the patients were recorded to obtain BMI. Data was entered and analysed using SPSS version 20. RESULTS: Of the total sample, 69 (63.3%) were females and 40 (36.7%) were males. Mean age of the participants was 44.13±15.777. Mean vitamin D levels were 26.35±18.72. A total of 83 (76.14%) patients were either vitamin D deficient 66 (60.6%) or insufficient 17 (15.6%) while 26 (23.9%) were sufficient in vitamin D. There was statistically significant difference in vitamin D status in diabetic versus non diabetic patients (p=0.015). As regards BMI and vitamin D status, the difference was also statistically significant (p=0.018). CONCLUSIONS: Vitamin D deficiency is widely prevalent in our region. There is also a high prevalence of obesity and diabetes mellitus and they are inversely related to low vitamin D levels.


Assuntos
Diabetes Mellitus Tipo 2 , Obesidade , Deficiência de Vitamina D , Adulto , Estudos Transversais , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/epidemiologia , Paquistão/epidemiologia , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/epidemiologia
9.
Pan Afr Med J ; 33: 140, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31558938

RESUMO

Introduction: The aim of this study was to estimate the prevalence of Diabetes Mellitus (DM) and Impaired Fasting Glucose (IFG) in the peri-urban adult population living in the island of Anjouan, Comoros and to investigate the factors associated with diabetes mellitus. Methods: The survey was a cross-sectional study, in which a sample of 902 individuals (540 women and 362 men) aged 25 to 64 was selected using empirical sampling "quotas" or "reasoned choice" survey method. Hypertension and obesity abdominal measurements of these subjects were collected during face-to-face interviews and following day fasting blood glucose was measured in capillary blood. Results: Participation rate was 83.5%. The mean age of subjects was 39.5 ± 11.63 years. The sex ratio was 0.67. Overall crude diabetes and IFG prevalence were 8.5% and 8.1%, respectively. The risk factors for diabetes type 2 onset were a family history of diabetes (P = 0.006), older age (P = 0.000), glycemic control (P = 0.010), excess waist circumference (P = 0.03) and hypertension (p = 0.000), were significantly positively associated with DM, contrary to sex (P = 0.142). Conclusion: These high figures confirm that diabetes and factors associated do not spare Anjouan population. Awareness, primary prevention, are to set up for a better control of non-communicable diseases.


Assuntos
Glicemia/metabolismo , Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus/epidemiologia , Intolerância à Glucose/epidemiologia , Adulto , Fatores Etários , Doenças Cardiovasculares/etiologia , Comores/epidemiologia , Estudos Transversais , Diabetes Mellitus Tipo 2/epidemiologia , Jejum , Feminino , Humanos , Hipertensão/epidemiologia , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Obesidade Abdominal/epidemiologia , Prevalência , Fatores de Risco , Circunferência da Cintura
10.
J Assoc Physicians India ; 67(7): 30-33, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31559765

RESUMO

Objectives: Individual with diabetes may have several from of Dyslipidemia. Dyslipidemia has been considered to be factor that plays a risk in progression of micro vascular disease, especially in diabetes.1 The present study is intended to Study of correlation between Apolipoprotein B and Dyslipidemia in type 2 diabetes patients and prevalence of dyslipidemia in type 2 diabetic patients. Material and Methods: Prospective cross- sectional study conducted on 100 cases of type 2 diabetes mellitus. Groups are divided according to A/C ratio and association of dyslipidemia was seen. Serum Apolipoprotein B was measured using immunoturbidimetric method. Results: Pearson's correlation analysis of Apo B with lipid parameters in diabetic patients showed that, LDL, TC and Tg were positively correlated with Apo- B. There was a positive and linear correlation between LDL and Tg. Apo- B was negatively correlated with HDL-C. Conclusion: The majority of patients studied had low HDL-C, elevated non HDL- C, elevated total cholesterol, elevated triglycerides, elevated LDL -C and elevated apo B. Apolipoprotein B had a positive linear correlation with total cholesterol, triglycerides, LDL-C, non-HDL-C. The strongest positive correlation was with nonHDL-C. Patients with low HDL-C had high apo B levels.


Assuntos
Apolipoproteínas B/metabolismo , Diabetes Mellitus Tipo 2/epidemiologia , Dislipidemias/epidemiologia , Proteinúria/metabolismo , HDL-Colesterol , Humanos , Estudos Prospectivos , Centros de Atenção Terciária , Triglicerídeos
11.
J Assoc Physicians India ; 67(7): 34-37, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31559766

RESUMO

Objective: The study assessed the four-year incidence of diabetic peripheral neuropathy (DPN) and the risk factors that can predict incident neuropathy in a south Indian population with type 2 diabetes. Research Design and Methods: 1175 diabetic individuals were identified with known diabetes at baseline. At baseline, individuals underwent assessment of fasting plasma glucose and HbA1c levels, body mass index, waist-hip ratio, blood pressure, blood cholesterol and lipid levels, and ophthalmic evaluation including visual acuity, specular microscopy of the corneal endothelium, cataract grading and diabetic retinopathy assessment. Subjects were re-examined after four years for the assessment of incident neuropathy; 713 individuals were found eligible at follow-up. The presence of neuropathy was assessed at baseline and at follow-up and was defined as a Vibration Perception Threshold of ≥ 20 Volts. Results: : The four-year incidence of any neuropathy was 28.4%. Factors predictive of incident diabetic neuropathy were greater age at baseline (OR =1.068), higher body mass index (OR =1.034), presence of diabetic retinopathy (OR =4.879) and lower socioeconomic status (OR =4.841), when adjusted for several potential confounding factors. Conclusion: The four-year incidence of diabetic neuropathy in a south Indian population with type 2 diabetes is 28% and can be predicted by ophthalmic and clinical variables. These factors may be utilized in the assessment, monitoring and intervention in individuals with diabetes in an effort to prevent or delay the development of diabetic peripheral neuropathy.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Neuropatias Diabéticas/epidemiologia , Retinopatia Diabética/epidemiologia , Humanos , Incidência , Fatores de Risco
13.
BMJ ; 366: l5003, 2019 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-31511236

RESUMO

OBJECTIVE: To assess what proportions of studies reported increasing, stable, or declining trends in the incidence of diagnosed diabetes. DESIGN: Systematic review of studies reporting trends of diabetes incidence in adults from 1980 to 2017 according to PRISMA guidelines. DATA SOURCES: Medline, Embase, CINAHL, and reference lists of relevant publications. ELIGIBILITY CRITERIA: Studies of open population based cohorts, diabetes registries, and administrative and health insurance databases on secular trends in the incidence of total diabetes or type 2 diabetes in adults were included. Poisson regression was used to model data by age group and year. RESULTS: Among the 22 833 screened abstracts, 47 studies were included, providing data on 121 separate sex specific or ethnicity specific populations; 42 (89%) of the included studies reported on diagnosed diabetes. In 1960-89, 36% (8/22) of the populations studied had increasing trends in incidence of diabetes, 55% (12/22) had stable trends, and 9% (2/22) had decreasing trends. In 1990-2005, diabetes incidence increased in 66% (33/50) of populations, was stable in 32% (16/50), and decreased in 2% (1/50). In 2006-14, increasing trends were reported in only 33% (11/33) of populations, whereas 30% (10/33) and 36% (12/33) had stable or declining incidence, respectively. CONCLUSIONS: The incidence of clinically diagnosed diabetes has continued to rise in only a minority of populations studied since 2006, with over a third of populations having a fall in incidence in this time period. Preventive strategies could have contributed to the fall in diabetes incidence in recent years. Data are limited in low and middle income countries, where trends in diabetes incidence could be different. SYSTEMATIC REVIEW REGISTRATION: Prospero CRD42018092287.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Carga Global da Doença/tendências , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/prevenção & controle , Humanos , Incidência
14.
J Assoc Physicians India ; 67(8): 20-24, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31562711

RESUMO

Objective: The purpose of the study was to assess if non-alcoholic fatty liver disease (NAFLD) in diabetic patients increases the risk and/or severity of diastolic dysfunction. Research design and methods: We studied 70 type 2 diabetic individuals without a history of ischemic heart disease, hepatic diseases, or excessive alcohol consumption, in whom NAFLD was diagnosed by ultrasonography. All patients had normal left ventricular systolic function and blood pressure values under medication. Left ventricular diastolic dysfunction was assessed by pulsed wave Doppler and tissue Doppler imaging, studying mitral inflow patterns and E wave, E' wave velocities, E/A and E/E' ratios. Results and Conclusions: Fifty seven patients (81.43%) had NAFLD, and when compared with the other 13(18.57%) patients, age, sex, BMI, waist circumference, hypertension, smoking, diabetes duration, microvascular complication status, and medication use were not significantly different. In addition, the left ventricular (LV) mass and volumes, ejection fraction, systemic vascular resistance, arterial elasticity, and compliance were also not different. NAFLD patients had lower E' (8.42±0.89 vs.9.72±0.54, P <0.0001) tissue velocity, higher E-to-E' ratio (9.64±1.83 vs. 7.78±0.89, p<0.001), higher LV-end diastolic pressure (EDP) (15.52 ± 0.69 vs. 14.40±0.9 p <0.0001), higher LV EDP/end diastolic volume LV EDP/EDV (mmHg/ mL) (0.19 ±0.15 vs. 0.17±.02 p < 0.001) and higher glycosylated haemoglobin (HbA1C) (8.53±1.02 vs.7.65±0.66 p<0.01) than those without steatosis. All of these differences remained significant after adjustment for hypertension and other cardio metabolic risk factors. Our data show that in patients with type2 diabetes and NAFLD, even if the LV morphology and systolic function are preserved, early features of LV diastolic dysfunction detected. The frequency of diastolic dysfunction was significantly higher in diabetic patients with NAFLD versus controls.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Disfunção Ventricular Esquerda/epidemiologia , Diástole , Fígado Gorduroso Alcoólico , Hemoglobina A Glicada , Humanos , Função Ventricular Esquerda
15.
BMC Public Health ; 19(1): 1169, 2019 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-31455247

RESUMO

BACKGROUND: As the prevalence of type 2 diabetes (T2DM) increases in low- to middle-income countries, the burden on individuals and health care systems also increases. The use of diabetes risk assessment tools could identify those at risk, leading to prevention or early detection of diabetes. The aim of this study was to evaluate the appropriateness of 6 existing T2DM risk screening tools in detecting dysglycemia in Zamboanga City, Philippines. METHODS: This study used a case-control design in an urban setting in the southern Philippines. There were 200 participants in two groups: 1) those diagnosed with diabetes (n = 50; recruited from diabetes clinics) and 2) those with no previous diagnosis of diabetes (n = 150; recruited from community locations). Participants completed six tools (the Finnish Diabetes Risk Score [FINDRISC], the Canadian Diabetes Risk Score [CANRISK], the Indian Diabetes Risk Score [IDRS], the American Diabetes Association [ADA] risk score, an Indonesian undiagnosed diabetes mellitus [UDDM] scoring system, and a Filipino tool). Scores were compared to fasting plasma glucose levels, which are recommended in Philippines clinical practice guidelines as a valid, available, and low cost option for T2DM diagnosis. Appropriateness of tools was determined through accuracy, sensitivity, specificity, positive/negative predictive value (PPV, NPV), and positive/negative likelihood ratios. RESULTS: The Filipino tool had the highest specificity (0.73) and PPV (0.27), but lowest sensitivity (0.68). The IDRS and Indonesian UDDM tool had the highest NPV at 0.96, but were not amongst the highest in other scores. The CANRISK tied for highest area under the receiver operating characteristic (ROC) curve (AUC), AUC (0.80), but other scores were not noteworthy. Overall, the FINDRISC was the most effective with highest sensitivity (0.94), tied for highest AUC (0.80), and with middle scores in other variables (specificity: 0.45, PPV: 0.20, NPV: 0.95), when using the published cut-off score of 9. When increasing the cut-off score to 11, specificity increased (0.71) and sensitivity was not greatly affected (0.86). CONCLUSIONS: Our results suggest that the FINDRISC is more suitable than other known diabetes risk assessment tools in an urban Filipino population; effectiveness increased with a higher cut-off score.


Assuntos
Diabetes Mellitus Tipo 2/diagnóstico , Programas de Rastreamento/métodos , População Urbana/estatística & dados numéricos , Adulto , Estudos de Casos e Controles , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Filipinas/epidemiologia , Medição de Risco/métodos , Sensibilidade e Especificidade
16.
BMC Public Health ; 19(1): 1171, 2019 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-31455280

RESUMO

BACKGROUND: Diabetes as being a chronic disease with a number of complications deteriorates the quality of life among the people with type 2 diabetes. Health related quality of life is widely used as an important health outcome measure worldwide. This study assessed the quality of life among the people living with type 2 diabetes in rural area of eastern Nepal. METHODS: A cross sectional study was conducted among type 2 diabetic patient of rural area of eastern Nepal. Pre-tested Nepali version of D-39 questionnaire was administered through face to face interview to assess the quality of life. Door to door visit was done to identify all the type 2 diabetic patients residing in Baniyani village. Data was entered in Micro-soft excel 2007 and further processed in SPSS v.11.5 for analysis. RESULTS: Highest quality of life mean (SD) score was in social burden domain (56.26 ± 12.07), followed by sexual functioning domain (54.35 ± 9.47), Anxiety and worry domain (54.33 ± 7.76), energy and mobility domain (51.46 ± 8.73) and diabetes control domain (50.08 ± 10.84). There was negative correlation between age and domains sexual functioning (p = 0.001) and energy and mobility (p = 0.002). In bivariate analysis, there was significance difference by sex in sexual functioning (p = 0.002), educational status in diabetes control (p = 0.021), smoking habit in energy and mobility (p = 0.038), duration of disease in diabetes control (p = 0.002) and sexual functioning (p = 0.001), presence of co-morbidity in social burden (p = 0.034) and family history of diabetes in anxiety and worry (p = 0.042). CONCLUSION: Increasing age affects sexual life and mobility of the type 2 diabetic patient. The domain sexual functioning is difference by sex and presence of co-morbidity. Similarly, domain diabetic control is affected by duration of disease and educational status of the patient. And having family history of diabetes affects the mental state of the type 2 diabetic patient.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Qualidade de Vida , População Rural/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nepal/epidemiologia , Inquéritos e Questionários
17.
BMC Public Health ; 19(1): 1174, 2019 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-31455291

RESUMO

BACKGROUND: Previous studies assessing the relationship between depression and diabetes mellitus did not consider the severity of depression. In the present study we assessed the risk of developing type 2 diabetes mellitus (T2DM) among people with various severity of depression. METHODS: This prospective longitudinal cohort study included 9,936 individuals residing in Stockholm County, Sweden who responded to the baseline questionnaire in 1998-2000. The participants were followed from 1 year after the baseline up to 2015 for the occurrence of T2DM, using the National Patient Register, Swedish Prescribed Drug Registers, and Cause of Death Register. Depression and anxious distress were assessed using psychiatric rating scales and defined according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). RESULTS: Depression was associated with a statistically significant increased risk of T2DM after adjusting for potential confounders (OR 1.48, CI 1.10, 1.99). The strongest association was observed for severe depression (OR 1.72, CI 1.15, 2.59). Further, those with depression, regardless of severity, and with concurrent moderate/severe anxious distress had an increased risk of T2DM (OR 1.73, CI 1.13, 2.63) compared to those with neither depression nor anxious distress. CONCLUSIONS: The study adds evidence that depression is associated with a higher risk for developing T2DM, and the association is stronger among people with severe depression.


Assuntos
Ansiedade/epidemiologia , Depressão/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Índice de Gravidade de Doença , Adulto , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco , Suécia/epidemiologia
18.
West Afr J Med ; 36(2): 133-137, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31385599

RESUMO

BACKGROUND: Anaemia is a common disorder occurring in about 33% of the global population. It is an important cardiovascular risk factor and a key indicator of some chronic complications of Diabetes Mellitus (DM). This study aimed to determine the burden of anaemia and its correlation with some clinical and biochemical parameters among patients with DM attending a tertiary health facility in Zaria, Northwestern Nigeria. SUBJECTS, MATERIALS AND METHODS: This was a case-control study in which 168 participants were enrolled (84 DM patients, 84 controls). It was conducted in the Endocrinology and Metabolic clinics of Ahmadu Bello University Teaching Hospital, Zaria. Consenting DM patients were enrolled consecutively and subsequently, sex- and age-matched with non-diabetic controls. Data on age, gender and Haemoglobin (Hb) concentrations were collated for all study participants. Additional data on type of DM, duration of DM once diagnosis, treatment, type of treatment, history of hypertension, chronic kidney disease, peripheral neuropathy, and Fasting Blood Sugar (FBS) were collated for all cases. Data were collated and analyzed using SPSS version 21. Level of significance was set at <0.05. Ethical approval for the study was obtained from the Institutional Health Research Ethics Committee and informed consent was obtained from the all the participants. RESULTS: Females constituted 39/84(46.4%) of each arm of the study. The mean ± SD of age for both cases and controls was 53.7 ± 8.9 years. The mean ± SD duration of DM, treatment for DM and FBS were 8.4 ± 5.7 years, 5.0 ± 3.6 years and 6.1 ± 2.5mmol/L respectively. Cases had significantly lower Hb concentration compared to controls (12.1±2.2g/dl vs. 13.1 ± 1.4g/dl, t= -3.446, p = 0.001). Overall prevalence of anaemia among cases and controls was 36/84(42.9%) vs. 26/84(31.0%) Z = 1.6, p = 0.110. Among cases, haemoglobin concentration had very weak, inverse and non-statistically significant relationships with age, duration of DM diagnosis, duration of therapy and FBS levels. There was a significant relationship between anaemia on one hand and type of DM and treatment on the other. The odds of DM patients with history of CKD or uncontrolled FBS having anaemia were OR= 0.600 (95% CI 0.196, 1.836) and OR=1.755 (95% CI 0.737, 4.181) respectively. CONCLUSION: The burden of anaemia amongst patients with DM is high in Zaria, Northwestern Nigeria, and it is associated with poor glycaemic control. Hence, the need to include haematological assessment as part of routine care of patients with DM.


Assuntos
Anemia/epidemiologia , Glicemia/análise , Diabetes Mellitus Tipo 2/epidemiologia , Hemoglobina A Glicada/análise , Adulto , Idoso , Estudos de Casos e Controles , Diabetes Mellitus/epidemiologia , Diabetes Mellitus Tipo 2/sangue , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Doenças do Sistema Nervoso Periférico/epidemiologia , Prevalência , Insuficiência Renal Crônica/epidemiologia
19.
Medicine (Baltimore) ; 98(32): e16825, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31393416

RESUMO

Observational studies have reported that childhood obesity is positively associated with risks of type 2 diabetes (T2D) and coronary artery disease (CAD) in adults; however, whether this association is causal is still unclear. In the present study, we conducted the 2-sample Mendelian randomization (MR) studies to investigate whether childhood obesity is causally associated with T2D and CAD in adults.Seven single-nucleotide polymorphisms (SNPs) that significantly associated with childhood obesity were used as instrumental variables. The 2-sample MR analyses were performed with the summary-level data of large-sample genome-wide association studies to evaluate the causal effects of childhood obesity on adult T2D and CAD and the levels of cardiometabolic traits.The 2-sample MR analyses suggested that each 1-unit increase in the log-odds of having childhood obesity was causally associated with an increased risk of adult T2D (odds ratio [OR] = 1.16, 95% confidential interval [CI] = 1.06-1.28; P = 1.0 × 10) and CAD (OR = 1.07, 95% CI = 1.02-1.12; P = 4.0 × 10) based on the inverse-variance weighted method. The MR analyses also suggested that childhood obesity was positively associated with the levels of adult body mass index, waist circumference, hip circumference, waist and hip ratio, log-transformed fasting glucose, log-transformed homeostatic model assessment (HOMA) of insulin resistance (%), and triglycerides. The childhood obesity was negatively associated with the adult high-density lipoprotein cholesterol level; however, there was no evidence of a causal association between childhood obesity and the levels of fasting glucose, 2-hour glucose, HbA1c (%), log-transformed HOMA of ß-cell function (%), low-density lipoprotein cholesterol, or total cholesterol in adults.In conclusion, a genetic predisposition to childhood obesity was associated with an increased risk of adult T2D and CAD, providing causal relations between childhood obesity and the risks of T2D and CAD in adults; however, the results need to be validated with larger-scale intervention studies.


Assuntos
Doença da Artéria Coronariana/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Obesidade Pediátrica/epidemiologia , Obesidade Pediátrica/genética , Glicemia , Índice de Massa Corporal , Pesos e Medidas Corporais , Feminino , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Humanos , Resistência à Insulina , Lipídeos/sangue , Masculino , Polimorfismo de Nucleotídeo Único , Fatores de Risco
20.
Cancer Causes Control ; 30(10): 1057-1065, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31401707

RESUMO

PURPOSE: As obesity and type 2 diabetes (T2D) have been increasing worldwide, we investigated their association with breast cancer incidence in the Reykjavik Study. METHODS: During 1968-1996, approximately 10,000 women (mean age = 53 ± 9 years) completed questionnaires and donated blood samples. T2D status was classified according to self-report (n = 140) and glucose levels (n = 154) at cohort entry. A linkage with the Icelandic Cancer Registry provided breast cancer incidence through 2015. Cox regression with age as time metric and adjusted for known confounders was applied to obtain hazard ratios (HR) and 95% confidence intervals (CI). RESULTS: Of 9,606 participants, 294 (3.1%) were classified as T2D cases at cohort entry while 728 (7.8%) women were diagnosed with breast cancer during 28.4 ± 11.6 years of follow-up. No significant association of T2D (HR 0.95; 95% CI 0.56-1.53) with breast cancer incidence was detected except among the small number of women with advanced breast cancer (HR 3.30; 95% CI 1.13-9.62). Breast cancer incidence was elevated among overweight/obese women without (HR 1.18; 95% CI 1.01-1.37) and with T2D (HR 1.35; 95% CI 0.79-2.31). Height also predicted higher breast cancer incidence (HR 1.03; 95% CI 1.02-1.05). All findings were confirmed in women of the AGES-Reykjavik sub-cohort (n = 3,103) who returned for an exam during 2002-2006. With a 10% T2D prevalence and 93 incident breast cancer cases, the HR for T2D was 1.18 (95% CI 0.62-2.27). CONCLUSIONS: These findings in a population with low T2D incidence suggest that the presence of T2D does not confer additional breast cancer risk and confirm the importance of height and excess body weight as breast cancer risk factors.


Assuntos
Neoplasias da Mama/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Sobrepeso/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Islândia/epidemiologia , Incidência , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Fatores de Risco
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