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1.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 52(2): 340-344, 2021 Mar.
Artículo en Chino | MEDLINE | ID: mdl-33829712

RESUMEN

Objective: To explore the relationship between abdominal obesity and diabetes among middle-aged and older adults with normal body mass index (BMI) and to provide reference information for formulating targeted diabetes prevention and control measures for this population. Methods: Data were extracted from the China Health and Retirement Longitudinal Study (CHARLS) done in 2015. Middle-aged and older adults who were aged 45 and older and had normal BMI were included in the study. According to their status of diabetes, the subjects were divided into two groups, non-diabetes and diabetes groups. χ 2 test was used to investigate the difference between two groups. Logistic regression was used to do the multivariate analysis of factors influencing diabetes. Results: A total of 5 197 middle-aged and older adults with normal BMI ranging between 18.5 and 24 kg/m 2 were included. The prevalence of diabetes was 11.26% (585/5 197) and the prevalence of abdominal obesity was 41.56% (2 160/5 197). Univariate analysis showed that the difference in age, residence, the status of hypertension, dyslipidemia and abdominal obesity between non-diabetic group and the diabetic group were statistically significant ( P<0.01). The prevalence of diabetes among adults with abdominal obesity was 14.2% (307/2 160) and that among people with no abdominal obesity was 9.2% (278/3 037). Compared with people with no abdominal obesity, the prevalence of diabetes among people with abdominal obesity was higher and the difference were statistically significant ( P<0.01). Multivariate logistic regression analysis showed that, among middle-aged and older adults with normal BMI, those with abdominal obesity, aged 60 years and older, living in urban areas, having hypertension and having dyslipidemia had higher probability of developing diabetes. Conclusion: Abdominal obesity and diabetes are becoming a serious problem among middle-aged and older adults with normal BMI and abdominal obesity may be related to higher risks of diabetes. It is recommended that more attention is given to abdominal obesity in this population to reduce the possibilities of diabetes.


Asunto(s)
Diabetes Mellitus , Hipertensión , Obesidad Abdominal , Anciano , Índice de Masa Corporal , China/epidemiología , Diabetes Mellitus/epidemiología , Humanos , Hipertensión/epidemiología , Estudios Longitudinales , Persona de Mediana Edad , Obesidad Abdominal/complicaciones , Obesidad Abdominal/epidemiología , Prevalencia , Factores de Riesgo
2.
Mymensingh Med J ; 30(2): 432-441, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33830125

RESUMEN

Diabetes Mellitus (DM) represents one of the biggest challenges in our country affecting hundred millions of people worldwide, both in developed countries and in developing ones. The objectives of the study were to assess the proportion of diagnosed and undiagnosed cases of diabetes mellitus among above 40 years old population in a selected rural area in Jamalpur, Bangladesh. A descriptive type of cross sectional study was conducted from September 2018 to December 2018. The respondents of the study were taken purposively. Using semi-structured questionnaire data were derived from face to face interview. The data were analyzed by using statistical for social science package (SPSS) 25.0 version for data entry and analysis. 53.4% of the respondents were aged between 40-50 years and 60.6% were female, 98.3% were Muslim, 57.2% were housewife. The study revealed that nearly half of the respondents (44.9%) had no formal education, 27.1% had primary, 14.8% had secondary, 8.9% had graduate and above and 4.2% had higher secondary education. 43.6% of the respondents' monthly family income had <10000 BDT. 27.5% had family history of diabetes. 33.5% of the respondents had body weight of 51-60 kg and 20.8% were overweight and only 2.1% were obese. Active respondents were 35.6%, 28.8% were moderately active, 24.6% were mildly active and 11% were sedentary in their life style. Majority of the respondents (72.5%) did not perform regular exercise. Excessive sweet or sugar regularly has taken 32.6% of the respondents. About diabetes knew 91.5% of the respondents and only 8.5% did not know about diabetes. Majority of the respondents (72.9%) did not know how diabetes & its complications can be prevented. This study found that 54.1% of the respondents continued oral drugs/insulin regularly for treatment of diabetes mellitus. Most of the respondents (88.1%) did not monitor blood glucose level regularly. 97.5% of the respondents did not attend any diabetes awareness program. The prevalence of diabetes was 22.88%. The proportion of diagnosed diabetic cases was 15.7% and the proportion of undiagnosed diabetic was 7.2% according to their fasting blood sugar. A relatively high proportion of diabetic cases were observed in that rural Bangladeshi population. The study found that about one third of the diabetic cases were undiagnosed and untreated which was significant and alarming. The study showed that the association between education of the respondents and status of diabetes was statistically strongly significant (p<0.001). The study revealed that there was strong association between family history of diabetes of the respondents and status of diabetes (p=0.006).


Asunto(s)
Diabetes Mellitus , Adulto , Bangladesh/epidemiología , Estudios Transversales , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Población Rural
3.
Artículo en Inglés | PAHO-IRIS | ID: phr-53413

RESUMEN

[ABSTRACT]. Objectives. To assess the association between childhood hunger experiences and the prevalence of chronic diseases later in life. Methods. A cross-sectional study was conducted using baseline data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil), a nationally representative study of persons aged 50 years and older (n = 9 412). Univariate and bivariate analyses were used to describe the sample, and multivariate logistic regressions to examine the association between childhood hunger and hypertension, diabetes, arthritis and osteoporosis. Adjusted odds ratios and predicted probabilities were calculated. Results. 24.7% of Brazilians aged 50 and over experienced hunger during childhood. This harmful exposure was significantly more common among non-white people, individuals with lower educational attainment, lower household income and heavy manual laborers. Regional variation was also observed, as the prevalence of individuals reporting childhood hunger was higher in the North and Northeast regions. The multivariate analysis revealed that older adults who reported having experienced hunger during childhood had 20% higher odds of developing diabetes in adulthood (aOR = 1.20, 95% CI: 1.02 – 1.41) and 38% higher odds of developing osteoporosis (aOR = 1.38, 95% CI: 1.15 – 1.64) than adults who did not experience hunger during childhood, after controlling for covariates. Conclusions. The study showed an association between childhood hunger and two chronic diseases in later life: diabetes and osteoporosis. This work restates that investing in childhood conditions is a cost-effective way to have a healthy society and provides evidence on relationships that deserve further investigation to elucidate underlying mechanisms.


[RESUMEN]. Objetivos. Evaluar la asociación entre las experiencias de hambre en la niñez y la prevalencia de enfermedades crónicas en las etapas posteriores de la vida. Métodos. Se realizó un estudio transversal utilizando como línea de base los datos del Estudio Longitudinal del Envejecimiento en Brasil (ELSI-Brasil), un estudio nacional representativo de personas de 50 años o más (n = 9 412). Se emplearon análisis univariado y bivariado para describir la muestra, y regresión logística multivariada para examinar la asociación entre el hambre en la niñez y la hipertensión, la diabetes, la artritis y la osteoporosis. Se calcularon las razones de posibilidades ajustadas y las probabilidades previstas. Resultados. El 24,7% de los brasileños de 50 años o más pasó hambre en la niñez. Esta experiencia perjudicial fue considerablemente más común en las personas no blancas, las personas con menor nivel de instrucción, las personas con ingresos familiares bajos y los trabajadores de mano de obra pesada. También se observó una variación regional, puesto que la prevalencia de individuos que expresaron haber pasado hambre en la niñez fue mayor en las regiones Norte y Nordeste. Luego de controlar las covariables, el análisis multifactorial reveló que los adultos mayores que dijeron haber pasado hambre en la niñez tenían una probabilidad 20% mayor de tener diabetes en la edad adulta (aOR = 1,20, IC 95%: 1,02 – 1,41) y 38% mayor de tener osteoporosis (aOR = 1,38, IC 95%: 1,15 – 1,64) que los adultos que no habían pasado hambre en la niñez. Conclusiones. El estudio reveló una asociación entre el hambre en la niñez y dos enfermedades crónicas en las etapas posteriores de la vida: la diabetes y la osteoporosis. Este trabajo reafirma que invertir en las condiciones de vida de las personas en la niñez es una manera costoeficaz de tener una sociedad saludable, al tiempo que aporta evidencia acerca de relaciones que merecen investigarse más a fin de esclarecer los mecanismos subyacentes.


[RESUMO]. Objetivos. Avaliar a associação entre a experiência de passar fome na infância e a prevalência posterior de doenças crônicas. Métodos. Um estudo transversal foi realizado a partir de dados básicos do Estudo Longitudinal da Saúde dos Idosos Brasileiros (ELSI-Brasil), uma pesquisa com representatividade nacional realizada com pessoas de 50 anos ou mais (n = 9.412). Análises univariadas e bivariadas foram usadas para descrever a amostra e a regressão logística multivariada foi aplicada para examinar a associação entre passar fome na infância e hipertensão, diabetes, artrite e osteoporose. Foram calculadas razões de chances (odds ratio, OR) ajustadas e probabilidades previstas. Resultados. Verificou-se que 24,7% dos brasileiros com 50 anos ou mais passaram fome na infância. Esta exposição prejudicial foi significativamente mais frequente em pessoas não brancas, com nível de instrução menor e renda familiar mais baixa e em trabalhadores braçais. Observou-se também uma variação regional, com uma maior prevalência de pessoas que relataram ter passado fome na infância nas Regiões Norte e Nordeste. Na análise multivariada, nos idosos que informaram ter passado fome na infância, a probabilidade foi 20% maior de ter diabetes na idade adulta (ORaj 1,20; IC 95% 1,02–1,41) e 38% maior de ter osteoporose (ORaj 1,38, IC 95% 1,15–1,64) em comparação aos adultos que não passaram fome na infância, após o controle de covariáveis. Conclusões. O estudo demonstrou associação entre passar fome na infância e duas doenças crônicas na vida adulta: diabetes e osteoporose. Este trabalho reitera que investir na infância é uma maneira custo-efetiva de se criar uma sociedade saudável e fornece evidências sobre relações que devem ser pesquisadas mais a fundo para esclarecer os processos subjacentes.


Asunto(s)
Hambre , Enfermedad Crónica , Envejecimiento , Diabetes Mellitus , Osteoporosis , Brasil , Hambre , Enfermedad Crónica , Envejecimiento , Brasil , Hambre , Enfermedad Crónica , Envejecimiento , Osteoporosis
4.
BMJ ; 372: n693, 2021 03 31.
Artículo en Inglés | MEDLINE | ID: mdl-33789877

RESUMEN

OBJECTIVE: To quantify rates of organ specific dysfunction in individuals with covid-19 after discharge from hospital compared with a matched control group from the general population. DESIGN: Retrospective cohort study. SETTING: NHS hospitals in England. PARTICIPANTS: 47 780 individuals (mean age 65, 55% men) in hospital with covid-19 and discharged alive by 31 August 2020, exactly matched to controls from a pool of about 50 million people in England for personal and clinical characteristics from 10 years of electronic health records. MAIN OUTCOME MEASURES: Rates of hospital readmission (or any admission for controls), all cause mortality, and diagnoses of respiratory, cardiovascular, metabolic, kidney, and liver diseases until 30 September 2020. Variations in rate ratios by age, sex, and ethnicity. RESULTS: Over a mean follow-up of 140 days, nearly a third of individuals who were discharged from hospital after acute covid-19 were readmitted (14 060 of 47 780) and more than 1 in 10 (5875) died after discharge, with these events occurring at rates four and eight times greater, respectively, than in the matched control group. Rates of respiratory disease (P<0.001), diabetes (P<0.001), and cardiovascular disease (P<0.001) were also significantly raised in patients with covid-19, with 770 (95% confidence interval 758 to 783), 127 (122 to 132), and 126 (121 to 131) diagnoses per 1000 person years, respectively. Rate ratios were greater for individuals aged less than 70 than for those aged 70 or older, and in ethnic minority groups compared with the white population, with the largest differences seen for respiratory disease (10.5 (95% confidence interval 9.7 to 11.4) for age less than 70 years v 4.6 (4.3 to 4.8) for age ≥70, and 11.4 (9.8 to 13.3) for non-white v 5.2 (5.0 to 5.5) for white individuals). CONCLUSIONS: Individuals discharged from hospital after covid-19 had increased rates of multiorgan dysfunction compared with the expected risk in the general population. The increase in risk was not confined to the elderly and was not uniform across ethnicities. The diagnosis, treatment, and prevention of post-covid syndrome requires integrated rather than organ or disease specific approaches, and urgent research is needed to establish the risk factors.


Asunto(s)
/complicaciones , Hospitalización/estadística & datos numéricos , Insuficiencia Multiorgánica/epidemiología , Readmisión del Paciente/estadística & datos numéricos , Adulto , Anciano , /mortalidad , Enfermedades Cardiovasculares/epidemiología , Estudios de Casos y Controles , Diabetes Mellitus/epidemiología , Inglaterra/epidemiología , Grupos Étnicos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Alta del Paciente/estadística & datos numéricos , Enfermedades Respiratorias/epidemiología , Estudios Retrospectivos , Factores de Riesgo , /aislamiento & purificación
5.
Rev. ciênc. méd., (Campinas) ; 30: 215047, 10 mar. 2021.
Artículo en Portugués | LILACS | ID: biblio-1150814

RESUMEN

Objetivo O estudo descreveu a percepção dos usuários hipertensos e diabéticos sobre atenção à saúde prestada em Unidades Básicas de Saúde. Métodos Métodos básicos adotados: estudo qualitativo ocorreu no município de Itapeva (SP), no ano de 2015. Foram realizadas entrevistas semiestruturadas com 12 usuários acima de 18, durante mês e uma análise temática para interpretação. Resultados Foram identificados 2 eixos principais, a saber: 1) "Vivência do cuidado em Saúde" e 2) "Acessibilidade na atenção à Saúde". No eixo 1, foram identificados subeixos: acolhimento, dificuldade de atendimento, agenda programada, atendimento a demanda espontânea, concentração nas especialidades médicas, acesso ao serviço de urgência. Já no eixo 2, os seguintes subeixos: dificuldade e facilidade de transporte do paciente ao serviço de urgência. Conclusão No cenário estudado, os usuários que se sentiram acolhidos perceberam como resolutiva a atenção. Esse cenário propõe que, nos espaços estudados, há limitações na execução de tarefas que são da competência da Atenção Primária à Saúde, e o modo como estão efetivando a atenção não favoreceu o entendimento correto do funcionamento da Atenção Primária à Saúde proposto pelo Ministério da Saúde. Priorizar a educação em saúde e o empoderamento do usuário perante sua condição crônica são estratégias possíveis, consolidando a clínica ampliada. A necessidade de continuar estudos que explorem a percepção dos usuários com relação à atenção à saúde é relevante para compreender as barreiras e pontos positivos do serviço, e assim auxiliar no seu planejamento estratégico de ações, programas e atividades destinados aos usuários com doenças crônicas não-transmissíveis.


Objective The study describes the perceptions of hypertensive and diabetic users regarding the health care provided in Basic Health Units. Methods The basic methods adopted were a qualitative study that took place in the city of Itapeva (SP) in 2015, semi-structured interviews that were conducted with 12 users older than 18 during the course of one month, and, finally, a thematic analysis for interpretation. Results Two main axes were identified, namely: 1) Experience of health care and 2) Accessibility in health care. In the first axis, six sub-axes were identified: reception, difficulties in service, scheduled agenda, meeting spontaneous demand, concentration on medical specialties, access to emergency services. On the second axis, the sub-axes discussed were the difficulty and ease of transporting the patient to the emergency department. Conclusion In the studied scenario, users who felt welcome perceived the attention received as resolving. This scenario suggests that there are limitations in the studied spaces as to the execution of tasks that are the competence of Primary Health Care and that the way that care is being provided has not favored the correct understanding of the functioning of Primary Health Care as proposed by the National Ministry of Health. Health education and user empowerment in the face of their chronic conditions are possible strategies consolidating the expanded clinic. There is a relevant need to further study and explore the users' perception of health care in order to understand the barriers and positive points of the service, and thus assist in their strategic planning of actions, programs, and activities aimed at users with chronic non-communicable diseases.


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Atención Primaria de Salud , Investigación Cualitativa , Diabetes Mellitus , Accesibilidad a los Servicios de Salud , Hipertensión
6.
Ciudad Autónoma de Buenos Aires; Comisión Nacional de Evaluación de Tecnologías de Salud; Marzo 2021. 30 p. (Informe de Evaluación de Tecnologías Sanitarias N°16, 16).
Monografía en Español | LILACS, BINACIS, ARGMSAL | ID: biblio-1151376

RESUMEN

El presente informe es producto del trabajo colaborativo de la Comisión Nacional de Evaluación de Tecnologías de Salud (CONETEC), dependiente del Ministerio de Salud de la Nación y creada por RM N° 623/2018. La CONETEC realiza evaluaciones y emite recomendaciones a la autoridad sanitaria sobre la incorporación, forma de uso, financiamiento y políticas de cobertura de las tecnologías sanitarias desde una perspectiva global del sistema de salud argentino. En sus evaluaciones y recomendaciones, la CONETEC tiene en cuenta criterios de calidad, seguridad, efectividad, eficiencia y equidad, evaluados bajo dimensiones éticas, médicas, económicas y sociales. Sus resultados son consensuados mediante discusiones públicas y ponderados a través de un marco de valor explícito, con la participación de todos los actores involucrados en el proceso de toma de decisiones en salud. Los informes y recomendaciones de esta comisión surgen de este proceso público, transparente y colaborativo, siendo de libre consulta y acceso para toda la sociedad.


Asunto(s)
Sistemas de Infusión de Insulina , Niño , Adolescente , Mujeres Embarazadas , Diabetes Mellitus/terapia
7.
Methods Mol Biol ; 2212: 45-53, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33733349

RESUMEN

The genetic epistasis effect has been widely acknowledged as an essential contributor to genetic variation in complex diseases. In this chapter, we introduce a powerful and efficient statistical method, called W-test, for genetic epistasis testing. A wtest R package is developed for the implementation of the W-test method, which provides various functions to measure the main effect, pairwise interaction, higher-order interaction, and cis-regulation of SNP-CpG pairs in genetic and epigenetic data. It allows flexible stagewise and exhaustive association testing as well as diagnostic checking on the probability distributions in a user-friendly interface. The wtest package is available in CRAN at https://CRAN.R-project.org/package=wtest .


Asunto(s)
Algoritmos , Islas de CpG , Diabetes Mellitus/genética , Epistasis Genética , Polimorfismo de Nucleótido Simple , Programas Informáticos , Biología Computacional/métodos , Metilación de ADN , Conjuntos de Datos como Asunto , Diabetes Mellitus/diagnóstico , Pruebas Genéticas , Genotipo , Humanos , Probabilidad , Tamaño de la Muestra
8.
Emerg Infect Dis ; 27(4): 1164-1168, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33754981
9.
BMJ Case Rep ; 14(3)2021 Mar 25.
Artículo en Inglés | MEDLINE | ID: mdl-33766961

RESUMEN

COVID-19 affects a wide spectrum of organ systems. We report a 52-year-old man with hypertension and newly diagnosed diabetes mellitus who presented with hypoxic respiratory failure due to COVID-19 and developed severe brachial plexopathy. He was not treated with prone positioning respiratory therapy. Associated with the flaccid, painfully numb left upper extremity was a livedoid, purpuric rash on his left hand and forearm consistent with COVID-19-induced microangiopathy. Neuroimaging and electrophysiological data were consistent with near diffuse left brachial plexitis with selective sparing of axillary, suprascapular and pectoral fascicles. Given his microangiopathic rash, elevated D-dimers and paucifascicular plexopathy, we postulate a patchy microvascular thrombotic plexopathy. Providers should be aware of this significant and potentially under-recognised neurologic complication of COVID-19.


Asunto(s)
Neuropatías del Plexo Braquial/etiología , /complicaciones , Brazo/patología , Neuropatías del Plexo Braquial/diagnóstico , Diabetes Mellitus , Exantema/complicaciones , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Humanos , Hipertensión/complicaciones , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Neuralgia/complicaciones , Posicionamiento del Paciente/efectos adversos , Insuficiencia Respiratoria/etiología , /aislamiento & purificación
10.
BMC Endocr Disord ; 21(1): 56, 2021 Mar 26.
Artículo en Inglés | MEDLINE | ID: mdl-33771154

RESUMEN

BACKGROUND: Diabetes is associated with poor coronavirus disease 2019 (COVID-19) outcomes. However, little is known on the impact of undiagnosed diabetes in the COVID-19 population. We investigated whether diabetes, particularly undiagnosed diabetes, was associated with an increased risk of death from COVID-19. METHODS: This retrospective study identified adult patients with COVID-19 admitted to Tongji Hospital (Wuhan) from January 28 to April 4, 2020. Diabetes was determined using patients' past history (diagnosed) or was newly defined if the hemoglobin A1c (HbA1c) level at admission was ≥6.5% (48 mmol/mol) (undiagnosed). The in-hospital mortality rate and survival probability were compared between the non-diabetes and diabetes (overall, diagnosed, and undiagnosed diabetes) groups. Risk factors of mortality were explored using Cox regression analysis. RESULTS: Of 373 patients, 233 were included in the final analysis, among whom 80 (34.3%) had diabetes: 44 (55.0%) reported a diabetes history, and 36 (45.0%) were newly defined as having undiagnosed diabetes by HbA1c testing at admission. Compared with the non-diabetes group, the overall diabetes group had a significantly increased mortality rate (22.5% vs. 5.9%, p <  0.001). Moreover, the overall, diagnosed, and undiagnosed diabetes groups displayed lower survival probability in the Kaplan-Meier survival analysis (all p <  0.01). Using multivariate Cox regression, diabetes, age, quick sequential organ failure assessment score, and D-dimer ≥1.0 µg/mL were identified as independent risk factors for in-hospital death in patients with COVID-19. CONCLUSIONS: The prevalence of undiagnosed pre-existing diabetes among patients with COVID-19 is high in China. Diabetes, even newly defined by HbA1c testing at admission, is associated with increased mortality in patients with COVID-19. Screening for undiagnosed diabetes by HbA1c measurement should be considered in adult Chinese inpatients with COVID-19.


Asunto(s)
/sangre , Diabetes Mellitus/sangre , Diabetes Mellitus/mortalidad , Hemoglobina A Glucada/metabolismo , Mortalidad Hospitalaria/tendencias , Anciano , China/epidemiología , Diabetes Mellitus/diagnóstico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo
11.
Nephrol Nurs J ; 48(1): 65-63, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33683845

RESUMEN

Diabetes mellitus is the leading cause of chronic kidney disease (CKD). Managing diabetes mellitus is challenging. and patients have difficulty understanding self-management of the disease. The existing literature on self-management and patient-to-nurse relationships offers a deeper understanding of the challenges for patients with diabetes mellitus, their risk of CKD, how self-management impacts that risk, and how nurses can enhance self-management. Improving self-management of diabetes mellitus can decrease the risk for CKD. Essential self-management strategies to improve the quality of life of patients with diabetes mellitus include self-care behaviors, monitoring biological measures, and medication adherence.


Asunto(s)
Diabetes Mellitus , Automanejo , Diabetes Mellitus/enfermería , Diabetes Mellitus/terapia , Humanos , Insuficiencia Renal Crónica/prevención & control , Medición de Riesgo
12.
Surg Clin North Am ; 101(2): 255-267, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33743968

RESUMEN

Type 2 diabetes mellitus (T2D) and associated comorbid medical conditions are leading causes of strain on the American health care system. There has been a synchronous rise of obesity to epidemic proportions. If poorly treated, T2D is a scourge for patients, leading to end-organ damage and early mortality. Although T2D is considered best managed with lifestyle modification, medical management, and pharmacotherapy, recent studies have confirmed the superiority of metabolic surgery to conventional treatment algorithms as a path to remission. Increasing access to metabolic surgery will continue to yield benefits to patient health and improve the macroeconomic health of the world.


Asunto(s)
Cirugía Bariátrica/métodos , Diabetes Mellitus/prevención & control , Obesidad Mórbida/cirugía , Diabetes Mellitus/epidemiología , Diabetes Mellitus/etiología , Salud Global , Humanos , Incidencia , Obesidad Mórbida/complicaciones
13.
Medicine (Baltimore) ; 100(9): e24672, 2021 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-33655931

RESUMEN

ABSTRACT: This study aimed at assessing the association of maternal diabetes mellitus (DM), the adiponectin gene (APM1) gene polymorphisms, and their interactions with risk of congenital heart disease (CHD) in offspring.A case-control study of 464 mothers of CHD patients and 504 mothers of healthy children was conducted.After adjusting for potential confounding factors, our study suggested that mothers with gestational DM (GDM) during this pregnancy (adjusted odds ratio [aOR = 2.96]), GDM in previous pregnancy experiences (aOR = 3.16), and pregestational DM in the 3 months before this pregnancy (aOR = 4.52) were at a significantly higher risk of CHD in offspring, when compared with those without any diabetes. The polymorphisms of maternal APM1 gene at rs1501299 (T/T vs G/G: aOR = 3.45; T/G vs G/G: aOR = 1.73) and rs2241766 (G/G vs T/T, aOR = 3.36; G/T vs T/T, aOR = 1.93) were significantly associated with risk of CHD in offspring. In addition, significant interactions between maternal DM and the APM1 genetic variants on the development of CHD were found.Our findings indicate that maternal DM, APM1 gene genetic variants, and their interactions are significantly associated with risk of CHD in offspring. However, more studies in different ethnic populations and with a larger sample and prospective design are required to confirm our findings.


Asunto(s)
Adiponectina/genética , Diabetes Mellitus , Diabetes Gestacional , Cardiopatías Congénitas/genética , Efectos Tardíos de la Exposición Prenatal/genética , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Oportunidad Relativa , Polimorfismo Genético , Embarazo , Factores de Riesgo
14.
Medicine (Baltimore) ; 100(9): e24886, 2021 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-33655948

RESUMEN

BACKGROUND: Assessing the effectiveness and safety of acupuncture for chronic constipation in patients with diabetes mellitus is the main purpose of this systematic review protocol. METHODS: The following electronic databases will be searched from their respective inception dates to December 1st 2020: PubMed, the Cochrane Library, Embase, World Science Net, the Allied and Complementary Medicine Database, the Web of Science, China National Knowledge Infrastructure, the Chongqing VIP Chinese Science and Technology Periodical Database and the Wanfang Database. All published randomized controlled trials in English or Chinese related to acupuncture for constipation in patient with diabetes mellitus will be included. The Bristol stool scale, spontaneous complete bowel movements, and observing symptoms (yes/no) including defecation feeling, defecation weakness, feeling of incomplete evacuation, bloating, and flatulence were considered as primary measures. The treatment efficiency consideration according to Bristol stool scale was considered as secondary measure. Two reviewers will conduct the study selection, data extraction and assessment independently. The assessment of risk of bias and data synthesis will be conducted with Review Manager Software (RevMan) V.5.2. RESULTS: The results will provide a high-quality synthesis of current evidence for researchers in this subject area. CONCLUSION: The conclusion of our study will provide an evidence to judge whether.Acupuncture is an effective intervention for chronic constipation in patients with diabetes mellitus. ETHICS AND DISSEMINATION: Formal ethical approval is not necessary as the data cannot be individualized. The results of this protocol will be disseminated in a peer-reviewed journal or presented at relevant conferences. PROSPERO REGISTRATION NUMBER: INPLASY202110079.


Asunto(s)
Terapia por Acupuntura/métodos , Estreñimiento/terapia , Diabetes Mellitus , Calidad de Vida , Enfermedad Crónica , Humanos
17.
Cardiovasc Diabetol ; 20(1): 69, 2021 03 23.
Artículo en Inglés | MEDLINE | ID: mdl-33757510

RESUMEN

BACKGROUND: During COVID-19 pandemic, elective invasive cardiac procedures (ICP) have been frequently cancelled or postponed. Consequences may be more evident in patients with diabetes. OBJECTIVES: The objective was to identify the peculiarities of patients with DM among those in whom ICP were cancelled or postponed due to the COVID-19 pandemic, as well as to identify subgroups in which the influence of DM has higher impact on the clinical outcome. METHODS: We included 2,158 patients in whom an elective ICP was cancelled or postponed during COVID-19 pandemic in 37 hospitals in Spain. Among them, 700 (32.4%) were diabetics. Patients with and without diabetes were compared. RESULTS: Patients with diabetes were older and had a higher prevalence of other cardiovascular risk factors, previous cardiovascular history and co-morbidities. Diabetics had a higher mortality (3.0% vs. 1.0%; p = 0.001) and cardiovascular mortality (1.9% vs. 0.4%; p = 0.001). Differences were especially important in patients with valvular heart disease (mortality 6.9% vs 1.7% [p < 0.001] and cardiovascular mortality 4.9% vs 0.9% [p = 0.002] in patients with and without diabetes, respectively). In the multivariable analysis, diabetes remained as an independent risk factor both for overall and cardiovascular mortality. No significant interaction was found with other clinical variables. CONCLUSION: Among patients in whom an elective invasive cardiac procedure is cancelled or postponed during COVID-19 pandemic, mortality and cardiovascular mortality is higher in patients with diabetes, irrespectively on other clinical conditions. These procedures should not be cancelled in patients with diabetes.


Asunto(s)
Angiografía Coronaria , Diabetes Mellitus , Cardiopatías/diagnóstico por imagen , Cardiopatías/terapia , Intervención Coronaria Percutánea , Tiempo de Tratamiento , Listas de Espera , Factores de Edad , Anciano , Anciano de 80 o más Años , Comorbilidad , Bases de Datos Factuales , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/mortalidad , Femenino , Cardiopatías/mortalidad , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Medición de Riesgo , Factores de Riesgo , España/epidemiología , Factores de Tiempo , Listas de Espera/mortalidad
18.
Eur Rev Med Pharmacol Sci ; 25(5): 2415-2417, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33755985

RESUMEN

Coronavirus Disease 2019 (COVID-19) pandemic has made more awful effect on wellbeing and economy worldwide on an extraordinary scale. Angiotensin I Converting Enzyme 2 (ACE2), the principal receptor of SARS-CoV2, has been found to be communicated with Dopa decarboxylase in unwinding the connection of catecholamines with COVID-19 infection. Cardiovascular (CV) sickness, diabetes, hypertension, and related conditions cause significant risks during the current situation and the affected people are under basic observation around the world. The hypertension and diabetes are related with alterations in the degrees of catecholamines associated with renal gland. The naive form of renal dopaminergic framework is related with the expanded reabsorption of sodium resulting in downregulation of the ACE2 expression. Catecholamine biosynthesis is managed by counter-controlling angiotensin type 1R (AT1R) and angiotensin type 2R (AT2R), incitement of AT2 lessens catecholamine biosynthesis by means of a diminishing in cGMP levels likewise incitement of AT1 initiate catecholamine biosynthesis. This audit sums up the conceivable contribution of catecholamines in intense COVID-19 contamination and furthermore featured possible restorative adequacy of catecholamine flagging pathways against the incessant SARS-CoV-2.


Asunto(s)
/terapia , Catecolaminas/metabolismo , Diabetes Mellitus/metabolismo , Hormonas , Humanos , Hipertensión/metabolismo , Pandemias , Receptores Virales
19.
Virol J ; 18(1): 64, 2021 03 25.
Artículo en Inglés | MEDLINE | ID: mdl-33766078

RESUMEN

BACKGROUND: Variation in host genetic factors may result in variation in the host immune response to the infection. Some chronic diseases may also affect individuals' susceptibility to infectious diseases. The aim of this study was to evaluate the association of the host genetic factors mostly involved in inflammation, as well as hypercholesterolemia and diabetes with mild flu in an Iranian population. METHODS: In this cross-sectional study, nasopharyngeal swab samples were collected from 93 patients referred to primary care centers of Markazi, Semnan, and Zanjan provinces (central Iran) due to flu-like symptoms between March 2015 and December 2018. Of these, PCR test identified 49 influenza A/H1N1 and 44 flu-negative individuals. Twelve single-nucleotide polymorphisms (SNPs) in RPAIN, FCGR2A, MBL-2, CD55, C1QBP, IL-10, TNF-α and an unknown gene were genotyped using iPLEX GOLD SNP genotyping analysis. Hypercholesterolemia and diabetes status was determined based on the physician diagnosis. Association of the host genetic variants, hypercholesterolemia and diabetes with mild A/H1N1 flu was assessed with univariable and multivariable logistic regression analysis as implemented in Stata software (v.14). Statistical tests were considered as significant at 0.05 levels. RESULTS: Frequency of diabetes and hypercholesterolemia, as well as participants mean age was significantly higher in the flu-negative rather than the flu-positive group. Of 12 SNPs, nine did not show any significant association with mild flu in our study (rs1801274, rs1800451, rs2564978, rs361525, rs1800450, rs1800871, rs1800872, rs1800896, rs1800629). Possessing G vs. A allele in two SNPs (rs3786054 and rs8070740) was associated with a threefold increase in the chance of mild flu when compared to flu-negative patients (95% CI: 1.1, 22.0). Possessing C allele (vs. A) in the rs9856661 locus also increased the chance of mild flu up to 2 folds (95% CI: 1.0, 10.0). CONCLUSION: The results showed that possessing the G allele in either rs3786054 or rs8070740 loci in C1QBP and RPAIN genes, respectively, increased the risk of H1N1 infection up to 3.3 folds, regardless of the patient's age, BMI, diabetes, and hypercholesterolemia. Complementary functional genomic studies would shed more light on the underlying mechanism of human immunity associated with these genetic markers. The identified genetic factors may have the same role in susceptibility to similar respiratory infections with RNA viruses, like SARS, MERS and COVID-19. Future genetic association studies targeting these RNA viruses, especially COVID-19 is recommended. Studies on other ethnic groups would also shed light on possible ethnic variations in genetic susceptibility to respiratory RNA viruses. Trial registry IR.PII.REC.1399.063.


Asunto(s)
Diabetes Mellitus/genética , Diabetes Mellitus/virología , Estudios de Asociación Genética , Hipercolesterolemia/genética , Hipercolesterolemia/virología , Gripe Humana/genética , Gripe Humana/virología , Adulto , Anciano , Alelos , Estudios Transversales , Diabetes Mellitus/epidemiología , Femenino , Predisposición Genética a la Enfermedad , Genotipo , Humanos , Hipercolesterolemia/epidemiología , Subtipo H1N1 del Virus de la Influenza A/aislamiento & purificación , Gripe Humana/epidemiología , Irán/epidemiología , Masculino , Persona de Mediana Edad , Polimorfismo de Nucleótido Simple , Análisis de Regresión , Adulto Joven
20.
Molecules ; 26(4)2021 Feb 11.
Artículo en Inglés | MEDLINE | ID: mdl-33670177

RESUMEN

For centuries, natural medicines have represented the only option for treating human diseases and, nowadays, plant phytochemicals are considered as promising compounds to treat or prevent chronic conditions. Among them, hop flowers (Humulus lupulus L.), typically used in brewing industries to give the typical aroma and flavor to beer, have attracted particular attention for their health promoting properties. Several in vivo/vitro studies and human interventional trials have demonstrated the beneficial effects of these molecules on weight gain, lipid metabolism, glucose homeostasis, insulin sensitivities, and inflammation by acting on different targets. All these activities suggest a possible role of bitter hop acid in preventing metabolic syndrome and its related diseases. A systematic quest on PubMed and Scopus databases was performed to identify pre-clinical and clinical studies focusing on this topic. This systematic review summarizes the results obtained by different cell lines, animal models, and human interventional trials to propose iso-α-acids as medical nutrition therapy to treat or prevent metabolic syndrome and its related disorders as diabetes, dislipidemia inflammation, etc.


Asunto(s)
Diabetes Mellitus/tratamiento farmacológico , Humulus/química , Inflamación/tratamiento farmacológico , Síndrome Metabólico/tratamiento farmacológico , Ácidos/química , Ácidos/uso terapéutico , Cerveza , Flores/química , Humanos , Metabolismo de los Lípidos/efectos de los fármacos , Fitoquímicos/química , Fitoquímicos/farmacología
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