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Prasad K, Hegde S, Rao S, D'souza RK, George T, Suresh S, Baliga MS. Usefulness of Indian Diabetes Risk Score in Predicting Treatment-Induced Hyperglycemia in Women Undergoing Adjuvant Chemotherapy for Breast Cancer. South Asian J Cancer 2025; 14:4-14. [PMID: 40124160 PMCID: PMC11925627 DOI: 10.1055/s-0043-1775805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2025] Open
Abstract
In the curative treatment of cancer with adjuvant chemotherapy, antineoplastic drugs, along with glucocorticoids, can induce hyperglycemia. The objective of this study was to assess the utility of the Indian Diabetes Risk Score (IDRS) in predicting treatment-induced hyperglycemia in women who were nondiabetic and normoglycemic at the start of chemotherapy. This prospective study was conducted with nondiabetic women who required adjuvant chemotherapy. Participants voluntarily completed the IDRS, providing information on age, waist circumference, family history of diabetes, and physical activity. Chemotherapy-induced hyperglycemia was defined as fasting blood glucose levels ≥100 mg/dL or random blood glucose levels ≥140 mg/dL during treatment. Data were categorized into women who developed hyperglycemia and those who remained normoglycemic during treatment and were analyzed using Fisher's exact test. A significance level of p < 0.05 was applied. Receiver operating characteristic (ROC) curves were constructed to validate the IDRS for predicting hyperglycemia. A total of 208 women met the inclusion criteria and participated in the study. The results revealed that 38.93% (81/208) developed hyperglycemia by the end of chemotherapy, as observed during their first follow-up after treatment. Fisher's exact test demonstrated a significant difference in the total IDRS score and its domains, including family history, physical activity, and waist circumference ( p = 0.017-< 0.001), but not age. ROC analysis indicated that an IDRS score above 60 increased the likelihood of developing hyperglycemia, with a sensitivity of 81.3%, specificity of 54.7%, and an area under the curve of 0.727. These findings suggest that the IDRS is a sensitive tool for predicting adjuvant chemotherapy-induced hyperglycemia in breast cancer patients without diabetes. To the best of the authors' knowledge, this is the first study to evaluate the utility of the IDRS in predicting treatment-induced hyperglycemia in women undergoing adjuvant chemotherapy for breast cancer. Ongoing efforts are focused on understanding the underlying mechanisms and strategies for mitigation.
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Affiliation(s)
- Krishna Prasad
- Department of Medical Oncology, Mangalore Institute of Oncology, Mangaluru, Karnataka, India
| | - Sanath Hegde
- Department of Radiation Oncology, Mangalore Institute of Oncology, Mangaluru, Karnataka, India
| | - Suresh Rao
- Department of Radiation Oncology, Mangalore Institute of Oncology, Mangaluru, Karnataka, India
| | - Rhea Katherine D'souza
- Department of Research, Research Unit, Mangalore Institute of Oncology, Mangaluru, Karnataka, India
| | - Thomas George
- Department of Research, Research Unit, Mangalore Institute of Oncology, Mangaluru, Karnataka, India
| | - Sucharitha Suresh
- Department of Community Medicine, Father Muller Medical College, Mangalore, Karnataka, India
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Laurindo LF, Rodrigues VD, Minniti G, de Carvalho ACA, Zutin TLM, DeLiberto LK, Bishayee A, Barbalho SM. Pomegranate (Punica granatum L.) phytochemicals target the components of metabolic syndrome. J Nutr Biochem 2024; 131:109670. [PMID: 38768871 DOI: 10.1016/j.jnutbio.2024.109670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 04/08/2024] [Accepted: 05/14/2024] [Indexed: 05/22/2024]
Abstract
Pomegranate (Punica granatum L.) is a multipurpose dietary and medicinal plant known for its ability to promote various health benefits. Metabolic syndrome (MetS) is a complex metabolic disorder driving health and socioeconomic challenges worldwide. It may be characterized by insulin resistance, abdominal obesity, hypertension, and dyslipidemia. This study aims to conduct a review of pomegranate's effects on MetS parameters using a mechanistic approach relying on pre-clinical studies. The peel, juice, roots, bark, seeds, flowers, and leaves of the fruit present several bioactive compounds that are related mainly to anti-inflammatory and antioxidant activities as well as cardioprotective, antidiabetic, and antiobesity effects. The use of the juice extract can work as a potent inhibitor of angiotensin-converting enzyme activities, consequently regulating blood pressure. The major bioactive compounds found within the fruit are phenolic compounds (hydrolysable tannins and flavonoids) and fatty acids. Alkaloids, punicalagin, ellagitannins, ellagic acid, anthocyanins, tannins, flavonoids, luteolin, and punicic acid are also present. The antihyperglycemia, antihyperlipidemia, and weight loss promoting effects are likely related to the anti-inflammatory and antioxidant effects. When considering clinical application, pomegranate extracts are found to be frequently well-tolerated, further supporting its efficacy as a treatment modality. We suggest that pomegranate fruit, extract, or processed products can be used to counteract MetS-related risk factors. This review represents an important step towards exploring potential avenues for further research in this area.
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Affiliation(s)
- Lucas Fornari Laurindo
- Department of Biochemistry and Pharmacology, School of Medicine, Faculdade de Medicina de Marília (FAMEMA), São Paulo, São Paulo, Brazil; Department of Biochemistry and Pharmacology, School of Medicine, Universidade de Marília (UNIMAR), São Paulo, São Paulo, Brazil
| | - Victória Dogani Rodrigues
- Department of Biochemistry and Pharmacology, School of Medicine, Faculdade de Medicina de Marília (FAMEMA), São Paulo, São Paulo, Brazil
| | - Giulia Minniti
- Department of Biochemistry and Pharmacology, School of Medicine, Universidade de Marília (UNIMAR), São Paulo, São Paulo, Brazil
| | - Antonelly Cassio Alves de Carvalho
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, Universidade de Marília (UNIMAR), São Paulo, São Paulo, Brazil
| | - Tereza Laís Menegucci Zutin
- Department of Biochemistry and Pharmacology, School of Medicine, Universidade de Marília (UNIMAR), São Paulo, São Paulo, Brazil; Postgraduate Program in Structural and Functional Interactions in Rehabilitation, Universidade de Marília (UNIMAR), São Paulo, São Paulo, Brazil
| | - Lindsay K DeLiberto
- Department of Pharmacology, College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, FL USA
| | - Anupam Bishayee
- Department of Pharmacology, College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, FL USA.
| | - Sandra Maria Barbalho
- Department of Biochemistry and Pharmacology, School of Medicine, Universidade de Marília (UNIMAR), São Paulo, São Paulo, Brazil; Postgraduate Program in Structural and Functional Interactions in Rehabilitation, Universidade de Marília (UNIMAR), São Paulo, São Paulo, Brazil; Department of Biochemistry and Nutrition, School of Food and Technology of Marília (FATEC), São Paulo, São Paulo, Brazil.
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Ahuja M, Sharma JB, Perumal V, Sharma P, Bansal R, Sarkar A, Agrawal M. A Survey on Relation of Menopause to Metabolic Syndrome - SAFOMS STUDY (South Asian Federation of Menopause Societies) - Interim Analysis. J Midlife Health 2023; 14:291-298. [PMID: 38504731 PMCID: PMC10946686 DOI: 10.4103/jmh.jmh_17_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 02/08/2024] [Accepted: 02/12/2024] [Indexed: 03/21/2024] Open
Abstract
Background Metabolic syndrome (MS) is a spectrum of disorders that includes dysglycemia, dyslipidemia, central obesity, and hypertension. South Asian Indians are more prone to harbor MS at a younger age compared to Caucasians. However, there is a lack of large-scale data correlating menopause to MS in South Asian settings. Aims and Objectives The study aimed to determine the prevalence of MS and its components in pre- and postmenopausal women. It also assessed the relationship of age, menopausal status, personal and family history, anthropometric parameters, and biochemical markers to MS. Materials and Methods It was an interim analysis of a multicountry cross-sectional study in the South Asian Federation of Menopause Society (SAFOMS) countries: India, Pakistan, Bangladesh, Nepal, and Sri Lanka conducted through both online and physical methods. The survey questionnaire consisted of questions about details of personal history, demographics, and family history related to MS. Anthropometric measurements such as height, weight, basal metabolic index (BMI), waist circumference, and blood pressure readings were noted. Relevant history, history of polycystic ovarian syndrome, hypertensive disorders of pregnancy, and vasomotor symptoms were enquired. Biochemical evaluation of markers associated with MS was undertaken. Results In this interim analysis, 638 women were recruited. Out of them, 406 (63.6%) women were premenopausal and 232 (36.4%) were postmenopausal. 392 (61.4%) women had MS, while 246 (38.6%) women did not have MS. Increasing age, BMI, and visceral adiposity (waist circumference) were significantly correlated with incidence of MS. Raised fasting blood sugar, hemoglobin A1C, total cholesterol, low-density lipoprotein, serum triglyceride, and reduced high-density lipoprotein levels were significantly associated with the incidence of MS in both pre- and postmenopausal women. Peri- and postmenopausal hot flashes, night sweats, and sleep disturbances were also significantly associated with MS. Personal history of hypertension, diabetes, and dyslipidemia were the strongest factors to be associated with MS with a significantly high odds ratio. Conclusion The study has highlighted the role of BMI and waist circumference as the first warning signs, which will encourage to go for regular biochemical screening through lipid profile and fasting blood glucose measurements. Our study is a stepping stone for all future studies for relation of menopause to MS.
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Affiliation(s)
- Maninder Ahuja
- Director Ahuja Health Services, Consultant Gynecologist, Faridabad, Haryana, India
| | | | - Vanamail Perumal
- Department of Biostatistics and Research, Tiruchi SRM Medical College Hospital and Research Centre, Tiruchirappalli, Tamil Nadu, India
| | - Priyanka Sharma
- Department of Obstetrics and Gynecology, ESIC Medical College and Hospital, Faridabad, Haryana, India
| | - Ramandeep Bansal
- Department of Obstetrics and Gynecology, PGIMER, Chandigarh, India
| | - Avir Sarkar
- Department of Obstetrics and Gynecology, ESIC Medical College and Hospital, Faridabad, Haryana, India
| | - Mohini Agrawal
- Department of Obstetrics and Gynecology, AIIMS, New Delhi, India
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Agarwal V, Thirthalli J, Kumar CN, Christopher R, U Arunachal G, Reddy KS, Rawat VS, Gangadhar BN, Wood J, Nimgaonkar V. Parental consanguinity among patients with schizophrenia in a rural community of South India: A clinical and genetic investigation. Asian J Psychiatr 2021; 64:102814. [PMID: 34425412 DOI: 10.1016/j.ajp.2021.102814] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/12/2021] [Accepted: 08/10/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND Studies from certain regions of the world indicate that consanguineous marriages are a risk factor for the development of schizophrenia in offspring. However the evidence is inconsistent partly due to methodological limitation of which hospital based recruitment contributing to significant bias. The studies from the Indian subcontinent, is scarce, where rates of consanguinity is high. METHODS The schizophrenia patients living in a geographically defined rural south Indian community and randomly selected controls dwelling in the same community sharing sociocultural, economic and lifestyle factors were recruited. They were assessed for parental consanguinity using the clinical interviews as well as DNA-based estimates. The latter was conducted by calculating the coefficient of inbreeding 'f'. A participant was considered to have consanguineous parentage if his/her parents shared a common ancestor no more remote than a great-great-grandparent, corresponding to DNA-based estimates of 'f' ≥ 0.0156. RESULTS The rates of parental consanguinity assessed by clinical interview were comparable in both groups (Cases: 10.71 %, Controls: 7.25 %; χ2 = 0.493, p = 0.4825). However, DNA-based rates of parental consanguinity showed that 'f' was significantly higher among cases than controls (Mann-Whitney U = 11315.5; p = 0.022). Seventy-five cases (62.5 %) and 108 control participants (48.6 %) had 'f' ≥ 0.0156 (χ2 = 6.008; p = 0.014). The results were consistent across different quality control measures. CONCLUSION Schizophrenia is associated with higher parental consanguinity, suggesting a role for multiple recessive risk alleles in its etiology. Replication in future studies in diverse settings would add further strength to this.
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Affiliation(s)
- Vikas Agarwal
- Department of Psychiatry, National Institute of Mental Health And Neuro Sciences, Bengaluru, India
| | - Jagadisha Thirthalli
- Department of Psychiatry, National Institute of Mental Health And Neuro Sciences, Bengaluru, India.
| | | | - Rita Christopher
- Department of Neurochemistry, National Institute of Mental Health And Neuro Sciences, Bengaluru, India
| | - Gautham U Arunachal
- Department of Human Genetics, National Institute of Mental Health And Neuro Sciences, Bengaluru, India
| | - K Shanivaram Reddy
- Department of Psychiatric Social Work, National Institute of Mental Health And Neuro Sciences, Bengaluru, India
| | - Vikram Singh Rawat
- Department of Psychiatry, All India Institute of Mediacal Sciences, Rishikesh, India
| | - Bangalore N Gangadhar
- Department of Psychiatry, National Institute of Mental Health And Neuro Sciences, Bengaluru, India
| | - Joel Wood
- Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Hospital, Pittsburgh, USA
| | - Vishwajit Nimgaonkar
- Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Hospital, Pittsburgh, USA; Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, USA
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Combined Effects of Unhealthy Lifestyle Behaviors on Metabolic Syndrome among Postmenopausal Women. Healthcare (Basel) 2021; 9:healthcare9070848. [PMID: 34356226 PMCID: PMC8304088 DOI: 10.3390/healthcare9070848] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/01/2021] [Accepted: 07/02/2021] [Indexed: 11/30/2022] Open
Abstract
This study aimed to identify the combined effects of unhealthy lifestyle behaviors, including diet, sedentary behavior, and physical activity on metabolic syndrome (MS) and components of MS among postmenopausal women. Secondary data analysis was conducted using the Korean National Health and Nutrition Examination Survey (2014–2018) with a cross-sectional study design. Logistic regression analysis was conducted with data from 6114 Korean postmenopausal women. While no significant effects of unhealthy lifestyle behaviors, either individually or as a combination, were found for MS, prolonged sedentary behavior without poor dietary behavior and insufficient physical activity was associated with increased likelihood of abdominal obesity (adjusted odds ratio [AOR]: 1.59, 95% confidence interval [CI]: 1.10–2.29) and impaired fasting glucose (AOR: 1.54, 95% CI: 1.13–2.10). The combination of poor dietary behavior and prolonged sedentary behaviors was also associated with increased likelihood of abdominal obesity (AOR: 1.48, 95% CI: 1.10–2.00) and impaired fasting glucose (AOR: 1.49, 95% CI: 1.14–1.96). In addition, prolonged sedentary behavior and insufficient physical activity together were associated with increased likelihood of abdominal obesity (AOR: 2.81, 95% CI: 1.90–4.20) and impaired fasting glucose (AOR: 1.59, 95% CI: 1.13–2.24). Finally, combining poor dietary behavior, prolonged sedentary behavior, and insufficient physical activity was also associated with increased likelihood of abdominal obesity (AOR: 2.05, 95% CI: 1.50–2.80) and impaired fasting glucose (AOR: 1.71, 95% CI: 1.32–2.23). Strategies for replacing sedentary behavior of postmenopausal women with activities are warranted for prevention of abdominal obesity and impaired fasting glucose.
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Omar N, Dimassi DE, Chandra P, Hammoudeh S. Metabolic syndrome among adults in Qatar: A review of the literature across medical specialties. Qatar Med J 2021; 2020:43. [PMID: 33598415 PMCID: PMC7856911 DOI: 10.5339/qmj.2020.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 08/19/2020] [Indexed: 01/07/2023] Open
Abstract
This study aims to collate all metabolic syndrome-related studies among adults in Qatar, shedding light on gaps in knowledge related to this topic to be addressed in future research studies. PubMed was used in searching for metabolic syndrome-related articles in Qatar, which was executed using relevant terms and was conducted with no restrictions. A second search was executed at a later stage to include any recent publications. A total of 20 articles were found to be relevant and related to the topic in hand. Three definitions of metabolic syndrome were used across the reviewed studies, which were classified based on medical specialties. The main findings and key components of each study were summarized. Studies were unevenly distributed across various medical specialties. This article serves to direct future research activities by identifying what aspects of the disease have been covered under current or past research projects and what more needs to be addressed comprehensively in view of clinical and public health significance.
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Affiliation(s)
| | | | | | - Samer Hammoudeh
- Medical Research Center, Research Affairs, Hamad Medical Corporation, Doha, Qatar E-mail:
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Abd El–Wahab EW, Shatat HZ, Charl F. Adapting a Prediction Rule for Metabolic Syndrome Risk Assessment Suitable for Developing Countries. J Prim Care Community Health 2020; 10:2150132719882760. [PMID: 31662026 PMCID: PMC6822183 DOI: 10.1177/2150132719882760] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background: Metabolic syndrome (MetS) is a cluster of cardiometabolic disturbances that increases the risk of cardiovascular diseases (CVD) and type 2 diabetes mellitus (DM). The early identification of high-risk individuals is the key for halting these conditions. The world is facing a growing epidemic MetS although the magnitude in Egypt is unknown. Objectives: To describe MetS and its determinants among apparently healthy individuals residing in urban and rural communities in Egypt and to establish a model for MetS prediction. Methods: A cross-sectional study was conducted with 270 adults from rural and urban districts in Alexandria, Egypt. Participants were clinically evaluated and interviewed for sociodemographic and lifestyle factors and dietary habits. MetS was defined according to the harmonized criteria set by the AHA/NHLBI. The risk of ischemic heart diseases (IHDs), DM and fatty liver were assessed using validated risk prediction charts. A multiple risk model for predicting MetS was developed, and its performance was compared. Results: In total, 57.8% of the study population met the criteria for MetS and were at high risk for developing IHD, DM, and fatty liver. Silent CVD risk factors were identified in 20.4% of the participants. In our proposed multivariate logistic regression model, the predictors of MetS were obesity [OR (95% CI) = 16.3 (6.03-44.0)], morbid obesity [OR (95% CI) = 21.7 (5.3-88.0)], not working [OR (95% CI) = 2.05 (1.1-3.8)], and having a family history of chronic diseases [OR (95% CI) = 4.38 (2.23-8.61)]. Consumption of caffeine once per week protected against MetS by 27.8-fold. The derived prediction rule was accurate in predicting MetS, fatty liver, high risk of DM, and, to a lesser extent, a 10-year lifetime risk of IHD. Conclusion: Central obesity and sedentary lifestyles are accountable for the rising rates of MetS in our society. Interventions are needed to minimize the potential predisposition of the Egyptian population to cardiometabolic diseases.
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Affiliation(s)
- Ekram W. Abd El–Wahab
- Department of Tropical Health, High Institute of Public Health, Alexandria University, Egypt
- Ekram W. Abd El- Wahab, Tropical Health Department, High Institute of Public Health, Alexandria University, 165 El Horreya Road, Alexandria, 21561, Egypt.
| | - Hanan Z. Shatat
- Department of Tropical Health, High Institute of Public Health, Alexandria University, Egypt
| | - Fahmy Charl
- Department of Occupational Health and Air Pollution (Division of Occupational Health and Industrial Medicine), High Institute of Public Health, Alexandria University, Egypt
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Shin S, Jee H. Prevalence of metabolic syndrome in the Gulf Cooperation Council countries: meta-analysis of cross-sectional studies. J Exerc Rehabil 2020; 16:27-35. [PMID: 32161732 PMCID: PMC7056482 DOI: 10.12965/jer.1938758.379] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 02/05/2020] [Indexed: 12/22/2022] Open
Abstract
Metabolic syndrome is a collection of health-related conditions that lead to serious health condition. An individual with metabolic syndrome may acquire greater risk for adult-onset complications such as cardiovascular or neurological disorders. The aim of this study was to review and provide the prevalence of metabolic syndrome in Gulf Cooperation Council countries (GCC). Literature searches were performed on PubMed, Google scholar, and Web of Science Core Collection for English-language articles along with national studies. The following search terms were used during search: “prevalence of metabolic syndrome in GCC,” “prevalence of metabolic syndrome in middle east,” “prevalence of metabolic syndrome in Arab,” and “prevalence of metabolic syndrome name of country.” Thirty-seven studies were selected for final review out of 132 studies. The weighted pooled prevalence of metabolic syndrome was 27.3% with high heterogeneity (I2=98.94%; Cochran Q-test P<0.01). The results showed comparatively high and rising rate of metabolic syndrome in the GCC area. Preventative strategy should be considered to reduce the risk of morbidity or mortality related to metabolic syndrome.
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Affiliation(s)
- Seungmin Shin
- Physical Education Department, King Fahd University of Petroleum & Minerals, Dhahran, Saudi Arabia
| | - Haemi Jee
- Department of Physical Therapy, Namseoul University, Cheonan, Korea
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Yasmeen S, Khan U, Khan GM, Fatima SS. Association of tissue inhibitor of metalloproteinase 2 with non-alcoholic fatty liver disease in metabolic syndrome. Arch Physiol Biochem 2019; 125:441-446. [PMID: 29912573 DOI: 10.1080/13813455.2018.1481095] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The aim of this case-control study was to assess TIMP2 level in subjects with or without metabolic syndrome (MetS) and to associate levels with non-alcoholic fatty liver changes (NAFLD). Thirty-three MetS subjects and 55 controls were recruited. Anthropometric data, lipid and glucose profile, TIMP2 and liver ultrasound was performed. High TIMP2 was seen in MetS group (145.28 ± 23.11 pg/ml) versus controls (19.06 ± 1.19 pg/ml; p < .001). Serum cholesterol, triglyceride, LDL-c and glucose levels were significantly higher in MetS subjects (p < .05). MetS individuals (72.72%) showed positive fatty liver changes versus 14.5% controls. Elevated TIMP2 positively correlated with waist circumference, body fat, blood glucose and NAFLD. Furthermore, every unit rise in waist circumference and TIMP2 and a unit decrease in HDL were associated with higher odds of developing NAFLD (p < .05). There may be concurrent relationship between TIMP2 and NAFLD in MetS that requires further evaluation to improve risk assessment and early diagnosis of MetS.
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Affiliation(s)
- Saira Yasmeen
- Department of Physiology, Basic Medical Sciences Institute, Jinnah Post graduate Medical Centre , Karachi , Pakistan
| | - Unab Khan
- Department of Family, Medicine Aga Khan University , Karachi , Pakistan
| | - Ghulam Mustafa Khan
- Department of Physiology, Basic Medical Sciences Institute, Jinnah Post graduate Medical Centre , Karachi , Pakistan
| | - Syeda Sadia Fatima
- Department of Biological and Biomedical Sciences, Aga Khan University , Karachi , Pakistan
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Mirzaei M, Khajeh M, Askarishahi M, Azizi R. Behavioral and familial predictors of diabetes mellitus in adults aged 20-69 in Yazd, Iran during 2014-2015. Diabetes Metab Syndr 2018; 12:667-671. [PMID: 29678604 DOI: 10.1016/j.dsx.2018.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 04/09/2018] [Indexed: 12/29/2022]
Abstract
INTRODUCTION The present study aimed to assess the behavioral and familial predictors of diabetes mellitus as well as their interaction in the risk of diabetes mellitus type2. METHODS The present cross-sectional study was conducted using the Yazd health study (YaHS) data which was collected in 2013-14. Statistical population of this study consisted of all 9340 individuals aged between 20 and 69 in Yazd City. Logistic regression was used to determine behavioral factors and family history of diabetes and their interaction in the risk of diabetes. RESULTS In the present study, age, family history of type 2 diabetes, waist-to-hip ratio, BMI, educational level, physical activity and smoking were considered as the risk factors for type 2 diabetes.There was a significant interaction(negative interaction) between family history of diabetes and other risk factors only for BMI, so that the risk of developing type-2 diabetes was lower in the presence of two risk factors- family history of diabetes and BMI- than the risk of diabetes in the presence of each of these factors. CONCLUSION Results of the present study suggested that despite the consideration of family history as an independent risk factor for type 2 diabetes, if it was used as a tool to raise the awareness and sensitivity in people with type 2 diabetes, it would reduce the risk of developing this type of diabetes in people who had other risk factors for type 2 diabetes.
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Affiliation(s)
- Masoud Mirzaei
- Yazd Cardiovascular Research Centre, Shahid Sadoughi University, Yazd, Iran
| | | | - Mohsen Askarishahi
- Department of Biostatistics, school of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Reyhaneh Azizi
- Department of Endocrinology, Faculty of Medicine, Shahid Sadoughi University, Yazd, Iran
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Hammoudeh S, Ghuloum S, Mahfoud Z, Yehya A, Abdulhakam A, Al-Mujalli A, Al-Zirie M, Abdel Rahman MO, Godwin A, Younes N, Hani Y, Mook-Kanamori D, Mook-Kanamori M, El Sherbiny R, Al-Amin H. The prevalence of metabolic syndrome in patients receiving antipsychotics in Qatar: a cross sectional comparative study. BMC Psychiatry 2018; 18:81. [PMID: 29587717 PMCID: PMC5870932 DOI: 10.1186/s12888-018-1662-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 03/13/2018] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Metabolic abnormalities are common in patients maintained on antipsychotics. These abnormalities increase the risk of cardiovascular diseases and mortality in this population. The aim of this study is to assess the prevalence of metabolic syndrome (MetS) in subjects maintained on antipsychotics relative to controls in Qatar, and to assess the factors contributing to the development of MetS. METHODS A cross sectional design was used to collect data and fasting blood samples from subjects maintained on antipsychotics for at least six months (n = 112) and from a control group (n = 114). The groups were compared in regard to prevalence of MetS, and multiple regression analysis was used to determine the risk factors in each group. RESULTS The two groups (antipsychotics vs. control) were similar in regard to age (35.73 ± 10.28 vs. 35.73 ± 8.16 years) and gender ratio. The MetS was higher among the subjects on antipsychotics, but this difference did not reach statistical significance. Blood pressure (BP) was significantly higher in the antipsychotics group and BMI was the major risk factor to develop MetS in this group. CONCLUSIONS The prevalence of MetS in both groups is high and mostly attributed to obesity and high BP. Public health interventions are needed to address this major health problem overall. Larger studies are needed to further assess the impact of antipsychotics and mental illness on the development of MetS.
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Affiliation(s)
- Samer Hammoudeh
- Department of Research, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Suhaila Ghuloum
- Department of Psychiatry, Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ziyad Mahfoud
- Department of Health Policy and Research, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Arij Yehya
- Department of Research, Weill Cornell Medicine - Qatar, Doha, Qatar
| | | | | | | | | | - Angela Godwin
- Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar
| | - Noura Younes
- Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar
| | - Yahya Hani
- Department of Psychiatry, Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Dennis Mook-Kanamori
- Department of Physiology and Biophysics, Weill Cornell Medicine - Qatar, Doha, Qatar
| | | | - Reem El Sherbiny
- Department of Research, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Hassen Al-Amin
- Department of Psychiatry, Weill Cornell Medicine - Qatar, Education city, P.O. Box 24144, Doha, Qatar.
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Roy C, Tremblay PY, Ayotte P. Is mercury exposure causing diabetes, metabolic syndrome and insulin resistance? A systematic review of the literature. ENVIRONMENTAL RESEARCH 2017; 156:747-760. [PMID: 28482296 DOI: 10.1016/j.envres.2017.04.038] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 04/25/2017] [Accepted: 04/28/2017] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Several populations are exposed to mercury (Hg) via their environment, occupation or diet. It is hypothesized that Hg exposure can lead to the development of diabetes mellitus (DM). Metabolic syndrome (MS) is also a possible outcome as its symptoms are closely linked to those of DM. METHOD We conducted a systematic review of the literature by screening Web of Science, MEDLINE, SciFinder and Embase and we included original studies pertaining to the relationship of total Hg exposure (elemental, inorganic or organic) to DM, MS or insulin resistance. The studies were selected based on the PICOS (patients, intervention, comparator, outcomes and study design) criteria and their quality assessed using a nine-point scale. Study characteristics and results were extracted and presented in structured tables. We also extracted covariates entered as confounding factors to evaluate possible biases in selected studies. Finally, a weight of evidence approach was used to assess the causality of the relationship. RESULTS A total of 34 studies were included in the present review. Epidemiological data assessment suggests a possible association between total Hg concentrations in different biological matrices and incidence of DM or MS, but the relationship is not consistent. In vivo and in vitro studies support the biological plausibility of the relation between Hg exposure and DM or MS. Five out of nine of Bradford Hill's criteria were fulfilled: strength, temporality, plausibility, coherence and analogy. CONCLUSION Increased total Hg exposure may augment the risk of DM and MS, but the lack of consistency of the epidemiological evidence prevents inference of a causal relationship. Additional prospective cohort studies and careful consideration of confounding variables and interactions are required to conclude on the causal relationship of total Hg exposure on the development of DM or MS.
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Affiliation(s)
- Cynthia Roy
- Centre de Toxicologie du Québec, Institut national de santé publique du Québec (INSPQ), 945 Wolfe, Québec, QC, Canada G1V 5B3; Axe santé publique et pratiques optimales en santé, Centre de recherche du CHU de Québec, 2875 boul. Laurier, Édifice Delta 2, Bureau 600, Québec, QC, Canada G1V 2M2.
| | - Pierre-Yves Tremblay
- Centre de Toxicologie du Québec, Institut national de santé publique du Québec (INSPQ), 945 Wolfe, Québec, QC, Canada G1V 5B3; Axe santé publique et pratiques optimales en santé, Centre de recherche du CHU de Québec, 2875 boul. Laurier, Édifice Delta 2, Bureau 600, Québec, QC, Canada G1V 2M2
| | - Pierre Ayotte
- Centre de Toxicologie du Québec, Institut national de santé publique du Québec (INSPQ), 945 Wolfe, Québec, QC, Canada G1V 5B3; Axe santé publique et pratiques optimales en santé, Centre de recherche du CHU de Québec, 2875 boul. Laurier, Édifice Delta 2, Bureau 600, Québec, QC, Canada G1V 2M2; Département de médecine préventive et sociale, Université Laval, Pavillon Ferdinand-Vandry, Québec, QC, Canada G1V 0A6
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Bener A, Al-Hamaq AOAA, Kurtulus EM, Abdullatef WK, Zirie M. The role of vitamin D, obesity and physical exercise in regulation of glycemia in Type 2 Diabetes Mellitus patients. Diabetes Metab Syndr 2016; 10:198-204. [PMID: 27381964 DOI: 10.1016/j.dsx.2016.06.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 06/06/2016] [Indexed: 02/01/2023]
Abstract
AIM The aims of this study were to determine the role of vitamin D, obesity and physical exercise in the regulation of glycemia in Type 2 Diabetes Mellitus patients in a highly consanguineous population. DESIGN Case and control study. SETTING The survey was carried out at the Hamad General Hospital and Primary Health Care (PHC) centers in the State of Qatar. SUBJECTS The study was conducted from November 2012 to June 2014 among subjects above 30 years of age. Of the 2224 registered with diagnosed diabetes and free diseases attending Hamad General Hospital and PHC centers agreed and gave their consent to study. METHODS Questionnaire included socio-demographic variables, body mass index (BMI), consanguinity, lifestyle habits, family history of diabetes, blood pressure and development of diabetes complications such as retinopathy, nephropathy, and neuropathy were collected at regular intervals throughout the follow-up. Univariate and multivariate statistical analysis were performed. RESULTS There were statistically significant difference between patients with diabetic and control in terms of ethnicity (p=0.012), level of education (p=0.002), occupation (p<0.001), monthly income (p<0.001), BMI(p=0.024), sport activity (p=0.018), cigarette smoking (p<0.001), consanguinity (p=0.029) and family history of Diabetes Mellitus (p<0.001) and co-morbidity hypertension (p=0.041). Further, the biochemistry values in the studied subjects with T2DM compared to healthy controls and the study revealed that serum Vitamin D, BMI, fasting glucose level, calcium, HbA1c, total cholesterol HDL, LDL, bilirubin, triglycerides, uric acid and blood pressure systolic and diastolic were higher in T2DM compared to their counterparts. Multivariate logistic regression showed that vitamin D deficiency ng/mL, Family History of T2DM, BMI (kg/m2) hypertension, consanguinity, income, mother occupation, ethnicity, educational level and Lack of physical exercise variables were significant predictors of diabetes. In the group of Diabetes Mellitus Type 2 patients, 39.3% as opposed to 51.2% in the control group had vitamin D deficiency, 25(OH) D3 levels≤10ng/ml (p<0.001). In the group of Diabetes Mellitus Type 2 patients, 34.6% as opposed to 37.9% in the control group had vitamin D insufficiency, 25(OH)D3 levels <20ng/ml (p < 0.001). In the group of Diabetes Mellitus Type 2 patients, 22.8% as opposed to 14.2% in the control group had vitamin D sufficiency, 25(OH)D3 levels >30 10ng/ml (p < 0.001). CONCLUSION Vitamin D, family history of diabetes, consanguinity marriages' and hereditary gene-environment interactions and physical exercise may also contribute to the current diabetes epidemic in Qatari's Arab populations.
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Affiliation(s)
- Abdulbari Bener
- Department of Biostatistics & Medical Informatics, Cerrahpaşa Faculty of Medicine, Istanbul University, Istanbul, Turkey; Department of Evidence for Population Health Unit, School of Epidemiology and Health Sciences, University of Manchester, Manchester, UK.
| | | | - Eda Merve Kurtulus
- Department of Biostatistics & Medical Informatics, Cerrahpaşa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Waleed K Abdullatef
- Department of Cardiology and Cardiovascular Surgery, Heart Hospital, Hamad Medical Corporation,Qatar
| | - Mahmoud Zirie
- Department of Endocrinology, Hamad General Hospital, Hamad Medical Corporation, Qatar
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Kharroubi AT, Darwish HM. Diabetes mellitus: The epidemic of the century. World J Diabetes 2015; 6:850-67. [PMID: 26131326 PMCID: PMC4478580 DOI: 10.4239/wjd.v6.i6.850] [Citation(s) in RCA: 567] [Impact Index Per Article: 56.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 03/25/2015] [Accepted: 04/10/2015] [Indexed: 02/05/2023] Open
Abstract
The epidemic nature of diabetes mellitus in different regions is reviewed. The Middle East and North Africa region has the highest prevalence of diabetes in adults (10.9%) whereas, the Western Pacific region has the highest number of adults diagnosed with diabetes and has countries with the highest prevalence of diabetes (37.5%). Different classes of diabetes mellitus, type 1, type 2, gestational diabetes and other types of diabetes mellitus are compared in terms of diagnostic criteria, etiology and genetics. The molecular genetics of diabetes received extensive attention in recent years by many prominent investigators and research groups in the biomedical field. A large array of mutations and single nucleotide polymorphisms in genes that play a role in the various steps and pathways involved in glucose metabolism and the development, control and function of pancreatic cells at various levels are reviewed. The major advances in the molecular understanding of diabetes in relation to the different types of diabetes in comparison to the previous understanding in this field are briefly reviewed here. Despite the accumulation of extensive data at the molecular and cellular levels, the mechanism of diabetes development and complications are still not fully understood. Definitely, more extensive research is needed in this field that will eventually reflect on the ultimate objective to improve diagnoses, therapy and minimize the chance of chronic complications development.
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Bener A, Kim EJ, Mutlu F, Eliyan A, Delghan H, Nofal E, Shalabi L, Wadi N. Burden of diabetes mellitus attributable to demographic levels in Qatar: an emerging public health problem. Diabetes Metab Syndr 2014; 8:216-220. [PMID: 25450820 DOI: 10.1016/j.dsx.2014.09.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Diabetes is one of the main contributors to ill health and premature mortality worldwide and its prevalence has been rising during the last decades. AIM The aim of the present study was to quantify the burden of disease in terms of deaths and loss of healthy life years (DALYs) attributed to diabetes by its demographic levels in the State of Qatar. MATERIALS AND METHODS The methods were largely based on the established Global Burden of Disease methodology and use the burden of disease in terms of disability adjusted life years (DALYs) and the years lost due to disability (YLD) as the outcome measure. We calculated years lost due to disability (YLD) and years life lost (YLL) attributable to diabetes. The study was conducted during the period from June 2013 to January 2014. RESULTS The study findings revealed that disability adjusted life years (DALYs) has been increasing across the years and reached to 4.35 in 2011 from 2.58 in 2007. DALYs for men was remarkably higher than women during the period (2007-2011). Diabetes mellitus was the 6th leading cause of disease burden in Qatar (3.8%). The YLD showed a sharp increase in men (2.52 in 2011 from 1.34 in 2007) and women (1.05 in 2011 from 0.33 in 2007) during the year 2011. YLL portion of women enlarged considerably in 2011 (0.10) compared to 2010 (0.04). YLL for men and women was fluctuating across the years with a decrease in 2011 (18%) from 2007 (35%). Men and women in the age group 30-44 years had the highest peak across the years. CONCLUSION The study findings revealed that diabetes disease burden was considerably high in Qatar, particularly in the working age group. DALYs has been increasing across the years.
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Affiliation(s)
- Abdulbari Bener
- Department of Medical Statistics & Epidemiology, Hamad Medical Corporation, Department of Public Health, Weill Cornell Medical College, PO Box 3050, Qatar; Department of Evidence for Population Health Unit, School of Epidemiology and Health Sciences, The University of Manchester, Manchester, UK.
| | - Eun-Jung Kim
- Department of Public Health, Korea University, Seoul, Republic of Korea
| | - Fatih Mutlu
- Department of Mechanical & Industrial Engineering, Faculty of Engineering, Qatar University, Qatar
| | - Afnan Eliyan
- Department of Medical Statistics & Epidemiology, Hamad Medical Corporation, Department of Public Health, Weill Cornell Medical College, PO Box 3050, Qatar
| | - Hamsa Delghan
- Department of Mechanical & Industrial Engineering, Faculty of Engineering, Qatar University, Qatar
| | - Enas Nofal
- Department of Mechanical & Industrial Engineering, Faculty of Engineering, Qatar University, Qatar
| | - Luma Shalabi
- Department of Mechanical & Industrial Engineering, Faculty of Engineering, Qatar University, Qatar
| | - Nada Wadi
- Department of Mechanical & Industrial Engineering, Faculty of Engineering, Qatar University, Qatar
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