1
|
Hu Y, Han Y, Liu Y, Cui Y, Ni Z, Wei L, Cao C, Hu H, He Y. A nomogram model for predicting 5-year risk of prediabetes in Chinese adults. Sci Rep 2023; 13:22523. [PMID: 38110661 PMCID: PMC10728122 DOI: 10.1038/s41598-023-50122-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 12/15/2023] [Indexed: 12/20/2023] Open
Abstract
Early identification is crucial to effectively intervene in individuals at high risk of developing pre-diabetes. This study aimed to create a personalized nomogram to determine the 5-year risk of pre-diabetes among Chinese adults. This retrospective cohort study included 184,188 participants without prediabetes at baseline. Training cohorts (92,177) and validation cohorts (92,011) were randomly assigned (92,011). We compared five prediction models on the training cohorts: full cox proportional hazards model, stepwise cox proportional hazards model, multivariable fractional polynomials (MFP), machine learning, and least absolute shrinkage and selection operator (LASSO) models. At the same time, we validated the above five models on the validation set. And we chose the LASSO model as the final risk prediction model for prediabetes. We presented the model with a nomogram. The model's performance was evaluated in terms of its discriminative ability, clinical utility, and calibration using the area under the receiver operating characteristic (ROC) curve, decision curve analysis, and calibration analysis on the training cohorts. Simultaneously, we also evaluated the above nomogram on the validation set. The 5-year incidence of prediabetes was 10.70% and 10.69% in the training and validation cohort, respectively. We developed a simple nomogram that predicted the risk of prediabetes by using the parameters of age, body mass index (BMI), fasting plasma glucose (FBG), triglycerides (TG), systolic blood pressure (SBP), and serum creatinine (Scr). The nomogram's area under the receiver operating characteristic curve (AUC) was 0.7341 (95% CI 0.7290-0.7392) for the training cohort and 0.7336 (95% CI 0.7285-0.7387) for the validation cohort, indicating good discriminative ability. The calibration curve showed a perfect fit between the predicted prediabetes risk and the observed prediabetes risk. An analysis of the decision curve presented the clinical application of the nomogram, with alternative threshold probability spectrums being presented as well. A personalized prediabetes prediction nomogram was developed and validated among Chinese adults, identifying high-risk individuals. Doctors and others can easily and efficiently use our prediabetes prediction model when assessing prediabetes risk.
Collapse
Affiliation(s)
- Yanhua Hu
- College of Information Science and Engineering, Liuzhou Institute of Technology, Liuzhou, 545616, Guangxi Zhuang Autonomous Region, China
| | - Yong Han
- Department of Emergency, Shenzhen Second People's Hospital, Shenzhen, 518000, Guangdong Province, China
- Department of Emergency, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518000, Guangdong Province, China
| | - Yufei Liu
- Department of Neurosurgery, Shenzhen Second People's Hospital, Shenzhen, 518000, Guangdong Province, China
- Department of Neurosurgery, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518000, Guangdong Province, China
| | - Yanan Cui
- College of Information Science and Engineering, Liuzhou Institute of Technology, Liuzhou, 545616, Guangxi Zhuang Autonomous Region, China
| | - Zhiping Ni
- College of Information Science and Engineering, Liuzhou Institute of Technology, Liuzhou, 545616, Guangxi Zhuang Autonomous Region, China
| | - Ling Wei
- College of Information Science and Engineering, Liuzhou Institute of Technology, Liuzhou, 545616, Guangxi Zhuang Autonomous Region, China
| | - Changchun Cao
- Department of Rehabilitation, Shenzhen Dapeng New District Nan'ao People's Hospital, No. 6, Renmin Road, Dapeng New District, Shenzhen, 518000, Guangdong Province, China.
| | - Haofei Hu
- Department of Nephrology, Shenzhen Second People's Hospital, No. 3002 Sungang Road, Futian District, Shenzhen, 518000, Guangdong Province, China.
- Department of Nephrology, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518000, Guangdong Province, China.
| | - Yongcheng He
- Department of Nephrology, Shenzhen Hengsheng Hospital, No. 20 Yintian Road, Baoan District, Shenzhen, 518000, Guangdong Province, China.
- Department of Nephrology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, Sichuan, China.
| |
Collapse
|
2
|
Li T, Cao C, Xuan X, Liu W, Xiao X, Wei C. The association between creatinine to body weight ratio and the risk of progression to diabetes from pre-diabetes: a 5-year cohort study in Chinese adults. BMC Endocr Disord 2023; 23:266. [PMID: 38044422 PMCID: PMC10694873 DOI: 10.1186/s12902-023-01518-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 11/21/2023] [Indexed: 12/05/2023] Open
Abstract
OBJECTIVE Evidence on the association between the creatinine to body weight (Cre/BW) ratio and the risk of pre-diabetes to diabetes development remains limited. Our study aimed to examine the association between the Cre/BW ratio and incident diabetes in pre-diabetic patients. METHODS This retrospective cohort study included 24,506 pre-diabetic participants who underwent health checks from 2010 to 2016 in China. We used the Cox proportional-hazards regression model to explore the relationship between baseline Cre/BW ratio and diabetes risk in pre-diabetes patients. Using a Cox proportional hazards regression with cubic spline function and smooth curve fitting (cubical spline smoothing), we were able to determine the non-linear relationship between them. We also carried out a number of subgroup and sensitivity analyses. RESULTS The age range of the participants included in this study was 20-99 years, with a majority of 16,232 individuals (66.24%) being men. The mean baseline Cre/BW ratio was 1.06 (SD 0.22) umol/L/kg. 2512 (10.25%) participants received a diabetes final diagnosis over a median follow-up period of 2.89 years. After adjusting for covariates, the Cre/BW ratio had a negative association with incident diabetes in participants with pre-diabetes, per umol/L/kg increase in Cre/BM ratio was accompanied by a 55.5% decrease in diabetes risk (HR = 0.445, 95%CI 0.361 to 0.548). The Cre/BW ratio and risk of diabetes had a non-linear connection, with 1.072 umol/L/kg serving as the ratio's inflection point. The HR were 0.294 (95%CI:0.208-0.414) and 0.712 (95%CI:0.492-1.029), respectively, on the left and right sides of the inflection point. The sensitivity analysis demonstrated the robustness of these results. Subgroup analyses indicated that the Cre/BW ratio was strongly associated with the risk of diabetes among participants who were younger than 50 years, as well as among those with diastolic blood pressure (DBP) < 90 mmHg and triglyceride (TG) < 1.7 mmol/L. In contrast, among participants 50 years of age or older, those with DBP ≥ 90 mmHg, and those with TG ≥ 1.7 mmol/L, the relationship between the Cre/BW ratio and the risk of diabetes was attenuated. CONCLUSION This study demonstrates a negative, non-linear relationship between the Cre/BW ratio and the risk of diabetes among the Chinese population with pre-diabetes. From a therapeutic standpoint, it is clinically meaningful to maintain the Cre/BW ratio levels above the inflection point of 1.072 umol/L/kg.
Collapse
Affiliation(s)
- Tong Li
- Department of Nephrology, Shenzhen Second People's Hospital, Shenzhen, Guangdong Province, 518000, China
- Department of Nephrology, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong Province, 518000, China
| | - Changchun Cao
- Department of Rehabilitation, Shenzhen Dapeng New District Nan'ao People's Hospital, Shenzhen, Guangdong Province, 518000, China
| | - Xuan Xuan
- Department of Rheumatology, Shenzhen Second People's Hospital, Shenzhen, Guangdong Province, 518000, China
- Department of Rheumatology, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong Province, 518000, China
| | - Wenjing Liu
- Department of Geriatrics, Shenzhen Second People's Hospital, No.3002 Sungang Road, Futian District, Shenzhen, Guangdong Province, 518000, China
- Department of Geriatrics, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong Province, 518000, China
| | - Xiaohua Xiao
- Department of Geriatrics, Shenzhen Second People's Hospital, No.3002 Sungang Road, Futian District, Shenzhen, Guangdong Province, 518000, China.
- Department of Geriatrics, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong Province, 518000, China.
| | - Cuimei Wei
- Department of Geriatrics, Shenzhen Second People's Hospital, No.3002 Sungang Road, Futian District, Shenzhen, Guangdong Province, 518000, China.
- Department of Geriatrics, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong Province, 518000, China.
| |
Collapse
|
3
|
Bardenheier BH, Wu WC, Zullo AR, Gravenstein S, Gregg EW. Progression to diabetes by baseline glycemic status among middle-aged and older adults in the United States, 2006-2014. Diabetes Res Clin Pract 2021; 174:108726. [PMID: 33662490 DOI: 10.1016/j.diabres.2021.108726] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/04/2021] [Accepted: 02/11/2021] [Indexed: 10/22/2022]
Abstract
AIMS Primary prevention studies have indicated that structured lifestyle change programs in adults with an annual diabetes risk of 4.7% are cost-effective. However, few population-based studies have quantified the risk of diabetes among adults with prediabetes. METHODS We used the nationally representative U.S. Health and Retirement Study to identify adults aged ≥ 52 years with prediabetes (A1c: 5.7% - 6.4%) in 2006 and followed them to 2014 to assess diabetes status defined by A1c ≥ 6.5% in 2010 or 2014 or by self-report of a diabetes diagnosis by various risk factors. RESULTS Among the 1,406 adults with prediabetes (average 4.7 years of follow-up), risk factors significantly associated with subsequent incident diabetes with adjusted annual risk of diabetes ≥ 4.7% were: male gender (4.8%); aged 52-64 years (5.0%); Black race (5.5%); obesity (body mass index (kg/m2) ≥ 30.0, 6.8%); large waist circumference (women: > 35 in.; men: > 40 in., 4.9%); C-reactive protein levels ≥ 3 ug/L (5.5%); treated for high cholesterol (4.7%); treated for hypertension (5.3%); and moderate mobility loss (4.8%). CONCLUSIONS Primary prevention interventions among adults with prediabetes who also have moderate mobility loss or well-known risk factors for diabetes are likely to be cost-effective.
Collapse
Affiliation(s)
- Barbara H Bardenheier
- Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI, USA; Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.
| | - Wen-Chih Wu
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA; Department of Medicine, Alpert Medical School of Brown University, Providence, RI, USA; Center of Innovation in Long-Term Services and Supports, Providence Veterans Affairs Medical Center, Providence, RI, USA
| | - Andrew R Zullo
- Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI, USA; Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA; Center of Innovation in Long-Term Services and Supports, Providence Veterans Affairs Medical Center, Providence, RI, USA; Department of Pharmacy, Rhode Island Hospital, Providence, RI, USA|Department of Pharmacy, Rhode Island Hospital, Providence, RI, USA
| | - Stefan Gravenstein
- Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI, USA; Department of Medicine, Alpert Medical School of Brown University, Providence, RI, USA; Center of Innovation in Long-Term Services and Supports, Providence Veterans Affairs Medical Center, Providence, RI, USA
| | | |
Collapse
|
4
|
A population-based survey for dietary patterns and prediabetes among 7555 Chinese adults in urban and rural areas in Jiangsu Province. Sci Rep 2020; 10:10488. [PMID: 32591599 PMCID: PMC7320015 DOI: 10.1038/s41598-020-67028-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 06/01/2020] [Indexed: 12/18/2022] Open
Abstract
Background: Prediabetes is an important public health problem concern globally, to which dietary patterns have shown varied effects. This study aims to analyze the relationship between dietary patterns and prediabetes in Chinese adults. Methods: A total of 7555 adults from Jiangsu province, China, were recruited using a stratified multistage cluster sampling method. Information on diet intake, demographic, blood glucose and other indices were collected by structured questionnaires. Four dietary patterns of Meat diet, Healthy diet, Traditional diet and Fried food with staple diet were identified using Principle Component Analysis and followingly divided into T1 - T4 groups according to their quartiles of factor scores. Multivariate logistic regression analysis was used to investigate the association between dietary patterns and prediabetes. Results: Healthy diet was found to be associated with the lowest prevalence of prediabetes (P < 0.05). Multivariate logistic regression analysis after adjusting the confounding factors demonstrated that the lowest odds ratio with prediabetes was associated with the third quartile (T3 group) of Healthy diet (Odds Ratio = 0.745, 95% Confidence Interval: 0.645–0.860, P < 0.01), compared with the lower quartile (T1 group). The Meat diet was a potential risk factor for the isolated IFG (Odds Ratio = 1.227, 95%Confidence Interval: 1.070–1.406, P-value<0.01) while Fried food with staple diet was positively linked to the presence of IFG combined with IGT (Odds Ratio = 1.735, 95% Confidence Interval: 1.184–2.543, P-value < 0.01). Conclusions: Dietary patterns rich in meat but low in fresh fruit, fresh vegetable, milk, and fish are positively associated with higher risk of prediabetes, particularly the IFG. Higher Healthy diet consumption was associated with significantly lower risk of prediabetes.
Collapse
|
5
|
Alfawaz H, Naeef AF, Wani K, Khattak MNK, Sabico S, Alnaami AM, Al-Daghri NM. Improvements in Glycemic, Micronutrient, and Mineral Indices in Arab Adults with Pre-Diabetes Post-Lifestyle Modification Program. Nutrients 2019; 11:nu11112775. [PMID: 31731609 PMCID: PMC6893589 DOI: 10.3390/nu11112775] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/31/2019] [Accepted: 11/05/2019] [Indexed: 12/28/2022] Open
Abstract
The present study aimed to investigate the changes in dietary patterns of adult Saudis with prediabetes who underwent a six-month lifestyle modification program. A total of 160 Saudis with prediabetes (baseline fasting glucose 5.6–6.9 mmol/L), aged 20–60 years, were enrolled in one of the two arms: A one-time general advice about lifestyle modification (GA group) at orientation or a well-structured and monitored nutrition and lifestyle counseling for six months (guidance group). Fasting blood samples and a dietary recall for daily intakes of macro/micronutrients using a validated computerized food database “ESHA—the Food Processor Nutrition Analysis program” were collected pre- and post-intervention. Compliance to reference daily intake (RDI) was also calculated at both time points. At baseline, overall, severe deficiencies in the majority of micronutrient intakes were observed. Post intervention, clinically significant improvements in the glycemic indices (fasting glucose and insulin resistance) were seen over time in the guidance group. Also, significant improvements in dietary habits and physical activity levels were more apparent in the guidance group than the GA group, particularly in the daily intakes of total carbohydrate (46.9% compliance post vs. 20.3% at baseline); dietary fiber (21.9% vs. 3.1%); and some micronutrients like vitamin B6 (21.3% vs. 6.7%), vitamin B12 (45.3% vs. 28%), vitamin C (21.9% vs. 7.8%), riboflavin (40% vs. 10.7%), niacin (41.3% vs. 14.7%), magnesium (18.8% vs. 4.7%), iron (54.7% vs. 34.4%), and copper (37.3% vs. 13.3%). The study highlights the effects of a six-month lifestyle modification program in improving dietary micronutrient intakes of Saudis with prediabetes. Since micronutrient intake was observed to be low, fortification of these micronutrients in the Saudi diet is recommended.
Collapse
Affiliation(s)
- Hanan Alfawaz
- Department of Food Science and Nutrition, College of Food Science and Agriculture King Saud University, Riyadh 12372, Saudi Arabia; (H.A.); (A.F.N.)
- Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (K.W.); (M.N.K.K.); (S.S.); (A.M.A.)
| | - Alsoodeeri Fahadah Naeef
- Department of Food Science and Nutrition, College of Food Science and Agriculture King Saud University, Riyadh 12372, Saudi Arabia; (H.A.); (A.F.N.)
| | - Kaiser Wani
- Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (K.W.); (M.N.K.K.); (S.S.); (A.M.A.)
| | - Malak Nawaz Khan Khattak
- Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (K.W.); (M.N.K.K.); (S.S.); (A.M.A.)
| | - Shaun Sabico
- Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (K.W.); (M.N.K.K.); (S.S.); (A.M.A.)
| | - Abdullah M. Alnaami
- Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (K.W.); (M.N.K.K.); (S.S.); (A.M.A.)
| | - Nasser M. Al-Daghri
- Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (K.W.); (M.N.K.K.); (S.S.); (A.M.A.)
- Correspondence: ; Tel.: +966-14675939; Fax: +966-14675931
| |
Collapse
|
6
|
Plasma Asprosin Concentrations Are Increased in Individuals with Glucose Dysregulation and Correlated with Insulin Resistance and First-Phase Insulin Secretion. Mediators Inflamm 2018; 2018:9471583. [PMID: 29743813 PMCID: PMC5883982 DOI: 10.1155/2018/9471583] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 12/28/2017] [Accepted: 01/08/2018] [Indexed: 12/15/2022] Open
Abstract
Background Adipokines are reported to participate in many common pathologic processes of glucose dysregulation, such as insulin resistance, β-cell dysfunction, and chronic inflammation. Objective To detect the concentrations of plasma asprosin in subjects with impaired glucose regulation (IGR) and newly diagnosed type 2 diabetes (nT2DM) and its relationship to parameters of glucose and lipid metabolism, insulin resistance, and pancreatic β-cell function. Methods 143 eligible participants were included and were divided into three groups including normal glucose regulation (NGR, n = 52), IGR (n = 40), and nT2DM group (n = 51). The intravenous glucose tolerance test (IVGTT) and clinical and biochemical parameters were measured in all participants. Results Plasma asprosin levels were higher in IGR (82.40 ± 91.06 ng/mL, P < 0.001) and nT2DM (73.25 ± 91.69 ng/mL, P < 0.001) groups compared with those in the NGR (16.22 ± 9.27 ng/mL) group, especially in IGR subjects. Correlation analysis showed that plasma asprosin levels were positively correlated with waist circumference (Wc), fasting plasma glucose (FPG), postchallenge plasma glucose (2hPG), HbA1c, triglyceride (TG), and homeostasis model assessment for insulin resistance (HOMA-IR) and negatively correlated with homeostasis model assessment for β-cell function (HOMA-β), area under the curve of the first-phase (0-10 min) insulin secretion (AUC), acute insulin response (AIR), and glucose disposition index (GDI) (all P < 0.05). Multiple logistical regression analyses revealed that plasma asprosin concentrations were significantly correlated with IGR and nT2DM after controlling for age, sex, BMI, and WHR. Conclusions Circulating asprosin might be a predictor of early diagnosis in DM and might be a potential therapeutic target for prediabetes and T2DM.
Collapse
|
7
|
Flos Puerariae Extract Ameliorates Cognitive Impairment in Streptozotocin-Induced Diabetic Mice. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:873243. [PMID: 26060502 PMCID: PMC4427852 DOI: 10.1155/2015/873243] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 03/19/2015] [Accepted: 03/24/2015] [Indexed: 01/14/2023]
Abstract
Objective. The effects of Flos Puerariae extract (FPE) on cognitive impairment associated with diabetes were assessed in C57BL/6J mice. Methods. Experimental diabetic mice model was induced by one injection of 50 mg/kg streptozotocin (STZ) for 5 days consecutively. FPE was orally administrated at the dosages of 50, 100, or 200 mg/kg/day, respectively. The learning and memory ability was assessed by Morris water maze test. Body weight, blood glucose, free fatty acid (FFA) and total cholesterol (TCH) in serum, malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px), and acetylcholinesterase (AChE) activities in cerebral cortex and hippocampus were also measured. Results. Oral administration of FPE significantly improved cognitive deficits in STZ-induced diabetic mice. FPE treatment also maintained body weight and ameliorated hyperglycemia and dyslipidemia in diabetic mice. Additionally, decreased MDA level, enhanced CAT, and GSH-Px activities in cerebral cortex or hippocampus, as well as alleviated AChE activity in cerebral cortex, were found in diabetic mice supplemented with FPE. Conclusion. This study suggests that FPE ameliorates memory deficits in experimental diabetic mice, at least partly through the normalization of metabolic abnormalities, ameliorated oxidative stress, and AChE activity in brain.
Collapse
|
8
|
Abebe SM, Berhane Y, Worku A, Getachew A. Prevalence and associated factors of hypertension: a crossectional community based study in northwest ethiopia. PLoS One 2015; 10:e0125210. [PMID: 25909382 PMCID: PMC4409323 DOI: 10.1371/journal.pone.0125210] [Citation(s) in RCA: 117] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 03/23/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Hypertension, being the root cause of many of the body sytem and organs failure, remains to be a major public health challenge globally. Though the problem is huge in both developed and developing countries, data are scarce in developing countries like Ethiopia. Therefore, this study was aimed to determine the magnitude and associated factors of hypertension in North West Ethiopia. METHODS A cross-sectional survey was conducted on adults aged 35 years and above in the rural and urban communities of Dabat district and Gondar town in 2012. The data were collected using the WHO STEPwise strategy. Hypertension was defined as having a Systolic blood pressure of ≥140 mmHg and/ or a Diastolic BP of ≥ 90mmHg or a reported use of anti-hypertensive medications for raised blood pressure. Prevalence was computed with a 95% confidence interval. Selected risk factors were assessed using a biviarete logistic regression. RESULTS A total of 2200 participants were included in the study. The median age (±SD) was 47 (±12.4) years. The overall prevalence of hypertension was found to be 27.9% [95% CI 26.0, 29.8], with the proportion in the urban and rural residents being 30.7% and 25.3% respectively. The prevalence of hypertension was 29.3% for women and 26.3% for men. Out of the 598 hypertensive patients 241 (40.3%) had blood pressure measurements, and 99 (16.6%) had known hypertension and were on treatment. The proportion of systolic and diastolic hypertension in this subgroup of adults was 133(6.2%). The multivariable logistic regression analysis showed older age (AOR = 1.06; 1.05, 1.07), raised fasting glucose (AOR = 1.01; 1.001, 1.01), alcohol consumption (AOR = 1.71; 1.24, 2.36), and raised BMI (AOR =1.07; 1.04, 1.10) were significantly associated with hypertension. CONCLUSION The prevalence of hypertension was considerably higher in rural areas than previously reported. The health system needs to develop strategies to increase the reach of relevant screening and diagnostic services to both rural and urban populations.
Collapse
Affiliation(s)
- Solomon Mekonnen Abebe
- Institute of Public health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yemane Berhane
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Alemayehu Worku
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Assefa Getachew
- School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
9
|
Alves MG, Martins AD, Teixeira NF, Rato L, Oliveira PF, Silva BM. White tea consumption improves cardiac glycolytic and oxidative profile of prediabetic rats. J Funct Foods 2015. [DOI: 10.1016/j.jff.2015.01.019] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
10
|
Kontoghiorghe CN, Andreou N, Constantinou K, Kontoghiorghes GJ. World health dilemmas: Orphan and rare diseases, orphan drugs and orphan patients. World J Methodol 2014; 4:163-188. [PMID: 25332915 PMCID: PMC4202455 DOI: 10.5662/wjm.v4.i3.163] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 04/05/2014] [Accepted: 06/27/2014] [Indexed: 02/06/2023] Open
Abstract
According to global annual estimates hunger/malnutrition is the major cause of death (36 of 62 million). Cardiovascular diseases and cancer (5.44 of 13.43 million) are the major causes of death in developed countries, while lower respiratory tract infections, human immunodeficiency virus infection/acquired immunodeficiency syndrome, diarrhoeal disease, malaria and tuberculosis (10.88 of 27.12 million) are the major causes of death in developing countries with more than 70% of deaths occurring in children. The majority of approximately 800 million people with other rare diseases, including 100000 children born with thalassaemia annually receive no treatment. There are major ethical dilemmas in dealing with global health issues such as poverty and the treatment of orphan and rare diseases. Of approximately 50000 drugs about 10% are orphan drugs, with annual sales of the latter approaching 100 billion USD. In comparison, the annual revenue in 2009 from the top 12 pharmaceutical companies in Western countries was 445 billion USD and the top drug, atorvastatin, reached 100 billion USD. In the same year, the total government expenditure for health in the developing countries was 410 billion USD with only 6%-7% having been received as aid from developed countries. Drugs cost the National Health Service in the United Kingdom more than 20 billion USD or 10% of the annual health budget. Uncontrollable drug prices and marketing policies affect global health budgets, clinical practice, patient safety and survival. Fines of 5.3 billion USD were imposed on two pharmaceutical companies in the United States, the regulatory authority in France was replaced and clinicians were charged with bribery in order to overcome recent illegal practises affecting patient care. High expenditure for drug development is mainly related to marketing costs. However, only 2 million USD was spent developing the drug deferiprone (L1) for thalassaemia up to the stage of multicentre clinical trials. The criteria for drug development, price levels and use needs to be readdressed to improve drug safety and minimise costs. New global health policies based on cheaper drugs can help the treatment of many categories of orphan and rare diseases and millions of orphan patients in developing and developed countries.
Collapse
|
11
|
Al-Daghri NM, Alfawaz H, Aljohani NJ, Al-Saleh Y, Wani K, Alnaami AM, Alharbi M, Kumar S. A 6-month "self-monitoring" lifestyle modification with increased sunlight exposure modestly improves vitamin D status, lipid profile and glycemic status in overweight and obese Saudi adults with varying glycemic levels. Lipids Health Dis 2014; 13:87. [PMID: 24884616 PMCID: PMC4041045 DOI: 10.1186/1476-511x-13-87] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 05/15/2014] [Indexed: 01/08/2023] Open
Abstract
Background The over-all age-adjusted prevalence of diabetes mellitus type 2 (DMT2) in Saudi Arabia is unprecedented at 31%. Aggressive measures should be done to curb down increasing incidence. In this prospective 6-month study we aim to determine whether a self-monitoring, life-style modification program that includes increased sunlight exposure confer improvement in vitamin D status and health benefits among adult Saudi overweight and obese patients with varying glycemic status. Methods A total of 150 overweight and obese Saudi adults with varying glycemic status aged 30–60 years were included in this study. They were divided into 3 groups (Non-DMT2, Pre-diabetes and DMT2). Baseline anthropometrics and blood glucose were taken at baseline and after 6 months. Fasting blood sugar, lipid profile, calcium, albumin and phosphate were measured routinely. Serum 25(OH) vitamin D was measured using standard assays. Within the time period they were instructed to reduce total intake of fat, increased fiber intake and increase sun exposure. Results In all groups there was a significant improvement in vitamin D levels as well as serum triglycerides, LDL- and total cholesterol. However, a significant increase in serum glucose levels was noted in the non-DMT2 group, and a significant decrease in HDL-cholesterol in both non-DMT2 and pre-diabetes group. In the pre-diabetes group, 53.2% were able to normalize their fasting blood levels after 6 months, with 8.5% reaching the DMT2 stage and 38.3% remaining pre-diabetic. In all groups there was a significant increase in the prevalence of hypertension. Conclusion Improving vitamin D status with modest lifestyle modifications over a short-period translates to improvement in lipid profile except HDL-cholesterol among overweight and obese Saudi adults, but not BMI and blood pressure. Findings of the present study merit further investigation as to whether full vitamin D status correction can delay or prevent onset of DMT2.
Collapse
Affiliation(s)
- Nasser M Al-Daghri
- Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, King Saud University, PO Box, 2455, Riyadh 11451, Saudi Arabia.
| | | | | | | | | | | | | | | |
Collapse
|
12
|
Hickie IB, Scott J, Hermens DF, Scott EM, Naismith SL, Guastella AJ, Glozier N, McGorry PD. Clinical classification in mental health at the cross-roads: which direction next? BMC Med 2013; 11:125. [PMID: 23672522 PMCID: PMC3653738 DOI: 10.1186/1741-7015-11-125] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Accepted: 12/18/2012] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND After 30 years of consensus-derived diagnostic categories in mental health, it is time to head in new directions. Those categories placed great emphasis on enhanced reliability and the capacity to identify them via standardized checklists. Although this enhanced epidemiology and health services planning, it failed to link broad diagnostic groupings to underlying pathophysiology or specific treatment response. DISCUSSION It is time to adopt new goals that prioritize the validation of clinical entities and foster alternative strategies to support those goals. The value of new dimensions (notably clinical staging), that are both clinically relevant and directly related to emerging developmental and neurobiological research, is proposed. A strong emphasis on 'reverse translation' (that is, working back from the clinic to the laboratory) underpins these novel approaches. However, it relies on using diagnostic groupings that already have strong evidence of links to specific risk factors or patterns of treatment response. SUMMARY The strategies described abandon the historical divides between clinical neurology, psychiatry and psychology and adopt the promotion of pathways to illness models.
Collapse
Affiliation(s)
- Ian B Hickie
- Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, 100 Mallett Street, Camperdown, 2050, Australia
| | - Jan Scott
- Academic Psychiatry, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
- FondaMental Foundation, Fondation de Coopération Scientifique Hôpital A. Chenevier, 40 Rue de Mesly, Creteil, F-94000, France
- INSERM, U 955, IMRB, Psychiatry Genetic, Creteil, F-94000, France
| | - Daniel F Hermens
- Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, 100 Mallett Street, Camperdown, 2050, Australia
| | - Elizabeth M Scott
- Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, 100 Mallett Street, Camperdown, 2050, Australia
- School of Medicine, The University of Notre Dame, 160 Oxford Street, Darlinghurst, Sydney, 2010, Australia
| | - Sharon L Naismith
- Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, 100 Mallett Street, Camperdown, 2050, Australia
| | - Adam J Guastella
- Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, 100 Mallett Street, Camperdown, 2050, Australia
| | - Nick Glozier
- Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, 100 Mallett Street, Camperdown, 2050, Australia
| | - Patrick D McGorry
- Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville, 3052, Australia
- Orygen Youth Health Research Centre, Department of Psychiatry, University of Melbourne, 35 Poplar Road, Parkville, 3052, Australia
| |
Collapse
|
13
|
Doyle OM, Tsaneva-Atansaova K, Harte J, Tiffin PA, Tino P, Díaz-Zuccarini V. Bridging paradigms: hybrid mechanistic-discriminative predictive models. IEEE Trans Biomed Eng 2013; 60:735-42. [PMID: 23392334 DOI: 10.1109/tbme.2013.2244598] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Many disease processes are extremely complex and characterized by multiple stochastic processes interacting simultaneously. Current analytical approaches have included mechanistic models and machine learning (ML), which are often treated as orthogonal viewpoints. However, to facilitate truly personalized medicine, new perspectives may be required. This paper reviews the use of both mechanistic models and ML in healthcare as well as emerging hybrid methods, which are an exciting and promising approach for biologically based, yet data-driven advanced intelligent systems.
Collapse
Affiliation(s)
- Orla M Doyle
- Department of Neuroimaging, Institute of Psychiatry, King's College London, London, UK.
| | | | | | | | | | | |
Collapse
|
14
|
Finer N. Obesity and pre-diabetes. Clin Obes 2012; 2:1-2. [PMID: 25586040 DOI: 10.1111/j.1758-8111.2012.00046.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- N Finer
- University College London Hospitals, UCLH Centre for Weight Loss, Metabolic and Endocrine Surgery, and UCL Institute of Cardiovascular Science, London, UK
| |
Collapse
|