RESUMO
BACKGROUND: The impact of dynamic changes in the degree of atherosclerosis on the development of prediabetes remains unclear. This study aims to investigate the association between cumulative atherogenic index of plasma (CumAIP) exposure during follow-up and the development of prediabetes in middle-aged and elderly individuals. METHODS: A total of 2,939 prediabetic participants from the first wave of the China Health and Retirement Longitudinal Study (CHARLS) were included. The outcomes for these patients, including progression to diabetes and regression to normal fasting glucose (NFG), were determined using data from the third wave. CumAIP was calculated as the ratio of the average AIP values measured during the first and third waves to the total exposure duration. The association between CumAIP and the development of prediabetes was analyzed using multivariable Cox regression and restricted cubic spline (RCS) regression. RESULTS: During a median follow-up period of 3 years, 15.21% of prediabetic patients progressed to diabetes, and 22.12% regressed to NFG. Among the groups categorized by CumAIP quartiles, the proportion of prediabetes progressing to diabetes gradually increased (Q1: 10.61%, Q2: 13.62%, Q3: 15.65%, Q4: 20.95%), while the proportion regressing to NFG gradually decreased (Q1: 23.54%, Q2: 23.71%, Q3: 22.18%, Q4: 19.05%). Multivariable-adjusted Cox regression showed a significant positive linear correlation between high CumAIP exposure and prediabetes progression, and a significant negative linear correlation with prediabetes regression. Furthermore, in a stratified analysis, it was found that compared to married individuals, those who were unmarried (including separated, divorced, widowed, or never married) had a relatively higher risk of CumAIP-related diabetes. CONCLUSION: CumAIP is closely associated with the development of prediabetes. High CumAIP exposure not only increases the risk of prediabetes progression but also hinders its regression within a certain range. These findings suggest that monitoring and maintaining appropriate AIP levels may help prevent the deterioration of blood glucose levels.
Assuntos
Aterosclerose , Biomarcadores , Glicemia , Progressão da Doença , Estado Pré-Diabético , Humanos , Estado Pré-Diabético/sangue , Estado Pré-Diabético/diagnóstico , Estado Pré-Diabético/epidemiologia , Pessoa de Meia-Idade , Masculino , Feminino , China/epidemiologia , Idoso , Fatores de Risco , Glicemia/metabolismo , Medição de Risco , Biomarcadores/sangue , Fatores de Tempo , Estudos Longitudinais , Aterosclerose/sangue , Aterosclerose/epidemiologia , Aterosclerose/diagnóstico , Fatores Etários , PrognósticoRESUMO
BACKGROUND: An increased risk of diabetes mellitus (DM) after COVID-19 has been reported in the United States, Europe, and Asia. The burden of COVID-related DM has yet to be described in Africa, where the overall risk of DM has been increasing rapidly. Our objective was to compare the prevalence of pre-DM and DM in Nigerian individuals with a history of COVID-19 to individuals without known COVID-19 infection. METHODS: We undertook a retrospective cohort study with 256 individuals with a past medical history of COVID-19 with no history of pre-DM or DM and 256 individuals without a history of COVID-19 or pre-DM/DM. Participants were categorized as pre-DM (fasting capillary glucose 100-125 mg/dL) or DM (fasting capillary glucose ≥ 126 mg/dL). We employed univariate and multivariable logistic regression to identify key predictors and adjust for confounders related to hyperglycaemia risk factors. Additionally, we used multinomial logistic regression to analyze the relationship between COVID-19 history and diabetes status, distinguishing between normal, pre-diabetic, and diabetic glucose levels. All models were adjusted for age, gender, hypertension, physical activity, central adiposity, and family history of DM. RESULTS: Compared to the control group, those with a history of COVID-19 had a similar median age (38 vs. 40 years, p = 0.84), had a higher proportion of men (63% vs. 49%), and had a lower prevalence of central adiposity (waist: hip ratio ≥ 0.90 for males and WHR ≥ 0.85 for females) (48% vs. 56.3%, p = 0.06). Of the 256 with a history of COVID-19, 44 (17%) required in-patient care. The median (interquartile range) time interval between COVID-19 diagnosis and the glycaemic assessment was 19 (IQR: 14, 24) months. Pre-DM prevalence was 27% in the post-COVID-19 group and 4% in the control group, whereas the prevalence of DM was 7% in the post-COVID-19 group and 2% in the control group. After multivariable adjustment, the odds of pre-DM were 8.12 (95% confidence interval (CI): 3.98, 16.58; p < 0.001) higher, and the odds of DM were 3.97 (95% CI: 1.16, 13.63) higher in those with a history of COVID-19 compared to controls. In the adjusted multinomial logistic regression analysis, individuals with a history of COVID-19 exhibited significantly elevated risks for pre-diabetes (RRR = 7.55, 95% CI: 3.76-15.17) and diabetes (RRR = 3.44, 95% CI: 1.01-11.71) compared to those without COVID-19. CONCLUSION: Previous COVID-19 was found to be a risk factor for prevalent pre-diabetes and diabetes mellitus in Nigeria. More intensive screening for DM in those with a history of COVID-19 should be considered.
Assuntos
COVID-19 , Diabetes Mellitus , Estado Pré-Diabético , Humanos , COVID-19/epidemiologia , Masculino , Feminino , Estudos Retrospectivos , Nigéria/epidemiologia , Estado Pré-Diabético/epidemiologia , Diabetes Mellitus/epidemiologia , Adulto , Pessoa de Meia-Idade , Fatores de Risco , Prevalência , SARS-CoV-2RESUMO
Prevalence of heart failure (HF) and diabetes are markedly increasing globally. In a population of HF patients, approximately 40% have diabetes which is associated with a more severe HF, poorer cardiovascular outcomes and higher hospitalization rates for HF than HF patients without diabetes. Similar trends were shown in HF patients with prediabetes. In addition, the association between HF and renal function decline was demonstrated in patients with or without diabetes. However, the exact prevalence of dysglycemia in HF patients requires further investigation aiming to clarify the most accurate test to detect dysglycemia in this population. The relationship between HF and diabetes is complex and probably bidirectional. In one way, patients with diabetes have a more than two-fold risk of developing incident HF with reduced or preserved ejection fraction than those without diabetes. In the other way, patients with HF, when compared with those without HF, show an increased risk for the onset of diabetes due to several mechanisms including insulin resistance (IR), which makes HF emerging as a precursor for diabetes development. This article provides epidemiological evidence of undetected dysglycemia (prediabetes or diabetes) in HF patients and reviews the pathophysiological mechanisms which favor the development of IR and the risks associated with these disorders in HF patients. This review also offers a discussion of various strategies for the prevention of diabetes in HF patients, based first on fasting plasma glucose and HbA1c measurement and if normal on an oral glucose tolerance test as diagnostic tools for prediabetes and unknown diabetes that should be performed more extensively in those patients. It discusses the implementation of diabetes prevention measures and well-structured management programs for HF patients who are generally overweight or obese, as well as current pharmacotherapeutic options for prediabetes, including sodium-glucose cotransporter 2 inhibitors which are among the pillars of HF treatment and which recently showed a benefit in the reduction of incident diabetes in HF patients. Thus, there is an urgent need of routine screening for dysglycemia in all HF patients, which should contribute to reduce the incidence of diabetes and to treat earlier diabetes when already present.
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Glicemia , Diabetes Mellitus , Insuficiência Cardíaca , Humanos , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/epidemiologia , Insuficiência Cardíaca/sangue , Insuficiência Cardíaca/prevenção & controle , Insuficiência Cardíaca/fisiopatologia , Glicemia/metabolismo , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/sangue , Estado Pré-Diabético/diagnóstico , Estado Pré-Diabético/sangue , Estado Pré-Diabético/epidemiologia , Fatores de Risco , Resistência à Insulina , Prevalência , Biomarcadores/sangue , Medição de Risco , Valor Preditivo dos Testes , Hipoglicemiantes/uso terapêuticoRESUMO
BACKGROUND: The lipid accumulation product (LAP) and the visceral adiposity index (VAI) are suggested as dependable measures for assessing visceral fat levels. Prediabetes is recognized as a condition that precedes the potential onset of diabetes. The objective of this research is to investigate how VAI and LAP are related to prediabetes among the adult population in the United States. METHODS: Information from the 2007-2020 National Health and Nutrition Examination Survey (NHANES) was scrutinized in a cross-sectional study. To evaluate the connection between VAI or LAP and the presence of prediabetes, both univariate analysis and multivariate logistic regression were utilized. Threshold effect analysis and fitted smoothing curves were used to delve into the non-linear association between VAI or LAP and prediabetes. Additional analyses were performed on specific subgroups, along with tests to explore potential interactions. RESULTS: In general, 12,564 American adults were included. After full adjustment, prediabetes with VAI (OR: 1.128, 95% CI: 1.073-1.185) or LAP (OR: 1.006, 95% CI: 1.004-1.008) showed a positive correlation. Individuals in the 4th VAI quartile group faced a significant 61.9% elevated risk for prediabetes (OR: 1.619, 95% CI: 1.354-1.937) when contrasted to those in the 1st VAI quartile. Participants in the 4th LAP quartile group had a significant 116.4% elevated risk for prediabetes (OR: 2.164, 95% CI: 1.747-2.681) when contrasted to individuals of the 1st LAP quartile. Smooth curve fitting analysis revealed a nonlinear correlation of VAI or LAP and prediabetes, and threshold effect analysis was used to determine an inflection point of 4.090 for VAI and 68.168 for LAP. CONCLUSIONS: The values of VAI and LAP are positively associated with the prevalence of prediabetes. The VAI and LAP indices may be used as predictors of prediabetes.
Assuntos
Gordura Intra-Abdominal , Produto da Acumulação Lipídica , Inquéritos Nutricionais , Estado Pré-Diabético , Humanos , Estado Pré-Diabético/epidemiologia , Masculino , Feminino , Estudos Transversais , Adulto , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Gordura Intra-Abdominal/metabolismo , Adiposidade , Idoso , Fatores de RiscoRESUMO
Background: Nonalcoholic fatty liver disease (NAFLD) is a prevalent metabolic disorder strongly linked to type 2 diabetes mellitus (T2DM). Understanding the predictive value of lipid parameters in identifying abnormal glucose metabolism in NAFLD patients is crucial for early intervention. Methods: This study analyzed data from the National Health and Nutrition Examination Survey(NHANES) database (2017-2020) involving 1066 NAFLD patients. Participants were categorized into three groups: T2DM (n=414), prediabetes mellitus (pre-DM) (n=507), and normoglycemia (NG) (n=145). Traditional lipid parameters [triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C)] and nontraditional lipid parameters [atherogenic index of plasma (AIP), residual cholesterol (RC), and non-high-density lipoprotein cholesterol (non-HDL-C)] were evaluated for their association with T2DM and pre-DM. Results: Elevated TG levels were significantly associated with an increased risk of T2DM and pre-DM, whereas high HDL-C demonstrated a protective effect. Among nontraditional lipid parameters, increased AIP and RC were most strongly associated with T2DM risk, while high non-HDL-C was best associated with the development of pre-DM. Stratified analyses revealed that these associations were stronger in younger, non-obese, smoking, and female NAFLD patients. Conclusion: Nontraditional lipid parameters, particularly AIP and RC, show superior predictive value over traditional lipid parameters in identifying abnormal glucose metabolism in NAFLD patients. Incorporating these novel biomarkers into clinical practice could enhance early detection and prevention strategies for T2DM and pre-DM in this high-risk population.
Assuntos
Diabetes Mellitus Tipo 2 , Hepatopatia Gordurosa não Alcoólica , Inquéritos Nutricionais , Estado Pré-Diabético , Humanos , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/metabolismo , Hepatopatia Gordurosa não Alcoólica/sangue , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Hepatopatia Gordurosa não Alcoólica/metabolismo , Feminino , Masculino , Estado Pré-Diabético/sangue , Estado Pré-Diabético/epidemiologia , Estado Pré-Diabético/metabolismo , Pessoa de Meia-Idade , Adulto , Fatores de Risco , Lipídeos/sangue , Biomarcadores/sangue , Idoso , Estudos Transversais , Glicemia/metabolismo , Glicemia/análiseRESUMO
INTRODUCTION: Erectile dysfunction (ED) is a well-studied entity in diabetes mellitus (DM). As with DM, prediabetes also appears to be associated with changes in microvascular-related comorbidities. These include retinopathy, neuropathy, nephropathy, and ED. ED is a condition characterized by an inability to maintain penile erection for adequate sexual activity, either consistently or recurrently. Endothelial damage due to any cause corresponding to hyperglycemia signifies the relationship between prediabetes and ED. While the evaluation of ED in diabetics has been extensively studied worldwide, there is a paucity of knowledge about ED among prediabetics. MATERIALS AND METHODS: The study type was observational and was conducted at a tertiary center in India. Adult males aged 18-50 years with prediabetes were included in the study over a duration of 18 months. Evaluation for ED was performed using the International Index of Erectile Function 5 (IIEF-5). RESULTS: A total of 139 participants were enrolled in the present study. The severity of ED was categorized as follows: 32.4% of participants had mild ED, 11.5% had mild-to-moderate ED, and 6.5% had moderate ED. A positive association was found between prediabetes-related parameters and ED. CONCLUSION: There is a significant prevalence of ED in prediabetic males compared to the general population, as found in our study. Overall, 50.3% of participants were found to have ED. We recommend exploring this subject with more structured and larger studies.
Assuntos
Disfunção Erétil , Estado Pré-Diabético , Centros de Atenção Terciária , Masculino , Humanos , Disfunção Erétil/epidemiologia , Disfunção Erétil/etiologia , Estado Pré-Diabético/epidemiologia , Estado Pré-Diabético/complicações , Adulto , Índia/epidemiologia , Pessoa de Meia-Idade , Adulto Jovem , Adolescente , Prevalência , Índice de Gravidade de DoençaRESUMO
Objective: Given the limited evidence on the relationship between the triglyceride-glucose (TyG) index and the risk of prediabetes among young adults, our study aimed to investigate the potential impact of the TyG index on the future development of prediabetes in young individuals. Methods: This retrospective cohort study included 125,327 healthy adults aged 20 to 45 years. We utilized Cox proportional hazards regression models, combined with cubic spline functions and smooth curve fitting, to assess the relationship between baseline TyG index and the risk of prediabetes among young adults, exploring its non-linear association. A series of sensitivity analyses and subgroup analyses were conducted to ensure the robustness of our findings. Results: After adjusting for covariates, the study found a positive correlation between the TyG index and the risk of prediabetes (HR=1.81, 95%CI: 1.54-2.13, p<0.0001). The risk of prediabetes increased progressively across quartiles of the TyG index (Q1 to Q4), with Q4 showing a significantly higher risk compared to Q1 (adjusted HR=2.33, 95% CI=1.72-3.16). Moreover, a non-linear relationship was identified between the TyG index and the risk of prediabetes, with an inflection point at 9.39. To the left of the inflection point, the HR was 2.04 (95% CI: 1.69 to 2.46), while to the right, the HR was 0.89 (95% CI: 0.48 to 1.65). Conclusion: Our study reveals a non-linear relationship and a saturation effect between the TyG index and the development of prediabetes among young individuals in China, with an inflection point at 9.39. Understanding this non-linear relationship can assist clinicians in identifying young individuals at high risk and implementing targeted interventions to reduce their risk of progressing to diabetes.
Assuntos
Glicemia , Estado Pré-Diabético , Triglicerídeos , Humanos , Estado Pré-Diabético/sangue , Estado Pré-Diabético/epidemiologia , Estado Pré-Diabético/diagnóstico , Estudos Retrospectivos , Adulto , Feminino , Masculino , Adulto Jovem , Glicemia/análise , China/epidemiologia , Triglicerídeos/sangue , Fatores de Risco , Pessoa de Meia-Idade , Estudos de Coortes , Seguimentos , População do Leste AsiáticoRESUMO
BACKGROUND AND AIMS: Prediabetes is often underdiagnosed and underreported due to its asymptomatic state in over 80% of individuals. Considering its role in promoting cancer incidence and limited evidence linking prediabetes and colorectal cancer (CRC), we conducted a systematic review and meta-analysis to evaluate the incidence of colorectal cancer in people with prediabetes. METHODS: A comprehensive search through PubMed/Medline, Embase, Scopus, and Google Scholar was performed until June 1, 2022, to screen for studies reporting CRC incidence/risk in prediabetics. Binary random-effects models were used to perform meta-analysis and subgroup analyses. Sensitivity analysis was done using leave-one-out method. The quality of the studies was assessed by the Newcastle Ottawa Scale for observational studies. RESULTS: Seven prospective and one retrospective study comprising 15 cohorts and a pooled number of 854,876 cases and 219,0511 controls were included in the analysis (2 Japan, 2 Korea, 1 Sweden, 1 UK, 1 China, and 1 USA). After combining all the studies, the forest plots for adjusted analysis shows a statistically significant increase in odds of having CRC with prediabetes (OR=1.16; 1.08-1.25, p< 0.01; I2=56.06%) and unadjusted analysis also shows a statistically significant increase in odds of having CRC with prediabetes (OR=1.62; 1.35-1.95, p< 0.01; I2=85.72% ). Sensitivity analysis using the Leave-one-out method did confirm equivalent results. Subgroup analysis based on type of study, the odds of developing CRC was higher in prospective studies (OR=1.175; 1.065-1.298) (p=0.001) than retrospective studies (OR=1.162; 1.033- 1.306) (p=0.012). The odds of developing CRC were not significantly higher in ages >60 (OR=1.446; 0.887-2.356) (p=0.139) compared to less than 60 years. The strongest association b/w prediabetes and CRC was found on a median 5-10 years (aOR=1.257; 1.029-1.534) (p=0.025) follow-up compared to < 5 years and 10 years and higher. CONCLUSIONS: This study showed that the odds of developing CRC is 16% higher in patients with prediabetes than those with normal blood glucose. Lifestyle modifications such as weight loss, proper diet, and exercise are essential to control prediabetes. This study further warrants a specific prediabetes screening for patients already at high risk of colorectal cancer with other risk factors.
Assuntos
Neoplasias Colorretais , Estado Pré-Diabético , Humanos , Neoplasias Colorretais/epidemiologia , Estado Pré-Diabético/epidemiologia , Estado Pré-Diabético/diagnóstico , Fatores de Risco , Incidência , Medição de Risco , Fatores de Tempo , Pessoa de Meia-Idade , Feminino , MasculinoRESUMO
Importance: Subclinical hyperglycemia before pregnancy may be associated with the likelihood of maternal morbidity but is understudied among young people. Objective: To explore the association of preconception hemoglobin A1c (HbA1c) levels among adolescents and young adults with risk of gestational diabetes at first live birth. Design, Setting, and Participants: This retrospective cohort study used linked 2009 to 2017 birth registry, hospital discharge, and New York City Department of Health A1C Registry data for birthing individuals aged 10 to 24 years with no history of diabetes and at least 1 preconception HbA1c test in New York, New York. Statistical analysis was performed from August to November 2022. Exposure: Preconception HbA1c values categorized as no diabetes (HbA1c <5.7%) or prediabetes (HbA1c ≥5.7% to <6.5%). Main Outcomes and Measures: The primary outcome was gestational diabetes at first birth. Secondary outcomes included hypertensive disorders of pregnancy, preterm birth, cesarean delivery, and macrosomia. Log binomial regression was used to estimate the relative risk (RR) of gestational diabetes at first birth by preconception HbA1c level, adjusting for prepregnancy characteristics. The optimal HbA1c threshold for gestational diabetes was examined using receiver operating curve regression. Results: A total of 14â¯302 individuals (mean [SD] age, 22.10 [1.55] years) met study eligibility criteria. Of these, 5896 (41.0%) were Hispanic, 4149 (29.0%) were Black, 2583 (18.1%) were White, 1516 (10.6%) were Asian, and 185 (1.3%) had other or unknown race and ethnicity. Most (11â¯407 individuals [79.7%]) had normoglycemia before pregnancy, and 2895 individuals (20.2%) had prediabetes. Adjusting for prepregnancy characteristics, those with preconception prediabetes had more than twice the risk of gestational diabetes vs those with normoglycemia (adjusted RR [aRR], 2.21; 95% CI, 1.91-2.56). Preconception prediabetes was associated with small increases in the likelihood of a hypertensive disorder of pregnancy (aRR, 1.18; 95% CI, 1.03-1.35) and preterm delivery (aRR, 1.18; 95% CI, 1.02-1.37). The aRRs for cesarean delivery (aRR, 1.09; 95% CI, 0.99-1.20) and macrosomia (aRR, 1.13; 95% CI, 0.93-1.37) were increased but not statistically significant. The optimal HbA1c threshold to identify gestational diabetes among adolescents and young adults was 5.6%. The threshold did not vary by obesity status but was slightly lower among Hispanic individuals (HbA1c of 5.5%). Conclusions and Relevance: In this study of adolescents and young adults with at least 1 preconception HbA1c test, prediabetes was associated with increased likelihood of maternal cardiometabolic morbidity at first birth. Efforts to optimize cardiometabolic health before pregnancy may avert excess maternal risk.
Assuntos
Diabetes Gestacional , Hemoglobinas Glicadas , Humanos , Feminino , Hemoglobinas Glicadas/análise , Gravidez , Adolescente , Adulto Jovem , Estudos Retrospectivos , Diabetes Gestacional/epidemiologia , Diabetes Gestacional/sangue , Cidade de Nova Iorque/epidemiologia , Resultado da Gravidez/epidemiologia , Estado Pré-Diabético/epidemiologia , Estado Pré-Diabético/sangue , Nascimento Prematuro/epidemiologia , Criança , AdultoRESUMO
Background and Objectives: In the literature, relationships between being married and having prediabetes or diabetes are inconsistent. We aimed to investigate whether marriage is a protective or risk factor for prediabetes and to uncover new insights into its impact on prediabetes. Materials and Methods: In this cross-sectional observational study, questionnaires were distributed by email to 1039 staff members who participated in an employee health check from a hospital affiliated with a medical university in Taiwan. Fasting blood glucose and triglyceride (TG) levels were checked and the questionnaires elicited basic demographic characteristics and included the Copenhagen Burnout Inventory and Nordic Musculoskeletal Questionnaire. The chi-square test or Fisher's exact test, logistic regression, and mediation analysis were conducted for statistical analysis. Results: Among the group aged 20-37 years, married (OR = 1.89, 95%CI: 1.08, 3.33), obesity (OR = 2.95, 95%CI: 1.49, 5.83), neck and shoulder pain (OR = 1.31, 95%CI: 1.01, 1.69), and elevated TG levels (OR = 1.01, 95%CI: 1.00, 1.01) were independent risk factors for prediabetes (impaired fasting glucose). For those >38 years old, overweight (OR = 2.08, 95%CI: 1.27, 3.43), obesity (OR = 4.30, 95%CI: 2.38, 7.79), and elevated triglyceride (TG) (OR = 1.003, 95%CI: 1.00, 1.01) were the independent risk factors for impaired fasting glucose. Increased TG levels serve as a mediating factor (Zm = 2.64, p < 0.01) linking marriage to an increased risk of prediabetes for the group aged 20-37 years. Conclusions: TGs play a significant role in the association between marriage and prediabetes among the group aged 20-37 years. Therefore, dietary habits, especially those of young adult couples should be considered. Our findings connect marital status to prediabetes, facilitating advances in diabetes prevention.
Assuntos
Pessoal de Saúde , Casamento , Estado Pré-Diabético , Triglicerídeos , Humanos , Estado Pré-Diabético/sangue , Estado Pré-Diabético/epidemiologia , Estado Pré-Diabético/psicologia , Adulto , Estudos Transversais , Masculino , Feminino , Triglicerídeos/sangue , Casamento/estatística & dados numéricos , Pessoal de Saúde/estatística & dados numéricos , Pessoal de Saúde/psicologia , Fatores de Risco , Pessoa de Meia-Idade , Inquéritos e Questionários , Taiwan/epidemiologia , Glicemia/análise , Modelos LogísticosRESUMO
OBJECTIVES: This study aimed to evaluate the association between different levels of physical activity and risk of developing type 2 diabetes (T2D) mellitus among adults with prediabetes in Chinese population. METHODS: This prospective population-based cohort study included 12,424 participants (mean [SD] age, 52.8 [16.8] years; 82.2% men) with prediabetes at 2014 survey of the Kailuan study. Physical activity information was collected through the International Physical Activity Questionnaire-Short Form and categorized by metabolic equivalent (MET) of task as low, moderate, and high. Cox regression models were built to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between physical activity levels and incident T2D. RESULTS: During a median follow-up of 3.6 years, 2,207 (17.8%) participants developed T2D. The incident rate of T2D were 55.83/1000, 35.14/1000, and 39.61/1000 person-years in the low, moderate, and high physical activity level group, respectively. Both moderate (HR 0.57, 95% CI 0.49 to 0.67) and high (HR 0.76, 95% CI 0.66 to 0.89) physical activity levels were associated with lower risks of developing T2D compared to low physical activity level (P for trend < 0.001). The association between high physical activity level and T2D was primarily observed in participants without metabolic syndrome (P for interaction < 0.001). Moreover, participants with moderate or high levels of physical activity had significantly decreased fasting blood glucose levels during follow-up when compared to those with low level (P group*time < 0.001). CONCLUSION: This study suggested that individuals with prediabetes might benefit from moderate and high levels of physical activity.
Assuntos
Diabetes Mellitus Tipo 2 , Exercício Físico , Estado Pré-Diabético , Humanos , Diabetes Mellitus Tipo 2/epidemiologia , Estado Pré-Diabético/epidemiologia , Masculino , Pessoa de Meia-Idade , Feminino , Exercício Físico/fisiologia , Estudos Prospectivos , Adulto , Fatores de Risco , China/epidemiologia , Idoso , Estudos de Coortes , Incidência , Inquéritos e Questionários , Glicemia/metabolismo , SeguimentosRESUMO
Introduction: Cardiometabolic diseases are rapidly becoming primary causes of death in developing countries, including Ghana. However, risk factors for these diseases, including obesity phenotype, and availability of cost-effective diagnostic criteria are poorly documented in an African-ancestry populations in their native locations. The extent to which the environment, occupation, geography, stress, and sleep habits contribute to the development of Cardiometabolic disorders should be examined. Purpose: The overall goal of this study is to determine the prevalence of undiagnosed diabetes, prediabetes, and associated cardiovascular risks using a multi-sampled oral glucose tolerance test. The study will also investigate the phenotype and ocular characteristics of diabetes and prediabetes subgroups, as well as determine if lifestyle changes over a one-year period will impact the progression of diabetes and prediabetes. Methods and analysis: The study employs a community-based quasi-experimental design, making use of pre- and post-intervention data, as well as a questionnaire survey of 1200 individuals residing in the Cape Coast metropolis to ascertain the prevalence and risk factors for undiagnosed diabetes and prediabetes. Physical activity, dietary habits, stress levels, sleep patterns, body image perception, and demographic characteristics will be assessed. Glucose dysregulation will be detected using oral glucose tolerance test, fasting plasma glucose, and glycated hemoglobin. Liver and kidney function will also be assessed. Diabetes and prediabetes will be classified using the American Diabetes Association criteria. Descriptive statistics, including percentages, will be used to determine the prevalence of undiagnosed diabetes and cardiovascular risks. Inferential statistics, including ANOVA, t-tests, chi-square tests, ROC curves, logistic regression, and linear mixed model regression will be used to analyze the phenotypic variations in the population, ocular characteristics, glycemic levels, sensitivity levels of diagnostic tests, etiological cause of diabetes in the population, and effects of lifestyle modifications, respectively. Additionally, t-tests will be used to assess changes in glucose regulation biomarkers after lifestyle modifications. Ethics and dissemination: Ethics approval was granted by the Institutional Review Board of the University of Cape Coast, Ghana (UCCIRB/EXT/2022/27). The findings will be disseminated in community workshops, online learning platforms, academic conferences and submitted to peer-reviewed journals for publication.
Assuntos
Fatores de Risco Cardiometabólico , Doenças Cardiovasculares , Estado Pré-Diabético , Humanos , Gana/epidemiologia , Estado Pré-Diabético/epidemiologia , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Feminino , Masculino , Fatores de Risco , Adulto , Prevalência , Teste de Tolerância a Glucose , Pessoa de Meia-Idade , Estilo de Vida , Diabetes Mellitus/epidemiologiaRESUMO
BACKGROUND: The worldwide prevalence of type 2 diabetes mellitus in adults is experiencing a rapid increase. This study aimed to identify the factors affecting the survival of prediabetic patients using a comparison of the Cox proportional hazards model (CPH) and the Random survival forest (RSF). METHOD: This prospective cohort study was performed on 746 prediabetics in southwest Iran. The demographic, lifestyle, and clinical data of the participants were recorded. The CPH and RSF models were used to determine the patients' survival. Furthermore, the concordance index (C-index) and time-dependent receiver operating characteristic (ROC) curve were employed to compare the performance of the Cox proportional hazards (CPH) model and the random survival forest (RSF) model. RESULTS: The 5-year cumulative T2DM incidence was 12.73%. Based on the results of the CPH model, NAFLD (HR = 1.74, 95% CI: 1.06, 2.85), FBS (HR = 1.008, 95% CI: 1.005, 1.012) and increased abdominal fat (HR = 1.02, 95% CI: 1.01, 1.04) were directly associated with diabetes occurrence in prediabetic patients. The RSF model suggests that factors including FBS, waist circumference, depression, NAFLD, afternoon sleep, and female gender are the most important variables that predict diabetes. The C-index indicated that the RSF model has a higher percentage of agreement than the CPH model, and in the weighted Brier Score index, the RSF model had less error than the Kaplan-Meier and CPH model. CONCLUSION: Our findings show that the incidence of diabetes was alarmingly high in Iran. The results suggested that several demographic and clinical factors are associated with diabetes occurrence in prediabetic patients. The high-risk population needs special measures for screening and care programs.
Assuntos
Diabetes Mellitus Tipo 2 , Estado Pré-Diabético , Modelos de Riscos Proporcionais , Humanos , Estado Pré-Diabético/epidemiologia , Masculino , Feminino , Pessoa de Meia-Idade , Irã (Geográfico)/epidemiologia , Adulto , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/mortalidade , Estudos Prospectivos , Idoso , Fatores de RiscoRESUMO
Aim: To investigate the correlation of the triglyceride-glucose (TyG) index and its combined obesity indicators with chest pain and cardiovascular disease (CVD) in the pre-diabetes and diabetes population. Methods: This cross-sectional investigation encompassed 6488 participants with diabetes and pre-diabetes who participated in the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2016. The association of the TyG and combined obesity index with chest pain and CVD was investigated using weighted logistic regression models and restricted cubic spline (RCS) analysis. The receiver operating characteristic (ROC) curve analysis was performed to compare different indicators. Results: In multivariate logistic regression fully adjusted for confounding variables, our analyses revealed significant associations between TyG, TyG-BMI, TyG-WC, and TyG-WHtR and chest pain, with adjusted ORs (95% CI) of 1.21 (1.05, 1.39), 1.06 (1.01, 1.11), 1.08 (1.04, 1.14), and 1.27 (1.08, 1.48), respectively. For total-CVD, the adjusted ORs (95% CI) were 1.32 (1.08, 1.61), 1.10 (1.03, 1.17), 1.13 (1.06, 1.19), and 1.63 (1.35, 1.97), respectively, among which TyG, TyG-WC, and TyG-WHtR present curvilinear associations in RCS analysis (all P-nonlinear < 0.05). Furthermore, the ROC curve showed that TyG-WC had the most robust predictive efficacy for total-CVD, coronary heart disease (CHD), and myocardial infarction (MI), while TyG-WHtR had the best predictive ability for angina and heart failure. Conclusion: There are significant associations of TyG and its related indicators with chest pain and total-CVD among the pathoglycemia population. TyG-WC and TyG-WHtR demonstrated superior predictive capability for the incidence of cardiovascular events.
Assuntos
Glicemia , Doenças Cardiovasculares , Dor no Peito , Inquéritos Nutricionais , Obesidade , Estado Pré-Diabético , Triglicerídeos , Humanos , Feminino , Masculino , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/diagnóstico , Pessoa de Meia-Idade , Estudos Transversais , Estado Pré-Diabético/sangue , Estado Pré-Diabético/epidemiologia , Estado Pré-Diabético/diagnóstico , Estado Pré-Diabético/complicações , Triglicerídeos/sangue , Dor no Peito/sangue , Dor no Peito/epidemiologia , Dor no Peito/diagnóstico , Glicemia/análise , Obesidade/complicações , Obesidade/sangue , Obesidade/epidemiologia , Adulto , Estados Unidos/epidemiologia , Diabetes Mellitus/sangue , Diabetes Mellitus/epidemiologia , Idoso , Fatores de RiscoRESUMO
BACKGROUND: In recent times, a number of new indices for measuring visceral obesity have been developed. This research sought to investigate the relationship between four visceral obesity indices and prediabetes and diabetes. METHODS: Conducted in 2011 as a cross-sectional analysis in Dalian, China, this study utilized logistic regression models to explore the relationships between four visceral obesity indices and prediabetes and diabetes. It also assessed the dose-response relationships using restricted cubic splines (RCS), performed subgroup analyses, and conducted interaction tests. The predictive values of four visceral obesity indices were evaluated using receiver operating characteristic (ROC) curves. RESULTS: The study enrolled 10,090 participants, with prediabetes and diabetes prevalence at 80.53%. Multifactorial logistic regression revealed positive relationships between the four visceral obesity indices and prediabetes and diabetes. The results of the RCS analysis revealed a linear relationship between the body roundness index (BRI), cardiometabolic index (CMI) and prediabetes and diabetes. Conversely, a non-linear relationship was observed between Chinese visceral adiposity index (CVAI), lipid accumulation product (LAP) and prediabetes and diabetes. Subgroup analyses demonstrated stronger relationships of CMI, CVAI, and LAP with prediabetes and diabetes among females. ROC curves suggested that LAP could be an effective predictor of these conditions. CONCLUSION: This research confirmed that four visceral obesity indices are linked with a higher risk of prediabetes and diabetes in middle-aged and elderly individuals in Dalian. Importantly, LAP could be an effective predictor of prediabetes and diabetes. Effective weight management significantly reduces the risk of both prediabetes and diabetes.
Assuntos
Obesidade Abdominal , Estado Pré-Diabético , Humanos , Estado Pré-Diabético/epidemiologia , Feminino , Estudos Transversais , Masculino , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/complicações , China/epidemiologia , Pessoa de Meia-Idade , Adulto , Índice de Massa Corporal , Idoso , Prevalência , Fatores de Risco , Diabetes Mellitus/epidemiologia , PrognósticoRESUMO
BACKGROUND: Not many large-sample investigations are available that compare the potency of the relationship of remnant cholesterol (RC) and other lipid parameters with diabetes and prediabetes. The goals of our study are to discover the relationship between RC and prediabetes, diabetes, and insulin resistance (IR) and to investigate RC, high-density lipoprotein cholesterol (HDL-C), non-HDL-C, triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), TC/HDL-C, LDL-C/HDL-C, and TG/HDL-C, which are the lipid parameters that are most positively related to diabetes, prediabetes, and IR. METHODS: This research enrolled 36 684 subjects from China's eight provinces. We employed multiple logistic regression analysis for testing the relationship between lipid parameters and diabetes, prediabetes, and IR. RESULTS: After adjusting for potential confounders, and comparing the results with other lipid parameters, the positive relationship between RC and diabetes (odds ratio [OR] 1.417, 95% confidence interval [CI]: 1.345-1.492), prediabetes (OR 1.555, 95% CI: 1.438-1.628), and IR (OR 1.488, 95% CI: 1.404-1.577) was highest. RC was still related to diabetes, prediabetes, and IR even when TG <2.3 mmol/L (diabetes: OR 1.256, 95% CI: 1.135-1.390; prediabetes: OR 1.503, 95% CI: 1.342-1.684; and IR: OR 1.278, 95% CI: 1.140-1.433), LDL-C <2.6 mmol/L (diabetes: OR 1.306, 95% CI: 1.203-1.418; prediabetes: OR 1.597, 95% CI: 1.418-1.798; and IR: OR 1.552, 95% CI: 1.416-1.701), or HDL-C ≥1 mmol/L (diabetes: OR 1.456, 95% CI: 1.366-1.550; prediabetes: OR 1.553, 95% CI: 1.421-1.697; and IR: OR 1.490, 95% CI: 1.389-1.598). CONCLUSION: RC is more positively related to diabetes, prediabetes, and IR than conventional lipids and lipid ratios in the general population, the relationships between RC and diabetes, prediabetes, and IR are stable, even if HDL-C, LDL-C, or TG are at appropriate levels.
Assuntos
Colesterol , Resistência à Insulina , Estado Pré-Diabético , Triglicerídeos , Humanos , Estado Pré-Diabético/sangue , Estado Pré-Diabético/epidemiologia , Feminino , Masculino , Pessoa de Meia-Idade , Colesterol/sangue , Adulto , China/epidemiologia , Triglicerídeos/sangue , Lipídeos/sangue , Idoso , Diabetes Mellitus/sangue , Diabetes Mellitus/epidemiologia , LDL-Colesterol/sangue , HDL-Colesterol/sangue , Biomarcadores/sangue , Estudos Transversais , Fatores de RiscoRESUMO
BACKGROUND: Prediabetes has been found to be associated with an elevated overall risk of cancer, which may be site-specific. we performed a protocol for systematic review and meta-analysis to investigate the correlation between prediabetes and the incidence of gastric cancer (GC). METHODS: A thorough review of the literature was conducted in the PubMed, Embase, and Web of Science databases to identify pertinent observational studies with longitudinal follow-up. The random-effects model was employed to consolidate the data, taking into account the potential impact of heterogeneity. RESULTS: A total of 13 datasets from 8 prospective cohort studies were included. The prevalence of prediabetes was 9.6%. During the mean follow-up duration of 7.1 to 12.2 years, 33,135 patients were diagnosed with GC. According to the results of the pooled analysis, prediabetes was associated with a mildly higher incidence of GC over time (risk ratio: 1.07, 95% confidence interval: 1.01-1.13, Pâ =â .03; I2â =â 44%). Subsequent subgroup analyses indicated that the relationship between prediabetes and the heightened risk of GC may not be substantially influenced by factors such as the country in which the study was conducted, the average age of participants, their gender, the definition of prediabetes used, the prevalence of prediabetes at the beginning of the study, the incidence of GC within the studied population, or the adjustment made for body mass index (P for subgroup difference all >.05). CONCLUSION: The presence of prediabetes may increase the risk of GC by a mild amount when compared with people with normoglycemia in community-derived adult populations.
Assuntos
Estado Pré-Diabético , Neoplasias Gástricas , Humanos , Neoplasias Gástricas/epidemiologia , Estado Pré-Diabético/epidemiologia , Incidência , Fatores de Risco , Prevalência , Masculino , FemininoRESUMO
BACKGROUND: Glucose metabolic disorder is associated with the risk of heart failure (HF). Adiposity is a comorbidity that is inextricably linked with abnormal glucose metabolism in older individuals. However, the effect of adiposity on the association between glucose metabolic disorder and HF risk, and the underlying mechanism remain unclear. METHODS: A total of 13,251 participants aged ≥ 60 years from a cohort study were categorized into euglycemia, prediabetes, uncontrolled diabetes, and well-controlled diabetes. Adiposity was assessed using body mass index (BMI), waist-to-hip ratio (WHR), and visceral fat area (VFA). Adiposity-associated metabolic activities were evaluated using adiponectin-to-leptin ratio (ALR), homeostatic model assessment of insulin resistance (HOMA-IR), and triglyceride-glucose index (TyG). The first occurrence of HF served as the outcome during the follow-up period. RESULTS: A total of 1,138 participants developed HF over the course of an average follow-up period of 10.9 years. The rate of incident HF occurrence was higher in prediabetes, uncontrolled diabetes, and well-controlled diabetes participants compared to that in euglycemia participants. However, the high rates were significantly attenuated by BMI, VFA, and WHR. For WHR in particular, the hazard ratio for incident HF was 1.18 (95% confidence interval (CI): 1.03, 1.35, Padj.=0.017) in prediabetes, 1.59 (95% CI: 1.34, 1.90, Padj.<0.001) in uncontrolled diabetes, and 1.10 (95% CI: 0.85, 1.43, Padj.=0.466) in well-controlled diabetes. The population attributable risk percentage for central obesity classified by WHR for incident HF was 30.3% in euglycemia, 50.0% in prediabetes, 48.5% in uncontrolled diabetes, and 54.4% in well-controlled diabetes. Adiposity measures, especially WHR, showed a significant interaction with glucose metabolic disorder in incident HF (all Padj.<0.001). ALR was negatively associated and HOMA-IR and TyG were positively associated with BMI, WHR, VFA, and incident HF (all Padj.<0.05). ALR, HOMA-IR, and TyG mediated the associations for BMI, WHR and VFA with incident HF (all Padj.<0.05). CONCLUSIONS: Adiposity attenuated the association of glucose metabolic disorder with incident HF. The results also showed that WHR may be an appropriate indicator for evaluating adiposity in older individuals. Adiposity-associated metabolic activities may have a bridging role in the process of adiposity attenuating the association between glucose metabolic disorder and incident HF. TRIAL REGISTRATION: retrospectively registered number: ChiCTR-EOC-17,013,598.
Assuntos
Adiposidade , Biomarcadores , Glicemia , Insuficiência Cardíaca , Estado Pré-Diabético , Humanos , Insuficiência Cardíaca/epidemiologia , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/sangue , Insuficiência Cardíaca/fisiopatologia , Masculino , Feminino , Idoso , Estudos Prospectivos , Pessoa de Meia-Idade , Glicemia/metabolismo , Medição de Risco , Incidência , Fatores de Risco , Biomarcadores/sangue , Estado Pré-Diabético/epidemiologia , Estado Pré-Diabético/diagnóstico , Estado Pré-Diabético/sangue , Fatores de Tempo , Fatores Etários , Índice de Massa Corporal , Resistência à Insulina , Relação Cintura-Quadril , Obesidade/epidemiologia , Obesidade/diagnóstico , Obesidade/sangue , Obesidade/fisiopatologia , Adiponectina/sangue , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/sangue , Prognóstico , Gordura Intra-Abdominal/fisiopatologia , Gordura Intra-Abdominal/metabolismo , LeptinaRESUMO
Type 2 diabetes mellitus (T2DM) and pre-diabetes (pre-DM) are significant health concerns in Pakistan. This systematic review and meta-analysis estimate the prevalence of T2DM and pre-DM, assessing regional, gender, and urban-rural differences. We searched PubMed, Scopus, Cochrane, and PakMediNet databases, identifying 3478 articles. After screening, 17 studies from 1995 to 2018 were included. The pooled prevalence of T2DM and pre-DM in Pakistan was found to be 10.0 % and 11.0 %, respectively. This equates to approximately 24 million individuals with T2DM and 26 million with pre-DM, totaling 50 million affected. Rural areas showed higher T2DM prevalence post-2000, with an odds ratio (OR) of 1.25 (95 % CI: 0.73 to 2.14). Gender analysis revealed a slightly higher, though statistically insignificant, prevalence of T2DM in females and a significantly higher prevalence of pre-DM in males (OR: 0.79, 95 % CI: 0.63 to 0.98). Regionally, Punjab had the highest T2DM prevalence (16 %), followed by Baluchistan (15 %), Sindh (14 %), and Khyber Pakhtunkhwa (KPK) (11 %). There is a substantial burden of T2DM and pre-DM in Pakistan, with significant regional and gender differences. Targeted interventions and resource allocation are needed to address the rising prevalence of diabetes, focusing on early detection and lifestyle modifications.
Assuntos
Diabetes Mellitus Tipo 2 , Estado Pré-Diabético , Humanos , Paquistão/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Prevalência , Estado Pré-Diabético/epidemiologia , Masculino , Feminino , População Rural/estatística & dados numéricosRESUMO
BACKGROUND AND OBJECTIVES: Prevalence of prediabetes and undiagnosed diabetes are different in rural and urban dwellings, with varying driving factors. This study aimed to determine the differences in risk factors of prediabetes and undiagnosed diabetes among Yoruba speaking adult dwellers in selected rural and urban communities in Nigeria using haemoglobin A1c. METHODS: A cross-sectional study was conducted in five selected states in Southwestern Nigeria. Using a multistage sampling technique, 2,537 participants with no prior diagnosis of prediabetes or diabetes mellitus (DM) were enrolled and their glycated haemoglobin (HbA1c) determined. Descriptive statistics, univariate and multiple logistic regression analysis was used to determine the prevalence and risk factors of prediabetes and diabetes at 5% level of significance. RESULTS: Increased age, sex, family history of diabetes, being married, participants' history of hypertension, cardiovascular disease and Gestational Diabetes Mellitus (GDM) or delivery of big babies, BMI, systolic and diastolic blood pressure were significantly associated with prediabetes and diabetes in both urban and rural areas. However, adjusted odds ratio showed that family history of diabetes (2.14, 95% CI: 1.26-3.61 versus 1.36, 95% CI: 1.00-1.85) and past GDM among women (2.67, 95% CI: 0.62, 11.39 versus 1.32, 95% CI: 0.61, 2.89) clearly predict dysglycaemia in the rural compared to urban participants, respectively. CONCLUSIONS: Family history of diabetes and past GDM disproportionately predict dysglycaemia in rural compared to urban participants. Periodic screening for dysglycaemia and public health education, especially in child-bearing women, are necessary measures to reduce the burden of dysglycaemia in Nigeria.
CONTEXTE ET OBJECTIFS: La prévalence du prédiabète et du diabète non diagnostiqué diffère entre les zones rurales et urbaines, avec des facteurs déterminants variés. Cette étude visait à déterminer les différences dans les facteurs de risque du prédiabète et du diabète non diagnostiqué chez les adultes yoruba-parlants vivant dans des communautés rurales et urbaines sélectionnées au Nigeria, en utilisant l'hémoglobine A1c. MÉTHODES: Une étude transversale a été menée dans cinq États sélectionnés du sud-ouest du Nigeria. Utilisant une échantillonnage en plusieurs étapes, 2 537 participants sans diagnostic antérieur de prédiabète ou de diabète sucré (DS) ont été recrutés et leur hémoglobine glyquée (HbA1c) déterminée. Des statistiques descriptives, ainsi que des analyses de régression logistique univariée et multivariée, ont été utilisées pour déterminer la prévalence et les facteurs de risque du prédiabète et du diabète à un seuil de signification de 5 %. RÉSULTATS: L'augmentation de l'âge, le sexe, les antécédents familiaux de diabète, le mariage, les antécédents d'hypertension, de maladie cardiovasculaire et de diabète gestationnel (DG) ou l'accouchement de gros bébés, l'IMC, la pression artérielle systolique et diastolique étaient significativement associés au prédiabète et au diabète dans les zones urbaines et rurales. Cependant, les odds ratio ajustés ont montré que les antécédents familiaux de diabète (2,14, IC à 95 % : 1,26-3,61 contre 1,36, IC à 95 % : 1,00-1,85) et les antécédents de DG chez les femmes (2,67, IC à 95 %: 0,62, 11,39 contre 1,32, IC à 95 % : 0,61, 2,89) prédisent clairement la dysglycémie en milieu rural par rapport aux participants urbains, respectivement. CONCLUSIONS: Les antécédents familiaux de diabète et les antécédents de DG prédisent de manière disproportionnée la dysglycémie en milieu rural par rapport au milieu urbain. Un dépistage périodique de la dysglycémie et une éducation sanitaire, en particulier chez les femmes en âge de procréer, sont des mesures nécessaires pour réduire le fardeau de la dysglycémie au Nigeria. MOTS-CLÉS: Prédiabète, diabète non diagnostiqué, Facteurs de risque, Rural-urbain, Différences, Basé sur l'hémoglobine glyquée, Nigeria.