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The association between Angina and Triglyceride-Glucose Index among non-Diabetic Patients: A NHANES Cross-Sectional study: 2001-2020

Abstract Background A current alternative test of insulin resistance that has been considered a predictor of metabolic syndrome and cardiovascular disease (CVD) is the triglyceride-glucose (TyG) index. However, it is unknown if the TyG index may estimate the risk and incidence of angina in the non-diabetic population. This research examines the correlation between the TyG index and angina in non-diabetic individuals. Methods Data from the National Health and Nutrition Examination Survey (NHANES) were used in this study from 2001 to 2020; non-diabetic individuals aged 18 years or older were our targeted sample. We divided the sample regarding the angina as follows: no angina, no exertional chest pain, possible angina, and definitive angina. As well, the categories of TyG index were < = 8.22, 8.23–8.60, 8.61–9.01, and 9.02+. The analysis was conducted using a 4-year weight at fasting (WTSAF4YR) according to NHANES analysis criteria. The receiver operating characteristic (ROC) analysis was utilized to determine the sensitivity and specificity of the TyG index for estimating the endpoints of interest (angina). Univariate and multivariate logistic regression were performed to determine the factors correlated with the study outcomes, and the analysis was performed using IBM, SPSS Version 28.0. Results We involved 6,762 non-diabetic individuals, including 49 individuals who had possible angina, and 487 individuals had definitive angina, in addition 1,690 individuals with TyG above 9.02. We addressed a statistically difference between TyG and gender, as 55.9% of participants with high TyG (> 9.02) were males. The Pearson chi-square test showed no statistically significant difference between angina subgroups and TyG index categories, p-value: 0.065. In addition, six regression models confirmed that higher values of TyG index were not associated with the presence of no exertional chest pain, definitive angina, or possible angina. In addition, the TYG test had low diagnostic accuracy for identifying patients with angina (Sensitivity: 52.8%, Specificity: 52.83% AUC; 52.82%, P-value < 0.05). Conclusion The TyG index cannot be utilized as an alternate predictive marker for angina in the non-diabetic population since it has no correlation to angina risk factors.

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Exploring patient treatment decision making for osteoarthritis in the UAE: a cross-sectional adaptive choice-based conjoint study

ObjectiveTo assess osteoarthritis (OA) patients’ preferences for pharmaceutical treatment via Adaptive Choice-Based Conjoint (ACBC) method.MethodsA United Arab Emirates (UAE) based Patient and Public Involvement (PPI) group designed the ACBC questionnaire with 10 attributes and 34 levels. The questionnaire was developed using Sawtooth Software and analyzed through Hierarchical Bayesian (HB). Results were standardized using Z-score via SPSS.ResultsStudy participants were 1030 OA patients, 83.6% aged 50 or older and 83.4% female. The avoidance of medication’s side effects accounted for 66% relative importance compared to 6% relative importance for the medication’s benefits. The “way of taking the medicine” attribute had the highest coefficient of variation (70%) and the four side effect attributes “risk of gastric ulcer, addiction, kidney and liver impairment, and heart attacks and strokes” had a coefficient of variation from 18 to 21%.ConclusionsArab OA patients are similar to other ethnic groups in trading-off benefits and side effects and consistently prioritizing the avoidance of medications’ side effects. Although the “Way of taking medicine” was the least important attribute it was associated with the highest variation amongst patients. OA patients also prefer prescribed medications to internet-purchased and over-the-counter options.

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Triglyceride-Glucose Index as Predictor for Hypertension, CHD and STROKE Risk among non-Diabetic patients: A NHANES Cross-Sectional Study 2001-2020

Abstract Background This study aimed to investigate the association between the TyG index and the risk of coronary heart disease (CHD), congestive heart failure (CHF), heart attack (HA), stroke, and hypertension (HTN) among non-diabetic patients in the USA. Methods In this retrospective, cross-sectional study, we used data from the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2020. Our study sample comprised non-diabetic NHANES participants aged ≥ 18 years. To determine the sensitivity and specificity of the triglyceride-glucose (TyG) index for predicting the onset of CHD, CHF, HA, stroke, and HTN, we conducted receiver operating characteristic (ROC) curve analysis. Results A total of 10,937 non-diabetic individuals participated in our study. Individuals with a TyG index greater than 8.96 displayed noteworthy elevations in various parameters, including BMI, systolic/diastolic blood pressure, total cholesterol, LDL, and Apo-B levels (p < 0.001). Additionally, 360, 359, 385, 237, and 3254 patients were found to have CHD, stroke, HA, CHF, and HTN, respectively. We evaluated the predictive ability of the TyG index for each endpoint, obtaining the following area under the curve (AUC) values: 54.75% for CHF (95% CI: 0.542–0.614), 52.32% for stroke (95% CI: 0.529–0.584), 55.67% for HA (95% CI: 0.595–0.646), 55.59% for HTN (95% CI: 0.574–0.597), and 50.31% for CHD (95% CI: 0.592–0.646) (p < 0.05). Conclusion The TyG index showed a strong correlation with cardiovascular risk factors in nondiabetic individuals, suggesting its potential as a predictor of cardiovascular risk. However, its use as a standalone screening tool is limited because of its low predictive value.

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Clinical and Diagnostic Characteristics of Calcaneal Apophysitis: A Systematic Review and Thematic Analysis.

Calcaneal apophysitis is an overuse injury in pediatric patients that causes heel pain and reduction in function. The aim of this study is to explore this condition and offer medical insight into its presentation and symptomatology, along with current treatment options. We explored PubMed/Medline for studies involving calcaneal apophysitis in pediatric patients. The search included all articles published from database inception until June 1, 2021. We only included articles published in English. Clinical information and demographics extracted from the reported studies were analyzed and assessed. Only 28 studies met our criteria, with a total of 1,362 cases. Of the cases reported, 973 affected boys (71.4%). Presentation was bilateral in 589 cases (43.2%) and unilateral in 433 cases (31.8%). Radiographic imaging was used for the diagnosis of 358 cases (26.3%). All reported treatment modalities were conservative, and these included physical therapy and rest, kinesiotherapy and taping, and orthotic devices. A total of 733 cases (53.7%) reported improved outcomes,32 cases (2.3%) reported no improvement, and the remainder of cases did not report prognostic outcomes (44%). Calcaneal apophysitis is an overuse disease commonly found in the pediatric population. Educating parents and coaches with regard to its symptomatology, etiology, and treatment is essential to diagnose the condition earlier and provide better outcomes.

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Association between pediatric asthma and adult polycystic ovarian syndrome (PCOS): a cross-sectional analysis of the UAE healthy future Study (UAEHFS).

Asthma and polycystic ovarian syndrome (PCOS) are linked in several possible ways. To date, there has been no study evaluating whether pediatric asthma is an independent risk factor for adult PCOS. Our study aimed to examine the association between pediatric asthma (diagnosed at 0-19 years) and adult PCOS (diagnosed at ≥20 years). We further assessed whether the aforementioned association differed in two phenotypes of adult PCOS which were diagnosed at 20-25 years (young adult PCOS), and at >25 years (older adult PCOS). We also evaluated whether the age of asthma diagnosis (0-10 vs 11-19 years) modified the association between pediatric asthma and adult PCOS. This is a retrospective cross-sectional analysis using the United Arab Emirates Healthy Future Study (UAEHFS) collected from February 2016 to April 2022 involving 1334 Emirati females aged 18-49 years. We fitted a Poisson regression model to estimate the risk ratio (RR) and its 95% confidence interval (95% CI) to assess the association between pediatric asthma and adult PCOS adjusting for age, urbanicity at birth, and parental smoking at birth. After adjusting for confounding factors and comparing to non-asthmatic counterparts, we found that females with pediatric asthma had a statistically significant association with adult PCOS diagnosed at ≥20 years (RR=1.56, 95% CI: 1.02-2.41), with a stronger magnitude of the association found in the older adult PCOS phenotype diagnosed at >25 years (RR=2.06, 95% CI: 1.16-3.65). Further, we also found females reported thinner childhood body size had a two-fold to three-fold increased risk of adult PCOS diagnosed at ≥20 years in main analysis and stratified analyses by age of asthma and PCOS diagnoses (RR=2.06, 95% CI: 1.08-3.93 in main analysis; RR=2.74, 95% CI: 1.22-6.15 among those diagnosed with PCOS > 25 years; and RR=3.50, 95% CI: 1.38-8.43 among those diagnosed with asthma at 11-19 years). Pediatric asthma was found to be an independent risk factor for adult PCOS. More targeted surveillance for those at risk of adult PCOS among pediatric asthmatics may prevent or delay PCOS in this at-risk group. Future studies with robust longitudinal designs aimed to elucidate the exact mechanism between pediatric asthma and PCOS are warranted.

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High prevalence of cardiometabolic risk factors amongst young adults in the United Arab Emirates: the UAE Healthy Future Study

BackgroundCardiovascular disease (CVD) is the leading cause of death in the world. In the United Arab Emirates (UAE), it accounts for 40% of mortality. CVD is caused by multiple cardiometabolic risk factors (CRFs) including obesity, dysglycemia, dyslipidemia, hypertension and central obesity. However, there are limited studies focusing on the CVD risk burden among young Emirati adults. This study investigates the burden of CRFs in a sample of young Emiratis, and estimates the distribution in relation to sociodemographic and behavioral determinants.MethodsData was used from the baseline data of the UAE Healthy Future Study volunteers. The study participants were aged 18 to 40 years. The study analysis was based on self-reported questionnaires, anthropometric and blood pressure measurements, as well as blood analysis.ResultsA total of 5167 participants were included in the analysis; 62% were males and the mean age of the sample was 25.7 years. The age-adjusted prevalence was 26.5% for obesity, 11.7% for dysglycemia, 62.7% for dyslipidemia, 22.4% for hypertension and 22.5% for central obesity. The CRFs were distributed differently when compared within social and behavioral groups. For example, obesity, dyslipidemia and central obesity in men were found higher among smokers than non-smokers (p < 0.05). And among women with lower education, all CRFs were reported significantly higher than those with higher education, except for hypertension. Most CRFs were significantly higher among men and women with positive family history of common non-communicable diseases.ConclusionsCRFs are highly prevalent in the young Emirati adults of the UAE Healthy Future Study. The difference in CRF distribution among social and behavioral groups can be taken into account to target group-specific prevention measures.

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