Burden Of Metabolic Risk Factors Research Articles

Biopsychosocial factors associated with physical activity among Resettlers of the former Soviet Union in Germany: a cross-sectional analysis

ObjectivePrevious research suggests an overall lower cardiovascular disease mortality among ethnic German Resettlers from the Former Soviet Union. However, evidence points to a high burden of metabolic risk factors and...

Burden of risk factors in women and men with unrecognized myocardial infarction: a systematic review and meta-analysis †.

Unrecognized myocardial infarction (MI) is an MI that remains undetected in the acute phase and is associated with an unfavourable prognosis. With this systematic review and meta-analysis, we evaluated the burden of cardiovascular risk factors in individuals with unrecognized MI. We searched general population-based cohort studies diagnosing unrecognized MI by electrocardiogram or myocardial imaging up to 24 November 2023. Pooled mean differences (MDs) or risk ratios (RRs) with 95% confidence intervals (CIs) were determined, and random-effects meta-analyses were performed. Fourteen cohort studies were included involving 200 450 individuals (mean age 62.8 ± 9.9 years, 56.0% women), among which 4322 (2.2%) experienced unrecognized MI (mean age 66.3 ± 8.2 years, 47.8% women) and 4653 (2.1%) recognized MI (mean age 68.5 ± 7.3 years, 33.8% women). Compared to individuals without MI, those with unrecognized MI had higher body mass index (MD 0.27, 95% CI 0.16-0.39) and systolic blood pressure (MD 4.48, 95% CI 2.81-6.15) levels, and higher prevalence of hypertension (RR 1.27, 95% CI 1.06-1.51) and diabetes mellitus (RR 1.67, 95% CI 1.36-2.06). Furthermore, individuals with unrecognized MI had lower prevalence of hypertension (RR 0.92, 95% CI 0.88-0.97) and diabetes mellitus (RR 0.80, 95% CI 0.70-0.92). Individuals with unrecognized MI are characterized by a substantial burden of metabolic risk factors. Our findings suggest insufficient recognition and management of cardiovascular risk factors among individuals with unrecognized MI.

The burden of metabolic risk factors in North Africa and the Middle East, 1990-2019: findings from the Global Burden of Disease Study.

The objective of this study is to investigate the trends of exposure and burden attributable to the four main metabolic risk factors, including high systolic blood pressure (SBP), high fasting plasma glucose (FPG), high body-mass index (BMI), and high low-density lipoproteins cholesterol (LDL) in North Africa and the Middle East from 1990 to2019. The data were retrieved from Global Burden of Disease Study 2019. Summary exposure value (SEV) was used for risk factor exposure. Burden attributable to each risk factor was incorporated in the population attributable fraction to estimate the total attributable deaths and disability-adjusted life-years (DALYs). While age-standardized death rate (ASDR) attributable to high-LDL and high-SBP decreased by 26.5% (18.6-35.2) and 23.4% (15.9-31.5) over 1990-2019, respectively, high-BMI with 5.1% (-9.0-25.9) and high-FPG with 21.4% (7.0-37.4) change, grew in ASDR. Moreover, age-standardized DALY rate attributed to high-LDL and high-SBP declined by 30.2% (20.9-39.0) and 25.2% (16.8-33.9), respectively. The attributable age-standardized DALY rate of high-BMI with 8.3% (-6.5-28.8) and high-FPG with 27.0% (14.3-40.8) increase, had a growing trend. Age-standardized SEVs of high-FPG, high-BMI, high-SBP, and high-LDL increased by 92.4% (82.8-103.3), 76.0% (58.9-99.3), 10.4% (3.8-18.0), and 5.5% (4.3-7.1), respectively. The burden attributed to high-SBP and high-LDL decreased during the 1990-2019 period in the region, while the attributable burden of high-FPG and high-BMI increased. Alarmingly, exposure to all four risk factors increased in the past three decades. There has been significant heterogeneity among the countries in the region regarding the trends of exposure and attributable burden. Urgent action is required at the individual, community, and national levels in terms of introducing effective strategies for prevention and treatment that account for local and socioeconomic factors. Bill & Melinda Gates Foundation.

Male hypogonadism in overweight and obesity

Obesity-related gonadal dysfunction in males has been defined recently as male obesity secondary hypogonadism (MOSH). Affected individuals present with signs and symptoms related to the sex hormone imbalance but also with a burden of metabolic risk factors and occasionally compromised fertility. In pathophysiological terms, excess body fat is associated with leptin and insulin resistance. Accelerated synthesis of leptin and hyperinsulinemia downregulate the expression of kisspeptin receptors and, consequently, the action of kisspeptin. This critical neuropeptide is known to control gonadotropin secretion. In obese males, enhanced activity of the aromatase enzyme is associated with an increase in the conversion of circulating testosterone to estrogen, further promoting a state of hypogonadism. In addition, high fat and low fiber intake alter the intestinal microbiome and the dysfunction of the gut-brain axis. Weight loss appears to be the key to readjusting the function of the hypothalamus-pituitary-gonadal axis. It can be achieved with lifestyle measures in combination with weight loss medications or bariatric surgery. The degree of weight loss appears to resolve the symptoms related to hypogonadism and improve fertility chances. However, the role of hormone replacement is also important, as testosterone replacement has been shown to reduce fat mass and increase the amount of lean body mass while also contributing to weight loss and the regulation of body mass index and waist circumference. This narrative review analyzes the evidence on developing obesity-related endocrinopathies and the available management options. Further research is required to estimate the cut-off of body mass index associated with a higher risk for hypogonadism.

The association between metabolic risk factors, nonalcoholic fatty liver disease, and the incidence of liver cancer: a nationwide population-based cohort study.

Liver cancer is a detrimental complication in patients with chronic viral hepatitis and alcoholic or nonalcoholic fatty liver disease (NAFLD). However, metabolic risk factors underlying NAFLD usually cause substantial differences in their clinical outcomes. Recently, several studies have used a novel definition of metabolic dysfunction-associated fatty liver disease (MAFLD) to reassess patients with NAFLD and pointed out the importance of metabolic risk factors. Since patients with NAFLD, MAFLD, or metabolic syndrome (MetS) have different burden of metabolic risk factors, it is crucial to decipher the risk of developing hepatic complications in these populations. Through a longitudinal nationwide cohort study, the risk of liver cancer was investigated in patients with MetS alone, NAFLD alone, overlap NAFLD/MAFLD, and coexisting MetS and NAFLD. The general characteristics, comorbidities, and incidence of liver cancer were also compared. Intriguingly, patients diagnosed with MetS alone did not have a significant risk of developing HCC compared to control individuals, while patients with NAFLD alone, NAFLD/MAFLD, and coexisting NAFLD and MetS exhibited 6.08-, 5.81-, and 15.33-fold risks of developing HCC, respectively. Apart from metabolic risk factors, renal function status and liver cirrhosis were the independent risk factors for the development of HCC among these groups. Our data emphasize that metabolic dysfunction has a significant impact on hepatocarcinogenesis in patients with NAFLD. Moreover, coexisting multiple metabolic risk factors would dampen the risk of developing HCC in patients with NAFLD. Closely tracing HCC formation through laboratory examination or imaging is crucial in these patients.

The Burden of Metabolic Risk Factors in North Africa and the Middle East, 1990-2019: Findings from the Global Burden of Disease Study

The Burden of Metabolic Risk Factors in North Africa and the Middle East, 1990-2019: Findings from the Global Burden of Disease Study

Sex Differences in Rates of Change and Burden of Metabolic Risk Factors Among Adults Who Did and Did Not Go On to Develop Diabetes: Two Decades of Follow-up From the Tehran Lipid and Glucose Study.

We investigated the cumulative burden and linear rates of change of major metabolic risk factors (MRFs) among Iranian adults in whom type 2 diabetes did and did not develop. We included 7,163 participants (3,069 men) aged 20-70 years at baseline with at least three examinations during 1999-2018. Individual growth curve modeling was used for data analysis. Statistical interactions for sex by diabetes status were adjusted for age, family history of diabetes, smoking status, and physical activity level. Study sample included 743 (316 men) new case subjects with diabetes. In both men and women, compared with individuals in whom diabetes did not develop, individuals in whom diabetes developed had a higher burden of all MRFs and a greater rate of change in BMI, fasting plasma glucose (FPG), systolic blood pressure (SBP), and diastolic blood pressure; however, the differences in burden and rate of change between those who did and did not develop diabetes were greater in women than in men. During the transition to diabetes, women experienced more adverse change in BMI, FPG, triglyceride, and HDL cholesterol (HDL-C) (diabetes-sex interaction P values <0.05) and faster rates of change in BMI, FPG, HDL-C, and total cholesterol (interaction P values <0.01) and SBP (interaction P = 0.055) than men. The greater exposure of women to and burden of MRFs before onset of diabetes may have implications for implementing sex-specific strategies in order to prevent or delay diabetes complications.

Ethnic differences in infectious burden and the association with metabolic risk factors for cardiovascular disease: a cross-sectional analysis

BackgroundThe burden of metabolic risk factors for cardiovascular disease (CVD), such as type 2 diabetes, elevated cholesterol and hypertension, is unequally distributed across ethnic groups. Recent findings suggest an association of infectious burden (IB) and metabolic risk factors, but data from ethnic groups are scarce. Therefore, we investigated ethnic differences in IB and its association with metabolic risk factors.MethodsWe included 440 Dutch, 320 Turkish and 272 Moroccan participants, 18–70 years, of the 2004 general health survey in Amsterdam, the Netherlands. IB was defined by seropositivity to the sum of 6 infections: Herpes Simplex Virus 1 and 2; Hepatitis A, B and C; and Helicobacter pylori. Associations between IB categories 4–6 (high), 3 (intermediate) and 0–2 (low) infections and metabolic risk factors were assessed by logistic regression. Finally, we determined the contribution of IB to the association between ethnicity and the metabolic risk factors by comparing adjusted logistic regression models with and without IB categories.ResultsA high IB was more frequently observed among the Turkish and Moroccans than among the Dutch. After adjustment for age, sex, ethnicity, educational level, physical activity and body mass index, high IB was associated with type 2 diabetes (odds ratio high vs low IB (OR) =2.14, 95%-confidence interval (CI) 1.05–4.36). The association was weaker and not statistically significant, for elevated cholesterol (OR = 1.39, 95%-CI 0.82–2.34) and hypertension (OR = 1.49, 95%-CI 0.88–2.51). IB attenuated ethnic differences particularly for type 2 diabetes.ConclusionsOur study showed that Turkish and Moroccan adults in Amsterdam have a higher IB than Dutch adults, which was associated with the differences in type 2 diabetes. Due to the cross-sectional nature of the study, we cannot draw a conclusions with regards to the time-sequence of cause and effect. Nevertheless, the findings ask for further research into the nature of association of IB with metabolic risk factors in a longitudinal setting.

Influence of Metabolic Risk Factors on Risk of Hepatocellular Carcinoma and Liver-Related Death in Men With Chronic Hepatitis B: A Large Cohort Study

Little is known about the absolute risk of hepatocellular carcinoma (HCC) and liver-disease related death, in association with metabolic risk factors, for patients with hepatitis B virus (HBV) infection. We collected data from 5373 male Taiwanese civil servants who visited Taiwan's Government Employees' Central Clinics and received routine free physical examinations from 1989 through 1992. We obtained information on liver-related morbidity and mortality in HBV carriers, 40-65 years of age (n=1690), with different metabolic risk factors. We compared their medical histories with those of study participants without HBV or HCV infection in the same age range (n=1289). We used patients' baseline data on obesity, diabetes, hypertriglyceridemia, and high blood pressure to assign them to metabolic risk categories. We then performed a case-cohort analysis of the effects of hepatitis B viral factors on risk for HCC, based on metabolic factors and insulin resistance. Over a median follow-up period of 19 years, 158 of the 1690 HBV carriers developed HCC and 126 died from liver-related diseases. Among participants without HBV or HCV infection, only 6 developed HCC or died from liver-related disease. HBV carriers with different metabolic risk factors had significant differences in cumulative incidence of HCC and liver-related death. Patients with 3 or more metabolic risk factors had a substantially higher risk for HCC (10-year cumulative incidence, 13.60%) than patients with a low metabolic risk profile (10-year cumulative incidence, 4.83%; adjusted-hazard ratio, 2.32; 95% CI, 1.18-4.54). Smoking had a significant effect on this association (Pinteraction= .0044). Having 3 or more metabolic risk factors, compared with no factors, significantly increased the risk of HCC (adjusted-hazard ratio, 5.06; 95% CI, 2.23-11.47) and 10-year cumulative incidence of HCC (25.0% in smokers with 3 or more metabolic risk factors vs 3.87% in smokers with none; P < .0001) in smokers, but did not increase risk of HCC in nonsmokers. Metabolic risk factors and insulin resistance had the largest effect on HCC risk in patients with levels of HBV-DNA <10,000 copies/mL. In a study of men with chronic HBV infection ages 40-65 years in Taiwan, we associated a high burden of metabolic risk factors with increased risk of HCC; smoking has a significant effect on this association.

Prevalence and sociodemographic correlates of metabolic syndrome in school-aged children and their parents in nine Mesoamerican countries.

To ascertain the prevalence and sociodemographic correlates of cardiometabolic risk factors in adults and school-aged children from Mesoamerica. Cross-sectional study with convenience sampling. In adults, metabolic syndrome was defined according to the National Cholesterol Education Program's Adult Treatment Panel III (ATP III) criteria. In children, we calculated a continuous sex- and age-standardized metabolic risk score using variables corresponding to adult ATP III criteria. Metabolic syndrome prevalence in adults and risk score distribution in children were compared across levels of sociodemographic characteristics with use of Poisson and linear regression, respectively. Capital cities of Guatemala, El Salvador, the Dominican Republic, Honduras, Nicaragua, Panama, Costa Rica, the Mexican State of Chiapas (Tuxtla Gutiérrez city) and Belize. Families (n 267), comprising one child aged 7-12 years and their biological parents. The prevalence of metabolic syndrome was 37·9 % among women and 35·3 % among men. The most common component was low HDL cholesterol, 83·3 % in women and 78·9 % in men. Prevalence was positively associated with age. In women, metabolic syndrome was inversely related to education level whereas in men it was positively associated with household food security and height, after adjustment. The metabolic risk score in children was inversely related to parental height, and positively associated with height-for-age and with having parents with the metabolic syndrome. Metabolic syndrome is highly prevalent in Mesoamerica. The burden of metabolic risk factors disproportionately affects women and children of lower socio-economic status and men of higher socio-economic status.

A higher burden of metabolic risk factors and underutilization of therapy among women compared to men might influence a poorer prognosis: a study among acute myocardial patients in Albania, a transitional country in Southeastern Europe.

AimTo determine the clinical profile, burden of risk factors, and quality of care among patients hospitalized for an acute myocardial infarction (AMI) with special focus on gender differences.MethodsThe study included 256 AMI patients admitted to the Coronary Care Unit of “Mother Teresa” hospital in Tirana during 2013-2014. We obtained information on patients’ demographic data, AMI characteristics, complications (heart failure [HF] and ventricular fibrillation [VF]), risk factors and medication use prior and during the AMI hospitalization. Age-adjusted Poisson regression analyses were applied to explore gender differences (women vs men) with regard to clinical profile and quality of care and results are expressed as incidence rate ratios (IRR).Results55.4% of patients had ≥3 risk factors, 44.5% developed HF, and 5.7% developed VF. Only 40.4% of patients received all 4 medication classes (beta-blockers, angiotensin-converting-enzyme inhibitor/angiotensin receptor blockers, statins, and aspirin) and 46.4% had revascularization. Significantly more women than men were obese, (P = 0.042) had diabetes, (P = 0.001) developed HF (P < 0.001) or experienced a VF episode (P < 0.001). After adjusting for age, differences with regard to obesity (IRR = 2.17; 95% confidence interval [CI] 1.15-4.09), diabetes (IRR = 1.35; 95% CI 1.07-1.71), HF (IRR = 1.32; 95% CI 1.02-1.74) and VF (IRR = 2.82; 95% CI 1.07-7.43) remained significant. There were no differences with regard to individual drug classes taken. However, women had fewer revascularization procedures than men (IRR = 0.65; 95% CI 0.43-0.98).ConclusionWomen were found to have more unfavorable clinical profile, higher complication rates, and underutilization of therapy, which may be influenced by socioeconomic differences between genders and lead to a differential prognosis.

P16.29 Prevalence of metabolic risk factors in hiv-infected population under antiretroviral therapy in northern malawi

Introduction With increased availability of antiretroviral therapy (ART), the life expectancy of people with human immunodeficiency virus (HIV) infection is expected to improve substantially. On the other hand, life-long ART may be associated with increased obesity, diabetes, and hypertension. The situation of obesity, diabetes, and hypertension in HIV-infected population in Malawi is unclear. Methods We conducted a cross-sectional study including adult HIV-infected patients under ART treatment in a teaching hospital from northern Malawi. Trained field workers performed anthropometric measurements, blood pressure exam, and finger prick test for blood glucose. We followed the WHO and International Diabetes Federation (IDF) criteria to define obesity, hypertension, and diabetes. We compared the prevalence of metabolic risk factors in our study population to that in the 2009 STEPwise approach to Surveillance (STEPS) survey in Malawi. Results The study included 410 participants (20.97% males). The prevalence of overweight (25≤BMI Conclusion Our study provides an initial assessment of the burden of metabolic risk factors among HIV-infected population under long-term ART treatment in Malawi. The high prevalence of metabolic risk factors in this population is concerning. Long-term impact on the burden of noncommunicable diseases warrants further investigation. Disclosure of interest statement This study was funded by Luke international belongs Pingtung Christian hospital. And that was leaded by National Taiwan University for academic research.

Metabolic characterization of adults with binge eating in the general population: the Framingham Heart Study.

OBJECTIVETo describe the metabolic profile of individuals with objective binge eating (OBE) and to evaluate whether associations between OBE and metabolic risk factors are mediated by body mass index (BMI).DESIGN AND METHODSParticipants from the Framingham Heart Study, Third Generation and Omni 2 cohorts (n = 3551, 53.1% women, mean age 46.4 years) were screened for binge eating. We used multivariable-adjusted regression models to examine the associations of OBE with metabolic risk factors.RESULTSThe prevalence of OBE was 4.8% in women and 4.9% in men. Compared to non-binge eating, OBE was associated with higher odds of hypertension (OR 1.85, 95% CI 1.32–2.60), hypertriglyceridemia (OR 1.42, 95% CI 1.01–2.01), low HDL (OR 1.70, 95% CI 1.18–2.44), insulin resistance (OR 3.18, 95% CI 2.25–4.50) and metabolic syndrome (OR 2.75, 95% CI 1.94–3.90). Fasting glucose was 7.2 mg/dl higher in those with OBE (p=0.0001). Individuals with OBE had more visceral, subcutaneous and liver fat. Most of these associations were attenuated with adjustment for BMI, with the exception of fasting glucose.CONCLUSIONSBinge eating is associated with a high burden of metabolic risk factors. Much of the associated risk appears to be mediated by BMI, with the exception of fasting glucose.

Correction

HomeCirculation ResearchVol. 115, No. 4Correction Free AccessCorrectionPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessCorrectionPDF/EPUBCorrection Originally published1 Aug 2014https://doi.org/10.1161/RES.0000000000000027Circulation Research. 2014;115:e8This article corrects the followingGlobal Perspective on Acute Coronary SyndromeIn the Circulation Research article by Vedanthan et al (Global Perspective on Acute Coronary Syndrome: A Burden on the Young and Poor. Circ Res. 2014;114:1959–1975. DOI: 10.1161/CIRCRESAHA.114.302782), corrections were needed.Figure 9 is incorrect and should have two panels.The legends for Figures 3, 4, and 5 should include the following statement, referencing the source of the data derived to create the figures: “Data derived from Global Burden of Metabolic Risk Factors of Chronic Diseases and World Population Prospects, 2012 Revision.”The errors have been corrected in the online version of the article, which is available at http://circres.ahajournals.org/content/114/12/1959. Previous Back to top Next FiguresReferencesRelatedDetailsRelated articlesGlobal Perspective on Acute Coronary SyndromeRajesh Vedanthan, et al. Circulation Research. 2014;114:1959-1975 August 1, 2014Vol 115, Issue 4 Advertisement Article InformationMetrics © 2014 American Heart Association, Inc.https://doi.org/10.1161/RES.0000000000000027 Originally publishedAugust 1, 2014 PDF download Advertisement

Economic globalization, inequality and body mass index: a cross-national analysis of 127 countries

This article investigates to what extent the worldwide increase in body mass index (BMI) has been affected by economic globalization and inequality. We used time-series and longitudinal cross-national analysis of 127 countries from 1980 to 2008. Data on mean adult BMI were obtained from the Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group. Globalization was measured using the Swiss Economic Institute (KOF) index of economic globalization. Economic inequality between countries was measured with the mean difference in gross domestic product per capita purchasing power parity in international dollars. Economic inequality within countries was measured using the Gini index from the Standardized World Income Inequality Database. Other covariates including poverty, population size, urban population, openness to trade and foreign direct investment were taken from the World Development Indicators (WDI) database. Time-series regression analyses showed that the global increase in BMI is positively associated with both the index of economic globalization and inequality between countries, after adjustment for covariates. Longitudinal panel data analyses showed that the association between economic globalization and BMI is robust after controlling for all covariates and using different estimators. The association between economic inequality within countries and BMI, however, was significant only among high-income nations. More research is needed to study the pathways between economic globalization and BMI. These findings, however, contribute to explaining how contemporary globalization can be reformed to promote better health and control the global obesity epidemic.

Tackling the global diabetes burden: will screening help?

Worldwide, cases of type 2 diabetes have doubled from nearly 150 million in 1980 to almost 350 million today, 1 Danaei G Finucane MM Lu Y et al. on behalf of the Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (Blood Glucose)National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2·7 million participants. Lancet. 2011; 378: 31-40 Summary Full Text Full Text PDF PubMed Scopus (2648) Google Scholar and effective strategies to reduce the burden of disease are greatly needed. A large and highly variable proportion of cases are undiagnosed, 2 Yang W Lu J Weng J et al. Prevalence of diabetes among men and women in China. N Engl J Med. 2010; 362: 1090-1101 Crossref PubMed Scopus (2631) Google Scholar and in view of the available evidence-based treatments, 3 Simmons RK Echouffo-Tcheugui JB Griffin SJ Screening for type 2 diabetes: an update of the evidence. Diabetes Obes Metab. 2010; 12: 838-844 Crossref PubMed Scopus (35) Google Scholar early detection through diabetes screening is worth careful consideration. Diabetes screening and diagnosis can be done with relative ease, which further escalates popular support for wide-scale screening. However, these compelling arguments overlook the screening costs, potential harms, and lack of clear evidence that screening improves health outcomes compared with current routine clinical diagnosis. In The Lancet, Rebecca Simmons and colleagues 4 Simmons RK Echouffo-Tcheugui JB Sharp SJ et al. Screening for type 2 diabetes and population mortality over 10 years (ADDITION-Cambridge): a cluster-randomised controlled trial. Lancet. 2012; (published online Oct 4.)http://dx.doi.org/10.1016/S0140-6736(12)61422-6 PubMed Google Scholar report their findings from the ADDITION study, the most earnest attempt to date to try to settle the diabetes screening quandary. Screening for type 2 diabetes and population mortality over 10 years (ADDITION-Cambridge): a cluster-randomised controlled trialIn this large UK sample, screening for type 2 diabetes in patients at increased risk was not associated with a reduction in all-cause, cardiovascular, or diabetes-related mortality within 10 years. The benefits of screening might be smaller than expected and restricted to individuals with detectable disease. Full-Text PDF Open AccessDiabetes and endocrinology: a call for papersThe 20th century saw an increased understanding and dissemination of information on disorders affecting metabolism and endocrine function. A debate on the nomenclature—including use of “the indefensible word ‘endocrine’”—took place within the pages of The Lancet in 1917.1–4 Nearly 100 years on, much progress has been made, and endocrine and metabolic disorders have come together in a diverse and colourful specialty, encompassing a variety of conditions affecting all parts of the body. Disorders of hormone secretion are indiscriminate in adversely affecting health and wellbeing by targeting reproduction, homoeostasis, metabolism, growth, and development. Full-Text PDF

O5-3.5 Revisiting the cardiovascular risk transition: the associations of metabolic risk factors with national income since between 1980 and 2008

IntroductionCardiovascular diseases and their metabolic risk factors including overweight and obesity, blood pressure, cholesterol, and glucose have been predicted to rise with increasing income, originally referred to as the “diseases...

Global control of diabetes: information for action

On Dec 20, 2006, the UN General Assembly passed resolution 61/225, in recognition that diabetes “poses severe risks for families, Member States and the entire world”.1 In The Lancet, the Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group2 presents evidence that strongly supports this resolution, and reinforces the need to strengthen worldwide diabetes surveillance.