Higher Odds Of Diabetes Research Articles

Associations of dichlorophenols, trichlorophenols, and ortho-phenylphenol with the risk and prognosis of diabetes and prediabetes: A population-based study

2,4-dichlorophenol (2,4-DCP), 2,5-DCP, 2,4,5-trichlorophenol (2,4,5-TCP), 2,4,6-TCP, and ortho-phenylphenol (OPP) are widely present in the environment. However, their associations with risk and prognosis of diabetes and prediabetes remains unclear. We investigated the associations of these five phenols with the risk of diabetes and prediabetes, and with all-cause and cardiovascular disease (CVD) mortality, in adults with diabetes or prediabetes (n=6419). Information on diabetes and prediabetes indicators, and mortality data was collected from the National Health and Nutrition Examination Survey. Logistic and Cox regression models were used to explore the associations of the five phenols with risk and prognosis of diabetes and prediabetes. Participants in the highest urinary 2,4-DCP and 2,5-DCP tertiles had higher odds of diabetes [adjusted odds ratio (aOR), 1.34, 95 % confidence interval (CI): 1.10, 1.62; aOR, 1.29, 95 % CI: 1.07, 1.56, respectively] than those in the lowest tertiles. Participants with urinary OPP concentrations above the limit of detection (LOD), but below median had an aOR of 1.25 (95 % CI: 1.08, 1.46) for prediabetes compared to those with concentrations below the LOD. In adults with diabetes, the highest 2,4-DCP and 2,5-DCP tertiles were associated with all-cause mortality [adjusted hazard ratio (aHR), 1.49; 95 % CI: 1.08, 2.06; aHR, 1.49; 95 % CI: 1.08, 2.05, respectively] and CVD mortality (aHR, 2.58; 95 % CI: 1.33, 4.97; aHR, 1.96; 95 % CI: 1.06, 3.60, respectively) compared with the lowest tertiles. Compared with 2,4,5-TCP concentrations below the LOD, those above median were associated with all-cause mortality (aHR: 1.75; 95 % CI: 1.24, 2.48) and CVD mortality (aHR: 2.34; 95 % CI: 1.19, 4.63) in adults with prediabetes. Furthermore, the associations between these phenols and mortality were strengthened in some subgroups. Environmental exposure to 2,4-DCP, 2,5-DCP, 2,4,5-TCP, and OPP increases the risk or adverse prognosis of diabetes or prediabetes in adults in the US. Further studies are required to confirm these findings.

Prevalence of Diabetes and the Relationship Between Wealth and Social Demographic Characteristics Across 6 Low-and-Middle Income Countries.

As the global burden of diabetes persists, research is needed to understand the role of wealth and correlates of diabetes across regions of the world. The purpose of this study is to examine the prevalence and role of wealth and diabetes across 6 low- and middle- income countries while also accounting for independent correlates of diabetes by country. Data from the Study on Global Ageing and Adult Health (SAGE), SAGE Wave 1 was used. Self-reported diabetes status was the primary dependent variable and wealth quintile, number of dwelling characteristics and possession of a set of assets, was the independent variable. Logistic regression models examined the relationship between wealth and presence of diabetes across 6 countries with the highest wealth quintile, quintile 1, serving as the reference group. Sample size by country included Ghana N = 5573, South Africa N = 4227, Russia N = 4947, Mexico N = 5448, India N = 12198, and China N = 15050. Average age across country ranged from 49 to 63 years of age. Prevalence of diabetes across country included 3.4% and 9.2% for Ghana and South Africa, respectively. In Russia, 8.3%; Mexico, 18.1%; India, 4.9%; and China, 5.9% of the sample reported having diabetes. In the adjusted logistic model, wealth was associated with higher odds of diabetes in Ghana (OR 2.26; CI 1.28; 4.13), South Africa (OR 4.57; CI 2.25; 10.32), Mexico (OR 2.00; CI 1.14; 3.60), India (OR 2.45; CI 1.60; 3.86), and China (OR 2.16; CI 1.62, 2.93). These findings add to the growing body of evidence in our understanding between wealth and diabetes. As diabetes persists as a leading cause of death globally, future work should focus on mechanisms underlying the relationship between wealth and diabetes while also developing interventions to mitigate his burgeoning disease affecting communities across low- and middle-income countries.

Modifiable Risk Factors for Alzheimer's Disease and Related Dementias Among Middle Eastern and North African Immigrants to the United States.

Modifiable risk factors across the life course play a role in the development of Alzheimer's disease and related dementias (ADRD). Studies have identified racial and ethnic disparities in ADRD risk factors. Few studies have explored the epidemiology of ADRD risk among Middle Eastern and North African (MENA) Americans, largely due to their classification as White in US national health surveys. Our aim was to estimate ADRD risk factors among MENA immigrants compared to US- and foreign-born non-Hispanic White adults. We linked cross-sectional 2000-2017 National Health Interview Survey and 2001-2018 Medical Expenditure Panel Survey data (N = 108695; age ≥ 18 years). Modifiable risk factors for ADRD that were evaluated (yes or no) included less than ninth grade education, hearing loss, traumatic brain injury, hypertension, alcohol use, obesity, smoking, depressive symptoms, marital status, physical inactivity, and diabetes. Bivariate analysis and multivariable logistic regression were conducted. Regression models were adjusted by age and sex. Compared to US-born White adults, MENA immigrants had higher odds of reporting less than 9th grade education (OR = 1.93; 95% CI = 1.17-3.21) and psychological health concerns (OR = 1.28; 95% CI = 1.06-1.56). Compared to foreign-born White adults, MENA immigrants had higher odds of diabetes (OR = 1.48; 95% CI = 1.06-2.08) and psychological health concerns (OR = 1.24; 95% CI = 1.01-1.54). The findings provide the first comprehensive look at potentially modifiable risk factors for ADRD among MENA immigrants based on a life course model. Without a racial/ethnic identifier for MENA individuals on a national level, ADRD risk factors among US-born MENA adults and MENA immigrants cannot be examined. More research is needed to explore these risk factors by life stage (early, midlife, and late) to further determine ADRD risk and prevention strategies for MENA Americans.

The burden of hypertension, diabetes, and overweight/obesity by sedentary work pattern in Bangladesh: Analysis of Demographic and Health Survey 2017-18.

Most low- and middle-income countries, including Bangladesh, are currently undergoing epidemiologic and demographic transitions with an increasing burden of hypertension, diabetes, and overweight/obesity. Inadequate physical activity is a risk factor for these conditions and work-related activities contribute to most of the physical activities in Bangladesh. We investigated the association of the sedentary nature of occupation with hypertension, diabetes, and overweight/obesity in Bangladesh. If a person's systolic/diastolic blood pressure, fasting plasma glucose concentration, and body mass index were ≥130/80 mmHg, ≥7 mmol/l, and ≥23 kg/m2, respectively, they were classified as hypertensive, diabetic, and overweight/obese. The nature of occupation/work was classified into three types: non-sedentary workers (NSW), sedentary workers (SW), and non-workers (NW). After describing the sample according to exposure and outcomes, we performed simple and multivariable logistic regression to investigate the association. Among 10900 participants (60.7% females, mean age: 40.0 years), about 43.2%, 13.2%, and 42.8% were NSW, SW, and NW, respectively. NSW, SW, NW, and overall people, respectively, had 6.7%, 14.5%, 11.7%, and 9.9% prevalence rates for diabetes; 18.0%, 32.9%, 28.3%, and 24.4% prevalence rates for overweight/obesity; and 18.0%, 32.9%, 38.3%, and 28.0% prevalence rate for hypertension. SW had higher odds of diabetes (AOR: 1.44, 95% CI: 1.15-1.81), overweight/obesity (AOR: 1.83, 95% CI: 1.52-2.21), and hypertension (AOR: 1.47, 95% CI: 1.21-1.77) than NSW. NW had higher odds of diabetes (AOR: 1.43, 95% CI: 1.19-1.71) or hypertension (AOR: 1.37, 95% CI: 1.22-1.56) but not higher odds of overweight/obesity (AOR: 1.11, 95% CI: 0.98-1.27) than NSW. We found higher prevalence and odds of the studied conditions among SW than NSW. Workplace physical activity programs may improve the physical activity and health of SW.

Association of medical comorbidities in obese subjects diagnosed with heparin-induced thrombocytopenia.

Heparin-induced thrombocytopenia can occur in obese subjects. The medical comorbidities associated with obesity may contribute to the pathogenesis of this disease. It is unknown, however, which specific medical comorbidities and if higher odds of thrombosis are present in obese heparin-induced thrombocytopenia patients. We sought to determine whether obese heparin-induced thrombocytopenia subjects had higher odds of both comorbidities and thrombosis, hypothesizing that this patient population would have higher odds of both these conditions. This was a multi-center retrospective study utilizing TriNetX©, an electronic health record database, in subjects aged 18-99 years diagnosed with heparin-induced thrombocytopenia. The cohort was divided into two groups (1) non-obese (body mass index < 30 kg/m2) and (2) obese (body mass index ⩾ 30 kg/m2). We evaluated patient characteristics, diagnostic, laboratory, medication, and procedure codes. A total of 1583 subjects (696 (44.0%) non-obese and 887 (56.0%) obese) were included. Obese subjects had higher odds of diabetes with complications (OR = 1.73, 95% CI = 1.35-2.22, p < 0.001) and without complications (OR = 1.81, 95% CI = 1.47-2.22, p < 0.001). This association was still present after correcting for demographic and clinical factors. There were no increased odds of thrombosis observed in the obesity group. Our study found that obese heparin-induced thrombocytopenia subjects had higher odds of having a diabetes mellitus comorbidity, but did not have higher odds of thrombosis. Given obesity is considered a hypercoagulable state, further study may be needed to understand why obese subjects diagnosed with heparin-induced thrombocytopenia do not have higher rates of thrombosis.

Rural-urban health differences among aging adults in India

BackgroundThe aim of this study was to determine the rural-urban health differences among aging adults in India. MethodsThe national cross-sectional data of 67,489 individuals (≥45 years) in 2017–2018 from 35 states and union territories of India (excluding Sikkim) in 2017–2018 were analysed. Various sociodemographic data, well-being indicators, lifestyle factors and physical conditions were assessed by face-to-face interviews and physical measurement. Univariable and multivariable logistic regression was utilized to assess the predictors between residence status (rural dweller, urban migrant, and urban dweller) and various health indicator outcomes. ResultsMajority (70.4 %) of the participants lived in rural areas, 10.3 % were urban migrants and 19.3 % urban dwellers. In the multivariable logistic regression analysis, urban migrants and urban dwellers had a higher self-rated health status, cognitive functioning, physical inactivity, overweight or obesity and abdominal obesity than rural dwellers, while urban migrants and/or urban dwellers had lower functional disability, insomnia symptoms, current smokeless tobacco use, current smoking, heavy episodic drinking and underweight than rural dwellers. Furthermore, urban migrants and/or urban dwellers had higher odds of diabetes, hypertension, heart disease, cancer, high cholesterol than rural dwellers, while urban migrants and/or urban dwellers had lower odds of persistent headaches, major injury, recurrent fall, physical pain, periodontal disease, vision impairment, and gastrointestinal problems than rural dwellers. ConclusionAmong 30 health indicators assessed, 16 had an urban migrant and/or urban dweller advantage, 8 had urban migrant and/or urban dweller penalty, and 6 did not differ between rural-urban groups. Public health promotion and health care should address differing health care needs of rural and urban middle-aged and older adults.

Trends and risk factors of diabetes and prediabetes in US adolescents, 1999–2020

AimsTo assess the national trends in prevalence of diabetes and prediabetes and their major risk factors among adolescents in the US. MethodsWe analyzed data on 6,936 adolescents aged 12 to 19 years from the National Health and Nutrition Examination Surveys (NHANES) between 1999 and 2020. Diabetes was defined by self-reported physician-diagnosis (diagnosed) and by fasting plasma glucose and HbA1c levels (undiagnosed). Prediabetes was identified by fasting plasma glucose and HbA1c levels. Logistic regression was performed to estimate the associations of major risk factors with diabetes and prediabetes. ResultsThe prevalence of prediabetes in adolescents increased from 11.5% in 1999–2002 to 36.3% in 2015–2020. The prevalence of diabetes increased from 0.82% (0.62% of diagnosed and 0.20% of undiagnosed) in 1999–2002 to 1.14% (0.76% of diagnosed and 0.38% of undiagnosed) in 2015–2020, but the increase was not statistically significant (P value = 0.69). Obesity was significantly associated with higher odds of diabetes and prediabetes while boys and Mexican Americans had a significantly higher risk of prediabetes than their counterparts. ConclusionsThe prevalence of prediabetes among adolescents in the US has more than tripled from 1999 to 2020. Obese adolescents are at the greatest risk for diabetes and prediabetes.

Unveiling the effects of living standards on diabetes and hypertension with the mediating role of overweight and obesity: a cross-sectional study in Bangladesh

ObjectiveThe purpose of the study was to ascertain how the standard of living is associated with the likelihood of developing diabetes and hypertension directly as well as indirectly through overweight...

The positive association between antipsychotic-induced weight gain and therapeutic response: New biotypes of schizophrenia

Co-occurrence of antipsychotic-induced weight gain (AIWG) and therapeutic response (TR) did exist in clinic but was rarely studied. This study aims to identify potential TR/ AIWG biotypes and explore the clinical, genetic and neuroimaging features. This study enrolled 3030 patients to identify potential TR/AIWG biotypes and explore the clinical, genetic and neuroimaging features. We found three biotypes: TR+nonAIWG (46.91%), TR+AIWG (18.82%), and nonTR+nonAIWG (34.27%). TR+AIWG showed lower weight and lipid level at baseline, but higher changing rate, and higher genetic risk of obesity than TR+nonAIWG and nonTR+nonAIWG. GWAS identified ADIPOQ gene related to TR+AIWG biotypes and top-ranked loci enriched in one-carbon metabolic process, which related to both schizophrenia and metabolic dysfunction. Genetically predicted TR+AIWG was associated with higher odds of diabetes (OR=1.05). The left supplementary motor area was significantly negatively correlated with PRS of obesity. The distinguishing ability with multi-omics data to identify TR+AIWG reached 0.787. In a word, the “thin” patients with a higher risk of obesity are the target population of early intervention.

Relationship between bisphenol A and the cardiovascular disease metabolic risk factors in American adults: A population-based study

BackgroundBisphenol A (BPA) is widely used in personal care and consumer products. However, no study has reported a specific relationship between BPA concentrations and metabolic hazardous elements for cardiovascular diseases (CVDs). Consequently, in this study, we used six years of population-based NHANES data (2011–2016) to analyse the association between BPA concentrations and metabolic risk factors for CVDs. MethodsA total of 1467 participants were enrolled in our project. The participants in the study were divided into quartiles based on BPA levels (Q1: ≤0.6 ng/ml, Q2: 0.7–1.2 ng/ml, Q3: 1.3–2.3 ng/ml, Q4: ≥2.4 ng/ml). This study used multiple linear and multivariate logistic regression models to determine the association among BPA concentrations and CVD metabolic risk factors. ResultsWhen the concentration of BPA was in Q3, fasting glucose concentrations were decreased by 3.87 mg/dl, and 2-h glucose concentrations were decreased by 16.24 mg/dl. When the concentration of BPA was in Q4, fasting glucose concentrations were decreased by 12.15 mg/dl, and diastolic blood pressure was increased by 2.08 mmHg. At the same time, compared to participants in the first quartile (Q1), those from the fourth quartile (Q4) of BPA concentrations had 21% higher odds of hypertension, 30% higher odds of obesity, 30.2% higher odds of central obesity, 4.5% higher odds of elevated HbA1c, 17% higher odds of elevated non-HDL cholesterol, and 60.8% higher odds of diabetes (compared to the lowest quartile, Q1). ConclusionsWe found that higher concentrations of BPA were linked with a higher metabolic risk for CVDs. Further regulation of BPA may need to be considered for the prevention of CVDs in adults.

Abstract P509: Does HDL-C Classification as a Criterion for Metabolic Syndrome Contribute to Alleviated Risks of Future Atherosclerosis and Incident Diabetes Among Midlife Women? The Study of Women’s Health Across the Nation (SWAN)

Introduction: In women, metabolic syndrome (MetS) is identified when at least 3 of the following risk factors exist: waist circumference &gt; 88 cm, HDL-C &lt; 50 mg/dL, triglycerides (TG) ≥ 150 mg/dL, fasting glucose ≥ 110 mg/dL, and hypertension. However, previous studies challenged the belief that HDL-C is protective for midlife women, casting doubts on HDL-C as one of the criteria for diagnosing MetS in this population. Hypothesis: We hypothesize that among midlife women classified as having MetS based on criteria independent of HDL-C, HDL-C classification does not contribute to risk of future subclinical atherosclerosis or incident diabetes. Methods: Participants from the SWAN study with complete data on MetS were classified into the following groups: 1) no MetS or 2) MetS independent of HDL-C; which was classified into MetS with HDL-C ≥ 50 mg/dL (MetS high), or MetS with HDL-C &lt; 50 mg/dL (MetS low). Carotid intima-media thickness (cIMT) was measured after 13.8±0.6 years of follow-up. Incident diabetes was recorded based on medication use, fasting glucose ≥ 126 mg/dL and/or self-reports over time. Linear regression and discrete-time survival analysis were used for analysis. Results: Among 2994 women age 45.9±2.7 years, 2528 had no MetS (88%), 85 had MetS high (3%), and 235 had MetS low (8%) at baseline. In model 1, compared to no MetS group, MetS high or low group had higher cIMT and higher odds of diabetes. The risk did not differ between MetS low vs. high group. Adjusting for levels of MetS criteria other than HDL-C explained the associations of each of the two MetS groups with cIMT. Conversely, MetS with low HDL-C remained associated with a higher risk of incident diabetes ( Table 1 ). Conclusions: Midlife women with MetS have elevated risk for incident diabetes and subclinical atherosclerosis regardless of HDL-C levels. The elevated risk is explained by levels of criteria of MetS other than HDL-C for cIMT but not for diabetes. Low HDL-C on top of other MetS criteria doesn’t contribute equally to future cardiovascular risk prediction in midlife women.

The Associations between Upper and Lower Body Muscle Strength and Diabetes among Midlife Women.

We hypothesized that a combined index of upper and lower body muscle strength would be more strongly associated with diabetes than either measure alone. Women recruited into the Integrated Women’s Health Program had their handgrip strength (HGS) measured using a dynamometer and underwent a timed 5-repetition chair stand (RCS) test. HGS < 18 kg and RCS performance ≥ 12 s assessed upper and lower body strength, respectively, both individually and combined in a muscle strength index (MSI). Diabetes was defined as physician-diagnosed, use of anti-diabetic medication, or fasting blood glucose ≥ 7.0 mmol/L. Binary logistic regression examined the associations between muscle strength and diabetes. Of 1170 midlife women, 12.1% had diabetes. A low HGS was independently associated with diabetes (aOR: 1.59, 95% CI: 1.03, 2.44). Prolonged RCS was also associated with diabetes (aOR: 1.59, 95% CI: 1.09, 2.30), but this was not independent of visceral adiposity and muscle mass. A poor MSI had higher odds of diabetes (aOR: 2.37, 95% CI: 1.40, 4.03), independent of age, ethnicity, education level, menopausal status, smoking, alcohol consumption, physical activity, height, visceral adiposity, and muscle mass. The combination of both upper and lower body muscle strength into a composite MSI was more strongly associated with diabetes than either weak HGS or prolonged RCS alone in midlife women.

Positive or U-Shaped Association of Elevated Hemoglobin Concentration Levels with Metabolic Syndrome and Metabolic Components: Findings from Taiwan Biobank and UK Biobank.

Iron overnutrition has been implicated with a higher risk of developing metabolic and cardiovascular diseases, including metabolic syndrome (MetS), whereas iron deficiency anemia exacerbates many underlying chronic conditions. Hemoglobin (Hb) concentration in the blood, which reflects a major functional iron (i.e., heme iron) in the body, may serve as a surrogate of the nutritional status of iron. We conducted sex-specific observational association studies in which we carefully titrated the association between Hb deciles and MetS and its components among the Taiwanese Han Chinese (HC) from the Taiwan Biobank and Europeans of White ancestry from the UK Biobank, representing two large ethnicities. Our data show that at higher-than-normal levels of Hb, increasing deciles of Hb concentration were significantly associated with MetS across all sex subgroups in both ethnicities, with the highest deciles resulting in up to three times greater risk than the reference group [Taiwanese HC: OR = 3.17 (95% CI, 2.75–3.67) for Hb ≥ 16.5 g/dL in men, OR = 3.11 (2.78–3.47) for Hb ≥ 14.5 g/dL in women; European Whites: OR = 1.89 (1.80–1.98) for Hb ≥ 16.24 g/dL in men, OR = 2.35 (2.24–2.47) for Hb ≥ 14.68 g/dL in women]. The association between stronger risks and increasing Hb deciles was similarly observed with all metabolic components except diabetes. Here we found that both the highest Hb decile groups and contrarily the lowest ones, with respect to the reference, were associated with higher odds of diabetes in both ethnic groups [e.g., Taiwanese HC men: OR = 1.64 (1.33–2.02) for Hb ≥ 16.5 g/dL, OR = 1.71 (1.39–2.10) for Hb ≤ 13.5 g/dL; European Whites women: OR = 1.39 (1.26–1.45) for Hb ≥ 14.68 g/dL, OR = 1.81 (1.63–2.01) for Hb ≤ 12.39 g/dL]. These findings confirm that elevated Hb concentrations, a potential indicator of iron overnutrition, may play a role in the pathophysiology of MetS and metabolic components.

Hypertension and Diabetes Status by Patterns of Stress in Older Adults From the US Health and Retirement Study: A Latent Class Analysis.

BackgroundHypertension and diabetes disproportionately affect older non‐Hispanic Black and Hispanic adults in the United States. Chronic stress may partially explain these disparities. This study identified underlying stress profiles of older US adults, analyzed stress profiles in relation to hypertension and diabetes, examined the distribution of stress profiles by race and ethnicity, and assessed patterns of change in latent classes of stress over time.Methods and ResultsLatent class analysis was conducted with a nationally representative sample of older US adults who completed 3 waves of the HRS (Health and Retirement Study) (ie, 2010 [n=6863], 2014 [n=4995], and 2018 [n=3089]). Latent classes of stress in 2010 (ie, stress profiles) were identified using 15 indicators of unmet needs within 5 categories (ie, physiological, safety/security, belonging, esteem, and self‐fulfillment). Hypertension and diabetes status were examined as outcomes of latent class membership at 3 time points, and race and ethnicity were examined in association with class membership, adjusting for sociodemographic covariates. Finally, a latent transition analysis examined the stability of latent class membership and racial and ethnic differences in the patterns of stress profiles experienced from 2010 to 2018. Five classes were identified: Generally Unmet Needs (13% of sample), Generally Met Needs (42% of sample), Unmet Self‐Efficacy/Goal Needs (12% of sample), Unmet Financial Needs (20% of sample), and Unmet Social Belonging Needs (13% of sample). Compared with the Generally Met Needs class, the Generally Unmet Needs class had higher odds of hypertension (odds ratio [OR], 1.80; [95% CI, 1.35–2.39]) and diabetes (OR, 1.94; [95% CI, 1.45–2.59]), and the Unmet Financial Needs class had higher odds of diabetes (OR, 1.50; [95% CI, 1.10–2.05]). Non‐Hispanic Black participants compared with non‐Hispanic White participants had higher odds of being members of the Generally Unmet Needs, Unmet Self‐Efficacy/Goal Needs, and Unmet Financial Needs classes (OR, 2.70; [95% CI, 1.59–4.58]; OR, 1.99; [95% CI, 1.15–3.43]; and OR, 4.74; [95% CI, 3.32–6.76], respectively). Class membership remained relatively stable over time, with 93% of participants remaining in Generally Met Needs and 78% of participants remaining in Generally Unmet Needs across time points. Compared with non‐Hispanic White participants, non‐Hispanic Black participants had lower odds of Generally Met Needs class membership at any time point (OR, 0.60; [95% CI, 0.42–0.84]) and had lower odds of moving into the Generally Met Needs class and higher odds of moving into the Unmet Financial Needs class from 2010 to 2014 (OR, 0.33; [95% CI, 0.13–0.86]; and OR, 3.02; [95% CI, 1.16–7.87], respectively).ConclusionsUnderlying classes of stress based on unmet needs were associated with hypertension and diabetes status. Racial and ethnic differences were observed for both latent class membership and transitions between classes over time. Latent classes of stress associated with unmet needs, hypertension, and diabetes and the ability to transition between classes may explain the perpetuation of racial and ethnic disparities in cardiovascular health. Interventions targeting unmet needs may be used to confront these disparities.

Comorbidities in childhood-onset and adult-onset asthma

BackgroundAge of asthma onset has emerged as an important determinant of asthma phenotypes; however, the comorbidities that predominate in either childhood- or adult-onset asthma are not known. ObjectiveTo identify comorbidities associated with adult-onset asthma vs childhood-onset asthma and with age of asthma diagnosis. MethodsWe analyzed data on 27,437 adult participants in the National Health and Nutrition Examination Surveys conducted from 2001 to 2018. Logistic regression adjusted for covariates was used to identify comorbidities associated with the asthma phenotypes and age of asthma diagnosis. ResultsApproximately 12.6% of participants were ever diagnosed with asthma; the prevalence of childhood-onset (before 18 years old) and adult-onset (≥ 18 years old) current asthma was 2.7% and 5.5%, respectively. After adjustment for covariates including age, adult-onset asthma was associated with higher odds of obesity (odds ratio [OR], 1.46; 95% confidence interval [CI], 1.09-1.96), hypercholesterolemia (OR, 1.67; 95% CI, 1.08-2.56), borderline high serum triglycerides (OR, 1.78; 95% CI, 1.17-2.71), and osteoarthritis (OR, 1.52; 95% CI, 1.04-2.20) than was childhood-onset asthma. Older age of asthma diagnosis (per 5-year increase) was also associated with higher odds of diabetes (OR, 1.04; 95% CI, 1.00-1.07) and hypertension (OR, 1.05; 95% CI, 1.02-1.07), whereas younger age of asthma diagnosis was associated with higher odds of chronic obstructive pulmonary disease (OR, 1.12; 95% CI, 1.04-1.19). ConclusionAge- and covariates-adjusted prevalence of obesity, dyslipidemia, arthritis, diabetes, and hypertension is higher in adult-onset asthma than in childhood-onset asthma, and with older age of asthma diagnosis. Conversely, the prevalence of chronic obstructive pulmonary disease increases with younger age of asthma diagnosis.

Serum liver enzymes and diabetes from the Rafsanjan cohort study

BackgroundWe evaluated the relation between ALT, AST, GGT and ALP with diabetes in the Rafsanjan Cohort Study.Materials and methodsThe present study is a cross-sectional research including 9991 adults participated via sampling. We used data obtained from the Rafsanjan Cohort Study (RCS), as a part of the prospective epidemiological research studies in IrAN (PERSIAN). Elevated serum levels of ALT, AST, GGT and ALP were defined according to the reference range of the laboratory in the cohort center. Serum liver enzymes levels within the normal range were categorized into quartiles, and their relationship with diabetes was evaluated by logistic regressions.FindingsIn present study, elevated serum levels of ALT, AST, GGT, and ALP were associated with increased odds of diabetes (adjusted ORs: 1.81, 95%CI 1.51–2.17; 1.75, 95%CI 1.32–2.32; 1.77, 95%CI 1.50–2.08; 1.60, 95%CI 1.35–1.90 respectively). Also, in subjects with normal levels of ALT, GGT and ALP, a dose–response increase was shown for diabetes.ConclusionElevated levels of ALT, AST, GGT and ALP are related to a higher odds of diabetes. Also, increased levels of ALT, GGT and ALP even within normal range were independently related with the increased odds of diabetes. These results indicated the potential of elevated liver enzymes as biomarkers for the possible presence of diabetes.

Household solid fuel use with diabetes and fasting blood glucose levels among middle-aged and older adults in China.

To explore the impacts of household solid fuel use for cooking and heating on diabetes and fasting blood glucose (FBG) levels, we used data from the China Health and Retirement Longitudinal Study, a national survey including middle-aged and older adults. Multivariable logistic and linear regression models were used to explore the relationship between household solid fuel use (coal, crop residue, and wood) for cooking and heating with diabetes and FBG levels. Subgroup analyses were also performed based on age, sex, region of residence, smoking status, and body mass index to examine potential interactions between the variables and household solid fuel use. Among the 6195 participants, 75.4% and 61.4%, respectively, used solid fuels for heating and cooking. Relative to clean fuel users, solid fuel users had higher odds of diabetes (heating: OR, 1.21; 95% CI, 1.01-1.44; cooking: OR, 1.31; 95% CI, 1.12-1.53) and higher FBG levels (heating: β = 3.23; 95% CI, 1.10-5.36; cooking: β = 2.86; 95% CI, 0.95-4.77). Simultaneous use of solid fuels for cooking/heating was also positively associated with diabetes (OR, 1.31; 95% CI, 1.07-1.61) and FBG (β = 4.30; 95% CI, 1.82-6.78). No significant interactions were detected between subgroup variables and the impacts of solid fuel use on diabetes and FBG. Household solid fuel use is positively associated with diabetes and FBG levels. These findings imply that inhibiting household solid fuel use may contribute to decreasing diabetes development in China.

Folate Status and Mortality in US Adults With Diabetes: A Nationally Representative Cohort Study.

BackgroundPublic health concerns have gradually shifted from inadequate intakes to potential adverse effects associated with excessive folate intakes following the full implementation of mandatory folate fortification. This study aimed to examine the associations of red blood cell (RBC) folate with all-cause and cardiovascular disease (CVD) mortality among patients with diabetes.MethodsData of 15,514 adults aged 20 years or older, who participated in the National Health and Nutrition Examination Survey (1988–1994), were analyzed as the baseline examination. The participants were linked to mortality data from the survey date until December 31, 2015. The associations of RBC folate with all-cause and CVD mortality were examined using multivariable Cox regression models.ResultsDuring 297,708 person–years of follow-up (median of 19.2 years), 6,106 total deaths occurred, including 1,867 deaths from CVD, 1452 deaths from ischemic heart disease, and 415 deaths from stroke disease. The participants with the highest quartile of RBC folate had higher odds of diabetes (fully-adjusted odds ratio: 1.94 [95% CI: 1.53–2.48]). In Cox regression analyses, compared with the participants with the lowest quartile of RBC folate for diabetes, those from quartile 3 and quartile 4 had HRs (95% CIs) of 1.12 (0.87, 1.43) and 1.30 (1.04, 1.63) in all-cause mortality, respectively; in CVD mortality, the HRs were 1.73 (1.08, 2.76) and 1.47 (0.98, 2.22); in ischemic heart disease mortality, they were 2.01 (1.19, 3.39) and 1.62 (1.05, 2.50), respectively. However, high levels of RBC folate were negatively associated with all-cause mortality, CVD mortality and ischemic heart disease mortality in non-diabetes.ConclusionFrom the nationally representative data, increasing levels in RBC folate were independently associated with an increased risk of all-cause and CVD mortality among those diagnosed with diabetes, but high levels of RBC folate had a mild protective effect in non-diabetes. The underlying mechanism regarding folate and adverse outcomes in diabetes warrants further clarification.

Trends in the prevalence and associated factors of prediabetes and diabetes in Bangladesh: Evidence from population-based cross-sectional surveys

AimsDiabetes is a major health problem in Bangladesh, but nationally representative studies on its trends and associated factors are scarce to guide policy formulation. Therefore, the study aims to determine trends in the prevalence and associated factors of prediabetes and diabetes in Bangladesh. MethodsThe study included two population-based cross-sectional surveys from Bangladesh Demographic and Health Survey (n = 7,505 in 2011 and n = 11,959 in 2017–18). Chi-square association tests were performed to determine the associated factors. Logistic regression models (univariate and multivariable) were used to estimate unadjusted and adjusted relative risks of having diabetes, reported with odds ratios. Age-adjusted prevalence was also reported for both surveys. ResultsThe overall age-adjusted prevalence of prediabetes and diabetes decreased from 52.77% (95% CI: 52.61–52.92) and 10.43% (95% CI: 10.33–10.53) in 2011 to 34.10% (95% CI: 33.43–34.78) and 8.50% (95% CI: 8.11–8.90) in 2017–18. Compared to males, females had a higher odds of diabetes in 2011, but in 2017–18 a significant inverse result was observed. In both surveys, the odds of prediabetes and diabetes increased with advancing age, obesity, better wealth status, and hypertension. ConclusionThe study shows that the prevalence of prediabetes and diabetes is high in Bangladesh despite decreasing trends. Therefore, the study recommends promoting healthy lifestyles and regular screening for non-communicable diseases.

IDF21-0198 Lens autofluorescence ratio, is associated with diabetes in the general Chinese population

Background: Advanced glycation end products (AGEs) play a major role in the pathogenesis of diabetes-related complications. The levels of AGEs in lens, detected by their autofluorescence, is increased in individuals with diabetes. Aim: The present study explored the relationship between lens fluorescence ratio (LFR) and diabetes in order to strengthen the understanding of the disease mechanism of diabetes and find new markers of diabetes. Method: In this cross-sectional study, 4705 participants were recruited from 8 provinces in China between September 2019 to January 2021. The biomicroscope (ClearPath DS‑120) was used to measured the LFR. Diabetes was ascertained by self-report history or based on WHO 1999 diagnostic criteria. Results: LFR was higher in individuals with diabetes than those without (23.27 ± 6.51 vs. 19.45 ± 5.08, p < 0.001). LFR correlated with fasting plasma glucose (FPG) (r = 0.30, P < 0.001), serum glycated haemoglobin A1c (HbA1c) (r = 0.29, P < 0.001) in the overall population, but stronger in the diabetes population. Participants in the highest quartile of LFR had over a 4-fold risk of diabetes compared with the lowest quartile (OR 4.28, 95% CI 3.32, 5.52, p < 0.001). Univariate analysis revealed that an increase in LFR of one percent was associated with a 1.13-fold higher odds of diabetes (OR 1.13, 95% CI 1.11, 1.15, p < 0.001) and this association became weakened after controlling for cardiometabolic factors (OR 1.06, 95% CI 1.04, 1.08, p < 0.001). Mediation analysis showed that, insulin resistance, which was assessed by triglyceride-glucose (TyG) index, may mediate the relationship between LFR and diabetes. The AUC value of LFR for screening diabetes was 0.673. Discussion: This multicenter cross-sectional study of a general community population shows that LFR is associated with the risk of diabetes, which can be independent of conventional risk factors, including age, sex, waist circumference, blood lipids, the metabolic syndrome, eGFR and HbA1c. Participants in the highest quartile of LFR had over a fourfold risk of diabetes compared with the lowest quartile in our study. After adjusting for age, sex, waist circumference, blood lipids, the metabolic syndrome, eGFR and HbA1c, participants in the highest quartile of LFR remain to have over a onefold risk of diabetes compared with the lowest quartile. Our research firstly showed that insulin resistance, which was assessed by TyG index, may mediate the positive relationship between LFR and diabetes by the mediation analysis. There is increasing evidence that AGEs are related to the development of insulin resistance. In the present study, the level of LFR in diabetic population was significantly higher than that in non-diabetic population, which was in agreement with previous findings. In this large population-based study we found that with the AUC value of LFR in identifying diabetes 0.673.