Independent Risk Factor For Diabetes Research Articles

Gut microbiota predict retinopathy in patients with diabetes: A longitudinal cohort study

The gut microbiota has emerged as an independent risk factor for diabetes and its complications. This research aimed to delve into the intricate relationship between the gut microbiome and diabetic retinopathy (DR) through a dual approach of cross-sectional and prospective cohort studies. In our cross-sectional study cross-sectional investigation involving ninety-nine individuals with diabetes, distinct microbial signatures associated with DR were identified. Specifically, gut microbiome profiling revealed decreased levels of Butyricicoccus and Ruminococcus torques group, alongside upregulated methanogenesis pathways among DR patients. These individuals concurrently exhibited lower concentrations of short-chain fatty acids in their plasma. Leveraging machine learning models, including random forest classifiers, we constructed a panel of microbial genera and genes that robustly differentiated DR cases. Importantly, these genera also demonstrated significant correlations with dietary patterns and the molecular profiles of peripheral blood mononuclear cells. Building upon these findings, our prospective cohort study followed 62 diabetes patients over a 2-year period to assess the predictive value of these microbial markers. The results underlined the panel’s efficacy in predicting DR incidence. By stratifying patients based on the predictive genera and metabolites identified in the cross-sectional phase, we established significant associations between reduced levels of Butyricicoccus, plasma acetate, and increased susceptibility to DR. This investigation not only deepens our understanding of how gut microbiota influences DR but also underscores the potential of microbial markers as early indicators of disease risk. These insights hold promise for developing targeted interventions aimed at mitigating the impact of diabetic complications.Key points• Microbial signatures are differed in diabetic patients with and without retinopathy• DR-related taxa are linked to dietary habits and transcriptomic profiles• Lower abundances of Butyricicoccus and acetate were prospectively associated with DR

Urinary orosomucoid and retinol binding protein levels as early diagnostic markers for diabetic kidney Disease

BackgroundDiabetic kidney disease (DKD) is the most common microvascular complication of diabetes, which has been a major cause of end-stage renal failure. Diagnosing diabetic kidney disease is important to prevent long-term kidney damage and determine the prognosis of patients with diabetes. In this study, we investigated the clinical significance of combined detection of urine orosomucoid and retinol-binding protein for early diagnosis of diabetic kidney disease.MethodsWe recruited 72 newly diagnosed patients with type 2 diabetes and 34 healthy persons from August 2016 to July 2018 at the First Affiliated Hospital of Henan Polytechnic University (Jiaozuo Second People’s Hospital). Using the Mogensen grading criteria, participants were classified as having diabetes or diabetic kidney disease, and healthy persons constituted the control group. Urine orosomucoid and retinol-binding protein levels were measured and correlated with other variables.ResultsWith the aggravation of renal damage, the level of urinary mucoid protein gradually increased. Urinary retinol-binding protein and microalbumin levels were significantly higher in the diabetes group than in control and nephropathy groups. Orosomucoid and retinol-binding protein might be independent risk factors for diabetes and diabetic kidney disease. Urinary orosomucoid significantly correlated with retinol-binding protein and microalbumin levels in the diabetic kidney disease group.ConclusionElevated urine orosomucoid and retinol-binding protein levels can be detected in the early stages of type 2 diabetic kidney disease. Both of these markers are important for diabetic kidney disease detection and early treatment.

Neighborhood deprivation and household socioeconomic status as risk factors for diabetes in Brussels

Abstract Background Socioeconomic (SE) differences in diabetes prevalence have been shown both at the individual and neighborhood level. Disentangling the role of SE determinants of diabetes at different levels can help to identify more targeted strategies to reduce SE differences in diabetes prevalence. As contextual factors may differ it is important to explore this in different settings. In this study we investigated the association of diabetes with household socioeconomic status (SES) and neighborhood deprivation in Brussels taking into account individual risk factors. Methods The study sample included participants ≥ 15 years of the Belgian National Health Interview Survey (HIS) 2013 and 2018 residing in Brussels (n = 5045). Information on neighborhood deprivation, assessed through a composite indicator (income, employment, nationality,..), was linked to the HIS data. A multilevel analysis was conducted to assess the association of self-reported diabetes with household SES and neighborhood deprivation adjusting for age, sex, obesity, nationality and country of birth. Results The overall prevalence of diabetes in the study sample was 6.8%. Individual risk factors associated with a higher diabetes prevalence were older age, obesity and being born outside the EU. Belonging to a household with a low income (OR 2.3;95% CI 1.2-2.5 - ref. highest income group), low education at household level (OR 1.6;95% CI 1.0-2.5 - ref. highest education group) and living in a deprived neighborhood (OR 2.0, 95%CI 1.3-3.1 - ref. living in wealthy area) were all independently associated with a higher diabetes prevalence. Conclusions Neighborhood deprivation and low household SES are independent risk factors of diabetes. Actions to reduce SE differences in diabetes prevalence should take into account determinants at the individual, household and neighborhood level. Further research should explore the role of environmental risk factors to explain the higher diabetes prevalence in deprived areas. Key messages • Differences in diabetes prevalence between rich and poor neighborhoods remain when accounting for individual characteristics and household socioeconomic status. • Environmental factors may explain the higher diabetes prevalence in deprived neighborhoods.

Correlation analysis of anthropometric indices and type 2 diabetes mellitus in residents aged 60 years and older.

In recent years, the incidence of obesity in people aged 60 and over has increased significantly, and abdominal obesity has been recognized as an independent risk factor for diabetes. Aging causes physiologic decline in multiple body systems, leading to changes in obesity indicators such as BMI. At present, the relationship between abdominal obesity markers and Diabetes mellitus (DM) in people aged 60 years and older remains unclear. Therefore, it is necessary to study the correlation between anthropometric indices and diabetes and explore potential predictors. The basic demographic information of participants aged 60 and above in Zhongshan City in 2020 was collected. Physical parameters, blood glucose and other biochemical indices were measured comprehensively. Binary logistic regression analysis was used to explore the relationship between abdominal obesity indicators [Waist circumference, Neck Circumference, Waist-to-hip ratio, Chinese Visceral Obesity Index (CVAI), and visceral obesity index] and diabetes mellitus. ROC characteristic curve was used to analyze the predictive ability of abdominal obesity indicators to DM, and the non-restrictive cubic spline graph was used to visualize the screened obesity indicators and diabetes risk. Among 9,519 participants, the prevalence of diabetes was 15.5%. Compared with low CVAI, High CVAI level was significantly associated with increased prevalence of DM in males and females (all p < 0.05), in males (OR, 2.226; 95%CI: 1.128-4.395), females (OR, 1.645; 95%CI: 1.013-2.669). After adjusting for potential confounding factors, there were gender differences between neck circumference and the prevalence of DM, and above-normal neck circumference in males was significantly associated with increased prevalence of DM (OR, 1.381; 95% CI: 1.091-1.747) (p < 0.05). Among these anthropometric indices, CVAI is consistent with the features of fat distribution in older individuals and shows superior discriminative power as a potential predictor of DM, compared to traditional anthropometric parameters.

Development of a Clinical Prediction Model for Diabetes in Chronic Pancreatitis: The PREDICT3c Study.

Diabetes that arises from chronic pancreatitis (CP) is associated with increased morbidity and mortality. Methods to predict which patients with CP are at greatest risk for diabetes are urgently needed. We aimed to examine independent risk factors for diabetes in a large cohort of patients with CP. This cross-sectional study comprised 645 individuals with CP enrolled in the PROCEED study, of whom 276 had diabetes. We conducted univariable and multivariable regression analyses of potential risk factors for diabetes. Model performance was assessed by area under the receiver operating characteristic curve (AUROC) analysis, and accuracy was evaluated by cross validation. Exploratory analyses were stratified according to the timing of development of diabetes relative to the diagnosis of pancreatitis. Independent correlates of diabetes in CP included risk factors for type 2 diabetes (older age, overweight/obese status, male sex, non-White race, tobacco use) as well as pancreatic disease-related factors (history of acute pancreatitis complications, nonalcoholic etiology of CP, exocrine pancreatic dysfunction, pancreatic calcification, pancreatic atrophy) (AUROC 0.745). Type 2 diabetes risk factors were predominant for diabetes occurring before pancreatitis, and pancreatic disease-related factors were predominant for diabetes occurring after pancreatitis. Multiple factors are associated with diabetes in CP, including canonical risk factors for type 2 diabetes and features associated with pancreatitis severity. This study lays the groundwork for the future development of models integrating clinical and nonclinical data to identify patients with CP at risk for diabetes and identifies modifiable risk factors (obesity, smoking) on which to focus for diabetes prevention.

Diagnostic performance of diabetes biomarkers in non-alcoholic fatty liver disease

PurposeNon-alcoholic fatty liver disease (NAFLD) and diabetes often occur together and share physiological pathways; also, NAFLD may be an independent risk factor for diabetes. Whether fasting plasma glucose (FPG), postprandial glucose (PPG) or HbA1c have the same diagnostic accuracy in people with and without NAFLD could inform specific screening recommendations for those with NAFLD. MethodsCross-sectional analysis of the Third National Health and Nutrition Examination Survey (NHANES III). Diabetes was defined as PPG ≥200 mg/dL, FPG ≥126 mg/dL, and HbA1c ≥6.5%. We estimated sensitivity and specific between the six possible pairwise combinations between the three diabetes definitions in people with and without NAFLD. With Poisson regressions, we investigated whether people with NAFLD were more likely to be diagnosed with two biomarkers yet missed with the third one. ResultsThere were 3652 people with mean age 55.6 years and 49.4% were men; 673 (18.4%) people met criteria for NAFLD. In people with NAFLD, compared to NAFLD-free individuals, the specificity was lower in all pairwise comparisons except when PPG was the reference compared with HbA1c. Without strong differences, the sensitivity of FPG was slightly superior to PPG and HbA1c. People with NAFLD were more likely to be diagnosed with FPG and PPG yet missed with HbA1c (Prevalence Ratio = 2.15; P = .020). ConclusionsWhile these three diabetes biomarkers may capture different patients both in people with and without NAFLD, in the NAFLD population FPG appears to have the best sensitivity and there were no strong differences between PPG and HbA1c in terms of specificity. AcknowledgmentsRMC-L is supported by a Wellcome Trust International Training Fellowship (Wellcome Trust 214185/Z/18/Z).

EVALUATION OF SERUM URIC ACID, GLUCOSE AND OTHER GLYCEMIC PARAMETER IN TYPE II DIABETIC INDIVIDUALS

Background: In spite of antioxidant property serum uric acid (SUA) has a positive association with blood glucose. SUA is considered as a strong and an independent risk factor for diabetes but low serum level of uric acid has been reported in the hyperglycemic state. Diabetes mellitus is a metabolic disorder of multiple etiologies resulting from defect in insulin action. So, aim of this study is to assess whether there is any change in SUA level and to establish whether there is any association with type II diabetes mellitus (DM) or not. Methods: A cross sectional study was conducted in 264 cases of DM. SUA, fasting blood glucose (FBG), post-prandial blood glucose (PPBG) and glycated hemoglobin (HbA1c) level were measured. Pearson’s correlation was employed to calculate the ‘r’ value by using SPSS version 15. Results: In our study prevalence of hyperuricemia was 18.5%. Mean SUA in male and female was 5.95 mg/dl and 5.54 mg/dl respectively in DM. HbA1c has positive correlation with FBG and PPBG (r value = 0.720 and 0.775, respectively p=&lt;0.001), while SUA has negative correlation with HbA1c, FBG and PPBG (r value= -0.179, p =0.004, -0.070, p=0.257 and -0.078, p=-0.204 respectively.). Conclusions: SUA level is increased in DM. SUA was high among male and SUA initially increased when FBS and HbA1c increases then decreases as FBG and HbA1c level were further increased. SUA has negative correlation with FBG, PPBG and HbA1c, while HbA1c has a positive correlation with FBG and PPBG.

Clinical Significance of Lifetime Maximum Body Mass Index in Predicting the Development of T2DM: A Prospective Study in Beijing.

BackgroundOverweight and obesity are well-known risk factors for type 2 diabetes mellitus (T2DM). The effect of the maximum body mass index (BMImax), which indicates the highest body weight before the diagnosis of T2DM, is not fully understood. This study aimed to explore the predictive value of BMImax in the progression of diabetes.MethodsThis prospective study recruited 2018 subjects with normal glucose tolerance in Beijing, China. The subjects were followed up for eight years, and the association between BMImax and glucose outcomes was evaluated.ResultsNinety-seven of the 2,018 participants developed diabetes by the end of the study. Compared to individuals with normal glucose tolerance, those who developed diabetes were characterized by higher levels of fasting plasma glucose (FPG), 2 h postload glucose (PBG), glycosylated hemoglobin (HbA1c), systolic blood pressure (SBP), and low-density lipoprotein cholesterol (LDL-c), a higher prevalence of a familial history of diabetes and a lower level of high‐density lipoprotein cholesterol (HDL-c). Multivariate regression analysis of sex-stratified groups suggested that FPG, HbA1c, SBP and familial history of diabetes were independent risk factors for diabetes, but that BMImax was a unique indicator for female patients.ConclusionsBMImax might be an independent predictor of T2DM in females, but it does not seem to be associated with the risk of diabetes in males. BMImax could be regarded as an indicator in the prevention and management of diabetes.

The adiposity indicators in relation to diabetes among adults in China: a cross-sectional study from China Health and Nutrition Survey.

Diabetes is a metabolic disease which has been confirmed to be involved with abnormal or excessive body fat accumulation. There is still a lack of nationwide research in China to discuss the relationship between adiposity indicators included body mass index (BMI), waist circumference (WC), visceral adiposity index, waist-height ratio, waist-to-hip ratio (WHR) and diabetes. The question of which one is the best indicator of obesity to predict diabetes in China remains to be unclear. Data were collected from the China Health and Nutrition Survey (CHNS) in 2009, including 7,930 participants aged over 18 years old for cross-sectional analysis. Information about height, weight, WC, hip circumference, smoking status, alcohol consumption, physical activity, energy intake and blood samples were analyzed. Binary logistic regression models were used to explore the association of WC, BMI, WHR, waist-to-height ration (WHtR) and visceral adipose index (VAI) with the prevalence of diabetes in the 2009 CHNS respectively. Predictive potential of five adiposity indicators was validated by the area under the receiver operator characteristic curve (AUROC). The optimal cut-off points were determined by Youden's index, which was used to estimate the performance of adiposity indicators. The study shows patients in the highest quartile were more likely to have diabetes than those in the lowest quartile of WC (OR: 4.237, 95% CI: 3.265-5.499), BMI (OR: 3.312, 95% CI: 2.601-4.218), WHR (OR: 3.199, 95% CI: 2.493-4.104), WHtR (OR: 3.760, 95% CI: 2.891-4.890), VAI (OR: 4.347, 95% CI: 3.411-5.541). The area under the receiver operator characteristic curve of WC, BMI, WHR, WHtR and VAI for diabetes was 0.700, 0.663, 0.668, and 0.697 and 0.694, respectively. The optimal cut-offs regarding diabetes in Chinese are WHtR ≥0.520 for men and VAI ≥1.878 for women. Our findings indicate that WC, WHtR, BMI, WHR and VAI are all independent risk factors for diabetes among Chinese adults. WHtR is the most accurate indicator for diabetes in men, while VAI for women.

Growth Hormone and Insulin-Like Growth Factor 1 Regulation of Nonalcoholic Fatty Liver Disease.

Patients with obesity have a high prevalence of nonalcoholic fatty liver disease (NAFLD), representing a spectrum of simple steatosis to nonalcoholic steatohepatitis (NASH), without and with fibrosis. Understanding the etiology of NAFLD is clinically relevant since NAFLD is an independent risk factor for diabetes and cardiovascular disease. In addition, NASH predisposes patients to the development of cirrhosis and hepatocellular carcinoma, and NASH cirrhosis represents the fastest growing indication for liver transplantation in the United States. It is appreciated that multiple factors are involved in the development and progression of NAFLD. Growth hormone (GH) and insulin-like growth factor 1 (IGF1) regulate metabolic, immune, and hepatic stellate cell function, and alterations in the production and function of GH is associated with obesity and NAFLD/NASH. Therefore, this review will focus on the potential role of GH and IGF1 in the regulation of hepatic steatosis, inflammation, and fibrosis.

Body Roundness Index Is a Superior Obesity Index in Predicting Diabetes Risk Among Hypertensive Patients: A Prospective Cohort Study in China.

Objective: Individuals with both hypertension and diabetes have been confirmed to significantly increase the risk of cardiovascular disease morbidity and mortality compared with those with only hypertension or diabetes. This study aimed to evaluate the potential of different anthropometric indices for predicting diabetes risk among hypertensive patients.Methods: The study group consisted of 6,990 hypertensive adults without diabetes who were recruited in China. Demographic and clinical assessment, physical examinations, laboratory tests, and anthropometric measurements, including body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and novel indices (ABSI, AVI, BAI, BRI, CI, WWI, and WHHR), were performed at baseline and during the (median) 3-year follow-up. Cox regression analyses were conducted to estimate effects from these indices for the onset of diabetes. Receiver operator characteristic (ROC) analyses were conducted to assess the predictive capacities of the anthropometric indices and determine the optimal cut-points.Results: A total of 816 (11.7%) developed diabetes during our prospective study. Multivariate Cox regression analyses revealed weight, WC, WHR, WHtR, BAI, BRI, and WWI as the independent risk factor for diabetes among hypertensive patients, regardless of whether it was treated as a continuous or categorical variable (P < 0.05). Further Cox analyses combining BMI and different central obesity indices showed that elevated WC, WHR, WHtR, AVI, BRI, CI, regardless of the general obesity status, were found to be each independently associated with increased diabetes risk (P < 0.05). Dynamic increases of BRI < 5.24 to BRI ≥ 5.24 were associated with increased risk (HR = 1.29; 95% CI, 1.02, 1.64), and its reversal was associated with reduced risk (HR = 1.56; 95% CI, 1.23, 1.98) compared with the others (HR = 1.95; 95% CI, 1.63, 2.32). ROC analysis indicated that the areas under the ROC curves (AUC) of the anthropometric indices ranged from 0.531 to 0.63, with BRI (cut-off value = 4.62) and WHtR having the largest area.Conclusions: Based on this novel study, BRI was the most superior predictor and independent determinant for diabetes onset among the hypertensive population. Hypertensive patients with BRI > 4.62, regardless of general obesity status, were at high risk of diabetes. Thus, the prompt screening and diagnosis of diabetes should be carried out among these patients for timely integrated intervention.

The association of Diabetes and the human papillomavirus: a nationwide population-based cohort study.

Previous studies have investigated the correlation between diabetes and HPV vaccination; however, there is little evidence about the association between viral infection and diabetes. This study aims to investigate the association between diabetes and human papillomavirus infection. Using the National Health and Nutrition Examination Survey (2015-2016), records of 571 diabetic and 4,170 non-diabetic patients were extracted. Comparative analyses were used to evaluate differences in the HPV testing results between the two groups. Multivariate logistic regression analyses were used to evaluate independent risk factors for diabetes among all subjects. Positive tests were detected in 6.7% of the oral HPV, 19.5% of the Cobas HPV Swab (high-risk group), 40.9% of the Roche HPV linear array (vaginal swab), and 43.8% of the Roche HPV linear array (penile swab). The results of multivariate regression analysis, after adjusting for age, gender, race, marital status, and presence of comorbidities, showed no statistically significant association between positive or negative HPV testing and presence of diabetes mellitus, with an exception for the penile swab using Roche HPV linear array (P-value= 0.020). This retrospective database study of HPV infection and diabetes showed no significant association between patients with HPV and those with diabetes.

Impact of income and eating speed on new-onset diabetes among men: a retrospective cohort study

ObjectiveTo examine the impact of income and eating speed on new-onset diabetes among men.DesignThis was a retrospective cohort study.SettingWe used the administrative claims and health check-up data for fiscal years...

Prevalence and socioeconomic predictors of diagnosed and undiagnosed diabetes in oldest-old and younger Caucasian seniors: results from the PolSenior study.

Type 2 diabetes is one of the most common diseases in the aging population; however, data concerning correlates of diabetes in age-advanced individuals are limited. The study aimed to identify the socioeconomic correlates of diabetes in representative groups of oldest-old (≥ 85 years) and younger (65 to 84 years) Polish Caucasian seniors. PolSenior is a multicentre, population-based study conducted in Poland. Fasting plasma glucose levels and data from detailed medical questionnaires were obtained from 2128 male and 1961 female study participants aged ≥ 65 years. Multivariate logistic regression was used to identify significant socioeconomic risk factors for diabetes and undiagnosed diabetes. The overall prevalence of diabetes in the study group was 21.9% (24.0% in women vs. 19.9% in men, p = 0.002), with an estimated weighted prevalence for all older Poles of 23.1%. Nearly one-fifth of cases were previously undiagnosed. Diabetes was more common in the younger elderly (65-84 years) than in the oldest-old (≥ 85 years) (23.4% vs. 18.6%, p < 0.001). The frequency of diabetes was higher in women than in men (24.0% vs. 19.9%, p < 0.002); however, men remained undiagnosed more commonly than women (4.7% vs. 3.3%, p = 0.029). The frequency of diabetes was higher among urban than rural dwellers (23% vs. 20.4%, p = 0.048). It was also related to marital status in women (p = 0.036) and occupation in men (p = 0.015). Multivariate logistic regression analysis revealed that the independent risk factors for diabetes were body mass index (BMI) and marital status in women, while in men it was solely BMI. Undiagnosed diabetes was more frequent among rural than city dwellers (4.8% vs. 3.5%, p = 0.03). In multivariate logistic regression analysis, only BMI and place of residence remained significant risk factors for being undiagnosed. The prevalence of diabetes in the ≥ 65-year-old population exceeds 20% but is lower in the oldest-old than in the younger elderly and is modified by socioeconomic factors. Many elderly individuals remain undiagnosed and do not benefit from the currently available therapy.

Non-skilled occupation as a risk factor of diabetes among working population: A population-based study of community-dwelling adults in Hong Kong.

Diabetes among working population brings to society concerns on productivity and social welfare cost, in addition to healthcare burden. While lower socio‐economic status has been recognised as a risk factor of diabetes; occupation, compared with other socio‐economic status indicators (e.g., education and income), has received less attention. There is some evidence from studies conducted in Europe that occupation is associated with diabetes risk, but less is known in Asia, which has different organisational cultures and management styles from the West. This study examines the association between occupation and diabetes risk in a developed Asian setting, which is experiencing an increasing number of young onset of diabetes and aging working population at the same time. This is a cross‐sectional study of working population aged up to 65 with data from a population‐based survey collecting demographic, socio‐economic, behavioural and metabolic data from Hong Kong residents, through both self‐administered questionnaires and clinical health examinations (1,429 participants). Non‐skilled occupation was found to be an independent risk factor for diabetes, with an odds ratio (OR) of 3.38 (p < 0.001) and adjusted OR of 2.59 (p = 0.022) after adjusting for demographic, behavioural and metabolic risk factors. Older age (adjusted OR = 1.08, p < 0.001), higher body mass index (adjusted OR = 1.23, p < 0.001) and having hypertriglyceridemia (adjusted OR = 1.93, p = 0.033) were also independently associated with diabetes. Non‐skilled workers were disproportionately affected by diabetes with the highest age‐standardized prevalence (6.3%) among all occupation groups (4.9%–5.0%). This study provides evidence that non‐skilled occupation is an independent diabetes risk factor in a developed Asian setting. Health education on improving lifestyle practices and diabetes screening should prioritise non‐skilled workers, in particular through company‐based and sector‐based diabetes screening programmes. Diabetes health service should respond to the special needs of non‐skilled workers, including service at non‐office hour and practical health advice in light of their work setting.

Prevalence, incidence and risk factors of diabetes in Australian adults aged ≥45 years: A cohort study using linked routinely-collected data

AimsTo use linked routinely-collected health data to estimate diabetes prevalence and incidence in an Australian cohort of adults aged ≥45 years, and examine risk factors associated with incident disease. Research design and methodsThe EXamining ouTcomEs in chroNic Disease in the 45 and Up Study (EXTEND45) Study is a linked data study that combines baseline questionnaire responses from the population-based 45 and Up Study (2006–2009, n = 267,153) with multiple routinely-collected health databases up to December 2014. Among participants with ≥1 linked result for any laboratory test, diabetes status was determined from multiple data sources according to standard biochemical criteria, use of glucose-lowering medication or self-report, and the prevalence and incidence rate calculated. Independent risk factors of incident diabetes were examined using multivariable Cox regression. ResultsAmong 152,169 45 and Up Study participants with ≥1 linked laboratory result in the EXTEND45 database (mean age 63.0 years; 54.9% female), diabetes prevalence was 10.8% (95% confidence interval [CI] 10.6%–10.9%). Incident disease in those without diabetes at baseline (n = 135,810; mean age 62.5 years; 56.1% female) was 10.0 per 1,000 person-years (95% CI 9.8–10.2). In all age groups, diabetes incidence was lower in women compared to men, an association that persisted in the fully adjusted analyses. Other independent risk factors of diabetes were older age, being born outside of Australia (with the highest rate of 19.2 per 1,000 person-years observed in people born in South and Central Asia), lower education status, lower annual household income, residence in a major city, family history of diabetes, personal history of cardiovascular disease or hypertension, higher body mass index, smoking and long sleeping hours. ConclusionsOur study represents an efficient approach to assessing diabetes frequency and its risk factors in the community. The infrastructure provided by the EXTEND45 Study will be useful for diabetes surveillance and examining other important clinicaland epidemiologicalquestions.

Perinatal exposure to earthquake stress increases the risks of hypertension and diabetes in subsequent adult life: A cross-sectional study.

The objective of the current study was to determine whether exposure to earthquake stress during pregnancy and infancy impacted on the risk of chronic adult health problems. All subjects were divided into three groups: the infant exposure group, the fetus exposure group, and the non-exposure group. All subjects completed a standardized interview that included questions on demographic information, traumatic experiences during the earthquake, Anthropomorphic parameters such as body height, weight, and blood pressure were measured. Traumatic events in childhood and adulthood were assessed by the Childhood Trauma Questionnaire (CTQ) and Life Event Scale (LES), respectively. Totally1325 subjects were included; 399 subjects experienced the earthquake as fetuses, 374 subjects who experienced the earthquake as infants and 552 subjects did not experience the earthquake. The three groups were comparable in sociodemographic and baseline characteristics except age (Infant exposure vs Prenatal exposure vs No exposure=39.5±0.6 vs 38.5±0.8 vs 37.5±0.9, p<.001). Fetal and infant exposure to earthquakes was associated with elevated systolic blood pressure (both were+3mmHg, p<.001). After adjustment for covariates, earthquake exposure in infants (odds ratio [OR]=2.010, 95% confidence interval [CI]=1.216~3.322) and fetuses (OR=1.509, 95% CI=1.014~2.248) was a significant and independent risk factor for hypertension. Earthquake expose in fetuses was a significant and independent risk factor for diabetes (OR=2.307, 95% CI=1.136~4.686). Earthquake exposure in infants and fetuses is a significant and independent risk factor for hypertension. Earthquake exposure in fetuses is significant and independent risk factor for diabetes.

Impact of ductal interventions on diabetes in patients with chronic pancreatitis.

Even though ductal interventions in chronic pancreatitis (CP) are known to improve pain, its impact on diabetes is unclear. In this cohort study, we evaluated the impact of ductal interventions on diabetes in these patients. Consecutive patients with CP visiting the pancreas clinic between August 1, 2011, and July 21, 2012, were enrolled and followed until December 2018. Detailed clinical, laboratory, imaging, and treatment data were recorded at enrolment and follow-up. Patients were followed up every 6months through hospital visit and/or telephonic interview. Risk factors for diabetes were evaluated using logistic regression. The impact of ductal interventions on diabetes was evaluated using Kaplan-Meier survival analyses and Cox proportional hazards. A total of 644 patients were enrolled of which 137 were excluded. Of these, 326 (64.3%) patients had idiopathic CP, and 283 (55.8%) patients underwent ductal intervention. The cumulative incidence of diabetes was 57.9%. Median duration between symptom onset and ductal intervention was similar irrespective of diabetes (2.6 [0.6-6.0] vs 3.0 [1.0-5.5] years; P=0.69). Alcohol intake and pancreatic ductal calculi were independent risk factors for diabetes (odds ratio [95% confidence interval] of 2.05 (1.18-3.55), P=0.01, and 2.05 (1.28-3.28), P=0.003, respectively). Kaplan-Meier analyses revealed that diabetes free interval was significantly longer in patients undergoing ductal interventions, predominantly in those with idiopathic CP with obstructive ductal calculi (hazard ratio [95% confidence interval] 0.39 [0.28-0.55]; P<0.0001). There were no differences in glycemic status in patients with non-idiopathic CP and those with pre-existing diabetes. Early ductal intervention could delay development of diabetes in patients with idiopathic CP with obstructive ductal calculi.

Metabolic Syndrome and Diabetes Risk Among Young Adult Students in the Health Sciences from Kathmandu, Nepal.

BackgroundThe widespread dissemination of unhealthy dietary habits, childhood-teenage obesity, and sedentary lifestyle in young adults has paved the way for public health burden metabolic syndrome and early onset of type 2 diabetes mellitus. The aim of this study was to assess the prevalence and risk factors for metabolic syndrome and diabetes among young adult students.MethodsThis cross-sectional study was conducted among students of age group (18 to 25 years) studying at Manmohan Memorial Institute of Health Sciences and Central Institute of Science and Technology. The diabetes risk score of each individual was calculated by the Finnish Diabetes Risk Score (FINDRISC tool). Independent risk factors for diabetes and metabolic syndrome were measured by multivariable logistic regression analysis. The p-value of <0.05 was considered statistically significant in this study.ResultsA total of 825 students were recruited and 739 (89.6%) students completed the study with all the fulfilled criteria. The metabolic syndrome (Harmonized Joint Scientific Statement (HJSS) criteria) was present in 7.1%, and the most prevalent defining component was low HDL-C (78%); 74.8% of students were under low risk, 22.18% were at slightly elevated risk, 2.02% were at moderate risk, and 1.01% were at high risk of diabetes. The cardiometabolic risk factors like BMI, TC, and LDL-C were higher at a significant level (p<0.001) with an increased diabetes risk score. Independent lifestyle risk factor for metabolic syndrome was current smoking (AOR, 4.49, 95% CI 1.38–14.62) whereas, an independent lifestyle risk factor for diabetes was low adherence to physical exercise (AOR, 4.81, 95% CI, 2.90–7.99).ConclusionMetabolic syndrome is present, although in low numbers in young adults putting them at risk to develop diabetes in the near future. Early assessment of metabolic syndrome and diabetes risk in young may provide insights for preventive and control plans for risk population.

1466-P: Prevalence of Glucose Intolerance in the Roma Population from a Rural Area in the South Part of Romania: Călărași County

Background and Aim: The aim of this study was to evaluate the prevalence of glucose intolerance (diabetes, prediabetes) in Roma population living in rural settlements from Călărași County in the south part of Romania. Methods: This cross-sectional, epidemiological, non-interventional study was conducted from March 2014 to May 2017 in several settlements from Călărași County, in Romania. We included 603 patients, 448 Roma (320 females/128 males) and 155 Romanian Caucasians (104 females/51 males), aged between 18 and 88 yr. Glucose intolerance was defined using American Diabetes Association criteria. Body mass index was classified using the definition of World Health Organization. Metabolic waist was defined as waist circumference over 80 cm in women and 94 cm in men. Results: Prevalence of diabetes (newly diagnosed diabetes and known diabetes) was greater in Romanian Caucasians group, but in both groups larger than the published national data (34.8% vs. 23.6%, p=0.008). Obesity was present in 43.2% (n=67) of the Romanian Caucasians and 43.3% (n=194) of the Roma population (p=0.97). The average age was lower in Roma population (49.91±16.97 vs. 56.43±13.36 years, p&amp;lt;0.001). In Roma population group, the prevalence of prediabetes, newly diagnosed diabetes and known diabetes was 12.5% (n=56), 13.6% (n=61) and 10% (n=45) respectively. In Romanian Caucasians group, the prevalence of prediabetes, newly diagnosed diabetes and known diabetes was 12.9% (n=20), 14.8% (n=23), and 20% (n=31) respectively. Conclusions: The study revealed a high prevalence of diabetes and obesity among the Romanian Caucasians and Roma population in the south part of Romania, Călărași County. Independent risk factors for diabetes in the Roma population were the metabolic waist (OR=2.539; 95% CI 1.309-4.925) and physical activity less than 30 minutes/day (OR=2.099; 95% CI 1.279-3.444). Disclosure E. Rusu: None. G.M. Enache: None. F. Rusu: None. M.C. Baleanu: None. G. Radulian: None.