Lower Prevalence Of Diabetes Research Articles

Cognitive reserve is associated with education, social determinants, and cognitive outcomes among older American Indians in the Strong Heart Study

Cognitive reserve, a component of resilience, may be conceptualized as the ability to overcome accumulating neuropathology and maintain healthy aging and function. However, research measuring and evaluating it in American Indians is needed. We recruited American Indians from 3 regional centers for longitudinal examinations (2010-13, n = 818; 2017-19, n = 403) including MRI, cognitive, clinical, and questionnaire data. We defined cognitive reserve by measuring the residual from individual regressions of cognitive tests over imaged brain volumes, adjusted for age and sex. Analyses examined three different metrics of cognitive reserve against sociodemographic, clinical, and longitudinal cognitive data in causal mediation models. Better cognitive reserve was significantly associated with more education, higher income, lower prevalence of depression, lower prevalence of diabetes, and lower prevalence of kidney disease, but we found no statistically significant evidence for an association with plasma biomarkers for Alzheimer’s disease and related dementias, APOE e4 carrier status, alcohol use, body mass, or hypertension. Better cognitive reserve was associated with better cognitive function over mean 6.7 years follow-up (range 4-9 years); and the association for education with cognition over time was mediated in part (15-24%) by cognitive reserve. Cognitive reserve, although challenging to measure, appears important for understanding the range of cognitive aging in American Indians.

Association of dietary decanoic acid intake with diabetes or prediabetes: an analysis from NHANES 2005-2016.

With the increasing prevalence of prediabetes and diabetes, exploring dietary factors associated with prediabetes and diabetes has become a global health research priority. This study aimed to assess the relationship between dietary decanoic acid (DDA) intake and the risk of diabetes and prediabetes. Data from the National Health and Nutrition Examination Survey (NHANES) 2005-2016 included 11,477 adult participants. DDA intake was assessed through two 24-h dietary recalls and participants were grouped according to the diagnostic criteria for diabetes and prediabetes. Multivariate regression models were applied to analyze the relationship between DDA intake and diabetes and prediabetes, with subgroup analyses conducted to explore potential interactions. Dietary decanoic acid intake was significantly negatively associated with the risk of diabetes. In the fully adjusted model, each 1 g/day increase in DDA intake was associated with a 19% reduction in the odds of developing diabetes from prediabetes (OR = 0.81, 95% CI: 0.68-0.96, p = 0.015) and this negative association was more pronounced in individuals with higher education level (P for interaction = 0.006). Compared with the DDA intake ≤0.18 g/day, DDA intake >0.58 g/day is related to reduced risk of progression to diabetes in prediabetic patients. However, the relationship between DDA intake and the risk of prediabetes was not statistically significant in the fully adjusted model (OR = 0.95, 95% CI: 0.84-1.07, p = 0.404). This study found that higher DDA intake may be associated with lower prevalence of diabetes among prediabetic population, and high education level strengthen this relationship.

Effects of initial peritoneal dialysis prescription on clinical outcomes in Japanese peritoneal dialysis patients: a cohort study

Effects of the initial peritoneal dialysis (PD) prescription on clinical outcomes are unknown in Japan. We conducted a cohort study using data from Peritoneal Dialysis Outcomes and Practice Patterns Study. The patients were divided into two groups by the volume of the initial PD prescription (≤ 4 L/day or > 4 L/day). Cause-specific Cox proportional hazards survival models were used to model the association between different PD prescriptions and the clinical outcomes. The outcomes included transfer to HD, mortality, the composite of mortality and transfer to HD, peritonitis, hospitalization, and the patient-reported outcomes (PROs). Of the 342 patients, 98 were prescribed ≤ 4 L/day, and 244 were prescribed > 4 L/day. Patients prescribed ≤ 4 L/day were older with a lower percentage being male, had more cardiovascular and cerebrovascular disease but lower diabetes prevalence, were more likely to be receiving CAPD, used more assisted PD, and had lower BMI and mean serum creatinine levels. There were no significant differences between groups in terms of transfer to HD, mortality, transfer to HD or mortality, hospitalization, incidence of peritonitis, and PROs. Patients with initial PD prescriptions of ≤ 4 L/day compared to > 4 L/day had similar clinical outcomes. This practice may provide health economic benefits in Japan.

Electrocardiographic findings for predicting the left anterior descending artery chronic total occlusion in patients with inferior ST-segment elevation myocardial infarction

In determining the culprit vessel responsible for inferior ST-segment elevation myocardial infarction (STEMI) as either the right coronary artery (RCA) or left circumflex (LCX), the electrocardiographic value has been validated. However, its ability to predict whether inferior STEMI is complicated by left anterior descending artery (LAD) chronic total occlusion remains uncertain. Based on the involvement of arteries other than the culprit vessels, 189 patients with inferior STEMI from our chest pain center were categorized into four groups: LAD occlusion group (n = 20), LAD stenosis > 50% group (n = 116), normal LAD group (n = 27), and other vessel stenosis > 50% group (n = 26). All groups underwent coronary angiography within 24 h of admission, and electrocardiogram (ECG) and clinical data were retrospectively analyzed. In the LAD occlusion group, hypertension was significantly more prevalent (P = 0.015). Although there was a trend toward higher previous cerebral infarction and lower diabetes prevalence in the Normal LAD group, neither was statistically significant (P = 0.070 and P = 0.088). The LAD occlusion group demonstrated the highest serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and the most reduced LVEF, with a higher susceptibility to cardiogenic shock (P < 0.01). This group also had a higher use of intra-aortic balloon pump (IABP) and a greater occurrence of ventricular fibrillation or tachycardia compared to the other groups (P < 0.05). The QRS duration in lead V4 (QRS V4) was 99.4 ± 19.1 ms in the LAD occlusion group, 87.5 ± 14.9 ms in the LAD stenosis group, 89.6 ± 11.4 ms in the normal LAD group, and 87.7 ± 11.7 ms in the other vessel stenosis group (P = 0.010). The difference between ST-segment depression in V4 and ST-segment elevation in lead III (ST V4↓- ST III↑) in the LAD occlusion group was the largest at -0.06 (-1.19, 1.05) mm (P = 0.029). ROC curve analysis revealed that the sensitivity of QRS V4 > 97.7ms and ST V4↓- ST III↑> 0 mm diagnosing inferior STEMI complicated with LAD occlusion was 54.5% and 50%, with a specificity of 75.1% and 78.0%, respectively. Multivariate logistic regression analysis indicated that QRS V4 (OR = 1.062, P = 0.003), ST V4↓- ST III↑ (OR = 1.641, P = 0.050), and Killip classification (OR = 2.115, P = 0.004) were all independent risk factors for LAD occlusion. In patients with inferior STEMI complicated by LAD occlusion without anterior myocardial infarction, cardiac function is poorer. The ST-segment deviation between the leads V4 and III, and the duration of QRS in the lead V4, can aid in diagnosis.

Abstract 4138426: Geographic Disparities in Cardiometabolic Health Widened Across US States Between 2011 and 2021

Background: Geographic inequities in cardiovascular mortality are pervasive in the US. Pandemic-related delays in screening and treatment, economic loss, and worsening social determinants may have widened geographic disparities in cardiometabolic health, particularly in states that were hardest hit by these spillover effects. Understanding changes in state-based inequities could inform targeted public health efforts to advance cardiovascular health. Questions: Did the prevalence of cardiometabolic risk factors (diabetes, hypertension, hyperlipidemia, obesity) and lifestyle factors (alcohol consumption, physical inactivity, tobacco use) change between 2011 and 2021? How did between-state differences change over this period? Methods: We included adults from the CDC’s Behavioral Risk Factor Surveillance System. Survey-weighted logistic regressions models were used to calculate age and sex-adjusted risk difference between states with the highest and lowest adjusted prevalence rates of each risk factor in 2011 and 2011, respectively. An interaction term for state and year was included to assess for differential changes in between-state disparities. Results: From 2011 to 2021, there were increases in the age- and sex-adjusted prevalence of diabetes (10.9% [95% CI, 10.7,11.0] to 12.4% [12.2,12.6]), hypertension (32.4% [32.1,32.7] to 33.7% [33.4,34.0]), and obesity (27.5% [27.2,27.7] to 33.1% [32.8,33.5]). Geographic inequities widened, with increases in the difference between states with the highest vs lowest prevalence of diabetes (5.7% [5.3,6.1] to 7.8% [7.3,8.3]), hypertension (14.2% [13.6,14.8] to 17.2% [16.4,17.9]) and obesity (14.3% [13.6,15.0] to (15.7% [14.7,16.7]) (Table). The prevalence of alcohol consumption (18.0% [17.7,18.2] to 15.6% [15.3,15.8]), physical inactivity (25.7% [25.4,27.4] to 24.0% [23.6,23.7]), and tobacco use (44.9% [44.5,45.3] to 36.3% [35.8,36.8]) decreased, and between-state differences did not widen. Conclusion: In this national study, the prevalence of hypertension, obesity, and diabetes increased from 2011 to 2021, and state-based inequities widened. Our findings highlight the urgent need for public health interventions to address widening state-based disparities in cardiometabolic health.

CMR phenotypes and clinical outcomes in NYHA class I versus II-IV hypertrophic cardiomyopathy: identifying high-risk asymptomatic patients

Abstract Background Cardiac myosin inhibition therapy can deliver symptomatic benefit for NYHA class≥II patients with obstructive hypertrophic cardiomyopathy (HCM) and is being actively explored for non-obstructive phenotypes. However, expanding interest in clinical outcome reduction supports growing need to identify high risk cohorts across both symptomatic and asymptomatic cohorts. We aimed to examine phenotypic characteristics of NYHA-I versus NYHA≥II patients with HCM and their association with future outcomes. Methods 727 patients with HCM from the CIROC Registry who completed simultaneous CMR and patient health assessments, inclusive of NYHA evaluation and quality of life surveys, were studied. Baseline clinical and CMR characteristics were compared between NYHA-I and NYHA≥II cohorts, followed by risk modelling for the prediction of major adverse cardiovascular events (MACE), defined as: all-cause mortality, heart failure hospitalization, ventricular arrhythmia, new onset atrial fibrillation, or stroke. Cox models were constructed to identify independent predictors of MACE. Results Of the 727 patients, 546 (75%) reported NYHA-I and 181 (25%) NYHA≥II symptoms. Baseline characteristics are shown in Table 1. Compared to NYHA≥II, NYHA-I patients were younger, more likely male, and had a lower prevalence of diabetes and hypertension. No meaningful differences in CMR chamber volumes, function, left ventricular (LV) mass, or fibrosis burden were observed. Over a median follow up of 3.7 years, 109 patients (15%) experienced MACE: 12% in NYHA-I and 23% in NYHA≥II sub-groups (p&amp;lt;0.001). Baseline LV mass z-scores (determined from sex-matched, BSA-indexed SCMR healthy reference values) were independently associated with MACE by multivariable Cox modelling. An optimal LV mass z-score threshold of 3.9 for prediction of MACE was identified and combined with NYHA status to stratify patients into 4 categories. Kaplan-Meier curves showed patients with LV Mass z-scores &amp;gt;3.9 experienced worse event-free survival in both NYHA sub-groups (Figure 1a). Cox modelling in the overall cohort (Figure 1b) showed NYHA-I patients with LV Mass z-scores &amp;gt;3.9 experienced a 2.2-fold increased risk (p=0.007) of MACE, this exceeding the risk of NYHA ≥II patients below this threshold. Separate NYHA I and ≥II sub-group multivariable models showed LV Mass z-score &amp;gt;3.9 to remain a strong and independent predictor of MACE, providing respective hazards of 2.6 and 4.7 (p=0.001 and &amp;lt;0.001). Conclusions NYHA-I patients with HCM experience significantly lower rates of MACE versus NYHA≥II. However, LV mass z-scoring permits powerful sub-stratification of these sub-groups, identifying NYHA-I patients with higher LV mass who will experience worse outcomes versus NYHA≥II patients with lower LV mass. This simple yet powerful stratification offers unique potential to identify asymptomatic patients with HCM who may benefit from targeted therapeutics to reduce future MACE.

Mediterranean Diet Prior to Ischemic Stroke and Potential Circulating Mediators of Favorable Outcomes.

Background/Objectives. A Mediterranean diet (MD) has been associated with neuroprotective effects. We aimed to assess the MD's association with stroke prognosis and the potential mediators involved. Methods. Seventy patients with acute anterior circulation ischemic stroke were included. Dietary patterns were evaluated using the MEDAS scale, a food-frequency questionnaire, and a 24 h recall. Circulating biomarkers including insulin resistance (HOMA index), adipokines (resistin, adiponectin, leptin), choline pathway metabolites (TMAO, betaine, choline), and endothelial progenitor cells (EPCs) were measured. Early neurological improvement (ENI) at 24 h, final infarct volume, and functional outcome at 3 months were assessed. Results. Adherence to MD and olive oil consumption were associated with a lower prevalence of diabetes and atherothrombotic stroke, and with lower levels of fasting glycemia, hemoglobinA1C, insulin resistance, and TMAO levels. Monounsaturated fatty acids and oleic acid consumption correlated with lower resistin levels, while olive oil consumption was significantly associated with EPC mobilization. Multivariate analysis showed that higher MD adherence was independently associated with ENI and good functional prognosis at 3 months. EPC mobilization, lower HOMA levels, and lower resistin levels were associated with ENI, a smaller infarct volume, and good functional outcome. Conclusions. MD was associated with better prognosis after ischemic stroke, potentially mediated by lower insulin resistance, increased EPC mobilization, and lower resistin levels, among other factors.

Epidemiological factors for abnormal glucose levels in undergraduate students from the south of Tamaulipas, Mexico

Introduction: Type 2 diabetes mellitus (DM2) is an epidemic that requires actions in all areas of the health field in order to reduce its counterproductive effects. Mexico has a prevalence of diabetes of 10%. The objective of this study was to estimate the prevalence of DM2 in adolescents and young people in the southern region of the state of Tamaulipas.Methods: Adolescents and undergraduate students residing in southern Tamaulipas were included. Informed consent was obtained and a risk factor questionnaire was applied. Subsequently, glycemia profiles and anthropometric data were obtained and the information was categorized.Results: A total of 307 adolescents and young adults participated, we found a low prevalence of diabetes with 2%, but cases of prediabetes (18%) well above the national average. Alcohol consumption and smoking had a high prevalence, 14% of the participants presented obesity in classes II and III.Conclusions: A low percentage of DM2 was found, but prediabetes is well above the national average. This study serves as a background for the evaluation of health policies as well as the management of new guidelines to combat diseases such as DM2.

The Comorbidity of HIV and Diabetes among HIV Patients Attending Katsina General Hospital, Katsina State, Nigeria

Study’s Novelty/Excerpt This study focuses on the prevalence of diabetes among HIV patients specifically attending the antiretroviral therapy (ART) center of Katsina General Hospital, providing localized insights previously unreported. Unlike broader studies, this research uniquely highlights the inadequacies in diabetes diagnosis within this specific ART center, emphasizing the need for more rigorous screening protocols. Additionally, the study’s identification of specific factors such as older age, higher BMI, higher viral load, alcohol use, and duration on antiretroviral therapy as increasing the odds of diabetes offers targeted avenues for improving patient care and outcomes in similar clinical settings. Full Abstract Assessing the magnitude of diabetes, a disease that accounts for increasing morbidity and mortality among HIV patients, would help reduce financial losses incurred in treating the disease, considering that the disease is mostly reported when acute and chronic complications are about to begin. This study was conducted to identify the prevalence of diabetes among patients attending the antiretroviral (ART) center of Katsina General Hospital. The study aimed to identify the prevalence of diabetes among HIV patients to identify whether new cases are always recorded or otherwise in the study center. Two hundred (200) HIV-infected adults (aged ≥ 18) who had been on antiretroviral therapy for at least six months in the hospital were recruited. Participants’ demographics, HIV characteristics, the presence of diabetes via self-report, clinic folders, and measurement of their plasma fasting glucose and insulin levels on the day of the interview were evaluated. The magnitude of diabetes comorbidity was 3%. There was a weak positive relationship between fasting plasma glucose and alcohol (r=0.004), age (r=0.04), low-density lipoprotein (r=0.01), cholesterol (r=0.01), and viral load (r=0.032). Therefore, these factors are associated with increased odds of having diabetes. Thus, older age, higher BMI, higher viral load, alcohol, and duration on antiretroviral therapy increase the odds of having diabetes among HIV-positive adults. A lower prevalence of diabetes in clinic folders was found, for instance, indicating inadequate diagnosis of the disease in the center. Screening for the incidences of diabetes, addressing modifiable risk factors, and providing integrated care in the center would help improve the quality of life of comorbid patients.

Risk of stroke in patients with atrial fibrillation and chronic lymphocytic leukemia.

e19030 Background: There has been a noticeable increase in the incidence of Atrial Fibrillation (AF) in patients with Chronic lymphocytic leukemia (CLL), especially patients treated with first-line therapy medications such as ibrutinib. However, these patients' risk of thromboembolic events is not well defined. Methods: Data for hospitalized patients with AF was obtained from The National Inpatient Sample (NIS) database from 2016-2018. Baseline risk factors were identified using ICD-10 codes. Patients who were already on anticoagulation were excluded. A logistic regression model was used to establish the relationship between variables and to adjust for underlying risk factors. The primary outcome was ischemic stroke between CLL and non-CLL patient cohorts. Results: The total number of patients was 1784456, out of which 1171644 patients were included in the study. There were 1165283 patients without CLL and 6361 with CLL. AF patients with CLL had more males (62.5% vs. 37.5%; P&lt;.001), were older (74.6 vs. 78.82; P&lt;.001), and had a lower prevalence of diabetes, hypertension, coronary artery disease, and hyperlipidemia. Pre-match analysis showed a lower rate of stroke in patients with AF and CLL compared to those without CLL (2.7% vs 4.2%; p&lt;0.001). Post-match analysis revealed similar results with a lower risk of strokes in patients with CLL (4% vs 2.7%; p&lt;0.001). Binary logistic regression analysis for primary and secondary outcomes revealed similar results pre-match and post-match. Patients who have AF and CLL had lower rates of stroke compared to those without CLL (OR: 0.647(0.530–0.790); p&lt;0.001). Conclusions: AF patients with CLL were associated with a lower risk of ischemic stroke compared to those without CLL despite a higher risk profile as assessed by traditional risk factors. These findings should be considered while making decisions for therapies for the prevention of thromboembolic events.

Application of cytogenetic studies to assess relapse in patients after allogeneic bone marrow transplantation

Ergospirometry is a modern approach to the diagnosis of physical health that involves the use of exercise testing to measure cardiopulmonary function. Aims: To compare the distribution of health characteristics and their relationship between participants, to evaluate the accuracy of hypertension, hyperlipidemia and diabetes in both groups, to measure respiratory rate and heart rate between ergospirometric testing and traditional testing for physical health assessment. Study design: A comparative cross-sectional design to assess ergospirometric testing and traditional testing for physical health assessment. Methodology: The study employed a comparative cross-sectional design, utilizing convenience sampling to recruit participants for ergospirometric testing on a treadmill and the traditional 6-Minute Walk Test. Sample size determination yielded 100 participants (50 per group). Data on sociodemographic, comorbidities, and physiological parameters were collected and analyzed using descriptive statistics, chi-square tests, and independent sample t-tests. Results: The study compared Ergometric testing on a treadmill with the Traditional 6-Minute Walk Test across various parameters. Participants undergoing Ergometric testing were younger with more females and smokers, while the Walk Test group had higher BMI and exercise rates. Ergometric testing revealed higher rates of hypertension (P = 0.034) and hyperlipidemia (P = 0.021) but lower diabetes prevalence (P = 0.016). Additionally, Ergometric testing showed a better detection of respiratory parameters, exercise stress detection (P = 0.009), and cardiovascular parameters as compared to Traditional testing. Furthermore, it has a higher sensitivity 85% and specificity 80% compared to the traditional testing having sensitivity 75%, and specificity 70%. Scientific Novelty: Spirometry testing has made an impact on physical examination today; using advanced technology to achieve the best, sensitivity and specificity marks changes in the actual examination. Conclusion: Ergometric testing (treadmill) shows a significant advantage over traditional testing (6-Minute Walk Test) in diagnosing physical health conditions with a high sensitivity, specificity, and comprehensive parameter assessment.

Ethnic disparities in the prevalence of diabetes and its association with sleep disorder among older adults in rural southwest China

ABSTRACT Objectives This study aimed to examine ethnic disparities in the prevalence of diabetes and its association with sleep disorders among the older adults Han and ethnic minority (Bai, Ha Ni, and Dai) population in rural southwest China. Methods A cross-sectional survey of 5,642 was conducted among the rural southwest population aged ≥60 years, consisting of a structured interview and measurement of fasting blood glucose, height, weight, and waist circumference. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. Results The overall prevalence of diabetes and sleep disorder was 10.2% and 40.1%, respectively. Bai participants had the highest prevalence of diabetes (15.9%) and obesity (9.9%)(P < 0.01), while Ha Ni participants had the lowest prevalence of diabetes (5.1%) and obesity (3.4%)(P < 0.01). The highest prevalence of sleep disorder (48.4%) was recorded in Bai participants, while Dai participants had the lowest prevalence of sleep disorder (25.6%)(P < 0.01). In all four studied ethnicities, females had a higher prevalence of sleep disorder than males (P < 0.01), and the prevalence of sleep disorder increased with age (P < 0.01). The results of multivariate logistic regression analysis indicated older adults with sleep disorder had a risk of developing diabetes (P < 0.05). Moreover, the higher educational level, family history of diabetes, and obesity were the main risk factors for diabetes in participants (P < 0.01). Conclusion There are stark ethnic disparities in the prevalence of diabetes and sleep disorders in southwest China. Future diabetes prevention and control strategies should be tailored to address ethnicity, and improving sleep quality may reduce the prevalence of diabetes.

Ergospirometric testing: a modern approach to the diagnosis of physical health

Ergospirometry is a modern approach to the diagnosis of physical health that involves the use of exercise testing to measure cardiopulmonary function. Aims: To compare the distribution of health characteristics and their relationship between participants, to evaluate the accuracy of hypertension, hyperlipidemia and diabetes in both groups, to measure respiratory rate and heart rate between ergospirometric testing and traditional testing for physical health assessment. Study design: A comparative cross-sectional design to assess ergospirometric testing and traditional testing for physical health assessment. Methodology: The study employed a comparative cross-sectional design, utilizing convenience sampling to recruit participants for ergospirometric testing on a treadmill and the traditional 6-Minute Walk Test. Sample size determination yielded 100 participants (50 per group). Data on sociodemographic, comorbidities, and physiological parameters were collected and analyzed using descriptive statistics, chi-square tests, and independent sample t-tests. Results: The study compared Ergometric testing on a treadmill with the Traditional 6-Minute Walk Test across various parameters. Participants undergoing Ergometric testing were younger with more females and smokers, while the Walk Test group had higher BMI and exercise rates. Ergometric testing revealed higher rates of hypertension (P = 0.034) and hyperlipidemia (P = 0.021) but lower diabetes prevalence (P = 0.016). Additionally, Ergometric testing showed a better detection of respiratory parameters, exercise stress detection (P = 0.009), and cardiovascular parameters as compared to Traditional testing. Furthermore, it has a higher sensitivity 85% and specificity 80% compared to the traditional testing having sensitivity 75%, and specificity 70%. Scientific Novelty: Spirometry testing has made an impact on physical examination today; using advanced technology to achieve the best, sensitivity and specificity marks changes in the actual examination. Conclusion: Ergometric testing (treadmill) shows a significant advantage over traditional testing (6-Minute Walk Test) in diagnosing physical health conditions with a high sensitivity, specificity, and comprehensive parameter assessment.

Adipocines and longevity: connections and paradoxes

Adipose tissue is an active endocrine organ that regulates energy homeostasis throughout the body by releasing hundreds of biologically active substances called adipokines. Dysregulation of adipokines is a key feature of insulin resistance with the development of metabolic syndrome and type 2 diabetes mellitus, which is an age-dependent pathology. In turn, dysregulation of adipokines and insulin resistance are associated with the development of metabolic deficiency and senile asthenia syndrome in older age groups. Previous studies have shown that the absence of insulin resistance and low prevalence of diabetes among centenarians are metabolic prerequisites for increased lifespan, suggesting a possible role for adipokine homeostasis in healthy longevity. Among numerous adipokines, adiponectin is considered a protective factor, showing a negative correlation with major metabolic disorders associated with age and obesity, and a positive association with life expectancy and insulin sensitivity among centenarians. Despite all the apparent protective effects of adiponectin, large-scale epidemiological studies have revealed the opposite aspect of adiponectin as a predictor of all-cause mortality and cardiovascular disease in patients with heart failure as well as kidney disease. In this review, the clinical significance of adiponectin is considered in centenarians from the point of view of the development of the main geriatric syndrome - senile asthenia, as well as cardiovascular risk and mortality.

Abstract P426: County-Level Structural Racism and Diabetes Prevalence Among White and Black US Adults

Background: Diabetes Mellitus affects 12.7% non-Hispanic Black adults as opposed to 7% non-Hispanic White Adults. We hypothesized that higher structural racism (SR) is associated with greater diabetes prevalence among Black and White adults. Methods: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) study recruited 30,239 US Black and White adults from 48 contiguous US states in 2003-2007. We linked a novel county-level structural racism (CSR) metric reflecting domains of housing dissimilarity, school dissimilarity, high school graduation, incarceration, poverty, primary care access, and ambulatory care access. CSR was determined linked to REGARDS participants’ county location at time of recruitment. Diabetes was defined as fasting blood glucose ≥126 mg/dL or random blood glucose ≥200 mg/dL or use of diabetes medications. We excluded those missing CSR score and diabetes status. Poisson regression estimated relative risk (RR) of prevalent diabetes by higher (more adverse) CSR. Results: Among the 28,329 included participants (mean [SD] age 65 years, [9.43], 55% female participants, 42% Black participants). There was a greater proportion of Black adults in areas with higher CSR. As is shown in Table 1 , higher CSR was associated with higher RR of prevalent diabetes overall. However, higher CSR was associated with lower RR in race stratified models. Conclusions: Adverse levels of CSR were associated with lower diabetes prevalence in Black adults. It is unclear if this observation reflects operationalization of CSR, omitted variable bias, survival bias, or a true structural racism-diabetes association. Table 1 - Relative risk (RR) of Diabetes Prevalence age and sex adjusted per 1-point higher CSR*

Prevalence of hypertension, diabetes mellitus, and their risk factors in an informal settlement in Freetown, Sierra Leone: a cross-sectional study

BackgroundNoncommunicable diseases (NCDs), especially hypertension and diabetes mellitus are on the increase in sub-Saharan Africa (SSA). Informal settlement dwellers exhibit a high prevalence of behavioural risk factors and are highly vulnerable to hypertension and diabetes. However, no study has assessed the prevalence of hypertension, diabetes, and NCDrisk factors among informal settlement dwellers in Sierra Leone. We conducted a study in June 2019 to determine the prevalence of hypertension, diabetes, and NCD risk factors among adults living in the largest Sierra Leonean informal settlement (KrooBay).Methods and materialsWe conducted a community-based cross-sectional survey among adults aged ≥ 35 years in the KrooBay community. Trained healthcare workers collected data on socio-demographic characteristics and self-reported health behaviours using the World Health Organization STEPwise surveillance questionnaire for chronic disease risk factors. Anthropometric, blood glucose, and blood pressure measurements were performed following standard procedures. Logistics regression was used for analysis and adjusted odd ratios with 95% confidence intervals were calculated to identify risk factors associated with hypertension.ResultsOf the 418 participants, 242 (57%) were females and those below the age of 45 years accounted for over half (55.3%) of the participants. The prevalence of smoking was 18.2%, alcohol consumption was 18.8%, overweight was 28.2%, obesity was 17.9%, physical inactivity was 81.5%, and inadequate consumption of fruits and vegetables was 99%. The overall prevalence of hypertension was 45.7% (95% CI 41.0-50.5%), systolic hypertension was 34.2% (95% CI 29.6–38.8%), diastolic blood pressure was 39.9% (95% CI 35.2–44.6), and participants with diabetes were 2.2% (95% CI 0.7–3.6%). Being aged ≥ 55 years (AOR = 7.35, 95% CI 1.49–36.39) and > 60 years (AOR 8.05; 95% CI 2.22–29.12), separated (AOR = 1.34; 95% 1.02–7.00), cohabitating (AOR = 6.68; 95% CL1.03-14.35), vocational (AOR = 3.65; 95% CI 1.81–7.39 ) and having a university education (AOR = 4.62; 95% CI 3.09–6.91) were found to be independently associated with hypertension.ConclusionThe prevalence of hypertension,and NCD risk factors was high among the residents of the Kroobay informal settlement. We also noted a low prevalence of diabetes. There is an urgent need for the implementation of health education, promotion, and screening initiatives to reduce health risks so that these conditions will not overwhelm health services.

Kazakh adults in Xinjiang have a prevalent obesity problem but a low prevalence of diabetes

BackgroundThe prevalence of diabetes and obesity has been continuously rising worldwide over the last three decades, particularly in China. The prevalence varies widely among different ethnicities. In this study, we investigated the prevalence of diabetes and obesity, as well as the associated factors for diabetes in Kazakh adults in Xinjiang to improve diabetes screening.MethodsWe collected data from the Xinjiang physical examination in 2018, including a total sample of 118,505 Kazakh adults in Altay District. Data on demographic characteristics, medical history, physical examination, fasting plasma glucose (FPG) and serum lipid profiles were collected. The chi-square test was used to examine the differences between multiple variables. Multivariate logistic regression was performed to identify the factors associated with diabetes.ResultsThe mean age was 43. 66 years (SD 14.14). 49.3% of the population were women and 75.5% were rural residents. The mean FPG was 5.33 mmol/L (SD 1.22). The prevalence of diabetes was 6.3% and 4.1% received a new diagnosis by FPG. 26.6% were diagnosed with impaired fasting glucose (IFG). The mean body mass index (BMI) was 26.29 kg/m2 (SD 14.14) and the mean waist circumference was 87.69 cm (SD 12.74). 33.2% of the population were overweight, and 33.0% were obese. The prevalence of central obesity was 51.4%. Diabetes was mostly positively associated with hypertension (OR = 3.821, P<0.001), hypertriglyceridemia (OR = 2.757, P<0.001), and hyper-LDL-cholesterolemia (OR = 2.331, P<0.001) in the Kazakh population. The ORs for overweight, obesity and central obesity predictive of diabetes were 1.265, 1.453 and 1.222 ( all P<0.001), respectively.ConclusionsDespite having a high prevalence of obesity and central obesity, the Kazakh population had a considerably low prevalence of diabetes. Obesity was not the most important risk factor for diabetes in Kazakh individuals. The awareness of diabetes was low. When screening for diabetes in Kazakhs, those with hypertension or dyslipidemia should receive more attention.

Associations of HIV and prevalent type 2 diabetes mellitus in the context of obesity in South Africa.

It is unclear how rising obesity among people with HIV (PWH) impacts their risk of type 2 diabetes mellitus (diabetes). We examined associations between HIV, prevalent diabetes and adiposity among South African PWH and their peers without HIV (PWOH). HIV status was ascertained by antibody testing. Diabetes was defined as current use of oral hypoglycemics, insulin, and/or HbA1c ≥6.5%. Adiposity was measured by body mass index (BMI), waist circumference and waist-to-height ratio. Their associations were examined using sex-stratified multivariable fractional polynomial generalized linear models, reporting adjusted prevalence and prevalence ratios (adjPR). The mean age among 1,254 PWH and 4,381 PWOH was 41 years (95%CI 28, 56). The prevalence of diabetes among males was similar between PWH [11.3% (7.1, 15.5)] and PWOH [9.8% (8.5, 11.1); p=0.740]. By contrast, diabetes prevalence was higher among female PWOH [15.7% (14.4, 17.0)] than female PWH [10.5 (8.3, 12.8)%; adjPR: 0.67 (0.51, 0.82); p<0.001]. This difference was accentuated with obesity but reversed with leanness. At BMI ≥25 kg/m2, female PWH had lower diabetes prevalence [adjPR: 0.58 (0.41, 0.76); p<0.001] than female PHIV. In contrast, at BMI <18 kg/m2, female PWH had higher prevalence [adjPR: 1.72 (-1.53, 4.96); p=0.756] than female PWOH. We found sex-specific differences in the relationship between adiposity and diabetes prevalence by HIV serostatus in South Africa. Notably, females living with obesity and HIV had lower prevalence of diabetes than females living with obesity and without HIV, which may have particular implications for diabetes prevention programs in the region.

Prevalence of Pre-diabetes, Diabetes and Associated Risk Factors among Staff and Students of Federal Polytechnic, Kaura-Namoda

Obesity and overweight are major public health issues worldwide. This study was aimed at assessing the prevalence of diabetes and its associated risk factors among the staff and students of Federal Polytechnic Kaura-Namoda. A total of 159 participants took part in the study, consisting of 60 staff and 99 students. Anthropometric measurement and the World Health Organization’s (WHO) cut-offs were used to classify body weight into underweight, normal weight, overweight and obesity. Fasting blood glucose (FBG) level was determined using glucometer. Blood pressure was measured using an electronic blood pressure monitor. The overall prevalence of diabetes was 2.5%, with 2.0% being known cases and 0.5% newly diagnosed individuals. The prevalence of diabetes was higher in staff (2%) than in students (0.5%). The prevalence of pre-diabetes was 5.7%, with 4.4% occurring in staff and 1.3% in students. While the prevalent overweight and obesity were 51% and 23.9% respectively, among the participants, with students being more affected than staff. Hypertension was found in males (1.9%) and none in females. Also, pre-hypertension was more prevalent in students (32%) than in staff (0%). Pre-diabetes was more prevalent in overweight, obese, hypertensive, and 40 years or above participants. There was a correlation between diabetes and age, obesity, and hypertension. In conclusion, low prevalence of overweight, obesity, hypertension, and diabetes were found among the staff and students of Federal Polytechnic Kaura Namoda. The adoption of regular physical exercise, healthy eating habits, and a healthy lifestyle is therefore recommended among the staff and students for improved health status.

Area-level deprivation and individual-level socioeconomic correlates of the diabetes care cascade among black south africans in uMgungundlovu, KwaZulu-Natal, South Africa.

South Africa is experiencing a rapidly growing diabetes epidemic that threatens its healthcare system. Research on the determinants of diabetes in South Africa receives considerable attention due to the lifestyle changes accompanying South Africa's rapid urbanization since the fall of Apartheid. However, few studies have investigated how segments of the Black South African population, who continue to endure Apartheid's institutional discriminatory legacy, experience this transition. This paper explores the association between individual and area-level socioeconomic status and diabetes prevalence, awareness, treatment, and control within a sample of Black South Africans aged 45 years or older in three municipalities in KwaZulu-Natal. Cross-sectional data were collected on 3,685 participants from February 2017 to February 2018. Individual-level socioeconomic status was assessed with employment status and educational attainment. Area-level deprivation was measured using the most recent South African Multidimensional Poverty Index scores. Covariates included age, sex, BMI, and hypertension diagnosis. The prevalence of diabetes was 23% (n = 830). Of those, 769 were aware of their diagnosis, 629 were receiving treatment, and 404 had their diabetes controlled. Compared to those with no formal education, Black South Africans with some high school education had increased diabetes prevalence, and those who had completed high school had lower prevalence of treatment receipt. Employment status was negatively associated with diabetes prevalence. Black South Africans living in more deprived wards had lower diabetes prevalence, and those residing in wards that became more deprived from 2001 to 2011 had a higher prevalence diabetes, as well as diabetic control. Results from this study can assist policymakers and practitioners in identifying modifiable risk factors for diabetes among Black South Africans to intervene on. Potential community-based interventions include those focused on patient empowerment and linkages to care. Such interventions should act in concert with policy changes, such as expanding the existing sugar-sweetened beverage tax.