scholarly journals Differences in the prevalence of erectile dysfunction between novel subgroups of recent-onset diabetes

Diabetologia ◽  
2021 ◽  
Author(s):  
Haifa Maalmi ◽  
Christian Herder ◽  
Gidon J. Bönhof ◽  
Klaus Strassburger ◽  
Oana-Patricia Zaharia ◽  
...  

Abstract Aims/hypothesis In men with diabetes, the prevalence of erectile dysfunction increases with advanced age and longer diabetes duration and is substantially higher in men with type 2 diabetes than those with type 1 diabetes. This study aimed to evaluate the prevalence of erectile dysfunction among the five novel subgroups of recent-onset diabetes and determine the strength of associations between diabetes subgroups and erectile dysfunction. Methods A total of 351 men with recent-onset diabetes (<1 year) from the German Diabetes Study baseline cohort and 124 men without diabetes were included in this cross-sectional study. Erectile dysfunction was assessed with the International Index of Erectile Function (IIEF) questionnaire. Poisson regression models were used to estimate associations between diabetes subgroups (each subgroup tested against the four other subgroups as reference) and erectile dysfunction (dependent binary variable), adjusting for variables used to define diabetes subgroups, high-sensitivity C-reactive protein and depression. Results The prevalence of erectile dysfunction was markedly higher in men with diabetes than in men without diabetes (23% vs 11%, p = 0.004). Among men with diabetes, the prevalence of erectile dysfunction was highest in men with severe insulin-resistant diabetes (SIRD) (52%), lowest in men with severe autoimmune diabetes (SAID) (7%), and intermediate in men with severe insulin-deficient diabetes (SIDD), mild obesity-related diabetes (MOD) and mild age-related diabetes (MARD) (31%, 18% and 29%, respectively). Men with SIRD had an adjusted RR of 1.93 (95% CI 1.04, 3.58) for prevalent erectile dysfunction (p = 0.038). Similarly, men with SIDD had an adjusted RR of 3.27 (95% CI 1.18, 9.10) (p = 0.023). In contrast, men with SAID and those with MARD had unadjusted RRs of 0.26 (95% CI 0.11, 0.58) (p = 0.001) and 1.52 (95% CI 1.04, 2.22) (p = 0.027), respectively. However, these associations did not remain statistically significant after adjustment. Conclusions/interpretation The high RRs for erectile dysfunction in men with recent-onset SIRD and SIDD point to both insulin resistance and insulin deficiency as major contributing factors to this complication, suggesting different mechanisms underlying erectile dysfunction in these subgroups. Graphical abstract

2021 ◽  
Author(s):  
Christian Herder ◽  
Haifa Maalmi ◽  
Klaus Strassburger ◽  
Oana-Patricia Zaharia ◽  
Jacqueline M. Ratter ◽  
...  

A novel clustering approach identified five subgroups of diabetes with distinct progression trajectories of complications. We hypothesized that these subgroups differ in multiple biomarkers of inflammation. Serum levels of 74 biomarkers of inflammation were measured in 414 individuals with recent adult-onset diabetes from the German Diabetes Study (GDS) allocated to five subgroups based on data-driven analysis. Pairwise differences between subgroups for biomarkers were assessed with generalized linear mixed models before (model 1) and after adjustment (model 2) for the clustering variables. Participants were assigned to five subgroups: severe autoimmune diabetes (SAID, 21%), severe insulin-deficient diabetes (SIDD, 3%), severe insulin-resistant diabetes (SIRD, 9%), mild obesity-related diabetes (MOD, 32%) and mild age-related diabetes (MARD, 35%). In model 1, 23 biomarkers showed ≥1 pairwise difference between subgroups (Bonferroni-corrected p<0.0007). Biomarker levels were generally highest in SIRD and lowest in SIDD. All 23 biomarkers correlated with ≥1 of the clustering variables. In model 2, three biomarkers (CASP-8, EN-RAGE, IL-6) showed at least one pairwise difference between subgroups (e.g. lower CASP8, EN-RAGE and IL-6 in SIDD vs. all other subgroups, all p<0.0007). Thus, novel diabetes subgroups show multiple differences in biomarkers of inflammation, underlining a prominent role of inflammatory pathways in particular in SIRD.


2021 ◽  
Author(s):  
Christian Herder ◽  
Haifa Maalmi ◽  
Klaus Strassburger ◽  
Oana-Patricia Zaharia ◽  
Jacqueline M. Ratter ◽  
...  

A novel clustering approach identified five subgroups of diabetes with distinct progression trajectories of complications. We hypothesized that these subgroups differ in multiple biomarkers of inflammation. Serum levels of 74 biomarkers of inflammation were measured in 414 individuals with recent adult-onset diabetes from the German Diabetes Study (GDS) allocated to five subgroups based on data-driven analysis. Pairwise differences between subgroups for biomarkers were assessed with generalized linear mixed models before (model 1) and after adjustment (model 2) for the clustering variables. Participants were assigned to five subgroups: severe autoimmune diabetes (SAID, 21%), severe insulin-deficient diabetes (SIDD, 3%), severe insulin-resistant diabetes (SIRD, 9%), mild obesity-related diabetes (MOD, 32%) and mild age-related diabetes (MARD, 35%). In model 1, 23 biomarkers showed ≥1 pairwise difference between subgroups (Bonferroni-corrected p<0.0007). Biomarker levels were generally highest in SIRD and lowest in SIDD. All 23 biomarkers correlated with ≥1 of the clustering variables. In model 2, three biomarkers (CASP-8, EN-RAGE, IL-6) showed at least one pairwise difference between subgroups (e.g. lower CASP8, EN-RAGE and IL-6 in SIDD vs. all other subgroups, all p<0.0007). Thus, novel diabetes subgroups show multiple differences in biomarkers of inflammation, underlining a prominent role of inflammatory pathways in particular in SIRD.


2020 ◽  
Author(s):  
Roderick C Slieker ◽  
Louise A Donnelly ◽  
Hugo Fitipaldi ◽  
Gerard A Bouland ◽  
Giuseppe N. Giordano ◽  
...  

ABSTRACTAims/hypothesisFive clusters based on clinical characteristics have been suggested as diabetes subtypes: one autoimmune and four subtypes of type 2 diabetes (T2D). In the current study we replicate and cross-validate these T2D clusters in three large cohorts using readily measured variables in the clinic.MethodsIn this cross-sectional study, 15,940 individuals were clustered based on age, BMI, HbA1c, random or fasting C-peptide and HDL in three independent cohorts. Clusters were cross-validated against the original clusters based on HOMA measures. In addition, between cohorts, clusters were cross-validated by re-assigning people based on each cohort’s cluster centres.ResultsFive distinct T2D clusters were identified and mapped back to the original four ANDIS clusters. Using C-peptide and HDL instead of HOMA-B and HOMA-S three of the clusters mapped with high sensitivity (80.6 – 90.7%) to the previously identified Severe Insulin Deficient (SIDD), Severe insulin resistant (SIRD) and Obese (MOD) clusters. The previously described ANDIS MARD cluster could be mapped to the two milder groups in our study – one characterised by high HDL, and the other having not any extreme characteristic (MDH cluster). When these two milder groups were combined they mapped well to the previously labelled MARD cluster (sensitivity 79.4%). In the cross-validation between cohorts, particularly the SIDD and MDH cluster cross-validated well with sensitivities ranging from 73.3% to 97.1%. SIRD and MD showed a lower sensitivity ranging from 36.1% to 92.3% where individuals shifted from SIRD to MD and vice versa.Conclusions/interpretationClusters based on C-peptide instead of HOMA measures result in clusters that resemble those based on HOMA measures, especially for SIDD, SIRD and MOD. By adding HDL, the MARD cluster based upon HOMA measures resulted in the current clustering in two clusters with one cluster having high HDL levels. Cross-validation between cohorts showed generally a good resemblance between cohorts. Together, our results show that the clustering based on clinical variables readily measured in the clinic (age, HbA1c, HDL, BMI and C-peptide) results in informative clusters that are representative of the original ANDIS clusters and stable across cohorts.


2021 ◽  
Author(s):  
Jacqueline M. Ratter-Rieck ◽  
Haifa Maalmi ◽  
Sandra Trenkamp ◽  
Oana-Patricia Zaharia ◽  
Wolfgang Rathmann ◽  
...  

Frequencies of circulating immune cells are altered in type 1 and type 2 diabetes compared with healthy individuals and associate with insulin sensitivity, glycemic control and lipid levels. This study aimed to determine whether specific immune cell types are associated with novel diabetes subgroups. We analyzed automated white blood cell counts (n=669) and flow cytometry data (n=201) of participants of the German Diabetes Study with recent-onset (<1 year) diabetes, who were allocated to five subgroups based on data-driven analysis of clinical variables. Leukocyte numbers were highest in severe insulin-resistant diabetes (SIRD) and moderate obesity-related diabetes (MOD) and lowest in severe autoimmune diabetes (SAID). CD4<sup>+</sup> T cell frequencies were higher in SIRD vs. SAID, MOD and mild age-related diabetes (MARD), and frequencies of CCR4<sup>+</sup> regulatory T cells were higher in SIRD vs. SAID and MOD and MARD vs. SAID. Pairwise differences between subgroups were partially explained by differences in clustering variables. Frequencies of CD4<sup>+</sup> T cells were positively associated with age, BMI, HOMA2-B and HOMA2-IR, and frequencies of CCR4<sup>+</sup> regulatory T cells with age, HOMA2-B and HOMA2-IR. In conclusion, different leukocyte profiles exist between novel diabetes subgroups and suggest distinct inflammatory processes in these diabetes subgroups.


Author(s):  
Faizah Mughal ◽  
Ashok Kumar ◽  
Jai Dev Maheshwari ◽  
Ali Nawaz Bijarani ◽  
Tayyaba Kazmi ◽  
...  

Background: The menstrual cycle describes the healthy reproductive system of the women which is controlled by different hormones. Aim: The goal of the study is to evaluate the prevalence of irregular menstruation in different endocrine changes and to identify their association with the age of women in reproductive life. Methodology: It was a cross-sectional study conducted on women attending the gynecological clinic of Karachi from March 2019 to June 2019. Of the 165 women with different hormonal changes 100 presented with menstrual cycle abnormality. Results: Among the women with menstrual irregularities 51% women presented with insulin resistance, 23% with hyperandrogenism, 19% with hypothyroidism and 7% hyperprolactinemia. Age-related association was observed in menstrual irregularities women with insulin resistant and hyperandrogenism. Conclusion: Menstrual cycle is a physiological process, any irregularities in cycle can be caused by  even  minimal  hormonal  imbalance.  As  a  result,  it  is  critical  to  address  endocrine abnormalities in order to improve women's reproductive health.


2016 ◽  
Vol 9 (1) ◽  
pp. 160-160
Author(s):  
H. Fejza ◽  
◽  
I. Tolaj ◽  
D. Tahirsylaj ◽  
A. Idrizi ◽  
...  

Objective: To research the prevalence of male sexual dysfunction among men population in Kosovo. Design and Method: The cross-sectional study was done during the year 2015, including 530 male respondents of all ages living in Kosovo. The respondents completed the Brief Sexual Symptom Checklist for Men to assess sexual desire, erectile dysfunction, ejaculatory and orgasmic dysfunctions, penile curvature and pain during sex. The data were collected using Survey Monkey while statistical analyses were performed using SPSS software package (Version 20.0, Chicago, IL, USA). Results: The prevalence of man not satisfied with their sexual function was 32.2%. The problem was present for more than a year in 54% of respondents. Premature ejaculation was the leading problem (34%) followed by erectile dysfunction (24.4%) and problems with little or no interest in sex (17.9%). The problem was age related: the respondents younger than 25 years reported as a main problem premature ejaculation (31%) while respondents with age above 50 reported the erection as a main problem (60.5%). The 76.4% of men are ready to talk about those problems with their doctor. Conclusions: The prevalence of male sexual dysfunction in Kosovo is similar to other studies and is age related. Younger population reported premature ejaculation while the oldest population recognized erectile dysfunction as a main problem.


2021 ◽  
Author(s):  
Jacqueline M. Ratter-Rieck ◽  
Haifa Maalmi ◽  
Sandra Trenkamp ◽  
Oana-Patricia Zaharia ◽  
Wolfgang Rathmann ◽  
...  

Frequencies of circulating immune cells are altered in type 1 and type 2 diabetes compared with healthy individuals and associate with insulin sensitivity, glycemic control and lipid levels. This study aimed to determine whether specific immune cell types are associated with novel diabetes subgroups. We analyzed automated white blood cell counts (n=669) and flow cytometry data (n=201) of participants of the German Diabetes Study with recent-onset (<1 year) diabetes, who were allocated to five subgroups based on data-driven analysis of clinical variables. Leukocyte numbers were highest in severe insulin-resistant diabetes (SIRD) and moderate obesity-related diabetes (MOD) and lowest in severe autoimmune diabetes (SAID). CD4<sup>+</sup> T cell frequencies were higher in SIRD vs. SAID, MOD and mild age-related diabetes (MARD), and frequencies of CCR4<sup>+</sup> regulatory T cells were higher in SIRD vs. SAID and MOD and MARD vs. SAID. Pairwise differences between subgroups were partially explained by differences in clustering variables. Frequencies of CD4<sup>+</sup> T cells were positively associated with age, BMI, HOMA2-B and HOMA2-IR, and frequencies of CCR4<sup>+</sup> regulatory T cells with age, HOMA2-B and HOMA2-IR. In conclusion, different leukocyte profiles exist between novel diabetes subgroups and suggest distinct inflammatory processes in these diabetes subgroups.


2020 ◽  
Vol 5 (15) ◽  
pp. 185-192
Author(s):  
Nor Jannah Nasution Raduan ◽  
Mohd Razali Salleh ◽  
Ghazali Ahmad ◽  
Zaleha Ismail

Depression and cognitive impairment are the most common complications of patients on hemodialysis. The objective of this study is to identify contributing factors to depression and cognitive impairment in hemodialysis patients. This is a cross-sectional study involving 110 hemodialysis patients in Hospital Kuala Lumpur. The samples were recruited through universal sampling. Patients were assessed with the Beck Depression Inventory and Montreal Cognitive Assessment. This study found that 18.2% of patients had depression, and 48.2% had cognitive impairment. Factors associated with depression were unmarried status, low education level, and cognitive impairment. Factors associated with cognitive impairment were low education level, depression, and unemployment. Keywords: hemodialysis, depression, cognitive, ESRD eISSN: 2398-4287© 2020. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia. DOI: https://doi.org/10.21834/ebpj.v5i15.2468.


2021 ◽  
pp. 247412642198922
Author(s):  
Brittany C. Tsou ◽  
T.Y. Alvin Liu ◽  
Jun Kong ◽  
Susan B. Bressler ◽  
J. Fernando Arevalo ◽  
...  

Purpose: This work evaluated the use and type of dietary supplements and home monitoring for nonneovascular age-related macular degeneration (AMD), as well as the prevalence of genetic testing among patients with AMD. Methods: A cross-sectional study was conducted of 129 participants older than 50 years who completed self-administered questionnaires regarding usage and type of dietary supplements and home monitoring, as well as the participants’ use of genetic testing for AMD. Results: Of 91 participants with AMD, 83 (91.2%) took vitamins, including 55 (60.4%) who used an Age-Related Eye Disease Study (AREDS) or AREDS2 formulation. Of 38 without AMD, 31 (81.6%) took vitamins (difference from participants with AMD = 9.6% [95% CI, 0%-23.2%]), including 2 on an AREDS formulation. Among 82 participants with AMD who were AREDS candidates (intermediate or advanced AMD in 1 or both eyes), 51 (62.2%; 95% CI, 51.7%-72.7%) took an AREDS or AREDS2 formulation, and 31 (37.8%) did not (5 were unsure). Additionally, 50 (61.0%; 95% CI, 50.4%-71.6%) AREDS candidates did some type of home monitoring. Only 1 (1.2%; 95% CI, 0%-3.6%) underwent genetic testing for AMD. Among 9 with AMD who were not AREDS candidates, 4 (44.4%) used an AREDS formulation, 4 (44.4%) did not, and 1 (11.1%) was unsure; only 1 (11.1%) of these 9 performed home monitoring. Conclusions: Despite similar results from past surveys and AREDS2 data supporting supplement use in 2013 and home monitoring in 2014, these findings suggest about one-third of AREDS candidates do not do so, providing further support for improving education regarding appropriate supplement and home monitoring usage. Genetic testing for AMD also appears infrequent.


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