scholarly journals Different strokes for different folks: epidemiology of cerebrovascular diseases amongst Chinese-Canadians residing in Toronto

2015 ◽  
Vol 42 (S1) ◽  
pp. S36-S36
Author(s):  
JY Chu ◽  
JK Chu ◽  
DK Chu ◽  
S Lam
Keyword(s):  
Diabetes Mellitus ◽  
Retrospective Study ◽  
Population Based ◽  
Cerebrovascular Diseases ◽  
Retrospective Case ◽  
Chinese Canadians ◽  
Vascular Stenosis ◽  
Stroke Epidemiology ◽  
The Relationship

Introduction: It has been recognized in the past few decades that different ethnic groups living in Canada may have different stroke epidemiology. This presentation is focused on the stroke patterns of Chinese-Canadians living in the Toronto area. Methods: Two retrospective case-controlled studies were carried out between 1990- 2000 to study the stroke characteristics of Chinese-Canadians living in Toronto. Statistical analysis was carried out by the Institute of Clinical Evaluative Sciences. A further retrospective study was also carried out in 2011 to look at the relationship between stroke and diabetes mellitus amongst this population. Results: Chinese-Canadians were found to have 1/6 the prevalence of extracranial vascular stenosis. They have a higher frequency of intracranial vascular disease which may be due to the higher frequency of hypertension and diabetes mellitus. Higher incidence of intracranial hemorrhage was found compared to Caucasian controls which may be due to the lack of awareness and optimal treatment of their hypertension. Details of the results of these three studies will be presented. Conclusions: This is the first long term retrospective study of the stroke patterns and epidemiology for Chinese-Canadians residing in Toronto. Further prospective population-based study will be vital to study the important interactions between genetics and environment in the pathogenesis of different strokes for different folks.

scholarly journals Stroke Risk among Patients with Type 2 Diabetes Mellitus in Zhejiang: A Population-Based Prospective Study in China

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Lihua Guo ◽  
Min Yu ◽  
Jieming Zhong ◽  
Haibin Wu ◽  
Jin Pan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
General Population ◽  
Stroke Risk ◽  
Population Based ◽  
Stroke Subtypes ◽  
The Relationship

Objective. This study aimed to explore the incidence of stroke and stroke subtypes among patients with type 2 diabetes mellitus (T2DM) based on the long-term surveillance data in Zhejiang, China, during 2007 to 2013.Materials and Methods. During January 1, 2007, and December 31, 2013, a total of 327,268 T2DM and 307,984 stroke patients were registered on Diabetes and Stroke Surveillance System, respectively. Stroke subtypes were classified according to standard definitions of subarachnoid hemorrhage, intracerebral hemorrhage, and ischemic stroke. The incidence of stroke and stroke subtypes was calculated by standardized incidence ratio (SIRs) with 95% confidence intervals (CIs) compared with general population.Results. The incidence of stroke and stroke subtypes among patients with T2DM was significantly higher than in general population. Stroke risk was found significantly increased with an SIR of 3.87 (95% CI 3.76–3.99) and 3.38 (95% CI 3.27–3.48) in females and males, respectively. The excess risk of stroke was mainly attributable to the significantly higher risk of cerebral infarctions with the risk for T2DM being four times that for general population.Conclusions. The relationship between stroke and T2DM was strong, especially in female. The incidence of stroke and stroke subtypes among patients with T2DM was up to 3-fold higher than in general population in Zhejiang province, especially the subtype of cerebral infarctions.

Long-Term Exposure to PM2.5 and Cognitive Decline: A Longitudinal Population-Based Study

2021 ◽  
pp. 1-9
Author(s):  
Giulia Grande ◽  
Jing Wu ◽  
Petter L.S. Ljungman ◽  
Massimo Stafoggia ◽  
Tom Bellander ◽  
...  
Keyword(s):  
Air Pollution ◽  
Cognitive Decline ◽  
Population Based ◽  
Cerebrovascular Diseases ◽  
Air Pollutant ◽  
National Study ◽  
Piecewise Regression ◽  
Risk Increase ◽  
Restricted Cubic Splines

Background: A growing but contrasting evidence relates air pollution to cognitive decline. The role of cerebrovascular diseases in amplifying this risk is unclear. Objectives: 1) Investigate the association between long-term exposure to air pollution and cognitive decline; 2) Test whether cerebrovascular diseases amplify this association. Methods: We examined 2,253 participants of the Swedish National study on Aging and Care in Kungsholmen (SNAC-K). One major air pollutant (particulate matter ≤2.5μm, PM2.5) was assessed yearly from 1990, using dispersion models for outdoor levels at residential addresses. The speed of cognitive decline (Mini-Mental State Examination, MMSE) was estimated as the rate of MMSE decline (linear mixed models) and further dichotomized into the upper (25%fastest cognitive decline), versus the three lower quartiles. The cognitive scores were used to calculate the odds of fast cognitive decline per levels of PM2.5 using regression models and considering linear and restricted cubic splines of 10 years exposure before the baseline. The potential modifier effect of cerebrovascular diseases was tested by adding an interaction term in the model. Results: We observed an inverted U-shape relationship between PM2.5 and cognitive decline. The multi-adjusted piecewise regression model showed an increased OR of fast cognitive decline of 81%(95%CI = 1.2–3.2) per interquartile range difference up to mean PM2.5 level (8.6μg/m3) for individuals older than 80. Above such level we observed no further risk increase (OR = 0.89;95%CI = 0.74–1.06). The presence of cerebrovascular diseases further increased such risk by 6%. Conclusion: Low to mean PM2.5 levels were associated with higher risk of accelerated cognitive decline. Cerebrovascular diseases further amplified such risk.

scholarly journals The Effect of Surrounding Greenness on Type 2 Diabetes Mellitus: A Nationwide Population-Based Cohort in Taiwan

2020 ◽  
Vol 18 (1) ◽  
pp. 267
Author(s):  
Hui-Ju Tsai ◽  
Chia-Ying Li ◽  
Wen-Chi Pan ◽  
Tsung-Chieh Yao ◽  
Huey-Jen Su ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Vegetation Index ◽  
Normalized Difference Vegetation Index ◽  
Population Based ◽  
Research Database ◽  
Individual Level ◽  
The Relationship

This study determines whether surrounding greenness is associated with the incidence of type 2 diabetes Mellitus (T2DM) in Taiwan. A retrospective cohort study determines the relationship between surrounding greenness and the incidence of T2DM during the study period of 2001–2012 using data from the National Health Insurance Research Database. The satellite-derived normalized difference vegetation index (NDVI) from the global MODIS database in the NASA Earth Observing System is used to assess greenness. Cox proportional hazard models are used to determine the relationship between exposure to surrounding greenness and the incidence of T2DM, with adjustment for potential confounders. A total of 429,504 subjects, including 40,479 subjects who developed T2DM, were identified during the study period. There is an inverse relationship between exposure to surrounding greenness and the incidence of T2DM after adjustment for individual-level covariates, comorbidities, and the region-level covariates (adjusted HR = 0.81, 95% CI: 0.79–0.82). For the general population of Taiwan, greater exposure to surrounding greenness is associated with a lower incidence of T2DM.

scholarly journals Association Between Road Traffic Noise and Incidence of Diabetes Mellitus and Hypertension in Toronto, Canada: A Population‐Based Cohort Study

2020 ◽  
Vol 9 (6) ◽  
Author(s):  
Saeha Shin ◽  
Li Bai ◽  
Tor H. Oiamo ◽  
Richard T. Burnett ◽  
Scott Weichenthal ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Sound Pressure Level ◽  
Sound Pressure ◽  
Road Traffic ◽  
Traffic Noise ◽  
Population Based ◽  
Pressure Level ◽  
Road Traffic Noise

Background Exposure to road traffic noise has been linked to cardiometabolic complications, such as elevated blood pressure and glucose dysregulation. However, epidemiologic evidence linking road traffic noise to diabetes mellitus and hypertension remains scarce. We examined associations between road traffic noise and the incidence of diabetes mellitus and hypertension in Toronto, Canada. Methods and Results Using the Ontario Population Health and Environment Cohort, we conducted a retrospective, population‐based cohort study of long‐term residents of Toronto, aged 35 to 100 years, who were registered for provincial publicly funded health insurance, and were without a history of hypertension (n=701 174) or diabetes mellitus (n=914 607). Road traffic noise exposure levels were assessed by the equivalent continuous A‐weighted sound pressure level (dBA) for the 24‐hour day and the equivalent continuous A‐weighted sound pressure level for the night (11 pm –7 am) . Noise exposures were assigned to subjects according to their annual residential postal codes during the 15‐year follow‐up. We used random‐effect Cox proportional hazards models adjusting for personal and area‐level characteristics. From 2001 to 2015, each interquartile range increase in the equivalent continuous A‐weighted sound pressure level (dBA) for the 24‐hour day (10.0 dBA) was associated with an 8% increase in incident diabetes mellitus (95% CI, 1.07–1.09) and a 2% increase in hypertension (95% CI, 1.01–1.03). We obtained similar estimates with the equivalent continuous A‐weighted sound pressure level for the night (11 pm –7 am) . These results were robust to all sensitivity analyses conducted, including further adjusting for traffic‐related air pollutants (ultrafine particles and nitrogen dioxide). For both hypertension and diabetes mellitus, we observed stronger associations with the equivalent continuous A‐weighted sound pressure level (dBA) for the 24‐hour day among women and younger adults (aged <60 years). Conclusions Long‐term exposure to road traffic noise was associated with an increased incidence of diabetes mellitus and hypertension in Toronto.

scholarly journals Association of Higher Circulating Insulin Antibody with Increased Mean Amplitude Glycemic Excursion in Patients with Type 2 Diabetes Mellitus: A Cross-Sectional, Retrospective Case-Control Study

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Jian Zhu ◽  
Lu Yuan ◽  
Wen-ji Ni ◽  
Yong Luo ◽  
Jian-hua Ma
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Case Control Study ◽  
Mean Amplitude ◽  
Case Control ◽  
Retrospective Case ◽  
Cross Sectional ◽  
The Relationship ◽  
Control Study

Insulin antibody (IA) may potentially affect a patient’s glycemic control due to its variability in both binding and/or releasing insulin. However, the association between IA titer and daily glycemic variability (GV) is still unknown. We thus performed this cross-sectional, retrospective case-control study to assess the relationship between IA titer and mean amplitude glycemic excursion (MAGE) in type 2 diabetes mellitus (T2DM) patients using a continuous glucose monitoring (CGM) system. We recruited 100 eligible patients (IA>5%, IA positive) and divided them into two groups—a low (L) group and a high (H) group—based on their IA titer. The control (C) group consisted of 47 patients (IA≤5%, IA negative) matched for age, BMI, gender, and glycosylated hemoglobin A1c (HbA1c). The CGM determined the GV of enrolled patients. The primary outcome was the relationship between the IA titer and the MAGE, and the secondary outcome was the differences of GV among the three groups. We found that patients in the H group had higher levels of blood glucose fluctuation parameters than those in the L and C groups. The Ln(IA) was positively correlated with Ln(MAGE) even after adjusting for age, gender, BMI, HbA1c, and fasting and postprandial C-peptide(r=0.423, p<0.001). Multiple linear stepwise regression analysis revealed that Ln(IA) was an independent factor of Ln(MAGE) (beta=0.405, p<0.001). In conclusion, the higher circulating IA titer was associated with increased MAGE in T2DM patients, indicating that those patients with elevated IA titer should receive GV assessment and individualized treatment.

scholarly journals The Impact of Pre- and Post-Stroke Statin Use on Stroke Severity and Long-Term Outcomes: A Population-Based Cohort Study

2019 ◽  
Vol 47 (5-6) ◽  
pp. 260-267 ◽  
Author(s):  
Clare Flach ◽  
Maria Elstad ◽  
Walter Muruet ◽  
Charles D.A. Wolfe ◽  
Anthony G. Rudd ◽  
...  
Keyword(s):  
Population Based ◽  
Stroke Recurrence ◽  
Stroke Severity ◽  
Stroke Incidence ◽  
Post Stroke ◽  
Improvement Programs ◽  
The Impact ◽  
The Relationship ◽  
Statin Use

Background: The benefit of statins on stroke incidence is well known. However, data on the relationship between pre- and post-stroke statin use, recurrence, and survival outcomes are limited. We aim to investigate the short- and long-term relationships between statin prescription, stroke recurrence, and survival in patients with first-ever ischemic stroke. Methods: Data were collected from the population-based South London Stroke Register for the years 1995–2015. Patients were assessed at the time of first ever stroke, 3 months, and annually thereafter. Data on vascular risk factors, treatments prescribed, sociodemographic characteristics, stroke subtype, survival, and stroke recurrence were collected. Cox proportional hazard analyses were used to assess the relationship of statin prescriptions pre- and post-stroke on stroke severity, long-term recurrence and survival. Results: Patients prescribed statins both pre- and post-stroke showed a 24% reduction in mortality (adjusted Hazard Ratio [aHR] 0.76, 0.60–0.97), those who were prescribed statins pre-stroke and then stopped post-stroke showed greater risk of mortality (aHR 1.85, 1.10–3.12) and stroke recurrence (aHR 3.25, 1.35–7.84) compared to those that were not prescribed statins at any time. No associations were observed between pre-stroke statin and severity of the initial stroke overall, though a protective effect against moderate/severe stroke (Glasgow Coma Scale ≤12) was observed in those aged 75+ years (aOR 0.70, 0.52–0.95). Conclusions: Statins play a significant role in improving the survival rates after a stroke. Adherence to the National Guidelines that promote statin treatment, primary and secondary prevention of stroke should be monitored and a focus for quality improvement programs.

scholarly journals SLEEP APNEA ASSOCIATED COMORBIDITIES AND MORTALITY IN AN OLDER VETERAN POPULATION

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S263-S264
Author(s):  
Denise M Kresevic ◽  
muralidahar pallaki ◽  
Christopher J Burant ◽  
Clare Gideon ◽  
Emily Schroeder ◽  
...  
Keyword(s):  
Heart Failure ◽  
Older Adults ◽  
Sleep Apnea ◽  
Mortality Rate ◽  
Population Based ◽  
Older Individuals ◽  
Male Veterans ◽  
The Relationship ◽  
Overall Mortality

Abstract Evidence continues to mount that sleep apnea (SA) occurs in 10-25% of Americans and is associated with significant morbidity and mortality (Schulman 2018). Among veterans, SA has been reported four times more often as compared to other non-veteran cohorts. (Wong 2015). The risk of developing dementia is increased in older individuals with OSA (Shastri, Bangar, & Holmes, 2015). The prevalence and characteristics of older adults with dementia and sleep apnea is not well known and long-term population-based studies on mortality have been lacking. Recent studies have reported overall mortality rates of 19%, in those individuals with SA, an increased rate of 1.5-3 times the mortality rate as compared to those individuals those without SA. Current recommendations support SA screening of high risk individuals including those with symptoms of snoring, fatigue, memory and concentration problems and mood changes. (Krist 2018). Despite a large number of older adults with suspected SA and comorbidities, the majority are not screened, referred, diagnosed and treated. In this VA pilot study of outpatient older male veterans with dementia and SA, N=195, mean age 75.83 years, SD=9.1, 51.3% were white, 37.5% were black. Frequently found comorbidities were: hypertension 88%, congestive heart failure 41%, Diabetes. 62% and, stroke 21%. Of note, among those who died, SA was significantly related to congested heart failure (r=.32, p&lt;.001) and COPD (r=.40, p&lt;.001). The overall mortality rate of 27% was higher than previous reports. Further investigation is needed to better understand the relationship between comorbidities, and SA, screening, treatment and mortality.

scholarly journals Effects of Serum Albumin Levels on Antithrombin Supplementation Outcomes Among Patients With Sepsis-Associated Coagulopathy: A Retrospective Study

2019 ◽  
Vol 12 ◽  
pp. 1179545X1985836
Author(s):  
Masatomo Ebina ◽  
Kazunori Fujino ◽  
Akira Inoue ◽  
Koichi Ariyoshi ◽  
Yutaka Eguchi
Keyword(s):  
Retrospective Study ◽  
Serum Albumin ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Term Survival ◽  
Hazards Model ◽  
The Relationship

Background:Severe sepsis is commonly associated with mortality among critically ill patients and is known to cause coagulopathy. While antithrombin is an anticoagulant used in this setting, serum albumin levels are known to influence serum antithrombin levels. Therefore, this study aimed to evaluate the outcomes of antithrombin supplementation in patients with sepsis-associated coagulopathy, as well as the relationship between serum albumin levels and the effects of antithrombin supplementation.Methods:This retrospective study evaluated patients who were >18 years of age and had been admitted to either of two intensive care units for sepsis-associated coagulopathy. The groups that did and did not receive antithrombin supplementation were compared for outcomes up to 1 year after admission. Subgroup analyses were performed for patients with serum albumin levels of <2.5 g/dL or ⩾2.5 g/dL.Results:Fifty-one patients received antithrombin supplementation and 163 patients did not. The Cox proportional hazards model revealed that antithrombin supplementation was independently associated with 28-day survival (hazard ratio [HR]: 0.374, P = 0.025) but not with 1 year survival (HR: 0.915, P = 0.752). In addition, among patients with serum albumin levels of <2.5 g/dL, antithrombin supplementation was associated with a significantly lower 28-day mortality rate (9.4% vs 36.8%, P = .009).Conclusion:Antithrombin supplementation may improve short-term survival, but not long-term survival, among patients with sepsis-associated coagulopathy.

scholarly journals The Predictive Effect of Health Examination in the Incidence of Diabetes Mellitus in Chinese Adults: A Population-Based Cohort Study

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Xiaomin Fu ◽  
Yingmin Jia ◽  
Jing Liu ◽  
Qinghua Lei ◽  
Lele Li ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cox Regression ◽  
Population Based ◽  
Health Examination ◽  
The Public ◽  
Kaplan Meier ◽  
Potential Risk Factors ◽  
The Relationship ◽  
Predictive Effect

Background. The incidence of diabetes mellitus (DM) was increasing in recent years, and it is important to screen those nondiabetic populations through health examination to detect the potential risk factors for DM. We aimed to find the predictive effect of health examination on DM. Methods. We used the public database from Rich Healthcare Group of China to evaluate the potential predictive effect of health examination in the onset of DM. The colinear regression was used for estimating the relationship between the dynamics of the health examination index and the incident year of DM. The time-dependent ROC was used to calculate the best cutoff in predicting DM in the follow-up year. The Kaplan-Meier method and Cox regression were used to evaluate the HR of related health examination. Results. A total of 211,833 participant medical records were included in our study, with 4,172 participants diagnosing as DM in the following years (among 2-7 years). All the initial health examination was significantly different in participants’ final diagnosing as DM to those without DM. We found a negative correlation between the incidence of years of DM and the average initial FPG ( r = − 0.1862 , P < 0.001 ). Moreover, the initial FPG had a strong predictive effect in predicting the future incidence of DM ( AUC = 0.961 ), and the cutoff was 5.21 mmol/L. Participants with a higher initial FPG (>5.21 mmol/L) had a 2.73-fold chance to develop as DM in follow-up ( 95 % CI = 2.65 – 2.81 , P < 0.001 ). Conclusion. Initial FPG had a good predictive effect for detecting DM. The FPG should be controlled less than 5.21 mmol/L.

Sign in / Sign up

Export Citation Format

Share Document