Established CVD and DM2 risk factors: reappraisal in relation to South Asians

2019 ◽  
pp. 139-172
Author(s):  
Raj S. Bhopal
Keyword(s):  
Risk Factors ◽  
South Asians ◽  
Asian Populations ◽  
Glycaemic Load ◽  
Disease Outcomes ◽  
Related Risk ◽  
Wide Range ◽  
Insufficient Physical Activity ◽  
Physiological Risk

The causal basis of the established CVD and type 2 diabetes risk factors rests mainly on cohort studies, sometimes with supplementary data from trials, Mendelian randomization studies, and experiments in animals. In South Asian populations, specifically, the direct evidence is limited but the associations between risk factors and disease outcomes are generally as expected. The lifestyle-related risk factors can be grouped into those where an excess is a problem (e.g. diets leading to adiposity or a high glycaemic load) and those where a deficit is a problem (e.g. insufficient physical activity). These kinds of risk factors, particularly in the context of adverse socio-economic circumstances, provide an excellent basis for causal thinking. So far, even combined with a wide range of biochemical and physiological risk factors, however, such factors are insufficient, though necessary, parts of a convincing explanation for the excess of DM2 and CVD in South Asians.

scholarly journals Risk Factors and Prediction Models for Venous Thromboembolism in Ambulatory Patients with Lung Cancer

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 778
Author(s):  
Ann-Rong Yan ◽  
Indira Samarawickrema ◽  
Mark Naunton ◽  
Gregory M. Peterson ◽  
Desmond Yip ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Venous Thromboembolism ◽  
High Risk ◽  
Prediction Models ◽  
Poor Performance ◽  
Risk Models ◽  
Related Risk ◽  
Wide Range ◽  
Ambulatory Patients

Venous thromboembolism (VTE) is a significant cause of mortality in patients with lung cancer. Despite the availability of a wide range of anticoagulants to help prevent thrombosis, thromboprophylaxis in ambulatory patients is a challenge due to its associated risk of haemorrhage. As a result, anticoagulation is only recommended in patients with a relatively high risk of VTE. Efforts have been made to develop predictive models for VTE risk assessment in cancer patients, but the availability of a reliable predictive model for ambulate patients with lung cancer is unclear. We have analysed the latest information on this topic, with a focus on the lung cancer-related risk factors for VTE, and risk prediction models developed and validated in this group of patients. The existing risk models, such as the Khorana score, the PROTECHT score and the CONKO score, have shown poor performance in external validations, failing to identify many high-risk individuals. Some of the newly developed and updated models may be promising, but their further validation is needed.

Diabetes in South Asians

2011 ◽  
pp. 1799-1803
Author(s):  
A. Ramachandran ◽  
C. Snehalatha
Keyword(s):  
South Asian ◽  
Indian Subcontinent ◽  
South Asians ◽  
Stress Factors ◽  
Rapid Urbanization ◽  
Asian Populations ◽  
Adults And Children ◽  
Diabetic Population

Developing countries, mainly in the Indian subcontinent and China, contribute nearly 80% to the rising global diabetic population. Conservative estimates, based on population growth, ageing of population, and rate of urbanization in Asia, show that India and China will remain the top two countries with the highest number of people with diabetes by 2025: 71 and 38 million, respectively. Two other South Asian countries, Pakistan and Bangladesh, also are in the top ten list. The South Asian populations of Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan, and Sri Lanka are racially heterogeneous, but all have high risk for diabetes and cardiovascular diseases. Type 1 diabetes is relatively less common, and nearly 95% of all diabetic cases in these regions are type 2 diabetes. The steady rise in the prevalence of diabetes seen in last three decades coincides with rapid urbanization and industrialization, and associated sociological and political changes, occurring in these countries (1). Among the populations, physical activity has reduced significantly, intake of energy-dense food has increased, and mental and physical stress factors associated with urban living have also increased. A tilt in the energy balance towards conservation and fat deposition has contributed to the alarming increase in the rate of obesity, both in adults and children.

Related Risk Factors between Subclinical Carotid Atherosclerosis and Diabetic Retinopathy in Newly Diagnosed Type 2 Diabetes Mellitus in China

2019 ◽  
Author(s):  
Fengqi Guo ◽  
Ting Zhou ◽  
Juan Tang ◽  
Mingxia Dong ◽  
Qianping Wei
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Subclinical Atherosclerosis ◽  
Vascular Diseases ◽  
Newly Diagnosed ◽  
Related Risk

Abstract Purpose To analyze the clinical features and related risk factors in diabetic retinopathy (DR) and subclinical atherosclerosis, the micro- and macro-vascular diseases in newly diagnosed type 2 diabetes mellitus (T2DM). Methods A retrospective study of 435 cases of inpatients with newly diagnosed T2DM from 2013–2017, and compare the 2 types of T2DM related vascular complications. Results The macro- and microvascular complications are not rare at this stage. Subclinical atherosclerosis was found in 251 subjects (57.7%), which was higher than that of DR (13.1%). In addition, some cases of subclinical atherosclerosis co-existed with DR, suggesting that DR was related with subclinical atherosclerosis (r=0.098, P=0.041). Older age showed a significant association with both subclinical atherosclerosis and DR. Single factor analysis indicated that dyslipidemia was the common risk factor in DR and subclinical atherosclerosis. Conclusions It should be paid attention to the screening of both DR and subclinical atherosclerosis in each age group of newly diagnosed T2DM. Except for the control of blood glucose, the control of the dyslipidemia is important in the prevention and treatment of the micro- and macro-vascular diseases.

scholarly journals Adipocytokine Associations with Insulin Resistance in British South Asians

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
D. R. Webb ◽  
K. Khunti ◽  
S. Chatterjee ◽  
J. Jarvis ◽  
M. J. Davies
Keyword(s):  
Metabolic Disease ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
South Asian ◽  
South Asians ◽  
Risk Groups ◽  
Serum Samples ◽  
Asian Populations ◽  
Glucose Dysregulation

Aims. Adipocytokines are implicated in the pathogenesis of type 2 diabetes and may represent identifiable precursors of metabolic disease within high-risk groups. We investigated adiponectin, leptin, and TNF-αand assessed the contribution of these molecules to insulin resistance in south Asians.Hypothesis. South Asians have adverse adipocytokine profiles which associate with an HOMA-derived insulin resistance phenotype.Methods. We measured adipocytokine concentrations in south Asians with newly diagnosed impaired glucose tolerance or Type 2 Diabetes Mellitus in a case-control study. 158 (48.5% males) volunteers aged 25–75 years with risk factors for diabetes but no known vascular or metabolic disease provided serum samples for ELISA and bioplex assays.Results. Total adiponectin concentration progressively decreased across the glucose spectrum in both sexes. A reciprocal trend in leptin concentration was observed only in south Asian men. Adiponectin but not leptin independently associated with HOMA-derived insulin resistance after logistic multivariate regression.Conclusion. Diasporic south Asian populations have an adverse adipocytokine profile which deteriorates further with glucose dysregulation. Insulin resistance is inversely associated with adiponectin independent of BMI and waist circumference in south Asians, implying that adipocytokine interplay contributes to the pathogenesis of metabolic disease in this group.

scholarly journals The related risk factors of diabetic retinopathy in elderly patients with Type 2 diabetes mellitus: A cohort study

2020 ◽  
Author(s):  
Ying-Chu Chiu ◽  
Tien-Lung Tsai ◽  
Meiyin Su ◽  
Tsan Yang ◽  
Peng-Lin Tseng ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Family History ◽  
Elderly Patients ◽  
Betel Nut ◽  
Family History Of Diabetes ◽  
Related Risk ◽  
History Of

Abstract Background: Diabetic retinopathy (DR) caused by small vessel disease was the main cause of blindness in person with diabetes, and it mainly occurred in patients with Type 2 diabetes mellitus (T2DM). Taiwan was one of the Asian countries with the highest prevalence rate of DR, there were only few studies for the risk of DR in patients with T2DM in Taiwan. According to some studies have shown DR was a major cause of blindness on elderly both in developed and other developing countries. The purpose was to investigate the related risk factors of DR in elderly patients with T2DM. Methods: During July 2010 to December 2017, 4010 T2DM patients without DR were preselected for this study, but 792 patients completed the continuously follow-up evaluation. Patients were invited to have an outpatient visit at least every three months, and they were asked to fill out a brief questionnaire and collect their blood samples. Additionally, statistical methods used independent sample T-test, Chi-square tests and logistic regression in univariate analysis to analyze the relationships between onset DR and each related factor; and finally the optimal multivariate logistic regression model would be determined by stepwise model selection. Results: Of the 792 effective samples, 611 patients (77.1%) progressed to DR and 181 patients (22.9%) did not get DR during the follow-up period. According to the results, the significant factors were women (OR, 2.20; 95%CI, 1.52-3.17), longer diabetic duration (OR, 1.05; 95% CI, 1.03-1.08), family history of diabetes (OR, 1.55; 95% CI: 1.09-2.21), higher concentration glycated hemoglobin (HbA1c) (OR, 1.27; 95% CI: 1.12-1.44), higher mean low density lipoprotein cholesterol (LDL-c) (OR, 1.01; 95% CI: 1.00-1.01), and chewing betel nut (OR, 2.85; 95% CI: 1.41-5.77). Conclusions: This prospective cohort study showed that gender, behavior of chewing betel nut, diabetic duration, family history of diabetes, HbA1c, and LDL-c, were important factors for the development of DR in elderly patients with T2DM. It suggested that those patients should well control their HbA1c and LDL-c and quit chewing betel nut to prevent from DR, especially for female patients with family history of diabetes and longer duration of diabetes.

scholarly journals The Association between Sleep Quality and Type Two Diabetes at 20 Year Follow-up in the Southall And Brent REvisited (SABRE) Cohort: a Tri-ethnic Analysis

2020 ◽  
Author(s):  
Zhen Ling Ong ◽  
Nishi Chaturvedi ◽  
Therese Tillin ◽  
Caroline Dale ◽  
Victoria Garfield
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Sleep Quality ◽  
South Asians ◽  
Diabetes Risk ◽  
Poor Sleep ◽  
Falling Asleep ◽  
Traditional Risk Factors

Objective: The risk of developing type 2 diabetes associated with poor sleep quality is comparable to that of traditional risk factors (e.g. overweight, physical inactivity). In the United Kingdom, these traditional risk factors could not explain the two to three-fold excess risks in South Asian and African Caribbean men compared to Europeans. This study investigates the (i)the association between mid-life sleep quality and later-life type 2 diabetes risk and (ii)a potential modifying effect of ethnicity. Research Design and Methods: The Southall and Brent REvisited (SABRE) cohort comprised Europeans, South Asians, and African Caribbeans (median follow-up = 19 years). Complete case analysis was performed on 2190 participants without diabetes at baseline (age= 51.7 ± 7SD). Competing risks regressions were used to estimate the hazard ratios (HRs) of developing type 2 diabetes associated with four self-reported baseline sleep exposures (difficulty falling asleep, early morning waking, waking up tired and snoring) while adjusting for confounders. Modifying effects of ethnicity were analysed by (i) testing for interactions and (ii) performing ethnicity-stratified analysis. Results: Snoring was strongly associated with increased type 2 diabetes risk but only among South Asians in a fully-adjusted model (HR 1.42, 95%CI=1.08-1.85, P=0.011). Our results revealed no elevated risk for any of the sleep exposures across all three ethnic groups. Conclusions: The association between snoring and type 2 diabetes appeared to be modified by ethnicity, with South Asians at greatest risk.

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