The association between rest-activity rhythms and glycemic markers: the US National Health and Nutrition Examination Survey, 2011-2014

Abstract OBJECTIVES Previous studies conducted in mostly homogeneous sociodemographic samples have reported a relationship between weakened and/or disrupted rest-activity patterns and metabolic dysfunction. This study aims to examine rest-activity rhythm characteristics in relation to glycemic markers in a large nationally-representative and diverse sample of American adults. METHODS This study used data from the National Health and Nutrition Examination Survey 2011-2014. Rest-activity characteristics were derived from extended cosine models using 24-hour actigraphy. We used multinomial logistic regression and multiple linear regression models to assess the associations with multiple glycemic markers (i.e., glycated hemoglobin, fasting glucose and insulin, homeostatic model assessment of insulin resistance, and results from the oral glucose tolerance test), and compared the results across different categories of age, gender, race/ethnicity and body-mass index. RESULTS We found that compared to those in the highest quintile of F statistic , a model-fitness measure with higher values indicating a stronger cosine-like pattern of daily activity, participants in the lowest quintile (i.e, those with the weakest rhythmicity) were 2.37 times more likely to be diabetic (OR Q1 vs. Q5 2.37 (95% CI 1.72, 3.26), p-trend <.0001). Similar patterns were observed for other rest-activity characteristics, including lower amplitude (2.44 (1.60, 3.72)), mesor (1.39 (1.01, 1.91)), and amplitude:mesor ratio (2.09 (1.46, 2.99)), and delayed acrophase (1.46 (1.07, 2.00)). Results were consistent for multiple glycemic biomarkers, and across different sociodemographic and BMI groups. CONCLUSIONS Our findings support an association between weakened and/or disrupted rest-activity rhythms and impaired glycemic control among a diverse US population.

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Type 2 diabetes mellitus unawareness, prevalence, trends and risk factors: National Health and Nutrition Examination Survey (NHANES) 1999–2010

Journal of International Medical Research ◽

10.1177/0300060517693178 ◽

2017 ◽

Vol 45 (2) ◽

pp. 594-609 ◽

Cited By ~ 39

Author(s):

Nana Zhang ◽

Xin Yang ◽

Xiaolin Zhu ◽

Bin Zhao ◽

Tianyi Huang ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Regression Model ◽

National Health ◽

Multinomial Logistic Regression ◽

Nutrition Examination Survey ◽

Health And Nutrition

Objectives To determine whether the associations with key risk factors in patients with diagnosed and undiagnosed type 2 diabetes mellitus (T2DM) are different using data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2010. Methods The study analysed the prevalence and association with risk factors of undiagnosed and diagnosed T2DM using a regression model and a multinomial logistic regression model. Data from the NHANES 1999–2010 were used for the analyses. Results The study analysed data from 10 570 individuals. The overall prevalence of diagnosed and undiagnosed T2DM increased significantly from 1999 to 2010. The prevalence of undiagnosed T2DM was significantly higher in non-Hispanic whites, in individuals <30 years old and in those with near optimal (130–159 mg/dl) or very high (≥220 mg/dl) non-high-density lipoprotein cholesterol levels compared with diagnosed T2DM. Body mass index, low economic status or low educational level had no effect on T2DM diagnosis rates. Though diagnosed T2DM was associated with favourable diet/carbohydrate intake behavioural changes, it had no effect on physical activity levels. Conclusion The overall T2DM prevalence increased between 1999 and 2010, particularly for undiagnosed T2DM in patients that were formerly classified as low risk.

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Association between thyroid hormones and insulin resistance indices based on the Korean National Health and Nutrition Examination Survey

Scientific Reports ◽

10.1038/s41598-021-01101-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yun Mi Choi ◽

Min Kyung Kim ◽

Mi Kyung Kwak ◽

Dooman Kim ◽

Eun-Gyoung Hong

Keyword(s):

Insulin Resistance ◽

National Health ◽

Thyroid Dysfunction ◽

Overt Hypothyroidism ◽

Model Assessment ◽

Nutrition Examination Survey ◽

Free T4 ◽

Tyg Index ◽

Health And Nutrition ◽

Post Menopausal

AbstractThyroid dysfunction has been implicated as a potential pathophysiological factor in glucose homeostasis and insulin resistance (IR). This study aimed to identify the correlation between thyroid dysfunction and IR. We used data from the sixth Korean National Health and Nutrition Examination Survey to evaluate a total of 5727 participants. The triglyceride glucose (TyG) index and homeostasis model assessment of insulin resistance (HOMA-IR) were calculated to represent IR. Correlation analysis was performed between thyroid dysfunction and IR. The log-transformed TSH (LnTSH) and free T4 were significantly correlated with the TyG index (TSH, beta coefficient 0.025, 95% confidence interval [CI] 0.014–0.036, p < 0.001; free T4, − 0.110 (− 0.166 to − 0.054), p < 0.001) but not HOMA-IR. Overt hypothyroidism is correlated with increased TyG index in pre-menopausal females (0.215 (0.122–0.309) p < 0.001). On the other hand, overt hyperthyroidism is correlated with increased HOMA-IR in males (0.304 (0.193–0.416), p < 0.001) and post-menopausal females (1.812 (1.717–1.907), p < 0.001). In euthyroid subjects, LnTSH and TyG index were significantly correlated in females. In conclusion, both hyperthyroidism and hypothyroidism might be associated with IR but by different mechanisms. It might be helpful to assess IR with appropriate indexes in patients with thyroid dysfunction.

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Selenium Status Is Associated With Insulin Resistance Markers in Adults: Findings From the 2013 to 2018 National Health and Nutrition Examination Survey (NHANES)

Frontiers in Nutrition ◽

10.3389/fnut.2021.696024 ◽

2021 ◽

Vol 8 ◽

Author(s):

Barbara R. Cardoso ◽

Sabine Braat ◽

Ross M. Graham

Keyword(s):

Insulin Resistance ◽

National Health ◽

Smoking Status ◽

Selenium Concentration ◽

Model Assessment ◽

Nutrition Examination Survey ◽

Selenium Status ◽

High Exposure ◽

Health And Nutrition ◽

Increased Risk

Although literature has been consistently showing an increased risk of type 2 diabetes (T2DM) in populations with high exposure to selenium, there is a lack of information quantifying the association between diabetes-related markers and the nutritional status of selenium. Therefore, we aimed to investigate the association between blood selenium concentration and glucose markers in a representative sample of the US population, which is known to have moderate to high exposure to selenium. This cross-sectional analysis included 4,339 participants ≥18 years from the 2013 to 2018 National Health and Nutrition Examination Survey (NHANES). All participants were assessed for whole blood selenium concentration, fasting plasma insulin and glucose, HbA1c, and HOMA-IR (Homeostatic Model Assessment for Insulin Resistance). In this cohort, all participants presented with adequate selenium status [196.2 (SD: 0.9) μg/L] and 867 (15%) had diabetes mellitus. Selenium was positively associated with insulin, glucose and HOMA-IR in models adjusted for age and sex. When the models were further adjusted for smoking status, physical activity, metabolic syndrome and BMI, the associations with insulin and HOMA-IR remained but the association with glucose was no longer significant. A 10 μg/L increase in selenium was associated with 1.5% (95% CI: 0.4–2.6%) increase in insulin and 1.7% (95% CI: 0.5–2.9%) increase in HOMA-IR in fully adjusted models. There was no evidence of an association between selenium and diabetes prevalence. Our findings corroborate the notion that selenium supplementation should not be encouraged in populations with high dietary intake of selenium.

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Physical Activity and Risk of Diagnosed and Undiagnosed Prediabetes among Males and Females in the National Health and Nutrition Examination Survey, 2007-2014

Journal of Diabetes Research ◽

10.1155/2020/3538746 ◽

2020 ◽

Vol 2020 ◽

pp. 1-11

Author(s):

Mabeline Velez ◽

Lisa Chasan-Taber ◽

Eva Goldwater ◽

Nicole VanKim

Keyword(s):

Physical Activity ◽

National Health ◽

Lower Risk ◽

Leisure Time ◽

Multinomial Logistic Regression ◽

Vigorous Physical Activity ◽

Occupational Physical Activity ◽

Nutrition Examination Survey ◽

Health And Nutrition ◽

Males And Females

Aims. The purpose of the study was to assess the effect of leisure and occupational physical activity on the risk of diagnosed and undiagnosed prediabetes among females and males. Methods. A sample of 17,871 non-pregnant adults was drawn from the 2007-2014 National Health and Nutrition Examination Survey. Multinomial logistic regression tested associations between moderate-to-vigorous physical activity (MVPA) and risk of diagnosed prediabetes and undiagnosed prediabetes, compared to no prediabetes. Results. Females and males who met guidelines for total MVPA (i.e., ≥10 MET-hrs/week) had a statistically significant lower risk of undiagnosed prediabetes (OR range: 0.50-0.65) as compared to those with no MVPA, however findings were no longer statistically significant after adjustment for diabetes risk factors. In terms of diagnosed prediabetes, females meeting guidelines had lower risk (OR range: 0.65-0.76), while only males engaging in the most MVPA had lower risk; findings were no longer significant after adjustment. Patterns were similar for leisure-time MVPA, but conflicting for occupational PA; females with 10-20 MET-hrs/week had a higher risk of diagnosed prediabetes (OR =1.71, 95% CI 1.11-2.61) and males with >20 MET-hrs/week had a higher risk for undiagnosed prediabetes (OR =1.17, 95% CI 1.02-1.35) after adjustment. Conclusions. This study adds to the sparse body of literature on physical activity and prediabetes, particularly with its inclusion of occupational MVPA.

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Low hydration status may be associated with insulin resistance and fat distribution: analysis of the Korea National Health and Nutrition Examination Survey (KNHANES) 2008–2010

British Journal Of Nutrition ◽

10.1017/s0007114520001063 ◽

2020 ◽

Vol 124 (2) ◽

pp. 199-208

Author(s):

Hyang K. Min ◽

Hyun Y. Ko ◽

Jin T. Kim ◽

Lise Bankir ◽

Sung W. Lee

Keyword(s):

Insulin Resistance ◽

National Health ◽

Fat Distribution ◽

Hydration Status ◽

Distribution Analysis ◽

Model Assessment ◽

Nutrition Examination Survey ◽

Generalised Additive Model ◽

Mediation Effects ◽

Health And Nutrition

AbstractWe aimed to identify the association of hydration status with insulin resistance (IR) and body fat distribution. A total of 14 344 adults participated in the Korea National Health and Nutrition Examination Survey 2008–2010. We used urine specific gravity (USG) to indicate hydration status, and HOMA-IR (homoeostasis model assessment of IR) and trunk:leg fat ratio (TLR) as primary outcomes. In multivariate logistic regression, the OR per 0·01 increase in USG for high IR was 1·303 (95 % CI 1·185, 1·433; P < 0·001). In multivariate generalised additive model plots, increased USG showed a J-shaped association with logarithmic HOMA-IR, with the lowest Akaike’s information criterion score of USG 1·030. Moreover, increased USG was independently associated with increased trunk fat, decreased leg fat and increased TLR. In mediation analysis, the proportion of mediation effects of USG on TLR via IR was 0·193 (95 % CI 0·132, 0·285; P < 0·001), while the proportion of mediation effects of USG on IR via TLR was 0·130 (95 % CI 0·086, 0·188; P < 0·001). Increased USG, a sign of low hydration status and presumably high vasopressin, was associated with IR and poor fat distribution. Direct effect of low hydration status may be more dominant than indirect effect via IR or fat distribution. Further studies are necessary to confirm our findings.

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A Strong Interaction between Serum γ-Glutamyltransferase and Obesity on the Risk of Prevalent Type 2 Diabetes: Results from the Third National Health and Nutrition Examination Survey

Clinical Chemistry ◽

10.1373/clinchem.2006.079814 ◽

2007 ◽

Vol 53 (6) ◽

pp. 1092-1098 ◽

Cited By ~ 64

Author(s):

Ji-Sun Lim ◽

Duk-Hee Lee ◽

Joo-Yun Park ◽

Soo-Hee Jin ◽

David R Jacobs

Keyword(s):

Type 2 Diabetes ◽

National Health ◽

Statistical Significance ◽

Clinical Importance ◽

Normal Serum ◽

Model Assessment ◽

Nutrition Examination Survey ◽

Odds Ratios ◽

Health And Nutrition

Abstract Background: Some studies have found an association of obesity with type 2 diabetes only among individuals with high normal serum γ-glutamyltransferase (GGT) activity, not in those with low serum GGT. If this interaction reflected pathophysiology, it would have scientific and clinical importance. The findings failed to reach statistical significance, however, and no articles have focused on the topic. We investigated possible interactions between serum GGT and body mass index (BMI) and their effects on the risk of prevalent type 2 diabetes and homeostasis model assessment (HOMA) insulin resistance. Methods: We analyzed 4011 adults ≥40 years old who participated in the 3rd US National Health and Nutrition Examination Survey. Results: BMI was associated with prevalent diabetes only among persons with high normal serum GGT activity (P for interaction = 0.002). In the highest serum GGT quartile, adjusted odds ratios for BMI 25–29.9, 30–34.5, and ≥35 kg/m2 compared with BMI<25 kg/m2 were 3.1, 5.1, and 6.2, respectively (P for trend <0.001). In the lowest serum GGT quartile, BMI was not associated with diabetes; corresponding adjusted odds ratios were 1.0, 0.9, 1.8, and 0.8 (P for trend = 0.551). After prevalent diabetes was excluded, there was a parallel interaction with HOMA levels (P for interaction <0.001). Conclusions: BMI was not associated with prevalent type 2 diabetes when GGT was low normal, suggesting that obesity itself may not be a sufficient risk factor for type 2 diabetes. Practically, this interaction can be useful in clinical settings to identify individuals at high risk for type 2 diabetes.

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