scholarly journals Revisiting comorbidities in gout: a cluster analysis

2013 ◽  
Vol 74 (1) ◽  
pp. 142-147 ◽  
Author(s):  
Pascal Richette ◽  
Pierre Clerson ◽  
Laure Périssin ◽  
René-Marc Flipo ◽  
Thomas Bardin

ObjectivesThe reciprocal links between comorbidities and gout are complex. We used cluster analysis to attempt to identify different phenotypes on the basis of comorbidities in a large cohort of patients with gout.MethodsThis was a cross-sectional multicentre study of 2763 gout patients conducted from November 2010 to May 2011. Cluster analysis was conducted separately for variables and for observations in patients, measuring proximity between variables and identifying homogeneous subgroups of patients. Variables used in both analyses were hypertension, obesity, diabetes, dyslipidaemia, heart failure, coronary heart disease, renal failure, liver disorders and cancer.ResultsComorbidities were common in this large cohort of patients with gout. Abdominal obesity, hypertension, metabolic syndrome and dyslipidaemia increased with gout duration, even after adjustment for age and sex. Five clusters (C1–C5) were found. Cluster C1 (n=332, 12%) consisted of patients with isolated gout and few comorbidities. In C2 (n=483, 17%), all patients were obese, with a high prevalence of hypertension. C3 (n=664, 24%) had the greatest proportion of patients with type 2 diabetes (75%). In C4 (n=782, 28%), almost all patients presented with dyslipidaemia (98%). Finally, C5 (n=502, 18%) consisted of almost all patients with a history of cardiovascular disease and renal failure, with a high rate of patients receiving diuretics.ConclusionsCluster analysis of comorbidities in gout allowed us to identify five different clinical phenotypes, which may reflect different pathophysiological processes in gout.

Author(s):  
Yieng Yii Wong ◽  
Azizul Hakim Sulaiman ◽  
Anis Aeida Mat Jaya ◽  
Pei Zan Wan ◽  
Anchaya Eh Wan ◽  
...  

Current global estimates of traditional and complementary medicine (T&CM) utilization range from 9.8% to 76%, with high rates of use being documented in Japan, South Korea, and Malaysia. Previous research has shown that patients with diabetes are more likely to use T&CM than individuals without diabetes. A multicenter cross-sectional survey of patients with type 2 diabetes mellitus was conducted at five primary care health clinics in Petaling district of Selangor, Malaysia from June 1, 2020 through September 30, 2020. A total of 476 patients were enrolled. 58.0% of men and 64.8% of women reported to use at least a type of T&CM. The prevalence of T&CM use among Malays, Chinese, and Indians was 71.1%, 33.3%, and 62.9% respectively. The most commonly used T&CM were herbal remedies (45.2%), followed by nutritional supplements (9.9%). 80.0% of the patients would follow their doctor’s instruction if the doctor asked them not to use T&CM, whereas 70.2% would consult their doctor about using T&CM. Factors associated with higher tendency for T&CM use comprised increased age, unemployed, oral antidiabetic monotherapy, presence of family history of diabetes, and coexisting chronic disease. T&CM therapies were common among multi-ethnic patient population with type 2 diabetes. The high rate of use warranted clinical attention and intervention to reduce the risk of drug-associated adverse events.


2020 ◽  
Vol 54 (5) ◽  
Author(s):  
Elizabeth R. Paterno

Objective. This study aims to determine the prevalence of risk factors of non-communicable diseases (NCDs) in 16barangays of the AMIGA municipalities of Cavite. Methods. The research is a cross-sectional study. Randomly chosen participants were interviewed using a translatedversion of the WHO Steps questionnaire. Interviewees were then invited to participate in another session wheretheir anthropometric measurements were taken and their fasting blood sugar and cholesterol levels were determined. Results. The research was done in 12 out of the 16 targeted barangays. A total of 1,527 participants were interviewedand 1,123 of them completed the study. The most significant findings in all 12 barangays were a very high rate ofpassive smoking (range of 60-80%); a relatively high proportion of respondents with obesity by all 3 parameters(BMI 29-52%; waist circumference 42-78%; and waist-to-hip ratio 41-78%) despite sufficient intake of fruits andvegetables and more than adequate physical activity; and a high proportion of participants with hypertension (morethan 30% in 8 out of 12 barangays) and diabetes mellitus (more than 8% in 7 out of 12 barangays). Conclusion. A high prevalence of risk factors of NCDs, particularly obesity, hypertension, and diabetes was foundin the 12 barangays of AMIGA that participated in the study. Results of this study should provide the baseline dataagainst which the success of an ongoing program in the area can be measured.


BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e041072
Author(s):  
Xiaofen Xiong ◽  
Ling Wei ◽  
Ying Xiao ◽  
Yachun Han ◽  
Jinfei Yang ◽  
...  

ObjectiveTo investigate the association between a parental and/or sibling history of diabetes and clinical characteristics.DesignA cross-sectional study.SettingThe data were collected from the endocrinology department of The Second Xiangya Hospital of Central South University from June 2017 to October 2019.ParticipantsA total of 894 newly diagnosed patients with type 2 diabetes were recruited. Data on clinical characteristics were collected from patient medical records. Pancreatic β-cell function and insulin resistance were calculated with the homeostatic model assessment. SPSS V.25.0 was used to perform the analysis.ResultsThe percentages of patients with parental and sibling histories of diabetes were 14.8% and 9.8%, respectively. The prevalence of diabetic ketoacidosis (DKA) was 3.9%. Compared with those with no parental history of diabetes, patients with a parental history of diabetes were characterised by early-onset disease (41.70±10.88 vs 51.17±14.09 years), poor glycaemic control of fasting blood glucose (10.84±5.21 vs 8.91±4.38 mmol/L) and a high prevalence of DKA (7.6% vs 3.3%). The patients with a sibling history of diabetes had later disease onset (56.05±9.86 vs 49.09±14.29 years) and lower BMI (24.49±3.48 vs 25.69±3.86 kg/m2) than those with no sibling history of diabetes. Univariate regression suggested that both parental history (p=0.037) and sibling history (p=0.011) of diabetes were associated with β-cell function; however, multiple regression analysis showed that only a sibling history of diabetes was associated with β-cell function (p=0.038). Univariate regression revealed a positive correlation between parental history of diabetes (p=0.023, OR=2.416, 95% CI 1.132 to 5.156) and DKA. Unfortunately, this correlation was not statistically significant for either patients with a parental history (p=0.234, OR=1.646, 95% CI 0.724 to 3.743) or those with a sibling history (p=0.104, OR=2.319, 95% CI 0.841 to 6.389) after adjustments for confounders.ConclusionA sibling history of diabetes was associated with poor β-cell function, and a parental history of diabetes was associated with poor glycaemic control and a high prevalence of DKA.


2020 ◽  
Vol 2 (4) ◽  
Author(s):  
Shweta R Singh ◽  
Bunsoth Mao ◽  
Konstantin Evdokimov ◽  
Pisey Tan ◽  
Phana Leab ◽  
...  

Abstract Background The rising incidence of infections caused by MDR organisms (MDROs) poses a significant public health threat. However, little has been reported regarding community MDRO carriage in low- and middle-income countries. Methods We conducted a cross-sectional study in Siem Reap, Cambodia comparing hospital-associated households, in which an index child (age: 2–14 years) had been hospitalized for at least 48 h in the preceding 2–4 weeks, with matched community households on the same street, in which no other child had a recent history of hospitalization. Participants were interviewed using a survey questionnaire and tested for carriage of MRSA, ESBL-producing Enterobacterales (ESBL-E) and carbapenemase-producing Enterobacterales (CPE) by culture followed by antibiotic susceptibility testing. We used logistic regression analysis to analyse associations between collected variables and MDRO carriage. Results Forty-two pairs of households including 376 participants with 376 nasal swabs and 290 stool specimens were included in final analysis. MRSA was isolated from 26 specimens (6.9%). ESBL-producing Escherichia coli was detected in 269 specimens (92.8%) whereas ESBL-producing Klebsiella pneumoniae was isolated from 128 specimens (44.1%), of which 123 (42.4%) were co-colonized with ESBL-producing E. coli. Six (2.1%) specimens tested positive for CPE (4 E. coli and 2 K. pneumoniae). The prevalence ratios for MRSA, ESBL-producing E. coli and ESBL-producing K. pneumoniae carriage did not differ significantly in hospital-associated households and hospitalized children compared with their counterparts. Conclusions The high prevalence of ESBL-E across both household types suggests that MDRO reservoirs are common in the community. Ongoing genomic analyses will help to understand the epidemiology and course of MDRO spread.


2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Uzair Abbas ◽  
Bushra Imdad ◽  
Sikander Adil Mughal ◽  
Israr Ahmed Baloch ◽  
Afshan Mehboob Khan ◽  
...  

Abstract Objective MicroRNAs are known to regulate 60% of genes at post translational level. MicroRNAs including Micro RNA-29 family play a vital role in cellular activities and have validate role in numerous metabolic disorders inclusive of diabetes mellitus and its complications. While micro RNA profile changes years before the occurrence of disease. This cross-sectional study was conducted in non-diabetic adults of diabetic and non-diabetic parents to explore the early changes in expression of micro RNA-29 family as it can be served as early biomarker of type 2 diabetes in non-diabetic adults. This study was conducted from January 2019 to January 2021. Micro RNA was extracted from plasma of 50 participants and expression was compared through qPCR. While data was analyzed through SPSS version 21.0. Results 29a and 29b had lower expression in participants with family history of DM compared to those having no family history of DM (P < 0.0001). While micro RNA 29c was found to be significantly higher in participants with positive family history of type 2 diabetes as compared to those without family history of diabetes (P = 0.001).


2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Zeena Salman ◽  
Gregory D. Kirk ◽  
Mark D. DeBoer

Cardiovascular disease (CVD) frequently has roots in childhood, including following childhood-onset hypertension. Incidence of CVD has increased in developing countries in East Africa during recent urbanization. Effects of these shifts on childhood hypertension are unclear. Our objectives were to (1) Determine the prevalence of hypertension among primary schoolchildren in Khartoum, Sudan; (2) Determine whether hypertension in this setting is associated with obesity. We performed a cross sectional study of 6-12y children from two schools randomly selected in Khartoum, Sudan. Height, weight, BMI, BP and family history of hypertension were assessed. Age-, height- and gender-specific BP curves were used to determine pre-hypertension (90–95%) and hypertension (>95%). Of 304 children, 45 (14.8%) were overweight; 32 (10.5%) were obese; 15 (4.9%) were pre-hypertensive and 15 (4.9%) were hypertensive. Obesity but not family history of hypertension was associated with current hypertension. In multiple logistic regression, adjusting for family history, children who were obese had a relative-risk of 14.7 (CI 2.45-88.2) for systolic hypertension compared to normal-weight children. We conclude that overweight and obesity are highly prevalent among primary schoolchildren in urban Sudan and are strongly associated with hypertension. That obesity-associated cardiovascular sequelae exist in the developing world at young ages may be a harbinger of future CVD in sub-Saharan Africa.


2020 ◽  
Vol 3 (5) ◽  
pp. 01-04
Author(s):  
Abdullah Ghouth

The Background and Purpose: to assess the prevalence of hypertension and micro-vascular complications among type 2 diabetic patients registered in primary health care center in Mukalla city at eastern Yemen. Methods: A Cross-sectional study was conducted in a randomly selected eligible patients from the diabetic registry of the AL Noor Charity Center (ACC), Mukalla city in Yemen. Results: Prevalence of hypertension in the T2DM patients were 46.7% (56/120). Retinopathy is the most micro-vascular complications among the adults having T2DM (73/120, 60.8%) while nephropathy is the least prevalence (13/120, 10.8%), prevalence of neuropathy was 49.2% (59/120). a high prevalence of retinopathy in males (66%) than females (55.7%) and a high prevalence of neuropathy in male adults (52.2%) than females (46%).No statistical significant difference were exit related to gender for any studied complications. Similar findings were observed regarding age related variations. Conclusion: A high prevalence of hypertension, retinopathy and neuropathy were reported among T2DM patients in Mukalla. Adopting effective and safe treatment strategies are highly recommended to prevent premature death and complications due to DM.


PEDIATRICS ◽  
1994 ◽  
Vol 93 (4) ◽  
pp. 594-601 ◽  
Author(s):  
Robin Chernoff ◽  
Terri Combs-Orme ◽  
Christina Risley-Curtiss ◽  
Alice Heisler

Objective. Most research on health problems of children in foster care has been cross-sectional, resulting in overselection of children who have been in care long-term and underrepresentation of children who are in care for a short time. Methodology. This paper reports on the health of a large cohort of children who had complete health examinations at the time of entry into foster care in a middle-size city during a 2-year period. Results. Results indicate that &gt;90% of the children had an abnormality in atleast one body system, 25% failed the vision screen, and 15% failed the hearing screen. The children were also lighter and shorter than the norm. Mental health screening revealed that 75% had a family history of mental illness or drug or alcohol abuse. Of children older than 3 years of age, 15% admitted to or were suspect for suicidal ideation and 7% for homicidal ideation. Of the children younger than 5 years of age, 23% had abnormal or suspect results on developmental screening examinations. At the time of entry into foster care, 12% of the children required an antibiotic. More than half needed urgent or nonurgent referrals for medical services and, for children &gt;3 years of age, more than half needed urgent or nonurgent referrals for dental and mental health services. Just 12% of the children required only routine follow-up care. Conclusions. The high prevalence and broad range of health needs of children at the time they enter foster care necessitate the design and implementation of better models of health care delivery for children in foster care.


2015 ◽  
Vol 5 (1) ◽  
pp. 11-17
Author(s):  
L Subedi ◽  
R B Sah

Retirement, change in housing, illness or death of spouse greatly affect the physical and mental well-being of the geriatric person. This study aims to find out the health status of geriatric age group in chitwan district of Nepal. A cross sectional study was carried out among 300 geriatric people where 15.7% of the geriatric were living alone, 50.3 % and 39.7% of geriatrics gave history of regular use of tobacco and alcohol respectively. Co-morbidities were found in 63% of geriatrics who suffered from 2 or more diseases. In Total 44% were found to have Ophthalmic problems, 23% were found to have ENT problems, 5.33% were found to mental disorders, 33% were found to have CVS problems, 43% were found to have GI problems, 15.67 % were found to have Metabolic disorder. The study highlighted a high prevalence of morbidity and health related problems in geriatric age groups.DOI: http://dx.doi.org/10.3126/jcmc.v5i1.12560


2018 ◽  
Vol 7 (1) ◽  
pp. 56
Author(s):  
Michael Lynge Pedersen

Objective: Type 2 diabetes (T2D) may develop slowly with few symptoms and may remain undetected for many years, leading to severe complications that potentially could have been prevented with timely diagnosis and treatment. Undiagnosed diabetes has been reported high in Greenland. However, awareness and knowledges about diabetes in the general population remains unexplored.Methods: This study was performed as an observational cross sectional study based on telephone interview among a random sample of Greenlanders. The interview was performed in Greenlandic or Danish according to participant’ preference and included information about age, gender, place of birth, place of residence, medical history of diabetes, awareness of the diabetes, risk factors, symptoms, complications, and local possibilities to get tested for diabetes.Results: In total, telephone contact was established with 196 adults. Of those, 161 participants completed the interview while 35 were unwilling to participate in the interview corresponding to a response rate of 82% (161/196). The majority of responders, 85.7%, were aware of diabetes and local testing possibilities. However, only around 65% were aware of risk factors of diabetes. Also, the knowledge about common symptoms of diabetes was quite low, around 50%, and in particular low, around 40%, among males and inhabitants in settlements.Conclusions: The vast majority of the population was aware of diabetes. However, the present study revealed shortage of knowledge of common risk factors, symptoms, and complications to diabetes. This is challenging the effort to prevent diabetes and new alternative information strategies are needed. Furthermore, the shortage of knowledges of risk factors may not be isolated to diabetes and further studies on health literacy in Greenland are recommended.


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