scholarly journals Deciphering the complex interplay between pancreatic cancer, diabetes mellitus subtypes and obesity/BMI through causal inference and mediation analyses

Gut ◽  
2020 ◽  
pp. gutjnl-2019-319990 ◽  
Author(s):  
Esther Molina-Montes ◽  
Claudia Coscia ◽  
Paulina Gómez-Rubio ◽  
Alba Fernández ◽  
Rianne Boenink ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Pancreatic Cancer ◽  
Causal Effect ◽  
Glycated Haemoglobin ◽  
Mendelian Randomisation ◽  
P Value ◽  
Causal Association ◽  
Related Factors ◽  
Logistic Regression Models ◽  
Mediation Analyses

ObjectivesTo characterise the association between type 2 diabetes mellitus (T2DM) subtypes (new-onset T2DM (NODM) or long-standing T2DM (LSDM)) and pancreatic cancer (PC) risk, to explore the direction of causation through Mendelian randomisation (MR) analysis and to assess the mediation role of body mass index (BMI).DesignInformation about T2DM and related factors was collected from 2018 PC cases and 1540 controls from the PanGenEU (European Study into Digestive Illnesses and Genetics) study. A subset of PC cases and controls had glycated haemoglobin, C-peptide and genotype data. Multivariate logistic regression models were applied to derive ORs and 95% CIs. T2DM and PC-related single nucleotide polymorphism (SNP) were used as instrumental variables (IVs) in bidirectional MR analysis to test for two-way causal associations between PC, NODM and LSDM. Indirect and direct effects of the BMI-T2DM-PC association were further explored using mediation analysis.ResultsT2DM was associated with an increased PC risk when compared with non-T2DM (OR=2.50; 95% CI: 2.05 to 3.05), the risk being greater for NODM (OR=6.39; 95% CI: 4.18 to 9.78) and insulin users (OR=3.69; 95% CI: 2.80 to 4.86). The causal association between T2DM (57-SNP IV) and PC was not statistically significant (ORLSDM=1.08, 95% CI: 0.86 to 1.29, ORNODM=1.06, 95% CI: 0.95 to 1.17). In contrast, there was a causal association between PC (40-SNP IV) and NODM (OR=2.85; 95% CI: 2.04 to 3.98), although genetic pleiotropy was present (MR-Egger: p value=0.03). Potential mediating effects of BMI (125-SNPs as IV), particularly in terms of weight loss, were evidenced on the NODM-PC association (indirect effect for BMI in previous years=0.55).ConclusionFindings of this study do not support a causal effect of LSDM on PC, but suggest that PC causes NODM. The interplay between obesity, PC and T2DM is complex.

scholarly journals Lifestyle Parameters in Patients with Diabetes Mellitus and in the General Adult Population—Trends over Five Years: Results of the Austrian National Health Interview Series

2021 ◽  
Vol 18 (18) ◽  
pp. 9910
Author(s):  
Thomas Ernst Dorner ◽  
Christian Lackinger ◽  
Sandra Haider ◽  
Katharina Viktoria Stein
Keyword(s):  
Diabetes Mellitus ◽  
Adult Population ◽  
Lifestyle Factors ◽  
Fruit And Vegetables ◽  
Related Factors ◽  
Logistic Regression Models ◽  
Muscle Strengthening ◽  
Health Interview ◽  
Patients With Diabetes ◽  
Austrian Population

Background: Not smoking, performing >150 min of aerobic physical activity (PA) and muscle strengthening exercises/week, and consuming >5 portions of fruit and vegetables/day are lifestyle recommendations for both the general population and people with diabetes mellitus (DM). Methods: A total of 15,771 and 15,461 persons from the Austrian Health Interview Surveys 2014 and 2019, respectively, including 4.9% and 6.0% of people with DM, were analysed in terms of their smoking, PA, and nutritional behaviours. Logistic regression models were performed for the lifestyle factors, adjusted for socio-demographic and health-related factors. Adjusted interactions between the survey year and DM on the lifestyle factors were computed. Results: The proportions of smokers were 23.9% and 20.2%, of people complying with the PA recommendations were 24.9% and 21.4%, and with fruit and vegetables recommendations were 7.1% and 5.5%, respectively, with significantly lower proportions of smokers and persons complying with the PA recommendations among people with DM. The fully adjusted odds ratios (95% confidence interval) for people with DM were 1.09 (0.94–1.26), 1.44 (1.23–1.69), and 0.90 (0.71–1.13) for smoking, not complying with PA recommendations, and not complying with fruit and vegetables recommendations, respectively. The proportion of people complying with PA recommendations decreased to a greater extent (p < 0.001) in people with DM (16.5% to 8.3%) compared to people without DM (25.3% to 22.3%). Conclusion: Diabetogenic lifestyle behaviours increased in the general Austrian population in recent years, which was especially true for people with DM regarding PA.

Effectiveness And Adherence To Hospital Infection Control Preventive Practice In Cardiac Implantable Electronic Devices

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Michel Lotfy Kolta ◽  
Maha Mohamed Mohamed Khalifa ◽  
Mazen Tawfik Ibrahmi ◽  
Said AbdElHaffez khaled
Keyword(s):  
Diabetes Mellitus ◽  
Infection Control ◽  
Electronic Devices ◽  
P Value ◽  
Related Factors ◽  
Cardiac Device ◽  
Control Protocol ◽  
The Past ◽  
Cardiac Implantable Electronic Devices ◽  
Device Implantation

Abstract Background Cardiac implantable electronic device (CIED) have been increasingly used in the past years, There is arise in CIED related complications in the past years with the increase in the number of devices implanted, CIED associated infection is challenging in its management, including system removal (generator and leads ), antimicrobial therapy, replantation at another site. Objectives The aim of the study is to evaluate the adherence to the steps of infection control protocol in cardiac device implantation related infection . Patients and Methods One hundred patients referred for cardiac device implantation was enrolled in the study and prospectively evaluated regarding applying of infection control measures and followed up for six months to study effect of adherence to these measures in prevention of postoperative device related infection. Results analysis of all factors of infection control protocol revealed significant correlation between postoperative device related infection and the following factors, Age ( p value = 0.010) , DM ( p value = 0.024) and number of Operators≥4.0 ( p = 0.001) as well as duration of sterilization ( p = 0.001), wearing double gloves (p = &lt;0.001). Conclusion Our results proved certain factors as significant risk factors for device related infection, they are either patient related factors including and diabetes mellitus or device related factors reflecting higher incidence with CRT devices (p = 0.025), others related to applying anti septic measures namely double glove technique and duration of skin disinfect prior to the procedure. Abbreviation list; CIED (cardiac implantable electronic devices), DRI (device related infection), CKD (chronic kidney disease), DM (diabetes mellitus), HTN (hypertension), CRT (cardiac resynchronization therapy), DDD (dual chamber device), VVI (ventricular demand pacing), ICD (implantable cardioverter defibrillator).

scholarly journals Mendelian Randomisation Study of Childhood BMI and Early Menarche

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Hannah S. Mumby ◽  
Cathy E. Elks ◽  
Shengxu Li ◽  
Stephen J. Sharp ◽  
Kay-Tee Khaw ◽  
...  
Keyword(s):  
Genetic Variants ◽  
Instrumental Variable ◽  
Causal Effect ◽  
Absolute Risk ◽  
Mendelian Randomisation ◽  
Age At Menarche ◽  
Causal Association ◽  
Common Variants ◽  
European Descent ◽  
Early Menarche

To infer the causal association between childhood BMI and age at menarche, we performed a mendelian randomisation analysis using twelve established “BMI-increasing” genetic variants as an instrumental variable (IV) for higher BMI. In 8,156 women of European descent from the EPIC-Norfolk cohort, height was measured at age 39–77 years; age at menarche was self-recalled, as was body weight at age 20 years, and BMI at 20 was calculated as a proxy for childhood BMI. DNA was genotyped for twelve BMI-associated common variants (in/nearFTO, MC4R, TMEM18, GNPDA2, KCTD15, NEGR1, BDNF, ETV5, MTCH2, SEC16B, FAIM2andSH2B1), and for each individual a “BMI-increasing-allele-score” was calculated by summing the number of BMI-increasing alleles across all 12 loci. Using this BMI-increasing-allele-score as an instrumental variable for BMI, each 1 kg/m2increase in childhood BMI was predicted to result in a 6.5% (95% CI: 4.6–8.5%) higher absolute risk of early menarche (before age 12 years). While mendelian randomisation analysis is dependent on a number of assumptions, our findings support a causal effect of BMI on early menarche and suggests that increasing prevalence of childhood obesity will lead to similar trends in the prevalence of early menarche.

scholarly journals Is there a causal relationship between executive function and liability to mental health and substance use? A Mendelian randomisation approach

2022 ◽  
Author(s):  
Sabrina M.I Burton ◽  
Hannah M Sallis ◽  
Alexander S Hatoum ◽  
Marcus R Munafo ◽  
Zoe E Reed
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Executive Function ◽  
Alcohol Consumption ◽  
Causal Relationship ◽  
Causal Effect ◽  
Smoking Initiation ◽  
Mendelian Randomisation ◽  
P Value ◽  
Causal Relationships

Background: Executive function consists of several cognitive control processes that are able to regulate lower level processes. Poorer performance in tasks designed to test executive function is associated with a range of psychopathologies such as schizophrenia, major depressive disorder (MDD) and anxiety, as well as with smoking and alcohol consumption. Despite these well-documented associations, whether they reflect causal relationships, and if so in what direction, remains unclear. We aimed to establish whether there is a causal relationship between a latent factor for performance on multiple executive function tasks - which we refer to as common executive function (cEF) - and liability to schizophrenia, MDD, anxiety, smoking initiation, alcohol consumption, alcohol dependence and cannabis use disorder (CUD), and the directionality of any relationship observed. Methods: We used a two-sample bidirectional Mendelian randomisation (MR) approach using genome-wide association study (GWAS) summary data from large cohorts (N=17,310 to 848,460) to examine whether causal relationships exist, and if so in which direction. Results: We found evidence of a causal effect of increased cEF on reduced schizophrenia liability (IVW: OR=0.10; 95% CI 0.05 to 0.19; p-value=3.43x10-12), reduced MDD liability (IVW: OR=0.52; 95% CI 0.38 to 0.72; p-value=5.23x10-05), decreased drinks per week (IVW: β=-0.06; 95% CI -0.10 to -0.02; p-value=0.003), and reduced CUD liability (IVW: OR=0.27; 95% CI 0.12 to 0.61; p-value=1.58x10-03). We also found evidence of a causal effect of increased schizophrenia liability on decreased cEF (IVW: β=-0.04; 95% CI -0.04 to -0.03; p-value=3.25x10-27), as well as smoking initiation on decreased cEF (IVW: β=-0.06; 95%CI -0.09 to -0.03; p-value=6.11x10-05). Conclusion: Our results indicate a potential bidirectional causal relationship between a latent factor measure of executive function (cEF) and schizophrenia liability, a possible causal effect of increased cEF on reduced MDD liability, CUD liability, and alcohol consumption, and a possible causal effect of smoking initiation on decreased cEF. These results suggest that executive function should be considered as a potential risk factor for some mental health and substance use outcomes, and may also be impacted by mental health (particularly schizophrenia). Further studies are required to improve our understanding of the underlying mechanisms of these effects, but our results suggest that executive function may be a promising intervention target. These results may therefore inform the prioritisation of experimental medicine studies (e.g., of executive function interventions), for both mental health and substance use outcomes, to improve the likelihood of successful translation.

scholarly journals Causal Association Between Birth Weight and Atrial Fibrillation: Evidence from a Two-Sample Mendelian Randomization Analysis

2020 ◽  
Author(s):  
Songzan Chen ◽  
Fangkun Yan ◽  
Tian Xu ◽  
Yao Wang ◽  
Kaijie Zhang ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Birth Weight ◽  
Mendelian Randomization ◽  
Causal Effect ◽  
Sensitivity Analyses ◽  
P Value ◽  
Causal Association ◽  
Genome Wide ◽  
A Genome ◽  
Mr Study

Abstract Background Although several observational studies have shown an association between birth weight (BW) and atrial fibrillation (AF), controversy remains. In this study, we aimed to explore the role of elevated BW on the etiology of AF. Methods A two-sample Mendelian randomization (MR) study was designed to infer the causality. The genetic data on the associations of single nucleotide polymorphisms (SNPs) with BW and AF were separately obtained from two large-scale genome-wide association study with up to 321,223 and 1,030,836 individuals respectively. SNPs were identified at a genome-wide significant level (p-value < 5 × 10− 8). The inverse variance-weighted (IVW) with fixed effects method was performed to obtain causal estimates as our primary analysis. MR-Egger regression was conducted to assess the pleiotropy and sensitivity analyses with various statistical methods were applied to evaluate the robustness of the results. Results In total, 122 SNPs were identified as the genetic instrumental variables. MR analysis revealed a causal effect of elevated BW on AF (OR = 1.21, 95% CI = 1.13–1.29, p-value = 2.39 × 10− 8). The MR-Egger regression suggested no evidence of directional pleiotropy (intercept = 0.00, p-value = 0.62). All the results in sensitivity analyses were consistent with the primary result, which confirmed the causal association between BW and AF. Conclusions The findings from the two-sample MR study indicate a causal effect of elevated BW on AF. This suggests a convenient and effective method to ease the burden of AF by reducing the number of newborns with elevated BW.

Is hyperglycemia a prognostic factor in pancreatic cancer?

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 14078-14078 ◽  
Author(s):  
S. F. Mekan ◽  
M. M. Safa ◽  
R. S. Komrokji ◽  
Z. A. Nahleh ◽  
A. R. Jazieh
Keyword(s):  
Diabetes Mellitus ◽  
Pancreatic Cancer ◽  
Median Survival ◽  
Tumor Biology ◽  
Stage Iv ◽  
Smoking History ◽  
Prior History ◽  
P Value ◽  
History Of ◽  
The Impact

14078 Background: Pancreatic hyperglycemia is one of the manifestations of pancreatic cancer.The purpose of this study is to explore the prevalence and significance of hyperglycemia at the time of diagnosis of pancreatic cancer. Methods: We reviewed retrospectively cases presenting to our institution with diagnosis of pancreatic carcinoma between 1999–2003. Hyperglycemia was defined as a blood sugar of greater than 140mg/dL. Results: There were 155 cases diagnosed with pancreatic cancer. Out of these, 67 (43.2%) were males and 71(45.8%) were females. The mean age was 63 years. Staging was reported in 134 patients: 19 patients (14%) were stage I, 23 (17%) stage II, 40 (30%) stage III and 52 (39%) stage IV. Median survival time was 8 months. Thirty-four (22%) patients had prior history of diabetes mellitus and were excluded from subsequent analysis. Sixty-four patients out of 121 patients (53%) were found to be hyperglycemic. These patients had no prior history of diabetes mellitus or were diagnosed with diabetes within six months. There was no difference between hyperglycemic patients and normoglycemic patients regarding age, sex, race, tumor location, smoking history, history of pancreatitis and hypertension. Hyperglycemic patients were more likely to have history of alcohol use compared to normoglycemic patients (p value = 0.005, OR = 4.07). Hyperglycemic patients were less likely to present with stage IV disease as compared to normoglycemic patients (25% vs. 55%) (p-value 0.002). The median survival in hyperglycemic patients was significantly longer than in normoglycemic patients (12 vs. 6 months, p-value = 0.02).There was a trend towards better survival among stage IV hyperglycemic patients as compared to normoglycemic patients (13 months vs 3 months) (p-value 0.38). Conclusions: In this retrospective analysis, 53% of pancreatic cancer patients without diabetes had hyperglycemia at presentation. These patients presented at an earlier stage compared to normoglycemic patients and had significantly longer survival. The impact of hyperglycemia on survival could be related to earlier presentation or difference in the tumor biology. The clinical significance of hyperglycemia in pancreatic cancer should be further studied in prospective fashion. No significant financial relationships to disclose.

MO994POST-TRANSPLANT DIABETES MELLITUS PREDICTORS AFTER PANCREAS-KIDNEY TRANSPLANT

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Maria Do Mar Menezes ◽  
Miguel Bigotte Vieira ◽  
Filipa Mendes ◽  
Ana Messias ◽  
Nuno Moreira Fonseca ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Hospital Discharge ◽  
Regression Models ◽  
Ldl Cholesterol ◽  
Diabetes Duration ◽  
P Value ◽  
C Peptide ◽  
Logistic Regression Models ◽  
Post Transplant

Abstract Background and Aims Pancreas-kidney transplantation (PKT) is an established treatment for selected patients with type 1 diabetes mellitus (T1DM) with either advanced or end-stage chronic kidney disease. We aimed to evaluate predictors for post-transplant diabetes mellitus (PTDM) at 24 months of follow-up after PKT. Method We analysed a longitudinal cohort of patients with chronic kidney disease and T1DM who underwent PKT at a tertiary referral centre from January 2011 to December 31, 2017. PTDM (post-transplant diabetes mellitus) was defined as the persistent need for pharmacologic treatment of diabetes mellitus after transplant. Continuous variables were recorded as means (±SD) or as medians (25-75% interquartile range), accordingly to data distribution. Categorical variables were recorded as proportions. Comparisons were made using t-tests, Wilcoxon rank-sum tests, or X2 test as appropriate. Unadjusted and adjusted multivariate logistic regression models were fitted to identify risk factors for PTDM at 24 months of follow-up. STATA 14.2 statistical package was used and p &lt;0.05 was considered statistically significant. Results From a total of 72 patients who underwent PKT during the study period, 47 patients completed at least 24 months of follow-up. The mean age at transplantation was 37±8 years, 30 (64%) were male, 43 (91%) were white and 4 (9%) were black. At 24-months of follow-up, the prevalence of diabetes mellitus was 28% (13/47). Number of mismatches, accumulated prednisolone dose, tacrolimus levels, previous rejection episodes, body mass index, cytomegalovirus status, serum creatinine, lipase, amilase at discharge were not associated with PTDM. Patients with persistent diabetes at 24-months of follow-up had a significantly longer pretransplant diabetes duration (29±10 versus 23±6 years; p-value = 0.026), had higher pretransplant LDL-cholesterol (137±46 versus 100±27 years; p-value = 0.003), and lower C-peptide at post-transplant hospital discharge (3.0 [2.0-3.3] versus 5.8 [4.5-6.5]; p-value = 0.004). Likewise, in univariate logistic regression models, longer diabetes duration and higher pretransplant LDL-cholesterol were found to be risk factors for PTDM at 24-months (OR 1.11, CI95% 1.00-1.22, p-value = 0.041; OR 1.03, CI95% 1.01-1.06, p-value = 0.014; respectively), while higher C-peptide at post-transplant hospital discharge was found to be protector (OR 1.03, CI95% 1.01-1.06, p-value = 0.014). In a multivariate model including age, pretransplant diabetes duration, pretransplant LDL-cholesterol, and C-peptide at post-transplant hospital discharge, only C-peptide at post-transplant hospital discharge remained significant (OR: 0.41, CI95% 0.18-0.95, p-value = 0.04). Conclusion Despite previous results in other studies, and new data researched, in our multivariate model, only lower C-peptide at post-transplant hospital discharge revealed being a predictor of PTDM after PKT.

scholarly journals Morbidity profile and use of personal protective equipment amongst traffic police of Mumbai

2019 ◽  
Vol 6 (12) ◽  
pp. 5277
Author(s):  
Rupali V. Sabale ◽  
Saurabh N. Tripathi ◽  
Gajanan D. Velhal
Keyword(s):  
Diabetes Mellitus ◽  
Police Officers ◽  
Personal Protective Equipment ◽  
Oxygen Therapy ◽  
P Value ◽  
Protective Equipment ◽  
Chi Square ◽  
Related Factors ◽  
Traffic Police ◽  
Chi Square Test

Background: Traffic police play a very significant role in controlling traffic system. The job of traffic police personnel is a tough job, which has a direct influence on their life. The aim of the present study was to assess prevalence of morbidities, use of personal protective equipment viz., mask, oxygen therapy and pressure stocking amongst Mumbai traffic police and study association of some job related factors with their present health profile.Methods: Record based study was conducted by analyzing 1959 health record forms filled by the traffic police of Mumbai. Frequency, percentages, Chi-square test and unpaired t test were calculated.Results: The mean age of traffic police was 46.87±7.95 years. The duration of years in traffic branch ranged from 6 months to 18 years. Prevalence of stress, hypertension, diabetes mellitus, eye, skin, and ear morbidities were 26%, 20.9%, 14.2%, 10.2%, 3.6%, 3.3% respectively. In traffic police officers, prevalence of hypertension (28.3% v/s 19.8%), diabetes mellitus (23.6% v/s 12.8%), ear morbidities (5.5% v/s 2.9%) and stress (31.1% v/s 25.3%) were significantly high as compared to traffic policemen (p value <0.05). There was significant association of prevalence of respiratory morbidities, ear morbidities with current work placement (p value <0.05). There was significant relation of duration in police service and stress, eye morbidities, diabetes mellitus, hypertension and respiratory morbidities. Proportion of traffic police using mask, oxygen therapy and pressure stockings were 60.2%, 21.5% and 15.8% respectively.Conclusions: Morbidities amongst traffic police is high. Use of personal protective equipment is very low. Worksite Prevention Program should be planned to reduce health problems amongst traffic police. 

Sign in / Sign up

Export Citation Format

Share Document