Abstract 658: New Onset Diabetes Does Not Pose Additional Risk - Analysis Of 15,111 Treated Hypertensive Patients With 40 Year Follow-up.

Hypertension ◽  
2014 ◽  
Vol 64 (suppl_1) ◽  
Author(s):  
Stefanie Lip
Keyword(s):  
Alkaline Phosphatase ◽  
Hospital Admissions ◽  
Cox Proportional Hazards ◽  
Outcome Analysis ◽  
Gamma Glutamyl Transpeptidase ◽  
Hypertensive Patients ◽  
Onset Diabetes ◽  
Diabetes Status ◽  
New Onset

Objective: It is unclear whether new onset diabetes (NOD) is a separate entity associated with excess risk in hypertensive patients. Methods: We studied 15111 hypertensive patients with up to 40 year follow-up at the Glasgow BP Clinic database. Diabetes status was defined based on hospital admissions for any diabetes related diagnosis or prescription of anti-diabetic drugs or diabetes monitoring materials. The date at first hospital encounter either for prescription or admission was considered as the onset of diabetes. NOD was classified into early and late (diagnosis <10yrs or >10years from first clinic visit). Cause-specific outcome analysis was performed using multivariate-adjusted Cox proportional hazards (Cox-PH) models. In order to address any potential competing risk introduced due to the long follow-up period, an additional composite end point of all-cause mortality+NOD was analysed. Results: There were 2521(17%) patients with DM, of whom 2061(14%) had NOD. The incidence rate of NOD was 9.2 per 1000 person-years. Prevalence of early NOD was 898 (6%) and late NOD 1163 (8%). The total time at risk was 239,952 person-years with a median survival time of 28.04 years (IQR: 16.24-39.95). There were 5225 deaths (52% from cardiovascular causes) during the follow-up period. Independent predictors of new-onset diabetes in order of decreasing significance were baseline glucose, BMI, age, alanine transaminase, alkaline phosphatase, gamma glutamyl transpeptidase and bilirubin. Of these age, glucose, BMI and alkaline phosphatase remained top predictors for the composite outcome of NOD+all-cause death. The mortality risk was the highest in those with prevalent DM (HR=1.5[95%CI=1.2;1.9]) and lowest in those with late NOD (0.79[0.68;0.92]). Early NOD and non-diabetic subjects had similar risks. Conclusions: Indices of liver function tests predict the risk of NOD and mortality in addition to BMI and baseline glucose. The risk posed by NOD is related to duration of diabetes primarily indicating the importance of efforts to delay onset of NOD.

scholarly journals Serum alkaline phosphatase levels and the risk of new-onset diabetes in hypertensive adults

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Yuanyuan Zhang ◽  
Chun Zhou ◽  
Jianping Li ◽  
Yan Zhang ◽  
Di Xie ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
Fasting Glucose ◽  
Serum Alkaline Phosphatase ◽  
Positive Association ◽  
Trial Registration ◽  
Clinical Trial Registration ◽  
Onset Diabetes ◽  
Increased Risk ◽  
New Onset

Abstract Background The association between alkaline phosphatase (ALP) and incident diabetes remains uncertain. Our study aimed to investigate the prospective relation of serum ALP with the risk of new-onset diabetes, and explore possible effect modifiers, in hypertensive adults. Methods A total 14,393 hypertensive patients with available ALP measurements and without diabetes and liver disease at baseline were included from the China Stroke Primary Prevention Trial (CSPPT). The primary outcome was new-onset diabetes, defined as physician-diagnosed diabetes or use of glucose-lowering drugs during follow-up, or fasting glucose ≥ 7.0 mmol/L at the exit visit. The secondary study outcome was new-onset impaired fasting glucose (IFG), defined as FG < 6.1 mmol/L at baseline and ≥ 6.1 but < 7.0 mmol/L at the exit visit. Results Over a median of 4.5 years follow-up, 1549 (10.8%) participants developed diabetes. Overall, there was a positive relation of serum ALP and the risk of new-onset diabetes (per SD increment, adjusted OR, 1.07; 95% CI: 1.01, 1.14) and new-onset IFG (per SD increment, adjusted OR, 1.07; 95% CI: 1.02, 1.14). Moreover, a stronger positive association between baseline ALP (per SD increment) with new-onset diabetes was found in participants with total homocysteine (tHcy) < 10 μmol/L (adjusted OR, 1.24; 95% CI: 1.10, 1.40 vs. ≥ 10 μmol/L: adjusted OR, 1.03; 95% CI: 0.96, 1.10; P-interaction = 0.007) or FG ≥ 5.9 mmol/L (adjusted OR, 1.16; 95% CI: 1.07, 1.27 vs. < 5.9 mmol/L: adjusted OR, 1.00; 95% CI: 0.93, 1.08; P-interaction = 0.009) Conclusions In this non-diabetic, hypertensive population, higher serum ALP was significantly associated with the increased risk of new-onset diabetes, especially in those with lower tHcy or higher FG levels. Clinical Trial Registration-URL Trial registration: NCT00794885 (clinicaltrials.gov). Retrospectively registered November 20, 2008.

scholarly journals Serum alkaline phosphatase levels and the risk of new-onset diabetes in hypertensive adults

2020 ◽  
Author(s):  
Yuanyuan Zhang ◽  
Chun Zhou ◽  
Jianping Li ◽  
Yan Zhang ◽  
Di Xie ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
Fasting Glucose ◽  
Serum Alkaline Phosphatase ◽  
Positive Association ◽  
Trial Registration ◽  
Clinical Trial Registration ◽  
Onset Diabetes ◽  
Increased Risk ◽  
New Onset

Abstract Background: The association between alkaline phosphatase (ALP) and incident diabetes remains uncertain. Our study aimed to investigate the prospective relation of serum ALP with the risk of new-onset diabetes, and explore possible effect modifiers, in hypertensive adults.Methods: A total 14,393 hypertensive patients with available ALP measurements and without diabetes and liver disease at baseline were included from the China Stroke Primary Prevention Trial (CSPPT). The primary outcome was new-onset diabetes, defined as physician-diagnosed diabetes or use of glucose-lowering drugs during follow-up, or fasting glucose ≥7.0mmol/L at the exit visit. The secondary study outcome was new-onset impaired fasting glucose (IFG), defined as FG <6.1mmol/L at baseline and ≥6.1 but <7.0mmol/L at the exit visit.Results: Over a median of 4.5 years follow-up, 1,549 (10.8%) participants developed diabetes. Overall, there was a positive relation of serum ALP and the risk of new-onset diabetes (per SD increment, adjusted OR, 1.07; 95%CI: 1.01, 1.14) and new-onset IFG (per SD increment, adjusted OR, 1.07; 95%CI: 1.02, 1.14). Moreover, a stronger positive association between baseline ALP (per SD increment) with new-onset diabetes was found in participants with total homocysteine (tHcy) <10μmol/L (adjusted OR, 1.24; 95%CI: 1.10, 1.40 vs. ≥10μmol/L: adjusted OR, 1.03; 95%CI: 0.96, 1.10; P-interaction=0.007) or FG ≥5.9mmol/L (adjusted OR, 1.16; 95%CI: 1.07, 1.27 vs. <5.9mmol/L: adjusted OR, 1.00; 95%CI: 0.93, 1.08; P-interaction =0.009)Conclusions: In this non-diabetic, hypertensive population, higher serum ALP was significantly associated with the increased risk of new-onset diabetes, especially in those with lower tHcy or higher FG levels.Clinical Trial Registration-URL: Trial registration: NCT00794885 (clinicaltrials.gov). Retrospectively registered November 20, 2008.

scholarly journals Serum alkaline phosphatase levels and the risk of new-onset diabetes in hypertensive adults

2020 ◽  
Author(s):  
Yuanyuan Zhang ◽  
Chun Zhou ◽  
Jianping Li ◽  
Yan Zhang ◽  
Di Xie ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
Fasting Glucose ◽  
Serum Alkaline Phosphatase ◽  
Positive Association ◽  
Trial Registration ◽  
Clinical Trial Registration ◽  
Onset Diabetes ◽  
Increased Risk ◽  
New Onset

Abstract Background: The association between alkaline phosphatase (ALP) and incident diabetes remains uncertain. Our study aimed to investigate the prospective relation of serum ALP with the risk of new-onset diabetes, and explore possible effect modifiers, in hypertensive adults. Methods: A total 14,393 hypertensive patients with available ALP measurements and without diabetes and liver disease at baseline were included from the China Stroke Primary Prevention Trial (CSPPT). The primary outcome was new-onset diabetes, defined as physician-diagnosed diabetes or use of glucose-lowering drugs during follow-up, or fasting glucose ≥7.0mmol/L at the exit visit. The secondary study outcome was new-onset impaired fasting glucose (IFG), defined as FG <6.1mmol/L at baseline and ≥6.1 but <7.0mmol/L at the exit visit.Results: Over a median of 4.5 years follow-up, 1,549 (10.8%) participants developed diabetes. Overall, there was a positive relation of serum ALP and the risk of new-onset diabetes (per SD increment, adjusted OR, 1.07; 95%CI: 1.01, 1.14) and new-onset IFG (per SD increment, adjusted OR, 1.07; 95%CI: 1.02, 1.14). Moreover, a stronger positive association between baseline ALP (per SD increment) with new-onset diabetes was found in participants with total homocysteine (tHcy) <10μmol/L (adjusted OR, 1.24; 95%CI: 1.10, 1.40 vs. ≥10μmol/L: adjusted OR, 1.03; 95%CI: 0.96, 1.10; P-interaction=0.007) or FG ≥5.9mmol/L (adjusted OR, 1.16; 95%CI: 1.07, 1.27 vs. <5.9mmol/L: adjusted OR, 1.00; 95%CI: 0.93, 1.08; P-interaction =0.009)Conclusions: In this non-diabetic, hypertensive population, higher serum ALP was significantly associated with the increased risk of new-onset diabetes, especially in those with lower tHcy or higher FG levels.Clinical Trial Registration-URL: Trial registration: NCT00794885 (clinicaltrials.gov). Retrospectively registered November 20, 2008.

U-shaped Association Between Dietary Zinc Intake and New-onset Diabetes: A Nationwide Cohort Study in China

2021 ◽  
Author(s):  
Panpan He ◽  
Huan Li ◽  
Mengyi Liu ◽  
Zhuxian Zhang ◽  
Yuanyuan Zhang ◽  
...  
Keyword(s):  
Chinese Adults ◽  
Dietary Zinc ◽  
Nutrition Survey ◽  
Zinc Intake ◽  
Health And Nutrition ◽  
Onset Diabetes ◽  
Household Food Inventory ◽  
Diagnosed Diabetes ◽  
New Onset

Abstract Aims We aimed to investigate the relationship of dietary zinc intake with new-onset diabetes among Chinese adults. Materials and Methods A total of 16 257 participants who were free of diabetes at baseline from the China Health and Nutrition Survey were included. Dietary intake was measured by 3 consecutive 24-hour dietary recalls combined with a household food inventory. Participants with self-reported physician-diagnosed diabetes, or fasting glucose ≥ 7.0 mmol/L, or glycated hemoglobin ≥ 6.5% during the follow-up were defined as having new-onset diabetes. Results A total of 1097 participants developed new-onset diabetes during a median follow-up duration of 9.0 years. Overall, the association between dietary zinc intake and new-onset diabetes followed a U-shape (P for nonlinearity &lt; 0.001). The risk of new-onset diabetes was significantly lower in participants with zinc intake &lt; 9.1 mg/day (per mg/day: hazard ratio [HR], 0.73; 95% CI, 0.60-0.88), and higher in those with zinc intake ≥ 9.1 mg/day (per mg/day: HR, 1.10; 95% CI, 1.07-1.13). Consistently, when dietary zinc intake was assessed as deciles, compared with those in deciles 2-8 (8.9 -&lt;12.2 mg/day), the risk of new-onset diabetes was higher for decile 1 (&lt;8.9 mg/day: HR, 1.29; 95% CI, 1.04-1.62), and deciles 9 to 10 (≥12.2 mg/day: HR, 1.62; 95% CI, 1.38-1.90). Similar U-shaped relations were found for plant-derived or animal-derived zinc intake with new-onset diabetes (all P for nonlinearity &lt; 0.001). Conclusions There was a U-shaped association between dietary zinc intake and new-onset diabetes in general Chinese adults, with an inflection point at about 9.1 mg/day.

scholarly journals Plasma Malondialdehyde and Risk of New-Onset Diabetes after Transplantation in Renal Transplant Recipients: A Prospective Cohort Study

2019 ◽  
Vol 8 (4) ◽  
pp. 453 ◽  
Author(s):  
Manuela Yepes-Calderón ◽  
Camilo Sotomayor ◽  
António Gomes-Neto ◽  
Rijk Gans ◽  
Stefan Berger ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Renal Transplant ◽  
Cox Proportional Hazards ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Dietary Antioxidants ◽  
Onset Diabetes ◽  
Plasma Malondialdehyde ◽  
New Onset

New-onset diabetes after transplantation (NODAT) is a frequent complication in renal transplant recipients (RTR). Although oxidative stress has been associated with diabetes mellitus, data regarding NODAT are limited. We aimed to prospectively investigate the long-term association between the oxidative stress biomarker malondialdehyde (measured by high-performance liquid chromatography) and NODAT in an extensively phenotyped cohort of non-diabetic RTR with a functioning graft ≥1 year. We included 516 RTR (51 ± 13 years-old, 57% male). Median plasma malondialdehyde (MDA) was 2.55 (IQR, 1.92–3.66) µmol/L. During a median follow-up of 5.3 (IQR, 4.6–6.0) years, 56 (11%) RTR developed NODAT. In Cox proportional-hazards regression analyses, MDA was inversely associated with NODAT, independent of immunosuppressive therapy, transplant-specific covariates, lifestyle, inflammation, and metabolism parameters (HR, 0.55; 95% CI, 0.36–0.83 per 1-SD increase; p < 0.01). Dietary antioxidants intake (e.g., vitamin E, α-lipoic acid, and linoleic acid) were effect-modifiers of the association between MDA and NODAT, with particularly strong inverse associations within the subgroup of RTR with relatively higher dietary antioxidants intake. In conclusion, plasma MDA concentration is inversely and independently associated with long-term risk of NODAT in RTR. Our findings support a potential underrecognized role of oxidative stress in post-transplantation glucose homeostasis.

scholarly journals Vitamin B12 and risk of diabetes: new insight from cross-sectional and longitudinal analyses of the China Stroke Primary Prevention Trial (CSPPT)

2020 ◽  
Vol 8 (1) ◽  
pp. e001423
Author(s):  
Lishun Liu ◽  
Xiao Huang ◽  
Binyan Wang ◽  
Yun Song ◽  
Tengfei Lin ◽  
...  
Keyword(s):  
Primary Prevention ◽  
Positive Association ◽  
Prevention Trial ◽  
Vitamin B ◽  
Longitudinal Analyses ◽  
Primary Prevention Trial ◽  
Cross Sectional ◽  
Onset Diabetes ◽  
New Onset

IntroductionPrevious studies in mostly Western populations have yielded conflicting findings on the association of vitamin B12 with diabetes risk, in part due to differences in study design and population characteristics. This study sought to examine the vitamin B12–diabetes association in Chinese adults with hypertension by both cross-sectional and longitudinal analyses.Research design and methodsThis report included a total of 16 699 participants from the China Stroke Primary Prevention Trial, with pertinent baseline and follow-up data. Diabetes mellitus was defined as either physician-diagnosed diabetes, use of glucose-lowering drugs, or fasting blood glucose (FBG) ≥7.0 mmol/L. New-onset diabetes was defined as any new case of onset diabetes during the follow-up period or FBG ≥7.0 mmol/L at the exit visit.ResultsAt baseline, there were 1872 (11.2%) patients with diabetes; less than 1.5% had clinical vitamin B12 deficiency (<148.0 pmol/L). Over a median follow-up period of 4.5 years, there were 1589 (10.7%) cases of new-onset diabetes. Cross-sectional analyses showed a positive association between baseline vitamin B12 levels and FBG levels (β=0.18, 95% CI 0.15 to 0.21) and diabetes (OR=1.16, 95% CI 1.10 to 1.21). However, longitudinal analyses showed no association between baseline vitamin B12 and new-onset diabetes or changes in FBG levels. Among a subset of the sample (n=4366) with both baseline and exit vitamin B12 measurements, we found a positive association between an increase in vitamin B12 and an increase in FBG.ConclusionsIn this large Chinese population of patients with hypertension mostly sufficient with vitamin B12, parallel cross-sectional and longitudinal analyses provided new insight into the conflicting findings of previous studies, and these results underscore the need for future studies to consider both baseline vitamin B12 and its longitudinal trajectory in order to better elucidate the role of vitamin B12 in the development of diabetes. Such findings would have important clinical and public health implications.

scholarly journals Predictors of new-onset diabetes mellitus in hypertensive patients: the VALUE trial

2008 ◽  
Vol 22 (8) ◽  
pp. 520-527 ◽  
Author(s):  
T A Aksnes ◽  
S E Kjeldsen ◽  
M Rostrup ◽  
Ö Störset ◽  
T A Hua ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Hypertensive Patients ◽  
Onset Diabetes ◽  
New Onset Diabetes Mellitus ◽  
New Onset

scholarly journals IMPACT OF PITAVASTATIN ON DEVELOPMENT OF NEW-ONSET DIABETES MELLITUS IN ASIAN POPULATION: THREE-YEAR CLINICAL FOLLOW UP RESULTS

2014 ◽  
Vol 63 (12) ◽  
pp. A2132
Author(s):  
Yoonjee Park ◽  
Seung-Woon Rha ◽  
Byoung Geol Choi ◽  
Se Yeon Choi ◽  
akkala goud ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Asian Population ◽  
Onset Diabetes ◽  
New Onset Diabetes Mellitus ◽  
New Onset

scholarly journals IMPACT OF SIMVASTATIN ON DEVELOPMENT OF NEW-ONSET DIABETES MELLITUS IN ASIAN POPULATION: THREE-YEAR CLINICAL FOLLOW UP RESULTS

2014 ◽  
Vol 63 (12) ◽  
pp. A2128
Author(s):  
Yoonjee Park ◽  
Seung-Woon Rha ◽  
Byoung Geol Choi ◽  
Se Yeon Choi ◽  
akkala goud ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Asian Population ◽  
Onset Diabetes ◽  
New Onset Diabetes Mellitus ◽  
New Onset

Endoscopic third ventriculostomy: outcome analysis in 368 procedures

2010 ◽  
Vol 5 (1) ◽  
pp. 68-74 ◽  
Author(s):  
Oumar Sacko ◽  
Sergio Boetto ◽  
Valérie Lauwers-Cances ◽  
Martin Dupuy ◽  
Franck-Emmanuel Roux
Keyword(s):  
Endoscopic Third Ventriculostomy ◽  
Hospital Admissions ◽  
Outcome Analysis ◽  
Morbidity Rate ◽  
Third Ventriculostomy ◽  
Safe Procedure ◽  
Chronic Hydrocephalus ◽  
Risk Of Failure ◽  
Increased Risk

Object Although endoscopic third ventriculostomy (ETV) has been accepted as a procedure of choice for the treatment of obstructive hydrocephalus, the outcome of this treatment remains controversial with regard to age, cause, and long-term follow-up results. The goal of this study was to assess the risk of failure associated with these factors in a retrospective cohort study. Methods Between 1999 and 2007, 368 ETVs were performed in 350 patients (165 patients < 18 years of age) with hydrocephalus at the University Hospital of Toulouse. Failure of ETV was defined as cases requiring any subsequent surgical procedure for CSF diversion or death related to hydrocephalus management. Results Tumors (53%), primary aqueductal stenosis (18%), and intracranial hemorrhage (13%) were the most common causes of hydrocephalus. The median follow-up period was 47 months (range 6–106 months), and the overall success rate was 68.5% (252 of the 368 procedures). Patients < 6 months of age had a 5-fold increased risk of ETV failure than older patients (adjusted hazard ratio [HRa] 5.0; 95% CI 2.4–10.4; p < 0.001). Hemorrhage-related (HRa 4.0; 95% CI 1.9–8.5; p < 0.001) and idiopathic chronic hydrocephalus (HRa 6.3, 95% CI 2.5–15.0, p < 0.001) had a higher risk of failure than other causes. Most failures (97%) occurred within 2 months of the initial procedure. The overall morbidity rate was 10%, although most complications were minor. Finally, the introduction of ETV in the authors' department reduced the number of shunt insertions and hospital admissions for shunt failures by half and was a source of cost savings. Conclusions Endoscopic third ventriculostomy is a safe procedure and an effective treatment option for hydrocephalus. Factors indicating potential poor ETV outcome seem to be very young children and hemorrhage-related and chronic hydrocephalus in adults.

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