scholarly journals Insulin resistance as estimated by the homeostatic method at diagnosis of gestational diabetes: estimation of disease severity and therapeutic needs in a population-based study

2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Alina Sokup ◽  
Barbara Ruszkowska-Ciastek ◽  
Krzysztof Góralczyk ◽  
Małgorzata Walentowicz ◽  
Marek Szymański ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Gestational Diabetes ◽  
Disease Severity ◽  
Population Based ◽  
Population Based Study ◽  
Therapeutic Needs

scholarly journals 0574 Prevalence and Characteristics of Rapid Eye Movement Obstructive Sleep Apnoea (REM OSA) in a Multi-Ethnic OSA Cohort

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A220-A220
Author(s):  
H Wong ◽  
Y Poh ◽  
Y Mok
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Disease Severity ◽  
Univariate Analysis ◽  
Tertiary Hospital ◽  
Population Based ◽  
Sleep Apnoea ◽  
Lower Prevalence ◽  
Population Based Study ◽  
Obstructive Sleep

Abstract Introduction Recent studies have shown that REM OSA is associated with increased incidence of hypertension and insulin resistance. However, there is a lack of Asian data on REM OSA. Our study aimed to examine the prevalence and characteristics of REM OSA in a multi-ethnic OSA cohort. Methods This was a retrospective observational study of all patients who underwent an overnight diagnostic polysomnography at a Singapore tertiary hospital from 1st August 2017 to 31st August 2018. All patients with a diagnosis of OSA (Apnoea Hypopnea Index (AHI) ≥5) were included in the study. REM OSA is defined as an overall AHI≥5, REM AHI/Non REM (NREM) AHI>2, NREM AHI<15 and at least 15 minutes of REM sleep. Results 457 OSA subjects were included in the analysis. 19% (87/457) had REM OSA. Univariate analysis showed that REM OSA was more prevalent among female OSA than male OSA [34/115 (29.6%) versus 53/342 (15.5%) respectively, p<0.001]. Compared to non REM OSA, REM OSA had milder OSA severity [mean AHI 12.74±4.71 versus 45.34±28.38, p<0.001] and lower prevalence of hypertension [21/87 (24.1%) versus 138/370(37.3%), p=0.02]. No differences were found between both groups for age (p=0.273), ethnicity (p=0.615), Body Mass Index (p=0.336), diabetes mellitus (p=0.245) and Epworth Sleepiness Scale (0.06). Gender and OSA severity differences between both groups remained statistically significant in multivariate analysis (higher prevalence of REM OSA in female, p=0.043 and milder disease severity in REM OSA, p=0.006). Conclusion REM OSA was common in our OSA cohort and had higher prevalence in female and milder disease severity compared to non REM OSA. However, we did not find an increased prevalence of hypertension or diabetes mellitus in REM OSA. Further population-based study on REM OSA is needed to understand this phenotype better. Support NIL

scholarly journals Very similar cardiometabolic profile in the moderate and high cardiovascular risk classes: a population-based study

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
M Chlabicz ◽  
J Jamolkowski ◽  
W Laguna ◽  
P Sowa ◽  
M Paniczko ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Population Based ◽  
Low Risk ◽  
Public Institution ◽  
Population Based Study ◽  
The Metabolic Syndrome ◽  
Cardiometabolic Profile

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Medical University of Bialystok, Poland Background Cardiovascular disease (CVD) is a major, worldwide problem and remain the dominant cause of premature mortality in the word. Simultaneously the metabolic syndrome is a growing problem. The aim of this study was to investigate the cardiometabolic profile among cardiovascular risk classes, and to estimate CV risk using various calculators. Methods The longitudinal, population-based study, was conducted in 2017-2020. A total of 931 individuals aged 20-79 were included. Anthropometric and biochemical profiles were measured according to a standardized protocols. The study population was divided into CV risk classes according to the latest recommendation. Comparisons variables between subgroups were conducted using Dwass-Steele-Critchlow-Fligner test. To estimate CV risk were used: the  Systematic Coronary Risk Estimation system, Framingham Risk Score and LIFEtime-perspective model for individualizing CardioVascular Disease prevention strategies in apparently healthy people (LIFE-CVD). Results The mean age was 49.1± 15.5 years, 43.2% were male. Percentages of low-risk, moderate-risk, high-risk and very-high CV risk were 46.1%, 22.8%, 13.5%, 17.6%, respectively. Most of the analyzed anthropometric, body composition and laboratory parameters did not differ between the moderate and high CV risk participants, whereas the low risk group differed significantly. In the moderate and high-risk groups, abdominal distribution of adipose tissue dominated with significantly elevated parameters of insulin resistance. Interestingly, estimating lifetime risk of myocardial infarction, stroke or CV death using LIFE-CVD calculator yielded similar results in moderate and high CV risk classes. Conclusion The participants belonging to moderate and high CV risk classes have a very similar unfavorable cardiometabolic profile which may result in the similar lifetime CV risk. This may imply the need for more aggressive pharmacological and non-pharmacological management of CV risk factors in the moderate CV risk population. It would be advisable to consider combining the moderate and high risk classes into one high CV risk class, or it may be worth adding one of the parameters of abdominal fat distribution to the CV risk calculators as an expression of increased insulin resistance. Abstract Figure 1.

scholarly journals BMI and risk of gestational diabetes among women of South Asian and Chinese ethnicity: a population-based study

Diabetologia ◽  
2021 ◽  
Author(s):  
Stephanie H. Read ◽  
Laura C. Rosella ◽  
Howard Berger ◽  
Denice S. Feig ◽  
Karen Fleming ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
South Asian ◽  
Population Based ◽  
Population Based Study ◽  
Chinese Ethnicity

P-646 Pregnancy outcomes in women with panhypopituitarism - A population-based study

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
I Feferkorn ◽  
A Badeghiesh ◽  
H Baghlaf ◽  
M Dahan
Keyword(s):  
Gestational Diabetes ◽  
Maternal Death ◽  
Pregnancy Outcomes ◽  
Post Partum ◽  
Population Based ◽  
Neonatal Outcomes ◽  
Pituitary Hormone ◽  
Population Based Study ◽  
Post Partum Hemorrhage

Abstract Study question What are the consequences of panhypopituitarism on pregnancy outcomes? Summary answer After controlling for confounding effects, women with panhypopituitarism have a higher prevalence of adverse obstetrical (including post-partum hemorrhage, hysterectomy and maternal death) and neonatal outcomes. What is known already Panhypopituitarism is a condition of inadequate or absent anterior pituitary hormone production. Pregnancy in women with panhypopituitarism is uncommon and there is only limited data (mainly case reports) regarding pregnancy outcomes in these women. Given the scarcity of data we sought to assess the association between panhypopituitarism and obstetrical and neonatal outcomes. Study design, size, duration A retrospective population-based study utilizing data from the Healthcare Cost and Utilization Project—Nationwide Inpatient Sample (HCUP-NIS). A dataset of all deliveries between 2004 and 2014 inclusively, was created. Within this group, all deliveries to women who had a diagnosis of panhypopituitarism during pregnancy were identified as part of the study group (n = 179), and the remaining deliveries comprised the reference group (n = 9,096,609). Participants/materials, setting, methods The HCUP-NIS is the largest inpatient sample database in the USA, and it is comprised of hospitalizations throughout the country. It provides information relating to 20% of US admissions and represents over 96% of the American population. Multivariate logistic regression analysis, controlling for confounding effects, was conducted to explore associations between panhypopituitarism and delivery and neonatal outcomes. According to Tri-Council Policy statement (2018), IRB approval was not required, given data was anonymous and publicly available. Main results and the role of chance Women with a diagnosis of panhypopituitarism were more likely to be older, to have a diagnosis of chronic hypertension, to have a diagnosis of pre-gestational diabetes mellitus and to be carrying twins or a higher order pregnancy (all p < 0.0001), than the controls. A significantly higher risk of post-partum hemorrhage (adjusted odds ratio-aOR:3.52; 95%CI:2.18–5.69,p < 0.0001), maternal infection (aOR:3.97; 95%CI:2.30–6.85,p < 0.0001), pulmonary embolism (aOR:14.90; 95%CI:2.06–107.82,p < 0.007), disseminated intravascular coagulation (aOR:20.29; 95%CI:10.60–38.85,p < 0.0001), maternal death (aOR:31.90; 95%CI:3.33–234.85,p = 0.001) and congenital anomalies (aOR:4.55; 95CI:1.86–11.16,p = 0.001), were found among the panhypopituitarism patients. Surprisingly, there was a lower incidence of caesarean delivery (aOR:0.69; 95%CI:0.50–0.96,p = 0.026) in the panhypopituitarism patients than the controls. No significant difference was found in the rate of pregnancy induced hypertension (95%CI:0.78-1.97), gestational hypertension (95%CI:0.14-1.41), preeclampsia (95%CI:0.96-2.99), gestational diabetes (95%CI:0.30-1.01), preterm delivery (95%CI:0.74-1.91), preterm premature rupture of membranes (95%CI:0.17-2.82), operative vaginal delivery (95%CI: 0.23-1.19), small for gestational age neonates (95%CI:0.27-2.02) or intra-uterine fetal demise (95%CI:0.13-6.71). Limitations, reasons for caution The limitations of our study are its retrospective nature and the fact that it relies on an administrative database. The severity of specific hormonal deficiencies and the presence and magnitude of posterior pituitary hormone deficiencies could not be assessed, nor could compliance with hormone replacement. Wider implications of the findings Until now, no control studies of outcomes with panhypopituitaryism in pregnancy are available in the medical literature. Physicians should be aware of and try to prevent the above possible maternal and fetal complications related to this endocrinopathy. Future studies should evaluate the role of medication compliance with pregnancy outcomes. Trial registration number not applicable

P–646 Pregnancy outcomes in women with panhypopituitarism - A population-based study

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
I Feferkorn ◽  
A Badeghiesh ◽  
H Baghlaf ◽  
M Dahan
Keyword(s):  
Gestational Diabetes ◽  
Maternal Death ◽  
Pregnancy Outcomes ◽  
Post Partum ◽  
Population Based ◽  
Neonatal Outcomes ◽  
Pituitary Hormone ◽  
Population Based Study ◽  
Post Partum Hemorrhage

Abstract Study question What are the consequences of panhypopituitarism on pregnancy outcomes? Summary answer After controlling for confounding effects, women with panhypopituitarism have a higher prevalence of adverse obstetrical (including post-partum hemorrhage, hysterectomy and maternal death) and neonatal outcomes. What is known already Panhypopituitarism is a condition of inadequate or absent anterior pituitary hormone production. Pregnancy in women with panhypopituitarism is uncommon and there is only limited data (mainly case reports) regarding pregnancy outcomes in these women. Given the scarcity of data we sought to assess the association between panhypopituitarism and obstetrical and neonatal outcomes. Study design, size, duration A retrospective population-based study utilizing data from the Healthcare Cost and Utilization Project—Nationwide Inpatient Sample (HCUP-NIS). A dataset of all deliveries between 2004 and 2014 inclusively, was created. Within this group, all deliveries to women who had a diagnosis of panhypopituitarism during pregnancy were identified as part of the study group (n = 179), and the remaining deliveries comprised the reference group (n = 9,096,609). Participants/materials, setting, methods The HCUP-NIS is the largest inpatient sample database in the USA, and it is comprised of hospitalizations throughout the country. It provides information relating to 20% of US admissions and represents over 96% of the American population. Multivariate logistic regression analysis, controlling for confounding effects, was conducted to explore associations between panhypopituitarism and delivery and neonatal outcomes. According to Tri-Council Policy statement (2018), IRB approval was not required, given data was anonymous and publicly available. Main results and the role of chance Women with a diagnosis of panhypopituitarism were more likely to be older, to have a diagnosis of chronic hypertension, to have a diagnosis of pre-gestational diabetes mellitus and to be carrying twins or a higher order pregnancy (all p < 0.0001), than the controls. A significantly higher risk of post-partum hemorrhage (adjusted odds ratio-aOR:3.52; 95%CI:2.18–5.69,p<0.0001), maternal infection (aOR:3.97; 95%CI:2.30–6.85,p<0.0001), pulmonary embolism (aOR:14.90; 95%CI:2.06–107.82,p<0.007), disseminated intravascular coagulation (aOR:20.29; 95%CI:10.60–38.85,p< 0.0001), maternal death (aOR:31.90; 95%CI:3.33–234.85,p=0.001) and congenital anomalies (aOR:4.55; 95CI:1.86–11.16,p=0.001), were found among the panhypopituitarism patients. Surprisingly, there was a lower incidence of caesarean delivery (aOR:0.69; 95%CI:0.50–0.96,p=0.026) in the panhypopituitarism patients than the controls. No significant difference was found in the rate of pregnancy induced hypertension (95%CI:0.78–1.97), gestational hypertension (95%CI:0.14–1.41), preeclampsia (95%CI:0.96–2.99), gestational diabetes (95%CI:0.30–1.01), preterm delivery (95%CI:0.74–1.91), preterm premature rupture of membranes (95%CI:0.17–2.82), operative vaginal delivery (95%CI:0.23–1.19), small for gestational age neonates (95%CI:0.27–2.02) or intra-uterine fetal demise (95%CI:0.13–6.71). Limitations, reasons for caution The limitations of our study are its retrospective nature and the fact that it relies on an administrative database. The severity of specific hormonal deficiencies and the presence and magnitude of posterior pituitary hormone deficiencies could not be assessed, nor could compliance with hormone replacement. Wider implications of the findings: Until now, no control studies of outcomes with panhypopituitaryism in pregnancy are available in the medical literature. Physicians should be aware of and try to prevent the above possible maternal and fetal complications related to this endocrinopathy. Future studies should evaluate the role of medication compliance with pregnancy outcomes. Trial registration number Not applicable

Elevated fasting vs post‐load glucose levels and pregnancy outcomes in gestational diabetes: a population‐based study

2019 ◽  
Vol 37 (1) ◽  
pp. 114-122 ◽  
Author(s):  
E. A. Ryan ◽  
A. Savu ◽  
R. O. Yeung ◽  
L. E. Moore ◽  
S. L. Bowker ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Pregnancy Outcomes ◽  
Population Based ◽  
Population Based Study ◽  
Glucose Levels
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