scholarly journals MON-634 Difference in Risk Factors Between Adults with Early Onset (<40 Years Old) Versus Late Onset (≥40 Years Old) Diabetes Mellitus Type 2 at the University of Santo Tomas Hospital from January 2015-December 2017

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Marilyn Katrina Castro Caro ◽  
Elaine Cheeay Cunanan
Keyword(s):  
Diabetes Mellitus ◽  
Early Onset ◽  
Late Onset ◽  
Microvascular Complications ◽  
Duration Of Diabetes ◽  
History Of ◽  
The Mean ◽  
Onset Group ◽  
Early Onset Group

Abstract INTRODUCTION: Diabetes will remain a threat to global health. The global burden of type 2 diabetes mellitus is significant and rising, with most of the increase occurring in the last two decades. While most of the rise in the prevalence of Type 2 diabetes mellitus occurs in the middle-aged and the elderly, it is becoming more common in younger patients. No longer just a disorder of mature age, there is now a well-recognized trend toward younger people presenting with the disease. METHODS: This was a cross sectional study of medical records of adult patients at the University of Santo Tomas Hospital who met the inclusion criteria from January 2015 to December 2017. The subjects were divided into early onset (&lt;40 years of age) and the late onset (≥40 years of age) group. Mean, standard deviation, counts and percentages were used to summarize data. The mean values of continuous variables between the two groups were analyzed using the independent sample t-test while categorical variables were analyzed using Chi square test. Logistic regression analysis was used to determine the association of age of onset and duration of diabetes to its complications. RESULTS: The mean age for the early onset group was 34 years old, while that of the late onset group was 51 years old. No gender predilection was observed in both groups. The subjects of the early onset group were mostly obese as compared to the late onset group who were mostly overweight. Both groups were mostly smokers, and had a positive family history with an almost equal proportion of females having a history of gestational diabetes. The early onset group had higher hba1c and worse lipid profiles upon diagnosis. The most common comorbid illnesses observed in both groups include hypertension, dyslipidemia, fatty liver and metabolic syndrome. In terms of macrovascular complications, the frequency of myocardial infarction was higher in the late onset group. For the microvascular complications, the proportion of retinopathy was higher in the early onset group while the frequency of neuropathy was higher in the late onset group. Lastly, for both groups, the duration of diabetes was associated with microvascular complications such that for every year increase in the duration of diabetes, patients were more likely to develop retinopathy and neuropathy. CONCLUSION: The mean age of Filipinos with early onset diabetes were at least 5 years younger as compared to Caucasians. Moreover, they were more obese, had worse lipid profiles and higher Hba1C levels. Among the macrovascular and microvascular complications, a higher proportion of the late onset group had peripheral neuropathy and had history of myocardial infarction while retinopathy was more prevalent in the early onset group. Lastly, for every year increase in the duration of diabetes, patients were more likely to develop retinopathy and neuropathy.

scholarly journals The Constellation of Macrovascular Risk Factors in Early Onset T2DM: A Cross-Sectional Study in Xinjiang Province, China

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Mingchen Zhang ◽  
Jiangfeng Mao ◽  
Ablikm Tuerdi ◽  
Xiaoyun Zeng ◽  
Li Quan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Early Onset ◽  
Late Onset ◽  
Microvascular Complications ◽  
Macrovascular Complications ◽  
Control Group ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Onset Group ◽  
Early Onset Group

Background. Despite a rapid popular of early onset type 2 diabetes (defined as diagnosis at <40 years old) recently, there is a lack of studies on this population in economically undeveloped area. We aimed to investigate the risk factors of macrovascular complications in the early onset T2DM patients in Xinjiang, China. Methods. A cross-sectional survey of 1736 consecutive patients with T2DM was conducted. Macrovascular complications and risk factors were documented. Another nondiabetic population matched with age and sex was as a control group. Logistic regression analysis was performed to obtain odds ratios (OR) for macrovascular complications in early and late onset T2DM, respectively. Results. The final analysis consisted of 1036 late onset and 219 early onset T2DM patients. The mean HbA1c in the early onset group was higher than that in the late onset group (9.1 ± 2.4% versus 8.3 ± 2.2%, P=0.039) despite a higher proportion of patients in the early onset group receiving insulin treatment (73.1% versus 58.7%, P<0.001). Compared to the control, early onset patients had higher blood pressure and worse lipid profiles (all P<0.01). More than half of the early onset T2DM patients already had macro- and microvascular complications, despite of their young age (39.5 ± 10.8) and short DM duration (6.6 ± 8.0). In the early onset group, women had a ~3-fold hazard of atherosclerotic plaques compared with men (OR 3.22, 95% CI 1.53–6.78). Conclusions. Patients with early onset T2DM have worse glycemic control and higher burden of atherogenic risk factors. The prevalence of macro- and microvascular complications is astonishingly high in these young adults with T2DM. Moreover, young women with T2DM are more susceptible to cardiovascular complications than their male counterpart.

scholarly journals Differences in Clinical and Dietary Characteristics, Serum Adipokine Levels, and Metabolomic Profiles between Early- and Late-Onset Gout

Metabolites ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 399
Author(s):  
Young Sun Suh ◽  
Hae Sook Noh ◽  
Hyun-Jin Kim ◽  
Yun-Hong Cheon ◽  
Mingyo Kim ◽  
...  
Keyword(s):  
Early Onset ◽  
Late Onset ◽  
Clinical Information ◽  
Plasminogen Activator Inhibitor ◽  
Ultra Performance Liquid Chromatography ◽  
Plasminogen Activator Inhibitor 1 ◽  
Baseline Serum ◽  
Onset Group ◽  
Early Onset Group ◽  
Pai 1

This study aimed to identify differences in clinical and dietary characteristics, serum adipokine levels, and metabolomic profiles between early- and late-onset gout. Eighty-three men with gout were divided into an early-onset group (n = 38, aged < 40 years) and a late-onset group (n = 45, aged ≥ 40 years). Dietary and clinical information was obtained at baseline. Serum adipokines, including adiponectin, resistin, leptin, and plasminogen activator inhibitor-1 (PAI-1), were quantified by a Luminex multiplex immunoassay. Metabolite expression levels in plasma were measured in 22 representative samples using metabolomics analysis based on ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry. Average body mass index, rate of consumption of sugar-sweetened beverages, and serum uric acid levels were significantly higher in the early-onset group (p < 0.05), as was the PAI-I concentration (105.01 ± 42.45 ng/mL vs. 83.76 ± 31.16 ng/mL, p = 0.013). Changes in levels of metabolites mostly involved those related to lipid metabolism. In the early-onset group, acylcarnitine analog and propylparaben levels were downregulated and negatively correlated with the PAI-1 concentration whereas LPC (22:6) and LPC (18:0) levels were upregulated and positively correlated with the PAI-1 concentration. Dietary and clinical features, serum adipokine concentrations, and metabolites differed according to whether the gout is early-onset or late-onset. The mechanisms of gout may differ between these groups and require different treatment approaches.

scholarly journals Assessing the Prevalence and Predicting Factors of an Abnormal Gated Myocardial Perfusion SPECT in Asymptomatic Patients with Type 2 Diabetes

2021 ◽  
Author(s):  
Elinaz Hosseinzadeh ◽  
Mohammadali Ghodsirad ◽  
Toktam Alirezaei ◽  
Maryam Arefnia ◽  
Mahasti Amoui ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Male Gender ◽  
Silent Myocardial Ischemia ◽  
Duration Of Diabetes ◽  
Predicting Factors ◽  
Asymptomatic Patients ◽  
History Of

Abstract IntroductionConsidering the significant prevalence of silent myocardial ischemia and its related morbidity and mortality in asymptomatic type two diabetic patients, it is not well known whether early screening with MPI is cost-effective. However, predicting factors are not elucidated. Materials and MethodsThis was a cross-sectional study including 63 asymptomatic patients with type 2 diabetes mellitus (T2DM), with normal ECG and ejection fraction. Patients with any history of documented valvular, congestive or ischemic heart disease, renal or hepatic failure were excluded. At first all patients were interviewed and checked for risk factors and then patients underwent a two-day rest/stress 99mTc-MIBI gated MPI SPECT. Data was assessed by QPS/QGS and 4DM software and evaluated by a nuclear medicine specialist with summed stress score (SSS) of more than 4 defined as CAD. ResultsThere were 42 females (67%) and 21 males (33%), with a mean age of 61.33 ± 6.98 years and 7.97 ± 4.86 years history of T2DM. CAD was detected in 26 (41.3%) patients and was significantly associated with male gender, smoking, requiring insulin therapy and EF (P-value = 0.019, 0.046, 0.05, 0.033, respectively). A significant association was found between the duration of diabetes, especially when >15y, and the probability of having CAD.. Multivariable logistic regression revealed that smoking; male gender and diabetes duration were the strongest independent predictors of abnormal MPI results.ConclusionWe found a high (46%) prevalence of abnormal stress MPI SPECT in patients with type 2 diabetes mellitus, despite being asymptomatic. Asymptomatic patients with a history of smoking, long duration of diabetes, being under insulin treatment and male gender might benefit from MPI for early detection of silent ischemia.

The Evolution of Dementia in Idiopathic Parkinson's Disease: Neuropsychological and Clinical Evidence in Support of Subtypes

1992 ◽  
Vol 4 (4) ◽  
pp. 147-160 ◽  
Author(s):  
Wayne G. J. Reid
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Early Onset ◽  
Late Onset ◽  
Age At Onset ◽  
Critical Determinant ◽  
Drug Study ◽  
Baseline Phase ◽  
Onset Group ◽  
Early Onset Group

One hundred and seven newly diagnosed, untreated patients with Parkinson's disease (PD) were divided into two groups according to their age at reported onset of symptoms. Of these, 79 patients were under age 70 (early-onset) and 28 patients were age 70 and over (late-onset). The group of 50 control subjects comprised spouses, friends of the PD patients, and community volunteers. The patients were participants in a multicenter drug study of Parkinson's disease. Each had received a detailed neurological and neuropsychological assessment in the baseline placebo phases of the study. Thirty-4 patients with early-onset and 12 patients with late-onset were reassessed 3 years after treatment with low-dose levodopa, with bromocriptine, or with a combination of the two drugs. The results of the baseline phase of the study revealed that 8% of the early-onset group and 32% of the late-onset group were classified as demented. The 3-year follow-up revealed that the prevalence of dementia had increased to 17% in the early-onset group and to 83% in the late-onset group. This study confirms that at least two distinct subtypes of Parkinson's disease exist. The subtypes differ both clinically and neuropsychologically. The age at onset of symptoms is a critical determinant of the rate and type of cognitive decline in Parkinson's disease.

scholarly journals Differences Ratio Level Soluble FMS-Like Tyrosine Kinase-1 and Placental Growth Factor Early And Late Onset on Preeclampsia and Normal Pregnancy

2018 ◽  
Vol 3 (1) ◽  
pp. 83
Author(s):  
Ria Andina ◽  
Yanwirasti Yanwirasti ◽  
Defrin Defrin
Keyword(s):  
Growth Factor ◽  
Tyrosine Kinase ◽  
Early Onset ◽  
Late Onset ◽  
Normal Pregnancy ◽  
Elisa Test ◽  
Placental Growth Factor ◽  
Cross Sectional ◽  
Onset Group ◽  
Early Onset Group

Preeclampsia is a major maternal morbidity and mortality worldwide including in Indonesia. PIGF concentrations were found to be lower and sFlt-1 to be higher in patients with preeclampsia than normal pregnancy. Futher, this factor has been proposed as a parameter that can help identify women with potentially preeclampsia.This study aims todeterminethe differences ratio level soluble rate fms-like tyrosine kinase-1 and placental growth factor early and late onset on preeclampsia and normal pregnancy. The cross sectional study design was conducted in RSUP M.Djamil, Rasidin Hospital, Reksodiwiryo Hospital and Biomedical Laboratory of Andalas University from July 2017 until January 2018. The sample of this study was pregnant women>20-42 weeks pregnancy totalling 80 people by consecutive sampling.Sample was divided into 3 groups. SFlt-1 and PlGF levels tested using ELISA test. Test the normality of data by Kolmogrov-Smirnov test by using unpaired T test.The results showed median sFLT-1 levels in the early onset group with normal pregnancy with p= 0,88, median sFLT-1 levels in the late onset group with normal pregnancy with p= 0,01 and median levels of sFLT-1 in the early onset group with late onset with p= 0.34. Mean of PlGF in the early onset group with normal pregnancy with p=0,30, mean of PlGF in the late onset group with normal pregnancy with p= 0.63, and mean of PlGF in the early onset group with late onset with p = 0.27. The conclusion of this study was that there was a difference ratio level Soluble Fms-Like Tyrosine Kinase-1 late onset in preeclampsia and normal pregnancy.

scholarly journals Timing of chemotherapy-induced neutropenia is a prognostic factor in patients with diffuse large B-cell lymphoma: a retrospective study

2021 ◽  
Author(s):  
Juan Qiu ◽  
Baoxuan Zhang ◽  
Bing Bu ◽  
Shu Fang ◽  
Lihua Song
Keyword(s):  
Early Onset ◽  
Cell Lymphoma ◽  
Late Onset ◽  
Independent Predictor ◽  
B Cell Lymphoma ◽  
Short Term ◽  
Term Efficacy ◽  
Large B Cell Lymphoma ◽  
Onset Group ◽  
Early Onset Group

Abstract Background Chemotherapy-induced neutropenia (CIN) has been shown to be associated with improved clinical outcomes in patients with various solid tumors. The aim of this study was to investigate the relationship between the timing and degree of chemo-induced neutropenia (CIN) and short-term efficacy and survival in newly diagnosed patients with diffuse large B-cell lymphoma (DLBCL).Methods A retrospective study was conducted on 236 newly diagnosed DLBCL patients who received at least 6 cycles of R-CHOP (like) or CHOP (like) between January 2012 and December 2018. According to the occurrence time of CIN, subjects were divided into CIN-absent group, early-onset CIN group and late-onset CIN group. According to the degree of CIN, they were divided into CIN-absent group, mild (grade 1-2) CIN group, and severe (grade 3-4) CIN group. Short-term efficacy was evaluated after 4 cycles of treatment. The Kaplan-Meier method was used to draw the survival curve, and the Cox proportional hazards model was applied to determine the correlation between the timing and extent of CIN and clinical features, short-term efficacy, progression-free survival (PFS) and overall survival (OS).Results After 4 treatment cycles, the objective response rate (ORR) of the early-onset group was higher than that of in the late-onset group and CIN absent group (95.7% VS 88.4% VS 81.0%). Multivariate analysis, Ann Arbor staging, choice of treatment plan and CIN timing were the independent prognostic factors for OS and PFS. OS and PFS in the early-onset group were longer than those of in the absent group [OS (HR:0.241; 95%CI: 0.110-0.530; P < 0.001), PFS (HR: 0.313; 95%CI: 0.169-0.579; P < 0.001)] and late-onset group [OS (HR: 0.332; 95%CI: 0.161- 0.685; P = 0.003), PFS (HR: 0.376; 95%CI: 0.204-0.693; P = 0.002)].Conclusions The timing of CIN is an independent predictor of prognosis in DLBCL patients treated with R-CHOP (like) or CHOP (like) regimens, and patients with early-onset CIN have longer survival times. The degree of CIN is not an independent predictor of prognosis in patients with DLBCL.

scholarly journals Age trajectories of disability in instrumental activities of daily living and disability-free life expectancy among middle-aged and older adults in Taiwan: an 11-year longitudinal study

2020 ◽  
Author(s):  
Wen-Ling Liao ◽  
Yu-Hung Chang
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Life Expectancy ◽  
Early Onset ◽  
Late Onset ◽  
Remaining Life ◽  
Iadl Disability ◽  
Disability Free Life Expectancy ◽  
Onset Group ◽  
Early Onset Group

Abstract Objectives: This study aims to identify the age trajectories of disability in instrumental activities of daily life (IADLs) over 11 years and their correlates, and to estimate disability-free life expectancy for identified trajectory groups in middle-aged and older adults.Methods: We included 3,118 participants aged 50 and over without IADL limitations at baseline from the Taiwan Longitudinal Study in Aging, followed across 1996-2007. We used group-based trajectory models to identify age trajectories of IADL disability, and multiple logistic regressions to examine their correlates. Sullivan method was used to compute IADL disability-free life expectancy for trajectory groups at different ages.Results: We identified two trajectories groups: 67.7% of participants classified as the late-onset group and 32.3% as the early-onset group. Female (adjusted odds ratio [aOR]: 1.93, 95% confidence interval [95% CI]: 1.54, 2.41), not being employed (aOR: 1.30, 95% CI: 1,08, 1,56), poor/fair self-rated health (aOR: 1.31, 95% CI:1.09, 1.58), hypertension (aOR: 1.32, 95% CI: 1.07, 1.63) , diabetes mellitus (aOR: 2.29, 95% CI: 1.72, 3.07), arthritis (aOR: 1.42, 95% CI: 1.11, 1.81), stroke (aOR: 2.21, 95% CI: 1.04, 4.70), and one-point increase in a 10-item depression scale (aOR: 1.04, 95% CI: 1.02, 1.06) were associated with early-onset of disability, whereas higher education (aOR: 0.59, 95% CI: 0.42, 0.81), regular exercise (aOR: 0.76, 95% CI: 0.62, 0.93), and participating voluntary or club activities (aOR: 0.78, 95% CI: 0.65, 0.93) related to the late-onset. IADL disability-free life expectancies at 65 years old in the late-onset group were 15.6 years for women and 14.4 for men, respectively, comprising 56.6% and 64.2% of their remaining life, whereas those of the early-onset group were 4.8 and 4.6 years for women and men respectively, comprising 22.5% and 27.2% of remaining life.Conclusions: Early-onset of IADLs disability may correlate to chronic conditions, and engagement in employment, exercise, and social participation were associated with a reduced risk of early disability in IADLs.

scholarly journals ASSOCIATION BETWEEN GLYCEMIC INDEX WITH THE COMPLICATIONS PREVALENT IN TYPE 2 DIABETES PATIENTS

2020 ◽  
Vol 8 (9) ◽  
pp. 1196-1200
Author(s):  
Mayur Mewada ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Glycemic Index ◽  
Lower Risk ◽  
Mixed Meal ◽  
Type2 Diabetes ◽  
History Of ◽  
The Mean ◽  
Sugar Levels

The glycemic index or G.I is a measure of the effects of carbohydrates on blood sugar levels. The individuals who followed a low-GI diet over many years are at a significantly lower risk for developing both type 2 diabetes and coronary heart disease than others. Therefore, attempt is made to study the complications prevalent in patients with long-standing diabetes and their co-relation with the glycemic index. Objectives: To calculate the glycemic index (G.I) of the diet (MeanG.I considering dietary chart of one week) of patients with Type2 Diabetes of more than 10 years duration.To study the complications prevalent at the time of inclusion in the study, in these patients with type 2 diabetes of chronic duration.To co-relate the G.I (Glycemic Index) of the diet with the prevalence of complications in patients with type 2 diabetes. Methodology: Patients attending diabetic OPD as well as indoor patients were included . All patients with a history of type 2 diabetes mellitus of more than ten year duration with documented reports for the same were included.Duration of study : 1 yearGlycemic index of the mixed meal consumed by the patient based on this weekly dietary chart was calculated.Study subjects : 102 Data analysis done by SPSS.Ethical clearance was taken. Results and Conclusions: All microvascular or macrovascular complications had a direct co-relation with glycemic index.The maximum glycemic index observed was 124.16 and the minimum was 36.73. The mean glycemic index seen was 72.06.

scholarly journals Clinical characteristics of patients under 40 years old with early-onset hyperuricaemia: a retrospective monocentric study in China

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e025528
Author(s):  
Yi Zhang ◽  
Yong Yang ◽  
Leixi Xue ◽  
Jian Wen ◽  
Lin Bo ◽  
...  
Keyword(s):  
Fatty Liver ◽  
Early Onset ◽  
Clinical Characteristics ◽  
Liver Enzymes ◽  
Late Onset ◽  
Density Lipoprotein ◽  
Control Group ◽  
And Control ◽  
Onset Group ◽  
Early Onset Group

ObjectiveTo investigate the clinical characteristics of patients with early-onset hyperuricaemia (HUC).MethodsA retrospective study using data from the Second Affiliated Hospital of Soochow University was conducted. 623 patients with HUC were divided into early-onset group and late-onset group. Another 201 healthy subjects ≤40 years old were regarded as control group. The data of physical measurements and biochemistry test were collected. Clinical data of early-onset group were compared with late-onset group and control group by analysis of variance (ANOVA) and χ2test. Principal component analysis (PCA) was applied. Logistic regression was used to identify the clinical factors correlated with patients with early-onset HUC.ResultsThe patients of early-onset group had different body mass index (BMI), serum albumin, alanine transaminase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (AKP), gamma-glutamyltransferase (GGT), creatinine (Cr), triglyceride (TG), total cholesterol (TC), low density lipoprotein (LDL), TG/high density lipoprotein (HDL) ratio, HDL and percentage of males, hypertension (HBP) as well as fatty liver compared with healthy people in the control group. Early-onset group patients had different albumin, ALT, fasting blood glucose, Cr, percentage of males and HBP compared with late-onset group patients. PCA identified four significant patterns including PC1 (labelled ‘TG and HDL’), PC2 (labelled ‘fatty liver and liver enzymes’), PC3 (labelled ‘TC and LDL’) and PC4 (labelled ‘AKP’). The results of univariate and multivariate logistic regression analysis showed that BMI, HBP and albumin were correlative factors for early onset of HUC when the patients with early-onset and late-onset HUC were involved, while gender, BMI, PC1, PC2 and PC4 were correlative factors for early-onset HUC when the early-onset and control groups were involved.ConclusionThis study described a group of patients with early-onset HUC with distinct clinical features. Gender, BMI, ‘TG and HDL’, ‘fatty liver and liver enzymes’ and ‘AKP’ have higher values than HBP, type 2 diabetes mellitus and ‘TC and LDL’ in patients under 40 years old with early-onset HUC.

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