scholarly journals Impact of Type 2 Diabetes on the Association Between Neurodegenerative Diseases and Cancer in Elderly Koreans: A 10-year Retrospective Cohort Study Using the National Health Insurance Service Database

Author(s):  
Hee-Cheol Kim ◽  
Ji-Hun Kim ◽  
Ho-Jun Lee ◽  
Yang-Tae Kim ◽  
Byeong-Churl Jang

Abstract BackgroundSome studies suggest that cancer and type 2 diabetes (T2D), as well as neurodegenerative diseases (NDs), are related to protein misfolding and possibly to each other. This study aimed to investigate the association between NDs and cancer, and to determine the impact of T2D on the association between NDs and cancer.MethodsA population-based 10-year follow-up study was conducted using the Korean National Health Insurance Service Database between 2002 and 2015. The study population included an ND group (n = 9,292) and control group (n = 46,742), aged ≥60 years. A multivariable Cox proportional hazards regression model was used to evaluate the hazard ratio (HR) and 95% confidence interval (CI) for cancer risk.ResultsVarious another NDs and/or T2D were newly diagnosed in ND and control groups during the 10-year follow-up periods. Newly developed another ND cases before cancer onset were 2,412 (26.0%) in the ND group and 15,435 (33.0%) in the control group (χ2 = 178.19, p < 0.01). Newly developed T2D cases before cancer onset were 4,691 (50.5%) and 25,695 (55.0%) in the ND and control groups, respectively (χ2 = 62.89, p < 0.01). As of December 31, 2015 (the end of the observation period), the number of cancer patients in the ND group was 2,040 (22.0%) and that in the control group was 8,628 (18.5%) (χ2 = 61.45, p < 0.01). The ND group was associated with an increased risk of cancer (HR, 1.25; 95% CI, 1.19–1.31). In both groups, newly diagnosed another NDs and T2D showed an additive effect on cancer incidence during the follow-up period. The additive effect on cancer incidence was higher in T2D than in ND.ConclusionThis study showed a positive association between NDs and cancer, and an additive effect of T2D on this association. Further replication studies are needed to address the association among NDs, cancer, and T2D.

2021 ◽  
Author(s):  
Hee-Cheol Kim ◽  
Ji-Hun Kim ◽  
Ho-Jun Lee ◽  
Yang-Tae Kim ◽  
Byeong-Churl Jang

Abstract Background Some studies suggest that cancer and type 2 diabetes (T2D), as well as neurodegenerative disease (ND), are related to protein misfolding and possibly to each other. This study aimed to investigate the association between NDs and cancer to evaluate the impact of T2D on the association between NDs and cancer. Methods A population-based 10-year follow-up study was conducted using the Korean National Health Insurance Service Database between 2002 and 2015. The study population included an ND group (n = 9,292) and control group (n = 46,742), aged ≥ 60 years. A multivariable Cox proportional hazards regression model was used to evaluate the hazard ratio (HR) and 95% confidence interval (CI) for cancer risk. Results Various NDs and/or T2D were newly diagnosed in ND and control groups during the 10-year follow-up periods. Newly developed ND cases before cancer onset were 2,412 (26.0%) in the ND group and 15,435 (33.0%) in the control group (χ2 = 178.19, p < 0.01). Newly developed T2D cases before cancer onset were 4,691 (50.5%) and 25,695 (55.0%) in the ND and control groups, respectively (χ2 = 62.89, p < 0.01). As of December 31, 2015 (the end of the observation period), the number of cancer patients in the ND group was 2,040 (22.0%) and that in the control group was 8,628 (18.5%) (χ2 = 61.45, p < 0.01). The ND group was associated with an increased risk of cancer (HR, 1.25; 95% CI, 1.19–1.31). In both groups, newly diagnosed ND and T2D patients showed an additive effect on cancer incidence during the follow-up period. The additional effect on cancer incidence was higher in T2D than in ND. Conclusion This study showed a positive association between NDs and cancer, and an additive effect of T2D on this association. Further replication studies are needed to address the association among NDs, cancer, and T2D.


BJS Open ◽  
2021 ◽  
Vol 5 (5) ◽  
Author(s):  
V Gonzalez ◽  
B Arver ◽  
L Löfgren ◽  
L Bergkvist ◽  
K Sandelin ◽  
...  

Abstract Background The value of preoperative breast MRI as an adjunct technique regarding its effect on re-excision rates has been a subject of discussion. No survival data regarding preoperative breast MRI are available from randomized studies. Methods Ten-year follow-up of the POMB randomized multicentre study was analysed, evaluating MRI and its effect on disease-free survival (DFS) and overall survival (OS). Patients with newly diagnosed breast cancer were randomized to either preoperative MRI or conventional imaging. Kaplan–Meier plots were used to analyse DFS and OS, and Cox regression to estimate hazard ratios (HRs). Results A total of 440 patients, aged 56 years or less, with newly diagnosed breast cancer were randomized to either preoperative MRI (220) or conventional imaging (220; control). Median follow-up for each group was 10 years. DFS rates were 85.5 and 80.0 per cent for the MRI and control groups respectively (P = 0.099). The risk of relapse or death was 46 per cent higher in the control group (HR 1.46, 95 per cent c.i. 0.93 to 2.29). OS rates after 10 years were 90.9 and 88.6 per cent in the MRI and control groups respectively (P = 0.427). The risk of death was 27 per cent higher in the control group (HR 1.27, 0.71 to 2.29). Locoregional, distant, and contralateral recurrence outcomes combined were increased in the control group (P = 0.048). A subgroup analysis of patients with breast cancer stages I–III showed that preoperative MRI improved DFS compared with conventional imaging, but this did not reach statistical significance (P = 0.057). Conclusion After 10 years of follow-up, preoperative breast MRI as an adjunct to conventional imaging resulted in slightly, but non-significantly, improved DFS and OS. Registration number: NCT01859936 (http://www.clinicaltrials.gov).


Author(s):  
Tatjana Sjakste ◽  
Ilva Poudžiunas ◽  
Valdis Pīrāgs ◽  
Māris Lazdiñš ◽  
Nikolajs Sjakste

Bioinformatic Analysis of Evolutional Conservatism and Functional Significance of Microsatellite Alleles of Human 14Q13.2 Region Associated with Type 2 Diabetes Mellitus The paper deals with bioinformatic and statistical analysis of the possible functional significance of the previously shown association of several microsatellite alleles in intron 6 of the human proteasome core particle PSMA6 gene (HSMS006) and four other microsatellites localised upstream in human chromosome 14q13.2 (HSMS801, HSMS702, HSMS701, HSMS602) with type 2 diabetes mellitus in Latvia and Botnia, Finland. Genotype analysis revealed that (CAA)8/(CAA)8 homozygotes of the HSMS602 marker were never found in Type 2 diabetes patients, although 6.56% of the individuals from the control groups were the (CAA)8/(CAA)8 homozygotes. For the HSMS801 marker the (AC)21/(AC)23 genotype was never found in the case group and in the control group it was detected with a frequency 4.40%; these differences were statistically significant (P < 0.05). In contrast to the Latvian population, the distribution of genotype frequencies in cases and controls taken from the Botnian dataset was almost similar. Haplotype analysis showed that in the Latvian population besides haplotypes including alleles differently represented in case and control groups, a combination of some alleles almost equally represented in both groups formed combinations that were more characteristic of either the case group or the control group. This indicates probable independent functional significance of these haplotypes that warrants further investigation. In the Botnian population, more allele combinations were observed, and the distribution of haplotypes in case and control groups differed from that observed in Latvia. The observed haplotype distributions might reflect differences between the studied populations: a homogenous and isolated Botnian vis-à-vis a mixed Latvian population. Linkage disequilibrium (LD) analysis of data on the Latvian population revealed nine of ten two-allele combinations manifesting a high LD. HSMS006 and HSMS602 combination had a low LD; among the analysed markers these were situated at the largest distance from one another. Data on the Botnian population showed that haplotypes in eight of ten combinations had a high LD, including the HSMS006 and HSMS602 combinations. It appears that the two populations differ also in linkage disequilibrium of two-loci haplotypes. Theoretical analysis of a potential functional role of the polymorphisms indicated the significance of the microsatellite length of HSMS602 and HSMS006 for the formation of DNA hairpins. The whole genomic region appears to be conservative in mammals.


Pathogens ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 504
Author(s):  
Irina P. Balmasova ◽  
Evgenii I. Olekhnovich ◽  
Ksenia M. Klimina ◽  
Anna A. Korenkova ◽  
Maria T. Vakhitova ◽  
...  

Since periodontitis and type 2 diabetes mellitus are complex diseases, a thorough understanding of their pathogenesis requires knowing the relationship of these pathologies with other disorders and environmental factors. In this study, the representability of the subgingival periodontal microbiome of 46 subjects was studied by 16S rRNA gene sequencing and shotgun sequencing of pooled samples. We examined 15 patients with chronic periodontitis (CP), 15 patients with chronic periodontitis associated with type 2 diabetes mellitus (CPT2DM), and 16 healthy subjects (Control). The severity of generalized chronic periodontitis in both periodontitis groups of patients (CP and CPT2DM) was moderate (stage II). The male to female ratios were approximately equal in each group (22 males and 24 females); the average age of the subjects was 53.9 ± 7.3 and 54.3 ± 7.2 years, respectively. The presence of overweight patients (Body Mass Index (BMI) 30–34.9 kg/m2) and patients with class 1–2 obesity (BMI 35–45.9 kg/m2) was significantly higher in the CPT2DM group than in patients having only chronic periodontitis or in the Control group. However, there was no statistically significant difference in all clinical indices between the CP and CPT2DM groups. An analysis of the metagenomic data revealed that the alpha diversity in the CPT2DM group was increased compared to that in the CP and Control groups. The microbiome biomarkers associated with experimental groups were evaluated. In both groups of patients with periodontitis, the relative abundance of Porphyromonadaceae was increased compared to that in the Control group. The CPT2DM group was characterized by a lower relative abundance of Streptococcaceae/Pasteurellaceae and a higher abundance of Leptotrichiaceae compared to those in the CP and Control groups. Furthermore, the CP and CPT2DM groups differed in terms of the relative abundance of Veillonellaceae (which was decreased in the CPT2DM group compared to CP) and Neisseriaceae (which was increased in the CPT2DM group compared to CP). In addition, differences in bacterial content were identified by a combination of shotgun sequencing of pooled samples and genome-resolved metagenomics. The results indicate that there are subgingival microbiome-specific features in patients with chronic periodontitis associated with type 2 diabetes mellitus.


2021 ◽  

Introduction: There are different drug-based treatments (i.e., oral or injective) for patients with type 2 diabetes. Pioglitazone and sitagliptin, among oral agents, can affect blood glucose control and lipid profile. Objectives: The purpose of the current investigation was the assessment of the effects of adding sitagliptin or pioglitazone (as the third drug) to the combined metformin-sulfonylurea treatment on glycemic control, inflammatory factors, and lipid profile. Methods: This clinical trial was carried out on 125 patients with type 2 diabetes undergoing metformin-glibenclamide treatment. The patients were randomly divided into three groups, namely the sitagliptin group receiving 100 mg of sitagliptin for 3 months (n=45), pioglitazone group receiving 30 mg of pioglitazone for 3 months (n=40), and control group (n=40). After the interventions, the anthropometric indices, glycated hemoglobin A1c level, lipid profile, fibrinogen, and high-sensitivity C-reactive protein (hs-CRP) were compared among the study groups. Results: The sitagliptin group demonstrated significantly lower levels of hs-CRP (0.53±0.26 mg/L) and fibrinogen (314.08±48.09 mg/dL), compared to those reported for the pioglitazone and control groups. In contrast, significantly lower triglyceride levels (115.02±32.92 mg/dL) and significantly higher high-density lipoprotein cholesterol (51.57±11.14 mg/dL) were observed in the pioglitazone group in comparison to those reported for the sitagliptin and control groups. Conclusion: The results of the present study suggest that sitagliptin reduces the levels of fibrinogen and hs-CRP. Nevertheless, pioglitazone has a more significant effect on the improvement of the lipid profile, compared to sitagliptin and combined metformin-sulfonylurea treatments.


2021 ◽  
Vol 11 (4) ◽  
pp. 438-443
Author(s):  
Jukkrit Wungrath ◽  
Nattapong Autorn

Background: More than 4.2 million cases of diabetes mellitus (DM) were reported in Thailand during 2019. Medication adherence is necessary to delay disease progression and prevent complications among uncontrolled type 2 DM patients. The objective of this research was to study how education via the Line application and telephone-based counseling impacted medication adherence knowledge by analyzing the behavior of uncontrolled type 2 diabetic patients. Methods: Uncontrolled type 2 DM patients in Doi Saket Hospital, Doi Saket district, Chiang Mai province, Thailand. were included in the study. The sample was divided into an experimental (n=30) and control group (n=30). Patients who met the inclusion criteria of having uncontrolled type 2 diabetes diagnosed by a physician for at least one year, capable of communicating in Thai, possessing a mobile phone with the Line application and able to partake in activities for eight weeks were recruited in the parallel-group randomized trial. The experimental group participated in the developed education program, while the control group received standard routine health education activities provided by their health care providers. The intervention was based on the 5Rs principle as right medicine, right dose, right route, right patient and right time and included activities via the Line application and telephone-based counseling. Participants were evaluated for their medication adherence knowledge and behavior. Results: After eight weeks of education through the Line application and telephone-based counseling, posttest mean scores of medication adherence knowledge of the experimental and control groups were 18.03 (SD=0.28) and 12.37 (SD=0.62), while posttest mean scores of medication adherence behavior of the experimental and control groups were 49.28 (SD=3.77) and 33.84 (SD=3.81), respectively. Results revealed that the experimental group had statistically significant (P<0.01) higher medication adherence knowledge and behavior mean scores. Conclusion: Education using the Line application and telephone-based counseling program improved medication adherence knowledge and behavior among uncontrolled type 2 DM patients. Other outcomes of social media interactions such as patient engagement, patient behavior and attitudes, and the efficacy of patient-health care provider communication levels are possible areas for future study.


2015 ◽  
Vol 22 (2) ◽  
pp. 175-185
Author(s):  
Ramona Maria Ştefan ◽  
Cristina Niţă ◽  
Anca Crăciun ◽  
Adriana Rusu ◽  
Nicolae Hâncu

AbstractBackground and Aims: We assessed the effect of intensive therapy on modifiable cardiovascular (CV) risk factors and CV risk as compared to conventional therapy in patients with newly diagnosed type 2 diabetes mellitus (T2DM).Material and Methods: This was an observational, prospective study, conducted in Romania. During 1-year follow-up period the enrolled participants received either multi-factorial pharmacotherapy associated with intensive therapeutic education (Intensive group), or conventional therapy (Control group). Current analysis included data (anthropometric measurements, blood pressure and biochemical parameters) recorded at months (M) 0, 6 and 12. CV risk was calculated at M1 and M12 using the UK Prospective Diabetes Study Risk Engine.Results: 138 patients aged 57.02±10.05 years were included in this analysis (69 in each group). At M6 and M12 a significant improvement of the majority of the modifiable risk factors in the Intensive group compared to the Control group was observed. At M12, coronary heart disease (CHD)/fatal-CHD risks were significantly lower in the Intensive (7.5%/3.1%) than in the Control (17.95%/10.3%) group (p<0.05). A similar trend was observed for the stroke/fatal-stroke risks.Conclusions: CHD/fatal-CHD and stroke/fatal-stroke risk burden decreased in newly diagnosed diabetic patients following multi-factorial pharmacotherapy association with intensive lifestyle changes during 1-year follow-up.


2010 ◽  
Vol 66 (2) ◽  
Author(s):  
Agatha J. Van Rooijen ◽  
Christa M. Viviers ◽  
Piet J. Becker

Urbanisation,  a  sedentary  lifestyle  and  increasing  obesity  due  to westernization and changed eating habits have been identified as independent risk factors for diabetes in the South African population. To establish the effectiveness of a daily walk and diet education intervention program. A randomized controlled trial was performed. The study population consisted of men and women of all races, ages 40 to 65 with Type 2 Diabetes Mellitus (DM) of duration at least one year attending the Steve Biko Diabetes Outpatient clinic. Patients of all weights were considered. Patients who had an HbA1c > 8 – 9.5% were included in the sample group.Four  weekly  group  classes  consisted  of  education  considered  essential  for  ongoing  nutrition  self-management  and physical activity. Yamax pedometers and walk prescriptions based on the average number of steps walked in three days were used. The participants had a follow-up assessment at 16 weeks and one year. The intervention and control groups were compared with respect to changes from baseline, using analysis of covariance (ANCOVA) with baseline values as covariates.The  difference  between  the  intervention  and  control  groups  in  the  change  in  HbA1c  from  the  baseline  was significant at the 16-week follow-up assessment (p=0.041) and in the total cholesterol and LDL-cholesterol at the  one-year follow-up assessment (p =0.047; p =0.014). These results suggest that HbA1c can be improved over a period of four months. More frequent contact with the patients is necessary.


2021 ◽  
pp. 097275312110000
Author(s):  
Madhava Sai Sivapuram ◽  
Vinod Srivastava ◽  
Navneet Kaur ◽  
Akshay Anand ◽  
Raghuram Nagarathna ◽  
...  

Background: Type 2 diabetes needs a better understanding of etiological factors and management strategies based on lifestyle and constitutional factors, given its high association rate with many cardiovascular, neurological disorders, and COVID-19 infection. Purpose: The present study was undertaken to investigate the effect of Diabetes-specific integrated Yoga lifestyle Protocol (DYP) on glycemic control and lipid profiles of diabetic adults. Along with the DYP intervention, the individuals residing in Chandigarh and Panchkula union territories in the northern part of India were assessed for Ayurveda-based body–mind constitutional type. Ayurveda describes body–mind constitution as “ prakriti,” which has been discussed from two angles, namely physiological and psychological as body and mind are correlated. Methods: Cluster sampling of waitlist control study subjects was used as the sampling method for the study. A total of 1,215 registered subjects (81 diabetic) responded in randomly selected clusters in Chandigarh and Panchkula. Ayurveda physicians did Ayurveda body–mind constitutional assessment called prakriti assessment (physiological body–mind constitution assessment) in 35 participants (23 diabetic, 12 prediabetic) as a part of the study. Results: A group of 50 subjects was randomly selected for yoga intervention out of 81 diabetes mellitus adults, and 31 subjects were enrolled as waitlist controls. A significant decrease in the glycosylated hemoglobin levels from 8.49 ± 1.94% to 7.97 ± 2.20% in the intervention group was noticed. The lipid profiles of the DYP intervention and control groups were monitored. Three-month follow-up results of lipid profile diagnostic tests in intervention and control groups showed a significant difference between the two groups ( P < 0.05). Most diabetic and prediabetic individuals were found to have pitta dosha ( pitta controls all heat, metabolism, and transformation in the mind and body) as dominant constitution type. Conclusion: The study results demonstrated significant positive effects of yoga in diabetic individuals. This study has indicated the evidence for the safety and efficacy of the validated DYP for community-level interventions to prevent maladies like brain damage and stroke.


Genetika ◽  
2015 ◽  
Vol 47 (1) ◽  
pp. 161-170 ◽  
Author(s):  
Maryam Rezazadeh ◽  
Nasim Sohrabifar ◽  
Hossein Jafari ◽  
Ardabili Mohaddes ◽  
Jalal Gharesouran

Polymorphisms of the Calpain10 and TCF7L2 genes were identified as possible type 2 diabetes susceptibility genetic markers. We conducted a case-control study to evaluate the relation between SNP43 of calpain-10 and rs12255372 and rs7903146 in the TCF7L2 with type2 diabetes in western-north of Iran. The role of these variants in Iranian population was less clear. A total of 202 patients and healthy controls were enrolled to analysis the frequency distribution of Calpain10 and TCF7L2 polymorphisms (SNP43, rs12255372 and rs7903146) using polymerase chain reaction-restriction fragment length polymorphism (PCR - RFLP) method. The frequency of allele A in controls was significantly greater than that of diabetic patients (P=0.031), whereas the difference between distribution of SNP43 genotypes (A/A, A/G, G/G) were non- significant in case and control groups. Non significant association was also observed between G/G, A/G or A/A genotypes and type 2 Diabetes. The frequency of the ?T? allele of rs12255372 (G/T) was significantly associated with type 2 diabetes (OR= 0.55, 95% confidence interval [CI], 1.11-1.51; P<0.001). No allelic association was found for rs7903146(C/T) polymorphism. The distribution of alleles in case and control groups are significantly different indicating the G allele is associated with type 2 diabetes. The rs12255372 (G/T) may be associated with type 2 diabetes.


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