scholarly journals Beta-Cell Age Calculator, a Translational Yardstick to Communicate Diabetes Risk with Patients: Tehran Lipid and Glucose Study

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Mohammadreza Bozorgmanesh ◽  
Farzad Hadaegh ◽  
Fereidoun Azizi

Aims. To provide a yardstick for physicians/patients to efficiently communicate/measure incident diabetes risk. Methods. We included data on 5,960 (3,438 women) diabetes-free adults, aged ≥20 years at baseline who either developed diabetes during two consecutive examinations or completed the followup. Age, systolic blood pressure, family history of diabetes, waist-to-height ratio (WHtR), triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDLD-C), and fasting plasma glucose (FPG) were introduced into an accelerated failure time regression model. Results. Annual diabetes incidence rate was 0.85/1000-person (95% CIs 0.77–0.94). Point-score-system incorporated age (1 point for >65 years), family history of diabetes (4 points), systolic blood pressure (−1 to 3 points), WHtR (−4 to 6 points), TG/HDL-C (1 point for ≥1.5), and FPG (0 to 27 points). Harrell’s C statistic = 0.830 (95% CIs 0.808–0.852) and Hosmer-Lemeshow χ2=9.7 (P for lack of fitness = 0.462) indicated good discrimination and calibration. We defined beta-cell age as chronological age of a person with the same predicted risk but all risk factors at the normal levels (i.e., WHtR 0.50, no family history of diabetes, Ln (TG/HDL-C) = 0.531, and FPG = 4.9 (mmol·L−1)). Conclusion. Hereby, we have made it also possible to estimate wide ranges of “beta-cell age” for most chronological ages to assist clinician with risk communication.

2021 ◽  
Author(s):  
Li Shu ◽  
Yingying Zhao ◽  
Yanqi Shen ◽  
Xiaolu Li ◽  
Mengting Qiu ◽  
...  

Abstract Background: Lipid accumulation product (LAP) is considered to be a new convenient useful indicator to assess the visceral fat. However, the association between LAP and family history of diabetes remains an undetermined concept. Therefore, we aimed to evaluate the risk factors of impaired fasting glucose (IFG) and diabetes, and explore the possible interacting influences of LAP with other factors on the risk of IFG and diabetes among Chinese normotension adults.Methods: A multistage stratified cluster sampling method was conducted to select urban residents aged 45-86 years in Bengbu, China. For each eligible participant, data on questionnaire survey, anthropometric measurements and laboratory tests were obtained. LAP was calculated and divided into four categories according to quartile. The effects of body mass index (BMI), waist circumference (WC), waist to height ratio (WHtR) and LAP for predicting IFG and diabetes were performed by multiple logistic regressions and receiver operating characteristic (ROC) analyses. The interaction effects were evaluated by relative excess risk of interaction (RERI), attributable proportion due to interaction (AP) and synergy index (SI). If the 95% CI of RERI and AP do not include 0, the 95% CI of SI do not include 1, the interactions are statistically significant. Results: 6467 normotension subjects (2695 men and 3772 women) were enrolled in our study, the prevalence of IFG and diabetes were 9.37% and 14.33%, respectively. It was revealed that the prevalence rates of IFG and diabetes were gradually increased according to increasing LAP quartiles (P for trend <0.001). When assessed using ROC curve analysis, LAP exhibited higher diagnostic accuracy for identifying IFG and diabetes than BMI, the area under the AUC curve was 0.650 (95% CI: 0.637 to 0.662). After adjustment for age, sex, educational level and other confounding factors, multivariate logistic regression analyses indicated that subjects with the fourth quartile of LAP were more likely to develop IFG (adjusted OR: 2.735, 95% CI: 1.794-4.170) and diabetes (adjusted OR: 1.815, 95% CI: 1.297-2.541) than those with the first quartile. A significant interaction between LAP and family history of diabetes was observed in participants (RERI=1.538, 95%CI: 0.167 to 3.612; AP=0.375, 95%CI: 0.118 to 0.631; SI=1.980, 95%CI: 1.206 to 3.251), but there is no statistically significant difference between LAP and general obesity. However, a significant interaction between LAP and abdominal obesity was indicated by the value of RERI (1.492, 95%CI: 0.087 to 3.723) and AP (0.413, 95%CI: 0.014 to 0.756), but not the value of SI (1.824, 95%CI: 0.873 to 3.526). Conclusion: LAP significantly associates with IFG and diabetes risk in the study population, it has better performance than BMI, WC and WHtR. Apart from that, our results also demonstrated that there might be synergistic effect between LAP and family history of diabetes on the risk of IFG and diabetes.


2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Ranjita Misra ◽  
Cindy Fitch ◽  
David Roberts ◽  
Dana Wright

This project utilized a cross-sectional study design to assess diabetes risk among 540 individuals from 12 counties using trained extension agents and community organizations in West Virginia. Individuals were screened for diabetes using (1) the validated 7-item diabetes risk assessment survey and (2) hemoglobin A1c tests. Demographic and lifestyle behaviors were also collected. The average age, body mass index, and A1c were51.2±16.4,31.1±7.5, and5.8±0.74, respectively. The majority were females, Non-Hispanic Whites with no prior diagnosis of diabetes. Screenings showed that 61.8% of participants were at high risk for diabetes. Family history of diabetes (siblings or parents), overweight or obese status, sedentary lifestyle, and older age were commonly prevalent risk factors. Higher risk scores computed from the 7-item questions correlated positively with higher A1c (r=0.221,P<0.001). In multivariate logistic regression analyses, higher diabetes risk was predicted by obesity, older age, family history of hypertension, and gestational diabetes. Females were 4 times at higher risk than males. The findings indicated that community-based screenings were an effective way to assess diabetes risk in rural West Virginia. Linking diabetes screenings with referrals to lifestyle programs for high risk individuals can help reduce the burden of diabetes in the state.


1981 ◽  
Vol 61 (s7) ◽  
pp. 359s-362s ◽  
Author(s):  
F. Wessels ◽  
D. Hoffmann ◽  
H. Wagner ◽  
H. Zumkley

1. The influence of family history of hypertension on the relationships between blood pressure, relative body weight, sodium/creatinine ratio of the 24 h urine, plasma renin activity and the plasma concentration of prolactin and parathormone were examined in 102 healthy male students. 2. Grouping together results from all students showed significant positive correlations between systolic blood pressure and prolactin, parathormone as well as relative body weight, between plasma renin activity and prolactin and a significant negative correlation between plasma renin activity and sodium/creatinine ratio of the 24 h urine. 3. By dividing the students into two groups according to their family history of hypertension we could demonstrate in those with family history of hypertension a highly significant positive correlation between mean blood pressure and sodium/creatinine ratio of the 24 h urine and an improvement of the correlations between systolic blood pressure and prolactin and between sodium/creatinine ratio of the 24 h urine and plasma renin activity. In students without family history of hypertension these relationships were no longer detectable. In the students without family history of hypertension the correlations between systolic blood pressure and relative body weight as well as between plasma renin activity and prolactin gained substantially in significance. In students with positive family history of hypertension these correlations could no longer be demonstrated. The correlations between systolic blood pressure and parathormone remained unaffected by family history of hypertension. 4. The results suggest that a genetic predisposition to essential hypertension is able to intensify the blood pressure effect of Na intake and of prolactin, which, besides its function as a sex hormone, is presumed additionally to be able to retain salt. However, the positive relationship between body weight and blood pressure, as well as between plasma renin activity and prolactin, the significance of which increases greatly in subjects without family history of hypertension, appears to be lost as the result of the increased sensitivity to salt in positive family history of hypertension.


2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Morena Ustulin ◽  
Sang Youl Rhee ◽  
Suk Chon ◽  
Kyu Keung Ahn ◽  
Ji Eun Lim ◽  
...  

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Sahar Dalvand ◽  
Jalil Koohpayehzadeh ◽  
Masoud Karimlou ◽  
Fereshteh Asgari ◽  
Ali Rafei ◽  
...  

Background. Because the use of BMI (Body Mass Index) alone as a measure of adiposity has been criticized, in the present study our aim was to fit a latent variable model to simultaneously examine the factors that affect waist circumference (continuous outcome) and obesity (binary outcome) among Iranian adults.Methods. Data included 18,990 Iranian individuals aged 20–65 years that are derived from the third National Survey of Noncommunicable Diseases Risk Factors in Iran. Using latent variable model, we estimated the relation of two correlated responses (waist circumference and obesity) with independent variables including age, gender, PR (Place of Residence), PA (physical activity), smoking status, SBP (Systolic Blood Pressure), DBP (Diastolic Blood Pressure), CHOL (cholesterol), FBG (Fasting Blood Glucose), diabetes, and FHD (family history of diabetes).Results. All variables were related to both obesity and waist circumference (WC). Older age, female sex, being an urban resident, physical inactivity, nonsmoking, hypertension, hypercholesterolemia, hyperglycemia, diabetes, and having family history of diabetes were significant risk factors that increased WC and obesity.Conclusions. Findings from this study of Iranian adult settings offer more insights into factors associated with high WC and high prevalence of obesity in this population.


Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Erica P Gunderson ◽  
Amy Krefman ◽  
Cora E Lewis ◽  
Janet Catov ◽  
Norrina B Allen

Hypothesis: Gestational diabetes mellitus (GDM) is a disorder of glucose metabolism during pregnancy characterized by pancreatic beta cell dysfunction and greater insulin resistance, but it is unclear whether dysfunction exists before pregnancy. The disposition index (DI) is a physiologic measure of beta cell compensation for insulin resistance strongly predictive of future diabetes. This prospective study evaluates whether a clinical approximation of DI before pregnancy is associated with risk of GDM. Methods: This analysis included 696 women (45% black, 55% white) enrolled in the CARDIA Study, a U.S. multi-center prospective cohort of young adults aged 18-30 at baseline (1985-86) who gave birth at least once during 30 years of follow up, reported GDM status and had fasting glucose and insulin measured before one or more post-baseline births. DI was defined as HOMA-B divided by HOMA-IR using standard formulas. Multinomial logistic regression models estimated odds ratios (OR) and 95%CI for GDM among pre-pregnancy DI tertiles (low, moderate, high) and fully adjusted for time to birth, race, age, parity, BMI, lifestyle behaviors and family history of diabetes, and also stratified by pre-pregnancy BMI. Results: 9% of women reported GDM (64/696) for 794 births. 55% of GDM and 30% of non-GDM were categorized as low DI. Low pre-pregnancy DI compared to moderate DI was associated with higher fully adjusted odds of GDM (OR=2.71, 95%CI:1.37-5.35) in the entire sample. In models stratified by pre-pregnancy BMI, low DI was associated with 4-fold higher odds of GDM among Overweight/Obese (OR=4.22, 95%CI: 1.35-13.91) and somewhat attenuated higher odds of GDM among Normal BMI (OR=1.94, 95%CI: 0.78–4.86); Table 1. Only family history of diabetes was strongly associated with GDM independent of DI. Conclusions: Inadequate beta cell compensation is present before pregnancy and discriminates greatest risk of GDM among high BMI, and may identify higher risk among women of normal BMI.


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