The association of cardio-metabolic risk factors and history of falling in men with osteosarcopenia: a cross-sectional analysis of Bushehr Elderly Health (BEH) program

Background Osteosarcopenia, defined as sarcopenia plus osteopenia/osteoporosis, may increase the risk of fractures and affects morbidity and mortality in the older population. Falling is also common in the elderly and increases the risk of fractures and mortality. We examined the association of cardio-metabolic risk factors with a history of falling in osteosarcopenic men. Methods We used the baseline data of the Bushehr Elderly Health (BEH) program. Osteosarcopenia was defined as having both sarcopenia (reduced skeletal muscle mass plus low physical performance and/or low muscle strength) and osteopenia/osteoporosis (T-score ≤ − 1.0). Falling was defined as a self-reported history of an unintentional down on the ground during the previous year before the study. We used logistic regression analysis to estimate the adjusted odds ratio (AOR) with a 95% Confidence Interval (CI) to quantify the associations. Results All elderly men diagnosed with osteosarcopenia (n = 341), with a mean age of 73.3(±7.4) years, were included. Almost 50(14.7%) participants reported falling. Age showed a positive association with falling (AOR: 1.09, 95%CI: 1.04–1.14). An increase of 10 mmHg in systolic blood pressure(SBP), reduces the odds of falling by 26%(AOR:0.74, 95%CI:0.62–0.89), while a positive association was detected for fasting plasma glucose (FPG), as 10 mg/dl increase in the FPG, raises the chance of falling by 14%(AOR = 1.14, 95%CI:1.06,1.23). Hypertriglyceridemia was inversely associated with falling (AOR = 0.33, 95% CI: 0.12, 0.89). Conclusions Falling is a major public health problem in rapidly aging countries, especially in individuals with a higher risk of fragility fractures. Older age-raised fasting plasma glucose and low SBP are associated with falling in osteosarcopenic patients. Considering the higher risk of fracture in osteosarcopenic men, comprehensive strategies are needed to prevent fall-related injuries in this high-risk population.

Influence of Fasting Plasma Glucose Level on Admission of COVID-19 Patients: A Retrospective Study

Background. The coronavirus disease 2019 (COVID-19) is a serious global health threat and has spread dramatically worldwide. Prolonged viral shedding is associated with a more severe disease course and inflammatory reaction. Blood glucose levels were significantly associated with an increased hazard ratio (HR) for poor outcomes in COVID-19 patients. Objective. Previous studies focused primarily on the relationship between blood glucose and mortality or severe outcomes, but there were few research studies on the relationship between fasting plasma glucose (FPG) and duration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA positive status. To explore the relationship between FPG levels and prolonged duration of SARS-CoV-2 viral positivity, the clinical data of COVID-19 patients were analyzed. Method. In this retrospective study, 99 cases of COVID-19 patients in Beijing Ditan Hospital were recruited, and their clinical and laboratory findings at admission were collected and analyzed. Furthermore, the risk factors for prolonged duration of SARS-CoV-2 RNA shedding were identified, and the relationship between FPG levels and the prolonged presence of SARS-CoV-2 RNA was evaluated. Result. We found that elevated FPG levels were correlated with longer duration of SARS-CoV-2 RNA positivity, classification of COVID-19, imaging changes of chest CT, inflammation-related biomarkers, and CD8+ T cell number in COVID-19 patients. In a logistic regression model, after adjusting for gender and age, COVID-19 patients with elevated FPG were more likely to had longer duration of SARS-CoV-2 RNA positivity than those with normal FPG levels (OR 3.053 [95% CI 1.343, 6.936]). Conclusion. Higher FPG levels (≥6.1 mmol/l) at admission was an independent predictor for prolonged SARS-CoV-2 shedding, regardless of a known history of diabetes. It suggests that intensive monitoring and control of blood glucose are important for all COVID-19 patients.

Study on the Effects of Individualized Nutritional Intervention on Pregnancy Outcome and Neonatal Immune Function in Patients with Gestational Diabetes Mellitus

Objective. To study the effects of individualized nutritional intervention on pregnancy outcome and neonatal immune function in patients with gestational diabetes mellitus (GDM). Methods. A retrospective analysis was conducted on 100 GDM patients from the obstetrics and gynecology department of our institute between February 2019 and February 2020. The patients were allocated into the control group given regular intervention and the experimental group given individualized nutritional intervention according to different intervention measures, with 50 cases in each group. The comparison was carried out for patients in the two groups with regard to their modality of delivery, neonatal health, their plasma glucose in fasting state, 2 h after eating, and before bedtime; glycohemoglobin at 8 months of pregnancy, at 9 months of pregnancy, during labor, and 1 month after delivery; their complications; and neonatal CD3+, CD4+, and CD8+ levels. Results. The experimental group outperformed the control group in terms of the spontaneous delivery rate, the number of healthy neonates, and neonatal CD3+, CD4+, and CD8+ levels ( P < 0.05 ). The plasma glucose in fasting state, 2 h after eating, and before bedtime; the glycohemoglobin at 8 months of pregnancy, at 9 months of pregnancy, during labor, and 1 month after delivery; and the incidence of complications of the experimental group were significantly lower than those of the control group ( P < 0.05 ). Conclusion. Individualized nutritional intervention increases the rate of spontaneous delivery in GDM patients, enhances neonatal immune function, stabilizes plasma glucose, and reduces complications.

Association of serum creatinine levels and risk of type 2 diabetes mellitus in Korea: a case control study

Background Reduced skeletal muscle has been suggested as a potential risk factor for type 2 diabetes mellitus (T2DM). Serum creatinine is the primary metabolite of creatine in skeletal muscle. Therefore, low serum creatinine levels may be associated with an increased risk of T2DM. We aimed to evaluate the association between serum creatinine levels and the risk of T2DM in Korea. Methods We analyzed a total of 264,832 nondiabetic adults older than 40 years of age who had undergone a national health examination at least once from 2009 to 2015 in the Korean National Health Insurance Service Cohort. Hazard ratios for T2DM were calculated. Results In men, serum creatinine levels and the risk for T2DM showed an inverse J-shaped association. This association was confirmed after adjustment for age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), and fasting plasma glucose. In women, there was a trend that serum creatinine levels were inversely associated with the risk of T2DM among those with serum creatinine below 1.1 mg/dl. However, serum creatinine levels were not significantly associated with the risk of T2DM after adjustment for age, BMI, SBP, DBP, and fasting plasma glucose. Conclusions Reduced levels of serum creatinine were significantly associated with an increased risk of T2DM in men with creatinine below 1.20 mg/dl. There was a trend that decreased levels of serum creatinine were associated with an increased risk of T2DM among women with serum creatinine below 1.1 mg/dl, although this result was not statistically significant.

Hyperglycemia Is Not Associated With Higher Volumetric BMD in a Chinese Health Check-up Cohort

Background and PurposeType 2 diabetes mellitus patients have an increased fracture risk despite having higher areal bone mineral density (aBMD) measured by DXA. This apparent paradox might be explained by the overestimation of BMD by DXA due to the higher fat mass in type 2 diabetes mellitus patients. Volumetric BMD (vBMD) as assessed by quantitative CT (QCT) is not influenced by fat mass. We assessed the association of vBMD and fasting plasma glucose in a large cohort of Chinese subjects and compared the vBMD in healthy and diabetic subjects. In addition, we compared the relation between aBMD, vBMD, glucose and fat mass in a subset of this cohort.Materials and Methods10309 participants from the China Biobank project underwent QCT based on chest low dose CT to compute vBMD of L1 and L2 vertebrae and FPG measurements between 2018 and 2019. Among them, 1037 subjects also had spine DXA scans. Data was analyzed using linear regression models.ResultsIn the total cohort (5889 men and 4420 women, mean age 53 years, range 30-96), there was no significant association between vBMD and FPG after adjustment for age (women: p=0.774; men: p=0.149). 291 women and 606 men fitted the diagnostic criteria of diabetes. Both women and men with diabetes had lower vBMD compared to non-diabetic subjects, but this became non-significant after adjusting for age in the total cohort (women: p=0.817; men: p=0.288) and after propensity score matching based on age (women: p=0.678; men: p=0.135). In the DXA subcohort, aBMD was significantly higher in men with diabetes after adjusting for age and this difference disappeared after further adjusting for total fat area (p=0.064).ConclusionWe did not find any effect of fasting plasma glucose or diabetes on the volumetric BMD measured with QCT after adjustment for age. Therefore, vBMD measured with QCT might be a more reliable measurement to diagnose osteoporosis and assess fracture risk than aBMD measured with DXA in diabetic patients.

Effect of Parkia biglobosa seed on lipid profile of dexamethasone-treated pregnant rats

This study was aimed at evaluating the effect of Parkia biglobosa seed on dexamethasone-treated pregnant rats. Locust bean seeds were purchased from an open market in Ado Ekiti, Nigeria. It was processed and ground into powder which was subsequently used in formulating feed for experimental animals. Fifteen female pregnant rats were divided in three groups of five each. Animals in group A were exposed to standard animal feed only. This served as the control group. Those in group B were exposed to animal feed mixed with locust beans + 0.3 mg/kg body weight of dexamethasone, while those in group C were exposed to animal feed mixed with locust beans. At the end of eight days treatment, animals were sacrificed and blood sample was collected into EDTA bottles and centrifuged. Plasma was separated and used for the determination of glucose and lipid profile. Exposure of animals to dexamethasone was observed to significantly (p<0.05) increased the concentration of plasma glucose concentration when compared with the control as well as animals treated with P. biglobosa only. Animals treated with dexamethasone along with P. biglobosa were observed to have higher concentrations of triglyceride, total cholesterol, low density lipoprotein (LDL) and very low density lipoprotein (VLDL) when compared with those in animals in the control group as well as those treated with P. biglobosa only. Observations from this study revealed that dexamethasone adversely perturbed and unhinged plasma glucose and lipid profile in female pregnant rats while P. biglobosa-formulated diet was observed to be a potent hypoglycemic and hypolipidemic agent.

DIABETES MELITUS TIPE 2: FAKTOR RISIKO, DIAGNOSIS, DAN TATALAKSANA

AbstrakDiabetes melitus menggambarkan sekelompok penyakit metabolik yang temuan umumnya adalah kadar glukosa darah yang meningkat. Pada usia 20-79 tahun, terdapat 463 juta atau setara 9,3% orang di dunia menderita diabetes pada tahun 2019. Diabetes melitus tipe 2 ditandai dengan defisiensi insulin relatif yang disebabkan oleh disfungsi sel pankreas dan resistensi insulin. Faktor risiko penyebabnya dibagi menjadi dua yaitu faktor risiko yang dapat dimodifikasi dan tidak dapat dimodifikasi. Gejala klasik diabetes seperti poliuria, polidipsia, polifagia dan penurunan berat badan yang tidak dapat dijelaskan sebabnya. Empat tes diagnostik untuk diabetes yaitu pengukuran glukosa plasma puasa, glukosa plasma 2 jam setelah TTGO 75 g, HbA1c, dan glukosa darah acak dengan adanya tanda dan gejala klasik diabetes. Tatalaksana dibagi menjadi dua, yaitu farmakologi dan non farmakologi. Tatalaksana non farmakologis terdiri atas edukasi, nutrisi medis, dan latihan fisik. Terapi farmakologis terdiri atas obat oral dan bentuk suntikan dalam bentu obat anti hiperglikemik dan insulin. Terapi farmakologi dan non farmakologi ini berjalan beriringan. Penulisan artikel ini menggunakan metode literature review dan diharapkan dapat dijadikan acuan kedepan dalam melakukan tindakan pencegahan dan pengobatan pasien diabetes melitus sehingga prevalensi berkurang dan komplikasi dapat dihindari. AbstractDiabetes mellitus describes a group of metabolic diseases whose common finding is elevated blood glucose levels. At the age of 20-79 years, there were 463 million or 9.3% of people in the world suffer from diabetes in 2019. Type 2 diabetes mellitus is characterized by relative insulin deficiency caused by pancreatic cell dysfunction and insulin resistance. The risk factors that cause it are divided into two, namely modifiable and non-modifiable risk factors. The classic symptoms of diabetes include polyuria, polydipsia, polyphagia and unexplained weight loss. The four diagnostic tests for diabetes are measurement of fasting plasma glucose, plasma glucose 2 hours after OGTT 75 g, HbA1c, and randomized blood glucose in the presence of classic signs and symptoms of diabetes. Treatment is divided into two, namely pharmacological and non-pharmacological. Non-pharmacological management consists of education, medical nutrition, and physical exercise. Pharmacological therapy consists of oral drugs and injections in the form of anti-hyperglycemic drugs and insulin. Pharmacological and non-pharmacological therapy goes hand in hand. The writing of this article uses the literature review method and is expected to be used as a future reference in carrying out prevention and treatment of diabetes mellitus patients so that prevalence is reduced and complications can be avoided.

Modifiable Risk Factors for Incident Dementia and Cognitive Impairment: An Umbrella Review of Evidence

Dementia and cognitive impairment can be attributed to both genetic and modifiable risk factors. Recently, considerable evidence emerged and urgently require standardized evaluation. To address it, we conducted an umbrella review of prospective studies regarding the associations of dementia and cognitive impairment with modifiable factors to evaluate the strength and validity of the existing evidence. We searched PubMed, Embase, CINAHL and Cochrane Database of Systematic Reviews to identify relevant systematic reviews and meta-analyses of prospective studies. Mendelian randomization studies were reviewed to assess the causality for these associations. For each association, we analyzed the summary effect size, 95% confidence interval, 95% prediction interval, heterogeneity, small study effect and excess significance bias. Based on these estimates, the evidence was graded into levels of convincing, highly suggestive, suggestive, or weak. In total, 12015 articles were identified, of which 118 eligible studies yielded 243 unique associations. Convincing evidence was found for associations of dementia and cognitive impairment with early-life education, midlife to late-life plasma glucose, body mass index, atrial fibrillation, benzodiazepine use, and gait speed. Suggestive to highly suggestive evidence was found for associations of dementia and cognitive impairment with midlife to late-life blood pressure, homocysteine, cerebrovascular diseases, hearing impairment, respiratory illness, anemia, smoking, alcohol consumption, diet, sleep, physical activity and social engagement. Among convincing evidence, Mendelian randomization studies verified genetic predicted causal relationships for education and plasma glucose with Alzheimer's disease. Modifiable factors identified in this study, especially those with high-level evidence, should be considered in dementia prevention. Trial registration: PROSPERO CRD42020195729.