scholarly journals Urinary Sodium Concentration Is an Independent Predictor of All-Cause and Cardiovascular Mortality in a Type 2 Diabetes Cohort Population

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Pierre-Jean Saulnier ◽  
Elise Gand ◽  
Stéphanie Ragot ◽  
Lise Bankir ◽  
Xavier Piguel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Cardiovascular Mortality ◽  
Independent Predictor ◽  
Sodium Intake ◽  
Sodium Concentration ◽  
Urinary Sodium ◽  
Prediction Of Mortality ◽  
Increased Risk

Objective.Sodium intake is associated with cardiovascular outcomes. However, no study has specifically reported an association between cardiovascular mortality and urinary sodium concentration (UNa). We examined the association ofUNawith mortality in a cohort of type 2 diabetes (T2D) patients.Methods. Patients were followed for all-cause death and cardiovascular death. BaselineUNawas measured from second morning spot urinary sample. We used Cox proportional hazard models to identify independent predictors of mortality. Improvement in prediction of mortality by the addition ofUNato a model including known risk factors was assessed by the relative integrated discrimination improvement (rIDI) index.Results. Participants (n=1,439) were followed for a median of 5.7 years, during which 254 cardiovascular deaths and 429 all-cause deaths were recorded.UNaindependently predicted all-cause and cardiovascular mortality. An increase of one standard deviation ofUNawas associated with a decrease of 21% of all-cause mortality and 22% of cardiovascular mortality.UNaimproved all-cause and cardiovascular mortality prediction beyond identified risk factors (rIDI = 2.8%,P=0.04and rIDI = 4.6%,P=0.02, resp.).Conclusions. In T2D,UNawas an independent predictor of mortality (low concentration is associated with increased risk) and improved modestly its prediction in addition to traditional risk factors.

scholarly journals Association of Urinary Sodium Excretion and Left Ventricular Hypertrophy in Patients With Type 2 Diabetes: A Cross-Section Study

2021 ◽  
Author(s):  
Jianfang Liu ◽  
Dan Guo ◽  
Peizhen Zhang ◽  
Xiaoyu Yang ◽  
Jiayang Lin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Logistic Regression ◽  
Sodium Excretion ◽  
Ventricular Hypertrophy ◽  
Sodium Intake ◽  
Urinary Sodium Excretion ◽  
Left Ventricular ◽  
Urinary Sodium

Abstract Background: It has been well documented that left ventricular hypertrophy (LVH) is highly associated with incidence of cardiovascular disease (CVD). Evidence indicated that high sodium intake has been observed related with LVH in general population. However, information is not available regarding the association between urinary sodium excretion and LVH in patients with type 2 diabetes (T2DM). This study aimed to explore the association between urinary sodium excretion and LVH in patients with T2DM.Methods: A total of 1356 patients with T2DM were recruited. Urinary sodium was measured from 24-hour urine samples of inpatients and morning fasting urine samples of outpatients. LVH was assessed by echocardiography. The associations between urinary sodium excretion and the risk factors for cardiovascular events, LVH and left ventricular mass index (LVMI) were examined using linear regression analysis, logistic regression and restricted cubic splines.Results: Urinary sodium excretion levels was positively associated with cardiometabolic risk factors, including systolic blood pressure (P<0.001), body mass index (P<0.001), waist circumference (P<0.001) and LVMI (P<0.001). In multivariable logistic regression analyses, increased urinary sodium excretion were significantly associated with increased risks of LVH [OR (95% CI), 1.47 (1.02-2.10); P=0.037] and CVD [OR (95% CI), 2.08 (1.20-3.61); P=0.009], after adjusted for demographics, lifestyle risk factors and cardiovascular risk factors. Multivariable-adjusted restricted cubic spline analyses of the association between urinary sodium excretion and LVMI showed a significant association (P=0.002) and provided no evidence of a nonlinear association (P=0.135).Conclusions: This study indicated that high urinary sodium excretion was independently associated with increased risk of LVH and CVD in patients with T2DM, suggesting that control of sodium intake is valuable in the prevention of diabetic cardiovascular complications.

scholarly journals Is Vitamin D Deficiency Related to Increased Cancer Risk in Patients with Type 2 Diabetes Mellitus?

2021 ◽  
Vol 22 (12) ◽  
pp. 6444
Author(s):  
Anna Gabryanczyk ◽  
Sylwia Klimczak ◽  
Izabela Szymczak-Pajor ◽  
Agnieszka Śliwińska
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Vitamin D ◽  
Cancer Risk ◽  
Vitamin D Deficiency ◽  
Cancer Development ◽  
Increased Risk

There is mounting evidence that type 2 diabetes mellitus (T2DM) is related with increased risk for the development of cancer. Apart from shared common risk factors typical for both diseases, diabetes driven factors including hyperinsulinemia, insulin resistance, hyperglycemia and low grade chronic inflammation are of great importance. Recently, vitamin D deficiency was reported to be associated with the pathogenesis of numerous diseases, including T2DM and cancer. However, little is known whether vitamin D deficiency may be responsible for elevated cancer risk development in T2DM patients. Therefore, the aim of the current review is to identify the molecular mechanisms by which vitamin D deficiency may contribute to cancer development in T2DM patients. Vitamin D via alleviation of insulin resistance, hyperglycemia, oxidative stress and inflammation reduces diabetes driven cancer risk factors. Moreover, vitamin D strengthens the DNA repair process, and regulates apoptosis and autophagy of cancer cells as well as signaling pathways involved in tumorigenesis i.e., tumor growth factor β (TGFβ), insulin-like growth factor (IGF) and Wnt-β-Cathenin. It should also be underlined that many types of cancer cells present alterations in vitamin D metabolism and action as a result of Vitamin D Receptor (VDR) and CYP27B1 expression dysregulation. Although, numerous studies revealed that adequate vitamin D concentration prevents or delays T2DM and cancer development, little is known how the vitamin affects cancer risk among T2DM patients. There is a pressing need for randomized clinical trials to clarify whether vitamin D deficiency may be a factor responsible for increased risk of cancer in T2DM patients, and whether the use of the vitamin by patients with diabetes and cancer may improve cancer prognosis and metabolic control of diabetes.

scholarly journals Sodium Intake and Incidence of Diabetes Complications in Elderly Patients with Type 2 Diabetes—Analysis of Data from the Japanese Elderly Diabetes Intervention Study (J-EDIT)

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 689
Author(s):  
Chika Horikawa ◽  
Rei Aida ◽  
Shiro Tanaka ◽  
Chiemi Kamada ◽  
Sachiko Tanaka ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Elderly Patients ◽  
Diabetes Complications ◽  
Vegetable Intake ◽  
Sodium Intake ◽  
Food Groups ◽  
High Sodium ◽  
Increased Risk

This study investigates the associations between sodium intake and diabetes complications in a nationwide cohort of elderly Japanese patients with type 2 diabetes aged 65–85. Data from 912 individuals regarding their dietary intake at baseline is analyzed and assessed by the Food Frequency Questionnaire based on food groups. Primary outcomes are times to diabetic retinopathy, overt nephropathy, cardiovascular disease (CVD), and all-cause mortality during six years. We find that mean sodium intake in quartiles ranges from 2.5 g to 5.9 g/day. After adjustment for confounders, no significant associations are observed between sodium intake quartiles and incidence of diabetes complications and mortality, except for a significant trend for an increased risk of diabetic retinopathy (p = 0.039). Among patients whose vegetable intake was less than the average of 268.7 g, hazard ratios (HRs) for diabetic retinopathy in patients in the second, third, and fourth quartiles of sodium intake compared with the first quartile were 0.87 (95% CI, 0.31–2.41), 2.61 (1.00–6.83), and 3.70 (1.37–10.02), respectively. Findings indicate that high sodium intake under conditions of low vegetable intake is associated with an elevated incidence of diabetic retinopathy in elderly patients with type 2 diabetes.

Cardiovascular events in patients with type 2 diabetes

2002 ◽  
Vol 2 (1_suppl) ◽  
pp. S4-S8
Author(s):  
Erland Erdmann
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Risk Factor ◽  
Adverse Effects ◽  
Cardiovascular Events ◽  
Left Ventricular ◽  
Diabetic Patients ◽  
Increased Risk

Diabetes is a common risk factor for cardiovascular disease. Coronary heart disease and left ventricular dysfunction are more common in diabetic patients than in non-diabetic patients, and diabetic patients benefit less from revascularisation procedures. This increased risk can only partly be explained by the adverse effects of diabetes on established risk factors; hence, a substantial part of the excess risk must be attributable to direct effects of hyperglycaemia and diabetes. In type 2 diabetes, hyperinsulinaemia, insulin resistance and hyperglycaemia have a number of potential adverse effects, including effects on endothelial function and coagulation. Risk factor modification has been shown to reduce the occurrence of cardiovascular events in patients with diabetes; indeed, diabetic patients appear to benefit more in absolute terms than non-diabetic patients. There is thus a strong case for intensive treatment of risk factors, including insulin resistance and hyperglycaemia, in patients with type 2 diabetes.

scholarly journals Insomnia is associated with an increased risk of type 2 diabetes in the clinical setting

2018 ◽  
Vol 6 (1) ◽  
pp. e000604 ◽  
Author(s):  
Erin S LeBlanc ◽  
Ning X Smith ◽  
Gregory A Nichols ◽  
Michael J Allison ◽  
Gregory N Clarke
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Clinical Setting ◽  
Clinical Importance ◽  
International Classification Of Diseases ◽  
Hospital Inpatient ◽  
Increased Risk ◽  
Traditional Risk Factors

ObjectiveTo determine the possible association between insomnia and risk of type 2 diabetes mellitus (T2DM) in the naturalistic clinical setting.Research design and methodsWe conducted a retrospective cohort study to examine the risk of developing T2DM among patients with pre-diabetes with and without insomnia. Participants with pre-diabetes (identified by a physician or via two laboratory tests) between January 1, 2007 and December 31, 2015 and without sleep apnea were followed until December 31, 2016. Patients were determined to have T2DM when two of the following occurred within a 2-year window: physician-entered outpatient T2DM diagnosis (International Classification of Diseases [ICD]-9 250.00; ICD-10 E11), dispensing of an antihyperglycemia agent, and hemoglobin A1c (A1c) >6.5% (48 mmol/mol) or fasting plasma glucose (FPG) >125 mg/dL. One hospital inpatient stay with an associated T2DM diagnosis was also sufficient for classification of T2DM.ResultsOur cohort consisted of 81 233 persons with pre-diabetes, 24 146 (29.7%) of whom had insomnia at some point during the 4.3-year average observation period. After adjustment for traditional risk factors, those with insomnia were 28% more likely to develop T2DM than those without insomnia (HR 1.28; 95% CI 1.24 to 1.33). The estimate was essentially unchanged after adjusting for baseline A1c level (HR 1.32; 95% CI 1.25 to 1.40) or FPG (HR 1.28; 95% CI 1.23 to 1.33).ConclusionsInsomnia imparts an increased risk of T2DM comparable with that conferred by traditional risk factors (eg, overweight, non-white race, cardiovascular risk factors). This association could have clinical importance because it suggests a new potentially modifiable risk factor that could be targeted to prevent diabetes.

P4993Tissue sodium concentration emerged as a determinant of hypertrophic vascular remodeling in type 2 diabetes

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
R Schmieder ◽  
S Jung ◽  
D Kannenkeril ◽  
J M Harazny ◽  
K Striepe ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Vascular Remodeling ◽  
Sodium Intake ◽  
Structural Parameters ◽  
Sodium Concentration ◽  
Sodium Content ◽  
Resistance Vessels ◽  
Retinal Arterioles ◽  
Tissue Sodium

Abstract Background Studies describe a linkage between greater sodium intake and higher incidence of organ damage and cardiovascular end points. Sodium intake is usually assessed by measuring 24-hour urinary sodium excretion, which is prone to high fluctuation. For the assessment of tissue sodium a new technique (23Na-MRI) has been developed. We analyzed whether tissue sodium is linked to vascular remodeling of small resistance vessels in patients with type-2 diabetes. Methods In patients with type 2 diabetes we assessed tissue sodium content and vascular structural parameters of the retinal arterioles, since structural changes of resistance vessels (150–300 μm) can be non-invasively and reliably assessed in the retinal circulation by Scanning Laser Doppler Flowmetry (SLDF). Patients with antidiabetic medication were off the therapy (antihypertensives were kept constant) for 4 weeks. The structural parameters of retinal arterioles assessed were outer- and inner diameter (OD & ID), wall thickness (WT), wall-to-lumen ratio (WLR) and wall cross sectional area (WCSA). Tissue sodium content was assessed non-invasively with a 3.0 T clinical MRI system in each patient. Subject placed their lower legs in the center of a 23Na knee coil and sodium content in skin and muscle (musculus triceps surae) were measured. Results In patients with type 2 diabetes (N=52) we observed a significant correlation between tissue sodium content (muscle and skin) and OD, WT and WCSA and a trend has been noticed between muscle sodium content and ID and WLR. Multiple linear regression analysis demonstrated that tissue sodium content is a significant determinant of hypertrophic vascular remodeling as indicated by increased WT and WCSA, independent of age, gender and 24-hour ambulatory diastolic blood pressure. Correlation coefficients Muscle sodium content (mmol/l) Skin sodium content (mmol/l) OD (μmol) r=0.402, p=0.003 r=0.299, p=0.033 ID (μmol) r=0.265, p=0.058 r=0.202, p=0.154 WT (μm) r=0.402, p=0.003 r=0.313, p=0.026 WLR r=0.247, p=0.078 r=0.171, p=0.230 WCSA (μm2) r=0.417, p=0.002 r=0.322, p=0.021 Conclusion With the novel 23Na-MRI technology, we could demonstrate that high tissue sodium concentration is linked to with hypertrophic vascular remodeling of retinal arterioles. Thus, the reduction of tissue sodium content may emerge as a therapeutic target.

scholarly journals Prevalence of Type 2 Diabetes and Associated Risk Factors Among Saharawi Refugees (P10-071-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Sigrun Henjum ◽  
Victoria Telle Hjellset ◽  
Marte Karoline Raberg Kjollesdal ◽  
Merethe Flaaten ◽  
Eivind Andersen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Waist Circumference ◽  
Overweight And Obesity ◽  
Refugee Camps ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Increased Risk ◽  
Associated Risk Factors

Abstract Objectives Economic development, globalization and urbanization has resulted in a shift in dietary consumption and energy expenditure in low- and middle-income countries, called the Nutrition Transition. At the same time, the prevalence of type 2 diabetes (T2D) and associated co-morbidities are rising worldwide. The Saharawi refugees have been living in refugee camps in the Algerian desert since 1975 and are totally dependent on food aid. High prevalence of overweight and obesity has been reported among Saharawi women. Limited knowledge about the prevalence of T2D and associated risk factors exists in this population; therefore, the aim with this study was to address this gap in the literature. Methods A cross-sectional survey was carried out in five Saharawi refugee camps, in Algeria and 180 women and 175 men were randomly selected. Participants’ blood glucose levels was assessed by HbA1c measurements and diagnosed with diabetes if HbA1c ≥48 mmol/mol and prediabetes if HbA1c was between 42–47 mmol/mol. The Finnish Diabetes Risk Score (FINDRISK) was used to assess various risk factors for T2D. Results Mean HbA1c among the Saharawi refugees was 38 mmol/mol. Seven and 15% were diagnosed with T2D and prediabetes, respectively, and 26% and 19% were overweight and obese, respectively. According to FINDRISK, 9% of the participants had high risk of developing diabetes, 10% had moderate risk, 37% had some risk and 44% had low risk. In multiple logistic regression models, after controlling for age, gender, number of children, BMI and education, the strongest predictor for diabetes was waist circumference, OR (95% CI): 1.1 (1.0, 1.1). The strongest predictor for prediabetes was age and waist circumference OR (95% CI): 1.0 (1.0, 1.1) and OR (95% CI): 1.1 (1.0, 1.1), respectively. Conclusions We found moderate prevalence of diabetes among the Saharawi refugees; however a high proportion had prediabetes and were suffering from overweight and obesity. In light of this, the rates of T2D are likely to increase dramatically in the near future. The Saharawi health authorities should pay attention to the increased risk of diabetes in this in this vulnerable population. Funding Sources Oslo Metropolitan University.

Evaluation of the Perception of Risk Factors for Type 2 Diabetes Instrument in an At-Risk, Nondiabetic Population

2016 ◽  
Vol 24 (2) ◽  
pp. 83E-100E ◽  
Author(s):  
Lisa L. Shah ◽  
Yelena Perkhounkova ◽  
Sandra Daack-Hirsch
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Factor Structure ◽  
Pearson Correlation ◽  
Positive Family History ◽  
Reliability And Validity ◽  
Internal Consistency Reliability ◽  
Perception Of Risk ◽  
Increased Risk

Background and Purpose: This study evaluated the psychometric properties of the Perception of Risk Factors for Type 2 Diabetes (PRF-T2DM), an instrument designed to measure awareness and vulnerability to diabetes and diabetes risk factors. Methods: 248 individuals at increased risk for diabetes because of a positive family history completed the PRF-T2DM. The factor-structure, internal consistency reliability, and construct validity of the PRF-T2DM were examined. Results: The 2-factor structure of the PRFT2DM was a good fit to our data. Overall Cronbach's alpha was .68. Pearson correlation between PRF-T2DM score and overall risk perception was significant (r = .26, p < .001). Replies to individual items supported the validity of the PRF-T2DM. Conclusion: The PRF-T2DM performed modestly in this population. Refinement in scoring and score interpretation may improve reliability and validity of the instrument.

scholarly journals Is the number of fast-food outlets in the neighbourhood related to screen-detected type 2 diabetes mellitus and associated risk factors?

2014 ◽  
Vol 18 (9) ◽  
pp. 1698-1705 ◽  
Author(s):  
Danielle H Bodicoat ◽  
Patrice Carter ◽  
Alexis Comber ◽  
Charlotte Edwardson ◽  
Laura J Gray ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Fast Food ◽  
Social Deprivation ◽  
Cross Sectional ◽  
Food Outlets ◽  
Increased Risk

AbstractObjectiveWe investigated whether a higher number of fast-food outlets in an individual’s home neighbourhood is associated with increased prevalence of type 2 diabetes mellitus and related risk factors, including obesity.DesignCross-sectional study.SettingThree UK-based diabetes screening studies (one general population, two high-risk populations) conducted between 2004 and 2011. The primary outcome was screen-detected type 2 diabetes. Secondary outcomes were risk factors for type 2 diabetes.SubjectsIn total 10 461 participants (mean age 59 years; 53 % male; 21 % non-White ethnicity).ResultsThere was a higher number of neighbourhood (500 m radius from home postcode) fast-food outlets among non-White ethnic groups (P<0·001) and in socially deprived areas (P<0·001). After adjustment (social deprivation, urban/rural, ethnicity, age, sex), more fast-food outlets was associated with significantly increased odds for diabetes (OR=1·02; 95 % CI 1·00, 1·04) and obesity (OR=1·02; 95 % CI 1·00, 1·03). This suggests that for every additional two outlets per neighbourhood, we would expect one additional diabetes case, assuming a causal relationship between the fast-food outlets and diabetes.ConclusionsThese results suggest that increased exposure to fast-food outlets is associated with increased risk of type 2 diabetes and obesity, which has implications for diabetes prevention at a public health level and for those granting planning permission to new fast-food outlets.

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