scholarly journals Sex Differences in Rates of Change and Burden of Metabolic Risk Factors Among Adults Who Did and Did Not Go On to Develop Diabetes: Two Decades of Follow-up From the Tehran Lipid and Glucose Study

Diabetes Care ◽  
2020 ◽  
Vol 43 (12) ◽  
pp. 3061-3069
Author(s):  
Azra Ramezankhani ◽  
Fereidoun Azizi ◽  
Farzad Hadaegh
Keyword(s):  
Risk Factors ◽  
Sex Differences ◽  
Metabolic Risk Factors ◽  
Metabolic Risk ◽  
Rates Of Change

scholarly journals Sex differences in rates of change and burden of metabolic risk factors among adults who did and did not go on develop diabetes: two decades of follow-up from the Tehran Lipid and Glucose study

2020 ◽  
Author(s):  
Azra Ramezankhani ◽  
Fereidoun Azizi ◽  
Farzad Hadaegh
Keyword(s):  
Risk Factors ◽  
Rate Of Change ◽  
Activity Level ◽  
Metabolic Risk Factors ◽  
Individual Growth ◽  
Metabolic Risk ◽  
Family History Of Diabetes ◽  
P Values ◽  
Rates Of Change ◽  
Diabetes Status

<b>Objective:</b> We investigated the cumulative burden and linear rates of change of major metabolic risk factors (MRFs) among Iranian adults in whom type 2 diabetes did and did not develop. <p><b>Research Design and Methods:</b> We included 7,163 participants (3,069 men) aged 20-70 years at baseline with at least three examinations during 1999-2018. Individual growth curve modeling was used for data analysis. Statistical interactions for sex by diabetes status were adjusted for age, family history of diabetes, smoking status and physical activity level. </p> <p><b>Results:</b> Study sample included 743 (316 men) new cases of diabetes. In both men and women, compared with individuals in whom diabetes did not develop, individuals in whom diabetes developed had a higher burden of all MRFs and a greater rate of change in body mass index (BMI), fasting plasma glucose (FPG), systolic and diastolic blood pressure (SBP and DBP); however, the differences in burden and rate of change between those who did and did not develop diabetes were greater in women than in men. So that, during the transition to diabetes, women experienced more adverse change in BMI, FPG, triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C) (diabetes-sex interaction P values <0.05), and faster rates of change in BMI, FPG, HDL-C and total cholesterol (TC) (interaction P values <0.01) and SBP (interaction P=0.055) than men. </p> <p><b>Conclusion: </b>The greater exposure of women to and burden of MRFs before onset of diabetes may have implications for implementing sex specific strategies in order to prevent or delay diabetes complications.</p>

scholarly journals The effectiveness of general practice-based health checks on health behaviour and incidence on non-communicable diseases in individuals with low socioeconomic position: a randomised controlled trial in Denmark

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e029180 ◽  
Author(s):  
Nina Kamstrup-Larsen ◽  
Susanne Oksbjerg Dalton ◽  
Morten Grønbæk ◽  
Marie Broholm-Jørgensen ◽  
Janus Laust Thomsen ◽  
...  
Keyword(s):  
Risk Factors ◽  
General Practice ◽  
Health Behaviour ◽  
Intervention Group ◽  
Metabolic Risk Factors ◽  
Health Check ◽  
Control Group ◽  
Metabolic Risk ◽  
Health Checks

BackgroundThe effectiveness of health checks aimed at the general population is disputable. However, it is not clear whether health checks aimed at certain groups at high risk may reduce adverse health behaviour and identify persons with metabolic risk factors and non-communicable diseases (NCDs).ObjectivesTo assess the effect of general practice-based health checks on health behaviour and incidence on NCDs in individuals with low socioeconomic position.MethodsIndividuals with no formal education beyond lower secondary school and aged 45–64 years were randomly assigned to the intervention group of a preventive health check or to control group of usual care in a 1:1 allocation. Randomisation was stratified by gender and 5-year age group. Due to the real-life setting, blinding of participants was only possible in the control group. Effects were analysed as intention to treat (ITT) and per protocol. The trial was undertaken in 32 general practice units in Copenhagen, Denmark.InterventionInvitation to a prescheduled preventive health check from the general practitioner (GP) followed by a health consultation and an offer of follow-up with health risk behaviour change or preventive medical treatment, if necessary.Primary outcome measuresSmoking status at 12-month follow-up. Secondary outcomes included status in other health behaviours such as alcohol consumption, physical activity and body mass index (measured by self-administered questionnaire), as well as incidence of metabolic risk factors and NCDs such as hypertension, hypercholesterolaemia, chronic obstructive pulmonary disease, diabetes mellitus, hypothyroidism, hyperthyroidism and depression (drawn from national healthcare registries).Results1104 participants were included in the study. For the primary outcome, 710 participants were included in the per protocol analysis, excluding individuals who did not attend the health check, and 1104 participants were included in the ITT analysis. At 12-month follow-up, 37% were daily smokers in the intervention group and 37% in the control group (ORs=0.99, 95% CI: 0.76 to 1.30). No difference in health behaviour nor in the incidence of metabolic risk factors and NCDs between the intervention and control group were found. Side effects were comparable across the two groups.ConclusionThe lack of effectiveness may be due to low intensity of intervention, a high prevalence of metabolic risk factors and NCDs among the participants at baseline as well as a high number of contacts with the GPs in general or to the fact that general practices are not an effective setting for prevention.Trial registration numberNCT01979107.

scholarly journals Sex differences in rates of change and burden of metabolic risk factors among adults who did and did not go on develop diabetes: two decades of follow-up from the Tehran Lipid and Glucose study

2020 ◽  
Author(s):  
Azra Ramezankhani ◽  
Fereidoun Azizi ◽  
Farzad Hadaegh
Keyword(s):  
Risk Factors ◽  
Rate Of Change ◽  
Activity Level ◽  
Metabolic Risk Factors ◽  
Individual Growth ◽  
Metabolic Risk ◽  
Family History Of Diabetes ◽  
P Values ◽  
Rates Of Change ◽  
Diabetes Status

<b>Objective:</b> We investigated the cumulative burden and linear rates of change of major metabolic risk factors (MRFs) among Iranian adults in whom type 2 diabetes did and did not develop. <p><b>Research Design and Methods:</b> We included 7,163 participants (3,069 men) aged 20-70 years at baseline with at least three examinations during 1999-2018. Individual growth curve modeling was used for data analysis. Statistical interactions for sex by diabetes status were adjusted for age, family history of diabetes, smoking status and physical activity level. </p> <p><b>Results:</b> Study sample included 743 (316 men) new cases of diabetes. In both men and women, compared with individuals in whom diabetes did not develop, individuals in whom diabetes developed had a higher burden of all MRFs and a greater rate of change in body mass index (BMI), fasting plasma glucose (FPG), systolic and diastolic blood pressure (SBP and DBP); however, the differences in burden and rate of change between those who did and did not develop diabetes were greater in women than in men. So that, during the transition to diabetes, women experienced more adverse change in BMI, FPG, triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C) (diabetes-sex interaction P values <0.05), and faster rates of change in BMI, FPG, HDL-C and total cholesterol (TC) (interaction P values <0.01) and SBP (interaction P=0.055) than men. </p> <p><b>Conclusion: </b>The greater exposure of women to and burden of MRFs before onset of diabetes may have implications for implementing sex specific strategies in order to prevent or delay diabetes complications.</p>

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