Dataset Information

IDENTIFYING PROBABLE DIABETES MELLITUS AMONG HISPANICS/LATINOS FROM FOUR U.S. CITIES: FINDINGS FROM THE HISPANIC COMMUNITY HEALTH STUDY/STUDY OF LATINOS.

ABSTRACT:

Objective

The aim of this study was to compare the ability of American Diabetes Association (ADA) diagnostic criteria to identify U.S. Hispanics/Latinos from diverse heritage groups with probable diabetes mellitus and assess cardiovascular risk factor correlates of those criteria.

Methods

Cross-sectional analysis of data from 15,507 adults from 6 Hispanic/Latino heritage groups, enrolled in the Hispanic Community Health Study/Study of Latinos. The prevalence of probable diabetes mellitus was estimated using individual or combinations of ADA-defined cut points. The sensitivity and specificity of these criteria at identifying diabetes mellitus from ADA-defined prediabetes and normoglycemia were evaluated. Prevalence ratios of hypertension, abnormal lipids, and elevated urinary albumin-creatinine ratio for unrecognized diabetes mellitus-versus prediabetes and normoglycemia-were calculated.

Results

Among Hispanics/Latinos (mean age, 43 years) with diabetes mellitus, 39.4% met laboratory test criteria for probable diabetes, and the prevalence varied by heritage group. Using the oral glucose tolerance test as the gold standard, the sensitivity of fasting plasma glucose (FPG) and hemoglobin A1c-alone or in combination-was low (18, 23, and 33%, respectively) at identifying probable diabetes mellitus. Individuals who met any criterion for probable diabetes mellitus had significantly higher (P<.05) prevalence of most cardiovascular risk factors than those with normoglycemia or prediabetes, and this association was not modified by Hispanic/Latino heritage group.

Conclusion

FPG and hemoglobin A1c are not sensitive (but are highly specific) at detecting probable diabetes mellitus among Hispanics/Latinos, independent of heritage group. Assessing cardiovascular risk factors at diagnosis might prompt multitarget interventions and reduce health complications in this young population.

Abbreviations

2hPG = 2-hour post-glucose load plasma glucose ADA = American Diabetes Association BMI = body mass index CV = cardiovascular FPG = fasting plasma glucose HbA1c = hemoglobin A1c HCHS/SOL = Hispanic Community Health Study/Study of Latinos HDL-C = high-density-lipoprotein cholesterol NGT = normal glucose tolerance NHANES = National Health and Nutrition Examination Survey OGTT = oral glucose tolerance test TG = triglyceride UACR = urine albumin-creatinine ratio.

SUBMITTER: Aviles-Santa ML

PROVIDER: S-EPMC6339459 | biostudies-literature | 2016 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

IDENTIFYING PROBABLE DIABETES MELLITUS AMONG HISPANICS/LATINOS FROM FOUR U.S. CITIES: FINDINGS FROM THE HISPANIC COMMUNITY HEALTH STUDY/STUDY OF LATINOS.

Avilés-Santa M Larissa ML Schneiderman Neil N Savage Peter J PJ Kaplan Robert C RC Teng Yanping Y Pérez Cynthia M CM Suárez Erick L EL Cai Jianwen J Giachello Aida L AL Talavera Gregory A GA Cowie Catherine C CC

Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists 20160613 10

<h4>Objective</h4>The aim of this study was to compare the ability of American Diabetes Association (ADA) diagnostic criteria to identify U.S. Hispanics/Latinos from diverse heritage groups with probable diabetes mellitus and assess cardiovascular risk factor correlates of those criteria.<h4>Methods</h4>Cross-sectional analysis of data from 15,507 adults from 6 Hispanic/Latino heritage groups, enrolled in the Hispanic Community Health Study/Study of Latinos. The prevalence of probable diabetes m ...[more]

PMID: 27295013

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Project description:Rationale & objectiveRecent studies suggest that periodontal disease may be associated with incident chronic kidney disease (CKD). However, studies have focused on older populations, and US Hispanics/Latinos were not well represented.Study designObservational cohort.Setting & participantsWe analyzed data from the Hispanic Community Health Study/Study of Latinos who completed a baseline visit with a periodontal examination and a follow-up visit, and did not have CKD at baseline.PredictorsPredictors included ≥30% of sites with clinical attachment loss ≥3 mm, ≥30% of sites with probing depth ≥4 mm, percentage of sites with bleeding on probing, and absence of functional dentition (<21 permanent teeth present).OutcomesOutcomes were incident low estimated glomerular filtration rate (eGFR) (eGFR <60 mL/min/1.73 m2 and decline in eGFR ≥1 mL/min/year); incident albuminuria (urine albumin:creatinine ratio [ACR] ≥30 mg/g); and change in eGFR and ACR.Analytic approachPoisson and linear regression.ResultsFor the sample (n = 7.732), baseline mean age was 41.5 years, 45.2% were male, 11.7% had ≥30% of sites with clinical attachment loss ≥3 mm, 5.1% had ≥30% of sites with probing depth ≥4 mm, 30.7% had ≥50% of sites with bleeding on probing, and 16.2% had absent functional dentition. During a median follow-up of 5.9 years, 149 patients developed low eGFR and 415 patients developed albuminuria. On multivariable analysis, presence versus absence of ≥30% of sites with probing depth ≥4 mm and absence of functional dentition were each associated with increased risk for incident low eGFR (incident density ratio, 2.31; 95% CI, 1.14-4.65 and 1.65, 95% CI, 1.01-2.70, respectively). None of the other predictors were associated with outcomes.LimitationsOnly a single kidney function follow-up measure.ConclusionsIn this cohort of US Hispanics/Latinos, we found that select measures of periodontal disease were associated with incident low eGFR. Future work is needed to assess whether the treatment of periodontal disease may prevent CKD.

Project description:BackgroundRecent studies suggest an association between diet quality and incident CKD. However, Hispanics/Latinos were under-represented in these studies. We examined the relationship of diet quality with change in kidney function in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).MethodsIndividuals who participated in HCHS/SOL visits 1 (2008-2011) and 2 (2014-2017) were analyzed (n=9921). We used Alternate Healthy Eating Index 2010 (AHEI-2010), Dietary Approaches to Stop Hypertension (DASH), and Mediterranean Diet (MeDS) scores as measures of dietary quality. Scores were calculated from two 24-hour dietary recalls administered at visit 1 and categorized into quartiles of each dietary score (higher quartiles correspond to a healthier diet). Kidney function was assessed at both visits using eGFR and urine albumin-creatinine ratio (UACR). Annualized change was computed as the difference in eGFR or UACR between visits divided by follow-up time in years. Weighted linear-regression models were used to examine the association between quartiles of each dietary quality index and annualized change in eGFR and UACR, adjusted for potential confounders.ResultsAt visit 1, the mean (SD) age of participants was 41 (0.28) years, and 56% were female. The baseline mean eGFR was 107.1 ml/min per 1.73 m2, and baseline median UACR was 6.1 mg/g. On average, eGFR declined by 0.65 ml/min per 1.73 m2 per year, and UACR increased by 0.79 mg/g per year over a 6-year period. Lower AHEI-2010 quartiles were associated with eGFR decline in a dose-response manner (P trend=0.02). Higher AHEI-2010 quartiles showed a trend toward lower annualized change in UACR, but the result did not reach significance. Neither MeDS nor DASH scores were associated with eGFR decline or change in UACR.ConclusionsUnhealthy diet, assessed at baseline by AHEI-2010, was associated with kidney-function decline over 6 years. Improving the quality of foods and nutrients according to the AHEI-2010 may help maintain kidney function in the Hispanic/Latino community.

Dataset Information

IDENTIFYING PROBABLE DIABETES MELLITUS AMONG HISPANICS/LATINOS FROM FOUR U.S. CITIES: FINDINGS FROM THE HISPANIC COMMUNITY HEALTH STUDY/STUDY OF LATINOS.

Objective

Methods

Results

Conclusion

Abbreviations

Publications

IDENTIFYING PROBABLE DIABETES MELLITUS AMONG HISPANICS/LATINOS FROM FOUR U.S. CITIES: FINDINGS FROM THE HISPANIC COMMUNITY HEALTH STUDY/STUDY OF LATINOS.

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