Exploring Association Between Individuals' Stature and Type 2 Diabetes Status: Propensity Score Analysis.
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ABSTRACT:
SUBMITTER: Talukder A
PROVIDER: S-EPMC6425527 | biostudies-literature | 2019
REPOSITORIES: biostudies-literature
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Project description:Statins have anti-inflammatory and immunomodulatory properties that may affect the development of tuberculosis (TB). We assessed the association between use of statins and the risk of active TB by propensity score matching. Furthermore, we analyzed the impact of statins on TB in patients according to the presence or absence of diabetes. The study was based on the National Health Insurance database and its subset database of the "medical checkup" population of South Korea. We identified 123,468 statin users and 439,546 non-statin users. After propensity score matching, 28,018 statin users and the same number of non-statin users were finally analyzed. The development of active TB was monitored in these matched pairs over 11 years. In the propensity score-matching analysis, the number of active TB cases was 30 in 30,303 person-years (0.99 per 1,000 person-years; 95% CI, 0.64-1.35) in the statin users and 235 in 167,857 person-years (1.40 per 1,000 person-years; 95% CI, 1.22-1.58) in the non-statin users. Statin users had a significantly lower risk of TB than non-statin users: hazard ratio (HR) 0.67 (95% CI, 0.46-0.98) (P = 0.04). A subgroup analysis showed that statin use reduced the risk of TB in subjects without diabetes, but not in patients with diabetes: HRs were, respectively, 0.28 (95% CI, 0.13-0.60) (P = 0.001) and 1.05 (95% CI, 0.66-1.67) (P = 0.84). There is epidemiologic evidence that statin decreases the risk of active TB. However, the protective effect of statins against TB is attenuated by diabetes.
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Project description:INTRODUCTION:We hypothesized that hypertensive patients harbor a higher risk of urinary bladder (UB) cancer. MATERIAL AND METHODS:We performed a population-based cohort study on adults using a National Health Insurance Research Database (NHIRD) dataset. Hypertension and comparison non-hypertensive (COMP) groups comprising 39,618 patients each were propensity score-matched by age, sex, index date, and medical comorbidities. The outcome was incident UB cancer validated using procedure codes. We constructed multivariable Cox models to derive adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs). Cumulative incidence was compared using a log-rank test. RESULTS:During a total follow-up duration of 380,525 and 372,020 person-years in the hypertension and COMP groups, 248 and 186 patients developed UB cancer, respectively, representing a 32% increase in the risk (aHR, 1.32; 95% CI, 1.09-1.60). Hypertensive women harbored a significantly increased risk of UB cancer (aHR, 1.55; 95% CI, 1.12-2.13) compared with non-hypertensive women, whereas men with hypertension had a statistically non-significant increased risk (aHR, 1.22; 95% CI, 0.96-1.55). The sensitivity analysis demonstrated that the increased risk was sustained throughout different follow-up durations for the entire cohort; a statistical increase in the risk was also noted among hypertensive men. CONCLUSION:This nationwide population-based propensity score-matched cohort study supports a positive association between hypertension and subsequent UB cancer development.
| S-EPMC6055751 | biostudies-literature
Project description:ObjectiveWe sought to determine the impact of Type 2 Diabetes Mellitus (T2D) anti-hyperglycemic medications (A-HgM) on risk of Alzheimer's disease (AD) and related dementias (ADRD) outcomes including vascular dementia, and non-AD dementia such as frontotemporal, Lewy body, and mixed etiology dementias.Research design and methodsThis retrospective cohort study used the US-based Mariner claims dataset. 1,815,032 T2D participants 45 years and older with records 6 months prior and at least 3 years after the diagnosis of T2D were included. Claims were surveyed for a diagnosis of AD and ADRD 12 months post T2D diagnosis. A propensity score approach was used to minimize selection bias. Analyses were conducted between January 1st and February 28th, 2021.ResultsIn this cohort study A-HgM exposure was associated with decreased diagnosis of AD (RR, 0.61; 95% CI, 0.59-0.62; p < 0.001), vascular dementia (RR, 0.72; 95% CI, 0.69-0.74; p < 0.001) and non-AD dementia (RR, 0.67; 95% CI, 0.66-0.68; p < 0.001). Metformin was associated with the greatest risk reduction and insulin with the least reduction in risk compared to patients not receiving A-HgM for ADRD risk. Of interest, patients with a diagnosis of AD, while either on metformin or insulin, were older in age and predominately female, than individuals on these drugs that did not develop AD. Mean (SD) follow-up was 6.2 (1.8) years.ConclusionAfter controlling for age, sex, and comorbidities, A-HgM in patients with T2D was associated with a reduced risk of AD and ADRD. These findings provide evidence in support of T2D as a risk factor for AD and ADRD and the beneficial impact of early and effective control of hyperglycemia to mitigate risk.
| S-EPMC9120543 | biostudies-literature
Project description:BackgroundDespite the growing number of studies on the coronavirus disease-19 (COVID-19), little is known about the association of menopausal status with COVID-19 outcomes.Materials and methodsIn this retrospective study, we included 336 COVID-19 inpatients between February 15, 2020 and April 30, 2020 at the Taikang Tongji Hospital (Wuhan), China. Electronic medical records including patient demographics, laboratory results, and chest computed tomography (CT) images were reviewed.ResultsIn total, 300 patients with complete clinical outcomes were included for analysis. The mean age was 65.3 years, and most patients were women (n = 167, 55.7%). Over 50% of patients presented with comorbidities, with hypertension (63.5%) being the most common comorbidity. After propensity score matching, results showed that men had significantly higher odds than premenopausal women for developing severe disease type (23.7% vs. 0%, OR 17.12, 95% CI 1.00-293.60; p = 0.003) and bilateral lung infiltration (86.1% vs. 64.7%, OR 3.39, 95% CI 1.08-10.64; p = 0.04), but not for mortality (2.0% vs. 0%, OR 0.88, 95% CI 0.04-19.12, p = 1.00). However, non-significant difference was observed among men and postmenopausal women in the percentage of severe disease type (32.7% vs. 41.7%, OR 0.68, 95% CI 0.37-1.24, p = 0.21), bilateral lung infiltration (86.1% vs. 91.7%, OR 0.56, 95% CI 0.22-1.47, p = 0.24), and mortality (2.0% vs. 6.0%, OR 0.32, 95% CI 0.06-1.69, p = 0.25).ConclusionsMen had higher disease severity than premenopausal women, while the differences disappeared between postmenopausal women and men. These findings support aggressive treatment for the poor prognosis of postmenopausal women in clinical practice.
| S-EPMC7844785 | biostudies-literature
Project description:Previous evidence revealed that central obesity played a vital role in the development of diabetes mellitus (DM). However, because of imbalanced confounding variables, some studies have not wholly established the association between central obesity and diabetes. Propensity score matching (PSM) analysis can minimize the impact of potential confounding variables. Therefore, the aim of the present study was to explore the relationship between central obesity and diabetes in the Japanese population by using PSM analysis. This retrospective cohort study included 15,453 Japanese adults who were free of diabetes at baseline between 2004 and 2015, which provided all medical records for individuals participating in the physical exam. Central obesity at baseline was an independent variable, and incident diabetes during follow-up was an outcome variable. Using a 1:1 PSM analysis, the present retrospective cohort study included 1639 adults with and without central obesity. Additionally, we employed a doubly robust estimation method to identify the association between central obesity and diabetes. Subjects with central obesity were 92% more likely to develop DM (HR = 1.65, 95%CI 1.12, 2.41). After adjusting for covariates, subjects with central obesity had a 72% increased risk of developing DM compared with subjects with non-central obesity in the PSM cohort (HR = 1.72, 95% CI 1.16, 2.56). Central obesity individuals had a 91% higher risk of DM than non-central obesity individuals, after adjustment for propensity score (HR = 1.91, 95% CI 1.29, 2.81). In sensitivity analysis, the central obesity group had a 44% (HR = 1.44, 95% CI 1.09, 1.90) and 59% (HR = 1.59, 95% CI1.35, 1.88) higher risk of DM than the non-central obesity group in the original and weighted cohorts after adjusting for confounding variables, respectively. Central obesity was independently associated with an increased risk of developing diabetes. After adjustment for confounding covariates, central obesity participants had a 72% higher risk of development of diabetes than non-central obesity individuals in the PSM cohort.
| S-EPMC9352654 | biostudies-literature
Project description:ObjectiveEvaluate whether arsenic-related diabetes risks differ between people of low and high socioeconomic status (SES).MethodsWe used data collected between October 2007-December 2010 from a population-based cancer case-control study (N = 1301) in Northern Chile, an area with high arsenic water concentrations (>800 µg/L) and comprehensive records of past exposure. Information on lifetime exposure and potential confounders were obtained using structured interviews, questionnaires, and residential histories. Type 2 diabetes was defined as physician-diagnosed diabetes or oral hypoglycemic medication use. SES was measured using a 14-point scale based on ownership of household appliances, cars, internet access, or use of domestic help. Logistic regression was used to assess the relationship between arsenic and diabetes within strata of SES.ResultsAmong those with low SES, the odds ratio (OR) for diabetes comparing individuals in the highest to lowest tertile of lifetime average arsenic exposure was 2.12 (95% confidence interval (CI) 1.29-3.49, p = 0.004). However, those in the high SES group were not at increased risk (OR = 1.12 [95% CI = 0.72-1.73]).ConclusionsOur findings provide evidence that risks of arsenic-related diabetes may be higher in Chile in people with low versus high SES.
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Project description:ObjectivesTo investigate the association between diabetes and cognitive dysfunction in the elderly population, and examine the impact of cognitive dysfunction on level of activities of daily living (ADL) in patients with diabetes.MethodsData analysis was conducted on 2,951 individuals aged over 65 years from the Chinese Longitudinal Healthy Longevity Survey cohort. Propensity score matching was utilized to mitigate selection bias. Multivariate binary logistic regression was performed to analyse the association between diabetes and cognitive dysfunction in the study subjects. In addition, the relationship between ADL and cognitive function in patients with diabetes was analysed using the Wilcoxon rank-sum test.ResultsA significant association (p = 0.017) was found between diabetes and the occurrence of cognitive dysfunction in older adults. Subgroup analyses revealed that diabetes patients with cognitive dysfunction exhibited a worse ADL dependence compared with those without cognitive dysfunction (p < 0.001).ConclusionThese findings indicate that diabetes is associated with cognitive dysfunction in older adults. Meanwhile, there is an association between cognitive impairment and ADL level in subjects with diabetes. As such, healthcare professionals should pay close attention to the occurrence of cognitive dysfunction and ADL decline during diagnosis and treatment, and proactive prevention and intervention strategies should be implemented.
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Project description: Not available
| S-EPMC10696756 | biostudies-literature
Project description:BackgroundStrong evidence supports that dietary modifications may decrease incident type 2 diabetes mellitus (T2DM). Numerous diabetes risk models/scores have been developed, but most do not rely specifically on dietary variables or do not fully capture the overall dietary pattern. We prospectively assessed the association of a dietary-based diabetes-risk score (DDS), which integrates optimal food patterns, with the risk of developing T2DM in the SUN ("Seguimiento Universidad de Navarra") longitudinal study.MethodsWe assessed 17,292 participants initially free of diabetes, followed-up for a mean of 9.2 years. A validated 136-item FFQ was administered at baseline. Taking into account previous literature, the DDS positively weighted vegetables, fruit, whole cereals, nuts, coffee, low-fat dairy, fiber, PUFA, and alcohol in moderate amounts; while it negatively weighted red meat, processed meats and sugar-sweetened beverages. Energy-adjusted quintiles of each item (with exception of moderate alcohol consumption that received either 0 or 5 points) were used to build the DDS (maximum: 60 points). Incident T2DM was confirmed through additional detailed questionnaires and review of medical records of participants. We used Cox proportional hazards models adjusted for socio-demographic and anthropometric parameters, health-related habits, and clinical variables to estimate hazard ratios (HR) of T2DM.ResultsWe observed 143 T2DM confirmed cases during follow-up. Better baseline conformity with the DDS was associated with lower incidence of T2DM (multivariable-adjusted HR for intermediate (25-39 points) vs. low (11-24) category 0.43 [95% confidence interval (CI) 0.21, 0.89]; and for high (40-60) vs. low category 0.32 [95% CI: 0.14, 0.69]; p for linear trend: 0.019).ConclusionsThe DDS, a simple score exclusively based on dietary components, showed a strong inverse association with incident T2DM. This score may be applicable in clinical practice to improve dietary habits of subjects at high risk of T2DM and also as an educational tool for laypeople to help them in self-assessing their future risk for developing diabetes.
| S-EPMC4636153 | biostudies-literature
Project description:BackgroundSchizophrenia (SCZ) and type 2 diabetes mellitus (T2D) are both complex diseases. Accumulated studies indicate that schizophrenia patients are prone to present the type 2 diabetes symptoms, but the potential mechanisms behind their association remain unknown. Here we explored the pathogenetic association between SCZ and T2D based on pathway analysis and protein-protein interaction.ResultsWith sets of prioritized susceptibility genes for SCZ and T2D, we identified significant pathways (with adjusted p-value < 0.05) specific for SCZ or T2D and for both diseases based on pathway enrichment analysis. We also constructed a network to explore the crosstalk among those significant pathways. Our results revealed that some pathways are shared by both SCZ and T2D diseases through a number of susceptibility genes. With 382 unique susceptibility proteins for SCZ and T2D, we further built a protein-protein interaction network by extracting their nearest interacting neighbours. Among 2,104 retrieved proteins, 364 of them were found simultaneously interacted with susceptibility proteins of both SCZ and T2D, and proposed as new candidate risk factors for both diseases. Literature mining supported the potential association of partial new candidate proteins with both SCZ and T2D. Moreover, some proteins were hub proteins with high connectivity and interacted with multiple proteins involved in both diseases, implying their pleiotropic effects for the pathogenic association. Some of these hub proteins are the components of our identified enriched pathways, including calcium signaling, g-secretase mediated ErbB4 signaling, adipocytokine signaling, insulin signaling, AKT signaling and type II diabetes mellitus pathways. Through the integration of multiple lines of information, we proposed that those signaling pathways, which contain susceptibility genes for both diseases, could be the key pathways to bridge SCZ and T2D. AKT could be one of the important shared components and may play a pivotal role to link both of the pathogenetic processes.ConclusionsOur study is the first network and pathway-based systematic analysis for SCZ and T2D, and provides the general pathway-based view of pathogenetic association between two diseases. Moreover, we identified a set of candidate genes potentially contributing to the linkage between these two diseases. This research offers new insights into the potential mechanisms underlying the co-occurrence of SCZ and T2D, and thus, could facilitate the inference of novel hypotheses for the co-morbidity of the two diseases. Some etiological factors that exert pleiotropic effects shared by the significant pathways of two diseases may have important implications for the diseases and could be therapeutic intervention targets.
| S-EPMC3552677 | biostudies-literature