Association between type 2 diabetes and osteoporosis risk: A representative cohort study in Taiwan.
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ABSTRACT:
SUBMITTER: Lin HH
PROVIDER: S-EPMC8277062 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:ObjectivesTo investigate the relationship between metabolically healthy obesity and cardiovascular disease risk in Taiwanese individuals.MethodsTaiwanese individuals were recruited from a nationwide, representative community-based prospective cohort study and classified according to body mass index as follows: normal weight (18.5-23.9 kilogram (kg)/meter(m)2) and obesity/overweight (≥24 kg/m2). Participants without diabetes, hypertension, and hyperlipidemia and who did not meet the metabolic syndrome without waist circumference criteria were considered metabolically healthy. The study end points were cardiovascular disease morbidity and mortality. Multivariable adjusted hazard ratios and 95% confidence intervals were obtained from a Cox regression analysis.ResultsAmong 5 358 subjects (mean [standard deviation] age, 44.5 [15.3] years; women, 48.2%), 1 479 were metabolically healthy with normal weight and 491 were metabolically healthy with obesity. The prevalence of metabolically healthy obesity/overweight was 8.6% in the Taiwanese general population, which included individuals who were >20 years old, not pregnant, and did not have CVD (n = 5,719). In the median follow-up period of 13.7 years, 439 cardiovascular disease events occurred overall and 24 in the metabolically healthy obesity group. Compared with the reference group, the metabolically healthy obesity group had a significantly higher cardiovascular disease risk (adjusted hazard ratio: 1.74, 95% confidence interval: 1.02, 2.99).ConclusionsIndividuals with metabolically healthy obesity have a higher risk of cardiovascular disease and require aggressive body weight control for cardiovascular disease control.
| S-EPMC7850496 | biostudies-literature
Project description:BackgroundThe associations with cancer and cardiovascular diseases (CVD) had inconsistent results. The study aimed to investigate the risk of cardiovascular diseases (CVD) between populations with and without cancer.MethodsPatients with common cancers in Taiwan were enrolled in the study between 2007 and 2018 using the Taiwan Cancer Registry. We focused on colorectal cancer, women's breast cancer, lung cancer, liver cancer, oral cancer, prostate cancer, and thyroid cancers. The study endpoint was fatal and non-fatal CVD, which was defined as ischemic heart disease and ischemic stroke according to the National Health Insurance Research Database. We compared the risk of CVD between patients with cancer and age- and sex-matched (1:1 ratio) participants who did not have cancer or CVD. Multivariable adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were obtained from Cox regression analysis. To evaluate the chronological trend, we estimated the HRs and 95% CI yearly since the diagnosis.ResultsAmong the 552,485 cancer patients (mean age, 60.6 years; women, 47.7%) during the median follow-up period of 4.1 years, 32,634 cases of fatal and non-fatal CVD were identified. Compared with that noted in the non-cancer population, the overall fully adjusted HR with 95% CI was 1.28 (1.25, 1.30) in the cancer population. The CVD risk was the highest in the first year, the adjusted HR with 95% CI was 2.31 (2.23, 2.40), and this risk decreased yearly.ConclusionsPatients with cancer had a significantly higher risk of fatal or non-fatal CVD. The risk was the highest in the first year since diagnosis and decreased yearly.
| S-EPMC9677651 | biostudies-literature
Project description:Aims/hypothesisThis study aimed to investigate whether the effects of sleep duration interacted with the presence of diabetes. We specifically sought to examine the relationship between sleep duration and all-cause and cause-specific mortality in people with type 2 diabetes across sex, age at diagnosis, duration of diabetes and treatment type.MethodsThe sample consisted of 273,029 adults, including 248,817 without diabetes and 24,212 with type 2 diabetes, who participated in the National Health Interview Survey from 2004 to 2013 and whose data were linked to a mortality database up to 31 December 2015. Sleep duration was measured using self-report, whereby participants were asked 'on average how long do you sleep each day (≤5, 6, 7, 8, 9 or ≥10 h/day)?' The relationship between sleep duration and mortality risk was investigated using Cox proportional hazards regression model, with adjustments for demographics, BMI, lifestyle behaviours and clinical variables.ResultsAbsolute mortality rate was higher in adults with diabetes and extremes of sleep duration (≤5 h/day, 215.0 per 10,000 person-years; ≥10 h/day, 363.5 per 10,000 person-years). There was a non-significant interaction between sleep duration and the presence of diabetes (p for interaction = 0.08). A J-shaped relationship existed between sleep duration and all-cause mortality risk in people with type 2 diabetes. Compared with the reference group (7 h/day), both shorter and longer sleep durations were associated with increased risk of all-cause mortality (≤5 h/day, HR 1.24 [95% CI 1.09, 1.40]; 6 h/day, HR 1.13 [1.01, 1.28]; 8 h/day, HR 1.17 [1.06, 1.30]; ≥10 h/day, HR 1.83 [1.61, 2.08]). Similar associations were also observed for mortality risk from CVD, cancer, kidney disease, Alzheimer's disease and chronic lower respiratory diseases. Longer sleep duration in those with a younger age at diabetes onset was associated with greater risks of all-cause and CVD mortality. Shorter sleep duration in individuals treated with both insulin and oral glucose-lowering medication was also associated with higher risks of all-cause and CVD mortality.Conclusions/interpretationThe associations between sleep duration and mortality risk may be different between diabetic and non-diabetic individuals. In people with type 2 diabetes, sleeping less or more than 7 h/day was associated with increased risk of all-cause and condition-specific mortality. The association was more prominent in those with a younger age at diabetes onset and receiving treatment with both oral glucose-lowering medication and insulin. This population may benefit from targeted sleep-related interventions to reduce the risks of adverse health outcomes. Graphical abstract.
| S-EPMC7527363 | biostudies-literature
Project description:BackgroundThe EAT-Lancet Commission has promulgated a sustainable dietary guideline and recommended that it was designed to improve the human health and support environmental sustainability.ObjectiveThis research was designed to explore the association between this healthy diet pattern (EAT-Lancet diet pattern, EAT-LDP) and risk of type 2 diabetes (T2D).MethodsBetween 2006 and 2010, a total of 59,849 participants from the UK Biobank without diabetes, cardiovascular disease, or cancers were included at baseline. The EAT-LDP score was constructed on the sum of 14 food components and then categorized into three tertiles. Multivariable Cox proportional hazards regression models were conducted to explore the association between EAT-LDP score and the risk of incident T2D. A mediation analysis was also implemented to disentangle the role of body mass index (BMI) and waist circumference in the relationship between EAT-LDP score and T2D.ResultsDuring a median follow-up of 10 years, 2,461 incident T2D cases were recorded. In analyses that compared tertile 3 of the EAT-LDP score (highest) with tertile 1 (lowest), the hazard ratio (HR) for T2D was 0.81 (95% CI: 0.72-0.90) after adjusting for sociodemographic status and health-related factors. Participants who reported a one-point increase in the diet score were associated with a 6% decrease in risk of T2D (HR: 0.94, 95% CI: 0.91-0.97). A significant indirect association was observed between the EAT-LDP score and T2D (β: 0.66, 95% CI: 0.65-0.67), indicating that 44% of the association of EAT-LDP score with T2D was mediated by BMI. Additionally, 40% of the association of EAT-LDP score with T2D was mediated by waist circumference was also observed.ConclusionsOur findings indicate that a higher adherence to EAT-LDP contributes to lower risk of T2D. Further independent validation is needed to be conducted before applying the EAT-LDP to inform dietary guidelines.
| S-EPMC8795697 | biostudies-literature
Project description:BackgroundAlthough gastric cancer patients generally experience drastic weight decrease post-gastrectomy, the impact of weight decrease on type 2 diabetes risk remains unclear. We investigated the type 2 diabetes risk after gastric cancer surgery according to postoperative weight decrease in gastric cancer survivors in South Korea, the country with the world's highest rate of gastric cancer survival.MethodsThis retrospective nationwide cohort study included gastric cancer surgery recipients between 2004 and 2014 who survived for ≥5 years post-surgery. We included patients without a history of diabetes at the time of surgery and those who had not received adjuvant chemotherapy before or after the surgery. Postoperative weight loss was defined as the per cent body weight loss at 3 years post-surgery compared with the baseline. The type 2 diabetes risk was evaluated using Cox regression analyses for five groups of postoperative weight decrease.ResultsIn 5618 included gastric cancer surgery recipients (mean age, 55.7 [standard deviation, SD, 10.9] years; 21.9% female; mean body mass index, 23.7 [SD, 2.9] kg/m2 ), 331 patients (5.9%) developed postoperative type 2 diabetes during follow-up duration of 8.1 years (median; interquartile range, 4.8 years; maximum, 15.2 years). Compared with those who gained weight post-surgery, patients with ≥ -15% to < -10% of postoperative weight decrease (hazard ratio, 0.65; 95% confidence interval, 0.49-0.87; P = 0.004) had the lowest type 2 diabetes risk. A non-linear association occurred between postoperative weight decrease and the type 2 diabetes risk in gastrectomy recipients (Akaike's information criterion [AIC] for non-linear model, 5423.52; AIC for linear model, 5425.61).ConclusionsA U-shaped non-linear association occurred between the type 2 diabetes risk and postoperative weight decrease in gastric cancer survivors who underwent gastrectomy. The lowest type 2 diabetes risk occurred in patients with ≥ -15% to < -10% of postoperative weight decrease at 3 years.
| S-EPMC10067472 | biostudies-literature
Project description:ObjectiveWe aimed to prospectively evaluate the association between major depressive episode (MDE) and risk of type 2 diabetes in a Chinese population.MethodsWe used data from the China Kadoorie Biobank study, in which 461,213 participants free of diabetes, coronary heart disease, stroke, and cancer were followed from baseline (2004-2008) to December 31, 2013. A modified Chinese version of Composite International Diagnostic Interview Short-Form (CIDI-SF) was used to assess past year MDE. Participants who responded positive to depression screening questions but did not meet the diagnosis criteria were considered as having depressive symptoms only. Incident diabetes cases were identified through linkage with established regional disease registries and national health insurance databases. Cox proportional hazards regression model was used to calculate hazard ratio (HR) and 95% confidence interval (CI) for the association after adjusting for diabetes risk factors.ResultsWe documented 8784 incident type 2 diabetes cases during a follow-up of 3291,908 person-years. We observed a higher incidence rate of type 2 diabetes in participants with MDE than those without, and the multivariable-adjusted HR was 1.31 (95% CI 1.04-1.66). Compared with participants without depressive symptoms, the HR (95% CI) was 1.19 (1.05-1.35) for participants with depressive symptoms only and 1.32 (1.05-1.68) for those with MDE.LimitationsThe prevelance of past year MDE based on CIDI-SF was low, which might result in a selection bias.ConclusionsIn our large prospective cohort study of Chinese adults, MDE was significantly and independently associated with an increased risk of type 2 diabetes.
| S-EPMC5909035 | biostudies-literature
Project description:Numerous studies have reported that antibiotics could lead to diabetes, even after adjusting for confounding variables. This study aimed to determine the causal relationship between antibiotics use and diabetes in a nationally representative cohort. This retrospective cohort study included adults aged 40 years or older who were enrolled in the Korean National Health Insurance Service-Health Screening Cohort. Antibiotic exposure was assessed from 2002 to 2005 and newly diagnosed diabetes mellitus was determined based on diagnostic codes and history of antidiabetic medication use from 2006 to 2015. Multivariate Cox proportional hazards model was used to assess the association between antibiotic use and diabetes incidence. The mean age of the 201,459 study subjects was 53.2 years. People who used antibiotics for 90 or more days had a higher risk of diabetes (adjusted hazard ratio [aHR] 1.16, 95% confidence interval [CI] 1.07-1.26) compared to non-users. Those who used five or more classes of antibiotics had a higher risk of diabetes than those who used one antibiotic class (aHR 1.14; 95% CI 1.06-1.23). The clear dose-dependent association between antibiotics and diabetes incidence supports the judicious use of antibiotics in the future.
| S-EPMC8568925 | biostudies-literature
Project description:Some studies suggest an association between onset and/or poor control of type 2 diabetes mellitus and inhaled corticosteroid (ICS) therapy for chronic obstructive pulmonary disease (COPD), and also between increased fracture risk and ICS therapy; however, study results are contradictory and these associations remain tentative and incompletely characterized. This matched cohort study used two large UK databases (1983-2016) to study patients (≥ 40 years old) initiating ICS or long-acting bronchodilator (LABD) for COPD from 1990-2015 in three study cohorts designed to assess the relation between ICS treatment and (1) diabetes onset (N = 17,970), (2) diabetes progression (N = 804), and (3) osteoporosis onset (N = 19,898). Patients had ≥ 1-year baseline and ≥ 2-year outcome data. Matching was via combined direct matching and propensity scores. Conditional proportional hazards regression, adjusting for residual confounding after matching, was used to compare ICS vs. LABD and to model ICS exposures. Median follow-up was 3.7-5.6 years/treatment group. For patients prescribed ICS, compared with LABD, the risk of diabetes onset was significantly increased (adjusted hazard ratio 1.27; 95% CI, 1.07-1.50), with overall no increase in risk of diabetes progression (adjusted hazard ratio 1.04; 0.87-1.25) or osteoporosis onset (adjusted hazard ratio 1.13; 0.93-1.39). However, the risks of diabetes onset, diabetes progression, and osteoporosis onset were all significantly increased, with evident dose-response relationships for all three outcomes, at mean ICS exposures of 500 µg/day or greater (vs. < 250 µg/day, fluticasone propionate-equivalent). Long-term ICS therapy for COPD at mean daily exposure of ≥ 500 µg is associated with an increased risk of diabetes, diabetes progression, and osteoporosis.
| S-EPMC6817865 | biostudies-other
Project description:ObjectiveTo investigate the relation of Hashimoto's thyroiditis (HT) to cholelithiasis and cholecystectomy in a retrospective population-based study.SettingCohort study.ParticipantsWe identified 1268 patients aged ?20 years with HT between 2000 and 2010 as the study cohort.Primary and secondary outcome measuresPatients without HT were randomly selected from a database and propensity-matched with the study cohort at a 1:4 ratio according to age, sex, comorbidities and year of the index date to measure the incidence of cholelithiasis and cholecystectomy.ResultsThe cumulative incidence of cholelithiasis was higher in the HT cohort than that in the non-HT cohort (log-rank test, p<0.001), with a 1.91-fold higher risk of choleithiasis (95% CI 1.58 to 2.33) after adjustment for comorbidities. The age-specific relative risk of cholelithiasis in the HT cohort was higher than that in the non-HT cohort for patients aged ?50 years (adjusted HR (aHR)=2.59, 95%?CI 1.33 to 5.03). The sex-specific relative risk of cholelithiasis in the HT cohort was higher than that in the non-HT cohort for women (aHR=1.99, 95%?CI 1.63 to 2.44). Compared with those in the non-HT cohort, patients with HT without (aHR=1.95, 95%?CI 1.53 to 2.49) and with (aHR=1.94, 95%?CI 1.51 to 2.49) thyroxine treatment were associated with a higher risk of cholelithiasis. Compared with those in the non-HT cohort, patients with HT had a higher risk of cholecystectomy (aHR=1.28, 95%?CI 1.02 to 1.61).ConclusionsInability to obtain information on several potential confounding factors and misclassification of important covariates are the major limitations of the study. Our study indicates HT per se was associated with the development of cholelithiasis, which has been validated by the association between cholecystectomy and HT. Surveys and health education on cholelithiasis in women aged ?50 years with HT should be considered by clinicians, and further prospective research should be done on this topic.
| S-EPMC6129049 | biostudies-literature
Project description:BackgroundOrganic food (OF) consumption has substantially increased in high income countries, mostly driven by environmental concerns and health beliefs. Lower exposure to synthetic pesticides has been systematically documented among consumers of organic products compared to non-consumers. While experimental studies suggest that pesticides currently used in food production may be associated with type 2 diabetes (T2D), no well-conducted prospective studies have investigated the potential association between consumption of organic products and the risk of T2D, controlling for potential confounding factors. The objective of this prospective study was to estimate the association between OF consumption and the risk of T2D.MethodsA total of 33,256 participants (76% women, mean (SD) age: 53 years (14)) of the French NutriNet-Santé prospective cohort study who completed the organic food frequency questionnaire were included (2014-2019). The proportion of OF in the diet (as weight without drinking water) was computed. The associations between the proportion of OF in the diet (as 5% increment and as quintiles) and the risk of T2D were estimated using multivariable Hazard Ratio (HR) and 95% confidence interval (95% CI) derived from proportional hazards models adjusted for confounders (sociodemographic, anthropometric, lifestyle, medical and nutritional factors).ResultsDuring follow-up (mean = 4.05 y, SD = 1.03 y, 134,990 person-years), 293 incident cases of T2D were identified. After adjustment for confounders including lifestyle (physical activity, smoking status, alcohol consumption) and nutritional quality of the diet assessed by the adherence to the French food-based dietary guidelines, OF consumption was associated with a lower risk of T2D. Participants with the highest quintile of OF consumption, compared with those with the lowest quintile, had 35% lower risk of T2D (95% CI = 0.43-0.97). Each increment of 5% in the proportion of OF in the diet was associated with 3% lower risk of T2D (HR 0.97, 95% CI = 0.95-0.99).ConclusionsIn this large prospective cohort study, OF consumption was inversely associated with the risk of T2D. Further experimental and prospective studies should be conducted to confirm these observations.Clinical trial registryThe study was registered at ClinicalTrials.gov ( NCT03335644 ).
| S-EPMC7653706 | biostudies-literature