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Vitamin D deficiency is associated with high prevalence of diabetes in Kuwaiti adults: results from a national survey.

ABSTRACT: Vitamin D homeostasis may play a critical role in glucose metabolism. Little is known on vitamin D deficiency and its association with diabetes in countries of the Arabia Gulf where the population is experiencing a rapid increase in the incidence of diabetes.In a cross-sectional study of 960 adults enrolled in the first National Nutrition Survey of the State of Kuwait (NNSSK), we examined vitamin D status in association with the prevalence of diabetes and prediabetes. Vitamin D status was measured by serum levels of 25-hydroxyvitami D (25(OH)D). Prevalences of diabetes and prediabetes were determined based on fasting glucose and HbA1C levels.The median level of serum 25(OH)D in Kuwaiti adults was 13.8 ng/ml. Approximately 56 % of the Kuwaiti adults had vitamin D inadequacy (25(OH)D = 12-19.9 ng/ml), and 27 % had vitamin D deficiency (25(OH)D < 12 ng/ml). The prevalences of prediabetes and diabetes were 40 and 27 %, respectively. Vitamin D inadequacy (OR = 1.7, 95 % CI: 1.0-2.9) and deficiency (OR =2.0, 95 % CI: 1.1-3.3) was each associated with about two-fold increased odds of prediabetes compared to sufficient vitamin D status (25(OH)D ≥ 20 ng/ml). Vitamin D inadequacy (OR =2.1, 95 % CI: 1.2-3.7) and deficiency (OR =2.0, 95 % CI: 1.1-3.9) were also associated with two-fold increased odds of diabetes.Data from Kuwaiti's first nutrition nutritional survey suggests a very high prevalence of vitamin D deficiency in Kuwaiti adults. Associations of low vitamin D status and high prevalence of diabetes point to the need of continuous monitoring of vitamin D status and further evaluating potential health consequences in this high-risk population.

SUBMITTER: Zhang FF

PROVIDER: S-EPMC4735959 | biostudies-other | 2016

REPOSITORIES: biostudies-other

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Project description:Introduction ?Inherited bleeding disorders vary in prevalence due to genetic disparity and ethnicity. Little is known about the prevalence of coagulation factor deficiency and bleeding disorders in middle-eastern population. Methods ?Young Saudi adults with at least one positive bleeding symptom reported in semi-structured validated condensed MCMDM-1vWD questionnaire were tested for complete blood count, routine and special coagulation tests, serum ferritin level, and capillary zone electrophoresis. After initial testing, those with prolonged prothrombin time (PT) or activated prothrombin time (APTT) had further testing to evaluate coagulation factors level. Platelet function was tested through platelet function analyzer (PFA)-100, and multiplate aggregometer (MEA) on patients suspected of having platelet disorders. Results ?Six-hundred-forty patients (male?=?347, 54.2%) were included. A possible platelet function defect was diagnosed in three patients with one matching Glanzmann's thrombasthenia trait pattern, and one that of Bernard-Soulier trait pattern. One patient was diagnosed with von Willebrand disease. Deficiencies in coagulation factor levels were revealed as F-VIII in 14 (7.4%), F-IX in 15 (7.6%), F-II in two (3.3%), F-V in 17 (26.1%), FVII in two (3.1%), and F-X in one (1.8%) of study subjects; low vWF activity (<50%) was found in 14 (8%). Abnormal values were found for various laboratory tests with prolongation of platelet function analyzer-epinephrine (PFA-EPI) in 11%, PFA-ADP or arachidonic acid in 15.2%, PT in 35.9%, and APTT in 63.7%. Five-hundred-seventy-six patients (90%) had normal results in the coagulation factor assays and were categorized as patients with bleeding of unknown cause (BUC). A diagnosis of a bleeding disorder was more frequently made in men than in women (38 vs. 26). Iron deficiency anemia was found in 18 (25%) females positively associated with F-IX deficiency ( p -value 0.000). Male gender (73.3%, p ?=?0.007) was independently associated with the diagnosis of coagulation factor deficiency. Conclusion ?The current study reports a higher prevalence of coagulation factors deficiency in Saudi population than reported in the western population.

Project description:ObjectivesWith the increasing burden of non-communicable diseases in low-income and middle-income countries, biological risk factors, such as hyperglycaemia, are a major public health concern in Bangladesh. Hyperglycaemia is an excess of glucose in the bloodstream and is often associated with type 2 diabetes mellitus. Nationally representative data of hyperglycaemia prevalence starting from age ≥18 years are currently unavailable for Bangladeshi adults. The objective of this study was to assess the prevalence and determinants of hyperglycaemia among adults in Bangladesh aged ≥18 years.Study designCross-sectional, population-based study.Setting and participantsData for this analysis were collected in November to December 2015, from a population-based nationally representative sample of 1843 adults, aged ≥18 years, from both urban and rural areas of Bangladesh. Demographic information, capillary blood glucose, blood pressure, height, weight, waist circumference and treatment history were recorded.Primary outcome measuresHyperglycaemia was defined as a random capillary blood glucose level of ≥11.1 mmol/L (ie, in the diabetic range) or currently taking medication to control type 2 diabetes, based on self-report.ResultsOverall, the prevalence of hyperglycaemia was 5.5% (95% CI 4.5% to 6.6%) and was significantly higher among urban (9.8%, 95% CI 7.7% to 12.2%) than rural residents (2.8%, 95% CI 1.9% to 3.9%). The age-standardised prevalence of hyperglycaemia was 5.6% (95% CI 4.6% to 6.8%). Among both urban and rural residents, the associated determinants of hyperglycaemia included hypertension and abdominal obesity. About 5% of the total population self-reported have been previously diagnosed with type 2 diabetes; among these adults, over 25% were not taking medications to control their diabetes.ConclusionsOur study found that about 1 in 20 Bangladeshi adults aged ≥18 years have hyperglycaemia. To control and prevent the development of type 2 diabetes, data from this study can be used to inform public health programming and provide descriptive information on surveillance of progress towards controlling diabetes in Bangladesh.

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Vitamin D deficiency is associated with high prevalence of diabetes in Kuwaiti adults: results from a national survey.

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