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Association between attentional function and postural instability in Japanese older patients with diabetes mellitus.

ABSTRACT: Aims:This study assessed the association between attentional function and postural instability in older Japanese patients with diabetes. Methods:This cross-sectional study included 168 older patients with diabetes who were referred to an outpatient diabetic clinic between June and July 2013. The Trail Making Test-A (TMT-A) was used to evaluate attentional function. Posturography was used to evaluate postural sway. Indices of postural sway were the total length and the enveloped area. Analysis of covariance was used to estimate the multivariable-adjusted means of indices of postural sway according to tertile of TMT-A. Results:After adjustment for age, sex, regular exercise, diabetic retinopathy, bilateral numbness and/or paresthesia in the feet, hemoglobin A1c level, quadriceps strength, and Mini-Mental State Examination score, patients with lower attentional function had higher postural sway length (tertile 3 vs. tertile 1, p = 0.010) and enveloped area (tertile 3 vs. tertile 1, p = 0.030) levels than those with higher attentional function. Conclusions:Among older patients with diabetes who did not have dementia, patients with lower attentional function may have more postural instability than those with higher attentional function.

SUBMITTER: Morimoto A

PROVIDER: S-EPMC6224902 | biostudies-other | 2016 Mar

REPOSITORIES: biostudies-other

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Association between attentional function and postural instability in Japanese older patients with diabetes mellitus.

Morimoto Akiko A Sonoda Nao N Ugi Satoshi S Morino Katsutaro K Sekine Osamu O Nemoto Ken-Ichi KI Ogita Mihoko M Tatsumi Yukako Y Murata Shin S Maegawa Hiroshi H Miyamatsu Naomi N

Diabetology international 20150818 1

<h4>Aims</h4>This study assessed the association between attentional function and postural instability in older Japanese patients with diabetes.<h4>Methods</h4>This cross-sectional study included 168 older patients with diabetes who were referred to an outpatient diabetic clinic between June and July 2013. The Trail Making Test-A (TMT-A) was used to evaluate attentional function. Posturography was used to evaluate postural sway. Indices of postural sway were the total length and the enveloped ar ...[more]

PMID: 30603247

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Project description:BackgroundObesity is a well-known risk factor for type 2 diabetes mellitus (T2DM). Studies have shown that the Chinese visceral adiposity index (CVAI), a novel visceral adiposity indicator, is positive associated with the risk of T2DM in the Chinese population. This study aimed to investigate the correlation between CVAI and incident T2DM in a Japanese population.MethodsWe performed a secondary analysis of open-access data from a retrospective cohort study. This study included 15,464 participants who received regular medical examinations at Murakami Memorial Hospital. All participants underwent a questionnaire survey, physical examination, and blood biochemical testing at baseline. The main outcome was new-onset T2DM during follow-up. Cox regression analysis and Kaplan-Meier analysis were used to analyze the risk of CVAI on T2DM, and we conducted smooth curve fitting. Receiver operating characteristic (ROC) curve analysis was performed to assess the predictive value of CVAI, body mass index (BMI), and waist circumference (WC) for incident T2DM.ResultsDuring a median follow-up time of 5.39 years, 373 new-onset T2DM events were observed. Kaplan-Meier curves showed that the incidence of T2DM increased as the CVAI increased (log-rank χ 2 = 187.1076 and 129.6067 in males and females, respectively, both P <0.001). After adjustment for covariates, per 1 increase of CVAI was associated with a 1.0133-fold and 1.0246-fold higher risk of incident T2DM in males and females, respectively (both P <0.001). Those individuals in the top CVAI quartile group had the highest risk of new-onset T2DM (HR = 3.1568 and 5.8415 in males and females, respectively, both P <0.05). A nonlinear relationship was identified by the smooth fitting curve between CVAI and T2DM events in both genders. ROC analysis indicated that CVAI had better predictive power than BMI and WC in both genders.ConclusionOur results demonstrate that CVAI was significantly associated with an increased risk of new-onset T2DM in Japanese adults.

Project description:BACKGROUND:There is increasing evidence that the lung is a target organ of diabetes. This study aimed to examine in detail the association between diabetes mellitus and pulmonary function using a national cohort. We also aimed to explore the non-linear association between pulmonary function and blood glucose, insulin resistance, and C-reactive protein (CRP). METHODS:A total of 30,442 participants from the National Health and Nutrition Examination Survey from the period between 2007 and 2012 were included. The cross-sectional association between diabetes mellitus and pulmonary function was assessed using multiple linear regression. Where there was evidence of non-linearity, we applied a restricted cubic spline with three knots to explore the non-linear association. Partial mediation analysis was performed to evaluate the underlying mechanism. All analyses were weighted to represent the US population and to account for the intricate survey design. RESULTS:A total of 8584 people were included in the final study population. We found that diabetes was significantly associated with reduced forced expiratory volume in one second (FEV1) and forced vital capacity. We further found L-shaped associations between hemoglobin A1c (HbA1c) and pulmonary function. There was a negative association between HbA1c and FEV1 in diabetes participants with good glucose control (HbA1c?<?7.0%), but not in patients with poor glucose control. A non-linear association was also found with fasting plasma glucose, 2 h-plasma glucose after oral glucose tolerance test, insulin resistance, and CRP. Finally, we found that diabetes duration did not affect pulmonary function, and the deleterious effect of diabetes on pulmonary function was mediated by hyperglycemia, insulin resistance, low-grade chronic inflammation (CRP), and obesity. CONCLUSIONS:Diabetes mellitus is non-linearly associated with pulmonary function. Our finding of a negative association between HbA1c and FEV1 in diabetes patients with good glucose control but not in patients with poor glucose control indicates that a stricter glycemic target should be applied to diabetic patients to improve pulmonary function. Given, the cross-sectional nature of this research, a longitudinal study is still needed to validate our findings.

Dataset Information

Association between attentional function and postural instability in Japanese older patients with diabetes mellitus.

Publications

Association between attentional function and postural instability in Japanese older patients with diabetes mellitus.

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